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Chapter 1: Introduction

An action research study conducted within an international rugby squad prior to and during the Rugby World Cup in 2018/2019


1.1       Inspiration


The ambition to improve the efficacy of organisational endeavour sits at the heart of most practitioner and academic focus in management practice and research (Levi, 2017).  The rewards for successfully aligning, directing and nurturing the collective capabilities and skills of members of a social group is the essence of the purpose of society (Darwin, 1859).  However, the latter part of the twentieth century was dominated by research into the role of the leader in organisational performance, resulting in the development of numerous theories of leadership in increasingly clear eras over that time (Van Seters and Field, 1990).  By comparison, the twenty-first century has seen an increasing focus on the value of teams and the social structures and behaviours that define them (Hackman and Morris, 1975; Tesluk and Mathieu, 1999; Wageman, 2001; Mathieu et al., 2008; Hackman, 2012; Wageman, Gardner and Mortensen, 2012; Puranam and Raveendran, 2013).  Even in the traditionally leader-centric and polarised world of venture capitalists and private equity investment, there is a shift in focus from the ‘inspiring leader’ to the power of collaboration.

“The value of a high-performing team has long been recognized.  It’s why savvy investors in start-ups often value the quality of the team and the interaction of the founding members more than the idea itself.  It’s why 90 percent of investors think the quality of the management team is the single most important nonfinancial factor when evaluating an IPO.  And it’s why there is a 1.9 times increased likelihood of having above-median financial performance when the top team is working together toward a common vision.”  (Keller and Meaney, 2017:1).

The world of sport provides inspiration for many individuals and organisations who aspire to exceptional collective efficacy, but even some of the world’s greatest and most celebrated individual sportspeople attribute success to group collaboration, and not just individualism, supporting the notion that high-functioning groups deserve more attention and understanding.

 “Talent wins games, but teamwork and intelligence win championships.” (Jordan, 1994:32)

Much as successful group collaboration can result in outstanding outcomes, ineffective group endeavour can exact a high cost on individuals (Kozlowski, 2011), on organisations (Hotz, 1999) and external affected parties (Fisher and Kingma, 2001).  

Attempts to define a formula for team formation and leadership, that can be understood, replicated and applied by organisational leaders in all circumstances remains an elusive ‘holy grail’ (Mohrman et al., 1995; Ulrich et al., 2017).  It is therefore unsurprising that when exceptional organisational or team success is observed, the attentions of practitioners and academics alike are drawn to the exemplar, seeking to understand how such high performance was achieved (Sandy, 2007; Burnes and O’Donnell, 2011).  It is one such exemplar – the winning of the Men’s Rugby World Cup (RWC) by England Rugby in 2003 - that inspired this research study and initiated the author’s quest over the last six years to try to identify critical factors that allow high performance teams to compete and succeed.  

This endeavour began with a Master in Business Administration (MBA) dissertation in 2015 which engaged directly with the leader of the exemplar case  - Sir Clive Woodward - and his Team and High Performance Coach, Humphrey Walters (Lees, 2015).  The phenomenon identified in that initial study which appeared unique was referred to by Sir Clive Woodward as “teamship”; a concept that he differentiated from effective teamwork as being less about the practical actions and interactions of team members, but rather about the underlying shared values, standards and behaviours of all members of an organisation (Woodward, 2004).  Whilst offering a practical definition of this term, the study was inconclusive in identifying underlying social mechanisms that might serve to provide insight into what factors may have contributed to the emergence of the notional state of “teamship” (Lees, 2015).

This initial study did however uncover clues that might help future researchers to delve deeper into how groups operating in similar conditions bond in such a way that “the whole is greater than the sum of the parts” (Koffka, 1935).  It is this concept that is explored in this study; how do the ‘parts’ (individual group members) bond together such that the collective effort increases the efficacy of the ‘whole’ (the group or team) in pursuit of the purpose of the group?

The author decided to pursue his investigations of “teamship” through completing a Doctorate in Business Administration (DBA).  It was felt that to maximise the potential of uncovering underlying mechanisms that may contribute to “teamship”, immersion into similar environments to the original exemplar phenomenon may be required, and an abductive approach to inquiry be adopted.  The logic of this decision is covered in detail in Chapter 4.  The practice-oriented approach of a professional doctorate encourages contributions to both theory and practice (Anderson et al., 2015)and is therefore well-suited to the ambitions of the study.

Utilising Action Research (AR) methodology, this study was executed with the German Rugby Football Union (RFU) Men’s Senior XVs squad as they prepared for, and competed in, the qualifying tournament for the RWC 2019 in November 2018 and the Rugby Europe International Championship (REIC) from January to April 2019.  In addition to his research role, the author was also asked to take an active role in the preparation of the squad as the Mental Skills and Team Development coach, and also as a member of the leadership team.  A biographical profile of the author is provided in Appendix A. 

The study comprises two cycles of competition with the sample over a period of eight months.  The researcher held both participant and research roles throughout the period and participated fully in all the preparation and competition over that time, including travelling with the team for international matches against Canada, Hong Kong, Kenya, Belgium, Romania, Spain, Portugal, Russia and Georgia, as well as ten weeks in the pre-competition training camps in Heidelberg, Germany.  The participant role carried specific responsibilities and requirements to identify team development issues and needs, and to design and implement interventions to change and improve teamwork and collaboration within the squads (players, staff and coaches).  The researcher stance was participant observation (Denzin, 1989; Flick, 2018).  The selection of AR as the research methodology was therefore consistent with both the sponsoring organisation’s core purpose, as well as the academic research problem and purpose.


This thesis documents and reports on the resultant action research study.  

1.2      Summary of the Research Problem, Purpose and Question

1.2.1      Defining the Research Problem

As described in Chapter 3, there is a dearth of empirical research relating to “teamship” – something that may appear surprising considering the extensive bodies of research and knowledge on other concepts with similar etymological origins such as ‘leadership’ and ‘followership’.  This lack of theoretical knowledge or empirical research suggested that the practical problem of understanding the original phenomenon of interest (England Rugby) would require an approach that was neither founded in theory, nor in any pre-conceived conceptual model; in order to examine “teamship” it was necessary to commence the research with an exploratory approach to the inquiry and to ‘forget’ about “teamship” in the design and execution of the study, and focus instead on the actual behaviours, actions and interactions that might be observable in a group operating under similar conditions to those experienced by the England Rugby squad in 2003.

With this in mind, the re-examination of the data and findings from the MBA and subsequent Master of Science (MSc) studies pointed towards the importance of group cohesion in organisational efficacy and indicated that the relationship between a) the purpose for the formation of the group and b) the personal motivation of its individual members may have influence on the existence and strength of that cohesion.  

There is an increasing body of empirical study across a range of different organisational types that explores the importance of cohesion to the efficacy of groups.  For examples Ellis et al. (2014) examined the importance of group cohesion in the treatment and recovery of patients suffering from post-traumatic stress disorder; Van Vuuren et al (2008)investigated group cohesion and organisational commitment of employees in a chemical company; and Leo et al (2016)explored the direction of the relationship between collective efficacy and cohesion in football teams.  These examples represent a tiny fraction of the empirical research that seeks to strengthen understanding of the relationship between the effectiveness of organisational endeavour (efficacy) and the commitment and bonds within and between its members (group cohesion).  The findings of this researcher’s early studies supported the assertions offered of the positive relationship between group cohesion and efficacy.

As described in Chapter 3, examination of group cohesiveness literature revealed problems with  regard to the unitary construction of the concept, as well as lack of temporal considerations of the stage of group development in the many cross-sectional research designs (RD) in this field.  Additionally, there is a low number of empirical investigations into the antecedents that contribute to group cohesiveness, as compared to analysis of the relationship between cohesiveness and performance (Casey-Campbell and Martens, 2009; Severt and Estrada, 2015).  Groupthink literature provides interesting and relevant insight into group cohesion and organisational efficacy, which is directly relevant to this study (Park, 1990, 2000; Rose, 2011; Forsyth, 2020).  Empirical research tends towards case study examinations of significant corporate and organisational disasters utilising documentation, archival records, and critical incident questioning as primary data.  Examples include BP Deepwater Horizon (Dunkley, 2012; Silver, 2014), the scandals at WorldCom and Enron (Maharaj, 2008), the Mount Everest disaster 1996 (Burnette, Pollack and Forsyth, 2011) and many others.  Group cohesion is identified frequently as a potential contributing symptom to groupthink, but without explanation as to how or why it is important or created (Severt and Estrada, 2015).


Whilst these and other groupthink studies support the assertion of group cohesion to task, organisation and inter-personal relationships, the methodologies employed in the research designs limit the ability of the researcher to understand how and why a group bonded in a particular way; specifically the issues of intentionality, behaviour, motives, emotions and environmental considerations (Hall, 2015).  Without collecting data in real-time as the particular case in question is evolving, the reliability of any interpretations of individual or collective motivation for actions taken is open to challenge; context and environment are critical factors in how people behave, and the motives of individuals for the actions that they take in any circumstance impact on how the group collaborates and performs.  

The challenges of access, approach and timing for a researcher to “be in the right place, at the right time, with the right research question” (Waddington, 2004:156) makes the exploration of the formation of group bonds exceptionally difficult.  Notwithstanding this challenge, the potential to make a contribution to both research and practice is clear.

The examination of a range of groupthink case studies, alongside a review of group cohesiveness literature and re-examination of the author’s original “teamship” study revealed several potentially important insights.

  1. Group cohesiveness theory remains inconclusive as to whether the construct is uni-dimensional (Lott and Lott, 1965) or multi-dimensional (Zaccaro and Lowe, 1988; Zaccaro and McCoy, 1988; Zaccaro, 1991; Wise, 2014; Severt and Estrada, 2015), with different perspectives asserting that group cohesion is driven by interpersonal relationships (‘affective cohesion’, ), by task orientation (‘instrumental cohesion’), or organisational commitment and loyalty (‘group pride’) (Beal et al., 2003). 

  2. Studies of groupthink cases and teams often associate task-orientation with shared purpose and instrumental cohesion (Burnette, Pollack and Forsyth, 2011) which results in collaborative teamworking, ignoring the fact that the group members may all share the same personal ambition, which is not the same as a shared goal or purpose (which would result in every group member either succeeding or failing collectively).  The assumption that teamwork indicates shared purpose has potentially catastrophic implications under stressful or dangerous conditions – proven in multiple cases.  The issue of interpretation of “purpose” (Argyle, 1972; Babington Smith and Farrell, 1979; Dyer, 1984; Wageman, 1995, 2001) and “shared purpose” (Campion, Medsker and Higgs, 1993; De Dreu, 2007; Mathieu et al., 2008; Adler and Heckscher, 2018) emerges as a potentially important problem in literature and of particular relevance to the changing interpretations of groups and teams in the 21st Century (Parmar et al., 2010; Hackman, 2012; Wageman, Gardner and Mortensen, 2012; Adler and Heckscher, 2018; Gartenberg, 2021).

  3. A review and re-coding of the author’s early “teamship” data indicated that the concern highlighted in ‘2’ above has a possible link to the personal motivations of an individual to belong and contribute to a particular group, and what they desire or need from that membership (Ryan and Deci, 2018), which in turn may indicate the level and type of their commitment to the group; put simply, how does what the individual wants align to the reason for the existence of the group?

This study addresses problems in literature and practice regarding group cohesiveness, group purpose and self-motivational needs.  

This research study therefore has both theoretical and practical purposes.

1.2.2     Theoretical Purpose


The theoretical purpose of the study was to examine the influence of individual motivation and group purpose on the functional and structural properties of cohesiveness in groups.

1.2.3     Practical Purpose


The practical purpose of the study was based upon the organisational needs of the sample case and those of the research sponsor (the Head Coach).  Section 2.3 provides detailed contextual background to the challenges facing the leadership team in taking responsibility for the group.  The individual and collective issues associated with those circumstances resulted in the requirement to bring alignment and unity to the organisation, and to assist individual members in preparing for the levels of personal and collective performance needed to compete successfully in the RWC19 Repechage and REIC tournaments. 

1.2.4     Research Question


Section 4.5 provides a detailed explanation of the genesis and importance of the research questions for this study, including sub-questions that were required in order to address the primary research question.  However, the research strategy, philosophy and methodology were determined on the clarity of the following research question:

What effects do the personal motivations of individuals in a team have on the group’s cohesiveness in the context of the purpose of its existence?

1.3      The Action Research approach


Action Research (AR) takes a unique approach to the creation of knowledge where the researcher is an active participant in the case itself, contributing with other participants to identify, define, and implement interventions with a view to effecting change within the organisation (Reason and Bradbury, 2012).  This co-creation of knowledge is an iterative process of action cycles (ACs) which review progress from the previous AC and uses this as the basis for the execution of a new AC of assessment, design, implementation and collective review (Coghlan, 2019).  It is recommended that an AR study comprises at least three ACs.

As can be understood, the starting point of an AR study is not with the formal collection of data as one might see with an inductive research design, nor is the starting point based in theory and hypothesis as is the case with deductive approaches.  Whilst there is a temptation to enter into the study with a conceptual model as used in retroductive studies, the pseudo-deductive approach of a retroductive approach narrows the focus of the researcher to looking for affirmation of their preconceptions and risks overlooking the discovery of realities affecting social interaction as experienced by the participants.

It can be seen therefore that the starting point of an AR study is the reality “…as understood and experienced by the participants” (Blaikie, 2010:89).  It is the role of the researcher to actively immerse and collaborate in the environment in order to explain and understand it, defining reality and the generation of new knowledge with the participants (Flick, 2018).  The practical (or ‘Core’) purpose of the study is that as understood by the participants in their efforts to change their experienced reality.  However, AR still requires disciplined and rigorous academic praxis (McNiff, 2017).  All AR studies must also address a clearly defined research problem and theoretical purpose.  The method by which the requirements of both Core and Theoretical Purpose are fulfilled is through a combination of first, second- and third-person practice.  First person practice involves self-awareness of one’s own values, beliefs, assumptions, ways of thinking, strategy and behaviour, and requires extensive reflexivity skills (Coghlan, 2019).  First-person reflexivity is critical to both understand and mitigate researcher bias which may otherwise impact upon the trustworthiness of data analysis and findings.  Second person analysis reports on the collective input and reactions of the participants and the researcher and includes the action-based work and interventions.  This is the practice-based element of the research and is likely to be of the greatest interest to the research sponsor.  Third person analysis takes an objective approach to analysis and interpretation of the data collected and reflects on findings in the context of theory and literature and informs the theoretical contribution from the research.

This study comprises three action cycles of a single case spanning two international rugby tournaments.  First- and second-person analysis is provided within each AC.  The third-person analysis applies a retroductive interpretation of the second-person analysis, ensuring the ontological integrity of the AR methodology.  To assist in increasing trustworthiness, reflexive interviews were conducted with four participants four months after completion of the field-based activity, discuss the participants’ reflections of all three ACs, and their perspective of researcher’s interpretations of events and social interactions.  

1.4      Contributions

1.4.1      To Theory


The research offers contributions to theory in four different areas of literature.  

Group Cohesiveness 

The study provides empirical support for theoretical models suggesting the multi-dimensionality of group cohesiveness as a fluid emergent state, functionally categorised as either affective and instrumental, and structurally segmented into group pride, interpersonal and task-orientation (Severt and Estrada, 2015).  The findings add to theory by identifying that the structures (or types) of cohesiveness co-exist, emerging longitudinally determined by the group purpose and the environment.  In addition, these bonds assume a primacy which can change over time dependent on the nature of the instrumental task (and the task interdependence required) and the strength of the affective cohesion.  When considered in concert with an analysis of member self-motivation, it can be seen that cohesiveness emanates from individuals to the group (its purpose, members and social identity) and that the cohesion is therefore constructed at an individual level and manifests at a group-level.  This results in the assertion that group cohesiveness should be reconceptualised as a fluid emergent multi-dimensional state with primary, secondary and tertiary bonds, constructed at the individual-level.

Group Purpose  

Taking a critical realist perspective to interpret the symptoms of disharmony between the group and its parent organisation led to a realisation that “purpose” for a group can differ vertically between organisational levels.  In addition, misunderstanding or misalignment of purpose vertically can lead to negative outcomes both instrumentally and affectively for the group and its participants.  This leads to the identification that group purpose is a multi-level, multi-functional construct comprising: (1) an organisational-level, which determines an existential purpose for the group; (2) a group-level purpose which is the operational requirement given to the group leader(s); and (3) an individual-level purpose which is the operationalisation of the purpose determined by the group leader to inspire and bond its members.  Purpose does not need to be identical at each level, but it does need to be clear.

A comparison of the in vivo empirical findings and the a priori literature review of groupthink cases led to the realisation that current theoretical and practical acceptance of the terms “shared”, “common” and “collective” in regard to definitions of purpose and tasks in groups and teams is misleading and can have negative effects.  In the field work, the emergence of affective cohesion as the dominant bonds in the group led to the identification that members had both shared process and group-level (entity-level) outcome – “We all win, or we all lose together.”  

The combination of these two contributions regarding group purpose has major implications for both theory and practice.  For example, when the groupthink case study of the Mount Everest disaster of 1996 (Burnette, Pollack and Forsyth, 2011)is reconsidered with the application of both these assertions, a very different interpretation of member and leader behaviour and decisions can be drawn, which could lead to significant a priori group design decisions in future expeditions.  This process could be applied to all groupthink case analyses of organisational failure.

Group Typology and Stages of Development  


The nature of AR means that the researcher takes both a practitioner and scholarly approach to the study.  The combination of these when applied to AR intention (affecting change in a group) means that both practice and theory can be applied and assessed.  The outcome of that in this study is the recognition of (1) stages and developments of groups (from formation to dispersion) which are based on the nature of the group purpose and the processes required to achieve them; and (2) a recognition of group types based upon the same.  The study therefore contributes a novel model of the stages of group development which is markedly different, but complementary to Tuckman’s models from 1965 and 1977 (Tuckman, 1965; Tuckman and Jensen, 1977), and those from Van de Ven et al (Van De Ven, Delbecq and Koenig, 1976) Gersick (Gersick, 1988), Akrivou et al (Akrivou, Boyatzis and McLeod, 2006)and Sheard and Kakabadse (Sheard and Kakabadse, 2002).  In addition, the functional and structural properties of each development stage also define a typology of groups accordingly.  The identifiable properties are based on existing concepts, as well as those developed in this study, and as such are measurable.  This means that this model can be studied empirically in future studies, which will add rigour to the theories offered by this doctoral study.  

Group Processes – “Teamship”


Affective Interdependence and the identification of “team” as an emergent group state.  The longitudinal design of the study, and its span of all stages of development, allowed the observation of the development of individuals within the group, identifying behaviours that supported an emerging culture and group norms, and behaviours that did not.  The practitioner role of the researcher required interventions both at an individual-participant and a group-level throughout the study, allowing for understanding of the changes – or not – of member self-motivation and group efficacy.  This combination of observation at both levels resulted in the definition of “teamship” as being “The actions, behaviours and attitudes of individuals that support the purpose, ethos and culture of the group”.  In addition, the description of behaviours associated with “teamship” is consistent with those posited in Self-Categorisation Theory (SCT) (Turner et al., 1987; Turner and Onorato, 1998) regarding depersonalisation and also in Social Identity Theory (SIT) (Tajfel, 1974; Tajfel and Turner, 1979).  “Teamship” is therefore empirically placed into literature in support of these existing theories.

Rugby is a sport requiring high levels of collaboration, courage, self-sacrifice and interpersonal understanding. Interdependence Theory (Thompson, 1967) provided a useful framework in this study for observing the temporal development of group processes.  However, as the efficacy of the group improved and the environmental circumstances altered (increased pressure of actual competition, prolonged period of isolation and insulation of the group, decline in conditions and resources) high levels of interpersonal emotional support were observed leading to increased task efficacy and group cohesiveness.  Participant interviews revealed significant changes in motivation, shifting from extrinsic to intrinsic motivators (Ryan and Deci, 2000).  It is therefore posited by this study that a fourth type of interdependence should be added; Affective Interdependence.  The behaviours and attitudes associated with it are observable and measurable at both an individual and team level, and it can therefore be explored in future studies.  This emergent behaviour is also key in the determination of the final group type (“Affective Group”) proposed in the typology of groups.

The combination of the findings from this study described above has allowed the author to delineate between the concepts of “groups” and “teams”.  It is proposed that a team has a purpose that requires shared processes to achieve a group-level outcome, and where affective interdependence is evident.  This implies that a team is not a formative entity, but an emergent state from group development.  This assertion requires the integration and acceptance of the findings of this study, but if accepted, has potentially significant contributions to group and team literature and study.

1.4.2     To Method

Use of retroduction to create insight from abductive analysis.  


AR seeks the co-creation of knowledge with the participants; it takes an emic not an etic epistemological stance.  In order to contribute to theory, a third-person interpretation of data provides comparison with extant literature to determine novel contributions to knowledge.  However, if the researcher conducts an a posteriori analysis of the raw data inductively there is the risk that the epistemological foundation of AR could be compromised; the new knowledge would not be based on a shared interpretation of reality with the participants, but on the subjective interpretation of the raw data.  This study has therefore taken a retroductive approach to the third-person analysis, drawing codes and themes not from the raw data, but from the second-person in vivo interpretations and actions documented in the thesis.  This ensures that the reality created and interpreted by the participants is that which forms the template of themes from which findings are drawn.  The researcher contribution is then to apply theoretical interpretation to these findings to identify novel contributions, thus preserving the integrity of ‘where’ the knowledge came from.

Use of Critical Realism to uncover causal mechanisms.  An AR study seeks to affect change in the sample.  The process of doing so involves phases of diagnosis, planning action, taking action and evaluating action, and then using the interpretations to assume an understanding of reality and causation, and then to enter further interventionist cycles.  This infers that the researcher and participants believe that their reality is the result of social mechanisms, which can be changed through targeted intervention.  This is consistent with the ontological and epistemological foundations of critical realism (CR), which proposes reality exists on three levels: the observable empirical level, an accessible actual level, and an underpinning real level.  When trying to make sense of apparently irrational decisions and conflict between the parent organisation and the group, the researcher made a conscious decision to adopt a CR approach to trying to understand why there was a gulf between what resources were needed from the parent organisation to support the group, and what was actually made available.  Employing a CR perspective to the problem led to the recognition that “purpose” was constructed at different levels and that the misalignment between levels was the cause of the problems.  The application of CR in an AR study therefore contributes significantly to providing an abstracted lens of interpretation, which reduces researcher and participant bias, revealing multiple levels of reality, whilst ensuring the epistemological integrity of the co-creation of knowledge.

1.4.3     To Practice

The findings of the study have relevance to rugby and to other team sports.  However, the findings may prove important to any organisation that seeks to improve the collaboration and performance of groups or teams – both at a macro and micro level.  The models created will enable leaders to re-examine the purpose of the creation of groups and teams in their organisations, and to use this authenticity and clarity to determine the type of group required to fulfil that purpose using the Group Development and Typology from the study.  The findings in regard to the alignment of self-motivation to group purpose and requisite group processes (determined by the Typology model) will help to assess appropriate group membership for both leadership and non-leadership roles.

The increase of need for collaboration in organisations to achieve tasks has led to an unconscious acceptance that this equates to the need to create “teams”.  This study highlights that a team is a unique form of group development and is an emergent state that supports a purpose that has both shared process requirements and a group-level shared outcome.  The typology allows organisations to be comfortable in recognising that functioning groups are - in most scenarios - the most appropriate form of collaborative structure.  This realisation will change how groups are formed, developed and managed, and the expectations of operationalisation that may result.  In a world of increasing remote working, this distinction may be critical in both operational efficiency and efficacy, as well as the mental wellness of individuals. 

1.5      Organisation of the Thesis

The thesis is organised into nine chapters.  Chapter 1 locates the reader in the topic of interest and phenomenon of inspiration and provides a summary of key design criteria for the study.  Chapter 2 gives contextual background to both the original phenomenon and also to the specific case for the action research study in order that a balanced comparison between the two situations can be understood and sense made of the sample choices.  Chapter 3 examines literature in the core areas of “teamship”, group cohesion, motivation and self-determination, organisational purpose, groupthink, and group interdependence, as well as other relevant theory in regard to groups and teams.  Chapter 4 provides a detailed perspective on the creation of knowledge and theory, and how this resulted in the determination of the research question; the importance of this chapter relates to the need to demonstrate rigour and to maximise the potential to offer generalisable knowledge from AR.  Chapter 5 explains AR in detail, as well as the specific method employed in this study.  Chapter 6 details how the data was analysed and includes the analysis of all cycles of the AR sample.  Chapter 7 discusses the findings of the research and offers conceptual models that help to explain those findings.  Chapter 8 provides the contributions to theory, method and practice, as well as the limitations and recommendations from the study.  Chapter 9 concludes the thesis and discusses whether the research purpose and questions were appropriately addressed.  References are included only when literature has been specifically cited in the thesis.  Appendices provide supportive information, documents, analysis, as well as confirmation of the ethical compliance of the study.

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