Potential consequences of linear approximation in economics

Econometric models ; Monetary policy ; Equilibrium (Economics)

Boom and bust in telecommunications

Telecommunication

A method of teaching clinical problem-solving skills to primary health care student nurses

The article provides a description of a method of teaching a clinical problem-solving process to primary health care nurses/clinical nurse practitioners (PHC nurses). The process was developed in the Soweto PHC Nurse Training Unit over the past 30 years as a result of the changing availability and role of nurse and doctor teaching staff. Students doing the diploma for nurse clinicians (Diploma in Clinical Nursing Science, Health Assessment, Treatment and Care) are guided in the use of mind maps, assisted by constant clinical practice and group discussions to develop their clinical problem-solving process. This method has assisted in clinical trainingKeywords: clinical problem solving process; nurse clinicians; PHC nurse training; mind maps; self teachin

LXVII. On the chemical composition of the substances employed in pottery

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Action ascription and deonticity in everyday advice-giving sequences

Peer reviewe

Cromwell's Edinburgh press and the development of print culture in Scotland

Alasdair Mann, the noted scholar of book culture in early modern Scotland, has suggested that a significant change had occurred in Scotland's relationship with the printed word by the late seventeenth century. This study sets out to explain how the interregnum served as a ‘watershed’ during which a consumer demand was created for popular print and how this in turn necessitated a significant increase in the production and distribution of printed material. Beginning with the sale of the press and patent of Evan Tyler to the London Stationers’ Company in 1647, the article charts the key factors that transformed Scotland's printing industry from the production of official declarations and works for foreign markets to the production of polemical texts for a Scottish audience. These developments also witnessed publication of the first serial news journal and the growth of a competitive market for up-to-date printed news. More than just an anomaly that flourished during a decade of occupation, these fundamental changes altered Scotland by introducing the large-scale consumption of chapbooks and printed ephemera, thereby initiating the nation's enduring print culture

The impact of interpersonal relationships on rural doctors’ clinical courage

Introduction: Clinical courage occurs when rural doctors push themselves to the limits of their scope of practice to provide the medical care needed by patients in their community. This mental strength to venture, persevere and act out of concern for one’s patient, despite a lack of formally recognised expertise, becomes necessary for doctors who work in relative professional isolation. Previous research by the authors suggested that the clinical courage of rural doctors relies on the relationships around them. This article explores in more depth how relationships with others can impact on clinical courage. Methods: At an international rural medicine conference in 2017, doctors who practised rural/remote medicine were invited to participate in the study. Twenty-seven semistructured interviews were conducted exploring experiences of clinical courage. Initial analysis of the material, using a hermeneutic phenomenological frame, sought to understand the meaning of clinical courage. In the original analysis, an emic question arose: ‘How do interpersonal relationships impact on clinical courage’. The material was re-analysed to explore this question, using Wenger’s community of practice as a theoretical framework. Results: This study found that clinical courage was affected by the relationships rural doctors had with their communities and patients, with each other, with the local members of their healthcare team and with other colleagues and health leaders outside their immediate community of practice. Conclusion: As a collective, rural doctors can learn, use and strengthen clinical courage and support its development in new members of the discipline. Relationships with rural communities, rural patients and urban colleagues can support the clinical courage of rural doctors. When detractors challenge the value of clinical courage, it requires individual rural doctors and their community of practice to champion rural doctors’ way of working

Mechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm : a randomised controlled feasibility trial (COMPRESS-RCT)

Background Mechanical chest compression devices consistently deliver high-quality chest compressions. Small very low-quality studies suggest mechanical devices may be effective as an alternative to manual chest compressions in the treatment of adult in-hospital cardiac arrest patients. The aim of this feasibility trial is to assess the feasibility of conducting an effectiveness trial in this patient population. Methods COMPRESS-RCT is a multi-centre parallel group feasibility randomised controlled trial, designed to assess the feasibility of undertaking an effectiveness to compare the effect of mechanical chest compressions with manual chest compressions on 30-day survival following in-hospital cardiac arrest. Over approximately two years, 330 adult patients who sustain an in-hospital cardiac arrest and are in a non-shockable rhythm will be randomised in a 3:1 ratio to receive ongoing treatment with a mechanical chest compression device (LUCAS 2/3, Jolife AB/Stryker, Lund, Sweden) or continued manual chest compressions. It is intended that recruitment will occur on a 24/7 basis by the clinical cardiac arrest team. The primary study outcome is the proportion of eligible participants randomised in the study during site operational recruitment hours. Participants will be enrolled using a model of deferred consent, with consent for follow-up sought from patients or their consultee in those that survive the cardiac arrest event. The trial will have an embedded qualitative study, in which we will conduct semi-structured interviews with hospital staff to explore facilitators and barriers to study recruitment. Discussion The findings of COMPRESS-RCT will provide important information about the deliverability of an effectiveness trial to evaluate the effect on 30-day mortality of routine use of mechanical chest compression devices in adult in-hospital cardiac arrest patients