scholarly journals Learning from Surgery: How Medical Knowledge is Constructed

2013 ◽  
Vol 3 (1) ◽  
Author(s):  
Helena Serra
Keyword(s):  
Personal Experience ◽  
Medical Profession ◽  
Methodological Approach ◽  
Medical Knowledge ◽  
Research Field ◽  
Sociology Of Professions ◽  
Medical Experience ◽  
Partici Pant ◽  
Using Data ◽  
Based Medicine

Using data collected from surgeons working in a transplantation unit in Portugal this article aims to identify how medical knowledge is constructed within the context of surgery. The key theoretical guidelines are drawn from the sociology of professions and medical sociology, particularly social constructivist studies. A qualitative methodological approach was adopted, in which we opted for a partici-pant observation and on-site interviews. Three hypotheses are addressed: 1) the recent shift towards Evidence-Based-Medicine (EBM) influences the primacy of clinical experience in the construction of medical knowledge; 2) medical experience does not strongly links with EBM principles; 3) personal experience is central in the construction of medical knowledge and discourse. This article provides a new window into the study of medical profession, a step forward in the research field. Conclusions show new understanding about EBM practice, insofar as it ties the production of medical knowledge to professional dynamics and autonomy.

scholarly journals Immunomodulatory Nanomedicine for the Treatment of Atherosclerosis

2021 ◽  
Vol 10 (14) ◽  
pp. 3185
Author(s):  
Linsey J. F. Peters ◽  
Alexander Jans ◽  
Matthias Bartneck ◽  
Emiel P. C. van der Vorst
Keyword(s):  
Cell Proliferation ◽  
Drug Carriers ◽  
Research Field ◽  
General Introduction ◽  
Cellular Receptors ◽  
Cellular Processes ◽  
Potential Applications ◽  
Current Therapies ◽  
Based Medicine ◽  
Physiological Systems

Atherosclerosis is the main underlying cause of cardiovascular diseases (CVDs), which remain the number one contributor to mortality worldwide. Although current therapies can slow down disease progression, no treatment is available that can fully cure or reverse atherosclerosis. Nanomedicine, which is the application of nanotechnology in medicine, is an emerging field in the treatment of many pathologies, including CVDs. It enables the production of drugs that interact with cellular receptors, and allows for controlling cellular processes after entering these cells. Nanomedicine aims to repair, control and monitor biological and physiological systems via nanoparticles (NPs), which have been shown to be efficient drug carriers. In this review we will, after a general introduction, highlight the advantages and limitations of the use of such nano-based medicine, the potential applications and targeting strategies via NPs. For example, we will provide a detailed discussion on NPs that can target relevant cellular receptors, such as integrins, or cellular processes related to atherogenesis, such as vascular smooth muscle cell proliferation. Furthermore, we will underline the (ongoing) clinical trials focusing on NPs in CVDs, which might bring new insights into this research field.

Badania biograficzne rodzin więźniów. Refleksja metodologiczna Angelika Cieślikowska-Ryczko 1

2021 ◽  
pp. 135-162
Author(s):  
Angelika Cieślikowska-Ryczko
Keyword(s):  
Methodological Approach ◽  
Family Members ◽  
Research Field ◽  
Correctional Institution ◽  
Research Experience ◽  
Parental Relationships ◽  
Biographical Research ◽  
Narrative Interview ◽  
Definition Of ◽  
Autobiographical Narrative

The article deals with the life situation of the families of prisoners, in particular, parental relationships connected with the experience of incarceration in a correctional institution. During the realisation of the research I noticed many difficulties in finding contact with potential interlocutors, therefore I considered the families of prisoners as an environment “invisible in the research field”. In addition, I defined families of prisoners as marginalised and stigmatised environments. The main aim of the article is to show selected methodological dilemmas that can be encountered through the design and analysis of biographical research of family members of prisoners. The theoretical introduction of the paper as an extended definition of the penitentiary crisis allowed to characterise the dominant trends and directions of research on prisoners’ families. Further, it focused on selected problems of realisation of qualitative research (especially biographical research). I analyse the literature and present my own methodological approach based on the direction of interpretative sociology. Using the potential of the autobiographical narrative interview technique (of the German sociological school of Fritz Schütze), I collected 31 interviews with adult children of prisoners and 30 interviews with parents of prisoners. Finally, I refer to my own research experience and discuss the “usefulness and ineffectiveness” of an autobiographical narrative interview. Moreover, I characterise key reflections on the role of the researcher in obtaining autobiographical narrations. The article is an invitation to discuss the improvement of research procedures, especially in the area of research on family members of persons in prisons.

Contextual Density and US Automotive CO2 Emissions across the Rural–Urban Continuum

2015 ◽  
Vol 40 (6) ◽  
pp. 590-615 ◽  
Author(s):  
Andrew Perumal ◽  
David Timmons
Keyword(s):  
Urban Areas ◽  
Methodological Approach ◽  
Fuel Efficiency ◽  
Geographical Information ◽  
Population Densities ◽  
Spatial Differences ◽  
Using Data ◽  
Household Travel ◽  
Vehicle Fuel Efficiency ◽  
National Household Travel Survey

Using data from the 2009 National Household Travel Survey, we quantify the effects of settlement patterns on individual driving habits and the resulting automotive carbon dioxide (CO2) emissions. We employ CO2 emissions to capture this impact accurately, as it reflects both vehicle miles traveled and any spatial differences in vehicle fuel efficiency choices. While previous studies have compared automotive travel in urban and suburban areas, our approach characterizes emissions across the entire US rural–urban gradient, focusing on the effects of population density. Rather than using categorical measures of contextual density (city, suburb, town, etc.), we use a geographical information system to calculate continuous measures of contextual density, that is, density at different proximities to households. These measures of contextual density allow us to model travel effects induced by the gravitational pull of the population densities of urban cores. Further, our methodological approach frames location choice as an endogenous treatment effect; that is, residential locations are not randomly assigned across our sample and significantly alter driving behavior. We find that individuals living in urban cores generate the lowest per capita automotive CO2 emissions, due to close proximities of population concentrations. Rather than attracting individuals who would likely have low CO2 emissions anyway, urban location apparently mitigates the emissions of people who would otherwise tend to have high automotive CO2 emissions. We find larger elasticities with respect to density than previous studies and also find that the attractive forces of population densities affect driving patterns at distances up to sixty-one kilometers outside of urban areas.

scholarly journals Budgetary restrictions and ethical behaviours in a hospital context – evidence from general surgeons

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Cristina Piedade Silva ◽  
Rita Martins de Sousa
Keyword(s):  
Medical Profession ◽  
Participant Observation ◽  
Methodological Approach ◽  
Treatment Options ◽  
Patient Treatment ◽  
Ethical Behaviour ◽  
Content Type ◽  
Ethical Implications ◽  
General Surgeons ◽  
The Impact

Purpose The purpose of this paper is to study how budgetary constraints can have ethical implications on patient treatment options. Design/methodology/approach By applying a qualitative methodological approach (interviews) and participant observation, this paper studies the behaviour of surgeons in scenarios of financial restriction. Findings The empirical findings show that despite the conflict between the economy and the leges artis, surgeons maintain the ethical and deontological principles of their profession with fair rules of orientation. Practical implications The importance of this study can be realised by its continuity. One of the authors is already implicated on a wider research to investigate the influence of the economic scarcity of resources on general surgeons’ ethical behaviours. Social implications This paper is a contribution to understanding the rules that restrain the activities of surgeons. Politicians sometimes do not have a full understanding of the pressures that the medical profession faces in their day-to-day activities. Currently, with the addition of problems relate to COVID-19, politicians and populations seem to better understand the importance of the Serviço Nacional de Saúde (SNS), This paper hopes that this understanding will be not only a conjectural moment. Originality/value In conjunction with the economic recession that began in the first decade of this century, health institutions have long faced budgetary constraints that condition their material and human resources and correspondingly shape the scope of health professional activities. Until now, it has not been studied the impact of economic crises on the ethical behaviour of Portuguese surgeons. Therefore, this research is a first step and a useful contribution to understanding the rules that can restrain (or not) the ethical conduct of these health professionals.

Complex Action Methodology for Enterprise Systems (CAMES)

2019 ◽  
pp. 302-314
Author(s):  
Olaf Cames ◽  
Meghann L. Drury-Grogan
Keyword(s):  
Quantum Mechanics ◽  
Action Research ◽  
Communicative Action ◽  
Research Question ◽  
Methodological Approach ◽  
Field Studies ◽  
Quantum Probability ◽  
Behavioral Pattern ◽  
Research Field ◽  
Theory Of Communicative Action

This completed action research utilizes the conceptual framework of quantum mechanics in action science field studies for bias-free behavioral data collection and quantification. The research question tied to experimental verification if action research field studies can practically utilize the theory of communicative action and the theory of quantum mechanics to contextualize the quantification with pathological and distorted behavioral pattern. The result is a quantum-like formalism that provides intermediary conceptuality for organizational intervening initiatives. This process of contextualization behavior in projects via quantum probability experimentally evidenced. The chapter concludes by reviewing the results of two experiments that the hypotheses that the theory of quantum mechanics and the theory of communicative action qualifies as a building block for a planned methodological approach to intervene and steer problematic social structures in the desired direction.

Theoretical conceptions of intervention research addressing cancer control issues

2020 ◽  
Author(s):  
Cécile-Marie Dupin ◽  
Carla Estaquio ◽  
Hermann Nabi
Keyword(s):  
Methodological Approach ◽  
Health Sector ◽  
Cancer Control ◽  
Population Level ◽  
Intervention Research ◽  
Research Field ◽  
Population Health Intervention Research ◽  
Population Health Intervention ◽  
Underlying Mechanisms ◽  
New Research

Abstract Population health intervention research (PHIR) involves the use of scientific methods to produce knowledge about policy and program interventions that operate within or outside of the health sector and have the potential to impact health at the population level. PHIR is a relatively new research field that has gained momentum internationally. When developing PHIR, it is important to have a program theory with the potential to increase intervention success by identifying underlying mechanisms, areas of failure and unintended outcomes. Since 2010, the French National Cancer Institute (Institut National du Cancer—INCa) has supported a national, competitive, dedicated call for proposals in PHIR to tackle cancer control issues. After 5 years of activity, specific analysis of the proposals submitted for funding and/or funded (n = 63) from descriptive and analytic perspectives was called for. Analysis of the data revealed diversity in terms of targeted populations, partnerships engaged and methodological approaches. Projects were more likely to be funded (n = 15) if presented with a robust methodological approach and diversity in methodology, and/or with research objectives at different levels of action. The analysis also revealed that researchers do not explicitly describe theoretical constructs underpinning their interventions to combat cancer. PHIR still needs improvement to better incorporate social, institutional and policy approaches to cancer control. Researchers should apply a theory-driven approach to distinguish between ‘program failure’ and ‘theory failure’. Following up the funded projects will allow successes and failures to be evaluated with respect to the use (or non-use) of theory-driven approaches.

scholarly journals Residency Programs' Evaluations of the Competencies: Data Provided to the ACGME About Types of Assessments Used by Programs

2010 ◽  
Vol 2 (4) ◽  
pp. 649-655 ◽  
Author(s):  
Kathleen D. Holt ◽  
Rebecca S. Miller ◽  
Thomas J. Nasca
Keyword(s):  
Medical Education ◽  
Interpersonal Communication ◽  
Graduate Medical Education ◽  
Medical Knowledge ◽  
Residency Programs ◽  
The Public ◽  
Graduate Medical ◽  
Resident Assessment ◽  
Using Data ◽  
Almost All

Abstract Background In 1999, the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project began to focus on resident performance in the 6 competencies of patient care, medical knowledge, professionalism, practice-based learning and improvement, interpersonal communication skills, and professionalism. Beginning in 2007, the ACGME began collecting information on how programs assess these competencies. This report provides information on the nature and extent of those assessments. Methods Using data collected by the ACGME for site visits, we use descriptive statistics and percentages to describe the number and type of methods and assessors accredited programs (n  =  4417) report using to assess the competencies. Observed differences among specialties, methodologies, and assessors are tested with analysis of variance procedures. Results Almost all (>97%) of programs report assessing all of the competencies and using multiple methods and multiple assessors. Similar assessment methods and evaluator types were consistently used across the 6 competencies. However, there were some differences in the use of patient and family as assessors: Primary care and ambulatory specialties used these to a greater extent than other specialties. Conclusion Residency programs are emphasizing the competencies in their evaluation of residents. Understanding the scope of evaluation methodologies that programs use in resident assessment is important for both the profession and the public, so that together we may monitor continuing improvement in US graduate medical education.

Inflation shocks and income inequality

2019 ◽  
Vol 10 (2) ◽  
pp. 226-240
Author(s):  
Rolando Gonzales ◽  
Andrea Rojas-Hosse
Keyword(s):  
Genetic Algorithm ◽  
Methodological Approach ◽  
Mena Region ◽  
Content Type ◽  
Core Inflation ◽  
Research Gap ◽  
Using Data ◽  
The Impact ◽  
The Relationship ◽  
Detrimental Impact

Purpose The purpose of this paper is to analyze the effects of inflationary shocks on inequality, using data of selected countries of the Middle East and North Africa (MENA). Design/methodology/approach Inflationary shocks were measured as deviations from core inflation, based on a genetic algorithm. Bayesian quantile regression was used to estimate the impact of inflationary shocks in different levels of inequality. Findings The results showed that inflationary shocks substantially affect countries with higher levels of inequality, thus suggesting that the detrimental impact of inflation is exacerbated by the high division of classes in a country. Originality/value The study contributes to the literature about the relationship between inflation and inequality by proposing that not only the sustained increase in prices but also the inflationary shocks – the deviations from core inflation – contribute to the generation of inequality. Also, to the best of the authors knowledge, the relationship between inflation shocks and inequality in the MENA region has never been analyzed before, thus creating a research gap to provide additional empirical evidence about the sources of inequality. Additionally, the authors contribute with a methodological approach to measure inflationary shocks, based on a semelparous genetic algorithm.

scholarly journals 2nd Mexican Consensus of Endovenous Chemical Ablation (Scleorotherapy) 2018

Phlebologie ◽  
2019 ◽  
Vol 48 (06) ◽  
pp. 377-387
Author(s):  
F. Vega Rasgado ◽  
J. Ángel López Paredes ◽  
J. A. Serralde Gallegos ◽  
D. Bolaños Celaya ◽  
C. Ramírez Cadena ◽  
...  
Keyword(s):  
Latin American ◽  
Personal Experience ◽  
Venous Insufficiency ◽  
Evidence Based ◽  
European Consensus ◽  
Sclerosing Agents ◽  
Venous Diseases ◽  
Chemical Ablation ◽  
Based Medicine ◽  
Methods Of Application

Abstract Background Sclerotherapy has been carried out since 1516 and is accepted and performed worldwide according to many references from books and journals. Mexican doctors participated in other consensuses in order to obtain various agreements, references, methods and procedures that are universally accepted to establish this document, including the European consensus of sclerotherapy 2003 and its last revision in 2006, the Clinical practice guidelines for prevention, diagnosis and treatment of chronic venous insufficiency in 2009 in México, the Argentine and Latin American consensus for sclerotherapy in 2012, European sclerotherapy guidelines in chronic venous diseases of 2013,and various literature sources as well. The first Mexican consensus on sclerotherapy published in January 2014 which was reviewed and updated in this document. Objective Review and update the general bases of Endovenous Chemical Ablation (ECA) also known as Sclerotherapy, according to evidence-based medicine updating the previously published consensus. Method General questions about Endovenous Chemical Ablation (ECA) were established concerning: indications, contraindications, types of sclerosing agents and the concentrations used, patient position, methods of application, way to prepare and preserve the sclerosants, necessary equipment, injection volumes, differents administration ways, compressive therapy and special comments. To answer these questions the existing literature and the topics in which the reports showed uniformity were consulted. A panel of experts was constituted who provided their personal experience, the answers were formulated in the form of clinical guidelines or general recommendations to provide concrete answers to the specific questions, in some issues we include possible accepted variations.

“Medical Cannabis” as a Contested Medicine: Fighting Over Epistemology and Morality

2019 ◽  
Vol 45 (3) ◽  
pp. 488-514 ◽  
Author(s):  
Dana Zarhin ◽  
Maya Negev ◽  
Simon Vulfsons ◽  
Sharon R. Sznitman
Keyword(s):  
Medical Profession ◽  
Empirical Studies ◽  
Therapeutic Effects ◽  
Policy Debate ◽  
Medical Cannabis ◽  
Science And Policy ◽  
Moral Economies ◽  
Strong Objectivity ◽  
Based Medicine ◽  
Epistemological Views

Few empirical studies have explored how different types of knowledge are associated with diverse objectivities and moral economies. Here, we examine these associations through an empirical investigation of the public policy debate in Israel around medical cannabis (MC), which may be termed a contested medicine because its therapeutic effects, while subjectively felt by users, are not generally recognized by the medical profession. Our findings indicate that beneath the MC debate lie deep-seated issues of epistemology, which are entwined with questions of ethics and morality. Whereas some stakeholder groups viewed evidence-based medicine and mechanical objectivity as the only valid knowledge base, others called for recognition of a particular experience-based knowledge, championing regulatory, administrative, or strong objectivity. Stakeholders’ interpretations of what should be considered as ethical courses of (in)action corresponded to their epistemological views, with most criticizing the regulators for relying on regulatory subjectivity instead of objectivity. Our in-depth mapping of this arena allowed us not only to shed light on the emergence of the new entity called “medical cannabis” but also to reexamine the link between epistemology, ethics, and action and to elucidate how heterogeneous groups view the validity and objectivity of knowledge and the interface between medicine, science, and policy.

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