Clinical reasoning & meaning-making (a long post)

Clinical reasoning is a cornerstone of evidence-based healthcare, in fact some would argue it’s the cornerstone of all healthcare. While there are many different processes, the ultimate purpose of clinical reasoning is to ensure the person seeking help has their needs identified then met, and the clinician has a basis upon which to decide which treatment they should offer. The approach we use in clinical reasoning, including the information we prioritise and search for, and the way we synthesise the information to make sense of it will depend on the model we have to explain our treatment approach. For example, if we’re occupational therapists, we’re looking for information about the occupations the person wants and needs to do (identifying the person’s needs), and we search for information to help explain how and why this person is unable to manage their occupations at this time. Because occupational therapy is concerned with context – social, interpersonal and environmental, as well as looking at pathophysiological processes, we will also review psychosocial-spiritual factors (beliefs, attitudes, desires, interactions, values, etc) and the physical and social environment/s as part of our clinical reasoning. Meaning making But… there’s something missing from this picture of how we go about doing clinical reasoning: the very process of enquiring about “daily doing” (aka occupation) is likely to influence the per...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Clinical reasoning Occupational therapy Pain conditions Physiotherapy Professional topics Psychology Research Science in practice embodiment intersubjectivity making sense persistent pain Source Type: blogs

Related Links:

Publication date: Available online 23 October 2019Source: Molecular and Cellular ProbesAuthor(s): Yi ChenAbstractCyclooxygenase-2 (COX-2) is an inducible enzyme that plays a key role in the inflammatory cascade through the generation of prostaglandins. Recent studies have found that COX-2 is closely related to the occurrence and development of tumors, angiogenesis and metastasis of tumors. Overexpressed COX-2 has become a predictive biomarker for progression of pre-malignant towards cancer in some tissues, which makes the detection of COX-2 of great value and clinical significance. This review highlights COX-2-specific flu...
Source: Molecular and Cellular Probes - Category: Molecular Biology Source Type: research
Publication date: Available online 22 October 2019Source: Life SciencesAuthor(s): Li Lei, Meng Li, Yiqun Pang, Jun Wang, Yunpeng Wan, Chen Zhu, Yin ZongshengAbstractAimsPrevious study indicated that the increase of local bio-availability of 3′3′5-triiodothyronine (T3) influenced osteoarthritis (OA) initiation. We aimed to investigate the role of thyroid hormone receptors (THRs) signaling in OA osteoblasts.Materials and methodsTHRs expression in OA was detected by immunohistochemistry, immunofluorescence, RT-qPCR and western blotting. These effects on the expression of angiogenesis-related factors were examined ...
Source: Life Sciences - Category: Biology Source Type: research
Publication date: Available online 22 October 2019Source: Life SciencesAuthor(s): Pollyana S. Siqueira-Lima, Jullyana S.S. Quintans, Luana Heimfarth, Fabiolla R.S. Passos, Erik W.M. Pereira, Marilia M. Rezende, José E.R. Menezes-Filho, Rosana S.S. Barreto, Henrique D.M. Coutinho, Adriano A.S. Araújo, Aline S. Medrado, Ligia A. Naves, Horácio F. Bomfim, Angélica M. Lucchese, Sathiyabama Rajiv Gandhi, Lucindo J. Quintans-JúniorAbstractNeuropathic pain (NP) is a difficult condition to treat because of the modest efficacy of available drugs. New treatments are required. In the study we aimed ...
Source: Life Sciences - Category: Biology Source Type: research
Publication date: Available online 22 October 2019Source: Carbohydrate PolymersAuthor(s): Madhusudhan Alle, Bhagavanth Reddy G, Tae Hoon Kim, Seok Ho Park, Seoung Hwan Lee, Jin-Chul KimAbstractAn ultrafast (e.g. 75 sec) synthesis of carboxymethyl xanthan gum (CMXG) capped gold nanoparticles (AuNPs) (CMXG@AuNPs) was developed using microwave irradiation (MWI) method. The synthesis of AuNPs was optimized by varying CMXG amount, gold ion concentration, and MWI time. The CMXG@AuNPs exhibited a spherical shape, high crystallinity, and narrow size distribution (i.e. 8-10 nm). The electrostatic interaction-mediated ...
Source: Carbohydrate Polymers - Category: Biomedical Science Source Type: research
Publication date: February 2020Source: Biomedical Signal Processing and Control, Volume 56Author(s): Gabriella Olmo, Francesca Farolfi, Federica Miola, Stefano Giorgi, Alessia Di Sapio, Antonio BertolottoAbstractFatigue is one of the most distressing symptoms of Multiple Sclerosis, impairing quality of life, work performance and social interactions. Moreover, it is difficult to objectively assess, and is often evaluated via subjective questionnaire; however, objective metrics are highly desirable.Objective of this paper is to implement a differential fatigue measure based on evoked potentials, and assess its reliability an...
Source: Biomedical Signal Processing and Control - Category: Biomedical Science Source Type: research
In this study, a series of deletion mutants or point mutants of horPDPN were produced for analyzing the PMab-219 epitope using flow cytometry. The analysis of deletion mutants showed that N-terminus of PMab-219 epitope exists between 55th amino acid (aa) and 60th aa of horPDPN. Furthermore, the analysis of point mutants demonstrated that the critical epitope of PMab-219, which was developed by CBIS method, could include Val59, Arg61, Ser62, and Thr63 of horPDPN, indicating that PMab-219 epitope is independent of PLAG domain or PLD of horPDPN. PMID: 31638470 [PubMed - as supplied by publisher]
Source: Monoclonal Antibodies in Immunodiagnosis and Immunotherapy - Category: Microbiology Tags: Monoclon Antib Immunodiagn Immunother Source Type: research
Publication date: Available online 22 October 2019Source: MitochondrionAuthor(s): Sonia A. Allen, Sandipan Datta, Jose Sandoval, Alexey Tomilov, Thomas Sears, Kevin Woolard, James M. Angelastro, Gino A. CortopassiAbstractAMP-activated protein kinase (AMPK) is a eukaryotic energy sensor and protector from mitochondrial/energetic stress that is also a therapeutic target for cancer and metabolic disease. Metformin is an AMPK inducer that has been used in cancer therapeutic trials. Through screening we isolated cetylpyridinium chloride (CPC), a drug known to dose-dependently inhibit mitochondrial complex 1, as a potent and dos...
Source: Mitochondrion - Category: Biochemistry Source Type: research
Publication date: Available online 23 October 2019Source: Microvascular ResearchAuthor(s): Chen Chen, Yan Li, Shiqiang Hou, Pierre M. Bourbon, Liuliang Qin, Kevin Zhao, Taiyang Ye, Dezheng Zhao, Huiyan ZengAbstractPathological angiogenesis is a hallmark of many diseases. Previously, we reported that orphan nuclear receptor TR3/Nur77 was a critical mediator of angiogenesis to regulate tumor growth, sepsis and skin wound healing. However, none of the TR3/Nur77 targeting molecule has been in clinical trial so far. Here, we designed and generated novel TR3 shRNAs and two minigenes that had therapeutic potential for cancer trea...
Source: Microvascular Research - Category: Biochemistry Source Type: research
Publication date: Available online 22 October 2019Source: Microchemical JournalAuthor(s): Hemerson Dantas dos Santos, Yasmin Almeida Alvarenga, Elisangela Fabiana BoffoAbstractCoffees from the Chapada Diamantina (State of Bahia, Brazil) are considered high quality, due to the use of high-quality production and processing criteria throughout the entire process. This work uses Nuclear Magnetic Resonance Spectroscopy to study the metabolic fingerprinting of these coffees, to contrast them to coffee from other regions. We analyzed 37 commercial samples, which are classified according to their quality (traditional, superior and...
Source: Microchemical Journal - Category: Chemistry Source Type: research
CONCLUSIONS In conclusion, our results showed that Carnosic acid has the potential to inhibit cancer cell growth in A-549 lung cancer cells by activating apoptotic death, inhibiting cell migration and invasion and suppressing PI3K/AKT/m-TOR signaling pathway. PMID: 31631173 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
More News: Accidents | Anesthesiology | Back Pain | Bowel Cancer | Brain | Brain Cancers | Cancer | Cancer & Oncology | Chronic Pain | Coffee | Computers | Disability | Education | Environmental Health | Epidemiology | Hawthorn | Health Management | HIV AIDS | Learning | Low Back Pain | Neurology | Occupational Health | Occupational Therapy | Osteoarthritis | Pain | Parkinson's Disease | Physiotherapy | Psychology | Rehabilitation | Rheumatology | Science | Study | Teaching | UK Health | Universities & Medical Training