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.

Changing musical emotion : a computational rule system for modifying score and performance

When communicating emotion in music, composers and performers encode their expressive intentions through the control of basic musical features such as: pitch, loudness, timbre, mode, and articulation. The extent to which emotion can be controlled through the systematic manipulation of these features has not been fully examined. In this paper we present CMERS, a Computational Music Emotion Rule System for the control of perceived musical emotion that modifies features at the levels of score and performance in real-time. CMERS performance was evaluated in two rounds of perceptual testing. In experiment I, 20 participants continuously rated the perceived emotion of 15 music samples generated by CMERS. Three music works, each with five emotional variations were used (normal, happy, sad, angry, and tender). The intended emotion by CMERS was correctly identified 78% of the time, with significant shifts in valence and arousal also recorded, regardless of the works’ original emotion.

Understanding legitimacy in a changing global economy

In a knowledge economy where technologically mediated information plays an important role, greater understanding is required of its impact on organisational sustainability. This paper examines the link between mediated information within a global economy and its relationship to a key to long-term organisational success– legitimacy. Aligning organisational legitimacy and the demands of a range of internal and external stakeholders is a central concern for managers when challenges to legitimacy continue to arise. Particularly during times of internally or environmentally driven change, challenges are created for managers seeking to ensure their organisation avoids questioning about its legitimacy. This paper presents the proposition that the perceptions of collective opinion derived from mass media provide a lens to a global world upon which managers base decisions to protect and repair organisational legitimacy. Legitimacy is determined from a broad social arena that can cross national and international boundaries (Lomi, 2000). Experience of legitimacy concerns, therefore, are often outside the traditional realms of managerial knowledge, and experience and of local business association networks (Aldrich, 1999). While the organisational landscape has been changing, at the same time, mass media have increased the focus on bringing news about events, and interpretations of events, from a broad and even global social area (Mutz, 1998). In addition, electronically facilitated media have exposed both organisational stakeholders and managers to views and interpretations of the world more quickly and more explicitly than in previous times. This paper proposes a relationship between perceptions of collective opinion derived from mass media and organisational legitimacy in such an environment.

The meaning of cancer for Australian Aboriginal women : changing the focus of cancer nursing

Aim: The purpose of the study was to explore why Aboriginal women participate in cancer screening programs but appear reluctant to following-up results, or accept medical advice about treatment. Methods: Interpretive ethnography, a qualitative methodology, was used to explore Aboriginal women’s perception of cancer, and the cultural context in which meaning was constructed and influenced treatment decision. Data collection, which occurred over two years, involved fieldwork, participant-observation, face-to-face interviews and focus groups, in two rural Aboriginal communities. Forty eight interviews were recorded from a cross section of the communities, including cancer survivors and patients, family members, health care providers and other women from the community. Results: Key findings were that Aboriginal women’s had a fearful and fatalistic attitude toward cancer, doubted the efficacy of treatment and carried an enduring ambivalence toward the authority of whiteman’s medicine. The women faced a dilemma of wanting access to cancer treatment options but feared entering hospital or clinics not attuned to their cultural needs. Conclusion: The findings highlight the need for a culture-centred approach that decentres the authority of conventional services and instead gives prominence to Aboriginal cultural values as a focal point in cancer control. It should be the responsibility of cancer nurses and others to engage with their local Aboriginal communities to build relationships that foster an exchange of learning about cultural differences that make a difference to how cancer control is practiced.

Extending the dynamic range of robotic vision

Conventional cameras have limited dynamic range, and as a result vision-based robots cannot effectively view an environment made up of both sunny outdoor areas and darker indoor areas. This paper presents an approach to extend the effective dynamic range of a camera, achieved by changing the exposure level of the camera in real-time to form a sequence of images which collectively cover a wide range of radiance. Individual control algorithms for each image have been developed to maximize the viewable area across the sequence. Spatial discrepancies between images, caused by the moving robot, are improved by a real-time image registration process. The sequence is then combined by merging color and contour information. By integrating these techniques it becomes possible to operate a vision-based robot in wide radiance range scenes.

Libr@ries : changing information space and practice

This volume examines the social, cultural, and political implications of the shift from traditional forms of print-based libraries to the delivery of online information in educational contexts. Despite the central role of libraries in literacy and learning, research of them has, in the main, remained isolated within the disciplinary boundaries of information and library science. By contrast, this book problematizes and thereby mainstreams the field. It brings together scholars from a wide range of academic fields to explore the dislodging of library discourse from its longstanding apolitical, modernist paradigm. Collectively, the authors interrogate the presuppositions of current library practice and examine how library as place and library as space blend together in ways that may be both complementary and contradictory. Seeking a suitable term to designate this rapidly evolving and much contested development, the editors devised the word “libr@ary,” and use the term arobase to signify the conditions of formation of new libraries within contexts of space, knowledge, and capital.

The Changing world and service problems in bankruptcy

In an age where financial transactions are conducted worldwide and mobility of citizens throughout the world is common, lawyers seeking to serve Bankruptcy Notices and Creditor’s Petitions encounter many problems. To assist lawyers in overcoming some of the service problems that are arising as a result of this changing world, a number of recent cases are considered that highlight a number of issues, including American Express Australia Limited v Michaels [2010] FMCA 103, Deputy Commissioner of Taxation v Barnes (2008) 70 ATR 776; [2008] FMCA 7, Battenberg v Restom & Ors (2005) 223 ALR 692; upheld by the Full Federal Court in Battenberg v Restrom and Ors (2006) 149 FCR 128 at 133; [2006] FCAFC 20 and Envee Energy Pty Ltd (In Liquidation) v Stockford [2007] FMCA 1426. While the fact situation of every bankruptcy case will differ, recent decisions may assist lawyers in dealing effectively with bankruptcy matters in these times of transition. Lawyers can facilitate completion of the litigious process within the relevant legislative framework in order to satisfy their responsibility to clients and to the Court by considering this case law.

Changing lanes : an exploration of the journey from dance through choreography to directing and the spoken word

This paper reveals a journey of theatrical exploration. It is a journey of enquiry and investigation backed by a vigorous, direct and dense professional history of creative work.

Innovative and entrepreneurial activity in the public sector : the changing face of public sector institutions

This paper investigates the elements which support innovative and entrepreneurial activity in New Zealand’s state owned enterprises (SOEs). An inductive case study design, involving interview data, textual analysis, and observation, was applied to three SOEs. Findings reveal that those aspects typically associated with entrepreneurship, such as innovation, risk acceptance, pro-activeness and growth, are often supported by a number of unexpected elements within the public sector. These elements include culture, branding, operational excellence, cost efficiency, and knowledge transfer. The implications are twofold. First, that innovative and entrepreneurial activity in the public sector can go beyond policy-making, with SOEs representing an important policy decision and sector of the New Zealand Government. And second, that the impact of several SOEs on international markets suggests competition on the global stage will increasingly come from both public and private sector organizations.

Changing pedagogic codes in a class of landscape architects learning 'ecologically sustainable development'

Professional discourse in education has been the focus of research conducted mostly with teachers and professional practitioners but the work of students in the built environment has largely been ignored. This article presents an analysis of students’ visual discourse in the final professional year of a landscape architecture course in Brisbane, Australia. The study has a multi-method design and includes drawings, interviews and documentary materials, but focuses on the drawings in this paper. Using the theory of Bernstein, the analysis considers student representations as interrelations between professional identity and discretionary space for legitimate knowledge formation in landscape planning. It shows a shift in how students persuade the teacher of their expanding views of this field. The discussion of this shift centres on the professional knowledge that students choose rather than need to learn. It points to the differences within a class that a teacher must address in curriculum design in a contemporary professional course.