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Item Open Access Reducing the environmental impact of surgery on a global scale: Systematic review and co-prioritization with healthcare workers in 132 countries(Oxford University Press, 2023)Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results: In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.Item Open Access Motivation of sessional teaching staff to remain employed in pre-registration nursing programs: A systematic review(Elsevier Ltd, 2025-06-19)Aim: To identify motivational and demotivational factors for sessional teaching staff to undertake employment in pre-registration nursing programs. Background: Sessional teaching staff are part of the nurse education team; however high turnover can cause challenges to the university and impact the quality of teaching and learning for students. Understanding the motivational factors for working as sessional staff can help create a more sustainable nurse education workforce. Design: Systematic review. Methods: The review protocol was registered with the Open Science Framework and the search was conducted in September 2024 using the databases CINAHL, Education Source, ERIC, PsycInfo® and MEDLINE. The inclusion criteria were sessional teaching staff, teaching into pre-registration nursing programs in tertiary education settings. Themes were deductively developed following data extraction. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Results: Four studies were included in this review. Two themes were developed: i) Motivation to remain employed; ii) Demotivational factors to remain employed. The top motivating elements for sessional staff were the enjoyment of teaching, the work flexibility and the ability to nurture the next generation of nurses. Demotivational factors for working sessionally included feeling disconnected from the nursing school and not having adequate resources and support for teaching. Conclusions: Sessional teaching staff provide benefits to nurse education programs. Universities need to enhance motivational factors such as flexibility and address the lack of sense of belonging, support and resourcing of sessionals to create a sustainable academic workforce and to ensure the quality of nurse education.Item Open Access More than lights and sirens : Assessing the impact of a national accreditation scheme from the perspective of change in an evolving profession - Paramedicine(Australian Catholic University, 2025)Introduction/Background: This thesis provides an in-depth analysis of the intricate relationship between curriculum design, accreditation processes, and the evolving landscape of paramedicine in Australia, particularly within the context of the National Registration and Accreditation Scheme (NRAS), which was established in 2018. The research explores the impact of the advent of the NRAS on the development and delivery of paramedicine education, examining its influence on both the academic and professional readiness of paramedic graduates. By contextualising the historical evolution of paramedic practice in Australia, this study examines the current status and challenges facing the profession, with a focus on the regulatory and educational frameworks that support it. Aim: The primary aim of this study is to investigate how paramedicine courses developed under the Australian Paramedicine National Registration and Accreditation Scheme effectively prepare graduates to meet the dynamic and ever-changing demands of their profession. The research aims to identify the strengths and weaknesses within current educational frameworks, providing insights into how these frameworks can be enhanced better to equip paramedic students for the realities of professional practice. Methods: Employing a multi-modal methodology, this study engages with various data sources, including academic literature, regulatory documents, and interviews with key stakeholders in the paramedicine field. A comparative analysis with international jurisdictions is also conducted to identify potential areas for improvement and innovation within the Australian context. This methodological approach enables a comprehensive examination of the educational, regulatory, and professional frameworks that underpin paramedicine education in Australia, providing a solid foundation for the study’s findings and recommendations. Findings: The findings suggest that while accreditation processes ensure baseline professional competency, they do not prescribe curriculum content, resulting in varied interpretations and implementation across institutions. This has led to inconsistencies in how key areas—such as primary healthcare, governance, and interprofessional collaboration—are integrated into paramedicine programs. Rather than attributing this solely to a lack of standardisation, the study acknowledges the broader challenge of balancing regulatory flexibility with the need for consistency in graduate preparedness. International comparisons further highlight how structured, but adaptable curriculum frameworks can support both innovation and coherence in education. Discussion: The discussion synthesises key findings from an analysis of paramedicine curricula, accreditation frameworks, and evolving models of care. It reveals that while Australian paramedicine education programs demonstrate strong alignment with emergency response and acute care, significant gaps persist in primary healthcare, governance, and community-based care. The study highlights inconsistencies in curriculum integration across universities, reflecting the broader challenge of aligning educational standards with accreditation requirements. A critical finding is that accreditation frameworks, although essential in ensuring professional competency, do not provide prescriptive curriculum guidance, resulting in variability in program design. The RESPIGHT model analysis revealed disparities in how universities integrate primary healthcare and interprofessional collaboration, underscoring concerns about graduate preparedness for expanded roles in healthcare systems. Additionally, international comparisons suggest that paramedicine education in Australia may benefit from adopting structured curriculum frameworks that strike a balance between regulatory oversight and curricular flexibility. Conclusions and Recommendations: This study concludes that while accreditation provides an essential foundation for ensuring paramedic competence, variability in curriculum design has contributed to inconsistencies in graduate outcomes, particularly in areas aligned with expanded scopes of practice. It recommends the development of structured curriculum frameworks that align with accreditation standards while maintaining flexibility to respond to local and emerging healthcare needs. Enhanced emphasis on primary healthcare, leadership, and collaboration between education providers, industry, and regulatory bodies will be essential to preparing graduates for future practice. To address these challenges, this study recommends a structured approach to curriculum development, incorporating standardised frameworks that align with accreditation requirements while allowing flexibility for emerging healthcare trends. Strengthening primary healthcare education, embedding governance and leadership training, and fostering stronger collaboration between universities, accreditation bodies, and industry stakeholders are critical steps in ensuring paramedic graduates are well-prepared for contemporary practice.Item Open Access Examining the role of consumer hope in sustainable consumption behaviour(Australian Catholic University, 2025)Sustainable consumption is gaining importance as businesses and consumers are shifting their focus from conventional to eco-friendly products. While awareness is rising due to government initiatives and advertising, many consumers remain skeptical of sustainability claims, limiting their engagement with such products. Most research on sustainable consumption focuses on cognitive factors like attitudes and values, with limited attention to emotions. Existing studies present a paradox—negative emotions like guilt are well-studied, while positive emotions, particularly hope, are underexplored. This study systematically reviews 123 research articles to examine how hope influences sustainable consumption behavior. Based on the review, a research model is developed incorporating cognitive factors (green self-identity, perceived natural content, environmental knowledge, and perceived greenwashing) as drivers of consumer hope, which in turn leads to sustainable consumption. The study also explores how goal attainment moderates this relationship and compares consumer behavior at home versus while traveling. Using structural equation modeling and Fuzzy-set Qualitative Comparative Analysis, the study analyzes data from 584 consumers (298 at home, 286 traveling). The findings support all hypotheses except the moderating role of environmental knowledge in the greenwashing-hope relationship. The study offers theoretical contributions and practical insights for marketers and policymakers to enhance transparent communication, environmental education, and strategies fostering hope for sustainable consumption.Item Open Access Entrepreneurial marketing and start-up performance : The mediating role of hope and resilience(2025)This research examines the role of positive emotions in translating entrepreneurial marketing into start-up performance. While previous studies have explored the relationships between entrepreneurial marketing and performance (Bachmann et al., 2021), entrepreneurial marketing and aggregate emotional responses (Cavanaugh et al., 2011; Woodman et al., 2009), and the impact of these emotional responses on performance outcomes (Alqatani et al., 2023), there have not yet been investigations on specific positive emotions, namely that of hope and resilience, and their role in translating entrepreneurial marketing into performance. Hence, this research expands our understanding of how the hope and resilience of the start-up founder may influence start-up performance. This thesis employs a systematic literature review (SLR), two experiments, a survey, and a post-hoc fuzzy set qualitative comparative analysis (fsQCA) to achieve the research aim of investigating the types of founders and the configurations of conditions leading to start-up performance. The SLR is conducted to identify the gaps in the relevant literature and potential future directions for investigations to enhance the literature on the mediating role of emotions in the relationships between entrepreneurial marketing and start-up performance. The experiment demonstrates the causal effect of hope and resilience on start-up performance by capitalising on and bridging one of the research questions. This study also employs a survey to develop and test the nomological network of the constructs of entrepreneurial marketing, hope, resilience, and performance in the context of Australian start-ups. In addition, given that recovery and adaptation to contextual conditions are crucial for any start-up, this thesis explores the moderating effect of technological turbulence on the association between entrepreneurial marketing and resilience and how strategic agility moderates the impact of entrepreneurial marketing on hope in recovery from adverse situations. The study further employs an fsQCA to identify the different positive emotions of founders that affect start-up performance. The research sheds light on critical positive emotional factors that enhance start-up performance, such as hope and resilience. This research has three underpinning theories: the appraisal theory (Roseman & Smith, 2001), the broaden-and-build theory of positive emotions (Fredrickson, 2004), and the contingency theory (Whalen et al., 2016). The appraisal theory posits that emotions are elicited by individuals’ evaluations (appraisals) of events or situations, which determine their emotional responses based on perceived significance and relevance to personal goals. This theory emphasises that different appraisals of entrepreneurial marketing can lead to varied emotional responses, such as hope and resilience in start-up founders, even in similar circumstances. This research also develops literature on the broaden-and-build theory of positive emotions (Fredrickson, 2004), which asserts that positive emotions (e.g., hope and resilience) broaden the thought-action repertoires of individuals (e.g., start-up founders) and enhance their creativity and openness to new experiences in their start-ups. Over time, these broadened mindsets help build lasting personal resources, such as marketing skills and social connections, which contribute to overall success and performance. This research also develops literature on the contingency theory (Whalen et al., 2016) by incorporating strategic agility and technological turbulence as moderators. The findings of this research are significant to start-up founders and policymakers. Theoretically, the SLR highlights several gaps that indicate avenues for future researchers. The experimental study posits hope and resilience are two missing causal mechanisms in start-up performance. The survey further highlights the reliability and validity of the nomological network of constructs employed in the conceptual model. Understanding the relationship between entrepreneurial marketing, hope and resilience, strategic agility, and technological turbulence can be leveraged to develop effective strategies that enhance start-up performance. Consequently, this research contributes to the marketing and entrepreneurship literature by providing valuable knowledge to start-up founders to improve performance.
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