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.

Medienvermittelte transnationale Öffentlichkeiten im Zeitalter praktischer Hybridisierung (English title: Mediated transnational publics in environments of practical hybridisation)

This article is concerned with the repercussions of societal change on transnational media. It offers a new understanding of multilingual programming strategies by examining “Radio MultiKulti” (RM), a public service radio station discontinued from 1/1/2009 by Rundfunk Berlin-Brandenburg. In its fourteen years of existence, “RM” had to implement a well-intended and politically-motivated logic of ‘multiethnic, intercultural service station’. However, as we demonstrate, such a direction, despite some achievements, has resulted in the constraints to RM’s journalistic activities and language policy, drawing criticism for the station’s economic viability. This paper proposes that multilingual media services are to be framed by the concept of practical hybridity that allows a necessary responsiveness towards an ever-changing media environment, at the moment within digital culture. Our approach draws on Mikhail Bakhtin’s and Yuri Lotman’s theoretical approaches to hybridity, as well as in-depth interviews conducted with “RM” staff from 2005 onwards, further interviews with key agents outside RM and a continuous monitoring of the public debate which culminated at the end of 2008 in the controversial decision to close the radio station. Against this background, the concluding remarks are meant to contribute to the scholarly debate on hybridization as well as to inform multilingual media policy in the 21st century.

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.

Consumer trends in digital news and information in Australia

We all know that the future of news is digital. But mainstream news providers are still grappling with how to entice more customers to their online sites. This paper provides context for a survey currently underway on user intentions towards online news and entertainment, by exploring: 1. Consumer behaviours and intentions with regards to accessing online news and information; 2. Current trends in the Australian online news and information sector; and 3. Key issues and emerging opportunities in the Australian (and global) environment. Key influences on use of online news and information are pricing and access. The paper highlights emerging technical opportunities and flags service gaps. These gaps include multiple disconnects between: 1. Changing user intentions towards online and location based news (news based on a specific locality as chosen by the user) and information; 2. The ability by consumers to act on these intentions via the availability and cost of technologies; 3. Younger users may prefer entertainment to news, or ‘infotainment’; and 4. Current online offerings of traditional news providers and opportunities. These disconnects present an opportunity for online news suppliers to appraise and resolve. Doing so may enhance their online news and information offering, attract consumers and improve loyalty. Outcomes from this paper will be used to identify knowledge gaps and contribute to the development of further analysis on Australian consumers and their behaviours and intentions towards online news and information. This will be undertaken via focus groups as part of a broader study.

Exploration and exploitation : the interplay between knowledge and continuous innovation

In rapidly changing environments, organisations require dynamic capabilities to integrate, build and reconfigure resources and competencies to achieve continuous innovation. Although tangible resources are important to promoting the firm’s ability to act, capabilities fundamentally rest in the knowledge created and accumulated by the firm through human capital, organisational routines, processes, practices and norms. The exploration for new ideas, technologies and knowledge – to one side – and – on the other one – the exploitation of existing and new knowledge is essential for continuous innovation. Firms need to decide how best to allocate their scarce resources for both activities and at the same time build dynamic capabilities to keep up with changing market conditions. This in turn, is influenced by the absorptive capacity of the firm to assimilate knowledge. This paper presents a case study that investigates the sources of knowledge in an engineering firm in Australia, and how it is organised and processed. As information pervades the firm from both internal and external sources, individuals integrate knowledge using both exploration and exploitation approaches. The findings illustrate that absorptive capacity can encourage greater leverage for exploration potential leading to radical innovation; and reconfiguring exploitable knowledge for incremental improvements. This study provides an insight for managers in quest of improving knowledge strategies and continuous innovation. It also makes significant theoretical contributions to the literature through extending the concepts of

The mobile Internet and small business : an exploratory study of needs, uses and adoption with full-adopters of technology

The technological environment in which contemporary small and medium-sized enterprises (SMEs) operate can only be described as dynamic. The exponential rate of technological change, characterised by perceived increases in the benefits associated with various technologies, shortening product life cycles and changing standards, provides for the SME a complex and challenging operational context. The primary aim of this research was to concentrate on those SMEs that had already adopted technology in order to identify their needs for the new mobile data technologies (MDT), the mobile Internet. The research design utilised a mixed approach whereby both qualitative and quantitative data was collected to address the question. Overall, the needs of these SMEs for MDT can be conceptualised into three areas where the technology will assist business practices; communication, eCommerce and security.

Business on-line? An empirical study of factors leading to the adoption of Internet technologies by Australian SMEs

E-commerce technologies such as a website, email and the use of web browsers enables access to large amounts of information, facilitates communication and provides niche companies with an effective mechanism for competing with larger organisations world-wide. However recent literature has shown Australian SMEs have been slow in the uptake of these technologies. The aim of this research was to determine which factors were important in impacting on small firms' decision making in respect of information technology and e-commerce adoption. Findings indicate that generally the more a firm was concerned about its competitive position such a firm was likely to develop a web site. Moreover the 'Industry and Skill Demands' dimension suggested that as the formal education of the owner/manager increased, coupled with the likelihood that the firm was in the transport and storage or communication services industries, and realising the cost of IT adoption was in effect an investment, then such a firm would be inclined to develop a web site.

Mobile data technologies and SME adoption and diffusion : an empirical study on barriers and facilitators

The technological environment in which Australian SMEs operate can be best described as dynamic and vital. The rate of technological change provides the SME owner/manager a complex and challenging operational context. Wireless applications are being developed that provide mobile devices with Internet content and e-business services. In Australia the adoption of e-commerce by large organisations has been relatively high, however the same cannot be said for SMEs where adoption has been slower than other developed countries. In contrast however mobile telephone adoption and diffusion is relatively high by SMEs. This exploratory study identifies attitudes, perceptions and issues for mobile data technologies by regional SME owner/managers across a range of industry sectors. The major issues include the sector the firm belongs to, the current adoption status of the firm, the level of mistrust of the IT industry, the cost of the technologies and the applications and attributes of the technologies.

Mobile data technology for small business : needs, uses, and adoption

The technological environment in which contemporary small and medium-sized enterprises (SMEs) operate can only be described as dynamic. The exponential rate of technological change, characterised by perceived increases in the benefits associated with various technologies, shortening product life cycles and changing standards, provides the SME a complex and challenging operational context. The primary aim of this research was to identify the needs of SMEs in regional areas for mobile data technologies (MDT). In this study a distinction was drawn between those respondents who were full-adopters of technology, those who were partial-adopters and those who were non-adopters and these three segments articulated different needs and requirements for MDT. Overall the needs of regional SMEs for MDT can be conceptualised into three areas where the technology will assist business practices, communication, e-commerce and security.

Exploring the needs for SMEs for mobile data technologies : the role of qualitative research techniques

The seemingly exponential nature of technological change provides SMEs with a complex and challenging operational context. The development of infrastructures capable of supporting the wireless application protocol (WAP) and associated 'wireless' applications represents the latest generation of technological innovation with potential appeals to SMEs and end-users alike. This paper aims to understand the mobile data technology needs of SMEs in a regional setting. The research was especially concerned with perceived needs across three market segments : non-adopters, partial-adopters and full-adopters of new technology. The research was exploratory in nature as the phenomenon under scrutiny is relatively new and the uses unclear, thus focus groups were conducted with each of the segments. The paper provides insights for business, industry and academics.

Copyright, digital media literacies and preservice teacher education

This article considers copyright knowledge and skills as a new literacy that can be developed through the application of digital media literacy pedagogies. Digital media literacy is emerging from more established forms of media literacy that have existed in schools for several decades and have continued to change as the social and cultural practices around media technologies have changed. Changing requirements of copyright law present specific new challenges for media literacy education because the digitisation of media materials provides individuals with opportunities to appropriate and circulate culture in ways that were previously impossible. This article discusses a project in which a group of preservice media literacy educators were introduced to knowledge and skills required for the productive and informed use of different copyrights frameworks. The students’ written reflections and video production responses to a series of workshops about copyright are discussed, as are the opportunities and challenges provided by copyright education in preservice teacher education.

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.

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.