Challenges of measuring and linking patient outcomes to nursing interventions in acute care settings

Measuring and linking patient outcomes to nursing intervention is an important task that has professional, financial and political ramifications. The importance and complexity of measuring patient outcomes accurately should not be overlooked, as there are a number of emergent factors that influence this process. These include the turbulent context of practise, variations in care due to the large number of health professionals, individual patient characteristics impacting on outcomes, determining appropriate nursing outcome measures, nursing's lack of autonomy within the system and difficulties experienced while trying to link patient outcomes to nursing interventions. So that the results reflect reality, it is important for researchers in the field to take note and consider these factors when measuring patient outcomes. The present article aimed to examine and discuss a number of these factors as they relate to the evaluation of patient care.

The influence of collectivism in society and its implications for research on information systems and national culture

This paper argues that the nature of IS research that deals with indigenous culture must be informed as much by context as it is by culture models, which has been the focus of such research in the past. This is considered important because it better reflects the meaning of the data collected for the researcher. To appreciate the importance of context this papers also argues that research subjects from designated individualist societies will inform the researcher in different ways from those subjects located in collectivist societies. To illustrate the practical implications of this argument the paper reports three separate case studies in IS research where the researchers reflect on the impact that a collectivist view has had on the research findings. The paper suggests that (1) similar ethnicity and appearance are significant in gaining the trust of subjects in a collectivist society; that is the researcher is part of the in-group as they belong to the same culture or ethnic group; that (2) who introduced the researcher to the subject is significant in that trust is best reflected when a member of the group/collective plays an important role in the research process itself; and that (3) an ability to (a) communicate in the natural language and (b) understand the implicit body language and (c) cultural codes is important in gaining significant and more meaningful research outcomes. This is enabled via the implicit meanings embedded in members of the collectivist society.

Women in research? Investigating research opportunities for female academics in Australia

Women continue to be surprisingly under-represented in academia, given the increasing numbers of female postgraduate students and the flexible working conditions offered by most Australian Universities. To date, research has emphasised multiple causes for the 'gender gap' in academia, including the structural characteristics of the university system, cultural and societal barriers to the advancement of women, the influence of marital status on the productivity of women academics and the interaction of cultural, social and personality factors on women's professional careers. However, the implications of a 'gender gap' in academic rank reach beyond arguments of equality between sexes, to questions regarding consequences of a male-dominated professoriate to the nature and subjects of academic research in Australia. The aim of this paper is to investigate the factors that determine the rank of Australian academics and in part, to investigate whether there is a gender gap of rank or authority, through an analysis of data collected on all Australian academics by the Federal Department of Education, Science and Training. The implications of these findings on opportunities for female academic researchers and for research outcomes will be discussed.

Inclusion and accountability: communications research with consumers with disabilities

Over the past two decades there has been an increasing focus on doing research with and for consumers rather than on consumers. Research that is collaborative and inclusive has been called for by people with disabilities. People with disabilities are a group of telecommunications consumers who are disadvantaged because of social barriers and access issues with equipment, services and information. In this paper, the benefits and challenges of collaborative (e.g. participatory, participatory action, emancipatory) research with these consumers and the processes that can facilitate inclusive and accountable research outcomes are addressed. Throughout the paper, four questions will be explored: Who determines which research issues are explored and the methods that are used? What is the level of consumer involvement in the research process? How can academics and government ensure that consumer-focused research is inclusive and participatory? How, and to whom, should research results be made available?

In the first part of the paper, the perspectives on consumer research by people with disabilities are presented. Respect for and appreciation of consumers' views underpins the philosophical stance needed by researchers and funding bodies before serious engagement in empowering, person-centred research can be successful.

In the second part of the paper, there is a focus on defining the features of collaborative research approaches. Participatory research, participatory action research, and emancipatory research are variations that incorporate differing levels of consumer involvement. Each of these, however, embrace shifts in philosophy and methods away from more traditional 'scientific' research. Such changes result in a greater sense of inclusion and project ownership by consumers.

The third part of the paper addresses some of the issues associated with collaborative research for consumers with disabilities, for academic researchers, and for government funding bodies. Differing understandings of the social nature of disablement influence attitudes toward consumer involvement and are demonstrated in the choice of research questions, project aims, and the methodologies used. Differing agendas are reflected in reactions to the traditional project requirements and processes of government, the preferred research methodologies of researchers, and the perceived accountability of researchers or government for the dissemination and sharing of research results. The challenges to successful engagement with consumers in collaborative research have been identified in the literature and a number of strategies recommended (Barnes, 2003; Clear, 1999; Mercer, 2002; Oliver, 1992, 1997; Zarb, 1997). Application of inclusive strategies by researchers and funding bodies is essential for positive change and inclusive, empowering outcomes.

The paper concludes with a case study of a DCITA-funded research project. The project is evaluated using participatory/emancipatory research criteria modified from Zarb (1992) and addresses consumer, researcher, and funding body participation. The four questions used in the discussion of the paper are applied to this particular project. In addition, the benefits and learnings from the project will be compared with the outcomes desired by consumers who espouse collaborative research approaches.

Nurse practitioner competency standards: findings from collaborative Australian and New Zealand research

Background: The title, Nurse Practitioner, is protected in most jurisdictions in Australia and New Zealand and the number of nurse practitioners is increasing in health services in both countries. Despite this expansion of the role, there is scant national or international research to inform development of nurse practitioner competency standards.

Objectives: The aim of this study was to research nurse practitioner practice to inform development of generic standards that could be applied for the education, authorisation and practice of nurse practitioners in both countries.

Design: The research used a multi-methods approach to capture a range of data sources including research of policies and curricula, and interviews with clinicians. Data were collected from relevant sources in Australia and New Zealand.

Settings: The research was conducted in New Zealand and the five states and territories in Australia where, at the time of the research, the title of nurse practitioner was legally protected.

Participants: The research was conducted with a purposeful sample of nurse practitioners from diverse clinical settings in both countries. Interviews and material data were collected from a range of sources and data were analysed within and across these data modalities.

Results: Findings included identification of three generic standards for nurse practitioner practice: namely, Dynamic Practice, Professional Efficacy and Clinical Leadership. Each of these standards has a number of practice competencies, each of these competencies with its own performance indicators.

Conclusions: Generic standards for nurse practitioner practice will support a standardised approach and mutual recognition of nurse practitioner authorisation across the two countries. Additionally, these research outcomes can more generally inform education providers, authorising bodies and clinicians on the standards of practice for the nurse practitioner whilst also contributing to the current international debate on nurse practitioner standards and scope of practice.

In search of a future strategy for market research services : clients' views on market research suppliers

The market research environment is transforming rapidly and research suppliers may not be keeping up with changing research client needs. This paper examines research client perceptions of current research supplier performance and future competencies. The key findings are that research suppliers need to move their staffing profiles beyond technical expertise in conducting research (generating outputs) to functional expertise in understanding research outcomes within internal and external organizational contexts. The transition from data collector to expert advisor may involve anew business model and new pricing strategies based on intellectual expertise rather than margins on data collection services.

Exploring first year teachers’ identity transformation through theatre-based research

Why are beginning teachers leaving the profession in large numbers? Are they leaving because of their dissatisfaction with teaching? Are they leaving because of the conditions of their work that shape their identity? Teacher identity work emphasises it is important beginning teachers understand their professional identity as something shifting, fluid and emerging – not fixed. These and other water metaphors – such as ‘washout’, ‘sink or swim’, and ‘thrown in the deep end’ – are often used to describe beginning teachers’ experiences. Such words and metaphors assist to portray the fluid and unpredictable nature of identity transformation. However, these survival terms also influence beginning teachers to believe that their transition to teaching will be difficult. Recently there has been an increased concern over beginning teacher attrition linked to the difficulties they encounter in their early years of teaching. Yet the conditions of beginning teachers’ work in Victorian schools in Australia – including the contractual nature of employment of first year (1yr) teachers – encourage these 1yr practitioners to view their work as semi-permanent. As a result these 1yr teachers do not see themselves as teaching for extended periods of time, as was once the case. Throughout 2011 twelve 1yr teachers shared their experiences of identity transformation in semi-structured interviews with the researcher. Their interview data was analysed through a theatre-based research method, examining how first experiences shape teachers’ future practice and identity. This presentation includes excerpts from the theatre-based research performance ‘The First Time’, and expands on the methodological approaches taken to analyse the data in a way that reflects the fluid and unpredictable nature of teachers’ identity formation and transformation. This qualitative study allows categories of description to emerge from the data rather than pre-determining categories of investigation. As such the processes of scripting, rehearsing, and performing, were utilised to analyse and re-present the data. In an aim to uncover questions that have been buried by answers, the research is oriented as a phenomenographic inquiry. This mode of inquiry seeks to describe, analyse, and understand the qualitatively different experiences 1yr teachers undergo in their identity formation and transformation. The results of this research reveal that beginning teachers’ identity transformation through their first experiences have both individual features specific to each teacher’s roles and aspirations, and extra-individual factors such as interactions, affiliations, and status, which shape their identity. Categories of description that have emerged from the analysis include survival, liminal, and hegemonic discourses, artifacts as symbols of belonging, and the impact of the contractual nature of teaching. Implications of this research focus on the importance for beginning teachers to develop an understanding of the transformative nature of identity in relation to the practice of teaching, to counter the negative preconceptions beginning teachers are told to expect as rites of passage upon entering the profession. The research outcomes have implications for teacher educators and in-service teachers negotiating the waters of an ever-changing profession.

Use of the My Health Record by people with communication disability in Australia: A review to inform the design and direction of future research

BACKGROUND: People with communication disability often struggle to convey their health information to multiple service providers and are at increased risk of adverse health outcomes related to the poor exchange of health information. OBJECTIVE: The purpose of this article was to (a) review the literature informing future research on the Australian personally controlled electronic health record, 'My Health Record' (MyHR), specifically to include people with communication disability and their family members or service providers, and (b) to propose a range of suitable methodologies that might be applied in research to inform training, policy and practice in relation to supporting people with communication disability and their representatives to engage in using MyHR. METHOD: The authors reviewed the literature and, with a cross-disciplinary perspective, considered ways to apply sociotechnical, health informatics, and inclusive methodologies to research on MyHR use by adults with communication disability. RESEARCH OUTCOMES: This article outlines a range of research methods suitable for investigating the use of MyHR by people who have communication disability associated with a range of acquired or lifelong health conditions, and their family members, and direct support workers. CONCLUSION: In planning the allocation of funds towards the health and well-being of adults with disabilities, both disability and health service providers must consider the supports needed for people with communication disability to use MyHR. There is an urgent need to focus research efforts on MyHR in populations with communication disability, who struggle to communicate their health information across multiple health and disability service providers. The design of studies and priorities for future research should be set in consultation with people with communication disability and their representatives.

Spatial analysis of urban stormwater quality

Urban stormwater non-point source pollutants are recognized as a major cause of receiving waters quality deterioration. To date most research has focused on specifying temporal variations of stormwater quality parameters which includes high uncertainties and also increases the risk of pollution control structures failure. Traditionally, the temporal variations of quality parameters in forms of either pollutograph or Event Mean Concentration (EMC) is obtained by sampling stormwater at the outlet of urban catchments for quality analysis in addition to measurement of flow rate over years. Spatial variations of the runoff quality are the key factor in non-point source pollution studies. This research investigates spatial variability of urban runoff quality parameters such as Total Phosphorous (TP), Total Nitrogen (TN), Suspended Solids (SS) and Biochemical Oxygen Demands (BOD) in relation to land use of urban catchments. In spatial analysis, stormwater will be sampled over the whole catchment area for a number of rainfall events during a year without any requirement to measure flow rate. This research showed comparable results for average pollutant concentrations with those of other urban catchments in Australia where traditional sampling method was used. The research outcomes will reliably estimate pollutants concentration for improved and efficient design of pollution control structures for each land use.

CHC students online : responses to course organisation

Previous research by the authors has shown that Confucian Heritage Students participating in online problem solving discussions show a high degree of message postings that are related to the organization of the course of study, rather than to its contents and intellectual challenges. The authors argue that this is consistent with the more broadly based research outcomes relating to the achieving strategy that is quite typically exhibited among CHC students. This interview based study explores the perceptions of CHC students as they engage with collaborative learning online, and shows that the concerns relate to matters to do with assessment, with the reliability and timeliness of group member inputs, and the possibilities of plagiarism.

Pedagogy of the flesh : artaud and pedagogical fault lines

In the form of an installation, this panel will question the problems of combining the fleshiness of our bodies and the technologies of (re-)presentation in the production of knowledge that is contemporary teaching in a material environment. Do the aesthetics and methods of the performing arts open up new, dynamic approaches towards teaching practices? Conversely, how do traditional approaches to classroom management and learning undermine the performativity of our disciplinary concerns? We wish to challenge in the strongest possible terms the appropriateness of the traditional format for academic conferences with their monologic presentation of research outcomes. We crave new and unimagined formats for conferences that rely upon the very theatrical devices that we study, master, enact, and live through. This installation will express each participant's response to these provocations and will provide an interactive environment with many dialogic elements. Participants will use video images, live performers, and other theatrical devices to create an installation that deconstructs the experience of teaching. Signalling though the flames, should our teaching be any less?

The installation will be available for perusal as five simultaneous events occur in over-lapping space. This will last approximately 45 minutes and will be followed by a round-table discussion for the remainder of our time.

Reconstructing child welfare through participatory and child-centred professional practice : a conceptual approach

The 'child' in child welfare/protection is seen as a dependent waif and an object of interest, on whose behalf adults speak and act. An alternative perspective has argued for child-centredness, and includes concepts of child liberation, rights and citizenship. Policymakers and practitioners who may accept the underlying principles may be concerned about the appropriateness and applicability of such principles in relation to practice with children and their parents in child welfare/protection cases. This paper discusses a conceptual framework for research that aims to explore participatory and child-centred professional practice by critically evaluating and developing, for professional practice, the practical meanings of 'participatory' and 'children as citizens'. We do not present research outcomes based on empirical data; instead, we present our conceptual framework as the first stage of research in progress into participatory and child-centred professional practice.

Understanding educational process in leadership development

This thesis is a case study of educational process in the leadership development program of the Australian Defence Force Academy. The intention is to determine the relative emphasis in educational process on the conventional command and managerial compliance (Type A) style and the emergent contingent and creative (Type B) style of leadership. The Type A style is theorised as emphasizing hierarchy and control, whereas the emphasis in a Type B style is on adaptive and entrepreneurial behaviour. This study looks at the learning process in a cultural and structural context rather than focus on curriculum and instructional design. Research in this wider context is intended to enable development processes to successfully bridge a gap between theory and practice, implicit in studies that identify theories 'in-operation' as different from the theories 'espoused' (Argyris 1992, Savage 1996). In terms of espoused and in-use theory, the study seeks to produce a valid and reliable result to the question: what is the relative emphasis on the two leadership styles in the operation of the three educational mechanisms of curriculum, pedagogy (teaching practice) and assessment? The quantitative analysis of results (n = 114) draws attention to both leadership styles in terms of two and three-way relationships of style, cadet or work group and service type. The data shows that both Type A and Type B leadership styles are evident in the general conversation of the organisation. This trend is present as espoused theory in the curriculum of the Defence Academy. However, the data also confirm a clear and strong emphasis towards command and managerial compliance as theory-in-use, particularly by cadets. This emphasis is noticeably evident in the teaching and assessment practice of the Defence Academy. Other research outcomes include the observation that: Contextually, while studies show it is difficult to isolate skills from their cultural and biographical context (Watkins, 1991:15), this study suggests that it is equally difficult to isolate skills development from this context. There is a strong task or instrumental link identified by cadet responses in terms of content and development process at the Defence Academy, in contrast to the wider developmental emphasis in general literature and senior officer interviews. There is a lack of awareness of teaching strategies and development activity consistent with espoused Type B leadership theory and curriculum content. This gap is compounded by the use in the Defence Academy of personnel without teaching expertise or suitable developmental experience. The socialisation of cadets into the military workplace is the primary purpose of training. This purpose appears taken for granted by all concerned - staff, cadets and senior officers. Defence Academy development processes appear to be faced with a dilemma. Arguably, training and learning from experience are limited approaches to development. Training, which involves learning by replication, and learning from experience, which is largely imitative, are both of little use when people are faced with novel and ambiguous situations. This study suggests that in order to support the development of capabilities that go beyond training based competence a learning and development approach is needed. This more expansive approach requires educational planners to consider the cultural and social context that can inadvertently promote the status quo in practice over espoused outcomes.

Molecular biology of natriuretic peptides in reptiles and birds

The heart produces natriuretic peptides that are critical regulators of blood pressure and renal function. This study examined the molecular evolution of natriuretic peptides in vertebrates and discovered novel forms of the peptides in birds. The research outcomes advanced our knowledge of the importance of these peptides in animal physiology.