Relationship-centred care in health: A 20-year scoping review

Relationship-centred care (RCC) is a framework for conceptualizing health care which recognizes that the nature and quality of relationships in health care influence the process and outcomes of health care. Our goal was to undertake a scoping review of the peer-reviewed and grey literature on RCC in health. Using Arksey and O’Malley’s scoping review methodology we identified literature about RCC in teaching, learning and clinical practice. Electronic databases were searched, and targeted searches were also conducted for grey literature to capture unpublished material. Subsequently, data abstraction tools were used with eligible studies for analysis. Sixty-nine publications originated mainly from the United States and the United Kingdom by authors from various academic disciplines, of which medicine and nursing were dominant. Thematic analysis revealed that the most commonly cited definition of RCC emerged from the Pew-Fetzer report and focused on the central role of relationships between practitioners and their patients, the community and other practitioners in providing quality care and improving outcomes. The concept of RCC was found to be influenced by theories of sociology, social psychology and psychiatry. The practice of RCC was demonstrated through organizational environments that model RCC, practice settings that focus on the patient or family in care planning, and health professional education that is based on RCC principles. RCC is important to: humanize health care and improve patient care. Our review identified three sub-categories that could add to the relational dimension of the practitioner-organization: practitioner–education, practitioner–profession, and practitioner–practice. Recommendations for future research include: outcome and process studies of health professions education and health care that focuses on RCC. The RCC approach provides a paradigm to move beyond the patient-centred care model by focusing on the central role of all relationships in the delivery and outcomes of care

Applications of geographic information science in the archaeological research of the Fincastle Kill Site (D1Ox 5) Alberta, Canada, and Tel Beth-Shemesh, Israel

vii, 119 leaves : ill. (some col.) ; 28 cm.Many scientists have used the expediency of geographic information science (GIS) for archaeological analyses, such as predictive site location modeling and producing topographical site surveys. However, the use of GIS to explore the spatial relationships among the architecture, geography and site artifacts has rarely been done. This research focuses on visualizing and analyzing these relationships using GIS. The sites of Tel Beth Shemesh, Israel and the Fincastle Kill Site (DIOx 5), north-east of Taber, Alberta, were used as case studies, as they were very differnt types of sites. Based on field measurments and by using specific GIS applications and software, components of these sites were reconstructed in virtual space as GIS models. Other recorded field data were used as input parameters into the models in order to attain the most accurate representations and analyses of the sites. The analysis at Fincastle Kill Site used two types of GIS models: 1) a viewshed model to assess possible bison hunting techniques and 2) surface interpolation models that delineated correlations between high density and low density areas of archaeological remains. The investigation at Tel Beth-Shemesh used a GIS model to store, visualize, interpret and assess the quality and accuracy of the field data recorded during 2001 - 2004 excavations. Predominately, the work in this thesis did not aim at answering any profound questions about the archaeology of either site, although in some cases it did, but rather focused on developing useful GIS tools for the archaeologist. These GIS models show the value of the applications, and their applicability to archaeological sites around the world

Preterm low birthweight and the role of oral bacteria

Preterm and low birthweight (PTLBW) continues to be a major cause of mortality and morbidity across the world. In recent years, maternal periodontal disease has been implicated as a risk factor for adverse pregnancy outcomes. There is conflicting evidence to support such an outcome as illustrated by descriptive, case control and randomised controlled trials involving pregnant women from across the world, using different measurement tools to determine the level of periodontal disease. Whilst considering the literature, there is evidence for both arguments, based on the effect of periodontal inflammatory by products. Bacteria associated with periodontal disease are not dissimilar to those known to be associated with genito-urinary bacterial infections and adverse pregnancy outcomes. Several groups have demonstrated the apparent translocation of Fusobacterium nucleatum, Prevotella nigrescens, Prevotella intermedia, Porphyromonus gingivalis, Treponema denticola to the foetal placental unit whereby a maternal or foetal response has been detected resulting in premature birth or low birthweight. The normal process of parturition involves a cascade of events including a build-up of inflammatory mediators as linked to inflammation, whereby the maternal environment becomes hostile and threatens the well-being of the infant, and the foetus expelled. The question remains therefore, is there a greater risk of delivering a PTLBW infant when the mother has detectable periodontal disease, or is the release of inflammatory mediators and their translocation via the haematogenous route sufficient to induce a poor pregnancy outcome? The data investigated would suggest that there is a positive outcome when certain oral gram-negative bacteria create a cumulative effect sufficient to trigger early delivery, which represents the final straw to result in preterm or low birthweight delivery. There is equally sufficient epidemiological evidence that does not support this outcome, but it is agreed that maintaining oral health during pregnancy is beneficial to the mother and her infant

Foreign funding and national cinema: a case study of the Irish film industry

Bibliography: p. 135-143