Managerial leadership for research use in nursing and allied health care professions : a narrative synthesis protocol

BACKGROUND: Nurses and allied health care professionals (physiotherapists, occupational therapists, speech and language pathologists, dietitians) form more than half of the clinical health care workforce and play a central role in health service delivery. There is a potential to improve the quality of health care if these professionals routinely use research evidence to guide their clinical practice. However, the use of research evidence remains unpredictable and inconsistent. Leadership is consistently described in implementation research as critical to enhancing research use by health care professionals. However, this important literature has not yet been synthesized and there is a lack of clarity on what constitutes effective leadership for research use, or what kinds of intervention effectively develop leadership for the purpose of enabling and enhancing research use in clinical practice. We propose to synthesize the evidence on leadership behaviours amongst front line and senior managers that are associated with research evidence by nurses and allied health care professionals, and then determine the effectiveness of interventions that promote these behaviours.Methods/design: Using an integrated knowledge translation approach that supports a partnership between researchers and knowledge users throughout the research process, we will follow principles of knowledge synthesis using a systematic method to synthesize different types of evidence involving: searching the literature, study selection, data extraction and quality assessment, and analysis. A narrative synthesis will be conducted to explore relationships within and across studies and meta-analysis will be performed if sufficient homogeneity exists across studies employing experimental randomized control trial designs. DISCUSSION: With the engagement of knowledge users in leadership and practice, we will synthesize the research from a broad range of disciplines to understand the key elements of leadership that supports and enables research use by health care practitioners, and how to develop leadership for the purpose of enhancing research use in clinical practice.

Accounting narrative evaluation: using texture as a measure of quality

This paper applies a texture-based approach to evaluating accounting narratives. We employ the texture index created by Sydserff and Weetman (1999) as it is purported to evaluate narratives more accurately than previous methods. Not enough emphasis has been placed on the utilisation of linguistic tools in the accounting context. We see that a rigorous test serves the accountability function and may contribute positively to investor protection and confidence. We support the contention that improving narrative evaluation will help increase the quality of accounting narratives as they are presented in corporate annual reports. Quality for purpose of this paper is defined as a function of readability and understandability. These characteristics are considered essential for informed investment decision-making. We focus on the usefulness of the texture index in determining an appropriate measure of both readability and understandability by applying the texture index to a sample of corporate annual reports. Our results show conditional support for the use of the texture index as a viable alternative to readability tests.

Second person : a point of view? The function of the second person pronoun in narrative prose fiction

This thesis looks at the functions and effects of the ‘second-person’ pronoun in narrative prose fiction, with particular focus on the fluidity and ambiguity of the mode that I will call Protean-'you.' It is a mode in which it is unclear whether the ‘you’ is a character, the narrator, a reader/narratee, or no-one in particular—or a combination of these—so that readers find ‘second-person’ utterances at once familiar and deeply strange. I regard the ‘second person’ as a special case of narrative ‘person’ that, at its most fluid, can produce an experience of reading quite unlike that of reading traditional ‘first-‘ and ‘third-person’ narrative. Essentially, this unique experience comes about because Protean-‘you’ neglects to constitute the stable modes of subjectivity that readers expect to find within narrative textuality. These stable modes of subjectivity, modelled on what I will refer to as Cartesianism’s hegemonic notion of the self, have been thoroughly formalised and naturalised within the practices of ‘first-‘ and ‘third-person’ narrative. The Protean-‘you’ form of ‘second-person’ narrative, conversely, is a mode of narrative discourse that puts readers in a place of doubt and uncertainty, its unsettling equivocations forcefully disrupting accustomed, mimetic explanations of narrative and denying us access to the foundational, authorising subject of classical Cartesian thought. Rather than founding a notion of ‘second-person’ narrative and narrative ‘person’ generally on Cartesianism's ‘self-ish’ logic of unified, privatised identity, I turn to C.S, Peirce's notion of the semiotic self and to developments in post-structuralist thought. Essentially, the conception of subjectivity underpinning my arguments is Peirce's proposition that the self is to be conceived of not as a cogito, but as a sign by which the conscious entity knows itself. It is a sign, moreover, that is constantly being re-read, reinterpreted, so that identity is never self-complete. This reconception of subjectivity is necessary because 1 will argue that the effects of Protean-‘you’ arise in some part from a tension between Cartesianism's hegemony and what philosophical pragmatism and post-structuralism glimpse as the actual condition of the human subject—the subject as dispersed and contingent rather than unified and authoritative. Most discussions of ‘second-person’ narrative conceive of the mode in terms of implicit communicative relations, in some measure instituting Cartesianism's notion of the intentionalist self at the centre of literary meaning. I contrast the paradigmatic address model that arises from this conception against a model that approaches the analysis of ‘second-person’ narrative modality in terms of a referential function, that is, in terms of the object or objects referred to deictically by the ‘second-person’ pronoun. Two principal functions of ‘second-person’ textuality are identified and discussed at length. The first is generalisation, which is rarely dissipated altogether, a situation that contributes to the ambiguities of the pronoun's reference in much ‘second-person’ fiction. The second principal function is that of address, that is, the allocutionary function. Clearly, although stories that continually refer to a ‘you’ can seem quite baffling and unnatural, not all ‘second-person’ narratives unsettle the reader. In order to make the ‘second person's’ outlandish narratives knowable and stable, we bring to bear on them in our habits of reading whatever hermeneutic frames, whatever interpretive keys, come to hand, including a large number of unexceptional forms of literary and ‘natural’ discourse that employ the ‘second-person’ pronoun. These forms include letter writing and internal dialogue (i.e., talking to one's self), the language of the courtroom, the travelogue, the maxim, and so on. In looking at the ways in which the radicalising potentials of ‘second-person’ discourse are contained or recuperated, I focus on issues of vraisemblance and mimesis. Vraisemblance can be described as the ‘system of conventions and expectations which rests on/reinforces that more general system of ‘mutual knowledge’ produced within a community for the realisation and maintenance of a whole social world’. All of the forms of the vraisemblable are already instituted within social, cultural relations, so that what vraisemblance describes is the way we fit the inscriptions we read-that is, the way in which we naturalise what we read-into those given cultural and social forms. I also look at the conventionalising and naturalising work done by notions of mimesis in explaining relations between the world, our being in it, and texts, proposing that mimesis provides a principle buttress by which the good standing of the metaphor of ‘person’ is preserved in traditional and pre-critical modes of analysis. Indeed, the critic’s recourse to ‘person’ is in some measure always an engagement with mimesis. Any discussion that maintains that mimesis is in some way productive of meaning-which this thesis in fact does-must identify mimesis as a merely conventional category within practices of reading and semiosis more generally, and at the very least remove that term from its traditional position of transparent primacy and authority. Some of the most interesting and insightful arguments about ‘second-person’ narrative propose that the ‘second person’s’ most striking effects derive from the constitution of an ‘intersubjective’ experience of reading in which the subject positions of the ‘you’-protagonist, reader-narratee and narrator are combined into a fluid and indeterminate multiple subjectivity. Notions of intersubjectivity frequently position themselves as liberating the reader from Cartesianism's fixed, authoritative modes of subjectivity, Frequently, however, they tend implicitly to reinstate Cartesianism's notion of the self at the centre of textual practice and subjectivity. I look at Daniel Gunn's novel ‘Almost You’, at length in this context, illustrating the constant overdetermination of the ‘you’ and the novel's narrating voice, and demonstrating that this overdetermination leaves the origin of the narrative discourse, the identity of the narrator, and the ontological nature of both principal protagonists utterly ambiguous. The fluidity and ambiguity of Protean-‘you’ in ‘Almost You’ is discussed in terms of ‘second-person’ intersubjectivity, but with a view to demonstrating the indebtedness by the notion of intersubjectivity to Cartesianism's hegemony of ‘person’. I then turn to a discussion of what might be a more ‘old fashioned’ if perhaps ultimately more far-reaching approach to the ‘second person’s’ often startling ambiguities. This is Keats's notion of negative capability, a capacity or quality in which a person ‘is capable of being in uncertainties, Mysteries, doubts, without any irritable reaching after fact and reason.’ I suggest that Protean-‘you’ texts will license all of the readings of ambiguity and fluidity proposed in my discussion of ‘Almost You’, but conclude that the instances of indeterminacy illustrate no more than that: the fluidity and deep ambiguity, and thus, finally, the lack of coherence, of Protean-‘you’ discourse. This has particular implications for how we are to consider readers’ experiences of narrative texts. More fundamentally, it has implications for how we are to consider readers as subjects. I suggest that unstable, ambiguous instances of ‘second-person’ narrative can tear the complex and systematic embroidery of ideological suture that unifies Cretinism’s experience or sense of subjectivity, leaving the reader in a condition of epistemological and ontological havoc. I go on to argue that much of the deeply unsettling effect of Protean-‘you’ discourse anises because its utterances explicitly gesture towards Cretinism’s notion of self. Protean-‘you’ involves a sense of address that is much more pronounced than we are accustomed to facing when reading literary narrative, alerting us to the presence of inscribed anthropomorphic subjects. At the very same time, protean-‘you’ leaves its inscribed subjects indeterminate, ambiguous. This conflict generates a tension between the anticipation of the emergence of speaking and listening selves and our inability to find them. I go on to propose that Protean-‘you’ narrative's lack of coherence is also to be understood as the condition of narrative actuality generally, but a condition that is vigorously mediated against by dominant practices of reading and writing, hocusing my discussion in this respect on the issue of narrative ‘person,’ I argue that narrative ‘person’ is constituted within texts as an apparent unity, but that it is in fact, produced as unitary solely within the practice of making sense, that is, Within our habits of reading, and so is never finally unified. I propose that this is the case for ‘first-‘ and ‘third-person’ modes no less than for the ‘second.’ Where ‘second-person’ narrative at its most radical and Protean differs from conventional ‘first-‘ and ‘third-person’ narratives is the degree to which each has been circumscribed by practices of tantalization, containment and limit, and, in particular, Cretinism’s hegemony of ‘person.’ It may be that the most significant insights ‘second-person’ narrative has to offer are to be found within its capacity to reveal to the engaged reader the underlying condition of narrative discourse, and more generally, its capacity to reveal the actual condition of the human subject-a condition in which, exactly like its textual corollary of narrative ‘person,’ the self is glimpsed as thoroughly dispersed and contingent.

Teaching narrative journalism and the APN Professional Development Program

This paper extends the familiar concept of ‘journalism-as-storytelling’ into a description of some of its practical applications in a university and industry partnership resulting in a commercial training arrangement in early 2007. It describes the APN/USQ Professional Development Program for newspaper employees (with no formal journalism qualification) and exemplifies how print journalism courses may be adapted to teach narrative writing techniques. It demonstrates how foundation skills in journalistic practice may be incorporated into an adapted teaching model, suggesting that “the basics” of narrative writing should not be thought of as discrete components of journalism education. This argument is further supported by the description of a robust pedagogical approach informed by Mezirows’ transformative learning theory for a cross-disciplinary knowledge base.

Enhancing narrative coherence in simulated interviews about child abuse

Purpose – Simulated child interviews, where adults play the role of a child witness for trainee investigative interviewers, are an essential tool used to train investigators to adhere to non-leading, open-ended questions. The aim of this study is to examine whether the use of a training procedure that guides persons playing the role of a child in simulated interviews results in interviewees producing more coherent narratives (measured by the number of story grammar details).

Design/methodology/approach – A total of 80 police officers individually engaged in ten-minute interviews, whereby an untrained (colleague), or trained respondent, played the role of the child interviewee. For each child respondent condition, the interviews varied according to child age (five or eight years).

Findings – As predicted, trained respondents reported a higher proportion of story grammar elements and a lower proportion of contextual information than the untrained respondents, as well as more story grammar elements in response to open-ended questions. However, there were limitations in how well both groups tailored their story grammar to the age of the child they were representing.

Originality/value – These findings demonstrate that our training procedure promotes a more coherent interviewee account, and facilitates a response style that is more reinforcing of open-ended questions.

Power and discourse in information systems practice : a narrative research method

Relationships of authority and control and their effect on information systems actors has interested IS researchers since at least the 1980’s. The study of power itself has also troubled organisational and sociological theorists, from which information systems researchers have drawn various lines of attack. Our approach to power rests on an historical synchronic theory that seeks to uncover the places and operation of power through an examination of narrative ‘testaments’ which are analysed not from the perspective of the giving individual but from the structural elements of discourse that they may represent. This paper compliments previous research methods on the topic of power especially in expert reports and systems development methodologies; provides specific guidance on how to apply the notion of discourse synchronically; and reconstructs the commercial practice of information systems, not as a broad church, but as one of competing and epistemologically incommensurate discourse, where the fates of the powerful are balanced against the fearful and silent disciplined.

Sharing ownership in multicultural music : a hands-on approach in teacher education in South Africa

South Africa prides itself in a rich and colorful array of the Arts where music plays a significant role in social regeneration, unity and reconciliation. Little research has been undertaken in teacher education courses in South Africa regarding the inclusion of African music within multicultural music practice. Using the theoretical frameworks of understanding multiculturalism, I report on the teaching and learning of multicultural music at Pretoria University. My narrative highlights what I had learned and reports on the interview data with the tertiary music educator in October 2010. Using Interpretative Phenomenological Analysis, two themes are discussed: the need for multicultural music and the inclusion of students as indigenous culture bearers. Lessons learnt at Pretoria University can be replicated elsewhere in Australia where the sharing of ownership in multicultural music as a hands-on approach is viewed positively, promoting understanding and respect in a shared space and place.

Love and leadership: constructing follower narrative identities of charismatic leadership

Most extant research on charismatic leadership has an essentialist orientation that characterises it as leader behaviour, leader communication or follower dependency. Our approach is more discursively oriented. To research charismatic leadership, we used aesthetic narrative positivism, which undertook utilitarian as well as critical method. We examined followers' implicit narratives of their lived experiences of charismatic leadership in organisational settings. We examined metaphors for this experience. Most respondents identified with positive affect, a form of love story; a minority experienced negative affect, especially anger; and some experienced both positive and negative emotions. We posit that if one adopts a certain identity within the context of a dramatic narrative, one might be attributed with charismatic qualities by followers. In this way, we suggest that charismatic leadership might be less a gift from God and more a 'gift from followers'. © The Author(s) 2013.

Beyond narrative: sound design as dramaturgy in contemporary performance

Autobiographical performance is often characterised by a linguistic approach to storytelling. This paper presents discoveries from a practice-led research inquiry into the mediated translation of narrative elements within the making of autobiographical performance Train Tracks and Rooftops. Specifically, it presents the way sonic texts emerged within the process of translating away from narrative form. The paper sets out the technical aspects of the process and critiques the shift in meaning that comes from an understanding of sound dramaturgy and sound as performance architecture. The experience of the maker/performers' relationship to their live and mediated voice is discussed.

Between anxiety and hope: the experiences of women with vulval intraepithelial neoplasia during their illness trajectory - a qualitative approach

The vulvar intraepithelial neoplasia (VIN) is a rare chronic skin condition that may progress to an invasive carcinoma of the vulva. Major issues affecting women's health were occurring symptoms, negative influences on sexuality, uncertainty concerning the illness progression and changes in the body image. Despite this, there is little known about the lived experiences of the illness trajectory. Therefore, the aim of this study was to describe the experiences of women with VIN during the illness trajectory. In a secondary data analysis of the foregoing qualitative study we analysed eight narrative interviews with women with VIN by using thematic analysis in combination with critical hermeneutics. Central for these women during their course of illness was a sense of "Hope and Fear". This constitutive pattern reflects the fear of recurrence but also the trust in healing. The eight narratives showed women's experiences during their course of illness occurred in five phases: "there is something unknown"; "one knows, what IT is"; "IT is treated and should heal"; "IT has effects on daily life"; "meanwhile it works". Women's experiences were particularly influenced by the feeling of "embarrassment" and by "dealing with professionals". Current care seems to lack adequate support for women with VIN to manage these phases. We suggest, based on our study and the international literature, that new models of counselling and providing information need to be developed and evaluated.

The direct-democratic challenge to evidence-based policy making: Questioning the governmental PISA narrative in Swiss school policy

The democratic deficit of evidence-based policymaking and the little attention the approach pays to values and norms have repeatedly been criticized. This article argues that direct-democratic campaigns may provide an arena for citizens and stakeholders to debate the belief systems inherent to evidence. The study is based on a narrative analysis of Program for International Student Assessment (PISA) reports, as well as of newspaper coverage and governmental information referring to PISA in Swiss direct-democratic campaigns on a variety of school policy issues. The findings show that PISA reports are discursive instruments rather than ‘objective evidence’. The reports promote a narrative of economic progress through educational evidence that is adopted without scrutiny by governmental coalitions in direct-democratic campaigns to justify school policy reforms. Yet, the dominant PISA narrative is contested in two counter-narratives, one endorsed by numerous citizens, the other by a group of experts. These counter-narratives question how PISA is used by an ‘expertocracy’ to prescribe reforms, as well as the performance ideology inherent to. Overall, these findings suggest that direct-democratic campaigns may make more transparent how evidence is produced and used according to existing belief systems. Evidence, on the other hand, may be a stimulus for democratic discourse by feeding the debate with potential policy problems and solution. Thus, direct-democratic debates may reconcile normative positions of citizens with the desire to base decisions on empirical evidence.

A novel approach for assessing shifting cultivation dynamics in a regional conservation hotspot - insights from nort-eastern Madagascar

The north-eastern escarpment of Madagascar has been deemed a global hotspot of biodiversity due to its high levels of endemic speciesbeing heavily threatened by accelerated deforestation rates and landscape changes. The main concern for conservation of the remaining humid primary forests is the shifting cultivation practices of local smallholder farmers for rice production. According to the mainstream narrative, human population growth leads to a shortening of crop-fallow cycles and thus to the accelerated conversion of forests to agricultural land. However, little is currently known about the dynamic changes between forest and shifting cultivation systems at the regional level. Existing land cover change analyses in this area have so far only focused on binary forest to non-forest changes and have therefore failed to account for the dynamic nature of the change processes between forest and different agriculture land use systems. This can be partly explained by the significant challenge to delineate shifting cultivation systems on land cover maps using traditional remote sensing classification approaches. To address this gap we therefore applied a novel GIS approach, that was originally developed for the assessment of shifting cultivation dynamics in Laos and has so far never been applied elsewhere, to map shifting cultivation of different crop-fallow lengths as well as permanent agriculture land use at the regional level. Change analyses of land use maps between 1995 and 2011 allowed us to comprehend the general trends of land use trajectories and their spatial variation. This more detailed understanding of land use change dynamics is key to plan for successful interventions to slow forest loss while at the same time improving local livelihoods. We further believe that this approach holds great potential for conservation monitoring in this resource-rich but povertyprone conservation hotspot.

Identity Construction in Europe: A Discursive Approach. IES WORKING PAPER 2/2010

Proposing a discursive approach to studying identity, this paper presents Positioning Theory as a theoretical framework for conceptualizing the construction of identity in discourse. The Positioning Diamond is employed to analyse the discourse surrounding the Danish Euro referendum. The analysis reveals how identities are constructed in discourse that promotes a ‘yes’ or ‘no’ vote in the referendum, highlighting the generally implicit allocation of rights and duties to actors within a specific narrative context. The penultimate section discusses appropriate criteria for evaluating discursive accounts, distinguishing between cases in which truth, normative and ethical criteria are applicable. Finally, the paper concludes with a discussion of policy considerations and recommendations.

An archaeology of the instant? Action and narrative in microscopic archaeological residue analyses

The discovery and interpretation of microscopic residues on stone artefacts is an expanding front within archaeological science, allowing reconstructions of the past use of specific tools. With notable exceptions, however, the field has seen little theoretical development, relying largely on a rationale in which either individual findings are widely generalized or the age of the site determines the importance of the results. Here an approach to residue interpretation is proposed that draws on notions of narrative, scale, action and agency as one means of expanding the theoretical scope and application of residue studies. It is suggested that the individual resonance of the findings of residue analyses with people in the present day can be used to provide a more nuanced understanding of past actions, which in turn allows both better integration and communication of those findings within and outside the archaeological comm unity, and begins to overcome the problems associated with the typically small sample sizes analysed in stone-tool residue studies.