Radiation therapists’ perspectives of the role of reflection in clinical practice

2010 ◽  
Vol 9 (3) ◽  
pp. 131-141 ◽  
Author(s):  
Angela Cashell
Keyword(s):  
Clinical Practice ◽  
Focus Groups ◽  
Personal Growth ◽  
Daily Practice ◽  
Perceived Barriers ◽  
Professional Lives ◽  
Small Group Teaching ◽  
Definition Of

AbstractA recurring theme from the literature is that the definition of reflection is nebulous and/or complex. Many authors have suggested that more research needs to be conducted to better understand an individual’s perception of reflection and reflective practice, and how these concepts affect their clinical practice as well as their personal growth and development. This paper offers the findings of a qualitative study of radiation therapists in Canada. The aim of the study was to explore radiation therapist’s understanding of the concept of reflection, and to understand how they incorporated it into their daily practice. Secondary objectives were to examine some of the perceived barriers to its use, and the possible challenges of implementing reflective writing. Two focus groups were initially conducted, and a follow-up questionnaire was developed using the themes generated from the focus groups. The questionnaire was distributed to radiation therapists at two large cancer centres in Toronto, Canada. Most participants indicated that it is an integral part of their practice and professional lives, and that they use a variety of different methods for engaging in reflection. It is not without its barriers, but many of these can be overcome by providing time, coaching and a supportive work environment. Respondents were divided as to whether they would benefit from being taught reflection; however, small group teaching would be the favoured method. Further study is suggested to determine whether there are any improvements to patient care and in particular patient outcomes.

scholarly journals ISMAR-study presentation: in-hospital epidemiology and clinical management of respiratory and cardiac comorbidities in cardiac and respiratory disease units

2014 ◽  
Vol 9 ◽  
Author(s):  
Roberto Tramarin ◽  
Mario Polverino ◽  
Maurizio Volterrani ◽  
Bruna Girardi ◽  
Claudio Chimini ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Management ◽  
Real Life ◽  
Length Of Hospital Stay ◽  
Relevant Information ◽  
Hospital Epidemiology ◽  
Discharge Data ◽  
Definition Of ◽  
Current Guidelines

Background: Cardiovascular and respiratory diseases are leading causes of morbidity and their co-occurrence has important implications in mortality and other outcomes. Even the most recent guidelines do not reliably address clinical, prognostic, and therapeutic concerns due to the overlap of respiratory and cardiac diseases. Study objectives and design: In order to evaluate in the reality of clinical practice the epidemiology and the reciprocal impact of cardio-pulmonary comorbidity on the clinical management, diagnostic workup and treatment, 1,500 cardiac and 1,500 respiratory inpatients, admitted in acute and rehabilitation units, will be enrolled in a multicenter, nationwide, prospective observational study. For this purpose, each center will enroll at least 50 consecutive patients. At discharge, data analysis will be aimed at the definition of cardiac and pulmonary inpatient comorbidity prevalence, demographic characteristics, length of hospital stay, and risk factors, taking into account also procedures, pharmacological and non-pharmacological treatment, and follow up in patients with cardio-respiratory comorbidity. Conclusions: The purely observational design of the study aims to give new relevant information on the assessment and management of overlapping patients in real life clinical practice, and new insight for improvement and implementation of current guidelines on the management of individual diseases.

Glioma patient-reported outcomes: patients and clinicians

2021 ◽  
pp. bmjspcare-2020-002699
Author(s):  
Marthe Peeters ◽  
Germaine Ottenheijm ◽  
Paul Bienfait ◽  
Daniëlle Eekers ◽  
Anja Gijtenbeek ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Patient Reported Outcomes ◽  
Successful Implementation ◽  
Nurse Specialist ◽  
Patient Reported ◽  
Semistructured Interviews ◽  
Routine Assessment

IntroductionRoutine assessment of patient-reported outcomes (PROs) in oncology has shown to improve the quality of the delivered care and to prolong survival. However, for successful implementation of routine assessment of PROs, more knowledge on their usability in clinical practice is needed.ObjectiveThis study aimed to cross-sectionally assess the perspective of patients and clinicians on the practicality of routinely measuring PROs in clinical practice for glioma patients.MethodsSemistructured interviews were conducted evaluating the role of healthcare professionals (HCP) in discussing results of PRO measures (PROMs), and the preferred topics, methods and frequency of PRO assessment. Glioma patients, their proxies and HCPs involved in the treatment of glioma patients from eight centres in the Netherlands were included.ResultsTwenty-four patients, 16 proxies and 35 HCPs were interviewed. The majority of patients, proxies and HCPs (92%, 81% and 80%, respectively) were willing to discuss PRO results during consultations. Although HCPs prefer that results are discussed with the nurse specialist, only one-third of patients/proxies agreed. Functioning of daily life was considered important in all three groups. Most participants indicated that discussion of PROM results should take place during standard follow-up visits, and completed at home about 1 week in advance. On group level, there was no preference for administration of questionnaires on paper or digitally. Lastly, all centres had staff available to send questionnaires on paper.ConclusionThis study shows that routine assessment of PROs is desired by patients, proxies and HCP’s in neuro-oncological care in Dutch hospitals.

eHealth in cardiac rehabilitation

2020 ◽  
pp. 171-176
Author(s):  
Ines Frederix ◽  
Paul Dendale
Keyword(s):  
Cardiac Rehabilitation ◽  
Progress Monitoring ◽  
Care Delivery ◽  
Cost Effective ◽  
Daily Practice ◽  
Point Of View ◽  
Successful Implementation ◽  
Sustained Delivery ◽  
Definition Of

TeleCR is an innovative and (cost-)effective preventive care delivery strategy that can overcome the challenges associated with traditional centre-based cardiac rehabilitation (CR). This chapter describes how it can be implemented in daily practice. From an organizational point of view, it implies a shift in traditional and operational workflows and reorganization of the (non-)human resources for care delivery. The establishment of a well-coordinated tele-team, the definition of clear goals, profound progress monitoring and follow-up, and the creation of an environment that promotes sustained delivery of teleCR are paramount. Tackling the current legal and technological challenges is another prerequisite for successful implementation.

scholarly journals Assessment of Dental Implants with Modified Calcium-Phosphate Surface in a Multicenter, Prospective, Non-Interventional Study: Results up to 50 Months of Follow-Up

2019 ◽  
Vol 10 (1) ◽  
pp. 5
Author(s):  
Carles Subirà-Pifarré ◽  
Cristina Masuet-Aumatell ◽  
Carlos Rodado Alonso ◽  
Ricardo Medina Madrid ◽  
Cosimo Galletti
Keyword(s):  
Clinical Practice ◽  
Survival Rate ◽  
Calcium Phosphate ◽  
Observational Study ◽  
Dental Implants ◽  
Daily Practice ◽  
High Rate ◽  
Osseointegrated Implants ◽  
Study Results

Prescription of implant treatments is very widespread at present, mainly due to the low rate of annual loss and, to date, few studies have assessed their survival in the routine clinical practice of dentistry. The purpose of this observational study was to evaluate the effectiveness of dental implants with a calcium-phosphate surface in the daily practice of dental clinics. A multicenter, prospective, non-interventional, observational study was performed, in which three experienced practitioners (one maxillofacial and two oral surgeons) inserted implants using standard external and internal hexagon connections in adult patients requiring ≥1 osseointegrated implants to replace missing teeth. Follow-up was performed for 24 months after implant loading. Two hundred and twelve subjects were included (51.5% men), with a mean age of 51.2 ± 11.90 years, in whom 544 implants were inserted. 87.2% of the patients received 1–4 implants. The preferred connection system was internal hexagon (73.5%). There were nine failures, with an interval survival rate (ISR) at 24 months of 100% and a cumulative survival rate (CSR) of 98.3%. In conclusion, implants with a modified calcium-phosphate surface are associated with a high rate of survival and may be considered a method of choice in clinical practice.

“Just don’t be creepy”: A phenomenological study of the experiences of men in massage therapy

2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Amanda Baskwill ◽  
Meredith Vanstone
Keyword(s):  
Clinical Practice ◽  
Patient Preferences ◽  
Phenomenological Study ◽  
Massage Therapy ◽  
Professional Lives ◽  
Clear Communication ◽  
Predominantly Female ◽  
Societal Expectations ◽  
The Impact

AbstractBackgroundSocietal expectations around traditional binary gender roles result in some professions being considered “men’s work” or “women’s work”. Massage therapy (MT) is one such profession that, despite being predominantly female, is joined by an increasing number of men with a desire to help others.MethodsThis descriptive phenomenological study asked male massage therapists in Ontario, Canada, about their experience of gender in their professional lives. Fourteen men shared their experiences of practice, which included discriminatory hiring and patient preferences for female practitioners. These issues resulted in difficulty establishing a clinical practice. To create a successful practice, men described the need for professionalism, clear communication, and a comfortable treatment environment.Results and conclusionsResearchers should explore the impact of discrimination on men in MT, patient preferences based on the therapist’s gender, and the role of education in perpetuating societal heterosexual norms. Finally, as with any shift in culture, all levels of organization must take action to remove discrimination and bias within the profession of MT.

Treatment of Advanced Colorectal Cancer (CRC) in Daily Practice: Results of a Survey in two Italian Regions, Piemonte and Valle D'aosta

1998 ◽  
Vol 84 (5) ◽  
pp. 562-566 ◽  
Author(s):  
Alessandro Comandone ◽  
Roberto Berardo ◽  
Roberto Faggiuolo ◽  
Antonella Boglione ◽  
Paola Bergnolo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Performance Status ◽  
Daily Practice ◽  
New Drugs ◽  
Therapeutic Choice ◽  
Italian Regions ◽  
Important Health ◽  
Definition Of ◽  
No Gold Standard

Aims and background Colorectal cancer (CRC) is one of the most important health problems in Western countries: it is the fourth cancer in terms of incidence and the second cause of cancer death. Surgery is the main therapeutic choice and there is broad consensus on the role of adjuvant chemotherapy (CT) after resection. Unfortunately, 50% of the patients will relapse and die of the disease. Palliative CT based on 5-fluorouracil (5FU) may induce a 9-48% response rate with a median survival of 11.5 months. At present there is no gold standard for CT in advanced CRC and the situation has become more complicated since the advent of new drugs (Raltitrexed, Irinotecan, Oxaliplatin). The aim of this study was the identification of the different approaches to treatment of advanced CRC among the clinicians (oncologists, radiologists, internal medicine specialists, surgeons) who practice CT. Methods and study design Forty-six clinicians from two Italian Regions (Piemonte and Valle d'Aosta) were interviewed by telephone. Results 5FU modulated with Lederfolin according to the classic Machover scheme is the main option in daily practice. More sophisticated therapies are reserved to patients with a good performance status (PS) and are prescribed only in the larger centers. The planned therapies usually consist of six courses. Restaging may be performed after three or six courses. A marked difference has been recorded in the evaluation of a situation of no change (NC): 25.5% of the clinicians evaluate stable disease as a positive result. In the event of disease progression or relapse, 35% of the clinicians do not prescribe second-line CT. In case of further treatment, the options are totally subjective. Conclusions A national survey on this issue is necessary under the auspices of AIOM (Associazione Italiana Oncologia Medica) and involving oncologists, epidemiologists and statisticians, in order to define the reasons for variations in therapy in advanced CRC and determine the differences between clinicians of different age, specialization and location. This survey could lead to a definition of guidelines for the treatment of advanced CRC.

Comparing three methods for scoring late breast cosmesis in patients treated with lumpectomy and radiation therapy (RT).

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 128-128
Author(s):  
Andrew Thomas Wong ◽  
Celina Robertson-Parris ◽  
Sonal Sura ◽  
Carol White ◽  
Manjeet Chadha
Keyword(s):  
Radiation Therapy ◽  
Clinical Practice ◽  
Clinical Outcomes ◽  
Comparative Studies ◽  
Acute Treatment ◽  
Comparative Review ◽  
Small Cohort ◽  
Scar Visibility

128 Background: For intact breast, the Harvard and LENTSOMA criteria are widely used to report late cosmesis. These scales require clinician’s interpretation and thus may be subject to variation between evaluators. Computerized tools exempt from evaluator bias are available to assess cosmesis. The objective of this study was to perform a comparative review of late breast cosmesis using the Harvard, LENTSOMA, and BCCT.core scales (Cardoso JS. et al; doi:10.1016/j.artmed.2007.02.007). Methods: A frontal bilateral breast photograph was used for analysis. Late cosmesis was scored with reference to the baseline breast appearance, ~ 1 year from RT distant from the acute treatment effects. Cosmesis was graded as excellent, good, fair, or poor using the Harvard scale. For LENTSOMA, only atrophy/retraction was assessed from the frontal breast photographs. The BCCT.core software was used as a validated tool for objectively scoring cosmesis and computes a score based on symmetry, color, and scar visibility. All outcomes were assessed by the same investigator (AW). Results: A total of 33 patients had 1-year baseline and follow up photographs. All were treated on a 3-week hypofractionated RT schedule, and none received chemotherapy. One hundred photographs, 1 to 5.7 years from end of RT, were scored. Late cosmesis among patients with good/excellent scores at 1-year remained unchanged by all 3 methods. Among patients graded as fair at 1-year, there was improvement in late comesis detected by Harvard and BCCT.core scoring. Late cosmesis by LENTSOMA criteria remained unchanged from baseline. Conclusions: Our experience suggests easy applicability of BCCT.core for scoring cosmesis in clinical practice. We observed no significant differences in cosmetic score by the methods used. However, these observations were made on a small cohort of patients and evaluation on a larger cohort is needed. The role of objective user-independent grading of cosmesis might be helpful in large comparative studies of clinical outcomes. [Table: see text]

The Role of Veterinary Sciences In Chemical Disasters and Emergencies

1989 ◽  
Vol 4 (2) ◽  
pp. 155-159 ◽  
Author(s):  
A. Mantovani
Keyword(s):  
Health Status ◽  
Biological Monitoring ◽  
Food Chain ◽  
Chemical Pollution ◽  
Veterinary Services ◽  
Animal Populations ◽  
Contingency Plans ◽  
Definition Of

AbstractThe roles of the veterinary sciences in disasters and emergencies related to exposures of the environment to harmful chemicals are reviewed. Characteristics of chemical emergencies which require the use of the veterinary sciences are discussed. Veterinary services are important in the: 1) definition of the kind and severity of the pollution through biological monitoring; 2) use of animals as monitors of the environment; 3) use of changes in the health status of animals for identification of pathophysiologic changes to man and other animals (sentinels); 4) maintenance of the hygiene of elements of the food chain; 5) evacuation and management of animal populations; 6) disposal of carcasses; and 7) treatment and follow-up of involved animal populations. Veterinary services are important components of responses to incidents marked by chemical pollution and must be included in the development of contingency plans to meet the demands created by chemical pollution.

Definition of the Role of Contemporary Surgical Management in Cisternal and Parenchymatous Cysticercosis Cerebri

Neurosurgery ◽  
1991 ◽  
Vol 28 (2) ◽  
pp. 231-237 ◽  
Author(s):  
William T. Couldwell ◽  
Chi-Shing Zee ◽  
Michael L. J. Apuzzo
Keyword(s):  
Symptomatic Improvement ◽  
Brain Parenchyma ◽  
Cystic Mass ◽  
Increased Intracranial Pressure ◽  
Focal Neurological Deficit ◽  
Definition Of ◽  
Mass Lesions ◽  
The Brain

Abstract With increasing immigration from endemic regions, the incidence of neurocysticercosis in North America is rising. This retrospective study was undertaken to examine the role of surgery in those cases presenting with large cystic parenchymal and cisternal lesions in the current era of anthelminthic agents administered orally. A total of 237 patients presented with newly diagnosed neurocysticercosis to our institution over a recent 5-year period (mean age, 31.2 years). Among those who presented with cystic mass lesions predominantly affecting the brain parenchyma and cisternal spaces. 20 (8.4%; mean age, 40.2 years) with large cystic lesions subsequently underwent surgical intervention, either because of an emergent presentation or because they were refractory to medical management. Clinical presentation included increased intracranial pressure, focal neurological deficit, and seizure. Radiographic imaging (computed tomography and/or magnetic resonance imaging) demonstrated 12 cases with cisternal lesions, 7 with parenchymal lesions, and 1 involving both compartments. Based on imaging guidelines, 30 operative procedures (excluding shunt revisions) were performed (14 craniotomies, 8 cerebrospinal fluid diversions, 7 stereotactic procedures, and 1 burr hole drainage). Fifteen (75%) showed neurological or symptomatic improvement over a median follow-up period of 36.4 months. There were three surgery-related complications and no deaths.

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