Reversal of liver failure in sickle cell vaso-occlusive crisis

Issues concerning patient advocacy and nursing advocacy are explored in relation to the nurse's role and the UKCC code of conduct. The author's personal experiences of being an advocate are described. Potential conflict between the nurse's role and doctor's role in relation to advocacy is identified. The best person to take on the role of patient advocate is discussed.     

The advanced nurse practitioner in the ITU. A personal perspective

An attempt is made to define the role of the Advanced Nurse Practitioner (ANP). Implications of Post-Registration Education and Practice (PREP) (UKCC, 1990), The New Deal (NHS Management Executive, 1992) and The Scope of Professional Practice (UKCC, 1992) are considered. Advanced traditional and practical nursing skills are reviewed. An opportunity for professionalism and increased autonomy for nurses is explored.     

Clarifying the UKCC's position in relation to higher level practice

The UKCC is currently consulting on its proposals to recognize and regulate a higher level of practice (UKCC, 1998a). These proposals follow the work undertaken by the UKCC from 1996-1998 on advanced and specialist practice and seek to build on the current postregistration education and practice (PREP) framework (UKCC, 1994). This article outlines the background to the consultation and puts the proposals into context. It is hoped that it will encourage practitioners to respond to the consultation, as the UKCC is very keen to hear the views of specialist nurses, midwives and health visitors. Copies of the UKCC's consultation document are available from Katrina Neal, Professional Officer (0171 333 6542) and are also available on our web site (http:/(/)www.ukcc.org.uk.). Responses should reach Sarah Waller, Director of Standards Promotion at the UKCC, by 20 October 1998.     

Self-advocacy and self-esteem.

Explored the utility of treating self-esteem as an attitude that might be vulnerable to the same kinds of experimental manipulations usually directed at more traditional, less consequential attitudinal issues. Within an attitudinal advocacy paradigm, 109 undergraduates wrote 3 essays either about their personality attributes or about social propositions. Half the Ss writing on each of these topics were told to advocate a positive position (i.e., self-laudatory or proposition supporting) in their essays. The remaining Ss, although induced to advocate positive positions, were led to believe that they could elect to write negative (self-deprecatory or issue-opposing) essays. As anticipated, Ss who wrote the self-laudatory essays subsequently rated themselves more favorably than did Ss who wrote in support of social propositions. The latter Ss showed a corresponding advocacy effect with regard to the social proposition that they had espoused. The manipulation of perceived choice did not influence the magnitude of the advocacy effect. The results are regarded as encouraging with respect to the application of laboratory-derived attitude change procedures to issues of high personal relevance and clinical importance. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural assessment in home healthcare

As the nurse becomes adept at performing cultural assessments and culturally competent care, it will become clear that "although it is critical to conduct a cultural assessment with culturally and ethnically diverse groups, it is also important to realize that every client needs a cultural assessment. Every client has values, beliefs, and practices that must be considered when a clinician renders healthcare services. Therefore, cultural assessments are not limited to specific ethnic groups, but rather should be conducted on each individual" (Campinha-Bacote, 1995, p.148). Nurses who have been identified as good transcultural nurses have been found to be empathetic, caring, open, and flexible. They have a positive attitude toward cultural differences and have a genuine interest in learning from the client about the client's culture (Emerson, 1995). Talabere (1996) states that openness, appreciation of another's perspective, holistic communication, genuine interest, and a nonjudgmental attitude are central to cultural sensitivity. When a culturally sensitive nurse develops mutually agreeable goals with a patient from another culture, a kind of cultural synergy occurs, resulting in care that is "meaningful, satisfying and beneficial to clients" (Leininger, 1988, p.155).     

Repetition blindness between visually different items: the case of pictures and words

Repetition blindness (RB) is the failure to see or recall the second of two visually similar or identical items in rapid serial visual presentation. It was initially demonstrated by Kanwisher (1987), who proposed that a second token of a given word or object type cannot be established when the two items occur close in time. Bavelier and Potter (1992) showed that RB also occurs between visually different items that are phonologically similar. They proposed that RB may occur not only when the targets are physically similar, but also when they have to be registered or encoded in short-term memory (STM) along dimensions on which they are similar. This hypothesis predicts that RB between visually different items should not be restricted to words, but should occur with any stimuli, as long as the task requires these stimuli to be encoded along dimensions on which they are similar. Moreover, it also implies that a task that changes the preferred code of targets will affect the size of RB. The first prediction was confirmed by establishing RB between phonologically similar pictures and words, whether semantically related (the picture of a cat and the word "cat") or not (the picture of a sun and the word "son"), when using a task that requires phonological encoding (Experiments 1 and 2). The second prediction was also supported: the magnitude of RB depended on whether the task required similar or different codes for pictures and words (Experiments 3 and 4). These experiments confirm that RB between visually different items is due to the similarity of the codes initially used in STM. The results suggest that RB can occur at any step during the instantiation of a token, arising not only from a failure to create a new token, but also from a failure to stabilize an opened token. In this view, tokens are to be seen as dynamical entities, built over time as a function of type activation and task requirements, and varying in stability as a function of the information that is entered into them.     

Isolation and characterization of apoptosis-resistant mutants from a radiosensitive mouse lymphoma cell line

This paper reports the findings of a research study funded by the English National Board for Nursing, Midwifery and Health Visiting (ENB), which explored the impact of community care reforms on mental health and learning disability nurses and their practice. In this study we were struck by the divergent views of our respondents about the nature of mental health and learning disability nursing as practice disciplines and the implications of these views for the future shape of preregistration educational preparation. We noted, in particular, the debate between those who advocate what is referred to as specialist educational preparation and others who favour generic preparation. The specialist-generic debate is relevant to nursing as a whole but was magnified in the context of our study because genericism was perceived by many of our respondents as a threat to the minority branches and especially to those (arguably mental health and learning disability) that are not rooted in the biomedical tradition of general nursing. This paper seeks to contribute to this debate as it impinges on the two nursing specialties by developing models of future nurse education grounded in the empirical data from our research and interrogating them to draw out their central features. Two models are clearly independent: the 'specialist' and the 'generic' models. Another three models are partial in that they draw upon the first two: the 'pragmatic' model, the 'unity-of-nursing' model, and the 'social care' model. A common feature of the pragmatic and unity-of-nursing models is that they support the existing DipHE programme, which is now the dominant form of preregistration nurse preparation in the UK. The social care model is applicable principally to learning disability nursing.     

Clients, roles, and functions of the school psychologist.

The basic credo held by American school psychologists is that of child advocacy. Yet, with most school psychologists being employed by local school systems—where administrators often place institutional needs over individual student needs—the practitioner role is usually conflict-laden. Even though the preferred practitioner role is generally direct service to children through counseling or indirect student help via teacher consultation or parent counseling, at this time the school practitioner's major role in many settings is that of "gate keeping," which involves testing and certifying pupil eligibility for special education. If we look forward to the time when inappropriate gatekeeping—that is, formally labeling the mildly handicapped as eligible for special education—is eliminated, other functions performed must be strengthened and made more desirable to make the role of the school psychologist more viable. In addition to competent counseling skills, the ability to provide effective teacher consultation within schools is essential, not only for dealing with behavior, but instruction as well. The upgrading of school psychologists' skills is essential to ensure that, regardless of possible conflicts engendered, there will be at least one highly skilled child advocate working in the schools. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediational lawyering in the civil commitment context: A therapeutic jurisprudence solution to the counsel role dilemma.

A mediational lawyering role is proposed as a therapeutic jurisprudence alternative to the two traditional lawyering roles in civil commitments: client-centered-expressed interests (adversary/advocacy) model (lawyers advocate positions that clients favor and allow clients to make ultimate decisions in litigation) and best interests (nonadversarial) model (lawyers join in seeing that clients obtain the help that clients would want if only they knew what is in their own best interests). With a client who has mental disabilities, the adversarial lawyer operates under a presumption that client wishes release from mental health facility or not to be committed; the presumption of the best interests lawyer is that client needs protection, habilitation, and/or treatment. The mediational model is more therapeutic for clients with mental disabilities because it combines the therapeutic aspects and avoids the antitherapeutic aspects of the traditional roles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social science and social policy: Amoral methodology in a matrix of values.

Over the past 30 yr., science has become increasingly institutionalized and decreasingly dependent upon scientists working alone or in very small groups. Additional sets of values are increasingly involved in decisions about what research to conduct, how to conduct it, how to report it, and whether to advocate its use. Social science particularly relates to a value matrix at all stages of its planning, financing, conduct, and reporting. Categories of values and their interrelationships as a matrix are discussed: values of the scientist, the institution in which he works, the financial backer of research, and the human populations studied. Project Camelot, a multidisciplinary study of developing societies' internal war potential and effects of government action, is used as an example of the workings of the matrix. The ethical and moral implications of an increasingly sophisticated social science and of the several technologies that might develop from it are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Activation of phonological codes during eye fixations in reading.

Two experiments addressed the issue of whether phonological codes are activated early in a fixation during reading using the fast-priming technique (S. C. Sereno & K. Rayner, 1992). Participants read sentences and, at the beginning of the initial fixation in a target location, a priming letter string was displayed, followed by the target word. Phonological priming was assessed by the difference in the gaze duration on the target word between when the prime was a homophone and when it was a control word equated with the homophone on orthographic similarity to the target. Both experiments demonstrated homophonic priming with prime durations of about 35 ms, but only for high-frequency word primes, indicating that lexicality was guiding the speed of the extraction of phonological codes early in a fixation. Evidence was also obtained for orthographic priming, and the data suggest that orthographic and phonological priming effects interact in a mutually facilitating manner. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does the specialist nurse enhance or deskill the general nurse?

Much conflict and confusion surrounds the title and role of the specialist nurse, leading in some instances to disharmony between general and specialist nurses. It has been suggested that too many highly specialized nurses in a general area may lead to a deskilled workforce and fragmented care. Attempts to define the key concepts of specialist practice as described by the UKCC has resulted in elitism, conflict and abuse of the title. One suggestion to eliminate this conflict is for specialist nurses to achieve key competencies that encompass the role of the clinical expert. These key competencies should be devised by specialist nurses, in the absence of national guidelines, and be agreed by employers. They should incorporate the key roles of: change agent, expert clinician, educator, researcher and coordinator. It is contended that if all concerned have a clearer definition of the title, role and what is expected from the specialist nurse then this will result in reduced conflict and improved quality of care.     

Enhancing family advocacy networks: an analysis of the roles of sponsoring organizations

Family participation in shaping system reforms in children's mental health has increased over the past ten years. In 1990 the National Institute of Mental Health funded the development and enhancement of 15 statewide advocacy organizations that were to be controlled and staffed by families of children who have serious emotional disorders. These family advocacy organizations had three major goals: to establish support networks, to advocate for service system reforms, and to develop statewide family advocacy networks. Seven family advocacy networks worked with sponsoring organizations because they needed assistance and/or could not receive funding directly. State and local chapters of the National Alliance for the Mentally Ill and the National Mental Health Association served in this capacity. Because there were no guidelines to educate sponsoring organizations about their interorganizational roles and responsibilities, staff of some sponsoring organizations used approaches that were supportive and effective, while staff in other organizations used methods that were counterproductive. The information and recommendations discussed in this paper are based on evaluation data and observations of the relationships between seven sponsoring organizations and family advocacy groups over a three-year period. This paper proposes a conceptual framework that includes: (1) a clear definition of the sponsoring organization's roles, and (2) an analysis of the advantages, limitations, and critical issues for the sponsoring organization.     

Ethics and advocacy.

Notes that the issue of advocacy continues to be a divisive one within the American Psychological Association (APA). It has been suggested that opposition to the policy of advocacy is more often grounded in a disagreement with the public position of the APA than with the policy itself. Thus, disputants are easily classified as "liberal" or "conservative" even though the professional and ethical aspects of advocacy remain insufficiently or only obliquely addressed. The present author identifies what these aspects are and proposes criteria to be satisfied if advocacy is to be ethically sound. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes to personal professional profiles: are they friends or foe?

This article investigates the attitudes of a group of teaching staff to the value and use of personal professional profiles (PPPs) in relation to the UKCC's requirements for periodic re-registration (UKCC, 1994). The data for the study were gathered using a postal questionnaire (65 of which were returned from a distribution of 200). Analysis of the questionnaires provided insight into how PPPs were regarded by the target group and raised some interesting questions about the future of 'Standards for Education and Practice Following Registration' (UKCC, 1994). A further study is planned to build upon the findings made in this preliminary investigation.     

Toni Bernay (1936-2007).

Presents an obituary for Toni Bernay. Bernay died in Los Angeles on April 30, 2007, after a brief but valiant battle with a recurrence of lymphoma. She was a leader among practitioners, a visionary who inspired advocacy for psychology, women, and cancer patients. Upon her death, her colleagues described her as "a forceful advocate," "a dynamite lady who has been a wonderful mentor," "a powerful force for women's rights," and "a vibrant presence who empowered women in the profession." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Survey of the degree to which ET nurses are performing current procedural terminology-coded services

ET nurses practice in many different settings including hospitals, home health, independent practice, and contract services. Reimbursement for their services is widely varied. To contribute meaningfully to health care reform, the services being provided by ET nurses must be identified. Familiarity with how these services overlap with those provided by other health care providers is essential. Current Procedural Terminology (CPT) codes, the language of payment within the health care system, are prepared and published annually by the American Medical Association for purposes of physician payment. Physicians are being paid for services that are also performed by ET nurses. This study identifies the CPT-coded services used in the practice of the ET nurse and also codes that overlap those for which physicians are paid. Identification of ET nurse-provided CPT-coded services delineates the ET nursing scope of practice and may serve as a foundation to address other practice issues, including reimbursement.     

Radiology nursing: legal issues surrounding the expanded role

The annual conference for the Royal College of Nursing's Forum of Nurses in Radiology and Cardiology took place in Birmingham last year. Participants were asked to consider the ways in which their professional practice could develop within The Scope of Professional Practice (UKCC, 1992a) guidelines and the possible problems they feared could arise. The legal issues which arose from their answers were then analysed. The aim of this article is to examine, in the light of the legal issues, the chosen areas of expansion within the nurse's role and the concerns felt by the participants in order to draw up lessons for nursing generally.