scholarly journals Benefits of EPAs at risk? The influence of the workplace environment on the uptake of EPAs in EPA-based curricula

2021 ◽  
Author(s):  
Karsten Arthur van Loon ◽  
Linda Helena Anna Bonnie ◽  
Nynke van Dijk ◽  
Fedde Scheele
Keyword(s):  
At Risk ◽  
Postgraduate Medical Education ◽  
Training Programme ◽  
Workplace Environment ◽  
Medical Specialists ◽  
Professional Activities ◽  
National Training ◽  
Local Medical Care

Abstract Introduction Entrustable Professional Activities (EPAs) have been applied differently in many postgraduate medical education (PGME) programmes, but the reasons for and the consequences of this variation are not well known. Our objective was to investigate how the uptake of EPAs is influenced by the workplace environment and to what extent the benefits of working with EPAs are at risk when the uptake of EPAs is influenced. This knowledge can be used by curriculum developers who intend to apply EPAs in their curricula. Method For this qualitative study, we selected four PGME programmes: General Practice, Clinical Geriatrics, Obstetrics & Gynaecology, and Radiology & Nuclear Medicine. A document analysis was performed on the national training plans, supported by the AMEE Guide for developing EPA-based curricula and relevant EPA-based literature. Interviews were undertaken with medical specialists who had specific involvement in the development of the curricula. Content analysis was employed and illuminated the possible reasons for variation in the uptake of EPAs. Results An important part of the variation in the uptake of EPAs can be explained by environmental factors, such as patient population, the role of the physician in the health-care system, and the setup of local medical care institutions where the training programme takes place. The variation in uptake of EPAs is specifically reflected in the number and breadth of the EPAs, and in the way the entrustment decision is executed within the PGME programme. Discussion Due to variation in uptake of EPAs, the opportunities for trainees to work independently during the training programme might be challenging. EPAs can be implemented in the curriculum of PGME programmes in a meaningful way, but only if the quality of an EPA is assessed, future users are involved in the development, and the key feature of EPAs (the entrustment decision) is retained.

Pilot study of a nurse-led adult lacrimal clinic at a tertiary ophthalmic centre

2020 ◽  
Vol 29 (22) ◽  
pp. 1341-1347
Author(s):  
Nicola Dunlop ◽  
Michelle Ting ◽  
Geoffrey Rose ◽  
Joanna Baduna ◽  
Daniel Ezra
Keyword(s):  
Pilot Study ◽  
Waiting Times ◽  
Training Programme ◽  
Diagnosis And Management ◽  
Anatomy And Physiology ◽  
Lacrimal System ◽  
Nurse Consultant ◽  
Management Plans

This article provides the reader with an outline of the anatomy and physiology of the lacrimal system and illustrates how a variety of pathologies within this system can result in the development of a watery eye. It describes the role of the nurse consultant in the diagnosis and management of patients with watery eye in the lacrimal clinic, and how the training programme for the development of such skills was implemented. Following training, within the realms of an established pilot study, the nurse consultant began to implement her skills in a newly established nurse-led lacrimal clinic. Patients seen in the lacrimal clinic would previously have been assessed and managed by a doctor. To confirm the accuracy of this approach, an audit was undertaken comparing the nurse-led diagnosis and management plans with that of an oculoplastic doctor. In addition, patient waiting times in the clinic and patient satisfaction were assessed, as important indicators of quality of care.

scholarly journals Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy (‘4P medicine’)

2017 ◽  
Vol 72 (3) ◽  
pp. 191-197 ◽  
Author(s):  
Matthias Orth ◽  
Maria Averina ◽  
Stylianos Chatzipanagiotou ◽  
Gilbert Faure ◽  
Alexander Haushofer ◽  
...  
Keyword(s):  
Patient Autonomy ◽  
Personalised Medicine ◽  
Laboratory Medicine ◽  
The European Union ◽  
Medical Specialists ◽  
Laboratory Results ◽  
Training Programmes ◽  
The Right

The role of clinical pathologists or laboratory-based physicians is being challenged on several fronts—exponential advances in technology, increasing patient autonomy exercised in the right to directly request tests and the use of non-medical specialists as substitutes. In response, clinical pathologists have focused their energies on the pre-analytical and postanalytical phases of Laboratory Medicine thus emphasising their essential role in individualised medical interpretation of complex laboratory results. Across the European Union, the role of medical doctors is enshrined in the Medical Act. This paper highlights the relevance of this act to patient welfare and the need to strengthen training programmes to prevent an erosion in the quality of Laboratory Medicine provided to patients and their physicians.

Fixated Threat Assessment Centers: preventing harm and facilitating care in public figure threat cases and those thought to be at risk of lone-actor grievance-fueled violence

CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 630-637 ◽  
Author(s):  
Justin Barry-Walsh ◽  
David V. James ◽  
Paul E. Mullen
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Threat Assessment ◽  
Assessment Centers ◽  
Mental Health Clinicians ◽  
Mentally Disordered ◽  
Public Figures ◽  
Risk Assessment And Management

The rediscovery of the importance of mental illness in the risk assessment and management of those who threaten, approach, and harm public figures has led to a new way of dealing with those that threaten public figures. This approach emphasises the role of “fixation” which may be defined as an intense preoccupation pursued to an abnormally intense degree. It integrates a threat assessment paradigm with the literature on stalking. The need for such an approach was highlighted in research on the prevalence of harassment of public figures. Psychiatry has a key role in this approach which sees mental health clinicians and Police work together in Fixated Threat Assessment Centres (FTACs). An FTAC functions by assessing the level of concern and sharing information to facilitate interventions that are often mental health based. The purpose is not the hopeless task of identifying those who will go on to perpetrate serious violence, rather to intervene in the group they emerge from, to prevent harm. As well as decreasing risk to the persons fixated upon, this approach improves care to the mentally disordered people who harass and threaten them and, in doing so, decreases the likelihood of their criminalization while enhancing their quality of life. As expertise in the area has grown, policing and security agencies in several countries have expanded the FTAC model to cover individuals thought at risk of lone-actor grievance-fueled violence, a term that captures both different forms of mass killing and lone actor terrorism.

QUALITATIVE PROFESSIONAL TRAINING OF FUTURE RESCUERS AS THE KEY TO INCREASING SOCIETY AND STATE SECURITY

2021 ◽  
Author(s):  
Hren L. ◽  
Koshkarov Yu.
Keyword(s):  
Professional Training ◽  
Human Potential ◽  
Professional Activity ◽  
Professional Activities ◽  
State Security ◽  
Self Development ◽  
Civil Defence ◽  
Professional Capacity

The article reveals the essence of such concepts as: "the sphere of civil defence", "professional activity", "professional training", "self-esteem", "motivation", "motivation to succeed"; based on the analysis of the scientific literature, it was found that most of the works of scientists are devoted to the study of professional capacity of personnel during the elimination of the causes and consequences of emergencies; it is proved that the quality of professional training of future rescuers depends on the formation of their focus on successful professional activities, which implies the disclosure of human potential in the process of his professional development and self-development; the technology of formation of orientation of students on successful professional activity of future rescuers is offered; proved the important role of working on their own self-concept for self-realization and benefit society and the state.

scholarly journals Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020

2020 ◽  
Vol 17 (16) ◽  
pp. 5998 ◽  
Author(s):  
Giuseppina Campisi ◽  
Rodolfo Mauceri ◽  
Francesco Bertoldo ◽  
Giordana Bettini ◽  
Matteo Biasotto ◽  
...  
Keyword(s):  
At Risk ◽  
Maxillofacial Surgery ◽  
Oral Pathology ◽  
Consensus Conference ◽  
Decision Making Process ◽  
Dental Management ◽  
Patients At Risk ◽  
The Common

The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). The present paper reports the update of the conclusions from the Consensus Conference—held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)—after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SICMF and SIPMO), written on the inputs of the experts of the Italian Allied Committee on ONJ (IAC-ONJ). The conference focused on the topic of MRONJ, and in particular on the common practices at risk of inappropriateness in MRONJ diagnosis and therapy, as well as on MRONJ prevention and the dental management of patients at risk of MRONJ. It is a matter of cancer and osteometabolic patients that are at risk since being exposed to several drugs with antiresorptive (i.e., bisphosphonates and denosumab) or, more recently, antiangiogenic activities. At the same time, the Conference traced for dentists and oral surgeons some easy applicable indications and procedures to reduce MRONJ onset risk and to diagnose it early. Continuous updating on these issues, so important for the patient community, is recommended.

scholarly journals Role of nutritional care and general guidance for patients with advanced or metastatic gastric cancer

2021 ◽  
Author(s):  
Takuro Mizukami ◽  
Yongzhe Piao
Keyword(s):  
Gastric Cancer ◽  
Nutritional Status ◽  
Care Management ◽  
Metastatic Gastric Cancer ◽  
Nutritional Care ◽  
Medical Specialists ◽  
Clinical Meaning ◽  
General Guidance

Patients with advanced or metastatic gastric cancer often suffer from malnutrition, which can have an impact on quality of life, increase the toxicity of chemotherapy and reduce overall survival. Options available to the clinician to manage a patient’s nutritional status include screening and assessment of malnutrition at diagnosis, monitoring during the ‘cancer journey’, early detection of precachexia and the ongoing use of a multidisciplinary team (oncologists, other medical specialists and nutritionists). Because malnutrition is frequently overlooked and under treated in patients with advanced or metastatic gastric cancer, this narrative review focuses on the clinical meaning of nutritional status in gastric cancer and provides general guidance regarding nutritional care management for patients with advanced or metastatic gastric cancer.

scholarly journals Monitoring the quality of the initial performance of the potential engineer-pedagogues as a pedagogical problem

2020 ◽  
pp. 45-65
Author(s):  
Roman Horbatiuk ◽  
Vitalii Kabak
Keyword(s):  
Academic Success ◽  
Professional Training ◽  
Process Development ◽  
Educational Process ◽  
Teaching Staff ◽  
Control Input ◽  
Educational Activities ◽  
Professional Activities

The article reveals the concept of the monitoring the quality of future engineer-pedagogues’ educational activities and outlines the approaches to its determination in the current studies on the basis of psychological and pedagogical literature analysis. The purpose of the article is to determine the essential characteristics of the concept of monitoring the quality of future engineer-pedagogues educational activities, its capabilities and areas of implementation in the process of their professional training. The research methods are analysis of psychological and pedagogical sources and results of scientific research, questionnaire, testing of academic success, observation, analysis of reporting documentation and statistical data of educational institutions. The results. The benefit of the study is that the notion of monitoring within the system of training the experts of engineering and pedagogical specialities has been defined as the process of continuous, scientifically justified, diagnostic and prognostic, targeted and activity-based supervision over the state and didactic process development of students in order to select optimal professionally-oriented tasks, means, and methods how the assignments are carried out. The authors analyze the principal stages of monitoring the quality of future engineer-pedagogues’ educational activities within the system of higher education by means of formation of students’ general and special (professional) competencies during acquiring a number of educational components oriented towards their further professional activities. The authors describe the key role of monitoring the quality of future engineer-pedagogues’ educational activities as an instrument used to obtain integral vision about the quality of training of students of engineering and pedagogical specialities and the necessity to perform such procedure systematically. The article presents the results of survey questionnaire designed for teachers and students about the types of control (input (preliminary), current, progress, and final) while monitoring the quality of future engineer-pedagogues’ educational activities. Conclusions. The main attention should be given to the necessity to provide flexible and variable forms, methods, and means of control while monitoring the quality of future engineer-pedagogues’ educational activities; to the role of teaching staff in this process, including stimulation, control and encouragement of students’ cognitive activities, contributing the individualization of educational process.

scholarly journals REMAINING SOCIALLY CONNECTED AT 100 AND BEYOND REDUCES IMPACT OF LONELINESS ON NUTRITIONAL STATUS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S39-S39
Author(s):  
Seung Eun Jung ◽  
Alex bishop ◽  
Seoyoun Kim ◽  
Janice Hermann
Keyword(s):  
Social Support ◽  
At Risk ◽  
Nutritional Status ◽  
Well Being ◽  
Cross Sectional Study ◽  
Nutrition Interventions ◽  
Cross Sectional ◽  
Social Provisions

Abstract Understanding factors influencing centenarians’ nutritional status can offer insight into effective nutrition interventions to improve quality of life among this population. This cross-sectional study was conducted to evaluate the moderating role of social support in the relationship between loneliness and nutritional status among Oklahoma centenarians (n=140). Nutritional status was assessed with the Mini Nutrition Assessment (MNA). Perceived social support was assessed with the 24-item Social Provisions Scale. Loneliness was examined with the 10-item UCLA loneliness scale. Ordinal logistic regression revealed that those who lacked social support were more likely to be at risk for malnutrition (OR=2.28, p<.05). Further, the interactive model revealed that centenarians who reported lack of support and loneliness were almost 2.8 times as likely to be at risk for malnutrition compared to their socially embedded counterparts (p<.01). Findings suggest that nutrition interventions offering centenarians opportunities to feel socially connected could improve their nutritional well-being.

Chronic Pain Management: The Occupational Therapist's Role

1987 ◽  
Vol 50 (8) ◽  
pp. 262-263 ◽  
Author(s):  
Jenny Strong
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Occupational Therapists ◽  
Occupational Therapist ◽  
Pain Patient ◽  
Chronic Pain Management ◽  
Medical Specialists ◽  
Pain Clinics

This paper describes the contribution the occupational therapist makes in improving the quality of life of the patient with chronic benign pain. Working closely with medical specialists, the occupational therapist is able to contribute much towards the rehabilitation of the patient. Occupational therapists are currently providing pain patient services from specialist pain clinics, community centres, general hospitals and private practice settings. The role of the occupational therapist in chronic pain management is highlighted by a case history.

scholarly journals Role of Occupational Therapy While Working with Cerebral Palsy Children Using Orthopedic Assistive Devices

2021 ◽  
Vol 4 (2) ◽  
pp. 39-59
Author(s):  
Ashot Shahinyan ◽  
Marianna Harutyunyan
Keyword(s):  
Cerebral Palsy ◽  
Data Collection ◽  
Occupational Therapy ◽  
Quantitative Methods ◽  
Well Being ◽  
Assistive Devices ◽  
Professional Activities ◽  
Occupational Therapy Intervention

The main aim of the following research paper is to identify and interpret the preconditions and instructions for the implementation of effective Occupational Therapy intervention during the use of orthopedic assistive devices. In trying to highlight the role, professional skills, and perspectives of the occupational therapist, it will be possible to identify the key provisions that, if applied, will encourage the maximum participation of a child with Cerebral Palsy in several activities that are meaningful to him/her, thereby improving his/her quality of life and well-being. The methodology of data collection, processing, and analysis of the research is based on a combined method approach, which allows combining quantitative data collection and use of quantitative methods to later conclude the data obtained through certain numerical patterns. Structural interviews and designed questionnaires were used with 50 children having Cerebral Palsy and their parents or caregivers. The results showed that today in Armenia, due to the problems of obtaining and using orthopedic assistive devices, as well as the lack of professional supervision and monitoring, it is limited or does not ensure the maximum independent participation of children with Cerebral Palsy in community life, self-care, and professional activities.

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