Resource Practices Research Articles

Unmet medical needs in otorhinolaryngology

Unfulfilled medical wishes and the resulting disappointments often have infrastructural causes and are the result of inadequate services or limited available resources in amedical practice. As annoying as these might be, they can hardly be influenced by the individual therapeutic competence of the ENT physician. The situation is different in the case of unfulfilled medical wishes of patients who cannot be adequately helped for avariety of reasons, whether because of the severity of their illness or because of the particular, predominantly psychosomatic constellations. This can lead to disappointment and unfulfilled expectations on both sides. This article focuses on diseases for which there are no clear organic findings and therefore no clear treatment options, such as surgery or medication, or in which the organic findings are tangible but do not sufficiently explain the underlying condition. In such cases, the treatment measures initiated are not sufficient and do not satisfy the patient. The patient feels misunderstood, which puts additional strain on the relationship between physician and patient. Abasic psychosomatic understanding of underlying and subjectively dominant organic complaints-by physicians and patients-is helpful here. In this way, the symptom can also be understood and recognized as apossible expression of psychogenic distress in order to pave way to the necessary initiation of causal therapy. The article is intended to reflect on this and make suggestions for dealing with the topic, using the example of tinnitus suffering in particular.

Innovating neurosurgical training: a comprehensive evaluation of a 3D-printed intraventricular neuroendoscopy simulator and systematic review of the literature

ObjectiveThe objective of this study was to develop and evaluate a low-cost 3D-printed simulator to improve the ability of neurosurgical residents to handle and coordinate endoscopes in performing technically demanding procedures such as neuroendoscopic removal of ventricular tumors or endoscopic third ventriculostomy (ETV).MethodsThe simulator was developed, printed in-house, and evaluated in a trial involving neurosurgery residents who performed ETV and intraventricular tumor resection tasks using it. Participants completed a questionnaire that assessed various aspects of the simulator's effectiveness, including anatomical visualization, procedural understanding, competency enhancement, and subjective impressions.ResultsA total of 12 participants were included in the evaluation. The majority (n = 7, 53.85%) were male, with a mean age of 29.8 ± 3.27 years and 4 ± 2 years of neurosurgical experience. All participants agreed or strongly agreed (4.5 ± 0.50) that the 3D printed simulator helped develop systematic intraventricular visualization and understanding of surgical steps (4.42 ± 0.64). The handling of the endoscope was rated as realistic (4.5 ± 0.50), while the haptic qualities of the tumor were rated lower (3.83 ± 0.80; 3.92 ± 0.64). Training increased competence (4.25 ± 0.45) and coordination skills (4.5 ± 0.50), with 75% (n = 9) feeling more confident with neuroendoscopic instruments and 91.7% (n = 11) in future procedures.ConclusionThe developed 3D-printed simulator offers an accessible and practical training resource for neurosurgical residents, addressing the limitations of traditional training methods. The simulator appears to improve procedural skills and the competence of future neurosurgeons, potentially improving patient safety and outcomes in neurosurgical practice.

Genetic testing and counseling for hypertrophic cardiomyopathy: An evidence-based practice resource oftheNational Society of Genetic Counselors.

Hypertrophic cardiomyopathy (HCM) is a common hereditary condition affecting approximately 1 in 500 adults. It is characterized by marked clinical heterogeneity with individuals experiencing minimal to no symptoms, while others may have more severe outcomes including heart failure and sudden cardiac death. Genetic testing for HCM is increasingly available due to advances in DNA sequencing technologies and reduced costs. While a diagnosis of HCM is a well-supported indication for genetic testing and genetic counseling, incorporation of genetic services into the clinical setting is often limited outside of expert centers. As genetic counseling and testing have become more accessible and convenient, optimal integration of genomic data into the clinical care of individuals with HCM should be instituted, including delivery via genetic counseling. Drawing on recommendations from recent disease guidelines and systematic evidence reviews, we highlight key recommendations for HCM genetic testing and counseling. This practice resource provides a comprehensive framework to guide healthcare providers in the process of genetic test selection, variant classification, and cascade testing for genetic evaluation of HCM.

Medical Science Liaisons: A Guide for Advanced Practice Registered Nurses

Medical science liaisons (MSLs) are part of the field medical affairs (FMA) department of pharmaceutical companies and are scientific resources for advanced practice registered nurses (APRNs). Following strict regulations and antikickback statutes, MSLs operate differently from sales and engage in unbiased, nonpromotional scientific exchange to provide clinical resources to APRNs. They also collaborate with shareholders like professional organizations, clinical trial sites, and academic institutions. Understanding MSL engagement allows APRNs multiple avenues both externally and within the pharmaceutical industry to leverage their experience to enhance clinical practice.

Addressing psychological barriers to student learning: our role as learning developers

Since the launch of ALDinHE’s Health Community of Practice (CoP) in 2021, members have been sharing practice ideas and resources via monthly activities. One activity that stimulated particular interest related to the topic of psychological barriers to student learning (i.e. low confidence, anxiety, perfectionism and imposter syndrome) and how, as learning developers, we might address these. Although healthcare students may be particularly vulnerable to these kinds of issues (Bogardus et al., 2022), they are on the rise among all students (Curran and Hill, 2019). Therefore, it is pertinent to consider how they infiltrate learning development practice and how they can best be supported. The purpose of this workshop was firstly, to explore the professional boundary issues that this may raise, and secondly, to share and explore practice possibilities. This involved showcasing ideas from the aforementioned Health CoP activity and drawing on relevant research. In doing so, we aimed to open up a wider discussion about how learning development spaces can foster emotional growth and provide takeaways that participants can apply to their own practice.

Effects of active breaks on educational achievement in children with and without ADHD: study protocol and rationale of the Break4Brain project

The Break4Brain project aims to elucidate the effects of both acute and chronic physical activity (PA) on educational achievement in children with and without Attention Deficit Hyperactivity Disorder (ADHD). This study will be conducted in two phases: a cross-over design followed by a hybrid type 1 implementation-effectiveness trial, which includes both a cluster randomized controlled trial (RCT) and a qualitative study. In phase I, 60 children aged 10–12, with 30 each from ADHD and non-ADHD groups, will participate in a laboratory-based study over 4 days within 1 month. They will participate in three counterbalanced experimental conditions: (i) PA with cognitive engagement, (ii) PA without cognitive engagement, and (iii) a cognitively engaging control. This phase will assess acute changes in brain function, academic performance, working memory, inhibitory control, and sustained attention. Phase II will involve 600 children aged 10–12, randomly assigned to either a video-based PA program or a control group (300 children per group) in an 8-week cluster RCT. This phase will also incorporate a qualitative approach to explore the implementation context through pre- and post-intervention semi-structured interviews with teachers and school staff, and questionnaires for students. The outcomes of interest in this phase will include working memory, cognitive flexibility, selective attention, and academic performance. For the cross-over study, we hypothesize that PA conditions will enhance the studied outcomes compared to the control condition. In the RCT, we anticipate that the 8-week active breaks program will result in significant improvements in the selected outcomes compared to the control group. This study is expected to make pioneering contributions by including novel variables and focusing on the ADHD population. Furthermore, if the cluster RCT proves effective, it could offer a practical and cost-effective resource for integrating active breaks into daily school routines.

Patient and practice characteristics related to patient’s consent for health data exchange

Abstract Background Sharing patient health data electronically between healthcare providers can prevent medical errors and improve patient safety. In the Netherlands, exchange of health information is facilitated on a national level and is only allowed with patient consent. Consequently, it is important to know which factors are related to this patient consent. Methods Routine electronic health records data from up to 10% of Dutch general practices (sourced from the Nivel Primary Care Database) were utilized, covering the period from 2016 to 2020. We examined whether patient consent for health data exchange varied depending on patient and practice characteristics, which are expected to have a relationship with granting consent for health data exchange. Therefore, multilevel analysis was performed. Results The percentage of patients granting consent ranged between 40%-50% in the period 2016 to 2019, while this was 97% in 2020, due to the governmental corona opt-in regulation. Significant disparities were observed across several of the included patient and practice characteristics in relation to patient consent for all the years examined. In most years, patient consent provision varied by gender, age, socioeconomic position, location, and healthcare use. Practice characteristics showed notable differences in patient consent across information systems, patient volumes, and practice types over all years examined. Conclusions We observed significant variations in patient consent for health data exchange, both among the included patient (need) and practice characteristics. These differences may stem from unequal exposure to opportunities to grant consent, differences in risk of inadequate communication between healthcare providers, levels of health literacy, and practice resources. These factors should be taken into account by policymakers when further implementing and upscaling the national health data exchange system. Key messages • Variations in patient consent for health data exchange were observed among different patient groups and general practices. • Variations in patient consent for health data exchange may stem from unequal exposure to opportunities to grant consent, levels of health literacy, and practice resources, among other factors.

PECULIARITIES OF THE ACTIVITIES OF WOMEN CULTURAL AMBASSADORS WHO CREATE A POSITIVE IMAGE OF UKRAINE IN THE WORLD IN THE CONTEXT OF THE RUSSIAN-UKRAINIAN WAR

The article emphasises that public diplomacy is one of those areas and dimensions where a woman, using all her skills, can best prove herself. After all, public diplomacy really has no restrictions, reservations, templates, frameworks, clearly defined rules and canons, protocol and regulations. It can have a wide variety of manifestations, include different tools, and at the same time speak freely to any foreign-language, foreign-culture audience. Today, especially in times of war, a woman of any profession can become influential in the field of public diplomacy, and this will be valuable in helping Ukraine. However, it is now important to support Ukrainian women, open up new opportunities for development, teach public diplomacy tools, promote the potential of public diplomacy at the community level, and create special organisations, platforms, initiate discussion and expert platforms so that Ukrainian women unite, share experiences in public diplomacy, seek and find material and spiritual resources for projects, and thus feel more confident and bold - this will be invaluable to our country. Everyone can engage in public diplomacy. And in the context of Russia's current brutal war against Ukraine, it is a duty for all Ukrainians: both those who have recently been forced to move abroad and those who have long lived in exile and are part of the Ukrainian diaspora. Even those who leave Ukraine for a short time for one reason or another unwittingly become ambassadors of their country. Today, any step, contact, speech, appeal, or larger action by a Ukrainian man or a Ukrainian woman may result in the attention and positive attitude of a foreigner who is a representative of the civil society of a particular country, which in turn may provide financial or military assistance to Ukraine. However, on the other hand, public diplomacy, in my expert opinion, is not for everyone. It is, indeed, a very thorough and complex phenomenon, something that requires flair, experience, practice, knowledge, skill, mastery and considerable resources, both intellectual, spiritual and material.

Music-specialized teachers’ reasoning on music practice in preschool: Music knowledge, courage, and visions

According to the Swedish curriculum (SKOLFS 2018, p. 50), preschool teachers bear the responsibility for teaching and incorporating music into preschool practice. However, due to limited time dedicated to music in preschool teacher education, teachers specialized in music play a critical role as valuable resources in practice. Existing music education research has focused predominantly on music in preschool from the perspectives of preschool teachers and students, rather than specifically examining a group of teachers specialized in music. Hence, this study aims to explore and discuss how teachers specialized in music approach music practice within preschool settings. The study adopts an educational philosophy and music didaktik perspective in analyzing focus group discussions with teachers specialized in music. The results reveal that music knowledge focuses on craftsmanship, courage, and visions for the music specialist. Alternative combinations of theoretical perspectives shed light on a complex and intertwined practice with shifting emphases.

Teaching Strategies in Business English Translation Based on Ecological Translation

This paper addresses the singularity of the teaching evaluation system and the limited practical teaching resources in business English translation. It proposes a diversified teaching evaluation system based on ecological translation, expands practical teaching resources, and emphasizes the importance of teaching cultural differences and strengthening ecological translation theory. This approach aims to innovate and optimize the teaching mode of business English translation, thereby improving the quality of teaching and promoting students’ deep understanding and application skills of business English. Consequently, this strategy brings new opportunities for development in the field of business English education.

Integrating planetary health education into tertiary curricula: a practical toolbox for implementation

ObjectiveTo present a series of case studies from our respective countries and disciplines on approaches to implementing the Planetary Health Education Framework in university health professional education programs, and to propose a curriculum implementation and evaluation toolbox for educators to facilitate the adoption of similar initiatives in their programs. We emphasize the importance of applying an Indigenous lens to curriculum needs assessment, development, implementation, and evaluation.MethodsCase studies from Australia and United States were collated using a six-stage design-based educational research framework (Focus, Formulation, Contextualization, Definition, Implementation, Evaluation) for teaching planetary health and methods of curriculum evaluation. These components were then mapped to derive the curriculum implementation toolbox reflecting the six-stage design-based educational research framework.ResultsThe case studies demonstrated different approaches to successful integration of the Planetary Health Education Framework in medicine, nursing, public health, and allied health disciplines. This integration often involved Indigenous perspectives on environmental stewardship, holistic health, and community well-being into the curriculum. The case studies also highlighted the importance of community engagement, cultural competency, and interdisciplinary collaboration in curriculum development. Findings from case studies were used to propose a curriculum implementation toolbox to assist educators in adapting and integrating planetary health education into their own programs.DiscussionWhile valuable frameworks for teaching planetary health in health science programs exist, challenges remain in implementing these frameworks in real-world educational environments. The proposed curriculum implementation toolbox offers practical strategies and resources for educators to incorporate these principles into their teaching. Additionally, the case studies reported here contribute to the growing body of literature on planetary health education pertinent to addressing the triple planetary crisis.

Using quick response codes to access digital health resources in the general practice waiting room

Background Quick response (QR) codes are an established method of communication in today’s society. However, the role of QR codes for linking to health information in general practice waiting areas has not yet been explored. Methods This mixed-methods study used both quantitative data measuring QR scans and qualitative data from follow-up semi-structured interviews with visitors to two general practice waiting areas to determine access to an online health information site and their experience of using the QR code. The technology acceptance model was used to guide the interview questions. Quantitative data were analysed descriptively, and qualitative data were analysed thematically using an inductive approach. Results A total of 263 QR scans were recorded across the two sites between October 2022 and October 2023. Twelve participants were interviewed. Eleven themes were identified; six were categorised as facilitators and five were barriers to QR code engagement. Motivation for engagement included boredom and curiosity. Facilitators for engaging with the QR code included familiarity secondary to the recent COVID-19 pandemic, benefits of accessing potentially sensitive information with anonymity, convenience of revisiting later and reduced paper waste. Barriers included size and location of the QR code as a limiting factor to engagement, waiting room wait time, privacy and security concerns, and the potential to exclude those without access to technology or those with low technological literacy. Conclusion Using QR codes in the general practice waiting area is a convenient method of presenting health information to visitors and patients. Our findings indicate that this may be an appropriate method to share health information in waiting areas. Facilitators and barriers identified in this study may assist with optimising engagement with health information via QR codes while waiting for appointments.

Assessing Chat Generative Pre-training Transformer’s Proficiency in Identifying, Diagnosing, and Managing Orthopedic Fractures

Abstract Background: The exploration of Chat generative pre-training transformer’s (GPT’s) applications in medicine is gaining momentum, with artificial intelligence, particularly ChatGPT, showing promise in enhancing orthopedic care. ChatGPT can assist clinicians by providing relevant information based on patient symptoms, medical history, and radiological findings, aiding in differential diagnosis, and suggesting appropriate imaging modalities. This study focuses on evaluating the effectiveness of ChatGPT-4 in diagnosing and managing common orthopedic fractures. Methods: This study involved inputting a diverse set of fracture images into the ChatGPT-4 model. The process commenced by prompting ChatGPT with four questions: “What does the radiograph show?” The second prompt instructed ChatGPT with the actual diagnosis, followed by inquiries on how a clinician should manage the condition and potential complications. All generated responses underwent grading by two authors (musculoskeletal radiologist and orthopedic trainee), utilizing a 5-point Likert scale. Intraclass correlation coefficient (ICC) analysis measurements were performed to assess inter-rater reliability. Descriptive statistical analysis was then employed to provide a comprehensive summary of the study’s findings. Results: ChatGPT demonstrated limitations in identifying diagnoses based on inputted X-ray images. However, it excelled in providing comprehensive information about fracture management and potential complications. There was excellent interobserver reliability with a kappa of 0.9. Conclusion: Our study underscores the utility of ChatGPT as a valuable tool for aiding in the management of common fractures, offering a comprehensive overview of diagnosis, management, and potential complications. The findings highlight its potential role as a supplementary resource in orthopedic practice.

Identification of patients on chronic prescription opioids at risk for opioid use disorder using pharmacy claims data.

Using pharmacy claims data from a single commercial health plan to identify opportunities for opioid use disorder (OUD) focused screening and interventions communicated via targeted prescriber messaging. Participants included members ≥18 years using more than 90 morphine milligram equivalents (MMED) daily based on all opioid claims, had >1 paid claim for an opioid product, and had ≥90 days of total opioid therapy. Members were excluded with ≥1 claims for an oral chemotherapy agent (except methotrexate). Intervention was completed with a secure communication to the primary outpatient opioid prescriber that included resources for diagnosis, treatment, and best practices for opioid prescribing. The main outcome measure was any documented change to opioid use following the intervention. Seven hundred forty-five members were identified; a subset (n = 20) was further assessed, and all had identified OUD risk factors; providers were subsequently sent a communication. Sixteen providers acknowledged receipt and 11 patients (55%) had at least one documented intervention following communication receipt. Provision of targeted, evidence-based recommendations to providers for patients identified to be at risk of OUD from pharmacy claims data can result in increased recognition and intervention. Future efforts to explore feasibility of provider education detailing efforts and continued evaluation of efficacy are needed.

The Impact of Supportive Leadership on Work Stress: An Empirical Research in the Ministry of Iraqi Interior

Purpose: The purpose of this research is to discover the effect of supportive leadership on work stress in the Ministry of Iraqi Interior / Human Resources Management to achieve a happy life for its employees and hence achieve the desired level of performance. Theoretical Framework: The current research deals with introducing the Ministry of Iraqi Interior / Human Resources Management to the latest developments in the administration field through supportive leadership style and work stress, as well as presenting the latest concepts, importance, and models that previous researchers have arrived at. It contributes to expanding the researched organization's awareness of adopting any of these models that are appropriate for their goals and future direction. Design/Methodology/Approach: The research analyses administrative data within the Ministry of Iraqi Interior / Human Resources Management (2023-2024), using the dimensions of supportive leadership (empowering employees, fairness of treatment, and inspirational motivation) and the dimensions of work stress (role ambiguity, role conflict, workload, and work nature). It will determine the factors affecting them. Findings: The findings of this current research have approved the key effect hypothesis (supportive leadership style and its dimensions have a significant and negative impact on work stress and its dimensions). Research Implications: The results most leaders of human resources in the under-study organization practice the dimension of fair treatment more than other dimensions (empowering employees, and inspirational motivation. Originality/Value: This research seeks to enhance awareness of the importance of the negative role of a supportive leadership style on work stress. This research has dropped the knowledge gap between them and uses a framework that is compatible and harmonious to save the lives of the employees and at the same time increase organizational performance.

Barriers Impeding the Contribution of Indigenous Knowledge to Rural Development in Mabheleni, South Africa

Indigenous knowledge is increasingly recognised as a critical resource in rural development practice in many African countries, South Africa included. However, the use and contribution of indigenous knowledge in the development of rural communities in South Africa is inhibited by numerous factors. Drawing from the lens of deliberative democracy, this article reports on a study that explored the barriers impeding the contribution of indigenous knowledge towards rural development in Mabheleni. This deep rural and underdeveloped community falls under the Umzumbe Municipality in KwaZulu-Natal, South Africa. This study used a qualitative approach. Semi-structured interviews were conducted with 10 participants and one focus group discussion with 10 participants in Mabheleni. Thematic analysis was used to analyse the data. The study findings indicated that lack of recognition of indigenous knowledge itself in development practice, the use of a top-down approach by government officials, and barriers to community participation impede the potential contribution of indigenous knowledge to rural development. Therefore, the study recommends a bottom-up approach to rural development practice.

Evaluating the impact of coal seam roof groundwater using variable weights theory: A special emphasis on skylight-type water inrush pattern

Study regionThis study is based in the rapidly developing large-scale coal base located in Northwest China. Study focusThis study focuses on addressing a critical yet overlooked aspect of large-scale coal resource development in arid regions: the impact on coal seam roof groundwater. Recognizing the paramount importance of safeguarding groundwater resources for sustainable mining practices, the research introduces a novel concept of “skylight-type secondary water inrush pattern” and develops a comprehensive evaluation methodology to quantify its extent. New hydrological insights for the regionThe study presents groundbreaking hydrological insights into the behavior of groundwater systems impacted by coal mining in arid regions. It reveals that secondary water inrush pattern, a phenomenon driven by hydrodynamics, extends beyond the immediate mechanical footprint of mining, posing significant challenges for groundwater resource management. This research underscores the importance of considering not just the structural alterations to aquifers but also the broader hydrological consequences of mining activities. By integrating multivariate geological information with a variable weights theory, the developed evaluation method provides a nuanced understanding of how mining alters groundwater abundance and flow patterns. These new insights challenge traditional approaches and offer a scientific basis for designing effective strategies to mitigate water damage, manage mine groundwater, and promote sustainable mining practices in arid environments.

Cost-Effectiveness Analysis of Operating Room and In-Office Reconstruction of Skin Cancer Defects.

Reconstruction of skin cancer and Mohs micrographic surgery (MMS) defects of the head and neck is performed in both in-office and operating room (OR). This study intends to understand cost differences between reconstructive surgery for skin cancer defects in the OR and clinic to perform a cost-effectiveness analysis with single-institution patient satisfaction data. Population-based retrospective analysis of cost data and an institutional, prospective survey of patient satisfaction. National insurance database and institutional survey. The Merative® MarketScan database was queried to identify claims involving the reconstruction of skin cancer defects of the head/neck between 2013 and 2020 for cost-analysis by setting (OR vs clinic). Patients undergoing operative and clinic-based reconstruction of MMS defects by 3 different surgeons at a single institution in 2023 were surveyed for satisfaction using a 5-point Likert scale. Data was coupled for cost-benefit analysis. Analysis was performed using propensity-matched samples. Using Marketscan, 1206 patients were analyzed for cost data. OR cases had a higher median baseline cost of $2308 (interquartile range [IQR]: 1484-3889) compared to procedures in the office (median $987, IQR: 784-1454, P < .001). Survey data from 116 patients revealed no significant difference in scores between OR and clinic cases (clinic: 4.57 vs OR: 4.60, P = .8752). Using propensity-matched subsets, providers incur an additional $4744 for a reduction in satisfaction of 0.083 when performing cases in the OR. Lower cost is associated with reconstructive procedures performed in the office. This study is the first cost analysis of head and neck skin cancer reconstruction based on procedural settings and will be valuable to surgeons in considering practice patterns and resource utilization.

The Conceptual Framework: A Practical Guide.

There is no single definition of the conceptual framework (CF) or consensus on how it is best applied in the research process. However, in this piece, the authors argue that the CF is a tool used to link the literature review, research methodology, and study design. The CF grounds the study in the previous literature, theories, and models. It helps the researcher articulate their rationale for why the study should be performed, justify their study design, and describe the lens through which they analyze a phenomenon or research question. Researchers may find the variable use of terms such as theory, theoretical framework, and CF to be confusing. The authors address the distinction between these terms and present strategies to develop and use the CF throughout the research process. The authors provide practical examples and resources for additional learning.

Foundations of experiential knowledge: recovering a forgotten resource for social work

This article explores the conceptual and theoretical foundation of experiential knowledge. A scoping review shows that limited studies have so far been published about experiential knowledge in the context of social work. Although the value of personal experiences is commonly acknowledged, these are generally not considered ‘real knowledge’. Two main problems are identified, the first being that in dominant positivist scientific conceptions, experiential knowledge is not seen as scientifically relevant. The second is that, epistemologically, it seems problematic to turn personal experiences into collective knowledge. Regarding the first issue, it is argued that from a social-constructivist angle, experiential knowledge is valid knowledge. Not only can denying the value of knowledge based on lived experiences be considered an epistemic injustice, but it also ignores it as a valuable resource for professional education and practice. The second issue needs to be further explored considering the complex processes of experiential knowledge production, using the opportunities that narrative and participative social work research methods offer.