Understanding clinical reasoning in osteopathy: a qualitative research approach.

BACKGROUND: Clinical reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the clinical reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand clinical reasoning in osteopathy from the perspective of osteopathic clinical educators and the extent to which it was similar or different from clinical reasoning in other health professions. METHODS: This study was informed by constructivist grounded theory. Participants were clinical educators in osteopathic teaching institutions in Australia, New Zealand and the UK. Focus groups and written critical reflections provided a rich data set. Data were analysed using constant comparison to develop inductive categories. RESULTS: According to participants, clinical reasoning in osteopathy is different from clinical reasoning in other health professions. Osteopaths use a two-phase approach: an initial biomedical screen for serious pathology, followed by use of osteopathic reasoning models that are based on the relationship between structure and function in the human body. Clinical reasoning in osteopathy was also described as occurring in a number of contexts (e.g. patient, practitioner and community) and drawing on a range of metaskills (e.g. hypothesis generation and reflexivity) that have been described in other health professions. CONCLUSIONS: The use of diagnostic reasoning models that are based on the relationship between structure and function in the human body differentiated clinical reasoning in osteopathy. These models were not used to name a medical condition but rather to guide the selection of treatment approaches. If confirmed by further research that clinical reasoning in osteopathy is distinct from clinical reasoning in other health professions, then osteopaths may have a unique perspective to bring to multidisciplinary decision-making and potentially enhance the quality of patient care. Where commonalities exist in the clinical reasoning processes of osteopathy and other health professions, shared learning opportunities may be available, including the exchange of scaffolded clinical reasoning exercises and assessment practices among health disciplines

Combining high conductivity with complete optical transparency: A band-structure approach

A comparison of the structural, optical and electronic properties of the recently discovered transparent conducting oxide (TCO), nanoporous Ca12Al14O33, with those of the conventional TCO's (such as Sc-doped CdO) indicates that this material belongs conceptually to a new class of transparent conductors. For this class of materials, we formulate criteria for the successful combination of high electrical conductivity with complete transparency in the visible range. Our analysis suggests that this set of requirements can be met for a group of novel materials called electrides.Comment: 3 pages, 3 figures, submitted for publicatio

Exploring the use of image processing to survey and quantitatively assess historic buildings

Before architectural conservation takes place, a survey is conducted to assess the condition of the building and estimate the cost of the work. For façades, scaffolding is erected so that experts can access the building’s whole extent and gather data for analysis. This paper presents the results of a collaborative and cross-disciplinary research project aiming to automate data capture and analysis techniques for conservation of stone façades. Our research demonstrates the feasibility of a new methodology for the survey and assessment of historic buildings and will facilitate frequent surveys with minimal disruption to the general public in cities. The project has embedded architects’ expert knowledge into intelligent algorithms for automatically analysing images of facades. The combination of technologies allows for an efficient data capture while minimising the requirement for manual data analysis as well as more accurate estimates of its cost

Positional Differences in Running and Non-Running Activities During Elite American Football Training.

The aim of this investigation was to describe differences in training loads between position groups within professional American football. Integrated micro technology data was collected on 63 NFL football players during an American football training camp. Five key metrics (total distance, high speed distance, Player Load, Player Load per Minute, and Total Inertial Movement Analysis (IMA)) served to quantify both running and non-running activities. Players were classified into position groups (DB, DL, LB, OL, QB, RB, TE, and WR). Training sessions were identified by their relationship to the upcoming match (e.g., -4, -3, -2). Running and non-running activities varied between position groups relative to the training day. Differences in total distance were between DB and WR were observed to be unclear between the three training days (Game Day (GD) -4: 74 ± 392 m; GD -3: -122 ± 348; GD - 2: -222 ± 371 m). However, moderate to large differences were observed between these two positions and the other positional groups. A similar relationship was observed in Player Load and Player Load per Minute, with the DB and WR groups performing greater amounts of load compared to other positional groups. Differences in High Speed Distance varied across positional groups, indicating different outputs based on ergonomic demands. The OL and DL groups ran less but engaged in a higher amount of non-running activities (Total IMA) with differences ranging from moderate to large across the three training days. Total IMA differences between offensive and defensive linemen were unclear on GD -4 (-4 ± 9) and GD -2 (-2 ± 8) and likely moderate on GD -3 (-9 ± 9). Positional differences with regard to running and non-running activities highlight the existence of position specific training within a training micro-cycle. Additionally, Total IMA provides a useful metric for quantifying sport specific movements within the game of American football

An exploration of the multiple motivations for spending less time at work

Funder: Cambridge Political Economy Society TrustThis article makes a significant empirical contribution to our understanding of why people in the United Kingdom without childcare responsibilities actively reduce or limit the amount of time they spend in paid employment. We show how the negative aspects of employment (push factors) and the desire to spend time in more varied and enjoyable ways (pull factors) interact to produce decisions to enact working time reductions (WTRs). The push factors include excessive workloads and difficult or tedious tasks which can result in stress and mental exhaustion. For people working non-standard schedules, their lack of control over hours can make it difficult to enjoy the free time that is available. The pull factors we have identified include traumatic experiences such as illness or the early death of a loved one which can lead to an increased awareness of the salience of time. Also important was the desire to develop skills and subjectivities unrelated to work-time identities. An overarching theme in the interviews was the idea that full-time work leads to a loss of autonomy, and a reduction in hours is a route to greater freedom. These motivations are contrasted with understandings of WTRs present in the empirical and predominantly quantitative literature which highlight the structural constraints that often force women in particular into part-time work as a result of childcare responsibilities. An exploration of the motivations of short-hour workers is pertinent, given increasing concern that long hours of work exacerbate multiple social, economic and environmental problems. We suggest that a deeper understanding of why individuals want to work less could help facilitate ‘priming’ campaigns aimed at increasing demand for WTRs more generally.</jats:p

Weak lensing surveys and the intrinsic correlation of galaxy ellipticities

We explore the possibility that an intrinsic correlation between galaxy ellipticities arising during the galaxy formation process may account for part of the shear signal recently reported by several groups engaged in weak lensing surveys. Using high resolution N-body simulations we measure the projected ellipticities of dark matter halos and their correlations as a function of pair separation. With this simplifying, but not necessarily realistic assumption (halo shapes as a proxy for galaxy shapes), we find a positive detection of correlations up to scales of at least 20 h^-1mpc (limited by the box size). The signal is not strongly affected by variations in the halo finding technique, or by the resolution of the simulations. We translate our 3d results into angular measurements of ellipticity correlation functions and shear variance which can be directly compared to observations. We also measure similar results from simulated angular surveys made by projecting our simulation boxes onto the plane of the sky and applying a radial selection function. Interestingly, the shear variance we measure is a small, but not entirely negligible fraction (from ~10-20 %) of that seen by the observational groups, and the ellipticity correlation functions approximately mimic the functional form expected to be caused by weak lensing. The amplitude depends on the width in redshift of the galaxy distribution. If photometric redshifts are used to pick out a screen of background galaxies with a small width, then the intrinsic correlation may become comparable to the weak lensing signal. Although we are dealing with simulated dark matter halos, whether there is a signal from real galaxies could be checked with a nearby sample with known redshifts.Comment: 12 pages, 11 ps figures, emulateapj.sty, submitted to Ap