Accounting for actions and omissions:a discourse analysis of student nurse accounts of responding to instances of poor care

Aims: To explore how nursing students account for decisions to report or not report poor care witnessed on placement and to examine the implications of findings for educators. Background: Concern has been raised about the extent to which cases of poor care go unreported. Failure to report cases may have serious consequences for patient safety. Design: Semi structured interviews were conducted with 13 under graduate students at a UK university during 2013. They were asked to consider their response to episodes of poor practice witnessed on placement. Methods: Data were transcribed verbatim and categorized according to whether or not students reported concerns. Cases were analysed in accordance with Potter and Wetherall’s version of discourse analysis to identify the discursive strategies used to account for decisions to report or not report poor practice. Results: Participants took care to present themselves in a positive light regardless of whether or not they had reported an episode of concern. Those who had reported tended to attribute their actions to internal factors such as moral strength and a commitment to a professional code. Those who had not or would not report concerns provided accounts which referred to external influences that prevented them from doing so or made reporting pointless. Conclusion: This study provides information about how students account for their actions and omissions in relation to the reporting of poor care. Findings suggest ways educators might increase reporting of concerns

Factors influencing student nurse decisions to report poor practice witnessed while on placement

Background: While it is commonly accepted that nursing care is generally of a good standard, it would be naïve to think that this is always the case. Over recent years concern about aspects of the quality of some nursing care has grown. In tandem with this, there is recognition that nurses do not always report poor practice. As future registrants, student nurses have a role to play in changing this culture. We know, however, relatively little about the factors that influence student decisions on whether or not to report. In the absence of a more nuanced understanding of this issue, we run the risk of assuming students will speak out simply because we say they should. Objectives: To explore influences on student decisions about whether or not to report poor clinical practice which is a result of deliberate action and which is witnessed while on placement. Methods: Qualitative interviews were conducted with thirteen pre-registration nursing students from the UK. Participants included both adult and mental health nurses with an age range from 20–47. Data were analysed to identify key themes. Category integrity and fit with data was confirmed by a team member following initial analysis. Results: Four themes emerged from the data. The first of these, ‘I had no choice’ described the personal and ethical drivers which influenced students to report. ‘Consequences for self’ and ‘Living with ambiguity’ provide an account of why some students struggle to report, while ‘Being prepared’ summarised arguments both for and against reporting concerns. Conclusion: While there is a drive to promote openness in health care settings and an expectation that staff will raise concerns about quality of care, the reality is that the decision to do this can be very difficult. This is certainly the case for some student nurses. Our results suggest ways in which educationalists might intervene to support students who witness poor practice to report

United States Policy Regarding Technology Transfer to the People\u27s Republic of China

This Comment will focus on the nature and likely effect of the new United States export licensing rules regulating the transfer of technology to China. Part I will address the history and development of United States export control policy to China. Part II will discuss both the ideo- logical debate over the appropriate China technology transfer policy, and the general licensing procedures under the United States Export Admin- istration Act. Part III will analyze the substantial changes in and practi- cal effect of the new licensing guidelines for China, and the policy reasons behind the changes. Part IV will assess the probable impact of the new export policy on United States-China trade relations and the potential problems United States exporters are likely to face in foreign trade with China. As of January, 1984, United States exporters were very optimis- tic about current predictions that trade between the United States and China will reach record figures in 1984. A gradual trend toward liber- alization of technology transfer controls to Communist China reflects the friendly attitude the countries are presently exhibiting toward one an- other, and each country\u27s recognition that better relations are mutually beneficial. However, as United States-Soviet relations demonstrate, friendly relations can quickly turn hostile, thereby upsetting trade rela- tions carefully negotiated over many years. Therefore, United States exporters should keep in mind that Sino- United States economic relations will be inextricably linked to the polit- ical climate and the economic conditions in each country. While the benefits of increased trade between China and the United States are po- tentially great for both countries, so too are the potential harms if either country\u27s expectations for a prosperous and smooth trading relationship are disappointed

On solutions to the non-Abelian Hirota-Miwa equation and its continuum limits

In this paper, we construct grammian-like quasideterminant solutions of a non-Abelian Hirota-Miwa equation. Through continuum limits of this non-Abelian Hirota-Miwa equation and its quasideterminant solutions, we construct a cascade of noncommutative differential-difference equations ending with the noncommutative KP equation. For each of these systems the quasideterminant solutions are constructed as well.Comment: 9 pages, 1 figur

Quasideterminant solutions of a non-Abelian Hirota-Miwa equation

A non-Abelian version of the Hirota-Miwa equation is considered. In an earlier paper [Nimmo (2006) J. Phys. A: Math. Gen. \textbf{39}, 5053-5065] it was shown how solutions expressed as quasideterminants could be constructed for this system by means of Darboux transformations. In this paper we discuss these solutions from a different perspective and show that the solutions are quasi-Pl\"{u}cker coordinates and that the non-Abelian Hirota-Miwa equation may be written as a quasi-Pl\"{u}cker relation. The special case of the matrix Hirota-Miwa equation is also considered using a more traditional, bilinear approach and the techniques are compared

Does Titan's Landscape Betray the Late Acquisitions of Its Current Atmosphere?

Titan may have acquired its massive atmosphere relatively recently in solar system history. The sudden appearance of a thick atmosphere may have changed Titan's global topography. This change in global topography may be expressed in the latitudinal distribution of landform types across its surface

On a direct approach to quasideterminant solutions of a noncommutative KP equation

A noncommutative version of the KP equation and two families of its solutions expressed as quasideterminants are discussed. The origin of these solutions is explained by means of Darboux and binary Darboux transformations. Additionally, it is shown that these solutions may also be verified directly. This approach is reminiscent of the wronskian technique used for the Hirota bilinear form of the regular, commutative KP equation but, in the noncommutative case, no bilinearising transformation is available.Comment: 11 page

An update on the potential for male contraception : emerging options

The human population continues to grow and is estimated to rise to 10.1 billion by the end of the century. Therefore, there is still an unmet need for safe and highly effective contraceptive options for both men and women. Current options available to men include withdrawal, condoms, and vasectomy. Methods in development fall into two categories: hormonal and nonhormonal. This review will provide an overview of the testosterone combinations and immunocontraception of hormonal targets. Nonhormonal immunocontraception of sperm proteins will also be examined, together with the use of agents to disrupt other sperm-associated targets and pathways. The categories focused on include epididymal proteins, testicular kinases, epigenetic reader proteins, opioids, lonidamine derivatives, retinoic acid, microRNAs associated with spermatogenesis, and plant extracts. Considering these developments, the number of options available to men is likely to increase in the near future

Comparative Techno-economic assessment of biomass and coal with CCS technologies in a pulverized combustion power plant in the United Kingdom

The technical performance and cost effectiveness of white wood pellets (WWP) combustion in comparison to three types of coal namely U.S., Russian and Colombian coals are investigated in this study. Post-combustion capture and storage (CCS) namely with amine FG+, and oxy-fuel with carbon capture and storage (oxy-fuel) are applied to a 650 MW pulverized combustion (PC) plant. The impacts of the Renewable Obligation Certificate (ROC) and carbon price (CP) policy in accelerating the CCS deployment in the framework of GHG emissions mitigation, are also evaluated. The operational factors affecting CCS costs and emissions in the power generation plants are taken into consideration, hence, the Integrated Environmental Control Model (IECM 8.0.2) is employed for a systematic estimation of plant performance, costs and emissions of different scenarios of fuel and CCS technologies. This study showed that the utilization of white wood pellets (WWP) in electricity generation can annually avoid about 3 M tonnes CO2 emissions from a 650 MW power plant. However, this mitigation process had impact on the plant efficiency and the cost of electricity. Further, the BECCS using white wood pellets has showed a better efficiency and lower cost of electricity with the oxy-fuel technology than the post-combustion CCS technology. However, in order to boost biomass energy CCS (BECCS) deployment with the WWP, an increase of the ROC for biomass power plants, or, an increase of the carbon price for the coal power plants is recommended. It was found that, the sensitivity of COE towards the ROC was higher than towards the carbon price variation. This result can be interpreted as the ROC has more positive impact than the carbon price, on the COE from the point of customers view without adding more burdens on the power generation companies