The professional role of breast cancer nurses in multi-disciplinary breast cancer care teams

Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses' unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses' innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role. © 2004 Elsevier Ltd. All rights reserved.

Learning with other health professions in the United Kingdom MPharm degree:Multidisciplinary and placement education

This paper reviews the approach to multidisciplinary and placement education in UK schools of pharmacy. The methodology involved triangulation of course documentation, staff interviews and a final year student survey. Staff members were supportive of multidisciplinary learning. The advantages were development of a wider appreciation of the students? future professional role and better understanding of the roles of other professional groups. The barriers were logistics (student numbers; multiple sites; different timetables), the achievement of balanced numbers between disciplines and engagement of students from all participating disciplines. Placement education was offered by all schools, predominantly in hospital settings. Key problems were funding and the lack of staff resources. Currently, multidisciplinary learning within the UK for pharmacy students is inadequate and is coupled with relatively low levels of placement education. In order for things to change, there should be a review of funding and support from government and the private sector employers.

Professionalisation and ophthalmic optics

This thesis is a sociological study of the ophthalmic optical profession in Britain. It includes a survey of the development of ophthalmic optics as an occupation and three questionnaire, surveys, one each of first and final year ophthalmic optics students, and one of practising opticians. The developmental survey showed that four themes have been important in the occupation's process of professionalisation - the actions of the opticians' leaders, the gradual unification of the bodies, representing segments of the profession, the struggle with medicine and the involvement of ophthalmic opticians in state-organised optical welfare schemes. The student surveys showed that the profession is now recruiting largely from middle class, state educated groups, and increasingly from women, who hold significantly different attitudes to income, independence and career commitment. In general, both first and final year students considered service to be rather more important than furthering knowledge. Practising opticians have been recruited increasingly, from middle class backgrounds, mostly from state selective secondary schools, but with a large minority from non-state schools. The self-recruitment rate of the profession (18.9%) is very similar to that for British medical students. Significant differences in concepts of professionalism were found among ophthalmic opticians of different ages, sexes and types of practice but few among those in different areas of practice. In general, ophthalmic opticians seemed to stress service more·than furthering knowledge. It is suggested that the leaders of the profession have 'negotiated' considerable autonomy for its members and that the possibilities for commercialism within the ophthalmic optician's professional role are intrinsically no greater than those in more 'established' professions.

Foundations of an intervention package to improve communication in residential care settings:a mixed methods study

Background: The prevalence of hearing loss is considerably higher in individuals in residential care than in people within the community-dwelling population, and yet hearing aids and hearing services are relatively underused. Care staff have a key role in supporting access to services. Objectives: This study identifies staff perspectives on hearing loss and their views about potential hearing service improvements. Study design: A four-stage mixed methods study was used, made up of qualitative interviews, observation, a survey and a stakeholder involvement meeting. Results: The qualitative stages indicated that staff were concerned about their levels of interaction with residents. Staff considered maximizing communication as part of their professional role. The quantitative survey indicated that these views were widely held by staff, and the stakeholder stage identified the need for social support and dedicated staff training opportunities. Conclusion: Care home staff regard communication as a shared issue. Future interventions could enhance access to hearing services and provide care home staff with training in hearing loss and hearing aid management. © 2013 Informa Healthcare.

The role of the innate immune system in the clearance of apoptotic cells

Rapid clearance of dying cells is a vital feature of apoptosis throughout development, tissue homeostasis and resolution of inflammation. The phagocytic removal of apoptotic cells is mediated by both professional and amateur phagocytes, armed with a series of pattern recognition receptors that participate in host defence and apoptotic cell clearance. CD14 is one such molecule. It is involved in apoptotic cell clearance (known to be immunosuppressive and anti-inflammatory) and binding of the pathogen-associated molecular pattern, lipopolysaccharides (a pro-inflammatory event). Thus CD14 is involved in the assembly of two distinct ligand-dependent macrophage responses. This project sought to characterise the involvement of the innate immune system, particularly CD14, in the removal of apoptotic cells. The role of non-myeloid CD14 was also considered and the data suggests that the expression of CD14 by phagocytes may define their professional status as phagocytes. To assess if differential CD14 ligation causes the ligand-dependent divergence in macrophage responses, a series of CD14 point mutants were used to map the binding of apoptotic cells and lipopolysaccharides. Monoclonal antibodies, 61D3 and MEM18, known to interfere with ligand-binding and responses, were also mapped. Data suggests that residue 11 of CD14, is key for the binding of 61D3 (but not MEM18), LPS and apoptotic cells, indicating lipopolysaccharides and apoptotic cells bind to similar residues. Furthermore using an NF-kB reporter, results show lipopolysaccharides but not apoptotic cells stimulate NF-kB. Taken together these data suggests ligand-dependent CD14 responses occur via a mechanism that occurs downstream of CD14 ligation but upstream of NF-?B activation. Alternatively apoptotic cell ligation of CD14 may not result in any signalling event, possibly by exclusion of TLR-4, suggesting that engulfment receptors, (e.g. TIM-4, BAI1 and Stablin-2) are required to mediate the uptake of apoptotic cells and the associated anti-inflammatory response.

(Para)translated ideologies in Simone de Beauvoir's 'Le deuxième sexe': the (para)translator's role

At the beginning of the 80s new approaches to translation were emerging in such a way that, in the global context of postmodernism and poststructuralism, they provoked a reassessment of Translation Studies (TS), acknowledging ideologies as a relevant concept to TS and considering the political and visible role of the translator. This introduction aims to establish a basic theoretical framework in which we can develop an analysis of the ‘alterations’ that, consciously or unconsciously, translators have imposed on Le deuxième sexe (1949, Gallimard) by Simone de Beauvoir for the last fifty years. Furthermore, it is essential to examine the divergences of the censoring attitude adopted by the first male translators (Parshley, Palant and Milliet) who considered this text to be a sex manual, and the one adopted by more recent female translators (Martorell and Simons) who considered it to be a philosophical book on feminism. Nevertheless, despite this tendency to consider that translators are the only professionals responsible for the translation process, it is necessary to bear in mind the work carried out by the paratranslator, who is the real censor and ‘decider’ of the way a work is presented to the translation community. Paratranslators work with paratexts (also known as ‘analysis-spaces’), and this makes it possible to study the ideological adaptation that a cultural object undergoes when it is incorporated into a new culture and society (covers, volumes, tables of contents, titles, iconic or visual elements and so forth). In short, the analysis of the texts and paratexts of Le deuxième sexe, along with its subsequent translations and rewritings into Spanish, Portuguese and English, will help reveal the function of the censoring apparatus and demonstrate the essential role that –without exception– ideologies play in the professional work of translation and paratranslation, since they have a decisive influence on the reception of the cultural (and ideological) object, in both the society in which it is created and that in which it is received.

Do pharmacy graduates possess the necessary professional skills?

Background - Expansion of the pharmacists' role within the United Kingdom has raised the question as to whether pharmacy graduates are equipped with the professional skills and attributes they will need to fulfil such roles. Aim - To describe the professional skills and attributes pre-registration recruiters perceive pharmacy graduates should exhibit and to establish whether final year students perceive they possess these skills and attributes. Method - Five individuals were interviewed from a variety of pre-registration employers; 90 final year students completed a questionnaire (response 69.2%). Results - The recruiters thought that whilst graduates possess sufficient knowledge, they show weaknesses such as inability to apply theoretical knowledge into practice and the lack of good communication and interpersonal skills. Conversely, a majority of students felt that they did possess the necessary skills to enter pre-registration training. Conclusion - Schools of pharmacy need to ensure that students have an opportunity to develop key professional skills to assist students in securing pre-registration positions. © 2010 FIP.

The management of stress amongst professional carers within a social services department

This thesis considers four broad areas:(i) ANALYSIS OF THE STRESS FIELD.(a) research studies, relevant to the British Social Services considering the cultural setting, and the rigor with which they were conducted; (b) models of stress, specifically examining the theoretical soundness and practical application of the Medical, Engineering and Transactional models;(c) organisational models of stress relating specifically to human service organisations.(ii) QUALITATIVE AND QUANTITATIVE RESEARCH METHODOLOGIES.(a) the appropriate application of each respective methodology and the particular usefulness of qualitative research designs; (b) the relevance of understanding the language and terminology associated with the subject area prior to the implementation of survey methods; (iii) FIELDWORK.(a) Phase 1. By use of focus groups, in-depth interviews and diary keeping amongst a small range of teams and managers, the Researcher develops a basic conceptual framework of stress within a Social Services context. In addition a small scale personality inventory was administered to participants.(b) Phase 2. This consisted of three key elements: 6 case studies in which the Researcher implements and appraises the impact of a range of intervention strategies designed to assist teams and their managers in dealing more effectively with stress; the administration of a large scale survey to all the field social work teams within the Social Services Department; an analysis of the user role within the stress process by way of two focus groups.(iv) THEORETICAL DEVELOPMENT.

Status and professional association councils. Available in 4 volumes.

This thesis examines the predictive value of a conceptual distinction between status-seeking associations and status-maintaining associations for enhancing understanding of ten selected professional associations and of the attitudes, values, behaviour and policies of their governing organs. Thirty four specific hypotheses have been tested by such research methods as questionnaires administered to individuals and associations, participant observation and an examination of association minutes and publications. Certain hypotheses have been found to be valid for particular matched pairs and/or groups of associations. The findings of the study suggest that the present conceptualisation of profession, the individual professional, professionalism, professionalisation, professional status and that relating to the role of the professions in society needs to be refined and modified in varying degrees in application to accounting associations, business graduate associations and management associations. The concept of the `ideal type' profession is shown to be of limited value in understanding certain aspects of the activities of business graduate and management associations. The findings of the study suggest that in future the professional associations examined may attach less importance to their qualifying role and lay more stress upon their representational role. The professional association faces a managerial challenge to adjust and adapt to a range of `external' pressures and `internal' demands from members and may increasingly need to be regarded as an organisation that possesses certain combinations or sets of characteristics rather than as a type of organisation that possesses a particular or relatively exclusive set. With a blurring of the distinction between the professional and state sector vocational education, and a growing customer/market orientation associated with the changing nature of work, membership of a professional association may, in future, come to be associated rather more with securing access to a relevant range of services and less with qualification for a particular career.

The corporatization of community pharmacy:implications for service provision, the public health function, and pharmacy's claims to professional status in the United Kingdom

Background Pharmacy has experienced both incomplete professionalization and deprofessionalization. Since the late 1970s, a concerted attempt has been made to re-professionalize pharmacy in the United Kingdom (UK) through role extension—a key feature of which has been a drive for greater pharmacy involvement in public health. However, the continual corporatization of the UK community pharmacy sector may reduce the professional autonomy of pharmacists and may threaten to constrain attempts at reprofessionalization. Objectives The objectives of the research: to examine the public health activities of community pharmacists in the UK; to explore the attitudes of community pharmacists toward recent relevant UK policy and barriers to the development of their public health function; and, to investigate associations between activity, attitudes, and the type of community pharmacy worked in (eg, supermarket, chain, independent). Methods A self-completion postal questionnaire was sent to a random sample of practicing community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to nonresponders 4 weeks later. Data were analyzed using SPSS (SPSS Inc., Chicago, IL, USA) (v12.0). A final response rate of 51% (n = 1023/1998) was achieved. Results The level of provision of emergency hormonal contraception on a patient group direction, supervised administration of medicines, and needle-exchange schemes was lower in supermarket pharmacies than in the other types of pharmacy. Respondents believed that supermarkets and the major multiple pharmacy chains held an advantageous position in terms of attracting financing for service development despite suggesting that the premises of such pharmacies may not be the most suitable for the provision of such services. Conclusions A mixed market in community pharmacy may be required to maintain a comprehensive range of pharmacy-based public health services and provide maximum benefit to all patients. Longitudinal monitoring is recommended to ensure that service provision is adequate across the pharmacy network.

Teachers' conceptions of their role

An analysis is made of the conceptions which serving teachers have of their role, though no attempt is made to relate this to their practice of teaching. A series of role items was collected to afford a description of the teacher's role in terms of school and society expectations as well as classroom behaviours. These were taken from the literature and from interviews with teachers, and confirmed in a preliminary survey. Presented as a questionnaire, replies to the main investigation were made by 881 teachers, working in a variety of schools from nurseries to comprehensives. Two attempts have been made to construct a role model. The first, depending on the judgement of items fitting theoretically derived roles, failed, due to diffuseness in the role of teacher. The second used factor analysis; six factors were extracted which represent meaningful and distinct areas of role. The analysis has depended largely on examination of scores taken from these factors. Teachers in all types of school have similar conceptions of discipline. Nursery-infant and junior staff generally agree on the other areas investigated, but the concepts of secondary teachers are distinct. They are more conservative and less child-centered. When the class being taught is held constant, few differences in role conception are found to be related to sex, being a parent, graduate status, or personality, as measured in terms of the extrovert and neurotic dimensions. The first few years of teaching bring considerable changes in role conception, and further changes occur with prolonged experience. Deputy heads in junior schools and nursery nurses have quite distinct role conceptions; those of all other teachers, including those holding senior posts in secondary schools, are similar. The perception of school climate influences the role conception of primary teachers directly, but it does not influence that of secondary teachers. The greatest variation in role conception is related to scores on the radical scale of Oliver and Butcher. Primary school teachers experience little constraint, but that reported by secondary school teachers is considerable, especially that coming from the head. Despite difficulties caused by the wide division between primary and secondary education, teachers have an accurate perception of the roles their colleagues adopt. A few misunderstandings may be due to a feeling of idealism amongst nursery and infant teachers. There is evidence in their conception of role that would enhance the professional standing of teachers, but this is not in a form which is likely to be recognised by the public.

The role of industrial design in technological innovation

This is an exploratory study in a field which previously was virtually unexplored. The aim is to identify, for the benefit of innovators, the influence of industrial design on the commercial success of new science-based products used for professional and industrial purposes. The study is a contribution to the theory of success and failure in industrial innovation. The study begins by defining the terminology. To place the investigation in context, there is then a review of past attempts by official policy-making bodies to improve the competitiveness of British products of manufacture through good design. To elucidate the meaning of good design, attempts to establish a coherent philosophy of style in British products of manufacture during the same period are also reviewed. Following these reviews, empirical evidence is presented to identify what actually takes place in successful firms when industrial design is allocated a role in the process of technological innovation. The evidence comprises seven case studies of new science-based products used for professional or industrial purposes which have received Design Council Awards. To facilitate an objective appraisal, evidence was obtained by conducting separate semi-structured interviews, the detail of which is described, with senior personnel in innovating firms, with industrial design consultants, and with professional users. The study suggests that the likelihood of commercial success in technological innovation is greater when the form, configuration, and the overall appearance of a new product, together with the detail which delineates them, are consciously and expertly controlled. Moreover, uncertainty in innovation is likely to be reduced if the appearance of a new product is consciously designed to facilitate recognition and comprehension. Industrial design is an especially significant factor when a firm innovates against a background of international competition and comparable levels of technological competence in rival firms. The likelihood of success in innovation is enhanced if design is allocated a role closely identified with the total needs of the user and discrete from the engineering function in company organisation. Recent government measures, initiated since this study began, are corroborative of the findings.

Revisiting the role stress-commitment relationship:can managerial interventions help?

Purpose: The purpose of this paper is to investigate the moderating influences of empowerment and professional development on role stress-commitment relationships, while examining and confirming the effects of role stress on organisational commitment. Design/methodology/approach: The results are drawn from a cross-sectional survey of 184 front-line employees (FLEs) from a travel service organization. Multiple and moderated regression analyses were employed to test the hypothesised direct and interaction effects. Findings: The results show that role stressors influence affective organizational commitment in FLEs negatively. Role ambiguity did not, unexpectedly, influence continuance commitment positively, but role conflict did. Professional development and empowerment are important management tools that can be used to combat the detrimental effect of role stress on organizational commitment. The paper finds empowerment to be particularly useful in combating the dysfunctional effects of role ambiguity on affective commitment, while professional development is a key tool that helps to combat the dysfunctional effects of role conflict on affective and continuance commitment. However, there are caveats associated with the implementation of these management tools. Practical implications: It is important for management to understand role stress from the FLE perspective, and strategically use intervention tools to help moderate the effects of role stress on organizational commitment components. Originality/value: This study adds further support to the literature that role ambiguity and role conflict should be studied as distinct components of role stress because treating role stress as a single construct may result in suboptimal outcomes for managers, and misleading findings for researchers. In this context, the paper contributes to literature by investigating the moderating impact of empowerment and professional development on the role stress-affective commitment/continuance commitment relationships. The findings suggest that different managerial strategies are required to combat the effect of each of these role stressors on the affective and continuance components of commitment respectively. © Emerald Group Publishing Limited.

The impact of buddying on psychological capital, work engagement and turnover intentions:an empirical study of socialization in the professional services sector

This article reports on a study investigating the impact of new employees' satisfaction with buddying on work engagement and explores the role of psychological capital in mediating this relationship. The study took place within a professional services organization wherein data were collected from 78 graduate newcomers in receipt of buddying. Satisfaction with buddying was found to have a positive relationship to both work engagement and psychological capital. The satisfaction with the buddy/work engagement relationship was fully mediated by psychological capital, providing support for Saks & Gruman's (2011) socialization resources theory. The results underscore the valuable role buddying can play as part of organizational socialization from a positive organizational behavior perspective. The research contributes to the growing evidence that positively oriented human resource practices can develop personal resources of newcomers within organizations. Recommendations are made for how the organization can improve and build upon this resource, thus developing the psychological capital of newcomers. © 2012 Wiley Periodicals, Inc.