26199 research outputs found
Sort by
Critical appraisal skills for ensuring the quality-of-care provision and how to meet the requirements
No full textThe nature and sources of evidence and information available to clinicians when making shared decisions with patients, and helping them to choose the most appropriate care to meet their health needs, have changed rapidly. The increased range and differing reliability of sources of information, for both patients and clinicians, require the care provider to be competent in critical appraisal. The three key skill areas are: the ability to recognise where claims about the benefits of treatments, some derived from research, have an unreliable basis; to understand whether comparisons of treatments are fair and reliable; and subsequently, how best to help the patient make an informed choice about treatments. It is more important than ever to develop a competency-based assessment of critical appraisal skills for dentistry
Individualizing first-line treatment for advanced urothelial carcinoma: A favorable dilemma for patients and physicians
Get PDFThe treatment landscape for patients with advanced urothelial carcinoma (UC) has evolved rapidly in recent years. In current guidelines, combination treatment with enfortumab vedotin plus pembrolizumab is the first-line (1L) standard of care, and other recommended 1L treatment options are platinum-based chemotherapy followed by avelumab as switch-maintenance treatment in patients without progression, or combination treatment with nivolumab, cisplatin, and gemcitabine for cisplatin-eligible patients only. Individual patients differ in terms of their health status, disease characteristics, expected toxicities, and treatment preferences; thus, a “one-size-fits-all” approach to treatment is unlikely to be optimal. The availability of several treatment options creates the potential for individualized treatment. In this review, we discuss factors that may be considered when selecting 1L treatment for patients with advanced UC, including efficacy and safety data from phase 3 trials and real-world studies, quality of life, patient priorities for treatment, patient and disease characteristics, treatment sequencing, biomarkers, and treatment access and cost. Patients and physicians should discuss the benefit-risk balance of all available 1L options to enable shared decision-making. Longer follow-up from clinical trials and additional real-world studies are needed to further inform treatment selection
P338: Efficacy of the Savi Scout System inWide Local Excision for Breast Cancer: A Single-Institution Study at King’s College Hospital
Get PDFEmancipatory learning of a hermeneutic phenomenology methodology course
Get PDFWhilst various pedagogical approaches have been developed, there is little understanding of which are best for postgraduate research studies. This is particularly salient for a complex and evolving methodology such as hermeneutic phenomenology. We undertook a hermeneutic phenomenology study to capture participants’ lived experiences and meanings of attending a hermeneutic phenomenology methodology course (in person and/or online). An open invitation was issued to participants who had previously attended a hermeneutic phenomenology methodology course. Participants were invited to provide a crafted narrative (using text, poems, artwork and/or photos) and to indicate whether they would be willing to take part in a follow-up interview. Data analysis was undertaken collaboratively and used philosophical notions and wider theories to illuminate what was revealed. Thirteen participants provided data using text, poems, or photographs. Data analysis revealed four experiential qualities: ‘Attuning to a learning space’ that describes the facilitators’ comportment and attunement; ‘Learning-with-others’ highlights the value of being-with other learners; ‘Revealing new ways of knowing’ surfaced through the notions of quickening and hearkening; and finally ‘Transformation in thinking’ describes how attending the course had changed how participants perceive themselves and others as new understandings brought them to the edge of their knowing to glimpse new horizons. These four qualities coalesced into the phenomenon ‘emancipatory learning’. The study foregrounds the significance of a reflexive and immersive pedagogy that emphasises how dialogue, participation, reflexivity, and collaboration can enable participants to attune to learning ‘how to learn’ hermeneutic phenomenological research
A Behavioural and Electrophysiological Exploration of the Effect of Vocal Emotion on Visual Spatial Attention in Adolescents with Traits of Attention-Deficit Hyperactivity Disorder
Get PDFAccurate recognition of emotions from vocal expressions is associated with emotion regulation and social competence in children and adolescents (Lemerise & Arsenio, 2000; Crick & Dodge, 1994). Emotion dysregulation is highly prevalent in individuals with ADHD (Shaw et al., 2014), who also display vocal emotion recognition (VER) difficulties (Sells et al., 2023). However, it is debated whether VER difficulties in ADHD reflect generic attention deficits, in favour of cognitive-behavioral theories (Barkley, 1997, 2012) or specific perceptual processing atypicalities in favour of motivational-dysregulation (Sonuga-Barke, 2012) and socio-cognitive models (Lemerise & Arsenio, 2000). This thesis aimed to contribute to this theoretical debate within the literature. Chapter One introduces the vocal emotion processing literature and the theoretical debates in ADHD. Chapter Two presents a systematic review of the VER literature and provides meta-analytic evidence for the presence of generic VER deficits in ADHD. However, a gap in the literature was identified to more robustly examine the potential presence of specific perceptual processing atypicalities in ADHD using preattentive paradigms and neuroimaging measures. Therefore, the present thesis aimed to disentangle a) the preattentive processing of vocal emotion from b) the capture of attention by vocal emotion in ADHD using a novel emotional spatial cueing (ESC) paradigm. Chapter Three presents a study which successfully validated a set of vocal emotional stimuli in adults and adolescents. Chapter Four presents four experiments which validated the ESC paradigm using reaction times, and event-related potential (ERP) measures in adults. This study isolated the Cue-P2 component as a neural marker of preattentive vocal emotion processing in adults. Finally, Chapter Five provides evidence for a positive association between the neural marker of preattentive vocal emotion processing and traits of ADHD (inattention and hyperactivity) in a community sample of 60 adolescents. This is the first study to provide evidence for a preattentive hypersensitivity to vocal emotion in ADHD, in favour of motivational-dysfunction theories (Sonuga-Barke, 2012)
Critical thinking and mental health nurse education
Get PDFAims
This paper examines critical thinking as a fundamental proficiency essential for inclusion into international mental health nurse education. Pragmatic solutions ensure the ongoing development of critical thinking mental health nurses.
Background
The suitability of current mental health nurse education is under scrutiny globally. Critics claim that regulatory and educational standards have shifted from a focus on mental health specific skills to generic physical health-based competencies, which do not adequately equip mental health nurses for clinical practice. The vital skill of critical thinking within mental health nurse theory and practice has been diluted.
Design (stating that it is a position paper or critical review, for example)
This paper is a critical review of mental health nurse education.
Method
By summarising the global contextual background of generic based nursing education highlights the impact of the loss of mental health specific skill-sets. Critical thinking is identified as a vital skill for the 21st century mental health nurse. This paper provides pragmatic suggestions to include critical thinking into nurse education in the absence of global reform and systemic educational change. Personal lived experience is used to illustrate the importance of critical thinking and service users experience of care.
Conclusions
Critical thinking can be a partial solution to the current dilution of mental health nurse education occurring across the global North. Nurse educators should strive to embed critical thinking into mental health nurse education in order to develop lifelong critical thinkers who are not afraid to question the hegemonic perspective and continually ask, "why?",
Relevance for clinical practice
Recommendations are for nurse educators to be consciously aware of methods to encourage critical thinking, such as Socratic questioning, the consideration of epistemic injustice, co-production, critical reflexivity, and including case based ethical learning
Engagement in a dialogic activity after watching a video on climate change has an effect on students’ mitigation action beliefs
No full textVideos can be a valuable resource for learning about climate change and stimulating deliberative discussion on the actions to mitigate it. This quasi-experimental study aimed to investigate the effects of combining video watching with a dialogic activity, and the specific contributions of these two activities, on students’ knowledge, beliefs about mitigation actions, and self-reported pro-environmental behaviour. The dialogic activity involved students creating a fictional dialogue about mitigation actions among different stakeholders, and it was conducted either collectively or individually. 75 undergraduate students participated in three conditions: (a) watching a video only or combined with a dialogic activity, either (b) collectively in small groups or (c) individually. Results showed gains in students’ knowledge on climate change, for all conditions. Watching a video combined with a dialogic activity was found to have a significantly more positive effect on students’ climate change mitigation action beliefs, than watching a video alone. These findings highlight the value of watching a video on climate change for students’ knowledge acquisition on the subject, but also the value of engaging in a dialogic activity to promote more comprehensive beliefs about the actions that need to be taken to mitigate climate change
Sponsorship programmes and corruption in sport: management responses to a growing threat
No full textThe JCMT Gould Belt Survey: First results from the Corona Australis molecular cloud and evidence of variable dust emissivity indices in the Coronet region
Get PDFWe present 450 m and 850 m James Clerk Maxwell Telescope (JCMT) observations of the Corona Australis (CrA) molecular cloud taken as part of the JCMT Gould Belt Legacy Survey (GBLS). We present a catalogue of 39 starless and protostellar sources, for which we determine source temperatures and masses using SCUBA-2 450 m/850 m flux density ratios for sources with reliable 450 m detections, and compare these to values determined using temperatures measured by the Herschel Gould Belt Survey (HGBS). In keeping with previous studies, we find that SCUBA-2 preferentially detects high-volume-density starless cores, which are most likely to be prestellar (gravitationally bound). We do not observe any anti-correlation between temperature and volume density in the starless cores in our sample. Finally, we combine our SCUBA-2 and Herschel data to perform SED fitting from 160–850 m across the central Coronet region, thereby measuring dust temperature T, dust emissivity index β and column density N(H2) across the Coronet. We find that β varies across the Coronet, particularly measuring β = 1.55 ± 0.35 in the colder starless SMM-6 clump to the north of the B star R CrA. This relatively low value of β is suggestive of the presence of large dust grains in SMM-6, even when considering the effects of T − β fitting degeneracy and 12CO contamination of SCUBA-2 850 m data on the measured β values
Britain's 'Mr X': Sir Frank Roberts and the making of British foreign policy, 1930-68
Get PDFOver four decades as a diplomat, Sir Frank Roberts dealt with headline issues, including policy towards Germany during the years of appeasement, the Second World War alliance with the Soviet Union, the origins of the Cold War, NATO affairs, the Berlin and Cuban Missile Crises, European integration, and relations with the Federal Republic of Germany. Collaborating with the renowned American diplomat, George F. Kennan (the cryptonymous author 'X' of an influential 1947 article), his despatches from Moscow in 1946 shaped Britain's Cold War strategy. In 1954 he played an integral part in the diplomacy behind the rearmament of the Federal Republic and her incorporation into NATO, helping to build an enduring structure of transatlantic security. This account of Roberts' career is based on meticulous transatlantic research and sheds new light on British foreign policy across an era in which Britain slipped from global pre-eminence to regional power status