Search Results (14)

Background/Objective: In nursing practice, differences have been noted between the shared habitus acquired during academic training and professional practices within healthcare systems. In this context, nurses tend to experience an impact on their autonomy due to the ways in which their professional habitus has been established, which, in some way, alters the cultural capital acquired during their academic training. The objective of this study was to identify factors that facilitate and/or limit autonomy in nursing practice based on professional habitus. Method: This research was conducted using a hermeneutic qualitative study framed within a critical approach that incorporated Bourdieu’s theory of fields (habitus, field, and capital). This study included 11 registered nurses working in hospital settings, 17 nursing students, and six university professors. Data collection included 34 sociodemographic forms, 34 individual semi-structured interviews, and five focus group discussions conducted with an interview guide. The collected data were analyzed using an interpretative hermeneutic approach, integrating grounded theory and Bourdieu’s theory of fields, focusing on the concepts of habitus, field, and capital. Results: This study identified a central theme—clarification of the nurse’s role (professional habitus)—alongside three subthemes: (1) strengthening the nursing identity (identity habitus), (2) optimizing nursing education (optimization habitus), and (3) reinforcing professional credibility (validation habitus). Autonomy was found to be influenced by hierarchical structures, power relations, and institutional constraints within the healthcare social field, which led to limitations in the accumulation of nurses’ symbolic capital. Conclusions: The professional habitus of nurses is shaped by various elements within the healthcare social field. This field is constrained by hierarchical structures and factors such as subordination to the hegemonic biomedical discourse and the medical profession, limited recognition of humanized care, institutional restrictions on acknowledging the nursing process, and a lack of solidarity and leadership. These constraints ultimately hinder the accumulation of symbolic and social capital in nursing, leading to a loss of autonomy and hindering professional development. Full article

Background/Objectives: There exist several interconnected issues that hinder the development of family medicine in Commonwealth realms such as the United Kingdom, Canada, New Zealand, and Australia. These issues affect both the medical and nursing professions. Family physicians, in most countries including the United Kingdom, are not considered “specialists” and are called “general practitioners” instead. The term GP is an outdated and potentially demeaning term relegated to the early 20th century when they did not receive any more than a few rotations as staff grades before being allowed to run their own community clinic. Registered nurses often cover a minor and subaltern role when working as practice nurses in the UK. They are often replaced by cost-effective, licensed practical nurses in most other English-speaking countries. Nurse practitioners in the UK, though being de facto entirely equal to family physicians in countries like Canada, Australia, New Zealand, and most US states, do not hold a special registration status. Their training is not defined in specific legislation, and they do not function as alternatives to general practitioners in the sense that patient may register with them alone which is often the case in Canada or the USA. Family medicine is, therefore, generally left lacking leadership with members of the medical and nursing professions often struggling for “power” in a way that undermines the foundation of family medicine which is to serve the health needs of a large population ranging from children to seniors. Methods: The purpose of this paper is to describe a solution to management in a Family Medicine Clinic in Calgary, Alberta, Canada. Results: In this model, the physician-nurse team developed a highly trained role of Clinical Nurse Specialist which serves as an overall clinic manager. Conclusions: The implementation of the Clinical Nurse Specialist-led model in family medicine has improved clinic efficiency, patient access, and provider satisfaction. This approach demonstrates a viable framework for enhancing primary care management across Commonwealth realms. Full article

The carceral apparatus in the U.S. can be understood as mechanisms of policing, criminalizing, and incarcerating through the criminal justice system in its traditional sense but also encompassing mechanisms of social control, surveillance, and violence exerted through other systems such as family policing organizations, social service agencies, and helping professions. As we are witnessing the impacts of the toxic drug supply crisis and continued reliance on the “war on drugs” policies, these carceral functions are deeply felt among people who use drugs and have substance use disorders. This qualitative study uses the Foucauldian lens of biopolitics and biopower to examine how power operates in carceral systems and impacts women who use substances. By conducting and analyzing in-depth interviews with four women who identify as systems-involved in the U.S., this study highlights that power operates in a multitude of ways. The findings highlight the gendered experience these individuals face navigating these systems of circularity, including the minimization of bodily autonomy, the destruction of social reproduction, and coercive performances to the patriarchal gaze. The findings also amplify the women’s perspective on systemic change and offer alternatives to current carceral approaches. This research provides insights for social service professionals in all fields for more liberatory approaches to working with women in carceral settings and proposes a radical departure from current trajectories of social control and criminalization. Full article

Background: Among all professions, teaching is significantly affected by psycho-social risks with approximately 33.33% of educators reporting work-related fatigue. Suggestopedia, an effective pedagogical approach developed in Bulgaria, claims to induce positive psychological and cognitive benefits in both teachers and students. In order to gather scientific evidence, given the above statement, we designed a methodology to detect fatigue in Suggestopedia teachers based on neurocognitive analysis and psychological assessment. Methods: An increase in the EEG theta and alpha band powers is considered among the most reliable markers of fatigue. The proposed methodology introduces a robust framework for fatigue analysis. Initially, the changes in EEG band powers using the resting state EEG activity before and after teaching are measured. Subsequently, validated psychological questionnaires are used to gain subjective feedback on fatigue. The study participants include a control group (traditional teachers) and the test group (suggestopedia teachers) to assess whether suggestopedia practice mitigates fatigue among teachers. Observations: In a pilot study, the EEG data was analyzed by evaluating the interrelations between EEG bands and the alpha–beta ratio. The results of the proposed study are expected to provide comprehensive analysis for the fatigue levels of teachers. In future research, our goal is to position the described methodology as a robust approach for evaluating cognitive and emotional states. Full article

In this article, the occupation of the imam is analysed using a profession-theoretical approach. Following Oevermann, we view professionalised action as a relational practice, characterised by a paradoxical unity of diffuseness and specificity. Drawing on empirical data on imams in Switzerland, we highlight several factors that contribute to a shift towards more diffuse social relationships between professionals and their clients: task-specific boundaries become blurred, and temporal and spatial limits break down. These factors help to explain why imams in Switzerland report feeling stressed and overburdened. We argue that the role of the imam can, in principle, be conceptualised as a profession. From the perspective of a power approach to professions, however, the concept of profession can only be applied to the occupation of an imam to a limited extent, as it is not universal, but remains reserved for men. Full article

While there is significant research on the impact of food insecurity, there is less so through the lens of young people and the youth work response. Therefore, this research presents findings from a small-scale United Kingdom-based study asking what are young people’s and youth workers perceptions of food insecurity and the youth work response. Focus group research methodology was adopted. The research recognised that food insecurity is part of a wider issue of poverty and inequality, and we explored how this is perceived by young people and youth workers at the Personal, Cultural, and Structural levels whilst also situating issues of food insecurity in the global context. Themes of togetherness, relationship, otherness, disempowerment, and learning were identified as key components in the youth work response to food insecurity. A number of recommendations are made, including the importance of highlighting the power of youth work in responding to young people experiencing food insecurity. The youth work approach has application to all professions working to challenge issues of food insecurity and social injustice. Full article

This research investigates the application of deep learning in sentiment analysis of Canadian maritime case law. It offers a framework for improving maritime law and legal analytic policy-making procedures. The automation of legal document extraction takes center stage, underscoring the vital role sentiment analysis plays at the document level. Therefore, this study introduces a novel strategy for sentiment analysis in Canadian maritime case law, combining sentiment case law approaches with state-of-the-art deep learning techniques. The overarching goal is to systematically unearth hidden biases within case law and investigate their impact on legal outcomes. Employing Convolutional Neural Network (CNN)- and long short-term memory (LSTM)-based models, this research achieves a remarkable accuracy of 98.05% for categorizing instances. In contrast, conventional machine learning techniques such as support vector machine (SVM) yield an accuracy rate of 52.57%, naïve Bayes at 57.44%, and logistic regression at 61.86%. The superior accuracy of the CNN and LSTM model combination underscores its usefulness in legal sentiment analysis, offering promising future applications in diverse fields like legal analytics and policy design. These findings mark a significant choice for AI-powered legal tools, presenting more sophisticated and sentiment-aware options for the legal profession. Full article

Predicting nurse turnover is a growing challenge within the healthcare sector, profoundly impacting healthcare quality and the nursing profession. This study employs the Synthetic Minority Over-sampling Technique (SMOTE) to address class imbalance issues in the 2018 National Sample Survey of Registered Nurses dataset and predict nurse turnover using machine learning algorithms. Four machine learning algorithms, namely logistic regression, random forests, decision tree, and extreme gradient boosting, were applied to the SMOTE-enhanced dataset. The data were split into 80% training and 20% validation sets. Eighteen carefully selected variables from the database served as predictive features, and the machine learning model identified age, working hours, electric health record/electronic medical record, individual income, and job type as important features concerning nurse turnover. The study includes a performance comparison based on accuracy, precision, recall (sensitivity), F1-score, and AUC. In summary, the results demonstrate that SMOTE-enhanced random forests exhibit the most robust predictive power in the classical approach (with all 18 predictive variables) and an optimized approach (utilizing eight key predictive variables). Extreme gradient boosting, decision tree, and logistic regression follow in performance. Notably, age emerges as the most influential factor in nurse turnover, with working hours, electric health record/electronic medical record usability, individual income, and region also playing significant roles. This research offers valuable insights for healthcare researchers and stakeholders, aiding in selecting suitable machine learning algorithms for nurse turnover prediction. Full article

Social responsibility has been a core value of the nursing profession, particularly in the area of health disparity. Nevertheless, it is unclear what is meant by social responsibility. This study examined ways to define the concept of the social responsibility of nursing organizations to understand the meaning of social responsibility in the nursing profession. Methods: The concept analysis process reported by Walker and Avant was used to clarify the meaning of social responsibility in nursing organizations. Results: Defining the attributes of the social responsibility of nursing organizations included accessing, educating, and practicing as approaches for strategizing the social and structural change in inequity, caring for oppressed groups suffering socially from those with privilege and power, and taking action for health policy changes in social and political unequal contexts. The antecedents of social responsibility in nursing organizations included recognizing personal characteristics, the perspective of vulnerable populations, and the social and environmental status quo, as well as educating public services on the ethical and moral reasoning of social issues. The consequences of the social responsibility of nursing organizations were achieving social justice as equal access to basic human health needed at a societal level, equal access to effective nursing practices, and the development of health promotion policies for world health administrative practices in nursing. Conclusion: This study provides guidance to direct future studies by identifying conceptual attributes in the context of the social responsibility of nursing organizations. Full article

The work of an engineer involves the conceptualization, design, and implementation of new and improved artifacts. However, what sets engineering apart from other professions is the direct responsibility of engineers to think critically and design innovative solutions to solve complex problems in social systems. Unfortunately, the solutions often do not consider the dynamics of the environment or the cultures that will receive them, leading to obsolescence due to the lack of technical knowledge of maintenance and repair. This exacerbates the disruptive power of technology in culture and society, leading to a gap in engineering education that needs to be addressed. Critical theories attempt to reformulate the teaching and practice of engineering in social-environmental contexts of vulnerability, utilizing systemic models to anticipate solutions based on possible scenarios. However, these theories do not consider the mental models of professional engineers, relying mostly on educational studies. To address this gap, this article explores a novel approach to the problem of sustainability mindset in engineering by understanding the characteristics and structures of engineering systems of practice and conveying it through causal loop diagrams. The results identify causal loops that reinforce or affect the application of sustainable practices, which can be used as leverage points within the systems of practice structure to improve the performance and interest of engineering students in sustainable development endeavors and promote more professionals working with a sustainable mindset. Full article

The competence of machine learning approaches to carry out clinical expertise tasks has recently gained a lot of attention, particularly in the field of medical-imaging examination. Among the most frequently used clinical-imaging modalities in the healthcare profession is chest radiography, which calls for prompt reporting of the existence of potential anomalies and illness diagnostics in images. Automated frameworks for the recognition of chest abnormalities employing X-rays are being introduced in health departments. However, the reliable detection and classification of particular illnesses in chest X-ray samples is still a complicated issue because of the complex structure of radiographs, e.g., the large exposure dynamic range. Moreover, the incidence of various image artifacts and extensive inter- and intra-category resemblances further increases the difficulty of chest disease recognition procedures. The aim of this study was to resolve these existing problems. We propose a deep learning (DL) approach to the detection of chest abnormalities with the X-ray modality using the EfficientDet (CXray-EffDet) model. More clearly, we employed the EfficientNet-B0-based EfficientDet-D0 model to compute a reliable set of sample features and accomplish the detection and classification task by categorizing eight categories of chest abnormalities using X-ray images. The effective feature computation power of the CXray-EffDet model enhances the power of chest abnormality recognition due to its high recall rate, and it presents a lightweight and computationally robust approach. A large test of the model employing a standard database from the National Institutes of Health (NIH) was conducted to demonstrate the chest disease localization and categorization performance of the CXray-EffDet model. We attained an AUC score of 0.9080, along with an IOU of 0.834, which clearly determines the competency of the introduced model. Full article

Musculoskeletal symptoms are increased in farmers, whereas the prevalence of chronified pain is unknown. Online interventions based on acceptance and commitment therapy (ACT) have shown encouraging results in the general population, representing a promising approach for reducing pain interference in green professions (i.e., farmers, foresters, gardeners). We conducted a pragmatic RCT comparing a guided ACT-based online intervention to enhanced treatment-as-usual in entrepreneurs, contributing spouses, family members and pensioners in green professions with chronic pain (CPG: ≥grade II, ≥6 months). Recruitment was terminated prematurely after 2.5 years at N = 89 (of planned N = 286). Assessments were conducted at 9 weeks (T1), 6 months (T2) and 12 months (T3) post-randomization. The primary outcome was pain interference (T1). The secondary outcomes encompassed pain-, health- and intervention-related variables. No treatment effect for reduction of pain interference was found at T1 (β = −0.16, 95%CI: −0.64–0.32, p = 0.256). Improvements in cognitive fusion, pain acceptance, anxiety, perceived stress and quality of life were found only at T3. Intervention satisfaction as well as therapeutic and technological alliances were moderate, and uptake and adherence were low. Results are restricted by low statistical power due to recruitment issues, high study attrition and low intervention adherence, standing in contrast to previous studies. Further research is warranted regarding the use of ACT-based online interventions for chronic pain in this occupational group. Trial registration: German Clinical Trial Registration: DRKS00014619. Registered: 16 April 2018. Full article

The American healthcare payment model introduced Pharmacy Benefit Managers (PBMs) into a position of power that currently puts into question the state of the pharmacy profession, especially in the community field. Reimbursement plans had been designed to benefit all stakeholders and save patients money but have only been shown to increase costs for these involved parties. There exist unresolved gaps in care as a result of the healthcare structure and underutilized skills of trained pharmacists who do not have the federal means to provide clinical services. Four collaborative payment models have been proposed, offering methods to quell the monetary problems that exist and are predicted to continue with the closure of community pharmacies and sustained influence of PBMs. These models may additionally allow the expansion of pharmacy career paths and improve healthcare benefits for patients. With a reflective perspective on the healthcare structure and knowledge of positive impacts with the inclusion of pharmacists, solutions to payment challenges could present a progressive approach to an outdated system. The impact of the COVID-19 pandemic highlights a dependency on pharmacists and community settings. This outlook on pharmacists may persist and an established expansion of services could prove beneficial to all healthcare stakeholders. Full article

The story of my evolution as a practice-based collaborative researcher is a story that comes full circle. Through exploring my own experiences of compassion fatigue and vicarious trauma as a hospital-based social worker, I am able to investigate the phenomenon across the profession and provide a critique of the needs of practitioners working in the complex environment of hospitals and health care. Parallel to this is an investigation into the need for practice research in this complex environment and in the profession overall as seen through the lens of a collaborative research partnership with social work hospital colleagues that transformed my approach to research. I have drawn on personal narrative, autoethnography and reflexive processing to investigate my own impact on and from this research. I conclude with an understanding of the power of storytelling in participatory action research and in the potential in collaborative research methodologies for authentic reciprocity and relationship to traverse the practice–research divide. Full article