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The wrist is a complex joint that bridges the hand to the forearm. Patients with wrist disorders increasingly prefer minimally invasive procedures for wrist joint diagnosis and treatment. Wrist arthroscopy offers direct visualization of the structures of the joint anatomy and existing disease processes while causing minimal damage to surrounding soft tissue. However, it requires a high level of technical ability for wrist arthroscopy practitioners. Therefore, an improved focus on wrist arthroscopy training combining new educational media and traditional practice should aid in the development of novel wrist arthroscopy training mode. This article aims to describe the status of wrist training and evaluation systems and introduce a new progressive wrist training system.

Hoarding disorder is a surprisingly common problem which impacts on most areas of life. People who hoard typically have multiple agencies involved in their care due to the complex health and safety impact and risks associated with hoarding. 'Treatment' involves finding ways of supporting discarding large amounts, typically underpinned by CBT principles. We evaluated the impact and outcomes of a conference designed to boost professionals' confidence and understanding in working with hoarding problems, both individually and with other agencies with a view to improving inter-agency service provision. Changes in professionals' confidence and understanding were evaluated immediately before and after the conference. Conference participants' qualitative responses related to service improvements were analysed using content analysis. People with personal experience of hoarding issues subsequently participated in a focus group where the results of the conference were presented. These data were analysed using thematic analysis. Confidence and understanding in working with hoarding problems substantially increased from pre- to post-conference. Professionals identified a range of possible improvements, most commonly working more closely and improving communication with other agencies. People with personal experience suggested improvements across three over-arching themes: developing an improved understanding of hoarding, the need for improved resources, and improved multi-agency working. A multi-agency conference increased confidence and understanding in professionals working with hoarding problems, and improvements specified by both people with personal experience and professionals provide a useful guide to service improvement. Results provide a framework in which CBT approaches should be embedded. Key learning aims: (1) To assess the effectiveness of a multi-agency hoarding conference at improving understanding and confidence in working with hoarding problems. (2) To explore professionals' perceptions of improvements to multi-agency service provision. (3) To explore perceptions of improvements that could be made to multi-agency service provision from people with personal experience of hoarding problems. [ABSTRACT FROM AUTHOR]

Web usage is now growing day by day in every industrial sector. Public Relation Industry setup is one of the renowned industries in Pakistan. The findings of this mixed method research study shows that total statistic total28,senior and Mid senior level Practitioner were selected for qualitative and Quantitate research out of which N=10 shows anxiety towards Web usage N=5, shows Interest to Web usage and N=4 think they lack training in Web usage so fear uneasiness present in web usage and N=9 shows interest in web usage training and qualitative research findings shows that PR Practitioner show uneasiness to web usage because these maximum number of Practitioner have no idea how to use Web for PR campaign and make communication better in each level there is dire need to examine the skills that required to work in contemporary era of Pakistan on both senior and mid senior level. Practitioners agreed that we need practice how to work on Web and how we improve our working standard but there is anxiety and uneasiness also present on senior level practitioner how to use Web in PR campaigns and very few PR Practitioners agreed that we think that changes in traditional to new media usage is risky so we don't even think about changes in terms of web usage so we need to work on that area because experienced PR specialist have no skills how to practice Web base life for PR set up so PR professionals battle with the expert utilization of Web.Mostly Senior and mid senior level of Practitioner agreed that we need training for better results and meet the requirements of new clients properly. The results of this mixed method study shows that senior PR Practitioner show anxiety and uneasy in terms of change in communication patterns findings of this study is significant to understand suggestion of Web usage and need of PR practices and show where we actually stand in terms of old and new perception. [ABSTRACT FROM AUTHOR]

Pelvic organ prolapse is a significant quality of life issue for many women. Prolapse can be managed effectively with a mechanical device called a pessary therefore many women choose this as a conservative treatment option. Despite the extent to which pessaries are used in the UK, there are no clear guidelines regarding the training required for pessary practitioners. This article reviews literature related to pessary practitioner training. Methods: 13 publications were reviewed. Results: eight themes were identified, namely 'prevalence of pessary training', 'type of pessary training', confidence in pessary care provision', 'impact on pessary care', 'skills and knowledge required to be a pessary practitioner', 'barriers', 'speciality of pessary care providers', and 'ongoing support'. Conclusion: at present practitioners report a lack of pessary training, which impacts on care. Effective training includes didactic learning of agreed knowledge requirements, practice of clinical skills and ongoing support. [ABSTRACT FROM AUTHOR]

Background: During clinical training, osteopathy students are required to develop skills and attitudes that challenge their capabilities and viewpoints. The aim of this project was to inform pedagogical processes that could reduce the stress associated with beginning clinical practice. Methods: Data were collected from two sources: (1) semi-structured interviews and (2) audiovisual material prepared by students for other purposes but which also shed light on their experiences of clinical placement. With participants' consent, data were thematically analysed using constant comparison. Results: Osteopathic students entering clinical practice experienced high levels of performance anxiety that caused physical and psychological stress. Despite achieving objectively-measured competencies in clinical assessments, students perceived they were not ready to perform as practitioners (e.g., appear confident, overcome nervousness and manage the consultation time). Conclusions: To reduce performance anxiety associated with the transition to beginning practitioner, professional education needs to expand to include timely opportunities to learn practice performance skills. [ABSTRACT FROM AUTHOR]

One of the main topics in the field of reflection is the multitude of questions concerning practice and how skillfulness is developed within a professional field, and this has been the case for decades. As early as in Schön’s seminal work, The Reflective Practitioner: How professionals think in action, published in 1983, these questions were in focus more or less throughout the whole text. While Schön, however, besides dealing with reflection, also addresses the tools that a novice student uses to become familiar with a practice, he does not explicitly address the question of body skillfulness to any large extent. This is, however, the focus in this article. I establish Merleau-Ponty’s theoretical framework, and, via Dreyfus’s famous five-stage model, discuss professional competence and bodily learned skillfulness. Even if Merleau-Ponty’s perspectives have been well known for decades now, they have yet to be incorporated more fully into the development of reflective practices, as well as into theories that try to describe reflective practice. [ABSTRACT FROM PUBLISHER]

This study provides a narrative analysis of the challenges and opportunities faced by scholars in the field of geoscience education (GED). A set of interviews was conducted with five GED professionals in 2010. Participants discussed challenges and opportunities in GED both for individual practitioners and as a discipline. Select participants were interviewed again 2 years later to reflect on their earlier statements and describe subsequent developments in their thoughts, perceptions, and lived experiences. Participants also discussed, and revisited 2 years later, the GED research topics they considered to be of widespread interest and those they did not. Their notable results were unsurprising: Practitioners in 2010 battled for acceptance and legitimacy and continue to do so. Professional isolation remains a major perceived issue, as do career prospects and accessibility of GED publications. Practitioners face an ongoing struggle with a lack of formalized training in educational research methods. However, GED is perceived as a young, vibrant field in which practitioners enjoy healthy intraprofessional relationships and opportunities for collaboration. Participants agreed that abundant space exists in which to generate ideas and to collect and generate data. They also suggested that acceptance, perceived legitimacy, and professional respect are all increasing, albeit slowly. Challenges and opportunities were assembled into metaphorical models to illustrate the experiences and ontologies reported by the participants. Three recommendations are made for institutions and for aspiring and practicing GED workers: (1) repurposing of GED literature types, (2) addressing the disconnect between teaching reform and the tenure process through targeted marketing, and (3) formalizing and codifying training processes for GED professionals. [ABSTRACT FROM AUTHOR]

Background: The demand for complementary and alternative medicine (CAM) treatment in the European Union (EU) has led to an increase in the various CAM interventions available to the public. Our aim was to describe the CAM services available from both registered medical practitioners and registered non-medical practitioners. Methods: Our literature search comprised a PubMed search of any scientific publications, secondary references and so-called grey literature, a search of government websites and websites of CAM organisations to collect data in a systematic manner, and personal communications, e.g., via e-mail contact. Due to the different reliability of data sources, a classification was developed and implemented. This weighted database was condensed into tables and maps to display the provision of CAM disciplines by country, showing the distribution of CAM providers across countries. Results: Approximately 305,000 registered CAM providers can be identified in the EU (∼160,000 non-medical and ∼145,000 medical practitioners). Acupuncture (n = 96,380) is the most available therapeutic method for both medical (80,000) and non-medical (16,380) practitioners, followed by homeopathy (45,000 medical and 5,800 non-medical practitioners). Herbal medicine (29,000 practitioners) and reflexology (24,600 practitioners) are mainly provided by non-medical practitioners. Naturopathy (22,300) is dominated by 15,000 (mostly German) doctors. Anthroposophic medicine (4,500) and neural therapy (1,500) are practised by doctors only. Conclusion: CAM provision in the EU is maintained by approximately 305,000 registered medical doctors and non-medical practitioners, with a huge variability in its national regulatory management, which makes any direct comparison across the EU almost impossible. Harmonisation of legal status, teaching and certification of expertise for therapists would be of enormous value and should be developed. [ABSTRACT FROM AUTHOR]

This article, the first of two, provides an account of an extended literature review that was undertaken in order to establish the evidence base for the learning and teaching of skills for child protection practice. It considers the contribution to the knowledge base from child abuse inquiries and from policies, guidelines and other documents from governmental departments and professional bodies. The subsequent analysis of terminology used for the review illustrates the complexity of searching for evidence that relates to concepts about which there are many differing perspectives, and also highlights the relevance to the study of activities undertaken by practitioners from a wide range of backgrounds. The paper describes the review method beginning with an initial search from which several hundred articles were located, only six of which generated evidence of value to the study. These six, however, highlighted a range of skills that provided the basis for a second, more focused search. Following an account of organization and analysis of material, the paper concludes with discussion of some of the challenges presented during the process of this review, the complexities of which are reflected in the paper's title. A second paper will present the findings. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper, the second in a series of two, presents and analyzes the results of an extended literature review undertaken for a Master's dissertation, the purpose of which was to establish the evidence base for the learning and teaching of skills for child protection practice. The review, discussed in the previous paper, was carried out in two stages. An initial search yielded a very small number of studies of direct relevance but they provided the trigger and the key words for a second search. Many potentially useful areas had to be omitted from the second stage because of limited resources, but the two stages in the search generated large amounts of material, much of which was indirectly relevant to child protection practice. The review did not achieve the original aim of determining skills that are identified through research and other evidence as being essential for child protection practice, but it was possible to draw some conclusions. For example, evidence was found of the importance of a range of communication skills, whether these be child focused, carer focused or inter-professional. Skills in managing conflict and challenge were found to be crucial, with the importance of role clarification being acknowledged. There was some evidence of the use of decision-making skills and problem-solving skills, but little research that explored procedural skills. This paper reports on gaps in the literature identified by the review, and indicates where further research would be beneficial. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]