The sustainable use of diverse plants accustomed by different ethnic groups in Sibi District, Balochistan, Pakistan.

The present study was conducted to analyze the utilization of medicinal plants (traditional as well as cultivated) and there recipes accustomed by different ethnic groups of Sibi District (SD), Balochistan, Pakistan. The study was carried out between 2018 and 2021 by using semi-structured and open-ended questionnaire.. The randomly selected methods applied for this study were mainly based on household surveys walk through and interview with indigenous communityage 40 to 80, a total of 75 plants, belonging to 63 genera and distributed among 33 plant families were recorded. The dominant Plant families were the Fabaceae (12%) of all studied taxa, followed by the Amaranthaceae (7%), Asteraceae (6%), Cucurbitaceae, Solanaceae, Poaceae (4% each), Rhamnaceae and Zygophyllaceae (3%). Thirty traditional Food Recipes (TFR) and Traditional Medicinal Recipes (TMR) were novel being first time reported from SD., which are utilized by the local communities in their daily routine. These ethnic TFR and TMR have a tremendous role in preservation and sustainable use of traditional food habits and culture. It was also documented that along with cultivated, the wild edible and medicinal plant preparations play a significant role in in the economic potential and primary health care system of the local communities. The study recommends the specific measures, such as small industries, improved export means, tourism and educational activities, to protect the traditional knowledge and biocultural heritage of the region before its erosion.

Objective structured assessment of debriefing: bringing science to the art of debriefing in surgery.

OBJECTIVE: : To identify the features of effective debriefing and to use this to develop and validate a tool for assessing such debriefings. INTRODUCTION: : Simulation-based training has become an accepted means of surgical skill acquisition. A key component of this is debriefing-yet there is a paucity of research to guide best practice. METHODS: : Phase 1-Identification of best practice and tool development. A search of the Medline, Embase, PsycINFO, and ERIC databases identified current evidence on debriefing. End-user input was obtained through 33 semistructured interviews conducted with surgeons (n = 18) and other operating room personnel (n = 15) from 3 continents (UK, USA, Australia) using standardized qualitative methodology. An expert panel (n = 7) combined the data to create the Objective Structured Assessment of Debriefing (OSAD) tool. Phase 2-Psychometric testing. OSAD was tested for feasibility, reliability, and validity by 2 independent assessors who rated 20 debriefings following high-fidelity simulations. RESULTS: : Phase 1: 28 reports on debriefing were retrieved from the literature. Key components of an effective debriefing identified from these reports and the 33 interviews included: approach to debriefing, learning environment, learner engagement, reaction, reflection, analysis, diagnosis of strengths and areas for improvement, and application to clinical practice. Phase 2: OSAD was feasible, reliable [inter-rater ICC (intraclass correlation coefficient) = 0.88, test-retest ICC = 0.90], and face and content valid (content validity index = 0.94). CONCLUSIONS: : OSAD provides an evidence-based, end-user informed approach to debriefing in surgery. By quantifying the quality of a debriefing, OSAD has the potential to identify areas for improving practice and to optimize learning during simulation-based training.

Junior doctors' reflections on patient safety.

AIM: To determine whether foundation year 1 (FY1) doctors reflect upon patient safety incidents (PSIs) within their portfolios and the potential value of such reflections for quality of care. METHODS: A cross-sectional retrospective review of every 'reflective practice' portfolio entry made by all FY1 doctors within an Acute Teaching Hospital Trust was conducted in February 2010. Entries were reviewed by two independent blinded researchers to determine whether they related to a PSI that is, any unintended or unexpected incident that could have or did lead to patient harm. For all entries rated positive by both reviewers, a content analysis approach was used to code PSI into incident type, contributing factors and patient outcome according to validated frameworks developed by the National Patient Safety Agency. RESULTS: 139 reflective practice entries were completed by 30 trainees (15 men, 15 women, mean age 24 years). Of the 139 entries, 49% reflected on a PSI. Of these, 22% were due to errors in clinical assessment; 22% were due to delayed access to care; 18% were due to infrastructure/staffing deficiencies; and 16% were due to medication errors. The most common contributing factors were team/social factors (23%), patient factors (22%), communication and task factors (both 17%). The majority of PSIs led to no harm. Six entries described PSIs resulting in patient death, the majority of which were attributable to diagnostic errors. CONCLUSIONS: FY1 doctors commonly reflect on PSIs within their professional portfolios. Such critical reflection can encourage learning but may also promote patient safety and the quality of healthcare across all medical specialties.