465 research outputs found

    Analysis of mental imagery in grade one.

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    Thesis (Ed.M.)--Boston Universit

    Challenges in Communication about Covid Medical Risks: : A Speculative Educational Template

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    The most recent descriptions of how the pandemic is playing out in medical offices and hospitals describe scenarios that are truly unprecedented. The impact of COVID-19 on individuals sick enough to seek professional health care highlights the importance of communication skills in explaining potential risks. Clinicians need to be sophisticated in thinking about how to approach each patient. We propose an educational framework for pre-service and in-service health care professionals to improve communication skills during this crisis. To assist Covid patients and their family members, clinicians need to be mindful of the ways that the likelihood of serious impact and consequences of treatments are perceived by each patient and their loved ones. The four-quadrant scheme we offer is a way to help providers orient themselves to their task and prepare to speak effectively about medical choices related to Covid. It is obvious that most situations demand more than one type of communication competency, but the focus here is on what might be advisable as the primary or “lead” skill. Thinking through what would be the preferred “leading” strategies is crucial for clinicians aiming to help COVID-19 patients think about the risks they are facing. Addressing the psychological state of each individual patient is vital. The most important element in managing COVID-19 is to empower patients with the appropriate information and emotional support. Additionally, we hope this model will inspire health professions faculty to think in new ways about teaching and coaching options in the practice-based learning of communication skills

    Minority Women in the Healthcare Workforce in New England

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    Research on health disparities affecting people of color typically focuses on their health status, health treatment and health outcomes with a particular emphasis on the relatively high rates of morbidity and mortality from selected diseases for ethnic and racial minority groups. This fact sheet offers a different but related focus on gender and race/ethnicity in the health care workforce. Our rationale is that the Sullivan Commission on Diversity in the Healthcare Workforce concluded that the lack of minority doctors, nurses and dentists is a significant cause of racial/ethnic health disparities and that the ability to recruit, train and retain minority health care professionals is critical in any effort to reduce health disparities in the future

    Unmet care needs in people living with advanced cancer: a systematic review

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    Purpose: The support needs of cancer patients vary according to the phase of their cancer journey. Recent developments in healthcare are such that the advanced cancer phase is increasingly experienced as a chronic illness phase, with consequent changes in patient support needs. Understanding these needs, and identifying areas of unmet need, can enable us to develop services that are more adequate to the task of supporting this population. Methods: We conducted a systematic search of four electronic databases to identify studies examining the unmet needs of people living with advanced cancer. Relevant data were extracted and synthesised; meta-analyses were conducted to obtain pooled estimates for prevalence of needs. Results: We identified 23 studies (4 qualitative) for inclusion. Unmet needs were identified across a broad range of domains, with greatest prevalence in informational (30–55 %), psychological (18–42 %), physical (17–48 %), and functional (17–37 %) domains. There was considerable heterogeneity amongst studies in terms of methods of assessment, coding and reporting of needs, respondent characteristics, and appraised study quality. Conclusions: Heterogeneity made it difficult to compare across studies and inflated confidence intervals for pooled estimates of prevalence—we need standardised and comprehensive approaches to assessment and reporting of unmet needs to further our understanding. Nonetheless, the review identified prominent needs across a range of (interacting) experiential domains. Moreover, by focussing on unmet needs for support, we were able to extrapolate potential implications for service development

    Improved standardization of transcribed digital specimen data

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    There are more than 1.2 billion biological specimens in the world's museums and herbaria. These objects are particularly important forms of biological sample and observation. They underpin biological taxonomy but the data they contain have many other uses in the biological and environmental sciences. Nevertheless, from their conception they are almost entirely documented on paper, either as labels attached to the specimens or in catalogues linked with catalogue numbers. In order to make the best use of these data and to improve the findability of these specimens, these data must be transcribed digitally and made to conform to standards, so that these data are also interoperable and reusable. Through various digitization projects, the authors have experimented with transcription by volunteers, expert technicians, scientists, commercial transcription services and automated systems. We have also been consumers of specimen data for taxonomical, biogeographical and ecological research. In this paper, we draw from our experiences to make specific recommendations to improve transcription data. The paper is split into two sections. We first address issues related to database implementation with relevance to data transcription, namely versioning, annotation, unknown and incomplete data and issues related to language. We then focus on particular data types that are relevant to biological collection specimens, namely nomenclature, dates, geography, collector numbers and uniquely identifying people. We make recommendations to standards organizations, software developers, data scientists and transcribers to improve these data with the specific aim of improving interoperability between collection datasets.Peer reviewe

    Childhood abuse and the content of delusions

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    Original article can be found at: http://www.sciencedirect.com/science/journal/01452134 Copyright Elsevier Ltd.We aimed to investigate possible associations between histories of childhood abuse and the content of delusions for individuals with psychotic disorders. 39 participants with a psychotic disorder including one or more delusional beliefs successfully completed structured interviews about childhood trauma, delusional beliefs and associated anomalous perceptual experiences including hallucinations. The presence of hallucinations was predicted by greater physical abuse. Greater abuse in general was associated with delusions involving ‘special abilities’ (grandiosity) and, at trend levels, with those involving ‘defective self’. Though preliminary, these results suggest that further investigation is warranted. The presence and nature of abuse may be relevant to delusional presentations and should form an essential part of clinical assessment of psychotic disorder.Peer reviewe

    Milestone 3.2 - DiSSCo Digital Maturity Self -Assessment Tool - Design Blueprint

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    This Milestone 3.2 report for DiSSCo Prepare Work Package 3 Task 3.1 sets out the initial design blueprint for a DiSSCo Digital Maturity Self-Assessment Tool, building on the analyses in the Milestone 3.1 report ‘Improving Digital Capability - Case Studies and Analysis’ (Hardy et al, Dec 2020) and in the Milestone 3.3. Report, including consideration of two existing tools in our sector. This tool is intended to support teams, institutions and national nodes in developing organisational readiness for provision of the DiSSCo services and data, helping them to identify and target areas for improvement. The aim is for this to tie in to future provision of training and support, as well as helping to identify the gaps at aggregate level where that training may be most useful. In addition , we believe there is a case for a platform that can support both this and the related Task 7.3 Policy Tool, such that these or other tools are consistent for users and can interact with one another where relevant, avoiding any duplication. This blueprint is intended for wider discussion among the DiSSCo members, so that tool content can be developed in more detail as part of the Deliverable for this Taskinfo:eu-repo/semantics/publishedVersio

    How do hospital professionals involved in a randomised controlled trial perceive the value of genotyping vs. PCR-ribotyping for control of hospital acquired C. difficile infections?

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    Background: Despite scientific advances in typing of C. difficile strains very little is known about how hospital staff use typing results during periods of increased incidence (PIIs). This qualitative study, undertaken alongside a randomised controlled trial (RCT), explored this issue. The trial compared ribotyping versus more rapid genotyping (MLVA or multilocus variable repeat analysis) and found no significant difference in post 48 hour cases (C difficile transmissions). Methods: In-depth qualitative interviews with senior staff in 11/16 hospital trusts in the trial (5 MLVA and 6 Ribotyping). Semi-structured interviews were conducted at end of the trial period. Transcripts were content analysed using framework analysis supported by NVivo-8 software. Common sub-themes were extracted by two researchers independently. These were compared and organised into over-arching categories or ‘super-ordinate themes’. Results: The trial recorded that 45% of typing tests had some impact on infection control (IC) activities. Interviews indicated that tests had little impact on initial IC decisions. These were driven by hospital protocols and automatically triggered when a PII was identified. To influence decision-making, a laboratory turnaround time < 3 days (ideally 24 hours) was suggested; MLVA turnaround time was 5.3 days. Typing results were predominantly used to modify initiated IC activities such as ward cleaning, audits of practice or staff training; major decisions (e.g. ward closure) were unaffected. Organisational factors could limit utilisation of MLVA results. Results were twice as likely to be reported as ‘aiding management’ (indirect benefit) than impacting on IC activities (direct effect). Some interviewees considered test results provided reassurance about earlier IC decisions; others identified secondary benefits on organisational culture. An underlying benefit of improved discrimination provided by MLVA typing was the ability to explore epidemiology associated with CDI cases in a hospital more thoroughly. Conclusions: Ribotyping and MLVA are both valued by users. MLVA had little additional direct impact on initial infection control decisions. This would require reduced turnaround time. The major impact is adjustments to earlier IC measures and retrospective reassurance. For this, turnaround time is less important than discriminatory power. The potential remains for wider use of genotyping to examine transmission routes
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