The first time

'The First Time' employs performed research to investigate the 'firsts' of twelve first year teachers in Victorian schools. Based on interview data generated over the period of a year, the performance highlights 'firsts' as epiphanic or revelatory moments of professional identity transformation. The performance is crafted to reflect the fluid and unpredictable nature of teachers' professional identity. 'The First Time' uses only the words of the teachers, and is performed by teachers - including first year teachers. It reveals the destabilising effects of contextual factors on teachers' professional identity. Status and belonging are positioned within survival, liminal, and hegemonic discourses, and expressed through artefacts as symbols of belonging. The low status ascribed to contractual work underpins beginning teachers' commitment to the profession. The premier performance (https://www.youtube.com/playlist?list=PLB1ED0FDEF2AA8836) was initially devised to analyse the interview data through the process of scripting, rehearsal, and performance. This version sees the addition of a concluding dance work, which reflects the results of the research. The voices of the participants from their interview recordings shape the dance work.Performed by: Melissa Learmonth, Beaux Glenn, Arna Pletes, Krystal Holzer, Ashlea Thompson, Tom Ellis, Lauren Wallis, Fiona McGrath, and Claire Hesse.

Medication errors in ED: do patient characteristics and the environment influence the nature and frequency of medication errors?

Background: Medication safety is of increasing importance and understanding the nature and frequency of medication errors in the Emergency Department (ED) will assist in tailoring interventions which will make patient care safer. The challenge with the literature to date is the wide variability in the frequency of errors reported and the reliance on incident reporting practices of busy ED staff. Methods: A prospective, exploratory descriptive design using point prevalence surveys was used to establish the frequency of observed medication errors in the ED. In addition, data related to contextual factors such as ED patients, staffing and workload were also collected during the point prevalence surveys to enable the analysis of relationships between the frequency and nature of specific error types and patient and ED characteristics at the time of data collection. Results: A total of 172 patients were included in the study: 125 of whom patients had a medication chart. The prevalence of medication errors in the ED studied was 41.2% for failure to apply patient ID bands, 12.2% for failure to document allergy status and 38.4% for errors of omission. The proportion of older patients in the ED did not affect the frequency of medication errors. There was a relationship between high numbers of ATS 1, 2 and 3 patients (indicating high levels of clinical urgency) and increased rates of failure to document allergy status. Medication errors were affected by ED occupancy, when cubicles in the ED were over 50% occupied, medication errors occurred more frequently. ED staffing affects the frequency of medication errors, there was an increase in failure to apply ID bands and errors of omission when there were unfilled nursing deficits and lower levels of senior medical staff were associated with increased errors of omission. Conclusions: Medication errors related to patient identification, allergy status and medication omissions occur more frequently in the ED when the ED is busy, has sicker patients and when the staffing is not at the minimum required staffing levels.

Leadership self-development in China and Vietnam

The transition towards a socialist market-oriented economy has presented many challenges to both China and Vietnam. One of the key human resource challenges has been to develop business leadership skills in a flexible, timely and cost-effective manner. This paper focuses on the self-initiated approach to professional development that has been introduced by managers at a grassroot level to improve business leadership (referred to as self-development). Given the limited research on self-development in China and Vietnam, the intention of this paper is to enrich understanding of why managers in a complex and dynamic transitional environment undertake self-development activities. The findings of this study suggest that there is no ‘one-size-fits-all’ paradigm to understand self-development across contexts. First, the western model of leadership competencies at the different management levels do not necessarily fit the needs that managers are targeting in their self-development activities in China and Vietnam. Second, despite some similarities between China and Vietnam, the Chinese managers were more interested in technical leadership skills than the Vietnamese managers whose self-development foci were centred on improving their moral standards. Such differences highlight each country's stage of economic and social development while reinforcing the influence of contextual factors. It also suggests that self-development is best understood as a process within a specific context.

Reflections on doing inclusive research in the 'making life good in the community' study

BACKGROUND: The involvement of people with intellectual disability in research is framed as inclusive, denoting their active participation in its processes. However, questions are raised about ownership and control, genuineness of involvement, and the need for honest accounts to develop practice. Such issues are particularly pressing in Australia, where there is the absence of a strong self-advocacy movement to partner with academics or hold them to account. METHOD: Action research was used to reflect on and progressively refine the support provided by a research mentor to a co-researcher with intellectual disability employed on a large multimethod study. RESULTS AND CONCLUSIONS: Accepting the co-researcher's strengths and designing support on the job rather than teaching them to "pass" before venturing out in the field are important in ceding control. Support required for a co-researcher is more than practical and involves developing a relationship that can actively challenge views and foster reflection. Ownership of questions and disseminating of outcomes are hampered by contextual factors such as tender processes, short-term positions, and a failure to acknowledge the support required to present findings.

Understanding context in knowledge translation: a concept analysis study protocol.

AIM: To conduct a concept analysis of clinical practice contexts (work environments) that facilitate or militate against the uptake of research evidence by healthcare professionals in clinical practice. This will involve developing a clear definition of context by describing its features, domains and defining characteristics. BACKGROUND: The context where clinical care is delivered influences that care. While research shows that context is important to knowledge translation (implementation), we lack conceptual clarity on what is context, which contextual factors probably modify the effect of knowledge translation interventions (and hence should be considered when designing interventions) and which contextual factors themselves could be targeted as part of a knowledge translation intervention (context modification). DESIGN: Concept analysis. METHODS: The Walker and Avant concept analysis method, comprised of eight systematic steps, will be used: (1) concept selection; (2) determination of aims; (3) identification of uses of context; (4) determination of defining attributes of context; (5) identification/construction of a model case of context; (6) identification/construction of additional cases of context; (7) identification/construction of antecedents and consequences of context; and (8) definition of empirical referents of context. This study is funded by the Canadian Institutes of Health Research (January 2014). DISCUSSION: This study will result in a much needed framework of context for knowledge translation, which identifies specific elements that, if assessed and used to tailor knowledge translation activities, will result in increased research use by nurses and other healthcare professionals in clinical practice, ultimately leading to better patient care.

Expanding a successful community-based obesity prevention approach into new communities : challenges and achievements

OBJECTIVE: A previously successful community-based obesity prevention intervention with a focus on school settings was expanded into new communities with varying contexts. In order to understand the complexities involved in implementing health promotion activities in schools, this study examined experiences of school staff and project officers including barriers, contextual factors and achievements. METHODS: School environment assessments were conducted in schools across four Victorian communities with school staff (n=1-5 staff plus a trained researcher per group in 9 primary and 8 secondary schools) 12-18 months post-intervention. Process reports from project officers were also reviewed and analysed (n=4). RESULTS: School staff commonly reported time pressures as a barrier to implementation and project officers working within schools reported competing priorities and limited health promotion experience of staff; lack of stakeholder engagement; low participation in some activities and insufficient implementation time. Contextual factors included community socioeconomic status, student ethnicity and living rurally. Achievements included student and staff enjoyment from programme activities, staff capacity building, partnerships, embedding activities into existing infrastructure and programmes, and having consistent health-related messages repeated through a variety of strategies. CONCLUSIONS: Community-based interventions with a focus on school settings need to consider system level, organisational and contextual (i.e. socioeconomic, ethnicity, family and town characteristics) factors when expanding previously effective strategies into new communities. Implementation benefits may have added whole of school benefits in addition to child health. Focussing on overcoming the challenges experienced in this complex initiative is required for future interventions.

Prosecutors’ perceptions of the utility of video-evidence for adult complainants of sexual assault

Playing an adult sexual complainant’s video-recorded police interview as the basis for his or her evidence-in-chief is a reform Australia could adopt to help improve criminal justice responses to these cases. This article presents a qualitative evaluation of prosecutor’s support for this reform and their views about what conditions would determine its utility. Focus groups were held with 13 prosecutors from across New Zealand (which already has this reform) and Australia. Collectively, prosecutors supported the availability of video-evidence for adult complainants. They perceived the utility of this reform depends on the following conditions: (1) the quality of the police interview; (2) how credibly the complainant presents on video; (3) contextual factors that influence the complainant’s ability to give live evidence; and (4) the degree of stakeholder support. These findings suggest that Australia should extend video-evidence to adult complainants of sexual assault guided by careful planning aroundthese four areas.

Unhealthy food promotion to under 18s: deeper insights, new interpretations.

 This work explores unhealthy food and beverage promotion to children and adolescents with members of the marketing and food and beverage industries, and public health professionals. It identifies areas of partial agreement, while emphasizing that responses cannot be separated from contextual factors that influence the way stakeholders understand this issue.

Marginalisation of dental students in a shared medical and dental education programme

OBJECTIVES: Internationally, there are a number of universities at which medical and dental education programmes share common elements. There are no studies about the experiences of medical and dental students enrolled in different programmes who share significant amounts of learning and teaching. METHODS: Semi-structured interviews and focus groups were conducted with 36 students and staff in a learning programme shared between separate medical and dental faculties. They were transcribed and an iterative process of interpretation and analysis within the theoretical framework of the contact hypothesis and social identity theory was used to group data into themes and sub-themes. RESULTS: Dental students felt 'marginalised' and felt they were treated as 'second-class citizens' by medical students and medical staff in the shared aspects of their programmes. Contextual factors such as the geographical location of the two schools, a medical : dental student ratio of almost 3 : 1, along with organisational factors such as curriculum overload, propagated negative attitudes towards and professional stereotyping of the dental students. Lack of understanding by medical students and faculty of dental professional roles contributed further. CONCLUSIONS: Recommendations for reducing the marginalisation of dental students in this setting include improving communication between faculties and facilitating experiential contact. This might be achieved through initiating a common orientation session, stronger social networks and integrated learning activities, such as interprofessional problem-based learning and shared clinical experiences.

Engaging patients, clinicians and health funders in weight management: the Counterweight Programme

Background. The Counterweight Programme provides an evidence based and effective approach for weight management in routine primary care. Uptake of the programme has been variable for practices and patients.

Aim. To explore key barriers and facilitators of practice and patient engagement in the Counterweight Programme and to describe key strategies used to address barriers in the wider implementation of this weight management programme in UK primary care.

Methods. All seven weight management advisers participated in a focus group. In-depth interviews were conducted with purposeful samples of GPs (n = 7) and practice nurses (n = 15) from 11 practices out of the 65 participating in the programme. A total of 37 patients participated through a mixture of in-depth interviews (n = 18) and three focus groups. Interviews and focus groups were analysed for key themes that emerged.

Results. Engagement of practice staff was influenced by clinicians’ beliefs and attitudes, factors relating to the way the programme was initiated and implemented, the programme content and organizational/contextual factors. Patient engagement was influenced by practice endorsement of the programme, clear understanding of programme goals, structured proactive follow-up and perception of positive outcomes.

Conclusions. Having a clear understanding of programme goals and expectations, enhancing self-efficacy in weight management and providing proactive follow-up is important for engaging both practices and patients. The widespread integration of weight management programmes into routine primary care is likely to require supportive public policy.

Teachers' beliefs about the possibilities and limitations of digital games in classrooms

Teachers' beliefs about what it is (or is not) possible to achieve with digital games in educational contexts will inevitably influence the decisions that they make about how, when, and for what specific purposes they will bring these games into their classrooms. They play a crucial role in both shaping and responding to the complex contextual factors which influence how games are understood and experienced in educational settings. Throughout this article the authors draw upon data collected for a large-scale, mixed-methods research project focusing on literacy, learning and teaching with digital games in Australian classrooms, to focus explicitly on the attitudes, understandings and expectations held about digital games by diverse teachers at the beginning of the project. They seek to identify the beliefs about games that motivated teachers' participation in a digital games research project while focusing, as well, on concerns that teachers express about risks or limitations of such a project. The authors' aim is to develop a detailed picture of the mindsets that teachers bring to games-based learning environments, and the relevance of these mindsets to broader debates about the relationship between games, learning and school.

Barriers and enablers to safeguarding children and adults within a disability services context: Insights from an Australian Delphi Study

Research conducted in the 1990s revealed the tragic irony that exposure to the disability support system, and particularly to its institutional forms, was a major risk factor related to the neglect and abuse of children and adults with a disability. Subsequently, a range of policies have been introduced to minimize risk. However, recurring events of abuse and neglect in the disability services sector in high and middle income countries demonstrate that processes geared to safeguard children and adults with a disability from abuse and neglect remain insufficient. To establish the wider fabric of organizational factors that contribute to effective safeguarding practices within the Australian disability support sector, a modified online Delphi study was conducted, capturing the views of disability services staff and managers (n=249) regarding barriers and enablers to effective safeguarding. This study identified issues concerning organizational culture, management practice, workforce development, client capacity building and contextual factors. During Round Two of the Delphi, participants were asked to rate the categorized enabler statements according to importance on a 10-point Likert scale, to ascertain the degree of consensus. A total of 262 of the statements were regarded as important or very important. The Delphi result highlighted the considerable gap between the wider systemic and cultural processes that, in the eyes of disability services staff and management, contribute to good safeguarding practice and the safeguarding measures currently in place. The article calls for a holistic approach to safeguarding that addresses procedural issues and to the transformation of the wider systemic and cultural fabric of an organization.

A multiple case history and systematic review of adoption, diffusion, implementation and impact of provincial daily physical activity policies in Canadian schools

BACKGROUND : Few children meet physical activity (PA) recommendations, and are therefore at increased risk for overweight/obesity and adverse health outcomes. To increase children's opportunities for PA, several Canadian provinces have adopted school-based daily PA (DPA) policies. It is not clear why some jurisdictions have adopted DPA policies, and others have not, nor whether these policies have been implemented and have achieved their intended outcomes. The purpose of this study was to understand the processes underlying adoption and diffusion of Canadian DPA policies, and to review evidence regarding their implementation and impact.

METHODS: We adopted a multiple case history methodology in which we traced the chronological trajectory of DPA policies among Canadian provinces by compiling timelines detailing key historical events that preceded policy adoption. Publicly available documents posted on the internet were reviewed to characterize adopter innovativeness, describe the content of their DPA policies, and explore the context surrounding policy adoption. Diffusion of Innovations theory provided a conceptual framework for the analyses. A systematic literature search identified studies that had investigated adoption, diffusion, implementation or impact of Canadian DPA policies.

RESULTS: Five of Canada's 13 provinces and territories (38.5%) have DPA policies. Although the underlying objectives of the policies are similar, there are clear differences among them and in their various policy trajectories. Adoption and diffusion of DPA policies were structured by the characteristics and capacities of adopters, the nature of their policies, and contextual factors. Limited data suggests implementation of DPA policies was moderate but inconsistent and that Canadian DPA policies have had little to no impact on school-aged children's PA levels or BMI.

CONCLUSIONS: This study detailed the history and current status of Canadian DPA policies, highlighting the conditional nature of policy adoption and diffusion, and describing policy and adopter characteristics and political contexts that shaped policy trajectories. An understanding of the conditions associated with successful policy adoption and diffusion can help identify receptive contexts in which to pioneer novel legislative initiatives to increase PA among children. By reviewing evidence regarding policy implementation and impact, this study can also inform amendments to existing, and development of future PA policies.

Out of Character? Legal responses to intimate partner homicides by men in Victoria 2005-2014

This report reviews 51 cases of intimate partner homicide by men in Victoria, from 2005-2014, to investigate how family violence is recognised in homicide prosecutions. Research and death reviews in Australia and overseas have found that systemic failures in legal responses to family violence contribute to intimate partner homicides. In 2010, Domestic Violence Resource Centre Victoria and Monash University began a project to explore the impact of the 2005 homicide law reforms on intimate partner homicides. The first phase of the project examined cases of women who killed their intimate partners, focusing on whether the reforms had improved the recognition of family violence victimisation as a factor. This report presents findings from the second phase, which examines legal responses to men who have killed in the context of sexual intimacy. In analysing the cases, it looks at key contextual factors, legal outcomes, family violence risk factors, how prior family violence is understood and discussed by legal professionals, how evidence of prior family violence is used by the prosecution and whether it is admitted as evidence, the types of arguments and narratives made in defence of the accused, the recognition of family violence through the sentencing process, and the use of provocation as a mitigating factor.

Issues of Indigenous representation: white advocacy and the complexities of ethical leadership

This paper explores the tensions and complexities for two principals as they work towards equity and improved social and educational outcomes for their Indigenous students. Drawing on Foucault’s fourfold ethical frame and poststructuralist notions of the subject, this paper presents the different ways the white female principals of Indigenous schools are formed as subjects. We illustrate how the multiplicities of their subject formation are influenced by the historicity and contextual factors of the schools and communities. These factors play a significant part in how these principals work as advocates and differently experience and negotiate the tensions around representation of and for Indigenous schools and communities. In realising equity goals for Indigenous students, the paper draws on Foucault’s work to illustrate the imperative of school leaders’ cognisance of, and capacity to work with, these factors.