Perceptions of the role of the clinical nurse practitioner in the Cape Metropolitan doctor-driven community health centres

Background: The purpose of this study was to evaluate the role of the clinical nurse practitioner (CNP) in a doctordriven primary health care setting. A descriptive study was undertaken, using both a quantitative and a qualitative methodology. The study was undertaken in community health centres (CHC) in the Cape Metropolitan area.Method: A situational analysis was conducted of all 41 CHCs in the Cape Metropolitan area. Three focus group interviews were then undertaken with CNPs, doctors and managers to determine the factors influencing the effective functioning of the CNP. Results: Five-seven percent of the 88 CNPs were totally inactive with regard to consulting patients and only 28% were utilised in a full-time capacity. The major themes to emerge were the factors that determine the effective functioning of the CNP, including self-confidence gained from regular practise, support for their role from doctors and managers, role clarity, and enrolment in the course for the appropriate reason. Conclusions: When enrolling nurses for the CNP course, preference should be given to nurses who will be able to immediately put their training into practise. The managers need to foster a strong CNP identity and ensure maximum opportunities to practise in order for nurses to attain the status of a secure CNP. The doctors need to appreciate the nurses' value in the multidisciplinary team and offer the necessary support. Furthermore, the nurses' role needs to be properly conceptualised by policy makers and contextualised at ground level for them to be effectively utilised in a doctor-driven CHC. SA Fam Pract 2004;46(10): 21-2

Variations in pre-analytical FFPE sample processing and bioinformatics: challenges for next generation molecular diagnostic testing in clinical pathology

Advances in cellular pathology techniques will improve diagnostic medicine. However, such improvements have to overcome many challenges including variations in pre-analytical sample processing, bioinformatics data analysis and clinical interpretation of data. In order to resolve such challenges, bioinformatics needs to become more tightly coupled to the experimental methodology development

Illinoian and Sangamon Vegetation in Southwestern Kansas and Adjacent Oklahoma

167-255http://deepblue.lib.umich.edu/bitstream/2027.42/48393/2/ID238.pd

SPD deformation of pearlitic, bainitic and martensitic steels

The deformation behavior of nearly fully pearlitic, bainitic and martensitic steels during severe plastic deformation is summarized in this paper. Despite their significantly different yield stresses and their microstructures, their hardening behavior during SPD is similar. Due to the enormous hardening capacity the SPD deformation is limited by the strength of the tool materials. The microstructure at the obtainable limit of strain are quite similar, which is a nanocrystalline structure in the order of 10 nm, dependent on the obtainable strain. The nanograins are partially supersaturated with carbon and the grain boundaries are stabilized by carbon. Another characteristic feature is the anisotropy in grain shape which results in an anisotropy of strength, ductility and fracture toughness. The results are important for the development of ultra-strong materials and essential for this type of steels which are frequently used for application where the behavior under rolling contact and sliding contact is important

Is disclosing an autism spectrum disorder in school associated with reduced stigmatization?

This is the final version. Available on open access from SAGE Publications via the DOI in this recordDisclosing an autism diagnosis is associated with reduced stigmatization for autistic adults. However, it is unknown whether this is true for autistic adolescents. We used a vignette-and-questionnaire design to study stigmatizing attitudes with adolescents (aged 11- 12 and 14-16 years, total N=250) in a UK school. We investigated the effect of disclosing that a fictional adolescent was autistic on stigmatizing attitudes of peers by testing the effect of disclosure on the social and emotional distance pupils wanted to maintain from the autistic adolescent and their assessment of the adolescent’s responsibility for their own behaviour. Moderation of effects by gender and age-group were analysed. Disclosing autism made no improvement to the social and emotional distance peers wanted to maintain from the autistic adolescent, but was associated with significant reduction in personal responsibility attributed to the adolescent’s behaviour. Boys attributed more personal responsibility to the autistic adolescent than girls, but this gender effect was reduced when autism was disclosed. These findings suggest that disclosing autism to other pupils may be of limited use in reducing stigmatization by peers in UK schools.Wellcome Trus

People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming

This is the final version. Available from the publisher via the DOI in this record.Data from participants who consented will be deposited in the UK Data Service, in 2019.‘Stereotyped or repetitive motor movements’ are characterised as core features in the diagnosis of autism, yet many autistic adults (and the neurodiversity movement) have reclaimed them as ‘stimming’. Supported by a growing body of scientific research, autistic adults argue that these behaviours may serve as useful coping mechanisms, yet little research has examined stimming from the perspective of autistic adults. Through interviews and focus groups, we asked 32 autistic adults to share their perceptions and experiences of stimming, including the reasons they stim, any value doing so may hold for them and their perceptions of others’ reactions to stimming. Using thematic analysis, we identified two themes: stimming as (1) a self-regulatory mechanism and (2) lacking in social acceptance, but can become accepted through understanding. Autistic adults highlighted the importance of stimming as an adaptive mechanism that helps them to soothe or communicate intense emotions or thoughts and thus objected to treatment that aims to eliminate the behaviour.Wellcome TrustLeverhulme Trus