474 research outputs found

    Can professional nursing value claims be refused? Might nursing values be accepted provisionally and tentatively?

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    Value-act relationships are less secure than is commonly supposed and this insecurity is leveraged to address two questions. First, can nurses refuse professional value claims (e.g., claims regarding care and compassion)? Second, even when value claims are accepted, might values be held provisionally and tentatively? These questions may seem absurd. Nurses deliver care and nursing is, we are told, a profession the members of which hold and share values. However, focusing attention on the problematic nature of professional value claims qua claims permits a more conciliatory and realistic stance to be taken towards nurses holding alternative values and value interpretations. This could prove beneficial

    Can philosophy benefit nurses and/or nursing? Heidegger and Strauss, problems of knowledge and context

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    When researchers and scholars claim their work is based on a philosophical idea or a philosopher’s corpus of ideas (and theory/theorist can be substituted for philosophy/philosopher), and when “basing” signifies something significant rather than subsidiary or inconsequential, what level of understanding and expertise can readers reasonably expect authors to possess? In this paper some of the uses to which philosophical ideas and named philosophers (Martin Heidegger and Leo Strauss) are put in exegesis is critiqued. Considering problematic instances of idea-name use may enable the question: “Can philosophy benefit nurses and/or nursing?” to be better understood if not answered

    Complexity and ambition in nurse education

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    Educators who fail to recognise complexity in the educative encounter may be less ambitious in interactions with students than would otherwise be the case and, potentially, this could result in compromised learning. It is proposed that complexity and ambition are useful descriptors that highlight, albeit loosely, topics meriting consideration

    Pain relief for women with cervical intraepithelial neoplasia undergoing colposcopy treatment

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    Treatment for CIN is usually undertaken in an outpatient colposcopy clinic to remove the pre-cancerous cells from the cervix. It commonly involves lifting the cells off the cervix with electrically heated wire (diathermy) or laser, or destroying the abnormal cells with freezing methods (cryotherapy). This is potentially a painful procedure. The purpose of this review is to determine which, if any, pain relief should be used during cervical colposcopy treatment. We identified 17 trials and these reported different forms of pain relief before, during and after colposcopy. Evidence from two small trials showed that women having a colposcopy treatment had less pain and blood loss if the cervix was injected with a combination of a local anaesthetic drug and a drug that causes blood vessels to constrict (narrow), compared with placebo. Although taking oral pain-relieving drugs (e.g. ibuprofen) before treatment on the cervix in the colposcopy clinic is recommended by most guidelines, evidence from two small trials did not show that this practice reduced pain during the procedure. Most of the evidence in this field is of a low to moderate quality and further research may change these findings. Additionally, we were unable to obtain evidence with regards to dosage of the local anaesthetic drug or method of administering local anaesthetic into the cervix. There is need for high-quality trials with sufficient numbers of participants in order to provide the data necessary to estimate these effects

    Dynamic p-enrichment schemes for multicomponent reactive flows

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    We present a family of p-enrichment schemes. These schemes may be separated into two basic classes: the first, called \emph{fixed tolerance schemes}, rely on setting global scalar tolerances on the local regularity of the solution, and the second, called \emph{dioristic schemes}, rely on time-evolving bounds on the local variation in the solution. Each class of pp-enrichment scheme is further divided into two basic types. The first type (the Type I schemes) enrich along lines of maximal variation, striving to enhance stable solutions in "areas of highest interest." The second type (the Type II schemes) enrich along lines of maximal regularity in order to maximize the stability of the enrichment process. Each of these schemes are tested over a pair of model problems arising in coastal hydrology. The first is a contaminant transport model, which addresses a declinature problem for a contaminant plume with respect to a bay inlet setting. The second is a multicomponent chemically reactive flow model of estuary eutrophication arising in the Gulf of Mexico.Comment: 29 pages, 7 figures, 3 table

    Implications of shunt morphology for the surgical management of extrahepatic portosystemic shunts

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    Objectives: To describe the implications of extrahepatic portosystemic shunt morphology for 14 the chosen site of shunt closure in dogs and cats. Methods: A retrospective review of a consecutive series of dogs and cats managed for 16 congenital extrahepatic portosystemic shunts was used. Results: In total 54 dogs and 10 cats met the inclusion criteria revealing five distinct shunt 18 types; left gastro-phrenic, right gastro-caval (types Ai, Aii and Aiii), spleno-caval, colo-caval 19 and left gastro-azygos. Without exception, findings of computed tomography angiography and 20 direct gross observations at the time of surgery confirmed four consistent sites of 21 communication between the anomalous shunting vessel and the systemic venous system; the 22 caudal vena cava at the level of the epiploic foramen, the left phrenic vein at the level of the 23 oesophageal hiatus, the azygos vein at the level of the aortic hiatus and the caudal vena cava 24 or iliac vein at the level of the sixth or seventh lumbar vertebrae. The use of intra-operative mesenteric portography was effective in confirming that at the time of surgery all portal 26 tributary vessels were proximal to the point of shunt attenuation. Conclusions: Findings confirmed that for the common types of extrahepatic portosystemic 28 shunts seen there were only four consistent sites of communication between the shunt and the 29 systemic venous system. This information supports the use of a systematic approach for 30 location and attenuation of shunts in dogs and cats

    Inventory of Data Sources for Estimating Health Care Costs in the United States

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    To develop an inventory of data sources for estimating health care costs in the United States and provide information to aid researchers in identifying appropriate data sources for their specific research questions