Inter-family transfers and altruism

Examines various models of altruistically motivated transfers between family members. The issues investigated are, keeping up with the Joneses type behaviour, the transfer of intermediate commodities, the transfer process as an informal way of insurance, and the efficiency of market exchange as opposed to private transactions.

Smartpumps: a negotiated relative advantage?

Significant improvements in smart healthcare are only possible if a multidisciplinary approach is taken to the design, implementation, and application of technology in their respective social context. Pregnant women living with type 1 diabetes (PWT1D) face a series of challenges including ongoing management of diet and physical activity, continued delivery and adjustment of insulin doses. These women often feel socially and geographically isolated, due to the rarity of their condition, the paucity of accurate personal healthcare information, and the demands of a high-risk pregnancy. ITenabled smartpumps which allow information to be shared between women with type 1 diabetes and their healthcare team, are one possible solution to this problem. This paper highlights the adoption and application of IT-enabled smartpumps by PWT1D. Using a Cross Community Information Systems (CCIS) approach we examine some of the benefits and drawbacks of smartpumps from the perspective of a range of stakeholders associated with the health and wellbeing of PWT1D and their unborn children. Ultimately we argue that with a considered approach to their adoption and use smartpumps provide an effective tool for ongoing support and collaboration within the healthcare team.

The teacher educator as (re)negotiated professional : critical incidents in steering between state and market in Australia

A dominant discourse in western higher education circles is currently concerned— even obsessed—with the marketisation of knowledge as a commodity to be purchased and traded [Healy (1998); Poole (1998); Richardson (1998)]. These developments are broadly allied with managerial changes that some have called ‘steering at a distance’ [Kickert (1991); Marceav (1993)] whereby the control by the state of individual higher education workers is maintained and intensified at the same time that pressure is applied to 'wean' universities from government funding. This paper explores a different kind of 'steering', the kind that is being engaged by Australian teacher educators confronted by developing competitiveness in higher education. We argue that these changes compel teacher educators to (re)negotiate their professionalisms; to re-examine their attitudes towards, and values within, education and its practices as they (individually and collectively) steer new courses through the state and the market. We illustrate our argument by referring to three critical incidents in the professional lives of teacher educators located within a globalised, multi-campus and provincial Australian university, yet with important implications also for teacher educators outside Australia. We posit the (re)negotiated professionalisms manifested in those incidents as a few among several potential kinds of steering by Australian teacher educators.

Light the towel : narrative and the negotiated unconscious

This investigation is a practice-based inquiry. It takes place in the context of writing and editing a novel manuscript: The earth does not get fat (Prendergast 2012). The unpublished novel manuscript is a fractured narrative, a tale told in multiple first-person voices. One of the problems the writer encountered, as the novel developed, was a problem from the perspective of logic and continuity: the stories did not fit together in a linear way. As a result, the writer felt estranged from the writing and, at the same time, strangely familiar with it. Despite having produced the narrative, the writer felt that it was ‘other’. This paper summarises the writer's methodology; it explains the writer's attachment to this fractured style of telling. This fractured style is assessed within the context of the mind's ability to produce its effects without full consciousness. The analysis of authorial intention therefore focuses upon the influence of altered states of consciousness upon narrative material. In particular, the writer uses Andreas Mavromatis’ (1987) work on hypnagogia: described as ‘the unique state of consciousness between wakefulness and sleep’ to describe the experience of the operation of the unconscious in authorial intention.

Light the towel: narrative and the negotiated unconscious

The thesis consists of a creative component: a novel in multiple first-person voices, and a theoretical component: investigating the interaction between conscious and unconscious processes, in creative writing. The concept of alterity as ‘otherness’, at the heart of the theoretical inquiry, derives its momentum from the experience of the operation of the ‘other’ in the ‘I’ in narrative composition.

The use of self-assessment schedules in negotiated learning

The paper describes an approach to assessment in which students create a comprehensive and analytical summary of their learning in a given subject. The self-assessment schedule, as it is called, has been used in contexts in which there is an emphasis on self-directed and negotiated learning. Unlike most assessment methods which focus on a relatively few aspects of a subject in some depth, the aim of the self-assessment schedule is to capture and account for a wide range of formal and informal learning. The application of the schedule in postgraduate courses is discussed and the views of staff and students reported.

Multisite analysis of the timing and outcomes of unplanned transfers from subacute to acute care

Objective The aim of the present study was to examine the timing and outcomes of patients requiring an unplanned transfer from subacute to acute care. Methods Subacute care in-patients requiring unplanned transfer to an acute care facility within four Victorian health services from 1 January to 31 December 2010 were included in the study. Data were collected using retrospective audit. The primary outcome was transfer within 24h of subacute care admission. Results In all, 431 patients (median age 81 years) had unplanned transfers; of these, 37.8% had a limitation of medical treatment (LOMT) order. The median subacute care length of stay was 43h: 29.0% of patients were transferred within 24h and 83.5% were transferred within 72h of subacute care admission. Predictors of transfer within 24h were comorbidity weighting (odds ratio (OR) 1.1, P≤0.02) and LOMT order (OR 2.1, P<0.01). Hospital admission occurred in 87.2% of patients and 15.4% died in hospital. Predictors of in-hospital mortality were comorbidity weighting (OR 1.2, P<0.01) and the number of physiological abnormalities in the 24h preceding transfer (OR 1.3, P<0.01). Conclusions There is a high rate of unplanned transfers to acute care within 24h of admission to subacute care. Unplanned transfers are associated with high hospital admission and in-hospital mortality rates. What is known about the topic? Subacute care is becoming a high acuity environment where many patients are at significant risk of clinical deterioration. Systems for recognising and responding to deteriorating patients are well developed in acute care, but still developing in subacute care. What does this paper add? This is the first Australian multisite study of clinical deterioration in patients situated in subacute care facilities. One-third of unplanned transfers occur within 24h of admission to subacute care. Patients who require unplanned transfer from subacute to acute care have unexpectedly high hospital admission rates and high in-hospital mortality rates. The frequency and completeness of physiological monitoring preceding transfer was low. What are the implications for practitioners? Patients in subacute care require regular physiological assessment and early escalation of care if there are physiological abnormalities. Risk of clinical deterioration should be a factor in the decision to admit patients to subacute care after an acute illness or injury. There is a need to improve systems for recognising and responding to deteriorating patients in subacute care settings.

Dual resource transfers and interruption in external debt service

Externai debt service requires a dual resource transfer. Trade surpluses have to be generated in order to make foreign exchange revenues available for debt repayment. In addition, with developing countries' externai debt being largely a public liability, debt service requires that resources can be effectively transferred from the private to the public sector. This paper derives a statistical model for dealing with dual constraints in the presence of binary dependent variables and applies it to the dual resource transfer problem. The results from the estimation of the model for a sample of 31 middle-income developing countries in the period of 1980 to 1990, strongly support the hypothesis that both externai and fiscal constraints are important in explaining externai debt service disruptions.