Testing the effectiveness of a Practice Development intervention on changing the culture of evidence based practice in an acute care environment

In this age of evidence-based practice, nurses are increasingly expected to use research evidence in a systematic and judicious way when making decisions about patient care practices. Clinicians recognise the role of research when it provides valid, realistic answers in practical situations. Nonetheless, research is still perceived by some nurses as external to practice and implementing research findings into practice is often difficult. Since its conceptual platform in the 1960s, the emergence and growth of Nursing Development Units, and later, Practice Development Units has been described in the literature as strategic, organisational vehicles for changing the way nurses think about nursing by promoting and supporting a culture of inquiry and research-based practice. Thus, some scholars argue that practice development is situated in the gap between research and practice. Since the 1990s, the discourse has shifted from the structure and outcomes of developing practice to the process of developing practice, using a Practice Development methodology; underpinned by critical social science theory, as a vehicle for changing the culture and context of care. The nursing and practice development literature is dominated by descriptive reports of local practice development activity, typically focusing on reflection on processes or outcomes of processes, and describing perceived benefits. However, despite the volume of published literature, there is little published empirical research in the Australian or international context on the effectiveness of Practice Development as a methodology for changing the culture and context of care - leaving a gap in the literature. The aim of this study was to develop, implement and evaluate the effectiveness of a Practice Development model for clinical practice review and change on changing the culture and context of care for nurses working in an acute care setting. A longitudinal, pre-test/post-test, non-equivalent control group design was used to answer the following research questions: 1. Is there a relationship between nurses' perceptions of the culture and context of care and nurses' perceptions of research and evidence-based practice? 2. Is there a relationship between engagement in a facilitated process of Practice Development and change in nurses' perceptions of the culture and context of care? 3. Is there a relationship between engagement in a facilitated process of Practice Development and change in nurses' perceptions of research and evidence-based practice? Through a critical analysis of the literature and synthesis of the findings of past evaluations of Nursing and Practice Development structures and processes, this research has identified key attributes consistent throughout the chronological and theoretical development of Nursing and Practice Development that exemplify a culture and context of care that is conducive to creating a culture of inquiry and evidence-based practice. The study findings were then used in the development, validation and testing of an instrument to measure change in the culture and context of care. Furthermore, this research has also provided empirical evidence of the relationship of the key attributes to each other and to barriers to research and evidence-based practice. The research also provides empirical evidence regarding the effectiveness of a Practice Development methodology in changing the culture and context of care. This research is noteworthy in its contribution to advancing the discipline of nursing by providing evidence of the degree to which attributes of the culture and context of care, namely autonomy and control, workplace empowerment and constructive team dynamics, can be connected to engagement with research and evidence-based practice.

Adaptive dual control of topic-based information retrieval

Information Retrieval is an important albeit imperfect component of information technologies. A problem of insufficient diversity of retrieved documents is one of the primary issues studied in this research. This study shows that this problem leads to a decrease of precision and recall, traditional measures of information retrieval effectiveness. This thesis presents an adaptive IR system based on the theory of adaptive dual control. The aim of the approach is the optimization of retrieval precision after all feedback has been issued. This is done by increasing the diversity of retrieved documents. This study shows that the value of recall reflects this diversity. The Probability Ranking Principle is viewed in the literature as the “bedrock” of current probabilistic Information Retrieval theory. Neither the proposed approach nor other methods of diversification of retrieved documents from the literature conform to this principle. This study shows by counterexample that the Probability Ranking Principle does not in general lead to optimal precision in a search session with feedback (for which it may not have been designed but is actively used). Retrieval precision of the search session should be optimized with a multistage stochastic programming model to accomplish the aim. However, such models are computationally intractable. Therefore, approximate linear multistage stochastic programming models are derived in this study, where the multistage improvement of the probability distribution is modelled using the proposed feedback correctness method. The proposed optimization models are based on several assumptions, starting with the assumption that Information Retrieval is conducted in units of topics. The use of clusters is the primary reasons why a new method of probability estimation is proposed. The adaptive dual control of topic-based IR system was evaluated in a series of experiments conducted on the Reuters, Wikipedia and TREC collections of documents. The Wikipedia experiment revealed that the dual control feedback mechanism improves precision and S-recall when all the underlying assumptions are satisfied. In the TREC experiment, this feedback mechanism was compared to a state-of-the-art adaptive IR system based on BM-25 term weighting and the Rocchio relevance feedback algorithm. The baseline system exhibited better effectiveness than the cluster-based optimization model of ADTIR. The main reason for this was insufficient quality of the generated clusters in the TREC collection that violated the underlying assumption.

Consumer-based brand equity for Australia as a long haul tourism destination in an emerging market

Purpose: Although the branding literature emerged during the 1940s, research relating to tourism destination branding has only gained momentum since the late 1990s. There remains a lack of theory in particular that addresses the measurement of the effectiveness of destination branding over time. The purpose of the research was to test the effectiveness of a model of consumer-based brand equity (CBBE) for a country destination.---------- Design/methodology: A model of consumer-based brand equity was adapted from the marketing literature and applied to a nation context. The model was tested by using structural equation modelling with data from a large Chilean sample (n=845), comprising a mix of previous visitors and non-visitors. The model fits the data well. Findings: This paper reports the results of an investigation into brand equity for Australia as a long haul destination in an emerging market. The research took place just before the launch of the nation’s fourth new brand campaign in six years. The results indicate Australia is a well known but not compelling destination brand for tourists in Chile, which reflects the lower priority the South American market has been given by the national tourism office (NTO).---------- Practical implications: It is suggested that CBBE measures could be analysed at various points in time to track any strengthening or weakening of market perceptions in relation to brand objectives. A standard CBBE instrument could provide long-term effectiveness performance measures regardless of changes in destination marketing organisation (DMO) staff, advertising agency, other stakeholders, and budget.---------- Originality/value: This study contributes to the nation-branding literature by being one of the first to test the efficacy of a model of consumer-based brand equity for a tourism destination brand.

The conceptualisation, sensitivity and measurement of holding costs and other selected elements impacting housing affordability (Literature review and research methodology for confirmation of PhD candidature)

It is widely held that strong relationships exist between housing, economic status, and well being. This is exemplified by widespread housing stock surpluses in many countries which threaten to destabilise numerous aspects related to individuals and community. However, the position of housing demand and supply is not consistent. The Australian position provides a distinct contrast whereby seemingly inexorable housing demand generally remains a critical issue affecting the socio-economic landscape. Underpinned by high levels of immigration, and further buoyed by sustained historically low interest rates, increasing income levels, and increased government assistance for first home buyers, this strong housing demand ensures elements related to housing affordability continue to gain prominence. A significant, but less visible factor impacting housing affordability – particularly new housing development – relates to holding costs. These costs are in many ways “hidden” and cannot always be easily identified. Although it is only one contributor, the nature and extent of its impact requires elucidation. In its simplest form, it commences with a calculation of the interest or opportunity cost of land holding. However, there is significantly more complexity for major new developments - particularly greenfield property development. Preliminary analysis conducted by the author suggests that even small shifts in primary factors impacting holding costs can appreciably affect housing affordability – and notably, to a greater extent than commonly held. Even so, their importance and perceived high level impact can be gauged from the unprecedented level of attention policy makers have given them over recent years. This may be evidenced by the embedding of specific strategies to address burgeoning holding costs (and particularly those cost savings associated with streamlining regulatory assessment) within statutory instruments such as the Queensland Housing Affordability Strategy, and the South East Queensland Regional Plan. However, several key issues require investigation. Firstly, the computation and methodology behind the calculation of holding costs varies widely. In fact, it is not only variable, but in some instances completely ignored. Secondly, some ambiguity exists in terms of the inclusion of various elements of holding costs, thereby affecting the assessment of their relative contribution. Perhaps this may in part be explained by their nature: such costs are not always immediately apparent. Some forms of holding costs are not as visible as the more tangible cost items associated with greenfield development such as regulatory fees, government taxes, acquisition costs, selling fees, commissions and others. Holding costs are also more difficult to evaluate since for the most part they must be ultimately assessed over time in an ever-changing environment, based on their strong relationship with opportunity cost which is in turn dependant, inter alia, upon prevailing inflation and / or interest rates. By extending research in the general area of housing affordability, this thesis seeks to provide a more detailed investigation of those elements related to holding costs, and in so doing determine the size of their impact specifically on the end user. This will involve the development of soundly based economic and econometric models which seek to clarify the componentry impacts of holding costs. Ultimately, there are significant policy implications in relation to the framework used in Australian jurisdictions that promote, retain, or otherwise maximise, the opportunities for affordable housing.

Confusion with diffusion? Unravelling is diffusion and innovation literature with a focus on SMEs

The aim of this paper is to contribute to the understanding of various models used in research for the adoption and diffusion of information technology in small and medium-sized enterprises (SMEs). Starting with Rogers' diffusion theory and behavioural models, technology adoption models used in IS research are discussed. Empirical research has shown that the reasons why firms choose to adopt or not adopt technology is dependent on a number of factors. These factors can be categorised as owner/manager characteristics, firm characteristics and other characteristics. The existing models explaining IS diffusion and adoption by SMEs overlap and complement each other. This paper reviews the existing literature and proposes a comprehensive model which includes the whole array of variables from earlier models.

Choice of image features for depth-axis control in image based visual servo control

This paper is concerned with choosing image features for image based visual servo control and how this choice influences the closed-loop dynamics of the system. In prior work, image features tend to be chosen on the basis of image processing simplicity and noise sensitivity. In this paper we show that the choice of feature directly influences the closed-loop dynamics in task-space. We focus on the depth axis control of a visual servo system and compare analytically various approaches that have been reported recently in the literature. The theoretical predictions are verified by experiment.

If it's encrypted it's secure! The viability of US state-based encryption exemptions

US state-based data breach notification laws have unveiled serious corporate and government failures regarding the security of personal information. These laws require organisations to notify persons who may be affected by an unauthorized acquisition of their personal information. Safe harbours to notification exist if personal information is encrypted. Three types of safe harbour have been identified in the literature: exemptions, rebuttable presumptions and factors. The underlying assumption of exemptions is that encrypted personal information is secure and therefore unauthorized access does not pose a risk. However, the viability of this assumption is questionable when examined against data breaches involving encrypted information and the demanding practical requirements of effective encryption management. Recent recommendations by the Australian Law Reform Commission (ALRC) would amend the Privacy Act 1988 (Cth) to implement a data breach scheme that includes a different type of safe harbour, factor based analysis. The authors examine the potential capability of the ALRC’s proposed encryption safe harbour in relation to the US experience at the state legislature level.

Modelling the process of dialogic communication in public relations: a role-based approach

This paper takes Kent and Taylor’s (2002) call to develop a dialogic theory of public relations and suggests that a necessary first step is the modelling of the process of dialogic communication in public relations. In order to achieve this, extant literature from a range of fields is reviewed, seeking to develop a definition of dialogic communication that is meaningful to the practice of contemporary public relations. A simple transmission model of communication is used as a starting point. This is synthesised with concepts relating specifically to dialogue, taken here in its broadest sense rather than defined as any one particular outcome. The definition that emerges from this review leads to the conclusion that dialogic communication in public relations involves the interaction of three roles – those of sender, receiver, and responder. These three roles are shown to be adopted at different times by both participants involved in dialogic communication. It is further suggested that variations occur in how these roles are conducted: the sender and receiver roles can be approached in a passive or an active way, while the responder role can be classified as being either resistant or responsive to the information received in dialogic communication. The final modelling of the definition derived provides a framework which can be tested in the field to determine whether variations in the conduct of the roles in dialogic communication actually exist, and if so, whether they can be linked to the different types of outcome from dialogic communication identified previously in the literature.

Developing creativity and innovation in management education : an artful event for transformative learning

This paper argues that management education needs to consider a trend in learning design which advances more creative learning through an alliance with art-based pedagogical processes. A shift is required from skills training to facilitating transformational learning through experiences that expand human potential, facilitated by artistic processes. In this paper the authors discuss the necessity for creativity and innovation in the workplace and the need to develop better leaders and managers. The inclusion of arts-based processes enhances artful behaviour, aesthetics and creativity within management and organisational behaviour, generating important implications for business innovation. This creative learning focus stems from an analysis of an arts-based intervention for management development. Entitled Management Jazz the program was conducted over three years at a large Australian University. The paper reviews some of the salient literature in the field. It considers four stages of the learning process: capacity, artful event, increased capability, and application/action to produce product. One illustrative example of an arts-based learning process is provided from the Management Jazz program. Research findings indicate that artful learning opportunities enhance capacity for awareness of creativity in one’s self and in others. This capacity correlates positively with a perception that engaging in artful learning enhances the capability of managers in changing collaborative relationships and habitat constraint. The authors conclude that it is through engagement and creative alliance with the arts that management education can explore and discover artful approaches to building creativity and innovation. The illustration presented in this paper will be delivered as a brief workshop at the Fourth Art of Management Conference. The process of bricolage and articles at hand will be used to explore creative constraints and prototypes while generating group collaboration. The mini-workshop will conclude with discussion of the arts-based process and capability enhancement outcomes.

Cluster-based network model for time-course gene expression data

We propose a model-based approach to unify clustering and network modeling using time-course gene expression data. Specifically, our approach uses a mixture model to cluster genes. Genes within the same cluster share a similar expression profile. The network is built over cluster-specific expression profiles using state-space models. We discuss the application of our model to simulated data as well as to time-course gene expression data arising from animal models on prostate cancer progression. The latter application shows that with a combined statistical/bioinformatics analyses, we are able to extract gene-to-gene relationships supported by the literature as well as new plausible relationships.

N2O emissions from agricultural lands: a synthesis of simulation approaches

Nitrous oxide (N2O) is primarily produced by the microbially-mediated nitrification and denitrification processes in soils. It is influenced by a suite of climate (i.e. temperature and rainfall) and soil (physical and chemical) variables, interacting soil and plant nitrogen (N) transformations (either competing or supplying substrates) as well as land management practices. It is not surprising that N2O emissions are highly variable both spatially and temporally. Computer simulation models, which can integrate all of these variables, are required for the complex task of providing quantitative determinations of N2O emissions. Numerous simulation models have been developed to predict N2O production. Each model has its own philosophy in constructing simulation components as well as performance strengths. The models range from those that attempt to comprehensively simulate all soil processes to more empirical approaches requiring minimal input data. These N2O simulation models can be classified into three categories: laboratory, field and regional/global levels. Process-based field-scale N2O simulation models, which simulate whole agroecosystems and can be used to develop N2O mitigation measures, are the most widely used. The current challenge is how to scale up the relatively more robust field-scale model to catchment, regional and national scales. This paper reviews the development history, main construction components, strengths, limitations and applications of N2O emissions models, which have been published in the literature. The three scale levels are considered and the current knowledge gaps and challenges in modelling N2O emissions from soils are discussed.

Exercise and cancer rehabilitation : a systematic review

Introduction: Cancer is increasingly being viewed as a chronic illness requiring long-term management, and there is a growing need for evidence-based rehabilitation interventions for cancer survivors. Previous reviews have evaluated the benefits of exercise interventions for patients undergoing cancer treatment and long-term survivors, but none have investigated the role of exercise during cancer rehabilitation, the period immediately following cancer treatment completion. This systematic review summarises the literature on the health effects of exercise during cancer rehabilitation and evaluates the methodological rigour of studies in this area to date.----------- Methods: Relevant studies were identified through a systematic search of PubMed and Embase to April 2009. Data on study design, recruitment strategy, participants, exercise intervention, adherence rates, and outcomes were extracted. Methodological rigour was assessed using a structured rating system.---------- Results: Ten studies were included. Breast cancer patients were the predominate patient group represented. Most interventions were aerobic or resistance-training exercise programmes, and exercise type, frequency, duration and intensity varied across studies. Improvements in physical functioning, strength, physical activity levels, quality of life, fatigue, immune function, haemoglobin concentrations, potential markers of recurrence, and body composition were reported. However, all studies were limited by incomplete reporting and methodological limitations.---------- Conclusions: Although the methodological limitations of studies in this new field must be acknowledged, initial evidence indicates that exercise is feasible and may provide physiological and psychological benefits for cancer survivors during the rehabilitation period. Future studies with rigorous study designs are now required to advance the field.

Harnessing ICT-based tool for improving the collaborative health planning debate : the case of Logan-Beaudesert, Australia

The field of collaborative health planning faces significant challenges posed by the lack of effective information, systems and a framework to organise that information. Such a framework is critical in order to make accessible and informed decisions for planning healthy cities. The challenges have been exaggerated by the rise of the healthy cities movement, as a result of which, there have been more frequent calls for localised, collaborative and evidence-based decision-making. Some studies suggest that the use of ICT-based tools in health planning may lead to: increased collaboration between stakeholder sand the community; improve the accuracy and quality of the decision making process; and, improve the availability of data and information for health decision-makers as well as health service planners. Research has justified the use of decision support systems (DSS) in planning for healthy cities as these systems have been found to improve the planning process. DSS are information communication technology (ICT) tools including geographic information systems (GIS) that provide the mechanisms to help decision-makers and related stake holders assess complex problems and solve these in a meaningful way. Consequently, it is now more possible than ever before to make use of ICT-based tools in health planning. However, knowledge about the nature and use of DSS within collaborative health planning is relatively limited. In particular, little research has been conducted in terms of evaluating the impact of adopting these tools upon stakeholders, policy-makers and decision-makers within the health planning field. This paper presents an integrated method that has been developed to facilitate an informed decision-making process to assist in the health planning process. Specifically, the paper describes the participatory process that has been adopted to develop an online GIS-based DSS for health planners. The literature states that the overall aim of DSS is to improve the efficiency of the decisions made by stakeholders, optimising their overall performance and minimizing judgmental biases. For this reason, the paper examines the effectiveness and impact of an innovative online GIS-based DSS on health planners. The case study of the online DSS is set within a unique settings-based initiative designed to plan for and improve the health capacity of Logan-Beaudesert area, Australia. This unique setting-based initiative is named the Logan-Beaudesert Health Coalition (LBHC).The paper outlines the impact occurred by implementing the ICT-based DSS. In conclusion, the paper emphasizes upon the need for the proposed tool for enhancing health planning.

Improving road safety through deterrence-based initiatives : a review of research

The efficacy of road safety countermeasures to deter motorists from engaging in illegal behaviours is extremely important when considering the personal and economic impact of road accidents on the community. Within many countries, deterrence theory has remained a cornerstone to criminology and criminal justice policy, particularly within the field of road safety, as policy makers and enforcement agencies attempt to increase perceptions regarding the certainty, severity and swiftness of sanctions for those who engage in illegal motoring behaviours. Using the Australian experience (particularly the tremendous amount of research into drink driving), the current paper reviews the principles underpinning deterrence theory, the utilisation of the approach within some contemporary road safety initiatives (e.g., Random Breath Testing) as well as highlights some methods to enhance a deterrent effect. The paper also provides direction for future deterrence-based research, in particular, considering the powerful impact of non-legal sanctions, punishment avoidance as well as creating culturally embedded behavioural change.

Orchestrating knowledge-based urban development : lessons from multimedia super corridor, Malaysia

In the era of knowledge economy, cities and regions have started increasingly investing on their physical, social and knowledge infrastructures so as to foster, attract and retain global talent and investment. Knowledge-based urban development as a new paradigm in urban planning and development is being implemented across the globe in order to increase the competitiveness of cities and regions. This chapter provides an overview of the lessons from Multimedia Super Corridor, Malaysia as one of the first large scale manifestations of knowledge-based urban development in South East Asia. The chapter investigates the application of the knowledge-based urban development concept within the Malaysian context, and, particularly, scrutinises the development and evolution of Multimedia Super Corridor by focusing on strategies, implementation policies, infrastructural implications, and agencies involved in the development and management of the corridor. In the light of the literature and case findings, the chapter provides generic recommendations, on the orchestration of knowledge-based urban development, for other cities and regions seeking such development.