“Open dialogue”

BACKGROUND: Residency programs have the intricate and complex role of training health care providers. But little is known about what residents and attendings consider norms of practice or the tensions among different values residents are expected to uphold. Thus, dialogical and reflective frameworks are being explored for resident learning. METHODS: This study examined the use of facilitated conversations with groups of residents and attending physicians while reviewing video-recorded resident-patient interactions...

The COVID-19 pandemic has dramatically shifted education and development priorities. The tragic death toll and high rates of morbidity across many countries are an unprecedented setback and a calamity for those affected physically and mentally. The economic and social effects of lockdowns, loss of production and business confidence, and global recession will cast a long shadow over education systems. Despite the 435 million items that Google already indexes under "COVID-19 education", many things remain unknown...

Rather than aiming to produce more 'rational' or more 'other-regarding' citizen judgements (the outcome of which is uncertain), deliberative democratic exercises should be re-designed to maximise democratic participation. To do this, they must involve citizens and experts, a novel arrangement that will benefit both cohorts. For the former, a more inclusive form of deliberation will offer an opportunity to contribute to political discussion and be listened to by people with political or policy-based authority...

INTRODUCTION: In order to foster dental and dental hygiene practices that are inclusive, sensitive to diversity, equitable, and without prejudice, a call to broadly teach cultural diversity within dental and dental hygiene education has been made. The research question of this study was "to what extent can an interactive and open dialogue about substance use, queer health, and social responsibility foster transformative learning?" METHODS: A collaborative and interdisciplinary project engaged the community as a teacher over the Summer and Fall of 2019 to address issues of substance use, queer health, and social responsibility and was delivered to 55 first-year undergraduate dental and 23 third-year dental hygiene students over three educational sessions...

In this contribution we seek to enrich the theoretical and methodological approaches of ethnobiology. The essay takes elements of Amerindian anthropology, classical ethnobiological studies and the freedoms provided by feminist philosophers to open up reflection. The central background of the essay is the method of "controlled equivocation" proposed by Viveiros de Castro (2004). We present a series of five ethnobiological equivocations ranging from the categorical equivocal, going through the subtle equivocal to the strictly ontological ones...

Background: The University College Dublin (UCD) Public and Patient Invovlement (PPI) ignite program is focused on embedding PPI in health and social care related research, education and training, professional practice and administration. During a PPI knowledge sharing event challenges were noted during the pre-commencement stage of research projects. This stage includes the time before a research projects/partnership starts or when funding is being applied for. As a response, we agreed there was a need to spend time developing a values-based approach to be used from the pre-commencement of PPI projects and partnerships...

Sometimes, life houses rare and unexpected events, such as moving abroad or meeting a special person unexpectedly. Recently, these situations have been indicated as "diversifying experiences" (DEs), defined as unusual and unexpected events that drag people outside their daily routine and accustomed schemas. The core mechanism of DEs would entail the disruption of our mental schema, which can facilitate unexpected connections among even distant ideas, thus enhancing people's cognitive flexibility, that is, a key component of creative thinking...

Introduction: Academic medicine has long faced the challenge of addressing health inequities, reflecting on how these contribute to structural racism, and perpetuating negative social determinants of health. Most recently, we have constructed opportunities for dialogues about racism, discrimination, and microaggressions (RDM). As such, we created a professional development program that encouraged participants to (1) openly discuss RDM and the impact they have in academia, (2) learn about tools to address and respond to RDM, and (3) move towards the creation of inclusive environments...

We assessed patient-provider communication in HIV care; data were from the 2019 Positive Perspectives Survey of people living with HIV (PLHIV) from 25 countries (n = 2389). A significantly greater proportion of recently diagnosed individuals were interested in being involved when it comes to decisions about their HIV treatment compared with any other group (72.8% [399/548], 63.1% [576/913], and 62.6% [581/928], diagnosis year: 2017-2019, 2010-2016, and pre-2010 respectively) but reported less understanding of their treatment compared with those reporting the longest duration (66...

From its inception, the NIH Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, an ambitious project focused on understanding the human brain, has made a concerted effort to integrate neuroethics into its science. In the past five years, the BRAIN Initiative has given rise to powerful tools and neurotechnologies capable of probing deeply into the brain circuits in animal models. As these tools mature and move to human applications they will raise a host of important neuroethical considerations not just for the medical community but for society as a whole...

Background: Despite mandates by the United States (U.S.) government to ensure the inclusion of women and minorities in federally funded research, communities of color continue to participate less frequently than non-Latinx Whites. There is limited research that examines maternal health outcomes and early childhood resources. Pacific Islanders (PI) have grown substantially in a county in the Pacific Northwest region of the U.S. (from 4,419 to 9,248, of which 52% are female). About 62.7% of PI women are not accessing prenatal care in the first trimester, and this is substantially higher than the national target of 22...

Ever since psychiatry emerged as a clinical discipline and field of scientific inquiry in the late 18th century, debates about diagnosis have been at its very heart. Considered by many a requirement for clinical communication as well as for systematic study, others have critiqued psychiatric diagnosis for being modeled on a medical conception of disease that is ill-suited to the specific nature of mental disorders. Based on a review of seminal positions in the conceptual history of psychiatry and an examination of their epistemological underpinnings, we propose to consider diagnosis as dialogue...

BACKGROUND: Female genital mutilation (FGM) is a deeply-rooted cultural practice mainly undertaken in Africa, the Middle East and Asian countries. Evidence to date suggests that although first-generation migrants to the West are abandoning FGM, the custom continues in some places, albeit in small numbers. This study examined how young people living in FGM affected communities in the United Kingdom (UK), interpreted and explained FGM. METHODS: A community-based participatory research (CBPR) approach was used to recruit and train nine young people aged 15-18 as co-researchers...

BACKGROUND: Although helping people living with HIV manage their antiretroviral therapy is a core competency of HIV nursing care, no educational intervention has sought to strengthen this competency. Thus, we codeveloped a simulation of a virtual patient (VP) having difficulty adhering to treatment to foster the relational skills that nurses require in such situations. OBJECTIVE: This viewpoint paper aims to describe the codevelopment process and the content of VP simulation, as well as the challenges encountered and the strategies used to overcome them...

BACKGROUND: Ethical conflict and subsequent nurse moral distress and burnout are common in the intensive care unit. There is a gap in our understanding of nurses' perceptions of how organizational resources support them in addressing ethical conflict in the intensive care unit. RESEARCH QUESTION/OBJECTIVES/METHODS: The aim of this qualitative, descriptive study was to explore how nurses experience ethical conflict and use organizational resources to support them as they address ethical conflict in their practice...

The legal standard for the determination of death by neurologic criteria in the United States is laid out in the Uniform Determination of Death Act (UDDA), which requires the irreversible cessation of all functions of the entire brain. Most other nations endorse a "whole-brain" standard as well. However, current practice in the determination of death by neurologic criteria is not consistent with this legal standard, because some patients who are diagnosed as brain-dead, in fact retain some brain function, or retain the capacity for the return of some brain function...

BACKGROUND: Clinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive service in order to inform and improve future implementation of CES. Yet, methods to measure outcomes of CES are scarce. In 2014, the European Moral Case Deliberation Outcomes Instrument (Euro-MCD) was developed to measure outcomes of Moral Case Deliberation (MCD). To further validate the instrument, we tested it in field studies and revised it...

PURPOSE: Developing a Dialogue/Virtual Agent (VA) that can handle complex tasks (need) of the user pertaining to multiple intents of a domain is challenging as it requires the agent to simultaneously deal with multiple subtasks. However, majority of these end-to-end dialogue systems incorporate only user semantics as inputs in the learning process and ignore other useful user behavior and information. Sentiment of the user at the time of conversation plays an important role in securing maximum user gratification...

Background: Opioid analgesic (OA) and anxiolytic, hypnotic and sedative (AHS) medicines use raise community concerns about risks of dependence: dose escalation, unintentional misuse. Objectives: We aimed to identify common consumer OA and AHS information gaps and concerns that led to information seeking from a hotline. Methods: We conducted a retrospective, mixed-method observational study of consumers' OA and AHS-related calls to an Australian national medicines call center (September 2002-30 June 2010). We analyzed these medicines' call characteristics compared to their respective rest of calls (ROC) and thematically explored narratives concerning withdrawal and misuse...

BACKGROUND: The aim of this study is to illustrate the historical role of the International Commission on Occupational Health (ICOH) congresses as an arena where national and international occupational medicine can dialogue and as the first example of scientific transferability of the research and prevention results that have had such an impact on global public health. METHODS: We used the ICOH Heritage Repository, in which ICOH congress proceedings (from the first congress in Milan in 1906 to the last congress, held in Dublin in 2018), are organised in an orderly way, updated and easily accessible according to open access logic...