scholarly journals “A debriefer must be neutral” and other debriefing myths: a systemic inquiry-based qualitative study of taken-for-granted beliefs about clinical post-event debriefing

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Julia Carolin Seelandt ◽  
Katie Walker ◽  
Michaela Kolbe
Keyword(s):  
Interpersonal Relationships ◽  
Western Europe ◽  
Ad Hoc ◽  
Scientific Evidence ◽  
Clinical Event ◽  
Clinical Settings ◽  
Healthcare Organizations ◽  
The Usa ◽  
Open Coding ◽  
Healthcare Administrators

Abstract Background The goal of this study was to identify taken-for-granted beliefs and assumptions about use, costs, and facilitation of post-event debriefing. These myths prevent the ubiquitous uptake of post-event debriefing in clinical units, and therefore the identification of process, teamwork, and latent safety threats that lead to medical error. By naming these false barriers and assumptions, the authors believe that clinical event debriefing can be implemented more broadly. Methods We interviewed an international sample of 37 clinicians, educators, scholars, researchers, and healthcare administrators from hospitals, universities, and healthcare organizations in Western Europe and the USA, who had a broad range of debriefing experience. We adopted a systemic-constructivist approach that aimed at exploring in-depth assumptions about debriefing beyond obvious constraints such as time and logistics and focused on interpersonal relationships within organizations. Using circular questions, we intended to uncover new and tacit knowledge about barriers and facilitators of regular clinical debriefings. All interviews were transcribed and analyzed following a comprehensive process of inductive open coding. Results In total, 1508.62 min of interviews (25 h, 9 min, and 2 s) were analyzed, and 1591 answers were categorized. Many implicit debriefing theories reflected current scientific evidence, particularly with respect to debriefing value and topics, the complexity and difficulty of facilitation, the importance of structuring the debriefing and engaging in reflective practice to advance debriefing skills. We also identified four debriefing myths which may prevent post-event debriefing from being implemented in clinical units. Conclusion The debriefing myths include (1) debriefing only when disaster strikes, (2) debriefing is a luxury, (3) senior clinicians should determine debriefing content, and (4) debriefers must be neutral and nonjudgmental. These myths offer valuable insights into why current debriefing practices are ad hoc and not embedded into daily unit practices. They may help ignite a renewed momentum into the implementation of post-event debriefing in clinical settings.

scholarly journals Promoting Interpersonal Relationships through Elbow Tag, a Traditional Sporting Game. A Multidimensional Approach

2021 ◽  
Vol 13 (14) ◽  
pp. 7887
Author(s):  
Verónica Muñoz-Arroyave ◽  
Miguel Pic ◽  
Rafael Luchoro-Parrilla ◽  
Jorge Serna ◽  
Cristòfol Salas-Santandreu ◽  
...  
Keyword(s):  
Decision Making ◽  
Social Interactions ◽  
Interpersonal Relationships ◽  
Predictive Power ◽  
Ad Hoc ◽  
Scientific Evidence ◽  
Point Of View ◽  
Registration System ◽  
Motor Behaviors ◽  
Quasi Experimental

The aim of this research was to study from a multidimensional point of view (decisional, relational and energetic) the interpersonal relationships established by girls and boys in the traditional sport game of Elbow Tag. Scientific evidence has shown that Traditional Sport Games (TSG) trigger different effects on male and female genders in relation to emotional experiences, decision-making, conflicts and motor relationships. Despite the fact that these dimensions are intertwined, there are hardly any studies that interpret motor behaviors holistically, i.e., taking a multidimensional (360°) view of these dimensions. For this study, a quasi-experimental design was used and a type III design was applied, inspired by the observational methodology N/P/M. A total of 147 university students participated (M = 19.6, SD = 2.3): 47 girls (31.97%) and 100 boys (68.02%). A mixed ‘ad hoc’ registration system was designed with acceptable margins of data quality. Cross-tabulations, classification trees and T-patterns analysis were applied. The results indicated that social interactions between girls and boys in a mixed group were unequal. This difference was mainly due to decision-making (sub-role variable), which has much greater predictive power than the energetic variables (MV and steps).

LEGAL RESPONSIBILITY PRESCRIBING OFF-LABEL DRUGS: IS SPAIN DIFFERENT?

2015 ◽  
Vol 101 (1) ◽  
pp. e1.57-e1
Author(s):  
Maria A. Peire
Keyword(s):  
Ad Hoc ◽  
Scientific Evidence ◽  
General Rule ◽  
Drug Dose ◽  
Legal Responsibility ◽  
Royal Decree ◽  
Off Label ◽  
The Usa ◽  
Therapeutic Alternatives

– In Spain the compassionate use and off-label prescription, are both regulated in the same law: the Royal Decree 1015/2009. This norm facilitates the access to drugs in specific clinical situations, similar to US regulation and in a different way to the UE regulation.– It is a legal practice to prescribe in an off-label manner if the following requirements are followed: there are no authorized therapeutic alternatives, prescribed in health centers, when access to these drugs is provided through a protocol of use after justifying (written) and properly informing (verbal) and obtaining the patient's consent.– When prescribing off-label the doctor's decision is based on contrasted scientific evidence (not merely on personal intuition nor personal experience). In fact, this anticipates an eventual update of the data sheet for new indications or populations, unlike the French situation where they have the ATU (Temporary Utilization Authorization).– In Spain the holder of the Marketing Authorization is obliged not to promote or advertise the use of the drug in different conditions to those approved (unlike the USA regulation).– The jurisprudential analysis from the Spanish Courts states that the doctor's responsibility is equal than that concerning on-label prescription, that is, only in the case of bad medical praxis (as in the USA). The most important cause of sentencing were: the lack of informed consent, lack of control of the medication and lack of correct follow-up of the illness, whereas this does not include the drug, dose, duration or even the patient's age.– In European Union the general rule dictated by the Courts is to permit off-label use if this is according to the best medical practice (lex artis ad hoc). Even more, there are some specific cases (in Germany, like in the USA) where it is possible to generate doctor's responsibility for no prescribing in a off-label manner.

EPIZOOTOLOGICAL FEATURES OF MODERN CATTLE LEUKEMIA

1970 ◽  
pp. 53-58
Author(s):  
V. V. Makarov ◽  
D. A. Lozovoy
Keyword(s):  
Dairy Cattle ◽  
Western Europe ◽  
Control Programs ◽  
Foreign Countries ◽  
Negative Order ◽  
Dairy Cattle Breeding ◽  
The Usa ◽  
Epizootic Process ◽  
National Programs

  Enzootic bovine leucosis (EBL) has been known for more than a century and a half. Its occurrence and registration may have historically been associated with intensive breeding of dairy cattle in Western Europe to increase target productivity. It is known that any limiting intervention in the nature of the animal organism is always accompanied by an uncontrolled and unpredictable change in the genotype of a wider range than the required, particularly negative order. In particular, a decrease in the resistance to macroorganisms and the possibility of the new diseases emergence, including infectious ones (for example, immunodeficiencies such as BLAD syndrome of black-motley cattle and stress syndrome in pigs, the occurrence of scrapie and other slow sheep infections). In the last two decades of the last century, in many disadvantaged countries, primarily Western European, national programs for the eradication of EBL have been developed and subsequently successfully implemented. First of all the motivation was the economy of dairy cattle breeding (mainly the extension of productive age, as well as the tightening of requirements in international trade in cattle and bull products, breeding, pricing, etc.). In an analytical article are reviewed the elements of epizootology of EBL in the foreign countries with special attention to the situation in the USA, scenarios of various control programs, and promising methods for assessing the role of infected animals in the epizootic process. A critical assessment of the problem of EBL in the Russian Federation is given, the reasons for the ineffectiveness of against leucosis measures are discussed.

Concept of Power Decentralization in Political Science and Approaches to its Methodological Study

2017 ◽  
pp. 229-235
Author(s):  
Halyna Kuzub
Keyword(s):  
Political Science ◽  
Moral Education ◽  
Symbolic Interactionism ◽  
Western Europe ◽  
Central Government ◽  
Local Level ◽  
Perfect State ◽  
Political Ideas ◽  
The Usa ◽  
Structural Functionalism

The problem of power decentralization is up to date in a modern political science. We can trace its historical genesis first in European and further in the USA political ideas. Decentralization of power was considered along with the study of a perfect state system, civil society and local self-government. It is argued that the major part of successful process of power decentralization in the Western Europe was due to the idea nature for their political culture. The article attempts to retrace the history of the idea of power decentralization. As a background of the investigations of such thinkers as J. Bodin, J. Althusius, J. Locke, J.-J. Rousseau, C.-L. Montesquieu, R. Owen, C. Fourier, J. S.Mill, T. Jefferson, A. de Tocqueville and M. Dragomanov were thoroughly investigated. The paper also considers the modern definitions of power decentralization. Likewise the value of structural functionalism, symbolic interactionism and constructivism are argued in terms of further surveys of power decentralization. To conclude, the author opines that civil servants training, their theoretical teaching and moral education have to become the main objectives in perspective investigations. Furthermore, the success of power decentralization depends not only on devoting authority by central government, but also on capacity of its implementation by deputies on the local level. Keywords: Decentralization of power, deconcentration of power, administrative and political decentralization, classical and non-classical philosophy, structural functionalism, symbolic interactionism, construc-tivism

Topical Analgesic Formulations: Following the Transdermal Treatment Paradigm Only?

2019 ◽  
Author(s):  
Jan M Keppel Hesselink
Keyword(s):  
Ad Hoc ◽  
Active Pharmaceutical Ingredient ◽  
Mechanisms Of Action ◽  
Onset Of Action ◽  
Good Tolerability ◽  
Short Commentary ◽  
Topical Analgesics ◽  
The Usa ◽  
Treatment Paradigm ◽  
Topical Analgesic

Topical analgesics are regarded as new inroads to treat peripheral neuropathic pain, with a number of advantages over oral treatments. Topical treatment reduces systemic induced side-effects and have good tolerability, without problems of misuse or abuse, or dependency. Furthermore, the onset of action is fast, mostly within 30 minutes. The mechanism of action of topical analgesics is either via transdermal delivery of the analgesic, or via intradermal mechanisms of action. In the latter case, plasma levels of analgesics in the blood are absent or very low. This perspective is missing in the approach of the ad hoc committee of the National Academies of Sciences, Engineering, and Medicine in the USA, installed by the FDA. In this short commentary, we plead for a more comprehensive approach of topical analgesics, including those formulations which explicitly are not based on transdermal penetration of the active pharmaceutical ingredient, but on intradermal mechanisms of action.

scholarly journals Feasibility of using a biofeedback device in mindfulness training - a pilot randomized controlled trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Brenna Lin ◽  
Christopher Prickett ◽  
Steven Woltering
Keyword(s):  
College Students ◽  
Mindfulness Meditation ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Well Being ◽  
Open Science ◽  
Control Group ◽  
Test Procedures ◽  
The Usa ◽  
Biofeedback Device

Abstract Background Stress can negatively impact an individual’s health and well-being and high levels of stress are noted to exist among college students today. While traditional treatment methods are plagued with stigma and transfer problems, newly developed wearable biofeedback devices may offer unexplored possibilities. Although these products are becoming commonplace and inexpensive, scientific evidence of the effectiveness of these products is scarce and their feasibility within research contexts are relatively unexplored. Conversely, companies are not required, and possibly reluctant, to release information on the efficacy of these products against their claims. Thus, in the present pilot, we assess the feasibility of using a real-time respiratory-based biofeedback device in preparation for a larger study. Our main aims were to assess device-adherence and collaboration with the company that develops and sells the device. Method Data were collected from 39 college students who self-identified as experiencing chronic stress at a Southwestern university in the USA. Students were randomized into either a mindfulness-only control group without a biofeedback device (n = 21), or an experimental group with biofeedback device (n = 18). Both groups received mindfulness meditation training. Pre-test and post-test procedures were conducted 2 weeks apart. Further, both participant compliance and company compliance were assessed and collaboration with the company was evaluated. Results Participant device-adherence as well as the company’s collaboration necessary for a full-scale study was determined to be low. This may also have affected our results which showed a strong main effect for time for all outcome variables, suggesting all groups showed improvement in their levels of stress after the intervention period. No group by time effects were identified, however, indicating no added benefit of the biofeedback device. Conclusions Our findings suggest feasibility of future studies requires full collaboration and detailed and agreed upon data sharing procedures with the biofeedback company. The particular device under investigation added no value to the intervention outcomes and it was not feasible to continue a larger-scale study. Further, as the technology sector is innovating faster than it can validate products, we urge for open science collaborations between public and private sectors to properly develop evidence-based regulations that can withstand technological innovation while maintaining product quality, safety, and effectiveness. Trial registration NCT02837016. Registered 19 July 2016.

scholarly journals Morphophysiological and molecular characterization of millet (Panicum miliaceum L.) varieties for crop improvement in Western Europe

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Massimo Vischi ◽  
Nicola Zorzin ◽  
Maria Bernhart ◽  
Johanna Winkler ◽  
Dipak Santra ◽  
...  
Keyword(s):  
Western Europe ◽  
Crop Improvement ◽  
Genetic Distances ◽  
Phenotypic Traits ◽  
Panicum Miliaceum ◽  
Novel Foods ◽  
Proso Millet ◽  
Ne Italy ◽  
The Usa

Abstract Background Global warming and issues in favour of a more sustainable agriculture suggest a reconsideration of minor cereals in European agrosystems. Compared to other summer crops, proso millet has a remarkable drought resistance and could be used to improve crop rotation and biodiversity. Proso millet is also increasingly sought by industry to produce novel foods such as those designed for coeliac patients. In this study, a thorough characterization of 11, commercially available, proso millet (Panicum miliaceum L.) varieties was carried out as a preliminary step for crop reintroduction and breeding in Western Europe. Methods The cultivars under evaluation were introduced from Austria, Poland, Russia, and the USA (University of Nebraska–Lincoln). Plants were grown at Udine (NE Italy) and Gleisdorf (Styria, Austria), under greenhouse and field conditions, respectively. Yield components and a range of morphophysiological characters were recorded in both locations. In parallel, 85 SSR markers were tested on DNA samples extracted from randomly chosen plants of each variety and the 12 responsive markers used to genotype the whole variety set. Results Morphometric analyses showed that varieties have several diverging phenotypic traits and architectures. In all instances, yields recorded at field level were much lower than potential yields. In this respect, US selections were comparable to earlier developed European varieties, suggesting that breeding for an increased adaptation is the keystone for a stable reintroduction of millet in Western Europe. Molecular analyses uncovered remarkably low genetic differences and heterozygosity levels within cultivars, confirming millet as an essentially autogamous species; in contrast, large genetic distances were noted among cultivars selected in different environments. Results of SSR genotyping combined with those originating from phenotypic analyses indicated possible crosses to source the genetic variability necessary for selection. Conclusions This study enabled the identification of cultivars that could be used to revitalize the crop in Western Europe and to produce genetically variable hybrid progenies exploitable by breeding.

scholarly journals Evaluation of Mobile Tablet Computers for Use in the Veterans Health Administration

2019 ◽  
Vol 8 (1) ◽  
pp. 18-22
Author(s):  
Jennifer Herout ◽  
Kathleen L. Frisbee ◽  
Nancy R. Wilck ◽  
Margo Kabel ◽  
Deyne Bentt ◽  
...  
Keyword(s):  
Veterans Health Administration ◽  
Clinical Settings ◽  
Veterans Health ◽  
Department Of Veterans Affairs ◽  
Health Administration ◽  
Clinical Environment ◽  
Healthcare Organizations ◽  
Advantages And Disadvantages ◽  
Facilitators And Barriers ◽  
Device Use

The Veterans Health Administration (VHA) within the Department of Veterans Affairs (VA) was interested in determining how mobile tablets may be perceived by clinicians for use in clinical settings. Therefore, we conducted an evaluation to assess how performance might differ between two devices and to gather feedback on device use. We conducted a within-subject comparison with 32 clinicians involving a usability test and two questionnaires. Qualitative data was organized around eight themes: facilitators and barriers to tablet use, observations of physical use, device specific advantages and disadvantages, and the Patient Viewer mobile application. Clinicians envisioned many facilitators to tablet use, but also voiced some concerns. Participants rated one device significantly better than the other for questionnaire items related to ‘Access and Efficiency’, ‘Introduction into the Clinical Environment’, ‘Usability and Usefulness’, and ‘Desire to Use’. Results can be used by mobile health app developers, healthcare organizations considering device purchases, and researchers conducting studies on tablets to inform respective work.

scholarly journals Could Emotional Intelligence Ability Predict Salary? A Cross-Sectional Study in a Multioccupational Sample

2021 ◽  
Vol 18 (3) ◽  
pp. 1322
Author(s):  
Martin Sanchez-Gomez ◽  
Edgar Breso ◽  
Gabriele Giorgi
Keyword(s):  
Emotional Intelligence ◽  
Interpersonal Relationships ◽  
Work Experience ◽  
Ad Hoc ◽  
Preliminary Evidence ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Repair Capacity ◽  
Relevant Variable ◽  
Correlation And Regression Analysis

The study of emotional intelligence (EI) in work environments is a trending topic. However, few studies have examined the relationship between EI and salary. Therefore, the presented research aims to analyze the influence of EI on salary using a multioccupational sample. The participants were 785 subjects aged between 18 and 58 years (M = 39.41; SD = 10.95). EI ability was measured using the Mobile Emotional Intelligence Test (MEIT), while the salary was collected together with other sociodemographic variables in a questionnaire created ad hoc. After controlling for the age, gender, social class, educational level, and work experience variables, the results of correlation and regression analysis showed that participants with higher EI and emotional-repair capacity generally have higher salary. These findings provide preliminary evidence that EI is a relevant variable in achieving career success. The ability to channel and manage emotions could help employees develop stronger interpersonal relationships, leading to higher positions and greater financial compensation.

FDA’s reduced exposure marketing order for IQOS: why it is not a reliable global model

2021 ◽  
pp. tobaccocontrol-2020-056316
Author(s):  
Lauren Kass Lempert ◽  
Stella Bialous ◽  
Stanton Glantz
Keyword(s):  
Public Relations ◽  
Tobacco Control ◽  
Scientific Evidence ◽  
Tobacco Product ◽  
Tobacco Products ◽  
Sales And Marketing ◽  
Philip Morris ◽  
The Us ◽  
The Usa ◽  
The Difference

The US Food and Drug Administration (FDA) issued orders in July 2020 authorising Philip Morris Products S.A. to market its heated tobacco product (HTP) IQOS inside the USA with claims that it reduces exposure to some dangerous substances. FDA’s ‘reduced-exposure’ orders explicitly prohibit the marketing of IQOS with claims that IQOS will reduce harm or the risk of tobacco-related diseases. Under US law, FDA’s IQOS orders are problematic because FDA disregarded valid scientific evidence that IQOS increases exposure to other dangerous toxins and that Philip Morris Products S.A. failed to demonstrate that consumers understand the difference between reduced-exposure and reduced-harm claims. Unfortunately, both ‘reduced-exposure’ and ‘reduced-harm’ are classified as ‘modified risk tobacco products’ under US law. Exploiting this confusion, Philip Morris International used the FDA decision as the basis for marketing and public relations campaigns outside the USA to press governments to reverse policies that ban or regulate the sales and marketing of HTPs, including IQOS. Parties to the WHO Framework Convention on Tobacco Control should reject tobacco companies’ unsubstantiated explicit or implied claims of reduced harm associated with HTPs and resist Philip Morris International’s and other companies’ calls to relax HTP regulations based on the FDA’s actions. Instead, parties should adopt policies aligned with the Framework Convention on Tobacco Control when dealing with HTPs and other novel tobacco products.

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