Somatic Cough Syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children: CHEST Guideline and Expert Panel Report

BACKGROUND: We conducted a systematic review on the management of psychogenic cough, habit cough, and tic cough to update the recommendations and suggestions of the 2006 guideline on this topic.

METHODS: We followed the American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework. The Expert Cough Panel based their recommendations on data from the systematic review, patients' values and preferences, and the clinical context. Final grading was reached by consensus according to Delphi methodology.

RESULTS: The results of the systematic review revealed only low-quality evidence to support how to define or diagnose psychogenic or habit cough with no validated diagnostic criteria. With respect to treatment, low-quality evidence allowed the committee to only suggest therapy for children believed to have psychogenic cough. Such therapy might consist of nonpharmacologic trials of hypnosis or suggestion therapy, or combinations of reassurance, counseling, and referral to a psychologist, psychotherapy, and appropriate psychotropic medications. Based on multiple resources and contemporary psychologic, psychiatric, and neurologic criteria (Diagnostic and Statistical Manual of Mental Disorders, 5th edition and tic disorder guidelines), the committee suggests that the terms psychogenic and habit cough are out of date and inaccurate.

CONCLUSIONS: Compared with the 2006 CHEST Cough Guidelines, the major change in suggestions is that the terms psychogenic and habit cough be abandoned in favor of somatic cough syndrome and tic cough, respectively, even though the evidence to do so at this time is of low quality.

"Should I prioritize medical problem solving or attentive listening?": the dilemmas and challenges that medical students experience when learning to conduct consultations

Objective: Communication skills can be trained alongside clinical reasoning, history taking or clinical examination skills. This is advocated as a solution to the low transfer of communication skills. Still, students have to integrate the knowledge/skills acquired during different curriculum parts in patient consultations at some point. How do medical students experience these integrated consultations within a simulated environment and in real practice when dealing with responsibility?

Methods: Six focus groups were conducted with (pre-)/clerkship students.

Results: Students were motivated to practice integrated consultations with simulated patients and felt like 'real physicians'. However, their focus on medical problem solving drew attention away from improving their communication skills. Responsibility for real patients triggered students' identity development. This identity formation guided the development of an own consultation style, a process that was hampered by conflicting demands of role models.

Conclusion: Practicing complete consultations results in the dilemma of prioritizing medical problem solving above attention for patient communication. Integrated consultation training advances this dilemma to the pre-clerkship period. During clerkships this dilemma is heightened because real patients trigger empathy and responsibility, which invites students to define their role as doctor.

Practice Implications: When training integrated consultations, educators should pay attention to students' learning priorities and support the development of students' professional identity.

Seaborne trade and the commercialisation of fifteenth- and sixteenth-century Gaelic Ulster

This study considers the frequently stated claim that the economy of Gaelic- speaking lordships in Ulster during the fifteenth and sixteenth centuries was predominately pastoral anduncommercialised, by drawing on a variety of sources not usually combined. It proposes that the increased European demand for fish and the growth of the fish industry across northern Europe played a crucial role in stimulating trade between the coastal areas of Ulster on the one hand, and Britain and continental Europe on the other. This led to the establishment of permanent markets and towns, which joined at least two new inland towns in the southern parts of the province, bringing about a commercial presence in most of the Ulster lordships before 1600. Gaelic Lords consolidated this development by building castles and friaries at these fixed trading places.

Teología india y nuevos desafios

El Episcopado latinoamericano en Santo Domingo puntualiza el tema de la "interculturación de la fé hacia nueva evangelización. En este clima y en el marco de la reflexión sobre los 500 años, representantes ecuménicos de las organizaciones de base de la Pastoral indígena desde México a Chile se han reunido en Quito entre 29 de Agosto y 6 de Septiembre. Presentamos el material recogido por la comisión encargada de la memoria.

Informationsberatung als zeitgemäßes Dienstleistungskonzept für wissenschaftliche Bibliotheken

Ausgangspunkt für die vorliegende Arbeit ist die These, dass Informationsberatung in Anlehnung an die in den USA verbreiteten Research Consultations eine ergänzende Methode zur prozessorientierten Förderung von Informationskompetenz an wissenschaftlichen Bibliotheken sein kann. Im Zuge der Diskussion dieser These werden zunächst die der Dienstleistung zugrunde liegenden Konzepte wie etwa das Rollenverständnis des consultant librarian und das des counseling librarian vorgestellt. Daraufhin wird die in der Fachliteratur geführte Diskussion um die Einordnung der Dienstleistung aufgegriffen und Informationsberatung gegenüber den herkömmlichen Dienstleistungen Auskunftsdienst und Informationskompetenzschulung abgegrenzt. Dabei zeigt sich, dass professionelle bibliothekarische Beratung im Zuge der Förderung des informellen Lernens einen neuen, eigenständigen und nutzerorientierten Service darstellt, der den aktuellen Bedarf nach individueller Betreuung durch persönliche Ansprechpartner und Expertenberatung deckt. Durch die inhaltliche und zeitliche Flexibilität der Dienstleistung können Nutzer am point of need abgeholt werden. Umsetzungsmodelle finden sich bspw. an der Wissensbar der SLUB Dresden, dem Helpdesk Lern- und Arbeitstechniken an der KIT-Bibliothek und dem Learning Center der Universitätsbibliothek Mannheim. Seitens der Berater werden u.a. Kompetenzen im Bereich des wissenschaftlichen Arbeitens sowie Kommunikations- und Sozialkompetenzen benötigt. Neben der Qualifizierung des bibliothekseigenen Personals durch Fortbildungen stellen Kooperationen mit kompetenzbildenden Einrichtungen der Universität eine Möglichkeit zur Implementierung der Dienstleistung dar, die von entsprechenden Marketingmaßnahmen begleitet sein muss. Abschließend wird die Rolle von wissenschaftlichen Bibliotheken im Hinblick auf die an deutschen Universitäten zunehmend etablierten Schreibzentren diskutiert.