26,585 research outputs found
Evaluating the clinical appropiatenes of nurses' prescribing practice: method development and findings from an expert panel analysis
No full textBACKGROUND: The number of nurses independently prescribing medicines in England is rising steadily. There had been no attempt systematically to evaluate the clinical appropriateness of nurses' prescribing decisions.AIMS: (i) To establish a method of assessing the clinical appropriateness of nurses' prescribing decisions; (ii) to evaluate the prescribing decisions of a sample of nurses, using this method.METHOD: A modified version of the Medication Appropriateness Index (MAI) was developed, piloted and subsequently used by seven medical prescribing experts to rate transcripts of 12 nurse prescriber consultations selected from a larger database of 118 audio-recorded consultations collected as part of a national evaluation. Experts were also able to give written qualitative comments on each of the MAI dimensions applied to each of the consultations.ANALYSIS: Experts' ratings were analysed using descriptive statistics. Qualitative comments were subjected to a process of content analysis to identify themes within and across both MAI items and consultations.RESULTS: Experts' application of the modified MAI to transcripts of nurse prescriber consultations demonstrated validity and feasibility as a method of assessing the clinical appropriateness of nurses' prescribing decisions. In the majority of assessments made by the expert panel, nurses' prescribing decisions were rated as clinically appropriate on all nine items in the MAI.CONCLUSION: A valid and feasible method of assessing the clinical appropriateness of nurses' prescribing practice has been developed using a modified MAI and transcripts of audio-recorded consultations sent to a panel of prescribing experts. Prescribing nurses in this study were generally considered to be making clinically appropriate prescribing decisions. This approach to measuring prescribing appropriateness could be used as part of quality assurance in routine practice, as a method of identifying continuing professional development needs, or in future research as the expansion of non-medical prescribing continues.<br/
Perceptions and practice of concordance in nurses’ prescribing consultations: findings from a national questionnaire survey and case studies of practice in England
No full textBackground:The number of nurses able to independently prescribe medicines in England is increasing. Patient adherence to prescribed medicines remains a significant problem [Department of Health, 2000. Pharmacy in the Future: Implementing the NHS Plan. A Programme for Pharmacy in the NHS. Stationary Office, London]. Concordance—a partnership approach to medicine consultations—is advocated as an effective solution [Medicines Partnership, 2003. Project Evaluation Toolkit. Medicines Partnership, London].Objectives:To investigate whether nurses were practising the principles of concordance within their prescribing interactions.Design:Phase (i) postal questionnaire survey. Phase (ii): case studies of practice.Settings:Phase (i) primary and secondary care trusts throughout England in which nurse prescribers were practicing. Phase (ii) six general practice settings; one community midwifery service; one specialist community palliative care service; one secondary care ophthalmology unit; one NHS walk-in centre.Participants:Phase (i) a random sample of 246 nurses registered as independent nurse prescribers with the Nursing and Midwifery Council in 2002/2003. Phase (ii) purposively selected sample of 14 nurse prescribers who participated in Phase (i) of the study; a total of 208 purposively selected patients completed self-administered questionnaires.Methods:Phase (i) postal questionnaires. Phase (ii) structured non-participant observation of 118 nurse prescribing consultations; 115 post-consultation patient questionnaires; 93-patient postal questionnaires.Results:99% of the nurses in the national survey stated they were practising the principles of concordance. The majority of patients surveyed also reported experiencing concordance in practice. Observation of practice revealed that although some principles of concordance were regularly integrated into nurses’ practice, other principles were less often in evidence. Some evidence from both observation of practice and patient questionnaires suggested that a professionally determined ‘compliance’ agenda may still be partially operating in practice.Conclusions:Most nurses believe they are practicing concordance in their prescribing consultations. The majority of patients also reported that they had experienced some of the principles of concordance in practice. Observation of practice highlighted that the shift from a professionally determined compliance agenda to the integration of concordance into nurses’ prescribing consultations had not yet taken place
Evaluating nurse prescribers’ education and continuing professional development for independent prescribing practice: Findings from a national survey in England
No full textBackground:The number of nurses able to independently prescribe medicines in England has risen steadily in recent years.Aim:To evaluate the adequacy of nurses’ educational preparation for independent prescribing and to describe nurses’ experiences of their continuing professional development as prescribers in practice.Design and method:Postal questionnaire survey.Participants:Random sample of 246 nurses registered as nurse independent prescribers with the Nursing and Midwifery Council.Results:The majority of nurses considered that the initial taught course element of their education programme met their needs, either to some extent (61% 151/246), or completely (22% 54/246). Most nurses (77% 190/246) received the specified 12 days support from their supervising medical practitioner and most were satisfied and positive about this experience. Nearly all of the nurses (>95%) reported that they were able to maintain a range of specified prescribing competencies in practice. Two thirds (62% 152/246) of the sample reported that they were receiving support/supervision for prescribing. Ninety five per cent (233/246) of the sample also reported that they engaged in self-directed informal continuing professional development, but only half of the sample had experience of formally provided professional development opportunities. Approximately half (52% 127/246) of the sample identified needs for continuing professional development.Conclusion:This first national survey of the education and professional development experiences of nurse independent prescribers in England provides evidence which highlights areas in which national policy is working well, and also points up issues which may need addressing as the roll out of nurse prescribing continues. The study also highlights characteristics and issues that health care policy makers and nurse educationalists internationally may wish to consider in developing and refining their own nurse prescriber education programmes
"To holy people and holy ground" : Danish Latter-day Saint immigrant women, 1850-1914
No full textDefence date: 14 April 2023Examining Board: Corinna Unger (European University Institute, supervisor); Lucy Riall (European University Institute); Julie K. Allen (Brigham Young University); Donna Gabaccia (University of Toronto Scarborough)While much scholarship has been done on Danish migration, Latter-day Saints and American women in the nineteenth century, despite their well-documented presence, the voices of Danish Latter-day Saint women remain silent in these narratives. This is somewhat understandable as they do not comfortably fit into the patterns of any of these historical narratives. They do not fit generally accepted nineteenth century Danish migration patterns or motivations. In the narrative of Latter-day Saint women, rural isolation and linguistic challenges create barriers to inclusion. Likewise, this forms a barrier to the narrative of American women, paired with polygamy and religious difference. Relegating Danish Latter-day Saint women to a silent role in the wings, never allowing them a place centre-stage because they are too ‘strange’, creates a significant gap in scholarship where these three spheres overlap. Drawing on a variety of sources, my research fills the gap of these overlapping areas by moving Danish Latter-day Saint immigrant women from the margins to the centre, demonstrating how the voices and experiences of these women, contribute to and enrich these historical narratives. I explore how they operated within, shaped, and challenged three different spheres: the Scandinavian ethnic community in Utah, a community of Latter-day Saint women in Utah and the wider sphere of American women in the nineteenth century. These three layers of community were interwoven in the lives of Danish Latter-day Saint immigrant women as they negotiated their ethnic origin, religion, migration, and gender roles. I demonstrate how Danish Latter-day Saint women shaped and participated in a Scandinavian ethnic community, where their ethnic culture, language, and networks played a significant role in their daily lives. Despite barriers to inclusion, many Danish women were also engaged in wider discourses and movements both in Utah and nationally, on religion, women’s suffrage, women’s health, and medical training
Cultural Variation in the Theory of the Firm
No full textThis paper presents a model of the firm that includes the possibility of firm and employee-on-the-job decision making based on alternatives to profit and utility maximization. Such alternatives are relevant and significant when explaining firm activity in cultural environments in which self interest is not considered to be a primary force driving human behavior. Three types of firms are defined and their properties compared: the Western firm, the Japanese firm, and the clan. The third is a combination of the first two. JEL Categories: D21, Z19Culture, firm, decision making
A Latter-day Saint reading of Tolkien
No full textThis chapter explores the religious themes evident in some of Tolkien’s writings, most notably The Silmarillion, The Hobbit, and The Lord of the Rings. The author will utilise existing scholarship on Tolkien’s religious views and the imagery already explored in light of his Roman Catholicism. What will be distinct, however, is that the author will reflect on how they relate to, and can deepen their understanding of, Latter-day Saint beliefs. Tenuous links will not be made - the author will address issues as they seem justified. The paper will begin with an exploration of Tolkien’s motivations for writing, and also his religious beliefs. The two intertwine nicely, and provide a justification, if one is necessary, for the use of his work in a religious context. This does not suggest that The Lord of the Rings can be used devotionally, rather that it can point towards greater truth. The remainder of the paper will explore themes from Tolkien’s writings in the Latter-day Saint context explained earlier
A Latter-day Saint reading of Tolkien
No full textThis presentation is not available through ChesterRep.This paper explores the religious themes evident in some of Tolkien’s writings, most notably The Silmarillion, The Hobbit, and The Lord of the Rings. The author will utilise existing scholarship on Tolkien’s religious views and the imagery already explored in light of his Roman Catholicism. What will be distinct, however, is that the author will reflect on how they relate to, and can deepen their understanding of, Latter-day Saint beliefs. Tenuous links will not be made - the author will address issues as they seem justified. The paper will begin with an exploration of Tolkien’s motivations for writing, and also his religious beliefs. The two intertwine nicely, and provide a justification, if one is necessary, for the use of his work in a religious context. This does not suggest that The Lord of the Rings can be used devotionally, rather that it can point towards greater truth. The remainder of the paper will explore themes from Tolkien’s writings in the Latter-day Saint context explained earlier
Asbestopluma Topsent
No full textGenus Asbestopluma Topsent Asbestopluma Topsent, 1901: 23. Type species: Cladorhiza pennatula Schmidt, 1875 (by subsequent designation). Diagnosis. Cladorhizidae with palmate and/or arcuate anisochelae, and, in one case, the latter in combination with tridentate anchorate anisochelae (Lopes, Bravo & Hajdu 2011).Published as part of Vacelet, Jean & Kelly, Michelle, 2014, A new species of Abyssocladia (Porifera, Demospongiae, Poecilosclerida, Cladorhizidae) and other carnivorous sponges from the far eastern Solomon Islands, pp. 386-396 in Zootaxa 3815 (3) on page 392, DOI: 10.11646/zootaxa.3815.3.4, http://zenodo.org/record/22857
Synxenidae Silvestri 1923
No full textFamily Synxenidae Silvestri, 1923 Diagnosis: Long, thin and dark trichomes, 17 pairs of legs, with last two pairs adapted for jumping, and 8–11 ocelli in each eye. Palps of gnathochilarium with well-developed lateral extensions (Condé & Nguyen Duy-Jacquemin 2008). Remarks: Only two genera have been described in the family, Condexenus Nguyen Duy-Jacquemin, 2006 and Phryssonotus Scudder, 1885. The latter genus includes several fossil species from amber.Published as part of Vohland, Katrin & Hamer, Michelle, 2013, A review of the millipedes (Diplopoda) of Namibia, with identification keys and descriptions of two new genera and five new species, pp. 251 in African Invertebrates 54 (1) on page 25
Civil Disobedience in Latter-day Saint Thought
No full textThe twelfth article of faith declares, “We believe in being subject to kings, presidents, rulers, and magistrates, in obeying, honoring, and sustaining the law” (A of F 1:12). On its face, this statement seems to be an unqualified acceptance of legal authority, one that would suggest that Latter-day Saints ought to shun civil disobedience. However, a closer look at Restoration scripture, teachings, and experience reveals a more complicated picture. To be sure, law-abidingness has long been central to the Saints’ identity, particularly in the twentieth and twenty-first centuries, and like the New Testament, Restoration scripture generally accepts the need to “render to Caesar the things that are Caesar’s” (Mark 12:17) and affirms the legitimacy of the “powers that be” (Rom. 13:1). However, there has never been a clear consensus among Latter-day Saint authorities on the precise extent to which the Saints owe deference to secular law. From the beginning, members of The Church of Jesus Christ of Latter-day Saints have insisted that there are limits on the duty of obedience that Latter-day Saints owe to Caesar.
This abstract has been adapted from the author\u27s introduction
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