Paper 4 : Schooling, identity and social connectivity

This paper will report on the progress of a large three year Australian Research Council (ARC) grant awarded to a multidisciplinary team of researchers in Victoria, Australia. The research, A multi-disciplinary investigation of how trauma and chronic illness impact on schooling, identity and social connectivity commenced in 2007 and is known as Keeping Connected (2007). The research is a collaborative grant in partnership with the Royal Children’s Hospital Education Institute, in association with the Melbourne Graduate School of Education, University of Melbourne and the Centre for Adolescent Health, Royal Children’s Hospital. The research aims to investigate qualitatively, longitudinally and through multiple perspectives how young people construct/reconstruct identity and relationships with schooling following disruption associated with chronic illness. Using a mixed methodology, but with a central focus on longitudinal qualitative studies from the perspective of the young people, the study aims to identify key elements of disruption or continued connection, and will illuminate identity issues of people facing this disruption at different age and schooling points. The research outcomes will support education and health practices and provide a differently focused empirical contribution to the literature on education and social connection. The paper works at mixing methods qualitatively, rather than focusing on the overall mixed method design of the study. Assemblages of social capital theory and sociomateriality may be a useful standpoint for the development of our empirical contribution.

Qualitative methods in early-phase drug trials : data and methods from a trial of N-acetylcysteine in schizophrenia

Objective: The pharmacokinetic profile of a drug often gives little indication of its potential therapeutic application, with many therapeutic uses of drugs being discovered serendipitously while being studied for different indications. As hypothesis-driven, quantitative research methodology is exclusively used in early-phase trials, unexpected but important phenomena may escape detection. In this context, this study aimed to examine the potential for integrating qualitative research methods with quantitative methods in early-phase drug trials. To our knowledge, this mixed methodology has not previously been applied to blinded psychopharmacologic trials.

Method: We undertook qualitative data analysis of clinical observations on the dataset of a randomized, double-blind, placebo-controlled trial of N-acetylcysteine (NAC) in patients with DSM-IV-TR–diagnosed schizophrenia (N = 140). Textual data on all participants, deliberately collected for this purpose, were coded using NVivo 2, and emergent themes were analyzed in a blinded manner in the NAC and placebo groups. The trial was conducted from November 2002 to July 2005.

Results: The principal findings of the published trial could be replicated using a qualitative methodology. In addition, significant differences between NAC- and placebo-treated participants emerged for positive and affective symptoms, which had not been captured by the rating scales utilized in the quantitative trial. Qualitative data in this study subsequently led to a positive trial of NAC in bipolar disorder.

Conclusions: The use of qualitative methods may yield broader data and has the potential to complement traditional quantitative methods and detect unexpected efficacy and safety signals, thereby maximizing the findings of early-phase clinical trial research.

Identifying key success factors for the adoption and implementation of a chemotherapy ordering system: a case study from the Australian private healthcare sector

This paper is designed to systematically assess the benefits of a chemotherapy ordering system (COS) for the private healthcare sector in Australia. By taking a rational economic perspective and modeling the principle-agent relationships using an actor network framework, it is possible to evaluate various scenarios and thereby assess the benefits, barriers and facilitators, possible COS can have. In this study, four hypotheses are tested using a mixed methodology which will serve to facilitate the decision making processes regarding the choice and implementation of the appropriate COS for Epworth.

Analysis of reverse logistics implementation practices by South Australian construction organisations

Purpose – A large number of benefits have been reported when reverse logistics (RL) is fully implemented in the construction industry. However, RL is yet to become common place in the construction sector, particularly in Australia. The particular sub-sector in which RL operates is small and weak and the remainder of the sector must embrace and accommodate it comfortably. Research is lacking on how to promoting RL in the construction industry. Very little has been done to identify the current practices that have the potential to promote RL industry-wide. The purpose of this paper is to identify the practices that work well in the sector, a strategy could be mapped out to promote RL to all stakeholders. Design/methodology/approach – In order to fill the above gap, the present study used a mixed method approach to gather and evaluate current practices and their potential to promote RL in South Australia’s construction industry. Practices that were identified using a comprehensive literature review were evaluated with a questionnaire survey and series of interviews involving construction professionals. Findings – The findings are that practices facilitating deconstruction is the most important, followed by practices facilitating the use of salvaged materials in new construction to promote RL in South Australia. Awareness of deconstruction benefits, challenges and procedures at the organisation level and facilities and services at industry level were associated with RL implementation. Availability of salvaged materials in the market was found to influence its use in new construction and as a consequence its demand. Designing for reverse logistics is another practice that could facilitate deconstruction and the onus of its promotion lies mainly with the designers. Research limitations/implications – This research was confined to one state in Australia. As such the generalisation to other states and other countries should be treated cautiously. Practical implications – The findings of this study can help inform the industry and its stakeholders on areas that they need to concentrate more on to make the South Australian construction industry a fully RL integrated one. To that end the authors propose some recommendations arising from the findings reported here. Originality/value – This study makes a contribution to the body of knowledge on reserve logistics within a previously unexplored South Australian context. In addition, the study provides valuable insights into the contribution of RL practices to the construction industry.

What do participants of the Crohn's and Colitis UK (CCUK) Annual York Walk think of their Inflammatory bowel disease care? A short report on a survey

There has been a growing interest in a patient-centered model of care in inflammatory bowel disease; however, no relevant study using a mixed methodology has been conducted to date. Thus, our multidisciplinary group aimed to explore the issue of patient involvement in care among the inflammatory bowel disease community. A mixed-methods anonymous survey was conducted during the Crohn's and Colitis UK annual event. Summary statistics were used to describe the sample, and a simple thematic analysis identified key themes in qualitative responses. There were 64 survey respondents, representing 73% of the total family/friend groups participating (N = 87). Overall, 75% of respondents answered that they had the opportunity to discuss their care with their inflammatory bowel disease practitioner and 81% felt their opinions were taken on board and valued. A clear majority (84%) had at some point been treated by a gastroenterologist. In contrast, less than half (44%) had the opportunity for a dietician consultation and only 28% had the opportunity for a psychologist/counselor consultation. Although satisfaction with inflammatory bowel disease care was high, access to specialty services was concerning. Efforts should be made to provide access to mental health practitioners for those with clinically significant anxiety and/or depression.

Mixed methods : a research design for management doctoral dissertations

Purpose – This paper seeks to examine two management doctoral research projects to highlight the advantages in mixed methods as the primary research design.
Design/methodology/approach – This paper summarises the methods of data collection and analysis which were used by two doctoral students in their management research. The researchers used mixed methods approaches (quantitative and qualitative) to explore different areas of management.
Findings – The paper supports the view that triangulation of research methods strengthens the findings and inferences made for understanding social phenomena in more depth, compared to using a single method.
Research limitations/implications – The paper relies excessively on two doctoral research projects which utilise sequential mixed methods. Therefore, arguments made in the paper are specific because other doctoral projects that have used different methods from those employed in the two projects were not considered.
Practical implications – Early researchers, in particular students commencing doctorate studies, should apply mixed methods research because it develops skills in the two most dominant data collection methods used in management research. This paper is a practical guide on how this could be done effectively.
Originality/value – The paper is drawn from two unique doctoral research projects. The paper’s originality and value is in providing experiences and practical insights on how mixed methods research is undertaken.

Methodological challenges to research among Chinese : using mixed methods to investigate older persons with depression in Macau

The article offers an example of using a mixed methods design that was implemented when investigating depression among Chinese older persons in Macau. A challenge in designing the study was that in light of literature on Chinese culture and somatization theory, the acceptability of the methodology was uncertain. Participants (n = 31) were purposively selected and quantitative data were collected using multiple standardized measures. Questions raised by the quantitative approach were then reflected through in-depth interviews. Four dominant categories emerged: (a) negative thinking, (b) physical limitations and complaints, (c) present living conditions and social support, and (d) the lives participants have lived. There was a high level of congruence between quantitative scores and narratives. The research approach was acceptable to the participants, and the findings contributed to an understanding of depression and therapeutic interventions for that population within Chinese culture.

"Flows and catchments" : a mixed method study utilising nvivo to facilitate cross-disciplinary collaboration incorporating practice-based research

This paper responds to the problem of how Practice-Based Research (PBR) can be usefully incorporated into a cross-disciplinary, Mixed Method project design, by considering a non-conventional use of the NVivo qualitative analysis software package. NVivo also proves valuable in maximising the creative-arts practice interdisciplinary potential within PBR itself. The ensuing discussion centres around Deakin University’s ‘Flows and Catchments’ research and teaching initiative.

The use of mixed methods in drug discovery: integrating qualitative methods into clinical trials

Contemporary methods in clinical trials are pivoted around hypothesis confirmation, not generation. This is a problem for new drug discovery, since the pharmacokinetic or receptor profile of most novel agents do not link to pathophysiology, which is very poorly understood. Therefore, it is difficult to impute the therapeutic potential of a candidate agent. Most psychotropic agents were discovered serendipitously, either through careful clinical observation or by researchers finding unexpected associations in datasets. Methods that increase the ability to detect latent signals in data are needed. These include mixed methods that incorporate qualitative methods into randomized controlled trials.

This chapter proposes a methodology for the integration of mixed methods in clinical trials, fusing qualitative and quantitative methods, and presents an exemplar using this approach.

Mixed methods show potential for signal detection, hypothesis generation, and associations that may be otherwise undetected in traditional clinical trials.