Tacit nursing knowledge: an untapped resource or a methodological headache?*

Nursing education in the United Kingdom currently draws heavily upon Schon's concept of the reflective practitioner, and Benner's concept of the expert It is claimed that experienced practitioners are unable to articulate all they know, and that their knowledge is of a qualitatively different type from that learned by beginners Schön states that professional education gives privileged status to systematic, preferably scientific, knowledge, that technical knowledge drives out the artistry and competence of skilful practice, and that knowing that takes precedence over knowing how In the first part of this paper, various writers on the subject of expert, tacit knowledge are discussed Second, the paper examines the implications of expert knowledge for nursing research Certainly it may be considered a methodological headache, since if expert knowledge is tacit it cannot be researched by exclusively verbal methods such as questionnaires; open-ended discussion may be appropriate, or perhaps participant observation Nor will the findings be neat and easily analysed But tacit knowledge is also an untapped resource for co-operative enquiry between researcher and practitioner, and nursing research has an important role in enhancing the knowledge creation capacity of practitioners     

Uninsured children: an untapped revenue source?

Simple procedures and staff changes can yield new benefits to your department and hospital's bottom line. Simply handing out application forms can increase child enrollment by approximately 14%. Hiring a new, dedicated worker to enroll children will pay for itself many times over. Once children are enrolled, financial benefits grow over time with each return visit to your ED.     

Archival fine-needle aspiration cytopathology (FNAC) samples: untapped resource for clinical molecular profiling

Microarray technologies provide high-resolution maps of chromosome imbalances and epigenomic aberrations in the cancer cell genome. Such assays are often sensitive to sample DNA integrity, voiding the utility of many archival pathology specimens and necessitating the special handling of prospective clinical specimens. We have identified the remarkable preservation of higher-molecular weight DNA in archival fine-needle aspiration cytopathology specimens from patients greater than 10 years of age. We further demonstrate the outstanding technical performance of 57 fine-needle aspiration cytopathology samples for aberration detection on high-resolution comparative genomic hybridization array, DNA methylation, and single nucleotide polymorphism genotyping platforms. Forty-four of 46 malignant aspirates in this study manifested unequivocal genomic aberrations. Importantly, matched Papanicolaou and Diff-Quik fine-needle aspiration cytopathology samples showed critical differences in DNA preservation and DNA integrity. Overall, this study identifies a largely untapped reserve of human pathology specimens for molecular profiling studies, with ramifications for the prospective collection of clinical biospecimens.     

An untapped resource in the nursing workforce: Licensed practical nurses who transition to become registered nurses

Background

A more diverse registered nurse (RN) workforce is needed to provide health care in North Carolina (NC) and nationally. Studies describing licensed practical nurse (LPN) career transitions to RNs are lacking.

Budgets: an underused resource

Though budgeting is an activity that management readily participates in, the budget often ends up being underused. The author discusses how budgeting activities can be used in revenue allocation, program implementation, planning, coordination, profitability, designation of responsibility, and measurement reviews.     

Informal interprofessional learning: an untapped opportunity for learning and change within the workplace

Abstract

In this paper, we explore the educational and workplace learning literature to identify the potential and significance for informal interprofessional learning within the workplace. We also examine theoretical perspectives informing informal workplace interprofessional learning. Despite numerous studies focusing on formal interprofessional education programs, we suggest that informal interprofessional learning opportunities are currently unrealized. We highlight reasons for a focus on learning within the workplace and the potential benefits within an interprofessional context.     

Predictors of Adherence to Triptans: Factors of Sustained vs Lapsed Users

Objective.— The present study was conducted to identify factors that predict adherence to triptans by migraine patients. Background.— Triptans have demonstrated efficacy for acute migraine yet many migraine sufferers discontinue their use. Design and Methods.— A survey study was conducted using 785 subjects (390 health maintenance organizations [HMO] and 395 non‐HMO). Of those, 586 were sustained users of triptans (defined by at least 1 refill within the past year), and 199 were classified as lapsed users (ie, individuals who had 0 refills in the past year). Groups were compared on a variety of measures including a comprehensive Migraine Survey that included items related to efficacy and adverse events associated with the patient's current medication, as well as the Headache Impact Test (HIT)‐6 and Migraine Disability Assessment Score (MIDAS) questionnaires. Data were analyzed with multivariate analysis of variance and stepwise multiple regression. Results.— Sustained users of triptans were significantly more satisfied with their medication, confident in the medication's ability to control headache, and reported control of migraine with fewer doses of medication. Sustained users also switched triptans products significantly less often than lapsed users, and reported greater benefit from triptan intervention in restoring normal daily functions, including improved cognitive ability, compared with lapsed users' ratings of their nontriptan medication. More lapsed users than sustained users reported adverse events associated with past triptan use. Results from multiple and logistic regression analyses correctly classified 95% of sustained users and identified the most significant predictors for sustained use as: satisfaction and belief in medication, reliability of response, effectiveness in rapidly restoring normal levels of productivity, and fewer doses of medication for resolving an attack. The HIT‐6 and MIDAS distinguished between sustained and lapsed triptan users on days unable to do household work and missed family and social events. Conclusions.— Predictors of adherence to triptans included satisfaction and confidence in triptans' ability to stop the migraine and associated symptoms and to return the individual to normal functioning. The findings suggest that lapsed users may not be receiving optimal treatment, and that if their past response to triptans was a consequence of inadequate education, they may benefit from additional education on proper use of triptans.     

无偿献血者免疫细胞资源库专家共识

<正>近年来,随着细胞学、免疫学、分子生物学等技术的快速发展,免疫细胞治疗作为1种安全有效的治疗手段应用于临床,在肿瘤综合治疗中的作用尤为突出,成为继手术、化疗和放疗之后的第4大治疗肿瘤较为有效方法。目前,用于治疗的免疫细胞主要来自于患者自体,这使得免疫细胞的质量和数量成为免疫细胞治疗产业化的瓶颈。无偿献血者是1个健康志愿者群体,据报道2017年我国无偿献血人数达1 459万人(次),献血量达(200—400)m L/人(次)。按照当前安全输血相关技术要求,在红细胞、     

北京地区全血献血者铁蛋白调查分析

目的 对北京地区全血献血者铁蛋白检测,分析与铁蛋白低值异常相关的影响因素,为全血献血者科学补铁提供依据.方法 以2018年3-6月北京地区27 071名全血献血者为研究对象,进行铁蛋白检测.使用Logis-tics 回归分析影响铁蛋白低值异常的献血者相关信息,确定最容易出现铁蛋白低值异常的全血献血者类型.结果 北京地区...