Trauma nursing competency in the emergency department: a concept analysis.

OBJECTIVES: Despite numerous published concept analyses of nursing competency, the specific understanding of trauma nursing competency in emergency departments remains limited, with no clear definition. This study aimed to clarify the definitions and attributes of trauma nursing competencies in emergency departments. DESIGN: Walker and Avant's method was used to clarify the concept of trauma nursing competency in emergency departments. DATA SOURCES: PubMed, EMBASE, CINAHL and RISS were searched from inception to 23 April 2023. ELIGIBILITY CRITERIA: Relevant studies that included combinations of the terms 'nurse', 'nursing', 'emergency', 'trauma', 'competency', 'capability' and 'skill' were selected. We restricted the literature search to English and Korean full-text publications, with no limit on the publication period; grey literature was excluded. DATA EXTRACTION AND SYNTHESIS: This study uses defining attributes, antecedents and consequences extracted through data analysis. To aid comprehension of the model, related and contrary cases of the concept were created, and empirical referents were defined. RESULTS: After excluding duplicates, irrelevant studies, incomplete texts and articles unrelated to the context and study population, 15 of the initial 927 studies were included. Five additional studies were added after a manual search of the references. The final concept analysis therefore included 20 studies. The attributes of trauma nursing competency for emergency nurses included 'rapid initial assessments considering injury mechanisms', 'priority determinations based on degrees of urgency and severity', 'clinical knowledge of trauma nursing', 'skills of trauma nursing', 'interprofessional teamwork' and 'emotional care'. CONCLUSIONS: The concept analysis revealed that it is possible to promote the enhancement and development of trauma nursing competency in emergency departments across various contexts, such as clinical practice, education, research and organisational settings. This could ultimately improve trauma nursing quality and treatment outcomes.

The neural representation of body part concepts.

Neuropsychological and neuroimaging studies provide evidence for a degree of category-related organization of conceptual knowledge in the brain. Some of this evidence indicates that body part concepts are distinctly represented from other categories; yet, the neural correlates and mechanisms underlying these dissociations are unclear. We expand on the limited prior data by measuring functional magnetic resonance imaging responses induced by body part words and performing a series of analyses investigating the cortical representation of this semantic category. Across voxel-level contrasts, pattern classification, representational similarity analysis, and vertex-wise encoding analyses, we find converging evidence that the posterior middle temporal gyrus, the supramarginal gyrus, and the ventral premotor cortex in the left hemisphere play important roles in the preferential representation of this category compared to other concrete objects.

Concept analysis of conscience-based nursing care: a hybrid approach of Schwartz-Barcott and Kim's hybrid model.

BACKGROUND: The nursing profession considers conscience as the foundation and cornerstone of clinical practice, which significantly influences professional decision-making and elevates the level of patient care. However, a precise definition of conscience in the nursing field is lacking, making it challenging to measure. To address this issue, this study employed the hybrid approach of Schwartz Barcott and Kim to analyze the concept of conscience-based nursing care. METHODS: This approach involves a three-phase process; theoretical, fieldwork, and analytical. A systematic literature review was conducted using electronic databases during the first phase to find relevant papers. The content of 42 articles that met the inclusion criteria was extracted to determine the attributes, antecedents, and consequences of consciousness care using thematic analysis. Based on the working definition as a product of this phase, the plan of doing the fieldwork phase was designed. During this phase, data were collected through interviews with nurses all of whom were responsible for patient care in hospitals. In this phase, 5 participants were chosen for in-depth interviewing by purposeful sampling. Data were analyzed using directed content analysis. The findings of the theoretical and fieldwork phases were integrated and the final definition was derived. RESULTS: The integration of the theoretical and fieldwork phases resulted in identifying four key characteristics of conscience-based nursing care. Firstly, it involves providing professional care with a conscientious approach. Secondly, ethics is at the core of conscience-based care. Thirdly, external spirituality plays a significant role in shaping one's conscience in this context. Finally, conscience-based nursing care is both endogenous and exogenous, with professional commitment being the central focus of care. CONCLUSION: Conscience-based nursing care is an essential component of ethical care, which elevates clinical practice to professional care. It requires the integration of individual and social values, influenced by personal beliefs and cultural backgrounds, and supported by professional competence, resources, and a conducive organizational atmosphere in the healthcare field. This approach leads to the provision of responsive care, moral integrity, and individual excellence, ultimately culminating in the development of professionalism in nursing.

Defining the complexities of an occupational pattern-A concept analysis and theoretical validation.

BACKGROUND: The concept of an occupational pattern in occupational therapy and occupational science has evolved with varying definitions, ranging from activity patterns to patterns of daily occupation. AIMS: This study aimed to explore the concept of occupational pattern, develop an updated definition of the concept, and theoretically validate the concept's definition. METHOD: Walker and Avant's concept analysis method was used, where both theoretical frameworks and peer-reviewed scientific literature were searched and synthesized to clarify and define the concept. Furthermore, seven occupational therapists theoretically validated the concept. FINDINGS: The analysis included forty-nine references from various research contexts and theoretical perspectives. The synthesis yielded a conceptualization of the concept of occupational pattern, outlining it into three overarching categories: 'content in an individual's occupational pattern', 'designing an occupational pattern', and 'balancing the occupational pattern'. IMPLICATIONS: An updated operational definition of the multifaceted concept of an occupational pattern now exists, with practical implications for enhancing the education of occupational therapy students and guiding the utilization of the concept. Moreover, it holds significance for instrument development and outcome measurement in research; especially in lifestyle intervention studies within the field of occupational therapy.

Nurses' media competency: A concept analysis.

OBJECTIVES: To analyze and define the concept of nurses' media competency. DESIGN: Concept analysis. DATA SOURCES: We conducted a literature search in PubMed, CINAHL, PsycInfo, and RISS International, as well as a hand-search, for relevant articles published between January 1990 and April 2023. A total of 57 articles related to nurses' media competency, published in English or Korean, were included in this study. REVIEW METHODS: We used Walker and Avant's method of concept analysis to identify the defining attributes, antecedents, and consequences of the concept. RESULTS: The seven defining attributes of nurses' media competency were networking with members of the media, selecting the appropriate media platform, considering that the target audience is the public, creating one's own media products, delivering intended messages through the media, monitoring and responding to the media, and maintaining professional dignity. Antecedents of the concept included cultivation of desirable nursing professionalism, critical evaluation of policies and issues, recognition of media influence, establishment of education and guidelines for media use, and having facilities and availability of technologies for media use. Consequences of the concept were improved influence of individual nurses, enhanced public awareness of the nursing profession, stronger networks and collaboration among professionals, and contributions to the promotion of public health. CONCLUSIONS: This concept analysis presents a theoretical definition of nurses' media competency that can provide guidance on how to educate nurses to develop media competency and how to measure nurses' media competency.

Bridging the Chasm Between Cognitive Representations and Formal Structures of Linguistic Meanings.

This paper aims to show that properties of cognitive/conceptual representations and formal-logical structures of linguistic meaning can be inter-translated, recast, transformed into one another, and so united together, even though cognitive/conceptual representations and formal-logical structures of linguistic meaning are apparently distinct in ontology and divergent in their form or character. While cognitive/conceptual representations are ultimately rooted in sensory-motor systems, formal-logical structures of linguistic meaning are abstractions detached from and independent of the actualized world. This paper sketches out the foundations of how representations of linguistic meaning in terms of cognitive/conceptual structures in Cognitive/Conceptual Semantics can be unified with those in terms of formal-logical structures in Formal Semantics. This is done by recasting cognitive/conceptual representations in terms of formal-logical structures of linguistic meaning and re-encoding formal-logical structures of linguistic meaning in terms of cognitive/conceptual representations. Then, these two types of semantic representations, thus shown representationally equivalent, will be related to a series of derivations across levels in neuronal networks and dynamics. The general discussion on unifying cognitive/conceptual representations of linguistic meaning with formal-logical structures is contextualized within the broader context of theorizing in cognitive science.

On the dual nature of creativity: Same same but different?

The creativity literature is replete with dualistic constructs, suggesting shared mechanisms but also tempting overinterpretation of their interrelations. An explicit list of relevant concept associations indicates substantial commonality, yet also exposes certain inconsistencies. Dual-process accounts (A and B is relevant) hold promise in resolving discrepancies to the extent that we understand the relative contributions and conditions of A and B.

The Effects of Linear Order in Category Learning: Some Replications of Ramscar et al. (2010) and Their Implications for Replicating Training Studies.

Ramscar, Yarlett, Dye, Denny, and Thorpe (2010) showed how, consistent with the predictions of error-driven learning models, the order in which stimuli are presented in training can affect category learning. Specifically, learners exposed to artificial language input where objects preceded their labels learned the discriminating features of categories better than learners exposed to input where labels preceded objects. We sought to replicate this finding in two online experiments employing the same tests used originally: A four pictures test (match a label to one of four pictures) and a four labels test (match a picture to one of four labels). In our study, only findings from the four pictures test were consistent with the original result. Additionally, the effect sizes observed were smaller, and participants over-generalized high-frequency category labels more than in the original study. We suggest that although Ramscar, Yarlett, Dye, Denny, and Thorpe (2010) feature-label order predictions were derived from error-driven learning, they failed to consider that this mechanism also predicts that performance in any training paradigm must inevitably be influenced by participant prior experience. We consider our findings in light of these factors, and discuss implications for the generalizability and replication of training studies.

The hippocampus supports the representation of abstract concepts: Implications for the study of recognition memory.

Words, unlike images, are symbolic representations. The associative details inherent within a word's meaning and the visual imagery it generates, are inextricably connected to the way words are processed and represented. It is well recognised that the hippocampus associatively binds components of a memory to form a lasting representation, and here we show that the hippocampus is especially sensitive to abstract word processing. Using fMRI during recognition, we found that the increased abstractness of words produced increased hippocampal activation regardless of memory outcome. Interestingly, word recollection produced hippocampal activation regardless of word content, while the parahippocampal cortex was sensitive to concreteness of word representations, regardless of memory outcome. We reason that the hippocampus has assumed a critical role in the representation of uncontextualized abstract word meaning, as its information-binding ability allows the retrieval of the semantic and visual associates that, when bound together, generate the abstract concept represented by word symbols. These insights have implications for research on word representation, memory, and hippocampal function, perhaps shedding light on how the human brain has adapted to encode and represent abstract concepts.

Mechanisms of Concept Verbalization in the Ethnolinguistic Context.

This article investigates the verbalization mechanisms of the 'family' concept within the Kazakh, Russian, and English linguistic cultures. The research aims to examine the verbal representation mechanisms of the 'family' concept within the linguistic worldviews of the aforementioned cultures. The research material comprises dictionary definitions of the primary lexemes as presented in explanatory dictionaries and synonym dictionaries, proverbs and sayings, phraseological units, and data derived from an associative experiment. The employed analysis methods include component analysis, the descriptive method, the experimental method (psycholinguistic experiment), and the statistical method. This article furnishes a thorough analysis of the linguistic representation methods of the 'family' concept, illuminating its intricate and multidimensional nature. The authors endeavored to identify the concept's structure and describe linguistic units via the interpretation of semantic components. Based on the data procured from the psycholinguistic experiment, the components and layers of the 'family' concept, identified during the analysis, substantiate the theory that this concept plays a fundamental role in the shaping of society and individuals.

The tail of the caudate is sensitive to both gain and loss feedback during information integration categorization.

Although most category learning studies use feedback for training, little attention has been paid to how individuals utilize feedback implemented as gains or losses during categorization. We compared skilled categorization under three different conditions: Gain (earn points for correct answers), Gain and Loss (earn points for correct answers and lose points for wrong answers) and Correct or Wrong (accuracy feedback only). We also manipulated difficulty and point value, with near boundary stimuli having the highest number of points to win or lose, and stimuli far from the boundary having the lowest point value. We found that the tail of the caudate was sensitive to feedback condition, with highest activity when both Gain and Loss feedback were present and least activity when only Gain or accuracy feedback was present. We also found that activity across the caudate was affected by distance from the decision bound, with greatest activity for the near boundary high value stimuli, and lowest for far low value stimuli. Overall these results indicate that the tail of the caudate is sensitive not only to positive rewards but also to loss and punishment, consistent with recent animal research finding tail of the caudate activity in aversive learning.

The coronavirus disease 2019 infodemic: a concept analysis.

Aim: This study aimed to analyze the coronavirus disease 2019 (COVID-19) infodemic phenomenon in the medical field, providing essential data to help healthcare professionals understand it. Methods: This study utilized a hybrid model for concept analysis. In the theoretical phase (first phase), a literature review was conducted using ScienceDirect, PubMed, CINAHL, ProQuest, Scopus, Web of Science, DBpia, RISS, and KISS. Semi-structured interviews, involving eight physicians and six nurses, were used in the fieldwork phase (second phase). In the final analysis phase (third phase), the results of the preceding phases were combined. Results: Based on the findings of these phases, the COVID-19 infodemic can be defined as "the phenomenon of information flood, reproduction, dissemination, and asymmetry, which occurred during the pandemic through social networks among the public lacking essential knowledge of infectious disease, and is associated with negative and positive effects." Conclusion: Our findings can help the Ministry of Health and Welfare and healthcare professionals to understand the phenomenon of the infodemic and prepare necessary strategies and education programs for the public. Therefore, the provision of basic data is important for developing influential roles for healthcare professionals during infectious disease outbreaks.

Solving Bongard Problems With a Visual Language and Pragmatic Constraints.

More than 50 years ago, Bongard introduced 100 visual concept learning problems as a challenge for artificial vision systems. These problems are now known as Bongard problems. Although they are well known in cognitive science and artificial intelligence, only very little progress has been made toward building systems that can solve a substantial subset of them. In the system presented here, visual features are extracted through image processing and then translated into a symbolic visual vocabulary. We introduce a formal language that allows representing compositional visual concepts based on this vocabulary. Using this language and Bayesian inference, concepts can be induced from the examples that are provided in each problem. We find a reasonable agreement between the concepts with high posterior probability and the solutions formulated by Bongard himself for a subset of 35 problems. While this approach is far from solving Bongard problems like humans, it does considerably better than previous approaches. We discuss the issues we encountered while developing this system and their continuing relevance for understanding visual cognition. For instance, contrary to other concept learning problems, the examples are not random in Bongard problems; instead they are carefully chosen to ensure that the concept can be induced, and we found it helpful to take the resulting pragmatic constraints into account.

The Neural Corelates of Constructing Conceptual and Perceptual Representations of Autobiographical Memories.

Contemporary neurocognitive frameworks propose that conceptual and perceptual content of autobiographical memories-personal past experiences-are processed by dissociable neural systems. Other work has proposed a central role of the anterior hippocampus in initially constructing autobiographical memories, regardless of the content. Here, we report on an fMRI study that utilized a repeated retrieval paradigm to test these ideas. In an MRI scanner, participants retrieved autobiographical memories at three timepoints. During the third retrieval, participants either shifted their focus to the conceptual content of the memory, the perceptual content of the memory, or retrieved the memory as they had done so on previous trials. We observed stronger anterior hippocampal activity for the first retrieval compared with later retrievals, regardless of whether there was a shift in content in those later trials. We also found evidence for separate cortical systems when constructing autobiographical memories with a focus on conceptual or perceptual content. Finally, we found that there was common engagement between later retrievals that required a shift toward conceptual content and the initial retrieval of a memory. This final finding was explored further with a behavioral experiment that provided evidence that focusing on conceptual content of a memory guides memory construction, whereas perceptual content adds precision to a memory. Together, these findings suggest there are distinct content-oriented cortical systems that work with the anterior hippocampus to construct representations of autobiographical memories.

From integers to fractions: The role of analogy in transfer and long-term learning.

Fractions are the gatekeepers to advanced mathematics but are difficult to learn. One powerful learning mechanism is analogy, which builds fraction understanding on a pre-existing foundation of integer knowledge. Indeed, a short intervention that aligned fractions and integers on number lines improved children's estimates of fractions (Yu et al., 2022). The breadth and durability of such gains, however, are unknown, and analogies to other sources (such as percentages) may be equally powerful. To investigate this issue, we randomly assigned 109 fourth and fifth graders to one of three experimental conditions with different analogical sources (integers, percentages, or fractions) or a control condition. During training, children in the experimental conditions solved pairs of aligned fraction number line problems and proportionally-equivalent problems expressed in integers, percentages, or fractions (e.g., 3/8 on a 0-1 number line aligned with 3 on a 0-8 number line). Children in the control group solved fraction number-line problems sequentially. At pretest and a two-week delayed posttest, children completed a broad fraction knowledge battery, including estimation, comparison, categorization, ordering, and arithmetic. Results showed that aligning integers and fractions on number lines facilitated better estimation of fractional magnitudes, and the training effect transferred to novel fraction problems after two weeks. Similar gains were not observed for analogies using percentages. These findings highlight the importance of building new mathematical knowledge through analogies to familiar, similar sources.

Mapping semantic space: Exploring the higher-order structure of word meaning.

Multiple representation theories posit that concepts are represented via a combination of properties derived from sensorimotor, affective, and linguistic experiences. Recently, it has been proposed that information derived from social experience, or socialness, represents another key aspect of conceptual representation. How these various dimensions interact to form a coherent conceptual space has yet to be fully explored. To address this, we capitalized on openly available word property norms for 6339 words and conducted a large-scale investigation into the relationships between 18 dimensions. An exploratory factor analysis reduced the dimensions to six higher-order factors: sub-lexical, distributional, visuotactile, body action, affective and social interaction. All these factors explained unique variance in performance on lexical and semantic tasks, demonstrating that they make important contributions to the representation of word meaning. An important and novel finding was that the socialness dimension clustered with the auditory modality and with mouth and head actions. We suggest this reflects experiential learning from verbal interpersonal interactions. Moreover, formally modelling the network structure of semantic space revealed pairwise partial correlations between most dimensions and highlighted the centrality of the interoception dimension. Altogether, these findings provide new insights into the architecture of conceptual space, including the importance of inner and social experience, and highlight promising avenues for future research.

"It's hard to say anything definitive about what severity really is": lay conceptualisations of severity in a healthcare context.

BACKGROUND: Demand for healthcare outweighs available resources, making priority setting a critical issue. 'Severity' is a priority-setting criterion in many healthcare systems, including in Norway, Sweden, the Netherlands, and the United Kingdom. However, there is a lack of consensus on what severity means in a healthcare context, both in the academic literature and in policy. Further, while public preference elicitation studies demonstrate support for severity as a relevant concern in priority setting, there is a paucity of research on what severity is taken to mean for the public. The purpose of this study is to explore how severity is conceptualised by members of the general public. METHODS: Semi-structured group interviews were conducted from February to July 2021 with members of the Norwegian adult public (n = 59). These were transcribed verbatim and subjected to thematic analysis, incorporating inductive and deductive elements. RESULTS: Through the analysis we arrived at three interrelated main themes. Severity as subjective experience included perceptions of severity as inherently subjective and personal. Emphasis was on the individual's unique insight into their illness, and there was a concern that the assessment of severity should be fair for the individual. The second theme, Severity as objective fact, included perceptions of severity as something determined by objective criteria, so that a severe condition is equally severe for any person. Here, there was a concern for determining severity fairly within and across patient groups. The third theme, Severity as situation dependent, included perceptions of severity centered on second-order effects of illness. These included effects on the individual, such as their ability to work and enjoy their hobbies, effects on those surrounding the patient, such as next of kin, and effects at a societal level, such as production loss. We also identified a concern for determining severity fairly at a societal level. CONCLUSIONS: Our findings suggest that severity is a polyvalent notion with different meanings attached to it. There seems to be a dissonance between lay conceptualisations of severity and policy operationalisations of the term, which may lead to miscommunications between members of the public and policymakers.

A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact.

BACKGROUND: The growing adoption of continuous quality improvement (CQI) initiatives in healthcare has generated a surge in research interest to gain a deeper understanding of CQI. However, comprehensive evidence regarding the diverse facets of CQI in healthcare has been limited. Our review sought to comprehensively grasp the conceptualization and principles of CQI, explore existing models and tools, analyze barriers and facilitators, and investigate its overall impacts. METHODS: This qualitative scoping review was conducted using Arksey and O'Malley's methodological framework. We searched articles in PubMed, Web of Science, Scopus, and EMBASE databases. In addition, we accessed articles from Google Scholar. We used mixed-method analysis, including qualitative content analysis and quantitative descriptive for quantitative findings to summarize findings and PRISMA extension for scoping reviews (PRISMA-ScR) framework to report the overall works. RESULTS: A total of 87 articles, which covered 14 CQI models, were included in the review. While 19 tools were used for CQI models and initiatives, Plan-Do-Study/Check-Act cycle was the commonly employed model to understand the CQI implementation process. The main reported purposes of using CQI, as its positive impact, are to improve the structure of the health system (e.g., leadership, health workforce, health technology use, supplies, and costs), enhance healthcare delivery processes and outputs (e.g., care coordination and linkages, satisfaction, accessibility, continuity of care, safety, and efficiency), and improve treatment outcome (reduce morbidity and mortality). The implementation of CQI is not without challenges. There are cultural (i.e., resistance/reluctance to quality-focused culture and fear of blame or punishment), technical, structural (related to organizational structure, processes, and systems), and strategic (inadequate planning and inappropriate goals) related barriers that were commonly reported during the implementation of CQI. CONCLUSIONS: Implementing CQI initiatives necessitates thoroughly comprehending key principles such as teamwork and timeline. To effectively address challenges, it's crucial to identify obstacles and implement optimal interventions proactively. Healthcare professionals and leaders need to be mentally equipped and cognizant of the significant role CQI initiatives play in achieving purposes for quality of care.

The Dimensional Conceptualization of Personality Disorders: Personality Organization, Personality Functioning, and Personality Disorders.

Over the past several decades, significant criticism of the categorical classification system for personality disorders has highlighted the need to transition to a dimensional classification system. This study reviewed key issues involved in the potential conversion of the diagnostic system of personality disorders from a categorical to a dimensional model. The result suggests that Kernberg's concept of personality organization can be used to indicate the overall severity of personality pathology.

A concept analysis of person-centred handover practices: The meaning in emergency departments.

BACKGROUND: Transfer of patients from the prehospital to the in-hospital environment is a frequent occurrence requiring a handover process. Habitually, emergency care practitioners and healthcare professionals focus on patient care activities, not prioritising person-centred handover practices and not initiating person-centred care. AIM: The aim of this concept analysis was to define the concept person centred handover practices. METHODS: The eight steps for Walker and Avant's method of concept analysis. RESULTS: Thirty-one articles were included for final review including qualitative and quantitative studies, literature reviews and audits. This concept analysis guided the development of an concept definition of person-centred handover practices between emergency care practitioners and healthcare professionals in the emergency department as person- centred handover practices are those handovers being performed while including all identified defining attributes such as structure, verbal, and written information transfer, interprofessional process, inclusion of the patient and/ or family, occurs at the bedside, without interruption. CONCLUSIONS: Results suggested that person-centred handover practices involve verbal and non- verbal interprofessional communication within a specific location in the emergency department. It requires mutual respect from all professionals involved, experience and training, and the participation of the patient and / or family to improve patient outcomes and quality patient care. A definition for the concept may encourage the implementation of person-centred handover practices in emergency departments.