Exercise Tolerance Testing (ETT) is widely accepted as an important diagnostic and prognostic tool and its primary purpose is to assess patients with known or suspected coronary artery disease. Previous studies have focused on concordance between doctors and other supervising personnel in regards to safety outcomes. ETTs are increasingly supervised by nurses now as a result of medical devolvement in this role. This study contributes a new perspective to international literature and focuses on understanding the process of role development for cardiac nurses who supervise ETTs. The overall aim was to gain greater understanding of how cardiac nurses have developed in the role of supervising ETTs and what their process has been. This is a mixed methods study that has utilised both qualitative descriptive techniques and descriptive quantitative data. These data were obtained by individual interviews with ETT nurses and the Clinical Director of Cardiology, and a survey of technicians who work alongside the ETT nurses at a tertiary hospital. Data were also obtained from a national survey of cardiac centres in New Zealand. Both methods were employed to give greater depth to the subject and place local findings in context with national data and international literature. Findings show there have been a number of international and local evolutionary factors contributing to the emergence of the ETT nurse’s role over time. Specific themes emerged from the interviews that describe individual process of role development. Technicians identified that the ETT service has improved as a consequence of having ‘dedicated ETT nurses’. Variability in regards to work place practices, training and assessment were found in the national survey. There is further potential for both increasing the number of nurses practicing as ETT nurses and further expansion of the role, however continued fragmentation, inconsistent service delivery and variation in national standards for practice in New Zealand may be barriers to collective and individual role development.

Yes / Radiographer reporting of plain film radiographs is an established role in the UK. Despite this previous research has demonstrated widespread inconsistencies in implementation, scope and utilisation. A cross-sectional postal survey was undertaken to provide a longitudinal insight into changes in radiographer reporting practice. The sample comprised all individual hospital sites in the UK, Channel Islands and Isle of Man with both a radiology and trauma service A response rate of 63.7% (n = 325/510) was achieved. Reporting radiographers were in place at 179 sites (55.1%) but less likely to be employed at sites with a minor injury unit rather than a full emergency department (χ2 = 71.983; p < 0.001; d.f. = 1). Radiographer utilisation has increased since 2007, although local barriers to implementation and activity were identified. Geographical variation was evident in relation to reporter employment and anatomical scope. A significant association was noted between broader anatomical scope and a wider range of referral sources (χ2 = 34.441; p < 0.001; d.f. = 1). Delayed reporting of radiographs remains the standard service delivery model across the UK. This study confirms the significant contribution that radiographers are making to reporting capacity in the UK, although there continue to be geographical variations, particularly around anatomical scope and referral groups.

No / Accepted definitions and descriptions of advanced practice offer generic ideals for the development of advanced radiographer practitioner roles. However, they fail to specify a development pathway necessary for a clinical practitioner to attain advanced practitioner status and lack of clarity persists around the definition of advanced practice within the context of radiography [Price R. Critical factors influencing the changing scope of practice: the defining periods. Imaging & Oncology 2005;June:6–11.]. This paper will consider the expectations of practitioner and advanced practitioner competencies within the context of radiography practice in the United Kingdom and suggest criteria for an advanced practice development pathway that may be adopted by individual radiographers, or their managers, to assist professional development within any imaging speciality.

Sistemiška vaidmens kūrimo analizė, metodų kūrimas prasidėjo tik XX a. pradžioje. Aktoriaus rengimo mokyklų pradžia laikoma žymiausio aktorinio parengimo pedagogo, žymaus aktoriaus, režisieriaus K. Stanislavskio (1863 m.) sukurta savita sistema, kuri padarė įtaką visai teatro raidai. K. Stanislavskis turėjo daug savo pasekėjų ne tik Rusijoje, bet ir visame pasaulyje. Iš K. Stanislavskio sistemos išsivystė dvi teatro kryptys: 1. Psichologinis teatras (K. Stanislavskis, M.Čechovas, Š. Diulenas). 2. Fizinis teatras. (V. Meyerholdas, J.Grotowski, B.Brecht ir kt.). Šios kryptys turėjo didelę įtaką ir Lietuvos teatro mokyklos raidai. Nuo V. Boguslovskio, A. Sutkaus, A. Olekos-Žilinsko, J. Miltinio iki šių dienų Lietuvos teatro aktoriaus parengimas pakito nedaug, tačiau galima teigti, kad šiuolaikiniame Lietuvos teatre vyrauja režisūrinis teatras, kuriame svarbūs vizualūs ir muzikiniai/ritminiai sprendimai. Tačiau vaidmens kūrimo procesas daugiausiai remiasi psichologinio teatro metodais. Tiek aktoriams, tiek režisieriams svarbu, kad aktorius suvoktų savo uždavinį, suprastų spektaklio visumą, žadintų savyje emocinius išgyvenimus. Kad ir kaip nebepripažintų teatro kūrėjai K. Stanislavskio sistemos, aktoriai iki šios dienos ją laiko universaliausia ir patikimiausia mokykla. Taip pat galima pastebėti, kad režisieriai neieško individualaus metodo ir jo netaiko. Lietuvos aktorius yra išmokytas ir tebemokomas būti tikslia spektaklio vitražo dalimi. Studijų metu aktoriai supažindinami su... [toliau žr. visą tekstą] / Systematic analysis of role creation and methods development started just in the beginning of XX century. A unique system created by the most famous acting teacher, well known actor and director K. Stanislavski (1863) is believed to be the first impulsion for the acting schools introduction and thus made a big influence for the whole development of theatre. K. Stanislavski had many followers in the whole world, not only Russia. From K. Stanislavski’ system two types of theatre trends have evolved: 1) Psychological theatre (K. Stanislavski, M.Čechov, Š. Diulen) and 2) Physical theatre (V. Meyerhold, J.Grotowski, B.Brecht etc). These two trends were also influential for the development of Lithuanian theatre school. Since V. Boguslovski, A. Sutkus, A. Oleka-Žilinskas , J.Miltinis until these days the training of Lithuanian theatre actors has changed little, however, one could tell that in today Lithuanian theatre prevails staged type theatre where visual and musical or rhythm solutions are most important. On the other hand, the process of role creation is mostly based on methods from psychological theatre. Actors as well as directors care that the actor understands the wholeness of performance, stimulate inner emotional experiences. Accordingly, no matter how strong the disagreement of theatre founders for K. Stanislavski system would be actors still consider it as the most universal and reliable school. In addition, it is clear that directors do not try to find individual... [to full text]

Most recent research show that the role of the modern controller has changed from thetraditional bean counter towards a business partner role. However, all literature does notagree with this notion, claiming that the controller is still more of a bean counter. Further,what it actually means to be a business partner also differs between researchers. The rolechange has also brought several new challenges for the controller. The purpose of this studyis to examine what it means to be a controller at a consultancy company in the IT industry,and what challenges and opportunities exist for business partnering. This is achieved usingcase study as the research design, including qualitative data from interviews of ten controllersof different seniority. The findings are analyzed through a theoretical framework consistingof role theory combined with previous literature on the topic. The findings of the study showthat the role of the controller at the case company shared more similarities with the traditionaldescription of a bean counter than a business partner. While more elements of businesspartnering started to appear as seniority increases, the controllers still felt like they weredoing too much bean counting activities. However, some opportunities for businesspartnering were still found at the company. The study suggests four major challengescontributing to role issues and hindering the controllers from becoming business partners.The four challenges are related to (1) lack of adaptation to new technology, (2) a centralizedorganizational structure, (3) the interplay between financial and business departments, and (4)accountability issues.

The introduction of Education Health and Care plans proposed in the Children and Families Act (2014) extended the statutory support for children from up to 19 years of age, to 25 years of age. This has in turn extended the role of educational psychologists to work with young people/adults to the age of 25, and some (Atkinson, Dunsmuir, Lang & Wright, 2015) have argued that this is one of the most significant developments of the profession. This research, therefore, seeks to understand how current educational psychologists see their role and how it may change when working with post-16 education; it also seeks to understand what needs post-16 education may have and how educational psychologists can support these needs. The methodology used in this thesis has the ontological stance of interpretivism (Cottrell, 2014) and epistemological stance of social constructionism (Andrews 2012). Interviews were held with educational psychologists (phase 1) and with post-16 providers (phase 2) to explore the views both these main stakeholders had of the extension of the educational psychologists' role. Needs from both stakeholders, as well previous literature, were taken into account in order to understand what the educational psychologists' role in post-16 education would entail. Interviews were developed using hierarchical focusing (Tomlinson, 1989) and were analysed using Braun & Clarke's (2006) thematic analysis. Findings suggested that the extension of the educational psychologists' role to work with post-16 learners is not the most significant development that the profession has seen in recent years, but that there are certain points that the profession needs to address. The findings are relevant to the local authority's development of their offer to post-16 educational providers. The findings also contribute to the role of the educational psychologist in general.

Neuroscience is a relatively small and emerging clinical pharmacy specialism focusing on drug therapy for neurological disease. Against a professional momentum for specialist practice within pharmacy, there is paucity both of relevant research, and a clearly defined role for specialist pharmacy practice in neuroscience. A qualitative research study was undertaken, using constructivist grounded theory method, to explore how hospital based pharmacists practicing in neuroscience define and develop their role and specialism. Data were concurrently generated and analysed, through verbatim transcription of telephone interviews with fourteen pharmacists. Data analysis resulted in the identification of three processes: (1) Acquiring and utilising knowledge in practice; (2) Gatekeeping access to drug therapies; (3) Integrating into the neuroscience service. The key findings within each process are: (1) Pharmacists utilise different forms of knowledge and there can be barriers to gaining knowledge. Pharmacists identify strengths in their breadth of clinical knowledge and holistic consideration of patients’ drug therapy. (2) Pharmacists act as barriers to drug therapy but also act to expedite and secure access to drug therapy. (3) Pharmacists act as an organisational nexus between pharmacy and neuroscience services and identify the importance in practice of forming working relationships within neuroscience services, underpinned by trust. The study identified a basic social process: Maintaining an overview of drug therapy for patients with neurological disease. This process conceptualises the tensions experienced by the pharmacists between their role as near-patient facing clinical specialists, but also as pharmacist generalists. The study findings have implications for supporting pharmacy practice in neuroscience.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第18909号 / 人健博第23号 / 新制||人健||2(附属図書館) / 31860 / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 田村 恵子, 教授 山根 寛, 教授 木原 正博 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Neuroscience is a relatively small and emerging clinical pharmacy specialism focusing on drug therapy for neurological disease. Against a professional momentum for specialist practice within pharmacy, there is paucity both of relevant research, and a clearly defined role for specialist pharmacy practice in neuroscience. A qualitative research study was undertaken, using constructivist grounded theory method, to explore how hospital based pharmacists practicing in neuroscience define and develop their role and specialism. Data were concurrently generated and analysed, through verbatim transcription of telephone interviews with fourteen pharmacists. Data analysis resulted in the identification of three processes: (1) Acquiring and utilising knowledge in practice; (2) Gatekeeping access to drug therapies; (3) Integrating into the neuroscience service. The key findings within each process are: (1) Pharmacists utilise different forms of knowledge and there can be barriers to gaining knowledge. Pharmacists identify strengths in their breadth of clinical knowledge and holistic consideration of patients’ drug therapy. (2) Pharmacists act as barriers to drug therapy but also act to expedite and secure access to drug therapy. (3) Pharmacists act as an organisational nexus between pharmacy and neuroscience services and identify the importance in practice of forming working relationships within neuroscience services, underpinned by trust. The study identified a basic social process: Maintaining an overview of drug therapy for patients with neurological disease. This process conceptualises the tensions experienced by the pharmacists between their role as near-patient facing clinical specialists, but also as pharmacist generalists. The study findings have implications for supporting pharmacy practice in neuroscience.

Recent initiatives to modernise the National Health Service describe how improving pay structures and staff working lives can be achieved in the form of advanced practitioner and consultant posts. Role development in Radiography represents a fundamental change to professional practice of radiographers and is subject to the provisions of the statutory and professional codes of conduct which govern such practice. In Diagnostic Radiography the response to Government initiatives has led to a change in practice so that radiographers in these new posts provide reports for a variety of imaging modalities. At the same time as there have been changes in the practice of Radiography, the discipline of evidence-based medicine has emerged. Changes in clinical practice should be underpinned by evidence from research. The purpose of this paper is to discuss the methodological approaches used to conduct research that evaluates one of the most salient areas of development in Radiography practice, that is the role of radiographers as advanced or consultant practitioners when interpreting plain radiographs. We begin by discussing what an evaluation is and two broad approaches for conducting health services research, and then appraise the evidence about radiographer reporting in the context of these methods of evaluation. We then suggest future considerations about the methodological approaches to evaluating radiographer reporting practice and identify where there are evidence gaps and the need for further research to inform evidence-based Radiography.