scholarly journals Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Jessica Lawler ◽  
Katrina Maclaine ◽  
Alison Leary
Keyword(s):  
Clinical Practice ◽  
Large Scale ◽  
Medical Model ◽  
Free Text ◽  
Advanced Practice ◽  
Full Time ◽  
Mixed Methods Evaluation ◽  
Future Direction ◽  
The Right ◽  
Practice Framework

Abstract Background This study aims to understand how the implementation of the advanced clinical practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The advanced clinical practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service. Methods As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey free-text were analysed using thematic analysis in NVivo 10. Results The questionnaire received over 500 respondents (ten times that expected) and 15 interviews were carried out. Advanced clinical practice was considered by many respondents the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ‘ACP’ was the right job title for them. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing advanced clinical practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employer’s training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework: that of advanced clinical practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model. Conclusions Efforts to establish further clarity and structure around advanced clinical practice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place.

scholarly journals Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation

2020 ◽  
Author(s):  
Jessica Lawler ◽  
Katrina Maclaine ◽  
Alison Leary
Keyword(s):  
Clinical Practice ◽  
Large Scale ◽  
Medical Model ◽  
Free Text ◽  
Advanced Practice ◽  
Full Time ◽  
Mixed Methods Evaluation ◽  
Future Direction ◽  
The Right ◽  
Practice Framework

Abstract Background This study aims to understand how the implementation of the Advanced Clinical Practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The Advanced Clinical Practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service.Methods: As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey free-text were analysed using thematic analysis in NVivo 10.Results: The questionnaire received over 500 respondents (ten times that expected) and 15 interviews were carried out. Advanced Clinical Practice was considered by many respondents the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ‘ACP’ was the right job title for them. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing Advanced Clinical Practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employer’s training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework: that of Advanced Clinical Practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model.Conclusions: Efforts to establish further clarity and structure around advanced clinicalpractice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place.

scholarly journals Workforce Experience of the Implementation of An Advanced Clinical Practice Framework in England: A Mixed Methods Evaluation

2020 ◽  
Author(s):  
Jessica Lawler ◽  
Katrina Maclaine ◽  
Alison Leary
Keyword(s):  
Clinical Practice ◽  
Large Scale ◽  
Medical Model ◽  
Advanced Practice ◽  
Full Time ◽  
Mixed Methods Evaluation ◽  
Job Title ◽  
Future Direction ◽  
The Right ◽  
Practice Framework

Abstract Background This study aims to understand how the implementation of the Advanced Clinical Practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The Advanced Clinical Practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service. Methods: As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey freetext were analysed using thematic analysis using NVivo 10. Results: The questionnaire received over 500 respondents (a response rate ten times that expected) and 15 interviews were carried out. Advanced Clinical Practice was considered by many the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ACP was the right job title. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing Advanced Clinical Practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employers training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework, that of Advanced Clinical Practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model. Conclusions: Efforts to establish further clarity and structure around advanced clinical practice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place.

What is a primary care advanced practice role in Cornwall?

2020 ◽  
Vol 31 (1) ◽  
pp. 31-36
Author(s):  
Sarah Barea
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Quantitative Study ◽  
Broad Spectrum ◽  
Educational Level ◽  
Current Practice ◽  
Scope Of Practice ◽  
Advanced Practice ◽  
Primary Care Practitioners ◽  
Practice Framework

In this quantitative study, Sarah Barea analyses the current advanced practice roles in primary care in Cornwall Aim: To analyse current primary care advanced practice roles in Cornwall, measured against Health Education England's Multi-Professional Framework for Advanced Clinical Practice. Method: A quantitative questionnaire was sent to all primary care practitioners in the county practicing with an advanced title. Findings: In total, 34 respondents (approximately 60% of those invited) took part. Practitioners have a broad spectrum of experience and education and varied scope of clinical practice. The grading of roles does not compare with educational level, experience or scope of practice. This is consistent with current literature which explores the need to regulate the role. Conclusion: If the Advanced Practice Framework is implemented as planned, then there are gaps in current practice that need to be addressed in order to ensure practitioners have the competencies to provide safe, autonomous practice.

scholarly journals Incentivising use of structured language in biological descriptions: Author-driven phenotype data and ontology production

2018 ◽  
Vol 6 ◽  
Author(s):  
Hong Cui ◽  
James Macklin ◽  
Joel Sachs ◽  
Anton Reznicek ◽  
Julian Starr ◽  
...  
Keyword(s):  
Large Scale ◽  
Empirical Studies ◽  
Ontology Development ◽  
Free Text ◽  
Great Effort ◽  
Phenotypic Data ◽  
Manual Curation ◽  
Phenotype Data ◽  
The Moment ◽  
The Right

Phenotypes are used for a multitude of purposes such as defining species, reconstructing phylogenies, diagnosing diseases or improving crop and animal productivity, but most of this phenotypic data is published in free-text narratives that are not computable. This means that the complex relationship between the genome, the environment and phenotypes is largely inaccessible to analysis and important questions related to the evolution of organisms, their diseases or their response to climate change cannot be fully addressed. It takes great effort to manually convert free-text narratives to a computable format before they can be used in large-scale analyses. We argue that this manual curation approach is not a sustainable solution to produce computable phenotypic data for three reasons: 1) it does not scale to all of biodiversity; 2) it does not stop the publication of free-text phenotypes that will continue to need manual curation in the future and, most importantly, 3) It does not solve the problem of inter-curator variation (curators interpret/convert a phenotype differently from each other). Our empirical studies have shown that inter-curator variation is as high as 40% even within a single project. With this level of variation, it is difficult to imagine that data integrated from multiple curation projects can be of high quality. The key causes of this variation have been identified as semantic vagueness in original phenotype descriptions and difficulties in using standardised vocabularies (ontologies). We argue that the authors describing phenotypes are the key to the solution. Given the right tools and appropriate attribution, the authors should be in charge of developing a project’s semantics and ontology. This will speed up ontology development and improve the semantic clarity of phenotype descriptions from the moment of publication. A proof of concept project on this idea was funded by NSF ABI in July 2017. We seek readers input or critique of the proposed approaches to help achieve community-based computable phenotype data production in the near future. Results from this project will be accessible through https://biosemantics.github.io/author-driven-production.

THE FACTORS OF CAREER SELF-DETERMINATION OF STUDENTS OF HIGHER EDUCATION INSTITUTIONS

2019 ◽  
Vol 7 (1) ◽  
pp. 9-20
Author(s):  
Inna Yeung
Keyword(s):  
Higher Education ◽  
Higher Education Institutions ◽  
Well Being ◽  
Young Person ◽  
Self Determination ◽  
Full Time ◽  
Actual Problem ◽  
The Third ◽  
The Right

Choice of profession is a social phenomenon that every person has to face in life. Numerous studies convince us that not only the well-being of a person depends on the chosen work, but also his attitude to himself and life in general, therefore, the right and timely professional choice is very important. Research about factors of career self-determination of students of higher education institutions in Ukraine shows that self-determination is an important factor in the socialization of young person, and the factors that determine students' career choices become an actual problem of nowadays. The present study involved full-time and part-time students of Institute of Philology and Mass Communications of Open International University of Human Development "Ukraine" in order to examine the factors of career self-determination of students of higher education institutions (N=189). Diagnostic factors of career self-determination of students studying in the third and fourth year were carried out using the author's questionnaire. Processing of obtained data was carried out using the Excel 2010 program; factorial and comparative analysis were applied. Results of the study showed that initial stage of career self-determination falls down on the third and fourth studying year at the university, when an image of future career and career orientations begin to form. At the same time, the content of career self-determination in this period is contradictory and uncertain, therefore, the implementation of pedagogical support of this process among students is effective.

Why Has There Been No People’s Power Rebellion in North Korea?

2018 ◽  
pp. 1-34
Author(s):  
Andrew Jackson
Keyword(s):  
Rural Areas ◽  
North Korea ◽  
Large Scale ◽  
Political Elite ◽  
Information Control ◽  
Al Jazeera ◽  
The North ◽  
New Information ◽  
Effective System ◽  
The Right

One scenario put forward by researchers, political commentators and journalists for the collapse of North Korea has been a People’s Power (or popular) rebellion. This paper analyses why no popular rebellion has occurred in the DPRK under Kim Jong Un. It challenges the assumption that popular rebellion would happen because of widespread anger caused by a greater awareness of superior economic conditions outside the DPRK. Using Jack Goldstone’s theoretical expla-nations for the outbreak of popular rebellion, and comparisons with the 1989 Romanian and 2010–11 Tunisian transitions, this paper argues that marketi-zation has led to a loosening of state ideological control and to an influx of infor-mation about conditions in the outside world. However, unlike the Tunisian transitions—in which a new information context shaped by social media, the Al-Jazeera network and an experience of protest helped create a sense of pan-Arab solidarity amongst Tunisians resisting their government—there has been no similar ideology unifying North Koreans against their regime. There is evidence of discontent in market unrest in the DPRK, although protests between 2011 and the present have mostly been in defense of the right of people to support themselves through private trade. North Koreans believe this right has been guaranteed, or at least tacitly condoned, by the Kim Jong Un government. There has not been any large-scale explosion of popular anger because the state has not attempted to crush market activities outright under Kim Jong Un. There are other reasons why no popular rebellion has occurred in the North. Unlike Tunisia, the DPRK lacks a dissident political elite capable of leading an opposition movement, and unlike Romania, the DPRK authorities have shown some flexibility in their anti-dissent strategies, taking a more tolerant approach to protests against economic issues. Reduced levels of violence during periods of unrest and an effective system of information control may have helped restrict the expansion of unrest beyond rural areas.

White Backlash

2015 ◽  
Author(s):  
Marisa Abrajano ◽  
Zoltan L. Hajnal
Keyword(s):  
Ethnic Diversity ◽  
Republican Party ◽  
Large Scale ◽  
White Americans ◽  
Political Beliefs ◽  
White Backlash ◽  
Political Spectrum ◽  
Racial Divide ◽  
The Right ◽  
Political Backlash

This book provides an authoritative assessment of how immigration is reshaping American politics. Using an array of data and analysis, it shows that fears about immigration fundamentally influence white Americans' core political identities, policy preferences, and electoral choices, and that these concerns are at the heart of a large-scale defection of whites from the Democratic to the Republican Party. The book demonstrates that this political backlash has disquieting implications for the future of race relations in America. White Americans' concerns about Latinos and immigration have led to support for policies that are less generous and more punitive and that conflict with the preferences of much of the immigrant population. America's growing racial and ethnic diversity is leading to a greater racial divide in politics. As whites move to the right of the political spectrum, racial and ethnic minorities generally support the left. Racial divisions in partisanship and voting, as the book indicates, now outweigh divisions by class, age, gender, and other demographic measures. The book raises critical questions and concerns about how political beliefs and future elections will change the fate of America's immigrants and minorities, and their relationship with the rest of the nation.

Evaluation of Ovaries in Patients with Polycystic Ovary Syndrome using Shear Wave Elastography

2020 ◽  
Vol 16 (5) ◽  
pp. 578-583
Author(s):  
Aysegul Altunkeser ◽  
Zeynep Ozturk Inal ◽  
Nahide Baran
Keyword(s):  
Shear Wave ◽  
Large Scale ◽  
Polycystic Ovary ◽  
Shear Wave Elastography ◽  
Left Ovary ◽  
Control Group ◽  
Tissue Elasticity ◽  
Group I ◽  
Pcos Group ◽  
The Right

Background: Shear wave electrography (SWE) is a novel non-invasive imaging technique which demonstrate tissue elasticity. Recent research evaluating the elasticity properties of normal and pathological tissues emphasize the diagnostic importance of this technique. Aims: Polycystic ovarian syndrome (PCOS), which is characterized by menstrual irregularity, hyperandrogenism, and polycystic overgrowth, may cause infertility. The aim of this study was to evaluate the elasticity of ovaries in patients with PCOS using SWE. Methods: 66 patients diagnosed with PCOS according to the Rotterdam criteria (PCOS = group I) and 72 patients with non-PCOS (Control = group II), were included in the study. Demographic and clinical characteristics of the participants were recorded. Ovarian elasticity was assessed in all patients with SWE, and speed values were obtained from the ovaries. The elasticity of the ovaries was compared between the two groups. Results: While there were statistically significant differences between the groups in body mass index (BMI), right and left ovarian volumes, luteinizing hormone and testosterone levels (p<0.05), no significant differences were found between groups I and II in the velocity (for the right ovary 3.89±1.81 vs. 2.93±0.72, p=0.301; for the left ovary 2.88±0.65 vs. 2.95±0.80, p=0.577) and elastography (for the right ovary 36.62±17.78 vs. 36.79±14.32, p=0.3952; for the left ovary 36.56±14.15 vs. 36.26±15.10, p=0.903) values, respectively. Conclusion: We could not obtain different velocity and elastography values from the ovaries of the patients with PCOS using SWE. Therefore, further large-scale studies are needed to elucidate this issue.

scholarly journals P005 Rheumatology virtual clinics during COVID-19: are our patients satisfied?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Fajer A Altamimi ◽  
Una Martin
Keyword(s):  
Medical Information ◽  
Worker Safety ◽  
University Hospital ◽  
Free Text ◽  
Risk Of Infection ◽  
Further Training ◽  
Return Envelope ◽  
The Right ◽  
Reduced Risk

Abstract Background/Aims  Telemedicine can be broadly defined as the use of telecommunication technologies to provide medical information and services. It can be audio, visual, or text. Its use has increased dramatically during the COVID-19 pandemic to ensure patient and healthcare worker safety. Any healthcare professional can engage with it. It carries benefits like reduced stress and expense of traveling, maintenance of social distancing, and reduced risk of infection. There are some potential drawbacks such as lack of physical examination, liability and technological issues. Methods  A questionnaire was sent to 200 patients, selected from different virtual clinics (new and review, doctor and ANP led) run between March and May 2020 in the rheumatology department of University Hospital Waterford. We formulated 14 questions to cover the following aspects: demography, the purpose of the consult, punctuality, feedback, medico-legal concerns, and free text for comments. A self-addressed return envelope was included. Results  83 responses were received. 2 were excluded. The ratio of females to male respondents was 59: 41, with the majority over 60 years old. The main appointment type was review 67 (83%). 80% of patients were called either before or at the time of their scheduled appointment. The vast majority (98.8%) of our patients had confidence in our data protection and trusted our system to maintain their confidentiality. 95% stated that they felt comfortable, were given enough time to explain their health problem and felt free from stress. The respondents who preferred attending the clinic in person (17 in total) compared to the virtual were mostly follow up patients- 12 vs. 5 new. Conclusion  Patient satisfaction among those surveyed was high, despite having to introduce the service abruptly during the COVID-19 pandemic. There are many improvements we can adopt to improve our service and even maintain after the pandemic as a way of communicating with our stable patients. As we are covering a large geographical catchment, we can continue to implement the virtual clinic for some appointments. We should prioritize our efforts on identifying the right patient and the type of service we can offer, further training of staff, and increasing awareness of the patients as to how to get the most out of a virtual appointment. Disclosure  F.A. Altamimi: None. U. Martin: None. C. Sheehy: None.

scholarly journals Current advances of epigenetics in periodontology from ENCODE project: a review and future perspectives

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Young-Dan Cho ◽  
Woo-Jin Kim ◽  
Hyun-Mo Ryoo ◽  
Hong-Gee Kim ◽  
Kyoung-Hwa Kim ◽  
...  
Keyword(s):  
Large Scale ◽  
Periodontal Diseases ◽  
Research Trends ◽  
Main Body ◽  
Research Projects ◽  
Encode Project ◽  
Dna Elements ◽  
Crucial Information ◽  
Future Direction ◽  
Systemic Health

Abstract Background The Encyclopedia of DNA Elements (ENCODE) project has advanced our knowledge of the functional elements in the genome and epigenome. The aim of this article was to provide the comprehension about current research trends from ENCODE project and establish the link between epigenetics and periodontal diseases based on epigenome studies and seek the future direction. Main body Global epigenome research projects have emphasized the importance of epigenetic research for understanding human health and disease, and current international consortia show an improved interest in the importance of oral health with systemic health. The epigenetic studies in dental field have been mainly conducted in periodontology and have focused on DNA methylation analysis. Advances in sequencing technology have broadened the target for epigenetic studies from specific genes to genome-wide analyses. Conclusions In line with global research trends, further extended and advanced epigenetic studies would provide crucial information for the realization of comprehensive dental medicine and expand the scope of ongoing large-scale research projects.

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