A critical evaluation of hierarchical representations of community involvement: Some lessons from the UK

2005 ◽  
Vol 40 (1) ◽  
pp. 30-38 ◽  
Author(s):  
C. C. Williams
Keyword(s):  
Community Involvement ◽  
Critical Evaluation ◽  
The Uk ◽  
Hierarchical Representations

Prolonged disorders of consciousness: a critical evaluation of the new UK guidelines

Brain ◽  
2021 ◽  
Author(s):  
Neil Scolding ◽  
Adrian M. Owen ◽  
John Keown
Keyword(s):  
Royal College ◽  
Critical Evaluation ◽  
Disorders Of Consciousness ◽  
National Guidelines ◽  
Recent Developments ◽  
Nutrition And Hydration ◽  
Primary Focus ◽  
The Uk ◽  
American Academy Of Neurology ◽  
Neuroimaging Techniques

Abstract Earlier this year, the Royal College of Physicians in the UK published national guidelines on the management of patients with prolonged disorders of consciousness, updating their 2013 guidance ‘particularly in relation to recent developments in assessment and management and … changes in the law governing … the withdrawal of clinically assisted nutrition and hydration’. The report’s primary focus is on patients who could live for many years with treatment and care. This update, by a neurologist, an imaging neuroscientist, and a lawyer-ethicist, questions the document’s rejection of any significant role for neuroimaging techniques including functional MRI and/or bedside EEG to detect covert consciousness in such patients. We find the reasons for this rejection unconvincing, given (i) the significant advances made in the use of this technology in recent years; and (ii) the wider scope for its use envisaged by the earlier (2018) guidelines issued by the American Academy of Neurology. We suggest that, since around one in five patients diagnosed with prolonged disorders of consciousness are in fact conscious enough to follow commands in a neuroimaging context (i.e. those who are ‘covertly conscious’ or those with ‘cognitive motor dissociation’), and given the clinical, ethical and legal importance of determining whether patients with prolonged disorders of consciousness are legally competent or at least able to express their views and feelings, the guidance from the Royal College of Physicians requires urgent review.

scholarly journals Palliative Curriculum Re-imagined: A Critical Evaluation of the UK Palliative Medicine Syllabus

2018 ◽  
Vol 11 ◽  
pp. 117822421878037
Author(s):  
Julian Abel ◽  
Allan Kellehear
Keyword(s):  
Public Health ◽  
Social Support ◽  
Palliative Care ◽  
Palliative Medicine ◽  
Critical Evaluation ◽  
Well Being ◽  
Disease Models ◽  
Care Policy ◽  
The Uk ◽  
Illness And Disease

The UK Palliative Medicine Syllabus is critically evaluated to assess its relationship and relevance to contemporary palliative care policy and direction. Three criteria are employed for this review: (1) relevance to non-cancer dying, ageing, caregivers, and bereaved populations; (2) uptake and adoption of well-being models of public health alongside traditional illness and disease models of clinical understanding; and (3) uptake and integration of public health insights and methodologies for social support. We conclude that the current syllabus falls dramatically short on all 3 criteria. Suggestions are made for future consultation and revision.

scholarly journals The Potential and Pitfalls of Collector Collaboration in Southeast Arizona

2021 ◽  
pp. 1-8
Author(s):  
Mary E. Whisenhunt
Keyword(s):  
Community Involvement ◽  
Local Community ◽  
Private Property ◽  
Critical Evaluation ◽  
Archaeological Sites ◽  
Property A ◽  
Ethical Implications ◽  
Course Of Action ◽  
Legal Challenges ◽  
Crucial Information

ABSTRACT In locales where much of the archaeological record has been destroyed or heavily impacted by pothunting and development, engaging with collector informants—including those who legally excavated sites on private property in the 1980s—can help fill crucial information gaps. However, such collaboration can pose ethical, and potentially legal, challenges. In this article, I outline research goals and results from a survey project in southeast Arizona's York-Duncan Valley, discuss the legal and ethical implications involved in working with former pothunters, and offer a critical evaluation of project practice. Finally, I offer a set of recommendations for those considering similar collaborations. I argue that the rejection of individuals who are knowledgeable about damaged or destroyed archaeological sites effectively silences the sites forever. Data acquired from former pothunters led to the identification and recording of 25 of 87 archaeological sites in the York-Duncan Valley. These individuals also served as interlocutors with others in the local community, helping us foster the trusted relationships necessary to promote site preservation on private property. A long-term engagement strategy that incorporates an assessment determining whether collector informants are responsible or responsive and that nurtures community involvement in preserving local archaeology offers a more productive course of action.

Infectious diseases and tropical medicine

2016 ◽  
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Statistical Analysis ◽  
Infectious Diseases ◽  
Clinical Evidence ◽  
Critical Evaluation ◽  
Duration Of Treatment ◽  
The Uk ◽  
Clinical Problems ◽  
Key Questions

Some of the earliest clinical trials were conducted in infectious diseases. In the 1940s, the development of the first antibiotics for treating tuberculosis coincided with the recognition that rigorous clinical trials were required to determine optimum drug combinations and duration of treatment. The joint efforts of bacteriologists, clinicians, and statisticians promoted the development of clinical trials, acknowledging that clinically valid endpoints and careful statistical analysis are vital for trials to provide evidence of sufficient quality to guide clinical practice. This chapter covers key questions in this field addressed by good-quality trials. It covers clinical evidence important to practitioners both overseas and in the UK. It focuses on trials that have generated key data, while also covering trials which address clinical problems that are important worldwide and less commonly seen in the UK where critical evaluation of current trials might be difficult.

CLINICOPATHOLOGICAL STUDY OF A CRITICAL EVALUATION ON LIVER FUNCTIONS IN POSTCHOLECYSTECTOMY CASES

2021 ◽  
pp. 4-6
Author(s):  
Anil Kumar ◽  
Nyemwang W Konyak ◽  
Debarshi Jana
Keyword(s):  
Liver Function ◽  
Gall Bladder ◽  
Critical Evaluation ◽  
Liver Function Tests ◽  
General Surgeon ◽  
Normal Range ◽  
Medical College ◽  
Asymptomatic Patients ◽  
The Uk ◽  
Almost All

Introduction: Gallstones [cholelithiasis] are the most common biliary pathology. It is estimated that gallstones affect 10-15% of the population in Western societies. They are asymptomatic in majority of cases (780). In the UK, the prevalence of gallstones at the time of death is estimated to be 17% and may be increasing. Approximately 1-2% of asymptomatic patients will develop symptoms requiring surgery per year, making cholecystectomy one of the most common operations performed by general surgeon. Aims and objectives: To investigate the clinico-pathological analysis of calculous cholecystitis in relation to liver function tests in all preoperative and post operative cases. Patients are required to undergo liver function test prior to and after their line of management in order to facilitate the investigation. Patients with cholelithiasis as the main cause must undergo a cholecystectomy either open or laparoscopic. Comparative evaluations of derangement of hepatic parameters in the preoperative period of patient undergoing different forms of gallbladder operations (conventional or laparoscopic cholecystectomy). Materials and methods: The study was conducted in a series of 60 cases of chronic calculus cholecystitis. Patients were selected from surgical outpatient Department of Darbhanga Medical College and Hospital. Laheriasarai. The tenure of study was from April 2019 to December 2020. Result: The above study also showed 82% increase in ALT level. In our study ALT was increased in 60 % patients (6% within normal range and 54% more than the normal range) at deation and 70% patients (4% within normal range and 66% more than the normal range) on the second postoperative day in LC. In MC and CC it was about 16-32% and 32-40% respectively during the same period. Conclusion: Ultrasonography was the mainstay in conrmatory diagnosis of gall bladder pathologies and the ndings correlated well with clinical ndings in almost all the cases. It not only revealed the evidence of gall stones in gall bladder with signs of acute or chronic cholecystitis but also other changes in the common bile duct, liver, pancreas and so on.

scholarly journals A local dental network approach to COVID-19 pandemic: innovation through collaboration

2020 ◽  
pp. 205016842098097
Author(s):  
Simon Hearnshaw ◽  
Stefan Serban ◽  
Imran Suida ◽  
Mohammed Ajmal Zubair ◽  
Deksha Jaswal ◽  
...  
Keyword(s):  
Geographical Area ◽  
Critical Evaluation ◽  
Integrated Network ◽  
Policy Makers ◽  
Care Services ◽  
Large Geographical Area ◽  
Urgent Patient ◽  
Collaborative Structures ◽  
Set Up ◽  
The Uk

The coronavirus pandemic has had significant effects on individuals, healthcare systems and governments. In the UK, whilst routine dentistry was suspended, an urgent dental care system was required to support urgent patient need. Using an adapted model of Donabedians’ framework, a critical evaluation of the services developed and implemented is provided and the various innovative approaches involved in this work are discussed. The three domains of the framework are structure, process and outcome. Structure: We present the principles for selecting and initiating hubs, the integration with secondary care services and the supply of personal protective equipment. Process: The main elements are communication, the development of referral processes to manage complex cases and data collection. Outcome: Through work with local dental stakeholders, 23 clusters and 36 hubs were set up covering a large geographical area. The integrated network of hubs and clusters has strengthened collaboration between providers and policy makers. Various leadership approaches facilitated the readiness for the transition to recovery. The new local collaborative structures could be used to support local programmes such as flexible commissioning, peer-led learning and integration with primary care networks.

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