Degree of value alignment : a grounded theory of rural nurse resignations

INTRODUCTION: The shortage of nurses willing to work in rural Australian healthcare settings continues to worsen. Australian rural areas have a lower retention rate of nurses than metropolitan counterparts, with more remote communities experiencing an even higher turnover of nursing staff. When retention rates are lower, patient outcomes are known to be poorer. This article reports a study that sought to explore the reasons why registered nurses resign from rural hospitals in the state of New South Wales, Australia. METHODS: Using grounded theory methods, this study explored the reasons why registered nurses resigned from New South Wales rural hospitals. Data were collected from 12 participants using semi-structured interviews; each participant was a registered nurse who had resigned from a rural hospital. Nurses who had resigned due to retirement, relocation or maternity leave were excluded. Interviews were transcribed verbatim and imported into NVivo software. The constant comparative method of data collection and analysis was followed until a core category emerged. RESULTS: Nurses resigned from rural hospitals when their personal value of how nursing should occur conflicted with the hospital's organisational values driving the practice of nursing. These conflicting values led to a change in the degree of value alignment between the nurse and hospital. The degree of value alignment occurred in three dynamic stages that nurses moved through prior to resigning. The first stage, sharing values, was a time when a nurse and a hospital shared similar values. The second stage was conceding values where, due to perceived changes in a hospital's values, a nurse felt that patient care became compromised and this led to a divergence of values. The final stage was resigning, a stage where a nurse 'gave up' as they felt that their professional integrity was severely compromised. The findings revealed that when a nurse and organisational values were not aligned, conflict was created for a nurse about how they could perform nursing that aligned with their internalised professional values and integrity. Resignation occurred when nurses were unable to realign their personal values to changed organisational values - the organisational values changed due to rural area health service restructures, centralisation of budgets and resources, cumbersome hierarchies and management structures that inhibited communication and decision making, out-dated and ineffective operating systems, insufficient and inexperienced staff, bullying, and a lack of connectedness and shared vision. CONCLUSIONS: To fully comprehend rural nurse resignations, this study identified three stages that nurses move through prior to resignation. Effective retention strategies for the nursing workforce should address contributors to a decrease in value alignment and work towards encouraging the coalescence of nurses' and hospitals' values. It is imperative that strategies enable nurses to provide high quality patient care and promote a sense of connectedness and a shared vision between nurse and hospital. Senior managers need to have clear ways to articulate and imbue organisational values and be explicit in how these values accommodate nurses' values. Ward-level nurse managers have a significant responsibility to ensure that a hospital's values (both explicit and implicit) are incorporated into ward culture.

The Threshold Learning Outcome on self-management for the Bachelor of Laws degree : a proposed focus for teaching strategies in the first year law curriculum

The Australian Learning and Teaching Council (ALTC) Discipline Scholars for Law, Professors Sally Kift and Mark Israel, articulated six Threshold Learning Outcomes (TLOs) for the Bachelor of Laws degree as part of the ALTC’s 2010 project on Learning and Teaching Academic Standards. One of these TLOs promotes the learning, teaching and assessment of self-management skills in Australian law schools. This paper explores the concept of self-management and how it can be relevantly applied in the first year of legal education. Recent literature from the United States (US) and Australia provides insights into the types of issues facing law students, as well as potential antidotes to these problems. Based on these findings, I argue that designing a pedagogical framework for the first year law curriculum that promotes students’ connection with their intrinsic interests, values, motivations and purposes will facilitate student success in terms of their personal well-being, ethical dispositions and academic engagement.

The Australian Qualifications Framework for bachelor degree in property economics

The Australian Qualifications Framework (AQF) requires every course in Australia to be reviewed and compliant by 2015. This paper compares the difference between AQF level 7 and level 8 and outlines the paradigm shift in course development, improvement and quality assurance. The AQF requires an outcome oriented process which influences the development, monitoring and implementation of AQF courses. Firstly the graduate profile is defined to underscore the direction of the property course development. Required graduate attributes are then defined, together with course learning outcomes. Each unit/subject assessment is then designed to reflect the desired learning outcomes, and then finally the unit/subject content is backfilled. This reverse engineered process will ensure that all students have been taught and assessed on the graduate attributes which will form the graduate profile. Therefore, monitoring the inclusion of learning outcomes on unit/subject level during course restructure and development is crucial to achieve the course learning outcomes. This paper recommends that further evaluation needs to be conducted in the course development phases by involving professional accreditation bodies, industry representatives, students and recent graduates in this course development process. It also discusses challenges for developing an undergraduate property course.

Using the factors that have a positive impact on the retention of low socioeconomic students to prepare accelerated enrolled nurses for the science units of a nursing degree : a practice report

At a campus in a low socioeconomic (SES) area, our University allows enrolled nurses entry into the second year of a Bachelor of Nursing, but attrition is high. Using the factors, described by Yorke and Thomas (2003) to have a positive impact on the attrition of low SES students, we developed strategies to prepare the enrolled nurses for the pharmacology and bioscience units of a nursing degree with the aim of reducing their attrition. As a strategy, the introduction of review lectures of anatomy, physiology and microbiology, was associated with significantly reduced attrition rates. The subsequent introduction of a formative website activity of some basic concepts in bioscience and pharmacology, and a workshop addressing study skills and online resources, were associated with a further reduction in attrition rates of enrolled nursing students in a Bachelor of Nursing.

Speaking of supervision: A dialogic approach to building higher degree research supervision capacity in the creative arts

In the emergent field of creative practice higher degrees by research, first generation supervisors have developed new models of supervision for an unprecedented form of research that combines creative practice and written thesis. In a national research project, entitled 'Effective supervision of creative practice higher research degrees', we set out to capture and share early supervisors' insights, strategies and approaches to supporting their creative practice PhD students. From the insights we gained during the early interview process, we expanded our research methods in line with a distributed leadership model and developed a dialogic framework. This led us to unanticipated conclusions and unexpected recommendations. In this study, we primarily draw on philosopher and literary theorist Mikhail Bakhtin's dialogics to explain how giving precedence to the voices of supervisors not only facilitated the articulation of dispersed tacit knowledge, but also led to other 20 discoveries. These include the nature of supervisors' resistance to prescribed models, policies and central academic development programmes; the importance of polyvocality and responsive dialogue in enabling continued innovation in the field; the benefits to supervisors of reflecting, discussing and sharing practices with colleagues; and the value of distributed leadership and dialogue to academic development and supervision capacity building in research education.

Support services for higher degree research students: A survey of three Australian universities

A survey was conducted across three Australian universities to identify the types and format of support services available for higher degree research (HDR, or MA and Ph.D.) students. The services were classified with regards to availability, location and accessibility. A comparative tool was developed to help institutions categorise their services in terms of academic, administrative, social and settlement, language and miscellaneous (other) supports. All three universities showed similarities in the type of academic support services offered, while differing in social and settlement and language support services in terms of the location and the level of accessibility of these services. The study also examined the specific support services available for culturally and linguistically diverse (CALD) students. The three universities differed in their emphases in catering to CALD needs, with their allocation of resources reflecting these differences. The organisation of these services within the universities was further assessed to determine possible factors that may influence the effective delivery of these services, by considering HDR and CALD student specific issues. The findings and tools developed by this study may be useful to HDR supervisors and university administrators in identifying key support services to better improve outcomes for the HDR students and universities.

Correlation of carotid atheromatous plaque inflammation using USPIO-enhanced MR imaging with degree of luminal Stenosis

BACKGROUND AND PURPOSE Inflammation is a recognized risk factor for the vulnerable atherosclerotic plaque. The study explores the relationship between the degree of Magnetic Resonance (MR)"defined inflammation using Ultra Small Super-Paramagnetic Iron Oxide (USPIO) particles and the severity of luminal stenosis in asymptomatic carotid plaques. METHODS Seventy-one patients with an asymptomatic carotid stenosis of ĝ‰¥40% underwent multi-sequence USPIO-enhanced MR imaging. Stenosis severity was measured according to the NASCET and ECST methods. RESULTS No demonstrable relationship between inflammation as measured by USPIO-enhanced signal change and the degree of luminal stenosis was found. CONCLUSIONS Inflammation and stenosis are likely to be independent risk factors, although this needs to be further validated.

Effect of exposure period on degree of dominance of phosphine resistance in adults of Rhyzopertha dominica (Coleoptera: Bostrychidae) and Sitophilus oryzae (Coleoptera: Curculionidae)

Degree of dominance of phosphine resistance was investigated in adults of Rhyzopertha dominica F and Sitophilus oryzae L. Efficacy of the grain fumigant phosphine depends on both concentration and exposure period, which raises the possibility that dominance levels vary with exposure period. New and published data were used to test this possibility in adults of R dominica and S oryzae fumigated for periods of up to 144 h. The concentrations required for control of homozygous resistant and susceptible strains and their F1 hybrids decreased with increasing exposure period. For both species the response lines for the homozygous resistant and susceptible strains and their F1 hybrids were parallel. Therefore, neither dominance level nor resistance factor was affected by exposure period. Resistance was incompletely recessive and the level of dominance, calculated at 50% mortality level, was -0.59 for R dominica and -0.65 for S oryzae. The resistant R dominica strain was 30.9 times more resistant than the susceptible strain, compared with 8.9 times for the resistant S oryzae strain. The results suggest that developing discriminating doses for detecting heterozygote adults of either species will be difficult.

Acyclic Edge Coloring of Graphs with Maximum Degree 4

An acyclic edge coloring of a graph is a proper edge coloring such that there are no bichromatic cycles. The acyclic chromatic index of a graph is the minimum number k such that there is an acyclic edge coloring using k colors and is denoted by a'(G). It was conjectured by Alon, Sudakov, and Zaks that for any simple and finite graph G, a'(G) <= Delta+2, where Delta=Delta(G) denotes the maximum degree of G. We prove the conjecture for connected graphs with Delta(G)<= 4, with the additional restriction that m <= 2n-1, where n is the number of vertices and m is the number of edges in G. Note that for any graph G, m <= 2n, when Delta(G)<= 4. It follows that for any graph G if Delta(G)<= 4, then a'(G) <= 7.

Concentrates based on sorghum grain provide a basis for a finishing system for crossbred lambs

In parts of Australia, sorghum grain is a cheaper alternative to other cereal grains but its use and nutritive value in sheep feeding systems is not well understood. The aim of this work was to compare growth and carcass characteristics for crossbred lambs consuming several simple, sorghum-based diets. The treatments were: (1) whole sorghum grain, (2) whole sorghum grain + urea and ammonium sulfate, (3) cracked sorghum grain + urea and ammonium sulfate, (4) expanded sorghum grain + urea and ammonium sulfate, (5) whole sorghum grain + cottonseed meal, and (6) whole sorghum grain + whole cottonseed. Nine lambs were slaughtered initially to provide baseline carcass data and the remaining 339 lambs were gradually introduced to the concentrate diets over 14 days before being fed concentrates and wheaten hay ad libitum for 41, 56 or 76 days. Neither cracking nor expanding whole sorghum grain with added non-protein nitrogen (N) resulted in significantly (P > 0.05) increased final liveweight, growth rates or carcass weights for lambs, or in decreased days on feed to reach 18-kg carcass weight, although carcass fat depth was significantly (P < 0.05) increased compared with the whole sorghum plus non-protein N diet. However, expanding sorghum grain significantly (P < 0.05) reduced faecal starch concentrations compared with whole or cracked sorghum diets with added non-protein N (79 v. 189 g/kg DM after 59 days on feed). Lambs fed whole sorghum grain without an additional N source had significantly (P < 0.05) lower concentrate intake and required significantly (P < 0.05) more days on feed to reach a carcass weight of 18 kg than for all diets containing added N. These lambs also had significantly (P < 0.05) lower carcass weight and fat depth than for lambs consuming whole sorghum plus true protein diets. Substituting sources of true protein (cottonseed meal and whole cottonseed) for non-protein N (urea and ammonium sulfate) did not significantly (P > 0.05) affect concentrate intakes or carcass weights of lambs although carcass fat depth was significantly (P < 0.05) increased and the days to reach 18-kg carcass weight were significantly (P < 0.05) decreased for the whole sorghum plus cottonseed meal diet. In conclusion, processing sorghum grain by cracking or expanding did not significantly improve lamb performance. While providing an additional N source with sorghum grain significantly increased lamb performance, there was no benefit in final carcass weight of lambs from substituting sources of true protein for non-protein N.

Shaping (reflexive) professional identities across an undergraduate degree programme: A longitudinal case study

In our complex and incongruous professional worlds, where there is no blueprint for dealing with unpredictable people and events, it is imperative that individuals develop reflexive approaches to professional identity building. Notwithstanding the importance of disciplinary knowledge and skills, higher education has a crucial role to play in guiding students to examine and mediate self in relation to context for effective decision-making and action. This paper reports on a small-scale longitudinal project that investigated the ways in which ten undergraduate students over the course of a three-year Radiation Therapy degree shaped their professional identities. Theories of reflexivity and methods of discourse analysis are utilised to understand the ways in which individuals accounted for their professional identity projects at university. The findings suggest that, across time, the participants negotiated professional ‘becoming’ through four distinct kinds of reflexive modalities. These findings have implications for teaching strategies and curriculum design in undergraduate programs.

Optimum design of a Lanchester damper for a viscously damped single degree of freedom system subjected to inertial excitation

The problem of designing an optimum Lanchester damper for a viscously damped single degree of freedom system subjected to inertial harmonic excitation is investigated. Two criteria are used for optimizing the performance of the damper: (i) minimum motion transmissibility; (ii) minimum force transmissibility. Explicit expressions are developed for determining the absorber parameters.