Unrestricted Practice Research Articles

Practicing without a diploma, battling for a license: crossroads in the history of the professionalization of dentistry in Colombia

This paper addresses the professionalization of dentistry in Colombia during the first half of the twentieth century. To fully comprehend such a process, we must consider the tensions between the practice of non-certified and certified dentistry. As an outcome of such tensions, dentists began to acquire professional autonomy. We analyze applications for license files to practice dentistry without a degree, some of which were of women. The findings show the informal transfer of knowledge outside formal apprenticeship and the unrestricted practice of dentistry by many non-professionals but "permitted" dentists who faced a centralized and powerful professional bureaucracy.

The Concept and Practice of Wahare among Contemporary Muslims in Nigeria: Are there Correlations with Qur’ān 4:20?

Islam allows restricted polygyny with four wives simultaneously hitherto the common unrestricted practices among the Arabs before the appointment of the Messenger of Allah in their midst. Having an unlimited number of wives was not peculiar to the Arab culture alone, many nations in Africa are known to uphold the same practice. However, on the contact with Islam, every Muslim is required not to have more than four wives, simultaneously. The non-Muslim husband of more than four wives would be legally required to reduce the number of his wives to four upon his conversion to Islam. However, in Africa and in Nigeria in particular, some Muslims exceed the stipulated number and seek justification from the verse 20th of Suratu’n- Nisā and tag the practice as wahare and ‘Istibdāl. Other advocates of the practice twist the interpretation of the particular verse (Q4:3) regarding the permissibility of polygyny in support of the said practice. In view of this background, this paper aims to find out if there are correlations between the practice of wahare and ‘Istibdāl and the verse in question. Interviews, observations and review of literature were implored in this study. It was identified that the two different approaches to the practice of wahare /’Istibdāl are not supported by the verse 20th of Suratu’n- Nisā.

Eighty-two per cent of male professional football (soccer) players return to play at the previous level two seasons after Achilles tendon rupture treated with surgical repair

ObjectiveTo evaluate the time to return to playing following acute Achilles tendon rupture (ATR) and surgical repair in professional male football (soccer) players.MethodsProfessional male football (soccer) players who sustained an...

Electronic cigarette use in China: Awareness, prevalence and regulation.

INTRODUCTIONE-cigarettes were invented in China, and most of the world’s e-cigarettes have been produced in China. However, awareness and use of e-cigarettes in China are lower than in Europe and America. Against the backdrop of the increasing use of e-cigarettes, the supervision of e-cigarettes in China has been almost non-existent.METHODSA literature search was carried out in five popular Chinese and English databases. These databases were PubMed, EMBASE, the Cochrane Library, China national knowledge infrastructure (CNKI), and Wan-fang database.RESULTSTwenty-one studies were identified, and a comprehensive analysis of e-cigarette awareness ratio was conducted for different regions of China and according to gender, age group, and smoking status. We also examined e-cigarette use and associated risk factors, and the relationship between e-cigarette use and smoking cessation. In 2015, the prevalence of ‘ever use’ and ‘current use’ of e-cigarettes in China were 3.1% and 0.5%, respectively. The review indicates that the awareness ratio of e-cigarettes was about 66% in Hong Kong, whereas the ratio for Tianjin was lower (43.6%). Online sales were the main channel for selling e-cigarettes to 80% of the users. Awareness of e-cigarettes has been increasing in China. Awareness was higher in men compared to women in all age groups. Nevertheless, e-cigarette use in China was lower than in developed countries. E-cigarette users were more likely to try to quit smoking, but the relationship between e-cigarette use and smoking cessation is still unclear. Governance is necessary for e-cigarette use and marketing effort.CONCLUSIONSThis study investigated the awareness and use of e-cigarettes in China and the existing regulations for e-cigarette use and marketing. The lack of regulations for e-cigarette use and the unrestricted practice encourage the increase in adoption of e-cigarettes and misconceptions of the benefits of using e-cigarettes. Hence, it is crucial that the government of China prioritize the establishment and implementation of regulations for e-cigarette use and marketing.

Aesthetic freedom and democratic ethical life: A Hegelian account of the relationship between aesthetics and democratic politics

AbstractThis paper presents a novel Hegelian view of the relationship between aesthetics and democratic politics. My account avoids the drawbacks associated with approaches, such as Rancière's, that reconceive all of the political in aesthetic terms or, like Rockhill's, reduce the aesthetic to art. Instead, I maintain that the aesthetic is best understood as a distinct recognition relationship of individual freedom. My argument proceeds by highlighting shortcomings of Honneth's account of democratic Sittlichkeit and then addressing these impasses by integrating aesthetic freedom into the picture. The first two steps of my argument concern the fact that the form of life outlined by Honneth aspires to be a form of free life, yet his account of democratic Sittlichkeit gives rise to two dimensions of unfreedom. The first problem of unfreedom pertains to the scope of freedom. The relationships of freedom incorporated into Honneth's account fail to turn given social roles into the subject matter of a sufficiently unrestricted practice of freedom. The second problem of freedom concerns conformism. In a final step, I complete my argument that Honneth's account is unsatisfactory and incomplete by showing that aesthetic freedom is socially valid and thus ought to form part of our accounts of democratic ethical life.

Nature and scope of certified nurse-midwifery practice: A workforce study.

To describe the nature and scope of nurse-midwifery practice in Texas and to determine legislative priorities and practice barriers. Across the globe, midwives are the largest group of maternity care providers despite little known about midwifery practice. With a looming shortage of midwives, there is a pressing need to understand midwives' work environment and scope of practice. Mixed methods research utilising prospective descriptive survey and interview. An online survey was administered to nurse-midwives practicing in the state of Texas (N=449) with a subset (n=10) telephone interviewed. Descriptive and inferential statistics and content analysis was performed. The survey was completed by 141 midwives with eight interviewed. Most were older, Caucasian and held a master's degree. A majority worked full-time, were in clinical practice in larger urban areas and were employed by a hospital or physician group. Care was most commonly provided for Hispanic and White women; approximately a quarter could care for greater numbers of patients. Most did not clinically teach midwifery students. Physician practice agreements were believed unnecessary and prescriptive authority requirements restrictive. Legislative issues were typically followed through the professional organisation or social media sites; most felt a lack of competence to influence health policy decisions. While most were satisfied with current clinical practice, a majority planned a change in the next 3 to 5years. An ageing midwifery workforce, not representative of the race/ethnicity of the populations served, is underutilised with practice requirements that limit provision of services. Health policy changes are needed to ensure unrestricted practice. Robust midwifery workforce data are needed as well as a midwifery board which tracks availability and accessibility of midwives. Educators should consider training models promoting long-term service in underserved areas, and development of skills crucial for impacting health policy change.

Operating Room Personnel Viewpoints About Certified Registered Nurse Anesthetists.

The purpose of this project was to explore what attitudes physicians, nurses, and operating room technicians had about working with Certified Registered Nurse Anesthetists (CRNAs) to better understand practice barriers and facilitators. This Q methodology study used a purposive sample of operating room personnel from four institutions in the Midwestern United States. Participants completed a -4 to +4 rank-ordering of their level of agreement with 34 attitude statements representing a wide range of beliefs about nurse anesthetists. Centroid factor analysis with varimax rotation was used to analyze 24 returned Q sorts. Three distinct viewpoints emerged that explained 66% of the variance: favoring unrestricted practice, favoring anesthesiologist supervision, and favoring anesthesiologist practice. Research is needed on how to develop workplace attitudes that support autonomous nurse anesthetist practice and to understand preferences for restricted practice in team members other than physicians.

Federal Trade Commission policy paper promotes unrestricted practice.

Federal Trade Commission policy paper promotes unrestricted practice.

Stages and transitions in medical education around the world: Clarifying structures and terminology

Background: In a world that increasingly serves the international exchange of information on medical training, many students, physicians and educators encounter numerous variations in curricula, degrees, point of licensing and terminology.Aims: The aim of this study was to shed some light for those trying to compare medical training formats across countries.Methods: We surveyed a sample of key informants from 40 countries. Survey questions included: structure of medical education, moment that unrestricted practice is allowed, various options after general medical licensing, nomenclature of degrees granted and relevant terminology related to the medical education system. In addition, we searched the literature for description of country-specific information.Results: Based on the results, we described the six models of current medical training around the world, supplemented with a list of degrees granted after medical school and an explanation of frequently used terminology.Conclusions: The results of this questionnaire study lead to the conclusion that while there are many differences between countries, there appear to be six dominant models. The models vary in structure and length of medical training, point of full registration and degrees that are granted.

Volta ao mundo por ouvir-dizer: redes de informação e a cultura geográfica do Renascimento

Este artigo elucida que, ao privilegiar a observação, a curiosidade e a busca de aprimoramento intelectual, a cultura do Renascimento é um fator determinante na criação do viajante moderno. Outra peculiaridade do período reside na transformação do conhecimento geográfico em foco de interesse estratégico. Mas o segredo oficial, preservado pelas "casas de contratação", passou por um contínuo processo de corrosão. A necessidade das Coroas ibéricas de ratificar a posse sobre os novos territórios coloniais tornava a divulgação tão importante quanto o silêncio. Além disto, a experiência dos Descobrimentos foi assimilada por informantes de segunda-mão e transmitida através de canais diplomáticos e comerciais, numa trama que se ramificou por toda Europa. Tal organismo coletivo e não-oficial, que hoje chamaríamos de "rede", colocou dados relativos à Ásia, África e América à disposição dos cosmógrafos, e constituiu assim o núcleo fundamental da cartografia quinhentista. O artigo tenta mostrar que o fluxo do saber geográfico no período dos Descobrimentos caracterizou-se pela prática quase irrestrita da cópia e pela configuração informal e internacional do seu circuito de consumo.

Effect of Climate Change and Grazing on Populations of Cleistogenes squarrosa in Inner Mongolia Steppe

Most rangelands in northern China are water_limited ecosystems. Even small changes in precipitation amount or season can affect the biological components that maintain nutrient, water and energy movement within and through these ecosystems. Inner Mongolia steppe is generally semi_arid with most of the precipitation coming during the summer from June to August. Land_management practices, such as livestock grazing, are affecting ecosystem structure and function and these activities may accelerate impacts of climate changes. Grazing_related changes to ecosystems become more pronounced as humans shift from nomadic or unrestricted practices of livestock management to practices that focus on human settlement. At the scale of a management unit (e.g., watershed, allotment or paddock), precipitation amounts do not always correlate positively with vegetation productivity. Nutrient availability may strongly influence botanical composition and productivity. In general, spring and summer precipitation favors herbaceous vegetation that is more efficient in extracting water and will favor plants with C 4 (warm_season) vs. C 3 (cool_season) photosynthesis. The northern China steppes have few C 4 plants. Little experimental work is being done in the field to examine the ecological impacts of climate change and grazing and their interactions on C 4 plants in this region. Cleistogenes squarrosa is a C 4 plant. It is a short, perennial bunchgrass with drought tolerance, and tends to occupy medium degradation grassland in Inner Mongolia steppe. Therefore, it is a good indicator to study effect of climate change and grazing on C 4 plants. In order to understand the responses of Cleistogenes squarrosa populations and ecological strategies to climate change and grazing, we monitored the data of climate (precipitation and temperature), C. squarrosa population and its community for 18 years under non_grazing conditions. The grazing (free grazing outside of fence) and non_grazing (fenced) experiment was conducted for 6 years. The nutrient efficiency ratios of the main herbages were evaluated in this study. The experiment was conducted in the Leymus chinensis grassland of the Inner Mongolia Grassland Ecosystem Research Station located at 43°26′_44°08′ N, 116°04′_117°05′ E with elevation about 1 000 m above sea level. The results showed that aboveground biomass and its proportion in the community increased with annual mean temperature, and the regression equation between its aboveground biomass and mean temperature ( t ) and total rainfall ( r ) from April to August was: y=-12.451 1+0.018 7r+0.060 1t 2 ( R 2=0.533,p = 0.003). Generally, grazing significantly reduced plant height and aboveground biomass per bunchgrass, whereas its coverage, density and total aboveground biomass per square meter increased under grazing. Its nutrient efficiency ratios, such as N and S, were higher compared with other dominant species, such as L. chinensis . 100 g C produced required 3.17 g N and 0.31 g S for C. squarrosa , while L. chinensis population requires 4.24 g N and 0.41 g S under grazing. The high nutrient efficiency ratios maybe benefit C. squarrosa populations under competition with other species in the infertile soil.

NPs Declare Commitment to Quality Care and Demand Unrestricted Practice

NPs Declare Commitment to Quality Care and Demand Unrestricted Practice

Attitudes, knowledge, and practices of otolaryngologists treating patients infected with HIV

The AIDS epidemic has become one of the most important public health problems of this century. As the prevalence of HIV infection continues to rise, health care practitioners in all geographic regions can expect greater clinical exposure to patients infected with HIV. We conducted an anonymous survey of all practicing otolaryngologists in Ohio and California to investigate regional differences in attitudes, knowledge, and practices regarding the care of patients infected with HIV. We also examined the data with respect to year of completion of residency training to identify differences in attitudes or practices among otolaryngologists who trained in the era of AIDS (post-1982 graduates) in comparison with their predecessors (pre-1982 graduates). In comparison with Ohio otolaryngologists, California otolaryngologists reported more frequent clinical encounters with HIV-infected patients and displayed significantly better knowledge regarding the otolaryngologic aspects of HIV infection. Californians were more likely to support the right of an HIV-infected physician to maintain an unrestricted practice and would be less likely to disclose their HIV status to their patients and hospital if they were to become infected with HIV. Post-1982 graduates had more frequent encounters with HIV-infected patients than did pre-1982 graduates and demonstrated a better fund of knowledge. Although Californians were more likely than Ohioans to routinely double glove in surgery, the overall double gloving rate was low at 21%. Californians were no more likely than Ohioans to routinely use protective eyewear, water-impervious gowns, or indirect instrument-passing techniques in surgery. No differences were observed in prevalence of protective surgical precautions between pre-1982 and post-1982 graduates. The results of the survey indicate a need for broader acceptance and use of "universal" surgical precautions among otolaryngologists. (OTOLARYNGOL HEAD NECK SURG 1995;113:733-9.)

A retrospective analysis of the cost-effectiveness of dental sealants in a children's health center

A retrospective patient record analysis was conducted to study the cost-effectiveness of dental sealants placed under routine, unrestricted practice condition in a fluoridated community. The 26 dentists who provided care at the clinic over the period of the study used their own clinical judgement to determine sealant placement or alternative treatment. Dental services for 275 patients at a children's dental clinic for low-income families were evaluated. All children had at least 3 years between their first and last dental visit (mean = 5.8 years). A lifetable analysis was conducted to compare the probability of survival (restoration-free tooth years) and costs incurred to first molars of children who did not receive sealants, received any sealants, or received sealants on all first molars. Among the children with sealants, comparisons were also made between sealed and unsealed teeth in children who did and did not have a first molar restoration prior to sealant placement. Costs included the costs of sealants and restorative treatments for these teeth over time. Depending on the conditions under which sealants were placed, cost-savings or improving cost-effectiveness with time were found. A strategy of identifying children with prior restorations and sealing the remaining molars showed cost-savings within 4-6 years. For other comparisons, incremental cost-effectiveness ratios became more favorable over time.