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The research employs a single embodied case study design with the aim to examine the discourse of men accessing and receiving mental health support alongside those who are the providers of the support. Three groups of adults were interviewed: men who had experienced mental health problems and had attempted to access mental health support; lay people who supported them, such as partners and non‐mental health professionals and professionals, such as mental health nurses, social workers, clinical psychologists and general practitioners. Critical discourse analysis (CDA) is used to identify discourses around three emergent themes: well‐being, power and dominance and social capital. Participants seeking mental health support often referred to mental health services as not listening or that what was offered was not useful. A lack of belonging and community disconnectedness was apparent throughout all participant interviews. The study is reported according to the COREQ guidelines. [ABSTRACT FROM AUTHOR]

The global COVID‐19 pandemic challenged the world—how it functions, how people move in the social worlds and how government/government services and people interact. Health services, operating under the principles of new public management, have undertaken rapid changes to service delivery and models of care. What has become apparent is the mechanisms within which contemporary health services operate and how services are not prioritising the person at the centre of care. Person‐centred care (PCC) is the philosophical premise upon which models of health care are developed and implemented. Given the strain that COVID‐19 has placed on the health services and the people who deliver the care, it is essential to explore the tensions that exist in this space. This article suggests that before the pandemic, PCC was largely rhetoric, and rendered invisible during the pandemic. The paper presents an investigation into the role of PCC in these challenging times, adopting a Foucauldian lens, specifically governmentality and biopolitics, to examine the policies, priorities and practical implications as health services pivoted and adapted to changing and acute demands. Specifically, this paper draws on the Australian experience, including shifting nursing workforce priorities and additional challenges resulting from public health directives such as lockdowns and limitations. The findings from this exploration open a space for discussion around the rhetoric of PCC, the status of nurses and that which has been lost to the pandemic. [ABSTRACT FROM AUTHOR]

Film, a powerful publicising agent of knowledge, can have detrimental ideological and material implications contributing towards the systematic exclusion of disabled people. The paper explores how acquired physical disability is constructed within three contemporary mainstream fiction films. Guided by theoretical disability models and stereotypic representations of disability, identified by seminal authors in the field, the discussion highlights discourses that are perpetuated, challenged, or omitted within cinematic portrayals of disability. The paper also addresses how these discourses contribute to the maintenance or subversion of ableist power. The data underwent a multimodal analysis guided by critical and cinematic discourses. While steps towards more nuanced and diverse representations of acquired physical disability are evident, the films continue to perpetuate hegemonic discourses, emotionally provocative, and caricatured portrayals of disability. Arguably, contemporary disability fiction films are still largely produced for, and consumed by, abled audiences. Recommendations for transforming cinematic representations of the disabled are addressed. Films can communicate accurate knowledge as well as damaging stereotypes to the public. Disability has often been portrayed negatively in films and thus it is important to critically analyse films about disability. The paper discusses three contemporary films in which the main actors have an acquired physical disability. What is said about disability through the films' dialogue, and how disability is shown through camera angles, music, and props was analysed. The research found that films about acquired physical disability continue to produce negative stereotypes about disability. Thus, discrimination against disabled people is continued. Encouragingly, some stereotypes about disability were seen to be challenged in the contemporary films. Future films need to be more inclusive of disability. Characters need to be complex, all-rounded individuals, with disability being only one facet of their personhood. [ABSTRACT FROM AUTHOR]

Purpose: To explore levels of Navigator resilience, well‐being, burnout, and turnover intent. Design: A longitudinal, multi‐methods study concurrently collected quantitative and qualitative data over three years. Methods: A survey and Action Learning Groups. Findings: No statistically significant change in resilience, well‐being, burnout, or turnover intent. Supports, self‐care and leaving the position, were used to maintain well‐being. Conclusions: While quantitative measures did not change, qualitative data demonstrated how adaptive coping mechanisms maintain well‐being. Recommendations for nurses working in Navigator, or similar community/public health roles include work‐based programs targeting support, good leadership, governance systems including their impact on turnover intent. Clinical evidence: Job turnover intent can be used as a mechanism to monitor resilience and well‐being. [ABSTRACT FROM AUTHOR]

Background: Historically, in South Africa (SA), single motherhood has been part of the landscape and continues to increase. Disability in children is also increasing, yet it remains under-researched. Mothers are often left to raise their children with a disability alone, yet their voiced maternal experiences continue to largely be unheard, particularly in SA. Objectives: This study aimed to explore the lived experiences of single mothers raising a child with a disability in SA. Furthermore, the aim was to explore how these mothers navigate their complex realities and practice of mothering, and to amplify the voices of mothers. Finally, the study sought to shed light on the particular contextual factors that affect single maternal experiences in caring for a child with a disability. Method: Twelve South African single mothers raising a child with a disability between the ages of 7 years and 18 years were individually interviewed in this exploratory interpretivist study. Thematic analysis was utilised on the data. Results: The four themes highlight the complex, multi-level strain of raising a child with a disability, which has had a significant impact on the social, financial and emotional facets of single mothers' lives. Conclusion and contribution: The findings of the study are important for developing a thorough understanding of the needs of single mothers in this specific context as well as their daily experiences as mothers of children with disabilities. These needs include the necessity of psychosocial support and equipping single mothers with accurate knowledge about their child's disability so that they can make better accommodations for themselves and their child. [ABSTRACT FROM AUTHOR]

Background: Within the context of the increasing prevalence of prolonged critical illness, a situation intensified by the COVID‐19 global pandemic, advancing understanding of the experiences of families of survivors that are discharged home is important in understanding the complexity of life for these people. Aims: To examine research related to the experiences of families of survivors of prolonged critical illness that are discharged home. Study design: This review was conducted using the Whittemore and Knafl framework for integrated literature reviews. A literature search was conducted using the electronic databases of Web of Science, CINHAL, Scopus, and PubMed for English language studies published between January 2002 and October 2021. Article titles and abstracts were screened in view of finding a selection of articles that focussed on the experiences of families of people who have survived a prolonged intensive care stay that are discharged home. Study quality was assessed using the CASP (Critical Appraisal Skills Programme) tool. Data analysis of nine peer‐reviewed articles was informed by the Braun and Clarke approach to thematic analysis. The PRISMA guidelines were used to report the review process. Results: Nine articles were included in the review. Three major themes were identified, namely, (i) the negative impact on family caregiver health and well‐being, (ii) caregiver burden, and (iii) unmet support needs. Conclusions: Families of prolonged critical illness survivors that are discharged home face complex challenges that make their experience difficult and demanding. Family support needs once patients are discharged home are largely unrecognized in this population. Relevance to clinical practice: This review evidences the need to investigate further the experiences of families of survivors of prolonged critical illness. Further qualitative research has the potential to help inform service provision and support for these people. [ABSTRACT FROM AUTHOR]

Background: Improved survival of critically ill people has increased the number of patients who experience an extended stay in intensive care units (ICU). Evidence suggests the complexities, vulnerabilities, and traumas created by critical illness are substantial for both patients and their support people with a number experiencing devastating impairments across multiple domains of health and function including physical, mental, cognitive, and social health. However, research on survivors predominantly focuses on those who have experienced a relatively short length of stay; only a limited number of studies seek to explore the experiences of survivors and their support people who have had a prolonged stay in intensive care. Aims: To describe the experiences of survivors of prolonged critical illness (invasively mechanically ventilated in ICU for ≥eight days) and their support people during the first 12 months following hospital discharge in New Zealand. Study design: This research will be a multi‐centre study recruiting from three intensive care units in New Zealand. A narrative inquiry methodology will be used to interview 6–8 former long stay patients and 6–8 support people of a former long stay patient. Each participant will be interviewed at 3‐, 6‐, 9‐, and 12‐months following hospital discharge. Data will be collected via narrative inquiry interviews. Data analysis will combine two theoretical frameworks: the Clandinin and Connelly narrative inquiry three‐dimensional space and the Fairclough situation, discourse and context framework. Results: The phenomenon of investigation will be experiences after prolonged critical illness explored longitudinally across the first‐year post‐hospital discharge. Relevance to clinical practice: This protocol provides a methodological framework for exploring the lived experiences of survivors of prolonged critical illness and their support people. Data analysis will support understanding of the human journey of ICU survivorship and add to the body of knowledge on how to support post‐ICU recovery in this population. The barriers and enablers of survivorship at the micro, meso, and macro levels of the health service will also be illuminated. [ABSTRACT FROM AUTHOR]

Background: Historically, in South Africa (SA), single motherhood has been part of the landscape and continues to increase. Disability in children is also increasing, yet it remains under-researched. Mothers are often left to raise their children with a disability alone, yet their voiced maternal experiences continue to largely be unheard, particularly in SA. Objectives: This study aimed to explore the lived experiences of single mothers raising a child with a disability in SA. Furthermore, the aim was to explore how these mothers navigate their complex realities and practice of mothering, and to amplify the voices of mothers. Finally, the study sought to shed light on the particular contextual factors that affect single maternal experiences in caring for a child with a disability. Method: Twelve South African single mothers raising a child with a disability between the ages of 7 years and 18 years were individually interviewed in this exploratory interpretivist study. Thematic analysis was utilised on the data. Results: The four themes highlight the complex, multi-level strain of raising a child with a disability, which has had a significant impact on the social, financial and emotional facets of single mothers' lives. Conclusion and contribution: The findings of the study are important for developing a thorough understanding of the needs of single mothers in this specific context as well as their daily experiences as mothers of children with disabilities. These needs include the necessity of psychosocial support and equipping single mothers with accurate knowledge about their child's disability so that they can make better accommodations for themselves and their child. [ABSTRACT FROM AUTHOR]

Within the framework of the current drive to transform psychology in South Africa, this paper highlights "other" axes of identity that are arguably largely overlooked within the field. The conversation exposes the discipline of psychology – specifically within the South African context – and its many unexamined assumptions concerning "expected" identities of psychologists – specifically, those along heterosexual and able-bodied lines. By engaging in an autoethnographic conversation, the two authors, both "other", practising psychologists – one queer, one disabled – share and reflect on some of their experiences of feeling othered in their chosen profession. Drawing on parts of queer theory, critical disability literature, as well as the theoretical framework of biopolitical power, we start to make sense of our experiences of difference, deviance, and defiance. How the field of psychology marginalises "other" psychologists, and the impacts on those who bear the oppressions, is exposed; and a conversation is begun in which the discipline's assumptions around compulsory forms of identity – straight, not disabled, among others – are disrupted in productive ways. [ABSTRACT FROM AUTHOR]

Health literacy is a contemporary term used in health services, often used to describe individuals requiring additional support to access, understand and implement health service information. It is used as a measure of self‐efficacy in chronic disease models of care such as the nurse navigator service. The aim of the research was to investigate the concept of health literacy in the nurse navigator service, particularly in relation to the defined role objective of person‐centred care. Fairclough's critical discourse analysis was used to analyse the experiential, relational and expressive elements of texts, investigating the hidden truths which are represented in discourse. Texts from a variety of health service micro‐, meso‐ and macro‐hierarchical sources were selected for analysis using the nurse navigator evaluation data set and other associated texts. Health literacy in the nurse navigator service is a technology of government used to increase participation of individuals in their own health and well‐being. The discourse suggests that health literacy responsibilises both individuals and nurses and is discursively formed within a matrix of rational choice. In this context, health literacy contributes to structural vulnerability. [ABSTRACT FROM AUTHOR]

Positioning the individual at the centre of care (person‐centred care [PCC]) is essential to improving outcomes for people living with multiple chronic conditions. However, research also suggests that this is structurally challenging because health systems continue to adopt long‐standing, episodic care encounters. One strategy to provide a more cohesive, individualised approach to care is the implementation of the nurse navigator role. Current research shows that although PCC is a focus of navigation, such care may be hindered by the rigid, systematised health services providing siloed specialist care. In this paper, we utilised a case study method to investigate the experiences of a nurse navigator and patient. The nurse navigator and the patient participated in individual interviews, the transcripts of which were analysed using critical discourse analysis. Findings from a larger research project suggest that traditional measures (hospital avoidance, emergency department usage) which work as the service objectives of the nurse navigator service have the potential to stifle the delivery of PCC. The analysis from this case study supports the broader findings and further highlights the need for improved alignment between service objectives and the health and well‐being of the individuals utilising the services. [ABSTRACT FROM AUTHOR]

Action research methodology is well-suited to engaging with marginalised groups to inform policy and guide practice. Prisons are complex institutions with hierarchies of power; social systems that demand a research approach suited to social structure. The pilot project to be evaluated is designed to promote positive pregnancy and birth experiences for pregnant female prisoners and provide extraordinary learning opportunities for midwifery students. The project team includes staff from a regional university, the local health service and the state run prison service. Very early in the project it became evident that in addition to management patronage, the project needed the practical support of the Custodial Correctional Officers. Thus, officers as project 'champions' were recruited. Custodial Correctional Officers play an integral role in these social systems and although they are perceived to have power over prisoners, they too are subject to controls and in some instances have minimal power. The study will be conducted in two stages, the first of which will involve the Custodial Correctional Officers as participants, focus on the outcomes to date and how this may inform policy and practice. This article justifies the use of action research methodology for this purpose. [ABSTRACT FROM AUTHOR]

Aims: This paper describes findings from a survey conducted in New Zealand exploring nurses' decision‐making about when to delay care, delegate care, hand care over or leave care undone. Unanticipated findings identified processes that nurses go through when deciding to take planned/unplanned leave when wards are constrained through budget limitations. Background: Missed/rationed care is increasingly the focus of attention in international studies, identifying a complex interplay of organisational, professional and personal factors affecting nurses' decision‐making when faced with limited organisational time, human and material resources to provide care. Methods: The survey presented nurses with Likert‐scale questions with option for free text comments. This paper reports on the commentaries about work–life balance. Results: Nurses described workload pressures that lead to rationing care affected them, and the long‐term effect on them as individuals. Nurses verbalized the difficulties and associated guilt about taking leaving and sick leave when wards were short staffed. Conclusions: Nurses consider how their absence will affect the workspace and their home first, considering the impact on themselves last. Implications: The findings may provide valuable insights for nurse managers in relation to workforce allocations and resources where acknowledgement of work–life balance is considered. [ABSTRACT FROM AUTHOR]

Introduction: This paper reports on the findings of the Nursing and Midwifery Exchange Program, initiated to promote rural and remote nursing and midwifery, and to facilitate clinical skills development and clinical collaboration between health services in Queensland, Australia. The project was undertaken over an 18-month period in one state of Australia, offering structured, temporary exchange of personnel between metropolitan and rural health services. Background: Globally, there is an increasing awareness of nursing shortages, and with it, the need to ensure that nurses and midwives are prepared for specialist roles and practice. This is particularly important in rural and remote areas, where there are pre-existing barriers to access to services, and difficulties in attracting suitably qualified, permanent staff. Methods: A mixed methods approach to the evaluation was undertaken with two cohorts. One cohort was the nurses and midwives who participated in the exchange (n = 24) and the other cohort were managers of the participating health services (n = 10). The nurses and midwives who participated in the exchange were asked to complete a questionnaire that included questions related to embeddedness and job satisfaction. The managers participated in a Delphi series of interviews. Results: Those who participated in exchange reporting a higher score on the reported degree of understanding of rural client, which was accompanied with a moderate-to-large effect size estimate (d = 0.61). Nurses/midwives in the exchange group reported higher scores on their perceptions of aspects of their home community that would be lost if they had to leave, which was accompanied with a large effect size (d = 0.83). Overall, NMEP was reported by the participants to be a positive way to improve professional development opportunities for nurses and midwives. The findings also show the program supported practical collaboration and raised the profile of nursing and midwifery in rural areas. Conclusion: Exchange programs support clinical and professional development, raising the awareness of different contexts of practice and related skills requirements, and thereby supporting a greater understanding of different nursing roles. In the light of increasingly complex care required by patients with chronic conditions being managed in community-based services, programs such as NMEP provide the opportunity to build collaborative networks between referring and referral centres as well as contribute to the ongoing skills development. [ABSTRACT FROM AUTHOR]

This paper presents an analysis of narratives drawn from research that examined the views of clergy in regard to the provision of spiritual care in Lithuanian hospitals. The purpose of this research was to examine the shared responsibilities between what nurses do in the provision of holistic care and that of the clergy who are employed to provide spiritual care. A thematic analysis was undertaken, guided by questions related to how spirituality was perceived by the clergy; how spiritual care was defined; clergy's perceptions to nurses' provision of spiritual care, and whether there was a delineation between these two roles. Findings showed that although the clergy believed that their role was important in the provision of spiritual care, both nurses and clergy acknowledged that both played a role in spiritual support. However, scope of practice for each role was not yet defined. For nurses and clergy to understand their roles and the boundaries between them, clear standards of practice need to be developed. [ABSTRACT FROM AUTHOR]

Aims: The article examines nurses' experiences to institutionally enforced choices they must make regarding what patient care will be left undone. Cognitive dissonance theory is used to discuss how missed care is reconciled with the nurses' sense of professionalism and feelings of compassion. Background: Research into missed nursing care and care rationing is increasing, with an awareness that it impacts on nurses' coping ability. Methods: In‐depth video and telephone interviews were conducted with four experienced nurses who were asked to describe how they made choices regarding required patient care and how they managed care under workload pressures. Results: Thematic analysis of interview narratives revealed four key themes describing the experiences of nurses managing their work: compromising care; incongruity between professional standards and organisational resources; emotional exhaustion; and depersonalization. Conclusions: Nurses expressed concerns that their professional values regarding patient care are being lost in a quest to achieve financial targets. It raises questions regarding ethical and psychological dilemmas created for workers by work intensification. Implications for Nursing Management: Financial effectiveness negatively impacts on nurses' emotional and clinical well‐being cannot be easily dismissed, given that cognitive dissonance arises from attempting to provide quality care of patients whilst meeting organisational financial targets. [ABSTRACT FROM AUTHOR]

Background: Hospitals and other health care providers frequently experience difficulties contacting patients and their carers who live remotely from the town where the health service is located. In 2016 Nurse Navigator positions were introduced into the health services by Queensland Health, to support and navigate the care of people with chronic and complex conditions. One hospital in Far North Queensland initiated an additional free telephone service to provide another means of communication for patients and carers with the NNs and for off-campus health professionals to obtain details about a patient utilising the service. Calls made between 7am and 10pm, seven days per week are answered by a nurse navigator. Aim: To report utilisation of the service by navigated clients and remotely located clinicians compared to use of navigators' individual work numbers and direct health service numbers. We report the reason for calls to the free number and examine features of these calls. Methods: Statistical analysis examined the call reason, duration of calls, setting from where calls originated and stream of calls. Interactions between the reasons for calls and the features of calls, such as contact method, were examined. Results: The major reason for calls was clinical issues and the source of calls was primarily patients and carers. Clinical calls were longer in duration. Shorter calls were mainly non-clinical, made by a health professional. Setting for calls was not related to the reason. The most frequent number used was the individual mobile number of the NN, followed by the hospital landline. Although the free number was utilised by patients and carers, it was not the preferred option. Conclusion: As patients and carers preferred to access their NN directly than via the 1800 number, further research should explore options best suited to this group of patients outside normal business hours. [ABSTRACT FROM AUTHOR]

Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care left undone – suggesting that nurses, in certain contexts, are actively engaged in rationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource. [ABSTRACT FROM AUTHOR]

Aim: With increasing age and chronicity in populations, the need to reduce the costs of care while enhancing quality and hospital avoidance, is important. Nurse‐led co‐ordination is one such model of care that supports this approach. The aim of this research was to assess the impact that newly appointed Navigators have on service provision; social and economic impact; nurses' professional quality of life and compassion fatigue; and analysis of the change that has occurred to models of care and service delivery. Design: A concurrent mixed‐method approach was selected to address the research aims. Methods: The research project was funded in July 2018 and will conclude in December 2020. Several cohorts will be studied including; patients assigned to a navigator, patients not assigned to a navigator, family members of patients assigned a navigator; and a sample sized estimated at 140 navigators. Discussion: This study provides a comprehensive international longitudinal and mixed method framework for evaluating the impact of nurse navigators on quality of care outcomes for patients with chronic conditions. Impact—What problem will the study address?: Even with specialty focused co‐ordinated care, patients get lost in the system, increasing the incidence of non‐compliance and exacerbation of condition. Navigators work with patients across service boundaries allowing for care that is patient responsive, and permitting variables in clinical, social and practical elements of care to be addressed in a timely manner. This novel nurse‐led approach, supports hospital avoidance and patient self‐management, while encouraging expansion and opportunity for the nursing and midwifery workforce. [ABSTRACT FROM AUTHOR]

Introduction: Community nursing and midwifery is changing in response to a shift in care from hospital to home, brought about by increasing costs to care because of an aging population and increasing chronicity. Until now, community nursing positions and scope of practice has been dependent on service focus and location, which has led to the role being unclearly defined. Lack of appeal for a career in community practice and a looming workforce shortage necessitates a review into how community nursing and midwifery transition to practice is supported. Methods: This review sought to identify, assess and summarize available evidence relating to transitioning into community nursing and midwifery practice as a speciality. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. A narrative synthesis was then undertaken on papers that examined community nursing and midwifery pathway perspectives which define, and enable or inhibit a contemporary pathway. Thematic analysis used a theoretical framework developed for early career and rapid transition to nursing specialty practice. Results: There is a paucity of research that identifies community nursing and midwifery as a discreet scope of practice. Twelve papers were eventually included in the review. Verbatim findings were extracted from the papers and clustered into categories based on the chosen theoretical framework. Major themes were ‘the self’ (professional and personal); ‘transition processes’; and, a ‘sense of belonging’. Sub themes included narrative identifying inhibitors and enablers in each theme. Discussion: No definition of community practice or pathway was identified in nursing, although midwifery was clearly defined. Community nursing practice was described as generalist in nature although specialist knowledge is required. Being part of the community in the professional sense and personal sense was considered important. The importance of transition was identified where pre-entry exposure to community practice was seen as important. Stages in transition to practice were recognised as pre-entry; incomer; insider; and, a sense of belonging. The process of transition should be planned and individualised acknowledging past experience whilst acknowledging the specialist nature of community-based practice. [ABSTRACT FROM AUTHOR]

Background: This paper draws on a 2015 study in New Zealand that examined perceptions of registered nurses (RNs) and general practitioners (GPs) regarding the role of Nurse Practitioners (NPs) in long-term aged care facilities (LTACF). Aim: To explore the attitudes of RNs and GPs regarding the role of NPs in LTACFs. Design: A descriptive, mixed methods design with a survey and invitation to interview was used. RNs and GPs who provided hospital-level care were invited to participate. Findings: The findings showed RNs and GPs are open to considering the NP role in aged care. However, there remains a lack of understanding of what NPs do. Conclusions: This study suggests a shift in attitude towards accepting the NP role by RNs and GP working in LTACFs. [ABSTRACT FROM AUTHOR]

Qualitative research in general and the psychoanalytically informed research interview method specifically, can be emotionally demanding on researchers as they form relationships with participants. This is especially the case when researchers and participants share particular identities and experiences. In this paper I reflect on my experience of interviewing mothers raising children with a visible physical disability about their maternal subjectivity. At times this was an emotionally demanding and ethically challenging process as participants closely identified with certain aspects of my identity, particularly with my visible physical disability and motherhood peculiarities. Often participants unexpectedly reversed our roles, asking me intimate questions. I will deliberate these dilemmas using interview material. I argue for a mindful blurring with participants when this occurs. Using certain psychoanalytic-researcher concepts of intersubjectivity, transference-countertransference and psychoanalytic-researcher thirdness helped me successfully navigate these encounters. I will also explore the rich participant psychic functioning that was generated from this intersubjective relationship between myself and the participants. [ABSTRACT FROM AUTHOR]

This article draws on the free-text commentaries from trans-Tasman studies that used the MISSCARE questionnaire to explore the reasons why nurses miss care. In this paper, we examine the idea that nurses perpetuate a self-effacing approach to care, at the expense of patient care and professional accountability, using what they describe as the art of nursing to frame their claims of both nursing care and missed nursing care. We use historical dialogue alongside a paradigmatic analysis to examine why nurses allow themselves to continue working within settings that put their professional/personal selves aside in an attempt to deliver care within constraints that make completing care an impossible task. The findings suggest an ambivalence and conflict confront nurses attempting to provide care within the New Public Management environment. This can be seen in the tensions that draw a line between care as an art, and care as a financial target, juxtaposed with the inherent clash of values arising from the way nursing care is conceptualised within two contradictory paradigms. [ABSTRACT FROM AUTHOR]

Individual realities and perceptions are embedded in a web of dominant social and cultural views which shape the individual. Mothers of deaf children therefore cannot be understood in isolation, and neither can their experiences, perceptions, and well-being. The present research investigated the construction of deafness through the experiences of mothers raising a deaf child and considered the manner in which these constructions impacted their well-being and relationship with the child. The study explored the experiences of six Black South African hearing mothers of a deaf child between the ages of 3 and 8 years. Individual semi-structured interviews were conducted. Through an interpretive theoretical framework, this qualitative study noted seven main themes, namely, deafness is foreign and unknown, increased awareness and normalising of deafness, religious and Traditional African beliefs about disability/deafness, external pity and the mother's rejection of it, the discourse of the 'superiority' of speech and encouragement of speech and hearing, barriers to communicating with her child, and 'Why me?' attribution of cause and the emergence of blame. Extrapolation of the data suggests that there is a lack of awareness regarding the deaf individual, and this creates misinformed perceptions about deafness which impact negatively both mother and child. [ABSTRACT FROM AUTHOR]

Researchers using qualitative methods are required to be ethically mindful not to cause harm to participants. However, when emotional encounters between researchers and participants occur there are inherent ethical tensions that need to be continuously navigated. In this paper I contemplate the challenges I encountered whilst using a psychoanalytically informed research interview method (adapted from Cartwright, 2004; Kvale, 1999; Stromme, Gullestad, Stänicke & Killingmo, 2010). I interviewed women on the topic of maternal subjectivity when their children have a disability. The ethical quandaries included accessing nuanced data by engaging with participants' unconscious material; as well as the use of the transferencecountertransference situation outside of a psychotherapy setting. Literature has previously discussed the ethics of using this psychoanalytic method, particularly around the interpretation of data from a psychoanalytic lens. However, the aim in this paper is focused on the application of psychoanalytic concepts in the process of data collection and how to ethically manage these emotional engagements with participants. It will be argued that when researchers are also mindful, psychoanalytically-trained psychotherapists, who engage with their own subjectivity in personal psychoanalytic psychotherapy, this psychoanalytic inquiry method can be a very ethical way of being with participants. [ABSTRACT FROM AUTHOR]

The nurse practitioner (NP) position has not been embraced as eagerly as other new health practitioner roles in New Zealand (NZ), and there is little research about the role in the country. A study was carried out to find out more about the contribution NPs are making to primary health care, regardless of healthcare setting. Using a mixed-methods approach, the study mapped the contributions of NPs against indicators from a results-based model for primary health care developed by Watson et al (2009). The findings demonstrate that NPs are essential to maintaining the population's health in a cost-constrained healthcare environment and highlight the need for national policymakers and local decision makers to give the role a higher profile and to provide more resources and support. [ABSTRACT FROM AUTHOR]

The nurse practitioner (NP) position has not been embraced as eagerly as other new health practitioner roles in New Zealand (NZ), and there is little research about the role in the country. A study was carried out to find out more about the contribution NPs are making to primary health care, regardless of healthcare setting. Using a mixed-methods approach, the study mapped the contributions of NPs against indicators from a results-based model for primary health care developed by Watson et al (2009). The findings demonstrate that NPs are essential to maintaining the population's health in a cost-constrained healthcare environment and highlight the need for national policymakers and local decision makers to give the role a higher profile and to provide more resources and support. [ABSTRACT FROM AUTHOR]

Traditionally disability has been viewed in the popular imagination as either a highly positive or highly negative phenomenon. Disability and disabled people deserve to be seen in an integrated, holistic way and to have recognised as much diversity as characterises the human condition. The recent case of Oscar Pistorius fatally shooting Reeva Steenkamp has highlighted this tendency. Before this incident, Pistorius’ disability was viewed in a predominantly positive light. He had been described as a ‘supercrip’ who had, despite his physical impairments, ‘overcome’ his mobility limitations and was consequently attributed heroic status by some. However, after this fatal incident, the portrayal of Pistorius’ disability has, perhaps inevitably, shifted. This paper will offer possible psychosocial reasons for this tendency to view disability in a binary way. [ABSTRACT FROM AUTHOR]

Traditionally disability has been viewed in the popular imagination as either a highly positive or highly negative phenomenon. Disability and disabled people deserve to be seen in an integrated, holistic way and to have recognised as much diversity as characterises the human condition. The recent case of Oscar Pistorius fatally shooting Reeva Steenkamp has highlighted this tendency. Before this incident, Pistorius’ disability was viewed in a predominantly positive light. He had been described as a ‘supercrip’ who had, despite his physical impairments, ‘overcome’ his mobility limitations and was consequently attributed heroic status by some. However, after this fatal incident, the portrayal of Pistorius’ disability has, perhaps inevitably, shifted. This paper will offer possible psychosocial reasons for this tendency to view disability in a binary way. [ABSTRACT FROM PUBLISHER]

Surface-enhanced Raman spectroscopy (SERS) and tip-enhanced Raman spectroscopy (TERS) were until recently limited in their applicability to the majority of heterogeneous catalytic reactions. Recent developments begin to resolve the conflicting experimental requirements for SERS and TERS on the one hand, and heterogeneous catalysis on the other hand. This article discusses the development and use of SERS and TERS to study heterogeneous catalytic reactions, and the exciting possibilities that may now be within reach thanks to the latest technical developments. This will be illustrated with showcase examples from photo- and electrocatalysis. Graphical Abstract: [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine how front‐line health professionals identify and manage nonfatal strangulation events. Design: Integrative review with narrative synthesis was conducted. Data Sources: A comprehensive database search was conducted in six electronic databases (CINAHL, Wed of Science, DISCOVER, SCOPUS, PubMed and Scholar) resulting in 49 potentially eligible full texts, reduced to 10 articles for inclusion after exclusion criteria were applied. Review Methods: An integrative review was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) Statement guidelines. Data were extracted, and a narrative synthesis using Whittemore and Knafl (2005) framework was undertaken to determine how front‐line health professionals identify and manage nonfatal strangulation events. Results: The findings identified three main themes: an overall failure by health professionals to recognize nonfatal strangulation, a failure to report the event and a failure to follow up on victims after the event. Stigma and predetermined beliefs around nonfatal strangulation, along with a lack of knowledge about signs and symptoms, were the salient features in the literature. Conclusion: Lack of training and fear of not knowing what to do next are barriers to providing care to victims of strangulation. Failure to detect, manage and support victims will continue the cycle of harm through the long‐term health effects of strangulation. Early detection and management of strangulation are essential to prevent health complications, particularly when the victims are exposed to such behaviours repeatedly. Impact This review appears to be the first to explore how health professionals identify and manage nonfatal strangulation. It identified the significant need for education and robust and consistent screening and discharge policies to assist health providers of services where victims of nonfatal strangulation attend. No Patient or Public Contribution: This review contains no patient or public contribution since it was examining health professionals' knowledge of identifying nonfatal strangulation and the screening and assessment tools used in clinical practice. [ABSTRACT FROM AUTHOR]

Raman spectroscopy is one of the major characterization methods employed over the last few decades as a nondestructive technique for the study of heterogeneous catalysts and related catalytic reactions. However, the promise of practical applicability on millimeter-sized catalyst bodies, such as extrudates, has not been fulfilled completely. Large fluorescence signals and the highly scattering nature of the extrudates often hamper its practical usage. Different approaches to overcome this problem were examined, including the use of time-resolved Raman spectroscopy (TRRS), spatially offset Raman spectroscopy (SORS), surface-enhanced Raman spectroscopy (SERS), and combinations of these techniques. This paper demonstrates that especially TRRS can provide chemical information at depth within catalyst bodies, overcoming fluorescence background signals and allowing for visualization of analytes at different depths. It also examines the application of time-resolved SERS within catalyst bodies to gain insight into localized activity. With these options a wider applicability of Raman spectroscopy for industrial catalysis research becomes within reach. [ABSTRACT FROM AUTHOR]

Purpose: The move to national registration of health professionals and the creation of the Nursing and Midwifery Board of Australia (NMBA) provides both challenges and opportunities for the regulation of nurse practitioners (NPs) in Australia. Data sources: National and state health policy documents, accessible on the Internet, concerning the regulation and endorsement processes for NPs in Australia were examined. Conclusions: The similarities between two of the previous jurisdictional NP endorsement processes in New South Wales and Victoria provide a common ground on which to build a robust national system. However, there are also key differences between these two states. These differences were mainly in the evidence required to assess competency of NP applicants and the authority to prescribe medications. All Victorian NP applicants were required to complete an approved medication subject at a master's level. Implications for practice: A consistent endorsement process that delivers NPs of the highest standard and allows for efficient use of their skills and expertise is vital. This needs to be performed with the aim of providing high-quality care in a regulatory environment that protects the public and clearly articulates the level of competence expected of all NPs. [ABSTRACT FROM AUTHOR]

Aim. The aim of this paper was to examine the nurse practitioner legislative framework in Australia from a critical social theory perspective. Background. National regulation for nurses and midwives has superseded all previous state legislation with effect from July 2010. The aim of this change was to streamline regulation processes across all health professionals requiring regulation, in order to eliminate diverse state-based regulatory policies that were identified as hindering transferability of the workforce across Australia. This paper explores the changes with reference to nurse practitioners. Since their introduction to Australia different legislative practices between states have presented difficult endorsement procedures which have affected employment. Data sources. Information for the paper is drawn from a doctoral study which examined the politics of advancing nursing in Australia, with particular reference to the discourses of nurse practitioners. This is augmented by more recent legislative documents and policies, as well as media reports, to examine the process of change in legislation and the unfolding discourses on employment and practice. Implications to nursing. Nurse practitioner endorsement may be more complicated, defeating the original premise of transferability of a skilled workforce across state jurisdictions. Conclusion. This paper exposes the influence that powerful discourses can have on a major change to professional practice. [ABSTRACT FROM AUTHOR]

Nurse practitioners were introduced into Australia in 1990 to improve access to health care in isolated communities where medical doctors are scarce. The slow uptake of nurse practitioners in these areas has largely been the result of legislation not affording them access to provider numbers through the Medicare Australia Act 1973. This has denied nurse practitioners the opportunity to become primary care providers because they cannot prescribe medications and order diagnostic tests at rebated costs. Recently this Act changed, making provision for nurse practitioners. Ironically the enactment of the new legislation still prevents nurse practitioners from practicing effectively. This paper describes the discursive practices in legislation, driven by traditional power brokers, which perpetuate the traditional role of nurses as care givers and fails to support the evolution of nurse practitioners as care providers. These continued practices effectively prevent nurse practitioners from working to their potential, despite government reassurance under recent health care reform in Australia. [ABSTRACT FROM AUTHOR]

Triiodothyronine (T3) classically regulates gene expression by binding to high-affinity thyroid hormone receptors (TR) that recognize specific response elements in the promoters of T3-target genes and activate or repress transcription in response to hormone. However, a number of thyroid hormone effects occur rapidly and are unaffected by inhibitors of transcription and translation, suggesting that thyroid hormones may also mediate non-genomic actions. Such actions have been described in many tissues and cell types, including brown adipose tissue, the heart and pituitary. The site of non-genomic hormone action has been localized to the plasma membrane, cytoplasm and cellular organelles. These non-genomic actions include the regulation of ion channels, oxidative phosphorylation and mitochondrial gene transcription and involve the generation of intracellular secondary messengers and induction of [Ca2+]I, cyclic AMP or protein kinase signalling cascades. These observations have been interpreted to imply the presence of a specific, membrane associated, TR isoform or an unrelated high affinity membrane receptor for thyroid hormone. The recent identification of a progestin membrane receptor and the sub cellular targeted nuclear receptor isoforms ER46, mtRXR, mtPPAR, p28 and p46, has highlighted the potential importance of non-genomic actions of steroid hormones. Here we compare these recently identified receptors with the genomic, non-genomic and mitochondrial actions of thyroid hormones and consider their implications. [Copyright &y& Elsevier]

Aim: To stimulate discussion and debate about the inclusion of vulnerable populations in primary research to inform practice change and improve health outcomes. Background: Current research practices to safeguard vulnerable people from potential harms related to power imbalances may in fact limit the generation of evidence‐based practice. Evaluation: The authors draw on their experience working and researching with a recognized group of vulnerable people, incarcerated pregnant women, to provide insight into the application of ethics in both research and clinical practice. In a novel approach, the ethical principles are presented in both contexts, articulating the synergies between them. Suggestions are presented for how individuals, managers and organizations may improve research opportunities for clinical practitioners and enhance the engagement of vulnerable people to contribute to meaningful practice and policy change. Key Issues: Ethical practice guidelines may limit the ability to create meaningful change for vulnerable populations, who need authentic system change to achieve good health outcomes. Conclusion: Inclusive research and practice are essential to ensuring a strengths‐based approach to healthcare and addressing health needs of the whole population. Health systems and models of care recognizing the diverse lives and health needs of the broader population demand practical, sustainable support from clinical managers. Implications for Nursing Management: Practical suggestions for clinical managers to support point of care research is provided, embedding vulnerable voices in policy, practice development and care provision. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate workplace bullying and explore correlations between bullying, burnout and resilience amongst perioperative nurses in Australia. Background: Workplace bullying in perioperative nursing involves verbal, physical and psychological violence. However, no prior studies have measured Australian perioperative nurses' experiences of workplace bullying nor sought to understand if there is a relationship with burnout and resilience. Methods: A descriptive correlational study was conducted utilizing an online survey incorporating four validated instruments. Descriptive statistics and regression models analysed workplace bullying, burnout and resilience. Results: Over half of perioperative nurses (n = 158/257, 61%) were exposed to workplace bullying. Consequences included fatigue and exhaustion (n = 129/192, 67%), anxiety (n = 123/192, 64%) and sleeplessness (n = 121/192, 63%). Organisational processes (r =.458, p <.001), bullying acts (r =.289, p <.001) and avoidance and withdrawal at work (r =.440, p =.001) increased burnout. Psychosocial distress (r = −.216, p <.001) was associated with decreased resilience. Conclusions: Workplace bullying is a persistent issue with negative impacts upon burnout, resilience and well‐being. Implications for Nursing Management: The psychological well‐being of employees can be prioritized by establishing and maintaining an organisational climate of psychosocial safety, thereby inhibiting the potential of bullying to manifest and positively influencing employee well‐being to help promote workplace engagement, productivity and reduced burnout. [ABSTRACT FROM AUTHOR]

Introduction: Nurse Navigators were introduced in Queensland, Australia, in 2016. Nurse Navigators coordinate person‐centred care, create partnerships, improve care coordination and outcomes and facilitate system improvement, independently of hospital or community models. They navigate across all aspects of hospital and social services, liaising, negotiating and connecting care as needed. People stay with Nurse Navigators for as long as required, though the intent is to transition them from high‐care needs to self‐management. Nurse Navigators are a working model in rural and remote areas of Queensland. Objective: To describe where the rural and remote Nurse Navigator position fits within the Rural Remote Nursing Generalist Framework and to define the depth and breadth of the rural and remote Nurse Navigator's scope of practice. Design: Using template analysis, data from focus groups and interviews were analysed against the domains of the recently released National Rural and Remote Nursing Generalist Framework. Navigators working in rural and remote areas across Queensland Health were invited to an interview (n = 4) or focus group (n = 9), conducted between October 2019 and August 2020. Findings: Rural and remote Nurse Navigators are proficient in all domains of the framework and actively champion for their patients, carers and the communities where they live and work. Discussion: This research demonstrates that rural and remote Nurse Navigators are a working model of advanced nursing practice, acting as 'champions' of The Framework. Conclusion: The Nurse Navigator model of care introduced to Queensland exemplifies proficient registered nurse practice to the full extent of their knowledge and skill. [ABSTRACT FROM AUTHOR]

The article focuses on different innovative ideas for teaching particle physics. It informs that particle is a tricky topic to study and A-level specifications in Great Britain tend to focus on learning about the particles and how they behave. Students need to know the names of the quarks and the particles they make up and also need to know the properties, how they interact with each other and some simple Feynman diagrams. Queen Mary University of London, has developed a model using different colours of lego to represent the different particles.

We explore the complex ways in which mothers of visibly physically disabled children manage moments of abjection in their relationships with their children. Two women’s stories are told in order to illustrate the power of their disturbing experiences and the ways mothers strive to share the unsharable, thereby empathically connecting with themselves and their children. We argue that understanding maternal experiences is important in and of itself, and that such experiences offer a model for how others may find ways to embrace disability rather than reject, avoid, or hate it. A model of maternal ambivalence that can show how mothers negotiate the abject may go some way towards thinking about the unthinkable. In this way, a deeper social acceptance of disability becomes more attainable. [ABSTRACT FROM AUTHOR]

Aim: To understand the impact and causes of 'Failure to Attend' (FTA) labelling, of patients with chronic conditions. Background: Nurse navigators are registered nurses employed by public hospitals in Queensland, Australia, to coordinate the care of patients with multiple chronic conditions, who frequently miss hospital appointments. The role of the nurse navigator is to improve care management of these patients. Evidence for this is measured through improvement in patient self-management of their conditions, a reduction in preventable hospital admissions and compliance with attendance at outpatient clinics. Failure to attend (FTA) is one measure of hospital utilisation, identifying outpatient appointments that are cancelled or not attended. Method: The cohort for this study was patients with multiple chronic conditions, and nurse navigators coordinating their care. Data describing the concept of FTA were thematically analysed twelve months into this three year evaluation. Results: Although the patient is blamed for failing to attend appointments, the reasons appear to be a mixture of systems error/miscommunication between the patient and the health services or social reasons impacting on patient's capacity to attend. Themes emerging from the data were: access barriers; failure to recognise personal stigma of FTA; and bridging the gap. Conclusion: The nurse navigators demonstrate their pivotal role in engaging with outpatient services to reduce FTAs whilst helping patients to become confident in dealing with multiple appointments. There are many reasons why a patient is unable to attend a scheduled appointment. The phrase 'Failure to Attend' has distinctly negative connotations and can lead to a sense of blame and shame for those with complex chronic needs. We propose the use of the neutral phrase "appointment did not proceed" to replace FTA. Implications for Nursing management: This article advocates for further consideration of collaborative models that engage the patient in their care journey and for consideration of the language used within the outpatient acute hospital setting, proposing the term 'appointment did not proceed.' [ABSTRACT FROM AUTHOR]

Introduction: The management of patients who need chronic and complex care is a focus of attention internationally, brought about by an increase in chronic conditions, requiring significantly more care over longer periods of time. The increase in chronic conditions has placed pressure on health services, financially and physically, bringing about changes in the way care is delivered, with hospital avoidance and home-based care encouraged. In this environment, nurses play an important role in co-ordinating care across services. This review formed one part of a funded project that explored the nurse navigator role within a proposed 24-hour telephone-call service in one regional area that has a diverse population in terms of cultural identity and geographical location in relation to service access. Aim: The review reports on the extant literature on the nurse's role in the provision of afterhours telephone services for patients with chronic and complex conditions. The specific aim was to explore the effectiveness of services for patients in geographically isolated locations. Methods: The methodological approach to the review followed the Preferred Reporting System for Meta-Analyses (PRISMA) guidelines. A thematic analysis was used to identify themes with chronic care models underpinning analysis. Results: Three themes were identified; nurse-led decision making; consumer profile; and program outcomes. Each theme was divided into two sub-themes. The two sub-themes for decision making were: the experience of the staff who provided the service and the tool or protocol used. The two sub-themes for consumers profile were; the geographic/demographic identity of the consumers, and consumer satisfaction. The final theme of outcomes describes how the effectiveness of the service is measured, broken into two sub-themes: the economic/workforce outcomes and the consumer outcomes. Discussion: The provision of an after-hours telephone service, in whatever model used should align with a Chronic Care Model. In this way, after-hours telephone services provided by experienced nurses, supported by ongoing professional development and relevant protocols, form part of the ongoing improvement for chronic and complex care management as a health priority. [ABSTRACT FROM AUTHOR]

Background: Patients with complex chronic conditions experience fragmentation of care, unnecessary hospitalization and reduced quality of life, with an increased incidence of poor health outcomes. Aim(s): The aim of this paper was to explore how nurse navigators manage client care. This was achieved through an examination of narratives provided by the nurse navigator that evaluated their scope of practice. Method(s): All nurse navigators employed by Queensland Health were invited to participate in a study evaluating the effectiveness of the service. Eighty‐four self‐reported vignettes were thematically analysed to understand the work from the nurses' perspectives. Results: Two themes emerged from the vignettes. Theme 1, the layers of complexity, is comprised of three sub‐themes: the complex patient, the complex system and patient outcomes. Theme 2, professional attributes, has two sub‐themes: person‐centred care and clinical excellence. Conclusion: Navigators innovatively integrate services and address the fragmented nature of the health system. They apply expert clinical and social skills, through consistent and robust communication, to meet the needs of those with multiple chronic conditions. Implications for nursing management: Results provide insight into the new role, illuminating the work they achieve, despite system complexities. [ABSTRACT FROM AUTHOR]