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Greater Clarity (greater + clarity)
Selected AbstractsAn exploration of the contribution of the community nurse to rehabilitationHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2003Rosie Kneafsey RGN BSc Abstract Effective hospital and community rehabilitation services are increasingly recognised as a means of meeting the changing pattern of health and social care need. While the district or community nurse has the potential to play a central part in community rehabilitation provision, this role has received relatively scant attention in the literature. This paper describes research findings on community nurses' perceptions of their role and potential contribution to rehabilitation. As part of a wider, 2-year, qualitative investigation of the role of the nurse in rehabilitation, fieldwork was undertaken with both district and community staff nurses. This comprised focus group discussions and interviews with staff recruited as a consequence of the follow-up of patients' experiencing rehabilitation. The findings indicate that community-based nurses contributed to patient rehabilitation by making assessments, referring on to other members of the multi-professional team, advocating for and liaising with other services, helping people to adapt, teaching and motivating patients and carers, supporting and involving families, and providing technical care. A number of challenges to community-based nursing roles were apparent, including feelings of exclusion, lack of recognition, a lack of time for rehabilitation and paucity of referrals for rehabilitation. Greater clarity and recognition is needed of the community-based nursing contribution to rehabilitation, and there is a need to ensure that community nursing assessments contribute to patients' rehabilitation goals and the promotion of independent living. [source] Feeding and eating disorders in childhoodINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2010Rachel Bryant-Waugh DPhil Abstract Objective: To review the literature related to the current DSM-IV-TR diagnostic criteria for feeding disorder of infancy or early childhood; pica; rumination disorder; and other childhood presentations that are characterized by avoidance of food or restricted food intake, with the purpose of informing options for DSM-V. Method: Articles were identified by computerized and manual searches and reviewed to evaluate the evidence supporting possible options for revision of criteria. Results: The study of childhood feeding and eating disturbances has been hampered by inconsistencies in classification and use of terminology. Greater clarity around subtypes of feeding and eating problems in children would benefit clinicians and patients alike. Discussion: A number of suggestions supported by existing evidence are made that provide clearer descriptions of subtypes to improve clinical utility and to promote research. © 2010 American Psychiatric Association. (Int J Eat Disord 2010) [source] Contamination: Nursing Diagnoses with Outcome and Intervention LinkagesINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2007Laura V. Polk DNSc PURPOSE.,To relate the collaborative processes involved in the evolution of environmental nursing diagnoses and the linkages between two new nursing diagnoses and their associated interventions and outcomes; to describe the environmental health implications of contamination. DATA SOURCES.,Published research articles, official reports, textbooks, and collaborative discussion with experts in community and global health. DATA SYNTHESIS.,Reflection following review of the literature and collaboration with experts led to the development of a new schema for environmental diagnoses and development of two new diagnoses, allowing for greater clarity and distinction between the contamination diagnoses and risk for poisoning diagnosis. CONCLUSIONS.,An environmental nursing diagnosis schema, with its emphasis on contamination, infection, and violence, provides nurses with a holistic framework for making judgments about environmental influences related to individual, family, community, and global health. The diagnoses of Contamination and Risk for Contamination provide necessary language to describe human responses and risk states that may arise following exposure to environmental contaminants. PRACTICE IMPLICATIONS.,Development of environmental diagnostic labels and delineation of the linkages to nursing outcomes and interventions will allow nurses to take active roles in identifying environmental components that affect health and planning care that responds to environmental health needs. Greater clarity in the use of language will allow nurses to incorporate environmental concepts appropriately in nursing assessments and improve the accuracy of the diagnostic process and selection of distinct interventions and outcomes. This will result in better outcomes for patients and communities and permit greater accountability of nursing's contribution to environmental health. [source] Texts, Tensions, Subtexts, and Implied Agendas: My Quest for Cultural Pluralism in a Decade of WritingCURRICULUM INQUIRY, Issue 2 2004Carola Conle ABSTRACT Scanning my own academic work to discover hidden agendas revealed underlying issues that seemed important in cultural pluralism. They included the need for recognition and for public spaces in culturally pluralistic environments where the experiences of individuals from very different background are listened to and valued. It was particularly interesting that such settings seemed to be highly conducive to inquiry. The differences among people's experiences intensified an implicit inquiry dynamic when narrative was the medium of choice rather than argumentative discussion. In those settings, as well as in the reexamination of my own writing, becoming clearer about what was only indirectly expressed earlier brought greater clarity about important issues. [source] Decision-making in community-based paediatric physiotherapy: a qualitative study of children, parents and practitionersHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2006Bridget Young BA PhD Abstract Approaches to practice based on partnership and shared decision-making with patients are now widely recommended in health and social care settings, but less attention has been given to these recommendations in children's services, and to the decision-making experiences of non-medical practitioners and their patients or clients. This study explored children's, parents' and practitioners' accounts of shared decision-making in the context of community-based physiotherapy services for children with cerebral palsy. Semi-structured interviews were conducted with 11 children with cerebral palsy living in an inner city area of northern England, and with 12 of their parents. Two focus groups were conducted with 10 physiotherapy practitioners. Data were analysed using the constant comparative method. When asked explicitly about decision-making, parents, children and practitioners reported little or no involvement, and each party saw the other as having responsibility for decisions. However, when talking in more concrete terms about their experiences, each party did report some involvement in decision-making. Practitioners' accounts focused on their responsibility for making decisions about resource allocation, and thereby, about the usefulness and intensity of interventions. Parents indicated that these practitioner-led decisions were sometimes in conflict with their aspirations for their child. Parents and children appeared to have most involvement in decisions about the acceptability and implementation of interventions. Children's involvement was more limited than parents'. While parents could legitimately curtail unacceptable interventions, children were mostly restricted to negotiating about how interventions were implemented. In these accounts the involvement of each party varied with the type of issue being decided and decision-making appeared more unilateral than shared. In advocating shared decision-making, greater understanding of its weaknesses as well as its strengths, and greater clarity about the domains that are suitable for a shared decision-making approach and the roles of different parties, would seem a helpful step. [source] The second generation of human security: lessons from the UN and EU experienceINTERNATIONAL AFFAIRS, Issue 1 2010MARY MARTIN The concept of human security, while much contested in both academic and policy debates, and highly fragmented across different meanings and forms of implementation, offers a potential locus around which global security discourse might converge, particularly in light of current shifts in US security thinking. However, key pioneers of human security, such as the United Nations and Canada, appear to be losing their enthusiasm for the concept, just at the moment when others such as the European Union, are advancing a human security agenda. This article examines the divergence of human security narratives between the UN and the EU. It argues that the UN's use of the concept ran aground owing to a triple problematic of lack of clarity, confusion between previously distinct policy streams on human rights and human development and conceptual overstretch. After assessing the EU experience with the concept to date, the article argues that future use of human security will require greater focus on how it deepens ideas of individual security, rather than treating it as an agenda for broadening security. As well as a need to project clarity on the conceptual definition of human security, there is also a need to associate human security with greater clarity of intent. If successful, this would contribute to establishing second generation human security as a new policy paradigm. [source] Contamination: Nursing Diagnoses with Outcome and Intervention LinkagesINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2 2007Laura V. Polk DNSc PURPOSE.,To relate the collaborative processes involved in the evolution of environmental nursing diagnoses and the linkages between two new nursing diagnoses and their associated interventions and outcomes; to describe the environmental health implications of contamination. DATA SOURCES.,Published research articles, official reports, textbooks, and collaborative discussion with experts in community and global health. DATA SYNTHESIS.,Reflection following review of the literature and collaboration with experts led to the development of a new schema for environmental diagnoses and development of two new diagnoses, allowing for greater clarity and distinction between the contamination diagnoses and risk for poisoning diagnosis. CONCLUSIONS.,An environmental nursing diagnosis schema, with its emphasis on contamination, infection, and violence, provides nurses with a holistic framework for making judgments about environmental influences related to individual, family, community, and global health. The diagnoses of Contamination and Risk for Contamination provide necessary language to describe human responses and risk states that may arise following exposure to environmental contaminants. PRACTICE IMPLICATIONS.,Development of environmental diagnostic labels and delineation of the linkages to nursing outcomes and interventions will allow nurses to take active roles in identifying environmental components that affect health and planning care that responds to environmental health needs. Greater clarity in the use of language will allow nurses to incorporate environmental concepts appropriately in nursing assessments and improve the accuracy of the diagnostic process and selection of distinct interventions and outcomes. This will result in better outcomes for patients and communities and permit greater accountability of nursing's contribution to environmental health. [source] Archaeozoological evidence for pastoral systems and herd mobility: the remains from Sos Höyük and Büyüktepe HöyükINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 5 2001Sarah Howell-Meurs Abstract Characterization of pastoral economics in the archaeological record is recognized as being particularly difficult. While architectural evidence may provide ambiguous indicators of nomadism, animal remains afford greater clarity concerning assessment of herd and thus economic mobility. To highlight archaeozoological applications towards the analysis of herd movement as it may relate to the analysis and definition of economic systems, the mobility of the pastoral systems practised at Sos Höyük and Büyüktepe Höyük during the Early Bronze and Iron Age periods was investigated in terms of various facets of archaeozoological evidence. Sedentary occupation of these sites was suggested by the faunal remains on the basis of evidence, including use of seasonally available resources, relative abundance and representation of the main domesticates and dental data. These results suggest that analysis based upon multiple lines of archaeozoological evidence provides the most fruitful means of investigating pastoral mobility. Copyright © 2001 John Wiley & Sons, Ltd. [source] Living with uncertainty: concept advancementJOURNAL OF ADVANCED NURSING, Issue 6 2007Janice Penrod Abstract Aim., This paper reports a study to demonstrate how the scientific understanding of the concept of uncertainty was advanced through a phenomenological study of living with uncertainty. Background., Techniques for concept analysis have evolved to subsume strategies for advancing a concept towards greater clarity and utility for research and practice. Recently, it has been argued that a clear delineation of techniques for concept analysis as separate and distinct from techniques of concept advancement is warranted. This article applies such delineated processes to demonstrate the advancement of the concept of uncertainty. Method., Concept analysis was used to establish an integrated understanding of the state of the science. Gaps in understanding were carefully analysed, resulting in the research question guiding the next phase of concept advancement: what is the nature of the lived experience of uncertainty? A phenomenological investigation of the experience of uncertainty among family caregivers was conducted. Then, using methods of template comparison, the conceptual attributes identified through the phenomenological study were compared and contrasted with the theoretical definition derived through concept analysis. Finally, a new conceptual definition of higher order abstraction, with greater pragmatic utility, was derived. Findings., Uncertainty is rooted in the individual's perception of outcomes or meaning of a situation. Such perceptions challenge one's sense of confidence and/or control to yield varied types and modes of uncertainty. Uncertainty is present oriented. Both cognitive and precognitive ways of knowing are influential in ascribing meaning, anticipating outcomes and adapting strategies. Conclusions., One's sense of confidence and sense of control are primary essences that determine the nature of the experience of uncertainty. The experience of living with uncertainty is dynamic, with fluctuations in the types and modes of uncertainty in response to precognitive and cognitive ways of knowing. Probabilistic paradigms preclude existential and situational modes of uncertainty for which probabilities cannot be appreciated. [source] The sizes of species' geographic rangesJOURNAL OF APPLIED ECOLOGY, Issue 1 2009Kevin J. Gaston Summary 1Geographic range size and how it changes through time is one of the fundamental ecological and evolutionary characteristics of a species, and a strong predictor of extinction risk. However, the measurement of range size remains a substantial challenge. Indeed, there is significant confusion in the literature as to how this should be done, particularly in the context of the distinction between the fundamentally different concepts of extent of occurrence (EOO) and area of occupancy (AOO), and the use of these quantities, including in assessments of the threat status of species. 2Here we review the different approaches to determining the geographic distributions of species, the measurement of their range sizes, the relationships between the two, and other difficulties posed by range size measurement (especially those of range discontinuities when measuring EOO, and spatial scale when measuring AOO). 3We argue that it is important to (i) distinguish the estimation of the distribution of a species from the measurement of its geographic range size; (ii) treat measures of EOO and AOO as serving different purposes, rather than regarding them as more or less accurate ways of measuring range size; and (iii) measure EOO including discontinuities in habitat or occupancy. 4Synthesis and applications. With the availability and collation of extensive data sets on species occurrences, a rapidly increasing number of studies are investigating geographic range size, and particularly how various measures of range size predict macroecological patterns and inform assessments of the conservation status of species and areas. The distinction between EOO and AOO is becoming blurred in many contexts, but most particularly in that of threatened species assessments for Red Listing. Continued progress in these fields demands greater clarity in the meaning and derivation of measures of geographic range size. The two principal measures serve different purposes, and should not be regarded as alternatives that simply differ in accuracy. [source] Infection control in wound care: a study of fatalism in community nursingJOURNAL OF CLINICAL NURSING, Issue 1 2000BNurs, Christine E. Hallett PhD, DNCert, HVCert ,,As part of a study of community nurses' perceptions of quality in nursing care, the author conducted in-depth qualitative interviews with seven community-based nurses. ,,As part of the study, nurses were asked to describe episodes of wound care and to discuss the factors which could affect the quality of such care. ,,One of the most interesting themes to emerge from the data was the apparent ambivalence of the nurses' attitudes towards infection control in wound care. ,,Nurses discussed the concept of ,aseptic technique' in fatalistic terms and seemed uncertain about what could be achieved in terms of infection control. ,,Although their policy guidelines referred to ,aseptic technique', their educational experience appeared to have made them feel uncertain about the implementation of the measures involved. ,,With the proviso that this was a small scale qualitative study, the author concludes by suggesting that there is a need for greater clarity, both in what is taught and in what is included in practice policy with regard to infection control in wound care. [source] Theorizing TQM: An Austrian and Evolutionary Economics InterpretationJOURNAL OF MANAGEMENT STUDIES, Issue 2 2000Todd H. Chiles Born out of management practice, the principles of TQM (total quality management) have had a profound and unparalleled impact on modern business history. However, as a body of practical knowledge, TQM has been largely atheoretical. As a consequence, this important management philosophy has remained amorphous and shrouded in considerable conceptual haziness and ambiguity. Recent theorizing, primarily emphasizing the application of organizational behaviour theories to TQM, has begun to provide greater clarity, but much work remains to be done. This paper attempts to contribute to this nascent theory-building literature by employing theory from market process economics (MPE), namely, Austrian and evolutionary economics, which explains how processes of dynamic change, adaptation, and learning are driven by entrepreneurial creativity. We contend that the patterns in this body of theory match, to a remarkable degree, the patterns of practical knowledge contained in the TQM literature. We demonstrate this ,pattern-matching' by showing that MPE effectively provides the theoretical underpinnings of TQM's three main principles , customer focus, continuous improvement and teamwork , as well as the respective TQM topics of customer perceptions, adaptation in dynamic environments, and knowledge creation. Having established MPE as a credible theoretical lens for interpreting TQM, it can be used to clarify fuzzy areas that have remained in the TQM literature with the potential to take us beyond what we know now. We illustrate this with three examples that show how we can resolve debates in TQM over incentive systems, recognize that TQM embraces methodological pluralism in the collection and analysis of data, and highlight hidden dangers that attend benchmarking. While MPE has no monopoly on theoretical interpretations of TQM, it is unique in its ability to comprehensively cover the incredible breadth of this practical body of knowledge, and in its interpretation of TQM as a dynamic economic endeavour. [source] Eclecticism in health services for developmental disordersJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2000M McDowell Abstract: The term ,eclectic', as applied to health care for children with developmental disorders, portrays an individualized, adaptive service response to local constraints and pressures. While this may appear appropriate for the local setting, the end result is a broad diversity of health care approaches. This paper discusses three separate processes that interact at a local level, increasing the likelihood of an eclectic local model of health care for this population of children. The first process draws from the direct clinical work. Variable training, knowledge and skills among health care providers, in combination with differing beliefs around the nature of the problems and their management leads to health care which directly reflects the attributes of the local clinicians. A separate, second process fuelling variability is the differing models of departmental responsibility across Australia , which Government departments fund which aspect of care for children with disabilities. The final process relates to funding streams for health care. State public health, federal Medicare and private insurance all support health services for children with disabilities, with the financial incentives (budgets compared to fee-for-service) driving a divergence of practice. This paper concludes that the external political, administrative and financial frameworks within which health care is constructed will continue to promote clinical eclecticism to a degree that would probably be considered unacceptable in other areas of child health care. The solution can only arise from within the clinical work itself, with greater clarity of understanding around the nature of the disorders, the outcomes for which health care takes responsibility, and an increasing focus on an evidence based set of approaches towards achieving these. [source] A confusing world: what to call histology of three-dimensional tumour margins?JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2007M Moehrle Abstract Complete three-dimensional histology of excised skin tumour margins has a long tradition and, unfortunately, a multitude of names as well. Mohs, who introduced it, called it ,microscopically controlled surgery'. Others have described it as ,micrographic surgery', ,Mohs' micrographic surgery', or simply ,Mohs' surgery'. Semantic confusion became truly rampant when variant forms, each useful in its own way for detecting subclinical outgrowths of malignant skin tumours, were later introduced under such names as histographic surgery, systematic histologic control of the tumour bed, histological control of excised tissue margins, the square procedure, the perimeter technique, etc. All of these methods are basically identical in concept. All involve complete, three-dimensional histological visualization and evaluation of excision margins. Their common goal is to detect unseen tumour outgrowths. For greater clarity, the authors of this paper recommend general adoption of ,3D histology' as a collective designation for all the above methods. As an added advantage, 3D histology can also be used in other medical disciplines to confirm true R0 resection of, for example, breast cancer or intestinal cancer. [source] Revisiting pure economic loss: lessons to be learnt from the Supreme Court of Canada?LEGAL STUDIES, Issue 1 2005Dr Paula Giliker This article examines the treatment of pure economic loss claims in England and Canada. The two jurisdictions have much in common. Starting from the same case sources, the common law of each system has struggled to deal with claims for negligently-incurred pure economic loss. Yet, the systems diverged in the 1990s when the Canadian Supreme Court refused to follow the lead of Murphy v Brentwood DC and reiterated its adherence to the Anns two-stage test. It is submitted that, in view of recent developments which suggest the gradual convergence of the two systems, English law should carefully examine the categorisation approach adopted by the Canadian courts. The current English position is far from clear, and the Canadian model is capable of bringing transparency and greater clarity to this difficult area of law. [source] On conflict, containment and the relationship between themNURSING INQUIRY, Issue 3 2006Len Bowers A programme of research into conflict (e.g. violence, absconding, medication refusal) and containment (e.g. seclusion, special observation, physical restraint) in inpatient psychiatry has been under way at City University, London, UK, for the past 10 years. Recent research findings, plus the challenges posed by ongoing projects, have made apparent the need for greater clarity about the overarching concepts of ,conflict' and ,containment'. This paper pulls together research findings pertaining to this issue, and conducts a reasoned analysis of what common characteristics might underlie ,conflict' and ,containment'. It is concluded that these are patient threats to safety, and the staff maintenance of safety. Details are presented on the inclusions and exclusions that follow from taking such a position, and potential definitions offered. On the grounds of this conceptual analysis, plus evidence for moderate degrees of statistical association between behaviours and events in each domain, it is concluded that it is legitimate to conduct analyses at the level of total conflict and containment rates, as well as at the level of individual types of behaviours and events (e.g. verbal abuse, sedation). Some of the mathematical difficulties in the analysis of total conflict and containment are addressed, and results of a weighting exercise presented. This exercise challenges our perception of the severity of some containment measures that are becoming more commonly used in acute psychiatry. [source] Clarity of Responsibility and CorruptionAMERICAN JOURNAL OF POLITICAL SCIENCE, Issue 1 2007Margit Tavits This article demonstrates that political institutions influence the level of corruption via clarity of responsibility. The key hypothesis is that when political institutions provide high clarity of responsibility, politicians face incentives to pursue good policies and reduce corruption. These incentives are induced by the electorates' rejection of incumbents who do not provide satisfactory outcomes. However, if lines of responsibility are not clear, the ability of voters to evaluate and punish politicians,as well as to create incentives for performance,declines. The findings confirm that countries with institutions that allow for greater clarity of responsibility have lower levels of corruption. [source] The diverse and contested meanings of sustainable developmentTHE GEOGRAPHICAL JOURNAL, Issue 2 2004Colin C Williams We provide a heuristic framework that can be used as a lens for understanding the arguments being presented in the papers which comprise this special issue on sustainable development and environmental issues in Great Britain. This framework can also be used as an introduction to the wider literature on sustainable development because it is designed to bring greater clarity to this large, diverse and rapidly expanding field of enquiry populated by heterogeneous discourses, multiple approaches and a variety of recommendations as to the ways forward. [source] Voluntary Disclosures as a Mechanism for Defining Entity Status in Australian Not-for-Profit OrganisationsAUSTRALIAN ACCOUNTING REVIEW, Issue 2 2010Lorne Cummings This study examines managerial efforts to portray an entity's not-for-profit (NFP) status based on voluntary disclosure practices. The annual report text of 61 NFPs are analysed in accordance with,Salamon and Anheier's (1997),NFP definitional framework. Results indicate a predominant application of the structural-operational definition. Furthermore, the ,organised' attribute of this definition prevails over the ,non-profit-distributing' criterion that has been advocated by various parties. Standard-setting bodies may want to consider: (1) NFP management perspectives in any revised NFP definition; and (2) greater clarity in conceptual framework and standard-setting arrangements to improve overall transparency in NFP reporting practices. [source] The past, present and future of officers of ParliamentCANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 3 2003Paul G. Thomas This article analyses the past, present and future of these institutions, which were created to assist Parliament in holding responsible ministers and the bureaucracy accountable and to protect certain rights of individual Canadians. The fundamental issue is how to balance these offices' independence from both the executive and Parliament with an appropriate measure of accountability for their performance. The article examines five structural features that determine the nature of these interactions and suggests that there needs to be greater clarity in these relationships. The primary relationship in terms of responsibility and accountability of officers of Parliament should be with Parliament. Reforms are recommended to recognize and to reinforce the primacy of that relationship. Sommaire: Les hauts functionaries nommés par le Parlement n'avaient pas une grade attention au sein du système parlementaire du Canada jusqu à ce que le Commissaries à la protection de la vie privée ait été contraint de démissionner en juin 2003. Le présent article analyze le passé, le présent et l'avenir de ces institutions. La function de haut functionaries du Parlement a été créée pour aider ce demier à tenir les ministers et les bureaucrats imputable et afin de protéager certains droits des citoyens canadiens. La question fondamentale est de savoir comment trouver milieu entre l'indépendance de tels hauts fonctionnaires à l'égard du pouvoir executive et du Parliament et l'obligation de repondre corredement de leur performance. L'article examine cinq éléments structure qui déterminent la nature de ces interactions et conclut que ces relations doivent cmieux definies. En termes de responsabilité et d'imputabilité, les hauts functionaries devraient avant tout relever du Parliament. Des réformes sont recommand ées bur reconnaître et renforcer la suprématie de cette relation. [source] | |||||||||||||||||||