Dissertations / Theses on the topic 'Full scope of practice'
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1
McTaggart, Elizabeth Sarah. "Nurses' experiences of full scope LPN practice in acute care." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/32055.
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The practice of licensed practical nurses (LPNs) in acute care in British
Columbia (BC) is undergoing a shift to incorporate the enhanced range of entry-level
competencies introduced by the College of LPNs of British Columbia in
2000. The full range of new LPN competencies, which now constitute full scope,
became a requirement for practical nurse licensure in BC in 2007 and are
challenging LPNs and Registered Nurses (RNs) alike to reexamine and redefine
the LPN role and LPN/RN relations in acute care. Research exploring the
experiences of RNs and LPNs, in their own words, with full scope LPN practice in
acute care staff mixes has not previously been conducted in BC.
This qualitative descriptive study explored the perceptions of 5 RNs and 4
LPNs working in RN/LPN skill mixes, in various Lower Mainland acute care
settings where the LPNs work to full scope. Conventional qualitative content
analysis was used to analyze the data from one in-depth interview and 8 short-answer
surveys. Analysis of one in-depth interview with an LPN yielded 3
categories: professionalism, receptivity, and appropriateness. Analysis of the 8
survey responses from RNs and LPNs yielded 3 categories as well, namely:
defining the role, determining the impact and determining the fit of the role.
Findings in this study indicate that overall, both RNs and LPNs report that clear
communication, LPN role clarity, experience working together over time, and a
supportive work environment contribute to positive experiences of the RN/LPN
skill mix. Feelings of burden, inconsistent teamwork, lack of respect, concerns about
patient acuity levels, and varied perceptions of the ability of LPNs and RNs to
assume responsibility for patient care present areas of challenge in the
workplace.Applied Science, Faculty of
Nursing, School of
Graduate
2
Cafasso, Mandi. "Advocacy: A Vital Step in Attaining Full Practice Authority for the Advanced Practice Registered Nurse." Otterbein University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1429220363.
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Benson-Martin, Janine. "The scope of ECT practice in South Africa." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/2793.
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Includes abstract.Includes bibliographical references.
Electroconvulsive therapy (ECT) involves the administration of an electrical current to the brain in order to produce a tonic-clonic seizure which is deemed therapeutic. It is an effective and safe procedure for the treatment of severe mental illnesses such as major depression, mania and schizophrenia. Currently little is known about the characteristics of ECT practice in South Africa. This study aims to determine current electroconvulsive therapy (ECT) practice and to compare it with reported ECT practice internationally. This is a retrospective, descriptive study, to determine the characteristics of ECT practice in South Africa; data was collected using a self-report questionnaire. The study population consisted of doctors and nurses who practiced ECT in any 12 month period between 2011 and 2012. Both private and state facilities were included in the study. Initially contact was made with hospital mental health facilities to ascertain whether an ECT machine was present on site. Once formal approval was obtained from the appropriate designated bodies, questionnaires were sent to clinical staff involved in ECT at active sites. The 36-item questionnaire covered relevant questions on: utilization rates, equipment, staffing, practice and monitoring parameters, and indications for use. Forty two institutions had an ECT machine on site, of which thirteen institutions reported non-use. Questionnaires were sent to the 29 active ECT sites. Facilities responding to the questionnaire amounted to 83% (n=24), but of these, 21 units responded to the ECT utilization questions. ECT is performed as a modified procedure in six provinces by psychiatrists, registrars, medical officers and general practitioners. In-and outpatient ECT is offered in 79% (n=19) of hospitals. The number of persons treated with ECT/10 000 population per year (ppy) is 0.22 while the number of ECT procedures/10 000 ppy is 1.19. More patients in the private sector receive ECT as a treatment modality than in the public sector (U = 22, p = 0.045). ECT is performed in a minor theatre/operating room in 79% of units, while the rest is performed in a treatment room. All but one unit had a separate recovery room. Informed consent or assent was used in all institutions. Pre-ECT work-up most commonly involved a physical examination (95.5%, n = 21) and basic blood work investigations (87%, n=20). Bilateral, unilateral and bifrontal electrode placements are used, while various dosage- determination and monitoring methods are employed. The vast majority of patients (89.22%, n=869) receiving ECT are between the ages of 18 and 59. The most common indication for ECT is depression (84.77%, n=796). The utilization rate in South Africa is similar to that of countries like Bulgaria, Poland and India, but less than that of some high-income countries. Even though ECT practices in South Africa generally follow international guidelines, standardisation of practice is still recommended.
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Usatine, Richard, Jim Holt, Miranda Lu, and Alexandra Verdieck. "Dermoscopy: Expanding ‘Scope’ of Practice and Preventing Skin Cancer Deaths." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/6446.
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In this hands-on preconference workshop, we will introduce dermoscopy, a proven adjunctive tool that increases sensitivity and specificity of melanoma detection and improves diagnostic accuracy for basal and squamous cell carcinomas. Participants will learn how to use a dermatoscope in clinical practice and learn the two-step algorithm to diagnose unknown skin lesions and determine the need for biopsy. Biopsy techniques will be taught with a handson evidence-based approach that can be applied at one’s home institution. Participants will leave with fundamental competence in the use of dermoscopy for early skin cancer detection, improved understanding of biopsy techniques, tools to train others, free apps, Dermoscopedia, online resources, and online and in-person courses.
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Usatine, Richard, Jim Holt, Alex Verdieck-Devlaeminck, and Miranda Lu. "Dermoscopy: Expanding ‘Scope’ of Practice and Preventing Skin Cancer Deaths." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/6449.
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Community health outreach workers (CHOWs) have been demonstrated to increase CRC screening patient education for vulnerable, medically underserved patients as well as increase CRC screening rates in rural populations.1,2 This project examined the effectiveness of CHOWs in increasing CRC screening rates among low-income, underserved ethnic minorities in Portland, Maine. Eligible patients were ages 50-75; due for CRC screening; enrolled in Medicaid or had no health insurance; and spoke Arabic, English, French, Kinyarwanda, Somali, Spanish or Vietnamese. Seven CHOWs were trained in CRC screening outreach and assigned to patients from their own ethnic communities where they employed culturally sensitive interventions to reduce barriers to CRC screening. CHOWs attempted contact with patients by phone four times prior to sending a language-specific letter to patients recommending CRC screening. CHOWs offered fecal immunochemical testing (FIT) or colonoscopy and provided tailored education and frequent reminders for colonoscopies, explanations about procedures for bowel preps, transportation to colonoscopies, reminders and instructions for FIT completion as well as assistance with health insurance and financial barriers. Upon completion of this session, participants should be able to: Define the role of a community health outreach worker (CHOW) in CRC screening. State three common sociocultural barriers patients experience for CRC screening. Identify the efficacy of CHOWs in increasing CRC screening rates.
6
Hoppe, Elizabeth Susan. "Optometry's expanding scope of practice legislation, interprofessional relations, and risk." Ann Arbor, Mich. : University of Michigan, 1999. http://books.google.com/books?id=uxQvAAAAMAAJ.
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Nehring, Wendy M., American Nurses Association, and Nursing Division of the American Association on Mental Retardation. "Intellectual and Developmental Disabilities Nursing: Scope and Standards of Practice." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu_books/105.
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"Last published in 2004, this new second edition contains up-to-date information for practitioners committed to providing a continuum of services to individuals with intellectual and developmental disabilities (ID/D) across the lifespan." --nursebooks.orghttps://dc.etsu.edu/etsu_books/1111/thumbnail.jpg
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Lucero, Samantha. "Defining the Scope of Practice for Nurse Practitioners in MIAM." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4074.
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Minimally invasive aesthetic medicine (MIAM) is a relatively new field, which lacks a clearly defined scope of practice. The purpose of this project was to clarify the scope of practice for nurse practitioners in MIAM in California. Without a clearly defined scope of practice, nurse practitioners are unable to practice to the full extent of their license which causes them to be underutilized and face liability issues. This project sought to answer the question: What is the scope of practice of the nurse practitioner in MIAM in the state of California? The model of professional nursing practice regulation was the model used to guide this project. Sources of evidence included case law that has emerged since 1983; reviewing documents from 3 state boards of nursing; and a survey of nurse practitioners who practice in the field of MIAM. The evidence was analyzed noting themes while determining what the legal backbone is for nurse practitioner's scope of practice in California. This project found that nurse practitioners in this field keep up to date in their knowledge, educate their patients, utilize methods to maintain competency, feel support in their environment, assess and refer to others when appropriate, and teach both staff and patients evidence-based practices. It also found that standardized procedures are the legal backbone to understanding the scope of practice in California. A scope of practice was developed based on the findings of this project which was then reviewed by an expert. It is recommended that nurse practitioners utilize their resources to obtain and maintain knowledge as well as learn what the standardized procedures are in their facility. The implications for clarifying the scope of practice will serve this population to fully utilize their capabilities and practice safely, as well as help to develop this relatively new field.
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Finnell, Deborah S., Elizabeth L. Thomas, Wendy M. Nehring, Kris A. McLoughlin, and Carol J. Bickford. "Best Practices for Developing Specialty Nursing Scope and Standards of Practice." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6707.
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Nursing specialization involves focusing on nursing practice in an identified specific area within the entire field of professional nursing. A defined specialty scope of practice statement and standards of professional practice, with accompanying competencies, are unique to each nursing specialty. These documents help assure continued understanding and recognition of nursing’s diverse professional contributions. The purpose of this article is to demystify the process for specialty nurses who are creating or revising their specialty nursing scope and standards of practice. We provide best practices for the developmental process based on our recently published scope and standards of specialty nursing practice. The conclusion provides strategies to disseminate scope and standards documents to appropriate stakeholders.
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Halliday, Richard. "The transferware engraver : training, practice and scope at the Spode Works." Thesis, Manchester Metropolitan University, 2018. http://e-space.mmu.ac.uk/620679/.
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This investigation focuses on the transferware engraver at the Spode Works. Transfer-printing on earthenware arose as an attempt to replicate the look of eastern ceramics. Spode Works began producing transferware in 1784, and made significant improvements to the process, widening the market across the classes. Transferware patterns could be derived from Chinese-export wares, extant printed images known as source prints, in-house designs or other transferware products. The designs were cut into copper-plates with simple hand-tools by skilled, trained engravers. Prints in underglaze colour were taken from the copper-plates, applied to the blank ware, glazed, and fired to form the product. The research aims were both historical and transformative. (1) To support the preservation of Britain’s largest and most complete archive of hand-engraved copper-plates used in the production of transferware: a repository of craft and design knowledge. The Spode archive contains most of the production plates spanning the factory’s life, 1784 to 2008, and representing all styles and techniques. Due to the intrinsic material value, such archives face rationalisation; the Minton case being known from publication. (2) To ascertain the scope of work undertaken by the engravers and define their role in image selection and adaptation as mediators at the interface between design and production, subjects hitherto insufficiently defined. (3) To define the engravers’ artistic status during key stages of the factory’s life, and to examine their degree of specialisation. (4) To investigate the nature and experience of apprenticeship training for transferware engraving through extant engravings and apprentice’s accounts. Connoisseurship study of archival copper-plates alongside source-work, ceramics and literature formed the basis of the multiple-aspect approach. Within the compass of this thesis, two in-depth case studies are presented that demonstrate surprising continuity in the industry with engraving processes remaining substantially the same over the course of two centuries. The role that the engraver played in working source images or designs into transferware patterns had been poorly understood; it has emerged that the transferware engraver is an intermediary translator of imagery rather than a designer, and authorship in a transferware pattern is multiple. Interviews with those who formerly worked in the industry, documentation of the engraving process from start to finish and a brief personal engraving apprenticeship experience provided detailed primary evidence of engraving from the perspective of the insider. An engravers’ apprenticeship is learning by observation and practice where coordination between tool, hand, eye and brain are internalised. This research expands knowledge of engraving techniques and practices in a specialist area hitherto ignored in the engraving literature. It offers new historical understanding of the role of the engraver as intermediary between design and production. The research points out diagnostic features for understanding the material evidence of copper-plates. Detailed comparisons including micrographic images demonstrate the stratified evidence contained within large object archives (Spode) and small design archives (Mountford tissue pulls), evidence threatened by selective rather than comprehensive retention. It provides thoroughgoing assessment of practical techniques for digitisation and replication of copper-plates so that archive originals can be spared routine handling and security risks. Finally, the research highlights the Spode copper-plate archive as a repository of major importance for the study of craft and design.
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Bodin, Ida. "Cognitive work analysis in practice : Adaptation to project scope and industrial context." Licentiate thesis, Uppsala universitet, Avdelningen för visuell information och interaktion, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-284334.
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The Cognitive Work Analysis (CWA) framework is widely used by researchers for the analysis of complex systems. It, however, lacks the same impact amongst industrial practitioners. This thesis investigates possible adaptations of the framework to project and industrial constraints, and the consequences associated with such adaptations. Long haul heavy vehicle transportation is the application domain for the work presented in the thesis. The CWA framework has been applied within the Methods for Designing Future Autonomous Systems (MODAS) project. Adaptations have been made to fit the framework within the project constraints and the industrial contexts. Interviews with stakeholders in an industrial organization regarding possible use of models from the CWA framework have been made. The CWA was scaled to available resources when applied within the MODAS project. From this we realized that prioritization of work activity can have consequences on the resulting systems ability to handle unforeseen events. Further, a focus on the current system probed a rapid out-dating of the analysis due to technical development. The conclusion is that even if advantages are lost during adaptation due to practical constraints, the CWA framework could add value to practitioners within industry if adapted to the industrial context.
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Allen, Stephanie. "Establishing the scope of pilates through systematic evaluation: evidence and current practice." Thesis, Ulster University, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.603526.
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Pilates is an increasingly popular form of exercise that is widely used both within fitness and rehabilitation. There is also a growing evidence-base for Pilates however the authors of previously conducted studies acknowledge numerous limitations which affect the interpretation of the results. Hence the need for future well-designed randomised controlled trials (RCTs) with appropriate target populations, details of the intervention and use of standardised and valid outcome measures. The overall aim of this thesis was to investigate the scope of Pilates through systematic evaluation of current literature and current use of Pilates. This was achieved through exploring and establishing the types of clients attending Pilates classes, their rationale for attendance at classes and the facilitators and barriers to attending Pilates. In addition, clients' perceived effects of Pilates, the timeframe to achieve these effects and the ways in which exercises were planned and progressed in the class setting were also explored and established. This information was then related to the current literature-base to form a basis for recommendations to inform the design of high-quality RCTs. To achieve this, five novel studies were undertaken. The focus groups with Pilates instructors (n=27) and clients attending Pilates classes (n=25) highlighted that Pilates is a method of providing individually-modified and supervised exercises in a group setting for those self-managing long-term musculoskeletal conditions, particularly low back pain. The use of relaxation and education were also deemed to be additional facilitators to clients attending classes. A wide variety of effects were experienced by clients over the period of attendance at classes including reductions in pain, confidence to exercise and improvements in strength, flexibility, body awareness, posture, core stability and balance. However, numerous barriers were also expressed to practicing Pilates including cost, predominately female classes and lack of correction from the Pilates instructor when independently carrying out the exercises. The two large-scale questionnaire surveys of Pilates instructors (n=4201797, response rate 53%) and clients attending Pilates classes (n=762/971, response rate 78.5%) reinforced the findings of the previous focus group studies with Pilates used as an exercise approach for improving overall general health and well-being, in terms of health maintenance and in the rehabilitation of a wide variety of medical conditions, particularly musculoskeletal disorders. A wide variety of effects were again reported with the most prevalent including improvements to posture, core stability, body awareness and sense of well-being. Clients were long-term users of Pilates and the majority reported noticing the overall effect of Pilates from 3-6 months. Facilitators to this long-term attendance included personal adaptation of the exercises in a small group setting and collaborative goal-setting with barriers again including cost and lack of independent practice of Pilates. The final study, a systematic review of literature (n=38 randomised controlled trials) highlighted the potential for a number of positive effects of Pilates across a wide variety of populations particularly those with low back pain, the healthy population and a sedentary/obese population. These included reductions in pain and disability and improvements in strength, flexibility, balance, core stability, function, body composition parameters, general health, psychological effects and on hemodynamic and metabolic parameters. However, due to the numerous limitations in the studies in terms of heterogeneity of the Pilates interventions and lack of standardised outcome measures and control groups, caution must be taken when interpreting the results. In addition, many of the studies were at high risk of bias. Hence, it can be concluded that there is a need for further well-designed research trials to accurately determine the effectiveness of the Pilates method. The findings of the five studies have provided a basis for future recommendations in the design of a high quality RCT.
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Nakamura, Masanori 1966. "Move a, scope, and relativized minimality." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=56651.
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This thesis deals with two aspects of operators within the framework of Government and Binding theory; (i) how they are assigned their scope, and (ii) how they are licensed. In an attempt to answer these questions, the relation of Move $ alpha$ (such as scrambling, NP-movement, and wh-movement) to the scope of operators and the licensing of wh-elements, negative polarity items, and adverbs are examined. It is argued that scope assignment is dictated by the Scope Principle and the Empty Category Principle. It is also argued that licensing of operators is determined by the Feature-Dependent Item Criterion. These principles and criterion make use of the concept of Government Theory Compatibility, which is built into Relativized Minimality. It is suggested that this concept should be characterized in terms of a set of lexical features. The approach advocated here accounts for the interpretive and distributional behavior of operators without recourse to parameterization of LF principles.
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Buijsman, Stefan. "Philosophy of Mathematics for the Masses : Extending the scope of the philosophy of mathematics." Doctoral thesis, Stockholms universitet, Filosofiska institutionen, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-126252.
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One of the important discussions in the philosophy of mathematics, is that centered on Benacerraf’s Dilemma. Benacerraf’s dilemma challenges theorists to provide an epistemology and semantics for mathematics, based on their favourite ontology. This challenge is the point on which all philosophies of mathematics are judged, and clarifying how we might acquire mathematical knowledge is one of the main occupations of philosophers of mathematics. In this thesis I argue that this discussion has overlooked an important part of mathematics, namely mathematics as it is exercised by ordinary people (almost everyone without a mathematics degree). I do so by looking at the different theories that have been put forward in the recent debate, and showing for each of these that they are unable to account for the mathematical practices of ordinary people. In order to show that these practices do need to be accounted for, I also argue that ordinary people are (sometimes) doing mathematics, i.e. that they engage in properly mathematical practices. Because these practices are properly mathematical, they should be accounted for by any philosophy of mathematics. The conclusion of my thesis, then, is that current theories fail to do something that they should do, while remaining neutral on how well they perform when it comes to accounting for the practices of professional mathematicians.
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Raz, Edny. "Self-determination for the Palestinians : scope and limits." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=69766.
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Since 1991, the Israeli-Palestinian drama has shifted from the tragic course of war and violence, to a framework for peace. Israel's sovereignty is a fait accompli. The geo-political form of Palestinian self-determination is to be shaped by both parties, taking into account regional reality and international law.This study serves as a modest examination of the application of certain international law concepts in settling two conflicting national aspirations within a unique factual context.
The main theoretical definitions of self-determination and its legal status in international law are first reviewed, along with the socio-juridical aspect of nationhood. The analysis of those topics constitutes a starting point for discussing basic Palestinian legal arguments related to Israel's right to exist, as well as to the scope of Palestinian national entity.
The abandonment of "armed struggle" as a legitimate course of action, and of Palestinian legal claims justifying a hostile policy against Israel, are necessary pre-conditions for co-existence, in which each nation determines its political fate.
Another vital element for the realization of such a modus vivendi is the development of a relationship built on trust. A restrained application of Palestinian self-determination might be necessary in the interim. The complete expression of Palestinian free will is, for many, still a utopian idea. Its achievement is largely dependant upon the negation of Palestinian legal claims which are aimed at the invalidation of Israel as a legitimate, sovereign state.
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Hebert, Robin Lewis. "Initiation of In-hospital CPR: An Examination of Nursing Behaviour Within their Scope of Practice." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/35804.
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Cardiopulmonary resuscitation (CPR) and defibrillation are the interventions performed by health care professionals in order to preserve the life of a patient suffering cardiac arrest. These tasks are important to the role of nurses because they are the most common first responders to in-hospital cardiac arrest scenarios. The early initiation of CPR and defibrillation is essential in increasing the likelihood of a patient surviving cardiac arrest. Despite possessing the knowledge, skills, training, and professional obligation to deploy CPR and defibrillation independently, nurses may hesitate to perform the appropriate actions in a timely manner. This topic has been studied previously; however, there have been no studies directly examining this issue in the Ontario context. This thesis explored the factors that influence the behaviour of nurses in the first responder role by employing a mixed-methods research design. The quantitative portion of the study consisted of a series of scales on an online survey that examined teamwork factors and nurses’ experience with CPR events. The qualitative part of the study consisted of open-ended questions on the survey as well as individual interviews with nurses to understand the barriers and enablers to the role of nurses in the enactment of basic life support (BLS). The qualitative data were analyzed with a modified grounded theory approach. The qualitative data analysis followed the guidelines developed by Charmaz (2006) and employed the conceptual framework on optimizing scopes of practice developed by the Canadian Academy of Health Sciences (2014) to extrapolate findings on the influence of nurses’ scope of practice on their behaviour. This study revealed a number of contextual factors in Ontario influencing nurses’ deployment of CPR and defibrillation including variations in hospital unit types, geography, workload, the availability and quality of technology, legislation and regulation, accountability, as well as economic constraints.
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Brand, Emily Katherine. "Humanistic Vocal Pedagogy: Exploring a Voice Teacher’s Scope of Practice through a Perspective of Wellness." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1461093502.
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McLaine, Catherine Clare. "Diabetes and oral health complications: Australian diabetes health care professionals' knowledge and scope of practice." Thesis, Curtin University, 2013. http://hdl.handle.net/20.500.11937/2373.
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The research investigated Australian diabetes health professionals’ (DHPs’) knowledge and their intervention, health promotion, and care management of oral health issues which impact upon the person with diabetes. Results identified the need for enhanced provision of diabetes-specific oral health education, clinical resource tools, and the delivery of oral health services. The findings were discussed within the context of the current health system policies and their impact upon DHPs’ management of diabetes related oral health complications.
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Boyee, Jennifer Kristin. "PRACTICE AND APPLICATION OF KNOWLEDGE BY NUTRITION STUDENTS." UKnowledge, 2011. http://uknowledge.uky.edu/gradschool_theses/122.
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Practice and knowledge of upper‐level human nutrition and dietetics students (juniors and seniors, n=96) attending a midwestern university were compared to their comprehension and application of the Scope of Dietetics Practice. The sample consisted of 96 students, primarily (72%) in the 21 – 23 age category; females made up 83% and males comprised the remaining 17% of the sample. In this sample, 70% of the participants reported dietetics as their current major, and 30% stated that their major was human nutrition. Overall, students majoring in human nutrition responded neutrally to the questions concerning comprehension, knowledge, and implementation of the Scope of Dietetics Practice, while participants majoring in dietetics reported better knowledge, comprehension, and implementation of the Scope of Dietetics Practice. However, students majoring in human nutrition reported increased use of nutrition information to diagnose others than were students studying dietetics. In general, participants responded to questions regarding their practice and application of nutrition knowledge to themselves and others as would be expected, though there were differences between the students studying human nutrition and those studying dietetics.
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Greenwood, Jennifer. "The impact of geography, training, and experience on scope of practice among Certified Registered Nurse Anesthetists." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3440.
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The role of Certified Registered Nurse Anesthetists (CRNAs) in the delivery of anesthesia care is evolving given the recent recommendations for Institute of Medicine and provisions in the Affordable Care Act. Despite rigorous clinical training and consistent outcomes studies to support quality care given by CRNAs, the scope of practice of nurse anesthetists is frequently limited, and they do not practice to the full extent of their education and training. As health care spending becomes more constrained and demand for anesthesia services rises, the role of nurse anesthetists as more autonomous providers of anesthesia may be required to maintain access to quality care in a cost-conscious environment. Understanding the factors that influence one’s decision to engage in a broad scope of practice may guide training and recruiting practices. Using Bandura’s Self-Efficacy Theory as a framework to conceptualize scope of practice, an internet based survey of a cross-section of practicing CRNAs was conducted. Subjects responded to questions to describe the geography of their practice, experience as a civilian or military CRNA, and detailed clinical training variables. A composite score was created to gauge overall quality of clinical training. Each CRNA then rated their global scope of practice using a novel SOP-VAS, from 0-100. 1409 subjects participated in this study, yielding 1202 usable data sets. CRNAs practicing in rural locations exhibited higher mean SOP scores than those practicing in urban and suburban locations (p<0.001). CRNAs practicing in states that had opted-out of physician supervision had higher mean SOP scores (p<0.001). Years in Practice was positively correlated with SOP (p<0.01), however months on active duty in the military as a CRNA did not show a statistically significant correlation with SOP. Gender and the composite quality score also demonstrated a statistically significant affect on SOP. Regression modeling using significant predictors from prior analyses resulted in predictive model to describe SOP (p<0.001). Use of the novel SOP-VAS was found to be a reliable and valid tool to measure SOP among nurse anesthetists. Further study is warranted to identify additional factors that may contribute to scope of practice among nurse anesthetists.
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Bell, Janet. "An investigation into the scope of practice of a registered critical care nurse in a private hospital." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/16595.
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Thesis (MCur)--University of Stellenbosch, 2005.ENGLISH ABSTRACT: The critical care nurse works in an environment where patient need often shifts the parameters within which she or he practices. It is expected of a skilled critical care nurse to be able to make independent decisions and take action regarding patient care based on her or his knowledge and skills without discounting the parameters of her or his scope of practice. Practice experience has indicated that the critical care nurse is often uncertain about whether her or his clinical activities are protected by the regulations provided by the Nursing Council. This is more specifically true in the private hospital industry where medical advice or assistance is not always easily available. This situation led to the following research question: Do the available professional and legal guidelines provide an appropriate foundation to guide the practice of the registered critical care nurse in the private hospital sector critical care environment? A non-experimental descriptive study with a qualitative orientation was conducted in 19 private hospitals in the Western Cape. Through nonprobability, random sampling, 71 registered critical care nurses were included in the study. A questionnaire was designed and validated to collect the data. Quantitative data was analysed through Excel® while qualitative data was analysed thematically. It was found that the legal and professional guidelines in place at present do provide a foundation for the clinical activities of critical care nursing in the private hospital sector. It is suggested that it is rather the critical care nurses’ interpretation of the Scope of Practice (No.R.2598 of 30/11/1984 as amended) that limits their practice as opposed to the wording of the regulations. It is recommended that critical care nurses must determine nursing care parameters based on patient need, using the regulations as a foundation for critical, analytical and reflective practice rather than as a set of rules to be followed. Key words: Scope of practice, critical care practice, ICU nursing care, private hospital nursing practice.
AFRIKAANSE OPSOMMING: Die kritiekesorgverpleegkundige werk in ‘n omgewing waar pasiëntebehoeftes gereeld die parameters waarin sy of hy praktiseer, verskuif. Dit word van ’n bekwame kritiekesorgverpleegkundige verwag dat sy of hy onafhanklike besluite en aksies met betrekking tot pasiëntesorg, gebaseer op haar of sy kennis en vaardighede, sal neem sonder om die parameters van haar of sy bestek van praktyk te oorskry. Praktykondervinding het getoon dat die kritiekesorgverpleegkundige dikwels onseker is oor watter van haar of sy optredes deur die Regulasies, soos deur die Raad op Verpleging gespesifiseer word, beskerm word. Dit is nog meer spesifiek van toepassing in die privaathospitaal-industrie waar geneeskundige advies en bystand nie altyd maklik beskikbaar is nie. Die situasie het tot die volgende navorsingsvraag aanleiding gegee: Voorsien die beskikbare professionele en wetlike riglyne ’n geskikte grondslag om die praktyk van ’n geregistreerde kritiekesorgverpleegkundige in die privaatsektor- kritiekesorgomgewing te rig? ’n Nie-eksperimentele, beskrywende studie met ’n kwalitatiewe oriëntasie is in 19 hospitale in die Wes-Kaap onderneem. Deur nie-waarskynlikheids-, toevallige steekproefneming is 71 geregistreerde kritiekesorgverpleegkundiges in die studie ingesluit. ’n Vraelys is ontwerp en gevalideer om inligting in te samel. Kwantitatiewe data is deur middel van Excel ontleed terwyl kwalitatiewe data tematies ontleed is. Daar is gevind dat die wetlike en professionele riglyne wat tans beskikbaar is, ‘n grondslag bied vir die kliniese aktiwiteite van kritiekesorgverpleegkundiges in die privaathospitaal.. Dit word voorgestel dat dit die kritiekesorgverpleegkundige se interpretasie van die Bestek van Praktyk (No.R.2598 of 30/11/1984 soos aangepas) is wat hulle praktyk beperk, eerder as die bewoording van die regulasie self.
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Yeh, Yi-Lien. "An investigation of Taiwanese teachers' experience, beliefs and practice in piano teaching : exploring the scope for creativity." Thesis, University of Exeter, 2014. http://hdl.handle.net/10871/16572.
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This study aimed to explore Taiwanese piano teachersâ beliefs about good teaching, and their practice, particularly teachers who teach beginners or young children; and to gain understanding of how Taiwanese piano teachers perceive creativity in their teaching. The perceptions of piano teaching of seven Taiwanese teachers were explored through using a qualitative methodology, which included an open questionnaire, two interviews separated by observation of classroom practice, and a reflective diary prepared by the participants which was facilitated by video-stimulated recall. The principal areas and findings of my research were that Taiwanese piano teachersâ beliefs about what constituted good lessons are diverse. These were explored from three perspectives, namely, the characteristics of effective teachers, the components of effective lessons, and effective teaching strategies. The participant teachersâ attitudes towards creativity in teaching were also different, and can be categorised as ranging from fixed and rigid, to flexible and open. They identified several teaching strategies as creative teaching, such as using metaphor, storytelling, and Internet resources. Additionally, their various purposes in using creative teaching were observed to be to develop learnersâ musical abilities; for enjoyment; and to impart a specific teaching point. Although the teachersâ own experiences were found to have a positive effect on their teaching beliefs, the influence of these benefits was not always evident in their actual practice. Pupilsâ low motivation to learn and insufficient practice were considered as the common challenges and, when reflecting on their own teaching in the second interview and in the diaries, most of the participants focused mainly on analysis of pupilsâ playing errors, and tended to believe that repeated practice by the learners was the best approach to improving performance. In contrast, two teachers believed their expertise in both music and teaching could help their learners to deal with learning difficulties. Based on these research results, I conclude that creativity in piano lessons can be understood from two perspectives. The first relates to how teachers perceive their own teaching and whether they are content with what they do or seek to develop their teaching competence; the other is associated with teachersâ own philosophy of the function of education, which affects how teachers develop their teaching.
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Harkey, Kelli, Stephanie Little, and Janice Lazear. "The Struggle for Full Practice in North Carolina." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7083.
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That nurse practitioners (NPs) delivery high-quality care, equivalent to that provided by physicians, is well documented. However, many states have laws that restrict NPs from full practice authority, limiting their ability to comprehensively meet patient needs. North Carolina is a state that has very restrictive laws, with NPs working under physician supervision. In this article we address the effect restricted practice has had in North Carolina and the introduction of Senate Bill 695 (the Modernize Nursing Practice Act) that, if passed, would legislate full practice authority for NPs in our state.
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Reid, Doreen. "A prospective policy analysis of the elimination of the exclusive scope of practice from the Nursing Profession Act." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq39615.pdf.
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Duncan, Cameron Gene. "The Full Practice Authority Initiative: Lessons Learned from Nevada." Diss., The University of Arizona, 2014. http://hdl.handle.net/10150/337306.
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Purpose: Identify specific legislative barriers to full practice authority (FPA) legislation and describe how they were overcome during the 2013 legislative session in Nevada. Background: Legislative restrictions in 31 states prevent nurse practitioners from practicing to the full extent of their education and training. FPA legislation is introduced, but not often signed into law. A comprehensive literature review revealed multiple barriers to autonomous practice: conflict between medical and nursing roles, lack of nurse practitioner role recognition, financial challenges, and a lack of business knowledge. Barriers caused by policy limitations were most frequently mentioned: limited scope of practice, limited prescriptive authority, limited clinical privileges, credentialing limitations and reduced reimbursement rates. Methods: This study employed a qualitative, multiple case study design. Semi-structured interviews were conducted with four actively-involved contributors to the 2013 FPA initiative in Nevada. Homogeneous questions were used, guided by the use of a predetermined set of questions based on Kotter’s (1995) Change Management Model. Each interview began with the question, "What prompted this movement and why was it introduced at this time?" Participants were asked to identify perceived barriers to FPA legislation, and how they were overcome. Recorded interviews were transcribed into text, which led to thematic analysis. Results: Repetition of shared perceptions revealed eleven barriers separated into six main themes. 1) Vision includes the barrier of lacking a clear and shared vision. 2) Physician Support includes the barrier of lacking the support of physicians and Organized Medicine. 3) Addressing Stakeholders includes the barriers of the inability to address stakeholders, lack of role recognition and community support, and social media. 4) Community Organization Support includes the barriers of having a Board of Nursing with a poor reputation, and a lack of support from the Board of Pharmacy. 5) Leading Coalition includes the barriers of lacking a strong, leading coalition lacking history of leadership and legislative experiences, and choosing a legislator without experience, authority, and respect in the legislature and the community. 6) Resources include the barrier of lacking necessary resources including time and preparation. Implications: The findings of this study may be useful for those living in one of the 31 states without FPA legislation. This is one of the first published studies to identify the importance of literature identifying legislative barriers to FPA, and starts to fill the current gap in the literature surrounding this topic. This information may be invaluable in the preparation and introduction of FPA legislation in other states. The findings may also act as a stepping-stone to addressing the provider shortage in the U.S., and may be instrumental in improving access to care. Further research is needed to identify whether similar barriers found in this study are prevalent in other states with FPA legislation for nurse practitioners.
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Wang, Frederick. "Tax haven planning within the scope of the North American anti-avoidance legislation." Thesis, McGill University, 1986. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=63890.
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Bosse, Jordon, Katherine Simmonds, Charlene Hanson, Lynne Dunphy, Patricia M. Vanhook, and Lusine Poghosyan. "Position Statement: Full Practice Authority for Advanced Practice Registered Nurses Is Necessary to Transform Primary Care." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7415.
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Lack of full practice authority (FPA) for advanced practice registered nurses (APRNs) is a barrier to the provision of efficient, cost-effective, high-quality, and comprehensive health care services for some of our most vulnerable citizens ( Agency for Healthcare Research and Quality, 2014 , Buerhaus et al., 2015 , Pohl et al., 2010a , Seibert et al., 2004 ). APRNs have the education, knowledge, skills, and experience necessary to provide basic and comprehensive primary care services; they are a ready workforce, ideally positioned to improve access to care, contribute to health disparities reduction efforts, and lower the cost of providing such care ( National Center for Workforce Analysis 2013 , Perloff et al., 2016 ). However, barriers at the state and national levels continue to prevent these highly qualified health care providers from practicing to the full extent to which their education and training have prepared them. It is the position of the American Academy of Nursing (academy) that FPA of APRNs is essential to achieving health equity.
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Au, Chun-lam Antony, and 歐浚林. "A framework of credentialing and defining scope of practice in healthcare providers for colonoscopy and its applicability in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/207969.
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Introduction: In recent years, the incidence of colorectal cancer in Hong Kong has risen to become the most frequent cancer type whereas its mortality ranks second. As effective screening is demonstrated to improve survival outcomes, the government in response proposed a mass population colorectal cancer screening program for high-risk groups; screening methods include fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. Because colonoscopy is a highly operator-dependent and is therefore very prone to human error, processes to ensure it is performed safely include credentialing and defining scope of practice. As this concept is relatively new in Hong Kong, this study aims to investigate its applicability specific to colonoscopy in the city’s medical profession through determining competency indicators in the procedure.
Methods: A systematic review was performed using online databases—PubMed and Google Scholar—to retrieve sources of information. Aside from academic research, guidelines from professional associations from three countries were also incorporated in this paper; they are the Gastroenterological Society of Australia, the Canadian Association of Gastroenterology, and the American Society for Gastrointestinal Endoscopy.
Results: Technical aspects for competency include a mean withdrawal time of over 6 minutes;; first time examination adenoma detection rate of ≥ 25% and ≥ 15% in asymptomatic men and women ages > 50, respectively; ≥ 90% cecal intubation rate in all cases; perforation and post-polypectomy bleeding complication rates at < 1/1,000 and < 1/100 cases respectively;; and annual volume rates between 100 to 150 procedures. Experience is a significant factor in improving technical competency. Cognitive competency include correctly identifying and managing abnormalities, and knowledge of appropriate patient indications and contraindications for screening colonoscopy, risk management, and intervals for the procedure. .
Conclusion: Guidelines recommend annual volume rates to be used as the primary indicator of technical competency, whereas the minimum medical academic qualification is recommended to have residency in endoscopic surgery. As colonoscopy is provided in both the public and private healthcare sector, the credentialing committee should have authority to influence colonoscopy providers in both sectors. A suitable agency is the Hong Kong Academy of Medicine, as they accredit specialists, and colonoscopy overseas is typically performed by endoscopists having received specialty training.published_or_final_version
Public Health
Master
Master of Public Health
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DiChiacchio, Toni. "An Evidence Based Web Intervention to Facilitate Nurse Practitioner Participation in the Policy Making Process Related to Scope of Practice." Thesis, West Virginia University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3618096.
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Historically nurses have been strongly engaged in the political process, however in recent decades the profession has moved away from the policy arena. Without political engagement, issues that are important to the nursing profession are not addressed timely, if at all. One such issue is that of full practice authority for advanced practice registered nurses (APRNs). Well over 100 studies have been completed over the past 40 years showing the safe and quality care APRNs provide independently. Numerous well-respected, non-nursing organizations support the removal of state laws that impede the ability of APRNs to practice to the full extent of their education and training, particularly in light of the looming extinction of primary care physicians and the simultaneous increase in demand for primary care services (American Association of Retired People, 2011; Federal Trade Commission, 2012; Institute of Medicine, 2010; National Governor's Association, 2012). The purpose of this capstone project was to provide a website in which APRNs and APRN students could communicate quality information to legislators in support of full practice for APRNs in West Virginia during a legislative session in which a full practice bill was introduced. Website visitors who were APRNs or APRN students were asked to complete a survey on the website comparing their communication with legislators last year to their communication or intended communication, after they had been introduced to the website, during the current session. Findings included a strong statistical association between use of the website and communication with legislators along with a statistical association between use of the website and conveyance of quality information supporting full practice authority. The findings suggest that websites related to specific nursing issues could be a method to increase political involvement of nurses.
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Shin, Hyun Kun. "The nature and scope of Eastern thought and practice in contemporary literature on American physical education and sport (1953-1989) /." The Ohio State University, 1990. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487677267728948.
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Salako, Abiodun. "The impact of state nurse practitioner scope-of-practice regulations on access to primary care in health professional shortage areas." Diss., University of Iowa, 2019. https://ir.uiowa.edu/etd/7025.
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Primary care physician (PCP) shortages have been a barrier to accessing care for millions of Americans, particularly those living in areas facing the worst shortages - primary care health professional shortage areas (HPSAs). Increased use of nurse practitioners (NPs) has been proposed as a solution to the shortages as NPs can effectively substitute for PCPs. However, this proposal has been hampered by regulatory restrictions on NP scope-of-practice (SOP) that exist in many states. While some states permit NPs to practice and prescribe medications independent of physicians (NP independence), others require extensive physician supervision that limit NPs ability to provide care and substitute for PCPs. Despite the limitations that restrictive regulations pose to improving access to primary care, research evidence of their effect on access in primary care HPSAs is limited. This dissertation fills this gap in the literature.
Using individual-level data from the Medical Expenditure Panel Surveys (1996-2015) and a difference-in-differences approach, I exploit variation in NP independence across states and over time to evaluate the impact of NP independence on access to primary care in HPSAs Further, I examined for heterogeneity in the effect of NP independence between HPSAs and non-HPSAs as well as effect heterogeneity in HPSAs based on individual (age, insurance status, and insurance type) and health system characteristics (availability of primary care facilities and NP Medicaid reimbursement rate)
I find that NP independence led to a 5% increase in the number of individuals with a primary care provider and a 2% increase in the use of non-physicians (relative to physicians) as the primary care provider in HPSAs. However, non-HPSAs experienced no significant changes in access to care. Further, I find evidence of heterogeneity in the effect of NP independence in HPSAs for all three individual characteristics but find no significant effect heterogeneity for any of the health system characteristics. Non-elderly individuals experienced greater improvements in access following NP independence compared to their elderly counterparts, and while both insured and uninsured individuals experienced improvements in access to care, uninsured individuals benefitted more from NP independence. Further, I find evidence of greater improvements in access to care among Medicaid beneficiaries relative to their privately insured and Medicare counterparts.
These findings imply that removing regulatory restrictions on NP SOP could be an effective policy strategy for mitigating the effects of PCP shortages and improving access to care in HPSAs. Further, they demonstrate that NP independence could be a viable tool for addressing access to care issues in two traditionally underserved populations – the uninsured and Medicaid beneficiaries. Beyond addressing access issues, NP independence could also mitigate rising health care costs. The finding of increased use of lower-cost non-physicians rather than their more costly physician counterparts after NP independence indicates that this policy change could also bring about cost savings for society.
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Mullah, Moonira. "A survey of the working environment of medical technologists in South Africa." Thesis, Cape Peninsula University of Technology, 2018. http://hdl.handle.net/20.500.11838/3081.
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Thesis (MSc (Health and Wellness Sciences))--Cape Peninsula University of Technology, 2018Biomedical Laboratory Technologists play a fundamental role in the diagnosis of disease in patients. Their role in South Africa is currently undergoing profound changes with an emphasis placed on a four-year professional degree that will replace the National Diploma in Biomedical Technology at most Universities of Technology and Comprehensive Universities (UJ and NMU) by 2020. Training and competency programs, along with the retention of experienced staff, remain key in providing accurate laboratory results. It is therefore imperative to investigate this field in factors related to training, work experience and job satisfaction. This study aimed to evaluate the perceptions of Medical Technologists and Medical Technicians with regards to salary, interpersonal relationship, continuing professional development (CPD), work ethic and scope of practice within the profession. A mixed methods study was conducted to evaluate salary, career choice happiness and CPD compliance of Medical Technologists and Medical Technicians, as well as their perceptions around interpersonal relationships, work ethic and scope of practice. In sampling, a convenience sample was identified, after which a snowballing method was used. A link to a web-based survey was distributed to a group of Medical Technologists and Medical Technicians who attended the Society of Medical Laboratory Technology of South Africa (SMLTSA) Medical Laboratory Professionals congress. This congress was held in 2015 in Port Elizabeth, South Africa. A sample of 144 Medical Technicians and Medical Technologists was obtained, of which 98.6% were registered with the Health Professions Council of South Africa (HPCSA). Only 54.2% were active members of the Society of Medical Laboratory Technologist of South Africa. Age (r = 0.674, p < 0.05) and years worked at current employer (r = 0.533, p < 0.05) proved to have stronger relationships with salary than education (r = 0.195, p < 0.05). Those employed in the public sector earned significantly lower salaries than those in any other sector (p < 0.05), with the exception of those working in independent practice. Both Medical Technologists (44.2%) and Medical Technicians (34.4%) perceived that they did not receive the respect they deserved from Pathologists in their working relationship. In addition, 31.3% of Medical Technicians perceived that their roles were regarded as of lesser value, and that their knowledge, training and attained qualifications were not recognised by the Pathologists. Despite this, this study concluded respondents were generally happy with their career choice, as 71.9% of respondents reported. Findings of this study serve as a strong foundation for additional research on the topic of career happiness versus job satisfaction and retention of staff in medical diagnostic laboratories.
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Krogue, Paul Anthony, and Paul Anthony Krogue. "Barriers to Practice: Understanding Phsyician and Hospital Administrator Knowledge, Beliefs, and Attitudes of the Role and Scope of Practice of Acute Care Nurse Practitioners in the Acute Care Setting in Rural Montana." Diss., The University of Arizona, 2018. http://hdl.handle.net/10150/626676.
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Purpose: to describe the knowledge, beliefs, and attitudes of physicians and hospital administrators regarding the role and scope of practice of acute care nurse practitioners in rural Montana.
Background: Nurse practitioners have been increasingly called upon to provide high quality and cost-effective healthcare in variety of settings and have consistently shown to provide a high-level of patient care in both the primary and acute care settings. The acute care nurse practitioner specialty is relatively new, and with very few licensed acute care nurse practitioners in the state of Montana, the role and scope of practice is not well understood by physicians and hospital administrators who are often tasked with hiring and recruiting providers in the hospital setting. The Consensus Model, which served as the conceptual framework for this project, advocates that nurses provide care for the population that is specific to their licensure, accreditation, certification, and education.
Method: Some 28 physicians and hospital administrators completed a survey that included 21 Likert scale statements that were divided into the subscales of Knowledge, Belief, and Attitude.
Results included: 1) An existing gap in knowledge regarding the role and scope of practice of acute care nurse practitioners, 2) acute care nurse practitioners should always have some form of physician oversite, and 3) there is disparity in patient outcomes when patient care is provided by nurse practitioners.
Conclusion: Attitudes of survey respondents were overwhelmingly positive for the future of acute care nurse practitioners filling various provider roles in the hospital setting. These results can provide a foundation for future inquiry and can assist in the development of education and collaborative efforts to further advance the utilization of acute care nurse practitioners in Montana.
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Stojak, Marie-Lucie. "Legally permissible scope of current military activities in space and prospects for their future control." Thesis, McGill University, 1985. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=72779.
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Kurtzman, Ellen T. "Delivery of High Quality Primary Care in Community Health Centers| The Role of Nurse Practitioners and State Scope of Practice Restrictions." Thesis, The George Washington University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=3746006.
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In response to the increased demand for primary care in the United States—a byproduct of a growing elderly population and insurance expansion under the Affordable Care Act (ACA)—the total number and capacities of community health centers (HCs) is expected to grow. While HCs have historically depended on physicians to deliver the majority of their care, more and more, they are shifting to non-physician clinicians, especially nurse practitioners (NPs); yet, little is known about the quality of care delivered by NPs in HCs or about the role state occupational restrictions have on these practitioners or their patients.
Using quasi-experimental methods and data from the community health center subsample of the National Ambulatory Medical Care Survey (NAMCS), this dissertation explores three distinct, but related, research questions regarding NP-delivered care in HCs—its effectiveness and comparability to physician care, the extent that tradeoffs in the quantity and quality of care are made, and the real-world risks and benefits of states easing their scope of practice restrictions. Findings, which suggest that NP care is comparable to physician care in most ways and that the quality of NP-delivered care does not significantly vary irrespective of states’ NP independence status, have important implications for policy and practice.
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Kiser, Jessica Renee Wilder Rebecca S. "Assessment of full-time dental hygiene faculty participation in clinical practice." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2006. http://dc.lib.unc.edu/u?/etd,227.
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Thesis (M.S.)--University of North Carolina at Chapel Hill, 2006.Title from electronic title page (viewed Oct. 10, 2007). "... in partial fulfillment of the requirements for the degree of Master of Science in Dental Hygiene Education in the Department of Dental Ecology, School of Dentistry." Discipline: Dental Ecology; Dental Hygiene Education; Department/School: Dentistry.
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McIntyre, Allyson Christine. "Extending the scope of mid-infrared spectrometry for in situ process analysis through ATR immersion probes." Thesis, University of Strathclyde, 2011. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=16889.
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Dimitrov, Valeri. "Article 13 of the ECT in practice and its role in expropriation disputes : What is the scope of Article 13 of the ECT with respect to expropriation disputes?" Thesis, Uppsala universitet, Juridiska institutionen, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-384439.
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Cullen, Miriam C. "Australian midwives' practice domain." Curtin University of Technology, School of Nursing, 1997. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=12173.
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This exploratory, descriptive research used a case study approach to analyse the role of the midwife in providing maternal and infant care in Australia. Midwives from the states of New South Wales, Victoria and Western Australia comprised the target population. These midwives were considered to be representative of the general midwifery population practising in the diverse settings of Australia.A triangulation of methods (Denzin, 1970) was used for data collection. This included observational field work, a questionnaire survey of a randomly selected sample of registered midwives (n=1754), and in-depth interviews (n=75), using a grounded theory approach (Glaser and Strauss, 1967; Strauss and Corbin, 1990).The questionnaire, in-depth interviews and observational field work addressed the practice of midwives:1. as documented in policies and procedures in practice settings.2. as defined by the Australian College of Midwives Incorporated in Standards for the Practice of Midwifery (1989), based on the International Confederation of Midwives' Definition of a Midwife (World Health Organisation, 1976).Data obtained through the survey questionnaire were analysed using descriptive analysis (Wilson, 1985) to portray a summarization of the entire data set. A thematic content analysis was used for the open-ended questions of the survey (Burnard, 1991). In an attempt to discover the 'how and why' questions associated with the study's survey findings, the constant comparative method of analysis of data from in-depth interviews was deemed appropriate (Glaser, 1978; Field and Morse, 1985; Chenitz and Swanson, 1986). This allowed a more abstract level of conceptualization that led to the development of a paradigm reflective of the midwives' practice domain (Strauss and Corbin, 1990).Lack of opportunities to practise throughout all stages of pregnancy and childbirth was identified as ++the major problem limiting the Australian midwives' practice domain. An explanatory process of Optimising Opportunities for Holistic Midwifery Practice emerged explaining midwives' actions and interactions throughout the four stages of optimising: revealing the image; influencing decision making; changing the paradigm; and expanding the profession.The findings of the study provide an analysis of Australian midwifery practice that considers factors facilitating and/or impeding the professional role and development of Australian midwives, and their ability to provide care that meets consumer needs.
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Pilon, B., D. Link, T. Hansen-Turton, and Patricia M. Vanhook. "The Importance of Association: How a Nursing Focused Foundation and Associations Led the Charge to Greater Autonomy and Expanded Scope of Practice." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7426.
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Ketyer, Stephen Michael. "Limiting the scope of municipal authority over airport zoning in the United States : the New Jersey example." Thesis, McGill University, 1997. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=20538.
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The purpose of this thesis is: (1) to review the airport development and transportation policy of the United States (U.S.); (2) to provide an overview of the U.S. constitutional doctrines evolved under the Supremacy and Commerce Clauses, and their respective applications in the case law; (3) to review the regime of federal regulation of airport noise; (4) to examine the State Legislature's emphasis on "aeronautical progress" in the New Jersey State Aviation Act of 1938, as amended; (5) to examine the role of the State Aviation Act in zoning on and around airport land; and (6) to provide a detailed, thematic examination of relevant New Jersey and federal case law in this area.
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Pepper, Jennifer. "Family vs. full time : women's redesign of organizational practice through job sharing." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0017/MQ55003.pdf.
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Senore, Carlo. "Smoking cessation in general practice." Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22803.
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Available evidence from RCTs shows that GPs' counselling can be effective in reducing smoking prevalence and that some specific features of the intervention (for example the offer of follow-up visits) may enhance its effectiveness. The impact of such preventive activity, however, is dependent not only on intervention characteristics, but also on factors related to the recipients (smokers) and the providers (physicians). Paper 1 explores the role of pre-treatment factors in predicting quitting following GPs' counselling among 861 smokers enrolled in the Turin smoking cessation trial. Social support and smoke free environment reinforce the impact of GPs' counselling, which is less effective for more addicted smokers and for women. Counselling might be more effective, if GPs would take advantage of information on individuals' experience of behavioral change to tailor their message. Paper 2 compares a group of smokers (N = 965), who were invited to participate in the Turin smoking 1 cessation trial, to a matched sample of smokers (N = 277), listed in the files of 42 GPs collaborating in the trial. The patients in the second set were potentially eligible for recruitment, but were not invited to participate. Estimates of the effect of individual characteristics on patient recruitment indicate that GPs focused their efforts on heavier and diseased smokers. As this tendency may dilute the impact of their anti-smoking action, more effective educational strategies should be implemented when planning preventive interventions.
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Abdul, Rahman Rafiduraida. "The theory and practice of couples managing two full-time careers in Malaysia." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/the-theory-and-practice-of-couples-managing-two-fulltime-careers-in-malaysia(d1df32a9-56c4-44e0-8e05-f4897aca4710).html.
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This thesis investigates the experiences of Malaysian dual-career couples combining career and family. Semi-structured qualitative interviews were used to collect data from 23 dual-career couples. The findings indicate that being in a dual-career relationship impacts upon how they perceive the family’s provider role; career priorities; how decisions are made; and how family work is divided. The experiences described by the participants reflect their gender role ideologies and the salience of family and work roles. The results also reveal how interaction between partners can shape their ideologies and role salience, in addition to how religious and cultural values influence their gender attitudes. A number of challenges faced by the couples are identified. The supports and strategies that help them cope with housework, childcare and work demands are also critiqued. The thesis also highlights the implications of the government and organization’s policies and support to the couples and the kind of policies and support that the couples would like to see introduced. The similarities and differences between dual-career couples in the Malaysian context compared with the West are explored. Additionally, the findings extend the use of gender role ideology and role salience theories to develop an understanding of the couples’ experiences. A summarizing framework of their experiences based on the analysis is presented. In summary, the thesis firstly fills a gap in the dual-career couples’ literature which has previously focused upon Western couples only. Secondly, the study has examines the utility of gender role ideology and role salience as a framework to understand the context of dual-career couples. Thirdly, the current research also makes an important methodological contribution in a Malaysian context. Finally, it provides some recommendations for the government and organizations in Malaysia in terms of policies that promote work-family balance and gender equality for dual-career women.
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Gobes-Ryan, Sheila A. "Full-Time Teleworkers Sensemaking Process for Informal Communication." Scholar Commons, 2017. https://scholarcommons.usf.edu/etd/7402.
Full textAbstract:
Organizations have traditionally accomplished connectivity among their workers by co-locating them in shared organizational workplaces. However, information and communication technologies (ICTs) are offering alternative ways to accomplish this kind of connection. This change raises important questions about what it is possible to accomplish through such mediated communicative connections, and if there are work activities that are best accomplished face-to-face. Practitioners and researchers have historically identified informal communication as a process essential to organizational success that is difficult or impossible to accomplish outside of shared physical environments. This study documents the ways full-time teleworkers are accomplishing informal communication without being in shared work environments. In doing this, this work also identifies for what purposes these participants find shared organizational workplaces important and/or essential for successful informal communication.
To complete this study required that two additional questions needed to be addressed: 1) defining full-time telework in the context of modern ICT-mediated corporate work environments, and 2) a re-examination of the parameters of telework to define them for modern workplace environments, so as be able to use effectively to examine past and present telework research efforts. In order to document the context of each of the participants as fully as possible, a narrative case study based research protocol was used. Participants were engaged through two active interviews and a journaling exercise so as to identify and document instances of informal communication and their purposes or roles in their workdays.
This study’s key finding is that among this group of full-time teleworkers, all were engaging in informal communication to accomplish bonding and learning, both in ways that paralleled those communicative practices commonly accomplished in shared environments, but also in new ways that were made possible because of emergent sociomaterial practices supported by new information and communication technology affordances. While all the study’s participants indicated that their work processes, including informal communication, could be entirely accomplished virtually, nearly all noted the importance of face-to-face communication for key aspects of bonding and learning. Additionally, the successful work practices of these teleworkers were strongly dependent on the ubiquitous adoption of ICT tools and platforms throughout these participants’ organizations, and by the distribution and mobility of increasing numbers of workers, in these organizations and others, that are using these technologies as a routine part of their daily work practices.
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Bradley, Jessica. "Postmodern bodies and feminist art practice." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=69635.
Full textAbstract:
This thesis examines, from a feminist perspective, conceptions of the body proposed by poststructuralist philosophy and postmodernist art practice. Within both feminist and postmodern critiques of the humanist subject, the body has come to be understood as a site of cultural inscriptions. In tracing the relationship between postmodernism and feminism, the thesis addresses specifically the shift from celebratory, affirmative female imagery typical of feminist art in the seventies, to the semiotic analysis of images of women which, in the eighties, problematized the question of sexual difference as one of representation. During the eighties women artists generally eschewed figurative representations of the female body in recognition of its over-determined socio-sexual status. Within this historical framework, the tension between the "de-materialized" body of postmodernity and the insistently present body of gendered experience is explored both in the work of feminist theorists and contemporary women artists. In conclusion, three corporeal sites--the cultural, the epistemological and the psycho-sexual--are analysed in the postmodern practices of Jana Sterbak, Nell Tenhaaf and Kati Campbell.
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Graham, Robert 1950. "Understanding ArtsCanada : history, practice and idea." Thesis, McGill University, 1988. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=61852.
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Vangen, Siv. "Transferring insight on collaboration to practice." Thesis, University of Strathclyde, 1998. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=21362.
Full textAbstract:
The need to form inter-organisational collaborative working arrangements is now common across community, public and private sectors. Working collaboratively however, is extremely complex and failures abound. Much research has recently been directed at understanding the nature of inter-organisational collaboration. Insight gained through such research provides the basis for informing, pragmatically, those trying to manage collaborative activities in practice. To date, attempts at making the insight on collaboration available and accessible to practice appear limited in scope and success. Many of those who embark on collaborative working arrangements also seem unaware of the need to consider explicitly the management of their collaborative processes. the high level of complexity, coupled with poor awareness of the need to consider the management of collaboration render the task of making insight available to practice difficult. This is the challenge addressed by the research upon which this thesis is based. The aim of research was to generate process theory on the transfer of insight on collaboration to practice. The work was undertaken in Participatory Action Research and Action Research capacities with individuals pragmatically concerned with collaboration in practice. Ten Design Principles for Transferring Insight to Practice were developed. Conceptualisations of who should be targeted, how they should be targeted and what the substance of the insight should be were also developed. These developments address relevant issues pertaining the Transfer of Insight on Collaboration to Practice.
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Pongsaksri, Arisa. "A trans-cultural study of the practice of occupational therapists in Thailand and Australia : reframing theories of practice /." Curtin University of Technology, School of Occupational Therapy, 2004. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=15810.
Full textAbstract:
Culturally appropriate conceptual models for practice are of major interest to occupational therapists, an emerging health profession in Thailand. Currently in Thailand, occupational therapy education and practice derives its conceptual models from Western models. How these models are translated into practice in Thailand is unclear, as there are currently no research studies relating to the cultural and clinical practice demands of Thai occupational therapists and of service delivery in Thailand. In addition, how occupational therapists in Australia apply conceptual models in practice has also been given limited attention in the research literature. A comparison is made between Thai and Western Australian occupational therapists to examine the use of theoretical models in the Western cultural context and to investigate the influences of cultural differences on occupational therapy practice. The purpose of this study is to identify the conceptual models most frequently used by occupational therapists in Thailand and in Australia, to describe the application of these models to practice, and to explore the cultural influences impacting on the application to practice. The need for a derived but more culturally specific conceptual model for occupational therapy practice in Thailand was also investigated. Focus group interviews were conducted as the initial stage of the study, to obtain in-depth background information about occupational therapy practice. Content analysis using transcript-based analysis and systematic coding was used to analyse the focus group data. The results demonstrated three main conceptual approaches: among both Westem Australian and Thai occupational therapists. These three models were described as the Performance Model, the Whole Person Model, and the Medical Model.The findings from focus group interviews and related literature were used to develop a questionnaire. The questionnaire was designed as a self-report measure, using a 4 point scale ranging from ‘strongly agree’ to ‘strongly disagree’. It was arranged in 4 parts: Part A-Background Information, Part B- Models of Occupational Therapy Practice, Part C-Occupational Therapy Practice, and Part D-Practice Comment. Parts A, B and C consisted of closed-ended questions, whereas Part D was constructed to elicit open-ended questions. The survey data was collected from 138 Thai occupational therapists (ThaiOTs) and 155 Western Australian occupational therapists (WAOTs). A Chi-square test result demonstrated that ThaiOTs favoured the Medical Model for practice whilst WAOTs used the Performance Model and the Whole Person Model (p < 0.05). Principal component factor analysis was used to identify significant factors differentiating the practice of WA and Thai occupational therapists and to guide the development of the model of practice for ThaiOTs. The Mann-Whitney U Test results showed clear differences of therapist practice between Australia and Thailand in relation to their views about Clients, Professional Perspective (Therapists), Intervention, Cultural Implications, and Health Care Systems due to the influence of the culture and socio-cultural environment (p < 0.05). The outcomes from all stages in the study were used to develop a model of practice for Thai occupational therapists. This model named the ‘Samphan’ Framework of Practice focuses on the client and family as an inseparable unit, which differs from an individual, or client focus central to most Western models.
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Lapointe, Hélène. "Regional open skies agreements : law and practice." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22696.
Full textAbstract:
This thesis presents an analytic review of the different definitions of "Open Skies Treaty". It mainly introduces American, Canadian and European views of Open Skies. We also propose our definition of Open Skies in a North American context including our NAFTA partner, Mexico.Then, the thesis conducts a detailed study of the law and practice pertaining to regional Open Skies Agreements in Europe, Latin America, Australasia and in the Asia/Pacific region.
Afterwards, an analysis of the main provisions of the North American Free Trade Agreement is made with reference to air transport. Follows, an overview of the state of the Canadian air transport industry and policy.
More importantly, a complete analysis of the New Air Transport Agreement Between Canada and the United States implementing an Open Skies regime as for 1995 is made in Chapter V.
Finally, a critical analysis of this Open Skies Agreement is made and perspectives are given as to the future inclusion of Mexico, Chile and, later on, of all of Latin America.