Dissertations / Theses on the topic 'Practice-based study'

The purpose of the study wass to describe the professional and personal development of nursing students who were placed at the Saartjie Baartman Centre for Abused Women and Children for the service-learning trial run of this Gender-Based Violence module i

Abstract The purpose of this study was to analyse the effectiveness and cost of fissure sealant treatment in preventing dental caries in children in a practice-based research network using survival analysis. The survival times of first permanent molars in children were analysed in three countries: in Finland (age cohorts 1970–1972 and 1980–1982), in Sweden (1980–1982) and in Greece (1980–1982), and additionally at two municipal health centres in Finland (age cohorts 1988–1990 in Kemi and 1990 in Vantaa). The study population comprised altogether 8 551 children. The data were collected manually from paper dental records (Finland, Sweden and Greece), and an automatic data-mining system for collecting data from electronic dental records was used in the case of the two health centres in Finland (Kemi and Vantaa). Comparisons of the survival times of first molars caries-free were performed between sealed and non-sealed individual teeth, and between the subjects in cases where a subject’s all first permanent molars were either sealed or non-sealed before the age of eight years. The cumulative costs of caries risk determination, use of xylitol, fissure sealant treatment, and restorations were calculated based on the data from the digital dental records of the health centres of Kemi and Vantaa. The results stressed the importance of caries-risk assessment on a tooth and subject level, when estimating the need for sealing treatment. Sealing of first molars of very high caries risk children (caries present in any of the permanent first molars before the age of eight years) seemed to be insufficient to prevent further dental decay later on. Instead, sealants were beneficial in caries prevention in medium-risk children (caries present in any of the permanent first molars between the ages of eight and ten years). Low-risk children (no caries in any of the permanent first molars before the age of ten years) did not benefit remarkably from sealant treatment. When sealant treatment were targeted only at high caries risk children based on risk-determination at the age of two years and all their permanent first molars were sealed (Kemi), their total treatment costs later were higher compared to the low-risk children, who were left unsealed. Significant differences in the survival curves of sealed and non-sealed first molars on a tooth and subject level confirmed that a translational approach is needed to study the effectiveness of preventive dental treatment in practice. The practice-based study model provides a good overview on the situation in real-life circumstances and helps to incorporate the evidence-based dentistry study results into everyday dental practice<br>Tiivistelmä Tutkimuksen tarkoituksena oli analysoida fissuurapinnoituksen tehokkuutta ja kustannuksia lasten hammaskariesta ehkäisevänä toimenpiteenä käytäntöön perustuvan tutkimusmenetelmän ja elinkaarianalyysin avulla. Ensimmäisten pysyvien poskihampaiden elinkaarianalyysi tehtiin Suomen (ikäkohortit 1970–1972 ja 1980–1982), Ruotsin (1980–1982) ja Kreikan (1980–1982) aineistojen sekä lisäksi kahden suomalaisen terveyskeskusaineiston (Kemi 1988–1990 and Vantaa 1990) perusteella. Tutkimusaineisto koostui yhteensä 8 551 lapsesta. Tutkimukseen tarvittavat tiedot kerättiin manuaalisesti potilaspapereista Suomen, Ruotsin ja Kreikan aineistoista sekä elektronisesti suoraan kahden suomalaisen terveyskeskuksen (Kemi ja Vantaa) digitaalisista potilastietojärjestelmistä. Ensimmäisten pysyvien poskihampaiden elinkaarikäyriä verrattiin pinnoitettujen ja pinnoittamattomien hampaiden sekä pinnoitettujen ja pinnoittamattomien henkilöiden (kaikki neljä pysyvää ensimmäistä poskihammasta joko pinnoitettu tai pinnoittamatta kahdeksanteen ikävuoteen mennessä) välillä. Kumulatiiviset kustannukset karieksen riskimäärityksestä, ksylitolin käytöstä, pinnoituksista ja täytteistä laskettiin Kemin ja Vantaan terveyskeskusaineistojen perusteella. Tutkimuksen tulokset korostavat riskimäärityksen tärkeyttä pinnoituspäätöksen tekemisessä sekä hammaskohtaisesti että potilaskohtaisesti. Korkean kariesriskin lapsille (kariesta yhdessä tai useammassa ensimmäisessä pysyvässä poskihampaassa ennen kahdeksatta ikävuotta) pinnoitusten teho näytti olevan riittämätön estämään karieksen kehittymisen myöhemmällä iällä. Pinnoitukset olivat tehokkaita keskisuuren kariesriskin (kariesta yhdessä tai useammassa ensimmäisessä pysyvässä poskihampaassa kahdeksan ja kymmenen ikävuoden välillä) lapsilla. Matalan kariesriskin lapset (ei kariesta yhdessäkään ensimmäisessä pysyvässä poskihampaassa ennen kymmenettä ikävuotta) eivät hyötyneet merkittävästi pinnoitteiden kariesta ehkäisevästä vaikutuksesta. Kun pinnoitteet kohdennettiin valikoidusti lapsille joilla oli kahden vuoden iässä todettu korkea kariesriski ja heidän kaikki ensimmäiset pysyvät poskihampaat pinnoitettiin (Kemi), heidän osaltaan kokonaishoidosta seuranneet kustannukset myöhemmin olivat korkeampia verrattuna lapsiin joilla oli matala kariesriski ja joiden hampaita ei pinnoitettu. Pinnoitettujen ja pinnoittamattomien ensimmäisten pysyvien poskihampaiden hammas- ja henkilökohtaisten elinkaarikäyrien tilastolliset erot tutkituissa kohorteissa osoittavat, että käytäntöön perustuva tutkimusmenetelmä on suositeltava analysoitaessa hammashoidon tehokkuutta jokapäiväisessä toiminnassa. Käytäntöön perustuva tutkimusmalli antaa hyvän käsityksen todellisissa hoito-olosuhteissa tehtyjen toimenpiteiden tehokkuudesta ja avaa siihen uuden näkökulman sekä edesauttaa soveltamaan näyttöön perustuvan hammaslääketieteen tutkimustuloksia jokapäiväiseen hammaslääkärintyöhön vastaanotolla

This practice-based thesis focuses on the Emirati burqa or ‘mask’, a form of face covering worn by the majority of Emirati women in the United Arab Emirates until the late 1960s that reveals the eyes but does not cover the hair or body. Framed by Daniel Miller and Aida Kanafani’s theories of material culture and embodiment that focus on dress as an intimate sensory object, this practice-based thesis is the first in-depth study of the Emirati burqa that engages with the histories and materiality of the burqa as an intimate object once made and worn by Emirati women. At the core of this thesis is women’s practice: the practices of women burqa makers, the diverse female practices of burqa wearing and my practice as a woman artist from the UAE. Through experiments with traditional craft materials, inscription methods, workshop initiatives, film, photography and installation, my engagement is with performing the material culture of the female burqa as a response to its disappearing practices and its previously little recorded history. The thesis first analyses the history of the burqa face covering in the Arabian peninsula through a specific focus on the written and visual accounts of mid-nineteenth and mid-twentieth-century British travellers in Arabia. It then examines and records the material craft of Emirati burqa-making based upon interviews with burqa makers and textile producers and accompanying ethnographic fieldwork conducted in the UAE and India. This includes photographic documentation of the processes involved in the production of the burqa textile, a study of burqa manufacturing brands and packaging, and an analysis of the material construction of the burqa and how it is worn in the UAE. Based on interviews in the UAE, Bahrain and Qatar and a variety of visual and textual sources, the thesis identifies the different types of Emirati burqa in relation to age, status, and regional identities. It further shows that the Emirati burqa differs from those worn in the neighbouring Gulf States of Bahrain, Qatar, Oman and Saudi Arabia, and focuses on burqa wearing practices and associated uses of the burqa textile in the UAE. Engaging with these research findings, the culmination of the thesis is the body of art works exhibited in the 2014 London exhibition, ‘An Intimate Object’, that re-animates the burqa as a living object with its own history and new contemporary meanings. Focusing on the significance of the body and senses in knowledge production, the art practice shows the burqa has ‘a voice’ in a conversation that draws upon past traditions referencing protection and its value as a personal and precious object. The burqa speaks, its indigo residue bleeds as an active witness to its lost past. It also plays a part in rediscovery or keeping the past of this material object alive through contemporary art practice as an aesthetic and political strategy.

<p> Evidence-based practice (EBP) ensures excellent nursing care; however, limited literature exists for implementing EBP within schools. This mixed method study, using the Promoting Action on Research Implementation in Health Services (PARIHS) framework, explained EBP implementation within three school districts. Quantitative results identified the level of implementation and nursing characteristics predictive of EBP implementation. The mean EBP Implementation score (n = 64) was 8.36 (SD 9.75), indicating a low level of EBP implementation. EBP Belief scores was the only nursing characteristic that explained 34% of the variance. Qualitative results explained survey results, using a multiple case study design with interviews with six school nurses with high or low EBP Implementation scores. Analysis included pattern matching to propositional statements derived from PARIHS evidence, context, and facilitation concepts. Individual case stories varied and demonstrated both positive and negative patterns. Data synthesis examining propositions and themes indicated all cases supported four evidence propositions. No cases supported the evidence proposition about collecting and using routine student data. Three cases (n =3) with high EBP Implementation scores supported six evidence and context propositions. Three cases (n = 3) with low EBP Implementation scores supported thirteen propositions for the evidence, contest, and facilitation concepts. Common themes across cases were using evidence, cultural influences, structural supports, and impeding implementation. When integrating findings only three EBP Implementation scale items indicated routine implementation of evidence, which matched with evidence propositions supported across cases and the theme using evidence. Context and facilitation propositions and themes primarily explained low EBP Implementation items.</p>

In this exegesis I examine my creative project, a series of seven short documentary films entitled The Ripple Effect of PTSD (Melzer 2016a), and its impact on community, on the film participants, and on me as a filmmaker. The films document the experience of caregivers and family members of veterans with Post-Traumatic Stress Disorder (PTSD). The exegesis is framed by the literature on ethics and documentary film. In the first data chapter, I detail the work of building a community for my films, engaging with impact partners and producing a series of educational videos about PTSD. Also catalogued in this chapter is the success of the films. They were selected for film festivals, elicited positive feedback from the general public and were shared multiple times online. The following chapter discusses the impact of the creative project on the participants, highlighting their agency and empowerment as well as vulnerabilities. The discussion reveals the complex and multifaceted nature of power in documentary filmmaking. From impact on participants I move to consider the impact of the filmmaking process on me as a filmmaker drawing on the notions of ‘vicarious trauma’ and ‘emotion work/emotional labour’. I demonstrate that the fraught subject matter of the films, the distress of participants, and my novice status as a filmmaker exposed me to vicarious trauma. I further explain how different aspects of the filmmaking process, such as accessing and interviewing participants, and negotiating with the military, necessitated significant emotional labour. In the concluding chapter of the exegesis I highlight the key findings of research. Of particular importance is my illumination of the emotional dimensions of film production. I argue that quality documentary production requires significant emotional labour on behalf of a filmmaker, but the implications of this emotion work are rarely acknowledged in the literature. As such, I argue for the importance of expanding documentary filmmaking and ethics research to include a focus on the emotional health and wellbeing of the filmmaker.<br>Thesis (PhD Doctorate)<br>Doctor of Philosophy (PhD)<br>Queensland College of Art<br>Arts, Education and Law<br>Full Text

Introduction Simulation training is widely adopted in clinical medicine. Simulated environment provides a safe condition for participants to practice without any harm inflicted on patients. Within the spectrum of clinical anaesthesia, simulation mannequin was first developed in 1960. The first journal article with description about the use of simulator to teach intubation to anaesthesia residents occurred in 1969. The first report about simulated anaesthesia training was in 1988. Since then, there has been a flourishing trend of adopting this simulation training in clinical anaesthesia, across various subspecialties including obstetric anaesthesia, cardiac anaesthesia. For individual perspective, simulation training expanded beyond skill development into non technical skill training. This article is to review the impact of simulation training for individual development for anaesthesia residents or trainees. The aim is to evaluate the evidence of simulation training on individual anaesthesia resident performance and improvement on patient outcome. As a result, more vigorous use of simulation is adopted in modular subspecialty anaesthesia and also non-technical skill training for residents. Methods A search of literatures through search engines of Pubmed, Google Scholars, EMBASE, Cochrane library for ‘Simulation for training of clinical anaesthesia’ was done. After limit the search for English language and past 10 years, there are 223 articles. With appropriate exclusion criteria, 25 articles are selected for detail evaluation. Results Simulation has good effects in various aspects. For various anaesthesia subspecialties, simulation-based training can improve trainees’ confidence and capability in handling rare but life-threatening peri-operative crises. For assessments, simulation is an essential part of Israeli Board Examination in Anesthesia with good discriminating power. For technical skill development, simulation-based training can reduce residents’ time requirement to perform cricothyroidotomy and improve successful rate of central line insertion. The specific skill developed can retain for long period of time such as 12 months. For non-technical skills, there are conflicting results in behavioural scores. For patient safety and outcome perspective, there lacks the result from individual simulation-based training study. Conclusions Simulation in anaesthesia residents training is a worldwide practice. These simulation training allow residents to have exposure in various anesthesia subspecialty including cardiac, obstetrics, liver transplant. There are specific technical and non-technical skill development. Individual performance particularly time to complete cricothyroidotomy and confidence, understanding of procedures and anatomy by residents are also enhanced. Thus, simulation should be allocated more proportion of anaesthesia resident training in Hong Kong. Although there remains no study showing better patient outcome after simulation-based individual training, future studies should be done to confirm such presence and degree of association with simulation training.<br>published_or_final_version<br>Community Medicine<br>Master<br>Master of Public Health

Evidence based practice (EBP) is a worldwide phenomena defined as the “conscientious explicit and judicious use of current best evidence in making decisions about the patient’s care”. The evidence based practice concept’s aim is to effectively guide health care professionals to build knowledge that will be supported by evidence. Evidence based practice must be supported by evidence based teaching. Nurse educators must be up to date with evidence based teaching as well as the latest evidence based teaching strategies, in order to teach the new millennial nursing students and for the new qualifications structure. Teaching the concept of evidence based practice by implementing evidence based teaching to nursing students will enable them to transform the future of healthcare by delivering high quality care practice. A paucity of evidence is available on evidence based teaching and teaching strategies in the South African context. Therefore the researcher used a systematic review methodology to explore and describe the best available evidence based teaching strategies and to develop a guideline on evidence based teaching strategies for nurse educators. The data bases searched included: MEDLINE, CINAHL, PubMed and Google Scholar. Manual searches were done and completed with the assistance of librarians. A total number of n=50 studies were identified as potentially relevant to the study. The number or articles included for critical appraisal were 20. On completion of the critical appraisal n=17 articles were identified for the review. The included studies for the review were n=7 Level 1, systematic reviews and n=10 Level 2, quasi-experimental studies. Three studies were excluded after critical appraisal from two reviewers, appraisal was done independently, and consensuses were reached between the two reviewers. The Joanna Briggs Institutes critical appraisal and data extraction instruments were used for the study. The descriptive data synthesis was done of the included studies as well as a comparison of teaching strategies to determine which one to better than the other one. Although n = 4 of the teaching strategies (concept mapping, internet-based learning, evidence based interactive strategy and cultural competence) significantly increased knowledge, the overall results found that a variety of teaching strategies to be implemented to increase the knowledge outcomes of the nursing students. The different teaching strategies found were: e-learning, concept mapping, internet-based learning, web-based learning, gaming, problem-based learning, and case studies, evidence based learning and cultural competence. However, more research is needed to investigate the best use of the different teaching strategies and compare the impact of a variety of teaching strategies on increasing knowledge of the nursing student.

The purpose of this case study is to demonstrate the effectiveness of an Advanced Practice Nurse in providing spiritual and nursing care within a faith community setting. The study will describe the process of developing a Parish Nurse program using a Nurse Practitioner to offer wholistic health care to parishioners. It will also illustrate the collaborative process of developing a free health center within a faith based organization, using the Nurse Practitioner to manage the health center and deliver health care services. In order to demonstrate the need for parish nurse care, the case study used an anonymous survey to provide insight into the health status of the congregation, as well as to determine perceived needs of parishioners. Excerpts from the researcher s journal and audio-taped interviews of parishioners and key leaders within the community was used to express congregants experiences of receiving parish nurse care, and to convey the need for a free community health center in the target population. A utilization review was conducted to demonstrate the profile of the patients who have accessed the services of the health center. The findings revealed three commons themes of parish nurse care; presence, spiritual support, and health care liaison. The study also revealed parishioners had an expedited referral process and improved patient provider relationships. Additional findings determined that the free health center was able to be operated by many of the members of the faith based organization, and was effective in managing chronic conditions such as hypertension and diabetes. Advanced Practice Nurses who are Parish Nurses have an opportunity to practice in a more wholistic manner, and offer advanced level care to parishioners and the community at large to improve health outcomes.<br>D.N.P.<br>School of Nursing<br>Other<br>Nursing Practice DNP

The critical factor in determining students' interest and motivation to learn science is the quality of the teaching. However, science typically receives very little time in primary classrooms, with teachers often lacking the confidence to engage in inquiry-based learning because they do not have a sound understanding of science or its associated pedagogical approaches. Developing teacher knowledge in this area is a major challenge. Addressing these concerns with didactic "stand and deliver" modes of Professional Development (PD) has been shown to have little relevance or effectiveness, yet is still the predominant approach used by schools and education authorities. In response to that issue, the constructivist-inspired Primary Connections professional learning program applies contemporary theory relating to the characteristics of effective primary science teaching, the changes required for teachers to use those pedagogies, and professional learning strategies that facilitate such change. This study investigated the nature of teachers' engagement with the various elements of the program. Summative assessments of such PD programs have been undertaken previously, however there was an identified need for a detailed view of the changes in teachers' beliefs and practices during the intervention. This research was a case study of a Primary Connections implementation. PD workshops were presented to a primary school staff, then two teachers were observed as they worked in tandem to implement related curriculum units with their Year 4/5 classes over a six-month period. Data including interviews, classroom observations and written artefacts were analysed to identify common themes and develop a set of assertions related to how teachers changed their beliefs and practices for teaching science. When teachers implement Primary Connections, their students "are more frequently curious in science and more frequently learn interesting things in science" (Hackling & Prain, 2008). This study has found that teachers who observe such changes in their students consequently change their beliefs and practices about teaching science. They enhance science learning by promoting student autonomy through open-ended inquiries, and they and their students enhance their scientific literacy by jointly constructing investigations and explaining their findings. The findings have implications for teachers and for designers of PD programs. Assertions related to teaching science within a pedagogical framework consistent with the Primary Connections model are that: (1) promoting student autonomy enhances science learning; (2) student autonomy presents perceived threats to teachers but these are counteracted by enhanced student engagement and learning; (3) the structured constructivism of Primary Connections resources provides appropriate scaffolding for teachers and students to transition from didactic to inquiry-based learning modes; and (4) authentic science investigations promote understanding of scientific literacy and the "nature of science". The key messages for designers of PD programs are that: (1) effective programs model the pedagogies being promoted; (2) teachers benefit from taking the role of student and engaging in the proposed learning experiences; (3) related curriculum resources foster long-term engagement with new concepts and strategies; (4) change in beliefs and practices occurs after teachers implement the program or strategy and see positive outcomes in their students; and (5) implementing this study's PD model is efficient in terms of resources. Identified topics for further investigation relate to the role of assessment in providing evidence to support change in teachers' beliefs and practices, and of teacher reflection in making such change more sustainable.

Introduction and aim: In Zimbabwe, a one-year midwifery-training programme, based on a competency-based curriculum, aims to develop essential competencies for midwifery clinical practice and sound professional judgement, as required by the International Confederation of Midwives (ICM) Global Standards for Midwifery Education. This study aimed to explore midwives’ preparation for practice to the level defined by ICM core competencies in Zimbabwe. Methods: A critical realist mixed-method study included an exploratory correlational approach for the quantitative phase and classical grounded theory for the qualitative phase. In the quantitative phase, complete sampling was used to recruit a cohort of 85 midwives from three midwifery schools (School A, School C and School B; recruitment rate 53.8%) before they received the results of their state final examinations. Confidence and competence data were collected from participants, their ward supervisors/senior midwives, peers and clinical instructors using a 360° assessment tool developed for the study, based on one currently used for assessment at the participating schools. This consisted of a checklist of 20 ICM competencies each scored as a rating scale from 0-10 in six areas of midwifery care. Data were collected at initial recruitment, after the participants had received their examination results and after three months of clinical practice, with 58 from School A and School C providing data at the final time point (68.2% retention rate). The qualitative study used in-depth interviews to explore the knowledge views and practices of midwives regarding ICM core competencies, using theoretical sampling to recruit 36 participants (21 newly qualified midwives, 4 tutors, 5 ward supervisors, 3 clinical instructors, and 3 acting clinical instructors) from School A and School C until data saturation was reached. Data analysis: IBM SPSS Statistics 22 was used to analyse quantitative data. Cronbach’s alpha was used to estimate the internal consistency of subscales and the overall scale of the 360° assessment tool. Most analyses were descriptive, and Pearson’s chi-square, Fisher’s exact and the Mann-Whitney U test was used to compare data by school. Kendall’s correlation and multiple linear regressions were used to explore which variables were associated with total confidence and competence scores. Constant comparative analysis was used on the qualitative data to develop categories to build a grounded theory of social processes facilitating or hindering competence and confidence development in midwives. Results: The 360° assessment tool was reliable although some assessors appeared not to have observed the participant performing an episiotomy or resuscitating a new born. Participants’ confidence scores were generally higher than their assessors’ competence scores. Confidence and competence scores at School C generally increased over time, but confidence scores at School A fell after the midwives had spent three months in clinical practice. The number completing the quantitative phase limited the generalisability and precision of the multiple regressions but the main predictor of confidence and competence was school. The qualitative phase explained the difference between schools in terms of school policies, the way facilitators planned and organised clinical settings to facilitate student learning, and facilitator characteristics. Students at School A were allowed to pass assessments without reaching the required standard while those at School C were marked more harshly, but were subsequently appreciative of this approach, recognising its necessity for competence development. Following transduction, a Competence and Confidence Development Model was proposed to explain how the dualistic nature of an individual and their confidence and competence were related via a student learning typology combining individualism-collectivism and rate of learning with six phases of skill acquisition. Conclusions: Midwifery schools in Zimbabwe must consider policies, the training environment, student learning styles and the teaching processes required for students to acquire the clinical skills and theoretical knowledge necessary to become competent qualified practitioners.

This study explored the practice of creating subjective autobiographies through reflective methods and relevant theoretical concerns. Autobiographical bandes dessineés (autobioBDs) is a trend in European comics that is characterised by highly imaginative and subjective representations of the autobiographical self. AutobioBD stories attempt an emotional truth by depicting the author-artist’s authentic reactions to people, places or events. Autofiction and worldbuilding theory provide a theoretical basis for the study’s reflective outcomes. Autofiction is a literary concept used to describe ideas like the autobiographical pact, whereas worldbuilding describes systems of creating and understanding the imaginary worlds found in texts. Together, a lexicon emerges that conceptualises the autobiographical protagonist as a textual self, playing through autobiographical events in a textual world. By systematically reflecting during engagement with an autobioBD practice, specific insights were generated. A Practice-Based Research (PBR) methodology with reflective methods serves to excavate and engage with previously tacit knowledge of creative practice. This study contributes towards the existing autobioBD scholarship by demonstrating insights against a reflection from the artist-researcher’s point of view.<br>Mini Dissertation (MA (Fine Arts))--University of Pretoria, 2020.<br>Visual Arts<br>MA (Fine Arts)<br>Unrestricted

There are a number of reasons for the move towards sustainable development and ecosystem based fisheries management. Public concern and awareness over the impact of development on the environment started in the 1960s and 1970s with the emergence of the environment movement and the global sustainability debate. This was in response to visible effects of degradation on the environment caused by human activities, and a challenging of traditional assumptions that the natural environment had the capacity to provide unlimited resources for continued economic and population growth. The past two decades has been characterised by an acknowledgement that previous management approaches have failed to effectively address the issues effecting oceans and fisheries, and the growing realisation that a holistic approach is required to ensure the proper governance and management of the oceans and fisheries. The overall objective of EBFM is to sustain healthy marine ecosystems and the fisheries they support. There is now a large literature on EBFM, but much less on implementation and no general agreed framework for assessing EBFM. A systems approach is one way to deal with the above difficulties. The central proposition of this thesis has argued that managing under ESD/EBFM principles is complex and one needs to understand the big picture in order to identify and understand the parts. This approach has been used throughout each stage of the thesis by way of unpacking the whole into its constituent parts and developing an understanding of the key dependencies and relationships; and repacking by discussing the importance of integrated governance and management in terms of consistency when translating from general concepts and definitions into principles, criteria, objectives, and the specific approaches for implementation. To assess management strategies in the context of the overall “fisheries system” that links the marine ecosystem, users, scientists, government agencies and other stakeholders, it is helpful to begin to get a sense of what such a system might look like. To achieve this, an integrated model has been developed, which displays the broad dimensions and interconnected and interlinked nature of ecosystems and human systems under EBFM principles. The model was further developed in terms of the biosocioecomic and the governance and management dimensions, which are underpinned by a set of frameworks. These provide a framework for describing and understanding of the dimensions, components, characteristics and key drivers for each of the dimensions. Australia has adopted ESD and EBFM which forms the basis for governance and management of oceans and fisheries across all jurisdictions. In moving from the more theoretical and conceptual aspects to an application of ESD/EBFM, the model was applied to Australia, providing empirical material through which to qualitatively assess its application. It was argued that the conceptual model could be used to successfully represent the real world in moving from a broad representation of ESD and EBFM to the detailed implementation at the fisheries level in Australia. One area of the model that requires further development, and is necessary for fully implementing EBFM, concerns societal choice and values. Future key challenges at the international level and nationally for Australia is the need to simultaneously govern and manage both current and emerging issues, which will require different approaches; and the need to move to a fully integrated assessment approach so that adaptive management can be implemented.

This thesis examined the usefulness of a paradox-based approach to the study and practice of organisational change. Lewis (2000) defines paradox as contradictory yet interrelated elements that seem logical in isolation but absurd and irrational when appearing simultaneously. Given that organisational change is inherently complex and contradictory (e.g., Cameron & Quinn, 1988), paradox is proposed as a means of providing researchers, practitioners, and organisational members with a new way of thinking about, and working with, the complex nature of change. Three studies were undertaken to investigate the contribution of paradox to the study and practice of organisational change. The first study was concerned with identifying a comprehensive set of the paradoxes relevant to organisational change. This study utilised an interview-based methodology to identify change-related paradoxes for three organisational stakeholder groups, namely managers, change agents, and change participants. Ten managers, ten change agents, and ten change participants working in professional and administrative roles within a large Australian University participated in the study. Results identified 16 different change-related paradoxes, 15 of which were similar to organisational paradoxes that had been previously identified in the literature. There were both similarities and differences in paradox identification between the three stakeholder groups. Three of the 16 paradoxes were identified by all three stakeholder groups, while others were identified by two out of the three groups, or by just one group independent of the other two. Change agents demonstrated a unique ability to identify paradoxes that had also been identified by either managers, or change participants. The paradoxes uniquely identified by the different stakeholder groups seemed to be consistent with the role expectations and role identities for the groups. This study builds on existing literature by using empirical methods to specify exactly which paradoxes are relevant to the study and practice of organisational change. It also demonstrates that all three organisational stakeholder groups are able to identify change-related paradoxes. The purpose of the second research study was to better understand how each of the three stakeholder groups interpret the paradoxes relevant to organisational change. Twenty managers, 19 change agents, and 19 change participants in professional and administrative positions within a large Australian University completed a 307-item paired-comparison questionnaire suitable for multidimensional scaling analysis (MDS). The items in the questionnaire were generated using 13 of the 16 paradoxes identified in the first study. MDS was used to reveal the underlying structure of the data set for all three stakeholder groups. Results found four-dimensional solutions for all groups. The dimensions were sufficiently similar across the groups to produce a fourth solution using the three groups combined. The four paradoxical dimensions identified in this solution were: approach to change (participative versus directive); scope of change (incremental versus transformational); attitude to change (acceptance-oriented versus action-oriented), and focus of change (local-level versus system-level). The first two of these dimensions had been identified previously in the literature while the third and fourth dimensions add to the existing literature. This four-dimensional solution offers a practical framework to aid the study and practice of organisational change. External unfolding analysis was used to aid in the interpretation of the MDS solutions. This analysis considered the extent to which each of the items in the questionnaire were perceived to result in resistance to change, achieving the intended outcomes of the change, and achieving satisfying change outcomes. For all four solutions, results were significant for approach to change. Participative change was associated with more satisfying change outcomes, and directive change was associated with greater change resistance, and greater likelihood of achieving the intended outcomes of the change. The third research study was concerned with demonstrating that identification and resolution of change-related paradox is a learnable skill and can therefore be improved through training. Sixty-three participants (29 men and 34 women) occupying professional and administrative roles at a large public sector organisation participated in the study. Participants were allocated to either a control or experimental group. Case studies were used to provide time 1 and time 2 measures of both groups' ability to identify and resolve paradox. A training intervention methodology was developed based on a review of the adult learning and training literatures, as well as previously-utilised methodologies of paradox identification and resolution identified from the literature. The four-dimensional schema of change-related paradox developed in the second research study was used to define the four paradoxes in the training intervention. A 2 x 2 repeated measures MANOVA was used to test whether training improved the ability to identify paradox. Results found that training improved participants' ability to identify the approach to change and scope of change paradoxes, but not the focus of change paradox. Eight Wilcoxin Signed-Ranks tests were used to determine whether training improved ability to resolve change-related paradox. Results showed that training improved the ability to resolve the approach to change, scope of change, and attitude to change paradoxes, but not the focus of change paradox. Resolution was also found to be relatively infrequent among participants, suggesting that it is a difficult undertaking. It was concluded that a paradox-based approach to the study and practice of organisational change is useful in that it offers a new framework to inform change theory and enhance change implementation.<br>Thesis (PhD Doctorate)<br>Doctor of Philosophy (PhD)<br>School of Psychology<br>Full Text

Nurses routinely obtain genomic data when collecting family health histories. However, they report low confidence in their knowledge and understanding of genomics and the genetically engineered medications prescribed for their patients. The purpose of this project was the development and implementation of an evidence-based online education program about genetics and genomics to increase the nurses' understanding and ability to provide competent care for their patients receiving treatments based on the science of genomics. Knowles's principles of adult learning theory guided the development and delivery of the online education project to 12 medical-surgical registered nurses employed in a hospital in the northeastern United States. The Johns Hopkins nursing evidence-based practice model provided a guideline for organizing and evaluating the level and quality of evidence. A 2-tailed paired t test showed that the nurses' knowledge and understanding about genetics and genomics increased after participating in the evidence-based education program. The increase in nurses' knowledge on genomics has the potential to provide nurses with the competence and confidence to collaborate with physicians and pharmacists regarding treatment plans incorporating genomics, resulting in effective team collaboration and a positive social change that could improve patient outcomes.

This thesis addresses interpretative issues arising from notated music, particularly recent guitar music typifying progressive notational and aesthetic trends, from a perspective based on the concepts of mimesis and gesture. Drawing on Adorno’s theory of musical reproduction, scholarship on musical gesture and recent models of performers’ relationship to notation, I propose interpretative strategies aiming at the vindication of the role of the body in the discussion of musical works, while also examining the performing conventions challenged by recent developments in guitar notation. Artistic practice is fundamental to this thesis as it accounts for the exploration of various interpretative strategies and choices derived from the application of the aforementioned concepts. An accompanying folio of videos and recordings documents the impact of these theoretical concepts upon my performing practice. The starting point is a discussion of the performing issues of Brian Ferneyhough’s Kurze Schatten II, a peak of complexity in the guitar literature, and the relationship between musical gesture and the metaphorical domains to which this work alludes. Subsequently, the interpretative strategies proposed here are applied to aesthetic models differing from that of Ferneyhough as well as to music appealing to multi-parametric notation – here considered as a strand deriving from Ferneyhough’s aesthetics – requiring a paradigm shift in its interpretative approach.

Non-fiction film shares a long and relatively uncharted history with the museum. Today, filmmaking is a widespread yet critically neglected area of modern museological practice. This practice-based PhD situates itself within these critical gaps to examine the knowledge producing potential of film archives and film practice at the Manchester Museum. Its primary historical sources are a group of taxidermy objects at the Manchester Museum, an archive of 16mm acetate films at the North West Film Archive and a collection of travel journals at Cheshire Archives and Local Studies. These diverse collections were generated by Maurice Egerton, the 4th Baron of Tatton in Cheshire during his travels in Africa in the first decades of the twentieth century. This thesis brings all three together for the first time since their moment of production. These collections recur throughout the thesis as I ask how film archives can complicate and enrich our understanding of collections and how filmmaking practice might continue to bring new types of knowledge into the museum and archive. Two research films are submitted with and discussed within the thesis. The first, 'Living Worlds at the Manchester Museum', adapts observational methods from visual anthropology to record objects and staff during the re-display of the mammal gallery at the Manchester Museum in 2011. The second, 'Articulating Archives' is the result of a creative collaboration in 2014 with Year 8 secondary school students and the institutions and archives named above. Within the production and analyses of these films I draw on diverse critical sources to suggest that film can illuminate properties of materiality, embodied knowledge and performed engagement that textual accounts fall short of capturing.

Dental education combines theories and practice regarding preparing students for clinical practice. Presently, dental education has implemented technological simulators in teaching pre-clinical embodied practice. Many studies of simulation technologies have revealed they have some advantages over simpler techniques. However, there is still little evidence to support knowledge of how to design pre-clinical courses integrating technology in simulation-based teaching and learning. This challenge also affects the Prosthodontic department in designing pre-clinical simulation laboratory courses, as dental educators encounter difficulties in teaching with the new technological simulator – the DentSim system. An ethnographic case study was used to obtain detailed information about students’ practice. The knowledge from in-depth investigation may help professional educators and educational designers decide which technologies and instructional approaches are suitable for the courses. The Activity-Centred Analysis and Design (ACAD) framework was used for capturing and understanding detailed information about the course. Thirteen third-year dental students, who had no experience practising on the pre-clinical course and with the DentSim system, volunteered to participate in the study. The data were gathered by using two approaches: participant observations and interviews. In summary, this thesis identified some principles for improving the design of an effective pre-clinical laboratory course regarding balancing and integrating the DentSim system and other aspects of practice. The thesis should also be of value to other professional educators and educational designers who would like to implement similar technologies and approaches in their courses and/or to undertake similar research in this field.

Doctor of Philosophy<br>Similar to their colleagues throughout the world, nurses and midwives in New South Wales (NSW), Australia, welcome evidencebased practice (EBP) as a means to improve patient or client outcomes. This thesis explores the way nurses and midwives understand evidence for EBP and aims to determine whether members of these professions currently have the knowledge and skills necessary to implement evidence‐based care. Three separate studies were conducted to explore NSW nurses’ readiness for EBP. Attitudes, knowledge and skill were investigated using an EBP questionnaire returned by 383 nurses. The views of 23 nursing opinion leaders were elicited during qualitative in‐depth interviews, and their ideas on maximising the potential for future nurses to confidently engage in EBP were explored. Current approaches to teaching EBP in undergraduate nursing programs were investigated by examining documents issued by NSW nursing education providers. The results demonstrate many differences between the ways NSW nurses currently understand evidence for EBP, and a range of approaches to teaching EBP in undergraduate nursing programs. Under current conditions, nurses graduating from universities in NSW commence practice with varying levels of preparation for EBP and enter into a professional arena that is itself struggling to cope with the concepts and language of this approach to improving healthcare. v Evidence for the effectiveness of EBP is slowly accumulating and despite some small positive signs, the collective results of this thesis suggest that current educational approaches are not capable of producing the kind of results that are both necessary and desirable for the promotion of evidence‐based nursing practice in NSW. Articulating a commitment to EBP, using a common language and a consistent approach are among the recommendations made for the future promotion of EBP in nursing education.

This practice-based research project uses a study of the key technological, political and social triggers that have brought about the normalisation of surveillance to identify the ways in which cinema has, over the last two decades, reflected the transformation of top/down institutional monitoring into a complex, criss-crossing dynamic that allows citizens to look up and challenge authority figures as well as peer across at each other both off- and online. The research illustrates that the domestication and demystification of monitoring has resulted in citizens playing an active part in the surveillance game while also making them more accepting of an institutional gaze that whistleblowers like NSA contractor Edward Snowden have demonstrated is being used to a greater extent than ever before. At the same time, the vast majority of contemporary films utilise the aesthetics and practices of surveillance primarily for the purpose of spectacle rather than presenting narratives and characters that help to investigate how the new monitoring dynamic is changing the way in which we watch and interact with each other, the media and our popular culture. While recognising the many positive aspects of ‘new’ surveillance this thesis argues that cinema must return to its historical position as a scrutiniser of institutional and domestic-based monitoring and my creative practice is a direct response to the shortcomings of current big screen depictions. The feature screenplay, Function Creep, contemporises the characters and tropes of classic surveillance narratives like Francis Ford Coppola’s The Conversation (1974) and Sydney Pollack’s Three Days of the Condor (1975) while the short film, Groucho, uses satire and stylistic experimentation to investigate counter surveillance by citizens in a domestic setting and the way in which Internet content can reach and engage a global audience.

Higher Education Institutions (HEIs) are knowledge-intensive organisations competing in the context of knowledge and research activities, as well as programmes and services offered. Research is integral to institutional competition to determine their status and standing and it underpins academics' responsibilities in developing intellectual skills and capacity of learners. Whilst universities adopt formalised approaches to developing research activities, there is a growing trend towards informal groupings or communities of practice (CoPs) where like-minded individuals seek to share common interests in particular research areas. These CoPs offer an alternative approach to developing research within HEIs, especially where efforts to improve faculty research have met with mixed success as there are no clear guidelines and relatively little is known about the mechanisms that facilitate research amongst academics. While there have been past research in various sectors on how CoPs benefit organisations, little has been focussed in the HE sector, in particular how it benefits individuals in terms of doing research and this forms the distinctiveness of this research. The aim is to illuminate, explore and gain insights of individuals' perceptions of the value and impact of CoP membership within research communities in HE and the potential impact on subsequent research. The CoP concept and the benefits identified in past research in general sectors serve as the focal framework of this research and other theories i.e. value, perception and HE, are included to support and ground further analysis in the overall study. This research takes the social constructionist standpoint, trying to understand individuals' experience of participating in these research communities, through the interpretive lens. It adopts the qualitative approach using observation and interviews (supplemented by storytelling and critical incident technique) to gather data which are then analysed using the narrative analysis approach paying attention to individuals' experience expressed through their stories and incidents. An analysis of data revealed that individuals found these research communities' membership valuable as it has helped and supported them in terms of doing research and have impacted them personally, professionally, intellectually and socially. Twenty perceived values have been discovered; twelve of which are supported by past organisational research, but mirrored also in HE i.e. autonomy and freedom to think beyond; sources to ideas; sounding board; intellectual discussion; like-mindedness; alternative perspective and cross pollination of ideas; informal ground for learning and training; networking, information sharing and updates; support and guidance; sense of belonging; identity; and intrinsic fulfilment. Although, there are some similarities in these twelve perceived values, they have benefited and impacted on individuals in their own way. The other eight perceived values i.e. overcoming intellectual isolation; move towards collaborative research; response to research pressure; synergy and leverage; time and energy saving; foster tangible returns; drive research; and opportunity to meet, have emerged from doing research in the HE sector and provide new insights not previously discussed. Thus, the contributions of this research are it has drawn on a wide range of literature put together in a unique way; it has extended the CoP concept by applying it to HE for the purpose of doing research; and further understanding on how individuals benefit from their membership, which was never conducted in such a way in past research. Above all, it has offered new insights and raised awareness of the values of research-based CoPs' membership to individuals and this adds to the research literature in CoP as well as the HE context.

Background Evidence-based practice has increasingly been recognized as a priority by professional physiotherapy organizations and influential researchers and clinicians in the field. Numerous studies in the past decade have documented that physiotherapists hold generally favorable attitudes to evidence-based practice and recognize the importance of using research to guide their clinical practice. Research has predominantly investigated barriers to research use. Less is known about the circumstances that actually support use of research by physiotherapists. This study explores the conditions at different system levels that physiotherapists in Sweden perceive to be supportive of their use of research in clinical practice. Methods Patients in Sweden do not need a referral from a physician to consult a physiotherapist and physiotherapists are entitled to choose and perform any assessment and treatment technique they find suitable for each patient. Eleven focus group interviews were conducted with 45 physiotherapists, each lasting between 90 and 110 minutes. An inductive approach was applied, using topics rather than questions to allow the participants to generate their own questions and pursue their own priorities within the framework of the aim. The data were analyzed using qualitative content analysis. Results Analysis of the data yielded nine favorable conditions at three system levels supporting the participant’s use of research in clinical practice: two at the individual level (attitudes and motivation concerning research use; research-related knowledge and skills), four at the workplace level (leadership support; organizational culture; research-related resources; knowledge exchange) and three at the extra-organizational level (evidence-based practice guidelines; external meetings, networks, and conferences; academic research and education). Conclusions Supportive conditions for physiotherapists’ use of research exist at multiple interdependent levels, including the individual, workplace, and extra-organizational levels. Research use in physiotherapy appears to be an interactive and interpretative social process that involves a great deal of interaction with various people, including colleagues and patients.

<p> Social workers are responsible for providing the majority of mental health and substance abuse services in the United States in the role of direct service. Lesbian, gay, and bisexual (LBG) individuals utilize these services at rates that are believed to be higher than other populations. The field of social work embraces social justice as one of its core principles. This cross-sectional survey of 220 BSW and/or MSW social workers investigates two questions: what is the relationship among key aspects of social worker critical consciousness, i.e., attitudes about social justice, change agency, and awareness of heterosexism; and in what ways does critical consciousness influence practice (promising practices) with LGB clients in behavioral health programs. Findings suggest that social workers who have greater critical consciousness have greater self-reported skills and knowledge scores and engage in more LGB promising practices. Specifically, respondents with more consciousness as evidenced by awareness of heterosexism, positive attitudes towards LGB persons, and greater engagement in social justice activity in their personal and professional lives, including their encouragement of client engagement in social justice activity, have higher skills and knowledge scores and utilize more LGB promising practices. Implications for social work practice and education are discussed and areas for future research are presented.</p>

The first part of the thesis outlines and discusses governmental policy and strategy relating to work-based learning (WBL) programmes in Higher Education (HE) in England. It draws on key policy documents, the literature on WBL, and interviews with government policy advisors. The thesis then turns to a case-study based overview of the operation of such programmes at postgraduate level in three universities, and. academics, students and employer representatives experiences of, and attitudes towards, su~h programmes. A number of positive aspects were identified, including flexibility, student career developmen\ and' student's enhanced influence over the learning process and content. On the other hand, there were also instances of a disjuncture between government policy and practice, a lack of awareness and interest in such programmes, resistance, and implementation constraints. The conclusions examine the policy issues and implications of the research for the development of WBL within British higher education.

Through the evolution of digital media technology, social networks and more recently Web 3.0 (e.g. Cloud-based) technologies, culture and memory is being transformed, both in relation to how memories are represented, and how they may be engaged with or re-accessed. As digital technology alters ways in which knowledge is produced, stored, connected and shared, new terrains, tools and artefacts are formed; new cultural practices alter the ways in which we remember and the ways in which memory is processed, destabilising traditional “historically encoded social habits: religion, authority, morality, traditional values, or political ideology” (Diamantaki 2013). This doctoral project consists of two parts exploring questions of memory in contemporary time. The practice work submitted develops various imaginaries and investigates how to enable mnemonic practices so that works function as memory palaces where bodies and ‘collective' and ‘networked memories' (Hoskins, 2010) can be realised. The work, briefly summarised, includes communal activities in public spaces (a series of workshops and heritage day events, Rendezvous, centrally social activities organised between Fabrica and various charitable organisations in Brighton). It includes a series of installation works, as a transitional process of memory between body, object, an investigation of ubiquitous technology, are investigated – iremembr (2009-15); Rendezvous (2010-15); Untitled#21 (2012). And it leads to the development of an installation piece, 200.104.200.2 (2013-15), that seeks to offer or extend the possibilities of the act of remembering, of memory, as a post-Internet experience; a complex temporal, social, spatial and material, overlapping and merging human and silicon memory. In this, the written component of the combined and larger project, questions concerning memory and digital technology, and how to explore them, are taken up in theoretical terms, and the works I have produced returned to and explored in these contexts. A central project here has been to locate new forms of qualities of ‘digital' memory in a memory map or topology that builds on adapts, and develops other models. Aspects of zones of memory are explored centrally in each of the later thesis chapters each of which also takes up a particular aspect of my practice. The intention – and the contribution to the development of critical thinking around the digital – particularly critical thinking that comes through digital media art practice, is to question how digital technology intervenes in the process of memory; how the concept of digital memory is being thought about; leading me to investigate what does this new digital terrain do as it overlaps and re-writes to some extent the older ones? How does it change ‘how memory happens'.

The mining industry is a major contributor to the Australian economy. The value of mining and exploration shares traded on the Australian Stock Exchange are contingent on the estimates of mineral deposits, which are disclosed publically in accordance with a reporting code maintained by the Australasian Joint Ore Reserves Committee (the JORC Code). Expert resource geologists, known as Competent Persons, provide classified estimates of mineral endowment that underpin these public statements. The JORC Code requirements for qualifying as Competent Persons are membership of an approved professional association and a minimum of five years’ relevant experience. This research set out to address a primarily practical issue: How do the mining industry, mining companies and individuals cooperate to develop resource geologists with sufficient competency to provide expert recommendations for public reporting of mineral resources? A corollary to this is ‘Are the current standards sufficient to identify the competency expectations placed on Competent Persons?’ It is challenging to place the subsequent research in any one discipline as the study draws on multiple theories across multiple domains to facilitate a relevant description of the practicebased competency development. To properly understand the the practice of resource geologists operating in a sub-sector within the JORC Code system, the research needed to explore and consolidate diverse theories such as theories on social structures, workplace learning theories and statistical reasoning education theories. In addition, as a mixed methods study, the research draws on a wide range of tools from qualitative iterative coding and theming techniques to the more rigorous statistical tools of t-tests, paired t-tests, ANOVA and the philosophically different Rasch Analysis method. This study reflects a broad curiosity in diverse concepts and theories that is combined with the researcher’s desire to provide a meaningful practical contribution to the mining industry. The practical outcome of this research is a revised set of criteria to meet Competent Persons status under the JORC Code that is supported by a competency development model. These models are generalised to reflect a revised competency model, based on the dual expectations of practice exposure and reasoning ability, and an associated competency development model, which synthesises contributions of workplace learning experiences. The contributions to the theory include a revised theory of workplace learning networks emerging from the practice context of transient professional workers. These networks are enduring, transient and egocentric and operate beyond organisational confines.

Evidence-based practice is an integral part of multi-disciplinary healthcare, but its routine clinical implementation remains a challenge internationally. Written asthma action plans are an example of sub-optimal evidence-based practice because, despite being recommended, these plans are under-issued by health professionals and under-used by patients/carers. This thesis is a critical analysis of the generation and implementation of evidence in this area and provides fresh insight into this specific theory/practice gap. This submission brings together, in five published papers, a body of work conducted by the candidate. Findings report that known barriers to action plan use (such as a lack of practitioner time) are symptomatic of deeper and more complex underlying factors. In particular, over-reliance on knowledge derived from randomised controlled trials and their systematic review, as the primary and sole source of evidence for healthcare practice, hindered the implementation of these plans. A lack of evidence reflecting the personal experience of using these plans in the real world, rather than in trial settings, contributed to a mismatch between what patients/carers want from asthma action plans and what they are currently being provided with by professionals. This submission illustrates the benefits of utilising a broader range of knowledge as a basis for clinical practice. The presented papers report how new and innovative research methodologies (including meta-ethnography and cross-study synthesis) can be used to synthesise individual studies reporting the personal experiences of patients and professionals and how such findings can then be used to better understand why interventions can be implemented in trial settings rather than everyday practice. Whilst these emerging approaches have great potential to contribute to evidence-based practice by, for example, strengthening the ‘weight’ of experiential knowledge, there are methodological challenges which, whilst acknowledged, have yet to be fully addressed.

Thesis (Ph. D.)--University of Sydney, 2008.<br>Title from title screen (viewed 11 February 2009). Includes tables and questionnaires. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliographical references. Also available in print form.

Both scholars and practitioners extensively acknowledge the importance of innovation in an economic environment that is characterized by rapid technological changes, compression of product and process life cycles, a surge in competition and the succession of economic booms and busts. Recent development of the innovation literature clearly indicates that there are many tensions, paradoxes and dilemmas associated with innovation activities. The studies published on the theme also demonstrate that understanding, managing and resolving these tensions are key points for realizing successful innovation and ensuring firms’ survival. How tensions get reconciled is therefore attracting increasing interest in the research community which has introduced the concept of ambidexterity to describe the capability of firms to achieve and manage conflicting activities by realizing high levels of both in a simultaneous way. Although ambidexterity is a relatively young theme, today it has become a central concept in management research, receiving contributions from various literature research streams. The recent expansion of the theme, with many papers published in the last two years, has produced a great number of contributions which call for a synthesis of recent results and development. This dissertation thus opens with a systematic review of existing studies on ambidexterity by using also “bibliometric analysis” techniques. This analysis allowed us to map and summarize the results achieved on the issue and to highlight some important methodological and theoretical gaps: we would like to address some of them in this dissertation. The literature analysis showed first that most existing empirical studies have focused on the one hand on demonstrating the positive effects of ambidexterity and on the other on identifying the enabling factors of such a capability. How firms can develop, nurture and sustain ambidexterity capability, however, still remains a major point of discussion and the need for additional conceptual and empirical investigations about this issue persists. Second, existing studies on ambidexterity, have identified three main solutions for resolving tensions: the structural separation of units for dealing with tensions (structural solution), the creation of a context where employees are encouraged to perform contradictory tasks at the same time (contextual solution) and the critical role played by managers in sustaining and guiding ambidexterity. The literature review however outlines that researchers have mainly focused attention on one single solution while there are no works that consider the possibility that these solutions are complementary and can coexist in the same organization. Finally, organizations are recognized as being in continuous interaction with their competitive environment, and they co-evolve with it by reconfiguring their activities and design to meet environmental changes. It therefore appears unlikely that one single design would provide the exhaustive functionality required to deal with the entire range of boundary conditions and new tensions that an organization faces over time. However, there are no studies that take a temporally sensitive perspective, capturing ambidexterity's co-evolution with the organization’s environment. Based on these considerations, the need for further studies aimed at analyzing how companies can achieve ambidexterity and how ambidexterity co-evolves with the competitive environment clearly emerges. To better reveal the complexity of the phenomenon, the use of a more fine-grained unit of analysis is strongly recommended: using a granular level of analysis (as opposed to what has been done in empirical studies which adopt the firm or the business unit as the level of analysis) makes it possible to really answer the "how" question of such a complex phenomenon. Shifting the focus from the organization level to a more fine-grained level – such as a single organizational process, project or phase - can also open up interesting areas of research by allowing a more detailed picture to be depicted of the dynamics and mechanisms that lie at the basis of the development of ambidexterity capability. However, studies that examine ambidexterity at a micro level are relatively scarce. Following these suggestions, we therefore decided to analyse ambidexterity capability in the “search phase” of the innovation process (early phase). This phase is in fact characterized by the tension between searching for knowledge that deepens and improves firms’ existing core knowledge (Local Search) and simultaneously searching for completely new and unfamiliar knowledge that expands the existing knowledge base of the firm (Distant Search). How firms can deal with this tension, and therefore succeed in building ambidexterity capability in the search phase, is therefore the focus of this dissertation. Consistent with the definition of capabilities as “constituted in the everyday practices”, we have additionally decided to focus the attention on the analysis of the practices through which firms search for knowledge. Adopting a practices-based perspective represents in fact a worthwhile tool that allows us to obtain a closer understanding of complex and multifaceted phenomena such as ambidexterity capability. Therefore our research questions are: 1. Are there any differences, in terms of search practices, between firms that show ambidexterity capability in the search phase of the innovation process and firms that do not show such a capability? What are these differences? 2. How can firms succeed in realizing ambidexterity capability in the search phase? 3. How does the achievement of ambidexterity capability change while co-evolving with the external environment? In order to answer these research questions we followed a combined research approach. Given the different forms of the research questions (the first research question is a “What” form of question, while research questions two and three are a “How” form of question), two different methodologies are in fact used. The research approach of this dissertation can thus be broadly divided into two parts: a first part which aims to answer the first research question through a survey methodology where search practices (practices used to carry out the search for knowledge) are treated as a “black-box” and a second part that answers research questions two and three by adopting a case study methodology where the internal structure of search practices is examined. To answer the first question we created a questionnaire designed to investigate the use of a set of practices for searching for knowledge with a double purpose: to generate knowledge in order to improve the knowledge base already present in the firm - "Local search "- or create completely new knowledge and expand the existing knowledge base of the company - "Distant search". The questionnaire also includes scales designed to measure the ambidexterity capability during the search phase. The questionnaire, which has been sent to a sample of Italian medium-high tech companies, allowed us to obtain a picture of the use of different practices for the generation of both local and distant knowledge. Through an exploratory factor analysis we have additionally identified reliable, valid and one-dimensional measures of search, linked to its two dimensions: "local search" and "distant search". The analysis conducted on the data, cluster analysis and comparison of clusters have also allowed us to verify that indeed there are differences between ambidextrous and non-ambidextrous firms in the search phase, and to identify the distinctive characteristics of those firms that have developed this capability, thus answering the first research question. To answer the second and third research questions we have instead adopted a qualitative methodological approach. The qualitative research has involved one high-tech Italian firm, with the purpose of delving into how tensions that arise during the search phase of innovation process are managed and resolved. The case study has been conducted by adopting a longitudinal approach, through numerous interviews aimed at grasping the changes that have affected the search activities and the consequent achievement of ambidexterity. The case study has contributed to the literature on ambidexterity capability in two main ways. On the one hand it has enabled us to identify a potential three-phased process followed by the firm in achieving ambidexterity. On the other, the case study has clearly shown that there is no one single ambidextrous configuration that makes it possible to support all the environmental conditions that the organization must deal with over time. In other words, the organizational solution adopted to achieve ambidexterity changes over time, also depending on some features of the external environment.<br>Studiosi e managers ampiamente riconoscono l'importanza dell'innovazione per sopravvivere e competere in un ambiente competitivo sempre più turbolento e caratterizzato da rapidi cambiamenti tecnologici, da un aumento della concorrenza, dal susseguirsi di eventi improvvisi e spesso imprevedibili. Gli sviluppi più recenti della letteratura sull’innovazione indicano chiaramente che l’attività innovativa è caratterizzata da una serie di tensioni, paradossi e dilemmi: gli studi pubblicati sull’argomento dimostrano come la comprensione, gestione e risoluzione di tali tensioni rappresentino punti chiave per realizzare innovazioni di successo e per garantire la sopravvivenza delle imprese nel lungo termine, in particolare delle imprese appartenenti a settori high-tech. Di conseguenza, nell’ultimo decennio, il tema della risoluzione delle tensioni sta destando sempre più interesse nella comunità scientifica, la quale ha introdotto il concetto di ambidexterity per descrivere la capacità delle imprese di gestire attività contrastanti realizzando alti livelli di entrambe in modo simultaneo. Oggi l’ambidexterity rappresenta dunque uno dei temi centrali negli studi di Management, il quale sta registrando una crescita esponenziale di contributi sia empirici che teorici provenienti da diversi filoni di ricerca quali ad esempio l’“organization design”, l’“organizational learning”, l’“innovation management”, lo “strategic management”. Ne consegue che il dibattito sul tema, inizialmente focalizzato, sta diventando oggi sempre più complesso e sconnesso. Il presente lavoro si apre quindi con una revisione sistematica degli studi realizzati sul tema dell’ambidexterity, avvalendosi anche di tecniche di analisi bibliometrica. Questa analisi ha permesso di mappare e sintetizzare i risultati raggiunti sul tema e di evidenziare alcuni importanti gap sia di natura teorica che di natura metodologica. In primo luogo emerge che gran parte degli studi esistenti, i quali utilizzano principalmente approcci quantitativi, si sono concentrati da un lato a dimostrare gli effetti positivi dell’ambidexterity e dall'altro a identificare i fattori che permettono di realizzare tale capacità. Come le aziende possono sviluppare, coltivare e sostenere capacità ambidestre rimane tuttavia una questione non ancora ben analizzata. In secondo luogo, gli studi esistenti presentano tre principali soluzioni per la risoluzione delle tensioni: la creazione di unità dedicate fisicamente separate (soluzione strutturale), la creazione di un contesto nel quale i dipendenti sono incoraggiati a perseguire contemporaneamente obiettivi contrastanti (soluzione contestuale) ed infine il ruolo critico dei managers nel sostenere e guidare l’ambidexterity. La revisione della letterature fa tuttavia emergere che gli studiosi tendono a focalizzare l’attenzione principalmente su una soltanto di queste soluzioni, mentre mancano studi che considerano la possibilità che le diverse soluzioni siano complementari e possano coesistere all’interno della stessa organizzazione. Infine, è ampiamente riconosciuto che le organizzazioni interagiscono continuamente con un ambiente competitivo in evoluzione, cui devono essere in grado di adattarsi per sopravvivere in un’ottica di co-evolution. Appare dunque improbabile che una singola configurazione organizzativa riesca a soddisfare un ambiente competitivo che cambia e le conseguenti nuove tensioni che l’organizzazione deve affrontare. Gli studi esistenti adottano tuttavia una visione statica nell’analizzare l’ambidexterity; mancano studi che utilizzino una prospettiva longitudinale, in grado di affrontare questo problema, di analizzare cioè come l’ambidexterity evolve, in modo dinamico, con l'ambiente esterno. Sulla base di queste considerazioni è emersa la necessità di ulteriori studi rivolti ad analizzare da un lato come le imprese riescono a realizzare l’ambidexterity e dall’altro come l’ambidexterity co-evolve con l'ambiente competitivo. Per rivelare la complessità del fenomeno si è deciso di utilizzare un livello di analisi più “granulare”. Diversamente da quanto fatto negli studi empirici esistenti, che adottano l'impresa o la business unit come unità di analisi, utilizzare un livello di analisi più circoscritto - un unico processo organizzativo, progetto o fase (per esempio la fase di search del processo innovativo) – permette infatti di studiare con maggior accuratezza come un fenomeno così complesso viene generato ed evolve nel tempo. Spostare il focus da un livello macro a livelli sempre più micro può inoltre aprire interessanti aree di ricerca, permettendo di delineare un’immagine dettagliata delle dinamiche e dei meccanismi che si trovano alla base dell’ambidexterity capability. Sulla base di queste considerazioni abbiamo pertanto deciso di studiare l’ambidexterity nella fase di “search” del processo innovativo (definita anche early phase). Questa fase infatti è caratterizzata dalla tensione tra la ricerca di conoscenza che approfondisce e migliora la base di conoscenza esistente in azienda (Local Search) e la simultanea ricerca di conoscenza completamente nuova e lontana dalla base di conoscenze esistente in azienda (Distant Search). Come le imprese possono affrontare e gestire questa tensione, e quindi costruire l’ambidexterity capability nella fase di search, è il focus di questa tesi. Coerentemente con la definizione di capability che vengono designate come il risultato di “everyday practices”, abbiamo inoltre deciso di focalizzare l’analisi sulle pratiche messe in atto dalle imprese per ricercare conoscenza. Adottare una prospettiva “practices-based” rappresenta infatti un approccio valido per conseguire una migliore comprensione di fenomeni complessi e multiformi come l’ambidexterity. Le domande fondamentali alla base di questa ricerca sono pertanto: 1. Esistono differenze, in termini di pratiche per il search, tra le imprese che hanno sviluppato capacità ambidestre nella fase di search ed imprese che non presentano tale capacità? Quali sono queste differenze? 2. Come possono le imprese realizzare l’ambidexterity nelle prime fasi del processo innovativo? 3. Come cambiano le soluzioni organizzative adottate dalle imprese per il raggiungimento dell’ambidexterity, co-evolvendo con l’ambiente competitivo? Al fine di rispondere alle domande di ricerca sono stati utilizzati due diversi approcci: un primo approccio considera le pratiche per il search come una “black-box” per rispondere alla prima domanda di ricerca, mentre il secondo analizza le diverse dimensioni che costituiscono la struttura interna delle pratiche, per rispondere alla seconda ed alla terza domanda di ricerca. Ai due approcci corrispondono due diverse metodologie di ricerca: studio quantitativo per l’approccio “black-box” e studio qualitativo per l’altro approccio. Per rispondere alla prima domanda di ricerca è stato creato un questionario volto ad indagare l’utilizzo di un insieme di pratiche per il search con riferimento al duplice obiettivo che queste possono avere: generare conoscenza volta a migliorare la base di conoscenze già presente in azienda - “local search” - oppure generare conoscenza completamente nuova ed in grado di ampliare la base di conoscenze esistenti in azienda – “distant search”. Il questionario comprende inoltre delle scale volte a misurare l’ambidexterity capability nella fase di search. Tale questionario, che è stato inviato ad un campione significativo di imprese italiane appartenenti a settori medium-high tech, ha dapprima permesso di ottenere un quadro sull’utilizzo delle diverse pratiche per la generazione di conoscenza. Tramite un’analisi fattoriale di tipo esplorativo, sono state inoltre identificate le dimensioni che descrivono il “local search” e “distant search”; tali dimensioni rispondono ai requisiti di attendibilità, validità e unidimensionalità. Le analisi condotte (cluster analisi e confronto dei clusters) hanno inoltre permesso di verificare che effettivamente esistono delle differenze tra imprese ambidestre e non ambidestre nel search e di identificare le caratteristiche distintive delle imprese che hanno sviluppato tale capacità, rispondendo pertanto alla prima domanda di ricerca. Per rispondere alla seconda e alla terza domanda di ricerca è stato invece adottato un approccio metodologico di tipo qualitativo. L’indagine qualitativa ha coinvolto nello specifico una impresa high-tech italiana, con la finalità di indagare in profondità come essa è riuscita a gestire le tensioni che emergono nella fase di search del processo innovativo e, di conseguenza, a realizzare l’ambidexterity. Il caso è stato condotto secondo un’ottica longitudinale, con numerose interviste al top management finalizzate a cogliere i cambiamenti che hanno interessato le attività di search e le conseguenti soluzioni organizzative adottate per la realizzazione dell’ambidexterity. Lo studio di caso contribuisce alla letteratura sull’ambidexterity capability in due modi principali. Da un lato permette di delineare il processo tramite cui l’impresa riesce a realizzare l’ambidexterity colmando uno dei gap evidenziati dall’analisi della letteratura. Dall’altro lato il caso studio chiaramente mostra come non esista un’ unica configurazione ambidestra che renda possibile sostenere tutte le condizioni ambientali che l'organizzazione deve affrontare nel corso del tempo. In altre parole, la soluzione organizzativa adottata per realizzare l’ambidexterity cambia nel corso del tempo, a seconda delle caratteristiche dell'ambiente esterno.

While literature in areas of constructivism learning theory, use of computer technology in education, and the implementation of project-based learning in the classroom have received widespread attention, there is no reported research that specifically examines the effectiveness of using a project-based learning model for computer technology instruction for pre-service teachers' programs in general, and in art education in particular. Thus, the research problem was to examine through pre- and post-test control-group experimental research design whether two different teaching methods, constructivism teaching approach (project-based learning) and traditional (step-by-step) teaching approach, result in significant differences in learning computer usage, the application of computer technical skills, design projects, and attitudes toward using of technology. The research was conducted at University of North Texas during the fall semester of 2004. Both quantitative and qualitative methods were used to collect the data. The quantitative data, collected from a pre-post test and pre and post questionnaire, was analyzed using a t-test. No significant difference was found between the groups as it relates to computer usage, one aspect of the application of computer technical skills (Photoshop usage), and attitudes towards technology. There was, however, a statistical difference between the groups in the use of the other aspect of computer application technical skills (Illustrator). The qualitative data was collected from three sources, the final design project, the focus group interview, and the reflective papers and summarized quantitatively. A rubric was used to assess the final design project and the scores from the rubric were analyzed using the Mann-Whitney U test. A significant difference was found between the groups as it relates to the assessment of the final project design. The constructivist (project-based learning) group scored higher than the traditional (step-by-step) group. The analysis of the focus group interviews revealed more positive responses for the project-based learning group as opposes to the step-by-step group. The analysis of the reflective papers also revealed more positive responses by the project-based learning group as oppose to the step-by-step group. Overall, the results of the study indicate that the constructivist approach project-based learning did improve student learning.

This study focuses on three albums of original music performed and recorded by the author as the leader of the Haftor Medbøe Group and released variously by Linn Records and Fabrikant Records between 2006 and 2010. Through the prisms of historiography, community and boundary, cultural migration, and collaboration, the thesis explores creative identity and practice as formatively and summatively applied in the realisation of the published works. The thesis employs personal reflection on the composition and performance of the published works to present an account of evolving engagement with current and historical thinking on narrative, trope and identity in jazz music and its communities. The discussion will challenge accepted constructions of linear, canonical history in jazz, offering instead a pluralist understanding of its stylistic and aesthetic development over the past century. The assumptive and selective modalities through which jazz histories and practices are collectively constructed will be viewed in parallel with the author's retrospective understanding of personal creative history and cumulative identity. The imagining of global, national and local communities of jazz production and reception will be examined in relation to their influence on the cultural positioning of the author as a jazz composer and performer. In looking beyond historical perceptions of jazz as an instrument of American cultural diplomacy and dominance, it will be shown that the European adoption of the musical language of jazz has, using the example of Nordic Tone, given rise to discrete reinterpretations and divergences from the genre's ethnic roots. The role of national identity in non-American conceptions of jazz is consequently examined in the context of the author's experience of creative and collaborative practice through the published works. It will be argued that in spite of being culturally rooted in early 20th Century America, jazz has become a ‘glocally'-informed music, with locally and individually framed values of genre authenticity and guardianship extant alongside traditionalist claims to heritable lineage. Through considering and reflecting on cultural and national identities and communities, the thesis will demonstrate that musical practice and collaboration are informed and affected by complex conscious and subconscious relationships with these themes, that are ultimately synthesised in the published works.

Aim: This paper is a report on a study that explored the professional development of intensive care unit nurses in journal clubs. Background: Evidence-based practice is important in nursing care (Krom, Batten, & Bautista, 2010). However few nurses feel comfortable using evidence to guide their practice (Pravikoff, Tanner, & Pierce, 2005). Journal clubs are a way to establish science as conversation (Wright, 2004) and foster knowledge translation for evidence-based nursing practice (Goodfellow, 2004). Methods: Monthly journal club meetings were held with the participation of a total of 71 healthcare professionals (65 nurses, 2 physicians, 2 pharmacists, 1 physiotherapist, and 1 respiratory therapist), who worked in two intensive care units of an Ontario hospital. After six months of meetings, 21 individual interviews were conducted with nurses, physicians, pharmacists, and nurse educators. Additional data collection included two focus groups, surveys, a review of staff meeting minutes, and researcher field notes. Findings: Journal clubs provided nurses with incentive to read research articles, improved nurses’ confidence in reading research, created a community of peers who worked collaboratively to improve clinical practice, provided a structure for nurses to reflect-on-practice, and led to reported changes in clinical practice. However, the data suggests that any gains in competence of nurses with the critical appraisal of research articles were probably modest. Barriers to participating in journal clubs and evidence-based practice are also identified. Conclusion: Journal clubs can foster knowledge translation and evidence-based practice through creating a community of practice and by providing nurses with motivation, structure, and confidence to read research articles. However, nurses reported a lack of critical appraisal skills and uncertainty about how to implement evidence into practice. Journal clubs may have a greater impact when implemented alongside other knowledge translation strategies such as working with clinical nurse specialists in order to enhance evidence-based practice.

Chamber music originated in the intimate setting of a small room, or chamber, but has in recent times found a large and appreciative audience at performances in mainstream concert halls. In parallel, many artists and promoters are recreating the intimate concert experience in small venues, many of which are community venues away from the mainstream venue circuit. Australia’s Artico Ensemble is a quartet of professional musicians specialising in creating chamber music performances in small community venues such as churches, museums, and private homes in and around Brisbane, Queensland. Their experiences form the basis of this Doctoral research study, in which a mixed-method ethnographic case study of Artico Ensemble investigates the experience of engaging in this type of performance from the viewpoint of the three partners involved: the artists, the audience and the venue administrators. In this dissertation, the four ensemble members provide the artists’ story, and results of an audience survey create a demographical profile of Artico Ensemble’s audience members, an analysis of their listening and concert attending habits and an exploration of their experience of attending the specific case study concert. Personal interviews with venue administrators highlight their experience of and motives for undertaking management of these events. Generated by the study’s second line of enquiry, this dissertation also presents findings regarding the strengths and challenges of this type of music making for all involved. To clarify its context, comparisons are drawn with International and Australian literature investigating arts participation, audience and community engagement, and the chamber music experience. As a member of Artico Ensemble, my position as artist and researcher will provide the lived-in experience of self-reflective and practice-led artistic research. This doctoral study crosses over into practice-based research through the inclusion of two short documentary trailers, which have served to generate data as well as highlight study findings.<br>Thesis (Professional Doctorate)<br>Doctor of Musical Arts (DMA)<br>Queensland Conservatorium<br>Arts, Education and Law<br>Full Text

Background: Mentoring is an intervention for implementing evidence into practice, but little is known about this intervention. The overall aim of this dissertation was to examine mentoring as a knowledge translation (KT) intervention to inform clinical practice. Methods: 1) A systematic review was used to determine the effectiveness of mentoring as a KT intervention. 2) An interpretive descriptive qualitative study was conducted to explore the use of mentoring in the Registered Nurses' Association of Ontario’s Best Practice Guidelines Implementation/ Knowledge Transfer Fellowship program. Findings: 1) Of 10,669 citations from 1988 to 2012, 10 studies were eligible. Findings showed that mentoring alone (n = 1 study) improved one behavioral outcome. When mentoring was used as part of a multi-faceted intervention (n = 9), there were various effects on knowledge, beliefs/attitudes, use of research evidence in clinical practice, and the impacts on healthcare professionals, patients and organizations. 2) Qualitative interviews with 6 fellows, 8 mentors and 4 program leaders revealed that mentoring involved building relationships, establishing a learning plan, and using teaching and learning activities. Mentors were described as accessible, dedicated, and having expertise; fellows were described as dedicated, self-directed, and having mixed levels of expertise. Mentoring was described as positively impacting upon mentoring relationships, fellows, mentors, and organizations. Participants reported no negative outcomes. Conclusion: Mentoring was used as a KT intervention to support the implementation of evidence into clinical practice. The systematic review and qualitative study findings informed the Mentoring for Guideline Implementation model. Mentoring involved mentees selecting more experienced mentors who provided individualized support based on mentees’ learning needs, which resulted in mutual benefits for mentees and mentors. Future research is required to validate this new mentoring model, develop an instrument to measure the mentor-mentee relationship, and evaluate the effectiveness of mentoring as a KT intervention for guideline implementation in nursing.

Other information: The cardiac catheterisation laboratory (CCL) is a specialised medical radiology facility where both chronic-stable and life-threatening cardiovascular illness is evaluated and treated. Although there are many potential sources of discomfort and distress associated with procedures performed in the CCL, a general anaesthetic is not usually required. For this reason, an anaesthetist is not routinely assigned to the CCL. Instead, to manage pain, discomfort and anxiety during the procedure, nurses administer a combination of sedative and analgesic medications according to direction from the cardiologist performing the procedure. This practice is referred to as nurse-administered procedural sedation and analgesia (PSA). While anecdotal evidence suggested that nurse-administered PSA was commonly used in the CCL, it was clear from the limited information available that current nurse-led PSA administration and monitoring practices varied and that there was contention around some aspects of practice including the type of medications that were suitable to be used and the depth of sedation that could be safely induced without an anaesthetist present. The overall aim of the program of research presented in this thesis was to establish an evidence base for nurse-led sedation practices in the CCL context. A sequential mixed methods design was used over three phases. The objective of the first phase was to appraise the existing evidence for nurse-administered PSA in the CCL. Two studies were conducted. The first study was an integrative review of empirical research studies and clinical practice guidelines focused on nurse-administered PSA in the CCL as well as in other similar procedural settings. This was the first review to systematically appraise the available evidence supporting the use of nurse-administered PSA in the CCL. A major finding was that, overall, nurse-administered PSA in the CCL was generally deemed to be safe.;However, it was concluded from the analysis of the studies and the guidelines that were included in the review, that the management of sedation in the CCL was impacted by a variety of contextual factors including local hospital policy, workforce constraints and cardiologists' preferences for the type of sedation used. The second study in the first phase was conducted to identify a sedation scale that could be used to monitor level of sedation during nurse-administered PSA in the CCL. It involved a structured literature review and psychometric analysis of scale properties. However, only one scale was found that was developed specifically for the CCL, which had not undergone psychometric testing. Several weaknesses were identified in its item structure. Other sedation scales that were identified were developed for the ICU. Although these scales have demonstrated validity and reliability in the ICU, weaknesses in their item structure precluded their use in the CCL. As findings indicated that no existing sedation scale should be applied to practice in the CCL, recommendations for the development and psychometric testing of a new sedation scale were developed. The objective of the second phase of the program of research was to explore current practice. Three studies were conducted in this phase using both quantitative and qualitative research methods. The first was a qualitative explorative study of nurses' perceptions of the issues and challenges associated with nurse-administered PSA in the CCL. Major themes emerged from analysis of the qualitative data regarding the lack of access to anaesthetists, the limitations of sedative medications, the barriers to effective patient monitoring and the impact that the increasing complexity of procedures has on patients' sedation requirements. The second study in Phase Two was a cross-sectional survey of nurse-administered PSA practice in Australian and New Zealand CCLs.;This was the first study to quantify the frequency that nurse-administered PSA was used in the CCL setting and to characterise associated nursing practices. It was found that nearly all CCLs utilise nurse-administered PSA (94%). Of note, by characterising nurse-administered PSA in Australian and New Zealand CCLs, several strategies to improve practice, such as setting up protocols for patient monitoring and establishing comprehensive PSA education for CCL nurses, were identified. The third study in Phase Two was a matched case-control study of risk factors for impaired respiratory function during nurse-administered PSA in the CCL setting. Patients with acute illness were found to be nearly twice as likely to experience impaired respiratory function during nurse-administered PSA (OR=1.78; 95%CI=1.19-2.67; p=0.005). These significant findings can now be used to inform prospective studies investigating the effectiveness of interventions for impaired respiratory function during nurse-administered PSA in the CCL. The objective of the third and final phase of the program of research was to develop recommendations for practice. To achieve this objective, a synthesis of findings from the previous phases of the program of research informed a modified Delphi study, which was conducted to develop a set of clinical practice guidelines for nurse-administered PSA in the CCL. The clinical practice guidelines that were developed set current best practice standards for pre-procedural patient assessment and risk screening practices as well as the intra and post-procedural patient monitoring practices that nurses who administer PSA in the CCL should undertake in order to deliver safe, evidence based and consistent care to the many patients who undergo procedures in this setting.;In summary, the mixed methods approach that was used clearly enabled the research objectives to be comprehensively addressed in an informed sequential manner, and, as a consequence, this thesis has generated a substantial amount of new knowledge to inform and support nurse-led sedation practice in the CCL context. However, a limitation of the research to note is that the comprehensive appraisal of the evidence conducted, combined with the guideline development process, highlighted that there were numerous deficiencies in the evidence base. As such, rather than being based on high-level evidence, many of the recommendations for practice were produced by consensus. For this reason, further research is required in order to ascertain which specific practices result in the most optimal patient and health service outcomes. Therefore, along with necessary guideline implementation and evaluation projects, post-doctoral research is planned to follow up on the research gaps identified, which are planned to form part of a continuing program of research in this field.