Educational strategies to enhance reflexivity among clinicians and health professional students: a scoping study

Reflexivity involves the ability to understand how one's social locations and experiences of advantage or disadvantage have shaped the way one understands the world. The capacity for reflexivity is crucial because it informs clinical decisions, which can lead to improvements in service delivery and patient outcomes. In this article, we present a scoping study that explored educational strategies designed to enhance reflexivity among clinicians and/or health profession students. We reviewed articles and grey literature that address the question: What is known about strategies for enhancing reflexivity among clinicians and students in health professional training programs? We searched multiple databases using keywords including: reflexivity, reflective, allied health professionals, pedagogy, learning, and education. The search strategy was iterative and involved three reviews. Each abstract was independently reviewed by two team members. Sixty-eight texts met the inclusion criteria. There was great diversity among the educational strategies and among health professions. Commonalities across strategies were identified related to reflective writing, experiential learning, classroom-based activities, continuing education, and online learning. We also summarize the 19 texts that evaluated educational strategies to enhance reflexivity. Further research and education is urgently needed for more equitable and socially-just health care

An Interferometric and Spectroscopic Analysis of the Multiple Star System HD 193322

The star HD 193322 is a remarkable multiple system of massive stars that lies at the heart of the cluster Collinder 419. Here we report on new spectroscopic observations and radial velocities of the narrow-lined component Ab1 that we use to determine its orbital motion around a close companion Ab2 ($P = 312$ d) and around a distant third star Aa ($P = 35$ y).We have also obtained long baseline interferometry of the target in the $K^\prime$-band with the CHARA Array that we use in two ways. First, we combine published speckle interferometric measurements with CHARA separated fringe packet measurements to improve the visual orbit for the wide Aa,Ab binary. Second, we use measurements of the fringe packet from Aa to calibrate the visibility of the fringes of the Ab1,Ab2 binary, and we analyze these fringe visibilities to determine the visual orbit of the close system. The two most massive stars, Aa and Ab1, have masses of approximately 21 and $23 M_\odot$, respectively, and their spectral line broadening indicates that they represent extremes of fast and slow projected rotational velocity, respectively

Description and process evaluation of pharmacists’ interventions in a pharmacist-led information technology-enabled multicentre cluster randomised controlled trial for reducing medication errors in general practice (PINCER trial)

Objective To undertake a process evaluation of pharmacists' recommendations arising in the context of a complex IT-enabled pharmacist-delivered randomised controlled trial (PINCER trial) to reduce the risk of hazardous medicines management in general practices. Methods PINCER pharmacists manually recorded patients’ demographics, details of interventions recommended, actions undertaken by practice staff and time taken to manage individual cases of hazardous medicines management. Data were coded and double entered into SPSS v15, and then summarised using percentages for categorical data (with 95% CI) and, as appropriate, means (SD) or medians (IQR) for continuous data. Key findings Pharmacists spent a median of 20 minutes (IQR 10, 30) reviewing medical records, recommending interventions and completing actions in each case of hazardous medicines management. Pharmacists judged 72% (95%CI 70, 74) (1463/2026) of cases of hazardous medicines management to be clinically relevant. Pharmacists recommended 2105 interventions in 74% (95%CI 73, 76) (1516/2038) of cases and 1685 actions were taken in 61% (95%CI 59, 63) (1246/2038) of cases; 66% (95%CI 64, 68) (1383/2105) of interventions recommended by pharmacists were completed and 5% (95%CI 4, 6) (104/2105) of recommendations were accepted by general practitioners (GPs), but not completed at the end of the pharmacists’ placement; the remaining recommendations were rejected or considered not relevant by GPs. Conclusions The outcome measures were used to target pharmacist activity in general practice towards patients at risk from hazardous medicines management. Recommendations from trained PINCER pharmacists were found to be broadly acceptable to GPs and led to ameliorative action in the majority of cases. It seems likely that the approach used by the PINCER pharmacists could be employed by other practice pharmacists following appropriate training

Groups of singular alternating sign matrices

We investigate multiplicative groups consisting entirely of singular alternating sign matrices (ASMs), and present several constructions of such groups. It is shown that every finite group is isomorphic to a group of singular ASMs, with a singular idempotent ASM as its identity element. The relationship between the size, the rank, and the possible multiplicative orders of singular ASMs is explored

Spectroscopy, MOST Photometry, and Interferometry of MWC 314: Is it an LBV or an interacting binary?

MWC 314 is a bright candidate luminous blue variable that resides in a fairly close binary system, with an orbital period of 60.753$\pm$0.003 d. We observed MWC 314 with a combination of optical spectroscopy, broad-band ground- and space-based photometry, as well as with long baseline, near-infrared interferometry. We have revised the single-lined spectroscopic orbit and explored the photometric variability. The orbital light curve displays two minima each orbit that can be partially explained in terms of the tidal distortion of the primary that occurs around the time of periastron. The emission lines in the system are often double-peaked and stationary in their kinematics, indicative of a circumbinary disc. We find that the stellar wind or circumbinary disc is partially resolved in the K\prime-band with the longest baselines of the CHARA Array. From this analysis, we provide a simple, qualitative model in an attempt to explain the observations. From the assumption of Roche Lobe overflow and tidal synchronisation at periastron, we estimate the component masses to be M1 $\approx 5$ M$_\odot$ and M2$\approx 15$ M$_\odot$, which indicates a mass of the LBV that is extremely low. In addition to the orbital modulation, we discovered two pulsational modes with the MOST satellite. These modes are easily supported by a low-mass hydrogen-poor star, but cannot be easily supported by a star with the parameters of an LBV. The combination of these results provides evidence that the primary star was likely never a normal LBV, but rather is the product of binary interactions. As such, this system presents opportunities for studying mass-transfer and binary evolution with many observational techniques.Comment: 26 pages, 7 figures, 5 tables, 2 appendices with 7 additional tables and 2 additional figures. Accepted for publication in MNRA

Economic Inclusion in Grand Rapids

This report presents an updated review of progress toward economic inclusion in the Grand Rapids, Mich.area. It summarizes the changes between data reported by Dr. Mark White of the Center for Regional Analysisat George Mason University and the Center for Regional Economic Competitiveness in Addressing Economic Inclusion in Grand Rapids (2016) and the most recently available data obtained from public sources — primarily comparing data from 2014 to 2018. Data are displayed in various geographic groupings and disaggregated by demographic characteristics for comparison. This report, sponsored by the W.K. Kellogg Foundation (WKKF), is intended to aid ongoing strategy development for promoting inclusive growth in the Grand Rapids area

The HIPASS Catalogue - II. Completeness, Reliability, and Parameter Accuracy

The HI Parkes All Sky Survey (HIPASS) is a blind extragalactic HI 21-cm emission line survey covering the whole southern sky from declination -90 to +25. The HIPASS catalogue (HICAT), containing 4315 HI-selected galaxies from the region south of declination +2, is presented in Meyer et al. (2004a, Paper I). This paper describes in detail the completeness and reliability of HICAT, which are calculated from the recovery rate of synthetic sources and follow-up observations, respectively. HICAT is found to be 99 per cent complete at a peak flux of 84 mJy and an integrated flux of 9.4 Jy km/s. The overall reliability is 95 per cent, but rises to 99 per cent for sources with peak fluxes >58 mJy or integrated flux > 8.2 Jy km/s. Expressions are derived for the uncertainties on the most important HICAT parameters: peak flux, integrated flux, velocity width, and recessional velocity. The errors on HICAT parameters are dominated by the noise in the HIPASS data, rather than by the parametrization procedure.Comment: Accepted for publication in MNRAS. 12 pages, 11 figures. Paper with higher resolution figures can be downloaded from http://hipass.aus-vo.or

Alternating Signed Bipartite Graphs and Difference-1 Colourings

We investigate a class of 2-edge coloured bipartite graphs known as alternating signed bipartite graphs (ASBGs) that encode the information in alternating sign matrices. The central question is when a given bipartite graph admits an ASBG-colouring; a 2-edge colouring such that the resulting graph is an ASBG. We introduce the concept of a difference-1 colouring, a relaxation of the concept of an ASBG-colouring, and present a set of necessary and sufficient conditions for when a graph admits a difference-1 colouring. The relationship between distinct difference-1 colourings of a particular graph is characterised, and some classes of graphs for which all difference-1 colourings are ASBG-colourings are identified. One key step is Theorem 3.4.6, which generalises Hall's Matching Theorem by describing a necessary and sufficient condition for the existence of a subgraph $H$ of a bipartite graph in which each vertex $v$ of $H$ has some prescribed degree $r(v)$

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy