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Results for “reflection”

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At least 685 records · Page 38Linked to original sources

PubMed2003

Developing professional clinical skills for practice - the results of a feasibility study using a reflective approach to intimate examination.

OBJECTIVES: To develop a student-selected component (SSC) for junior medical students, to evaluate the feasibility of incorporating the development of skills in carrying out an intimate examination, whilst developing professional thinking skills using a reflective approach. SUBJECTS: The student selected component was designed for a maximum of 6 students over a 4-week period in Phase 2 (year 2 and 3) of the undergraduate medical curriculum. SETTING: The Clinical Skills Centre, the Faculty of Medicine Nursing and Dentistry, University of Dundee, Scotland, UK. METHODS: The SSC consisted of a weekly patient clerking from the ward, an analysis of the clinical and communication skills for any intimate examinations the patient would require, and practice using simulators and simulated patients. Students were supported by timed periods of structured reflection, which enabled them to discuss ethical issues and their own professional conduct related to carrying out an intimate examination. The SSC was evaluated on 3 levels; student satisfaction, learning professional thinking using a reflective approach, and observing behaviour change in relation to skill development, using a ward simulation exercise. RESULTS: The evaluation at the levels of student satisfaction, learning professional thinking and changes in behaviour associated with intimate examination demonstrated that the SSC had been well received by the students, who felt they had improved their skills in intimate examinations in the context of a ward simulation exercise, in parallel with their professional thinking skills. CONCLUSION: It is possible to develop the professional thinking of junior medical students at the same time as developing their technical competence in relation to intimate examinations. It may be advantageous to introduce students early to this reflective approach, using simulation to promote the integration of theory with practice.

Clinical Competence↗

PubMed2003

Subjectivity and vulnerability: reflections on the foundation of ethical sensibility.

This paper investigates the possibility of understanding the rudimentary elements of clinical sensitivity by investigating the works of Edmund Husserl and Emmanuel Levinas on sensibility. Husserl's theory of intentionality offers significant reflections on the role of pre-reflective and affective intuition as a condition for intentionality and reflective consciousness. These early works of Husserl, in particular his works on the constitution of phenomenological time and subjective time-consciousness, prove to be an important basis for Levinas' works on an ethics of alterity and infinite responsibility for the other person. In fact, it is difficult to understand the core of Levinasian ethics, of vulnerability as proximity, of ethical sensitivity as passivity and a suffering for the suffering of another, without understanding the influence from Husserl's work. Crucially, the paper will, on the basis of Levinasian ethics, establish an understanding of sensibility as vulnerability and receptivity that is fundamental also for understanding significant intuitions in clinical nursing. Clinical sensitivity and carefulness in nursing are shaped by the concrete and also bodily expressions of vulnerabilities in a receptivity that is pre-reflective and pre-ontological.

Ethics, Nursing↗

PubMed2001

Attenuated total reflection-Fourier transform infrared spectroscopy as a possible method to investigate biophysical parameters of stratum corneum in vivo.

We investigated the use of attenuated total reflection-Fourier transform infrared spectroscopy as a method to study differences in the molecular components of human stratum corneum in vivo. These variations as a function of the anatomic site and of the depth into its layered structure are important to understand the biology and physiology of the tissue. In this preliminary study we have investigated spectroscopic changes in 18 healthy individuals. Total reflection-Fourier transform infrared spectroscopy represents a potentially powerful tool to study biophysical properties of surfaces. We observed that, in vivo, biophysical parameters of the stratum corneum (such as hydration, lipid composition, and conformation of the aliphatic chains) are indeed dependent on the anatomic site. As in total reflection-Fourier transform infrared spectroscopy experiments the penetration depth of the evanescent field into the stratum corneum is comparable with the thickness of a layer of corneocytes, this technique can be used to follow the distribution of lipids, water, and proteins as a function of depth into the tissue. We found that, in vivo, these molecular components are non-uniformly distributed, in agreement with the presence of water and lipid reservoirs as observed with ex vivo ultrastructural investigations. Composition and conformational order of lipids are also a function of depth into the stratum corneum. Finally we compared the in vivo superficial hydration measured using the infrared absorption of the OH stretch of water, with the hydration measured using the Skicon hygrometer. Our results indicate that total reflection-Fourier transform infrared spectroscopy might be useful to measure important chemical and biophysical parameters of stratum corneum in vivo.

Adult↗

PubMed2002

Clinical evaluation of reflectance spectrophotometry for the measurement of gastric microvascular oxygen saturation in patients undergoing cardiopulmonary bypass.

OBJECTIVE: To evaluate the impact of cardiopulmonary bypass (CPB) on gastric mucosal oxygen saturation assessed by reflectance spectrophotometry in patients undergoing coronary artery bypass graft surgery. DESIGN: Prospective, observational study. SETTING: A division of cardiothoracic anesthesia in a university hospital. PARTICIPANTS: Twelve consecutive patients undergoing CPB. INTERVENTIONS: Monitoring, anesthesia, surgical procedure, and CPB for the patients followed routine clinical protocol as established in the departments. Microvascular oxygen saturation in gastric mucosa was assessed by reflectance spectrophotometry before, during, and after CPB. MEASUREMENTS AND MAIN RESULTS: Gastric mucosal oxygen saturation averaged 65 +/- 7% (mean +/- SD) before CPB, decreased significantly to 57 +/- 9% during CPB (p < 0.01), and was 59 +/- 8% after CPB. These changes in regional oxygen saturation were not mirrored in variables of systemic oxygenation. Gastric mucosal oxygen saturation always showed instantaneous reactions to various surgical and pharmacologic interventions. CONCLUSION: Reflectance spectrophotometry allowed the authors to assess gastric mucosal oxygen saturation with a high repetition rate, regardless of spontaneous circulation with pulsatile flow or nonpulsatile flow during CPB. This technique provided the means to monitor on-line the course of tissue oxygen saturation throughout the operative procedure. Reflectance spectrophotometry is an appropriate and sensitive assessment tool to monitor gastric mucosal oxygen saturation in patients undergoing CPB.

Aged↗

PubMed2001

Respiratory symptoms relate to physiological changes and inflammatory markers reflecting central but not peripheral airways. A study in 60-year-old 'healthy' smokers and never-smokers.

The aim of this study was to evaluate the relationship between respiratory symptoms, lung function and inflammatory markers in 'healthy' smokers. The study population was recruited from an epidemiological study with subjects of the same age, 60 years. Only smokers who considered themselves healthy (n=58) and a random sample of never-smokers (n=34) were investigated. All subjects underwent lung function tests--spirometry, carbon monoxide transfer (DLco) and the single-breath N2 method (N2 test)--together with high-resolution computed tomography (HRCT). A flexible bronchoscopy with a bronchoalveolar lavage (BAL) was performed in 30 smokers and 18 never-smokers. Bronchial biopsies were also taken. Smokers who reported non-specific respiratory problems, chronic bronchitis and wheezing in a symptom questionnaire had a lower forced expiratory volume in 1 sec (FEV1), FEV% and specific airway conductance (sGaw), lung function tests supposed to reflect the more central airways, than smokers without respiratory symptoms. A limited number of smokers with occasional non-specific respiratory problems also had more cytotoxic T cells (CD8) in bronchial biopsies. No differences were found in DLCO and the N2 test, lung function tests supposed to reflect the more peripheral airways including the alveoli, HRCT-diagnosed emphysema or inflammatory markers in blood and BAL between smokers with and without respiratory symptoms. It is concluded that even when smokers consider themselves 'healthy' they have mild symptoms that are related more to physiological changes and inflammatory markers that may reflect events in the central airways than to changes that may reflect events in the peripheral airways.

Biopsy↗

PubMed2006

Simultaneous in situ monitoring of surface and gas species and surface properties by modulation excitation polarization-modulation infrared reflection-absorption spectroscopy: CO oxidation over Pt film.

A method for in situ monitoring of surface and gas species utilizing separately the difference and sum reflectivity of two polarizations, normal and parallel to the surface, measured by polarization-modulation infrared reflection-absorption spectroscopy is presented. Surface and gas-phase spectra were separately but simultaneously obtained from the reflectivities. The technique is combined with modulation excitation spectroscopy to further enhance the sensitivity, and a small-volume cell was designed for this purpose. CO oxidation over a 40 nm Pt film on aluminum was investigated under moderate pressure (atmospheric pressure, 5% CO, and 5%-40% O2) at 373-433 K. The surface species involved in the oxidation process and the gas-phase species, both reactant (CO) and product (CO2), could be simultaneously monitored and analyzed quantitatively. In addition, the reflectivity change of the sample during the reaction was assigned to a near-surface bulk property change, that is, surface reconstruction to the oxide phase. Under an O2-rich atmosphere, two reactive phases, denoted as low- and high-activity phases, were identified. A large amount of atop CO was observed during the low-activity phase, while the adsorbed CO completely disappeared during the high-activity phase. The presence of an infrared-inactive CO2 precursor formed by the reaction between surface oxide and gaseous CO during the high-activity phase was inferred. The desorption of the CO2 precursor is facilitated under a CO-rich atmosphere, most likely, by surface reconstruction to metallic Pt and a competitive adsorption of CO on the surface.

Absorption↗

PubMed2004

Ultraviolet plumage reflectance distinguishes sibling bird species.

Realistic studies of plumage color need to consider that many birds can see near-UV light, which normal humans cannot perceive. Although previous investigations have revealed that UV-based plumage reflectance is an important component of various intraspecific social signals, the contribution of UV signals to inter-specific divergence and speciation in birds remains largely unexplored. I describe an avian example of an interspecific phenomenon in which related sympatric species that appear similar to humans (sibling species) differ dramatically in the UV. Both UV video images and physical reflectance spectra indicate that the dorsal plumage of the tanager Anisognathus notabilis has a strong UV-limited reflectance band that readily distinguishes this species from its sibling congener Anisognathus flavinuchus. The main human-visible distinction between A. notabilis (olive back) and coexisting A. flavinuchus (black back) also occurs among different geographic populations of A. flavinuchus. Notably, however, olive- and black-backed taxa interbreed (differentiated populations of A. flavinuchus) unless the additional UV distinction is present (A. notabilis vs. A. flavinuchus). Thus, UV-based reflectance can be an essential component of plumage divergence that relates to reproductive isolation, a key attribute of biological species.

Animal Communication↗

PubMedDate not supplied

Towards the reflective sports coach: issues of context, education and application.

The current demands faced by elite sports coaches and the nature of their educational experiences are outlined. Examination of current approaches to coach education are considered in relation to research evidence which describes the key skills required in elite sports coaching. Recently, reflective practice has emerged as a key skill with which to enhance coach learning and increase the value of coaches' educational experiences. In tracing this emergence, this study analyses the use of reflective practice and learning strategies within six governing body award coaching programmes. Results indicate that none of the programmes examined contained structures or processes for directly teaching or overtly nurturing reflective skills. However, almost all programmes offered a potential structure for this through completion of a coaching log or undertaking a period of mentoring. Finally, recommendations are made to coach educators for developing reflection within coach education programme structures.

Curriculum↗

PubMed1976

Reflection-impulsivity and behavioral problems in emotionally disturbed boys.

In order to investigate the difference in the behavioral problems presented by cognitively impulsive and reflective emotionally disturbed boys, the parents of 17 impulsive and 13 reflective boys in residential treatment were asked to rate their sons' behavior. Results indicated that in contrast to reflective emotionally disturbed boys, impulsives were more likely to talk of others blaming them unfairly, threaten to harm themselves, hit and bully other children, and be excessively rough in play. On the other hand, reflectives were more unwilling to talk with adults outside the family. Results were discussed in terms of supporting both previous research and Kagan and Kogan's (6) "fear of failure" hypothesis.

Achievement↗

PubMed2001

Is self-reflectiveness an unhealthy aspect of private self-consciousness?

A number of researchers (M. Conway & C. Giannopoulos, 1993; P. J. Watson & M. D. Biderman, 1993) have suggested that self-reflectiveness is an unhealthy aspect of private self-consciousness related to psychopathology. However, these studies did not control for the significant correlation that exists between self-reflectiveness and subscale factors of public self-consciousness: style consciousness and appearance consciousness. The purpose of this research was to address these interrelationships by comparing correlational results with those obtained from multiple regression analyses. Participants (N = 111) completed the Self-Consciousness Scale (A. Fenigstein, M. F. Scheier, & A. H. Buss, 1975) and the NEO-Five Factor Inventory (P. T. Costa & R. R. McCrae, 1992). The results suggested that when the effects of style consciousness and appearance consciousness are controlled, the relationship between self-reflectiveness and neuroticism is nonsignificant. Furthermore, multiple regression analyses suggested a significant relationship between self-reflectiveness and low levels of agreeableness. Aspects of self-consciousness may be better understood in the context of overlapping domains that consider both common and unique variance.

Adult↗

PubMedDate not supplied

Skin and hair reflectance in women with red hair.

Skin and hair reflectance were measured with the Photovolt Spectrophotometer in 33 young women with red hair. Four skin sites were measured: forehead, check, inner arm and shoulder. A subsample of 15 red-headed women were tested before and at the end of the summer to test for tanning effects. The study was designed to test for relationships between hair and skin colour by reflectance spectrophotometry. As expected, subjects generally had very pale skin colour, pronounced freckling and very little tanning ability. Eumelanin (brown-black) pigment, as estimated by reflectance at 650 nm, was minimal at all skin and hair sites. Hair and inner arm reflectance values were highly correlated at short wavelengths, suggesting phaeomelanin as the source of the relationship. Estimates of tanning ability by use of the R/G ratio were very low in this sample of redheads.

Adult↗

PubMed2006

Acute effect of black and green tea on aortic stiffness and wave reflections.

OBJECTIVE: While most studies have shown an inverse relation between tea consumption and cardiovascular risk, other studies have shown opposite results. Aortic stiffness and wave reflections are markers of cardiovascular disease and prognosticators of cardiovascular risk. METHODS: The acute effect of black and green tea on aortic stiffness and wave reflections was assessed in 29 healthy volunteers in a randomized, single-blind, sham-procedure controlled, cross-over design. In the black tea sub-study, 16 subjects received 6 gm of tea, caffeine (175 mg), or hot water in 3 different sessions. In the green tea sub-study, 13 subjects received 6 gm of tea, caffeine (125 mg), or hot water. Carotid-femoral pulse wave velocity and wave reflection indices were measured at baseline and for 3 hours after consumption. RESULTS: Black tea increased pulse wave velocity during the first 90 min (increase by 0.49 m/sec, P < 0.05), showing a rapid return towards baseline values thereafter (P = 0.07 for the whole study period); in contrast, green tea had no effect. Both black and green tea increased augmentation index (by 5.0% and by 6.6%, P < 0.01 and P < 0.001, respectively) throughout the study. These changes were less than the respective changes produced by caffeine. Both black and green tea had a significant pressor effect. No change in oxidant status was found with both types of tea. CONCLUSIONS: Both black and green tea increases acutely wave reflections and only black tea increases aortic stiffness. Tea flavonoids may play a role in the attenuation of the effects of caffeine contained in tea.

Adult↗

PubMedDate not supplied

Scanning and reflecting: major components of nursing leadership.

The effectiveness of nurse leaders rests partly on their abilities to scan for cues about themselves, other people, and situations; to reflectively determine the significance of these cues for leadership; and to shape their leadership in response to relevant cues. In this paper I describe the scanning and reflecting activities of six Canadian nurse managers. Scanning and reflecting are two of the major themes elucidated during a 3-year phenomenological study of their leadership. I also suggest how their scanning and reflecting might benefit care delivery, the nursing profession, and health care organizations.

Adult↗

PubMed2005

Large artery stiffness and pulse wave reflection: results of a population-based study.

OBJECTIVE: To assess the determination of large artery stiffness and pulse wave reflection in a population sample. METHODS: A 1% random population sample aged 25-65 years was selected in nine districts of the Czech Republic for a survey off cardiovascular risk factors (Czech post-MONICA). Of 891 individual screened in the Pilsen centre in the year 2000, arterial properties were studied in 291 (143 males and 148 females) using the Sphygmocor device. Pulse wave velocity (PWV) in the aorta and in the lowe limbs was measured to assess large artery stiffness. Wave reflection was assessed from radial pulse wave analysis; the main estimated parameter was peripheral augmentation index (PAI) defined as P2/P1 = ratio of pulse pressures measures at the peaks of secondary and primary waves. RESULTS: Aortic PWV increased with age (p < 0.001) and was similar in both sexes. Lower extremity PWV increased with age in women, but not in mean, and its mean value was higher in men (p < 0.001). PAI was higher in females in all age groups (p < 0.001) and increased steeply with age in both sexes (p < 0.001). PAI was increased in current smokers (p < 0.001 in both sexes) and in male smokers, the reflected wave returned earlier than in male non-smokers (p < 0.05). Correlation coefficient of PAI with aortic PWV was 0.22 (p < 0.01), and with central augmentation index (CAI), derived from PAI by mathematical transformation, was 0.94 (p < 0.001). Multiple regression analyses, where age, sex, systolic blood pressure (SBP), total cholesterol level, smoking, glucose level and body mass index were included as independent variables, were performed. PAI was better predicted than aortic or lower extremity PWV is these models (41%, 14% and 10% of variance explained, respectively). Age, female sex, smoking, SBP and total cholesterol predicted PAI level whereas age, SBP and glucose level were the main determinants pf aortic PWV. CONCLUSION: Of the studied arterial parameters, PAI showed the closest association with cardiovascular risk factors. The correlation between PAI and aortic PWV was loose, and both parameters had practically different determinants. PAI, which is obtained by direct measurement above radial artery, was practically identical with the mathematically derived CAI in the studied population sample, and therefore, it is a suitable parameter for studying the phenomenon of wave reflection.

Adult↗

PubMed2001

One year's experience with a program to facilitate personal and professional development in medical students using reflection groups.

PURPOSE: (1) to integrate sociobehavioral science concepts into the early curriculum through a continuity ambulatory clinical experience in primary care, and (2) to expose students to a learning environment in which self-awareness and emotional development are nurtured in the context of dealing with the stresses of an early clinical experience. METHODS: Second-year students spent half a day twice monthly in a primary care community practice, kept a journal of their experiences, and attended biweekly 60-minute Reflection Groups designed to foster personal awareness and empathic witnessing. Analysis of journal entries and Reflection Group field notes identified stressors occurring during the students' clinical encounters. RESULTS: Three sources of stress are illustrated: the role and responsibility of the physician, death and dying, and racial issues. Reflection Groups provided students with opportunities to identify and describe stressors, to feel less isolated, to begin the process of self-awareness development, and to integrate behavioral and social science concepts into clinical practice. Our program incorporates students' early clinical experience with facilitated opportunities to reflect on the emotional challenges of becoming a physician.

Journal Article↗

PubMed2005

Parental reflective functioning: an introduction.

Reflective functioning refers to the essential human capacity to understand behavior in light of underlying mental states and intentions. The construct, introduced by Fonagy, Steele, Steele, Moran, and Higgitt in 1991, and elaborated by Fonagy and his colleagues over the course of the next decade, has had an enormous impact on developmental theory and clinical practice. This paper introduces the construct of parental reflective functioning, which refers to the parent's capacity to hold the child's mental states in mind, and begins with a review of Fonagy and his colleagues' essential ideas regarding the reflective function. Next, the applicability of this construct to parental representations of the child and the parent-child relationship is considered. A system for coding parental reflective functioning, which will serve as the organizing framework for this special issue, is described. Finally, the three papers that make up this special section are introduced.

Child↗

PubMed2005

Maternal reflective functioning, mother-infant affective communication, and infant attachment: exploring the link between mental states and observed caregiving behavior in the intergenerational transmission of attachment.

This study examines the link between mental representations and maternal behavior within the intergenerational transmission of attachment. Maternal reflective functioning was hypothesized to predict the quality of mother-infant affective communication based on the AMBIANCE measure. Each of these measures was also considered as a predictor of the quality of infant attachment. The subjects were 45 mothers and their 10-14-month-old infants. Results supported each of the study's major hypotheses. The AMBIANCE measure and the reflective functioning measure had a strong negative correlation. Thus, the level of disruption in mother-infant affective communication was inversely related to the level of maternal reflective functioning. The AMBIANCE measure was also shown to be a very good predictor of infant attachment. Mothers with high AMBIANCE scores were more likely to have infants classified as disorganized or resistant, whereas mothers with low AMBIANCE scores were more likely to have infants classified as secure. A linear regression analysis indicated that maternal behavior mediates the impact of maternal reflective functioning upon infant attachment. Implications for attachment theory and early intervention are explored.

Adult↗

PubMed2003

Prediction of tablet hardness and porosity using near-infrared diffuse reflectance spectroscopy as a nondestructive method.

The main objective of this research is to use the near-infrared diffuse reflectance method to evaluate and quantify the effects of hardness and porosity on the near-infrared spectras of tablets. To develop a model equation, validate the model and test the model predictive ability. Seven theophylline tablet formulations of the same composition but with seven different hardness values (3, 6, 8, 10, 12, 15, and 17 kp) were prepared. Another seven theophylline tablets formulation with seven different porosity values (57.4, 50.3, 41.9, 40.3, 39.9, 37.3, and 35.1%) were prepared. Five placebo tablets formulation with different hardness and porosity values were also prepared. Laboratory hardness and porosity values were compared to near-infrared diffuse reflectance data. Linear regression, quadratic, cubic and partial least square techniques were used to determine the relationship between hardness, porosity and the near-infrared spectras. The results demonstrated that an increase in tablet hardness and a decrease in tablets porosity produced an increase in near-infrared absorbance. Series of model equations depending on the mathematical technique used for regression were developed from the calibration of hardness and porosity data using laboratory equipment vs. the near-infrared diffuse reflectance for each formulations. The results of near-infrared hardness and porosity predictions were very similar to laboratory hardness and porosity tests. The near-infrared diffuse reflectance spectroscopy method is an alternative nondestructive method for measurement of hardness and porosity of tablets.

Cellulose↗