Healthcare professionals' perspectives on enrolled nurses, practical nurses and other second-level nursing roles: A systematic review and thematic synthesis.

BACKGROUND: Significant workforce shortages and economic pressures have led to the expanded scope and reintroduction of new roles for second-level nurses in many Organization for Economic Co-operation and Development countries. Given this, there is a need to understand the emic and etic perspectives of second-level nurses, to ensure collaborative teamwork and safe patient care. OBJECTIVE: This review aimed to systematically identify, appraise, and synthesize qualitative research evidence on healthcare professionals' perspectives on second-level nursing roles in the healthcare workforce. These findings inform recommendations that would influence the development and implementation of these roles in healthcare organisations. DESIGN: A systematic review and thematic synthesis of qualitative research was conducted. Six databases were systematically searched and forward and backwards searching completed. Included studies focused on healthcare professionals' perspectives (including views of second-level nurses themselves) on second-level nursing roles. All included articles were from Organization for Economic Co-operation and Development countries. The Critical Appraisal Skills Programme checklist for qualitative research was used to assess the evidence quality. The results section of each included article was coded and descriptive themes were developed. An interpretative and iterative process led to the final analytic themes. FINDINGS: Twenty-six qualitative studies were identified from five countries over 26 years. Four analytic themes were identified: undifferentiated role; efficient but limited; subordinated task-doers; and broadening scope and strengthened identity. The synthesis demonstrated dichotomies wherein some second-level nursing roles were devalued, and others had increasing scope and responsibility. Role and boundary confusion was evident and had not decreased over time. Hierarchies in nursing practice underlined the split between critical thinking and hands-on approaches to care which, in some cases, debased the second-level nursing role because of its association with practical hands-on care. CONCLUSIONS: The analytic themes in this synthesis suggest that second-level nurses have faced the same issues over decades with little change. Perceptions of second-level nursing roles are primarily influenced by meso (organisational level) factors and micro (individual, behavioural) factors. The synthesis concludes that a cultural shift in valuing the hands-on care provided by second-level nursing is necessary, along with systems-level shift that clarifies the role of second-level nursing within healthcare teams to enhance collaborative practice. Further research should attend to macro-level influences on perceptions of second-level nurses, the work they do, and how this is valued or institutionally embedded. Tweetable abstract: Healthcare professionals' perspectives on second-level nursing roles: a systematic review and thematic synthesis

Proposal Workflow Management System A web-based application for replacing the manual approval process of grant proposal submission

The process of creating a research proposal and submitting it for final approval is a very time consuming process as any proposal may require multiple parties to review and authorize it and every step. There may even be complications that arise during the process such as absenteeism or delegation of authority. Issues of delegation of authority in the absences of a person in the work-flow process, such as who can be authorized to sign for what and for how long they may have that authority may also arise. Digital solutions exist for this work flow but lack the agility to meet changing needs in access control. Thus, there is a need for flexibility in changing security policies. We propose a separation of code and policy by utilizing the Extensible Access Control Markup Language (XACML) and making use of Attribute Based Access Control (ABAC) policies we can separate our workflow program from our access control thus allowing for a more fine-grained control of those policies This can help avoid the costly work of recoding when security policies change, it will also allow for a more flexible control of security policies demanded by an organization making use of this program

Calystegines as chemotaxonomic markers in the Convolvulaceae

An extended GC–MS study of 129 convolvulaceous species belonging to 29 genera (all 12 tribes) including the results of a previous survey (65 spp.) revealed the occurrence of one to six polyhydroxy alkaloids of the nortropane type (calystegines) in 62 species belonging to 22 genera of all tribes except the unique parasitic Cuscuteae. The large genus Ipomoea turned out to comprise calystegine-positive species in at least eight out of ten sections checked. The number of the calystegines used as reference compounds has been increased from seven (previous survey) to 11 (present study). Furthermore, the results concerning these additional four alkaloids could also be completed for all species of the previous survey. The plant material (epigeal vegetative parts and/or roots, flowers, fruits/seeds) was obtained from collections in the wild from a wide range of tropical, subtropical, and temperate locations of all continents as well as from cultivation in the greenhouse. All plant organs turned out to be potential locations for the occurrence of these metabolites though they are detectable often only in certain organs of a given species. Three genera (Cuscuta, Operculina, Polymeria) might have lost the ability to synthesize these plesiomorphic characters in the course of the evolution since the examination of several different organs and/or provenances of five species each failed to show calystegines as constituents. Nevertheless, the present data clearly demonstrate that the occurrence of calystegines is an almost consistent trait in the Convolvulaceae in principle, from basal to most advanced tribes

Calystegines as chemotaxonomic markers in the Convolvulaceae

An extended GC–MS study of 129 convolvulaceous species belonging to 29 genera (all 12 tribes) including the results of a previous survey (65 spp.) revealed the occurrence of one to six polyhydroxy alkaloids of the nortropane type (calystegines) in 62 species belonging to 22 genera of all tribes except the unique parasitic Cuscuteae. The large genus Ipomoea turned out to comprise calystegine-positive species in at least eight out of ten sections checked. The number of the calystegines used as reference compounds has been increased from seven (previous survey) to 11 (present study). Furthermore, the results concerning these additional four alkaloids could also be completed for all species of the previous survey. The plant material (epigeal vegetative parts and/or roots, flowers, fruits/seeds) was obtained from collections in the wild from a wide range of tropical, subtropical, and temperate locations of all continents as well as from cultivation in the greenhouse. All plant organs turned out to be potential locations for the occurrence of these metabolites though they are detectable often only in certain organs of a given species. Three genera (Cuscuta, Operculina, Polymeria) might have lost the ability to synthesize these plesiomorphic characters in the course of the evolution since the examination of several different organs and/or provenances of five species each failed to show calystegines as constituents. Nevertheless, the present data clearly demonstrate that the occurrence of calystegines is an almost consistent trait in the Convolvulaceae in principle, from basal to most advanced tribes

From geography department to business school: strategies for transplanting GIS courses between disciplines

A number of strategies have been adopted for the development and delivery of GIS curricula in various disciplines. The main strategies are described, evaluated and illustrated with reference to recent practice. The author then uses a transplantation analogy to describe the process whereby he adapted his own GIS modules following a move from a modestly sized geography department to a large business school. Several critical questions are posed, including: what is the best strategy for developing GIS courses for business students?; how does one ensure disciplinary and curricular fit in the transplantation process?; and what are the likely reactions and learning experiences of business students who take transplanted modules? Conclusions are drawn on the potential for geographers to assist in the development of GIS courses for other disciplines in the future