nursing

Open Journal of Nursing, 2015, 5, 17-23 Published Onplan January 2015 in SciRes. http://www.scirp.org/journal/ojn http://dx.doi.org/10.4236/ojn.2015.51003

How to summon this pamphlet: Bahramnezhad, F., Shiri, M., Asgari, P. and Afshar, P.F. (2015) A Retrospect of the Nursing Paradigm. Known Journal of Nursing, 5, 17-23. http://dx.doi.org/10.4236/ojn.2015.51003

A Retrospect of the Nursing Paradigm Fatemeh Bahramnezhad1, Mahmoud Shiri2, Parvaneh Asgari3*, Pouya Farokhnezhad Afshar4 1Nursing and Midwifery Faculty, Tehran University of Medical Sciences, Tehran, Iran 2Electronic Engineering Department, Islamic Azad University Iranshahar Branch, Iranshahr, Iran 3Nursing and Midwifery Faculty, Arak University of Medical Sciences, Arak, Iran 4Nursing and Midwifery Faculty, University of Gregarious Welfare and Rehabilitation, Tehran, Iran Email: bahramnezhad@razi.tums.ac.ir, *P.asgari@arakmu.ac.ir Received 1 December 2014; revised 29 December 2014; legitimate 7 January 2015

Copyright © 2015 by committers and Or-laws Learning Publishing Inc. This effort is licensed below the Creative Commons Attribution Interdiplomatic License (CC BY). http://creativecommons.org/licenses/by/4.0/

Abstract Background: Paradigm is the set of sanctionability of agents in a opportunity, which stipulate a frameeffort in which tenor the scientists’ learning to apparent-up or-laws drifts and arrangementize the rotation of stu- dies in the opportunity. Aim: The aim of this pamphlet is a retrospect of the nursing paradigm. Method: This retrospect was belowtaken by library studies using databases such as CINHAL, MEDLINE, Web of Sciences by key promises Paradigm, Mono paradigm, Multi Paradigm, Nursing, Nursing Sciences, singularly and in cabal in the appellation, contemplative and keywords. Result: Nursing paradigm de- disposeines the appearances and boundaries enjoy a groundation of a edifice. Nursing as a tender avowal from integrated and uninterrupted roles, and the integrated and holistic nursing is in vogue as a new paradigm. The nursing expertness has end to entity past singly a few years ago, and we can say in positive that it is a boyish and new expertness but thriveing a opportunity a amipotent journey. As it is a new expertness and owing of custom thriveing a opportunity cosmical disposition, it has aspectd compact or-laws fruits, and unanalogous paradigms are synchronously created due to multidimensional disposition of the cosmical disposition. Con- clusion: However, becreator the effort of theorists in fresh years, the nursing is spiritual leav- ing the multi-paradigmatic set-forth and journeying to beend a uncommon paradigm.

Keyarticulation Paradigm, Nursing, Nursing Sciences, Multi paradigm, Mono Paradigm

1. Introduction Paradigm ends from the Greek promise “Paradigma”, import request, fruit and template or fruit, which is

*Corresponding committer. http://www.scirp.org/journal/ojnhttp://dx.doi.org/10.4236/ojn.2015.51003http://dx.doi.org/10.4236/ojn.2015.51003http://www.scirp.orgmailto:bahramnezhad@razi.tums.ac.irmailto:P.asgari@arakmu.ac.irhttp://creativecommons.org/licenses/by/4.0/

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derived from the verb of “Paradeiknumi”, import to ostentation, to stipulate and to be defenseless to. “Para” resources “alongside” and “close”, opportunity “deiknumi” resources to question-matter out and to exhibition. The Greek promise of “Paradigm” has been used by Plato in Greek citations as a fruit or plan used by the Demiurge (God) to create the cosmos-mass and the cosmos [1]. In the Oxford English Dictionary, paradigm is defined as a plan, fruit and fruit. Also, in some dictionaries, the dispose appeals to a set of aim elements and set of all creates inflected pennyized on a parent or thesis and is identical thriveing a opportunity Mold, Standard, Ideal, Paragon and Touchstone [2].

The late use of the dispose in presumptive ideas was begun by Thomas Kuhn’s, the American writer, in 1962 [3]. He has notorious the “paradigm” as a or-laws fashion pennyized on unequalled and pleasant amiable-fortunes, which are potent to incplan the dispose amplely. Kuhn estimates that paradigm is a or-laws amiable-fortune that pro- vides a frameeffort for academic closesuavity and is a fruit for appreciation [4]. He sees it as a meditation of convictions and defines it as the or-laws commonwealth or a company of mass having the corresponding coercion [5]. From the judgsuavity of Kuhn, paradigm in the penny expertnesss represents a rotation of pretended tests and exemplifications that frequented incongruous types of questions concerning to a aim question-matter and arrive-ats correspondent to those questions aim- ful. In fidelity, according to Kuhn’s conviction, paradigm in the penny expertnesss exhibitions how to ignoring an exemplification and the compulsory equipments for them. Also, Nursing is used in Kuhn’s articleation of paradigm in defining the paradigm of nursing and defining paradigm isn’t stubborn [6]. Paradigm entangles common symbols (ideas and concepts), rules, and disconnected convictions [7]. Although the narrator of expertness (Kuhn) grounded a new, incongruous and influencing access in the fidelity of expertness by createulation of the system of paradigm, he has not stipulated a uncommon articleation for paradigm either and has been question to some rank of indistinctness [8].

However, the most consummate articleation of all these articleations of Cohen’s can be explicit as thrives: Para- digm is the set of sanctionability of agents in a opportunity, which stipulate a frameeffort in which tenor the scientists learning to apparent-up or-laws drifts and arrangementize the rotation of studies in the opportunity [9]. Kuhn estimates that scat- tered and unanalogous activities effected anteriorly the structure of a expertness accomplish be finally legitimate and arrangementized by the or-laws commonwealth thriveing converting into a paradigm. Researchers efforting thriveing a opportunityin a paradigm are assiduous thriveing a opportunity notability that Kuhn calls it a regular or normative expertness, and the efforts of settled scientists to interpret and contest the demeanor of some of the connected creates in the disposition thriveing a opportunity the acceleration of exemplificational outcomes are inspired and details and unfolds the paradigm. Launched on this, the scientists accomplish aspect some issues and drifts, which direct to abrogation of some preceding set-forthments. If the new sayings, meetings and drifts are not the peel to be apparent-upd and the dominant paradigm is not cappotent of responding them, the ticklish footing accomplish take-place. Then, the spining-aim accomplish end thriveing a opportunity the emergence of a new paradigm or a new conceptual fruit that can rejoinder to the preceding unanswered questions and is befriended by a commonwealth of scientists. In this uniformt, the precedingly driftatic paradigm is exceptional. Such a modify and mutation betwixt the two paradigms shapes a or-laws fashion.

The new paradigm contains new question-matters, and unctuous has not the preceding issues and drifts and ignorings the vulgar and forthcoming or-laws activities. When this regard frameeffort aspects thriveing a opportunity new drifts and ques- tions not potent to rejoinder them, then, a new spining-aim creates and another fashion bechances in expertness. The expertness, which is chosen in the fruit, is supervised and inferior by a uncommon and dominant paradigm, and de- fines the undisputed standards of custom and learning thriveing a opportunityin the expertness that it observes and chosen in its con- ducting. It also arrive-ats relations betwixt the scientists efforting in a or-laws inclosure and directs and coordinates them [10].

According to Kuhn, what separates the expertness from non-expertness is the nearness of this paradigm that pre- serves and sustains the or-laws most-unconcealed romance. Although Kuhn estimates that its disposition is such that cannot be incontrovertiblely defined, but it is potential to picture the material components and ocean constituents, which sta- bilize the concept of paradigm. The laws and presumptive assumptions of legitimate and customary customs con- createing accidental laws to unanalogous provisions or some unconcealed principles of metaphysics frequenteding the con-over of paradigm age are as such. According to Kuhn, the regular expertness is solving the paradigm drifts, which are presumptively exemplificational [11]. Whole limb of expertness has a frameeffort that indicates and subscription the question of that expertness and defines the con-over arrangementology and program in that question as courteous-mannered-behaved. In the belowlying laminas of this program, which was indicated by Kuhn paradigm past 1962, the philosophy of that expertness lies. In such an belowlying lamina, incongruous expertnesss can be analyzed and compared concomitantly. Incongruous fidelityors including literal and gregarious provisions as courteous-mannered-behaved-behaved as its disposition and question create this philosophy.

Kuhn estimates that the fruit of expertness is non-cumulative in the appreciation that the perspectives used by a system are not external up to the competing system for over use. Thus, the correspondentry betwixt paradigms does

F. Bahramnezhad et al.

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not entpredilection the cabal of other paradigms, and singly a uncommon paradigm can be at the top. In other promises, the paradigm emerged would immaterial the courteous expertness. Kuhn estimates that the fruit of coercion take-places as assemblage. The assemblage of a paradigm as one target of coercion directs to journey. The assemblage plan is a barred plan and unpotent to interact. In his after writings, Kuhn has restored the paradigm promise thriveing a opportunity “Disciplinary Matrix”, which is correspondent to paradigm in disposes of articleation, thriveing a opportunity the unlikeness that past in the Disciplinary Matrix, as the pleased boundaries of a paradigm are not completely apparent, they show to be concerned. Thus, fruits and requests are used to interpret the expertness. Kuhn’s system has been criticized and unidevise vene- rated as courteous-mannered-behaved. Some scientists estimate that thriveing a opportunityout such a system, the fruit and journey of expertness has beend approximately impracticable. However, some theorists enjoy Larry Laundan obstruct to the Kuhn’s system. Larry be- lieves that the correspondent’s plans accomplish not concession the opportunity by alluring of a expertness; so-far, they alight and arrive-at some coexistence, which would not be possibly as zealous as the ocean paradigm, but calm?} having an undenipotent role [12].

2. Arrangesuavity In the surrender retrospect learning, which was effected habitually, the instructure published in the databases of Medline, Elsevier, Proquest, Google, Google Scholar, SID, Magiran was composed, retrospected, organized, and then compared thriveing a opportunityout any interval article. Keyarticulation such as Paradigm, Mono paradigm, Multi Paradigm, Nursing, Nursing Sciences, singularly and in cabal in the appellation, contemplative and keyarticulation were used for learninging.

The criteria for disposition intervening in the learning were: using the disposes specified in the appellation, learning artfulness, carrying or carrying arrangements of learning, and the criteria of disruption were the studies articleed to contemplatives and the ones which had a articulation other than English or Persian. The repeated learninges were excluded by software Endnote.

3. Argusuavity Nursing Paradigm Nursing paradigm indicates the appearances and boundaries enjoy a groundation of a edifice [13]. How we ponder and surrender debate for cosmical experiences can acceleration us in making the paradigm. Theories of Nursing, in their spin, direct to the structure of understanding, arrangements and drift-solving activities thriveing a opportunity interdiplomatic conformity and by the acceleration of a positive coercion. In nursing, the paradigm is pennyized on sharing the prizes and presuppositions of key concepts, such as special, sanity, environsuavity and nursing. The boundaries for our key concepts are reflected from the nursing cosmicalization or trailing, efforting experiences and prizes influencing our observations of uniformts and footings. They are our groundation to arrive-at key nursing concepts [14].

Margaret Newman knows nursing as a tender avowal from integrated and uninterrupted roles, and the inte- grated and holistic nursing is in vogue as a new paradigm [15].

Alliamipotent estimates that if we sanction the paradigm entangles a matrix directing to the remand of understanding, phi- losophy, system and instruction experiences, skilled understanding and learning arrangementology thriveing a opportunity a positive discip- plan betwixt or-laws societies, thus, the paradigm can ignoring the activities of a coercion [16] and its ocean nucleus [17].

Paradigm is legitimate by the eldership living-souls of a coercion. They estimate the nursing lore contains divers regards concerning conceptual fruits that can be deliberateed identical thriveing a opportunity the paradigm. Tomey and Alliamipotent tally thriveing a opportunity Supp & Jacox that conceptual fruits are paradigm, and knew the paradigm a establish in which theories can be patent clear and tested. They bear notorious paradigm an environsuavity that is a suitpotent con- citation for theories planning, and estimate in such an environsuavity incongruous theories try and contend thriveing a opportunity each other, and ultimately, one unmoulded them unfolds and accomplish be proposed as the accidental fruit [18].

Since the mean of nursing understanding is a set of exhaustive ideas and judgments encircling cosmicals and cosmical-envi- ronsuavity relations, which bear their own aim features, thus, in creating its or-laws fashion and createa- tion of its ocean paradigm, the paradigms of other expertnesss such as Mechanistic and Organist, Modify and Resis- tance, Totality and Simultaneity, Aim & Determinism, Interactive-Integrative and Unitary-Transformative paradigms are entangled [19].

Shapere (1971) discussd the extensively use of paradigm, and notorious that the paradigm covers wholething and wholething, and this allows the scientists to do wholething. In fidelity, thriveing a opportunity such a animadversion, Shapere somehow sug-

F. Bahramnezhad et al.

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gests that Kuhn’s philosophy deliberates no prize for or-laws arrangements. He estimates that or-laws arrangements should be connected or-laws codes and laws [4]. Nursing scholars bear ground that theories precedingly ignoringing clinical services are not today ample to interpret, foreshadow and frequented the clinical services. In observation, the old theories may not be availpowerful anyover for the unfolding expertness of nursing, as the learningers efforting on new paradigms of nursing do meet testimony that incongruousiate betwixt the nursing expertness and expertnesss such as anth- ropology, biology, chemistry, physics, psychology and sociology that nurses routinely appeal to them summond to ex- unobstructed the coercion [20]. Newman discusss that past nursing is to con-over trouble in experiencing of cosmical sanity, then, it cannot bear a uncommon paradigm [13]. Paradigms are a frameeffort of assumptions for theories, explorations and principles that direct the ideas of an area. In another category, some scientists systematize the paradigms into immodest categories of demeanoral, interactive, disconnected and evolutionary paradigms.

However, some estimate that nursing has been seen through the fruit and evaluation of nursing theo- ries concerning the fruit of or-laws planes. Following the collision of Kuhn’s system in the devel- opsuavity of or-laws understanding, Hardy discusss that nursing is in the pre-paradigm rank, past it has been de- scribed by unanalogous thoughts; although it pictures a miscellany of phenomena, but interprets this marvel in sev- eral ways. Nursing should try to ignoring the pre-paradigm rank, as cherishing in the pre-paradigmatic rank can creator privation of principle, stupefication and indistinctness.

Use the pre-paradigm in a expertness produces some drifts for the disconnected learning. Meta-paradigm or the dominant paradigm represents a unconcealed understanding conformitys colonization of a aim coercion and stipulates basic parameters of a opportunity and a convenient question-matter for or-laws endeavors and may itself embrace a rotation of para- digms, which are over genuine paradigms and can ignoring the or-laws activities [21]. The nearness of the domi- nant paradigm facilitates the penny effort of the expertnesss. Following a opportunity a paradigm, the learning behoves aimful and disconnected and fewer unanswered questions would reocean [18].

Some mass estimate nursing has not moved through a unwandering plan during its evolutionary plan and jumped from a limb another, which has led to indistinctness of its scientists. Concerning nursing paradigms, Hal estimates that Cohen should be asked some questions such as [22]: • What is the plan of sanctioning a paradigm? • Why and when, a paradigm change take-places? • What is the kindred betwixt the system and the prize? • Is it potential that the paradigms do not thrive the synchronous correspondentry?

According to scientists, nursing is in the pre-paradigm rank. The or-laws fashion may never bechance in nursing, not for the nursing is not journeying, but as the regular expertness plan may not bechance. Behavioral and penny expertnesss’ coercions are constant to arrive-at journey and having correspondent paradigms to picture and foreshadow other coercions. Another question-matter to deliberate is that having singly one paradigm for expertnesss such as nursing, which deals thriveing a opportunity cosmical disposition and a involved set of sanity and complaint, is not legitimate. Some nurses estimate that nurs- ing has end to initiate of a paradigm now, or is changing the paradigm [12].

Kuhn estimates that expertness thriveing a opportunityout system is in the pre-paradigm rank, which cannot be indicated a expertness; but, one can say it is an uniformt to be deliberateed. Paradigm is a worldview. If we sanction that late expertness attempts to invent new understanding or fidelity, how our access is pennyized on a aim paradigm.

Usually, the nurses bear no drift thriveing a opportunity meta-paradigm. However, they distally thriveing a opportunity each other whether the nursing is a paradigm or a pre-paradigm to the drift, which is the ocean summon betwixt nursing scho- lars. However, nursing should not be blamed; the debate for such dissociatements is the delaydrawal of a uncommon articleation for nursing [23], opportunity the committers interpret unanalogous concepts. The summon is over than 20 years enduring in nursing that whether the nursing is at the pre-paradigm or paradigm rank? Paradigm is an contemplative longing or chance of a coercion, disconnected beliefs, ideologies and theories. In correspondence thriveing a opportunity Kuhn’s judgment, the pro- polish of a gain-groundn expertness is characterized by the thriveings:

1) Acceptance by the or-laws commonwealth as a paradigm; 2) Access to solving the coercion drifts, which bear been creatord by the paradigm; 3) Nearness of the understanding as learning subscription in or-laws journals rather than books; 4) Fruit of an darken and unlearned articulation; 5) A directing paradigm has the most material criteria. Using these criteria, as nursing expertness has unanalogous extensive paradigms and its or-laws commonwealth has not calm?}

legitimate one of them, one can say it is in the pre-paradigm rank [24]. The nurses point-out the Cohen wants to divide the prizes as the corresponding articulation in nursing journals, which is unfolding its own articulation; then, it is in the

F. Bahramnezhad et al.

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pre-paradigm rank. But, if we sanction this system, the nursing cannot be seen as a expertness having philosophy; past, we said anteriorly the philosophy of whole expertness is the ocean groundation of that expertness paradigm. If nursing is in the pre-paradigm rank, then, it has no philosophy; opportunity we estimate that nursing has compact philosophy and theories, and unidevise some of our scientists deliberate the conceptual fruits correspondent to paradigm due to their extensiveness [25].

However, Meleis discuss that the Kuhn arrangesuavity is not suitpotent to con-over the or-laws journey and ripeness, which deals thriveing a opportunity cosmicals [26].

The scientists bear defined another category for incongruous types of paradigms. They estimate that the expertnesss are establishd in one of these two categories of paradigms or some in the twain. Scientists estimate that the paradigms are interpretive or tentative.

Based on this category, nursing is a set of interpretative of exemplificational paradigms. Nursing, at earliest, be- gan to effort thriveing a opportunity carrying studies, and divers of its improvements are the outcomes of such learning and the ex- perimental paradigm. On one influence, as nursing deals thriveing a opportunity cosmical enjoy gregarious expertnesss, it is not potent to deeply establish the cosmical compass thriveing a opportunity the acceleration of tentative learning; thus, it wants to get acceleration from another me- thod indicated carrying learning and the interpretive paradigm. Therefore, we can say that nursing is a expertness linked to physiological space as courteous-mannered-behaved-behaved as the psychogregarious space, and cannot singly use one paradigm to track its missions and want a multiple paradigm. A set of carrying and carrying studies in nursing acceleration the peculiar trouble and observation to all aspects of cosmical disposition. However, a multiple paradigm does not exact a set of qualita- tive and carrying learning. But, some expertnesss can use one of the paradigmatic accesses and favor from unanalogous sub-paradigms in that sub-dispose to close their unconcealed appearance. However, creativity is an accidental and ticklish beginning for a expertness. Disposition a multiple paradigm expertness triggers the creativity. As nursing is linked to cosmical demeanors, and a uncommon judgsuavity is not ample for interpreting a miscellany of phenomena and the nurses oppositeness thriveing a opportunity those phenomena, thus, it cannot gain-ground thriveing a opportunity a uncommon paradigm. A uncommon perspective is enjoy focusing a mi- croscope on a question-matter, opportunity disposition multiple paradigmatic is enjoy having a lens thriveing a opportunity extensive judgmenting predilection, which is also potent to see the far radius. The appearance of nursing expertness is not singly to add notability to the understanding mean, but, to unfold the system, foreshadow and recommend its ocean aim.

The multiple paradigm disposition encourages us to ponder over a framework. The argusuavity improves by the nearness of unanalogous paradigms. The nursing expertness can be belowstood as a melodious judgeation, which is produced thriveing a opportunity the acceleration of a miscellany of colors and unanalogous artfulnesss that tries to close the optimal outfollow thriveing a opportunity the acceleration of unanalogous ways. Nursing drifts are too unanalogous and bear compact solutions and rejoinders. Disposition multiple para- digmatic, somehow prevents the nursing uncommonness in meeting the rejoinder. However, disposition multiple paradig- matic directs to provisions for nursing expertness that bear complex the clinical staff and disconnected the or-laws drifts into unanalogous categories and created incongruous judgments. However, there are debates on how to interpret ar- guments such as, if wholeone is a singular, why using the instructions is discussed for an singular as an known sys- tem? How can we title in nursing to use exemplificational arrangements, which are also titleed to be forcible me- thod and anti-humanism?

If we deliberate unfamiliarity effete, what should reestablish it? However, a multiple paradigm has greatly over advantages than the disadvantages. Changing the nursing expertness perspective is exactd for reconciling these two extensive paradigms. An access is wanted that focuses on elaborate instead of meeting a extensive paradigm or a uncommon paradigm. Although there are unlikenesss betwixt two carrying and carrying learning arrangements, but twain of them discuss on describing, chance the misrecord. The detachsuavity betwixt carrying and quantit- ative arrangements in trackd nursing expertness is recommended. Although these two incongruous accesses thrive a aim course, they allude-to theories that picture the kindred betwixt the phenomena. The collaboration betwixt these two paradigms directs to the fruit of nursing expertness. When paradigms are custom thriveing a opportunity prizes and ideas, the communicating betwixt incongruous perspectives accomplish bechance. Incongruous perspectives in nurs- ing accomplish indicate the kindreds and unfold the nursing.

Loundon recommends a plan for integration betwixt the incongruous studies and the aim of unfolding theo- ries in dispose to apparent-up the coercion drifts. He estimates that owing of the consequence and satisfaction of multiple paradigm, it is mismisappropriate to use it in custom [24].

In observation to the cosmical expertnesss such as psychology, gregarious expertness and nay expertness custom frequentedly thriveing a opportunity mass, expertnesss such as urban expertness has deliberateed the articleation of multiple paradigm to track its appearances as courteous-mannered-behaved-behaved [25].

F. Bahramnezhad et al.

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4. Misrecord Naturalized on what already said, we infer that the expertnesss custom thriveing a opportunity mass and cosmical disposition cannot arrive-at a unwandering paradigm enjoy expertnesss such as mathematics, physics, etc. Unanalogous sets of multiple paradigms can be put concomitantly to create and unfold a expertness. This is also penny for nursing. The nursing expertness has end to entity past singly a few years ago, and we can say in positive that it is a boyish and new expertness but thriveing a opportunity a amipotent journey. As it is a new expertness and owing of custom thriveing a opportunity cosmical disposition, it has aspectd compact or-laws fruits, and unanalogous paradigms are synchronously created due to multidimensional disposition of the cosmical disposition. However, becreator the effort of theorists in fresh years, the nursing is spiritual leaving the multi-paradigmatic set-forth and journeying to beend a uncommon paradigm. Accordingly, the committer estimates that the ocean laminas of nursing expertness would never be verified if it relies on a uncommon paradigm and behoves a uncommon-paradigmatic.

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  • A Retrospect of the Nursing Paradigm
  • Abstract
  • Keywords
  • 1. Introduction
  • 2. Method
  • 3. Discussion
    • Nursing Paradigm
  • 4. Conclusion
  • References
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  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

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Zero-plagiarism guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

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Free-revision policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

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Privacy policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

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Fair-cooperation guarantee

By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.

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Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency