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Bigger Picture (bigger + picture)
Selected AbstractsPeer Commmentaries on David H. Uttal's Seeing the big picture: map use and the development of spatial cognitionDEVELOPMENTAL SCIENCE, Issue 3 2000Article first published online: 28 JUN 200 Mark Blades, Young children's understanding of indirect sources of spatial information, p. 265 Roger M. Downs, The genesis of carto-gnosis, p. 267 Mary Gauvain, The instrumental role of maps in the development and organization of spatial knowledge, p. 269 Lynn S. Liben, Map use and the development of spatial cognition: seeing the bigger picture, p. 270 Kevin Miller, Mapping symbolic development, p. 274 Nora S. Newcombe, So, at last we can begin, p. 276 Herbert L. Pick Jr, Commentary on ,Seeing the big picture', p. 278 David R. Olson, Knowledge artifacts, p. 279 Barbara Tversky, What maps reveal about spatial thinking, p. 281 [source] Telling stories from everyday practice, an opportunity to see a bigger picture: a participatory action research project about developing discharge planningHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2009Pia Petersson RN Abstract In spite of laws, rules and routines, findings from Swedish as well as international research show that discharge planning is not a simple matter. There is considerable knowledge about discharge planning, but the quality of the actual process in practice remains poor. With this in mind, a research and developmental health and social care network decided to use participation action research to explore the discharge planning situation in order to generate new ideas for development. This paper reports on the research process and the findings about our enhanced understanding about the discharge planning situation. Story dialogue method was used. The method is based on stories from everyday practice. The stories are used as ,triggers' to ask probing questions in a dialogical and structured form. Local theory is developed to help the participants to find solutions for action in the practice. Our findings were that the discharge planning situation could be seen as a system including three interconnected areas: patient participation, practitioners' competence and organizational support. To reach good quality in discharge planning, all these three issues need to be developed, but not only as routines and forms. Rather, when developing a discharge planning situation, a system where relational aspects such as confidence and continuity are essential and thus needs to be considered. To achieve a change, the core problem needs to be clarified. When the issue is complex, the solution needs to consider the bigger picture and not just the parts. Telling stories from everyday practice, and to systematically reflect and analyse those in interprofessional groups can create opportunities for enhanced understanding, as well as be a vehicle for future change of practice. [source] Review article: fructose malabsorption and the bigger pictureALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2007P. R. GIBSON Summary Fructose is found widely in the diet as a free hexose, as the disaccharide, sucrose and in a polymerized form (fructans). Free fructose has limited absorption in the small intestine, with up to one half of the population unable to completely absorb a load of 25 g. Average daily intake of fructose varies from 11 to 54 g around the world. Fructans are not hydrolysed or absorbed in the small intestine. The physiological consequences of their malabsorption include increasing osmotic load, providing substrate for rapid bacterial fermentation, changing gastrointestinal motility, promoting mucosal biofilm and altering the profile of bacteria. These effects are additive with other short-chain poorly absorbed carbohydrates such as sorbitol. The clinical significance of these events depends upon the response of the bowel to such changes; they have a higher chance of inducing symptoms in patients with functional gut disorders than asymptomatic subjects. Restricting dietary intake of free fructose and/or fructans may have durable symptomatic benefits in a high proportion of patients with functional gut disorders, but high quality evidence is lacking. It is proposed that confusion over the clinical relevance of fructose malabsorption may be reduced by regarding it not as an abnormality but as a physiological process offering an opportunity to improve functional gastrointestinal symptoms by dietary change. [source] Reductionist inference-based medicine, i.e. EBMJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2006John De Simone Abstract Rationale, aims and objectives, Unbeknown to many, reductionist and postmodern worldviews competitively coexist in science and society. The debate on evidence-based medicine (EBM) is at the tip of this ,iceberg'. Via systems thinking and complexity science EBM reveals crucial flaws and its reductionism entails an inability to appreciate (even tolerate) contrasting ideas and/or ,see a bigger picture'. An interdisciplinary approach provides insight into novel explanations. Thereafter, the conceptual barrier shifts to communication, a challenge which mandates attempts to steer the discourse by reframing the debate. Method, Interdisciplinary perspectives serve to illustrate a ,bigger picture'. Also, ,wicked' questions stimulate reflection, discern leverage points and dismantle resilient defences. Lastly, a proposal: exploring the value of ,glasses half full'. Conclusion, Some may realize that postmodern concepts behind compelling criticisms to EBM have already taken root, being shared by policymakers, practitioners and patients as well. [source] | ||||||||||