Measuring Scope of Practice Enactment among Primary Care Registered Nurses in Ontario

Background: Primary care is the sector of health care in which patients first establish contact with the health system, are provided person-focused care over time for all new or common needs, and receive coordinated integrated health services provided elsewhere by other members of the health care team. Registered Nurses (RNs) in Canada provide care within this sector in varying roles. The extent to which RNs enact their full scope of practice in primary care settings in Canada is not known. The Actual Scope of Practice questionnaire (ASCOP) is a 26 item Likert scale questionnaire developed by researchers in Canada and validated in the acute care setting to measure the extent to which RNs apply the knowledge, skills and competencies of the professional full scope of practice. Similar to the acute care setting, there is a need to measure scope of practice enactment in the primary care setting. Objectives: The overall aim of this thesis was to measure scope of practice enactment in the primary care setting. Two research objectives were addressed: (1) to revise and adapt the ASCOP questionnaire for use in the primary care setting, and (2) to determine internal consistency, construct validity, and sensitivity of the modified instrument, the ASCOP-PC. Methods: To address the first objective, a narrative literature review and synthesis and an expert panel review was conducted. To address the second objective a cross-sectional survey of 178 RNs working in primary care organizations in Ontario was conducted Results: The ASCOP, with few modifications, addressed key attributes of nursing scope of practice in the primary care setting. The ASCOP-PC yielded acceptable alpha coefficients ranging from 0.66 to 0.91 and explained variances from 44.2 to 62.6. Total mean score of 5.16 suggests that RNs within these models of care almost always engage in activities reflected in the ASCOP-PC. Interpretation: Findings from this study support the use of a the modified ASCOP questionnaire as a reliable and valid measure of scope of practice enactment among primary care nurses in the primary care setting.

Speeches and paradoxes of cultural mediation: A practice between the elite and the cultural poverty

This text analyzes the speeches of a group of cultural mediators working in Madrid in public and private institutions of arts. The group was organized as part of the activities of the European Project Divercity: Diving into Diversity in Museums and the City of the Complutense University in March 2015. The aim of the interview was to unravel what they mean by diversity in the profession, and analyze the contradictions and objectives professions that arise in this new field of work.

Community policing in Northern Ireland: a resistance narrative

Policing in stable democratic societies is predominantly concerned with the implementation and practice of the globally accepted philosophy of community policing. However, the subtle complexities of Northern Ireland's transitional landscape present acute problems for the community policing concept, both as a vehicle for police reform and as a tool for increasing the co-production of security through improved community interaction with the police. This article will examine the current position of the Police Service of Northern Ireland (PSNI) and their Policing with the Community policy. Providing an overview of contextual and contemporary developments, it will assess the efficacy with which the PSNI have realised community policing, as espoused in Patten Recommendation 44. It concludes by determining the role and extent of community engagement with policing in Northern Ireland and the resistances and contestations to the implementation of the community policing in a post-conflict society.

Exploring the Impact of a Difficult Breastfeeding Experience on Maternal Identity: A Narrative Analysis

Introduction: Due to the implied health benefits for mother and baby, breastfeeding has become a key public health issue. Literature reviewed highlighted the ‘medical’ and ‘natural’ mother discourse which surrounds motherhood and impacts on women’s decisions to breastfeed. Whilst the emotional and physical strains of a difficult experience have been explored, it is unclear how these experiences impact on women’s identities as mothers and in what ways women are able to narrate and share their embodied experiences. Methods: Seven first time mothers who described themselves as having had a difficult breastfeeding experience were interviewed to gather data pertaining to how mothers construct narratives of breastfeeding and the impact of these narratives on their identity as mothers. An interest in both socio-political discourse and embodiment theory derived from the literature review led to the use of visual methods in eliciting narratives and the employment of a critical narrative analysis in exploring the data gathered. Findings: The participants’ narratives drew from ‘medical’ and ‘natural’ mother discourses and were found to constrain subjective experience and leave participants with feelings of guilt, frustration and loss. A prevailing assumption that unruly, excessive bodies must be controlled by a rational ‘mind’ led to the body becoming a site for control and resistance for participants as they attempted to conform to norms of motherhood and breastfeeding. Discussion: Results identified the ways in which women as mothers can see their subjective experiences diminished and their voices silenced due to a lack of available discourse and entrenched ideologies surrounding the ‘good’ mother. It is suggested that adopting a social justice agenda within therapeutic practice might prevent the internalisation of oppressive discourse which can lead to mothers’ psychological distress. Moreover, it is suggested that exploring the body in therapy might resist a mind/body dualism and lead to increasingly compassionate and accepting relationships with our bodies; in turn increasing awareness of subjective experience.

What is narrative research? Starting out

Narrative research has become a very popular field in contemporary social sciences. It promises new fields of inquiry, creative solutions to persistent problems, a way to establish links with other disciplines such as cultural and literary studies, enhanced possibilities of applying research to policy and practice, and a fresh take on the politics of social research (see for instance Andrews et al., 2013 [ 2008]; Andrews et al., 2004 [2000]; Andrews, Squire and Tamboukou,, 2004; Elliott, 2005; Emerson and Frosh, 2004; Freeman, 2009a; Herman, 2009; Hyvarinen et al., 2010; Lieblich et al., 2004; Patterson, 2002; Riessman, 2008; Trahar, 2009; Wells, 2011). This book aims to introduce you, step by step and with contemporary examples, to narrative research in the social sciences. It will give you an overview of a range of narrative methods, and it will situate narrative research in relation to other social science methods. It will show you what narrative research offers, as well as its difficulties. It will do this by drawing on work from a variety of disciplines, in theoretical and applied fields, across diverse topics, from health and the internet, to politics and sexualities, and in a number of different national contexts.

Every nation under heaven: the importance of the biblical concept of nations for contemporary mission practice

Is there a concept of nationhood in the Bible that can provide us with a framework for cross-cultural Christian mission? This thesis argues that current evangelical missiology has accepted too willingly the categories of the secular Enlightenment understanding of ethnicity and nationhood, and that it needs to rethink its understanding of nations from a biblical standpoint. While the pressures of globalisation are seen by some as rapidly eclipsing the nation-state, this thesis will argue that we need to move beyond the narrower secular categories of citizenship, political power and the boundaries of the state to recover a more biblical understanding of nationhood. By reference to Genesis 10-11, Acts 2:1-11 and those passages in the Book of Revelation that discuss the destiny of the nations, it will show that the biblical understanding of nations includes deeper ideas of shared history, culture and language as the essential components of nationhood. It will explain how nations are part of the created order, and explore the impact of the Babel narrative on our understanding of nations in relation to God. It will demonstrate that Pentecost did not reverse the curse of Babel, but served rather to honour the dignity and value of nations and their languages. It will also argue that nations have a destiny in the New Creation according to the Book of Revelation. This biblical concept of nationhood has significant implications in several areas: the development of a public theology; a Christian response to nationalism; the question of how urban mission fits within mission to the nations; and the importance of indigenous languages in cross-cultural mission, especially in the multicultural cities of Europe.

Caught in the dance : dream poems, experiential narrative, and the continuity hypothesis

This thesis explores the efficacy of the dream poem as a narrative device and is the outcome of practice-led research. The creative component, a novella, includes significant dreams of the main characters in the form of lyric poetry. The author’s own dream reports are used as source material for the poetry, and are contextualised within a prose fiction framework. Caught in the Dance is an experiment in combining prose with dream poetry and in investigating the experiential power of dreams on the formation of character identity. The exegesis discusses dreaming as an experience and the place of that experience in the context of identity narratives. Central to this discussion is the continuity hypothesis regarding the symbiosis of waking and sleeping life. Fludernik’s theory of experiential narrative is applied to dreaming and to the composition of poetry. This theory moves the emphasis of narrativity from events and the action of telling to ‘grounding narrativity in the representation of experientiality’ (Fludernik 1996:20). Ricoeur’s theories on identity and narrative are also applied to the reading of dreams, and experiences in general. He calls the system through which we ‘read’ life the ‘semantics of action’ (Ricoeur 1991b:28). Fludernik’s and Ricoeur’s approaches build on each other and they are brought together in the context of theories of the self, consciousness, and the processing of experience. Lyric poetry, as a creative product of that same consciousness, is discussed as experienced narrative moment. Furthermore, those moments are identified as defining elements in the identity narratives of characters. By combining the experience of dreaming with the experience imparted through lyric poetry, this thesis argues that the continuity hypothesis serves effectively as a demonstration of the wider narratological importance of experiential narrative.

[the Teaching Of Social Sciences In Health: Between Practice And Theory].

The models of teaching social sciences and clinical practice are insufficient for the needs of practical-reflective teaching of social sciences applied to health. The scope of this article is to reflect on the challenges and perspectives of social science education for health professionals. In the 1950s the important movement bringing together social sciences and the field of health began, however weak credentials still prevail. This is due to the low professional status of social scientists in health and the ill-defined position of the social sciences professionals in the health field. It is also due to the scant importance attributed by students to the social sciences, the small number of professionals and the colonization of the social sciences by the biomedical culture in the health field. Thus, the professionals of social sciences applied to health are also faced with the need to build an identity, even after six decades of their presence in the field of health. This is because their ambivalent status has established them as a partial, incomplete and virtual presence, requiring a complex survival strategy in the nebulous area between social sciences and health.

Otoneurological Evaluation: Current Good Practice.

80

[recommendations For Physical Exercise Practice During Pregnancy: A Critical Review].

Physical exercise is recommended for all healthy pregnant women. Regular practice of exercises during pregnancy can provide many physical and psychological benefits, with no evidence of adverse outcomes for the fetus or the newborn when exercise is performed at mild to moderate intensity. However, few pregnant women engage in this practice and many still have fears and doubts about the safety of exercise. The objective of the present study was to inform the professionals who provide care for Brazilian pregnant women about the current recommendations regarding physical exercise during pregnancy based on the best scientific evidence available. In view of the perception that few systematic models are available about this topic and after performing several studies in this specific area, we assembled practical information of interest to both the professionals and the pregnant women. We also provide recommendations about the indications, contraindications, modalities (aerobics, resistance training, stretching and pelvic floor training), frequency, intensity and duration indicated for each gestational trimester. The review addresses physical exercise recommendation both for low risk pregnant women and for special populations, such as athletes and obese, hypertensive and diabetic subjects. The advantages of an active and healthy lifestyle should be always reinforced during and after gestation since pregnancy is an appropriate period to introduce new habits because pregnant women are usually more motivated to adhere to recommendations. Thus, routine exams, frequent returns and supervision are recommended in order to provide new guidelines that will have long-term beneficial effects for both mother and child.

The Environment Of Professional Practice And Burnout In Nurses In Primary Healthcare.

to assess how nurses perceive autonomy, control over the environment, the professional relationship between nurses and physicians and the organizational support and correlate them with burnout, satisfaction at work, quality of work and the intention to quit work in primary healthcare. cross-sectional and correlation study, using a sample of 198 nurses. The tools used were the Nursing Work Index Revised, Maslach Burnout Inventory and a form to characterize the nurses. To analyze the data, descriptive statistics were applied and Spearman's correlation coefficient was used. the nurses assessed that the environment is partially favorable for: autonomy, professional relationship and organizational support and that the control over this environment is limited. Significant correlations were evidenced between the Nursing Work Index Revised, Maslach Burnout Inventory and the variables: satisfaction at work, quality of care and the intent to quit the job. the nurses' perceptions regarding the environment of practice are correlated with burnout, satisfaction at work, quality of care and the intent to quit the job. This study provides support for the restructuring of work processes in the primary health care environment and for communication among the health service management, human resources and occupational health areas.

[construction Of Measurement Instruments In The Area Of Health].

Measurement instruments are an integral part of clinical practice, health evaluation and research. These instruments are only useful and able to present scientifically robust results when they are developed properly and have appropriate psychometric properties. Despite the significant increase of rating scales, the literature suggests that many of them have not been adequately developed and validated. The scope of this study was to conduct a narrative review on the process of developing new measurement instruments and to present some tools which can be used in some stages of the development process. The steps described were: I-The establishment of a conceptual framework, and the definition of the objectives of the instrument and the population involved; II-Development of the items and of the response scales; III-Selection and organization of the items and structuring of the instrument; IV-Content validity, V-Pre-test. This study also included a brief discussion on the evaluation of the psychometric properties due to their importance for the instruments to be accepted and acknowledged in both scientific and clinical environments.

Is Sport Practice A Risk Factor For Shoulder Injuries In Tetraplegic Individuals?

A retrospective cohort. To report the incidence rates of shoulder injuries diagnosed with magnetic resonance imaging (MRI) in tetraplegic athletes and sedentary tetraplegic individuals. To evaluate whether sport practice increases the risk of shoulder injuries in tetraplegic individuals. Campinas, Sao Paulo, Brazil. Ten tetraplegic athletes with traumatic spinal cord injury were selected among quad rugby athletes and had both the shoulders evaluated by MRI. They were compared with 10 sedentary tetraplegic individuals who were submitted to the same radiological protocol. All athletes were male with a mean age of 32.1 years (range 25-44 years, s.d.=6.44). Time since injury ranged from 6 to 17 years, with a mean value of 9.7 years and s.d. of 3.1 years. All sedentary individuals were male with a mean age of 35.9 years (range 22-47 years, s.d.=8.36). Statistical analysis showed a protective effect of sport in the development of shoulder injuries, with a weak correlation for infraspinatus and subscapularis tendinopathy (P=0.09 and P=0.08, respectively) and muscle atrophy (P=0.08). There was a strong correlation for acromioclavicular joint (ACJ) and labrum injuries (P=0.04), with sedentary individuals at a higher risk for these injuries. Tetraplegic athletes and sedentary individuals have a high incidence of supraspinatus tendinosis, bursitis and ACJ degeneration. Statistical analysis showed that there is a possible protective effect of sport in the development of shoulder injuries. Weak evidence was encountered for infraspinatus and subscapularis tendinopathy and muscle atrophy (P=0.09, P=0.08 and P=0.08, respectively). Strong evidence with P=0.04 suggests that sedentary tetraplegic individuals are at a greater risk for ACJ and labrum injuries.Spinal Cord advance online publication, 17 March 2015; doi:10.1038/sc.2014.248.

Esporte e midia : interfaces e significados dos conteudos esportivos atribuidos pelos anlunos

Universidade Estadual de Campinas . Faculdade de Educação Física

Trajetórias de vida : lembranças, caminhos e constituições dos saberes docentes de professores de Educação Física = Paths and trajectories of life : memories, paths and establishment of teaching knowledge of Physical Education Professors

Universidade Estadual de Campinas . Faculdade de Educação Física