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Deliberate practice

Reidun Norvoll, Marit Helene Hem, Reidar Pedersen
Coercion in mental health care gives rise to many ethical challenges. Many countries have recently implemented state policy programs or development projects aiming to reduce coercive practices and improve their quality. Few studies have explored the possible role of ethics (i.e., ethical theory, moral deliberation and clinical ethics support) in such initiatives. This study adds to this subject by exploring health professionals' descriptions of their ethical challenges and strategies in everyday life to ensure morally justified coercion and best practices...
October 14, 2016: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
Daniel S Lemke, Elaine K Fielder, Deborah C Hsu, Cara B Doughty
INTRODUCTION: Simulation-based medical education (SBME) improves medical knowledge compared with no intervention. In traditional SBME, more time is spent debriefing than practicing skills. Rapid cycle deliberate practice (RCDP) simulation allows learners to practice skills repetitively, receive brief interspersed feedback, and has been shown to improve individual performance of resuscitation skills in simulation; it has not been compared with traditional simulation methods. OBJECTIVE: The aim of the study was to compare traditional and RCDP SBME...
October 6, 2016: Pediatric Emergency Care
Paola Friedrich, Catherine G Lam, Geetinder Kaur, Elena Itriago, Raul C Ribeiro, Ramandeep S Arora
BACKGROUND: Understanding and addressing treatment abandonment (TxA) is crucial for bridging the pediatric cancer survival gap between high-income (HIC) and low-and middle-income countries (LMC). In childhood cancer, TxA is defined as failure to start or complete curative cancer therapy and known to be a complex phenomenon. With rising interest on causes and consequences of TxA in LMC, this study aimed to establish the lay-of-the-land regarding determinants of TxA globally, perform and promote comparative research, and raise awareness on this subject...
2016: PloS One
Adam W Hanley, Eric L Garland, Richard G Tedeschi
Objective: A growing body of theoretical and empirical work suggests that mindfulness may support more positive posttraumatic outcomes by reducing posttraumatic stress (PTS) and encouraging posttraumatic growth (PTG). Positive reappraisal (PR), a cognitive coping correlate of dispositional mindfulness (DM) has also been linked with greater PTG. However, neither DM nor PR have been modeled in relation to core posttraumatic constructs such as core belief disruption, intrusive rumination, deliberate rumination, PTS and PTG...
October 13, 2016: Psychological Trauma: Theory, Research, Practice and Policy
Elinor Clarke
Female genital mutilation (FGM) is a collective term for the deliberate alteration, removal and cutting of the female genitalia. It has no known health benefits and can have negative physical and psychological consequences. The number of women and girls in the UK that are affected by FGM is unknown. Recent NHS data suggested that FGM has been evident (declared or observed) in women who have accessed health care; however, there are gaps in knowledge and a limited evidence base on the health consequences of FGM...
October 13, 2016: British Journal of Nursing: BJN
Luigi Pagliaro, Agostino Colli
The clinician - the doctor who treats sick people - should be able to establish a good human relationship with his or her patients and their family; should be able to reach a diagnosis even in patients with rare diseases, or atypical presentations - or should refer the patient to a senior colleague; and should be able to recommend the best treatment (or no treatment at all). And he - or she - should be able to draw these abilities from the "deliberate practice" according to Ericsson, i.e. from the combination of experience with reflection - not, or with much lesser strength, from the medical literature as suggested by Evidence-Based Medicine...
September 2016: Recenti Progressi in Medicina
Tal Shafir
Emotion regulation is a person's active attempt to manage their emotional state by enhancing or decreasing specific feelings. Peripheral theories of emotion argue that the origins of emotions stem from bodily responses. This notion has been reformulated in neurophysiological terms by Damasio, who claimed that emotions are generated by conveying the current state of the body to the brain through interoceptive and proprioceptive afferent input. The resulting brain activation patterns represent unconscious emotions and correlate with conscious feelings...
2016: Frontiers in Psychology
C Bass, P Halligan
Interest in malingering has grown in recent years, and is reflected in the exponential increase in academic publications since 1990. Although malingering is more commonly detected in medicolegal practice, it is not an all-or-nothing presentation and moreover can vary in the extent of presentation. As a nonmedical disorder, the challenge for clinical practice remains that malingering by definition is intentional and deliberate. As such, clinical skills alone are often insufficient to detect it and we describe psychometric tests such as symptom validity tests and relevant nonmedical investigations...
2017: Handbook of Clinical Neurology
David Bishai, Melissa Sherry, Claudia C Pereira, Sergio Chicumbe, Francisco Mbofana, Amy Boore, Monica Smith, Leonel Nhambi, Nagesh N Borse
INTRODUCTION: This study describes the development of a self-audit tool for public health and the associated methodology for implementing a district health system self-audit tool that can provide quantitative data on how district governments perceive their performance of the essential public health functions. METHODS: Development began with a consensus-building process to engage Ministry of Health and provincial health officers in Mozambique and Botswana. We then worked with lists of relevant public health functions as determined by these stakeholders to adapt a self-audit tool describing essential public health functions to each country's health system...
November 2016: Journal of Public Health Management and Practice: JPHMP
D Carrieri, C Bewshea, G Walker, T Ahmad, W Bowen, A Hall, S Kelly
Current guidelines on consenting individuals to participate in genomic research are diverse. This creates problems for participants and also for researchers, particularly for clinicians who provide both clinical care and research to their patients. A group of 14 stakeholders met on 7 October 2015 in Exeter to discuss the ethical issues and the best practice arising in clinically based genomic research, with particular emphasis on the issue of returning results to study participants/patients in light of research findings affecting research and clinical practices...
September 27, 2016: Journal of Medical Ethics
Magnus Hultin, Maritha Jacobsson, Christine Brulin, Maria Härgestam
Leadership in acute care teams based on knowledge and communication - an interdisciplinary analysis of a serie of in-situ trauma team trainings Efficient communication is one of the key features of good teamwork. Call-outs (CO) and Closed-loop communication (CLC), as a component of secure and efficient communication, has been extensively taught in the team training context. This paper reports results from a thesis exploring how trauma teams communicate while working. Eighteen in-situ trauma team training sessions were documented with surveys, audio and video for later analysis...
2016: Läkartidningen
Julia Abelson, Frank Wagner, Deirdre DeJean, Sarah Boesveld, Franςois-Pierre Gauvin, Sally Bean, Renata Axler, Stephen Petersen, Shamara Baidoobonso, Gaylene Pron, Mita Giacomini, John Lavis
OBJECTIVE: As health technology assessment (HTA) organizations in Canada and around the world seek to involve the public and patients in their activities, frameworks to guide decisions about whom to involve, through which mechanisms, and at what stages of the HTA process have been lacking. The aim of this study was to describe the development and outputs of a comprehensive framework for involving the public and patients in a government agency's HTA process. METHODS: The framework was informed by a synthesis of international practice and published literature, a dialogue with local, national and international stakeholders, and the deliberations of a government agency's public engagement subcommittee in Ontario, Canada...
September 27, 2016: International Journal of Technology Assessment in Health Care
Panagiotis I Georgianos, Rajiv Agarwal
Contrary to the direct, graded, and causal relationship of hypertension with cardiovascular outcomes in the general population, among dialysis patients, blood pressure (BP) recorded either predialysis or postdialysis displays a U-shaped curve with mortality. This paradoxical phenomenon of lower BP or a decline in BP over time being associated with increased mortality and higher BP being associated with a lower mortality is described as "reverse" epidemiology of hypertension, raising substantial controversy on whether BP lowering causes harms or benefits among dialysis patients...
September 22, 2016: American Journal of Hypertension
Gregory Carter, Andrew Page, Matthew Large, Sarah Hetrick, Allison Joy Milner, Nick Bendit, Carla Walton, Brian Draper, Philip Hazell, Sarah Fortune, Jane Burns, George Patton, Mark Lawrence, Lawrence Dadd, Jo Robinson, Helen Christensen
OBJECTIVE: To provide guidance for the organisation and delivery of clinical services and the clinical management of patients who deliberately self-harm, based on scientific evidence supplemented by expert clinical consensus and expressed as recommendations. METHOD: Articles and information were sourced from search engines including PubMed, EMBASE, MEDLINE and PsycINFO for several systematic reviews, which were supplemented by literature known to the deliberate self-harm working group, and from published systematic reviews and guidelines for deliberate self-harm...
October 2016: Australian and New Zealand Journal of Psychiatry
Joshua L Hermsen, Thomas M Burke, Stephen P Seslar, David S Owens, Beth A Ripley, Nahush A Mokadam, Edward D Verrier
OBJECTIVE: Static 3-dimensional printing is used for operative planning in cases that involve difficult anatomy. An interactive 3D print allowing deliberate surgical practice would represent an advance. METHODS: Two patients with hypertrophic cardiomyopathy had 3-dimensional prints constructed preoperatively. Stereolithography files were generated by segmentation of chest computed tomographic scans. Prints were made with hydrogel material, yielding tissue-like models that can be surgically manipulated...
August 20, 2016: Journal of Thoracic and Cardiovascular Surgery
K A Clark, S Ikram, R P Evershed
Mummification was practised in ancient Egypt for more than 3000 years, emerging from initial observations of buried bodies preserved by natural desiccation. The use of organic balms (and other funerary practices) was a later introduction necessitated by more humid burial environments, especially tombs. The dark colour of many mummies led to the assumption that petroleum bitumen (or natural asphalt) was ubiquitous in mummification; however, this has been questioned for more than 100 years. We test this by investigating 91 materials comprising balms, tissues and textiles from 39 mummies dating from ca 3200 BC to AD 395...
October 28, 2016: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
Heather L McCauley, Jay G Silverman, Kelley A Jones, Daniel J Tancredi, Michele R Decker, Marie McCormick, S Bryn Austin, Heather A Anderson, Elizabeth Miller
OBJECTIVE: Identification and refinement of psychometric properties of the Reproductive Coercion Scale (RCS) for use in survey research and clinical practice. STUDY DESIGN: Young women ages 16-29 seeking services in 24 Pennsylvania and 5 California family planning clinics completed questionnaires. Data were pooled for analysis (n=4674), and underlying domains were assessed using Horn's Parallel Analysis and Exploratory Factor Analysis. Multidimensional item response theory was used to refine the scale and assess reliability and validity of a short-form RCS...
September 14, 2016: Contraception
Holger Langhof, Jonas Lander, Daniel Strech
BACKGROUND: The European Union's (EU) Clinical Trials Directive was replaced by an EU-Regulation as of 2016. The policy revision process was subject to a formal impact assessment exercised by the European Commission (EC) from 2008 to 2014. Following the EU principles of Good Governance, deliberation with stakeholders was an integral part of this impact assessment and the policy formulation process. Hence, two public consultations (PCs) were held by the EC in 2009 and 2011, respectively...
2016: Health Research Policy and Systems
Daniel A Yudkin, Tobias Rothmund, Mathias Twardawski, Natasha Thalla, Jay J Van Bavel
Humans show a rare tendency to punish norm-violators who have not harmed them directly-a behavior known as third-party punishment. Research has found that third-party punishment is subject to intergroup bias, whereby people punish members of the out-group more severely than the in-group. Alhough the prevalence of this behavior is well-documented, the psychological processes underlying it remain largely unexplored. Some work suggests that it stems from people's inherent predisposition to form alliances with in-group members and aggress against out-group members...
September 15, 2016: Journal of Experimental Psychology. General
Simon B Goldberg, Robbie Babins-Wagner, Tony Rousmaniere, Sandy Berzins, William T Hoyt, Jason L Whipple, Scott D Miller, Bruce E Wampold
Recent evidence suggests that psychotherapists may not increase in effectiveness over accrued experience in naturalistic settings, even settings that provide access to patients' outcomes. The current study examined changes in psychotherapists' effectiveness within an agency making a concerted effort to improve outcomes through the use of routine outcome monitoring coupled with ongoing consultation and the planful application of feedback including the use of deliberate practice. Data were available for 7 years of implementation from 5,128 patients seen by 153 psychotherapists...
September 2016: Psychotherapy
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