The ideological framework of nursing practice within a health care system in transition

Nurses who have practised within the NHS over the last decade have arguably experienced more change and concomitant demands upon their clinical practice than any other period in the history of modem nursing. The research problem is concerned with the material and temporal relationship that pertains between the processes of structural and organisational change within the health care system and nurses discourses of practice. The research question that follows, is what are the discourses or frames of meaning that nurses as a profession draw upon in managing the practical problems of delivering care to patients, and what are the social structural mechanisms that shape this knowledge. In addressing this question, the thesis employs a qualitative research method, a series of focus group discussions involving different groups of nurses in order to establish the range of discourses concerning the developments that have occurred in their professional practice. In particular those changes in practice that have directly resulted from the organisational reforms within the NHS that have been instigated by both Conservative and New Labour governments in the 1990s. The analysis of this qualitative data is not tied to either a subjectivist or objectivist understanding of social reality, but seeks to apply an analytical framework informed by the methodological principles of critical realism. The objective is to postulate those necessary rather than contingent causal social structural relationships that are the condition for the generation of these nursing discourses during a time of organisational transition within the NHS. The thesis concludes with the assertion that the professional practices of nurses are shaped by a range of disparate and often contradictory ideological elements, which in many ways mirror the tensions, contradictions and politics that characterise the state provision and delivery of health care within a late modem market economy. In addition, the specific context of nursing practice, whether this be the 'community' or the hospital-setting, is central to the shaping of the specific combination of ideological elements that nurses draw upon in their discourses of practic

Standard English, the National Curriculum, and linguistic disadvantage :a sociolinguistic account of the careful speech of Tyneside adolescents

PhD ThesisThis study investigates adolescents' use of standard English in situations requiring careful speech. An account is given of the historical, political, linguistic and educational development of the concept of standard English, with particular emphasis on spoken standard English. Popular conceptions of 'correct speech' are also considered, and all of these are related to requirements in the National Curriculum for England and Wales for the teaching of spoken standard English. This is related to a specific case, namely that of Tyneside English. This variety is described, and an account is given of the area and its main social and econornIc characteristics. Twenty four adolescents are chosen from two schools which contrast highly in terms of socioeconomic profile. The individuals are also selected to provide a spread of levels of attainment, and both sexes are equally represented. M Phonological, grammatical, lexical and discourse variables are quantified using Labovian quantification techniques and approaches which involve counting non-standard variants over a period of time. Principal linguistic variables are: glottalised variants of (p) (t) and (k); non standard verb and pronoun forms; non-standard lexical items, and certain kinds of discourse markers. This process provides evidence of the extent to which young people use or do not use spoken standard English. It is shown that in more careful speech young people from more and less privileged backgrounds use only small frequencies of non-standard variants, but that within this relatively small number differences do exist: certain items are used mainly by less privileged boys, others mainly by girls, others by more privileged individuals in general. Use of non-standard speech is shown to differ for different groups at different linguistic levels. Important differences in gender and in social class emerge, but attainment also appears to have a significant bearing on children's use of spoken standard English. The study concludes by discussing pedagogical approaches which might increase awareness of issues associated with standard English

Paul Strand's Ghana and photography after colonialism

This article reclaims Paul Strand’s book Ghana: An African Portrait (published in the year of his death,1976) as a conflicted attempt to represent postcolonial nationhood. Comparisons with Richard Wright’s Black Power (1954) are used to open up the central problem of how to represent a post-colonial state in the making while also dealing with the author/photographer’s own difference from the subjects and subjectivities depicted. This is explored through the thematic of portraiture, of looking and being looked at, particularly in how to portray the leadership of Kwame Nkrumah and the relationship between leader and post-colonial citizen

The Impact of Anti-BYOD Policies on Generation Z Hospitality Employee\u27s Engagement

As an industry hospitality typically reacts to problems rather than tackling them proactively. One of the greatest problems currently faced by the industry is the low engagement rates across employees. These low levels have been linked to many issues including low morale, productivity and high turnover rates. One way to try to remedy this issue before it worsens would be to look at future hospitality employees and try to understand what will engage them. Doing so will allow human resource leaders to make changes to any polices which currently do not synchronize with these engaging factors. With research suggesting that Generation Z are highly dependent on their mobile devices, the current anti-BYOD (bring your own device) polices which are common in the hospitality industry may prove to be disengaging. Hospitality industry leaders need to find a way to ensure engagement of these potential employees while not sacrificing the level of service associated with the industry. A survey was developed to measure the level of mobile device dependency, the level of disengagement as a result of anti-BYOD policies and the level of importance placed on customer service, should BYOD polices be implemented. Statistical analysis suggests that while both Generation Y & Z are disengaged by anti-BYOD policies, the difference between them was not significant. Interestingly, the high level of importance placed on customer service was not significantly different regardless of generation or level of device dependency. This suggests that giving both Generation Y & Z employees access to their mobile device during work would increase engagement levels and would not reduce the customer experience. There is further discussion suggesting evidence of Generation C, a psychographic interpretation of Generation Y & Z characteristics. Recommendations for both the industry and academia are also made

Imperial Modernism

Architectural Modernism related in complex ways to the late colonial context of the mid-twentieth century. This chapter explores the opportunities and visions invested in Modernism by both colonizers and the colonized, while relating these to the instrumental and exclusionary logic that gave Modernism such a powerful role within both the imperial apparatus and its succeeding post-colonial regimes. The relationship of Modernism and empire is thus understood in ways that open up or re-cast each other, especially in terms of metropolis and colony. It is in this spirit that the workings of the avantgarde, of official Modernism, of a climatically functional architecture for the tropics, of the vernacular, and of Modernism’s continuation after empire, are all treated

The Dialectics of the Biosocial: Addressing Ontological Dualism and Contemplating Transhumanism

‘Transhumanism’ is the name that has been adopted by a cultural and philosophical movement, a broad coalition of those concerned with the question of enhancing humanity through emergent and innovative bio- and information technologies. As such, it would appear to have little in common with the political programme of Marxism, not least because of a generally uncritical approach to the commodification of human biomaterial that is generally deemed integral to this grand project. The question posed in this paper is whether it is possible to look beyond the contradictory impulses that underpin the contemporary manifestations of transhumanism, and engage with a key theme of the transhumanist movement, that of accelerating the evolutionary development of humanity for the benefit of all? The paper addresses the difficult question of what is human nature, or the nature of being human. And, whether this ‘nature’ is purely a phenotypic quality shared with all biological life, and as such open to biological modification and transformation? Or does human nature constitute a quite different and unique set of attributes, what Marx identifies as ‘species being’, characterised by a very different understanding of transformation, that of productive activity or praxis

Reports from the Fifth EAHN Meeting in Tallinn

The fifth international meeting of the European Architectural History Network was held in Tallinn, at the National Library of Estonia, from 13 to 16 June 2018. The reports from this meeting aim to capture some of the main themes that came up during four intense days of academic discussions and exchange, meetings, and free-form interaction in different spatial and social settings. After the introduction by Andres Kurg, host of the Tallinn Meeting, five delegates review the five thematic tracks which organised the selected sessions and ran in parallel throughout the three days of the conference: Mediations, Comparative Modernities, Peripheries, Discovery and Persistence, and Body and Mind. In his closing keynote lecture, Reinhold Martin from Columbia University further reflected on the ample critical discussions which had taken place throughout the conference

The implementation of pharmacogenomics into UK general practice: a qualitative study exploring barriers, challenges and opportunities

Funder: St. George's University of LondonAbstract: Pharmacogenomics describes interpatient genetic variability in drug responses. Information based on whole genome sequencing will soon open up the field of pharmacogenomics and facilitate the use of genomic information relating to drug metabolism and drug responses. We undertook a qualitative study, aiming to explore the potential barriers, opportunities and challenges facing the implementation of pharmacogenomics into primary care. Semi-structured interviews were undertaken with 18 clinical participants (16 GPs and 2 other clinicians). All interviews were recorded and transcribed verbatim. Using a thematic analysis approach, data items were coded, ordered and themes constructed. Most participants were aged 55–60 years and worked as part-time clinical GPs with other clearly defined roles. The emerging themes covered several areas of concern, including the following: the utility of pharmacogenomics and the value of introducing such testing into primary care; how to educate the primary care workforce and ‘mainstream’ pharmacogenomics; the ethical, legal and social aspects of pharmacogenomics and its impact on patients; and potential impacts on the healthcare system particularly around economics and informatics. Most participants had concerns about pharmacogenomics and felt that there were a number of barriers and challenges to its implementation into routine primary care. Most striking were their concerns around the cost-effectiveness of using pharmacogenomics in primary care. At the same time most recognised the increasing availability of direct-to-consumer testing, and felt that this would drive the need to understand the ethical and social implications of using genomic information in primary care. This study has raised important issues that need to be considered when planning the implementation of pharmacogenomics into clinical practice. Prior to the implementation of genomic testing into day-to-day practice in UK primary care, it is important that considerations around education, cost-effectiveness and informatics are addressed, as well as the impact on patients

'Olde worlde’ urban? Reconstructing historic urban environments at exhibitions, 1884-1908

From 1884 until the Franco-British Exhibition in 1908, international and national exhibitions had a fad for including reconstructed historic urban streets in their attractions. This article investigates the meaning of such forms of urban heritage in the light of modernising cities. It shows that ideas about historical authenticity were complex and even contradictory, and traces this to the ways in which both a wide range of staff and employees, and also the big crowds at the displays, co-produced this meaning. It suggests that visitors particularly constructed meaning through haptic and emotional encounters with the past, providing evidence of the development of new memory practices for modernity