Collaboration : developing integration in multi-purpose services in rural New South Wales, Australia

Introduction: The Multi-purpose Service (MPS) Program was introduced to rural Australia in 1991 as a solution to poor health outcomes in rural compared with metropolitan populations, difficulty in attracting healthcare staff and a lack of viability and range of health services in rural areas. The aim of this study was to describe the main concerns of participants involved in the development of multi-purpose services in rural New South Wales (NSW). This article is abstracted from a larger study and discusses the extent to which collaboration occurred within the new multi-purpose service. Methods: A constructivist grounded theory methodology was used. Participants were from 13 multi-purpose services in rural NSW and 30 in-depth interviews were conducted with 6 community members, 11 managers and 13 staff members who had been involved in the process of developing a multi-purpose service. Results: The main concern of all participants was their anticipation of risk. This anticipation of risk manifested itself in either trust or suspicion and explained their progression through a phase of collaborating. Participants who had trust in other stakeholders were more likely to embrace an integrated health service identity. Those participants, who were suspicious that they would lose status or power, maintained that the previous hospital services provided a better health service and described a coexistence of services within the multi-purpose service. Conclusions: This study provided an insight into the perceptions of community members, staff members and managers involved in the process of developing a multi-purpose service. It revealed that the anticipation of risk was intrinsic to a process of changing from a traditional hospital service to collaborating in a new model of health care provided at a multi-purpose service.

Good Practice Report : Blended Learning

In early 2011, the Australian Learning and Teaching Council Ltd (ALTC) commissioned a series of Good Practice Reports on completed ALTC projects and fellowships. This report will: • Provide a summative evaluation of the good practices and key outcomes for teaching and learning from completed ALTC projects and fellowships relating to blended learning • Include a literature review of the good practices and key outcomes for teaching and learning from national and international research • Identify areas in which further work or development are appropriate. The literature abounds with definitions; it can be argued that the various definitions incorporate different perspectives, but there is no single, collectively accepted definition. Blended learning courses in higher education can be placed somewhere on a continuum, between fully online and fully face-to-face courses. Consideration must therefore be given to the different definitions for blended learning presented in the literature and by users and stakeholders. The application of this term in these various projects and fellowships is dependent on the particular focus of the team and the conditions and situations under investigation. One of the key challenges for projects wishing to develop good practice in blended learning is the lack of a universally accepted definition. The findings from these projects and fellowships reveal the potential of blended learning programs to improve both student outcomes and levels of satisfaction. It is clear that this environment can help teaching and learning engage students more effectively and allow greater participation than traditional models. Just as there are many definitions, there are many models and frameworks that can be successfully applied to the design and implementation of such courses. Each academic discipline has different learning objectives and in consequence there can’t be only one correct approach. This is illustrated by the diversity of definitions and applications in the ALTC funded projects and fellowships. A review of the literature found no universally accepted guidelines for good practice in higher education. To inform this evaluation and literature review, the Seven Principles for Good Practice in Undergraduate Education, as outlined by Chickering and Gamson (1987), were adopted: 1. encourages contacts between students and faculty 2. develops reciprocity and cooperation among students 3. uses active learning techniques 4. gives prompt feedback 5. emphasises time on task 6. communicates high expectations 7. respects diverse talents and ways of learning. These blended learning projects have produced a wide range of resources that can be used in many and varied settings. These resources include: books, DVDs, online repositories, pedagogical frameworks, teaching modules. In addition there is valuable information contained in the published research data and literature reviews that inform good practice and can assist in the development of courses that can enrich and improve teaching and learning.

Employee perceived workplace stress : examining core self-evaluations, political skill, coping strategies and support

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Crime: local and global

Crime: Local and Global covers the way local events (such as prostitution) have wider aspects than previously thought. Links with people traffickers, international organised crime and violence cannot be ignored any longer. Each crime or area of activity selected within this text has a global reach, and is made ever more possible due to the way globalisation has opened up markets, both legitimate and illegitimate. The book's approach and scope emphasises that we can no longer view 'crime' as something which occurs within certain jurisdictions, at certain times and in particular places. For example, the chapter on cybercrime highlights the 'illegal' acts that can be perpetrated by second lifers, anywhere in the world, but are they a crime?

Stephen Russell : Super Vanitas

This article is an analysis and contextualisation of 'Super Vanitas' a video installation by Stephen Russell that was held at Boxcopy ARI, Brisbane. It discusses the significance of the painting 'Death of Marat' (J.L. David, 1793) to the work and describes the methodological processes that are revealed in the work.

Violent urbanism is us

This paper explores violent urbanism in the recent science-fiction filem District 9 whhich depicts an alien immigration camp, filmed on location in Soweto in 2008 in the midst of a series of violent clashed between indigenous South Africans and the new wave of African immigrants. Violent Urbanism is the State of method of control of bodies and populations by those precise biological techniques that determine geopolitical sites for the control of cities. This film while presented as cinema verite speaks the real invasion of traditional, spatio-disciplinary regimes such as corporate-run detention centres, refugee camps, border control and enforced relocation by those imperceptible techniques which violate the body by reducing it to a biological datum, tool, or specimen to serve the security agenda of the twenty-first century nation-state. These techniques are chemical and biological warfare proliferation; genetic engineering; and surveillance systems, such as biometrics, whose purview is no longer limited to the specular but includes the molecular. District 9 evinces a compelling urban image of contemporary biopolitics that disturbs the received historiography of post-apartheid urbanism. Clearly Johannesburg is not the only place this could or is happening - the reach of biopolitics is worldwide. District 9 visualises with utter precision the corporate hijacking of the biological realm in contemporary cites, just as it asks the unsettling question, who exactly is the "audience" of Violent Urbanism?

Reduced variance in monozygous twins for multiple MR parameters : implications for disease studies and the genetic basis of brain structure

Twin studies offer the opportunity to determine the relative contribution of genes versus environment in traits of interest. Here, we investigate the extent to which variance in brain structure is reduced in monozygous twins with identical genetic make-up. We investigate whether using twins as compared to a control population reduces variability in a number of common magnetic resonance (MR) structural measures, and we investigate the location of areas under major genetic influences. This is fundamental to understanding the benefit of using twins in studies where structure is the phenotype of interest. Twenty-three pairs of healthy MZ twins were compared to matched control pairs. Volume, T2 and diffusion MR imaging were performed as well as spectroscopy (MRS). Images were compared using (i) global measures of standard deviation and effect size, (ii) voxel-based analysis of similarity and (iii) intra-pair correlation. Global measures indicated a consistent increase in structural similarity in twins. The voxel-based and correlation analyses indicated a widespread pattern of increased similarity in twin pairs, particularly in frontal and temporal regions. The areas of increased similarity were most widespread for the diffusion trace and least widespread for T2. MRS showed consistent reduction in metabolite variation that was significant in the temporal lobe N-acetylaspartate (NAA). This study has shown the distribution and magnitude of reduced variability in brain volume, diffusion, T2 and metabolites in twins. The data suggest that evaluation of twins discordant for disease is indeed a valid way to attribute genetic or environmental influences to observed abnormalities in patients since evidence is provided for the underlying assumption of decreased variability in twins.

Boardroom identities: can independence by 'cued' in directors?

Director independence is a cornerstone of fiduciary responsibility and good corporate governance. However, most directors are recruited because of the roles and networks they hold, meaning that there is an expectation that identities held by a director outside the boardroom will be used to benefit the company. While this often works well, it is acknowledged that many directors, either consciously or subconsciously, will at times allow themselves to be influenced by their other roles to the detriment of the governance process. In this paper we argue that identity theory can be used to explore the impact of ‘identity’ on corporate governance and that practical tools can be developed to actively assist directors to maintain ‘independence’ in the boardroom.

Application of Geographic Modeling Techniques to Quantify Spatial Access to Health Services Before and After an Acute Cardiac Event: The Cardiac ARIA Project

Background: Access to cardiac services is essential for appropriate implementation of evidence-based therapies to improve outcomes. The Cardiac Accessibility and Remoteness Index for Australia (Cardiac ARIA) aimed to derive an objective, geographic measure reflecting access to cardiac services. Methods: An expert panel defined an evidence-based clinical pathway. Using Geographic Information Systems (GIS), a numeric/alpha index was developed at two points along the continuum of care. The acute category (numeric) measured the time from the emergency call to arrival at an appropriate medical facility via road ambulance. The aftercare category (alpha) measured access to four basic services (family doctor, pharmacy, cardiac rehabilitation, and pathology services) when a patient returned to their community. Results: The numeric index ranged from 1 (access to principle referral center with cardiac catheterization service ≤ 1 hour) to 8 (no ambulance service, > 3 hours to medical facility, air transport required). The alphabetic index ranged from A (all 4 services available within 1 hour drive-time) to E (no services available within 1 hour). 13.9 million (71%) Australians resided within Cardiac ARIA 1A locations (hospital with cardiac catheterization laboratory and all aftercare within 1 hour). Those outside Cardiac 1A were over-represented by people aged over 65 years (32%) and Indigenous people (60%). Conclusion: The Cardiac ARIA index demonstrated substantial inequity in access to cardiac services in Australia. This methodology can be used to inform cardiology health service planning and the methodology could be applied to other common disease states within other regions of the world.

Measuring National Accessibility to Cardiac Services using Geographic Information Systems

The Cardiac Access-Remoteness Index of Australia (Cardiac ARIA) used geographic information systems (GIS) to model population level, road network accessibility to cardiac services before and after a cardiac event for all (20,387) population localities in Australia., The index ranged from 1A (access to all cardiac services within 1 h driving time) to 8E (limited or no access). The methodology derived an objective geographic measure of accessibility to required cardiac services across Australia. Approximately 71% of the 2006 Australian population had very good access to acute hospital services and services after hospital discharge. This GIS model could be applied to other regions or health conditions where spatially enabled data were available.

Cardiac ARIA Index: Measuring Accessibility to Cardiovascular Services in Rural and Remote Australia via Applied Geographic Spatial Technology

Cardiovascular disease (CVD) continues to impose a heavy burden in terms of cost, disability and death in Australia. Evidence suggests that increasing remoteness, where cardiac services are scarce, is linked to an increased risk of dying from CVD. Fatal CVD events are reported to be between 20% and 50% higher in rural areas compared to major cities. The Cardiac ARIA project, with its extensive use of geographic Information Systems (GIS), ranks each of Australia’s 20,387 urban, rural and remote population centres by accessibility to essential services or resources for the management of a cardiac event. This unique, innovative and highly collaborative project delivers a powerful tool to highlight and combat the burden imposed by cardiovascular disease (CVD) in Australia. Cardiac ARIA is innovative. It is a model that could be applied internationally and to other acute and chronic conditions such as mental health, midwifery, cancer, respiratory, diabetes and burns services. Cardiac ARIA was designed to: 1. Determine by expert panel, what were the minimal services and resources required for the management of a cardiac event in any urban, rural or remote population locations in Australia using a single patient pathway to access care. 2. Derive a classification using GIS accessibility modelling for each of Australia’s 20,387 urban, rural and remote population locations. 3. Compare the Cardiac ARIA categories and population locations with census derived population characteristics. Key findings are as follows: • In the event of a cardiac emergency, the majority of Australians had very good access to cardiac services. Approximately 71% or 13.9 million people lived within one hour of a category one hospital. • 68% of older Australians lived within one hour of a category one hospital (Principal Referral Hospital with access to Cardiac Catheterisation). • Only 40% of indigenous people lived within one hour of the category one hospital. • 16% (74000) of indigenous people lived more than one hour from a hospital. • 3% (91,000) of people 65 years of age or older lived more than one hour from any hospital or clinic. • Approximately 96%, or 19 million, of people lived within one hour of the four key services to support cardiac rehabilitation and secondary prevention. • 75% of indigenous people lived within one hour of the four cardiac rehabilitation services to support cardiac rehabilitation and secondary prevention. Fourteen percent (64,000 persons) indigenous people had poor access to the four key services to support cardiac rehabilitation and secondary prevention. • 12% (56,000) of indigenous people were more than one hour from a hospital and only had access one the four key services (usually a medical service) to support cardiac rehabilitation and secondary prevention.

Justice, globalisation and human rights

Criminal Justice: Local and Global covers the way the 'local' can be widened out to look at international, transnational and supranational aspects of justice. This means that issues such as corporate crime and human rights can be discussed in a comparative and critical way, examining the possibility, for example of an International Criminal Court, cross-national jurisdictions of regulation and control (such as Interpol) and so on. Each chapter covers a different area of regulation, punishment and process.

Crime : Local and Global

Crime: Local and Global covers the way local events (such as prostitution) have wider aspects than previously thought. Links with people traffickers, international organised crime and violence cannot be ignored any longer. Each crime or area of activity selected within this text has a global reach, and is made ever more possible due to the way globalisation has opened up markets, both legitimate and illegitimate. The book's approach and scope emphasises that we can no longer view 'crime' as something which occurs within certain jurisdictions, at certain times and in particular places. For example, the chapter on cybercrime highlights the 'illegal' acts that can be perpetrated by second lifers, anywhere in the world, but are they a crime?

‘Personal Response’ and English Teaching

A case study relating to secondary education, examining the teacher student relationship as it operates within the English classroom is the topic of this paper. It describes how a certain conception of 'personal response' to literature provided a means for the teacher/counsellor to form the ethical capacities of children. 'Personal response' is usually associated with the moment in which the child is freed to be most natural. But for all the emphasis upon the irreducibly individual nature of the 'genuinely felt response', this pedagogic exercise finds its place within a series of strategies designed both to cherish and correct the child, to nurture and to scrutinise, to guide and to reconstruct.