“Power” is a concept that has been discussed by nurse scholars and leaders within the nursing literature. The literature surrounding power concurs that power is necessary within the practice of nursing so that nurses are able to support patients and move the profession of nursing forward. There is a scarcity of research, however, regarding nurses’ perception of power within their own practices. Advanced practice nurses (APNs) are in positions in which they apply graduate education, specialized knowledge, and expertise to improve health care outcomes. Therefore, a qualitative study using an interpretive hermeneutic phenomenological approach was undertaken to discover APNs’ lived experience of power within their practices. In-depth, tape-recorded interviews were conducted with eight APNs from a large tertiary care facility. All of the participants agreed to a follow-up interview to review the summary of the study results. van Manen’s (1990) approach was used to analyze the data by subjecting the transcripts to a thematic analysis and reflective process. The overarching theme of the interviews is “building to make a difference” and the APNs’ perceived that this happened by “building on,” building with,” and “building for.” The APNs built on their knowledge and expertise, built with others in relationships and built for the capacity to make a difference. Power was a part of the everyday practices of these APNs and was described as “soft power,” a power that they shared to bring about change for the better. This shared power was reflected back on them resulting in increased power within their practices, a process described by the APNs as power creep.

Dans l’exercice de leur profession les pilotes doivent fréquemment faire face à des situations soudaines et inattendues, souvent potentiellement dangereuses. Ils sont formés pour les traiter efficacement mais cependant la brièveté du temps disponible avant que la situation ne dégénère, de l’ordre de quelques secondes, au plus la minute, fait que parfois la séquence cognitive perception-diagnostic-décision-action, peut être menée de façon incorrecte sous stress et aboutir à un incident grave ou même à un accident.A partir de l’analyse des comportements cognitifs élémentaires en situation critique dans cinq cas d’incidents et d’accidents, on arrive à déceler des dénominateurs communs aux réactions des pilotes, permettant l’explication des échecs constatés et l’établissement de recommandations. Le rôle primordial sous stress d’une fonction cognitive particulière associée à la mémoire à court terme est mis en lumière.Pour effectuer cette analyse il a été nécessaire de définir une modélisation dynamique du comportement cognitif des pilotes, où le facteur temps est explicité, permettant son étude dans des séquences très brèves de quelques secondes. Cette modélisation peut aussi s’appliquer à d’autres cas que ceux générant des accidents, par exemple à l’étude et à la définition des systèmes nécessitant une interface homme-système.La complexité et la particularité des actions opérationnelles dans des séquences très rapides où elles se combinent, a mené naturellement à effectuer les analyses en utilisant l’expertise de pilotes, suivant une méthode autorisant la validation des hypothèses retenues. / During the exercise of their profession, frequently pilots have to face sudden, unexpected, and often potentially dangerous, situations. They are trained to deal with these effectively, but the very short length of time available before the situation degenerates – in the order of a few seconds, a minute at most – means that the cognitive sequence of perception-diagnosis-decision-action can sometimes be carried out incorrectly due to stress and lead to a serious incident or even to an accident.An analysis of basic cognitive behaviour patterns during a critical situation in five cases of incidents and accidents, reveals common denominators within pilots’ reactions which make it possible to explain the failures observed and establish recommendations. The crucial role under stress played by a specific cognitive function associated with short-term memory is highlighted. In order to carry out this analysis it was necessary to create a dynamic model of the cognitive behaviour of pilots, bringing out the time factor, so as to make it possible to study very short sequences of a few seconds. This model can also be applied to cases other than those generating accidents, for instance to the studying and defining of systems requiring human-machine interface.The complexity and specificity of operational actions when combined into very rapid sequences led naturally to carrying out analyses making use of pilots’ expertise, according to a method which enabled validation of the hypotheses employed.

Ein protektives Ileostoma reduziert die schweren klinischen Folgen einer Anastomoseninsuffizienz nach Darmresektion wie Abszess, Sepsis und Tod. Die Rückverlagerung des Ileostomas ist selbst mit einer nennenswerten Morbiditäts- (3-40%) und Mortalitätsrate (0-4%) verknüpft. Dennoch gilt die ISRV als Ausbildungseingriff junger chirurgischer Weiterbildungsassistenten. In dieser Arbeit wurden alle erwachsene Patienten (n = 558), die eine ISRV im Zeitraum zwischen September 2008 und Januar 2017 erhalten haben, anhand einer prospektiv gesammelten Datenbank ermittelt und retrospektiv anhand der Patientenakten ausgewertet. Dabei wurden neben den Basis-Charakteristika der Patienten (Alter, Krankenversicherung, ASA, BMI, Raucheranamnese, Immunsuppression) und operativen Daten (Verschlusstechnik, Operationsdauer, Rate der segmentalen Darmresektionen, Adhäsiolyse) erfasst. Die postoperativen Komplikationsraten, gemessen anhand der Clavien- Dindo-Klassifikation, und die Länge des postoperativen Krankenhausaufenthaltes, wurden in Bezug auf den Ausbildungsstand des Operateurs analysiert. In der Facharzt-Kohorte (355 Patienten) zeigte sich eine signifikant kürzere Operationsdauer. Unter Berücksichtigung möglicher Störfaktoren zeigte sich kein signifikanter Unterschied zwischen beiden Gruppen bezüglich Major- Komplikationen. Die Rate an Anastomoseninsuffizienzen betrug 3% und die Gesamt-Morbiditätsrate 11%. Da sich nur die Operationsdauer abhängig vom Ausbildungsstand des Chirurgen unterschiedlich zeigte, kann die ISRV als guter Ausbildungseingriff für junge chirurgische Assistenten in Weiterbildung gesehen werden. / Defunctioning ileostomies reduce the consequences of distal anastomotic leakage following bowel resections. Ileostomy reversal in itself, however, is associated with appreciable morbidity (3–40%) and mortality (0–4%). Despite being a common teaching procedure, there is limited information on the impact of surgical proficiency levels on postoperative outcome. Methods Adult patients undergoing closure of a defunctioning ileostomy between September 2008 and January 2017 were identified from a surgical administrative database that was collected prospectively (n = 558). Baseline characteristics (age, ASA score, BMI, health care insurance coverage) and closure techniques were recorded. Operation time, rate of bowel resection, postoperative complications ranked by Clavien-Dindo classification and length of stay were analysed with respect to proficiency levels (residents vs. consultants). Two hundred three ileostomy reversals were performed by residents; 355 ileostomies were closed by consultants. Operation time was considerably shorter in the consultant group (p < 0.001). Major postoperative complication rates however were not different among the groups when adjusted for possible confounders (p = 0.948). The rate of anastomotic leakage was 3% and the overall major morbidity rate was 11%. Operation time rather than surgical outcome and overall morbidity were affected by surgical proficiency levels. Therefore, ileostomy reversal can be considered an appropriate teaching operation for young general surgery trainees.

Lorsqu’un mouvement est répété à plusieurs reprises, certaines différences subtiles peuvent être observées entre les répétitions de ce mouvement. Cette variabilité du mouvement et ses implications ont reçu beaucoup d’attention dans le domaine de la biomécanique, mais moins dans le domaine de la performance pianistique. En se basant sur les connaissances acquises dans le domaine de la biomécanique, cette revue exploratoire avait pour but de rassembler les informations recueillies jusqu’à présent quant à la variabilité de la performance pianistique en un seul document afin d’élucider certains enjeux : (i) quels outils techniques et méthodes d’analyse ont été employés afin de mesurer la performance pianistique et sa variabilité ; (ii) quelle est l’influence de l’expertise sur cette variabilité et ; (iii) combien d’essais devraient être employés dans un protocole de recherche afin d’obtenir une évaluation fiable de la performance pianistique. À l’aide des données récoltées, cette revue offre plusieurs recommandations aux chercheurs tenant à prendre en compte l’impact de la variabilité du mouvement et identifie les lacunes dans notre compréhension de la variabilité afin de proposer certaines avenues de recherche futures. Cette thèse démontre l’importance de conduire plus d’enquêtes sur la variabilité de la performance pianistique qui pourront contribuer à notre compréhension du système neuromusculaire et des processus cognitifs qui gouvernent la performance, ainsi qu’à l’implémentation de protocoles de recherche plus robustes.

This study looked at how individuals choose whom to work with when a task necessitates collaboration. Prior research done on collaborative environments as well as outcomes of collaboration suggests that who you collaborate with will depend on two primary factors: the individuals from which you have to choose and the circumstances surrounding the task. In the proposed study, these factors will be explored. This thesis identified the lack of literature on informal collaboration, addressing the gap in the literature regarding processes that individuals use when choosing collaborators. This research focused on the influencing factors of similarity and expertise involved in this decision processes. Furthermore, this study aimed to understand how individuals choose collaborators under differing conditions of difficulty, novelty, and interdependence necessitated by the task.

66 The credibility of testimony in criminal proceedings Abstract This thesis focuses on assessing the credibility of testimony in criminal proceedings with a closer focus on assessing the credibility of testimony by investigative, prosecuting and adjudicating bodies. For this purpose, in the first part of the thesis, the author defines the term "testimony", describes its role in the criminal proceeding and distinguishes its role in the criminal proceeding as opposed to that in the civil proceeding. Then, the author defines the term "interrogation" and identifies institutes of criminal law applied in the course of criminal proceedings, by which the testimony is obtained. In the following, third chapter, the author focuses on the explanation of the concept of credibility of testimony, and differentiates its various types. In the fourth and fifth chapter, the author identifies, describes and evaluates possible ways of assesing the credibility of testimony by investigative, prosecuting and adjudicating bodies in context of current case law. Special attention is paid to expertises, their assignment, interpretation and evaluation. The author analyzed current legislation and case law, and the options they offer for assessing the credibility. The formulated hypotheses have been confirmed. Current legislation...

Computer forensics is an ever-growing technological field of complexity and depth. Individuals must strive to keep learning and growing their skills as they help combat cybercrime throughout the world. This study attempts to establish a method of evaluating conceptual expertise in computer forensics to help indicate whether or not an individual understands the five basic phases of computer forensics: preparation, seizure of evidence, acquisition of data, analysis of data, and reporting the findings of the analysis. A survey was presented to a university class of 30 students taking a computer forensics course and as well as posted online asking computer forensics professionals to participate in the survey. Results show that novices that were enrolled in a computer forensics course were able to identify the phases of computer forensics more readily than professionals

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This study questions whether expertise plays a role in how mental health clinicians remember case details about their clients. Specifically, are expert clinicians better at teasing apart complex case details than novices? Clinicians’ diagnostic schemas may afford a mechanism for easily retaining and retrieving information about particular cases. American Board of Professional Psychologists certified clinicians acted as our expert participants. Undergraduate students enrolled in general psychology acted as novices. Results indicated experts recalled more information than non-experts for each of three hypothetical case vignettes—simple, complex-coherent, and complex-incoherent. As complexity of the vignettes increased the overall amount of recall increased for the complex-coherent vignette and then decreased for the complex-incoherent vignette for both groups. Experts also exhibited more false recalls of symptom specific details for the complex-incoherent case. This finding is evidence of schema-based knowledge and experts’ tendency to use schemas in an effort to make sense of illogical cases.