Processes for disciplining nurses for unprofessional conduct of a serious nature : a critique

Aims: This paper critiques the deliberative processes used by the discipline panels of an Australian statutory nurse regulating authority when appraising the alleged unprofessional conduct of nurses and determining appropriate remedies.

Background: Little is known about the nature and effectiveness of the deliberative processes used by nurse regulating authorities (NRAs) disciplinary panels established to appraise and make determinations in response to allegations of unprofessional conduct by nurses.

Methods: A qualitative exploratory descriptive/pragmatic research approach was used. Data were obtained from two case-orientated sampling units: (1) 84 Reasons for Determination made between 1994 and 2000 and (2) a purposeful sample of 12 former and current nurse regulating authority members, nurse regulating authority staff and a nurse regulating authority representative who had experience of disciplinary proceedings and/or who had served on a formal hearing panel. Data were analysed using content and thematic analysis strategies.

Results: Attitudinal considerations (e.g. whether a nurse understood the 'wrongness' of his or her conduct; accepted responsibility for his or her conduct; exhibited contrition/shame during the hearing; was candid in his or her demeanour) emerged as the singularly most significant factor influencing discipline panel determinations. Disciplinary action is taken appropriately against nurses who have committed acts of deliberate malfeasance. NRAs may not, however, be dealing appropriately with nurses when disciplining them for making honest mistakes/genuine practice errors.

Conclusion: Traditional processes used for appraising and disciplining nurses who have made honest mistakes in the course of their work need to be substantially modified as they are at odds with the models of human error management that are currently being advocated and adopted globally to improve patient safety and quality of care in health care domains.

Liveable Yarra - planning for the city's future using a deliberative process

Community engagement on planning processes is traditionally adversarial,with residents reacting to a development proposal or local amenity impacts.With the significant increase in inner-urban medium-high density developments andsubsequent pressure on physical and social infrastructure, the City of Yarra embarked on anew approach to the rewrite of its Planning Scheme. This paper describes the process by whichthe City of Yarra involved the community to help address some of the dilemmas and trade-offswhich are necessarily part of planning in an inner-urban area.To hear from a broad range of voices and receive informed recommendations, a deliberativeprocess, the Liveable Yarra project was formed. It aimed to have an in-depth two-wayconversation with the community about how Yarra can adapt to the challenges andopportunities brought about by growth and change.A 60 member People’s Panel, comprising a cross section of Yarra’s community, came togetherto learn, debate and provide recommendations to Council on the topics of housing, transport,built form and the local economy. The Panel was supplemented by feedback from a householdbaseline survey, Council’s Advisory Committees and targeted workshops with hard-to-reachcommunities.This was the first time a deliberative approach has been undertaken for a topic as multifacetedand far-reaching as rewriting a Local Government Planning Scheme. It allowed participantsto gain an understanding of the complexity of planning issues and the challenges this presentsto Council decision making. It’s expected that the revised Planning Scheme will moreaccurately reflect community expectations, improve liveability and enhance communityunderstanding of the complex issues faced by Council in planning the city’s future.Furthermore, in describing this approach, along with reflections from those Councillors,planners and community members involved, we hope to provide a model which other councilscould embrace to enhance their existing planning processes.

The intrinsic plasticity of farm businesses and their resilience to change. An Australian example.

This paper examines the idea that plasticity in farm management introduces resilience to change and allows farm businesses to perform when operating in highly variable environments. We also argue for the need to develop and apply more integrative assessments of farm performance that combine the use of modelling tools with deliberative processes involving farmers and researchers in a co-learning process, to more effectively identify and implement more productive and resilient farm businesses. In a plastic farming system, farm management is highly contingent on environmental conditions. In plastic farming systems farm managers constantly vary crops and inputs based on the availability of limited and variable resources (e.g. land, water, finances, labour, machinery, etc.), and signals from its operating environment (e.g. climate, markets), with the objective of maximising a number of, often competing, objectives (e.g. maximise profits, minimise risks, etc.). In contrast in more rigid farming systems farm management is more calendar driven and relatively fixed sequences of crops are regularly followed over time and across the farm. Here we describe the application of a whole farm simulation model to (i) compare, in silico, the sensitivity of two farming systems designs of contrasting levels of plasticity, operating in two contrasting environments, when exposed to a stressor in the form of climate change scenarios;(ii) investigate the presence of interactions and feedbacks at the field and farm levels capable of modifying the intensity and direction of the responses to climate signals; and (iii) discuss the need for the development and application of more integrative assessments in the analysis of impacts and adaptation options to climate change. In both environments, the more plastic farm management strategy had higher median profits and was less risky for the baseline and less intensive climate change scenarios (2030). However, for the more severe climate change scenarios (2070), the benefit of plastic strategies tended to disappear. These results suggest that, to a point, farming systems having higher levels of plasticity would enable farmers to more effectively respond to climate shifts, thus ensuring the economic viability of the farm business. Though, as the intensity of the stress increases (e.g. 2070 climate change scenario) more significant changes in the farming system might be required to adapt. We also found that in the case studies analysed here, most of the impacts from the climate change scenarios on farm profit and economic risk originated from important reductions in cropping intensity and changes in crop mix rather than from changes in the yields of individual crops. Changes in cropping intensity and crop mix were explained by the combination of reductions in the number of sowing opportunities around critical times in the cropping calendar, and to operational constraints at the whole farm level i.e. limited work capacity in an environment having fewer and more concentrated sowing opportunities. This indicates that indirect impacts from shifts in climate on farm operations can be more important than direct impacts from climate on the yield of individual crops. The results suggest that due to the complexity of farm businesses, impact assessments and opportunities for adaptation to climate change might also need to be pursued at higher integration levels than the crop or the field. We conclude that plasticity can be a desirable characteristic in farming systems operating in highly variable environments, and that integrated whole farm systems analyses of impacts and adaptation to climate change are required to identify important interactions between farm management decision rules, availability of resources, and farmer's preference.

Intelligent Automaticity in Moral Judgment and Decision-Making

Thesis (Ph.D.)--University of Washington, 2016-05

Do Institutional Participatory Projects Contribute to the Development of Political Capabilities?

Participation usually sets off from the bottom up, taking the form of more or less enduring forms of collective action with varying degrees of infl uence. However, a number of projects have been launched by political institutions in the last decades with a view to engaging citizens in public affairs and developing their democratic habits, as well as those of the administration. This paper analyses the political qualifying capacity of the said projects, i.e. whether participating in them qualifi es individuals to behave as active citizens; whether these projects foster greater orientation towards public matters, intensify (or create) political will, and provide the necessary skills and expertise to master this will. To answer these questions, data from the comparative analysis of fi ve participatory projects in France and Spain are used, shedding light on which features of these participatory projects contribute to the formation of political subjects and in which way. Finally, in order to better understand this formative dimension, the formative capacity of institutional projects is compared with the formative dimension of other forms of participation spontaneously developed by citizens.

Making apartments affordable: Moving from speculative to deliberative development

Urban planning policies in Australia presuppose apartments as the new dominant housing type, but much of what the market has delivered is criticised as over-development, and as being generic, poorly-designed, environmentally unsustainable and unaffordable. Policy responses to this problem typically focus on planning regulation and construction costs as the primary issues needing to be addressed in order to increase the supply of quality, affordable apartment housing. In contrast, this paper uses Ball’s (1983) ‘structures of provision’ approach to outline the key processes informing apartment development and identifies a substantial gap in critical understanding of how apartments are developed in Australia. This reveals economic problems not typically considered by policymakers. Using mainstream economic analysis to review the market itself, the authors found high search costs, demand risk, problems with exchange, and lack of competition present key barriers to achieving greater affordability and limit the extent to which ‘speculative’ developers can respond to the preferences of would be owner-occupiers of apartments. The existing development model, which is reliant on capturing uplift in site value, suits investors seeking rental yields in the first instance and capital gains in the second instance, and actively encourages housing price inflation. This is exacerbated by lack of density restrictions, such as have existed in inner Melbourne for many years, which permits greater yields on redevelopment sites. The price of land in the vicinity of such redevelopment sites is pushed up as landholders' expectation of future yield is raised. All too frequently existing redevelopment sites go back onto the market as vendors seek to capture the uplift in site value and exit the project in a risk free manner...

Teaching about deliberative politics: Case studies of classroom–community learning projects in four nations

Theories of deliberative politics position grass-roots community members as more than spectators of politics, and instead recognize their capacity for political engagement by discussing and evaluating options in order to make decisions about issues affecting community life. The processes and products of journalism can assist deliberative politics by providing community members with information resources that are vital for understanding the root causes of problems, weighing up competing claims, forming networks around shared concerns, reaching decisions and undertaking action. This article presents the findings of case studies of four community–classroom projects--one each from Australia, New Zealand, the United States and South Africa--that develop the capacity of journalism students to be effective contributors to deliberative politics. The research points to the importance of learning activities that prepare students to work in diverse communities, map significant community places and structures, identify leaders and stakeholders, engage in respectful dialogue about problems and perspectives, and appreciate community frames and values.

Public evaluations of novel food technologies: a qualitative citizen-scientist deliberative discourse approach

This qualitative research expands understanding of how information about a range of Novel Food Technologies (NFTs) is used and assimilated, and the implications of this on the evolution of attitudes and acceptance. This work enhances theoretical and applied understanding of citizens’ evaluative processes around these technologies. The approach applied involved observations of interactive exchanges between citizens and information providers (i.e. food scientists), during which they discussed a specific technology. This flexible, yet structured, approach revealed how individuals construct meaning around information about specific NFTs. A rich dataset of 42 ‘deliberate discourse’ and 42 postdiscourse transcripts was collected. Data analysis encompassed three stages: an initial descriptive account of the complete dataset based on the top-down bottom-up (TDBU) model of attitude formation, followed by inductive and deductive thematic analysis across the selected technology groups. The hybrid thematic analysis undertaken identified a Conceptual Model, which represents a holistic perspective on the influences and associated features directing ‘sense-making’ and ultimate evaluations around the technology clusters. How individuals make sense of these technologies is shaped by: their beliefs, values and personal characteristics; their perceptions of power and control over the application of the technology; and, the assumed relevance of the technology and its applications within different contexts. These influences form the frame for the creation of sense-making around the technologies. Internal negotiations between these influences are evident and evaluations are based on the relative importance of each influence to the individual, which tend to contribute to attitude ambivalence and instability. The findings indicate the processes of forming and changing attitudes towards these technologies are: complex; dependent on characteristics of the individual, technology, application and product; and, impacted by the nature and forms of information provided. Challenges are faced in engaging with the public about these technologies, as levels of knowledge, understanding and interest vary.

Deliberative Democracy in Northern Ireland: Opportunities and challenges for consensus in a consociational system

The 1998 Multiparty Agreement established a consociational system that contains within it an explicit dualism: unionist/nationalist, north and south of Ireland, and British and Irish. But although this formula has facilitated relatively stable and devolved governance, it is based on a distorted representation of a society in which there are much more complex divisions and, indeed, many common problems. Citizen-led efforts towards deliberative democracy since the 1980s have demonstrated both the will and the capacity for alternative, consensual political expressions. This chapter examines the challenges and opportunities facing these citizen-led initiatives in a political environment which, despite the significant decline in violence and terror, seems stubbornly resistant to the idea of broadening the various means of democratic participation.

Circles of support and accountability: criminal justice volunteers as the 'Deliberative public'

This paper provides a review of the role played by volunteers within one particular offender management and reintegration scheme in the United Kingdom. Circles of Support and Accountability (COSA) draw on the expertise of volunteer members of the public to create supportive monitoring frameworks around sex offenders following their release from prison. The paper presents evidence as to the motivations of these volunteers, and argues that they play a crucial role in the success of the scheme, as they provide an instrumentally-useful form of reintegrative social contact to a socially-excluded offender population, and perform a symbolically important role as representatives of the wider community in taking ownership of offender management practices on behalf of the wider society. This is particularly significant in grounding those processes in the communicative practices of the social sphere, providing powerful reasons for intervention that reinforce the work that COSA do.

Deliberative educational planning : including educators’ deliberations in educational policy making.

The objective of this chapter is to argue a case for the need to include teachers and professional educators in the policy making and implementation processes of the World Bank's Education Sector Strategy 2020. By drawing on evidence from the Consultation Plan, the chapter investigates how communicative practices about teachers are embedded in the discourse of the plan and how these influence the rationalisation of the policy. In doing so, the chapter will examine the relationships between social actions, systems rationalisation and life world rationalisation. Much like commercial and entrepreneurial organisations focus on the voice of the customer (VOC), that is on satisfying the stakeholders and end users in their processes, in this chapter, the voice of the teacher (VOT) is highlighted. The skills and knowledge of key stakeholders need to be leveraged and engaged in order to ensure that the policy achieves its desired aims. In order to frame this argument, notions of Habermas’ communicative action theory is used to show how policy engages in systems steering. Rather than understanding education strategy and reform as a process of engaging only government and policy makers, this chapter suggests that by engaging the practitioners and listening to the practical discourse around reform, teachers can be leaders of reforms rather than obfuscated agents.

Post-conventional Political Cultures via Processes of Direct Democracy: Theoretical Considerations Based on Jurgen Habermas and Lawrence Kohlberg

In this article, it is proposed to differentiate political cultures in two dimensions. First, inspired by Habermas' distinction of the contents of discourse, a distinction is suggested between moral, ethical-political and pragmatic elements of political culture as well as of an element of culture of balancing interests. Second, inspired by Kohlberg's stage models for the development of the individual moral consciousness and for moral culture, a distinction is similarly suggested between two pre-conventional, two conventional and two post-conventional collective stages of political culture. It can be shown that from a normative point of view, only deliberations made in a post-conventional political culture can produce reasonable or at least fair results. Conceptual considerations indicate processes of direct democracy as the method for promoting post-conventional political cultures. The more liberty that the citizens have to formulate and trigger processes of direct democracy, the more one can expect from them to generate post-conventional political cultures.

Planning across differences: collaborative planning processes for the California Central Valley's future

This dissertation examines the intersections between difference, participation, and planning processes. Rooted in scholarly conversations about deliberative democracy, collaborative planning, and nonprofit organizations in civil society, this research considers how planning practitioners can better plan across difference. Through case study research, this dissertation examines a collaborative planning process conducted by a nonprofit organization. Unlike more conventional participatory planning processes, the organization utilized scenario planning. Exercising their position in civil society, participation in the process was not open to all community members and the organization carefully selected a diverse set of participants. Findings from this research project indicate that this process, by moving away from a strict definition of rational discourse, focusing on multiple futures as opposed to a single, utopian future, and deliberately bringing together a broad cross-section of community members allowed for participants to speak freely and learn from one another’s perspectives and experiences. Experiences of process participants also demonstrate the degree to which cultural backgrounds shape participation in and expectations of planning processes. While there remains no clear answer in how to represent and respond to cultural differences in planning processes, the experiences of the organization, program staff, and community participants help scholars and practitioners move closer to planning across differences.