The value and challenges of collegiality in practice

The ability to work optimally with colleagues is considered to be a valuable determinant of success, but collegiality is a challenge to assess. Could you be more collegial, and what might be the benefits and drawbacks for clinical practice? How could you be more collegial and foster more collegiality amongst those you work with? What is collegiality and what does it mean to be collegial? Collegiality can be defined as the relationship between individuals working towards a common purpose within an organisation. The concept has its origins in the roman practice of sharing responsibility equally between government officials of the same rank in order to prevent a single individual from gaining too much power. In contrast, managerialism does not provide opportunities for exploring democratic consensus because it promotes being responsive and obedient to implementing the wishes of authority (Dearlove, 1997, King, 2004). Collegiality emphasises trust, independent thinking and sharing between co-workers. This encourages both autonomy and mutual respect and can impact on organisational efficacy (Donohoo, 2017). In modern day practice, the focus is less on sharing responsibility between officials of the same rank and more on ensuring that all employees within an organisation are treated with equal respect as individual people (Lorenzen, 2006)

Treatment effects of Ginkgo biloba extract EGb 761® on the spectrum of behavioral and psychological symptoms of dementia: meta-analysis of randomized controlled trials.

ABSTRACTBackground:In randomized controlled trials, Ginkgo biloba extract EGb 761® has been found to be effective in the treatment of behavioral and psychological symptoms of dementia (BPSD). To assess the effects of EGb 761® on specific BPSD, we analyzed data from all randomized, placebo-controlled, at least 20-week, trials of EGb 761® enrolling patients with dementia (probable Alzheimer's disease (AD), probable vascular dementia or probable AD with cerebrovascular disease) who had clinically significant BPSD (Neuropsychiatric Inventory (NPI) total score at least 6). Data were pooled and joint analyses of NPI single item composite and caregiver distress scores were performed by meta-analysis with a fixed effects model. Four trials involving 1628 patients (EGb 761®, 814; placebo, 814) were identified; treatment duration was 22 or 24 weeks; the daily dose of EGb 761® was 240 mg in all trials. Pooled analyses including data from the full analysis sets of all trials (EGb 761®, 796 patients; placebo, 802 patients) revealed significant superiority of EGb 761® over placebo in total scores and 10 single symptom scores. Regarding caregiver distress scores, EGb 761®-treated patients improved significantly more than those receiving placebo in all symptoms except delusions, hallucinations, and elation/euphoria. The benefit of EGb 761® mainly consists of improvement in symptoms present at baseline, but the incidence of some symptoms was also decreased. Twenty two- to twenty four-week treatment with Ginkgo biloba extract EGb 761® improved BPSD (except psychotic-like features) and caregiver distress caused by such symptoms

A Study On The Use Of Rubrics To Guide Writing And Self-Assessment In The L2 Elementary Classroom

The use of rubrics in the classroom to guide writing or as a means of self-assessment are not new concepts but ones that have received little study at the primary level. This study took the form of a classroom-based action research project, over a seven-week period, in a fourth- grade elementary school classroom, at an international school in Ecuador. Data was collected through responses to narrative writing prompts scored by the teacher and self-assessed by the students using the 6-Traits Writing Rubric. The students received direct instruction on writing traits as well as training on how to use the rubric. The findings were noteworthy in that they clearly indicated the overall quality of the students’ writing improved during the course of the study. They also showed that students had improved in their ability to self- assess, scoring themselves consistently in line with that of the teacher by the end of the study

Intergenerational Service Learning Program Improves Aging Knowledge and Expectations and Reduces Ageism in Younger Adults

This article discusses a study which evaluated the effects of an intergenerational service-learning exergaming program for older adults on younger adults’ aging knowledge, expectations, and perceptions. Eighteen college students (ages 19-26 years) served as trainers for an 8-week exergaming physical activity program for older adults (12 contact hours). Questionnaires assessing aging knowledge, ageist attitudes and aging expectations were completed at Weeks 1, 8, and 25 (follow-up); program evaluations were completed at Weeks 8 and 25. Significant improvement from Week 1 to Week 25 was found for: Aging knowledge scores (

Public Health Nursing Clinical Expertise as a Component of Evidence-Based Care

Evidence-based care in public health nursing is meant to guide practice through the integration of research evidence, clinical expertise, and client preference. Minimal study has explored clinical expertise, including what it means to be an expert, how practice wisdom informs decision-making, and whether experiential knowledge can be transformed to the benefit of others. Eight public health nurses, all of whom were highly experienced in providing home visiting services to high risk, pregnant and parenting families, participated in this qualitative inquiry. Interviews were conducted with the goal of exploring, describing, and understanding practice expertise from the perspective of those who know it best. The intended outcome of this research was to establish a source of practical knowledge that could be used in the recruitment and orientation of newly hired nursing staff. Data analysis was guided by a series of sequenced processes described by Colaizzi (1978). Five themes emerged from the data including: 1) public health nursing practice is derived from academic and experiential learning, 2) the knowledge of clinical experts contributes to the practice of others, 3) public health nursing expertise can be described through a collection of certain characteristics, 4) evidence-based nursing isn’t well understood in community health settings, nor are processes fully incorporated into practice; and 5) critical steps of evidence-based care may not fully translate to public health nursing practice. Evidence-based public health nursing practice is a relatively young and as such, there is a need for expanded research, knowledge development, and the creation of meaningful and applicable methods of adapting processes to better reflect the realities of practice

Deficiency of the BMP Type I receptor ALK3 partly protects mice from anemia of inflammation

Background: Inflammatory stimuli induce the hepatic iron regulatory hormone hepcidin, which contributes to anaemia of inflammation (AI). Hepcidin expression is regulated by the bone morphogenetic protein (BMP) and the interleukin-6 (IL-6) signalling pathways. Prior results indicate that the BMP type I receptor ALK3 is mainly involved in the acute inflammatory hepcidin induction four and 72 h after IL-6 administration. In this study, the role of ALK3 in a chronic model of inflammation was investigated. The intact, heat-killed bacterium Brucella abortus (BA) was used to analyse its effect on the development of inflammation and hypoferremia in mice with hepatocyte-specific Alk3-deficiency (Alk3fl/fl; Alb-Cre) compared to control (Alk3fl/fl) mice. Results: An iron restricted diet prevented development of the iron overload phenotype in mice with hepatocyte-specific Alk3 deficiency. Regular diet leads to iron overload and increased haemoglobin levels in these mice, which protects from the development of AI per se. Fourteen days after BA injection Alk3fl/fl; Alb-Cre mice presented milder anaemia (Hb 16.7 g/dl to 11.6 g/dl) compared to Alk3fl/fl control mice (Hb 14.9 g/dl to 8.6 g/dl). BA injection led to an intact inflammatory response in all groups of mice. In Alk3fl/fl; Alb-Cre mice, SMAD1/5/8 phosphorylation was reduced after BA as well as after infection with Staphylococcus aureus. The reduction of the SMAD1/5/8 signalling pathway due to hepatocyte-specific Alk3 deficiency partly suppressed the induction of STAT3 signalling. Conclusion: The results reveal in vivo, that 1) hepatocyte-specific Alk3 deficiency partly protects from AI, 2) the development of hypoferremia is partly dependent on ALK3, and 3) the ALK3/BMP/hepcidin axis may serve as a possible therapeutic target to attenuate AI

Horror of a Woman : Myra Bradwell, the 14th Amendment, and the Gendered Origins of Sociological Jurisprudence

On June 14, 1873, Myra Bradwell reprinted a short article from the St. Louis Republican in the Chicago Legal News announcing the U.S. Supreme Court’s decision in her case. This short article reveals an important insight that challenges some contemporary interpretations of Bradwell v. Illinois. First, it points out what we know, but sometimes overlook, that the Supreme Court holding in Bradwell did not prevent women from becoming lawyers or practicing law.6 More importantly, however, it suggests that Justice Bradley’s oftcited concurrence – where he reveals his horror of a woman, writing that “[t]he harmony, not to say identity, of interest and views which belong, or should belong, to the family institution is repugnant to the idea of a woman adopting a distinct and independent career from that of her husband”7 – that this opinion was perhaps not the dominant ideology of the day. Looking beyond the Supreme Court opinions, this paper attempts to assess what Bradwell v. Illinois meant to Myra Bradwell and the women’s rights movement

EGb 761® Does Not Affect Blood Coagulation and Bleeding Time in Patients with Probable Alzheimer’s Dementia - Secondary Analysis of a Randomized, Double-Blind Placebo-Controlled Trial

Following reports of bleeding upon Ginkgo intake, we assessed whether Ginkgo extract EGb 761® affects coagulation or platelet function or increases the risk of bleeding. In a double-blind, placebo-controlled trial, prothrombin time, activated partial thromboplastin time, international normalized ratio and bleeding time were measured in patients with Alzheimer’s dementia at baseline, weeks 6 and 26. A total of 513 patients were randomized to 120 mg (n = 169) or 240 mg EGb 761® (n = 170) or placebo (n = 174). No relevant changes were found for coagulation parameters and bleeding time. Numbers of bleeding-related adverse events were similar in all groups. Concomitant intake of acetylsalicylic acid was documented for 68 patients in the placebo group and 105 in the EGb 761® groups. Within these groups, the means at baseline and week 26 differed by less than 1 unit for prothrombin time and bleeding time and less than 0.1 unit for international normalized ratio. Data on warfarin treatment in nine patients each taking placebo or EGb 761® did not indicate enhancement of warfarin effects by EGb 761®. No evidence was found that EGb 761® affects hemostasis or increases the bleeding risk. No pharmacodynamic interactions with warfarin or acetylsalicylic acid were found

‘Do i care?’ young adults' recalled experiences of early adolescent overweight and obesity: a qualitative study

<p>Objective: Individual behaviour change to reduce obesity requires awareness of, and concern about, weight. This paper therefore describes how young adults, known to have been overweight or obese during early adolescence, recalled early adolescent weight-related awareness and concerns. Associations between recalled concerns and weight-, health- and peer-related survey responses collected during adolescence are also examined.</p> <p>Design: Qualitative semi-structured interviews with young adults; data compared with responses to self-report questionnaires obtained in adolescence.</p> <p>Participants: A total of 35 participants, purposively sub-sampled at age 24 from a longitudinal study of a school year cohort, previously surveyed at ages 11, 13 and 15. Physical measures during previous surveys allowed identification of participants with a body mass index (BMI) indicative of overweight or obesity (based on British 1990 growth reference) during early adolescence. Overall, 26 had been obese, of whom 11 had BMI99.6th centile, whereas 9 had been overweight (BMI=95th–97.9th centile).</p> <p>Measures: Qualitative interview responses describing teenage life, with prompts for school-, social- and health-related concerns. Early adolescent self-report questionnaire data on weight-worries, self-esteem, friends and victimisation (closed questions).</p> <p>Results: Most, but not all recalled having been aware of their overweight. None referred to themselves as having been obese. None recalled weight-related health worries. Recollection of early adolescent obesity varied from major concerns impacting on much of an individual's life to almost no concern, with little relation to actual severity of overweight. Recalled concerns were not clearly patterned by gender, but young adult males recalling concerns had previously reported more worries about weight, lower self-esteem, fewer friends and more victimisation in early adolescence; no such pattern was seen among females. Conclusion: The popular image of the unhappy overweight teenager was not borne out. Many obese adolescents, although well aware of their overweight recalled neither major dissatisfaction nor concern. Weight-reduction behaviours are unlikely in such circumstances.</p&gt