scholarly journals Planning ESKD treatment: a plea for a stepwise person-centered approach including conservative care

2019 ◽  
Vol 33 (3) ◽  
Author(s):  
Helena Sá ◽  
◽  
Raymond Vanholder ◽  
◽  
◽  
...  
Keyword(s):  
Conservative Care ◽  
Person Centered Approach

Reduction of major amputations in the diabetic ischaemic foot: A strategy to "take control" with conservative care as well as revascularisation

VASA ◽  
2001 ◽  
Vol 30 (Supplement 58) ◽  
pp. 6-14 ◽  
Author(s):  
Edmonds ◽  
Foster
Keyword(s):  
Natural History ◽  
Treatment Plan ◽  
Staging System ◽  
Vascular Control ◽  
New Approach ◽  
Conservative Care ◽  
Arterial Bypass ◽  
Therapeutic Footwear ◽  
Frequent Problem

The diabetic ischaemic foot has become an increasingly frequent problem over the last decade. However, we report a new approach consisting of a basic classification, a simple staging system of the natural history and a treatment plan for each stage, within a multi-disciplinary framework. This approach of "taking control" consists of two parts: 1. long-term conservative care including debridement of ulcers (to obtain wound control), eradication of sepsis (micribiological control), and provision of therapeutic footwear (mechanical control), and 2. revascularisation by angioplasty and arterial bypass (vascular control). This approach has led to a 50% reduction in the rate of major amputations in patients attending with ischaemic ulceration and absent foot pulses from 1989 to 1999 (from 4.6% to 2.3% per year). Patients who underwent angioplasty increased from 6% to 13%. Arterial bypass similarly increased from 3% to 7% of cases. However, even with an increased rate of revascularisation, 80% of patients responded to conservative care alone. This,we conclude, is an essential part of the management of all patients with ischaemic feet.

Stigma, mental health, and counseling service use: A person-centered approach to mental health stigma profiles.

2017 ◽  
Vol 14 (4) ◽  
pp. 490-501 ◽  
Author(s):  
Ivan H. C. Wu ◽  
Geoff J. Bathje ◽  
Zornitsa Kalibatseva ◽  
DukHae Sung ◽  
Frederick T. L. Leong ◽  
...  
Keyword(s):  
Mental Health ◽  
Service Use ◽  
Mental Health Stigma ◽  
Counseling Service ◽  
Person Centered Approach

Hello, Neighbor: Carl and Fred Rogers and a Process of Person-centered Mentorship

2020 ◽  
Author(s):  
Matthew J. Bolton
Keyword(s):  
Well Being ◽  
Early Career ◽  
Children's Television ◽  
Human Potential ◽  
Career Interests ◽  
Late 20Th Century ◽  
Carl Rogers ◽  
Childhood Exposure ◽  
Fred Rogers ◽  
Person Centered Approach

Though professionally unaware of each other, Carl and Fred Rogers had much–including religious upbringings, early career interests in child well-being, and primary aspects of their philosophies on life and human potential–in common. Carl Rogers became one of the most influential American psychologists to date, in formulating person-centered approaches to psychotherapy and life, and as a children’s television host Fred Rogers was–and has remained, in the eyes of generations of kids and adults alike over the last 50 some-odd years–in many ways perhaps the most exemplary late 20th century embodiment of Carl Rogers’ proposed way of being. Here, I–a mentor to motivated students in the meteorological and psychological sciences, and others in wider life–discuss my discovery of the person-centered approach, via childhood exposure to Fred Rogers; and provide perspective on the ways the person-centered approach can be utilized to foster more effective and meaningful mentorship and learning-based relationships.

Robust management tools for a person-centered medical organization

2020 ◽  
pp. 17-34
Author(s):  
Vitaliy Berdutin
Keyword(s):  
Human Factor ◽  
Interpersonal Relations ◽  
Medical Organization ◽  
Management Tools ◽  
Constant Attention ◽  
Medical Institutions ◽  
Basic Concepts ◽  
Medical Teams ◽  
Cultural Reality ◽  
Person Centered Approach

Modern social and cultural reality forces the heads of medical institutions to pay increased attention to the human factor, rethinking such basic concepts as «management» and «organization». It is important to cultivate the most comfortable person-centered work environment in medical teams. The main goal of this article was to demonstrate the feasibility of using robust management to maintain the constant attention of the medical administration on the interpersonal relations of employees. The article contains a brief description of robust management tools, a description of the person-centered approach, as well as examples of the use of robust regulators and socionic profiling estimators. The potential of robust management is not revealed when the management simply declares its merits, but when the entire medical team wants and can use it, actively involved in achieving the desired result.

Teaching a Clinical Method Adapted to Contemporary Medicine

2018 ◽  
Author(s):  
J. Donald Boudreau ◽  
Eric J. Cassell ◽  
Abraham Fuks
Keyword(s):  
Clinical Observation ◽  
Skills Training ◽  
Spoken Language ◽  
Communication Skills Training ◽  
Clinical Method ◽  
Medical Interviewing ◽  
The Status ◽  
Clinical Thinking ◽  
Contemporary Medicine ◽  
Person Centered Approach

A truly person-centered curriculum requires important changes to how the clinical method is taught. Medical interviewing demands explicit instruction in how the spoken language works and specific strategies that elevate the status of attentive listening so that this aspect is seen as important as the more mechanical aspects of traditional communication skills training. The term chief complaint is declared outdated and suggestions for its replacement are offered. The medical record is considered an important educational instrument, and recommendations are made so that it is in service of functional assessment and better aligned to a person-centered approach. Modifications to the physical examination, particularly a renewed emphasis on clinical observation, are outlined. The chapter concludes with a discussion of clinical thinking and judgment. A plea is made for inculcating a receptiveness toward a narrative competence within medicine.

scholarly journals Treatment Outcomes of Lesser Tuberosity Osteotomy Nonunion After Total Shoulder Arthroplasty

2018 ◽  
Vol 2 ◽  
pp. 247154921880777
Author(s):  
Zachary J Bloom ◽  
Cesar D Lopez, BA ◽  
Stephen P Maier ◽  
Brian B Shiu ◽  
Djuro Petkovic ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Shoulder Arthroplasty ◽  
Surgical Repair ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Radiographic Evaluation ◽  
Lesser Tuberosity ◽  
Conservative Care ◽  
Conservative Group

Introduction Lesser tuberosity osteotomy (LTO) during anatomic total shoulder arthroplasty has a 13% nonunion rate. Treatment for LTO nonunion is controversial and poorly described in the literature. The purpose of this study was to compare the surgical and nonsurgical treatment outcomes of LTO nonunion. Methods A retrospective case series of 9 consecutive patients with LTO nonunion after primary anatomic shoulder arthroplasty at 1 institution from 2010 to 2016 were studied. Outcomes measured were radiographic evaluation of LTO on axillary X-ray, clinical range of motion (ROM), subscapularis strength, and pain at the time of LTO nonunion diagnosis and after either conservative care or surgical repair of the LTO nonunion. Results LTO nonunion was treated surgically in 4 and conservatively in 5 patients with average follow-up of 30 and 22 months, respectively. There were no significant differences in age, sex, or smoking status between groups. Treatment decision was a shared model of surgeon and patient. Displaced LTO nonunion was treated surgically in 2 and conservatively in 3 patients. There were no differences in LTO union rate of 50% in the surgical versus 60% in the conservative group. Abdominal compression test was abnormal in 50% of surgical versus 40% of conservative groups. At follow-up, ROM was lower in the surgical group with 128° forward elevation (FE) and 33° external rotation (ER) compared to 148° FE and 62° ER. Only 1 patient with LTO nonunion required conversion to reverse replacement. Conclusion LTO nonunion after shoulder arthroplasty is rare. Surgical repair of LTO nonunion does not significantly improve clinical or radiographic outcomes compared to conservative care.

Living a Calling and Work–Family Interface: A Latent Profile Analysis

2021 ◽  
pp. 106907272110067
Author(s):  
Chunyu Zhang ◽  
Bryan J. Dik ◽  
Zengyun Dong
Keyword(s):  
Family Conflict ◽  
Latent Profile Analysis ◽  
Profile Analysis ◽  
Positive Outcomes ◽  
Chinese University ◽  
Work Conflict ◽  
Work Family ◽  
Person Centered Approach ◽  
Latent Profile ◽  
Family Enrichment

The positive outcomes of calling have been examined in a large and growing number of studies, yet little is known about how calling relates to the work-family interface. In this study, we adopted a person-centered approach using latent profile analysis to explore how living a calling relates to different work-family interface profiles. With a sample of 267 Chinese university counselors, we found three work-family interface profiles: slightly conflictual (51%), experiencing slightly higher than average levels of work-to-family conflict (WFC) and family-to-work conflict (FWC) and slightly lower than average levels of work-to-family enrichment (WFE) and family-to-work enrichment (FWE); work-to-family conflictual (15%), with higher levels of WFC and lower levels of FWC, WFE, and FWE; and enriched (34%), indicated by higher levels of WFE and FWE and lower levels of WFC and FWC. The results revealed that the greater the extent to which participants were living their calling, the more likely they were to be classified into the enriched profile. Our findings contribute to the literature on calling by offering person-centered insights on the relation between calling and the work-family interface.

Career Goal Profiles of Early Career Scientists: A Person-Centered Approach

2021 ◽  
pp. 089484532110172
Author(s):  
Ruth Noppeney ◽  
Anna M. Stertz ◽  
Bettina S. Wiese
Keyword(s):  
Doctoral Students ◽  
Latent Profile Analysis ◽  
Academic Career ◽  
Profile Analysis ◽  
Early Career ◽  
Career Goal ◽  
Transition Analysis ◽  
Flat Profile ◽  
Career Options ◽  
Person Centered Approach

Obtaining a doctorate offers various career options. This study takes a person-centered approach to identify interest profiles. Career goals (professorate, entrepreneur, etc.) were assessed at two time points (1-year interval) in a sample of doctoral students and doctorate holders from the STEM fields in German-speaking areas ( NT 1 = 2,077). Latent profile analysis revealed that a four-profile solution provided the best data fit: At T1, 33.0% of the participants aimed for a management position in industry, 16.9% pursued an academic career, 30.1% were interested in activities without leadership responsibilities, and 20.1% had a relatively flat career-goal profile. Latent transition analysis indicated that most changes occurred for those classified into the flat profile, while strong interest in a management career was very stable over time. Additionally, the attainment of the doctorate seemed to be a good predictor for profile membership: Doctorate holders were more likely to be clearly dedicated to an academic career.

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