Autonomous Practice Research Articles

Autonomous Language Learning Perceptions and Practices in the Japanese Context

Sakai and Takagi (2009) argue that Japanese students are very keen to achieve high scores in exams, which often determine their future and, therefore, they study outside of class, as well as in class to acquire adequate English proficiency. Accordingly, Japanese students need to take responsibility for their own learning to succeed in an exam-oriented culture. Thus, students’ success in language tests is related to learner autonomy. During the process of autonomous learning, students have more opportunities of experiencing significance, personal relevance, emotional engagement, and internalization. The purpose of this mixed methods study is to examine how Japanese students of English as a foreign language (EFL) perceive their own roles in autonomous language learning as well as their teachers' roles, how effectively they can make decisions while learning a foreign language, and what they do to acquire EFL outside the classroom settings. Quantitative data were collected and analysed from 148 college students who completed an online questionnaire. In addition, interviews were conducted with some of the participants. Students at higher levels of English as a foreign language assumed a greater share of responsibility for their education and were more driven than those at the intermediate level. Therefore, the study clearly demonstrates the necessity of incorporating autonomous learning into L2 language instruction.

DEA-registered clinical pharmacist practitioners: Progressing practice to increase patient care access.

This descriptive review aims to describe the impact of controlled substance prescriptive authority (CSPA) among Drug Enforcement Administration (DEA)-registered clinical pharmacist practitioners (pharmacists) within the Veterans Health Administration (VA). The practice perspectives of pharmacists with CSPA are also reviewed. A 3-part methodology included identification and query of DEA-registered pharmacists, practice impact data analysis, and time and motion prescribing analysis. Between quarter 1 of fiscal year 2018 and quarter 2 of fiscal year 2022, the number of DEA-registered pharmacists in the VA grew by 314%, from 21 to 87 pharmacists. Pharmacists in pain management and mental health reported benefits of CSPA, with the most common being practice autonomy (93%), increased efficiency (92%), and reduced burden on other prescribers (89%). Initial challenges to pharmacists obtaining DEA registration included a lack of incentive (46%) and concern about increased liability (37%). A time and motion analysis demonstrated that pharmacists with CSPA saved a median of 12 minutes for prescription writing compared to those without CSPA. There is an opportunity for DEA-registered pharmacists to meet patient care needs to fill gaps in care from physician shortages, improve health equity, and provide quality healthcare for vulnerable, underserved populations, especially in areas where controlled substance prescribing is common. To fully optimize the role of the pharmacist, it is imperative that state practice acts be expanded to include pharmacist DEA authority as part of collaborative practice and that fair and equitable payment models be established for pharmacist comprehensive medication management.

Late nineteenth-century popular printed poetry in Chile and its contribution to a radical cultural theory

ABSTRACT The subject of this study is Lira Popular in Chile, printed and distributed between 1866 and 1930. It was a publication halfway between literature and journalism, constituting a differentiated and autonomous communicational practice that can be considered a primary source through which to know the world visions and representations of the popular sectors in Chile at the turn of the century, beyond distinction worker – massive. The majority research in this area is one-dimensional studies conducted in response to questions the researchers themselves have prioritized. Instead, the question driving this study is: how to access the content of popular printed poetry in a way in which subjects, topics, and the inherent hierarchical relationships emerge from the very own sources? Through a content analysis, the main finding is an internal consistency on concerns and topics in the works of different poets, showing persons of popular origins acting and thinking politically, both within and outside the modern enlightenment, used as a guide to the concept of absent popular culture. The conclusions aim to the manner in which these findings can contribute to a theory popular culture and their subjects in the context of modern Latin America

A Bleak Future Awaits Nurses in Traditional Employment Worldwide: Insights on Practice and Career Alternatives

The COVID-19 pandemic has tested world leaders’ capacity to manage, and they have been found wanting. Traditional, institutionalised health services will shortly be unsustainable due to unconvincing leadership and inept managerial capacity to identify and alleviate risks to nurses and other workers on the pandemic front line. The aim of this paper is to share insights on nursing career and practice options to provide nursing services to our communities; and canvass anticipated resistance to nurses choosing autonomous practice models in independent business approaches to health care provision.From analysis of the evidence and literature, it was found that the systematic ill treatment and mismanagement of nurses during the COVID-19 pandemic is appalling. Nurses are exiting hospitals and health systems across the globe. Some are leaving nursing itself. On any measure, the situation is a wholesale disaster and a wanton waste of skilled and dedicated people. When hospital and health systems become too toxic for nurses and nursing services to function fully and thrive, and when government officials and politicians trivialise and disrespect the work and value of nursing, it is time for nurses to consider other employment and practice model options. In conclusion, A groundswell of support is needed for nurses to remove normalised policies that bind them to medical control, and to break medical monopoly on universal health insurance funding to permit access by nurses to sufficient specified items to earn a wage as independent practitioners.The implications for nursing and health policy makers are: nurse safety and practice integrity need to be central to policy deliberations that affect spending on risk management and reduction. Policies that put nurses and patients at increased risk encourage those with a choice, to abandon unsafe health system employment. Administrative accountability for staff and patient safety affected by their decisions has long been neglected in health systems around the world. It is time for a reckoning.

Colorectal surgery NP fellowship: A transition to autonomy.

The colorectal surgery advanced practice fellowship was developed for the purpose of providing a successful transition to the colorectal advanced practice specialty and was based on the success of the NP utilization model. The success of the fellowship led to NP practice autonomy, job satisfaction, and retention.

Impact of the COVID-19 pandemic on clinical autonomic practice in Europe A survey of the European Academy of Neurology (EAN) and the European Federation of Autonomic Societies (EFAS).

To investigate the impact of the coronavirus-disease-2019 (COVID-19) pandemic on European clinical autonomic practice. Eighty-four neurology-driven or interdisciplinary autonomic centers in 22 European countries were invited to fill in a web-based survey between September and November 2021. Forty-six centers completed the survey (55%). During the first pandemic year, the number of performed tilt-table tests, autonomic outpatient and inpatient visits decreased respectively by 50%, 45% and 53%, and every-third center reported major adverse events due to postponed examinations or visits. The most frequent newly-diagnosed or worsened cardiovascular autonomic disorders after COVID-19 infection included postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension, and recurrent vasovagal syncope, deemed likely related to the infection by ≥50% of the responders. Forty-seven percent of the responders also reported about people with new-onset of orthostatic intolerance, but negative tilt-table findings, and 16% about people with psychogenic pseudosyncope after COVID-19. Most patients were treated non-pharmacologically and symptomatic recovery at follow-up was observed in ≥45% of cases. By contrast, low frequencies of newly-diagnosed cardiovascular autonomic disorders following COVID-19 vaccination were reported, most frequently POTS and recurrent vasovagal syncope, and most of the responders judged a causal association unlikely. Non-pharmacological measures were the preferred treatment choice, with 50-100% recovery rates at follow-up. Cardiovascular autonomic disorders may develop or worsen following a COVID-19 infection, while the association with COVID-19 vaccines remains controversial. Despite the severe pandemic impact on European clinical autonomic practice, a specialized diagnostic work-up was pivotal to identify non-autonomic disorders in people with post-COVID-19 orthostatic complaints.

Organizational-Professional Conflict in the Collegiate and Secondary School Practice Settings: A Sequential, Mixed-Methods Study.

Athletic trainers (ATs) are employed in various settings, which may use 1 of 3 organizational infrastructure models: (1) the sport/athletic model, (2) the medical model, and (3) the academic model. These different settings and organizational infrastructure models may result in varying levels of organizational-professional conflict (OPC). However, how OPC may differ across infrastructure models and practice settings is not known. To examine the prevalence of OPC among ATs in various organizational infrastructures and explore ATs' perceptions of OPC, including its precipitating and mitigating factors. Sequential explanatory mixed-methods study with equal emphasis on quantitative and qualitative components. Collegiate and secondary school institutions. Five hundred ninety-four ATs from collegiate and secondary schools. We conducted a national cross-sectional survey using a validated scale to assess OPC. We then followed the quantitative survey with individual interviews. Trustworthiness was established with multiple-analyst triangulation and peer debriefing. Athletic trainers experienced low to moderate degrees of OPC with no differences across practice settings or infrastructure models. Poor communication, others' unfamiliarity with the AT's scope of practice, and lack of medical knowledge were precipitating factors for OPC. Organizational relationships founded on trust and respect for one another; administrative support in that ATs were listened to, decisions were endorsed, and appropriate resources provided; and autonomy given to the AT were key components to preventing OPC. Most ATs experienced primarily low to moderate OPC. However, OPC continues to permeate professional practice to some extent in collegiate and secondary school settings, regardless of the infrastructure model used. The findings of this study highlight the role of administrative support that allows for autonomous AT practice as well as effective communication that is direct, open, and professional to decrease OPC.

Perceptions of evaluator professional autonomy in North American evaluation practice

Scholarship from the sociology of professions has illustrated the important role that autonomy must play in professional relationships, especially in technically-specific and relationally-strong fields of practice like program evaluation. Theoretically, autonomy is important because the evaluation professional ought to be free to make recommendations in several key areas: framing the evaluation questions, including questions of unintended consequences; developing evaluation plans; choosing methods; analyzing data; making conclusions, including negative findings in reports; and, increasingly, ensuring that historically underrepresented stakeholders without voice are represented and involved in the evaluation process. This study found that evaluators in Canada and the USA reportedly did not perceive autonomy as related to the larger role of the field of evaluation, but rather as a contextual personal concern, that is, related to matters of personal circumstance, such as their workplace, years of experience, financial security, and the backing or lack thereof from professional associations. The article concludes with implications for practice and future research.

Some notes on the necessity of autonomous educational practice and two concerns

This article suggests a sophistical autonomous practice in response to Platonian Aristotelian philosophy’s domination over education. It shows the dangers of empty education in which education is reduced to schooling the perfect citizen in the image of a perfect state. An example is given in which schooling in empty education is reduced to a tool for authoritarian capitalism inscribed in the formation of the State to increase profit while undermining a democratic society. Instead, this article claims that education was introduced by the Sophists as verification of equality and will show how education works counter to anti-educational and anti-democratic tendencies of Platonian/Aristotelian discourses on education and schooling. The article identifies and develops a practice of ignorance of inequality as such inequality is inscribed in machine schooling and offers a sophistical practice instead. The article concludes by highlighting an autonomous tradition of educational practice making practice, as evident once Platonian and Aristotelian philosophy is refuted as saying anything meaningful about education.

Articulating difference: reading Biko-with-Hall

ABSTRACT This article centres a selected set of “race-class debates” from the 1970s that were characterized by a powerful reformulation of political critiques of the South African racial order, both from within Marxist thought and with the dramatic entry of Black Consciousness onto the political stage. Our discussion focuses on two exemplary interventions: Biko’s testimony at the SASO/BPC trial and his presentation of the theoretical basis of BC’s political strategy, and Stuart Hall’s 1980 essay “Race, Articulation and Societies Structured in Dominance”, and its reformulation of a Marxist perspective for thinking through race-class relations. With Hall we (re)discover theoretical terms for thinking through the problem of how relatively autonomous practices of domination come to be articulated. With Biko, we discover a strategic modality for approaching the political problem of collective subjectivity that holds lessons for how struggles against frameworks of domination might be politically articulated in their multiplicity.

Autonomy and agency: The event of punk

This article interrogates the contested politics of punk. Against the reactionary trend to accept the ephemerality of punk as evidence of its obvious failure, its political naivete and subsequent recuperation, I defend the continuing relevance of punk precisely as a political project. Identified as an event in Badiou’s sense, punk erupts spontaneously in parallel with complementary European resistance movements and, for a brief incandescent moment, convulses history, placing all criteria of meaning and value in question. So, even if it ‘disappeared just as quickly’, punk survives its transience through people who, haunted by its emancipatory promise and radicalized by its ‘aesthetics of resistance’, are motivated to ‘a new way of being’ in its memory. Channelling the late Mark Fisher (aka k-punk), this article recovers the lost politics of punk, invoking its fidelity to social transformation through autonomous cultural practice to fulfil its revolutionary promise. The argument concludes that, far from an exhausted ‘musical genre’, the event of punk remains efficacious precisely because it is not reducible to any of its actual historical iterations.

Mentoring novice NPs: Recommendations for navigating the transition to autonomous practice.

The transition to professional practice is a challenging time for the novice NP. Mentorship is an effective strategy to ease this transition and increase success in the role. This article provides recommendations for best practice in mentoring the transitioning novice NP.

Blogging with smartphones for independent writing practice beyond the EFL classroom

This study investigated how English as a Foreign Language (EFL) students at a university in Pakistan experienced blogging on their smartphones as a means to gain more extensive autonomous practice writing in English. The blogging was done as a stand-alone activity, independent of the students’ university EFL programme. Using a mixed-methods case study design, data were collected from 23 undergraduate students through interviews, surveys, and reflective written accounts. This paper foregrounded the students’ voices to reveal their attitudes to blogging, their experiences using smartphones for that purpose, and perceived changes in their English writing skills. The findings indicated that many of the participants developed a virtuous cycle, in which their interest and enjoyment of blogging, along with perceived improvements in their ability to communicate in English, contributed to increase both confidence and motivation to write more. The findings also pointed to other worthwhile social and educational outcomes that could be fostered through this type of activity. As a result, the study has implications for teachers and learners in a wide range of EFL contexts, i.e., offering further insights into strategies for harnessing existing digital tools in order to extend students’ opportunities to use the target language, within and beyond formal educational settings.

Mobile Commoning from the Margins to the Fore? Hostipitality on the Polish-Belarusian and Polish-Ukrainian Borders (2021–2022)

The article was written as an intervention piece in the midst of the massive escape of war refugees to Poland during the first four weeks of the war in Ukraine (24 February-24 March 2022). It aims to map and discuss the condition of grassroots hospitality (and inhospitality) in Poland between Autumn 2021 and Spring 2022. It was a time of shifting context in terms of policies: from the state of exception, migrant push-backs, and walling the border with Belarus, to the policy of solidarity with war refugees, legitimized humanitarianism and open border with Ukraine. In the course of half a year, the frames of bottom-up hospitality on Eastern borders of Poland changed entirely and abruptly. When a couple of thousands of migrants from the Middle East and beyond were camping in the border zone between Belarus and Poland, unable to claim asylum in the EU, practices of solidarity from the bottom up were barely tolerated by Polish state, if not criminalized and condemned. In these realities, structures of support remained an informal, fugitive, and underground network. But with the Russian attack on Ukraine on 24th February 2022, Poland opened its border for the unprecedented arrival of over two million people (during first month of the war) and bottom-up solidarity became a massive response of Polish society, which started to organize shelters, transportation, food and medicines. The same politicians and media which were fighting hospitality to migrants — in terms of ‘crimes of solidarity’ — on the border with Belarus, this time welcomed it with enthusiasm and support. The article proposes to view the nascent rise of grassroots hospitality with Ukrainian migrants in terms of ‘mobile commoning’: precarious, makeshift and autonomous practices of solidarity with people on the move. Mobile commoning is considered here as potential basis for a different migration policy in the EU. At the same time, the Polish case is analyzed as an instructive study of the limits of political universalism which are constructed at and by the borders.

Contemporary Nurse-Midwifery Care in Colorado: A Survey of Certified Nurse-Midwife Practices in Hospital and Community Settings.

Lack of access to birth facilities and maternity care providers has contributed to rising US maternal mortality and morbidity rates, especially among women in rural areas. Evidence supports the increased use of midwives as a potential solution for access-to-care issues. This observational survey was conducted to identify the practice environment for Certified Nurse-Midwives® in Colorado for the purpose of informing future workforce expansion. Study results indicate that midwives provide services aligned with the midwifery model of care and have mostly autonomous practice in hospitals where midwifery practices are already established. However, there is limited use of midwives, as fewer than half of Colorado's 69 birthing hospitals have midwifery practices, and financial constraint created by low Medicaid reimbursement could be a limiting factor in establishing new midwifery practices. Policy recommendations based on survey results include (a) support for midwifery education and workforce development, (b) removal of hospital-level restrictions for privileges of midwives, and (c) consideration for public payment models that promote expansion of midwifery practices.

Non-pharmacological therapies for cancer patients in Portugal and Brazil: an experience report.

To describe the experience of nurses from a center in Portugal and two in Brazil regarding the use of non-pharmacological therapies in cancer patients. This is a professional experience report. In the Portuguese institution, a group of nurses has been performing massage therapy, reflexology, postural teaching, thermotherapy, relaxation, guided imagery, Reiki, music therapy, aromatherapy, among others, for 17 years, with significant results in pain and vital signs with satisfactory perceptions. In Brazil, the clinical application is incipient, clinical studies with auriculotherapy, relaxation with guided imagery and floral therapy are taking place, with significant results for physical symptoms, anxiety, and quality of life improvement. In both countries, nurses have made efforts to implement non-pharmacological therapies. While in the Portuguese reality they have been formally institutionalized in care, in Brazil the therapies take place with voluntary work and through intervention research. This report can encourage the translation of autonomous practice to clinical studies for proposing evidence of therapies in Integrative Oncology.

Struggling with Development

This research examines the concept of a regional wide-ranging autonomy principle that aims to promote local uniqueness and traditions and their impact on the rights and protections of traditional communities and their Traditional Knowledge (TK). Empirical data collected from early to mid-2021 in Barito Kuala District, Indonesia, was used. The results revealed that the local government has no practical autonomy, nor does it protect traditional communities from the negative effects of development projects as all regional Bills must uphold the limited affairs stated in the 2014 Regional Autonomy Act. The sources of this bottleneck are the ambiguities in the Constitution and the loopholes in the 2014 Act. These legal flaws are worsened by elite connections in central and local governments creating a ‘trade-off’, in which the local government must uphold the Unitary State doctrine while the central government remains silent about the corrupt political dynasties in the district. This study advances the existing contemporary understanding of decentralization and development projects that often contradict the law.
 
 Keywords: Indonesia decentralization; agricultural traditions; law and development; traditional farmers; national and local elites.

법치주의와 조화로운 자치재정권 확대

Since the revival of the local autonomy system in 1995, decentralization of local autonomy has emerged as a major national task in almost all governments, and many discussions have been made on it. As the Decentralization Act defines decentralization of local autonomy and emphasizes the importance of local finance in local autonomy, the autonomy and finance of local governments is essential to complete autonomy and decentralization. Just as it is difficult to conclude that the right to self-government is clearly recognized by the current constitutional provisions, the legal guarantee for self-government and finance is not very high compared to the number of articles in the law. In particular, it may be close to impossible to increase the sovereignty of taxation within the limits of the ideology of the rule of law. The local financial system in Korea was prepared and operated for convenience in administrative management, but since the era of democratization, it has developed in the direction of promoting fiscal soundness while reflecting many factors of autonomy. Since 2005, it has been organized to some extent in the form of ‘Revenue Authority - Appropriation Authority’. However, in the legal system, the link between the Local Autonomy Act and the Local Finance Act is loose, and there are many overlapping articles, so the hierarchy of laws is not established. The general legal nature of the Local Finance Act is also somewhat skeptical. Individual laws can be evaluated without encompassing them. This is especially true when it comes to grants and subsidies. The need to strengthen fiscal decentralization is becoming more and more urgent, but the first thing to do is to face the barrier of tax legalism. Even taking into account the recognition of the ordinance enactment and the flexible tax rate, it is difficult to see it as a practical autonomy. Coexistence can be promoted through active interpretation in the current constitutional system, but there are essential limitations. With reference to extra-legislative tax under the Japanese constitution, autonomous finance under the French constitution, and the distribution of legislative power under the German constitution, the Korean constitution also requires a bold decision to recognize tax autonomy and autonomous finance. In addition to taxation, the scope of ordinance enactment rights on non-tax income such as fines for negligence is also a task that needs to be continuously reviewed in relation to the expansion of autonomous legislative power. We need to focus our attention and efforts so that the noble values of the democratic constitution, the ideology of the rule of law, and the vocation of the times, the decentralization of autonomy, do not collide and harmonize.

Relationships among perception of teacher autonomy support, achievement motivations, intellectual risk-taking, and science academic performance: a serial mediation model

ABSTRACT Based on self-determination theory and achievement goal theory, this study provided a serial multiple mediation model that examined how students’ perceptions of teacher autonomy support (PTAS) relate to different achievement motivations (mastery and performance-approach goals), and further associate with students’ intellectual risk-taking (IRT) engagement and academic performance (AP). A self-report questionnaire and a standardised science academic test were completed by 520 primary school students from China. The structural equation modelling revealed that the positive association between PTAS and students’ AP was serially mediated by achievement motivations and then intellectual risk-taking engagement. Though the unexpected negative direct effects of PTAS on AP suggested the need to optimise autonomous instructional practices, the positive indirect and total effects highlighted the contributions of PTAS to students’ achievement motivation and IRT engagement. The findings instantiated how autonomy support may promote students’ achievement motivations and further influence their learning engagement and academic performance in science. This study would be valuable for educational researchers and practicing teachers as it extends our understanding of what factors are influential in promoting students’ learning outcomes and how they correlate in science learning processes.

Autonomous Movements and Their Media

Social movements respond and adapt to the social and historical environment, and global connections have allowed activists to envision an array of alternatives. This has led present-day movements toward autonomous practices, such as non-hierarchical leadership, prefigurative politics, and decentralizing Western perspectives. Autonomous movements’ communication and media projects are formed by these political ideals and epistemologies, dependent upon their contextual situation. Such movements see change as inevitable and rigidity and dogmatism as stifling to the political imagination. Despite criticisms leveled against autonomous practices from other leftist political paradigms, these prefigured alternatives create change in the small and ephemeral ways available to them. This research outlines the political parameters of many current social movements, offering a framework by which to study grassroots media endeavors.