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PubMed2004

Professional career development for male nurses.

AIM: The aim of this paper is to report a study to: (a) explore Taiwanese male nurses' motivations for becoming a nurse; (b) reveal their professional developmental process in nursing; (c) understand the difficulties hindering their professional development from both professional and gender aspects; and (d) identify the strategies they use to cope with these difficulties. BACKGROUND: Hindered by historical, cultural, economic and warfare factors, the proportion of male nurses in Taiwan remains low. Taiwanese male nurses' career development process has not been well investigated yet. METHODS: A descriptive qualitative research design was used, with a convenience sample of 15 male nurses (mean age 30.8 years) with a Bachelor's degree in Nursing Science. Data were collected by semi-structured interviews and analysed by content analysis. RESULTS: Taiwanese male nurses' entrance into the nursing profession involved three phases: pre-study, study and employment. The difficulties encountered during career development were related to the gender expectations of patients and the general public. The nurses received support more from superiors than from colleagues. The strategies they used included (a) improving their professional knowledge and skills to obtain higher levels of satisfaction and better opportunities for promotion; (b) thinking aggressively about job promotion; (c) choosing specialist departments as appropriate environments for graduate study and personal growth; and (d) changing their professional track for personal growth. CONCLUSIONS: Based on the nature of nursing work and clinical experiences, Taiwanese male nurses believed that nursing was a profession suitable for both men and women. Their preparation for career development started at the pre-study phase. The major strategies they used were related to a strong desire for personal growth and professional promotion. Finally, a conceptual framework was developed to depict this complex phenomenon.

Adaptation, Psychological↗

PubMed2005

The development and implementation of an educational intervention on first episode psychosis for primary care.

INTRODUCTION: This paper describes the development and implementation of an educational intervention to help general practitioners (GPs) recognise young people with first episode psychosis. METHOD: The Medical Research Council complex interventions framework was used to guide the development of the intervention. The theoretical phase included a literature review of previous educational interventions in primary care and consideration of the literature on attitude formation and change, and the relationship between attitudes and behaviour. The modelling phase included focus groups with GPs and service users, and a training needs analysis questionnaire administered to GPs. The 2-stage intervention consisted of a video featuring role-plays of primary care consultations, GP-led discussion and discussion with early intervention service users. The acceptability and utility of the educational programme was evaluated using a 5-point Likert scale questionnaire administered at the end of each session. RESULTS: General practitioners from each of the 39 intervention practices participated in the initial session and from 27 practices in the booster session. Information about symptoms and signs of first episode psychosis was the most valued aspect of the initial session. The booster session was also well received, with GPs valuing the opportunity to gain insight into first episode psychosis from users. CONCLUSIONS: This paper adds a pragmatic description to the literature on the development of educational interventions in primary care. The Medical Research Council framework helped to identify and clarify component parts of the intervention and how the active components may relate to the expected outcome of behaviour change.

Adolescent↗

PubMed1999

Autonomy, liberalism and advance care planning.

The justification for advance directives is grounded in the notion that they extend patient autonomy into future states of incompetency through patient participation in decision making about end-of-life care. Four objections challenge the necessity and sufficiency of individual autonomy, perceived to be a defining feature of liberal philosophical theory, as a basis of advance care planning. These objections are that the liberal concept of autonomy (i) implies a misconception of the individual self, (ii) entails the denial of values of social justice, (iii) does not account for justifiable acts of paternalism, and (iv) does not account for the importance of personal relationships in the advance care planning process. The last objection is especially pertinent in light of recent empirical research highlighting the importance of personal relationships in advance care planning. This article examines these four objections to autonomy, and the liberal theoretical framework with which it is associated, in order to re-evaluate the philosophical basis of advance care planning. We argue that liberal autonomy (i) is not a misconceived concept as critics assume, (ii) does not entail the denial of values of social justice, (iii) can account for justifiable acts of paternalism, though it (iv) is not the best account of the value of personal relationships that arise in advance care planning. In conclusion, we suggest that liberalism is a necessary component of a theoretical framework for advance care planning but that it needs to be supplemented with theories that focus explicitly on the significance of personal relationships.

Advance Care Planning↗

PubMed1998

Vision 2006 brings data quality management into view.

One of the goals of the vision 2006 initiative has been to identify new career opportunities for HIM professionals. Recently, a group of AHIMA volunteers has provided a framework and tools for developing data quality management expertise. Here's an overview of their work and a look at resources for those who want to learn more.

Information Management↗

PubMed1987

New managerial roles in multiorganizational systems: implications for health administration education.

It is difficult to discuss the expertise needed to effectively manage multiunit health care corporations without examining the different work settings that comprise these organizations. This paper presents a framework to systematically describe the necessary tasks in multiunit corporations. Specific skills and knowledge areas are then described that may be missing from health administration programs' curricula.

Health Facility Administrators↗

PubMed2003

Clinical management where medicine meets management. Full team ahead.

Redesigning the diabetes team has meant national service framework targets have been hit. A trained technician has proved as adept in the diabetes review role as clinicians. The role of technician could be adapted to different specialties, such as asthma and coronary heart disease.

Case Management↗

PubMed2004

Shaping the future of medical rehabilitation research: Using the interdisciplinary research model.

This memorial lecture addresses the fundamental requirements for developing a framework for interdisciplinary rehabilitation research. The needs for funding, clinical trials, staffing, education, and infrastructure are examined from the vantage points of my experiences as an educator, investigator, chief executive officer, department chair, and dean. Developing an academic base for the specialty of physical medicine and rehabilitation and demonstrating our expertise in rehabilitation research are fundamental to academic acceptance and will enhance our ability to compete for future funding for our investigations.

Evidence-Based Medicine↗

PubMed1995

The phenomenon of stress as perceived by Project 2000 student nurses: a case study.

This case study was undertaken at a college of nursing in Northern Ireland with its first cohort of Project 2000 student nurses. The aim was to investigate perceived stress on the course. A qualitative approach was adopted utilizing Cox's (1991) transactional model of stress as the guiding theoretical framework. Data were collected through questionnaires and in-depth semi-structured interviews and analysed using a grounded theory methodology. Findings reveal that stress is perceived in relation to non-integration with tertiary education and non-integration with the ward team. This stress results from a tension between dependence and the quest for independence in the pursuit of academic freedom and clinical competence. The dependence/independence continuum has been identified as the core variable underpinning student-reported stress. Valuable insights have been gained in relation to how student nurses perceive and cope with stress associated with the introduction of the new Project 20000 curriculum, especially at this time of flux in nurse education. It is concluded that student stress could be minimized if tutors acknowledged its presence and reflected the course philosophy in their practice. Better liaison between the college and clinical areas may resolve some of the ward staff's negative attitudes and misunderstanding of the course aims. Finally, students have a need to develop clinical skills much earlier in the course than at present, in order to feel valued, to contribute to patient care and to integrate with the ward team.

Adult↗

PubMed1991

Pollution by animal production in The Netherlands: solutions.

Provided that the application rates of manure do not exceed the crop uptake of nutrients, pollution by animal production is mainly caused by nitrogenous substances. Applying manure outside the growing season causes pollution of groundwater and surface water due to leaching and runoff. In regions with a high livestock density, the evaporation of ammonia has a serious impact on the environment. It contributes to acidification and causes a nutrient imbalance in natural vegetation. The prevention of nutrient losses from manure is unprofitable. The environmental impact is not caused by the individual farmer but is a result of the sum of activities in a region. This means that legislation is necessary to impose limits in order to arrive at production without pollution. Within this framework, the farmer should optimise the utilisation of minerals from manure by more efficient animal nutrition and better handling of the manure. One of the most difficult problems is the prevention of ammonia evaporation. A reduction of these losses generally also has a favourable effect on odour emissions. A new development is the processing of manure surpluses into a dried manure of sufficient quality to compete on the fertiliser market. As is usually the case with pollution control, these measures raise the costs of livestock production.

Air Pollution↗

PubMed1993

The physics of frailty.

The contribution of frailty to human morbidity and mortality is immense. Yet it lacks a conceptual framework. By borrowing from the hypotheses provided by the thermophysicists, frailty can be understood in a way that both interrelates the relationship between form and function and provides medical science with an operational insight that yields clinical benefit. Frailty results where the organism is uncoupled from its environment yielding a break in the forward feedback cycle of stimulus to reaction to growth to increased functional competence to improved response to stimulus. Recognition of the centrality of this interrelatedness to health becomes a key theme for illness prevention and therapy.

Adaptation, Physiological↗

PubMed1993

Markov chain modelling of bioassay toxicity procedures.

Many bioassay procedures to test a new substance for toxicity, like some phase I clinical trials, can be modelled as first-order Markov chains with absorbing states. We provide a general framework for such procedures. We show how one may calculate under any dose response curve assumption final absorption probabilities, and a number of total average costs such as time required until trial completion, number of subjects treated, number of subjects exhibiting unacceptable levels of toxicity, and amount of medication administered. One may use the above information associated with the trial for an a priori comparison between competing designs under consideration. We provide an example of such a comparison.

Biological Assay↗

PubMed2006

Training and motivational factors as predictors of job satisfaction and anticipated job retention among implementers of a school-based prevention program.

Despite increasing dissemination of prevention programs, little is known about program implementers, including factors that promote satisfying job roles. Using Self-Determination Theory as a conceptual framework, we surveyed 128 implementers of the widely disseminated Primary Mental Health Project. Implementers reported 7.1 years average experience on the job (range 1-25 years), and 55% had two or more years of college. In a multivariate regression model, predictors of higher job satisfaction were: lower education level; positive perceptions of supervision and continuing education opportunities; and satisfaction at work of needs for autonomy and competence. For implementers with </=3 years experience, satisfaction of competence needs predicted job satisfaction; for implementers with >3 years experience, satisfaction of needs for autonomy and for relatedness predicted job satisfaction. Contrary to expectations, job satisfaction was unrelated to anticipated job retention.

Adult↗

PubMed2002

The socio-economic landscape of biotechnology in Spain. A comparative study using the innovation system concept.

Biotechnology is becoming a crucial factor for the innovation strategies of the industrialised countries. Thus, the analysis of the sector is gaining relevance for the identification of the technological strength and potential of a country (or region) in a context of globalisation. A specific national case study may serve for more general comparative analyses. We have selected the case of Spain as illustrative of the complexity and differences existing in Europe. By using the analytical framework of the "national systems of innovation" concept, we have performed a multistep analysis of the biotechnology sector in Spain, focussing first on regions of Madrid and Cataluña which together account for more than 50% of the sector in Spain. The firms in both regions have followed a common strategy based on diversification and investment in R&D and innovation, so as to be able to compete in an international and competitive environment. There are, however, some interesting differences between the two subsectors; the one from Cataluña being more based on industrial traditions, and the one from Madrid characterised by the emergence of more specialised firms. The study has been extended to the remainder of Spanish firms for comparative purposes. The case of Spain is illustrative of the divergences existing in the biotechnology sector in Europe. A comparison is made with the structural and organisational characteristics of the biotechnology sector in several European countries. It shows that there is diversity in the pattern of commercialisation between countries and within regions of countries. Understanding these differences may assist the design of appropriate policies to promote the development of biotechnology in Europe.

Adult↗

PubMed1999

The basal ganglia: a vertebrate solution to the selection problem?

A selection problem arises whenever two or more competing systems seek simultaneous access to a restricted resource. Consideration of several selection architectures suggests there are significant advantages for systems which incorporate a central switching mechanism. We propose that the vertebrate basal ganglia have evolved as a centralized selection device, specialized to resolve conflicts over access to limited motor and cognitive resources. Analysis of basal ganglia functional architecture and its position within a wider anatomical framework suggests it can satisfy many of the requirements expected of an efficient selection mechanism.

Animals↗

PubMed2002

Methods and approaches to study plant mitochondrial alternative oxidase.

The alternative oxidase is a non-proton motive 'alternative' to electron transport through the cytochrome pathway. Despite its wasteful nature in terms of energy conservation, the pathway is likely present throughout the plant kingdom and appears to be expressed in most plant tissues. A small alternative oxidase gene family exists, the members of which are differentially expressed in response to environmental, developmental and other cell signals. The alternative oxidase enzyme possesses tight biochemical regulatory properties that determine its ability to compete with the cytochrome pathway for electrons. Studies show that alternative oxidase can be a prominent component of total respiration in important crop species. All these characteristics suggest this pathway plays an important role in metabolism and/or other aspects of cell physiology. This brief review is an introduction to experimental methods and approaches applicable to different areas of alternative oxidase research. We hope it provides a framework for further investigation of this fascinating component of primary plant metabolism.

Journal Article↗

PubMed2001

Global context effect in normal and scrambled musical sequences.

The processing of chords is facilitated when they are harmonically related to the context in which they appear. The purpose of this study was to assess whether this harmonic priming effect depends on the version (normal vs. scrambled) of the context chord sequences. Normal sequences were scrambled by permuting chords two-by-two (Experiment 1) or four-by-four (Experiments 2 and 3). Normal chord sequences were judged less coherent than scrambled sequences. However, normal chord sequences showed facilitation for harmonically related rather than for unrelated targets, and this effect of relatedness did not diminish for scrambled sequences (Experiments 1-3). The data of musicians and nonmusicians were interpreted with Bharucha's (1987) spreading activation framework. Simulations suggested that harmonic priming results from activation that spreads via schematic knowledge of Western harmony and accumulates in short-term memory over the course of the chord sequence.

Auditory Perception↗

PubMed1993

Biological sciences and the nursing curriculum: a challenge for educationalists.

In recent years there has been considerable emphasis on the social and behavioural sciences in the nursing curriculum, with a corresponding tendency to devalue the role of the biological sciences. This paper argues the case for the biological sciences as being essential to the development of 'intelligent practitioners' and the progress of nursing. The notion of 'intelligent practice' is discussed against the background of a historical perspective which seeks to present a brief comparison of the traditional expectations of nursing practice with those for practice in the future. It is suggested that the application to nursing practice of relevant knowledge from the biological sciences is central to skillful practice and a 'caring' philosophy. Without such knowledge, nurses are unable to deliver safe, high-quality care and, in addition, 'handmaiden status' is perpetuated. In the past, the biological science component of the nursing curriculum was derived from medicine and the biomedical model: its teaching was, largely, inadequate and ineffective. If knowledge of biological science is crucial to 'intelligent practice' then there is an urgent need to review how this knowledge is structured and taught in the nursing curriculum. The conceptual model of 'bionursing' is suggested as a possible framework for developing a new approach to the structuring and teaching of biological sciences in the curriculum. Finally, consideration of biological sciences as an educational task, and the challenge of implementing a coherent, structured curriculum, are addressed.

Biological Science Disciplines↗

PubMed2001

Bridging theory and practice in the supervisory relationship: a sociocultural perspective.

AIM OF THE PAPER: This paper proposes alternative theoretical frameworks for conceptualizing supervisory relationships in clinical settings where professional development is the key activity. In discussing findings from the research, paradigm examples of students' mentor experiences will be used to illustrate socio-cultural theories of learning and their relevance to professional education in clinical settings. BACKGROUND RATIONALE: The concept of a theory-practice gap dominates approaches to preparing professionals for their future role. With increasing emphasis on work-based learning one of the many strategies designed to support students and professionals is supervision. This strategy has had mixed success. In many instances this is because of insufficient numbers of suitably experienced and prepared staff. Another factor is how supervision has been conceptualized. In professional education the term mentorship is often used synonymously with preceptorship and supervision. These terms are all concerned with activities intended to foster professional and educational development, and in many instances the learner is a novice working in an unfamiliar setting over a predefined period of time. RESEARCH AIMS AND DESIGN: This longitudinal study using a Constructivist/Naturalistic paradigm was designed to investigate factors influencing the professional development eight preregistration nursing students' during their practice experiences. A multimethod approach to data collection was used. An extensive literature review of nurse education texts was conducted. Research findings. The most significant influence was found to be effective mentorship. Characteristics of successful mentorship are best explained using frameworks derived from socio-cultural theories. Concepts of sponsorship, legitimate peripheral participation, scaffolding and zone of proximal development (ZPD) offer a more effective means to understand and implement an educational partnership for work-place learning.

Attitude of Health Personnel↗