Role development in health care assistants: the impact of education on practice

Rationale Health care provision has moved towards an approach to patient care that challenges the traditional role boundaries of health care workers. In nursing this has resulted in the delegation of 'nursing care' to health care assistants (HCAs). This study sought to evaluate the impact of a HCA Development Programme on care delivery. Secondly, it sought to understand the preparedness of HCAs to undertake the programme and the new roles set for them. Methodology The research method was a qualitative, inductive approach. For part one, data were gathered using a 360-degree approach. Semi-structured interviews were conducted with four HCAs, eight of each of their colleagues and four patients. For part two, 12 HCAs were interviewed. Data were analysed following the principles of thematic analysis. Findings The findings for part one showed positive changes to the HCAs' role, which included skill and knowledge development, increased confidence and initiative and a more holistic approach to care. A range of personal and contextual factors including relationships, hierarchy, staffing, experience, responsibility, patient dependency, attitudes and values affected the development of their role. The HCAs in part two voiced positive and negative views of their role development. Of the 12 HCAs interviewed, eight were prepared to attend the programme, two were undecided, and two were reluctant to attend. Conclusions The findings indicated that while the HCA Development Programme positively influenced the role of the HCA, there was a need to invest more into preparation for the restructuring of roles

Atmospheric Composition Change: Ecosystems-Atmosphere interactions

Ecosystems and the atmosphere: This review describes the state of understanding the processes involved in the exchange of trace gases and aerosols between the earth's surface and the atmosphere. The gases covered include NO, NO2, HONO, HNO3, NH3, SO2, DMS, Biogenic VOC, O3, CH4, N2O and particles in the size range 1 nm–10 μm including organic and inorganic chemical species. The main focus of the review is on the exchange between terrestrial ecosystems, both managed and natural and the atmosphere, although some new developments in ocean–atmosphere exchange are included. The material presented is biased towards the last decade, but includes earlier work, where more recent developments are limited or absent. New methodologies and instrumentation have enabled, if not driven technical advances in measurement. These developments have advanced the process understanding and upscaling of fluxes, especially for particles, VOC and NH3. Examples of these applications include mass spectrometric methods, such as Aerosol Mass Spectrometry (AMS) adapted for field measurement of atmosphere–surface fluxes using micrometeorological methods for chemically resolved aerosols. Also briefly described are some advances in theory and techniques in micrometeorology. For some of the compounds there have been paradigm shifts in approach and application of both techniques and assessment. These include flux measurements over marine surfaces and urban areas using micrometeorological methods and the up-scaling of flux measurements using aircraft and satellite remote sensing. The application of a flux-based approach in assessment of O3 effects on vegetation at regional scales is an important policy linked development secured through improved quantification of fluxes. The coupling of monitoring, modelling and intensive flux measurement at a continental scale within the NitroEurope network represents a quantum development in the application of research teams to address the underpinning science of reactive nitrogen in the cycling between ecosystems and the atmosphere in Europe. Some important developments of the science have been applied to assist in addressing policy questions, which have been the main driver of the research agenda, while other developments in understanding have not been applied to their wider field especially in chemistry-transport models through deficiencies in obtaining appropriate data to enable application or inertia within the modelling community. The paper identifies applications, gaps and research questions that have remained intractable at least since 2000 within the specialized sections of the paper, and where possible these have been focussed on research questions for the coming decade

Fluxes and concentrations of volatile organic compounds from a South-East Asian tropical rainforest

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Somatic and germline mutations of the TSH receptor and thyroid diseases.

Journal ArticleReviewFLWINinfo:eu-repo/semantics/publishe