Professional Scope Research Articles

Regulating health professional scopes of practice: comparing institutional arrangements and approaches in the US, Canada, Australia and the UK

BackgroundFundamentally, the goal of health professional regulatory regimes is to ensure the highest quality of care to the public. Part of that task is to control what health professionals do, or their scope of practice. Ideally, this involves the application of evidence-based professional standards of practice to the tasks for which health professional have received training. There are different jurisdictional approaches to achieving these goals.MethodsUsing a comparative case study approach and similar systems policy analysis design, we present and discuss four different regulatory approaches from the US, Canada, Australia and the UK. For each case, we highlight the jurisdictional differences in how these countries regulate health professional scopes of practice in the interest of the public. Our comparative Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis is based on archival research carried out by the authors wherein we describe the evolution of the institutional arrangements for form of regulatory approach, with specific reference to scope of practice.Results/conclusionsOur comparative examination finds that the different regulatory approaches in these countries have emerged in response to similar challenges. In some cases, ‘tasks’ or ‘activities’ are the basis of regulation, whereas in other contexts protected ‘titles’ are regulated, and in some cases both. From our results and the jurisdiction-specific SWOT analyses, we have conceptualized a synthesized table of leading practices related to regulating scopes of practice mapped to specific regulatory principles. We discuss the implications for how these different approaches achieve positive outcomes for the public, but also for health professionals and the system more broadly in terms of workforce optimization.

Estudio de la práctica fotográfica en Cusco en el período de 1897 a 1920

Se propone un estudio de la fotografía cusqueña entre 1897 y 1920, período del que se tiene conocimiento parcial de la actividad fotográfica en esta ciudad andina. Aun cuando los archivos de los fotógrafos de este período están perdidos o no han aparecido hasta la fecha, y aun ante la escasa bibliografía, se procurará precisar acerca de su dinámica comercial y creativa y sobre la relación que pudieron haber tenido entre ellos y con el contexto sociocultural en los años acotados. Se ha empleado una metodología cualitativa con enfoque interpretativo de documentos de época y diseño narrativo para poder hilvanar la información acopiada, con el objetivo de conocer cómo fue el desarrollo de la fotografía en Cusco hasta 1920, año de la llegada del fotógrafo Martín Chambi a esta ciudad. En el estudio, se detecta la actividad de varios fotógrafos, el alcance profesional de sus trabajos en la esfera pública, la oferta de postales y vistas para el turismo, la relación entre proyectos científicos y fotografía, y otros aspectos.

Whose Job Is It? Addressing the Overlap of Speech-Language Pathologists and Occupational Therapists When Caring for People With Dementia

Purpose This article discusses the complexities of caring for individuals with dementia with an interdisciplinary team approach. The overlap and potential conflict between speech-language pathologists (SLPs) and occupational therapists (OTs) are addressed. SLPs and OTs have potentially similar roles when caring for people with dementia, so it can be difficult to decipher whose job it is to implement similar therapy techniques. However, there are ways health care professionals can prepare themselves to work collaboratively and potentially avoid conflict among team members, such as overstepping their professional boundaries and scopes of practice. This article discusses three beneficial techniques for interprofessional collaboration: acquiring sufficient knowledge about the scopes of practice of both SLPs and OTs, developing effective communication skills, and identifying the intentions of each therapeutic technique. Conclusions There is no straightforward or universal answer to the question “Whose job is it?” when considering SLPs and OTs in caring for people with dementia. Deciding whether an SLP or an OT should implement certain aspects of therapy depends on the roles of each professional and how they can benefit the patient. Interdisciplinary team members must work together to identify how their roles interact and overlap. SLPs and OTs must have a solid knowledge base about each other's scopes of practice, develop effective communication skills, and be able to identify the intentions of their therapy. Developing these skills allows SLPs and OTs to work harmoniously in interprofessional teams.

Síndrome de Burnout: Incidência em docentes Universitários no interior do Estado do Tocantins

Teaching is a stressful profession that can lead to Burnout Syndrome (BS), which is characterized by emotional exhaustion and, consequently, physical exhaustion, bringing many losses to the teacher in a personal and professional scope. Thus, the study in question aims to measure the incidence of cases of Burnout Syndrome in a Private Higher Education Institution in the interior of the State of Tocantins. The present study is an exploratory and descriptive research, with qualiquantitative analysis. With the voluntary participation of 23 teachers from the Santa Catarina Educational Institute/ Faculdade Guarai- IESC/FAG. The sample consisted of 66% female teachers and 34% male teachers, aged between 22 and 60 years. Most of the participants, corresponding to 57% (13), obtained scores between 61 to 80 which, according to the parameters of the instrument used for the research, is the moment when the SB starts to settle down, making it necessary to search for professional help to prevent the worsening of symptoms. The study showed that the prevalence of Burnout Syndrome among teachers is relatively high, making it essential to carry out preventive activities and intervention and health promotion actions.

Teacher-student cooperation boosting grammar in the age of Big Data

The article focuses on the new language teaching and learning strategies offered by the use of corpora-based method. It gives an insight into how a corpus-based research incorporated into English grammar classroom activities not only clarifies the debatable aspects of traditional grammar rules but challenges students to launch their own language investigation, enlarging their professional scope and contributing to the development of their general and linguistic competences. The background for the pedagogical experiment was the need for a shift in the teacher–student model of interaction. To prove the benefits of semi-independent student’s research, the article covers four research cases performed by 3rd year students at Moscow State Linguistic University under the guidance of their English grammar lecturers. While working at their respective tasks, the students tried their hand at a proper piece of scientific study and mastered their skills at a new research instrument. Corpus data obtained, they worked in cooperation with their lecturers to arrive at conclusions reviving textbook materials. Thus, the rules and tendencies verified were no longer offered to the class as ready-made answers. The results of the experiment foreground the positive effect of students’ getting access to novel technologies transforming the traditional roles assigned in class.

Role of Information Professionals in Disseminating Knowledge to User Community in 21st Century

The paper deals with introduction to various forms of Information Technology tools and its uses for the information professionals in continue developing IT era. What is the need and importance of IT in the library field? This primary question rises in mind to discuss this IT tools in library field for further opportunities. Provided skills required for information professionals, followed by scope of information professionals in this changing IT era. At the end, it is having strengths, weaknesses and recommendations for the development of Information Professionals in IT era. Digital Libraries are collections of e-books and other information e-resources gathered for the purposes of reading, study, and reference. Historically, libraries have served as places. Libraries preserve knowledge so that none is lost, organize knowledge so that none is wasted, and make knowledge available so that no one need deprive in this information age. Library services have brought many changes to library operations by making access to knowledge more convenient to user.

Aritmética para o ensino comercial: um estudo a partir de manuais escolares

At the beginning of the 19th century, with the arrival of the Royal family in Brazil, D. Joao VI saw the need to encourage the emergence of an environment conducive to the formation of an elite capable of providing the administrative staff of the new seat of the imperial government and train professionals. To this end, different institutions were created for public administration, such as Banco do Brasil and for education such as military academies, aimed at higher education. In addition to the primary education that worked in “reading, writing and counting” classes and secondary education classes, there were also other classes in Brazil for professional education, such as arts and crafts courses and classes for men who knew how to read, write and calculate, in order to qualify traders in the main commercial plazas in the country. Created in the similarity of the Lisbon class, the Aula de Comercio began to operate in Brazil from 1809 under the jurisdiction of the Junta de Comercio, Agricultura, Fabricas e Navegacao. Commerce classes were created in Rio de Janeiro, Salvador and Recife. Regarding the contents studied, topics of Mathematics, geography, bookkeeping and political economy were present. The main reference for the teaching of mathematics was Bezout's book Elementos de Arithmetica, used in Portugal and Brazil. However, other books began to be written, especially after the 1846 reform. This paper aims to discuss the contents of Arithmetic present in didactic manuals for the instruction of traders who circulated in Rio de Janeiro in the first half of the 19th century. There are two commercial Arithmetic books that circulated at the time, namely Tratado de Arithmetica Commercial by Paulo Perestrello da Câmara and Arithmetica Elementar Commercial de Joao Guilherme Kottinger by Joao Guilherme Kottinger, published respectively in 1846 and 1847, after the reforms in Aula de Comercio in Rio de Janeiro. The knowledge of the contents proposed in the didactic works highlighted in this work, helped to understand the role of Arithmetic in the scope of training of trade professionals in the early 19th century and the use of this knowledge in the practice of traders. We found that many of the contents exposed in the works of Artithmetic have similarities with the commercial Arithmetics published since the Middle Ages. What is perceived is that the contents of these works are closer to the practical contents necessary for commerce than to teaching from Bezout's book. Examples of these contents are simple and compound interest; discounts and rebates; company and league rules; calculation of annuities and amortization; national and foreign weights and measures; exchange rates among others. The rules presented seek to cover the entire system that involves a negotiation: the organization of the company and how profits and dividends are managed in a company; in which currency the commodity is traded; interest or discounts on products; what are the conditions for trading to yield more profit and less loss; the forms of guarantee for the goods to reach their destination, the price to be charged for transportation, among other aspects. Thus, it is expected that, from the study of school manuals, there will be a greater approximation from the historical point of view about the knowledge of Arithmetic and the school culture present in the Commercial Classes, during the first decades of the 19th century.

Anesthesiologists-reanimatologists of Russia: a professional portrait of the community. A survey

Introduction. In different countries, the number, training, field of activity and social status of anesthesiologists vary greatly, as well as the exact professional scope of the specialty. To develop work plans and develop the professional community, the Federation of Anesthesiologists and Resuscitators of Russia conducted a questionnaire survey on the actual situation of the professional activities of anesthesiologists and resuscitators. Objectives. To characterize the professional component of the sociological portrait of the Russian doctor-anesthesiologist-resuscitator based on the results of a mass survey. Materials and methods. The questionnaire survey (paper forms and online questionnaires) was carried out in 83 regions of Russia; 3108 anesthesiologists and resuscitators participated in the study. Results. The main type of professional activity is: practical work — 96.3 %, teaching — 2.8 %, scientific activity — 0.9 %. It was found that 60 % of the survey participants devote all their working time to practical work, 71.3 % and 74 % of the respondents are not at all engaged in teaching and scientific work, respectively. The positions of respondents, their job responsibilities, categories of organizations, length of service and qualification categories of doctors, self-assessment of the level of professional skill, and ways of improving their qualifications were analyzed. Satisfaction with various aspects of their work, reasons for dissatisfaction with their work, issues of social protection, the desire to change jobs or the nature of work were also assessed. Conclusions. The sample of the survey is skewed, uniting specialists with a high status in the profession and young active colleagues. The need for continuing medical education is not yet sufficiently met. Information about professional vacancies on the website of the Federation of Anesthesiologists and Resuscitators may be a popular information resource.

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The article notes that nowadays the effectiveness of mastering English, which has long been the language of international communication and interaction for servicemen, is becoming essential. It is noted that there exist unresolved didactic problems reducing the quality of organizational and pedagogic tasks which emerge in the course of training. It is stated that in modern military aviation practice military pilots� professional activity is to a great extent characterized by their communicative competence which includes the following components: language competence (ability to communicate in all language aspects); competence of interaction (ability to use language to express communicative intention in an official situation of communication); socio-cultural competence (ability to build intercultural communication with foreign colleagues from other countries); compensatory competence (ability to successfully solve a difficult situation which might occur during flights). The article suggests the most appropriate methods of teaching and training future UAS crew members considering the specificity of goals and content of �English for Special Purposes� as a curriculum subject. Alongside with traditional methods, active teaching/learning methods such as problem-based learning tasks, analysis and solving of specific situations, role-playing games, variety of interactive exercises simulating near-real situations of professional scope are viewed as those of particular importance and efficiency. The main features of problem-based learning are determined: strengthening the focus on the personality of a cadet; expanding opportunities for interaction between a teacher and a cadet in the learning environment; development of cadets� intellectual mobility; increasing opportunities for creativity through independent work with a large number of databases offered by the teacher and present on the Internet; personalization of training through the creation of research projects featuring problematic nature; widespread access to new generation mobile devices, equipment and aircraft. The successive steps of designing a training course in �English for Special Purposes� for future UAS operators in a higher military educational institution are determined by the teacher. Key words: professional training, future UAS operators, English for Special Purposes, methods of problem-based learning.

Sialorrhoea Management Practices in Residential Older Adults Care Settings: A Qualitative Study.

The aim of this research was to explore both older adults' and health care professionals' experience and viewsof sialorrhoea management practices in older adult residential care settings. Sialorrhoea is quite a bothersome symptom among patients with certain neurological conditions. The complexity of sialorrhoea and its complications can be quite challenging for health care professionals. In the management of sialorrhoea, a multidisciplinary approach is proposed as an effective way of sialorrhoea management. Thematic analysis of collected data via semi-structured qualitative interviews with five focus groups involving 28 multidisciplinary health care members and 1 patient. The older adult and multidisciplinary health care professionals' view of the management of sialorrhoea in residential care settings were established under three main themes: 1) 'Sialorrhoea compromising patient's dignity', 2) 'Ad hoc local management' and 3) 'Further integration of care required'. At present, there have been no comprehensive multidisciplinary sialorrhoea management strategies to meet the various needs of older adults with sialorrhoea. It is important to minimize the negative impact of sialorrhoea on the patients. The recognition of issues associated with sialorrhoea provides constructive scope for the health care professionals to further investigate and develop more effective integrated sialorrhoea care protocols.

Undergraduate Rehabilitation Accreditation as a Tool in the Social Justice Movement

Accreditation of undergraduate rehabilitation education (URE) programs is a tool to further the cause of social justice. In addition to supporting this statement, this article explores the relationship between URE, accreditation curriculum, and the training of graduates to facilitate justice for all members of society. The social justice struggle for accreditation equity for URE is reviewed, as well as continued threats to accreditation, and the need for consistent professional identity and nomenclature. The new accreditation curriculum standards and their attention to social justice concepts is discussed. Accreditation advantages and disadvantages as they relate to justice are offered. Advantages include the strength of consistency of curriculum, while disadvantages involve leaning toward homogenization of the course of study, and a threat of return to a paternalistic view of consumers. In addition, financial challenges presented by the pandemic to URE programs is discussed, along with a strategy to address those issues. An analysis of advantages and disadvantages to accreditation as it relates to social justice and consumers reveals that benefits far outweigh potential issues. Further, short-term and long-term strategies to address threats to accreditation, challenges to consistent names for the profession, its graduates and professional scope, and a stratagem to address nomenclature is offered. Finally, strategies to strengthen the new curriculum to reflect current day understanding of social justice are presented. The country has awakened to social justice issues, and is time that intentional curriculum, driven by accreditation, trains graduates to become social justice advocates and allies.

Punjabi Depression Inventory: A culturally sensitive measure for Punjabi-speaking migrants residing in the UK

Background/aims:There is a lack of empirical research investigating the impact of culture on depressive symptoms within Punjabi-speaking individuals who reside in the UK, but originally migrated here from India. This study aims to develop and validate a new cultural measure of depression known as the Punjabi Depression Inventory (PDI). Therefore, the PDI is intrinsically linked to the Punjabi culture and language. The PDI is used to detect depression in Punjabi-speaking individuals which may be triggered as a result of their cultural experiences.Method:In developing the new PDI measure, 191 participants were recruited to complete the questionnaire, which was analysed using Principle Components Analysis (PCA).Results:Four subscales emerged from this data reduction analysis: (i) deflated; (ii) somatic; (iii) religion; and (iv) crying. On the whole, the early developments of the PDI demonstrated good factor structure and internal consistency for each of the four subscales.Discussion:The PDI could possibly be used as an aid to provide training to help mental health professionals and to enhance their cultural knowledge of working with this class of individuals. Furthermore, the emerging PDI measure may introduce an interesting new scope for mental health professionals to broaden their methods of assessment, formulation and treatment plans. This includes the introduction of a new cultural assessment which can be utilised to identify, and specifically target, cultural depression experienced by such a cohort.

Ethical Considerations for Short-Term Global Health Projects.

Various types of health professional volunteers from high-income nations are increasingly engaged in short-term global health projects in low- and middle-income countries. The goal of global health projects is to improve health for all people and address health inequities. Short-term projects lasting days to months can create challenges for volunteers and hosts. Despite attempting to do good, volunteer efforts may unwittingly cause harm to host organizations by planning projects without consideration for the local infrastructure, the community, and the health care staff. Although well-intentioned and often beneficial, volunteer efforts can fail to provide adequate follow-up or may disrupt or override local health efforts. In some low-resource settings, dire health needs and lack of supervision may result in volunteers practicing beyond their professional scope. Recently published guidelines, competencies, and position statements have addressed ethical behaviors for short-term global health experiences. Partnerships that are founded on principles of justice and autonomy provide an avenue for mutual collaboration. Short-term global health projects that focus on host needs are likely to strengthen local capacity to improve health outcomes. This article reviews guidelines for short-term global health experiences and addresses the ethical principles for planning effective projects.

An Ethics-based Approach to Global Health Research Part 2: Strategies for Overcoming Logistic and Implementation Challenges.

With the growth of global pharmacy partnerships and collaborative research, particularly between high-income countries and low- or middle-income countries, it is necessary to establish best practices for fair and ethical collaboration and research. There is a gap in the pharmacy literature in this regard. Through this commentary, authors will present a pathway for future global health researchers including generating ideas based on mutual needs of the partnership and the community; exploring the importance of regulations including the need to conduct research and partnership projects within the confines of each participant's professional scope of practice, expertise, and licensure; describing the need to develop agreements and the components that should be included in such an agreement; discussing ethical guidelines for research planning, obtaining ethical approval, and planning for adverse events; and illustrating ethical considerations for research implementation with considerations around consent, data collection, linking patients to care after the completion of the study, and dissemination. Global examples, with a pharmacy-specific approach where applicable, within each section highlight the importance of discussion and action around ethics and equity when pursuing collaborative research, recognizing that many of these situations involve difficult decisions.

Prevention, Health Promotion, and Social Work: Aligning Health and Human Service Systems Through a Workforce for Health

The seminal Consensus Study by the National Academies of Science, Engineering, and Medicine released in September 2019 describes the benefits of integrating health and social care service delivery, underscoring the central role of social determinants of health (SDOH) in health outcomes. Although the report's focus on the integration of health and social care contributes a much needed perspective to the national discourse on SDOH and offers a useful framework for organizing service delivery activities, the omission of prevention and health promotion throughout the report is a substantial limitation.We call for increased attention to and investment in prevention and health promotion in the proposed 5As framework. We contend that effectively addressing SDOH and improving alignment between health and social systems require reconceptualization of the traditional health care workforce and renewed state and national advocacy efforts.A paradigm shift encompassing a broader "workforce for health" that is well trained in prevention, health promotion, and advocacy is critical to addressing SDOH, improving population health outcomes, and achieving health equity. Given their professional mission, training, expertise, and scope of practice, social workers are well positioned to lead this effort.

Between a rock and a hard place: Registered nurses' accounts of their work situation in cancer care in Swedish acute care hospitals.

Hospital organizational features related to registered nurses' (RNs') practice environment are often studied using quantitative measures. These are however unable to capture nuances of experiences of the practice environment from the perspective of individual RNs. The aim of this study is therefore to investigate individual RNs' experiences of their work situation in cancer care in Swedish acute care hospitals. This study is based on a qualitative framework analysis of data derived from an open-ended question by 200 RNs working in specialized or general cancer care hospital units, who responded to the Swedish RN4CAST survey on nurse work environment. Antonovsky's salutogenic concepts "meaningfulness", "comprehensibility", and "manageability" were applied post-analysis to support interpretation of results. RNs describe a tension between expectations to uphold safe, high quality care, and working in an environment where they are unable to influence conditions for care delivery. A lacking sense of agency, on individual and collective levels, points to organizational factors impeding RNs' use of their competence in clinical decision-making and in governing practice within their professional scope. RNs in this study appear to experience work situations which, while often described as meaningful, generally appear neither comprehensible nor manageable. The lack of an individual and collective sense of agency found here could potentially erode RNs' sense of meaningfulness and readiness to invest in their work.

Oncology Nursing Considerations in a Clinical Trials Environment.

To provide non-research-trained oncology nurses with targeted information they need to know when caring for research participants on clinical trials. Professional scopes and standards, published literature, and governmental websites. To optimize the safe care of research participants enrolled in cancer clinical trials, oncology nurses must have knowledge of the study team composition, protocol navigation, grading of adverse events, patient education, and communication with clinical research nurses and study teams. Oncology nurses are integral to the success of clinical trials and the development of new therapies for cancer patients.

Exploring glocalization in the construction and implementation of global curricula.

11020 Background: Despite proposed advantages of global oncology curricular harmonization including physician mobility and improving the quality of care the challenges and unintended consequences require greater study. The aim of this study was to problematize the concept and implementation of global oncology curricula and their relationship to local contexts of power and culture. Methods: Fourteen international participants involved in the development and implementation of global oncology curricula completed in-depth, one-on-one semi-structured interviews lasting 40-60 minutes. Snowball sampling was employed. The participant sample was representative of different geographic regions, genders and professional scopes of practice to ensure diverse perspectives were sought. Through iterative analyses, using an abductive approach, the study team discussed and reviewed the data and made revisions through collaborative analysis to enhance comprehensiveness and to improve credibility. In the final analysis the meaning and implication of the themes were discussed yielding a conceptual analysis. Results: Our data have articulated 5 key challenges for global curricula including 1) Ambiguous or conflicting perspectives on the purpose and scope of Global Oncology Curricula 2) Insufficient representation of diverse perspectives and realities in the creation of the final curricula 3) A rigid conceptualization of competency requirements 4) A mismatch between the curricular requirements and local context and 5) The influence of power relationships and decision makers. Leveraging the strengths of diversity including fostering representation, addressing power differentials and factoring local contexts may be an approach to mitigating these challenges. Conclusions: Global oncology curricula may serve important advocacy roles within the healthcare system. Leveraging diversity may positively impact the common challenges in the construction and implementation of global oncology curricula.

Prospect of Tele-Pharmacists in COVID-19 Pandemic Situation in Bangladesh

Telemedicine and telehealth technologies are especially effective during epidemic outbreaks, when health authorities recommend implementing social distance systems. Currently, coronavirus COVID-19 has affected 210 countries around the world, killed more than 240,000 and infected more than 3.4 million, according to worldometer, 03 May, 2020. Home-care is especially important in these situations because hospitals are not seemingly safe during pandemic outbreaks. Also, the chance to get out of the home during the lockdown period is limited. Telephone-based measures improve efficiency by linking appropriate information and feedback. It can also help provide education at distance on various health issues and topics. In addition to increasing access to healthcare, telemedicine is a fruitful and proactive way to provide a variety of benefits to patients seeking healthcare; diagnose and monitor critical and chronic health conditions; improve healthcare quality and reduce costs. The article reveals scope of pharmacy professionals in telemedicine sector during epidemic outbreaks.

Bases para a Reforma da Atenção Primária à Saúde no Brasil em 2019: mudanças estruturantes após 25 anos do Programa de Saúde da Família

O ano de 2019 marcou a estruturação das bases para uma profunda reforma na Atenção Primária à Saúde (APS) do Brasil. Os desafios enfrentados através dessa reforma foram a falta de priorização política real da APS, o financiamento insuficiente da APS e focado na estrutura de serviços, os obstáculos ao acesso de primeiro contato, a escassez de profissionais qualificados, a necessidade de maior informatização da APS e a ausência de integração de dados clínicos, a fragilidade clínica e necessidade de ampliação do escopo profissional e a falta de informação de qualidade para tomada de decisão clínica e gerencial. Com ações direcionadas a cada um desses desafios, a Secretaria de Atenção Primária à Saúde do Ministério da Saúde criou estratégias sistêmicas e integradas entre si que representam mudanças estruturantes e investimentos em governança clínica para transformar a APS brasileira, garantindo mais e melhor saúde para a população, com mecanismos transparentes e técnicos para seu financiamento, organização, oferta, monitoramento e avaliação.