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Introduction
Published in Mickey C. Smith, E.M. (Mick) Kolassa, Walter Steven Pray, Government, Big Pharma, and the People, 2020
Mickey C. Smith, E.M. (Mick) Kolassa, Walter Steven Pray
I will use a thread throughout this Book – sometimes explicitly, sometimes implied – incorporating the term “dynamic tension”. Older Readers may remember it, as I do, from their “comic book days”. Simply put, it refers to a body-building technique which “pits muscle against muscle” with the result of overall fitness. While “Dynamic Tension” is a registered trademark of Charles Atlas, Ltd. in the context of instructional booklets for isotonic exercises, this book will use the term strictly for editorial and descriptive purposes with regard to the efforts of all three parties highlighted in this history to use their respective “muscles” with the aim of a robust medication delivery system. One that is “fit”.
Recurrent and voluntary dislocation of the shoulder
Published in Benjamin Joseph, Selvadurai Nayagam, Randall Loder, Ian Torode, Paediatric Orthopaedics, 2016
The first issue to address is the dynamic stabiliser compression muscles (subscapularis, infraspinatus, teres minor, inferior rotator cuff, anterior deltoid). Next, attention is paid to the rehabilitation of dynamic tension,
When Clinicians Marginalize Decision-Makers
Published in The American Journal of Bioethics, 2022
Caruso Brown (2022) brings forward an argument that clinicians and ethicists have a duty to consider decision-makers marginalized by hierarchical structures. The author presents a pragmatic approach that helps balance concerns for marginalized decision-makers (MDM) with the encroachment of medical power into family and cultural dynamics. This is an important dynamic tension to take care to navigate. Hierarchies exist in cultures and religions but also in healthcare where they create and perpetuate marginalization through intrinsic power dynamics. In fact these hierarchical influences in healthcare often exist prior to perceived disagreements where the author of the target article starts their analysis (Caruso Brown 2022). These power dynamics affect how parents and guardians interact with clinicians in subtle but impactful ways. Assessing for marginalization must be a first step in any encounter. This commentary will describe this situation and how Caruso Brown’s approach can be helpful if started prior to disagreement.
Values and value in simulated participant methodology: A global perspective on contemporary practices
Published in Medical Teacher, 2018
D. Nestel, N. McNaughton, C. Smith, C. Schlegel, T. Tierney
Our understanding about where and how value is gained in live simulations is increasingly informed by theories that outline the nuanced and complex relationships between learners and SPs as well as between learners and their environments. Battista (2017) describes how activity theory informs scenario-based simulations suggesting that learner engagement is part of a dynamic multimodal system that incorporates other learners as well as equipment, tools and active participants such as SPs (Battista 2017). Learning through engagement in a live simulation is more complex than dominant approaches of deliberate practice and skills-focused approaches may have led us to appreciate about learning with SPs. Fenwick and Dahlgren (2015) in their article on socio-material approaches to simulation-based education, discuss the ways in which “…professional learning is embodied, relational and situated in social-material relations” (Fenwick and Dahlgren 2015). The authors suggest that learning emerges through the myriad intersecting webs of relationships. There is an inherent tension within simulations, between the dynamic and responsive nature of many of the interactions and the deliberate planning that is required to provide such opportunities. This dynamic tension is part of SP methodology that informs design decisions from the inception of any educational project. Yet SPs are traditionally not introduced into this process until many of the design and implementation decisions have been made.
Should Volume Requirements Dictate Access to Care with TAVR?
Published in Structural Heart, 2018
Steven L. Goldberg, Richard Gray, Aaron Horne
Modern treatment of structural heart disease has had a favorable disruptive impact.1,2 Less invasive treatments for major cardiac illnesses have become both feasible and established. These therapies have allowed for many more patients to be treated than ever before, and have eased the burden of recovery for many others. The rapidity of uptake of transcatheter aortic valve replacement (TAVR) has been breathtaking, with the first devices approved for use only 6 years ago—only 15 years since the very first procedure. We are now at a crossroads in this medical/technological explosion as we assess demands and resources for these newer treatment options. As current analyses are being initiated, a dynamic tension may be appreciated—that of ensuring maximal societal/systemic efficiency, while allowing expansion to an ever-increasing patient population.