Search

Error is a neglected epistemological category in the history of science. This neglect has been driven by the commonsense idea that its elimination is a general good, which often renders it invisible or at least not worth noticing. At the end of the sixteenth century across Europe, medicine increasingly focused on "popular errors," a genre where learned doctors addressed potential patients to disperse false belief about treatments. By the mid-seventeenth century, investigations into popular error informed the working methodology of natural philosophers, rather than just physicians. In 1646, Thomas Browne published Pseudodoxia Epidemica, a large volume on popular error. Despite Browne's formal training as a physician, this work examined only a few medical errors and instead aspired to be an encyclopedia of error. Pseudodoxia Epidemica was highly popular, running to six editions, and was known by the Fellows of the Royal Society. Influenced by Browne, alongside Bacon's theory of the idols, natural philosophic practice in the late sixteenth and seventeenth century developed a focus on error that revised traditional attention to the discovery of knowledge. Fellows such as Robert Boyle and Robert Hooke proposed new ways to secure truth under the far-reaching influence of Bacon's refutations of "natural human reason" distorted by false idols, of syllogistic logic, and of "theories," his label for traditional philosophical systems that bias thought toward falsity. In three parts, this article traces the progression in early modern scientific approaches to handling error, and especially medical error – from physicians' efforts to identify and eradicate it through collaborative effort, to the striking tension in Browne's work between seeking to eliminate error while also showing a marked tolerance for it, to the Royal Society's Baconian objective of instrumentalizing error to find truth. Error emerges as its own epistemic category that serves as a driving force toward knowledge production. [ABSTRACT FROM AUTHOR]

Analyses of the relevance of family for young people are more visible than previously within youth research. Nonetheless, understanding of the nature and meaning of family relationships for those who experience separation from their family, including homeless youth, is relatively weak. Based on selected findings from a qualitative longitudinal study, this article explores the meaning-making processes of homeless young people with explicit attention to the ways in which "family" is produced and (re)negotiated in their lives over time. Four themes are presented—family as reliable and supportive; family as interrupted and "broken"; family as fragile and elusive; and family as fluid and ambiguous—revealing the unfolding nature of young people's constructions of family and family relationships. The enduring impact of separation, dislocation, and conflict on how young people "make sense" of familial experiences is discussed, and we conclude with the practice implications arising from the findings. [ABSTRACT FROM AUTHOR]

The article offers information on a study related to the confidence of surgical trainees in the operating room during the Graduate Medical Education. Topics discussed include impact of supervision in training the unskilled residents on patient outcomes; need to measure an attending physician's confidence in the resident for gaining confidence in a resident; and role of higher self-confidence for the same.

In this study, youth residents of the Mathare community of Nairobi, Kenya documented individual and community strengths using photovoice, a method that is grounded in the principles of community-based participatory research. Research was conducted in collaboration with the Mwelu Foundation, a youth-based participatory photography organization in Mathare. Template analysis was used to code the data, and industriousness, positive identity, community resources, and resilience emerged as the identified individual and community strengths. The project highlighted the value of photovoice for promoting empowerment and highlighting the perspectives of largely invisible populations. Implications of photovoice for social work research and practice are discussed. [ABSTRACT FROM PUBLISHER]

Introduction: The Fundamental Critical Care Support Course (FCCS) is a standardized multidisciplinary program designed to educate participants on the basics of identification and management of patients with critical illness. Our objective was to evaluate the effect of FCCS participation on confidence in the assessment and management of critically ill patients and attitudes towards multidisciplinary education and interprofessional care in a multidisciplinary group of participants. Methods: Participants enrolled in the FCCS course from May 2018 to November 2019 were solicited to participate in a series of surveys evaluating their course experience and confidence in critical care. Attitudes towards multidisciplinary education and interprofessional care were evaluated using the Student Perceptions of Interprofessional Clinical Education-Revised Instrument version 2 (SPICE-R2) tool. A prospective pre- and post-design with a self-report survey including retrospective pre-training assessment and a 3-month follow-up was conducted. Statistical analysis was performed using descriptive statics and non-parametric methods. Results: 321 (97.9%) of the course participants enrolled in the study and completed the confidence survey and SPICE-R2 tool pre-course. Nurses (113, 35.4%) and physicians (110, 34.4%) made up the largest groups of participants, although physician assistants and paramedics were also well represented. Confidence in recognition and management of critical illness significantly improved across all studied domains after course completion, with the mean total confidence score improving from 32.96 pre-course to 41.10 post-course, P < 0.001. Attitudes towards multidisciplinary education and interprofessional care also improved (mean score 41.37 pre-course vs 42.71 post-course, P < 0.001), although pre-course numbers were higher than expected which limited the significance to only certain domains. Discussion: In a multidisciplinary group, completion of FCCS training led to increased confidence in all aspects of critical illness measured. A modest increase in attitudes regarding multidisciplinary education and interprofessional care was also demonstrated. Further study is needed to assess whether this increased confidence translates to improvements in patient care and outcomes. [ABSTRACT FROM AUTHOR]

Providing high-quality special education services in rural settings has a variety of challenges such as geographic isolation and a lack of resources. One particularly challenging aspect of rural special education is providing general curriculum access. Computer-assisted instruction is one way to provide high-quality specialized instruction that does not require the attention of another teacher nor a paraprofessional while still possessing the ability to implement research-based specially designed instruction with fidelity. This article provides teachers with task analyses and considerations for creating their own computer-assisted instruction using widely available computer software. [ABSTRACT FROM AUTHOR]

Objectives: During 2010-2018, the Arkansas Department of Health reported 21 genotype-matched cases of tuberculosis (TB) among residents of a rural county in Arkansas with a low incidence of TB and in nearby counties. The Arkansas Department of Health and the Centers for Disease Control and Prevention investigated to determine the extent of TB transmission and provide recommendations for TB control. Methods: We reviewed medical and public health records, interviewed patients, and reviewed patients' social media posts to describe patient characteristics, identify epidemiologic links, and establish likely chains of transmission. Results: We identified 21 cases; 11 reported during 2010-2013 and 10 during 2016-2018. All case patients were US-born non-Hispanic Black people. Eighteen case patients had the outbreak genotype, and 3 clinically diagnosed (non–culture-confirmed) case patients had epidemiologic links to patients with the outbreak genotype. Social media reviews revealed epidemiologic links among 10 case patients not previously disclosed during interviews. Eight case patients (38%) had ≥1 health care visit during their infectious period, and 7 patients had estimated infectious periods of >12 months. Conclusions: Delayed diagnoses and prolonged infectiousness led to TB transmission in this rural community. TB education and awareness is critical to reducing transmission, morbidity, and mortality, especially in areas where health care providers have limited TB experience. Use of social media can help elucidate people at risk, especially when traditional TB investigation techniques are insufficient. [ABSTRACT FROM AUTHOR]

Purpose: At Children's Hospital Colorado (CHCO), there are approximately 40 000 inpatient anti-infective orders every year resulting over 100 000 dispenses. Significant quantities of anti-infectives are wasted, incurring roughly $100 000 in waste annually. Identifying areas for improvement will result in cost savings and ameliorate the impact of drug shortages. Summary: This descriptive report discusses the reasons for anti-infective waste at a free-standing, quaternary-care, pediatric hospital. The anti-infectives with the highest cost in waste ($) included meropenem ($38 084), micafungin ($21 690), amphotericin B liposome ($15 913). An internal audit of CHCO anti-infective waste revealed that drugs are wasted for the following reasons: patient discharge, medication order discontinuation or change, and misplaced doses. Conclusion: The CHCO Antimicrobial Stewardship Program and the Pharmacy have proposed 4 process improvement measures that will target anti-infective waste to reduce pharmaceutical waste and hospital costs. These measures may be applicable to other drug classes that likely suffer from a similar proportion of waste. [ABSTRACT FROM AUTHOR]