Bibliography: leaves 116-129.

This study draws on multiple modes of expression in texts that have been generated by my experience of midwifery development since I moved from England to Australia in early 1997. The Professional Doctorate in Midwifery at the University of Technology, Sydney (UTS) has enabled me to produce and study my work as a midwifery practitioner, researcher, educator, writer and activist and to engage in a process of scholarship that both informs and is generated by practice. This has allowed me to analyse the complex issues that I, and other midwives in Australia, face as we strategise to narrow the gap between our ideals and the realities of the professional and political constraints that challenge midwifery. The study analyses the rhetorical communications I have employed as both carriers of 'vision' and 'means of persuasion' and the deliberate strategies to make changes that I believe will benefit childbearing women. My portfolio challenges me and others, to explore how we are able to identify, enact, and convince others of the emancipatory potential of midwifery. Rhetorical innovations are therefore linked to the exposition of woman centred midwifery care; an overall goal being to enable situations in which women can experience the potential power that transforms lives, through their experiences of childbirth. In the process, I aim to produce new knowledge that will equip midwives to understand practice, policy and political situations and see new possibilities for responding and taking action. I have analysed and explained my work using a framework appropriated from rhetorical theory and drawing on a range of feminist perspectives. This involves identifying and critiquing the rhetorical innovations that I have used when trying to create possibilities and persuade others of the value of midwifery and the need to make changes happen in practice, education and regulation. My study analyses the rhetorical nature of my own work as presented in my portfolio in a range of carefully selected texts that I have authored during my candidature. These include journal and newsletter articles, conference papers, research activities, policy submissions, education and training materials, the development of midwifery standards, formal and informal communications, and other documents, all aimed in one way or another at the rhetorical strategy of stimulating interest and action. The portfolio texts that arise from this work form the empirical data that is studied. However, in varying ways these texts elicit understandings about the rhetoric and reality of Australian midwifery and the deliberate strategies that are employed by midwives to make changes that will benefit childbearing women. They therefore stand in their own right as contributions to the thesis with their own discursive and epistemological intent. The reflexive process employed in this thesis highlights comparisons between what is being positioned as the potential of midwifery with what is also presented as the reality played out in contemporary Australian maternity service provision and in midwifery education and regulation. The thesis weaves its way around the portfolio documents, attempting to bring to life and discuss the culture in which rhetorical innovations and intentional strategies are aimed at narrowing the gap between 'rhetoric and reality'.

Adulthood holds a paradoxical position in sociology. It is a central category in so far as it provides the unarticulated background to a majority of social inquiries, but it is largely defined by default, as the taken-for-granted status of the social actor, and the middle stage of life. The meaning of adulthood is only rarely addressed directly. This thesis explores a way to fill this lacuna in sociology. An emerging lag between the prevalent normative ideals of adulthood and contemporary social trends is identified as the core of the 'prolonged adolescence thesis' - a dominant view in the social sciences and everyday discourse, which holds that many twenty and thirtysomethings are deferring or rejecting adulthood. My thesis argues that this approach is informed by a model of adulthood that is losing its empirical validity. I further argue that the practices of these young people are congruent with salient features of current social conditions. Drawing on theories of social recognition and the analysis of interview material, I hold that even though the form social recognition takes is subject to pluralisation, recognition of individuals' full membership in society is the meaningful constant of adulthood. I also propose that the redefinition of contemporary adulthood is marked by an intersubjectively constituted 'recognition deficit': commentators and social scientists often misunderstand young adults' practices, notwithstanding the structural rewards which these practices reap. At the same time, young adults themselves eschew the conventional markers of adult status. In so doing they forge their own, radically different, adulthood. Underpinned by an ideology of youthfulness, and subject to the fluid social relations of contemporary modernity, this adulthood eludes fixity. Its normative criteria flow from the everyday practices of individuals who, far from prolonging their adolescence, are the new adults of today.

This thesis examines some of the antecedents and consequences of career decision status (i.e., being decided about and comfortable with career decisions). Antecedents investigated included: age, university level, work experience (quality and quantity), and accuracy of self-ratings. Work outcomes (as measured by job satisfaction, organisational commitment and performance) were the consequences of career decision status explored in this thesis. When the antecedents of age, university level and quantity of work experience were reviewed cross-sectionally all contributed to career decision status. It was concluded that age best predicted decidedness suggesting that the development of career decision status is part of a maturation process. Volume measured by the number of hours worked rather than pattern of work (i.e., full-time vs. part-time vs. casual) determined variability in scores on the career measures. Breadth of work experience (measured by number of jobs and employers) did not influence career decision status. When explored longitudinally it was found that decidedness decreased after participating in the work force and work experience programs. Quality rather than quantity of work experience was a more significant predictor of decidedness. Work experience and graduate programs should focus on the quality of experience provided, rather than quantity of time spent, if the purpose is to contribute to career decision making. In comparing the self-ratings of decided and undecided students it was found that decided students were no more perceptive about their capabilities than those who were undecided. This suggests that self-rating measures should be used in conjunction with objective measures if this information is to be used for the purpose of vocational assessments, even when students claim to be decided about their career choice. Some evidence exists to suggest that students rating themselves higher on comfort with career decisions were more capable of matching their career interests with job advertisements rather than on occupational titles alone. Comfort levels in career decision making may have an important role in evaluating available opportunities. In examining the relationship between work outcomes and career decision status in a longitudinal design it was concluded that job satisfaction promotes career comfort, decidedness predicts organisational commitment and this relationship is moderated by met expectations, and that neither being decided or comfortable predicts performance. Some evidence was found to suggest that those employees claiming high self-clarity (i.e., knowledge of their abilities, skills, and personality) were rated as higher performers. It may be beneficial for organisations to direct their efforts towards promoting comfort by providing quality work experience, and helping employees to clarify their strengths in terms of interests, abilities and attributes. It was concluded that career decidedness is still relevant to a contemporary work environment, but that comfort with career decisions has the potential for far greater impact.

The purpose of the research conducted in this thesis was two-fold. First, it was to examine the impact of temporal processing on the capability of participants to determine the order of perception and the identity of components in mixtures of three tastants. Secondly, it was to determine if interaction occurs between the two modalities of taste and olfaction, and to determine the capacity of humans to identify the components of taste-odour mixtures. Overall, the results of the studies provide new information about the capacity of humans to analyse chemosensory mixtures, which can be applied in studies of the impact of real food components. / Master of Science (Hons)

The selected publications presented here are concerned with the development of practice and knowledge in midwifery. The thesis underlying the publications is that the development of a positive personal relationship between women and their midwives is fundamental to effective and sensitive midwifery care. The methodology used is essentially different to the thesis written prospectively. This is because the publications presented arise from years of work informed by 'hands on' practice, development of policy, leading change and development, supported by research and communicated and disseminated through writing. The work presented therefore could be viewed as a long research project, with these activities forming an iterative process in thinking through and writing for publication, as well as continuing practice development and research. The extended essay serves to introduce the publications and show how they are linked through common themes developed over time. It also demonstrates the originality, importance and contribution of the publications. The publications presented may be viewed conceptually in a number of different ways however these are all related to the relationship between women and their midwives. The essay is presented in sections. The first is the Introduction to key concepts and theories. The second is The Midwife with Woman Relationship. This introduces publications that describe the nature and purpose of the relationship. The third section, Changing Practice: the New Midwifery is concerned with what the midwife does in the context of that relationship. Publications introduced in this section propose ways of working in the best interests of women and their families. The fourth section, Influencing Policy Nationally and internationally, is concerned with the creation of national policy that has supported the development of what I have called the New Midwifery. The fifth section, Transformative Change and Rediscovering Midwifery is concerned with developing the organisation and culture of care, that is its context, to enable midwives to work in the best interests of women and their families. The sixth section Developing Patterns of Practice that Enable Personal Relationships Between Women and Midwives: One-to-One Midwifery introduces publications concerned with the development and evaluation of new structures that facilitate continuity of care and thereby relationship.

Objective: Since short-term weight loss is often achievable in overweight individuals but long-term weight maintenance is generally poor, this thesis examines the effect of the nature of support programmes and macronutrient composition on weight maintenance following weight loss. Research design and methods: A 2x2 multifactorial design was used to compare two support programmes and two diets differing in macronutrient composition on maintenance of weight loss over a 2-year period. Two hundred women who had recently lost at least 5% of initial body weight were randomised into one of two support programmes. One provided intensive expert, health professional support with regular circuit training classes. The other provided brief and frequent �weigh-ins� and support facilitated by a nurse. Participants were also randomised with regard to recommended diet composition. One eating plan was high in carbohydrate and dietary fibre, emphasising low glycemic index foods. The second eating plan was relatively high in monounsaturated fat and protein and had a low overall glycaemic load. At baseline, 1 and 2-years, weight, waist circumference and blood pressure were measured and body composition was estimated using bioelectrical impedance. Three-day weighed diet records were collected to estimate dietary intake. A fasting blood sample was used to measure glucose, insulin and lipids. Results: At 2-years weight was measured for 87% of participants. On average those randomised to the Expert Support Programme reduced weight by 2.5kg while those on the Nurse Support Programme reduced weight by 3.6kg (difference between support programmes, P=0.976). On the High Carbohydrate Diet average weight loss was 2.4kg compared with a loss of 3.8kg on the High Monounsaturated fat Diet (difference between diets, P=0.419). At follow-up, there were no signficant differences between the support programmes with regards to body composition, systolic and diastolic blood pressures, blood lipid levels, glucose, insulin, and predicted insulin sensitivity. From a health system perspective and relative to the Nurse Support Programme, the Expert Support Programme cost $NZ 928, 970 per QALY gained (or $9, 290 per person). At follow-up, there were no signficant differences between the dietary prescriptions with regard to body composition, systolic and diastolic blood pressures, triglycerides, HDL-cholesterol, glucose, insulin and predicted insulin sensitivity. However, total and LDL cholesterol were significantly lower on the High Carbohydrate Diet compared with the High Monounsaturated fat Diet (total cholesterol 0.2mmol/l, P=0.044, LDL cholesterol 0.2mmol/l, P=0.042). At follow-up those on the High Monounsaturated fat Diet reported significantly higher intakes of saturated fat (1.5%TE), total fat (5%TE), monounsaturated fat (2.4%), and a significantly lower intake of carbohydrate (-5%TE) than those on the High Carbohydrate Diet. Conclusion: A relatively inexpensive nurse led programme appears to be as effective as a more costly expert health professional led programme in achieving weight maintenance over a 2-year period. This inexpensive and successful weight maintenance programme offers a feasible option for implementation in primary health care in New Zealand. Similarly, both dietary approaches produced comparable beneficial effects in terms of weight loss maintenance. However the High Carbohydrate Diet was associated with lower levels of total and LDL cholesterol, possibly due to a lower intake of saturated fat.

230 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, Dept. of Psychiatry, 1976

xx, 562 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, Dept. of Psychiatry, 1979

Typescript (photocopy) / xiii, 192 leaves, [44] leaves of plates : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--Dept. of Medicine, University of Adelaide, 1980