Daily Life Practice Research Articles

Feasibility and benefit of prehospital diagnosis, triage, and therapy by paramedics only in patients who are candidates for primary angioplasty for acute myocardial infarction

Despite data showing that time to treatment is very important in ST-elevation myocardial infarct patients, unacceptable long delays to reperfusion remain present in daily life practice. We sought to evaluate the feasibility and effect of improving logistics by early infarct diagnosis in the ambulance and immediate triage to a percutaneous coronary intervention (PCI) center performed by paramedics only without interference of a physician. In the On-TIME study, 209 patients were included after prehospital infarct diagnosis and triage in the ambulance (ambulance group, n = 209). Infarct diagnosis was made by highly trained paramedics with the help of a computerized electrocardiographic algorithm. The accuracy of diagnosis, time to treatment, left ventricular function, and clinical outcome were compared with the patients who were diagnosed and triaged at a referral non-PCI center (referred group, n = 258). Left ventricular function was assessed before discharge using a nuclear technique. Acute myocardial infarction was accurately diagnosed in 95% of patients in the ambulance group, as compared with 99% in the referred group (P = .01). The percentage of patients in whom pharmacologic pretreatment (heparin, aspirin, tirofiban, or placebo) was initiated in the ambulance within 90 minutes after the onset of symptoms was 59% in the ambulance group versus 43% in the referred group (P < .01). A left ventricular ejection fraction of <40% was present in 25% in the ambulance group, as compared with 38% in the referred group (P = .013). After multivariate analysis, ambulance triage was independently associated with a left ventricular ejection fraction >40% and a favorable long-term clinical outcome. Early, prehospital infarct diagnosis, triage, and therapy in the ambulance with direct transportation to the nearest PCI center, performed by trained paramedics only, is feasible in 95% of patients. Ambulance triage resulted in earlier diagnosis and initiation of therapy and was independently associated with a better left ventricular function and clinical outcome, as compared with triage and transportation from a referral non-PCI center.

Working with images in daily life and police practice: an assessment of the documentary tradition

There is a growing body of literature within the humanities and social sciences that is directly critical of the documentary tradition’s treatment and use of still and moving images as realistic data. The documentary tradition claims that it is possible to visually document social scenes with cameras. Postmodernism, poststructuralism, critical theory and related traditions argue that still and moving images amount to representations, their critique of realism. As instruments, cameras are open to a variety of uses ranging from the scientific to the artistic in orientation. Such uses of cameras comprise representational work. Following Garfinkel, this article suggests that the documentary method of sense making is employed in numerous practical situations. This article commences with an overview of the documentary tradition and then offers a brief case study of certain of these principles in operation within the practical work of the police and road users on public highways. Public highways and traffic flows along them are visually available social arrangements. Within police work that involves the regulation and management of traffic flows, stored images of vehicles can serve as documentary evidence of traffic violations. In this particular context and more generally on the highways, road users treat objects such as road signs and related items of roadside furniture, including cameras and road markings, as documents of some, for all practical purposes, real states of affairs. Road users make sense of the stream of visual information encountered as an ongoing practical accomplishment.

False beliefs: the current treatment of patients with depression.

All of these false beliefs may be related to the stigma associated with psychiatry; however, each of them is, in fact, a strong “theory,” independent but networking with the others. Each of these beliefs needs a specific educational campaign or should be addressed during medical studies. Very large studies realized in daily life practice populations with long-term follow-up are badly needed.

Beyond the Code of Ethics, Part I: Complexities of Ethical Decision Making in Social Work Practice

The authors have acquired experience in, and opinions on, ethical decision making while serving on a (U.S.) National Association of Social Workers (NASW) peer consultation ethics call line. The authors agree with scholars who view all human perceptions and activities as shaped by values, with the concurrent need to become more self-conscious about the ethical dimension of our daily life and professional practice. It is argued that our social work code of ethics is a necessary but insufficient tool for ethical decision making. The Code of Ethics (National Association of Social Workers, 1996) is frequently used as a risk management tool, offering guidelines for practice which may or may not be compatible with the goals of social justice for which social work ideally stands. Additionally, the unique and unexpected ways ethical issues emerge in clinical practice work against attempts to apply the Code as a rule book. Distinctions between ethical, legal, and clinical issues are difficult, given that the two latter domains have inevitable ethical implications. The authors urge readers to supplement a model of purely rational, ethical decision making with their emotions and intuition as shaped by our culture and our profession. Ethical judgments are best made in small groups where members bring different perspectives and intuitions to the process while agreeing on basic humanistic values.

Modern Representations and Daily Life Practice in China : The case of the Dehong Tai funeral reform

Modern Representations and Daily Life Practice in China : The case of the Dehong Tai funeral reform

歯科衛生士学校生のＨＩＶ／ＡＩＤＳに対する意識の解析

To raise the level of AIDS awareness among dental hygienist students, effective teaching methods should be established at training schools, because of the limitations of conventional teaching methods that focus on knowledge acquisition. HIV/AIDS awareness was analyzed in 296 dental hygienist students, with a view to find effective means of increasing their awareness. Our principal component analysis found that HIV/AIDS awareness consists of five principal components extracted from general awareness: (a) degree of acceptance, (b) sense of distance, (c) self-defense, (d) lack of sense of emergency concerning infection, and (e) fear of infection in daily life; and three principal components extracted from the awareness of dentistry: (a) degree of acceptance, (b) fear of infection in clinical practice, and (c) ethics as a dental hygienist. Comparing the principal components of the six distinct groups, we could assume that there is a connection between the degree of acceptance of HIV/AIDS on one hand, and AIDS education and clinical experience on the other. Furthermore, in analyzing the relationship between awareness and knowledge, it is presumed that there is a connection between the degree of acceptance in daily life and clinical practice, and knowledge about infection. This results would suggest that knowledge about infection has priority over other types of knowledge in order to raise the level of HIV/AIDS awareness.

Automating Communication in Civil Engineering

Currently, building companies are focusing many development efforts on improving information transformation processes. However, daily-life practice is characterized by islands of information. Building information normally resides in diverse and distinct sources, such as the heads of experienced engineers, literature, building codes, computer applications, drawings, and databases. Connecting these islands, e.g., by automating communication, is a major challenge. This paper presents an approach to open, high-level, computer-interpretable communication between project participants. “Open” means independent of the participants and their computer systems, “high-level” means that no human interpretation is required for handling information and knowledge, and “computer-interpretable” means that no human interaction is needed for data transfer. The (STEP) product-modeling approach provides a basis for this kind of communication. The writers extended this approach to project modeling and more scope layers. They applied their approach to the integration of design and construction of precast concrete structures.

Causality, responsibility and blame ‐ core issues in the cultural construction and subtext of prevention

AbstractIt is suggested that preventive thinking is founded in part on perceptions of causal connections, responsibility and blame. The perceived ability of health care and the individual to take active steps towards keeping the body healthy is incorporated in the preventive message. It would be wrong to suppose that these messages amount to a morally neutral description of an objective reality. Descriptions of causal relationships, be they by individual citizens or medical professionals, are inevitably selective, based on assessments and experience in daily life and clinical practice. Messages from preventive campaigns and information about health risks thus contain a hidden script, a culturally constructed subtext which is interpreted and dealt with by the actors involved. Explanations and interpretations of health risks among 40‐year‐old men going through a preventive programme of cholesterolemia in a farming region in Sweden is described. How these explanations and interpretations are communicated and constructed in the health care situation, and what implications they have in the every day life of these men, is discussed.

“Schülerarbeiten” als Quelle zur Erschließung der reformpädagogischen Unterrichts‐ und Erziehungsrealität der Schulfarm Insel Scharfenberg (Berlin) in der Weimarer Republik

The “Schulfarm Insel Scharfenberg “ (Berlin), a boarding school for boys, which was founded in 1922, was one of the most important experimental state schools belonging to the new education movement of the Weimar Republic. In contrast to its significance it has been more or less forgotten by researchers of the history of education. There exists a great number of published and unpublished written and pictorial sources for the study of its history, among them also pupils’ works. These varied works, which were not only produced in the context of lessons and subjects, were often inspired by the daily life on the island of Scharfenberg. Their themes were not restricted to a few aspects of life but covered almost every part of it. The essays and works of art which the boys produced show that the school saw itself as a radically democratic community in which life and education were based on the same rights for each member. Everybody actively took part in creating the lifestyle and educational principles of the “Schulfarm “. For the exploration of daily life and educational practice at the “Schulfarm” it is important to study all the available sources and in this context the works of the pupils are important materials.

REVIEWS AND NOTICES OF BOOKS

Book Review in this ArticlesMedical Examination of Schools and Scholars. Edited by T. N. Kelynack, M.D. With an Introduction by Sir Lauder Brunton, Bart., M.D., D.Sc., LL.D., etc.Childhood: National Health Manuals, vol. ii. Edited by T. N. Kelynack, M.D.Mentally Deficient Children: Their Treatment and Training. Third edition. By G. E. Shuttleworth, M.D., and W. A. Potts, M.D.Day and Evening Schools: Their Management and Organization, with Special Reference to the Problems of Adolescent Education. By F. H. Hayward, D.Litt., M.A., B.Sc.The Social Outlook: Papers on Social Problems read at the Second Oxford Conference of the Wesleyan Methodist Union for Social Service.Charity and Social Life: A Short Study of Religious and Social Thought in Relation to Charitable Methods and Institutions. By C. S. Loch, B.A., LL.D., D.C.L.Where Shall She Live? The Homelessness of the Woman Worker. By Mary Higgs and Edward E. Hayward, M.A.The Worker's Handbook. By Gertrude M. Tuckwell and Constance Smith.Women in Industry: From Seven Points of View. By Gertrude M. Tuckwell, Constance Smith, Mary R. Macarthur, May Tennant, Nettie Adler, Adelaide M. Anderson, Clementina Black. With a Preface by D. J. Shackleton, M.P.Sweated Industry and the Minimum Wage. By Clementina Black. With an Introduction by A. G. Gardiner.Hygiene and Morality. A Manual for Nurses and Others, giving an outline of the Medical, Social, and Legal Aspects of the Venereal Diseases. By Lavinia L. Dock, R.N.The White Slave Traffic.Popular Drugs: Their Use and Abuse. By Sidney Hillier, M.D.Hypnotism and Suggestion in Daily Life, Education, and Medical Practice. By Bernard Hollander, M.D.Famous Fanatics. By Guy Hayler.Sun‐cooked Food. A Treatise on How to Get the Highest Form of Human Energy from Food. By Eugene Christian. Sixth edition, retitled and rewritten.Health's Highway. By R. J. Mecredy.The Extra Pharmacopœia of Martindale and Westcott. Revised by W. Harrison Martindale, Ph.D., F.C.S., and W. Wynn Westcott, M.B., D.P.H.The Libraries of London: A Guide for Students. By Reginald Arthur Rye. Second edition, enlarged.The Green Book of London Society. Edited by Douglas Sladen and W. Wigmore.