Professionalisation in nursing : the Swiss case

In this study, the professionalisation of nursing in Switzerland is being investigated with the help of the theoretical approaches of the sociology of professions. These approaches - demand approach and supply approach - represent two opposing lines of argumentation. In the demand approach, the status of being a profession (monopolised autonomy by state licence, social standing) is ascribed to successful political strategies of the professional group. In the supply approach, the professions are seen as institutions which can only be explained in their relationship to the state. Thus, in one line of thought, the constitution of the professions is viewed as a process parallel to the modernisation of the state. Another line of thought understands the professions also as bearers of uncertainty of both individuals and collectives. In the course of global neo-liberal politics, the ethic aspect of this approach has been condensed into the soul of the professions - as an antagonist to the soullessness of state and market. Since the 1950s, leading nurses in teaching and practice in Switzerland have been active to create a new position for professional nursing. Their main concern is to develop autonomous, specific concepts in addition to the traditionally dominant concepts of medicine. As a result, a professional project evolved which aims to gain a state monopoly for professional nursing. The study shows that the demand approach can only explain single aspects and short historic phases in the development of the profession. In each development phase, state and market have created the prevailing conditions of nursing like, so to speak, a mould. This becomes manifest in each phase depending on the federal structures of the state. This corresponds to the supply approach of the sociology of the professions. Nursing has not reached the goal of state licensure. However, if the profession thanks to its professional soul independently stands up for its patients, it fulfils the role typical of professions in this theoretic approach. This soul was present in the nursing profession from its very beginning

Professionalisation in nursing : the Swiss case

In this study, the professionalisation of nursing in Switzerland is being investigated with the help of the theoretical approaches of the sociology of professions. These approaches - demand approach and supply approach - represent two opposing lines of argumentation. In the demand approach, the status of being a profession (monopolised autonomy by state licence, social standing) is ascribed to successful political strategies of the professional group. In the supply approach, the professions are seen as institutions which can only be explained in their relationship to the state. Thus, in one line of thought, the constitution of the professions is viewed as a process parallel to the modernisation of the state. Another line of thought understands the professions also as bearers of uncertainty of both individuals and collectives. In the course of global neo-liberal politics, the ethic aspect of this approach has been condensed into the soul of the professions - as an antagonist to the soullessness of state and market. Since the 1950s, leading nurses in teaching and practice in Switzerland have been active to create a new position for professional nursing. Their main concern is to develop autonomous, specific concepts in addition to the traditionally dominant concepts of medicine. As a result, a professional project evolved which aims to gain a state monopoly for professional nursing. The study shows that the demand approach can only explain single aspects and short historic phases in the development of the profession. In each development phase, state and market have created the prevailing conditions of nursing like, so to speak, a mould. This becomes manifest in each phase depending on the federal structures of the state. This corresponds to the supply approach of the sociology of the professions. Nursing has not reached the goal of state licensure. However, if the profession thanks to its professional soul independently stands up for its patients, it fulfils the role typical of professions in this theoretic approach. This soul was present in the nursing profession from its very beginning

Professionalisation in nursing : the Swiss case

In this study, the professionalisation of nursing in Switzerland is being investigated with the help of the theoretical approaches of the sociology of professions. These approaches - demand approach and supply approach - represent two opposing lines of argumentation. In the demand approach, the status of being a profession (monopolised autonomy by state licence, social standing) is ascribed to successful political strategies of the professional group. In the supply approach, the professions are seen as institutions which can only be explained in their relationship to the state. Thus, in one line of thought, the constitution of the professions is viewed as a process parallel to the modernisation of the state. Another line of thought understands the professions also as bearers of uncertainty of both individuals and collectives. In the course of global neo-liberal politics, the ethic aspect of this approach has been condensed into the soul of the professions - as an antagonist to the soullessness of state and market. Since the 1950s, leading nurses in teaching and practice in Switzerland have been active to create a new position for professional nursing. Their main concern is to develop autonomous, specific concepts in addition to the traditionally dominant concepts of medicine. As a result, a professional project evolved which aims to gain a state monopoly for professional nursing. The study shows that the demand approach can only explain single aspects and short historic phases in the development of the profession. In each development phase, state and market have created the prevailing conditions of nursing like, so to speak, a mould. This becomes manifest in each phase depending on the federal structures of the state. This corresponds to the supply approach of the sociology of the professions. Nursing has not reached the goal of state licensure. However, if the profession thanks to its professional soul independently stands up for its patients, it fulfils the role typical of professions in this theoretic approach. This soul was present in the nursing profession from its very beginning.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Feasibility and safety of passive cooling in a cohort of asphyxiated newborn infants

OBJECTIVE: Therapeutic hypothermia has become a standard neuroprotective treatment in term newborn infants following perinatal asphyxia. Active cooling with whole body surface or head cooling is complex, expensive and often associated with initial hypothermic overshoot. We speculated that passive cooling might suffice to induce and maintain hypothermia. METHODS: We analysed 18 asphyxiated term newborns treated with hypothermia in three tertiary neonatal and paediatric intensive care units. Target temperatures of 33.5 °C or 33.0 °C were induced and maintained by turning off the heating system of the open neonatal care unit and by using analgesics and sedatives. We compared our results with matching published data from the hypothermia trial of the National Institute of Child Health and Human Development (NICHD) neonatal research network. RESULTS: Four infants required no active cooling at all during the whole cooling period. The other 14 infants had passive cooling during 85% of the total cooling time, and active cooling with ice packs in 15% of the total cooling time. Overshoot was smaller in the present study than in the NICHD study. CONCLUSION: Passive cooling for asphyxiated newborns appears to be feasible for induction and maintenance of hypothermia with a lower risk of overshoot

Joint Analysis of Psychiatric Disorders Increases Accuracy of Risk Prediction for Schizophrenia, Bipolar Disorder, and Major Depressive Disorder

Genetic risk prediction has several potential applications in medical research and clinical practice and could be used, for example, to stratify a heterogeneous population of patients by their predicted genetic risk. However, for polygenic traits, such as psychiatric disorders, the accuracy of risk prediction is low. Here we use a multivariate linear mixed model and apply multi-trait genomic best linear unbiased prediction for genetic risk prediction. This method exploits correlations between disorders and simultaneously evaluates individual risk for each disorder. We show that the multivariate approach significantly increases the prediction accuracy for schizophrenia, bipolar disorder, and major depressive disorder in the discovery as well as in independent validation datasets. By grouping SNPs based on genome annotation and fitting multiple random effects, we show that the prediction accuracy could be further improved. The gain in prediction accuracy of the multivariate approach is equivalent to an increase in sample size of 34% for schizophrenia, 68% for bipolar disorder, and 76% for major depressive disorders using single trait models. Because our approach can be readily applied to any number of GWAS datasets of correlated traits, it is a flexible and powerful tool to maximize prediction accuracy. With current sample size, risk predictors are not useful in a clinical setting but already are a valuable research tool, for example in experimental designs comparing cases with high and low polygenic risk