Reducing Anxiety While Boosting Creativity: Lessons from the Progymnasmata

The fear of public speaking is a widely shared among individuals. This can be difficult to overcome when students are assigned several large, heavily-weighted speeches with few opportunities to become acclimated to standing in front of an audience. Several times throughout the semester students are assigned a 2–3 minute long speech inspired by the progymnasmata (a series of rhetorical exercises from Ancient Greece). The speeches vary widely from presenting a fable to impersonating an individual.https://digitalscholarship.unlv.edu/btp_expo/1053/thumbnail.jp

THE VALUE OF EXERCISES IN OBSTETRICS1 1Received March, 1966.

Since the turn of the century, the belief has persisted that women who attain a high standard of physical fitness through exercise, would tend to have normal, easy labours with good uterine function. Based on this belief, extensive exercise programmes were evolved by Read, Vaughan, Randell and Heardman to facilitate labour. However, the benefits of these exercises have been extensively debated in medical literature. The majority of opinions have accepted that antenatal education is of no significance in shortening the period of labour or influencing the occurrence of complications, but is of psychological value only (Buxton, 1962). Although the value of exercises is not entirely that which has been attributed to them and some exercises can be refuted, it will be shown that they have a definite place in the management of the obstetric patient

Callejo v. Bancomer, S.A.: The Need for a Commercial Activity Exception to the Act of State Doctrine

The ability of the United States courts to adjudicate claims against foreign sovereigns is limited by the Foreign Sovereign Immunities Act of 1976 ( FSIA ) and the act of state doctrine. In Dunhill, a plurality of the Court held that the concept of an act of state should not be extended to include the repudiation of a purely commercial obligation. Recently, the Fifth Circuit in Callejo v. Bancomer, S.A. examined the plurality\u27s commercial activity exception in Dunhill, yet declined to decide whether to adopt the exception with respect to the act of state doctrine. This Note analyzes the commercial activity exception to the act of state doctrine as espoused in Dunhill and examines the Fifth Circuit\u27s treatment of the exception in Callejo. Although the Callejo court avoided a decision on the validity of the exception, this Note argues that the facts in Callejo indicate that such a decision was necessary. The Note concludes that a rule-oriented approach to the situation should have been utilized and that, under such an approach, the Callejo plaintiffs\u27 claims should have been adjudicated

Callejo v. Bancomer, S.A.: The Need for a Commercial Activity Exception to the Act of State Doctrine

The ability of the United States courts to adjudicate claims against foreign sovereigns is limited by the Foreign Sovereign Immunities Act of 1976 ( FSIA ) and the act of state doctrine. In Dunhill, a plurality of the Court held that the concept of an act of state should not be extended to include the repudiation of a purely commercial obligation. Recently, the Fifth Circuit in Callejo v. Bancomer, S.A. examined the plurality\u27s commercial activity exception in Dunhill, yet declined to decide whether to adopt the exception with respect to the act of state doctrine. This Note analyzes the commercial activity exception to the act of state doctrine as espoused in Dunhill and examines the Fifth Circuit\u27s treatment of the exception in Callejo. Although the Callejo court avoided a decision on the validity of the exception, this Note argues that the facts in Callejo indicate that such a decision was necessary. The Note concludes that a rule-oriented approach to the situation should have been utilized and that, under such an approach, the Callejo plaintiffs\u27 claims should have been adjudicated

Framework for primary care organizations: the importance of a structural domain

Purpose. Conceptual frameworks for primary care have evolved over the last 40 years, yet little attention has been paid to the environmental, structural and organizational factors that facilitate or moderate service delivery. Since primary care is now of more interest to policy makers, it is important that they have a comprehensive and balanced conceptual framework to facilitate their understanding and appreciation. We present a conceptual framework for primary care originally developed to guide the measurement of the performance of primary care organizations within the context of a large mixed-method evaluation of four types of models of primary care in Ontario, Canada. Methods. The framework was developed following an iterative process that combined expert consultation and group meet-ings with a narrative review of existing frameworks, as well as trends in health management and organizational theory. Results. Our conceptual framework for primary care has two domains: structural and performance. The structural domain describes the health care system, practice context and organization of the practice in which any primary care organization operates. The performance domain includes features of health care service delivery and technical quality of clinical care. Conclusion. As primary care evolves through demonstration projects and reformed delivery models, it is important to evalu-ate its structural and organizational features as these are likely to have a significant impact on performance

Heart failure diagnosis in primary health care: clinical characteristics of problematic patients. A clinical judgement analysis study

BACKGROUND: Early detection of chronic heart failure has become increasingly important since the introduction of effective treatment. However, clinical diagnosis of heart failure is known to be difficult, especially in mild cases or early in the course of the disease. The purpose of this study is to analyse how patient characteristics contribute to difficulties in diagnosing systolic heart failure. METHODS: Design: A Clinical Judgement Analysis study of 40 case vignettes based on authentic patients, including relevant clinical data except echocardiography. Setting: Primary health care and two cardiology outpatient clinics in Stockholm. Subjects: 70 participants with different types of clinical experience; 27 specialists in general practice, 22 cardiologists, and 21 medical students. Main outcome measures: The assessed probability of heart failure for each case vignette, and the disagreement between the participants. The number of clinical variables (cues) indicative of heart failure in the case vignettes. RESULTS: The ten case vignettes with the least diverging assessments more often had increased relative cardiac volume and atrial fibrillation. No further specific clinical patterns could be found in subgroups of the case vignettes. The ten case vignettes with the most diverging assessments were those with an intermediate number of clinical variables. The case vignettes with the least diverging assessments more often represented patients with cardiac enlargement and atrial fibrillation. CONCLUSION: Diagnosing mild heart failure is difficult, as these patients are not easy to characterise. In our study, a larger number of positive cues resulted in more diagnostic conformity among the participants, and the most important information was cardiac enlargement. The importance of more objective diagnostic methods in diagnosing suspected cases of heart failure should be emphasised

Survivorship and improving quality of life in men with prostate cancer

Context: Long-term survival following a diagnosis of cancer is improving in developed nations. However, living longer does not necessarily equate to living well. Objective: To search systematically and synthesise narratively the evidence from randomised controlled trials (RCTs) of supportive interventions designed to improve prostate cancer (PCa)-specific quality of life (QoL). Evidence acquisition: A systematic search of Medline and Embase was carried out from inception to July 2014 to identify interventions targeting PCa QoL outcomes. We did not include nonrandomised studies or trials of mixed cancer groups. In addition to database searches, citations from included papers were hand-searched for any potentially eligible trials. Evidence synthesis: A total of 2654 PCa survivors from 20 eligible RCTs were identified from our database searches and reference checks. Disease-specific QoL was assessed most frequently by the Functional Assessment of Cancer Therapy-Prostate questionnaire. Included studies involved men across all stages of disease. Supportive interventions that featured individually tailored approaches and supportive interaction with dedicated staff produced the most convincing evidence of a benefit for PCa-specific QoL. Much of these data come from lifestyle interventions. Our review found little supportive evidence for simple literature provision (either in booklets or via online platforms) or cognitive behavioural approaches. Conclusions: Physical and psychological health problems can have a serious negative impact on QoL in PCa survivors. Individually tailored supportive interventions such as exercise prescription/referral should be considered by multidisciplinary clinical teams where available. Cost-effectiveness data and an understanding of how to sustain benefits over the long term are important areas for future research. Patient summary: This review of supportive interventions for improving quality of life in prostate cancer survivors found that supervised and individually tailored patient-centred interventions such as lifestyle programmes are of benefit.</p