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PubMed2006

Current trends in animal law and their implications for the veterinary profession.

In the last decade, the veterinary profession has experienced many changes, including the birth of a new area of law known as "animal law," and an increased scrutiny by the legal community and veterinary state boards. This article provides a sampling of some of the more challenging issues the profession is facing in the early part of the 21st century, namely, guardianship versus ownership, the awarding of non-economic damages in negligence lawsuits, and challenges in maintaining medical records.

Animal Rights↗
PubMed2005

Red Cross Emblem and the medical profession--the Indian scenario.

The Red Cross Emblem has come to symbolize the medical profession in our country. Many medical practitioners use the emblem to designate our profession. Others including hospitals (Government and private), chemists, pharmaceutical firms and sometimes public transport vehicle use the Red Cross Emblem.

Emblems and Insignia↗
PubMed2004

Children's perceptions of the nursing profession in Poland.

The drawing, as a kind of artistic language, used by the child-artist to express his or her thoughts and opinions concerning their environment is an immensely interesting form of cognition for the viewers of such artistic creations. The aim of the study was the analysis of the presentation of the image of the nursing profession created by children and the application of these experiences in vocational education of nurses. The objects of the analysis, were 182 artistic creations of children living in eastern Poland. The detailed analysis of the works was carried out by three independent competent judges who grouped the works according to the accepted indicators of evaluation. The young artists created the image of the nurse that presents a detailed range of professional duties, the quality of the child-nurse relationship and the prognostic vision of the new activities that will be put into practice in the future. The rich content of the drawings was complemented by the high artistic value of the composition. The study material collected should be used not only by nurses participating in care of children, but also in vocational education of nurses for more complete preparation of candidates to perform their future profession.

Adolescent↗
PubMed2005

Evidence-based medicine and its implications for the profession of chiropractic.

Evidence-based medicine (EBM) has grown in popularity and prominence in the world of orthodox medicine since the 1980s. The focus of this article is on the process of developing practice guidelines (one type of EBM) and its effects upon chiropractic, a profession with a "philosophy, science and art" that is constructed upon divergent epistemological and methodological tenets (namely, the idea of "vitalism"). The EBM movement is conceptualized as part of a larger political economy surrounding the health care environment that creates a new set of imperatives for orthodox medicine, and also branches of alternative medicine that are in the process of professionalization. The quantitative, positivist and empiricist assumptions of EBM dictate which approaches to treatment and which clinical procedures are legitimate and perhaps reimbursable under systems of managed care. The ramifications of practice guidelines and its effects upon the intraprofessional segments of the chiropractic profession are also discussed.

Chiropractic↗
PubMed2001

Nutrition education in health professions programs: a survey of dental, physician assistant, nurse practitioner, and nurse midwifery programs.

OBJECTIVE: This study determined the perceived needs and curriculum recommendations for nutrition education, and expected competencies in nutrition of graduates, of predoctoral dental, physician assistant, nurse practitioner, and midwifery programs. SUBJECTS: Surveys were mailed to all dental schools (n = 54) and physician assistant (n = 95), nurse practitioner (n = 150), and certified nurse midwifery programs (n = 42) in the United States. Surveys were addressed to the program directors of physician assistant, nurse practitioner, and certified nurse midwifery programs and the associate or assistant dean of academic affairs of dental schools. DESIGN: A 4-page survey was designed and pilot-tested. The survey included questions on respondents perceptions of and recommendations for their programs in nutrition education and expected nutrition competence level of their graduates. A reminder postcard was mailed 2 weeks after the initial mailing to nonrespondents; a second survey was mailed to nonrespondents 1 month after the postcard mailing. STATISTICAL ANALYSES: Data were analyzed using JMP-IN software. Frequencies, and chi 2 analyses, Wilcoxon rank sum test, Pearson chi 2 test. RESULTS: The overall response rate was 80.7% (n = 276). Perceived needs for competence in nutrition varied by respondents. Most of the physician assistant nurse midwifery, and nurse practitioner program directors had similar perceptions of graduates' competence in nutrition. Dental school academic administrators differed significantly from the program directors about the perceived need for knowing how to counsel on a modified diet and how and when to refer to a registered dietitian. Time was the most important factor that would enhance provision of nutrition education in the programs. Computer-based programs were the most frequently requested education tool to enhance nutrition education. APPLICATIONS/CONCLUSIONS: The disciplines agreed that graduates of dental schools and physician assistant, nurse practitioner, and nurse midwifery programs need some level of competence in nutrition relative to their discipline. Registered dietitians involved in health professions education can play an active role in developing practice-based, time-sensitive, and flexible strategies for nutrition education of these health professions groups.

Chi-Square Distribution↗
PubMed1998

New emerging zoonoses: a challenge and an opportunity for the veterinary profession.

The concept of emerging infectious diseases appeared in the late 1980s, when major outbreaks occurred around the globe and surprised many scientists who considered infectious diseases to be maladies of the past or limited to the under-developed world. Several reports identified erosion of the public health infrastructure among the factors contributing to new and re-emerging infectious diseases. As indicated by Morse, "Disease emergence often follows ecological changes caused by human activities such as agriculture or agricultural change, migration, urbanization, deforestation, or dam building". "Among these new diseases, surprisingly, most emergent viruses and many emergent bacteria are zoonotic". Several new zoonoses have been recently identified. Many of these diseases were either unknown, because we were not able to isolate the infectious agent or to distinguish them from other clinical syndromes, or discovered accidentally. Much of the recent identification of new pathogens has been based on new molecular biology tools or epidemiological studies. For all these diseases or infections, veterinarians played a key role in their identification, isolation of the causative organisms and understanding of the epidemiology of the infection. The role of the veterinary profession is very important in public health and on the rise again in the U.S.A., as it should be in many other countries. Surveillance, clinical curiosity and awareness, epidemiology and laboratory training are the essential tools and competency that the veterinary profession must use to meet the challenge of new emerging zoonoses.

Animals↗
PubMed1998

Reflection: a flawed strategy for the nursing profession.

The meaning and process of reflection and reflective practice appear to be currently accepted and institutionalized within the nursing profession. This paper, through use of a literature review, attempts to question the value that is consequently placed on this strategy and argues that on closer examination, reflection has no clear or universal definition, an uncertain framework for implementation, and is of unproven benefit to the professional practice of nurses. Given this evidence, the author concludes that reflection is a fundamentally flawed strategy that must be of limited benefit to the nursing profession.

Education, Nursing↗
PubMed2003

The role of performance indicators in changing the autonomy of the general practice profession in the UK.

Performance indicators (PIs) are widely used across the UK public sector, but they have only recently been applied to clinical care. In doing so, they challenge a previously guarded aspect of clinical autonomy-the assessment of work performance. This "challenge" is specific to a primary care setting and in the general practice profession. This paper reviews the qualitative findings from an empirical study within one English primary care group on the response to a set of clinical PIs relating to general practitioners (GPs) in terms of the effect upon their clinical autonomy. Prior to interviews with GPs, primary care teams received feedback on their clinical performance as judged by indicators. Five themes were crucial in understanding GPs responses: the credibility of PIs, the growing need to demonstrate competence, perceptions of autonomy, the ulterior purpose of PIs, and the identity of the assessor of their performance. PIs are playing a key role in changing the locus of performance assessment along two dimensions: location and expertise. As the locus helps to determine the nature of clinical autonomy, it is likely to have implications for the nature of the general practice profession.

Adult↗
PubMed2002

Transnational industrial power, the medical profession and the regulatory state: adverse drug reactions and the crisis over the safety of Halcion in the Netherlands and the UK.

Taking the controversy over the safety of the hypnotic, Halcion, in the Netherlands and the UK, as a case study, this article examines the problems for public health associated with responses to warnings about drug hazards by regulatory agencies, governmental expert advisers, the pharmaceutical industry and the medical profession. It is argued that regulators and the medical profession rely too heavily on manufacturers to investigate warnings from doctors' spontaneous reporting of adverse effects of drug products on the market. It is demonstrated that a pharmaceutical firm's commitment to search effectively for evidence against the safety of its own product in order to confirm doctors' warnings can have severe limitations. Deficiencies in the socio-institutional responses to post-market 'early warning systems' about drug hazards imply that the regulatory policies of 'early licensing' and minimal pre-market checks for new drugs are misconceived and threaten public health. To improve public protection from drug injury, the regulators should abandon their conviction that compelling evidence of drug hazards are required to confirm doctors' warning signals prior to regulatory intervention. Instead, they should adopt a policy of measured regulatory intervention as an immediate response to warning signals, while investigators, independent of the manufacturers, assess the significance of the signal.

Adverse Drug Reaction Reporting Systems↗
PubMed1999

The medical profession and alternative medicine in The Netherlands: its history and recent developments.

At the end of 1993, the Dutch parliament passed the Individual Health Care Professions Bill which replaced existing legislation. The new Act brings to an end the monopoly of the Dutch medical profession. The former prohibition on alternative practitioners to practice medicine was abolished. This article addresses the question of whether the Act affects the position of medical dominance in Dutch health care. It will be argued that the new Act preserves the present position of medical dominance to a large extent. Although alternative therapies have gained greater social recognition, there is little indication that the cultural and social authority of medicine is yet being challenged in the Netherlands. However, it could be argued that the Dutch health care system is moving in a more pluralistic direction.

Complementary Therapies↗
PubMed1997

Item re-scaling of an Italian version of the sickness impact profile: effect of age and profession of the observers.

An Italian version of the Sickness Impact Profile (SIP) obtained by professional and nonprofessional translators was checked for cross-cultural equivalence using a back-translation method followed by two scaling studies. The first scaling study involved 30 health professionals who ranked the items within each category for severity of dysfunction. By comparing Italian and US average ranks, 14 highly discordant items were identified. A revised translation was evaluated in a new study involving 120 observers stratified by age (< 65 versus > or = 65 years) and profession (health versus non health professionals) into 4 groups of the same size. The Italian and American item rank orders were almost equivalent, independently of the age and profession of the observers (93% of the ranks showing differences < 2), suggesting that this Italian version of SIP is cross-culturally unbiased. However, older age was associated with higher variability in the rank orders, and some caution is required for use in the geriatric population.

Adult↗
PubMed1996

The PDSA cycle at the core of learning in health professions education.

BACKGROUND: The Plan-Do-Study-Act (PDSA) cycle lies at the heart of continuous improvement and is a redefinition of the scientific method for application to the world of work. HEALTH CARE AS A CONTEXT FOR HEALTH PROFESSIONS LEARNING: Educational institutions could create the best "quality learning" environments for students by relating closely to health care organizations that create improvement environments for workers. When both become "learning" organizations and develop a relationship with each other, an important product will be the integration of processes for individual and organizational learning. THE PDSA CYCLE AS LEARNING THEORY: The PDSA cycle can be an integrating theory for both individual and organizational learning. It shares basic features of well-accepted theory about individual and organizational learning, including the concepts of change and action/reflection. EVALUATING LEARNING THROUGH PDSA CYCLES: An illustration is given of one set of implications of the PDSA cycle as learning theory. It describes an alternative way of thinking about the evaluation of learning, which surpasses the traditional emphasis on judgment in evaluation. CONCLUSIONS: The potential to place the PDSA cycle at the core of learning in health professions education is great. Contributing factors to this potential include the historical emphasis on the scientific method in health care, the relationship between clinical education and practice, recent improvements in our capacity to define and measure health outcomes, emergent pressures for change in health care and education, and compatible multiple functions of the PDSA cycle.

Competency-Based Education↗
PubMed1999

Beyond the classroom: integrating improvement learning into health professions education in Norway.

BACKGROUND: Students in the health professions must internalize the subject matter--professional knowledge--to acquire the necessary skills to serve as practitioners. Yet the ability to engage in continuous improvement is attainable only when combining professional knowledge with improvement knowledge. It is a challenge to strike a balance between theoretical teaching and practical training when working with personal quality improvement (QI), observing processes, and employing new methods and tools for problem solving and improvement work. EVOLUTION OF EFFORTS TO INTEGRATE IMPROVEMENT KNOWLEDGE INTO HEALTH PROFESSIONS EDUCATION: In February 1995 A National Strategy for Quality Improvement in Health Care stipulated that training in quality improvement be an integral part of the education of health care personnel. A program was developed at Bergen College in 1998 to integrate the philosophy and methodology of quality improvement (improvement knowledge) into students' learning of professional knowledge. This program involves a variety of pilot projects in personal improvement, practice-related instruction on training wards, observation practice, clinical studies, cross-education student projects, and thesis writing. PERSONAL IMPROVEMENT PROJECTS: With the starting point "quality is personal," students can work on personal change and improvement. If students learn methods and tools for improvement in their personal realm, they can transfer and use this knowledge in their professional work. Problems experienced by students in relation to their studies can be addressed by the Plan-Do-Check-Act problem-solving method. DISCUSSION: A longitudinal, personal-then-clinical, approach enables students to learn techniques and tools they can use as professionals, both in the care for patients and in contributing to organizational improvement.

Adult↗
PubMedDate not supplied

How many pharmacists are in our future? The Bureau of Health Professions Projects Supply to 2020.

OBJECTIVE: To describe a Bureau of Health Professions model for estimating the numbers and selected demographic characteristics of active pharmacists in the United States and to relate the model's findings. DESIGN: We constructed a model using as base counts data from the Pharmacy Manpower Project census of 1989 to 1991 and advancing the counts annually based on estimates of pharmacists entering and leaving the workforce. The total number of active pharmacists in any year was the sum of the male and female cohorts from age 24 through age 75. The model and its underlying assumptions included consideration of U.S. graduates through 1998, international pharmacy graduates who become licensed in the United States, new schools, type of entry-level degrees, and separation rates. A basic series and high and low alternative series were constructed based on different assumptions. RESULTS: The basic series projected 196,011 active pharmacists in 2000, 224,524 by 2010, and 249,086 by 2020. Estimated pharmacists per-100,000 population were 71.2 in 2000, 74.9 in 2010, and 76.7 in 2020. The workforce was projected to consist increasingly of women: 32% in 1991, 46% in 2000, 50% in 2003, and 64% in 2020. Percentages of graduates receiving the BS degree fell from 94% (1980) to 64.4% (1998) and were projected to decrease to 0% by 2005. Estimated U.S. graduates were 7,945 in 2000, 8,133 in 2010, and 8,452 in 2020. The mean age in 2000 was 38 years for women pharmacists, 46 for men, and 42 overall. Estimates of total pharmacists in 1998 were similar to those from other sources, increasing confidence in the model. CONCLUSION: The Bureau of Health Professions model, which can be readily revised as more and better data become available, provided estimates of active pharmacists by age and sex from 1991 to 2020. The model portrayed an increasingly female pharmacy workforce, with more pharmacists holding the PharmD degree. The model and data are useful for research, analysis, and health care planning.

Adult↗
PubMed1998

Health professions students as research partners in community oriented primary care.

This paper describes the process of involving health professions students in research in rural primary care and how their research has contributed to the development and expansion of a rural community health center. Since 1978 over 400 students have completed rotations at the center, and more than 200 have been health profession students, including medical, nursing, physician assistant, pharmacy, and health administration students. A total of 96 research projects were completed. These projects lie in two main areas: medical services and community outreach. Those related to medical services include measures of access to care, quality of care audits, clinical guideline development, practice patterns, prevalence studies, and qualitative research. Projects focusing on community outreach include community surveys, screening follow-ups, program evaluation, and program development. Principles that guide the selection and conduct of research projects include: Projects should be directly related to important work of the practice and reflect an interest of the student; projects are structured to include some or all of the following: literature search, data analysis, a visual display of quantitative information (table or graph), and application of relevant statistical tools; the student has a project supervisor; the student is a participant rather than an independent investigator; and a research flow sheet is used to orient students and NRHA staff to the larger research effort. Students are expected to present results, conclusions and recommendations to an appropriate group. Student research has made a significant contribution to both practice activities and practice policies.

Community Health Centers↗
PubMed2003

Sexology as a profession in France.

A national survey of sexologists was carried out in France in 1998-1999, among the individuals listed in the professional directories and the telephone book as "sexologists." It described the sociodemographic characteristics of sexologists, their initial profession and training in sexology, sex therapy and psychotherapeutic techniques, and how they practice sexology. A total of 959 individuals were identified and surveyed. The response rate was 63%. Two thirds of the sexologists were physicians and 60% were men. French sexologists appeared to be segmented into three subgroups: (1) one-third were general practitioners, trained in sexology and psychotherapeutic approaches, recognized themselves as sexologists, and devoted 40% of their professional activity to sexology. Men were about two thirds of this group; (2) one-third were nonphysicians (including psychologists and other health professionals, such as social workers and nurses), recognized themselves as sex therapists and devoted one third of their time to sexology. Men and women were equally represented in this group; (3) one-third were specialists, with less training in sexology and psychotherapeutic techniques, and did not generally recognize themselves as sexologists. They devoted a lesser part of their time to sexology and had academic and hospital practice. Men comprised more than 75% of this group. This study raised the issue of the diversity of primary professions involved in the field of sexology and showed that sexology is a secondary professional choice for the majority of sexologists.

Female↗
PubMed1999

[Nursing in the profession of the "sub-surgeons" between 1750 and 1850].

Between 1750 and 1850 surgical training was professionalized as a consequence of newly established technical colleges for surgeons in Germany and Austria led by doctors rather than craftsmen. At first, anatomy, debridement and obstetrics was taught, then a technical knowledge of medical treatment in general was instructed at specific medical/surgical schools. Depending on their years of training, graduates then worked as country doctors or as surgical assistants ("Subchirurgen", second class wound doctors). Nursing care was also on the curriculum; therefore some students worked temporarily as nurses. After graduating, many supervised nursing care in hospitals. This profession died out due to developments in the medical profession of the mid-19th century. However, they never belonged to the proletarian class of orderlies.

Curriculum↗
PubMed1994

Health professions education. The shaping of a discipline through federal funding.

The federal government has been the single most dominant force shaping the development of health professions over the past 50 years. Described as both a patron and proprietor of health professions education, the federal government's role is a factor that health professionals cannot ignore. This article focuses on the three major federal initiatives (Veterans Administration training programs, Title VII of the Public Health Service Act, and Medicare's Graduate Medical Education) which have most significantly influenced the training in and development of the disciplines of psychology and medicine. The significance for psychology's involvement in national health policy, particularly during this era of reform, is highlighted.

Education, Medical↗