Independent Profession Research Articles

Advanced practice nursing implementation in France: A mixed-method study.

To describe advanced practice nursing (APN) in the French healthcare landscape and to provide insights on how the role is defined and implemented and how the role is perceived by physicians. A mixed-method approach incorporating qualitative and quantitative data to offer a global understanding of APN implementation in France was used. Data were collected through questionnaires and interviews with APNs and physicians in diverse healthcare settings in France. The questionnaire assessed the roles, relationships with physicians and patients and the perceived implementation success of APNs. In-depth interviews explored experiences, definitions, challenges and perspectives of APNs. A thematic analysis was applied to the qualitative data to complete the quantitative exploration. Descriptive analyses were performed for quantitative data. A total of 41 APNs and 12 physicians were involved in this study between December 2022 and March 2023. The findings underscore APN as a pivotal, independent profession integrating advanced clinical expertise and interprofessional skills. The challenges encountered by APNs include role ambiguity, ongoing resistance and the need to address institutional barriers. Despite the fact that 73.2% of APNs reported that their role was well implemented, only 17.1% had clearly defined roles at the outset. This study revealed the dynamic and evolving nature of APN in France, highlighting its challenges and opportunities. Despite facing role ambiguity and resistance, APNs play a crucial role in the healthcare system. The results highlight the need for specific interventions to tackle challenges and facilitate successful integration of APN. These insights lay a foundation for future research and interventions aimed at boosting the impact and acceptance of APN in France, potentially influencing policy modifications and professional development. Problem Addressed: The study aimed to enhance comprehension of the implementation and role of advanced practice nursing (APN) in France. It focused on defining APN in the French context, identifying barriers and facilitators to its implementation and evaluating its impact. The study revealed that APN in France is evolving with expanded competencies and clinical autonomy, but faces challenges like role ambiguity and professional resistance. Key findings include the successful integration of APNs in healthcare settings, positive relationships with medical doctors and patient satisfaction. However, the study also highlighted the necessity to resolve role ambiguity and to improve the understanding and acceptance of APN roles among healthcare professionals for successful APN integration. Impact of the research: This research will primarily impact healthcare systems and policy-making in France, guiding the future development and integration of APN roles. It is also relevant for healthcare professionals, particularly nurses and physicians, by providing information about the evolving nature of APN and its benefits in patient care. Globally, the study contributes to the broader discourse on APN, offering insights that could inform APN implementation strategies in other countries facing similar healthcare challenges. COREQ-STROBE. No patient or public contribution.

The role of management consulting in the corporate governance system

The article is devoted to the study of topical issues related to management consulting in corporate governance. Management consulting plays an important role in the corporate governance system, helping companies to achieve their strategic goals and optimize their operations through innovative approaches and solutions. It has been determined that management consultants are becoming key figures in helping companies develop strategies, optimize processes and solve complex management problems. In the context of globalization and rapid technological transformation of business, management consulting is becoming an integral component for companies seeking to remain competitive and adapt to new market realities. The author characterizes that the development of management consulting is not only diverse, but also takes two main forms. On the one hand, (and this has developed historically), consulting is a method of improving the existing forms of management and business, because initially the consulting process was a process of imitating the experience of the most successful managers. On the other hand, consulting is becoming an independent profession. The article analyzes risk management in a corporate enterprise, which includes identification, assessment and mitigation of risks that may affect the organization's goals, operations or stakeholders. It is highlighted that corporate governance is the systems, processes and principles by which a business is managed, regulated and controlled. The importance of effective governance increases linearly with the size of the business and the number of shareholders. It is noted that foreign investors often look for companies with effective management, transparent and accountable business. For small and medium-sized enterprises seeking to expand their operations and enter foreign markets, having a sound corporate governance practice can be a significant advantage. For foreign investors, it demonstrates the reliability of the business, reduces the potential risks associated with investments, and can create more favorable conditions for investment. It is proved that the creation of reliable mechanisms is necessary to control the financial integrity and operational efficiency of the enterprise.

The Professionalization of Midwifery in the Late Middle Ages

The concept of midwifery as an independent profession for women, one that gave them the opportunity for autonomyandeducation,isevidentinthehistoricalrecordofWesternEuropeinthelateMiddleAges. Thisstudy looks at several determinant factors that define the concept of professionalization in a medieval context – such as education, the establishment of standards of practice and the ability to earn income – concluding that midwifery should be considered by historians as a specialized profession, separate from other healers, physicians, and lay midwives. The study reflects on the work of early Greek medical scholars and the advancement of knowledge by Trotula of Salerno and St. Hildegard von Bingen, as well as the autonomy of practicing midwives and their relationship to the established Church, to illustrate the status of midwifery as a distinct profession during the established time period.

Dentistry in Ancient Egypt

Dentistry, dated in Ancient Egypt as an independent profession since the early 3rd millennium BC, was the first specialty recorded in a document in ancient Egypt, but nothing proves teeth interventions in mummies. The mouth and dental preservation was very important in rituals and theology because, as a source of exterior speech, it allowed man to express his spiritual feelings. The emphasis put on the mouth, lips, tongue, palate and teeth, was connected with the soul, the expression, and articulation of words. In the ‘Opening of the mouth’ ceremony, the dead jaws were freed to rebirth, give a voice and utter the words and names of power. Thus the white and healthy child Horus’ teeth allow to make up the undamaged mouth (PT 79 a) and five onions, their symbolic representation, were given the dead as a sacred offering. The emphasis put on the mouth, lips, tongue, palate and teeth, was connected with the soul, the expression, and articulation of words. As source of exterior speech, they allow man to express his spiritual feelings. In the Memphite theology the intellectual God Creator Ptah have generated the world pronouncing their names. Teeth and lips represent the magical verbal action and the tongue means speech, the _logos_. Dental problems were well known and some indications of doctor’s different diagnosis and treatments were found in medical papyri. The most common dental diseases were: attrition, frequent until pulp exposure, receding gums, caries and the destruction of enamel, chronic suppurative periodontitis that causes mobility, dental abscess and sepsis, loose teeth, ulcerative stomatitis, alveolar diseases and heavy deposits of calculus. Egyptian paleopathology and molecular biology provide new medical information and had revolutionized all aspects of dentistry, changing previous beliefs. However Egyptians were creative or witty and had devised many treatments for the various affections, both chirurgical and medicinal in nature, using different drugs. By studying a critical scrutiny of the development of dentistry profession in ancient times, it has been possible an exploration of dental problems, diseases and treatments and establishing guidelines and difficulties.

Shopkeepers and urban change: moving beyond gentrification studies?

Though the literature on commercial gentrification has grown considerably since the 2000s, it has several blind spots. Indeed, research has primarily focused on neighborhoods located in central areas, examining the retail landscape as well as consumer practices and identities. In this article, we discuss this literature and put it in dialogue with the literature on retailers and, more broadly, on independent professions. On this basis, we propose an analytical framework for studying commercial change from the shopkeepers’ perspective. The discussion is conducted in light of the concrete transformations of a commercial street located in a formerly working-class suburb of Paris. This case study illustrates the relevance of our approach, showing that even in an archetypal gentrified street, the profiles and paths of shopkeepers are varied, as is their relation to urban change.

Ab. No. 158 Lack of Rural Rehab: A Case Report of Chronic Stiffness Post Tibia Fracture

Introduction: Even after 7 decades, referral depends on acceptance of physiotherapy as an independent profession. Even if prescribed, rural rehabilitation is not always executed with regular follow up.Neither documentation of rural physiotherapist-population ratio requirements, nor regulatory body to standardize rehabilitation level is available. Only 3% Anganwadi workers were informed about physiotherapy, though Maharashtra has 214 PHCs with wellness room for physiotherapy/yoga. Regain quality of life, return to employment, which was lacking a year after proximal tibial fracture, due to lack of referral to post-operative physiotherapy in Maharashtra’s Mangaon taluka. Methods: A 41-year-old patient with right undisplaced lateral tibial condyle fracture complained of limited knee range, stiffness, pain on standing, prolonged sitting, stairclimbing, reduced walking speed, loss of job as a coal miner. He was explained that restricted flexion was due to internal bony fragments, which caused fear of end range flexion, and was advised to undergo a revision surgery inspite of poor expected outcome. 4-week protocol included strengthening for quadriceps, hamstrings, hip abductors, flexors, calf, stretching, weight bearing exercises. Home exercises were regularly progressed. Adjuncts used were dry cupping, IASTM, dry needling. Result: Range increased from 10°-86° to 0°-112°, extensor lag, antalgic gait was corrected, thigh girth increased by 1.5 cm. Pain reduced while climbing stairs (4/10 to 0/10), standing after prolonged sitting (6/10 to 4/10), and walking (1/10 to 0/10). Squatting, cross leg sitting with minimal pain, return to work as a full-time coal miner was achieved. Revision surgery and disability were prevented. Conclusion: Rural early rehabilitative protocol could have prevented 1 year of unemployment, pain, stiffness. Implications: Highlights need for streamlined referral system to match evidence that recommends early ROM and weight bearing. Stimulate public –private partnerships for creating the role of physiotherapy assistant/technician at the existent PHCs. Facilitate followed-up tele-rehabilitation for rural physiotherapy.

Kwalifikacje zawodowe wybranych zawodów medycznych – charakterystyka wymogów prawnych i aspektów praktycznych

In terms of legal requirements for medical personnel, education plays a key role – in each of the analyzed medical professions – it must be a higher education. In the field of post-graduate education (after obtaining the right to practice), it is also possible to complete a specialization course, as a result of which one is able to obtain the title of specialist. As a part of this form of education, medical personnel should constantly improve their professional qualifications in various forms, e.g. qualification courses and specialized training. The provisions of the analyzed acts relating to the so-called independent medical professions indicate, above all, that in order to practice each of the medical professions, it is necessary to hold (maintain) the right to practice the profession and that is subject to the obligation of continuous education, verified by medical boards. The law specifies legal requirements for people who want to practice medicine, in the first place, students of medical faculties. They establish the conditions for obtaining the prerequisite to practice the profession and provide for the need of the continuous postgraduate education after fulfilling the education requirement. This solution introduces a significant scope of legal liability for people who want to practice a given medical profession, which guarantees an appropriate level of protection for patients. Legal regulations for medical professions are in many cases similar, although there are separate legal solutions.

Model Pengembangan Kemampuan Auditor Dalam Tantangan Era Sosiety 5.0 Di Indonesia

The development of technology-based scientific knowledge has led to digitization in all aspects, giving rise to the era of Society 5.0, which emphasizes the integration of human life with artificial intelligence technology, including business processes. Auditors, as one of the independent professions with a crucial role in maintaining the balance of business processes by ensuring transparency and compliance with agreed-upon procedures, must understand the Society 5.0 era. This understanding can be translated into the form of competency standards, which are the skills and abilities that auditors must possess to fulfill their duties and responsibilities inherent to their profession. The aim of this research is to identify the challenges faced by auditors in the Society 5.0 era and how to adapt the competency standards that need to be met. The research method used is qualitative with a scoping review approach and content analysis techniques in descriptive data. The research results show that the challenges for auditors in the Society 5.0 era include intense competition with artificial intelligence, which can replace audit functions. Therefore, auditor competency standards need to be enhanced in terms of mastering these technological systems to ensure effective control. Recommendations for future research could involve different methods and specify certain types of audits.

Within the National Health Fund (NFZ) or privately? Advantages and disadvantages of the physiotherapy services system

Introduction. With the entry into force of the Act on the Physiotherapist Profession, the profession of physiotherapist became an independent medical profession. The amendment to the Act in 2019 significantly expanded the scope of competences of contractors of the mentioned profession and strengthened its position in the health care system The aim of the study was to analyze the use of the physiotherapy services system within public and private health care. Material and methods. A total of 606 people (100%) were included in the study. The vast majority were women (506; 83.5%). The average age of the respondents was 28 years. The research tool was an original survey questionnaire created and made available via a Google form. Results. The most frequently used physiotherapy treatments within public health care included physical therapy (129; 34%) and kinesiotherapy (109; 28.8%), and the most frequently indicated reason for using the mentioned form was an injury or accident (83; 38.4%) and lifestyle-related pain (60; 27.8%). Most respondents considered the advantage of physiotherapy services provided as part of public health care to be the lack of fees for the visit (153; 63%) and the possibility of using the services of qualified specialists (42; 17.3%), while the greatest disadvantage was the long waiting time for the visit (138; 35.9%) and insufficient equipment of facilities (67; 17.4%). The most frequently used physiotherapy services in the private sector included: massage (179; 27.8%) and manual therapy (136; 21.1%), and the most common reasons for using these services were lifestyle-related pain (133; 36, 3%) and injury or accident (112; 30.6%). Most people considered short waiting times for services (218; 22.2%) and the involvement of a physiotherapist (211; 21.5%) as the greatest advantages of commercial services, and high prices of services (196; 61.1%) – a disadvantage. Conclusions 1. More than half of the people included in the study used physiotherapy services, including the vast majority – commercial services. 2. Differences were observed regarding the reasons for using physiotherapy services and the type of therapies used in public and private health care: public services were most often used by the respondents due to an injury or accident, while private services were used due to lifestyle-related pain, and the respondents most often used public physiotherapy services included physical therapy and kinesiotherapy, while in the private sector: massage and manual therapy. 3. Most respondents considered the advantage of physiotherapy services provided within public health care the lack of fees for a visit and the possibility of using the services of qualified specialists, while in the private sector – short waiting times for services and greater involvement of the physiotherapist. 4. According to the respondents, the disadvantages of physiotherapy services within public health care were long waiting times for therapy and insufficient equipment of the facility, and in the private sector – high prices of services.

The Story of the Historical Marker Honoring the McAllister Family Ophthalmic Legacy

On August 21, 2022, more than 100 individuals from at least nine different states gathered at Wills Eye Hospital in Philadelphia. Each of the three major eye care professions in the United States was amply represented. The occasion was to celebrate the contributions of John McAllister, Sr. and his descendants, whose early efforts led to the advancement of scientific knowledge, and to the evolution of eye care in the United States. John McAllister is widely regarded as the father (or grandfather) of optometry, since his work and the work of his progeny led to the beginning of optometry as an independent profession. The highlight of the event was the dedication of a historical marker honoring the ophthalmic legacy of the McAllister Family. The marker is situated in Old Town Philadelphia, very near where John’s original optical shoppe was located. The three eye care professions—opticianry, ophthalmology, and optometry—worked hand in hand to make this remarkable achievement possible. This paper tells the story of how and why it all came about.

On the formation of Soviet haematology as an independent scientific clinical discipline and medical profession

On the basis of a critical analysis of sources and the use of comparative historical research method, the authors reveal the fundamental role of Academician of the USSR Academy of Sciences I.A. Kassirsky in the formation of haematology as an independent clinical discipline in the USSR and put forward the thesis of the decisive importance in this process of the unified haematological school of A.N. Kryukov - I.A. Kassirsky.

Contemporary Clinical Psychologists in India: Challenges in the Professional Journey

The evolution of clinical psychology as an established, recognized, and independent profession has been progressive in India, but the challenges have been multifold. Clinical psychologist faces different challenges at an academic level, including legislation, undefined roles, inadequate opportunities, and dependency on west oriented assessments. Established clinical psychologist face issues such as low remuneration, unclear boundaries between terms of mental health professionals, lack of acknowledgment, and meager indigenous therapies that act as hurdles to its progress.

Ethics of mortgage advisers in the Netherlands: Professional attitudes and moral dilemmas

AbstractSince 2013, mortgage advisory has become an independent profession in the Netherlands. Initially working for mortgage providers, the newly nonpartisan advisers now work for standard advisory fees, thereby reducing conflicts of interest. In this article, I provide an ethical analysis of the different types of ethos of mortgage advisers, that is, the ways they see and talk about, and relate to their work in a certain way. The central research question is: What different kinds of ethos do mortgage advisers have, and which moral dilemmas do they experience in their advisory work? The existence of moral dilemmas is controversial in ethics but nonetheless experienced in real‐world business practice. An “ethological” understanding of morality is developed in this paper to understand how these dilemmas are experienced. Twenty‐nine mortgage advisers have participated in Q methodological research, a mixed qualitative–quantitative small‐sample method. Three different types of ethos were found: Principled Advisers, Moral Advisers, and Minimal Morality Advisers. In considering these three types, I argue that many mortgage advisers should professionalize their ethical stance and learn to address situations in which moral values are neglected. Business ethicists, in turn, need to acknowledge that something may be considered morally inappropriate but is still defensible in some other sense. In this paper, I develop a “layered” conception of business ethics that broadens the perspective from universal notions, such as “rights” and “duties,” toward a concrete ethos that people have in a certain professional practice.

The importance of constructing an osteopathic profession around modern common academic values and avoiding pseudoscience: The Spanish experience

IntroductionThe global health and wellness industry has an estimated value of $4 trillion USD, of which traditional and complementary medicine (osteopathy included) represent $359.7 billion USD (almost 9 %). While some European countries are gradually recognizing osteopathy as an independent health profession and regulating it in a timely manner, in Spain, osteopathy characterized by a lack of consensus within the professional community itself and the lack of regulation. In February 2019, the Government of Spain launched a campaign (#coNprueba) that was part of the "Plan against pseudotherapies and pseudosciences". In Spain, there is a serious possibility that it will be banned or that osteopathy will be classified as a subspecialization of other health professions (despite this contravening existing national laws). This could set a dangerous precedent for those countries where osteopathy is in the process of being recognized, as it could paralyze such implementation. AimThe aim is to understand how it might be possible to change this trend to promote the education of new osteopaths, foster a culture of research, and obtain regulated status. A narrative report based on the literature addresses current issues, including sources of debate and controversy. Discussion/conclusionThe hand of osteopathy is outstretched to define a collaborative strategy in defence of a freely accessed, plural, safe, and regulated profession in Spain. Spain's own efforts could help the international osteopathy community define its niche and identity and determine the most flexible way to combine tradition and modernity.

The growing needs of genetic counselling-Feasibility in utilization of tele-genetic counselling in Asia and Hong Kong.

The need for the expansion of genomic services has been at a record time high in the past decade. As technological advancement continues to strengthen the entire genetic and genomic pipeline and clinical operational workflow, the major challenge remains to be the speed of workforce development to meet service growth. In particular, the international expansion of genetic counselling (GC) services has been a topic of interest for the past few years. GC is an emerging profession in most of Asia, and in many countries the profession of GC often refers to physicians or front-line health workers with expertise in genetics to provide GC services rather than being a specific independent profession. As genetic and genomic services, especially pre-test and post-test GC, expand globally, the need to tackle the longstanding obstacles of GC personnel shortage and funding issues must not be overlooked. There is an urgent need internationally, and especially in Asia, where GC profession is comparatively less well-established, to seek alternative approaches to meet service demand. The present review examines the global development and feasibility of tele-genetics and tele-genetic counselling (TGC), and serves as the foundation to explore a possible roadmap in Hong Kong via the Hong Kong Genome Project.

Medicolegal knowledge and its practice among physiotherapists in Maharashtra

Background: Physiotherapy is a modern science and an independent profession. Physiotherapists are expected to conduct professional practice according to the existing laws and follow the guidelines of the respective state councils. Awareness about patients’ rights is increasing, as are malpractice cases and as professionals who are in constant contact with their clients, physiotherapists need to safeguard themselves from a medicolegal perspective. Having appropriate knowledge of medicolegal aspects and practicing accordingly will protect them against legal damages while maintaining professional integrity. This study aimed to find the level of medicolegal knowledge and its practice among physiotherapists in Maharashtra. Methods: An observational, cross-sectional study was conducted in Maharashtra, India. A self-made, validated questionnaire was distributed online and 100 physiotherapists across Maharashtra, accessed via the convenience sampling method, were surveyed. The collected data was analysed using descriptive statistics. Results: The average knowledge was 50.38%, but the average correct practice was 71.86%. These findings showed that the physiotherapists were practicing according to basic knowledge and they needed to improve their knowledge of aspects such as the Maharashtra Act II of 2004, documentation, applicable laws and professional indemnity to practice with unquestionable protection against legal proceedings. Conclusions: Physiotherapists in Maharashtra have basic knowledge of the governing body and of the legal aspects of their profession. With medical negligence cases on the rise, they need to update themselves about the details to conduct a safe and efficient practice. This will enhance their professional competence and provide legal and financial security.

Private Detective Activity in Slovenia – Organisation Matters

Abstract A private detective in Slovenia may perform detective activities as an independent profession or on the basis of an employment relationship for a natural or legal person with a registered private detective activity (ZDD-1, 2011). Private detectives completed a questionnaire when they attended the annual training in June 2018 – almost half of Slovenian private detectives participated in the survey. The study results show that almost half of self-employed private detectives investigate more drug abuse at work and abuse of competition clauses, while private detective agencies conduct more civil, legal, and administrative proceedings than other organisational forms. Some private detectives do not perform private detective tasks as their main activity, but as a secondary activity, and those individuals for whom private detective work is their primary/main profession mostly deliver packages, write reports and collect debtors’ data on behalf of their clients.

Breast cancer and occupation: Non-parametric and parametric net survival analyses among Swiss women (1990-2014).

Occupation can contribute to differences in risk and stage at diagnosis of breast cancer. This study aimed at determining whether occupation, along with skill level and the socio-professional category, affect the breast cancer survival (BCS) up to 10 years after diagnosis. We used cancer registry records to identify women diagnosed with primary invasive breast cancer in western Switzerland over the period 1990-2014 and matched them with the Swiss National Cohort. The effect of work-related variables on BCS was assessed using non-parametric and parametric net survival methods. Study sample included 8,678 women. In the non-parametric analysis, we observed a statistically significant effect of all work-related variables on BCS. Women in elementary occupations, with low skill level, and in paid employment not classified elsewhere, had the lowest BCS, while professionals, those with the highest skill level and belonging to top management and independent profession category had the highest BCS. The parametric analysis confirmed this pattern. Considering elementary occupations as reference, all occupations but Craft and related trades had a hazard ratio (HR) below 1. Among professionals, technicians and associate professionals, and clerks, the protective effect of occupation was statistically significant and remained unchanged after adjustment for age, calendar period, registry, nationality, and histological type. After adjusting for tumor stage, the HRs increased only slightly, though turned non-significant. The same effect was observed in top management and independent professions and supervisors, low level management and skilled laborers, compared to unskilled employees. These results suggest that work-related factors may affect BCS. Yet, this study was conducted using a limited set of covariates and a relatively small study sample. Therefore, further larger studies are needed for more detailed analyses of at risk occupations and working conditions and assessing the potential interaction between work-related variables and tumor stage.

Analisis Pelanggaran Kode Etik Advokat Didalam Persidangan Terkait Penyalahgunaan Keterangan Palsu Oleh Klien

As a constitution based on Pancasila and the Constitution of the Republic of Indonesia 1945, Indonesia guarantees the equality of all people before the law (Equality before law). In the realization and declaration of legal principles in society, the roles and functions of lawyers as free, independent and important professions, apart from judicial and law enforcement agencies such as the police and prosecutors, are important. The purpose of this article is to explain how the implementation of the Code of Ethics is sanctioned against lawyers who commit professional violations in Indonesia, and how lawyers sanctioned for violating the Code of Ethics can challenge. Lawyers are protected by laws, statutes, and codes of ethics in the practice of their profession. The lawyer's code of ethics is the application of assigned duties that must be consistent with the integrated criminal justice system by demanding moral accountability to the client and to God (violation of oath of office, malicious Prohibition of conduct, corruption)1. If an attorney violates the Violations section of the Code of Ethics, the case will be reviewed and heard by the Honorary Council.
 Keywords: Application; Code of Conduct Sanctions; Advocates

Masa Jabatan Pimpinan Organisasi Profesi Advokat melalui Keputusan Mahkamah Konstitusi RI

The 1945 Constitution of the Republic of Indonesia stipulates explicitly that Indonesia is a state based on law. In a constitutional state (rechtsaat) the state recognizes and protects the human rights of every individual. In a contstiutional state,everyone must be treated equally before the law (equality before the law). The principle of rule of law in the life of society and the state requires the role of an advocate as an independent and free profession. So that this freedom result in the absence of laws governing advocate. However, previously Article 38 of Law number 14 of 1970 had indicated the need to regulate the advocate profession in a separate law. After the law on advocate, namely Law No. 18 of 2003 does not yet clearly stipulate the term of office for the heads of advocate organizations. Therefore, the existence of a law that regulates the term of office for the leadershp of an advocate organization is very important in order to provide comfort and peace among fellow advocate professions.