Assessment of the Validity of Patient-Stated Allergies: De-labeling and Education

The initial direction of the project was to develop and implement a research-based protocol to de-label hospitalized patients with a patient-stated penicillin allergy who were not truly allergic (Phase I). The project was abruptly halted due to the lack of data to justify the need, lack of sufficient communication among stakeholders, questions regarding financial cost of implementation, and strong concerns regarding educational needs of nursing staff. After developing the initial protocol, the project team was redirected to provide evidence-based allergy assessment education to the nursing staff to foster reliable and accurate patient interviews and documentation of the results (Phase II). The education module was presented to ICU nursing staff in a PowerPoint presentation, which yielded positive evaluations. The electronic medical record was redesigned to allow for documentation of the enhanced allergy assessment. The learning materials were provided to the education department of the hospital for ongoing education of all patient care staff. The failure of Phase I of this project was due to the neglect of basic steps in project development, highlighting the importance of participation of all stakeholders from the beginning. The final project (Phase II) was a successful first step in improving nursing assessments of allergies

THE 2002 NO CHILD LEFT BEHIND ACT (NCLB), THE AMENDED 2004 INDIVIDUALS WITH DISABILITIES EDUCATIONAL ACT (IDEA), AND PROMOTING THE AMERICAN DEMOCRATIC IDEALS OF EQUITY AND ACCESS

Abstract There is a long history relative to the purpose of American public education. Since at least the Founders, in particular Thomas Jefferson, the purpose of public education has been to prepare children to assume the primary political office, that of citizen. The reasoning was that for a democracy to endure citizens would have to make political judgments relative to both preserving the democracy and furthering democratic ideals including equity and access to the ?good life.? This educational philosophy took root more firmly during the 19th century with the advancement of the Common School. The twentieth century saw the dramatic expansion of American public education to include women during the first half and minorities, especially African American children, during the later half. By the third quarter of the 20th century attention was given to the education of mentally and physically handicapped children. This study is a Critical Enquiry to determine if the technologies (methods) of implementation and assessment of the 2002 No Child Left Behind Act (NCLB) relative to the amended 2004 Individuals with Disabilities Educational Act (IDEA) are consistent with promoting the American democratic ideals of equity and access. The method of enquiry was through a deconstructive reading (analysis) of policy discourse of two Federal laws intended to improve the academic achievement of students in public schools: 2002 No Child Left Behind Act (NCLB) and the 2004 (as amended) Individuals with Disabilities Educational Act (IDEA). The framework for the enquiry consisted of the historical analytics of Michel Foucault and the language games of Jean-Frangois Lyotard. The Critical Enquiry revealed that the although both Acts have noble intents the methods of implementation and assessment seriously contradict the democratic ideals of both equity and access. Given this fundamental contradiction, the study suggests that all educational policies first be scrutinized through a Critical Enquiry before being fully promulgated and implemented

Noch viel Potenzial für Bio

Biologische Produkte haben einen festen Platz in der Gesellschaft. Doch nachhaltige Ernährung ist mehr als biologisch erzeugte Produkte. Die gesamte Ernährungsbranche muss die Herausforderungen angehen, die der Klima- und Ressourcenschutz an sie richtet. Die Vorlieben der Konsumenten bieten aber auch Chancen für neue Geschäftsmodelle

Weg von der Erbsenzählerei, hin zu den wesentlichen Fragen

In Teil II der Serie hinterfragt Heike Leitschuh den Sinn standardisierter Vergleichbarkeit von Nachhaltigkeitsberichten. Die Philosophie und Haltung des Unternehmens müsse in ihnen erkennbar sein. Der ideale Nachhaltigkeitsbericht ist für sie kurz, aber gehaltvoll

Wegweiser Nachhaltigkeit

Zwar ist der Begriff Nachhaltigkeit in aller Munde, doch vermag kaum jemand damit in der Praxis wirklich etwas anzufangen. Die Auseinandersetzung darüber, welche Verantwortung Unternehmen als Teil des gesellschaftlichen Systems dabei zukommen soll, steht noch ganz am Anfang. Aktuelle Ergebnisse einer Studie zeigen zumindest eine Wegrichtung auf

Social learning as a link between the individual and the collective: evaluating deliberation on social values

The role of social learning in deliberative processes is an emerging area of research in sustainability science. Functioning as a link between the individual and the collective, social learning has been envisioned as a process that can empower and give voice to a diverse set of stakeholder viewpoints, contribute to more adaptive and resilient management decisions and foster broader societal transformations. However, despite its widespread use in the context of participatory management of natural resources, the empirical properties of social learning remain understudied. This paper evaluates the role of social interaction and social capital in achieving transformative learning in discussions about social values. We employ a longitudinal design involving three consecutive surveys of 25 participants of an expert workshop focused on social values, as well as approximately 12 hours of transcribed audio and video recordings of participant interactions. Our mixed methods approach demonstrates the potential of using changes in social networks and definitions of social values that emerge from qualitative coding as indicators of social learning. We find that individuals with a weaker conceptual understanding of social values are more likely to change their definitions of the concept after deliberation. Though slight, these changes display a shift towards definitions more firmly held by other group members.Peer reviewe

Frequency of Penetration of the Digital Flexor Tendon Sheath and Distal Interphalangeal Joint Using a Direct Endoscopic Approach to the Navicular Bursa in Horses

OBJECTIVE: To evaluate the frequency of inadvertent penetration of the digital flexor tendon sheath (DFTS) and/or distal interphalangeal joint (DIPJ) when using a direct endoscopic approach to the navicular bursa, and to evaluate an alternate direct approach to the navicular bursa. STUDY DESIGN: Cadaveric study. SAMPLE POPULATION: Equine cadaver limbs (n = 40 for direct; n = 12 for alternate approach). METHODS: Four surgeons performed the direct endoscopic approach to the navicular bursa on 10 limbs each. Frequencies of inadvertent synovial penetration and iatrogenic damage were compared between surgeons. Use of an alternate direct approach, adopting a straight parasagittal trajectory, was evaluated by 2 surgeons. RESULTS: Inadvertent synovial penetration occurred in 45% of limbs (DFTS 37.5%; DIPJ 17.5%; and both structures 10%). Successful bursa entry was achieved on the first attempt in 45% of limbs. Significant variation in frequency of inadvertent synovial penetration was observed between surgeons (range 10–80%). Inadvertent synovial penetration did not occur when using the alternate direct technique. Iatrogenic damage to navicular bone fibrocartilage and/or deep digital flexor tendon occurred in 55% of limbs using the direct endoscopic approach and in 0% of limbs using the alternate direct approach. CONCLUSION: Because of the considerable risk of inadvertent penetration of the DFTS and/or the DIPJ when making a direct endoscopic approach to the navicular bursa, it is advisable to investigate for inadvertent penetration when treating navicular bursa sepsis using a direct approach. The alternate direct technique may reduce the risk of inadvertent penetration; however, the view within the bursa may be restricted

Subcutaneous rupture of the Achilles tendon and ipsilateral fracture of the medial malleolus

BACKGROUND: Although ankle fractures and an Achilles tendon rupture are relatively frequent in isolation, their association in the same injury is uncommon. CASE PRESENTATION: A 38 year old male tree surgeon fell six meters from a tree, sustaining a subcutaneous rupture of the Achilles tendon and an ipsilateral closed fracture of the medial malleolus. The injuries were diagnosed following clinical examination and imaging. CONCLUSION: This injury combination is infrequent, and management of the Achilles tendon rupture should take into account the necessity not to secondarily displace the fracture of the medial malleollus

Mental health literacy: a cross-cultural approach to knowledge and beliefs about depression, schizophrenia and generalized anxiety disorder

Many families worldwide have at least one member with a behavioral or mental disorder, and yet the majority of the public fails to correctly recognize symptoms of mental illness. Previous research has found that Mental Health Literacy (MHL)—the knowledge and positive beliefs about mental disorders—tends to be higher in European and North American cultures, compared to Asian and African cultures. Nonetheless quantitative research examining the variables that explain this cultural difference remains limited. The purpose of our study was fourfold: (a) to validate measures of MHL cross-culturally, (b) to examine the MHL model quantitatively, (c) to investigate cultural differences in the MHL model, and (d) to examine collectivism as a predictor of MHL. We validated measures of MHL in European American and Indian samples. The results lend strong quantitative support to the MHL model. Recognition of symptoms of mental illness was a central variable: greater recognition predicted greater endorsement of social causes of mental illness and endorsement of professional help-seeking as well as lesser endorsement of lay help-seeking. The MHL model also showed an overwhelming cultural difference; namely, lay help-seeking beliefs played a central role in the Indian sample, and a negligible role in the European American sample. Further, collectivism was positively associated with causal beliefs of mental illness in the European American sample, and with lay help-seeking beliefs in the Indian sample. These findings demonstrate the importance of understanding cultural differences in beliefs about mental illness, particularly in relation to help-seeking beliefs