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Reflective practice

May Y Choi, Cheryl Barnabe, Claire E Barber, Vivian Bykerk, Janet E Pope, Glen S Hazlewood
OBJECTIVE: Randomized controlled trials (RCTs) exist along a spectrum, from explanatory, designed to evaluate interventions under ideal conditions, to pragmatic, designed to reflect usual care. This study assessed the pragmaticism of RCTs of advanced therapeutics in rheumatoid arthritis (RA). METHODS: A systematic review was conducted to identify RA RCTs comparing biologic or targeted synthetic therapy in combination with methotrexate, to placebo or any other DMARD(s)...
June 15, 2018: Arthritis Care & Research
Lars Krutak
This essay describes the potential for using ethnographic evidence and mummified tattooed skin to reflect on past therapeutic tattoo practice in the Arctic. It also considers the ways in which circumpolar concepts of disease emerged in relation to the agency of nonhuman entities. I argue that specific forms of curative tattooing offer interpretive models for the paleopathological and bioarchaeological study of care through an ontological framework of analysis.
June 12, 2018: International Journal of Paleopathology
Alexandra Caniceiro, Sandra Plaut, Élyse Recoupe, Audrey Veaux
Cultural competency assumes an even greater dimension with foreign patients or when practising abroad. After travelling to Cambodia with the aim of enriching their nursing practices, four student nurses share their experiences, questions and reflections in this area.
June 2018: Revue de L'infirmière
Julien Billères, Frédérique Marrodal, Ivan Gicquel
Inter-day hospital supervisions in child psychiatry, through clinical and case studies, give caregivers a chance to review and reflect on their practices as well as training and tools. Experienced psychiatry experts share their knowledge. Through the exchanges, professionals analyse and develop practices. Caregivers from Toulouse describe the benefits observed through these practices both on a collective and individual level.
June 2018: Revue de L'infirmière
Jaclyn Chesner, Lauren M Ogrich, Carrie Ann Cusack, John R Durkin
BACKGROUND: Moonlighting refers to the practice of medicine outside one's training institution in exchange for financial compensation. High medical debt-to-income ratios drive residents to seek additional compensation during residency. OBJECTIVE: To gather information to establish the current practices of moonlighting and to better understand the thoughts and experiences of dermatology residency program directors regarding moonlighting. METHODS: All allopathic and osteopathic dermatology residency program directors in the United States and Puerto Rico received a blinded survey between February 1, 2017 and April 1, 2017 through an email link...
April 15, 2018: Dermatology Online Journal
Debra Ann Reilly, Steve Langan
Channeling feelings into the written word rather than the scalpel was at the heart of the creative writing challenge that the first author (DR) accepted when she joined the Seven Doctors Project at the University of Nebraska Medical Center in 2008. Burnout has become recognized as a factor undermining physicians' quality of life, and the practice of creative writing helps mitigate stress and sustain a successful practice. When physicians partner with and are mentored by a seasoned creative writer, creative writing can serve as an exercise in ethical reflection, which is particularly valuable at mid-career; this is the subject of the following dialogue between one physician writer and the facilitator of the Seven Doctors Project creative writing class...
June 1, 2018: AMA Journal of Ethics
Yong Lv, Rui Yuan, Tao Wang, Hewenxuan Li, Gangbing Song
Rolling bearings play a crucial role in rotary machinery systems, and their operating state affects the entire mechanical system. In most cases, the fault of a rolling bearing can only be identified when it has developed to a certain degree. At that moment, there is already not much time for maintenance, and could cause serious damage to the entire mechanical system. This paper proposes a novel approach to health degradation monitoring and early fault diagnosis of rolling bearings based on a complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN) and improved multivariate multiscale sample entropy (MMSE)...
June 14, 2018: Materials
Susan P Mollan, Brendan Davies, Nick C Silver, Simon Shaw, Conor L Mallucci, Benjamin R Wakerley, Anita Krishnan, Swarupsinh V Chavda, Satheesh Ramalingam, Julie Edwards, Krystal Hemmings, Michelle Williamson, Michael A Burdon, Ghaniah Hassan-Smith, Kathleen Digre, Grant T Liu, Rigmor Højland Jensen, Alexandra J Sinclair
The aim was to capture interdisciplinary expertise from a large group of clinicians, reflecting practice from across the UK and further, to inform subsequent development of a national consensus guidance for optimal management of idiopathic intracranial hypertension (IIH). METHODS: Between September 2015 and October 2017, a specialist interest group including neurology, neurosurgery, neuroradiology, ophthalmology, nursing, primary care doctors and patient representatives met. An initial UK survey of attitudes and practice in IIH was sent to a wide group of physicians and surgeons who investigate and manage IIH regularly...
June 14, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Jinbao Liu, Jichang Han, Yang Zhang, Huanyuan Wang, Hui Kong, Lei Shi
The storage of soil organic carbon (SOC) should improve soil fertility. Conventional determination of SOC is expensive and tedious. Visible-near infrared reflectance spectroscopy is a practical and cost-effective approach that has been successfully used SOC concentration. Soil spectral inversion model could quickly and efficiently determine SOC content. This paper presents a study dealing with SOC estimation through the combination of soil spectroscopy and stepwise multiple linear regression (SMLR), partial least squares regression (PLSR), principal component regression (PCR)...
June 5, 2018: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
Arno K Kumagai, Lisa Richardson, Sarah Khan, Ayelet Kuper
Given the constant pressures of overflowing clinics, hospital wards, and emergency departments; shortened duty hours; and increased accreditation requirements, over-burdened clinician teachers ask, "how does one teach for humanism and justice?" How does one step away-even momentarily-and focus teaching on the individual in front of us, the person who requires our attention and care? This approach must not only involve content (the patient's perspective of illness, social context, and life story) but it also must be tightly linked with the ways in which these lessons in living are learned and taught...
June 12, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Melaine Coward
Part one of this six-part continuing professional development series considered the role of nurse managers in supporting reflection for professional learning. It was aimed at enabling readers to consider critically the role of reflection in nursing and relate this to the Nursing and Midwifery Council's professional requirements. Part two explores approaches to and benefits of reflection for self-development. The notion of self-development may seem removed from professional practice and nurse leadership but the traits that demonstrate who we are, how we learn, how we act and how we influence are related to and transferable from self to professional self...
June 14, 2018: Nursing Management (Harrow)
Michael Bonert, Bradley A Saville
Kt/V is a nondimensional number and a scaling parameter that has, with arbitrary definitions, been recast as a measure of dialysis by Gotch and Lysaght. This editorial discusses the concept of nondimensional numbers within the context of dialysis measurement, modeling, and medical evidence. It concludes that Gotch's Kt/V, Lysaght's Kt/V, and standardized Kt/V are not well suited to measure dialysis. An ideal dialysis measure would be proportional to toxins cleared by the kidney, portable with regard to dialysis modality, practical (largely devoid of calculations) and reflective of the pathology/physiology...
2018: Canadian Journal of Kidney Health and Disease
Karin Huijsdens-van Amsterdam, Lieve Page-Christiaens, Nicola Flowers, Michael D Bonifacio, Katie M Battese Ellis, Ida Vogel, Else Marie Vestergaard, Javier Miguelez, Mario Henrique Burlacchini de Carvalho, Erik A Sistermans, Mark D Pertile
False-negative cell-free DNA (cfDNA) screening results involving Down syndrome are rare, but have high clinical impact on patients and their healthcare providers. Understanding the biology behind these results may allow for improved diagnostic follow-up and counseling. In 5 different centers offering cfDNA prenatal screening, 9 false-negative results were documented in 646 confirmed cases of trisomy 21; a false-negative rate of 1.4% (95% CI, 0.7-2.6). False-negative results included 4 cases of classical trisomy 21 and 5 cases with a de novo 21q;21q rearrangement...
June 13, 2018: European Journal of Human Genetics: EJHG
Sophia Samuel, Heather Thompson
The problem of medical practitioner burnout and loss of morale remains an ongoing challenge in the Australian health workforce. Collegiate recommendations are individualistic or personalised, or worse, punitive. Critical reflection in supervision is a long-accepted and key aspect of social work theory and practice. The use of critical reflection within a general practitioner support group is examined and key learnings from our findings over 3years are discussed. All participants reported the group enhanced individual and team workplace satisfaction, and wellbeing...
June 14, 2018: Australian Journal of Primary Health
Ruby Rajendra Shanker, Samantha J Anthony, Linda Wright
INTRODUCTION: Evolving methods of communication have increased public appeals for living organ and hematopoietic stem cell donations from strangers, giving public solicitations more visibility. Within the academic literature, perspectives have been divisive, reflecting ethical justifications for and against appeals for living unrelated donors. Transplant programs and clinicians face a variety of ethical dilemmas when patients and their solicited donors present to the hospital. OBJECTIVE: A scoping review methodology was designed to (1) explore the academic literature and (2) summarize and disseminate key research findings...
January 1, 2018: Progress in Transplantation
Alberto Consolaro, Mauricio de Almeida Cardoso
The teeth become very close to each other when they are crowded, but their structures remain individualized and, in this situation, the role of the epithelial rests of Malassez is fundamental to release the EGF. The concept of tensegrity is fundamental to understand the responses of tissues submitted to forces in body movements, including teeth and their stability in this process. The factors of tooth position stability in the arch - or dental tensegrity - should be considered when one plans and perform an orthodontic treatment...
March 2018: Dental Press Journal of Orthodontics
Arndt Feuerbacher, Jonas Luckmann, Ole Boysen, Sabine Zikeli, Harald Grethe
Organic agriculture (OA) is considered a strategy to make agriculture more sustainable. Bhutan has embraced the ambitious goal of becoming the world's first 100% organic nation. By analysing recent on-farm data in Bhutan, we found organic crop yields on average to be 24% lower than conventional yields. Based on these yield gaps, we assess the effects of the 100% organic conversion policy by employing an economy-wide computable general equilibrium (CGE) model with detailed representation of Bhutan's agricultural sector incorporating agroecological zones, crop nutrients, and field operations...
2018: PloS One
Elizabeth Armitage-Chan, Stephen A May
Professional studies teaching in medical and veterinary education is undergoing a period of change. Traditional approaches, aiming to teach students professional values and behaviors, are being enhanced by curricula designed to support students' professional identity formation. This development offers the potential for improving student engagement and graduates' mental well-being. The veterinary professional identity associated with emotional resilience and success in practice incorporates complexity in professional decision making and the importance of context on behaviors and actions...
June 13, 2018: Journal of Veterinary Medical Education
Basma Salameh
Background: Most patients who have been hospitalized at some point in time must have experienced a measure of pain despite improvements in health-care systems. Globally, there is a dearth in information with regard to pain management. Pain management is an essential process for nurses because they spend most time of the day with the patients. Therefore, nurses' level of knowledge and positive attitudes toward pain management reflect this vital and significant role played by nurses in critical care units...
May 2018: International Journal of Health Sciences
Ian G Wood, A Dominic Fortes, David P Dobson, Weiwei Wang, Lucjan Pajdzik, John Cosier
A low-temperature stage for X-ray powder diffraction in Bragg-Brentano reflection geometry is described. The temperature range covered is 40-315 K, with a temperature stability at the sample within ±0.1 K of the set point. The stage operates by means of a Gifford-McMahon (GM) closed-cycle He refrigerator; it requires no refrigerants and so can run for an extended period (in practice at least 5 d) without intervention by the user. The sample is cooled both by thermal conduction through the metal sample holder and by the presence of He exchange gas, at ambient pressure, within the sample chamber; the consumption of He gas is extremely low, being only 0...
June 1, 2018: Journal of Applied Crystallography
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