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.

The culture of contemporary writers' festivals

This thesis examines the culture of contemporary writers’ festivals in an international context. In the last five decades writers’ festivals have emerged in cities across the world, and during this time they have expanded their literary discussions and debates to include numerous other topics of broad interest to society. To examine the expanded popularity and function of writers’ festivals, this thesis establishes a new vantage point for theorising the content now typically generated by these events using concepts in urban festivals and public culture research. Importantly, the new vantage point addresses the limitations of current commentary on writers’ festivals which routinely claim they trivialize literature, and more generally, contribute to the decline of public culture. The thesis presents two case studies: one on the Brisbane Writers Festival in Australia and the other on the International Festival of Authors in Toronto, Canada. The first case study, which focuses on the 2007 Brisbane Writers Festival, illustrates the many overlapping and often conflicting discourses as well as opinions productively discussed and debated at writers’ festivals. Key topic discussed and debated at the Festival include local topics about the host city—its history, literature and politics, as well as broader literary, political and celebrity culture topics. The diversity of topics discussed at the 2007 Brisbane Writers Festival is typical of the majority of writers’ festivals similarly located outside the largest geographic centres of global literary production and circulation, and designated as ‘peripheral’ festivals in this research. The second case study on Toronto’s International Festival of Authors examines the ways in which the 2006 Festival almost exclusively focussed on literary and celebrity culture discourses, and promoted itself on these terms. The 2006 International Festival of Authors’ discussion and debate of a narrow range of topics is typical of the few writers’ festivals located in global centres of literary production and circulation, and unlike ‘peripheral’ festivals they are not experiencing the same growth in number or popularity. The aim of these ‘international’ Festivals is not to democratise their elite literary beginnings, but rather to promote ‘literature’ as a niche brand for quality writing that is valid on a global scale. This thesis will assert that while all writers’ festivals are influenced by the marketing desires of publishing companies, the aim of international writers’ festivals in marketing to a virtually and globally connected elite literary audience makes them more susceptible to experiencing declines in audience and author participation.

Development and validation of a novel approach to work sampling : a study of nurse practitioner work patterns

Objectives: This methodological paper reports on the development and validation of a work sampling instrument and data collection processes to conduct a national study of nurse practitioners’ work patterns. ---------- Design: Published work sampling instruments provided the basis for development and validation of a tool for use in a national study of nurse practitioner work activities across diverse contextual and clinical service models. Steps taken in the approach included design of a nurse practitioner-specific data collection tool and development of an innovative web-based program to train and establish inter rater reliability of a team of data collectors who were geographically dispersed across metropolitan, rural and remote health care settings. ---------- Setting: The study is part of a large funded study into nurse practitioner service. The Australian Nurse Practitioner Study is a national study phased over three years and was designed to provide essential information for Australian health service planners, regulators and consumer groups on the profile, process and outcome of nurse practitioner service. ---------- Results: The outcome if this phase of the study is empirically tested instruments, process and training materials for use in an international context by investigators interested in conducting a national study of nurse practitioner work practices. ---------- Conclusion: Development and preparation of a new approach to describing nurse practitioner practices using work sampling methods provides the groundwork for international collaboration in evaluation of nurse practitioner service.

Managing creativity and its paradoxes in the film industry

Purpose: The purpose of this paper is to illustrate the various types of paradoxes underlying the nature of creativity, which in turn affect the foundations of organizations and organization change in the 21 st century. The film industry best illustrate the interaction of such paradoxes, creativity and organizational change. This paper examines how small and medium-sized finns in the emerging Singapore film industry stay competitive by managing or not managing these paradoxes. Design/methodology/approach: The study reported in this paper explores the opinions, attitudes and experiences of key decision-makers in the Singaporean film industry. Findings: This paper introduces the idea that an analysis of the various paradoxes driven by creativity in today's society provides hints on a deeper understanding of organizational change and development in the 21" century. Practical implications: The findings indicate that managers need practical tools that will enable them to comprehend and better manage these emerging contradictions and fully understand the implications of paradoxical situations and organizational change. Research limitations: The distinctive nature of the Singaporean firms means that certain factors examined may be more or less significant in the film industry in other countries. Originality/value: The value of this paper lies in the knowledge that paradox considerations are becoming significant in understanding pluralism and the processes of organizational change.

Investigation to enhance high speed rail accessibility

High Speed Rail (HSR) is rapidly gaining popularity worldwide as a safe and efficient transport option for long-distance travel. Designed to win market shares from air transport, HSR systems optimise their productivity between increasing speeds and station spacing to offer high quality service and gain ridership. Recent studies have investigated the effects that the deployment of HSR infrastructure has on spatial distribution and the economic development of cities and regions. Findings appear mostly positive at higher geographical scales, where HSR links connect major urban centres several hundred kilometres apart and already well positioned within a national or international context. Also, at the urban level, studies have shown regeneration and concentration effects around HSR station areas with positive returns on city’s image and economy. However, doubts persist on the effects of HSR at an intermediate scale, where the accessibility trade off on station spacing limits access to many small and medium agglomerations. Thereby, their ability to participate in the development opportunities facilitated by HSR infrastructure is significantly reduced. The locational advantages deriving from transport improvements appear contrasting especially in regions that tend to have a polycentric structure, where cities may present greater accessibility disparities between those served by HSR and those left behind. This thesis fits in this context where intermediate and regional cities do not directly enjoy the presence of an HSR station while having an existing or planned proximate HSR corridor. With the aim of understanding whether there might be a solution to this apparent incongruity, the research investigates strategies to integrate HSR accessibility at the regional level. While current literature recommends to commit with ancillary investments to the uplift of station areas and the renewal of feeder systems, I hypothesised the interoperability between the HSR and the conventional networks to explore the possibilities offered by mixed traffic and infrastructure sharing. Thus, I developed a methodology to quantify the exchange of benefits deriving from this synergistic interaction. In this way, it was possible to understand which level of service quality offered by alternative transit strategies best facilitates the distribution of accessibility benefits for areas far from actual HSR stations. Therefore, strategies were selected for their type of service capable of regional extensions and urban penetrations, while incorporating a combination of specific advantages (e.g. speed, sub-urbanity, capacity, frequency and automation) in order to emulate HSR quality with increasingly efficient services. The North-eastern Italian macro region was selected as case study to ground the research offering concurrently a peripheral polycentric metropolitan form, the presence of a planned HSR corridor with some portions of HSR infrastructure implementation, and the project to develop a suburban rail service extended regionally. Results show significant distributive potential, in terms of network effects produced in relation with HSR, in increasing proportions for all the strategies considered: a regional metro rail strategy (abbreviated RMR), a regional high speed rail strategy (abbreviated RHSR), a regional light rail transit (abbreviated LRT) strategy, and a non-stopping continuous railway system (abbreviated CRS) strategy. The provision of additional tools to value HSR infrastructure against its accessibility benefits and their regional distribution through alternative strategies beyond the actual HSR stations, would have great implications, both politically and technically, in moving towards new dimensions of HSR evaluation and development.

Public-private partnerships : a survey with suggestions for research

The broad aim of this paper is to examine and comment on the development of public private partnerships (ppp) in an international context, concluding with suggestions for further research. The first section offers some working definitions. Section two reflects my attempt to provide a first, broad answer to my initial research question, what is the prevalence of such partnerships, taking a historical perspective. Section three focuses on the questions of what are the expectations of government and business in regard to ppp and what is their prevalence in more recent times. The final section highlights some of the findings of this initial research survey and suggests types of research questions that could be addressed....

"Money pouring out of its ears" : on the taxation of really profitable nonprofit organisations in Australia

Under current law Australia appears to be a tax haven for certain non-governmental institutions. Millions of ordinary business income may go untaxed and the deductibility for donations is unlimited - both are very generous tax measures in an international context. The basic problems of most Australian nonprofit organisations are not taxation; they are just that: nonprofit. Anybody interested in the non-governmental sector should be willing to face the question: What is an equitable tax treatment? The short-term tactic of ducking the question may not be the best or most beneficial long term strategy.

Young people whose parents are separated or divorced: A case for researching their experiences at the intersection of home and school

Background: Young people whose parents are separated or divorced form a significant and increasing proportion of young people who attend school. To date, empirical research with young people whose parents are separated or divorced has tended to focus on either their household context, or their school context, rather than on both contexts together. This paper redresses this singular focus by examining the intersection of the experiences of young people at both home and school. Purpose: The paper seeks to map the empirical evidence of young people's home and school experiences as they move between households and schools. Sources of evidence: The paper provides a narrative review of the literature from the 1990s to the present, locating Australian research within an international context. The review is framed by four main questions. What is the impact upon young people of the family transitions that occur when parents separate or divorce? What is the everyday impact upon young people of moving between one household and another? What does the research reveal regarding educational, social and emotional outcomes for this group? What does the research reveal regarding their school experiences? Main argument: The review reveals a paucity of Australian research at the intersection of home and school. It shows that, while young people from these contexts form a growing proportion of the school population, there is little empirical evidence of what is actually occurring in their everyday lives. The review reveals the importance of researching from the perspectives of the young people themselves. Conclusions: Evidence provided in the paper shows that many young people whose parents separate or divorce are affected socially, emotionally and educationally. Such evidence points to the need for research into the everyday experiences of the young people at school, in order to identify, from their perspective, how schools can better cater for these young people and their families.

The impacts of FOREX fluctuations on construction business performance : an organisational capabilities perspective

Construction projects are a high risk business activity. When undertaking projects in an international context, it is further complicated by the risk of fluctuations in the foreign exchange rates (FOREX). Construction business performance is affected by these fluctuations. They affect progress and cause delays, which in turn create problems for subcontractors, namely cost overruns, disputes, arbitration, total abandonment and litigation. FOREX fluctuations also cause the price of raw materials to increase, leading the cost overruns. Managing FOREX risk is critical and past research have focused on the need for adequate insurance, careful planning and management, and foreign exchange futures hedging to overcome issues that have been caused by the FOREX risk. Analysis of FOREX risk in international construction business usually focused only on issues at the project level. There is currently lack of understanding of Organisational Capabilities (OC) to manage the impacts of FOREX risk, which when examined, are seen in isolation. This paper attempts to bridge the gap by discussing the impacts of FOREX fluctuations on the international construction business. The focus is on the OC perspective and the need to develop OC framework to mitigate the risk in sustaining construction business performance.

Social media and niche sports: The netball ANZ championship and commonwealth games on twitter

This article analyses and compares Twitter activity for the niche sport of netball over the 2013 trans-Tasman ANZ Championship competition and the international Commonwealth Games event in 2014. Patterns within the Twitter data that were discovered through an analysis of the 2013 ANZ Championship season are considered in terms of the Commonwealth Games, and thus compared between a quasi-domestic and an international context. In particular, we highlight the extent to which niche sports such as netball attempt to capitalise on the opportunities provided by social media, and the challenges involved in coordinating event-specific hashtags, such as the #netball2014 hashtag promoted by the Commonwealth Games Federation.

Public Health Psychology: A Conceptual and Practical Framework

Introduction For many years concern for public health has transcended the boundaries of the medical sciences and epidemiology. For the last 50 years or so psychologists have been increasingly active in this field. Recently, psychologists have not only begun to see the need to take action to mould health promoting behaviours in individuals, but have also pointed out the need to join in an effort to develop appropriate social, political, economic and institutional conditions which would help to improve the state of public health. Psychologists have postulated the need to distinguish a new subdiscipline of psychology called public health psychology which, together with other disciplines, would further the realization of this goal. In the following article the historical and international context of health psychology and the changing nature of public health are put forward as having important implications for the establishment of a ‘public health psychology’. These implications are addressed in later sections of the article through the description of conceptual and practical framework of public health psychology in which theory, methods and practice are considered. Many aspects of the conceptual and practical framework of public health psychology have relevance to the health social sciences more generally and forming a basis for interdisciplinary work. The framework of public health psychology, together with the obstacles that need to be overcome, are critically examined within an overall approach that contends it is necessary to increase and improve the contribution of health psychology to public health.

Talking green: From Oz to Oz

This paper is an extension of Talking Green in Red States: Stories from the Great Plains (Gibson et al., 2014) that examined the communication strategies of planners involved in sustainability planning initiatives in the U.S. Great Plains. We expand these narratives beyond the Great Plains to Queensland, Australia by interviewing planners about their experiences when communicating and deliberating about issues of sustainability. Using a semi-formal structure, interviews are conducted as casual “coffee talks” (Maynard-Moody & Musheno, 2003). Together, these collected stories help us to understand how planners are “talking green” in conservative political atmospheres, across vastly differing geographies using an international comparative framework described by Reimer et al. (2014). The paper presents comparisons between the collected narratives, concerning similarities and differences in regard to the nuances of sustainability planning dialog. We relate the lessons learned about communication strategies of planners working in sustainability in Kansas and Queensland to the broader discourse of planning and politics, communicative planning and planning as storytelling, as they relate to sustainability planning in challenging situations. From this paper, the audience will better understand how: 1) to discuss environmental and sustainable planning in communities that have varying levels of distrust and suspicion towards these concepts; 2) to develop strategies to work around these planning communication issues, and; 3) international context affects these communication challenges.

Book Review "Selling sex: a hidden history of prostitution", R. Frances, UNSW Press, Sydney, 2007

In the opening pages of Selling Sex we are introduced to 'Joy', a statue of a young female sex worker which stood in East Sydney for eighteen months during 1995- 1997. Following complaints by local residents, the statue was removed from public view and returned to its owner. Evidently, Joy was considered a reminder of the community's 'bad old days', when it was better known for prostitution than restaurants. In a nation in which almost every sizable community has proudly erected monuments to military men, the removal of Joy reveals much about labour and gender relations in Australia. For Frances, the removal of Joy is symbolic, our historical treatment of sex workers having parallels with our treatment of the convicts. This work sets out to give these women (male prostitutes do not figure in this history) a voice and break with the stereotypes of 'abandoned whores' or 'sad victims'. It also sets out to place the sex industry in the broader national and international context in which it has historically operated...

Rauhan atomi, sodan koodi : Suomalaisen atomivoimaratkaisun teknopolitiikka 1955-1970

This dissertation investigates the atomic power solution in Finland between 1955 - 1970. During these years a national arrangement for atomic energy technology evolved. The foundations of the Finnish atomic energy policy; the creation of basic legislation and the first governmental bodies, were laid between 1955 - 1965. In the late 1960's, the necessary technological and political decisions were made in order to purchase the first commercial nuclear reactor. A historical narration of this process is seen in the international context of "atoms for peace" policies and Cold War history in general. The geopolitical position of Finland made it necessary to become involved in the balanced participation in international scientific-technical exchange and assistive nuclear programs. The Paris Peace Treaty of 1947 categorically denied Finland acquisition of nuclear weapons. Accordingly, from the "Geneva year" of 1955, the emphasis was placed on peaceful purposes for atomic energy as well as on the education of national professionals in Finland. An initiative for the governmental atomic energy commission came from academia but the ultimate motive behind it was an anticipated structural change in the supply of national energy. Economically exploitable hydro power resources were expected to be built within ten years and atomic power was seen as a promising and complementing new energy technology. While importing fuels like coal was out of the question, because of scarce foreign currency, domestic uranium mineral deposits were considered as a potential source of nuclear fuel. Nevertheless, even then nuclear energy was regarded as just one of the possible future energy options. In the mid-1960 s a bandwagon effect of light water reactor orders was witnessed in the United States and soon elsewhere in the world. In Finland, two separate invitations for bids for nuclear reactors were initiated. This study explores at length both their preceding grounds and later phases. An explanation is given that the parallel, independent and nearly identical tenders reflected a post-war ideological rivalry between the state-owned utility Imatran Voima and private energy utilities. A private sector nuclear power association Voimayhdistys Ydin represented energy intensive paper and pulp industries and wanted to have free choice instead of being associated themselves with "the state monopoly" in energy pricing. As a background to this, a decisive change had started to happen within Finnish energy policy: private and municipal big thermal power plants became incorporated into the national hydro power production system. A characteristic phenomenon in the later history is the Soviet Union s effort to bid for the tender of Imatran Voima. A nuclear superpower was willing to take part in competition but not on a turnkey basis as Imatran Voima had presumed. As a result of many political turns and four years of negotiations the first Finnish commercial light water reactor was ordered from the East. Soon after this the private nuclear power group ordered its reactors from Sweden. This work interprets this as a reasonable geopolitical balance in choosing politically sensitive technology. Conceptually, social and political dimensions of new technology are emphasised. Negotiations on the Finnish atomic energy program are viewed as a cooperation and a struggle, where state-oriented and private-oriented regimes pose their own macro level views and goals (technopolitical imaginaries) and defend and advance their plans and practical modes of action (schemata). Here, not only technologists but even political actors are seen to contribute to technopolitical realisations.

Rätt som argument : Leo Mechelin och finska frågan 1886-1912

Right as an Argument. Leo Mechelin and the Finnish Question 1886-1912 At the turn of the 20th century the Finnish Question rose up as a political and juridical issue at the international arena. The vaguely précised position of Finland in the Russian empire led to diverse conclusions concerning the correctness of the February manifesto of 1899. It was predominantly among a European elite of politicians, cultural workers and academics the issue rose some interest. Finns were active making propaganda for their cause, and they put an emphasis on the claim that the right was on the Finnish side. In the study Elisabeth Stubb compare the Finnish, Russian and European statements about the Finnish Question and analyse their use of right as an argument. The Finnish Question offers at the same time a case study of a national entity which possesses a political sphere of life but is not fully independent, and its possibilities to drive its interests in an international context. Leo Mechelin (1839-1914), the leader of the Finnish propaganda organization abroad, is used as a point of departure. The biographical stance is formed into a triangle, where Leo Mechelin, the idea of right and the Finnish Question abroad are the three cornerstones. The treatment of one cornerstone sheds a ligth on the two others. The metaphor of triangulation also worked as a method to reach "a third stance" in a scinetific and political issue that usually is polarised into two opposite alternatives. An adherence to a strict legal right could not in the end offer a complete, unquestionable and satisfactory solution to the Finnsih Question, it was dependent on "the right of state wisdom and sound insight". The Finnish propaganda abroad used almost completely alternative ways of making politics. The propaganda did not have a decisive effect on countries' official politics, but gained unofficial support, especially in the public opinion and in academic statements. Mechelin claimed that the political field was dependent on public opinion and scientific research. Together with the official politics these two fields formed a triangle that shared the task of balancing the political arena and preventing it from making unwise decisions of taking an unjust turn. The international sphere worked as a balancing part in the Finnish Question. Mechelin tried by claiming the status of state for Finland's part to secure the country a place at the official international arena. At the same time, and especially when the claim was not fully adopted, he emphasised, and in a European context worked for, that right would become the guiding light not only for international relations, but also for the policy making in the inner life of the state.