A social purpose model for nursing

The very current international debate regarding the construction of professional role-identity in nursing involves analysis of context, competency, reflection, and theory; what most of the literature shows is that nursing continues to struggle with inherited moral and behaviourist constructs in which essential is in opposition to essentialist caring values and remains part of a convoluted argument (Goodrick & Reay, 2010). Each of these two types of caring either figure or pre-figure in the ‘future of nursing’, which, in the 21st Century is contained within the market economy of healthcare reforms and international change (Holland, 2008; Ball & Pike 2009; Ball & Regan 2010). Therefore, how nursing’s past is mapped is germane to any current or future understanding of nursing in a multi-disciplinary workforce. The paper provides a historical mapping of the concept of new nursing from when it was utilised in another context nearly eighteen years ago to now in the United Kingdom (UK). The paper includes a critical discussion of nursing’s purposeful future to make the discussion more meaningful from an international perspective. Cartographically linking the past to the present is important, but if there is opportunity to define and identify the profession for a purposeful future, appropriate tools are needed to do so. Therefore, the paper offers a social purpose model in which a Subjective, Objective, and Contextual Ideal of what nursing is today can be explored critically and applied both to the student and mentor’s practice arena

A participatory action research study on handwritten annotation feedback and its impact on staff and students

Annotation was introduced to a United Kingdom (UK) School of Nursing following an institutional audit within a UK University. Handwritten annotation (writing in the margins of student assignments) was introduced to the grading procedure to enhance the quality of student feedback and learning. Once in practice, annotation could be examined and an action research study facilitated the process. Post-qualifying essay scripts were examined for styles of annotation to identify its strengths and weaknesses. Five staff participated in action research to examine staff perceptions of annotation. Findings showed that words or telegraphic signs that stand alone in the margins of a student essay can be seen as abstract signs to the novitiate reader and need contextualising. If there is a negative tone in the markers’ annotation it can be detected by the student and interpreted as unhelpful or disparaging. There are a number of ways of improving annotation, and good practice guidelines are offered in the conclusion to this paper

Evaluation of the primary/secondary care interface in relation to a primary care rheumatology service

Objective The rheumatology department at The Royal Oldham Hospital developed a primary care service aimed at bridging the gap between primary and secondary care for patients with potential rheumatological conditions, and this was given the name rheumatology Tier 2. The objective of this study was to evaluate this primary care rheumatology service (Tier 2)in order to assess its validity, patient satisfaction and effectiveness. Design Ten patients participated in individual semi-structured interviews. Three GPs were interviewed individually, and two GPs formed a focus group. Thematic analysis was used to interpret the findings. Setting Patients were recruited from seven consecutive rheumatology Tier 2 clinics. GPs were recruited from Oldham Primary Care Trust (PCT) as this was the main source of patient referrals for the service. Results The key findings were in relation to the integration of primary healthcare and hospital services, i.e. the primary/secondary care interface. This highlighted the importance of early assessment, diagnosis and treatment of patients with suspected inflammatory arthritis. Conclusion Early diagnosis and treatment with disease-modifying anti-rheumatic drugs improves patients’ outcomes. The rheumatology Tier 2 service built on this evidence and provided a rapid assessment and referral to secondary care for those patients with suspected inflammatory arthritis

Patient and practitioner views of a new rheumatology (Tier 2) primary care service

The rheumatology Tier 2 service in Oldham was implemented to see patients in a primary care setting for their initial assessment. They were treated and discharged within the service, or referred on to secondary care in order to limit inappropriate attendance in secondary care and fast-track patients with inflammatory disease to the rheumatology consultant. The aim of this study was to evaluate patients’ and general practitioners’ (GPs’) views about the transfer of rheumatological services from secondary to primary care. Patients and GPs were from a single primary care trust in Oldham, north west England. A thematic analysis of interview data was taken, and findings showed high patient satisfaction with the service, favouring the primary care environment to a hospital setting. GPs reported on cost-effectiveness of the service and better management of the disease. The Tier 2 service has the potential to set a new direction for multiagency care within a primary care setting

Liberating the NHS; commissioning, outsourcing and a new politics debate

In the short months following the result of the UK 2010 General election, a new Government White Paper has been released entitled: Equity and Excellence: Liberating the NHS (Department of Health (DH), 2010a). It strives to distance itself from previous health-care proposals (DH, 2009), yet if the initiatives of this latest paper are combined against previous initiatives, also using high impact declarative terms, such as competition and choice, it is clear that little has changed and more important principles than saving money are at risk

Taxonomic review of the Neotropical Tetragonoderus quadriguttatus assemblage (Coleoptera: Carabidae: Cyclosomini) with description of T. deuvei, new species, and new West Indian and Nearctic locality records

The Tetragonoderus (Peronoscelis) quadriguttatus assemblage is a postulated monophyletic part of the intersectus complex. This assemblage is characterized against a background that includes review of a classification of the genus and comparison, in the form of a key, to other unrelated Western Hemisphere genera that share elongate tibial spurs with Tetragonoderus Dejean. The principal, easily observed feature that unites the three members (T. laevigatus Chaudoir, 1876; T. deuvei, new species (type locality: Cuijaba, Mato Grosso, Brazil), and T. quadriguttatus Dejean) of the quadriguttatus assemblage is the four-spotted elytra (two spots per elytron). These species are treated in detail, including key, synonymy (as required), comparisons, description (external and male genitalic features), habitat (if known), locality data, and geographical range map. Also, T. subfasciatus Putzeys, 1846, the elytral color pattern of whose members may be confused with the spotted pattern of the quadriguttatus assemblage, is treated similarly. The following new synonymies were established: T. quadriguttatus Dejean 1829 = T. columbicus Steinheil 1875 = T. lacordairei Chaudoir 1876 = T. tetragrammus Chaudoir 1876; and T. laevigatus Chaudoir 1876 = T. chaudoiri Liebke 1928 (replacement name for the junior homonym, T. unicolor Chaudoir, 1876). Lectotypes are designated for T. unicolor Chaudoir, T. lacordairei Chaudoir, and T. subfasciatus Putzeys. A neotype is designated for T. quadriguttatus Dejean. New distribution records in the West Indies for T. quadriguttatus are recorded for the islands of Grand Cayman, Jamaica and Hispaniola. These records may be the result of recent natural overseas dispersal from northern South America, or they may be the result of human-mediated accidental introduction, or a combination of both. The southern Floridian (Nearctic) records for T. laevigatus probably represent a recent accidental introduction through commerce, followed by dispersal through flights of adults

Recent advances in understanding and managing chronic pelvic pain in women with special consideration to endometriosis

Chronic pelvic pain (CPP) in women is defined variably, but for clinical use it is cyclical or non-cyclical pain of at least 3-6 months' duration. It has major impacts on individuals and society. There are both structural and idiopathic causes. Whereas CPP is not curable in many cases, it is treatable. The most promising approach is multidisciplinary patient-centered care including cause-directed therapy, lifestyle changes, talking therapies, meditation, acupuncture, and physiotherapy (this is not a complete list). One of the most common structural causes for CPP is endometriosis. This review investigates current scientific concepts and recent innovations in this field as well as for CPP in general

A taxonomic review of the subtribe Pericalina (Coleoptera: Carabidae: Lebiini) in the Western hemisphere : with descriptions of new species and notes about classification and zoogeography

A taxonomic review of the lebiine sub tribe Pericalina in the Western Hemisphere, this paper includes a treatment of the genus-groups, a key to the genera, keys to subgenera, species groups, and species of each polybasic genus, descriptions of new species and new subgenera, new locality records for previously described species, re-rankings, and new synonymy. In total, 111 species and subspecies are treated, 26 of which are described as new

A taxonomic review of species of the Neotropical pericaline genus Oreodicastes Maindron, 1905 (Coleoptera: Carabidae: Lebiini)

Based on adult character states, a key is provided to the seven known species of Oreodicastes Maindron 1905 (type species Oxyglossus subcyaneus Chaudoir 1843). Two new species (with type locality) are described: O. virginia (Fa zenda dos Campos, Virginia, state of Minas Gerais, Brazil) and O. zikani (Macieiras, Itatiaia, state of Rio de Janeiro, Brazil)