The question of the possibility of a phenomenological sociology is of the utmost importance today. In this paper, techniques in transcendental-genetic phenomenology are introduced as applicable to ...sociological work. I introduce the concept of recoil, a habit of thought which negatively determines protentions and expectations concerning types sedimented in far retention. Recoil is seen to be an important element in the theory of alterity in social life, including the understanding of alters as invisible. Finally, arguments in favor of the use of the epoché in sociological work is given, as the epoché allows us to engage with the experience of the subject of study without a latent invidious comparison to a naturalistic substructure.
I outline an approach to the phenomenology of improvised music which takes typification and the development of multi‐ordered phenomenological structures as central. My approach here is firmly in line ...with classical Husserlian phenomenology, taking the discussion of types in Experience and Judgment (Husserl, 1973) and Brudzińska (2015) as guide. I provide a phenomenological analysis of musical types as they are found in improvisational contexts, focusing on jazz in the 20th century. Styles are higher‐order musical types. Musical types are structures that are temporally “thick,” relying on sedimented typification and knowledge, driving expectations as definitional. In most forms of music (including improvised music), musical styles involve maintaining a balance between confirming expectations and flouting expectations. I show that improvised music has a phenomenal structure which is enriched by the communicative and “ real‐time” nature of improvised music. Improvised music can be seen as an exploration of a possibility space rendered by the juxtaposition of the musical types afforded by a performance environment (instrumentation, harmonic and melodic traditions, etc.). I show that improvisation in music is a multi‐vectoral form of communication. The communication is founded in what Dieter Lohmar calls “non‐linguistic thinking.” The expression is constituted in the results of active and synthesis. The culmination of improvisational exploration of possibility spaces is the precisification and enrichment of styles‐as‐types, while in some cases developing new styles in the process.
Background
Surgical outpatient clinics continuously face challenges in delivering efficient and effective care. An expanding population and chronic staff shortages makes sustainability critical. The ...primary objective of this study was to identify modifiable factors contributing to longer wait times in an orthopaedic outpatient clinic.
Methods
A single‐centre prospective observational cohort study was conducted at Western Australia's state trauma centre. Over a four‐week period, clinicians completed forms identifying delays in clinic, and clinic numbers were captured through an electronic booking system. Data was analysed using SPSS v27.
Results
Face‐to‐face (FTF) and telehealth (TH) clinic volumes grew by 18.9% and 361.1% respectively between 2018 and 2022. For the study period, 754 forms were completed for attending clinic patients. This captured 42.4% and 96.8% of FTF and TH actual attendance. The average wait time for doctor consultation was 63.9 min. Wait times significantly reduced when x‐rays were performed prior to clinic (P < 0.001), and when an unaccredited registrar held the on‐call phone (P < 0.001). Trauma clinics ran overtime in 95% of cases compared to elective clinics in which 25% ran overtime. The golden staffing ratio was one doctor for 13 patients. TH experienced few delays related to technological fault.
Conclusion
This study demonstrates that clinic volume continues to rise. It highlights the demand for adequate staffing and identifies several modifiable factors that influence clinic efficiency. It demonstrates the growth of TH as an alternative modality for outpatient surgical services and its potential for future expansion.
Evaluation of an orthopaedic outpatient clinic's efficiency in a high demand trauma centre.
Background
The COVID‐19 pandemic led to a global shortage of iodinated contrast media (ICM) in early 2022. ICM is used in more than half of the computed tomography of the abdomen and pelvis (CTAP) ...performed to diagnose an acute abdomen (AA). In response to the shortage, the RANZCR published contrast‐conserving recommendations. This study aimed to compare AA diagnostic outcomes of non‐contrast CTs performed before and during the shortage.
Methods
A single‐centre retrospective observational cohort study of all adult patients presenting with an AA who underwent a CTAP was conducted during the contrast shortage period from May to July 2022. The pre‐shortage control comparison group was from January to March 2022; key demographics, imaging modality indication and diagnostic outcomes were collected and analysed using SPSS v27.
Results
Nine hundred and sixty‐two cases met the inclusion criteria, of which n = 502, 52.2% were in the shortage period group. There was a significant increase of 464% in the number of non‐contrast CTAPs performed during the shortage period (P < 0.001). For the six AA pathologies, only n = 3, 1.8% of non‐contrast CTAPs had equivocal findings requiring further imaging with a contrast CTAP. Of the total CTs performed, n = 464, 48.2% were negative.
Conclusion
This study showed that when non‐contrast CTs are selected appropriately, they appear to be non‐inferior to contrast‐enhanced CTAPs in diagnosing acute appendicitis, colitis, diverticulitis, hernia, collection, and obstruction. This study highlights the need for further research into utilizing non‐contrast scans for assessing the AA to minimize contrast‐associated complications.
The utilization of non‐contrast computer tomography imaging to diagnose the acute abdomen during the global contrast shortage.
Background and aim: The increasing opportunities for medical students to participate in international electives may improve students' professionalism and cultural competence. However, the students' ...overall experiences may be unpredictable, unstructured and lack supervision. There is scant evidence with respect to their learning outcomes. These reflections demonstrate that short-term supervised elective can provide students with structured learning experiences to achieve specific learning objectives.
Methods: We carried out daily debriefs and a weekly summary with seven Curtin Medical School students from Perth, Australia during an 18-days supervised elective in the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. The daily debriefs and the weekly summary in different disciplines become the content of the reflections discussed in this article.
Results: The main themes identified in the feedback were as follows: Skills in history taking and physical examination; clinical reasoning; diagnosis and management of diseases rarely seen in Australia; awareness of clinical ethics; merits and demerits of different systems of healthcare; sensitivity to issues in doctor-patient relationships; work ethics; enhancement of cultural competence; and personal development.
Conclusions: These reflections provide insight into how overseas electives may be structured to improve students' clinical reasoning skills in this hospital. These students achieved their learning outcomes under joint supervision from both institutions. The clinical skills learned from these experiences enhanced the students' professionalism and cultural competence, giving students the opportunities to appreciate the multitude healthcare model of bio-psycho-social-political-economical-spiritual dimensions.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
is an important cause of respiratory tract infections in children as well as adults that can range in severity from mild to life-threatening. Over the past several years there has been much new ...information published concerning infections caused by this organism. New molecular-based tests for
detection are now commercially available in the United States, and advances in molecular typing systems have enhanced understanding of the epidemiology of infections. More strains have had their entire genome sequences published, providing additional insights into pathogenic mechanisms. Clinically significant acquired macrolide resistance has emerged worldwide and is now complicating treatment.
susceptibility testing methods have been standardized, and several new drugs that may be effective against this organism are undergoing development. This review focuses on the many new developments that have occurred over the past several years that enhance our understanding of this microbe, which is among the smallest bacterial pathogens but one of great clinical importance.
The standard approach for documenting symptomatic adverse events (AEs) in cancer clinical trials involves investigator reporting using the National Cancer Institute's (NCI's) Common Terminology ...Criteria for Adverse Events (CTCAE). Because this approach underdetects symptomatic AEs, the NCI issued two contracts to create a patient-reported outcome (PRO) measurement system as a companion to the CTCAE, called the PRO-CTCAE. This Commentary describes development of the PRO-CTCAE by a group of multidisciplinary investigators and patient representatives and provides an overview of qualitative and quantitative studies of its measurement properties. A systematic evaluation of all 790 AEs listed in the CTCAE identified 78 appropriate for patient self-reporting. For each of these, a PRO-CTCAE plain language term in English and one to three items characterizing the frequency, severity, and/or activity interference of the AE were created, rendering a library of 124 PRO-CTCAE items. These items were refined in a cognitive interviewing study among patients on active cancer treatment with diverse educational, racial, and geographic backgrounds. Favorable measurement properties of the items, including construct validity, reliability, responsiveness, and between-mode equivalence, were determined prospectively in a demographically diverse population of patients receiving treatments for many different tumor types. A software platform was built to administer PRO-CTCAE items to clinical trial participants via the internet or telephone interactive voice response and was refined through usability testing. Work is ongoing to translate the PRO-CTCAE into multiple languages and to determine the optimal approach for integrating the PRO-CTCAE into clinical trial workflow and AE analyses. It is envisioned that the PRO-CTCAE will enhance the precision and patient-centeredness of adverse event reporting in cancer clinical research.
There is extensive evidence implicating the intestinal microbiota in inflammatory bowel disease IBD, but no microbial agent has been identified as a sole causative agent. Bacteroidales are ...numerically dominant intestinal organisms that associate with the mucosal surface and have properties that both positively and negatively affect the host. To determine precise numbers and species of Bacteroidales adherent to the mucosal surface in IBD patients, we performed a comprehensive culture based analysis of intestinal biopsies from pediatric Crohn's disease CD, ulcerative colitis UC, and control subjects. We obtained biopsies from 94 patients and used multiplex PCR or 16S rDNA sequencing of Bacteroidales isolates for species identification. Eighteen different Bacteroidales species were identified in the study group, with up to ten different species per biopsy, a number higher than demonstrated using 16S rRNA gene sequencing methods. Species diversity was decreased in IBD compared to controls and with increasingly inflamed tissue. There were significant differences in predominant Bacteroidales species between biopsies from the three groups and from inflamed and uninflamed sites. Parabacteroides distasonis significantly decreased in inflamed tissue. All 373 Bacteroidales isolates collected in this study grew with mucin as the only utilizable carbon source suggesting this is a non-pathogenic feature of this bacterial order. Bacteroides fragilis isolates with the enterotoxin gene bft, previously associated with flares of colitis, were not found more often at inflamed colonic sites or within IBD subjects. B. fragilis isolates with the ability to synthesize the immunomodulatory polysaccharide A PSA, previously shown to be protective in murine models of colitis, were not detected more often from healthy versus inflamed tissue.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Since its initial description in the 1940s and eventual elucidation as a highly evolved pathogenic bacterium, Mycoplasma pneumoniae has come to be recognized as a worldwide cause of primary atypical ...pneumonia. Beyond its ability to cause severe lower respiratory illness and milder upper respiratory symptoms it has become apparent that a wide array of extrapulmonary infectious and postinfectious events may accompany the infections in humans caused by this organism. Autoimmune disorders and chronic diseases such as asthma and arthritis are increasingly being associated with this mycoplasma, which frequently persists in individuals for prolonged periods. The reductive evolutionary process that has led to the minimal genome of M. pneumoniae suggests that it exists as a highly specialized parasitic bacterium capable of residing in an intracellular state within the respiratory tissues, occasionally emerging to produce symptoms. This review includes discussion of some of the newer aspects of our knowledge on this pathogen, characteristics of clinical infections, how it causes disease, the recent emergence of macrolide resistance, and the status of laboratory diagnostic methods.
PDF
