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A single drop of cyclopentolate 1% suffices for cycloplegic refraction. There were less frequent side effects using one drop of cyclopentolate, compared to two or three drops.

BackgroundOvertreatment (or unnecessary treatment) is when medical or dental services are provided with a higher volume or cost than is appropriate. This study aimed to investigate how a group of dentists in Switzerland, a wealthy country known to have high standards of healthcare including dentistry, evaluated the meaning of unnecessary treatments from an ethical perspective and, assessed the expected frequency of different possible behaviors among their peers.MethodsA vignette describing a situation that is susceptible for overtreatment of a patient was presented to a group of dentists. The vignette was followed by five options. A questionnaire including the vignette was posted to 2482 dentists in the German-speaking areas of Switzerland. The respondents were asked to rate each option according to their estimation about its prevalence and their judgment about the degree to which the behavior is ethically sound.Results732 completed questionnaires were returned. According to the responses, the most ethical and the most unethical options are considered to be the most and the least prevalent behaviors among dentists practicing in Switzerland, respectively.ConclusionsSuggesting unnecessary treatments to patients seems to be an ethically unacceptable conduct in the eyes of a sample of dentists in Switzerland. Although the respondents believed their colleagues were very likely to behave in an ethical way in response to a situation that is susceptible to overtreatment, they still seemed to be concerned about the prevalence of unethical behaviors in this regard.

Compared with the subspecialist faculty/housestaff system, the staff-only pediatric hospitalist system was associated with a marked reduction in cost and length of stay for patients with medically complex subspecialty diseases. In this era of resident duty-hour restrictions and medical complexity of conditions in inpatients, staff-only hospitalist programs may have a vital role in pediatric teaching hospitals.

Clinical reasoning is a complex cognitive process that is essential to evaluate and manage a patient’s medical problem. The aim of this paper was to provide a critical review of the research literature on clinical reasoning theories and models. To conduct our study, we applied the process of conducting a literature review in four stages in accordance with the approach of Carnwell and Daly. First, we defined the scope of the review as being limited to clinical reasoning theories and models in medical education. In the second stage, we conducted a search based on related words in PubMed, Google Scholar, PsycINFO, ERIC, ScienceDirect and Web of Science databases. In the third stage, we classified the results of the review into three categories, and in the fourth stage, we concluded and informed further studies. Based on the inclusion and exclusion criteria, 31 articles were eligible to be reviewed. Three theories and two models were recognized and classified into three categories. Several theories and models have been proposed in relation to clinical reasoning, but it seems that these theories and models could only explain part of this complex process and not the whole process. Therefore, to fulfill this gap, it may be helpful to build a Meta-model or Meta-theory, which unified all the models, and theories of clinical reasoning.

Introduction The variety of frameworks and models to describe resilience in the health system has led researchers and policymakers to confusion and the inability to its operationalization. Therefore, the purpose of this study was to create a meta-framework using the Critical Interpretive Synthesis method. Method For this purpose, studies that provide theories, models, or frameworks for organizational or health system resilience in humanitarian or organizational crises were systematically reviewed. The search strategy was conducted in PubMed, Web of Science, Embase, and Scopus databases. MMAT quality appraisal tool was applied. Data were analysed using MAXQDA 10 and the Meta-ethnography method. Results After screening based on eligibility criteria, 43 studies were reviewed. Data analysis led to the identification of five main themes which constitute different framework dimensions. Health system resilience phases, attributes, tools, and strategies besides health system building blocks and goals are various dimensions that provide a systematic framework for health system resilience analysis. Discussion This study provides a systemic, comprehensive framework for health system resilience analysis. This meta-framework makes it possible to detect the completeness of resilience phases. It examines the system’s resilience by its achievements in intermediate objectives (resilience system attributes) and health system goals. Finally, it provides policy solutions to achieve health system resilience using tools in the form of absorptive, adaptive, and transformative strategies.

Aim/Purpose: This study analyses the concept of doctorateness and its defining characteristics and gives a definition for it by examining the various ways it is used in doctoral education literature. Background: The term ‘doctorateness’ is an immature unclarified concept referred to as a common quality for all doctoral awards. With the emergence of different types of doctoral studies worldwide, a clear definition for this concept is a requirement. Defining doctorateness can result in major implications for research and the practice of doctoral education, as determining attributes of doctorateness will pose serious expectations regarding standard setting for the process and outcome of doctoral programs and requirements of doctoral students. Methodology: In this study, Walker and Avant’s eight step method of concept analysis is used. The method is a systematic approach frequently used to analyze relatively new concepts. Contribution: The current study moves beyond the earlier studies by isolating defining attributes of the concept and giving a clear conceptual definition for doctorateness. Findings: Five defining attribute of doctorateness refined from literature include independent scholar, developmental and transformative apprenticeship process, original conceptual contribution/scholarship, highest academic degree, and stewardship of the discipline. Based on the defining attributes a definition is formulated for the concept of doctorateness. In addition to giving a definition a conceptual model consisting of five conceptual areas of purpose, process, product, prerequisite, and impact according to the usage of concept in the literature is also presented. Recommendations for Practitioners: By using the conceptual model and defining attributes presented in this study practitioners and professionals in doctoral education can study the effective design for doctoral programs and utilize the definition as a basis for evidencing doctoral awards. Future Research: Defining attributes can also contribute to psychometric researches related to tool development and constructing tools with explicit criteria for doctorate judgment.

Varicella-zoster virus causes varicella (chickenpox) and zoster (shingles). Neurologic manifestations occur in both illnesses. We describe a previously healthy child who had aseptic meningitis without exanthem caused by reactivation of varicella-zoster virus. This has not been previously reported in the pediatric literature.