The intracarotid amobarbital test (IAT) examines hemispheric memory and language. We set out to determine whether memory performance on the IAT correlated with seizure relief after anterior temporal lobectomy in 117 patients with refractory epilepsy. The IAT assessed recognition memory performance for nine items with correction for false-positive recognitions. We then compared performance of one hemisphere with that of the other, defining a correctly lateralized memory deficit as worse performance when using the hemisphere containing the operated temporal lobe than when using the other hemisphere. The analysis included concurrent factors that might also affect outcome, such as age at first risk for epilepsy, presence or absence of tumor, and Full Scale IQ. A discriminant function analysis demonstrated that patients with a correctly lateralized memory deficit on the IAT had an increased probability of being seizure-free following surgery after controlling for other predictors. The performance of the nonoperated temporal lobe related to outcome, although less strongly. The magnitude of the difference in performance between the two hemispheres and the performance of the operated hemisphere did not relate to outcome. Patients who became seizure-free had an earlier age at first risk than did those with persistent seizures, and tumor presence weakly correlated with postoperative outcome. IQ did not correlate with outcome. We conclude that the IAT predicts seizure relief after anterior temporal lobectomy independent of other known risk factors we examined.

Governments’ choice of funding modality can produce powerful incentives for organisations to perform in preferred ways, but it can also divert limited resources, narrow accountability, and undermine capability. Through literature review and interviews, the research explored the international literature on public finance management in developing country contexts, and compared this to case studies of Indigenous organisations. The situation in Australia was found to differ in three ways: (1) performance indicators are imposed, rather than negotiated; (2) few existing public funding modalities reward performance or provide incentives; and (3) funding arrangements do not generally require receiving organisations to be accountable to their constituents. Stability and durability of funding modalities, and clarity in functions and jurisdictional boundaries, were also found to positively influence performance. Further research is required to design new performance frameworks that build around the organisation, rather than the grant, with indicators of governance capability and downward accountability to constituents.

Governance in Aboriginal settlements in desert Australia is changing at an unprecedented rate. Aboriginal leaders and community managers describe the change as bewildering, with ever-revolving agents and agencies and increasing quantities of administration. Governments are preoccupied with finding linear 'solutions' to new conceptualisations of the 'problem' and packaging these for top-down implementation. However, governance in practice involves multi-dimensional interactions of a complex system, which are difficult to predict, let alone to control for outcomes. Through the lens of complex adaptive systems (CAS) theory, this paper argues that there is potential to improve governance as an adaptive system through three principles that enhance local feedback: (1) application of the subsidiarity principle to different levels in the governance system would realise a better match between decentralised functions and local capacity; (2) connectivity would improve information flows and relationships between agents in the system, as a necessary precursor for informed decision-making; and (3) accountability, when taken beyond simplistic notions of financial reporting, would identify power relationships across the system and indicate where agents may exercise greater influence in the system. Consideration of these principles will help promote a shift from the perspective that assumes the system to be linear and manageable from the top-down to a perspective that embraces the notion of adaptive governance as a means of recognising the capacity of agents to influence the system that they inhabit.

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The economies of remote Indigenous settlements are dominated by public finances. The current system of governing public finance is highly saturated, fragmented and centralised, and this has a corrosive effect on local governance capability. The political accountability of leaders to their constituents is weakened in favour of an administrative accountability 'upwards' to higher authorities. New Public Management reforms have promoted administrative deconcentration, over political devolution, and this has been accompanied by an influx of public servants, Non-Government Organisations (NGOs) and private contractors, and a decline in Indigenous organisations and local government. The end result in many settlements is a marked disengagement of Indigenous people in their own governance. There is evidence of considerable political capabilities existing within local government electorates. Decentralised financing arrangements can be used to catalyse these capabilities and then address deficits in administrative and technical performance.