Health care reform: current updates and future initiatives for ambulatory care nursing

While the signing of the Patient Protection and Affordable Care Act was a historical event marking the beginning of health care reform in the United States, it signaled the start of a golden age for ambulatory care nursing. Ambulatory care RNs are well-positioned to fully participate in health care reform initiatives. RNs are well-positioned to lead, facilitate, and/or participate in all patient care medical homes' and accountable care organizations' quality and safety initiatives through enhanced use of major ambulatory care RN role dimensions such as advocacy, telehealth, patient education, care coordination and transitional care, and community outreach. RNs are also well-positioned to provide patient-centered care, coordinate care, and manage transitions across ambulatory care settings. For the golden age of ambulatory care nursing to become a reality, initiatives surrounding competencies, education modules, and leadership must be addressed immediately.     

Body Relationships in an Urban Adventure Setting

This article examines a recent tendency amongst researchers of sex tourism to include women within the ranks of sex tourists in destinations such as the Caribbean and Indonesia. It argues that a careful attention to the power relations, context, meanings and effects of the behaviours of male and female tourists who engage in sexual relations with local people, makes it clear that the differences are profound. The similarities and differences are analysed here with the conclusion that it is the different positions of men and women in the sex class hierarchy that create such differences. The political ideas that influence the major protagonists in this debate to include or exclude women will be examined. The article ends with a consideration of the problematic implications of arguing that women do it too .     

“No accounting for these people”: Shell in Ireland and accounting language

Accounting lays claims to be the language of business: a clear, technical, unambiguous means of communication for decisions on investment and economic development. Accounting concepts have increasingly entered mainstream debate on issues affecting society at large. This makes the fairness and effectiveness of accounting as a mode of communication more important for social justice than ever before. In a contentious development, if the discussion is framed primarily in accounting terms, this may disenfranchise those parties to the dispute whose issues are not readily expressed in the common vocabulary of business. Their concerns may become invisible in the debate. If this happens, then accounting has failed as a means of communication, and that failure is non-neutral in that it favours those whose position is best supported by economic arguments.This paper explores this phenomenon using the case of a dispute between Royal Dutch Shell and a local community in Ireland concerning a gas refinery located in an environmentally sensitive area. The issues in conflict are complex and at times intangible. I explore how the limitations of accounting as a language blinded the protagonists to an understanding of each other's concerns, marginalised the concerns of protestors from the public discourse, shifting power from objectors within the local community to those whose primary concern was the economic exploitation of natural resources. I argue that accounting failed as a mode of communication to progress a resolution of the dispute, and that this failure was both unnecessary, and systematic in its support of economic interests.     

Giving voice to heritage tourists: indicators of quality for a sustainable heritage experience at Petra,Jordan

ABSTRACT

The tourist experience should be placed at the heart of management and planning process to achieve the goal of sustainable heritage tourism. The concept of indicators and standards of quality, which emerged in the field of natural resources and outdoor recreation management as a conceptual framework for understanding visitors’ experiences, has been widely applied in nature-based parks rather than cultural heritage sites. This study applies the concept of indicators to heritage experience at Petra Archaeological Park in Jordan. Qualitative interviews were conducted with 29 tourists to understand the tourist experience at the park, and to formulate indicators of the tourism experience. Results suggest that cultural and natural scenic value, crowding, attractions accessibility, vendor persistence, and odor of animals waste are potential indicators for the tourism experience at the park. Related management implications and recommendations are also discussed.     

The legacy of Paul Volcker

Business Economics - Paul Volcker was a model public servant, not only his service as Fed Chair, but also in his work on international economic policy at the Treasury, and in his service in many...     

From iconic business leader to Russian icon museum founder: Bridging business and the arts across cultures

This case study portrays Gordon Lankton, a highly successful U.S. executive who, drawing upon the relationships he had built during two decades of doing business in Russia, succeeded in having Moscow's renowned State Tretyakov Gallery lend priceless icons to his new museum in a small Massachusetts town. We demonstrate how a charismatic and gently determined executive‐turned‐museum founder exhibited transformational leadership while bridging business and the arts across cultures. The case study includes an interview with Gordon Lankton and is followed by a commentary that features an interview with Kent dur Russell (the Museum of Russian Icons curator) and a strengths, weaknesses, opportunities, and threats (SWOT) analysis of Lankton's leadership style. © 2010 Wiley Periodicals, Inc.     

Ambulatory care registered nurse performance measurement

On March 1-2, 2010, a state-of-the-science invitational conference titled "Ambulatory Care Registered Nurse Performance Measurement" was held to focus on measuring quality at the RN provider level in ambulatory care. The conference was devoted to ambulatory care RN performance measurement and quality of health care. The specific emphasis was on formulating a research agenda and developing a strategy to study the testable components of the RN role related to care coordination and care transitions, improving patient outcomes, decreasing health care costs, and promoting sustainable system change. The objectives were achieved through presentations and discussion among expert inter-professional participants from nursing, public health, managed care, research, practice, and policy. Conference speakers identified priority areas for a unified practice, policy, and research agenda. Crucial elements of the strategic dialogue focused on issues and implications for nursing and inter-professional practice, quality, and pay-for-performance.     

Uncertainty and monetary policy

The experience of monetary policy making in an uncertain environmenthas encouraged increased attention to the concept of model uncertainty,that is, uncertainty as to which is the best model. A particulardifficulty has been the need to operationalise the concept inorder to yield definitive policy recommendations. If this typeof uncertainty is unquantifiable, then a policy rule determinedby a single model may not in fact be the best approach; pluralismof method and the exercise of judgement offer a potential solution.A rigorous foundation for such an approach is available in Keynes'sphilosophical analysis of decision making under uncertainty.It is concluded that more analytical attention needs to be devotedto agents’ own model uncertainty, and to judgement. Butultimately the scope for synthesis between the model uncertaintyand Keynes uncertainty approaches rests on whether or not thesubject matter is such that knowledge of it is best representedby one formal model.