Nurses joining family doctors in primary care practices: perceptions of patients with multimorbidity

<p>Abstract</p> <p>Background</p> <p>Among the strategies used to reform primary care, the participation of nurses in primary care practices appears to offer a promising avenue to better meet the needs of vulnerable patients. The present study explores the perceptions and expectations of patients with multimorbidity regarding nurses' presence in primary care practices.</p> <p>Methods</p> <p>18 primary (health) care patients with multimorbidity participated in semi-directed interviews, in order to explore their perceptions and expectations in regard to the involvement of nurses in primary care practices. Interviews were audio-recorded and transcribed. After reviewing the transcripts, the principal investigator and research assistants performed thematic analysis independently and reached consensus on the retained themes.</p> <p>Results</p> <p>Patients with multimorbidity were open to the participation of nurses in primary care practices. They expected greater accessibility, for both themselves and for new patients. However, the issue of shared roles between nurses and doctors was a source of concern. Many patients held the traditional view of the nurse's role as an assistant to the doctor in his or her various duties. In general, participants said they were confident about nurses' competency but expressed concern about nurses performing certain acts that their doctor used to, notwithstanding a close collaboration between the two professionals.</p> <p>Conclusion</p> <p>Patients with multimorbidity are open to the involvement of nurses in primary care practices. However, they expect this participation to be established using clear definitions of professional roles and fields of practice.</p

Engagement with the Mainstream in the Future of Post Keynesian Economics

This paper examines the reasons for the difficulties Post Keynesian economics has had in supplanting mainstream neoclassical theory and for its resulting marginalization. Three explanations are given: intellectual, sociological and political, where the latter two are largely responsible for the current relationship of Post Keynesian economics to the mainstream. The paper also reviews various strategies for improving the future of Post Keynesian economics, including a focus on methodological issues by maintaining an 'open systems' approach; a strategy of 'embattled survival'; the development of a positive alternative to mainstream economics; a strategy of 'constructive engagement' with the mainstream; and a dialogue with policymakers. While the global financial crisis has increased the potential for constructive engagement with the mainstream, significant barriers remain to the effectiveness of this approach. The crisis has, however, enhanced the possibility of engaging directly with policymakers and gaining a greater role in management education. © 2012 Copyright Taylor and Francis Group, LLC

Basic endogenous-money economy: An agent-based approach

We present an agent-based model of a simple endogenous-money economy. The model simulates agents representing individual persons who can work, consume, invent new products and related production technologies, apply for a loan from the bank and start up a business. Through the interaction of persons with the firms, we simulate the production of goods, consumption and labour market. This setting allows us to explore how an endogenous-money economy may build up from scratch, as an emergent property of actions and interactions among heterogeneous agents, once the money is being injected into a non-monetary self-production (or barter) economy. We provide and discuss the results of several computational experiments under three scenarios: (1) with just one firm, (2) with a limited number of firms and abundant workforce, (3) and with unlimited number of firms. © 2014 Springer-Verlag

PPP Financing in the Road Sector: A Disequilibrium Analysis Based on the Monetary Circuit

Public private partnerships, Monetary circuit, Roads, D60, E600, L920,

Muscle atrophy in aging and chronic diseases: is it sarcopenia or cachexia?

Cachexia and sarcopenia present several analogies in both the pathogenic mechanisms and the clinical picture. The loss of muscle mass and strength is a hallmark of these two clinical conditions. Although frequently overlapping and often indistinguishable, especially in old individuals, these two conditions should be considered distinct clinical entities. A prompt and accurate patient evaluation, guiding the physician through a proper differential diagnostic procedure and providing the best therapeutic options, is recommended. Given the several commonalities between cachexia and sarcopenia, it is likely that the therapeutic approaches may prove effective in both conditions. This review focuses on the most recent available literature and aims at providing physicians with the correct tools that are available to aid in diagnosing these two different entities that often clinically overlap. Currently available or proposed therapeutic strategies for pre-cachexia, cachexia and sarcopenia are also briefly described