scholarly journals Risk, uncertainty and medical practice: changes in the medical professions following disaster

2020 ◽  
Vol 16 (2) ◽  
pp. 285-303
Author(s):  
Sudeepa Abeysinghe ◽  
Claire Leppold ◽  
Akihiko Ozaki ◽  
Mariko Morita
Keyword(s):  
Medical Practice ◽  
Radiation Risk ◽  
Medical Professionals ◽  
Structured Interviews ◽  
Medical Work ◽  
Medical Expertise ◽  
Professional Boundaries ◽  
And Shifts ◽  
The Impact ◽  
The Way

Risk and uncertainty can destabilise and reconstruct the relationships between medicine, policy and publics. Through semi-structured interviews with medical staff following the Fukushima 3.11 Disaster, this paper demonstrates the way in which disruption (caused by disaster), coupled with uncertainty (in this case, around radiation risk) can serve to transform medical practices. After Fukushima, a deficit in publicly-trusted approaches to disaster management meant that the role and status of key medical professionals was transformed. This reorganisation of medical work included the development of new forms of expertise, the stretching of expertise beyond previously well-defined professional boundaries, and shifts in the way in which medical professionals understand and interact with publics. These changes signified the rise of new relationships between the medical workers and their community, as well as adjustments in what were regarded as the boundaries of medical work. Given both the ubiquitous threat of disasters and calls for increased engagement between the medicine and the public, this case study provides insight into the forms which such engagements can take, especially when bound by conditions of uncertainty. The paper draws upon the theoretical literature around the impact of uncertainty on policy, and combines this with medical sociological literature on the nature of medical expertise. The paper examines the shifting of medical expertise towards mode 2 forms, and evidences the impact of a democratised science of risk on the roles and functions of medical practice.

scholarly journals Decolonizing Diabetes

2019 ◽  
Vol 14 (2) ◽  
pp. 252-275
Author(s):  
Roger Stephen Pilon ◽  
Monique Benoit ◽  
Marion Maar ◽  
Sheila Cote ◽  
Fern Assinewe ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lived Experience ◽  
Indigenous Peoples ◽  
Research Question ◽  
Structured Interviews ◽  
Northern Ontario ◽  
Main Research ◽  
The Impact ◽  
The Way

This article presents insights into the colonial experience of Indigenous Peoples living with type 2 diabetes within seven First Nation communities in Northern Ontario. A constructivist grounded theory methodology, guided by a decolonizing and participatory action approach to conducting research with Indigenous Peoples, was utilised in this study. Twenty-two individuals with type 2 diabetes were interviewed. The main research question explored the impact of colonization on the lived experience and perceptions about developing type 2 diabetes for Indigenous Peoples.  Using semi-structured interviews, the three main categories that emerged from the analysis of the interview transcripts were changing ways of eating, developing diabetes, and choosing your medicine.  A substantive theory was developed that suggests that Indigenous Peoples, with type 2 diabetes, often live with the perception that there is ‘no going back’ to the way things once were prior to European contact. As a result, they have adapted the way they live with diabetes which can, at times, be at odds with Indigenous world views. An adaptation that considers a complementary approach to the way individuals live and manage diabetes including both Traditional and Western ways may provide a framework for a decolonized model of type 2 diabetes care for Indigenous Peoples.

scholarly journals Coming to Terms with Medical Terms – Exploring Insights from Native and Non-native English Speakers in Patient-physician Communication

2017 ◽  
Vol 25 (49) ◽  
pp. 79 ◽  
Author(s):  
Maria Dahm
Keyword(s):  
Medical Knowledge ◽  
Native English Speakers ◽  
Medical Professionals ◽  
Physician Communication ◽  
Medical Terminology ◽  
Structured Interviews ◽  
Medical Terms ◽  
English Speaking ◽  
Native English Speaking ◽  
The Impact

Using medical terminology involves a large risk of miscommunication in English-medium consultations as patients often do not know or misunderstand the terms commonly used by physicians, or even misuse terms in their interactions with medical professionals (Hadlow/Pitts 1991; Street 2003). Patients and physicians also frequently associate different meanings with the same medical terms, which further threatens patient-physician communication (Hadlow/Pitts 1991). To date most investigations on the impact of medical terminology have focused on native English speaking (NES) individuals in monolingual encounters, while insights from non-native English speaking (NNES) physicians and patients have been largely neglected. Through semi-structured interviews, this qualitative explorative study investigates the experiences of patients and physicians from diverse linguistic backgrounds in medical encounters within Australia. A particular focus is given to the way NES and NNES participants perceive and judge the impact of the meaning of medical terms on patient-physician communication. Findings suggest that both the use and meaning of medical terminology are perceived and judged very differently by individuals who come from different language backgrounds and who hold varying degrees of medical knowledge. Findings indicate that common blanket recommendations urging medical professionals to avoid or explain jargon may be futile since physicians and patient also diverge in their understanding of what constitutes jargon or medical terminology.

scholarly journals What are the elements needed to create an effective visual art intervention for people with dementia? A qualitative exploration

Dementia ◽  
2020 ◽  
pp. 147130122093848
Author(s):  
Emily K Shoesmith ◽  
Divine Charura ◽  
Claire Surr
Keyword(s):  
Visual Art ◽  
Structured Interviews ◽  
Professional Boundaries ◽  
People With Dementia ◽  
Five Factors ◽  
Key Stakeholders ◽  
Strong Focus ◽  
Art Intervention ◽  
Qualitative Exploration ◽  
The Impact

Background This article aimed to advance the understanding of ‘what works’ in visual art interventions from the perspective of key stakeholders, including people with dementia, their family members and visual art professionals. Method Semi-structured interviews were conducted with 22 participants, exploring their perceptions on barriers, facilitators, perceived benefits, experiences of delivering/attending a visual art intervention and any recommendations for implementation. Results Five factors were identified within the interviews that indicated important considerations for intervention structure and implementation, including benefits of group work, a skilled facilitator, participant choice, artistic ability and activity content. While art therapists expressed a clear protection of professional boundaries, the success of all of the visual art interventions was largely attributed to the supportive facilitator who possessed certain core values such as empathy and compassion and had knowledge in both artistic practice and the impact of living with dementia. It was clear the group dynamic was valued, and it was important to provide enjoyable, failure-free activity content with a strong focus on the creative process. Conclusion These findings offer a direction for evidence-based practice when implementing visual art interventions.

Clinical guidelines and clinical autonomy: exploring the missing link

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Maria Andri
Keyword(s):  
Medical Practice ◽  
Clinical Guidelines ◽  
Self Control ◽  
Medical Professionals ◽  
Work Organisation ◽  
Medical Work ◽  
Theoretical Understanding ◽  
Content Type ◽  
Labour Process ◽  
Clinical Autonomy

PurposeThis paper aims at understanding how clinical guidelines' use in the labour process relates to clinical autonomy, that is, the self-control medical professionals exercise over medical practice.Design/methodology/approachDrawing on a qualitative case study research strategy, this paper explores how medical professionals use clinical guidelines in the labour process in one public general hospital of the Greek National Health System. Supplemented by an extensive study of documents, semi-structured interviews were conducted with 33 doctors of several specialties.FindingsThe analysis shows (1) how clinical autonomy, as a self-control structure, mediates the use of clinical guidelines as a knowledge tool in the labour process, and (2) how employing clinical guidelines as a means towards coordinating medical work, but also towards regulating and standardising medical practice, is exercising pressure on the individualistic character of clinical autonomy.Originality/valueAdvancing the analytic value of workplace control structures, this paper contributes novel theoretical understanding of emerging tendencies characterising medical work organisation and clinical autonomy, and explains how medical professionals' non-adherence to clinical practice guidelines (CPGs) relates to CPGs' role as a resource to medical practice. Finally, this research proposes a more critical approach to health policy towards addressing the challenges associated with centrally introducing clinical guidelines in healthcare organisations.

scholarly journals A qualitative study exploring risk perception in congenital cardiac surgery: the perspective of UK surgeons

2021 ◽  
pp. 1-7
Author(s):  
Robyn R Lotto ◽  
Sarah E Seaton ◽  
Ian D Jones ◽  
Attilio A Lotto
Keyword(s):  
Clinical Care ◽  
Survival Rates ◽  
Comparative Approach ◽  
Moral Obligations ◽  
Structured Interviews ◽  
Care Needs ◽  
Managing Risk ◽  
Cardiac Surgeons ◽  
The Impact ◽  
The Way

Abstract Introduction: Managing risk is central to clinical care, yet most research focuses on patient perception, as opposed to how risk is enacted within the clinical setting by healthcare professionals. Aim: To explore how surgical risk is perceived, encountered, and managed by congenital cardiac surgeons. Methods: Semi-structured interviews were conducted with 20 congenital cardiac surgeons representing every unit across England and Wales. All interviews were transcribed verbatim, with analysis based on the constant comparative approach. Findings: Three themes were identified, reflecting the interactions between personal, institutional, and political context in which risk is encountered and managed. First, “communicating risk” highlights the complexity and variability in methods employed by surgeons to balance legal/moral obligations with parental need and expectations. Universally, surgeons described the need for flexibility in their approach in order to meet the needs of individual patients. Second, “scrutiny and accountability” captures the spectrum of opinion arising from the binary nature of the outcomes collated and the way in which they are perceived to be interpreted. Third, “nature of the job” highlights the personal and professional implications of conveying and managing risk and the impact of recent policy changes on the way this is enacted. Conclusion: Variations in approaches to communicating risk demonstrate a lack of consensus, compounded by insufficient evidence to determine or monitor a “best-care” approach. With current surgical outcomes suggesting little room for increasing survival rates, future care needs should shift to the “soft skills” in order to continue to drive improvements in parental and patient experience.

Clinical Judgment Revisited

1999 ◽  
Vol 38 (04/05) ◽  
pp. 279-286 ◽  
Author(s):  
L. L. Weed
Keyword(s):  
Decision Making ◽  
Medical Practice ◽  
Clinical Judgment ◽  
Medical Information ◽  
Patient Records ◽  
Practice Of Medicine ◽  
The Way

AbstractIt is widely recognised that accessing and processing medical information in libraries and patient records is a burden beyond the capacities of the physician’s unaided mind in the conditions of medical practice. Physicians are quite capable of tremendous intellectual feats but cannot possibly do it all. The way ahead requires the development of a framework in which the brilliant pieces of understanding are routinely assembled into a working unit of social machinery that is coherent and as error free as possible – a challenge in which we ourselves are among the working parts to be organized and brought under control.Such a framework of intellectual rigor and discipline in the practice of medicine can only be achieved if knowledge is embedded in tools; the system requiring the routine use of those tools in all decision making by both providers and patients.

Narrative, Intertext and Allusion in the Qur'anic Presentation of Job

1999 ◽  
Vol 1 (1) ◽  
pp. 1-25 ◽  
Author(s):  
A. H. Johns
Keyword(s):  
Key Words ◽  
Complex Network ◽  
Key Words And Phrases ◽  
Divine Revelation ◽  
Western Tradition ◽  
Islamic Tradition ◽  
The Impact ◽  
The Way

Job (Ayyūb) is a byword for patience in the Islamic tradition, notwithstanding only six Qur'anic verses are devoted to him, four in Ṣād (vv.41-4), and two in al-Anbiyā' (vv.83-4), and he is mentioned on only two other occasions, in al-Ancām (v.84) and al-Nisā' (v.163). In relation to the space devoted to him, he could be accounted a ‘lesser’ prophet, nevertheless his significance in the Qur'an is unambiguous. The impact he makes is achieved in a number of ways. One is through the elaborate intertext transmitted from the Companions and Followers, and recorded in the exegetic tradition. Another is the way in which his role and charisma are highlighted by the prophets in whose company he is presented, and the shifting emphases of each of the sūras in which he appears. Yet another is the wider context created by these sūras in which key words and phrases actualize a complex network of echoes and resonances that elicit internal and transsūra associations focusing attention on him from various perspectives. The effectiveness of this presentation of him derives from the linguistic genius of the Qur'an which by this means triggers a vivid encounter with aspects of the rhythm of divine revelation no less direct than that of visual iconography in the Western Tradition.

Invention of Judaism

2017 ◽  
Author(s):  
John J. Collins
Keyword(s):  
Way Of Life ◽  
The Impact ◽  
The Way

Judaism is often understood as the way of life defined by the Torah of Moses, but it was not always so. This book identifies key moments in the rise of the Torah, beginning with the formation of Deuteronomy, advancing through the reform of Ezra, the impact of the suppression of the Torah by Antiochus Epiphanes and the consequent Maccabean revolt, and the rise of Jewish sectarianism. It also discusses variant forms of Judaism, some of which are not Torah-centered and others which construe the Torah through the lenses of Hellenistic culture or through higher, apocalyptic, revelation. It concludes with the critique of the Torah in the writings of Paul.

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