Exploring the process of implementing a smoking cessation intervention in pregnancy training program for midwives

The question of how to implement evidence effectively reveals a deficiency in our knowledge and understanding of the compound factors involved in such a process (Kitson, Rycroft-Malone et al. 2008). Although there is some awareness of the complexities of the process, there has been little exploration of the effectiveness of implementing evidence-based programs in health care. Despite public awareness of the dangers of smoking in pregnancy, and widespread public health measures to prevent smoking-related disease, women still continue to smoke in pregnancy (Ananth, Savitz et al. 1997; Laws and Hilder 2008). Evaluation of public health measures concludes that smoking cessation interventions during pregnancy increase quit rates among pregnant women (Melvin, Dolan-Mullen et al. 2000; Albrecht, Maloni et al. 2004; Lumley, Oliver et al. 2007). Notwithstanding the potential for improvement in health outcomes for pregnant women and their unborn babies, smoking interventions are often conducted poorly or not at all. Although midwives understand why women smoke in pregnancy and parenthood and are aware of the risks of smoking to both the pregnancy and the unborn child, they require specific knowledge and skills in the provision of support and advice on smoking for pregnant women (Bull and Whitehead 2006) . Organisational-change research demonstrates the complexity of the process of planned change in professionalised institutions such as health care (Greenhalgh, Robert et al. 2005). Some innovations and interventions are never accepted, and others are poorly supported (Greenhalgh, Robert et al. 2004). Comprehension of the change process around health promotion is crucial to the implementation of new health promotion interventions within health care (Riley, Taylor et al. 2003). This study utilised a case study approach to explore the process of implementing a smoking cessation training program for midwives in Queensland metropolitan and regional clinical areas, who attended a ‘Train-the-Trainer program’. The study draws on the organisational change work of Greenhalgh et al (2004) as the theoretical framework through which situational and structural factors are explored and examined as they inform the implementation of smoking cessation programs. The research data constituted staged interviews with midwives who instituted training programs for midwives, as well as organisational and policy documentation. Analysis of the data identified some areas that were not fully addressed in the theoretical model; these formed the basis of the Discussion and Implications for Future Research.

Conflict or consensus : an investigation of stakeholder concerns during the participation process of major infrastructure and construction projects in Hong Kong

Public participate in the planning and design of major public infrastructure and construction (PIC) projects is crucial to their success, as the interests of different stakeholders can be systematically captured and built into the finalised scheme. However, public participation may not always yield a mutually acceptable solution, especially when the interests of stakeholders are diverse and conflicting. Confrontations and disputes can arise unless the concerns or needs of the community are carefully analysed and addressed. The aim of the paper is to propose a systematic method of analysing stakeholder concerns relating to PIC projects by examining the degree of consensus and/or conflict involved. The results of a questionnaire survey and a series of interviews with different entities are provided, which indicate the existence of a significant divergence of views among stakeholder groups and that conflicts arise when there is a mismatch between peoples’ perception concerning money and happiness on the one hand and development and damages on the other. Policy and decision-makers should strive to resolve at least the majority of conflicts that arise throughout the lifecycle of major PIC projects so as to maximise their chance of success.

Positive experiences for participants in suicide bereavement groups : a grounded theory model of elements that contribute to the process of adjusting to the loss

Grounded Theory was used to examine the experiences of 13 participants who had attended psycho-educational support groups for those bereaved by suicide. Results demonstrated core and central categories which fit well with group therapeutic factors developed by Yalom (1995) and emphasised the importance of universality, imparting information and instilling hope, catharsis and self-disclosure, and broader meaning making processes surrounding acceptance or adjustment. Participants were commonly engaged in a lengthy process of oscillating between loss oriented and restoration focused reappraisals. The functional experience of the group comprised feeling normal within the group, providing a sense of permission to feel and to express emotions and thoughts and to bestow meaning. Structural variables of information and guidance and different perspectives on the suicide and bereavement were gained from other participants, the facilitators, group content and process. Personal changes, including in relationships and in their sense of self, assisted participants to develop an altered and more positive personal narrative.

The process of remembering with The Forgotten Australians : digital storytelling and marginalized groups

Digital storytelling projects have proliferated in Australia since the early 2000s, and have been theorized as a means to disseminate the stories and voices of “ordinary” people. In this paper I examine through the case study of a 2009 digital storytelling project between the Australasian Centre for Interactive Design and a group identifying as Forgotten Australian whether digital storytelling in its predominant workshop-based format is able to meet the needs of profoundly marginalized and traumatized individuals and groups. For digital storytelling to be of use to marginalized groups as a means of communication or reflection a significant re-examination of the current approaches to its format, and its function needs to undertaken. This paper posits new ways of utilizing digital storytelling when dealing with trauma narratives.

Exploring the process of meaning making in healing after childhood sexual assault : a case study approach

Childhood sexual assault (CSA) is one of the most devastating of all traumatic experiences with population studies documenting survivors experiencing higher levels of pathology than general trends in survivors of other traumatic experiences. Yet recent research has demonstrated that far from being permanently crippled by their experiences, many adult survivors of CSA manage to heal and move forward in their lives to experience a rich and fulfilling existence. In this paper two case studies are presented to provide a detailed account of how a person who has experienced CSA may find a pathway to healing. Moreover, data demonstrates that meaning making, spiritual or otherwise, is a pivotal part of acceptance of CSA and ensuing growth. The case studies highlight the unique journeys of two women and the underlying similarities in their pathway to healing. Clinical implications of the research are discussed and specific strategies for encouraging healing and growth are outlined.

Modelling the flow of cane constituents through the milling process of a raw sugar factory

This thesis reports on an investigation to develop an advanced and comprehensive milling process model of the raw sugar factory. Although the new model can be applied to both, the four-roller and six-roller milling units, it is primarily developed for the six-roller mills which are widely used in the Australian sugar industry. The approach taken was to gain an understanding of the previous milling process simulation model "MILSIM" developed at the University of Queensland nearly four decades ago. Although the MILSIM model was widely adopted in the Australian sugar industry for simulating the milling process it did have some incorrect assumptions. The study aimed to eliminate all the incorrect assumptions of the previous model and develop an advanced model that represents the milling process correctly and tracks the flow of other cane components in the milling process which have not been considered in the previous models. The development of the milling process model was done is three stages. Firstly, an enhanced milling unit extraction model (MILEX) was developed to access the mill performance parameters and predict the extraction performance of the milling process. New definitions for the milling performance parameters were developed and a complete milling train along with the juice screen was modelled. The MILEX model was validated with factory data and the variation in the mill performance parameters was observed and studied. Some case studies were undertaken to study the effect of fibre in juice streams, juice in cush return and imbibition% fibre on extraction performance of the milling process. It was concluded from the study that the empirical relations developed for the mill performance parameters in the MILSIM model were not applicable to the new model. New empirical relations have to be developed before the model is applied with confidence. Secondly, a soluble and insoluble solids model was developed using modelling theory and experimental data to track the flow of sucrose (pol), reducing sugars (glucose and fructose), soluble ash, true fibre and mud solids entering the milling train through the cane supply and their distribution in juice and bagasse streams.. The soluble impurities and mud solids in cane affect the performance of the milling train and further processing of juice and bagasse. New mill performance parameters were developed in the model to track the flow of cane components. The developed model is the first of its kind and provides some additional insight regarding the flow of soluble and insoluble cane components and the factors affecting their distribution in juice and bagasse. The model proved to be a good extension to the MILEX model to study the overall performance of the milling train. Thirdly, the developed models were incorporated in a proprietary software package "SysCAD’ for advanced operational efficiency and for availability in the ‘whole of factory’ model. The MILEX model was developed in SysCAD software to represent a single milling unit. Eventually the entire milling train and the juice screen were developed in SysCAD using series of different controllers and features of the software. The models developed in SysCAD can be run from macro enabled excel file and reports can be generated in excel sheets. The flexibility of the software, ease of use and other advantages are described broadly in the relevant chapter. The MILEX model is developed in static mode and dynamic mode. The application of the dynamic mode of the model is still under progress.

Marital power process of Korean men married to foreign women : A qualitative study

This study explored how Korean men married to migrant women construct meaning around married life. Data were collected through in-depth interviews with 10 men who had had been married to migrant women for ≥ 2 years. Data collection and analysis were performed concurrently using a grounded theory approach. The core category generated was the process of sustaining a family unit. The men came to understand the importance of a distribution of power within the family in sustaining the family unit. Constituting this process were four stages: recognizing an imbalance of power, relinquishing power, empowering, and fine-tuning the balance of power. This study provides important insight into the dynamics of marital power from men's point of view by demonstrating a link between the way people adjust to married life and the process by which married couples adjust through the distribution and redistribution of power.

Waves for change : the role of the South Tarawa-based women's interests program in the decolonisation process of the Gilbert Islands

This thesis has created a space for women in the history of the decolonisation of the Gilbert Islands. It traces the historical development of the national women's interests program in the Republic of Kiribati (formerly of the Gilbert and Ellice Islands Colony (GEIC)) as it was implemented through a network of women's clubs during the 1960s and 1970s. This thesis has provided the first history and interpretation of the Indigenous women's interests movement as it impacted the Gilbert Islands. It offers a narrative of the movement in terms of three overlapping waves of women leaders, based on an analysis of fieldwork, archival research and interviews conducted on South Tarawa, Kiribati.

A novel process of group-oriented question reduction for rule-based recommendation websites

Several websites utilise a rule-base recommendation system, which generates choices based on a series of questionnaires, for recommending products to users. This approach has a high risk of customer attrition and the bottleneck is the questionnaire set. If the questioning process is too long, complex or tedious; users are most likely to quit the questionnaire before a product is recommended to them. If the questioning process is short; the user intensions cannot be gathered. The commonly used feature selection methods do not provide a satisfactory solution. We propose a novel process combining clustering, decisions tree and association rule mining for a group-oriented question reduction process. The question set is reduced according to common properties that are shared by a specific group of users. When applied on a real-world website, the proposed combined method outperforms the methods where the reduction of question is done only by using association rule mining or only by observing distribution within the group.

Weaknesses in the initialisation process of the Common Scrambling Algorithm Stream Cipher

The Common Scrambling Algorithm Stream Cipher (CSASC) is a shift register based stream cipher designed to encrypt digital video broadcast. CSA-SC produces a pseudo-random binary sequence that is used to mask the contents of the transmission. In this paper, we analyse the initialisation process of the CSA-SC keystream generator and demonstrate weaknesses which lead to state convergence, slid pairs and shifted keystreams. As a result, the cipher may be vulnerable to distinguishing attacks, time-memory-data trade-off attacks or slide attacks.

Whose story is it anyway? : the screenwriter as author in the process of adaptation

This project explores issues confronted when authoring a previously authored story, one received from history. Using the defection of Soviet spies, Vladimir and Evdokia Petrov as its focal point, it details how a screenwriter addresses issues arising in the adaptation of both fictional and biographical representations suitable for contemporary cinema. Textual fidelity and concepts of interpretation, aesthetics and audience, negotiating factual and fictional imperatives, authorial visibility and invisibility, moral and ethical conundrums are negotiated and a set of guiding principles emerge from this practice-led investigation.

Process of conducting qualitative research

In 2007 some of us were fortunate enough to be in Dundee for the Royal College of Nursing’s Annual International Nursing Research Conference. A highlight of that conference was an enactment of the process and context debate. The chair asked for volunteers and various members of the audience came forward giving the impression that they were nurses and that it was a chance selection. The audience accepted these individuals as their representatives and once they had gathered on stage we all expected the debate to begin. But the large number of researchers in the audience gave little thought to the selection and recruitment process they had just witnessed. Then the selected representatives stood up and sang A cappella. Suddenly the context was different and we questioned the process. The point was made: process or context, or both?

Wellbeing as a process of accrual : beyond subjectivity and beyond the moment

Although the notion of wellbeing is popular in contemporary literature, it is variously interpreted and has no common definition. Such inconsistencies in definition have particular relevance when considering wellbeing programs designed for children. By developing a broader conceptualisation of wellbeing and its key elements, the range of programs and services developed in the name of wellbeing will achieve a more consistent cross-disciplinary focus to ensure that the needs of the individual, including children, can more accurately be addressed. This paper presents a new perspective on conceptualising wellbeing. The authors argue that conceptualising wellbeing as an accrued process has particular relevance for both adults and children. A definition for accrued wellbeing is presented in an attempt to address some of the current deficiencies in existing understandings of an already complicated construct. The potential for the ideas presented when considering wellbeing as a process of accrual may have further application when considered beyond childhood.

Numerical optimization of soft-mold aided co-curing process of advanced grid-stiffened composite structures

The co-curing process for advanced grid-stiffened (AGS) composite structure is a promising manufacturing process, which could reduce the manufacturing cost, augment the advantages and improve the performance of AGS composite structure. An improved method named soft-mold aided co-curing process which replaces the expansion molds by a whole rubber mold is adopted in this paper. This co-curing process is capable to co-cure a typical AGS composite structure with the manufacturer’s recommended cure cycle (MRCC). Numerical models are developed to evaluate the variation of temperature and the degree of cure in AGS composite structure during the soft-mold aided co-curing process. The simulation results were validated by experimental results obtained from embedded temperature sensors. Based on the validated modeling framework, the cycle of cure can be optimized by reducing more than half the time of MRCC while obtaining a reliable degree of cure. The shape and size effects of AGS composite structure on the distribution of temperature and degree of cure are also investigated to provide insights for the optimization of soft-mold aided co-curing process.