Current medico-legal death investigation system in China.

PubMed

Chang, Lin; Zhang, Baosheng; Yan, Ping; Fowler, David; Li, Ling

2011-07-01

Medico-legal death investigation in China has a long history that can be traced back to the Chhin era in the third century BC. We conducted a national study on the current medico-legal death investigation system in China. Our study showed that, at present, medico-legal death investigations in China are conducted by c. 12,000 forensic medical experts mainly within five relatively independent agencies: the police organizations, the prosecutors' offices, the departments/divisions of forensic medicine/science in medical colleges and universities, the Institute of Forensic Science in the Ministry of Justice, and the government or private forensic societies. Owing to China's large population and area, the medico-legal death investigation is largely based on the administrative divisions. There is a wide variation in the scope, extent, and quality of investigations among the agencies and at the different levels of county/district, municipal, and provincial governments. This article gives a general overview of medicolegal death investigation in modern China. © 2011 American Academy of Forensic Sciences.

Effect of medicolegal liability on patterns of general and family practice in Canada.

PubMed Central

Woodward, C A; Rosser, W

1989-01-01

As part of the Federal/Provincial/Territorial Review on Liability and Compensation Issues in Health Care, in 1988 we surveyed Canadian general practitioners and family physicians to determine the effect of liability concerns on their practices in the previous 5 years. Questionnaires were sent to a random, stratified national sample of 1295 physicians, with a response rate of 64.6%. However, a high proportion of the returned questionnaires were ineligible because the physicians were not in general or family practice, were not involved in direct patient care, or had died or moved; thus, the corrected response rate was 50.8%. The newsletter of the Canadian Medical Protective Association was the source of information on liability most frequently cited (by 88.1% of the physicians) and most influential (to 62.4%). Only 15.5% of the physicians cited personal involvement with medicolegal issues as a source of information; the rate was higher for Ontario physicians and those in urban areas generally. A total of 74.6% of the respondents had altered their style of practice in the previous 5 years, and 56.3% reported changes in the scope of their practice. Concern about litigation was the most important reason for changing style of practice and reducing or eliminating administration of anesthesia, whereas lifestyle and other issues along with liability concerns most influenced decisions to reduce obstetric care and emergency department work. Our findings suggest that physicians' perceptions of liability issues have had a profound influence on primary care practice in Canada in the past several years. PMID:2766164

Forensic medicine experts' opinion on medico-legal autopsies in hospital deaths: a questionnaire survey.

PubMed

D'Souza, Deepak Herald; Pant, Sadip; Menezes, Ritesh George

2013-10-01

Medico-legal autopsy is conducted routinely in some countries and selectively in others in hospital deaths. This study was conducted to evaluate the views of the forensic medicine experts regarding this matter. A questionnaire pro forma was sent to sixty-five forensic medicine experts practicing in different medical institutions all around India. Designations and experiences of the participants were noted by requests in the same questionnaire. Their specific experience in conducting medico-legal autopsy in hospital deaths was also requested for. Responses were charted in frequency distribution tables and analyzed using SPSS, version 17.0. One-third of the participants felt that a medico-legal autopsy was necessary in all the hospital death cases as defined in the present study. Ten percent of the participants opined that a medico-legal autopsy was unnecessary in hospital deaths. The majority of the experts mentioned finding the cause of death, followed by finding the manner of death and collecting the evidentiary materials, as the reasons for medico-legal autopsy in hospital deaths. Twenty percent of the participants felt that internal findings at autopsy poorly matched with the case records. All the experts agreed that external autopsy findings matched with the hospital case records. Nearly two-third of the participants felt that it was difficult in some cases to interpret the autopsy findings without case records from the hospital where the deceased was treated. Our findings suggest that the exercise of carrying out medico-legal autopsy routinely in every hospital death as evident in the Indian framework is often unnecessary as per the experts' opinion. Autopsy findings in hospital deaths often correlate with hospital case records.

Comparative analysis of medicolegal compensation for occupational cancers in France and other western European countries: development proposals.

PubMed

Clin, Bénédicte; Ferrant, Ophélie; Marquignon, Marie-France; Letourneux, Marc

2009-12-01

In France, contemporary medicolegal reparation system of occupational diseases--in particular occupational cancer--has been questioned, constantly, due to changes in the state's legal system. For a long time, associated legislation was considered as a genuine social breakthrough. However, it shall remain acknowledged that over the past 15 years, it has been the French legal system itself that generated a certain level of inequality among victims of occupational diseases.. This inequality came to exist following certain jurisdictional understandings of legal matters, as well as the creation of exceptional schemes for granting compensation for physical injuries. It is agreed by both, courts and compensatory funds, that full compensation must be granted for particular group of victims. Yet, this is not the case as for granting compensation over occupational diseases, where reparation is on a set lump sum basis. In light of this proved inequality in the France legal system, with regard to the medicolegal reparation for loss or damage, associated with a claimant's occupational activity, we aim at investigating the procedures as practiced in various European countries occupational cancer in order to identify optimal compensation for these disorders.

Chronic traumatic encephalopathy (CTE) in a National Football League Player: Case report and emerging medicolegal practice questions.

PubMed

Omalu, Bennet I; Hamilton, Ronald L; Kamboh, M Ilyas; DeKosky, Steven T; Bailes, Julian

2010-01-01

We present a case of chronic traumatic encephalopathy (CTE) in a retired National Football League (NFL) Player with autopsy findings, apolipoprotein E genotype, and brain tissue evidence of chronic brain damage. This 44-year-old retired NFL player manifested a premortem history of cognitive and neuropsychiatric impairment, which included in part, chronic depression, suicide attempts, insomnia, paranoia, and impaired memory before he finally committed suicide. A full autopsy was performed with Polymerase Chain Reaction-based analyses of his blood to determine the apolipoprotein genotype. Histochemical and immunohistochemical analyses were performed on topographical gross sections of the brain. Autopsy confirmed a fatal gunshot wound of the head. The apolipoprotein E genotype was E3/E3 and the brain tissue revealed diffuse cerebral taupathy (Neurofibrillary Tangles and Neuritic Threads). This will be the third case of CTE in a national football player, which has been reported in the medical literature. Omalu et al., reported the first two cases in 2005 and 2006. This case series manifested similar premortem history of neuropsychiatric impairment with autopsy evidence of cerebral taupathy without any neuritic amyloidopathy. For a definitive diagnosis of CTE to be made, and for medicolegal purposes, a full autopsy must be performed with histochemical and immunohistochemical analyses of the brain to identify the presence of Neurofibrillary Tangles (NFTs) and Neuritic Threads (NTs). Further longitudinal prospective studies are required to confirm the common denominators and epidemiology of CTE in professional American football players, which have been identified by this case series.

Questioning Our Questions: Assessing Question Asking Practices to Evaluate a yPAR Program

ERIC Educational Resources Information Center

Grace, Sarah; Langhout, Regina Day

2014-01-01

The purpose of this research was to examine question asking practices in a youth participatory action research (yPAR) after school program housed at an elementary school. The research question was: In which ways did the adult question asking practices in a yPAR setting challenge and/or reproduce conventional models of power in educational…

Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal.

PubMed

Domingues, Ana Patrícia Rodrigues; Belo, Adriana; Moura, Paulo; Vieira, Duarte Nuno

2015-05-01

It was to analyse the most critical areas in Obstetrics and to suggest measures to reduce or avoid the situations most often involved in these disputes. Obstetrics cases submitted to the Medico-legal Council since the creation of the National Institute of Legal Medicine and Forensic Sciences in 2001 until 2011 were evaluated. A comprehensive characterization, determination of absolute/relative frequencies, hypothesis of a linear trend over the years and the association between each parameter was done. The analysis has shown no significantly linear trend. The most common reasons for disputes were perinatal asphyxia (50%), traumatic injuries of the newborn (24%), maternal sequelae (19%) and issues related to prenatal diagnosis and/or obstetric ultrasound (5.4%). Perinatal asphyxia showed no significantly linear trend (p=0.58) and was usually related to perinatal deaths or permanent neurologic sequelae in newborn children. Traumatic injuries of the newborn, mostly related to instrumented deliveries, shoulder dystocia or vaginal delivery in breech presentation, has shown a significantly increased linear trend (p<0.001), especially related to instrumented deliveries. The delay/absence of cesarean section was the clinical procedure questioned in a significantly higher number of cases of perinatal asphyxia (68.7%) and of traumatic lesions of the newborn due to instrumented deliveries (20.5%). It is important to improve and correct theoretical/practical daily clinical performance in these highlighted areas, in order to reduce or even avoid situations that could end up in medico-legal litigations.

Medico-legal and ethical problems associated with treatment of children born with congenital malformations.

PubMed

Foo, K B

1994-04-01

Recent advances in medicine and biomedical science have brought in their wake a whole array of moral, ethical and medico-legal problems. For eg, in relation to the withholding or withdrawal of treatment of neonates born with congenital malformations. While the technology to treat and thus to artificially prolong life is available, the related question of whether or not to do so and in what circumstances has to be considered. There is a paucity of cases in the courts. However, some useful principles can be drawn from a number of cases in the UK. The search for clearer legal and moral criteria has become more urgent. A way ahead appears to lie in the formation of Hospital Review Committees or some such mechanism which would enable the most appropriate decision to be taken in any one case bearing in mind the complex ethical and medico-legal issues involved.

Ireland and medical research with minors: some medico-legal aspects.

PubMed

Sheikh, Asim A

2008-07-01

The practice of medical research with minors in Ireland consist of practices pertaining to therapeutic and non-therapeutic medical research. Clinical trials (a category of therapeutic research), is governed by legislation. However, any other therapeutic research (non-clinical trials research) and non-therapeutic research, e.g. observational medical research such as a longitudinal study of children or non-therapeutic research such as blood sample collection for analysis of cause of disease, are unregulated by legislation. This, article will outline and describe some of the medico-legal issues involved in both types of research and will comment on matters such as what national law exists, how the directive on good clinical practice has been implemented, what guidelines, if any, exist.

The use of human samples obtained during medicolegal autopsies in research: An introduction to current conditions and initiatives in Japan.

PubMed

Tsujimura-Ito, Takako; Inoue, Yusuke; Muto, Kaori; Yoshida, Ken-Ichi

2017-04-01

Background Leftover samples obtained during autopsies are extremely important basic materials for forensic research. However, there are no established practices for research-related use of obtained samples. Objective This study discusses good practice for the secondary use of samples collected during medicolegal autopsies. Methods A questionnaire was posted to all 76 departments of forensic medicine performing medicolegal autopsies in Japan, and 48 responses were received (response rate: 63.2%). As a secondary analysis, we surveyed information provided on department websites. Results Ethical reviews conducted when samples were to be used for research varied greatly among departments, with 21 (43.8%) departments reporting 'fundamentally, all cases are subject to review', eight (16.7%) reporting 'only some are subject to review' and 17 (39.6%) reporting 'none are subject to review'. Information made available on websites indicated that 11 departments had a statement of some type to bereaved families about the potential research use of human samples obtained during autopsies. Nine of these included a notice stating that bereaved families may revoke their consent for use. Several departments used an opt-out system. Conclusion There is no common practice in the field of legal medicine on the ethical use for medical research of leftover samples from medicolegal autopsies. The trust of not only bereaved families but also society in general is required for the scientific validity and social benefits of medical studies using leftover samples from medicolegal autopsies through the use of opt-out consenting and offline and online dissemination and public-relations activities.

Medicolegal aspects of doping in football

PubMed Central

Graf‐Baumann, T

2006-01-01

This article describes the historical background of the medicolegal aspects of doping in sports and especially in football. The definitions of legal terms are explained and the procedure of individual case management as part of FIFA's approach to doping is presented. Finally, three medicolegal problems awaiting urgent solution are outlined: firstly, the difficulties in decision making arising from the decrease of the T/E ratio from 6 to 4; secondly, the therapeutic application of α‐reductase inhibitors for male pattern baldness in the face of the classification of finasteride as a forbidden masking agent; and lastly, the increasing use of recreational drugs and its social and legal implications in positive cases. PMID:16799105

Neoplastic disease in a medicolegal autopsy material. A retrospective study in northern Sweden.

PubMed

Gezelius, C; Eriksson, A

1988-01-01

Only a small fraction of sudden unexpected deaths are caused by neoplastic disease and thus subject ot medicolegal autopsy. The medicolegal autopsy forms an opportunity to study not only medically diagnosed and treated neoplasms, but also the natural evolution of untreated disease. In a series of 7,020 consecutive medicolegal autopsies in northern Sweden, we found 171 cases with malignant and/or intracranial neoplasms. In 41 cases, sudden death was caused by previously unknown tumors. The most common mechanisms of death in this group were disseminated cancer, intracranial tumors, pulmonary thromboembolism, hemoptysis, and aspiration of blood, and the most common locations were the bronchi and the lung. In some of these cases, the mechanism was sometimes dramatic, raising a question of violent death or intoxication. In 30 cases, sudden unexpected death was caused by previously known tumors, and also in this group disseminated cancer was the most common cause of death, and the most common locations were the bronchi and the lung. In 22 cases, tumors were found suicidal cases; in 14 of these, the tumor was considered to be a major causative factor to the suicide, while in eight cases the tumor was considered to be an incidental finding. The expected number of cancers in the 1,060 suicides investigated in this series was 27, according to the official cancer prevalence data. Thus, a possible over-representation of suicides among persons with cancer seems doubtful and needs further exploration.

Pediatric medicolegal autopsy in France: A forensic histopathological approach.

PubMed

Delteil, Clémence; Tuchtan, Lucile; Torrents, Julia; Capuani, Caroline; Piercecchi-Marti, Marie-Dominique

2018-01-01

The aim of postmortem medicolegal examination in pediatric death is primarily to establish the circumstances and causes of death and to exclude child abuse. In France, pediatric death is systematically documented by medicolegal or medical autopsy. In case of medicolegal autopsy, the complementary examinations, requested and financed by justice, are rarely limited to a histopathological examination. However in medical autopsies other tools are available to the pathologist as toxicology, biochemistry and molecular biology. The purpose of this article is to evaluate the efficacy of forensic histopathology in pediatric forensic autopsies. We analyze the main causes of pediatric death in a forensic context. Between 2004 and 2015, 157 infant deaths were identified in Marseille university hospital. The forensic histopathology and autopsy reports of all 157 cases were available for systematic review. Medical or surgical causes represented 41,3% of deaths in our center, accidental causes 8.1% and child abuse 28,8%. The definitive diagnosis was made at autopsy in 30% of cases and at histopathological examination in 70% highlighting that forensic histopathology is an indispensable tool in pediatric medicolegal autopsies. Significant histological abnormalities may be detected in selected organs such as the brain, lungs, heart, liver, adrenal glands and kidneys in spite of macroscopically normal appearances. This justifies systematic sampling of all organs. Despite the implementation of the French sudden infant death protocol which recommends medical autopsies, too many pediatric autopsies are carried out in a medicolegal context. 30% of the cases remain without diagnosis at the end of the autopsy and histological examination. This number could be reduced by the contribution of others laboratory investigation. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Beginning EFL Teachers' Beliefs about Quality Questions and Their Questioning Practices

ERIC Educational Resources Information Center

Pham, Ly Ngoc Khanh; Hamid, M. Obaidul

2013-01-01

Motivated by the scarcity of research that examines the impact of teacher beliefs on their actual practices in Vietnam, this study investigated the relationship between teachers' beliefs about quality questions and their questioning behaviours in terms of questioning purposes, content focus, students' cognitive level, wording and syntax. Thirteen…

On the placement of practice questions during study.

PubMed

Weinstein, Yana; Nunes, Ludmila D; Karpicke, Jeffrey D

2016-03-01

Retrieval practice improves retention of information on later tests. A question remains: When should retrieval occur during learning-interspersed throughout study or at the end of each study period? In a lab experiment, an online experiment, and a classroom study, we aimed to determine the ideal placement (interspersed vs. at-the-end) of retrieval practice questions. In the lab experiment, 64 subjects viewed slides about APA style and answered short-answer practice questions about the content or restudied the slides (restudy condition). The practice questions either appeared 1 every 1-2 slides (interspersed condition), or all at the end of the presentation (at-the-end condition). One week later, subjects returned and answered the same questions on a final test. In the online experiment, 175 subjects completed the same procedure. In the classroom study, 62 undergraduate students took quizzes as part of class lectures. Short-answer practice questions appeared either throughout the lectures (interspersed condition) or at the end of the lectures (at-the-end condition). Nineteen days after the last quiz, students were given a surprise final test. Results from the 3 experiments converge in demonstrating an advantage for interspersing practice questions on the initial tests, but an absence of this advantage on the final test. (c) 2016 APA, all rights reserved).

Dissociative identity disorder: Medicolegal challenges.

PubMed

Farrell, Helen M

2011-01-01

Persons with dissociative identity disorder (DID) often present in the criminal justice system rather than the mental health system and perplex experts in both professions. DID is a controversial diagnosis with important medicolegal implications. Defendants have claimed that they committed serious crimes, including rape or murder, while they were in a dissociated state. Asserting that their alter personality committed the bad act, defendants have pleaded not guilty by reason of insanity (NGRI). In such instances, forensic experts are asked to assess the defendant for DID and provide testimony in court. Debate continues over whether DID truly exists, whether expert testimony should be allowed into evidence, and whether it should exculpate defendants for their criminal acts. This article reviews historical and theoretical perspectives on DID, presents cases that illustrate the legal implications and controversies of raising an insanity defense based on multiple personalities, and examines the role of forensic experts asked to comment on DID with the goal of assisting clinicians in the medicolegal assessment of DID in relation to crimes.

The Association Between Medicolegal and Professional Concerns and Chest Pain Admission Rates.

PubMed

Brooker, Julie A; Hastings, Jeffrey W; Major-Monfried, Hannah; Maron, Chad P; Winkel, Maia; Wijeratne, H R Sagara; Fleischman, William; Weingart, Scott; Newman, David H

2015-07-01

For patients in whom acute coronary syndrome (ACS) is a concern, disposition decisions are complex and multifactorial and have traditionally been a source of considerable variation. An important factor in disposition decisions for these patients may be physician-perceived medicolegal risk and related professional concerns. The study aim was to determine, at the point of care, how much less frequently physicians report that they would admit possible ACS patients if there was either zero or a defined medicolegal risk. This was a point-of-care emergency physician survey. Research assistants approached physicians at or immediately following the moment of disposition decisions for patients who were being admitted for ACS. The primary outcome measures were the proportion of physicians reporting that patients would not have been admitted if medicolegal issues were of no concern and the proportion of physicians reporting that patients would not have been admitted if there was an "acceptable miss rate" of 1% to 2% for ACS patients. During the 3-month study period, 576 patients were admitted to an inpatient unit or to the ED observation protocol. Physicians were approached in 271 cases, and 259 surveys were completed. When presented with hypothetical zero medicolegal risk, physicians answered that they would not have admitted the patients in 30% of cases. With a hypothetical 1% to 2% acceptable miss rate, physicians indicated that they would not have admitted the patients in 29% of the cases. ED medicolegal and professional concerns may substantially increase admissions for possible ACS. An acceptable miss rate or a zero medicolegal risk environment could potentially lead to a major reduction in admissions that physicians feel to be clinically unnecessary. © 2015 by the Society for Academic Emergency Medicine.

Incidental Findings in Neuroimaging: Ethical and Medicolegal Considerations

PubMed Central

Leung, Lawrence

2013-01-01

With the rapid advances in neurosciences in the last three decades, there has been an exponential increase in the use of neuroimaging both in basic sciences and clinical research involving human subjects. During routine neuroimaging, incidental findings that are not part of the protocol or scope of research agenda can occur and they often pose a challenge as to how they should be handled to abide by the medicolegal principles of research ethics. This paper reviews the issue from various ethical (do no harm, general duty to rescue, and mutual benefits and owing) and medicolegal perspectives (legal liability, fiduciary duties, Law of Tort, and Law of Contract) with a suggested protocol of approach. PMID:26317093

Incidental Findings in Neuroimaging: Ethical and Medicolegal Considerations.

PubMed

Leung, Lawrence

2013-01-01

With the rapid advances in neurosciences in the last three decades, there has been an exponential increase in the use of neuroimaging both in basic sciences and clinical research involving human subjects. During routine neuroimaging, incidental findings that are not part of the protocol or scope of research agenda can occur and they often pose a challenge as to how they should be handled to abide by the medicolegal principles of research ethics. This paper reviews the issue from various ethical (do no harm, general duty to rescue, and mutual benefits and owing) and medicolegal perspectives (legal liability, fiduciary duties, Law of Tort, and Law of Contract) with a suggested protocol of approach.

Necessity of including medico-legal autopsy data in epidemiological surveys of individuals with major trauma.

PubMed

Bagher, A; Wingren, C J; Ottosson, A; Andersson, L; Wangefjord, S; Acosta, S

2015-08-01

It is rare that epidemiological surveys of patients with major trauma include both those admitted to the emergency department and those sent for medico-legal autopsy. The main aim of the present population-based study of major trauma was to examine the importance of medico-legal autopsy data. A new injury severity score (NISS)>15 or lethal outcome was used as criteria for major trauma and to identify patients at the emergency, anaesthesiology and forensic departments and/or being within the jurisdiction of the Malmö police authority and subjected to a medico-legal autopsy between 2011 and 2013. According to Swedish legislation all trauma related deaths should be reported to the police who refer these cases for medico-legal autopsy. Among the 174 individuals included, 92 (53%) died and 81 (47%) underwent medico-legal autopsy. One hundred twenty-six patients were primarily admitted to hospital and 48 died before admission to hospital and were sent directly for medico-legal autopsy. Forty-four in-hospital deaths occurred, of whom 33 (75%) were sent to medico-legal autopsy. In those sent directly to the department of forensic medicine the proportion of accidents was lower (p<0.001), self-inflicted injuries higher (p<0.001) and gunshot wounds higher (p=0.002) in comparison with those sent to hospital. The most prevalent drugs detected by forensic toxicology screening in the 81 fatalities were ethanol (20%), sedatives (16%), anti-depressives (15%) and illicit narcotics (9%). Forty-four cases (54%) were positive for at least one drug, and twenty-eight cases (35%) were positive for two or more drugs. Factors associated with a lower rate of medico-legal autopsies among trauma-related deaths at hospital were high age (p<0.001), lower NISS (p<0.001), a longer duration between trauma and death (p<0.001), falls (p=0.030) and trauma-related infections (p<0.001). This population based study covering clinical and forensic data shows that more than half of the individuals

Privacy Questions from Practicing School Nurses

ERIC Educational Resources Information Center

Bergren, Martha Dewey

2004-01-01

This Question and Answer (Q&A) article addresses practice issues related to school health records and school nursing documentation that were posed by school nurses in the field. Specifically, the questions addressed concern the following: education records, medication privacy issues, sharing of sensitive health information, privacy of…

Medicolegal autopsies in North Central Nigeria.

PubMed

Mandong, B M; Manasseh, A N; Ugwu, B T

2006-11-01

To determine the pattern and the causes of deaths reported to the coroner for medicolegal autopsies in North Central Nigeria. A descriptive retrospective study. Jos University Teaching Hospital, Jos, Nigeria between January 1996 to December 2003. Autopsies reports of 279 subjects whose causes of death were subjects of litigation. The causes of death in medicolegal autopsies. A total of 279 cases of medicolegal autopsies with identified causes of death were recorded representing 89% of all the autopsy examinations performed within the period. In 7.6% of cases, there was no identifiable cause of death. There were 127 males against 52 females with a male: female ratio of 4.5:1 and their ages ranged between two and 74 years with a mean of 34.7+/-8.2 years. Children aged < 15 years made up 29% of the cases and were distributed as follows: 4% of the children were aged 0-5 years, 9% between six to ten years while 17% were between 11 - 15 years. Accidental deaths made up 51% of the cases, homicides 36% and sudden deaths 13%. Road traffic accidents were responsible for 76% of all accidental deaths. Children were affected in 34% of the accidental deaths and half of them were pedestrians at the time of accident. The male: female ratio of deaths from road traffic accidents was 3:1 with mean age of 24 years. In all the accidental deaths, abdominal injuries were responsible for 47% while 30% died from chest injuries. Of the homicide cases male subjects outnumbered female in a ratio of 16:1 and children were affected in 28% of homicides. Injuries sustained during ethnic and religious crisis were responsible for 48% of the deaths from homicide and 15% of them were children. Armed robbery was responsible for 28% cases while physical assaults were responsible for 20% of homicides. Chest injuries were the causes of death in 54% and abdominal injuries in 36% of homicides. Cardiovascular deaths were responsible for 63% cases of all sudden natural deaths referred for Coroner's inquest

Sex differences in medico-legal action against doctors: a systematic review and meta-analysis.

PubMed

Unwin, Emily; Woolf, Katherine; Wadlow, Clare; Potts, Henry W W; Dacre, Jane

2015-08-13

The relationship between male sex and poor performance in doctors remains unclear, with high profile studies showing conflicting results. Nevertheless, it is an important first step towards understanding the causes of poor performance in doctors. This article aims to establish the robustness of the association between male sex and poor performance in doctors, internationally and over time. The electronic databases MEDLINE, EMBASE, and PsycINFO were searched from inception to January 2015. Backward and forward citation searching was performed. Journals that yielded the majority of the eligible articles and journals in the medical education field were electronically searched, along with the conference and poster abstracts from two of the largest international medical education conferences. Studies reporting original data, written in English or French, examining the association between sex and medico-legal action against doctors were included. Two reviewers independently extracted study characteristics and outcome data from the full texts of the studies meeting the eligibility criteria. Study quality was assessed using the Newcastle-Ottawa scale. A random effect meta-analysis model was used to summarize and assess the effect of doctors' sex on medico-legal action. Extracted outcomes included disciplinary action by a medical regulatory board, malpractice experience, referral to a medical regulatory body, complaints received by a healthcare complaints body, criminal cases, and medico-legal matter with a medical defence organisation. Overall, 32 reports examining the association between doctors' sex and medico-legal action were included in the systematic review (n=4,054,551), of which 27 found that male doctors were more likely to have experienced medico-legal action. 19 reports were included in the meta-analysis (n=3,794,486, including 20,666 cases). Results showed male doctors had nearly two and a half times the odds of being subject to medico-legal action than female

Questionable research practices among italian research psychologists.

PubMed

Agnoli, Franca; Wicherts, Jelte M; Veldkamp, Coosje L S; Albiero, Paolo; Cubelli, Roberto

2017-01-01

A survey in the United States revealed that an alarmingly large percentage of university psychologists admitted having used questionable research practices that can contaminate the research literature with false positive and biased findings. We conducted a replication of this study among Italian research psychologists to investigate whether these findings generalize to other countries. All the original materials were translated into Italian, and members of the Italian Association of Psychology were invited to participate via an online survey. The percentages of Italian psychologists who admitted to having used ten questionable research practices were similar to the results obtained in the United States although there were small but significant differences in self-admission rates for some QRPs. Nearly all researchers (88%) admitted using at least one of the practices, and researchers generally considered a practice possibly defensible if they admitted using it, but Italian researchers were much less likely than US researchers to consider a practice defensible. Participants' estimates of the percentage of researchers who have used these practices were greater than the self-admission rates, and participants estimated that researchers would be unlikely to admit it. In written responses, participants argued that some of these practices are not questionable and they have used some practices because reviewers and journals demand it. The similarity of results obtained in the United States, this study, and a related study conducted in Germany suggest that adoption of these practices is an international phenomenon and is likely due to systemic features of the international research and publication processes.

Questionable research practices among italian research psychologists

PubMed Central

Wicherts, Jelte M.; Veldkamp, Coosje L. S.; Albiero, Paolo; Cubelli, Roberto

2017-01-01

A survey in the United States revealed that an alarmingly large percentage of university psychologists admitted having used questionable research practices that can contaminate the research literature with false positive and biased findings. We conducted a replication of this study among Italian research psychologists to investigate whether these findings generalize to other countries. All the original materials were translated into Italian, and members of the Italian Association of Psychology were invited to participate via an online survey. The percentages of Italian psychologists who admitted to having used ten questionable research practices were similar to the results obtained in the United States although there were small but significant differences in self-admission rates for some QRPs. Nearly all researchers (88%) admitted using at least one of the practices, and researchers generally considered a practice possibly defensible if they admitted using it, but Italian researchers were much less likely than US researchers to consider a practice defensible. Participants’ estimates of the percentage of researchers who have used these practices were greater than the self-admission rates, and participants estimated that researchers would be unlikely to admit it. In written responses, participants argued that some of these practices are not questionable and they have used some practices because reviewers and journals demand it. The similarity of results obtained in the United States, this study, and a related study conducted in Germany suggest that adoption of these practices is an international phenomenon and is likely due to systemic features of the international research and publication processes. PMID:28296929

Medicolegal investigation of political killings in El Salvador.

PubMed

Thomsen, J L; Gruschow, J; Stover, E

1989-06-17

An axiom of Thomas Hobbes states that "people are never more helpless than when the force meant to protect their rights turns against them." Hobbes' axiom holds true today, with Amnesty International reporting that hundreds of thousands have been murdered by their governments. This article examines the medicolegal aspects of an investigation into the deaths of two Salvadoran peasants who were reportedly tortured and executed by soldiers in February 1988. One of the authors, Thomsen, participated in the investigation as a court-ordered expert, and as a representative of the American Association for the Advancement of Science and of a Salvadoran legal aid organization. His necropsy findings are reported with observations and comments. The article concludes with suggestions for initiatives that might be undertaken by individual physicians and institutions to improve the quality and impartiality of medicolegal investigations into political killings.

Medico-legal perspectives on sudden cardiac death in young athletes.

PubMed

Oliva, Antonio; Grassi, Vincenzo M; Campuzano, Oscar; Brion, Maria; Arena, Vincenzo; Partemi, Sara; Coll, Monica; Pascali, Vincenzo L; Brugada, Josep; Carracedo, Angel; Brugada, Ramon

2017-03-01

Sudden cardiac death (SCD) in a young athlete represents a dramatic event, and an increasing number of medico-legal cases have addressed this topic. In addition to representing an ethical and medico-legal responsibility, prevention of SCD is directly correlated with accurate eligibility/disqualification decisions, with an inappropriate pronouncement in either direction potentially leading to legal controversy. This review summarizes the common causes of SCD in young athletes, divided into structural (hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, congenital coronary artery anomalies, etc.), electrical (Brugada, congenital LQT, Wolf-Parkinson-White syndrome, etc.), and acquired cardiac abnormalities (myocarditis, etc.). In addition, the roles of hereditary cardiac anomalies in SCD in athletes and the effects of a positive result on them and their families are discussed. The medico-legal relevance of pre-participation screening is analyzed, and recommendations from the American Heart Association and European Society of Cardiology are compared. Finally, the main issues concerning the differentiation between physiologic cardiac adaptation in athletes and pathologic findings and, thereby, definition of the so-called gray zone, which is based on exact knowledge of the mechanism of cardiac remodeling including structural or functional adaptions, will be addressed.

The medico-legal investigation of abandoned fetuses and newborns--a review of cases admitted to the Pretoria Medico-Legal Laboratory, South Africa.

PubMed

du Toit-Prinsloo, L; Pickles, C; Smith, Z; Jordaan, J; Saayman, G

2016-03-01

There is a dearth of literature on the extent of fetal or newborn abandonment or "dumping" and the medico-legal investigation procedures these cases require. This is despite the fact that these occurrences are a worldwide phenomenon and by definition involve criminal law concerns such as illegal abortion, concealment of birth, murder, or neonaticide, depending on the country concerned. This article contributes to current literature in both respects and provides a retrospective case audit for the period 2004-2008 pertaining to all abandoned newborns and fetuses admitted to the Pretoria Medico-Legal Laboratory (PMLL) in South Africa. Demographic details, scope, and nature of the medico-legal investigation as well as formulation of cause of death were recorded. A total of 289 cases were identified for inclusion in this study, 57% of which were considered to have been non-viable fetuses, while 45 of the viable fetuses were deemed to have been stillborn. These instances involve the crimes of concealment of birth and at times illegal abortion, yet prosecution of these cases are relatively unheard of. Signs of live birth were identified in 38 of the cases in the study. Of these infants, 9 were deemed to have died from injuries they have sustained, and in a further 9 cases, no anatomical cause of death could be identified. Homicidal cases should be brought in cases where death ensued as a result of abandonment; however, it is not known how many cases were prosecuted. A comparatively large number of cases were found to have been admitted to the Pretoria Medico-Legal Laboratory. This is alarming because South African abortion laws are liberal and services are free at point of access in the public health care sector. A substantial percentage of cases of abandoned infants were found to have shown signs of life after birth implying a homicidal manner of death or death by abandonment, but it seems these cases are merely shelved.

[Alcohol and work: ethical-deontological and medico-legal remark upon the recent set of rules].

PubMed

Chiaravalli, M; Guzzetti, Laura; Tavani, M

2007-01-01

The Disposition of the Permanent Conference for the relation among the State, the Regions and the Autonomous Provinces of Trento and Bolzano, published in Gazzetta Ufficiale n. 75 on the 30th March 2006 the list of high-risk occupations under the influence of alcohol, activating de facto a previous law (Legge n. 125, 3017 march 2001, "Legge quadro in materia di alcol e di problemi alcolcorrelati"). We here present some ethical-deontological and medical-juridical profiles on the contents of this law and some consideration about its application. Particular attention is dedicated to deontological aspects about industrial safety rules and to medico-legal aspects about occupation under the influence of alcohol, with references to complex relations among worker's discretion right, employer's right to the protection of his own interests and qualified doctor's (or someone to him comparable) right to the respect for the deontological code, with regard to benefit recipient information before the medical treatment. Authors'purpose is to evidence critical points and interpretative ambiguities of a regulation lacking in its practical applications, to provide further proposals of consideration, available to revalue a thematic rich in questions and with a significant social impact.

Medicolegal diagnostic value and clinical significance of traumatic incomplete tears of the basilar artery.

PubMed

Djokic, Vesna; Savic, Slobodan; Atanasijevic, Tatjana

2003-06-01

Ruptures of arteries of the vertebrobasilary system are relatively frequent in medicolegal practice, and their origin may be both natural and violent. Tears that affects the whole thickness of the basilar artery cause subarachnoid hemorrhage (SAH), with an often rapid fatal outcome. 1-3 However, in some situations, arterial tears may be incomplete, involving the intima or both the intima and the media, but with preserved adventitia. 1, 4 Although such incomplete tears are not the source of immediate subarachnoid bleeding, their presence may be important from both a medicolegal and a clinical point of view. The aim of this article is to point out the significance of incomplete tears of basilar artery as a possible diagnostic sign of traumatic origin of SAH as well as a certain mechanism of injury, which involves forcible hyperextension and rotational movements of the head. The authors also describe their method of performing longitudinal section of the basilar artery, both at autopsy and for histologic examination, which is convenient for identifying multiple transversal incomplete tears of this blood vessel. The article is based on the analysis of three cases from the autopsy material of the Institute of Forensic Medicine in Belgrade.

Medicolegal Implications of Common Rhinologic Medications.

PubMed

Poetker, David M; Smith, Timothy L

2015-10-01

As otolaryngologists, we prescribe many medications to our patients. The objective of this article is to review the potential side effects and medicolegal risks of the common medications used to treat chronic rhinosinusitis. The authors evaluate some of the common side effects as well as the published literature on the lawsuits associated with those medications. Finally, the authors review the informed consent discussion and opportunities to improve patient care and decrease the risk of litigation. Published by Elsevier Inc.

Applications of social network media in medicolegal death investigation.

PubMed

Hookano, Ryan; Knight, Laura D; Brunelli, Ronald A; Stoppacher, Robert

2013-11-01

With the increased popularity of online social networking services (SNS) such as Facebook, LinkedIn, Twitter, and Google+, we propose that a wealth of new resources is available for medicolegal death investigation. Recognizing this potential, we identified cases in which social media had been useful in the past in our office and asked our investigative staff to consider using social media in current cases. These cases provided illustrative examples for this primer regarding how information from SNS was used in death investigations in our office. Information gleaned from online social media aided in establishing preliminary identification of a decedent, locating next-of-kin, investigating the circumstances of death as relevant to the manner of death, corroborating eyewitness accounts, and providing information relevant to time of death. Potential pitfalls were identified, such as shared accounts or online impostors. SNS proved useful to the medicolegal death investigator and medical examiner, so long as their limitations were recognized. © 2013 American Academy of Forensic Sciences.

[Prevention of the post-surgical insatisfactions and possible medico-legal complications].

PubMed

Flageul, G; Pessis, R

2017-10-01

The purpose of this work is to better understand the reasons for post-surgical instability and what makes up the bed of medico-legal complications. Beyond technical competence, it is essential to observe a very high degree of rigor in listening to the real motivations in order to give the most accurate possible surgical indications and in particular to know to detect and never to operate certain patients who, whatever we do, will always be dissatisfied. The quality of information is one of the essential elements of prevention: information is part of the care and there is no therapeutic success without a successful relationship between a caregiver and a carereceiver. Before the surgery, it is essential to pre-establish written proof of the proper delivery of the information by signing a receipt and an informed consent document. However, the information does not stop at the time of the operative gesture and it is necessary to be able to provide complete and timely information about any post-surgical complications. Furthermore, aesthetic medicine is well understood and rigorously implemented, contributes to the prevention of surgical and medico-legal complications, reducing the heaviness of certain surgical gestures. The question of e-reputation should in no way be neglected. From this point of view, prevention consists in controlling as much as possible the Internet environment. Indeed, where, in the past, in the presence of a dissatisfied patient awaited us, the fear of word-of-mouth or trial is added to the risk of harm E-reputation whose implications can be very damaging. At a time when the intensive use of the Internet allows anyone to get out of anonymity, we must also control these tools at the risk of sacrificing our expertise at the coronation of amateurs. Copyright © 2017. Published by Elsevier Masson SAS.

Medicolegal issues in multiple pregnancy.

PubMed

Gersell, Deborah J

2007-02-01

Any discussion of multiple pregnancy figures prominently in the consideration of the medicolegal aspects of placental pathology. Multiple gestations are common and becoming more so with assisted reproductive techniques, and multiples are associated with a disproportionate share of complications that may result in disputes over quality of care. Higher rates of intrauterine growth retardation, prematurity, stillbirth, morbidity, mortality, cerebral palsy, anomalous development, and malformation as compared with singletons are well documented in multiple pregnancy and should be anticipated. Monochorionic placentation and complications of vascular anastomosis are important factors contributing to poor outcome. Other factors, although occurring in all gestations, are relevant because they are more common in multiple gestations.

Guiding students towards sensemaking: teacher questions focused on integrating scientific practices with science content

NASA Astrophysics Data System (ADS)

Benedict-Chambers, Amanda; Kademian, Sylvie M.; Davis, Elizabeth A.; Palincsar, Annemarie Sullivan

2017-10-01

Science education reforms articulate a vision of ambitious science teaching where teachers engage students in sensemaking discussions and emphasise the integration of scientific practices with science content. Learning to teach in this way is complex, and there are few examples of sensemaking discussions in schools where textbook lessons and teacher-directed discussions are the norm. The purpose of this study was to characterise the questioning practices of an experienced teacher who taught a curricular unit enhanced with educative features that emphasised students' engagement in scientific practices integrated with science content. Analyses indicated the teacher asked four types of questions: explication questions, explanation questions, science concept questions, and scientific practice questions, and she used three questioning patterns including: (1) focusing students on scientific practices, which involved a sequence of questions to turn students back to the scientific practice; (2) supporting students in naming observed phenomena, which involved a sequence of questions to help students use scientific language; and (3) guiding students in sensemaking, which involved a sequence of questions to help students learn about scientific practices, describe evidence, and develop explanations. Although many of the discussions in this study were not yet student-centred, they provide an image of a teacher asking specific questions that move students towards reform-oriented instruction. Implications for classroom practice are discussed and recommendations for future research are provided.

Ethical Considerations on Disclosure When Medical Error Is Discovered During Medicolegal Death Investigation.

PubMed

Wolf, Dwayne A; Drake, Stacy A; Snow, Francine K

2017-12-01

In the course of fulfilling their statutory role, physicians performing medicolegal investigations may recognize clinical colleagues' medical errors. If the error is found to have led directly to the patient's death (missed diagnosis or incorrect diagnosis, for example), then the forensic pathologist has a professional responsibility to include the information in the autopsy report and make sure that the family is appropriately informed. When the error is significant but did not lead directly to the patient's demise, ethical questions may arise regarding the obligations of the medical examiner to disclose the error to the clinicians or to the family. This case depicts the discovery of medical error likely unrelated to the cause of death and describes one possible ethical approach to disclosure derived from an ethical reasoning model addressing ethical principles of respect for persons/autonomy, beneficence, nonmaleficence, and justice.

The medico-legal prerequisite for initiating quarantine and isolation practices in public health emergency management in hospitals in Ghana.

PubMed

Norman, I D; Aikins, M; Binka, F N

2011-12-01

Hospitals and other health facilities in Ghana do not appear to have standardized practices for quarantine and isolation in public health emergency management. This paper reviews the legislative framework governing the medico-legal prerequisites for initiating quarantine and isolation procedures as articulated in the Infectious Disease Act (Cap 78) 1908 amended, 1935, the Quarantine Act (Cap 77) 1915 amended, 1938, the Emergency Powers Act of 1994, (Act 472), and the National Disaster Management Act, 1996, (Act 517) in consonance with the 1992 Constitution of Ghana. The findings provide that (1) The legislative framework outlines systematic standards and protocols to be followed in the committal of person or persons in quarantine and isolation during public health emergencies. (2) These standards and protocols consider as imperative, the creation of standardized national templates for the initiation of quarantine and isolation measures. (3) The non-compliance of the standards and protocols renders vulnerable medical facilities and hospitals with their personnel to the threat of medical malpractice suits and breach of professional ethics. This paper provides suggestions to hospital administrators and medical personnel of how to develop administrative templates in compliance with the law in managing public health emergencies. It also provides examples of such templates for possible adoption by hospitals and other health administrators.

Death and AIDS: A Review of the Medico-Legal Literature.

ERIC Educational Resources Information Center

Huber, Jeffrey T.

1993-01-01

Notes that diagnosis of Acquired Immune Deficiency Syndrome (AIDS) continues to denote death sentence. Contends that AIDS is unique terminal illness in that no other single disease in history of American legal system has generated more litigation than AIDS. Examines medico-legal issues associated with AIDS-related death: estate planning,…

AIDS-MEDICOLEGAL ASPECTS.

PubMed

Kotabagi, R B; Pathak, P R; Apte, V V

1999-04-01

AIDS/HIV Positivity has been the most widely debated disease of this century. Reasons for this are manifold, viz-the non-availability of cure and consequent 100% mortality of a full blown case; its mode of transmission-homosexual and heterosexual activities; widespread occurrence amongst 'main liners'; and patients receiving blood and blood products etc. These aspects have created a dreaded halo around AIDS as well as social stigma. Even the medical community is not exempt from these problems. Unfortunately, legislatures around the world, more so in India, have lagged behind in clarifying many legal issues involved by not enacting specific laws pertaining to AIDS. Consequently many legal & ethical doubts arise in the minds of doctors when confronted with a case of AIDS either in a live patient or in a dead body. In addition, the disease being incurable & 100% fatal, makes it essential to adopt effective preventive measures which in turn need thorough knowledge of social aspects of the epidemic. Certain medicolegal, and ethical aspects of the problem of AIDS are recapitulated in this article for the benefit of the medical community.

Questions and Answers on Unfair Labor Practices. A Practitioner's Guide.

ERIC Educational Resources Information Center

Indiana Univ., Bloomington. Midwest Center for Public Sector Labor Relations.

An unfair labor practice is the violation of any right granted employees, unions, or employers by a collective bargaining law. This guide answers common questions about unfair labor practices in public sector labor relations. The booklet is divided into two sections, unfair employer labor practices and unfair union labor practices. The section…

Medico-legal reports and gatekeeping: one year of referrals to a forensic service.

PubMed

Gethins, E; Larkin, E; Davies, S; Milton, J

2002-01-01

Forensic psychiatrists and the services they provide have been subject to recent scrutiny and high public profile. This study examined part of the work of a regional and district forensic service by looking at a one-year cohort of referrals, and the factors contributing to patient admission, including requests for medico-legal reports. The sample consisted of all referrals to the East Midlands Centre for Forensic Mental Health, Leicester from 1 January 1998 to 31 December 1998. Information on referrals was collected retrospectively using a proforma to collate data from referral letters and the reports prepared by assessing clinicians. Two hundred and eighty referrals relating to 260 individuals were received. The sample characteristics were broadly similar to those reported in previous studies. The finding that 70% of those assessed were referred for medico-legal reports by courts or solicitors, and the fact that only 20% of this group finally entered the forensic service, led us to consider whether this work was legitimate use of National Health Service time. We examined this group more closely, and found that referral for a medico-legal report could be considered as a screening test for entry into the forensic services and there are good arguments for this work continuing.

[Medicolegal aspects of doping in sports].

PubMed

Pruvost, J; Depiesse, F

2004-08-01

To investigate the medico-legal aspects of national and international procedures for monitoring prescription drug use by competing athletes. We studied the French law No. 99-223 of March 23, 1999, relating to the protection of the health of athletes? We also studied annual statistics from the Ministry of Sports concerning anti-doping controls, substances detected by the National Doping Control Laboratory and penalties applied since 2000, as well as the World Anti-Doping Code, which came into effect on January 1, 2004, and should be universally applied by 2006. Athletes registered with a federation or unregistered athletes taking part in competitions approved by sporting federations can use prescription drugs but must follow strict rules. Athletes under investigation for drug use must declare all drugs or products recently taken. The use of prescription drugs not on the list of the prohibited substances is allowed, but evidence of the use of such drugs is the responsibility of the prescriber. A medical practitioner in France who considers it essential to prescribe prohibited drugs or drugs under certain restrictions must systematically inform the athlete about the regulations by providing various certificates and forms. For international athletes, a form authorizing therapeutic use must be submitted to the validation committee of the applicable international federation. Disciplinary, ordinal and penal sanctions are also described. Prescription drug use by an athlete is never a light matter and always engages the responsibility of the doctor. Anti-doping controls and sanctions encourage physicians to comply scrupulously with the medico-legal rules set forth by the public health code and the world anti-doping code.

Medicolegal hell in Texas.

PubMed Central

Korcok, M

1995-01-01

In the ¿war zones¿ of Texas, lawyers use billboards, television commercials and Yellow Page advertisements to announce their availability to help the ¿unjustly injured,¿ and medicolegal lawsuits are as common as the rain that sweeps in from the nearby Gulf of Mexico. Almost 75% of the suits are dismissed without award or settlement, since many are plainly frivolous. However, even these can mean torment for physicians, who have to hire lawyers, answer charges, collect paperwork, take time off work for depositions and consultations, and then worry about how insurers will react the next time premiums are due--even if they are cleared. Texas estimates that defensive medicine practised because of legal fears costs the state at least $702 million annually, spending that is bound to continue as long as one lawsuit is filed annually for every 5.3 doctors in the state. PMID:7553498

11 critical questions to ask when buying a physician practice.

PubMed

Jessee, William F

2012-07-01

Answering probing questions in advance of a practice purchase can help hospital and health system leaders make informed decisions. The questions are intended to stimulate careful consideration before entering into a practice acquisition; no single piece of information or answer should be considered definitive in the final decision-making process. Success depends on having a clear game plan and spending time ensuring that all players-board, management, physician leaders, and the physicians who will be employees--understand and support the plan.

Question Asking in the Science Classroom: Teacher Attitudes and Practices

NASA Astrophysics Data System (ADS)

Eshach, Haim; Dor-Ziderman, Yair; Yefroimsky, Yana

2014-02-01

Despite the wide agreement among educators that classroom learning and teaching processes can gain much from student and teacher questions, their potential is not fully utilized. Adopting the view that reporting both teachers' (of varying age groups) views and actual classroom practices is necessary for obtaining a more complete view of the phenomena at hand, the present study closely examines both cognitive and affective domains of: (a) teachers' views (via interviews) concerning: (1) importance and roles of teacher and student questions, (2) teacher responses, and (3) planning and teacher training; and (b) teachers' actual practices (via classroom observations) concerning: (1) number and (2) level of teacher and student questions, as well as (3) teachers' responses to questions. The data were collected from 3 elementary, 3 middle, and 3 high school science teachers and their respective classroom students. The findings lay out a wide view of classroom questioning and teachers' responses, and relate what actually occurs in classes to teachers' stated views. Some of the study's main conclusions are that a gap exists between how science researchers and teachers view the role of teacher questions: the former highlight the cognitive domain, while the latter emphasize the affective domain.

Answers to the 50 Most Important Questions about Private Mental Health Practice.

ERIC Educational Resources Information Center

Forman, Bruce D.; Silverman, Wade H.

Designed for anyone contemplating or presently established in private mental health practice, this book provides the answers to 50 pertinent questions concerning private practice. Questions were culled from a survey of graduate students in psychology, as well as experienced psychotherapists, psychiatrists, social workers, mental health counselors,…

[On the question of a practice.].

PubMed

Sévigny, R

1979-01-01

The author, a psycho-sociologist and a professor in the department of sociology at l'Université de Montreal, looks back and reflects on his practice as an intervener in different types of groups. He returns to his first experiences with T-groups and to the analysis of them which he made at the beginning of his practice. Furthermore, this analysis touches on questions that remain very relevant. Thus the author explains why, for social reasons, he came to privilege work with "real groups" rather than that with spontaneous groups. On the basis of twenty years of experience and a view of many group approaches it can be asked whether the question of man in society as a change agent should not be posed to a greater extent within groups. 1) Dans Sociologie A Sociétés, vol. 9, no 2, d'octobre 1977, le lecteur trouvera un article de moi qui préserve une réflexion plus systématique mais sans référence immédiate à ma propre pratique. Oe numéro, entièrement consacré au thème "psychologie, sociologie, intervention" comprend également plusieurs textes qui ne sont pas étrangers à certains thèmes développés ici. On y trouvera aussi de nombreuses références bibliographiques.

The clinical management of diabetic foot in the elderly and medico-legal implications.

PubMed

Terranova, Claudio; Bruttocao, Andrea

2013-10-01

Diabetic foot is a complex and challenging pathological state, characterized by high complexity of management, morbidity and mortality. The elderly present peculiar problems which interfere on one hand with the patient's compliance and on the other with their diagnostic-therapeutic management. Difficult clinical management may result in medico-legal problems, with criminal and civil consequences. In this context, the authors present a review of the literature, analysing aspects concerning the diagnosis and treatment of diabetic foot in the elderly which may turn out to be a source of professional responsibility. Analysis of these aspects provides an opportunity to discuss elements important not only for clinicians and medical workers but also experts (judges, lawyers, medico-legal experts) who must evaluate hypotheses of professional responsibility concerning diabetic foot in the elderly.

Teledermatology and clinical photography: safeguarding patient privacy and mitigating medico-legal risk.

PubMed

Stevenson, Paul; Finnane, Anna R; Soyer, H Peter

2016-03-21

Capturing clinical images is becoming more prevalent in everyday clinical practice, and dermatology lends itself to the use of clinical photographs and teledermatology. "Store-and-forward", whereby clinical images are forwarded to a specialist who later responds with an opinion on diagnosis and management is a popular form of teledermatology. Store-and-forward teledermatology has proven accurate and reliable, accelerating the process of diagnosis and treatment and improving patient outcomes. Practitioners' personal smartphones and other devices are often used to capture and communicate clinical images. Patient privacy can be placed at risk with the use of this technology. Practitioners should obtain consent for taking images, explain how they will be used, apply appropriate security in their digital communications, and delete images and other data on patients from personal devices after saving these to patient health records. Failing to use appropriate security precautions poses an emerging medico-legal risk for practitioners.

Medico-legal investigations of the Airbus, A320 crash upon Mount Ste-Odile, France.

PubMed

Ludes, B; Tracqui, A; Pfitzinger, H; Kintz, P; Levy, F; Disteldorf, M; Hutt, J M; Kaess, B; Haag, R; Memheld, B

1994-09-01

The authors present the medico-legal investigations and identification after the aircrash of the Airbus A320 upon the Mount Sainte-Odile (France). The identification team comprising investigators from the gendarmerie, forensic pathologists, odontologists, and scientists of the Institute from Legal Medecine rapidly retrieved and identified 85 of the 87 victims, with 17 being identified through DNA typing, three through fingerprints and the remaining through dental records and specific physical or X-ray findings. Full autopsies were performed on all fatalities to determine patterns of injury and cause of death. Results lead us to point out the importance of a multidisciplinary team of forensic practitioners especially trained for managing medico-legal investigation in mass disaster and the ability of DNA technology to solve complex identification problems.

Physical, social and emotional function after work accidents: a medicolegal perspective.

PubMed

Holtedahl, Robin; Veiersted, Kaj Bo

2007-01-01

The aim of this study was to analyse social and functional consequences of work accidents in a group of workers' compensation claimants who had been referred from the National Insurance Administration for a medicolegal assessment. The injured workers were evaluated on average 3 years after their accidents. Their medical records were analysed, and each injury was scored according to the Abbreviated Injury Scale (AIS). Participants completed the Short Form Questionnaire (SF-36). Factors relating to outcome on SF-36 were analysed using univariate and multivariate methods. 191 claimants returned the SF-36 (62%), 83% of the respondents had an AIS score of less than two, 33% reported working full time. Compared to population-based norms, the respondents reported significantly reduced health on all eight scales of SF-36. Better health and function was mainly associated with a higher level of education and more serious injuries. The extent of social support in the workplace after the accident was only partly related to outcome. The importance of psychosocial factors when making injury assessments in a medicolegal setting is highlighted.

Medicolegal Issues in Expedition and Wilderness Medicine.

PubMed

Dobiesz, Valerie A; Sullivan, William

2017-05-01

There is increased participation in wilderness expeditions to remote and austere environments, which increases the likelihood of an accident and/or medical emergency and the professional liability risks for trip organizers. Trip organizers, outfitters, tour guides, and health care providers must understand the medicolegal liabilities involved in and the legal protection and immunity available when rendering care in austere and challenging settings to mitigate risks and prepare for the level of medical care that may be required. There is a great deal of variability in the legal protections provided by Good Samaritan laws and interpretations may differ among jurisdictions. Copyright © 2017 Elsevier Inc. All rights reserved.

Ask Questions to Encourage Questions Asked

ERIC Educational Resources Information Center

belcastro, sarah-marie

2017-01-01

We delineate some types of structured practice (modeling, requests, feedback, and space-making) that help students learn to pose appropriate questions and to initiate exploration of those questions. Developing skills requires practice, so we suggest ways to embed structured practice into existing class sessions. Including structured practice is…

Dimensions of Questioning: A Qualitative Study of Current Classroom Practice in Malaysia

ERIC Educational Resources Information Center

Hussin, Habsah

2006-01-01

This study investigated questioning as practiced in Malaysian secondary school classrooms, to determine teachers' rationale for adopting certain techniques of questioning, and to use the findings to inform teacher education. Questioning is a central aspect of any classroom interaction as it serves so many functions but it is still an…

A review of medicolegal malpractice suits involving cervical spine: what can we learn or change?

PubMed

Epstein, Nancy E

2011-02-01

Utilizing Verdict Search (East Islip, New York), a medicolegal research service for civil and criminal court cases, 78 cervical spine surgical malpractice suits were identified (10-year period). Factors leading to cervical spine surgical litigation may represent an untapped source of risks/complications associated with these operations. Data with fewer adverse events are submitted to and/or published in spine journals, as they are discoverable in a court of law. Cervical spine surgery in 68 patients included 48 anterior operations (1 to 4 level anterior diskectomy/fusions, 1-level corpectomy/fusion). Twenty patients had posterior surgery (7 fusions, 13 laminectomies with/without fusions). Two patients had other operations/procedures, whereas 8 had no surgery. Four major questions were asked; (1) What were the operations/neurologic deficits that led to the suits?, (2) Who was sued?, (3) What purported and/or alleged "malpractice" events prompted the suits?, and (4) What were the outcomes of these suits? Postoperative neurologic deficits that led to suits included quadriplegia in 41 patients (21 anterior, 20 posterior operations). Other injuries/lesser postoperative deficits were observed in 15 patients, whereas 22 had pain alone. Malpractice suits involved 63 spine surgeons, whereas 15 did not. The 3 most common malpractice events prompting cervical suits, and typical for most surgery-related suits, included negligent surgery, lack of informed consent, and failure to diagnose/treat; the fourth unanticipated factor was failure to brace. Outcomes for these suits included 30 defense verdicts (10 quadriplegic patients), 22 plaintiffs' verdicts (average payout $4.0 million dollars), and 26 settlements (average $2.4 million dollars). Data gleaned from medicolegal suits may provide additional information regarding the morbidity associated with cervical surgery. These data may lessen patients' expectations, and limit spine surgeons' liability. In the future, consideration

Ask the right question: a critical step for practicing evidence-based laboratory medicine.

PubMed

Price, Christopher P; Christenson, Robert H

2013-07-01

The purpose of laboratory medicine is to facilitate better decision making in clinical practice and healthcare delivery. Decision making implies an unresolved issue, problem or unmet need. The most important criterion for any investigation to be of value in clinical practice is that it addresses an unmet need. The different ways in which laboratory investigations are utilized in patient care can be represented in the form of questions. It is important that these questions are articulated to highlight the variables that will impact on the effectiveness of the investigation in the scenario being considered. These variables include the characteristics of the patient (or population) and clinical setting, the nature of the decision and action taken on receipt of the test result and the expected outcome. Asking a question is the first step of the evidence-based laboratory medicine (EBLM) cycle, the other steps being acquiring the evidence, critically appraising the evidence, applying the evidence and auditing use of the evidence. Getting the question right determines the quality of the whole process, thus, defines the quality in practice of laboratory medicine. Whilst the main focus of the EBLM cycle is to provide a strong evidence base for use in clinical practice, it is clear that the five steps are equally applicable in commissioning, delivery and audit (performance management) of services. Asking the right question is crucial to improving the quality of evidence, and practice, in laboratory medicine, and should be used in routine laboratory medicine practice and management throughout healthcare.

Student questions in urban middle school science communities of practice

NASA Astrophysics Data System (ADS)

Groome, Meghan

This dissertation examines student questions within three Communities of Practice (CoP), all urban middle school science environments. The study analyzed student questions from a sociocultural perspective and used ethnographic research techniques to detail how the CoP's shaped questions in the classroom. In the first study, two case study girls attempted to navigate questioning events that required them to negotiation participation. Their access to participation was blocked by participation frameworks that elevated some students as "gatekeepers" while suppressing the participation of others. The next two studies detail the introduction of written questioning opportunities, one into a public middle school classroom and the other into an informal classroom. In both studies, students responded to the interventions differently, most notable the adoption of the opportunity by female students who do not participate orally. Dissertation-wide findings indicate all students were able to ask questions, but varied in level of cognitive complexity, and the diagnostic interventions were able to identify students who were not known to be "target students", students who asked a high number of questions and were considered "interested in science". Some students' roles were as "gatekeepers" to participation of their peers. Two out of three teachers in the studies reported major shifts in their teaching practice due to the focus on questions and the methods used here have been found to be effective in producing educational research as well as supporting high-need classrooms in prior research. In conclusion, these studies indicate that social factors, including participation frameworks, gender dynamics, and the availability of alternative participation methods, play an important role in how students ask science-related questions. It is recommended that researchers continue to examine social factors that reduce student questions and modify their teaching strategies to facilitate

Developing the Practice of Teacher Questioning through a K-2 Elementary Mathematics Field Experience

ERIC Educational Resources Information Center

Schwartz, Catherine

2015-01-01

This article presents findings from research on a field experience designed to help elementary preservice teachers learn the practice of teacher questioning during formal and informal interviews to analyze student mathematical thinking in K-2 classrooms. The practice of teacher questioning is framed as choosing a mathematical goal, analyzing…

Implementing Response to Intervention: Practices and Perspectives from Five Schools--Frequently Asked Questions

ERIC Educational Resources Information Center

Tackett, Kathryn Klingler; Roberts, Greg; Baker, Scott; Scammacca, Nancy

2009-01-01

One question frequently arises in the work of the Regional Comprehensive Centers: "What are states, districts, and schools doing about RTI?" This document addresses that question, with particular focus on instruction and the implementation of effective practices. It uses a frequently asked questions (FAQs) format, with answers based on…

Reflective Questions, Self-Questioning and Managing Professionally Situated Practice

ERIC Educational Resources Information Center

Malthouse, Richard; Watts, Mike; Roffey-Barentsen, Jodi

2015-01-01

Reflective self-questioning arises within the workplace when people are confronted with professional problems and situations. This paper focuses on reflective and "situated reflective" questions in terms of self-questioning and professional workplace problem solving. In our view, the situational context, entailed by the setting, social…

Impressions of defensive medical practice and medical litigation among South African neurosurgeons.

PubMed

Roytowski, D; Smith, T R; Fieggen, A G; Taylor, A

2014-11-01

From a litigation perspective, neurosurgery is considered a 'super high-risk' field, and this has been associated with rapidly increasing malpractice cover costs. In 2013 the annual Medical Protection Society fee for cover was R250,900. We wished to determine whether high malpractice cover was influencing how neurosurgeons managed patients. A 40-question online survey asking questions on defensive medicine was distributed to determine perceptions around liability risk and whether these influenced how patients were managed. Eighty-four per cent of respondents agreed that a medicolegal crisis existed, and over half (53.8%) had been sued for malpractice during their career. Altering practice behaviour to minimise the risk of a lawsuit is common. The increasing number of legal claims against respondents in this survey has resulted in most neurosurgeons practising defensive medicine. Arguably this will result in increased healthcare costs, inferior patient care and decreased access to skilled surgeons.

Medicolegal assessment of the ability to drive a motor vehicle in persons with epilepsy.

PubMed

Gube, Monika; Ell, Werner; Schiefer, Johannes; Kraus, Thomas

2010-04-01

Determining whether a patient with epilepsy ought to be allowed to drive a motor vehicle is a challenging matter for the physician. This situation is fraught with medicolegal uncertainties, not just for general practitioners, but also for specialists and occupational health physicians. A case is reported and discussed in the light of a selective review of the literature and the German medicolegal assessment guidelines for the determination of the ability to drive a motor vehicle. The risk associated with driving can be estimated as a function of the type of epilepsy from which the patient suffers and of the frequency of seizures. The expert can then express an opinion on the basis of this assessment, within the framework of the German medicolegal assessment guidelines and the German Driver Licensing Act ("Fahrerlaubnisverordnung"). There is no general duty of physicians to report a patient's unsuitability for driving a motor vehicle, but physicians have a right to report to the authorities that a patient should not be allowed to drive when the patient fails to comply with a recommendation not to drive and when a higher legally protected interest is at risk. The drawbacks of secondary prevention, as illustrated by the case presented here, could be minimized if the treating physician took the patient's occupational history and gave the relevant advice early on in the course of the patient's illness. Likewise, early counseling about driving would lessen the need for physicians to tell the authorities that patients should not drive in cases where the public interest overrides the patient's right to confidentiality.

Medicolegal implications of surgical errors and complications in neck surgery: A review based on the Italian current legislation

PubMed Central

Polistena, Andrea; Sanguinetti, Alessandro; Buccelli, Claudio; Conzo, Giovanni; Conti, Adelaide; Niola, Massimo; Avenia, Nicola

2016-01-01

Abstract Aim of the present paper is the review of the principal complications associated to endocrine neck surgery considering how expertise, full adoption of guidelines, appropriate technology and proper informed consent may limit the medicolegal claims at the light of the incoming new regulation of the medical professional legal responsibility. A literature search, using the Medline/PubMed database for full-length papers, was used. Postoperative recurrent laryngeal nerve (RLN) palsy and hypoparathy-roidism remain the principal causes of surgical malpractice claims . In the procedure of neck lymphadenctomy intra-operative haemorrhage, thoracic duct injury, injuries to loco-regional nerves can be observed and can be source of claims. After many years of increased medicolegal litigations, the Italian government is proposing a drastic change in the regulations of supposed medical malpractice in order to guarantee the patient’s right to a safe treatment and in the meantime to defend clinicians from often unmotivated and prejudicial legal cases. Surgical errors and complications in neck surgery are a relevant clinical issue. Only the combination of surgical and clinical expertise, application of guidelines, appropriate technology and a routinely use of specific informed consent can contain potential medicolegal implications. PMID:28352812

The First Survey of Forensically Important Entomofauna Collected from Medicolegal Autopsies in South Korea

PubMed Central

Shin, Sang Eon; Lee, Hyun Ju; Park, Ji Hye; Ko, Kwang Soo; Kim, Yu-Hoon; Kim, Kyung Ryoul

2015-01-01

Forensic entomology applies insect evidence to legal problems such as the estimation of minimum postmortem interval (mPMI). For this purpose, knowledge of the insect fauna that are attracted to human cadavers in each geographic region is a prerequisite. Despite many studies investigating the insect fauna attracted to meat, there has been no survey of the entomofauna on human cadavers in the East Asian temperate climate zone, particularly in Korea. Therefore, this study reports the entomofauna collected from medicolegal autopsies in northeastern Seoul and its suburbs. Insect samples were collected from 35 medicolegal autopsies in 2010, 2011, and 2013. Molecular and morphological methods were utilized for taxonomic identification. Among 1398 individual samples belonging to 3 orders, 13 families, 18 genera, and 32 species, the dominant family and species were Calliphoridae and Lucilia sericata, respectively. Despite its limited scale, this study provides a snapshot of the general entomofauna that are attracted to human cadavers in this region. PMID:26185759

Best Practice Strategies for Effective Use of Questions as a Teaching Tool

PubMed Central

Elsner, Jamie; Haines, Stuart T.

2013-01-01

Questions have long been used as a teaching tool by teachers and preceptors to assess students’ knowledge, promote comprehension, and stimulate critical thinking. Well-crafted questions lead to new insights, generate discussion, and promote the comprehensive exploration of subject matter. Poorly constructed questions can stifle learning by creating confusion, intimidating students, and limiting creative thinking. Teachers most often ask lower-order, convergent questions that rely on students’ factual recall of prior knowledge rather than asking higher-order, divergent questions that promote deep thinking, requiring students to analyze and evaluate concepts. This review summarizes the taxonomy of questions, provides strategies for formulating effective questions, and explores practical considerations to enhance student engagement and promote critical thinking. These concepts can be applied in the classroom and in experiential learning environments. PMID:24052658

Best practice strategies for effective use of questions as a teaching tool.

PubMed

Tofade, Toyin; Elsner, Jamie; Haines, Stuart T

2013-09-12

Questions have long been used as a teaching tool by teachers and preceptors to assess students' knowledge, promote comprehension, and stimulate critical thinking. Well-crafted questions lead to new insights, generate discussion, and promote the comprehensive exploration of subject matter. Poorly constructed questions can stifle learning by creating confusion, intimidating students, and limiting creative thinking. Teachers most often ask lower-order, convergent questions that rely on students' factual recall of prior knowledge rather than asking higher-order, divergent questions that promote deep thinking, requiring students to analyze and evaluate concepts. This review summarizes the taxonomy of questions, provides strategies for formulating effective questions, and explores practical considerations to enhance student engagement and promote critical thinking. These concepts can be applied in the classroom and in experiential learning environments.

Strategic Environmental Assessment in Germany - Practice and open questions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weiland, Ulrike, E-mail: uweiland@uni-leipzig.d

2010-04-15

Eight years after the enactment of the EU Strategic Environmental Assessment Directive (2001/42/EC) () it is time to investigate where and how SEA are being implemented in Germany in order to find out open questions and research needs. In this study, we analysed in which planning types SEA are common practice, and where can deficits be identified, and to what extent differences occur between spatial and sectoral planning with respect to carrying out SEA. Pressing challenges in performing SEA as well as open questions are addressed such as the handling of cumulative effects and the interrelationships between the environmental factors,more » and how the monitoring of environmental effects is considered by the practitioners. The results show that SEA is well implemented in local land-use planning, regional planning, and in local landscape planning, while the implementation in sectoral planning varies widely. The SEA in clean air planning is looked at in more detail, because this is discussed controversially in the specialist field, and obstacles against SEA are identified in this field. Finally some new topics are addressed for which solutions in spatial and environmental planning including SEA must be found, e.g. the consideration of biological diversity and the potential role of SEA in climate change. A European study on the identified open questions and their handling in different contexts and countries may allow for a qualitative amendment in practice.« less

[Medicolegal considerations about rape as a reason to decriminalize abortion].

PubMed

González-Wilhelm, Leonardo; Moreno, Leonardo; Carnevali, Raúl

2016-06-01

The Chilean senate is discussing a proposal to decriminalize abortion in 3 causals. One of these is when the pregnancy occurs as a result of a rape. To be legally able to perform the abortion in this circumstance, a health care team must confirm the occurrence of the facts constituting the offence. Regardless of the patient’s will, the accusation will be reported to the justice. In our view, in its current status the proposed rule does not consider certain medicolegal and procedural topics. Those flaws may determine in certain scenarios critical problems, such as: a) a wrongful conviction as a consequence of a false allegation of rape; (b) some pregnant due to a rape will not have access to the abortion procedure; (c) some accusations of rape will not be accredited nor criminally sanctioned. Employing a fictional case, we illustrate how those scenarios can actually be seen in practice. We also emphasize the difficulties and limitations that the health care team will encounter if the project is approved under the current conditions. Finally, we encourage the professional societies implicated in the theme to contribute in the legislatorial debate. Therefore, we give a set of proposals aimed to improve the bill before it may be enacted as a law.

Extrusion of Endodontic Filling Materials: Medico-Legal Aspects. Two Cases

PubMed Central

Santoro, Valeria; Lozito, Piercarlo; Donno, Antonio De; Grassi, Felice Roberto; Introna, Francesco

2009-01-01

The Authors describe two cases of alleged malpractice due to overfilling. The aim of this article is to underline some medico-legal aspects regarding the quantity of extruded material which may be considered acceptable and the consequent damage to the patient. Two cases are presented here: In the first case, the dentist’s liability is clear due to excessive extrusion of endodontic material beyond the apical region combined with incomplete obturation of the canals. In the second case however, because two different dentists were involved, establishing the connection of causality between their work and the damage reported by the patient was not easy. This situation makes it difficult to establish the limits of potential responsibility, coupled with the complete absence of radiographic signs of periapical rarefaction and the small quantities of material beyond the apex. From a medico-legal point of view, a dentist may be held responsible for compensation and financial expenses of a patient for restoration of damage resulting from a dental procedure. Italian guidelines offer no indications as to when overfilling should be considered the result of a procedural error, or if it fits within the range labelled as “acceptable” and this gap offers extremely subjective interpretations of legal consultants. So, it would therefore be useful to adopt more precise qualitative/dimensional parameters, keeping in mind that the guidelines offer therapeutic recommendations and are not rigid protocols. PMID:19543544

The answer is questions: accelerated-nursing students report practice questions are fundamental to first-time NCLEX-RN success.

PubMed

Blozen, Barbara B

2014-01-01

There are a number of anecdotal reports on demographic characteristics and academic success of accelerated-nursing students; yet few empirical studies have examined accelerated-nursing students NCLEX-RN success. Applying Knowles' adult learning theory as a guiding framework, the purpose of this qualitative study was to explore, from the accelerated-nursing students' perspective, the factors reported as contributing to their success on the NCLEX-RN. The research questions aimed to elicit participants' descriptions of their experiences and factors contributing to their success via individual interviews. The most significant finding the participants identified as the factor that contributed to their success was the practicing of NCLEX-RN questions. The findings of this study have several implications for educational policy and practice for universities and schools of nursing as the information gained from this study applies to recruitment and retention as well as curriculum and educational strategies in an accelerated-nursing program.

Gender identity disorder and its medico-legal considerations.

PubMed

Sharma, B R

2007-01-01

The general belief among behavioural scientists and physicians is that gender identity disorder or transsexualism is an identifiable and incapacitating disease which can be diagnosed and successfully treated by reassignment surgery in carefully selected patients. Although many advances have been made in the reassignment surgery techniques, phalloplasty still remains a major challenge; to date, no ideal technique has been developed. The new gender created by the reassignment surgery has, in turn, led to many legal complications for post-operative transsexuals because, in many developed and the developing countries, transsexuals are not given a legal identity, thereby adding to their agonies and miseries. This article examines the historical perspective, genesis and management of gender identity disorder, or transsexualism, and draws attention to the medico-legal considerations.

The pathology and medicolegal aspects of sexual activity.

PubMed

Eckert, W G; Katchis, S; Donovan, W

1991-03-01

The pathology of injury and its complications related to sexual activities has changed remarkably when compared with that of the past, which usually involved assaults or murders of female victims of varying ages, with moderate to serve beatings that may have accidentally resulted in the victim's death. Serial murderers, serial rapists, and molesters of both boys and girls have become much more prevalent in the last two decades in the United States. Unorthodox sexual behavior, such as "fisting," has increased in frequency, as has sexual violence related to cults, such as satanism. All of these present many challenges to medicolegal investigators. This report describes general and specific pathological sexual activities and injuries, some characteristics and methods of the perpetrators, and some specific cases as examples.

Toward automated consumer question answering: automatically separating consumer questions from professional questions in the healthcare domain.

PubMed

Liu, Feifan; Antieau, Lamont D; Yu, Hong

2011-12-01

Both healthcare professionals and healthcare consumers have information needs that can be met through the use of computers, specifically via medical question answering systems. However, the information needs of both groups are different in terms of literacy levels and technical expertise, and an effective question answering system must be able to account for these differences if it is to formulate the most relevant responses for users from each group. In this paper, we propose that a first step toward answering the queries of different users is automatically classifying questions according to whether they were asked by healthcare professionals or consumers. We obtained two sets of consumer questions (~10,000 questions in total) from Yahoo answers. The professional questions consist of two question collections: 4654 point-of-care questions (denoted as PointCare) obtained from interviews of a group of family doctors following patient visits and 5378 questions from physician practices through professional online services (denoted as OnlinePractice). With more than 20,000 questions combined, we developed supervised machine-learning models for automatic classification between consumer questions and professional questions. To evaluate the robustness of our models, we tested the model that was trained on the Consumer-PointCare dataset on the Consumer-OnlinePractice dataset. We evaluated both linguistic features and statistical features and examined how the characteristics in two different types of professional questions (PointCare vs. OnlinePractice) may affect the classification performance. We explored information gain for feature reduction and the back-off linguistic category features. The 10-fold cross-validation results showed the best F1-measure of 0.936 and 0.946 on Consumer-PointCare and Consumer-OnlinePractice respectively, and the best F1-measure of 0.891 when testing the Consumer-PointCare model on the Consumer-OnlinePractice dataset. Healthcare consumer

Knowledge and Perceptions of Health Workers' Training on Ethics, Confidentiality and Medico-Legal Issues.

PubMed

Barnie, Bernard Asamoah; Forson, Paa Kobina; Opare-Addo, Mercy Naa Aduele; Appiah-Poku, John; Rhule, Gyikua Plange; Oduro, George; Adu-Sarkodie, Yaw; Donkor, Peter

2015-02-01

Health care delivery in recent times has become more complicated, as patients expect health personnel to not only provide professional services but be accountable as well. It is thus imperative that health personnel are aware of their responsibility to the patient and also sensitive to medico legal issues if quality health care is to be assured. The aim of the study was to assess the knowledge and perception of health care workers on their training in ethics, confidentiality and medico-legal issues. It was expected that the results would inform policy on the training of the health workers. A cross-sectional survey was conducted among some categories of health workers (Doctors, Nurses and Health care assistants) at the Accident and Emergency directorate of Komfo Anokye Teaching Hospital, Ghana. A self-administered questionnaire was used to elicit information on ethics, confidentiality and medico- legal issues. Data collected was analyzed using SPSS version 16. A total of 103 health care workers were enrolled on the study representing 96% response rate. The study revealed that 74% had knowledge on ethics, confidentiality and medico- legal concepts; and 35.4% of the respondents indicated that health workers attitudes to ethics, confidentiality and medico- legal concepts was inadequate. About 28.3% indicated that their attitudes were good while 26.3% indicated attitudes were adequate with only 2% indicating that attitudes were very good. Nearly, 49% of the respondents also indicated that training on medico-legal issues should be taught during formal training and also on-the-job. Knowledge of health workers on ethics confidentiality and medico-legal issues is high and their perceptions are positive. However, regular training to update their knowledge will be necessary in order to ensure continuous improvement of the quality of health care delivery.

Question Asking in the Science Classroom: Teacher Attitudes and Practices

ERIC Educational Resources Information Center

Eshach, Haim; Dor-Ziderman, Yair; Yefroimsky, Yana

2014-01-01

Despite the wide agreement among educators that classroom learning and teaching processes can gain much from student and teacher questions, their potential is not fully utilized. Adopting the view that reporting both teachers' (of varying age groups) views and actual classroom practices is necessary for obtaining a more complete view of the…

A 20 year retrospective analysis of medicolegal deaths in a tertiary hospital setting in Nigeria.

PubMed

Akhiwu, W O; Nwafor, C C; Igbe, A P

2013-01-01

To determine and classify the various types of medicolegal deaths as seen at University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. This is a retrospective study of all the medicolegal deaths seen in the Department of Histopathology, (UBTH, Benin City over a 20 year period (January 1990-December 2009) as recorded in the autopsy registers of the department. A total of 5035 autopsies were done during the period, 89% of which were coroner cases. Four thousand, four hundred and eighty-one coroner cases representing 12.5% of all bodies received by the mortuary during the period were studied. The male to female ratio was 1.9:1, with an overall mean age of 38.3 years. The ages ranged from 1 day to 101 years with a peak incidence in the 25-44 years age group. A total of 553 children and 3928 adults were involved. The commonest indication for coroner's autopsy was sudden unexpected natural deaths (SUNDs) which accounted for 65.5% of the cases. Other causes of death were accidents, homicide, suicide, and undetermined causes representing 28.6, 5.0, 0.5, and 0.4%, respectively. Commonest cause of SUND was cardiovascular diseases with complications of hypertension being the most common CVS disease (26.9%). Road traffic accident was the commonest form of accident causing death (88.7%). Public enlightenment and health education about routine medical screening will help to reduce causes of natural deaths. This study shows the pattern of medicolegal autopsies in UBTH and this preliminary data will provide a baseline for future research and help in formulating policies to help in reduction of preventable causes of death.

Practice of forensic medicine and pathology in Sri Lanka.

PubMed

Balachandra, A Thambirajah; Vadysinghe, Amal N; William, Anita L

2011-02-01

The practice of forensic medicine and pathology in Sri Lanka is based on the British model. Medical students during their third and fourth years receive approximately 50 hours of lectures and tutorials in forensic medicine and pathology and then undergo an examination. After completing an internship, these doctors are sent to various hospitals throughout Sri Lanka where they may be asked to perform medicolegal examinations on victims and suspects in rape cases, persons suspected of being under the influence of drugs and/or alcohol, and, injured live patients. As well, they may be asked to perform medicolegal autopsies. Depending upon their experience, some medical officers may be designated as judicial medical officers and appointed full time to do medicolegal work. Up until 1980, judicial medical officers with at least 2 years of work experience were allowed to obtain their postgraduate qualifications in the United Kingdom. However, since 1981 and the establishment of its own Postgraduate Institute of Medicine in Colombo, Sri Lanka, medical officers are offered 2 postgraduate programs in forensic medicine and pathology, a diploma in legal medicine and a doctorate in medicine (forensic medicine). After completing the doctorate in forensic medicine, doctors are allowed to train abroad for a further year in an approved center. Upon return they can then be appointed as consultant judicial medical officers. The practice of forensic medicine and pathology in Sri Lanka is unique and vibrant. However, due to the country's prevailing civil war, the practice of forensic medicine and pathology is suboptimal.

Frequently asked questions about in vivo chlorophyll fluorescence: practical issues.

PubMed

Kalaji, Hazem M; Schansker, Gert; Ladle, Richard J; Goltsev, Vasilij; Bosa, Karolina; Allakhverdiev, Suleyman I; Brestic, Marian; Bussotti, Filippo; Calatayud, Angeles; Dąbrowski, Piotr; Elsheery, Nabil I; Ferroni, Lorenzo; Guidi, Lucia; Hogewoning, Sander W; Jajoo, Anjana; Misra, Amarendra N; Nebauer, Sergio G; Pancaldi, Simonetta; Penella, Consuelo; Poli, DorothyBelle; Pollastrini, Martina; Romanowska-Duda, Zdzislawa B; Rutkowska, Beata; Serôdio, João; Suresh, Kancherla; Szulc, Wiesław; Tambussi, Eduardo; Yanniccari, Marcos; Zivcak, Marek

2014-11-01

The aim of this educational review is to provide practical information on the hardware, methodology, and the hands on application of chlorophyll (Chl) a fluorescence technology. We present the paper in a question and answer format like frequently asked questions. Although nearly all information on the application of Chl a fluorescence can be found in the literature, it is not always easily accessible. This paper is primarily aimed at scientists who have some experience with the application of Chl a fluorescence but are still in the process of discovering what it all means and how it can be used. Topics discussed are (among other things) the kind of information that can be obtained using different fluorescence techniques, the interpretation of Chl a fluorescence signals, specific applications of these techniques, and practical advice on different subjects, such as on the length of dark adaptation before measurement of the Chl a fluorescence transient. The paper also provides the physiological background for some of the applied procedures. It also serves as a source of reference for experienced scientists.

Questioning Questions: Elementary Teachers' Adaptations of Investigation Questions Across the Inquiry Continuum

NASA Astrophysics Data System (ADS)

Biggers, Mandy

2018-02-01

Questioning is a central practice in science classrooms. However, not every question translates into a "good" science investigation. Questions that drive science investigations can be provided by many sources including the teacher, the curriculum, or the student. The variations in the source of investigation questions were explored in this study. A dataset of 120 elementary science classroom videos and associated lesson plans from 40 elementary teachers (K-5) across 21 elementary school campuses were scored on an instrument measuring the amount of teacher-direction or student-direction of the lessons' investigation questions. Results indicated that the investigation questions were overwhelmingly teacher directed in nature, with no opportunities for students to develop their own questions for investigation. This study has implications for researchers and practitioners alike, calling attention to the teacher-directed nature of investigation questions in existing science curriculum materials, and the need for teacher training in instructional strategies to adapt their existing curriculum materials across the continuum of teacher-directed and student-directed investigation questions. Teachers need strategies for adapting the teacher-directed questions provided in their existing curriculum materials in order to allow students the opportunity to engage in this essential scientific practice.

The effect of different levels of constructive teaching practices on teacher question asking behaviors

NASA Astrophysics Data System (ADS)

Erdogan, Ibrahim

The purposes of the study were: (1) to examine the effectiveness of the Iowa Chautauqua Professional Development Program (ICPDP) in moving elementary science teachers toward the use of more constructive teaching practices and (2) to investigate the effectiveness of different levels of teaching practices, especially in terms of a sample of teachers achieving "expert" state at the end of program compared with some attaining only with "competent" level. The variables considered were their perceptions of their own classroom practices, stated philosophy of teaching and learning, and their actual classroom practices and question asking behaviors observed via videotape recording. Structured questionnaires, focus group interviews, teacher reflections, and examination of lesson modules were used to collect data from thirty-three K-5 in-service teachers who were involved in a one-year ICPDP. Qualitative and quantitative analyses of data revealed that: (1) Teacher perceptions regarding their teaching and learning, and their actual teaching practices in classroom in terms of constructivist approaches were significantly changed after participation in the ICPDP. (2) Teacher perceptions of their classroom practices and stated philosophies of teaching and learning have a great affect on their actual practices that can be observed. (3) Teacher stated philosophies of teaching and learning significantly influence the quantity and quality of their use of questions in their classrooms. (4) The "expert" teachers accept students' alternative answers and deliberately ask high cognitive level questions that enable students to think critically and to guide them based on what the students are thinking. Alternatively, the "competent" teachers do not follow student responses and used questions which do not help students to understand their current level of understanding nor encourage students to reflect on their own thinking. (5) The role of "expert" teacher is more geared toward challenging

[Behavioral disorders in Parkinson's disease. Genetic, pharmacological and medico-legal aspects].

PubMed

Sobrido, M J; Dias-Silva, J J; Quintáns, B

2009-01-23

Patients with Parkinson's disease (PD) may present neuropsychiatric and conduct disorders at different stages of the development of the disease that make treatment even more difficult. The neurologist must be on the lookout for the possible appearance of alterations affecting impulse control, even from the early stages of the disease, so as to be able to prevent them or to plan a suitable adjustment of treatment. Some of the most common impulsivity disorders include hypersexuality, compulsive gambling and other addictive behaviours which, if left undetected and untreated, can end up having a destructive effect on the patient's socio-familial surroundings. Psychotic disorders (hallucinations, delusions) are often associated to advanced phases of PD and to the effect of dopamine therapy, and they are associated to a higher morbidity and mortality rate. Factors of a genetic or pharmacogenetic nature or a gene-environment interaction may account for the different individual susceptibility to disorders in the neuropsychiatric realm among patients with PD. It is wise to bear in mind the possible medico-legal implications that may stem from behavioral disorders, both for the patient and his or her family and for the physician, because situations could arise that trigger conflicts between confidentiality and preventing third parties from being harmed, as well as harm that can be attributed to the side effects of medicines. The specialist must be familiar with, foresee and propose suitable treatment for behavioral and neuropsychiatric disorders in PD with potential medico-legal implications.

Questioning Questions: Elementary Teachers' Adaptations of Investigation Questions across the Inquiry Continuum

ERIC Educational Resources Information Center

Biggers, Mandy

2018-01-01

Questioning is a central practice in science classrooms. However, not every question translates into a "good" science investigation. Questions that drive science investigations can be provided by many sources including the teacher, the curriculum, or the student. The variations in the source of investigation questions were explored in…

International Defensive Medicine in Neurosurgery: Comparison of Canada, South Africa, and the United States.

PubMed

Yan, Sandra C; Hulou, M Maher; Cote, David J; Roytowski, David; Rutka, James T; Gormley, William B; Smith, Timothy R

2016-11-01

Perception of medicolegal risk has been shown to influence defensive medicine behaviors. Canada, South Africa, and the United States have 3 vastly different health care and medicolegal systems. There has been no previous study comparing defensive medicine practices internationally. An online survey was sent to 3672 neurosurgeons across Canada, South Africa, and the United States. The survey included questions on the following domains: surgeon demographics, patient characteristics, physician practice type, surgeon liability profile, defensive behavior-including questions on the frequency of ordering additional imaging, laboratory tests, and consults-and perception of the liability environment. Responses were analyzed, and multivariate logistic regression was used to examine the correlation of medicolegal risk environment and defensive behavior. The response rate was 30.3% in the United States (n = 1014), 36.5% in Canada (n = 62), and 41.8% in South Africa (n = 66). Canadian neurosurgeons reported an average annual malpractice premium of $19,110 (standard deviation [SD] = $11,516), compared with $16,262 (SD = $7078) for South African respondents, $75,857 (SD = $50,775) for neurosurgeons from low-risk U.S. states, and $128,181 (SD = $79,355) for those from high-risk U.S. states. Neurosurgeons from South Africa were 2.8 times more likely to engage in defensive behaviors compared with Canadian neurosurgeons, while neurosurgeons from low-risk U.S. states were 2.6 times more likely. Neurosurgeons from high-risk U.S. states were 4.5 times more likely to practice defensively compared with Canadian neurosurgeons. Neurosurgeons from the United States and South Africa are more likely to practice defensively than neurosurgeons from Canada. Perception of medicolegal risk is correlated with reported neurosurgical defensive medicine within these countries. Copyright © 2016 Elsevier Inc. All rights reserved.

78 FR 38735 - Autopsy Performance Criteria: Standards, Guidelines and Best Practices

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

... DEPARTMENT OF JUSTICE Office of Justice Programs [OJP (NIJ) Docket No. 1626] Autopsy Performance... Working Group for Medicolegal Death Investigation will make available to the general public a document entitled, ``Autopsy Performance Criteria: Standards, Guidelines and Best Practices''. The opportunity to...

How Do Question Writers Compose External Examination Questions? Question Writing as a Socio-Cognitive Process

ERIC Educational Resources Information Center

Johnson, Martin; Constantinou, Filio; Crisp, Victoria

2017-01-01

The focus of this research is on the practice of education examination question writing. Educational examinations are tests that are taken by candidates in schools or colleges but that are externally developed, administered and marked by an assessment organisation. Whilst the practice of writing external examination questions is ubiquitous,…

Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2014 edition.

PubMed

Minakami, Hisanori; Maeda, Tsugio; Fujii, Tomoyuki; Hamada, Hiromi; Iitsuka, Yoshinori; Itakura, Atsuo; Itoh, Hiroaki; Iwashita, Mitsutoshi; Kanagawa, Takeshi; Kanai, Makoto; Kasuga, Yoshio; Kawabata, Masakiyo; Kobayashi, Kosuke; Kotani, Tomomi; Kudo, Yoshiki; Makino, Yasuo; Matsubara, Shigeki; Matsuda, Hideo; Miura, Kiyonori; Murakoshi, Takeshi; Murotsuki, Jun; Ohkuchi, Akihide; Ohno, Yasumasa; Ohshiba, Yoko; Satoh, Shoji; Sekizawa, Akihiko; Sugiura, Mayumi; Suzuki, Shunji; Takahashi, Tsuneo; Tsukahara, Yuki; Unno, Nobuya; Yoshikawa, Hiroyuki

2014-06-01

The 'Clinical Guidelines for Obstetrical Practice, 2011 edition' were revised and published as a 2014 edition (in Japanese) in April 2014 by the Japan Society of Obstetrics and Gynecology and the Japan Association of Obstetricians and Gynecologists. The aims of this publication include the determination of current standard care practices for pregnant women in Japan, the widespread use of standard care practices, the enhancement of safety in obstetrical practice, the reduction of burdens associated with medico-legal and medico-economical problems, and a better understanding between pregnant women and maternity-service providers. The number of Clinical Questions and Answers items increased from 87 in the 2011 edition to 104 in the 2014 edition. The Japanese 2014 version included a Discussion, a List of References, and some Tables and Figures following the Answers to the 104 Clinical Questions; these additional sections covered common problems and questions encountered in obstetrical practice, helping Japanese readers to achieve a comprehensive understanding. Each answer with a recommendation level of A, B or C was prepared based principally on 'evidence' or a consensus among Japanese obstetricians in situations where 'evidence' was weak or lacking. Answers with a recommendation level of A or B represent current standard care practices in Japan. All 104 Clinical Questions and Answers items, with the omission of the Discussion, List of References, and Tables and Figures, are presented herein to promote a better understanding among English readers of the current standard care practices for pregnant women in Japan. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

Qualitative evaluation of an educational intervention to reduce medicolegal risks for medical doctors experiencing significantly more cases than their peers in the UK and Ireland

PubMed Central

Jolly, John; Bowie, Paul; Price, Julie; Mason, Matt; Dinwoodie, Mark

2018-01-01

Objectives The Medical Protection Society (MPS) is a leading protection organisation for healthcare professionals worldwide. In the UK and Ireland, a small minority of MPS members experience significantly more medicolegal cases than their peers and are invited to participate in a risk education (RE) remediation process. To understand more about this educational intervention, we sought to explore participating doctors’ views of their experiences of this process and identify self-reported performance improvements and what elements of the intervention could be improved. Design Qualitative semistructured telephone interviews with a convenience sample of doctors with significantly more medicolegal cases than their peers identified by MPS. Setting UK and Ireland MPS members. Participants A convenience sample of 20 general medical practitioners and hospital specialists from a total of 79 who completed the RE process (25.3% response rate), with a particular focus on the Member Risk Review programme, between November 2013 and October 2015. Results 19 participants were male and 16 were based in general medical (office) practice. Three key themes were generated: personal and professional impacts and actions (eg, member has taken action to reduce clinical workload); comprehension and validity of RE interventions (eg, risks were related to wider patient management); and feedback and proposals (eg, the supportive nature of the educational interventions should be clear from the start). A number of recommendations were made by participants to improve the RE process and enhance the educational experience. Conclusions The RE process was largely valued by participants with many reporting that participation led to some positive professional behaviour changes and improvements in practice processes and personal well-being. PMID:29678988

[Medico-legal autopsy--selected legal issues: the autopsy protocol].

PubMed

Gaszczyk-Ozarowski, Zbigniew; Chowaniec, Czesław

2010-01-01

The majority of experts in the field of forensic medicine maintain that the minutes of the medicolegal autopsy should be taken by the forensic pathologist. The authors argue that it is the public prosecutor who is obliged to draw up the minutes, whereas the forensic pathologist issues the expert opinion. To support their stance, the authors make frequent references to several provisions of the Criminal Procedure Code of 1997. The authors also imply that due to organizational reasons and the ratio legis of the aforementioned code, the forensic pathologist should not be assigned the role of the minutes-taker, despite the lack of a specific exclusion rule governing such a case. Possible consequences caused by the lack of the properly drawn up minutes are briefly discussed as well.

An Appraisal of Decomposition Cases Received at the Johannesburg Forensic Pathology Service Medico-legal Mortuary During 2010-2011.

PubMed

Keyes, Craig A; Hill, Lawrence; Gordon, Guinevere M

2016-03-01

Decomposed bodies pose many questions for researchers regarding environmental effects, cause of death, and patterns. This study aimed to observe the factors associated with decomposed bodies autopsied at the Johannesburg Forensic Pathology Service Medico-legal Mortuary. A total of 4876 autopsies were conducted from 2010 to 2011, of which 109 were decomposed. Black individuals made up the largest proportion (67%) followed by White (26%). Males comprised 86.2%, while 12.8% were female. The mean age was 42.78 years. Most cases were in the early stages of decomposition (49.5%), with 32.1% bloated, 11.9% in active decay, 2.8% in advanced decay, and 3.7% were skeletal. Insect activity was identified in 25.7% of decomposition cases. Cause of death was determined in 48.6% of cases. Of all the cases, 64% were found indoors and 23% outdoors, while 23% had insufficient information regarding the location. Of considerable interest was the number of cases from hospitals and clinics. © 2015 American Academy of Forensic Sciences.

Enhancing Cognitive Presence in Online Case Discussions with Questions Based on the Practical Inquiry Model

ERIC Educational Resources Information Center

Sadaf, Ayesha; Olesova, Larisa

2017-01-01

The researchers in this study examined the influence of questions designed with the Practical Inquiry Model (PIM), compared with the regular (playground) questions, on students' levels of cognitive presence in online discussions. Students' discussion postings were collected and categorized according to the four levels of cognitive presence:…

From stack-firing to pyromania: medico-legal concepts of insane arson in British, US and European contexts, c. 1800-1913. Part I.

PubMed

Andrews, Jonathan

2010-09-01

This article surveys evolving and competing medico-legal concepts of pyromania and insane arson. Exploiting evidence from medical jurisprudence, medico-legal publications, medical lexicography and case histories, it seeks to explicate the key positions in contemporary professional debates concerning arson and mental derangement. A major focus is the application of the doctrines of moral and partial insanity, monomania, instinctive insanity and irresistible impulse to understandings of pyromania and insane arson. The limited extent to which mental defect provided a satisfactory diagnosis and exculpatory plea for morbid arson is also explored. Additionally, this article compares and contrasts contemporary debates about other special manias, especially kleptomania. Part 2 will be published in the next issue, History of Psychiatry 21 (4).

[Medico-legal autopsies in Berlin from 1999 to 2003].

PubMed

Schmeling, Andreas; Geserick, Gunther; Wirth, Ingo

2009-01-01

This paper presents statistical data on medico-legal autopsies at the three Berlin institutes from 1999 to 2003. With an autopsy frequency of 6.5% in 1999, Berlin was ranking at the top in Germany. The relatively high autopsy rate--compared to other German institutes--led to a higher share of women, a higher mean age of the examined bodies and a higher percentage of cases of natural death. In accordance with studies from other major cities, there were more cases with an unknown cause of death and a higher number of drug victims than in rural areas. The negative consequences of a far too low autopsy rate in Germany regarding legal certainty, the quality of medical care and the validity of the statistics of causes of death are discussed in connection with possible measures to increase the frequency of autopsies.

Medico-Legal Findings, Legal Case Progression, and Outcomes in South African Rape Cases: Retrospective Review

PubMed Central

Jewkes, Rachel; Christofides, Nicola; Vetten, Lisa; Jina, Ruxana; Sigsworth, Romi; Loots, Lizle

2009-01-01

.036), ano-genital injuries alone (AOR 7.00, 95% CI 1.44–33.9, p = 0.017), or both nongenital and ano-genital injuries (AOR 12.34, 95% CI 2.87–53.0, p = 0.001). DNA was not associated with case outcome. Conclusions This is the first study, to our knowledge, to show an association between documentation of ano-genital injuries, trials commencing, and convictions in rape cases in a developing country. Its findings are of particular importance because they show the value of good basic medical practices in documentation of injuries, rather than more expensive DNA evidence, in assisting courts in rape cases. Health care providers need training to provide high quality health care responses after rape, but we have shown that the core elements of the medico-legal response require very little technology. As such they should be replicable in low- and middle-income country settings. Our findings raise important questions about the value of evidence that requires the use of forensic laboratories at a population level in countries like South Africa that have substantial inefficiencies in their police services. Please see later in the article for the Editors' Summary PMID:19823567

Bio-medicolegal scientific research in Europe. A country-based analysis.

PubMed

Viel, Guido; Boscolo-Berto, Rafael; Cecchi, Rossana; Bajanowski, Thomas; Vieira, Nuno Duarte; Ferrara, Santo Davide

2011-09-01

The European mosaic of socio-cultural, economic and legal realities is reflected in forensic and legal medicine, in which a great variety of operational modes of forensic medical services, organisational systems, structures, functional competences and scientific research strategies can be observed. The present work analyses the European bio-medicolegal scientific output of the last 5.5 years (exact time window, January 1, 2005-June 1, 2010), categorising papers by nationality of the corresponding author and forensic sub-discipline in question, in order to identify the peculiarities of national sub-specialised competences and to build up international research projects. This country-based bibliometric analysis, based on the number of articles and the impact factor produced by each European country, also considering its economic profile (gross domestic product and per capita gross domestic product), highlights the prevailing productive role of Western and Southern Europe (Germany, Great Britain, Italy, Switzerland, Spain and France). Categorising scientific output by forensic sub-discipline and branch, significant in terms of impact factor are contributions from Germany (coming first in Pathology, Toxicology, Genetics, Anthropology and Biological Criminalistics), Great Britain (first in Clinical Forensic Medicine, Malpractice and Invalidity-Social Insurance), Switzerland (first in Criminology), Italy (second in Toxicology, Anthropology and Invalidity-Social Insurance), The Netherlands (third in Clinical Forensic Medicine and Medical Law and Ethics), Spain (third in Genetics, Criminalistics and Invalidity-Social Insurance) and France (third in Toxicology and Malpractice). Interestingly, several countries with low gross domestic product, such as Poland, Turkey and other Eastern European nations, show notable scientific production in specific sub-disciplines such as Pathology, Toxicology and Forensic Genetics, suggesting that fruitful international cooperation could be

Padova Charter on personal injury and damage under civil-tort law : Medico-legal guidelines on methods of ascertainment and criteria of evaluation.

PubMed

Ferrara, Santo Davide; Baccino, Eric; Boscolo-Berto, Rafael; Comandè, Giovanni; Domenici, Ranieri; Hernandez-Cueto, Claudio; Gulmen, Mete Korkut; Mendelson, George; Montisci, Massimo; Norelli, Gian Aristide; Pinchi, Vilma; Ranavaya, Mohammed; Shokry, Dina A; Sterzik, Vera; Vermylen, Yvo; Vieira, Duarte Nuno; Viel, Guido; Zoja, Riccardo

2016-01-01

Compensation for personal damage, defined as any pecuniary or non-pecuniary loss causally related to a personal injury under civil-tort law, is strictly based on the local jurisdiction and therefore varies significantly across the world. This manuscript presents the first "International Guidelines on Medico-Legal Methods of Ascertainment and Criteria of Evaluation of Personal Injury and Damage under Civil-Tort Law". This consensus document, which includes a step-by-step illustrated explanation of flow charts articulated in eight sequential steps and a comprehensive description of the ascertainment methodology and the criteria of evaluation, has been developed by an International Working Group composed of juridical and medico-legal experts and adopted as Guidelines by the International Academy of Legal Medicine (IALM).

Danger points, complications and medico-legal aspects in endoscopic sinus surgery

PubMed Central

Hosemann, W.; Draf, C.

2013-01-01

Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5–1%. A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education. PMID:24403974

Any Questions? Want to Stimulate Student Curiosity? Let Them Ask Questions!

ERIC Educational Resources Information Center

Weiss, Tarin Harrar

2013-01-01

Of the eight scientific practices highlighted in "A Framework for K-12 Science Education: Practices, Crosscutting Concepts, and Core Ideas," the first is for students to develop abilities to ask questions and define problems (NRC 2012). Constructing a range of questions about an object or phenomenon validates not only what students have…

How good are the internal controls in your group practice? Ten questions to contemplate.

PubMed

Grant, Barbara J; Foley, Lori A

2002-01-01

Internal controls are the methods and procedures used by any business to prevent or detect errors, safeguard assets (especially cash) from being misappropriated, and encourage staff adherence to prescribed managerial policies. Internal controls in a medical practice differ depending on the size and complexity of the practice. The key, however, is that they prevent or detect errors and efforts to circumvent the established policies and procedures of the organization. How good are the internal controls in your group practice? This article identifies ten questions you should use to evaluate your risk of asset misappropriation.

The effect of the medico-legal evaluation on asylum seekers in the Metropolitan City of Milan, Italy: a pilot study.

PubMed

Franceschetti, L; Magli, F; Merelli, V G; Muccino, E A; Gentilomo, A; Agazzi, F; Gibelli, D M; Gambarana, M; De Angelis, D; Kustermann, A; Cattaneo, C

2018-05-26

In the present-day situation, the clinical forensic documentation of an asylum seeker's narrative and his or her examination, together with the physical and psychological findings, may have very important effects on the outcome of the request for political asylum. Since 2012, the Municipality of Milan, the University Institute of Legal Medicine, and other institutions have assembled a team with the task of examining vulnerable asylum seekers and preparing a medical report for the Territorial Commission for International Protection (Prefecture, Ministry of Interiors), who will assess the application. We compared medico-legal reports and outcomes of 57 cases which were evaluated by the Commission after having undergone a medico-legal evaluation through the Istanbul Protocol criteria and examined, in particular, which medico-legal variables seem associated to the outcome. The results show that forensic assessment seems to have a significant and interesting correlation with the final assessment given by the Commission. For example, the higher the level of consistency, according to the Istanbul Protocol, the more frequently protection is granted. These data show how important clinical forensic medicine can be in such scenarios and how the presence of clinical forensic experts should be encouraged in such evaluations, as has been recently enshrined in Italy in the guidelines of a Ministerial Decree of April 3rd, 2017 for the assistance and the rehabilitation as well as the treatment of psychiatric disorders in refugees and asylum seekers who have undergone torture, rape, and other severe forms of psychological, physical, or sexual violence.

Principles and practice of external digital photography in ophthalmology

PubMed Central

Mukherjee, Bipasha; Nair, Akshay Gopinathan

2012-01-01

It is mandatory to incorporate clinical photography in an ophthalmic practice. Patient photographs are routinely used in teaching, presentations, documenting surgical outcomes and marketing. Standardized clinical photographs are part of an armamentarium for any ophthalmologist interested in enhancing his or her practice. Unfortunately, many clinicians still avoid taking patient photographs for want of basic knowledge or inclination. The ubiquitous presence of the digital camera and digital technology has made it extremely easy and affordable to take high-quality images. It is not compulsory to employ a professional photographer or invest in expensive equipment any longer for this purpose. Any ophthalmologist should be able to take clinical photographs in his/her office settings with minimal technical skill. The purpose of this article is to provide an ophthalmic surgeon with guidelines to achieve standardized photographic views for specific procedures, to achieve consistency, to help in pre-operative planning and to produce accurate pre-operative and post-operative comparisons, which will aid in self-improvement, patient education, medicolegal documentation and publications. This review also discusses editing, storage, patient consent, medicolegal issues and importance of maintenance of patient confidentiality. PMID:22446907

Principles and practice of external digital photography in ophthalmology.

PubMed

Mukherjee, Bipasha; Nair, Akshay Gopinathan

2012-01-01

It is mandatory to incorporate clinical photography in an ophthalmic practice. Patient photographs are routinely used in teaching, presentations, documenting surgical outcomes and marketing. Standardized clinical photographs are part of an armamentarium for any ophthalmologist interested in enhancing his or her practice. Unfortunately, many clinicians still avoid taking patient photographs for want of basic knowledge or inclination. The ubiquitous presence of the digital camera and digital technology has made it extremely easy and affordable to take high-quality images. It is not compulsory to employ a professional photographer or invest in expensive equipment any longer for this purpose. Any ophthalmologist should be able to take clinical photographs in his/her office settings with minimal technical skill. The purpose of this article is to provide an ophthalmic surgeon with guidelines to achieve standardized photographic views for specific procedures, to achieve consistency, to help in pre-operative planning and to produce accurate pre-operative and post-operative comparisons, which will aid in self-improvement, patient education, medicolegal documentation and publications. This review also discusses editing, storage, patient consent, medicolegal issues and importance of maintenance of patient confidentiality.

Long-term outcome of the shaken baby syndrome and medicolegal consequences: a case report.

PubMed

Laurent-Vannier, A; Toure, H; Vieux, E; Brugel, D G; Chevignard, M

2009-06-01

Studies of long-term outcome of the shaken baby syndrome (SBS) are scarce, but they usually indicate poor outcome. To describe long-term outcome of a child having sustained a SBS, to ascertain possible delayed sequelae and to discuss medicolegal issues. We report a single case study of a child having sustained a SBS, illustrating the initial clinical features, the neurological, cognitive and behavioural outcomes as well as her social integration. The child sustained diffuse brain injuries, responsible for spastic right hemiplegia leading to secondary orthopaedic consequences, as well as severe cognitive impairment, worsening over time: the developmental quotient measured at 15 months of age was 55 and worsened as age increased. At 6 years and 8 months, the child's IQ had fallen to 40. Behavioural disorders became apparent only after several months and precluded any social integration. The child eventually had to be placed in a specialised education centre at age 5. The SBS has a very poor outcome and major long-standing sequelae are frequent. Cognitive or behavioural sequelae can become apparent only after a long sign-free interval, due to increasing demands placed on the child during development. This case report confirms severity of early brain lesions and necessity for an extended follow-up by a multi-disciplinary team. From a medicolegal point of view, signaling the child to legal authorities allows protection of the child, but also conditions later compensation if sequelae compromise autonomy.

Artificial Intelligence in Medical Practice: The Question to the Answer?

PubMed

Miller, D Douglas; Brown, Eric W

2018-02-01

Computer science advances and ultra-fast computing speeds find artificial intelligence (AI) broadly benefitting modern society-forecasting weather, recognizing faces, detecting fraud, and deciphering genomics. AI's future role in medical practice remains an unanswered question. Machines (computers) learn to detect patterns not decipherable using biostatistics by processing massive datasets (big data) through layered mathematical models (algorithms). Correcting algorithm mistakes (training) adds to AI predictive model confidence. AI is being successfully applied for image analysis in radiology, pathology, and dermatology, with diagnostic speed exceeding, and accuracy paralleling, medical experts. While diagnostic confidence never reaches 100%, combining machines plus physicians reliably enhances system performance. Cognitive programs are impacting medical practice by applying natural language processing to read the rapidly expanding scientific literature and collate years of diverse electronic medical records. In this and other ways, AI may optimize the care trajectory of chronic disease patients, suggest precision therapies for complex illnesses, reduce medical errors, and improve subject enrollment into clinical trials. Copyright © 2018 Elsevier Inc. All rights reserved.

A qualitative study of the background and in-hospital medicolegal response to female burn injuries in India.

PubMed

Daruwalla, Nayreen; Belur, Jyoti; Kumar, Meena; Tiwari, Vinay; Sarabahi, Sujata; Tilley, Nick; Osrin, David

2014-11-30

Most burns happen in low- and middle-income countries. In India, deaths related to burns are more common in women than in men and occur against a complex background in which the cause - accidental or non-accidental, suicidal or homicidal - is often unclear. Our study aimed to understand the antecedents to burns and the problem of ascribing cause, the sequence of medicolegal events after a woman was admitted to hospital, and potential opportunities for improvement. We conducted semi-structured interviews with 33 women admitted to two major burns units, their families, and 26 key informant doctors, nurses, and police officers. We used framework analysis to examine the context in which burns occurred and the sequence of medicolegal action after admission to hospital. Interviewees described accidents, attempted suicide, and attempted homicide. Distinguishing between these was difficult because the underlying combination of poverty and cultural precedent was common to all and action was contingent on potentially conflicting narratives. Space constraint, problems with cooking equipment, and inflammable clothing increased the risk of accidental burns, but coexisted with household conflict, gender-based violence, and alcohol use. Most burns were initially ascribed to accidents. Clinicians adhered to medicolegal procedures, the police carried out their investigative requirements relatively rapidly, but both groups felt vulnerable in the face of the legal process. Women's understandable reticence to describe burns as non-accidental, the contested nature of statements, their perceived history of changeability, the limited quality and validity of forensic evidence, and the requirement for resilience on the part of clients underlay a general pessimism. The similarities between accident and intention cluster so tightly as to make them challenging to distinguish, especially given women's understandable reticence to describe burns as non-accidental. The contested status of

Multidisciplinary cancer care in Australia: a national audit highlights gaps in care and medico-legal risk for clinicians.

PubMed

Wilcoxon, Heidi; Luxford, Karen; Saunders, Christobel; Peterson, Janice; Zorbas, Helen

2011-03-01

Multidisciplinary care (MDC) is accepted as best practice in cancer treatment planning and care. Despite recognition of the importance of a team approach, limited data are available about the extent to which MDC has been implemented in Australia. The aim of the audit was to investigate the implementation of MDC for five main cancer types across Australia in line with best practice. A sample of 155 hospitals was surveyed to investigate the status of MDC for cancer treatment planning in Australia across five cancer types (breast, gynecological, lung, prostate and colorectal). The survey investigated team structure, meetings, patient consent, documentation of team recommendations and communication with the patient. Two-thirds of hospitals surveyed did not have a multidisciplinary team. Of those with such a team; in one-third patients were not informed their case would be discussed by the team, in half patient consent was not sought for all cases discussed by the team, in one-quarter the team's recommended treatment plan was not noted in the patient record. Less than 1% of teams reported routine attendance by the tumour-specific minimum core team. MDC is not being implemented in line with best practice or applied consistently across Australia. This audit has highlighted gaps in care delivery, despite national recommendations about MDC. Areas being neglected can affect the quality of care provided and may put clinicians at medico-legal risk. Recommendations to improve uptake and effectiveness of MDC are provided. © 2011 Blackwell Publishing Asia Pty Ltd.

Predicting self-reported research misconduct and questionable research practices in university students using an augmented Theory of Planned Behavior

PubMed Central

Rajah-Kanagasabai, Camilla J.; Roberts, Lynne D.

2015-01-01

This study examined the utility of the Theory of Planned Behavior model, augmented by descriptive norms and justifications, for predicting self-reported research misconduct and questionable research practices in university students. A convenience sample of 205 research active Western Australian university students (47 male, 158 female, ages 18–53 years, M = 22, SD = 4.78) completed an online survey. There was a low level of engagement in research misconduct, with approximately one in seven students reporting data fabrication and one in eight data falsification. Path analysis and model testing in LISREL supported a parsimonious two step mediation model, providing good fit to the data. After controlling for social desirability, the effect of attitudes, subjective norms, descriptive norms and perceived behavioral control on student engagement in research misconduct and questionable research practices was mediated by justifications and then intention. This revised augmented model accounted for a substantial 40.8% of the variance in student engagement in research misconduct and questionable research practices, demonstrating its predictive utility. The model can be used to target interventions aimed at reducing student engagement in research misconduct and questionable research practices. PMID:25983709

Predicting self-reported research misconduct and questionable research practices in university students using an augmented Theory of Planned Behavior.

PubMed

Rajah-Kanagasabai, Camilla J; Roberts, Lynne D

2015-01-01

This study examined the utility of the Theory of Planned Behavior model, augmented by descriptive norms and justifications, for predicting self-reported research misconduct and questionable research practices in university students. A convenience sample of 205 research active Western Australian university students (47 male, 158 female, ages 18-53 years, M = 22, SD = 4.78) completed an online survey. There was a low level of engagement in research misconduct, with approximately one in seven students reporting data fabrication and one in eight data falsification. Path analysis and model testing in LISREL supported a parsimonious two step mediation model, providing good fit to the data. After controlling for social desirability, the effect of attitudes, subjective norms, descriptive norms and perceived behavioral control on student engagement in research misconduct and questionable research practices was mediated by justifications and then intention. This revised augmented model accounted for a substantial 40.8% of the variance in student engagement in research misconduct and questionable research practices, demonstrating its predictive utility. The model can be used to target interventions aimed at reducing student engagement in research misconduct and questionable research practices.

Medico-legal and ethical aspects in the management of wandering patients following brain injury: questionnaire survey.

PubMed

Gaber, Tarek A-Z K

2006-11-30

Different methods are often used to deter head injury patients, who have a tendency to wander, from leaving the rehabilitation wards. The extent to which these patients could be restrained is controversial. Despite the fact that the majority of these patients lack mental capacity, Mental Health Act sections are rarely invoked. Under common law, informal patients should have the right to refuse treatment and to leave the hospital whenever they like. To examine the current practice in the management of wandering patients following brain injury in rehabilitation units in the UK and to formulate practical guidelines based on this common practice. A postal survey in the form of a structured questionnaire was sent to 58 consultants in Rehabilitation Medicine and Neuropsychologists based at different neurological rehabilitation units in the UK. A total of 30 clinicians (52%) completed the questionnaire. One-to-one supervision was the method most commonly used to manage wandering patients (83%) followed by implementation of a structured daily routine (73%) and the use of different medications (70%). Only 17% would lock the door without giving the patient lock combination/key and another 17% would physically restrain the patient without invoking mental health act (MHA) section; 60% would consider MHA section with great variability in the mental health team response time and the place where patient is managed once under MHA section. The questionnaire showed great variations in the methods and the medico-legal framework used in the management of wandering patients. There was, however, a tendency to avoid physical restraint which may reflect the recognition of the unlawfulness of detaining informal patients.

The medico-legal observation of an aggressive urogenital fibromatosis with isolated development not related to any traumatic event.

PubMed

Muccino, Enrico; Gentile, Guendalina; Mantero, Stefano; Marchesi, Matteo; Rancati, Alessandra; Zoja, Riccardo

2016-03-01

Desmoid tumor is a fibroproliferative neoplasm with an intermediate malignancy and it can be localized in every bodily district: some locations are considered exceptional, like the urogenital localization. The Author point out a rare case of giant idiopathic scrotal fibromatosis that was found during an autopsy. A widower, that lived alone in poor hygienic conditions, was found dead in his house. The Judicial Authority ordered the autopsy, that was performed two days later at the Medico-Legal Section of Milan University. External examinations revealed only the considerable dimension of the scrotum (cm 24 × 41). The cause of death was fixed in a cardiac tamponade due to a natural heart laceration localized in correspondence of a transmural infarction. The toxicological exam resulted negative, while the histopathological and immunohistochemical analysis qualify the scrotal mass as a desmoids tumor. Due to the absence of predisposing conditions and of fibroproliferative infiltration in bladder and retroperitoneal space, the neoplasm was configured as an idiopathic desmoid tumor. The presented case gives the reason for the discussion concerning medico-legal aspects that are typical of rare neoplasms. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Series: Practical guidance to qualitative research. Part 2: Context, research questions and designs.

PubMed

Korstjens, Irene; Moser, Albine

2017-12-01

In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By 'novice' we mean Master's students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. This second article addresses FAQs about context, research questions and designs. Qualitative research takes into account the natural contexts in which individuals or groups function to provide an in-depth understanding of real-world problems. The research questions are generally broad and open to unexpected findings. The choice of a qualitative design primarily depends on the nature of the research problem, the research question(s) and the scientific knowledge one seeks. Ethnography, phenomenology and grounded theory are considered to represent the 'big three' qualitative approaches. Theory guides the researcher through the research process by providing a 'lens' to look at the phenomenon under study. Since qualitative researchers and the participants of their studies interact in a social process, researchers influence the research process. The first article described the key features of qualitative research, the third article will focus on sampling, data collection and analysis, while the last article focuses on trustworthiness and publishing.

E-suicide note: A newer trend and its medico-legal implications in India.

PubMed

Behera, C; Karthik, Krishna; Dogra, Td; Lalwani, S; Millo, T; Singh, Sr

2014-06-01

Rapid advancements of information and communication technology in the form of electronic mails, mobile phones, social networking sites, etc have an increasing impact on people's day to day life. It has been observed that these readily available applications are used frequently to express suicidal intentions. There are many studies on conventional handwritten suicide notes but suicide note in electronic format is an emerging issue and an under-researched phenomena. The authors have termed it as "E-suicide note" and discuss its medico-legal implications in India with examples from their observations. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Past Examination Questions in Senior Secondary Chemistry: From Written Practice to Hands-On Experiments

ERIC Educational Resources Information Center

Chow, Cheuk-Fai; So, Wing-Mui Winnie; Cheung, Tsz-Yan

2016-01-01

This study applied an unconventional use of past examination papers by converting questions into hands-on experiments for students. Students in an experimental group were engaged in use of those experiments while the remainder attended conventional lectures with written practice. The results reflect that the experimental group positively improved…

Toward a standardized investigation protocol in sudden unexpected deaths in infancy in South Africa: a multicenter study of medico-legal investigation procedures and outcomes.

PubMed

du Toit-Prinsloo, Lorraine; Dempers, Johan; Verster, Janette; Hattingh, Christa; Nel, Hestelle; Brandt, V D; Jordaan, Joyce; Saayman, Gert

2013-09-01

South Africa manifests a socio-economic dichotomy that shows features of both a developed and developing country. As a result of this, areas exist where a lack of resources and expertise prevents the implementation of a highly standardized protocol for the investigation of sudden and unexpected deaths in infants (SUDI). Although the medico-legal mortuaries attached to academic centers have the capacity to implement standardized protocols, a previous study conducted at two large medico-legal mortuaries indicated otherwise. This study also revealed that the exact number and incidence of sudden infant death syndrome (SIDS) cases was unknown. These findings prompted a multicenter study of the medico-legal investigation procedures and outcomes in five academic centers in South Africa. A retrospective case audit was conducted for a 5-year period (2005-2009) at medico-legal laboratories attached to universities in Bloemfontein, Cape Town-Tygerberg, Durban, Johannesburg, and Pretoria. The total case load as well as the total number of infants younger than 1 year of age admitted to these mortuaries was documented. The case files on all infants younger than 1 year of age who were admitted as sudden and unexpected or unexplained deaths were included in the study population. Data collected on the target population included demographic details, the nature and scope of the post-mortem examinations, as well as the final outcome (cause of death). A total case load of 80,399 cases were admitted to the mortuaries over the 5 year period with a total of 3,295 (6.5 %) infants. In the infant group, 591 (0.7 %) died from non-natural causes and 2,704 (3.3 %) cases of sudden, unexpected and/or unexplained deaths in infants were admitted and included in the detailed case analysis study. One hundred and ninety-nine babies were between 0 and 7 days of age and 210 babies between 8 and 30 days. The remaining 2,295 infants were between 1 month and 12 months of age. Death scene investigation was

"Gym Class with Ed Fizz": Exploring Questionable Pedagogical Practices with Preservice Physical Education Teachers

ERIC Educational Resources Information Center

Robinson, Daniel B.; Gleddie, Doug

2011-01-01

Enabling preservice physical education teachers to critically consider questionable and taken-for-granted practices is an important component of a physical education teacher education (PETE) program. In an effort to offer a teaching and learning context in which to introduce such critical consciousness, the authors have included a staged physical…

Ten Practical Questions about Branding

ERIC Educational Resources Information Center

Moore, Robert M.; Rattenbury, Jeanne

2004-01-01

"Marketing" and "branding" were once considered dirty words on campus but faculty, staff, and board members now appreciate the value of getting their message out and managing their reputation. The question is not so much whether to invest, but when, how, and most important, what's the return on investment? A roundtable of accomplished marketing…

The medicolegal and forensic aspects of fires.

PubMed

Eckert, W G

1981-12-01

Fires, their consequences and their investigations, continue to provide forensic scientists, especially those involved in medicolegal investigation (the medical examiner or forensic pathologist), with constant work and variations in problems. The recent history of mass disasters involving high-rise buildings, transport accidents, and arson-related accidents in nightclubs and prisons has emphasized the necessity for corrective and preventive means to ensure safety to the occupants of any of these areas. Problems presented by fires include the determination of the cause of the fire, the identification of the victims, and the cause and manner of their deaths. The motivation of the fire setter and the settlement by the insurance company or legal means are also aspects to be considered. The imperceptible effects of the fires include many other aspects, among which loss of loved ones and family providers and loss of industrial revenue and job potential are all felt. The most frightening development of all, however, is the insidious surfacing of arson as a possible factor in many major fires. The most recent tragedies involving the Stouffer Inn fire and the Hilton International Hotel fire were both related to arsonous acts. The scope of this article is to review the subject as it affects the forensic medical practitioner directly or indirectly so that his or her investigation may be brought to completion in conjunction with other authorities involved in the case.

Questioning Techniques: A Study of Instructional Practice

ERIC Educational Resources Information Center

Hill, Joan Buchanan

2012-01-01

This study took place in an independent all girls' school which serves over six hundred students in grades pre-kindergarten through twelve. This study seeks to answer the question: To what extent do teachers use questions to encourage deeper thinking and fuller responses. Through a review of literature, observations, interviews and analysis,…

Guidelines on the diagnosis of noise-induced hearing loss for medicolegal purposes.

PubMed

Coles, R R; Lutman, M E; Buffin, J T

2000-08-01

These guidelines aim to assist in the diagnosis of noise-induced hearing loss (NIHL) in medicolegal settings. The task is to distinguish between possibility and probability, the legal criterion being 'more probable than not'. It is argued that the amount of NIHL needed to qualify for that diagnosis is that which is reliably measurable and identifiable on the audiogram. The three main requirements for the diagnosis of NIHL are defined: R1, high-frequency hearing impairment; R2, potentially hazardous amount of noise exposure; R3, identifiable high-frequency audiometric notch or bulge. Four modifying factors also need consideration: MF1, the clinical picture; MF2, compatibility with age and noise exposure; MF3, Robinson's criteria for other causation; MF4, complications such as asymmetry, mixed disorder and conductive hearing impairment.

The medicolegal landscape of spine surgery: how do surgeons fare?

PubMed

Makhni, Melvin C; Park, Paul J; Jimenez, Jesus; Saifi, Comron; Caldwell, Jon-Michael; Ha, Alex; Figueroa-Santana, Bianca; Lehman, Ronald A; Weidenbaum, Mark

2018-02-01

Because of the limited and confidential nature of most legal data, scarce literature is available to physicians about reasons for litigation in spine surgery. To optimally compensate patients while protecting physicians, further understanding of the medicolegal landscape is needed for high-risk procedures such as spine surgery. Based on these, surgeons can explore ways to better protect both their patients and themselves. To characterize the current medicolegal environment of spine surgery by analyzing a recent dataset of malpractice litigation. A retrospective study. All malpractice cases involving spine surgery available to public query between the years of 2010 and 2014. Case outcome for spine surgery malpractice cases between the years of 2010 and 2014. WestlawNext was used to analyze spine surgery malpractice cases at the state and federal level between the years 2010 and 2014. WestlawNext is a subscription-based, legal search engine that contains publicly available federal and state court records. All monetary values were inflation adjusted for 2016. One hundred three malpractice cases were categorized by case descriptors and outcome measures. Claims were categorized as either intraoperative complaints or preoperative complaints. Rulings in favor of the defendant (surgeon) were noted in 75% (77 of 103) of the cases. Lack of informed consent was cited in 34% of cases. For the 26 cases won by the plaintiff, the average amount in settlement was $2,384,775 versus $3,945,456 in cases brought before a jury. Cases involving consent averaged a compensation of $2,029,884, whereas cases involving only intraoperative complaints averaged a compensation of $3,667,530. A significant correlation was seen between increased compensation for plaintiffs and cases involving orthopedic surgeons (p=.020) or nerve injury (p=.005). Wrong-level surgery may be associated with lower plaintiff compensation (p=.055). The length of cases resulting in defense verdicts averaged 5.51 years

In Defense of the Questionable: Defining the Basis of Research Scientists' Engagement in Questionable Research Practices.

PubMed

Sacco, Donald F; Bruton, Samuel V; Brown, Mitch

2018-02-01

National Institutes of Health principal investigators reported their perceptions of the ethical defensibility, prevalence in their field, and their personal willingness to engage in questionable research practices (QRPs). Using ethical defensibility ratings, an exploratory factor analysis yielded a two-factor solution: behaviors considered unambiguously ethically indefensible and behaviors whose ethical defensibility was more ambiguous. In addition, increasing perceptions that QRPs affect science predicted reduced acceptability of QRPs, whereas increasing beliefs that QRPs are normative or necessary for career success predicted increased acceptability of QRPs. Perceptions that QRPs are risky were unrelated to QRP acceptability but predicted reduced extramural funding (i.e., researchers' lifetime extramural grants and total funding secured). These results identify risk (i.e., beliefs that QRPs are normative to stay competitive in one's field) and protective factors (i.e., beliefs that QRPs have a significant negative impact on society) related to QRP endorsement that could inform educational interventions for training research scientists.

Computed tomography use in minor head injury: attitudes and practices of emergency physicians, neurosurgeons, and radiologists in Turkey.

PubMed

Özan, Ebru; Ataç, Gökçe Kaan

2018-03-01

We aimed to determine the attitudes and practices of emergency physicians (EPs), neurosurgeons, and radiologists in Turkey regarding computed tomography (CT) use for adults with minor head injury (MHI). This cross-sectional study was conducted between August 2015 and October 2016 after obtaining the approval of the institutional ethical committee. The purpose of this study was disclosed to the participants prior to beginning the survey. The study was performed conducting a questionnaire via e-mail on three groups of participants including EPs, neurosurgeons, and radiologists. Participants comprised academic staff at university hospitals as well as department chiefs, specialists, and residents working at university, government, and private hospitals, all of whom are in charge of evaluating MHI patients. A total of 607 participants including 201 (33.1%) EPs, 179 (29.5%) neurosurgeons, and 227 (37.4%) radiologists responded to the survey; 31% of the participants reported awareness and 27.3% reported use of head CT rules in MHI. Awareness and use of the rules were most prominent in EPs group, while the lowest rates were observed in radiologists group (p<0.01). The leading factors inhibiting the use of head CT rules in MHI stated by EPs were medicolegal anxiety (73.6%), expectations of patients and/or patient relatives (72.6%), and time constraints (44.3%). The leading factors stated by neurosurgeons were medicolegal anxiety (60.9%) and expectations of patient and/or patient relatives (46.4%); "not being consulted in the decision-making process to obtain CT in MHI" (65.6%) and medicolegal anxiety (49.8%) were the leading factors stated by radiologists. The results of our study show that many physicians in Turkey do not have favorable attitudes regarding head CT rules in MHI. Medicolegal anxiety, expectations of patient and/or patient relatives, time constraints, wide availability of CT, and lack of adequate education on radiation protection or on patient dose from

Speech perception in medico-legal assessment of hearing disabilities.

PubMed

Pedersen, Ellen Raben; Juhl, Peter Møller; Wetke, Randi; Andersen, Ture Dammann

2016-10-01

Examination of Danish data for medico-legal compensations regarding hearing disabilities. The study purposes are: (1) to investigate whether discrimination scores (DSs) relate to patients' subjective experience of their hearing and communication ability (the latter referring to audio-visual perception), (2) to compare DSs from different discrimination tests (auditory/audio-visual perception and without/with noise), and (3) to relate different handicap measures in the scaling used for compensation purposes in Denmark. Data from a 15 year period (1999-2014) were collected and analysed. The data set includes 466 patients, from which 50 were omitted due to suspicion of having exaggerated their hearing disabilities. The DSs relate well to the patients' subjective experience of their speech perception ability. By comparing DSs for different test setups it was found that adding noise entails a relatively more difficult listening condition than removing visual cues. The hearing and communication handicap degrees were found to agree, whereas the measured handicap degrees tended to be higher than the self-assessed handicap degrees. The DSs can be used to assess patients' hearing and communication abilities. The difference in the obtained handicap degrees emphasizes the importance of collecting self-assessed as well as measured handicap degrees.

Imposition of virginity testing: a life-saver or a license to kill?

PubMed

Shalhoub-Kevorkian, Nadera

2005-03-01

Little is known about medical and juridical (medicolegal) responses to sexual abuse in Palestinian society. Conventional wisdom posits that the actions of the medicolegal community help victims of sexual abuse and deter offenders. This study focuses on the prevailing practice of imposing a virginity test (IVT) on women in Palestinian society when questions of sexual abuse or perceived misconduct arise. We found that the continuing practice of uncritically collecting forensic reports and the refusal to closely examine the specific dynamics of oppression (medical, cultural, legal, political) in which the victims of sexual abuse are necessarily implicated actually increases the power of medicine and law to adversely function as tools of oppression. However, as I elaborate below, despite the localized factors in play, it is critically important not to view the process of virginity testing merely through the rubrics of "culture"-an approach that more often than not impedes understanding and fails to contextualize what we observe.

Medicolegal Implications of Nosocomial Infections: A Case Report of Aspergillus Contamination during Cardiac Surgery.

PubMed

Tuchtan, Lucile; Piercecchi-Marti, Marie-Dominique; Dumon, Henri; Métras, Dominique; Léonetti, Georges; Bartoli, Christophe

2017-05-01

Nosocomial infections have become a major issue of public health and lead to an increasing number of suits for damages. We present a rare case of Aspergillus contamination during cardiac surgery, describe the medicolegal investigation, and present the new system for compensation of bodily injury after nosocomial infection in France, based on the law of March 4, 2002 on patient rights and quality in the health system. This case demonstrates the limits of compensation for nosocomial infections on the grounds of national solidarity. The expert report requested by the regional commission for conciliation and compensation is of fundamental importance in enabling the commission to decide between fault and inherent risk of treatment. © 2016 American Academy of Forensic Sciences.

When is a research question not a research question?

PubMed

Mayo, Nancy E; Asano, Miho; Barbic, Skye Pamela

2013-06-01

Research is undertaken to answer important questions yet often the question is poorly expressed and lacks information on the population, the exposure or intervention, the comparison, and the outcome. An optimal research question sets out what the investigator wants to know, not what the investigator might do, nor what the results of the study might ultimately contribute. The purpose of this paper is to estimate the extent to which rehabilitation scientists optimally define their research questions. A cross-sectional survey of the rehabilitation research articles published during 2008. Two raters independently rated each question according to pre-specified criteria; a third rater adjudicated all discrepant ratings. The proportion of the 258 articles with a question formulated as methods or expected contribution and not as what knowledge was being sought was 65%; 30% of questions required reworking. The designs which most often had poorly formulated research questions were randomized trials, cross-sectional and measurement studies. Formulating the research question is not purely a semantic concern. When the question is poorly formulated, the design, analysis, sample size calculations, and presentation of results may not be optimal. The gap between research and clinical practice could be bridged by a clear, complete, and informative research question.

[Medicolegal aspects in neuroradiologic emergencies].

PubMed

Picard, L

2004-09-01

Naturally, neuroimaging emergencies are a component of the global subject of emergencies that have for several years been a frequent subject in the press. The current situation is the consequence of the evolution of ideas from contractual liability to the frequently discussed principle of precaution. Examples offered by the daily practice allow to emphasize the main difficulties: diagnosis of headaches, seizure episode on public roads, head trauma, stroke... The medical liability of the neuroradiologist is not the same for diagnostic or interventional neuroradiology; it can sometimes be shared with other physicians. This liability includes the indication, the quality of the diagnosis, the information of the patient and relatives, the communication of results with other physicians, the maintenance of the equipment... Knowledge of potential pitfalls allows preventive measures including competence of the neuroradiologist, informed patient consent, and written precise protocols are the most important. However, according to the evolution of our societies, it is likely that it will become increasingly difficult to achieve a professional neuroradiology career without being questioned; it is thus advisable to be prepared for such eventuality.

Current practices and medico-legal aspects of pre-operative consent.

PubMed

Osime, O C; Okojie, O; Osadolor, F; Mohammed, S

2004-07-01

Written informed consent is a pre requisite for surgical intervention as it provides the forum for the patient to appreciate implications of the procedure and the doctor to explain details and effects of the surgery. To evaluate the practice of obtaining informed consent pre-operatively by surgeons in Benin City and proffer solutions that would enhance its practice. Cross-sectional study involving surgical patients or their relations or gurdian (in cases involving minors and unconscious patients) who were interviewed with structured ended questionnaires. Study was carried out at the University of Benin Teaching Hospital, Benin City, between 5th July and 6th September 2002. One hundred and thirty-three respondents; 53(39.2%) males and 80(60.2%) females were interviewed. Documentations regarding consent were noted in 118(88.7%) cases. Of these, 74.6% felt they had enough time to reflect on the consent obtained while 48(36.1%) respondents were meeting the individual who obtained their consent for the first time. The content of information offered patients prior to obtaining consent was found to be significantly related to the levels of education (X2= 31.44; P<0.001). Over a hundred respondents were not informed of risk of procedure. Nonetheless over 50% of respondents felt satisfied with information supplied. The quality of consent obtained from the average patient fell below expected standard. There is need for greater awareness amongst administrators of consent on the essence of improving quality of information given and mode of obtaining consent from patients.

Emergency medicine residency applicant perceptions of unethical recruiting practices and illegal questioning in the match.

PubMed

Thurman, R Jason; Katz, Eric; Carter, Wallace; Han, Jin; Kayala, Eve; McCoin, Nicole; Storrow, Alan B

2009-06-01

The authors hypothesized that unethical recruiting practices and illegal questioning occur during emergency medicine (EM) resident recruitment. The objectives were to estimate the prevalence of specific unethical recruiting practices and illegal questioning by EM programs based on the perceptions of residency applicants and to measure the effect of these perceptions on applicant appraisal of programs. This was a cross-sectional survey of all applicants who matched to U.S. EM programs in 2005 and 2006. The survey questionnaire was developed by the study authors and was validated by pretesting on a small group representative of the study population. The survey addressed specific questions regarding program recruiting behaviors and interview questioning. The hyperlink to the secure anonymous online survey questionnaire was distributed to all EM program directors, asking them in turn to forward the hyperlink to their newly matched incoming residency class. All data were calculated with Score method with continuity correction and reported in proportions with 95% confidence intervals (CIs). The authors received 671 survey responses. Among respondents, 56 (8.3%, 95% CI = 6.4% to 10.7%) stated that they were specifically asked to disclose at least one program's position on their rank list by a program representative, and 44 (6.6%, 95% CI = 4.9% to 8.9%) reported that they matched at a program residing lower on their rank list than at least one other program that had informed the applicant they were ranked to match. Furthermore, 201 respondents (30.0%, 95% CI = 26.5% to 33.7%) believed that they were asked at least one illegal question during their interviews, the most common of which was inquiry into their marital status (189 respondents: 28.2%, 95% CI = 24.8% to 31.9%). Respondents were 11 times more likely to move a program to a lower position of preference on their rank order list (12.2%, 95% CI = 9.8% to 15.0%) rather than a higher position (1.1%, 95% CI = 0.5% to 2

[Giving medico-legal opinions in cases with suspicion of medical mistake. part 2. Expert evidence in cases with suspicion of medical mistake - expectations, possibilities, threats…].

PubMed

Chowaniec, Czesław; Chowaniec, Małgorzata; Wilk, Mateusz

Problems of medical mistake and therapeutic failure are inextricably linked with realization of medical services. In recent years, mostly by the media and increasing demanding attitude, a rapid increase of initiated cases opened by judicial body in conjunction with medical mistake made by medical staff is observed. Making medico-legal opinions is not easy task and often face many difficulties. These consist of lacks in medical documentation, time rigor, formal tightening and need to create team that consist of both forensic medicine specialist and clinicians, who together shall write complex medico-legal opinion. This article touches the essence of the opinion-making problem in the aspect of medical mistake. It shows specifics of the role of forensic medicine specialist, his challenges and difficulties in creating opinions. The article confronts real possibilities of court experts with expectations of judicial body, outlining new challenges and dangers which court experts have to face.

Open Questions Limiting the Practice of Interorganizational Development.

ERIC Educational Resources Information Center

Schermerhorn, John R., Jr.

1981-01-01

Summarizes the open questions that must be answered by researchers if practioners of interorganizational development are to have adequate planning-and-action guidelines. Suggests the questions should help practitioners become more sensitive to potential action considerations that may require special thought and attention until a firmer knowledge…

[Clinical practice guidelines: juridical and medico legal issues in health care malpractice liability].

PubMed

Moreschi, Carlo; Broi, Ugo Da

2014-01-01

Clinical Practice Guidelines are clinical tools addressed to medical and health professionals and are normally employed to improve quality and safety of diagnostic and therapeutical procedures but may sometimes limit the autonomy of medical and other health care professionals. The adherence to Clinical Practice Guidelines should not be an exclusive step to evaluate the liability and respect of standards of care in case of medico-legal investigations being each clinical case very specific. Medical liability and respect of standards of care should be evaluated with the support of Clinical Practice Guidelines and the extensive examination of all specific features, professional background and experience requested to treat each single patient.

Questions for Surveys

PubMed Central

Schaeffer, Nora Cate; Dykema, Jennifer

2011-01-01

We begin with a look back at the field to identify themes of recent research that we expect to continue to occupy researchers in the future. As part of this overview, we characterize the themes and topics examined in research about measurement and survey questions published in Public Opinion Quarterly in the past decade. We then characterize the field more broadly by highlighting topics that we expect to continue or to grow in importance, including the relationship between survey questions and the total survey error perspective, cognitive versus interactional approaches, interviewing practices, mode and technology, visual aspects of question design, and culture. Considering avenues for future research, we advocate for a decision-oriented framework for thinking about survey questions and their characteristics. The approach we propose distinguishes among various aspects of question characteristics, including question topic, question type and response dimension, conceptualization and operationalization of the target object, question structure, question form, response categories, question implementation, and question wording. Thinking about question characteristics more systematically would allow study designs to take into account relationships among these characteristics and identify gaps in current knowledge. PMID:24970951

Issuing and Responding to Unusual Questions: A Conversation Analytic Account of Tom Andersen's Therapeutic Practice.

PubMed

Smoliak, Olga; Le Couteur, Amanda; Quinn-Nilas, Christopher

2018-03-08

Tom Andersen is considered one of the key contributors to the development of postmodern practice. Little is known, however, about the ways in which his ideas and practices are routinely carried out in situ. We used Conversation Analysis (CA) to investigate a session of couple therapy facilitated by Andersen. We show how Andersen and client participants oriented to and addressed problems of understanding that occurred between them. The source of this trouble was Andersen's use of unusual question formulations. We offer preliminary evidence that such unusual formulations served particular interactional and institutional (i.e., therapeutic) functions in their local contexts of use. We conclude by considering some implications of this analysis-and of conversation analytic inquiry more generally-for the practice of family therapy. © 2018 American Association for Marriage and Family Therapy.

Increasing the practice of questioning among pediatric nurses: "The Growing Culture of Clinical Inquiry" project.

PubMed

Laibhen-Parkes, Natasha

2014-01-01

This paper describes an innovative methodology implemented in an acute care pediatric setting to build nurses' confidence and competence in questioning practice. The Growing Culture of Clinical Inquiry (GCCI) project was composed of several evidence-based strategies to attain and maintain a spirit of clinical inquiry. These strategies included PowerPoint presentations, evidence-based practice (EBP) unit champions, patient-intervention-comparison-outcome (PICO) boxes, Clinical Inquiry Posters, summaries of evidence (SOE), layman's SOE, medical librarian in-services, and journal clubs. After 1 year of implementation, the GCCI project was evaluated and found to be a promising methodology for fostering a culture of inquiry among pediatric nurses. © 2014.

Emergency Nursing Review Questions: July 2017.

PubMed

Shaw, Tracy

2017-07-01

The review questions that are featured in each of issue of JEN are based on the Emergency Nursing Core Curriculum and other pertinent resources to emergency nursing practice, pediatric and adult. These questions offer emergency nurses an opportunity to test their knowledge about their practice. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Medical Students' vs. Family Physicians' Assessment of Practical and Logical Values of Pathophysiology Multiple-Choice Questions

ERIC Educational Resources Information Center

Secic, Damir; Husremovic, Dzenana; Kapur, Eldan; Jatic, Zaim; Hadziahmetovic, Nina; Vojnikovic, Benjamin; Fajkic, Almir; Meholjic, Amir; Bradic, Lejla; Hadzic, Amila

2017-01-01

Testing strategies can either have a very positive or negative effect on the learning process. The aim of this study was to examine the degree of consistency in evaluating the practicality and logic of questions from a medical school pathophysiology test, between students and family medicine doctors. The study engaged 77 family medicine doctors…

The medico-legal scene in Dubai: 2002-2007.

PubMed

Benomran, Fawzi A

2009-08-01

Various characteristics of the medico-legal scene in Dubai are described, along with an overview of all cases examined over a period of 6 years. During the period of study, a total of 17,683 cases were examined in the Department of Forensic Medicine of Dubai Police General Headquarters. This constituted a yearly average of (2947.16). The average annual increment was 11.13%, the percentage of increase between 2002 and 2007 being 68.96%. Of these 10,165 (57.48%) were clinical cases of injuries, 5404 (30.56%) postmortem examinations, 1525 (8.62%) clinical cases of sexual crimes, 409 (2.3%) age estimations, 58 (0.32%) medical responsibility, 20 (0.11%) criminal abortion, 61 (0.34%) civil actions and 38 (0.21%) miscellaneous cases. Of postmortem examinations, 4846 (89.7%) of them were males and 558 (10.3%) females. The age ranged from (0-90) years, with a mean age of 40.5 years. The peak incidence was in the age group (20-50) years, where the extremes of age were least represented (Fig. 1). Only in 361 cases (6.68% of the grand total) the deceased was a local citizen. Autopsies amounted to 394 cases, which constituted 7.29% of the total deaths examined. The four manners of death in descending order of frequency were natural 3003 (55.57%), accidental 1727 (32%), suicidal 498 (9.2%), homicidal 164 (3%). The manner was undetermined in 12 (0.22%) of the cases over the 6 year period.

Old age as an "alternative" to illness: gerontological and medico-legal aspects.

PubMed

Molinelli, Andrea; Viale, Laura; Landolfa, Maria Celeste; De Stefano, Francesco

2011-04-01

The current trend toward an ever increasing aging population forces society to face the problem of how to care for elderly people who are exposed to the risk of so-called "elder abuse," a phenomenon becoming increasingly widespread in Italy, as legislation does not provide a precise juridical definition of "elderly" nor does it provide for their specific protection. From a geriatric and medico-legal point of view, it is difficult to assess the cognitive performance of elderly individuals due to a number of factors, including the lack of evaluation tools with well-defined reference parameters for assessing decision-making capacities. Nonetheless, according to Italian penal code, abandoning a person incapable of self-support due to old age is considered a violation of the obligation of family assistance. Just as in the USA, which has instituted the Adult Protective Services, the Authors propose that the local health authorities provide help desks for the victims of elder abuse in Italy.

Update on Medical Practices that should be questioned in 2015

PubMed Central

Morgan, Daniel J.; Dhruva, Sanket S.; Wright, Scott M.; Korenstein, Deborah

2016-01-01

Importance Overuse of medical care, consisting primarily of overdiagnosis and overtreatment, is a common clinical problem. Objective To identify and highlight articles published in 2014 that are most likely to impact overuse, organized into the categories of overdiagnosis, overtreatment, and methods to avoid overuse. These manuscripts were reviewed and interpreted for their importance to clinical medicine. Evidence Review A structured review of English-language articles on PubMed published in 2014 and review of tables of contents of relevant journals to identify potential articles that related to medical overuse in adults. Findings We reviewed 910 articles, of which 440 addressed overuse. Of these, 104 were deemed most relevant based on the presentation of original data, quality of methodology, magnitude of clinical impact, and the number of patients potentially affected. The 10 most influential articles were selected by author consensus using the same criteria. Findings included lack of benefit for screening pelvic examinations (positive predictive value <5%), carotid artery and thyroid ultrasounds. Harms of cancer screening included unnecessary surgery and complications. Head CT scans were an overused diagnostic test (4% with clinically significant findings) and overtreatment included acetaminophen for low back pain, prolonged opioid use after surgery (3% of patients on >90 days), perioperative aspirin, medications to increase HDL, and stenting for renal artery stenosis. Conclusions and Relevance Many common medical practices should be reconsidered. It is hoped that our review promotes reflection on these 10 articles and lead to questioning other non-evidence based practices. PMID:26551354

Educational Choice: Practical Policy Questions. Occasional Paper Series No. 7.

ERIC Educational Resources Information Center

First, Patricia F.

The consideration of school choice plans raises policy questions for school administrators. This paper addresses pragmatic concerns about definitions and policy questions related to educational finance. Interdistrict choice, emphasizing families' right to choose among existing public schools, raises questions regarding transportation and…

Sudden and unexpected childhood deaths investigated at the Pretoria Medico-Legal Laboratory, South Africa, 2007 - 2011.

PubMed

Van Deventer, B S; Rossouw, S H; Du Toit-Prinsloo, L

2016-09-06

 Sudden and unexpected death is well known to occur in infants, and although sudden deaths are less frequent after the first birthday, they still account for a significant proportion of childhood deaths. In 2009, 1.9% of the total deaths in the USA were childhood deaths. In South Africa (SA) this proportion was much higher at 11.85%. According to the law, sudden and unexpected deaths are generally investigated as unnatural deaths. Establishing an exact underlying anatomical cause of death will depend on available resources and can be difficult in a substantial proportion of cases.  A retrospective descriptive case audit was conducted at the Pretoria Medico-Legal Laboratory (PMLL), SA, from 1 January 2007 through to 31 December 2011. All children aged 1 - 18 years who died suddenly and unexpectedly were included.  Ninety-eight cases were identified, which constituted nearly 1% of total admissions to the PMLL. The majority of the deaths were of children aged 1 - 5 years, and the male/female ratio was 1.04:1. In the largest proportion of cases (n=28, 28.6%), the medicolegal investigation, including autopsy and ancillary investigations, did not establish an underlying anatomical cause of death. In the cases where a cause of death was established, pneumonia was the most common diagnosis (n=22, 22.4%).  The fact that the cause of the largest proportion of deaths could not be ascertained emphasises the need for consideration of additional investigative techniques, such as molecular/genetic screening, which have provided an underlying cause of death in a significant number of cases in other countries. There is a lack of published research on the causes and incidence of sudden unexpected deaths in children in SA, and further research in this area is needed.

Medico-legal issues in radiological consultation.

PubMed

Mozumdar, Biswita C; Jones, Gary

2003-01-01

Providers increasingly use radiological services for diagnosis and treatment. Both the referring physician and the radiological consultant can contribute to efficient and effective consultation, and direct interaction may facilitate the process further. Furthermore, inadequate communication can influence poor patient outcome. We examine the roles and responsibilities of referring physicians and consultant radiologists, and present a malpractice case, Townsend v. Turk 218 Cal. App. 3d 278 (1990), to identify medico-legal issues in radiological consultation. Important issues are implied by the Townsend case. First, it is the clinician's responsibility to include clinical information that is appropriate and adequate. Further, the radiologist is a valuable resource in the selection of the optimal procedure, provided that he or she is aware of the patient's history. The second issue discussed by the court represents a possibly more pervasive problem. The interaction between a consulting radiologist--indeed any specialist--and a treating physician is subject to difficulties caused by different conceptions of professional boundaries. The position taken by the court in the Townsend case is consistent with the traditional view that a consulting radiologist has an attenuated duty to the patient. It also would seem to receive at least some support from the language contained in the current revision of the ACR Standard for Communication: Diagnostic Radiology, effective Jan. 1, 2002: ...The referring physician or healthcare provider also shares in the responsibility of obtaining results of imaging studies they have ordered. Despite the result of the Townsend case and the current formulation of the ACR Standards, however, radiologists face risks of litigation. Indeed, the emerging trend in radiological consultation is the direct communication of results to the patient. It is clear that improved communication between radiologists and referring physicians is both desirable and

[Medico-legal opinion in establishing "exposure to direct danger of death or grave detriment to health"].

PubMed

Jurek, Tomasz; Maksymowicz, Krzysztof

2005-01-01

This paper deals with the problem of competence of the forensic expert opinions on the exposure to "direct danger of death or grave detriment to health". According to the analysis of judicial verdicts and the comments of lawyers "direct danger" depends closely on the probability, time and number of occurrences between the behavior of the perpetrator and the threatening act. The competence of the forensic expert does not allow for the legal qualification of the act but for the assessment of from the medicolegal point of view, defining the threat and possible outcomes in a descriptive fashion. The assessment of "direct danger" should be the result of close cooperation between the judicial representative and forensic expert.

[Sudden death secondary to acute aortic syndromes in the North of Portugal: medico-legal study].

PubMed

Moreira, Pedro Costa; Santos, Agostinho

2013-01-01

An evaluation is presented on the clinical, pathological and sociodemographic characteristics of a sample of sudden death victims secondary to an Acute Aortic Syndrome (AAS) in the north of Portugal, submitted to medico-legal autopsy, during the period between January 2008 and December 2012. Autopsy reports were analyzed in which, through necropsy and histological examination, the confirmed cause of death was an Acute Aortic Syndrome. From the studied cases, 70.3% of the victims were male. The median age was 65,19 ± 14,35 years (minimum of 27 years and maximum of 88 years). Death occurred mainly at home (40,5%) and during the normal activities of daily living (43,1%). There was an history of prodromes in 64,9% of the cases, mainly syncope and pain or respiratory symptoms. In 62,2% of the cases no pain history was reported. In the internal examination three presentation forms were identified: cardiac tamponade (51,4%); hemotorax (16,2%) and intra-abdominal bleeding (32,4%). The occurence of an Acute Aortic Syndrome was related to an aneurysmatic formation in 81% of the cases. Atherosclerotic plaques were identified in 51,4% of the cases and left ventricular hypertrophy was identified in 54,1%. None of the victims had a family history of aortic pathology and 54,1% of them presented a history of arterial hypertension. Necropsy data analysis of sudden death victims allows a better understanding of the AAS presentation, thus complementing the existent clinical studies. This work reveals how forensic medicine can be a privileged medium for articulation with clinical practice.

Preventing and Addressing Challenging Behavior: Common Questions and Practical Strategies

ERIC Educational Resources Information Center

Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Corso, Robert M.

2012-01-01

The purpose of this article is to offer preschool teachers strategies for preventing challenging behavior and supporting the development of social skills and emotional competencies. This article is framed in a question and answer format using questions from teachers who the authors have worked with in the past. These questions and strategies are…

Epistaxis: the factors involved in determining medicolegal liability.

PubMed

Khan, Mohemmed N; Blake, Danielle M; Vazquez, Alejandro; Setzen, Michael; Baredes, Soly; Eloy, Jean Anderson

2014-01-01

The purpose of this study was to examine litigation involving epistaxis and analyze factors that determine liability. Jury verdicts and settlements regarding cases involving epistaxis were gathered utilizing the Westlaw database. Factors involved in litigation gathered included demographics, defendant specialty, procedure, alleged cause of malpractice, outcome, monetary award, and other variables. A total of 26 cases were analyzed. The majority of cases (57.7%) were decided in favor of the plaintiff or settled out of court. Total awards amounted to $24,501,252. Average awards for cases decided in favor of the plaintiff were $2,260,893 and ranged from $499,845 to $9,022,643. Settlements averaged $1,084,375 and ranged from $300,000 to $3,800,000. Common causes of malpractice encountered included delay in diagnosis, complications from medical procedures, and failure to recognize complications in a timely manner. Contrary to previous reports analyzing malpractice for varying medical procedures and complications, litigation in epistaxis is more commonly resolved in favor of the plaintiff or resolved through out-of-court settlements. Substantial financial awards and therapeutic complications from blindness to death make epistaxis a candidate for litigation. Of importance from a medicolegal stand is the fact that 30.8% (8) of the patients involved in epistaxis litigation died, either from complications of therapy or from experiencing epistaxis as a complication of another procedure/pathology. Using necessary diagnostic imaging, ensuring proper management techniques, and recognizing complications in a timely manner can serve to limit legal liability and enhance patient safety. © 2013 ARS-AAOA, LLC.

Four Questions

ERIC Educational Resources Information Center

Hark-Weber, Amara G., Ed.

2013-01-01

Teaching artists often find themselves working in schools and communities that are new to them, whether these are situations close to home or farther afield. This issue of Four Questions highlights teaching artists who travel extensively as part of their teaching and artistic practices and bring their expertise, energy, and creativity to…

Key Questions in Building Defect Prediction Models in Practice

NASA Astrophysics Data System (ADS)

Ramler, Rudolf; Wolfmaier, Klaus; Stauder, Erwin; Kossak, Felix; Natschläger, Thomas

The information about which modules of a future version of a software system are defect-prone is a valuable planning aid for quality managers and testers. Defect prediction promises to indicate these defect-prone modules. However, constructing effective defect prediction models in an industrial setting involves a number of key questions. In this paper we discuss ten key questions identified in context of establishing defect prediction in a large software development project. Seven consecutive versions of the software system have been used to construct and validate defect prediction models for system test planning. Furthermore, the paper presents initial empirical results from the studied project and, by this means, contributes answers to the identified questions.

Questioning diagnoses in clinical practice: a thematic analysis of clinical psychologists' accounts of working beyond diagnosis in the United Kingdom.

PubMed

Randall-James, James; Coles, Steven

2018-02-08

The British Psychological Society proposes that clinical psychologists are well placed to move beyond psychiatric diagnoses and develop alternative practices. This study sought to explore what the application of these guiding principles looks like in clinical practice, the challenges faced and possible routes forward. A purpose-designed survey was completed by 305 respondents and a thematic analysis completed. Thematic analysis was used to identify five superordinate themes relating to individuals, relational, others, structures and society, comprising of a total of 21 group themes. The presented group themes highlight an array of approaches to practicing beyond diagnosis and factors that help and hinder such action; from scaffolding change, becoming leaders, relating to the multi-disciplinary team, restructuring services and the processes of change. A key concept was "playing the diagnostic game". "Playing the diagnostic game" enables psychologists to manage an array of tensions and anxieties: conflicts between belief and practice, relationships with colleagues, and dilemmas of position and power. It also potentially limits a concerted questioning of diagnosis and consideration of alternatives. An alternative conceptual framework for non-diagnostic practice is needed to aid the collective efforts of clinical psychologists developing their practice beyond diagnosis, some of which have been highlighted in this study. Until then, ways of mitigating the perceived threats to questioning diagnosis need further exploration, theorising and backing.

Questions About Cervical and Breast Cancer Screening Knowledge, Practice, and Outcomes: A Review of Demographic and Health Surveys.

PubMed

Viens, Laura; Perin, Doug; Senkomago, Virginia; Neri, Antonio; Saraiya, Mona

2017-05-01

United Nation's Sustainable Development Goals and the World Health Organization's Global Monitoring Framework support a strong global commitment to reducing the high burden of cervical and breast cancers among low- and middle-income countries. Strategies include vaccination, screening, and early diagnosis. Population-based surveys, such as those conducted by the Demographic and Health Surveys (DHS) Program, can collect the information needed to guide cancer control efforts in a standardized comparable manner. We identified and evaluated the breadth of breast and cervical cancer screening information that was collected by the DHS from 1984 through 2015. Then, we determined if these surveys currently provide the specific and measurable data about both the quantity and quality of cancer screening needed to guide national efforts to reduce the overall effects of cervical and breast cancers. We searched the DHS website to identify surveys conducted between the start of the DHS Program in 1984 and November 2015 that included questions about breast and cervical cancer screening. The relevant questions were extracted from the questionnaire, translated into English, and grouped by themes. Of the 90 countries where DHS surveys have been implemented, cervical cancer screening questions were included in 22 countries (24.4%) and breast cancer screening questions in 18 countries (20.0%). The common themes identified were disease knowledge, screening knowledge, screening practice, and screening outcomes. Most countries with survey questionnaires available for review addressed at least one aspect of screening practice (88.9% of cervical and 87.5% of breast), although few countries queried knowledge and outcomes. Questions that assess varied aspects of breast and cervical cancer screening have been incorporated into relatively few DHS surveys. The themes identified could guide the design of a standard set of questions for use in future population-based surveys and enable evaluation

Organ retention and communication of research use following medico-legal autopsy: a pilot survey of university forensic medicine departments in Japan.

PubMed

Tsujimura-Ito, Takako; Inoue, Yusuke; Yoshida, Ken-ichi

2014-09-01

This study investigated the circumstances and problems that departments of forensic medicine encounter with bereaved families regarding samples obtained from medico-legal autopsies. A questionnaire was posted to all 76 departments of forensic medicine performing medico-legal autopsies in Japan, and responses were received from 48 (63.2%). Of the respondents, 12.8% had approached and communicated with bereaved families about collecting samples from the deceased person during an autopsy and the storage of the samples. In addition, 23.4% of these had informed families that samples might be used in research. Eighteen departments had received enquiries and requests from families about the samples, with most requests concerning their return. The response to such requests varied according to the department. Few departments interacted with the bereaved families regarding the procedure for obtaining autopsy samples, and their methods for handling family concerns differed depending on the person within the department authorised to contact the family. Moreover, the procedures for engaging in such communication have long been unclear, and no legal or ethical consensus or agreement with the general public has been established. It is important for researchers to further discuss the correct way for forensic medicine departments to communicate with bereaved families. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Forensic revolution need maintenance of dental records of patients by the dentists: A descriptive study.

PubMed

Gupta, Anamika; Mishra, Gaurav; Bhutani, Hemant; Hoshing, Chetan; Bhalla, Ashish

2016-01-01

With the growth of forensic odontology, dental records have become an essential source of information, especially for medicolegal cases in general practice. It is mandated by the law that every dentist must keep some kind of records for every patient they treat. After the death of an individual, remnants of teeth are usually damaged at the last among all body parts. Dental records assist in personal identification in cases of mass disasters, criminal investigations, and medicolegal issues. However, in India, rules for maintaining dental records are not very strictly followed. Thus, the aim of this study was to evaluate the knowledge regarding the maintenance of dental records among dentists in Punjab and Uttar Pradesh. Data collection was performed via a questionnaire. The study population responded to the questions pertaining to knowledge regarding forensic odontology methods and the mode of maintaining dental records in their regular practice through a personal interview. A descriptive analysis was carried out for the data. The data were summarized and analyzed using the statistical software Statistical Package for the Social Sciences (SPSS) version 18.0. A very low percentage (22%) of the dentists were seen to be maintaining records on a regular basis. Seventy-eight percent of the dentists were not maintaining any records. This study clearly indicates that the dentists in Punjab and Uttar Pradesh need to be properly trained for any kind of forensic and medicolegal needs.

17 CFR 201.234 - Depositions upon written questions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Depositions upon written... RULES OF PRACTICE Rules of Practice Initiation of Proceedings and Prehearing Rules § 201.234 Depositions upon written questions. (a) Availability. Depositions may be taken and submitted on written questions...

17 CFR 201.234 - Depositions upon written questions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Depositions upon written... RULES OF PRACTICE Rules of Practice Initiation of Proceedings and Prehearing Rules § 201.234 Depositions upon written questions. (a) Availability. Depositions may be taken and submitted on written questions...

Practical guidelines for setting up neurosurgery skills training cadaver laboratory in India.

PubMed

Suri, Ashish; Roy, Tara Sankar; Lalwani, Sanjeev; Deo, Rama Chandra; Tripathi, Manjul; Dhingra, Renu; Bhardwaj, Daya Nand; Sharma, Bhawani Shankar

2014-01-01

Though the necessity of cadaver dissection is felt by the medical fraternity, and described as early as 600 BC, in India, there are no practical guidelines available in the world literature for setting up a basic cadaver dissection laboratory for neurosurgery skills training. Hands-on dissection practice on microscopic and endoscopic procedures is essential in technologically demanding modern neurosurgery training where ethical issues, cost constraints, medico-legal pitfalls, and resident duty time restrictions have resulted in lesser opportunities to learn. Collaboration of anatomy, forensic medicine, and neurosurgery is essential for development of a workflow of cadaver procurement, preservation, storage, dissection, and disposal along with setting up the guidelines for ethical and legal concerns.

Some Big Questions about Design in Educational Technology

ERIC Educational Resources Information Center

Gibbons, Andrew S.

2016-01-01

This article asks five questions that lead us to the foundations of design practice in educational technology. Design processes structure time, space, place, activity, role, goal, and resource. For educational technology to advance in its understanding of design practice, it must question whether we have clear conceptions of how abstract…

Key Questions Related To Building Collaborative and Inclusive Schools.

ERIC Educational Resources Information Center

Idol, Lorna

1997-01-01

Provides 15 key questions that educators should consider in developing collaborative and inclusive schools. The questions are organized into three categories: general and philosophical questions pertaining to inclusion, questions about the basic mechanics of developing inclusion programs, and questions about the practical implementation of…

The Power of Questioning: Guiding Student Investigations

ERIC Educational Resources Information Center

McGough, Julie V.; Nyberg, Lisa M.

2015-01-01

This pedagogical picture book is a powerful tool in a small package. The authors of "The Power of Questioning" invite you to nurture the potential for learning that grows out of children's irrepressible urges to ask questions. The book's foundation is a three-part instructional model, Powerful Practices, grounded in questioning,…

How to buy a medical home? Policy options and practical questions.

PubMed

Berenson, Robert A; Rich, Eugene C

2010-06-01

In this paper, we describe a range of payment options to support the PCMH, identifying their conceptual strengths and weaknesses. These include enhanced FFS payment for office visits to the PCMH; paying additional FFS for "new" PCMH services; variations of traditional FFS combined with new PCMH-oriented per patient per month capitation; and combined capitation payments for traditional primary care medical services as well as new medical home services. In discussing options for PCMH payment reform we consider issues in patient severity adjustment, performance payment, and the role of payments to community service organizations to collaborate with the PCMH. We also highlight some of the practical challenges that can complicate reimbursement reform for primary care and the PCMH. Through this discussion we identify key dimensions to provider payment reform relevant to promoting enhanced primary care through the patient centered medical home. These consist of paying for the basic medical home services, rewarding excellent performance of medical homes, incentivizing medical home connections to other community health care resources, and overcoming implementation challenges to medical home payments. Each of these overarching policy issues invokes a substantial subset of policy relevant research questions that collectively comprise a robust research agenda. We conclude that the conceptual strengths and weaknesses of available payment models for medical home functions invoke a complex array of options with varying levels of real-world feasibility. The different needs of patients and communities, and varying characteristics of practices must also be factors guiding PCMH payment reform. Indeed, it may be that different circumstances will require different payment approaches in various combinations.

Questioning context: a set of interdisciplinary questions for investigating contextual factors affecting health decision making

PubMed Central

Charise, Andrea; Witteman, Holly; Whyte, Sarah; Sutton, Erica J.; Bender, Jacqueline L.; Massimi, Michael; Stephens, Lindsay; Evans, Joshua; Logie, Carmen; Mirza, Raza M.; Elf, Marie

2011-01-01

Abstract Objective  To combine insights from multiple disciplines into a set of questions that can be used to investigate contextual factors affecting health decision making. Background  Decision‐making processes and outcomes may be shaped by a range of non‐medical or ‘contextual’ factors particular to an individual including social, economic, political, geographical and institutional conditions. Research concerning contextual factors occurs across many disciplines and theoretical domains, but few conceptual tools have attempted to integrate and translate this wide‐ranging research for health decision‐making purposes. Methods  To formulate this tool we employed an iterative, collaborative process of scenario development and question generation. Five hypothetical health decision‐making scenarios (preventative, screening, curative, supportive and palliative) were developed and used to generate a set of exploratory questions that aim to highlight potential contextual factors across a range of health decisions. Findings  We present an exploratory tool consisting of questions organized into four thematic domains – Bodies, Technologies, Place and Work (BTPW) – articulating wide‐ranging contextual factors relevant to health decision making. The BTPW tool encompasses health‐related scholarship and research from a range of disciplines pertinent to health decision making, and identifies concrete points of intersection between its four thematic domains. Examples of the practical application of the questions are also provided. Conclusions  These exploratory questions provide an interdisciplinary toolkit for identifying the complex contextual factors affecting decision making. The set of questions comprised by the BTPW tool may be applied wholly or partially in the context of clinical practice, policy development and health‐related research. PMID:21029277

Immunohistochemical distribution of chromogranin A in medicolegal autopsy materials.

PubMed

Yoshida, Chiemi; Ishikawa, Takaki; Michiue, Tomomi; Zhao, Dong; Komatsu, Ayumi; Quan, Li; Maeda, Hitoshi

2009-04-01

Chromogranin A (CgA) was recently reported as a marker of various stress responses. The aim of this study was to investigate the immunohistochemical distribution of CgA in human tissues in medicolegal autopsy cases as a basis for postmortem investigation of stress responses. The autopsy cases (n=30, within 48 h postmortem) comprised cases of mechanical asphyxia (n=15: strangulation, n=8; hanging, n=7) and acute myocardial infarction/ischemia (AMI, n=15). Routinely formalin-fixed paraffin-embedded tissue sections, including those of the hypothalamus, pituitary gland, cardiac muscle, lungs, liver, kidneys, spleen, skeletal muscle, skin, thyroid gland, submandibular gland, pancreas, and adrenal gland, were stained with polyclonal anti-human CgA antibodies and CgA positivity was quantitatively examined. Localization of CgA immunopositivity was clearly demonstrated in specific cell components in all tissue sections. CgA was mainly observed in the anterior lobe of the pituitary, adrenal medulla, neurons and some gliocytes in the hypothalamus, submandibular gland, follicular epithelial cells and connective tissue in the thyroid gland and pancreatic islet cells. CgA immunopositivity showed no significant difference between mechanical asphyxia and AMI cases. Positivity was slightly higher in adenohypophysis, adrenal medullar, and pancreatic islet cells (approximately 50-80%) than in the thyroid and submandibular glands (approximately 30-60%); however, a large case difference was observed in hypothalamic CgA immunopositivity (0-100%). These findings suggest that hypothalamic CgA immunopositivity can be used as a marker for investigating individual differences in stress responses during the death process. Further investigation of other causes of death is needed.

Medical Malpractice in Dermatology-Part I: Reducing the Risks of a Lawsuit.

PubMed

Shah, Vidhi V; Kapp, Marshall B; Wolverton, Stephen E

2016-12-01

Malpractice risk is a common source of concern for the practicing physician. Dermatologists experience fewer lawsuits than most other specialists in medicine, but the risk is not negligible. All physicians should familiarize themselves with areas of potential risk and avoid medico-legal pitfalls. We present Part I of a two-part series addressing medico-legal questions common to most practitioners that cause a great deal of anxiety. Part I will focus upon risk management and prevention of future malpractice lawsuits, and Part II deals with suggestions and guidance once a lawsuit occurs. Herein, we discuss the primary sources of malpractice lawsuits delivered against healthcare practitioners including issues with informed consent, patient noncompliance, medical negligence, and inappropriate documentation, including use of electronic medical records. The overall goal is to effectively avoid these common sources of litigation. The risk management strategies discussed in this paper are relevant to the everyday practitioner and may offer physicians some degree of protection from potential liability.

Family-witnessed resuscitation in emergency departments: doctors' attitudes and practices.

PubMed

Gordon, E D; Kramer, E; Couper, Ian; Brysiewicz, P

2011-09-27

Resuscitation of patients occurs daily in emergency departments. Traditional practice entails family members remaining outside the resuscitation room. We explored the introduction of family witnessed resuscitation (FWR) as it has been shown to allow closure for the family when resuscitation is unsuccessful and helps them to better understand the last moments of life. Attending medical doctors have concerns about this practice, such as traumatisation of family members, increased pressure on the medical team, interference by the family, and potential medico-legal consequences. There was not complete acceptance of the practice of FWR among the sample group. Short-course training such as postgraduate advanced life support and other continued professional development activities should have a positive effect on this practice.The more experienced doctors are and the longer they work in emergency medicine, the more comfortable they appear to be with the concept of FWR and therefore the more likely they are to allow it. Further study and course attendance by doctors has a positive influence on the practice of FWR.

Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'.

PubMed

Amorin-Woods, Lyndon G; Parkin-Smith, Gregory F

2012-03-14

A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

Answering questions at the point of care: do residents practice EBM or manage information sources?

PubMed

McCord, Gary; Smucker, William D; Selius, Brian A; Hannan, Scott; Davidson, Elliot; Schrop, Susan Labuda; Rao, Vinod; Albrecht, Paula

2007-03-01

To determine the types of information sources that evidence-based medicine (EBM)-trained, family medicine residents use to answer clinical questions at the point of care, to assess whether the sources are evidence-based, and to provide suggestions for more effective information-management strategies in residency training. In 2005, trained medical students directly observed (for two half-days per physician) how 25 third-year family medicine residents retrieved information to answer clinical questions arising at the point of care and documented the type and name of each source, the retrieval location, and the estimated time spent consulting the source. An end-of-study questionnaire asked 37 full-time faculty and the participating residents about the best information sources available, subscriptions owned, why they use a personal digital assistant (PDA) to practice medicine, and their experience in preventing medical errors using a PDA. Forty-four percent of questions were answered by attending physicians, 23% by consulting PDAs, and 20% from books. Seventy-two percent of questions were answered within two minutes. Residents rated UptoDate as the best source for evidence-based information, but they used this source only five times. PDAs were used because of ease of use, time factors, and accessibility. All examples of medical errors discovered or prevented with PDA programs were medication related. None of the participants' residencies required the use of a specific medical information resource. The results support the Agency for Health Care Research and Quality's call for medical system improvements at the point of care. Additionally, it may be necessary to teach residents better information-management skills in addition to EBM skills.

Demographic variables, clinical aspects, and medicolegal implications in a population of patients with adjustment disorder.

PubMed

Anastasia, Annalisa; Colletti, Chiara; Cuoco, Valentina; Quartini, Adele; Urso, Stefania; Rinaldi, Raffaella; Bersani, Giuseppe

2016-01-01

Although adjustment disorder (AD) is considered as residual diagnosis and receives little attention in research, it plays an important role in clinical practice and also assumes an increasingly important role in the field of legal medicine, where the majority of diagnostic frameworks (eg, mobbing) often refer to AD. Our study aimed to look for specific stressor differences among demographic and clinical variables in a naturalistic setting of patients with AD. A restrospective statistical analysis of the data of patients diagnosed with AD from November 2009 to September 2012, identified via manual search from the archive of the outpatient setting at the University Unit of Psychiatry "A. Fiorini" Hospital, Terracina (Latina, Italy), was performed. The sample consisted of 93 patients (46 males and 47 females), aged between 26 and 85, with medium-high educational level who were mainly employed. In most cases (54.80%), a diagnosis of AD with mixed anxiety and depressed mood was made. In all, 72% of the sample reported a negative family history for psychiatric disorders. In 22.60%, a previous history of psychopathology, especially mood disorders (76.19%), was reported. The main stressors linked to the development of AD were represented by working problems (32.30%), family problems (23.70%), and/or somatic disease (22.60%) with significant differences with respect to age and sex. Half of the patients were subjected to a single first examination; 24.47% requested a copy of medical records. Confirming previous data from previous reports, our results suggest that AD may have a distinct profile in demographic and clinical terms. Increased scientific attention is hoped, particularly focused on addressing a better definition of diagnostic criteria, whose correctness and accuracy are critical, especially in situations with medicolegal implications.

Demographic variables, clinical aspects, and medicolegal implications in a population of patients with adjustment disorder

PubMed Central

Anastasia, Annalisa; Colletti, Chiara; Cuoco, Valentina; Quartini, Adele; Urso, Stefania; Rinaldi, Raffaella; Bersani, Giuseppe

2016-01-01

Introduction Although adjustment disorder (AD) is considered as residual diagnosis and receives little attention in research, it plays an important role in clinical practice and also assumes an increasingly important role in the field of legal medicine, where the majority of diagnostic frameworks (eg, mobbing) often refer to AD. Our study aimed to look for specific stressor differences among demographic and clinical variables in a naturalistic setting of patients with AD. Methods A restrospective statistical analysis of the data of patients diagnosed with AD from November 2009 to September 2012, identified via manual search from the archive of the outpatient setting at the University Unit of Psychiatry “A. Fiorini” Hospital, Terracina (Latina, Italy), was performed. Results The sample consisted of 93 patients (46 males and 47 females), aged between 26 and 85, with medium–high educational level who were mainly employed. In most cases (54.80%), a diagnosis of AD with mixed anxiety and depressed mood was made. In all, 72% of the sample reported a negative family history for psychiatric disorders. In 22.60%, a previous history of psychopathology, especially mood disorders (76.19%), was reported. The main stressors linked to the development of AD were represented by working problems (32.30%), family problems (23.70%), and/or somatic disease (22.60%) with significant differences with respect to age and sex. Half of the patients were subjected to a single first examination; 24.47% requested a copy of medical records. Conclusion Confirming previous data from previous reports, our results suggest that AD may have a distinct profile in demographic and clinical terms. Increased scientific attention is hoped, particularly focused on addressing a better definition of diagnostic criteria, whose correctness and accuracy are critical, especially in situations with medicolegal implications. PMID:27099504

How to Buy a Medical Home? Policy Options and Practical Questions

PubMed Central

Berenson, Robert A.

2010-01-01

In this paper, we describe a range of payment options to support the PCMH, identifying their conceptual strengths and weaknesses. These include enhanced FFS payment for office visits to the PCMH; paying additional FFS for “new” PCMH services; variations of traditional FFS combined with new PCMH-oriented per patient per month capitation; and combined capitation payments for traditional primary care medical services as well as new medical home services. In discussing options for PCMH payment reform we consider issues in patient severity adjustment, performance payment, and the role of payments to community service organizations to collaborate with the PCMH. We also highlight some of the practical challenges that can complicate reimbursement reform for primary care and the PCMH. Through this discussion we identify key dimensions to provider payment reform relevant to promoting enhanced primary care through the patient centered medical home. These consist of paying for the basic medical home services, rewarding excellent performance of medical homes, incentivizing medical home connections to other community health care resources, and overcoming implementation challenges to medical home payments. Each of these overarching policy issues invokes a substantial subset of policy relevant research questions that collectively comprise a robust research agenda. We conclude that the conceptual strengths and weaknesses of available payment models for medical home functions invoke a complex array of options with varying levels of real-world feasibility. The different needs of patients and communities, and varying characteristics of practices must also be factors guiding PCMH payment reform. Indeed, it may be that different circumstances will require different payment approaches in various combinations. PMID:20467911

Guidelines examination of victims of sexual assault harmonization of forensic and medico-legal examination of persons.

PubMed

Ludes, B; Geraut, A; Väli, M; Cusack, D; Ferrara, D; Keller, E; Mangin, P; Vieira, D N

2018-02-21

Sexual assault is a complex situation with medical, psychological, and legal aspects. Forensic experts play a major role in terms of forensic and gynecological medical examination and evidence collection in order to maintain the chain of custody. Victims should be examined by a specially trained medico-legal examiner in order to avoid multiple examinations in the surroundings that do not meet minimum health standards. The evolution and treatment of sexual assault victims are time-intensive and should optimally be provided by a team that includes a forensic medical doctor. These guidelines will be of interest to forensic medical doctors who will have responsibility for the examination and assessment of victims of sexual violence and can be used as a day-to-day service document and/or a guide to develop health service for victims of sexual violence.

A characterization of clinical questions asked by rehabilitation therapists.

PubMed

Kloda, Lorie Andrea; Bartlett, Joan C

2014-04-01

This study explored the information needs of rehabilitation therapists (occupational therapists, physical therapists, and speech-language pathologists) working with patients who have had strokes in order to characterize their clinical questions, defined as their formalized information needs arising in the context of everyday clinical practice. The researchers took a constructivist, interpretive approach, in which fifteen rehabilitation therapists working in various settings were recruited. Data were gathered using diaries, followed by diary-guided interviews, and thematically analyzed using template analysis. Rehabilitation therapists' clinical questions were characterized as having one or more of twelve foci and containing one or more of eight possible structural elements. Findings demonstrate that the evidence-based practice framework currently applied for questions relating to rehabilitation is inadequate for representing rehabilitation therapists' clinical questions. A new framework that is more comprehensive and descriptive is proposed. Librarians working with students and clinicians in rehabilitation can employ knowledge of the twelve foci and the question structure for rehabilitation to guide the reference interview. Instruction on question formulation in evidence-based practice can employ the revised structure for rehabilitation, offering students and clinicians an alternative to the traditional patient, intervention, comparison, outcome (PICO) structure. Information products, including bibliographic databases and synopsis services, can tailor their interfaces according to question foci and prompt users to enter search terms corresponding to any of the eight possible elements found in rehabilitation therapists' clinical questions.

Back to the Future - Part 2. Post-mortem assessment and evolutionary role of the bio-medicolegal sciences.

PubMed

Ferrara, Santo Davide; Cecchetto, Giovanni; Cecchi, Rossana; Favretto, Donata; Grabherr, Silke; Ishikawa, Takaki; Kondo, Toshikazu; Montisci, Massimo; Pfeiffer, Heidi; Bonati, Maurizio Rippa; Shokry, Dina; Vennemann, Marielle; Bajanowski, Thomas

2017-07-01

Part 2 of the review "Back to the Future" is dedicated to the evolutionary role of the bio-medicolegal sciences, reporting the historical profiles, the state of the art, and prospects for future development of the main related techniques and methods of the ancillary disciplines that have risen to the role of "autonomous" sciences, namely, Genetics and Genomics, Toxicology, Radiology, and Imaging, involved in historic synergy in the "post-mortem assessment," together with the mother discipline Legal Medicine, by way of its primary fundament, universally denominated as Forensic Pathology. The evolution of the scientific research and the increased accuracy of the various disciplines will be oriented towards the elaboration of an "algorithm," able to weigh the value of "evidence" placed at the disposal of the "justice system" as real truth and proof.

Tales of the Expected: The Influence of Students' Expectations on Question Validity and Implications for Writing Exam Questions

ERIC Educational Resources Information Center

Crisp, Victoria; Sweiry, Ezekiel; Ahmed, Ayesha; Pollitt, Alastair

2008-01-01

Background: Through classroom preparation and exposure to past papers, textbooks and practice tests students develop expectations about examinations: what will be asked, how it will be asked and how they will be judged. Expectations are also involved in the automatic process of understanding questions. Where a question and a student's expectations…

Defensive medicine among neurosurgeons in the Netherlands: a national survey.

PubMed

Yan, Sandra C; Hulsbergen, Alexander F C; Muskens, Ivo S; van Dam, Marjel; Gormley, William B; Broekman, Marike L D; Smith, Timothy R

2017-12-01

In defensive medicine, practice is motivated by legal rather than medical reasons. Previous studies have analyzed the correlation between perceived medico-legal risk and defensive behavior among neurosurgeons in the United States, Canada, and South Africa, but not yet in Europe. The aim of this study is to explore perceived liability burdens and self-reported defensive behaviors among neurosurgeons in the Netherlands and compare their practices with their non-European counterparts. A survey was sent to 136 neurosurgeons. The survey included questions from several domains: surgeon characteristics, patient demographics, type of practice, surgeon liability profile, policy coverage, defensive practices, and perception of the liability environment. Survey responses were analyzed and summarized. Forty-five neurosurgeons filled out the questionnaire (response rate of 33.1%). Almost half (n = 20) reported paying less than 5% of their income to annual malpractice premiums. Nearly all respondents view their insurance premiums as a minor or no burden (n = 42) and are confident that in their coverage is sufficient (n = 41). Most neurosurgeons (n = 38) do not see patients as "potential lawsuits". Relative to their American peers, Dutch neurosurgeons view their insurance premiums as less burdensome, their patients as a smaller legal threat, and their practice as less risky in general. They are sued less often and engage in fewer defensive behaviors than their non-European counterparts. The medico-legal climate in the Netherlands may contribute to this difference.

A Contemporary Medicolegal Analysis of Outpatient Medication Management in Chronic Pain.

PubMed

Abrecht, Christopher R; Brovman, Ethan Y; Greenberg, Penny; Song, Ellen; Rathmell, James P; Urman, Richard D

2017-11-01

Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO). The goal of this study was to identify patient medical comorbidities and aberrant drug behaviors, as well as prescriber practices associated with patient injury and malpractice claims. Another objective was to identify claims most likely to result in payments and use this information to propose a strategy for reducing medicolegal risk. The CRICO Strategies Comparative Benchmarking System is a database of claims drawing from >350,000 malpractice claims from Harvard-affiliated institutions and >400 other academic and community institutions across the United States. This database was queried for closed claims from January 1, 2009, to December 31, 2013, and identified 37 cases concerning noninterventional, outpatient chronic pain management. Each file consisted of a narrative summary, including expert witness testimony, as well as coded fields for patient demographics, medical comorbidities, the alleged damaging event, the alleged injurious outcome, the total financial amount incurred, and more. We performed an analysis using these claim files. The mean patient age was 43.5 years, with men representing 59.5% of cases. Payments were made in 27% of cases, with a median payment of $72,500 and a range of $7500-$687,500. The majority of cases related to degenerative joint disease of the spine and failed back surgery syndrome; no patients in this series received treatment of malignant pain. Approximately half (49%) of cases involved a patient death. The use of long

Evidence-based dental practice: part I. Formulating clinical questions and searching for answers.

PubMed

Adeyemo, W L; Akinwande, J A; Bamgbose, B O

2007-01-01

Evidence-based dentistry (EBD) is an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences. Evidence-based care is now regarded as the "gold standard" in health care delivery worldwide. EBD involves tracking down the available evidence, assessing its validity and relevance, and then using the "best" evidence to inform decisions regarding care. Although, the concept of evidence-based dentistry is not new, however, anecdotal evidence suggests that the awareness of this concept among Nigerian dental practitioners is low. This first of three articles on evidence-based dental practice discusses the historical background of evidence-based medicine/evidence-based dentistry, how to formulate clear clinical questions and how to track down (search) the available evidence in the literature databases.

Writing-Based Teaching: Essential Practices and Enduring Questions

ERIC Educational Resources Information Center

Vilardi, Teresa, Ed.; Chang, Mary, Ed.

2009-01-01

Written by the team at Bard College's Institute for Writing and Thinking, this book is designed to provide practical guidance regarding the challenges and potential of writing-based teaching, and suggestions for how to adapt the practices to particular classroom situations. The contributors share candid, first-hand accounts of what it is like to…

Patient information in orthopedic and trauma surgery. Fundamental knowledge, legal aspects and practical recommendations.

PubMed

Gleyze, P; Coudane, H

2016-02-01

Providing information to surgery patients is a form of health-care governed by clearly defined therapeutic and medicolegal rules, and in particular in France by the Act of March 4, 2002 and the Code of Good Practice. The patient's right to information is implemented in a face-to-face consultation, which should be fully codified, and in a specific clinical examination, followed by information regarding the affected organ, pathology, treatment options, possible surgery, and the preconditions, risks and results associated with the procedure. Information should be personalized and as complete as possible, communicating the state of knowledge as validated by scientific societies and medical institutions. State of the art technology (dedicated website, on-line information suites, etc.) is indispensable but needs to be mastered and to adhere to the guidelines of the Council of the National Order of Medicine. Information traceability, the retraction period and proof of content of the information are essential. A signed document delivered in an informative atmosphere optimizes the exercise. Patient information is an ethical and medicolegal obligation, but above all is the expression and demonstration of the health-care potential of the practitioner and our contribution to reducing the information gap, reinforcing the cement holding our society together. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Current practice of methylprednisolone administration for acute spinal cord injury in Germany: a national survey.

PubMed

Druschel, Claudia; Schaser, Klaus-Dieter; Schwab, Jan M

2013-05-15

Written mail-out survey. To determine current practice in high-dose methylprednisolone succinate (MPSS) administration for treatment of acute spinal cord injury (SCI) in Germany. Reanalysis of the National Acute Spinal Cord Injury Studies (NASCIS) resulted in criticism of the use of high-dose MPSS for treatment of acute SCI. Subsequently, SCI treatment guidelines were revised leading to a reduction in MPSS use across North America. The impact of these revisions on SCI treatment in Germany is not known. A questionnaire was sent to all trauma, orthopedic and neurosurgical departments of German university centers, affiliated teaching hospitals, and specialized SCI care centers. Survey included 6 questions about the administration of MPSS after acute SCI. Three hundred seventy-two respondents completed the survey (response rate: 51% overall, 76% university hospitals, 85% specialized SCI care centers). Overall, 55% of departments that treat SCI prescribe MPSS. Among them, 73% are "frequent" users administering MPSS to more than 50% of their patients. Ten percent prescribe according to NASCIS I, 43% NASCIS II, 33% NASCIS III, and 13% "generic protocols." As justification for MPSS treatment, "effectiveness" ranked before "common practice" and "medicolegal reasons." "Specialized" SCI care centers differ in that (1) MPSS is administered less frequently, (2) NASCIS I doses are not used, and (3) during the past several years, practice patterns are more likely to have shifted away from the treatment of SCI with MPSS. About one-half of the institutions continue to prescribe MPSS in the setting of acute SCI. A need for further education in almost one-fourth of German departments treating acute SCI is demonstrated through responses indicating use of the outdated NASCIS I protocol, a "legal need" or "unchanged MPSS application during the last years." "Specialized" SCI centers are more likely to change their practice in accordance with evolving literature. 3.

The medico-legal investigation of the El Aqsah Intifada.

PubMed

Hiss, Jehuda; Freund, Maya; Motro, Uzi; Kahana, Tzipi

2002-07-01

The majority (n = 445) of the Israeli and Palestinian fatal victims of the El Aqsah Intifada was examined at the National Center of Forensic Medicine in Tel Aviv. Analysis of the trauma sustained and the anthropologic profile of both the victims and the perpetrators elucidates the trends and contrasts them with the phenomenon in the past. The purpose of the forensic investigation of mass casualty incidents is manifold: establishing the minimal number of individuals involved, identifying the victims and perpetrators, collecting material evidence, and determining the modus operandi. The postmortem examination includes external description of the bodies and their injuries, photo-documentation, and sampling of tissues. Radiography, dental examination, and a ten-print card of each cadaver are also recorded. The modus operandi of the current Intifada is somewhat different from that of the previous wave of terrorism and includes more road shootings and vehicular terrorism. In addition, three suicide bombers who detonated explosive devices within crowded areas were young women, and the age of the perpetrators has increased from up to 35 years to individuals as old as 47, thus greatly enlarging the potential number of suicide terrorists. Virologic and biologic tests have been introduced to examine the tissues of the suicide bombers since they are possible sources of contagion to the wounded victims. The results of the medico-legal investigation of victims and perpetrators of terrorism enable us to establish the modus operandi and the profile of potential perpetrators, which can help in the prevention of similar attacks. Documentation of the different types of injuries in fatal victims of explosion and shooting contributes to improving the awareness of the medical staff treating the wounded of similar attacks. Further investigation into the reliability of virologic and biologic tests conducted on postmortem tissue is recommended.

Answering Questions and Questioning Answers. Part II. University of Central Florida Conference Papers.

ERIC Educational Resources Information Center

Miller, C. C.; And Others

1982-01-01

Brief analyses are provided of presentations made at a conference, held at the University of Central Florida in Orlando, which addressed questions and answers relating to research and education. Conference sessions explored the role of research in relation to educational practices with special focus on theory, research, issues and application.…

An audit of the toxicology findings in 555 medico-legal autopsies finds manner of death changed in 5 cases.

PubMed

Langlois, Neil E I; Gilbert, John D; Heath, Karen J; Winskog, Calle; Kostakis, Chris

2013-03-01

An audit of toxicological analysis in Coronial autopsies performed at Forensic Science South Australia was conducted on the cases of three pathologists. Toxicological analysis had been performed in 555 (68 %) from a total of 815 autopsies. It was found that the proffered manner of death was changed from the provisional report (provided immediately after the post-mortem examination) in five cases (just under 1 %) as a consequence of the toxicological findings. This is a limited study as it is retrospective, not all cases had toxicological analysis and the findings are constrained by the range of the substances that could be detected. Nonetheless, the audit supports the application of toxicological analysis in medico-legal death investigation and suggests that an inclusive policy should be adopted.

Canine pulp ratios in estimating pensionable age in subjects with questionable documents of identification.

PubMed

Cameriere, Roberto; Ferrante, Luigi

2011-03-20

One of the most interesting reasons for needing to estimate age in adult subjects is to ascertain the age of a person of questionable pensionable age. This problem is becoming increasingly important in Europe, owing to the high number of immigrants without valid birth certificates. The aim of this paper is to evaluate the application of the apposition of secondary dentine of canines by the method of Cameriere et al. [10], in order to estimate the pensionable age of subjects without proper birth certificates. Periapical X-rays of 180 canines from 90 subjects aged between 50 and 79, 46 men and 44 women, were analysed. Estimated ages were used to test the medico-legal question as to whether an individual was older or younger than 65 years of age. In subjects under 65, age was correctly evaluated in 91% and 89% of individuals using maxillary and mandibular canines, respectively. In subjects over 65, of pensionable age, estimates were correct in 85% and 88% of cases, respectively. The proportion of individuals with correct classifications was 89% for both maxillary and mandibular canines taken together. In only four subjects, the results of maxillary and mandibular canines were discordant; in the other 86 subjects, the test of maxillary and mandibular canines yielded concordant results. Among the latter, the proportion of individuals who were really aged 65 years or older, and who were correctly estimated as such, was 94%, and the proportion of individuals younger than 65 years of age who were correctly estimated as such was 96%. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Effect of questions used by psychiatrists on therapeutic alliance and adherence.

PubMed

Thompson, Laura; Howes, Christine; McCabe, Rose

2016-07-01

Psychiatrists' questions are the mechanism for achieving clinical objectives and managing the formation of a therapeutic alliance - consistently associated with patient adherence. No research has examined the nature of this relationship and the different practices used in psychiatry. Questions are typically defined in binary terms (e.g. 'open' v 'closed') that may have limited application in practice. To undertake a detailed examination of the types of questions psychiatrists ask patients and explore their association with the therapeutic alliance and patient adherence. A coding protocol was developed to classify questions from 134 out-patient consultations, predominantly by syntactic form. Bivariate correlations with measures of patient adherence and the therapeutic alliance (psychiatrist-rated) were examined and assessed using generalised estimating equations, adjusting for patient symptoms, psychiatrist identity and amount of speech. Psychiatrists used only four of ten question types regularly: yes/no auxiliary questions, 'wh-' questions, declarative questions and tag questions. Only declarative questions predicted better adherence and perceptions of the therapeutic relationship. Conversely, 'wh-' questions - associated with positive symptoms - predicted poorer perceptions of the therapeutic relationship. Declarative questions were frequently used to propose an understanding of patients' experiences, in particular their emotional salience for the patient. A refined defining of questioning practices is necessary to improve communication in psychiatry. The use of declarative questions may enhance alliance and adherence, or index their manifestation in talk, e.g. better mutual understanding. The function of 'so'-prefaced declaratives, also used in psychotherapy, is more nuanced than negatively connotated 'leading' questions. Hearable as displays of empathy, they attend closely to patient experience, while balancing the tasks of assessment and treatment. © The

The necessity of repeated assessment of imaging studies contained in medical records in medico-legal opinions.

PubMed

Borowska-Solonynko, A

The paper presents two case reports of living victims, in which imaging studies of the chest conducted at a medical facility were an essential part of the medico-legal opinion. The first case was that of a young male hospitalized due to CT evidence of bilateral rib fractions, who claimed to have been assaulted by police officers. The other case was that of a six week old baby hospitalized due to chest X-ray evidence of right hand side rib fractions. The chest X-ray was performed due to one bruise found on the baby's forehead and two small bruises on the back, which gave rise to suspicions of child abuse. In both cases, expert witnesses in radiology definitively excluded the presence of any fractures. These cases indicate that a new assessment of imaging studies contained in medical records is needed. Expert opinions based solely on the description of imaging studies may result in grave consequences.

[Practical approach to management of gynecomastia: six questions to be answered by the paediatrician regarding a patient with gynecomastia].

PubMed

2011-08-01

Pubertal gynecomastia is a common concern in the consultation of the adolescent. Usually, it is accompanied by an emotional component that can lead to changes in everyday attitudes of youth. The responsability of the pediatrician is to rule out other etiologies, to avoid unnecessary additional studies, to limit active therapeutic attitudes, and to reaffirm the variation of normality. We briefly describe six eminently practical questions to be answered by the physician.

Questioning the Questions

ERIC Educational Resources Information Center

Tienken, Christopher H.; Goldberg, Stephanie; DiRocco, Dominic

2010-01-01

Historical accounts of questioning used in the education process trace back to Socrates. One of the best examples of his use of questioning is found in Plato's "The Republic." Socrates used a series of strategic questions to help his student Glaucon come to understand the concept of justice. Socrates purposefully posed a series of…

The medico-legal investigation of sudden, unexpected and/or unexplained infant deaths in South Africa: where are we--and where are we going?

PubMed

du Toit-Prinsloo, L; Dempers, J J; Wadee, S A; Saayman, G

2011-03-01

Sudden Infant Death Syndrome (SIDS) has been reported to be the leading cause of death in infants under 1 year of age in many countries. Unfortunately, a paucity of published research data exists in South Africa, with regard to the incidence of and investigation into the circumstances surrounding Sudden Unexplained Deaths in Infants (SUDI) and/or SIDS. Currently, even though most academic centers conform to a protocol consistent with internationally accepted standards, there exists no nationally accepted infant death investigation protocol in South Africa. It is the aim of this study to review the current practice of infant death investigation in two representative but geographically and demographically distinct centers. Retrospective case audit over a five-year period (2000-2004) was conducted at two large medico-legal mortuaries in Pretoria (Gauteng) and Tygerberg (Cape Town). Case files on all infants younger than 1 year of age were reviewed. The outcome measures included number of deaths, demographic details and the nature and final outcome of the post mortem examinations. A total of 512 cases were identified as possible SIDS cases and of these, 171 was classified as SIDS. The study showed marked inter-case and inter-divisional variation in terms of the investigation of infant deaths at the two institutions. It is envisaged that this study will focus attention on the current lack of usable data regarding sudden/unexplained/unexpected infant deaths in South Africa, and aid in the formulation and implementation of a practical (yet internationally accountable) infant death investigation protocol, which could facilitate comparisons with other countries and initiate further structured research in this field.

Post-operative fatal blood aspiration after routine lung surgery.

PubMed

Plenzig, Stefanie; Soriano, Mauricio; Held, Hannelore; Verhoff, Marcel A

2017-08-01

A routine question encountered in medicolegal practice is whether the death of a patient in proximity to a surgical procedure is due to medical malpractice. The case of a 62-year-old man who died two weeks after undergoing a VATS sleeve resection of the upper right lung lobe in conjunction with radical lymphadenectomy, a routine surgical procedure, is reported. To address the issue of medical malpractice, a forensic autopsy was ordered by the investigative authority. During the autopsy, the lungs were removed as a whole and fixed in formalin and were later dissected in cooperation with a thoracic surgeon. In the course of this dissection, a bronchovascular fistula, which had led to the occlusion of the bronchial system with clotted blood, was discovered. Bronchovascular fistulas are a rare complication of bronchial sleeve resections. Because this surgical complication is essentially always fatal, it is highly pertinent to medicolegal practice. The presented case report also lists other important complications associated with bronchial anastomosis and elucidates a pragmatic approach to obtaining an expert clinical assessment of possible medical malpractice after operations through the example of a dissection performed in cooperation with a thoracic surgeon. Copyright © 2017 Elsevier B.V. All rights reserved.

Beyond Information Retrieval—Medical Question Answering

PubMed Central

Lee, Minsuk; Cimino, James; Zhu, Hai Ran; Sable, Carl; Shanker, Vijay; Ely, John; Yu, Hong

2006-01-01

Physicians have many questions when caring for patients, and frequently need to seek answers for their questions. Information retrieval systems (e.g., PubMed) typically return a list of documents in response to a user’s query. Frequently the number of returned documents is large and makes physicians’ information seeking “practical only ‘after hours’ and not in the clinical settings”. Question answering techniques are based on automatically analyzing thousands of electronic documents to generate short-text answers in response to clinical questions that are posed by physicians. The authors address physicians’ information needs and described the design, implementation, and evaluation of the medical question answering system (MedQA). Although our long term goal is to enable MedQA to answer all types of medical questions, currently, we currently implement MedQA to integrate information retrieval, extraction, and summarization techniques to automatically generate paragraph-level text for definitional questions (i.e., “What is X?”). MedQA can be accessed at http://www.dbmi.columbia.edu/~yuh9001/research/MedQA.html. PMID:17238385

Records--The Achilles' Heel of School Nursing: Answers to Bothersome Questions

ERIC Educational Resources Information Center

Schwab, Nadine C.; Pohlman, Katherine J.

2004-01-01

This article addresses practice issues related to school health records and school nursing documentation. Because the issues have been posed by practicing school nurses, the article is in Question and Answer (Q&A) format. Specifically, the questions addressed concern the following: ownership and storage location of student health records when…

Answering Student Questions During Examinations: A Descriptive Study of Faculty Beliefs.

PubMed

Stillwell, Susan B; Krautscheid, Lorretta C

2016-01-01

Examinations are used to evaluate individual student learning. Therefore, fair and consistent administration practices are essential. One issue associated with testing administration practices includes whether or not students should be allowed to ask questions during exams and how faculty should respond. Findings from this descriptive study indicate that faculty believe answering questions disrupts the testing environment, inhibits effective monitoring of the testing environment, and could provide unfair hints to students who ask questions. Yet, faculty permit students to ask questions to clarify unclear wording, to provide definitions, and to appear receptive to student needs. Recommendations for nursing education and research are provided.

A medico-legal review of cases involving quadriplegia following cervical spine surgery: Is there an argument for a no-fault compensation system?

PubMed

Epstein, Nancy E

2010-04-07

To determine whether patients who become quadriplegic following cervical spine surgery are adequately compensated by our present medico-legal system. The outcomes of malpractice suits obtained from Verdict Search (East Islip, NY, USA), a medico-legal journal, were evaluated over a 20-year period. Although the present malpractice system generously rewards many quadriplegic patients with substantial settlements/ Plaintiffs' verdicts, a subset receive lesser reimbursements (verdicts/settlements], while others with defense verdicts receive no compensatory damages. Utilizing Verdict Search, 54 cases involving quadriplegia following cervical spine surgery were reviewed for a 20-year interval (1988-2008). The reason(s) for the suit, the defendants, the legal outcome, and the time to outcome were identified. Operations included 25 anterior cervical procedures, 22 posterior cervical operations, 1 circumferential cervical procedure, and 6 cases in which the cervical operations were not defined. The four most prominent legal allegations for suits included negligent surgery (47 cases), lack of informed consent (23 cases), failure to diagnose/treat (33 cases), and failure to brace (15 cases). Forty-four of the 54 suits included spine surgeons. There were 19 Plaintiffs' verdicts (average US $5.9 million, range US $540,000-US $18.4 million), and 20 settlements (average US $2.8 million, range US $66,500-US $12.0 million). Fifteen quadriplegic patients with defense verdicts received no compensatory damages. The average time to verdicts/settlements was 4.3 years. For 54 patients who were quadriplegic following cervical spine surgery, 15 (28%) with defense verdicts received no compensatory damages. Under a No-Fault system, quadriplegic patients would qualify for a "reasonable" level of compensation over a "shorter" time frame.

Setting a research question, aim and objective.

PubMed

Doody, Owen; Bailey, Maria E

2016-03-01

To describe the development of a research question, aim and objective. The first steps of any study are developing the research question, aim and objective. Subsequent steps develop from these and they govern the researchers' choice of population, setting, data to be collected and time period for the study. Clear, succinctly posed research questions, aims and objectives are essential if studies are to be successful. Researchers developing their research questions, aims and objectives generally experience difficulties. They are often overwhelmed trying to convert what they see as a relevant issue from practice into research. This necessitates engaging with the relevant published literature and knowledgeable people. This paper identifies the issues to be considered when developing a research question, aim and objective. Understanding these considerations will enable researchers to effectively present their research question, aim and objective. To conduct successful studies, researchers should develop clear research questions, aims and objectives.

Standards and guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). Part VIII: Medicolegal considerations and recommendations.

PubMed

1986-06-06

These resuscitation guidelines were developed to "enhance the quality of care while protecting the patient's right to accept or reject therapy and to clarify the physician's role in making decisions to provide, withhold, or withdraw life support." Among the issues covered are the obligation to provide cardiopulmonary resuscitation (CPR), reasons to withhold or withdraw CPR, and the liability risks of CPR providers--laypersons, CPR teachers and organizations, and hospitals. Also discussed are the role of hospital ethics committees and medicolegal considerations in treating minors. The guidelines conclude with recommendations that states enact legislation allowing allied health personnel to render emergency care more effectively outside the hospital, providing "good samaritan" immunity to laypersons administering CPR, requiring basic life support training for police and firefighters, and acknowledging the patient's right to self determination in life-or-death decisions.

Planning Questions and Persevering in the Practices

ERIC Educational Resources Information Center

Gurl, Theresa J.; Fox, Ryan; Dabovic, Nikolina; Leavitt, Arielle Eager

2016-01-01

The implementation of the Common Core's Standards for Mathematical Practice can pose a challenge to all teachers of mathematics but especially to preservice teachers. These standards require teaching in a way that often differs from what preservice teachers have experienced as learners. Standard 1--"Make sense of problems and persevere in…

What Are the "Right" Questions and the "Right" Answers in Teaching Practice Supervision?

ERIC Educational Resources Information Center

Jyrhama, Riitta

This paper links the problem of questioning and answering in student teacher supervision with teachers' pedagogical thinking. The first section discusses whether asking the right questions or giving the right answers is more important and what is actually involved when the questions and answers are correct. The second section discusses the…

Roth 401(k): asking the right questions.

PubMed

Joyner, James F

2006-01-01

Roth 401(k) provisions are a newly available feature of 401(k) plans. Roth 401(k) provisions are after-tax savings that generally are tax-free at the time of distribution. Questions arise for plan sponsors about whether the new feature is beneficial, and to whom, and what needs to be done if the plan sponsor decides to offer this provision to its employees. This article tries to answer some of those common questions, including a simple computational analysis to try to answer the important question of how much an employee-participant genuinely benefits from this savings approach. Some practical issues of implementation are touched on, and some unanswered questions are identified.

Socrates was not a pimp: changing the paradigm of questioning in medical education.

PubMed

Kost, Amanda; Chen, Frederick M

2015-01-01

The slang term "pimping" is widely recognized by learners and educators in the clinical learning environment as the act of more senior members of the medical team publicly asking questions of more junior members. Although questioning as a pedagogical practice has many benefits, pimping, as described in the literature, evokes negative emotions in learners and leads to an environment that is not conducive to adult learning. Medical educators may employ pimping as a pedagogic technique because of beliefs that it is a Socratic teaching method. Although problems with pimping have previously been identified, no alternative techniques for questioning in the clinical environment were suggested. The authors posit that using the term "pimping" to describe questioning in medical education is harmful and unprofessional, and they propose clearly defining pimping as "questioning with the intent to shame or humiliate the learner to maintain the power hierarchy in medical education." Explicitly separating pimping from the larger practice of questioning allows the authors to make three recommendations for improving questioning practices. First, educators should examine the purpose of each question they pose to learners. Second, they should apply historic and modern interpretations of Socratic teaching methods that promote critical thinking skills. Finally, they should consider adult learning theories to make concrete changes to their questioning practices. These changes can result in questioning that is more learner centered, aids in the acquisition of knowledge and skills, performs helpful formative and summative assessments of the learner, and improves community in the clinical learning environment.

Effect of two types of control questions and two question formats on the outcomes of polygraph examinations.

PubMed

Horvath, Frank; Palmatier, John J

2008-07-01

Two major variations of polygraph "Control Question" testing, the Zone Comparison (ZoC) and the Modified General Question Test (MGQT) were evaluated. Within each, the type of control question, Exclusive or "time bar" (e.g., "Before you were 21, did you ever...") and Nonexclusive or "no time bar" (e.g., "Did you ever....?") was manipulated in a mock theft scenario, with 80 male and 40 female subjects randomly assigned to be either innocent or guilty. Polygraphic data collected by experienced field examiners were numerically scored by an evaluator blind to all aspects of the study. Decision accuracy was not related to the type of procedure (ZoC/MGQT) used or the subject's sex. Accuracy was significantly related to the type of control question [chi(2) (2) = 11.46, p = 0.003; tau c = 0.29]. Nonexclusive control questions produced greater accuracy than Exclusive control questions on both innocent and guilty subjects. These results and subjects' self-reports support the general "theory" on which control question (CQ) testing is based. The need for better empirical support of accepted dogma and current field practices is strongly indicated by these findings.

A Statistical Analysis of Student Questions in a Cell Biology Laboratory

ERIC Educational Resources Information Center

Keeling, Elena L.; Polacek, Kelly M.; Ingram, Ella L.

2009-01-01

Asking questions is an essential component of the practice of science, but question-asking skills are often underemphasized in science education. In this study, we examined questions written by students as they prepared for laboratory exercises in a senior-level cell biology class. Our goals were to discover 1) what types of questions students…

The perils of dental vacation: possible anaesthetic and medicolegal consequences.

PubMed

Feltracco, Paolo; Gaudio, Rosa Maria; Barbieri, Stefania; Tiano, Letizia; Iacobone, Maurizio; Viel, Giovanni; Tonetti, Tommaso; Galligioni, Helmut; Bortolato, Andrea; Ori, Carlo; Avato, Francesco Maria

2013-01-01

The aim of this paper is to emphasize anaesthesiologists' difficulty in detecting poor dentition in cases of poorly applied prostheses and/or advanced periodontal disease, and to establish whether it is possible, and in which conditions, to calculate compensation in cases of dental damage postlaryngoscopy and/or intubation. The main complex problem here lies in trying to reconstruct exactly what the dental situation was before the teeth were damaged. For this reason the important preoperative factors (dental prostheses, crown fractures, parodontal disease, etc.) must be clearly shown before surgery on a dental chart. Two cases of interest, both to anaesthesiologists practising intubation and medicolegal physicians who have to deal with potential claims, are briefly reported. The first patient was a 55-year-old diabetic patient, who underwent emergency surgery for acute abdominal pathology. He had gone outside Italy for dental treatment three years previously and now presented with very poor pre-existing dentition, carefully noted on an anaesthetic chart. He now demanded compensation for dental damage due to intubation in Italy; the resulting dental treatment was very expensive because substantial remedial work was required. The second patient had received treatment outside Italy, work which involved cosmetic coating of the teeth. After surgery in Italy, she demanded compensation because one tooth, which had been coated and appeared to be healthy, was broken after emergency intubation. In both cases, the patients demanded very high compensation. Dental tourism alone accounts for more than 250,000 patients each year who combine a holiday with dental treatment in Eastern Europe. However, if prosthetic devices or conservative treatments are not applied correctly, it should be noted that durability may be poorer than expected, but iatrogenic damage may also be caused.

Can workers answer their questions about occupational safety and health: challenges and solutions.

PubMed

Rhebergen, Martijn; Van Dijk, Frank; Hulshof, Carel

2012-01-01

Many workers have questions about occupational safety and health (OSH). Answers to these questions empower them to further improve their knowledge about OSH, make good decisions about OSH matters and improve OSH practice when necessary. Nevertheless, many workers fail to find the answers to their questions. This paper explores the challenges workers may face when seeking answers to their OSH questions. Findings suggest that many workers may lack the skills, experience or motivation to formulate an answerable question, seek and find information, appraise information, compose correct answers and apply information in OSH practice. Simultaneously, OSH knowledge infrastructures often insufficiently support workers in answering their OSH questions. This paper discusses several potentially attractive strategies for developing and improving OSH knowledge infrastructures: 1) providing courses that teach workers to ask answerable questions and to train them to find, appraise and apply information, 2) developing information and communication technology tools or facilities that support workers as they complete one or more stages in the process from question to answer and 3) tailoring information and implementation strategies to the workers' needs and context to ensure that the information can be applied to OSH practice more easily.

Eight Questions for Better Lessons

ERIC Educational Resources Information Center

Kriegel, Otis

2016-01-01

In this article, veteran educator Otis Kriegel provides eight questions that teachers can ask themselves as they create or tweak lesson plans. With practical, straightforward advice, Kriegel suggests that teachers be mindful of who their audience is, how much students already know, and what materials they'll need. He also urges teachers to…

The medico-legal aspects of road traffic deaths in children under 5 years of age.

PubMed

Terranova, Claudio

2015-11-01

The family tragedy that results from a child who dies in a road traffic accident may be exacerbated by judicial consequences for the adult/parent driving the vehicle, carrying the child, or responsible for properly immobilising the child in the safety device that was used. The author presents two court cases of the road traffic accident deaths of two children under the age of five years. The two cases are presented using a methodological approach, which integrates competencies in other fields into the medico-legal aspects. An analysis of the two cases provides the opportunity to discuss the driver's responsibility to properly use child safety seat and to analyse and evaluate the efficacy and limits of child restraint systems. In the two cases, the responsibility for the application of a child safety device was excluded. It was confirmed that child protective devices are not always sufficient to avoid lesions or death in road accidents that occur with significant speed or other specific dynamics. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Interdisciplinarity and the Question of Being

ERIC Educational Resources Information Center

Welch, James, IV

2012-01-01

The question of being adds another dimension to interdisciplinary theory and practice. The interdisciplinary approach to complex problems requires engaging with multiple perspectives from various disciplines, schools of thought, ideologies, and belief systems. All of these perspectives possess underlying and often unacknowledged ontological…

Omission of polysomnography in treatment of snoring: common reasons and medico-legal implications.

PubMed

Goh, Y H; Choy, D K

2000-07-01

Although polysomnography (PSG) is an important investigation in the treatment of snorers, it was observed that a large number of patients did not have pre-operative PSG assessment in a tertiary hospital in Singapore. Of the 118 Asian patients who underwent surgery for snoring from January 1997 to December 1998, 36 (30.5 per cent) of patients did not have pre-operative PSG and only 21 (17.8 per cent) of patients had post-operative PSG. In this cohort, 43 (36.4 per cent) patients presented with snoring as their only complaint and not associated with symptoms indicative of obstructive sleep apnoea syndrome (OSAS). Thirty-one of these 'simple snorers' underwent sleep studies with the following outcome: two (6.5 per cent) true simple snorers, two (6.5 per cent) upper airway resistance syndrome, nine (29 per cent) mild OSAS, seven (22.6 per cent) moderate OSAS and 11 (35.5 per cent) severe OSAS. Our study showed that without the aid of PSG, it would be difficult to predict the severity of sleep apnoea based on clinical history alone. In an increasingly litigation-conscious society such as Singapore, there is therefore little justification in omitting PSG in the treatment of snoring. The common reasons for omission of pre-operative PSG and the medico-legal implications are also discussed.

Identification of Best Practices for Resident Aesthetic Clinics in Plastic Surgery Training: The ACAPS National Survey

PubMed Central

Wu, Cindy; Bentz, Michael L.; Redett, Richard J.; Shack, R. Bruce; David, Lisa R.; Taub, Peter J.; Janis, Jeffrey E.

2015-01-01

Introduction: Resident aesthetic clinics (RACs) have demonstrated good outcomes and acceptable patient satisfaction, but few studies have evaluated their educational, financial, or medicolegal components. We sought to determine RAC best practices. Methods: We surveyed American Council of Academic Plastic Surgeon members (n = 399), focusing on operational details, resident supervision, patient safety, medicolegal history, financial viability, and research opportunities. Of the 96 respondents, 63 reported having a RAC, and 56% of plastic surgery residency program directors responded. Results: RACs averaged 243 patient encounters and 53.9 procedures annually, having been in existence for 19.6 years (mean). Full-time faculty (73%) supervised chief residents (84%) in all aspects of care (65%). Of the 63 RACs, 45 were accredited, 40 had licensed procedural suites, 28 had inclusion/exclusion criteria, and 31 used anesthesiologists. Seventeen had overnight capability, and 17 had a Life Safety Plan. No cases of malignant hyperthermia occurred, but 1 facility death was reported. Sixteen RACs had been involved in a lawsuit, and 33 respondents reported financial viability of the RACs. Net revenue was transferred to both the residents’ educational fund (41%) and divisional/departmental overhead (37%). Quality measures included case logs (78%), morbidity/mortality conference (62%), resident surveys (52%), and patient satisfaction scores (46%). Of 63 respondents, 14 have presented or published RAC-specific research; 80 of 96 of those who were surveyed believed RACs enhanced education. Conclusions: RACs are an important component of plastic surgery education. Most clinics are financially viable but carry high malpractice risk and consume significant resources. Best practices, to maximize patient safety and optimize resident education, include use of accredited procedural rooms and direct faculty supervision of all components of care. PMID:26146599

Four Questions to Ask Yourself

ERIC Educational Resources Information Center

Abilock, Debbie, Ed.

2007-01-01

One's commitment to intellectual freedom is manifested not just in the creation of a strong and clear selection policy or the celebration of Banned Books Week but by his or her willingness to examine his or her practices openly with others. In this article, the author proposes four questions to explore in one's teaching and in professional…

Questioning care at the end of life.

PubMed

Ruopp, Patricia; Good, Mary-Jo Delvecchio; Lakoma, Matthew; Gadmer, Nina M; Arnold, Robert M; Block, Susan D

2005-06-01

The goal of the larger study was to explore physicians' emotional responses to the death of their patients; this study analyzed a subset of physician transcripts to elucidate the construct of questioning care, which emerged from the larger study. To analyzes how physicians question care-expressing concern, unease, or uncertainty about treatment decisions and practices, errors, or adverse events-as they attend dying patients. Retrospective interview study of physicians caring for randomly selected deaths on the medical service of a major academic teaching hospital, using qualitative and quantitative measures. SETTING, SUBJECTS: 188 attendings, residents, and interns on the internal medical services of two academic medical centers were part of the larger study. A subsample of 75 physician narratives was selected for qualitative data analysis for this study. Qualitative measures included open-ended questions eliciting physicians' stories of the most recent and a most emotionally powerful patient death they have experienced. Grounded theory was used to analyze physician narratives. Quantitative instruments measured physician attitudes toward end-of-life care and responses to the most recent and most emotional patient death. Physicians question care more frequently in most emotional deaths (42%) than in most recent deaths (34%). Physicians question communication with patients and families and within medical teams, medical judgment and technique, standards of practice, and high-risk treatments, often assigning responsibility for medical management they perceive as inappropriate, futile, overly aggressive, or mistakes in judgment and technique. Responsibility ranges from the distal (the culture of medicine) to the proximal (personal). Frustration, guilt, and anger are more frequently expressed in these narratives when care is questioned. A typology of questioning care emerged from these physicians' narratives that parallels and reflects recent and classic research on

Identification of women at risk of depression in pregnancy: using women's accounts to understand the poor specificity of the Whooley and Arroll case finding questions in clinical practice.

PubMed

Darwin, Zoe; McGowan, Linda; Edozien, Leroy C

2016-02-01

Antenatal mental health assessment is increasingly common in high-income countries. Despite lacking evidence on validation or acceptability, the Whooley questions (modified PHQ-2) and Arroll 'help' question are used in the UK at booking (the first formal antenatal appointment) to identify possible cases of depression. This study investigated validation of the questions and women's views on assessment. Women (n = 191) booking at an inner-city hospital completed the Whooley and Arroll questions as part of their routine clinical care then completed a research questionnaire containing the Edinburgh postnatal depression scale (EPDS). A purposive subsample (n = 22) were subsequently interviewed. The Whooley questions 'missed' half the possible cases identified using the EPDS (EPDS threshold ≥ 10: sensitivity 45.7 %, specificity 92.1 %; ≥ 13: sensitivity 47.8 %, specificity 86.1 %), worsening to nine in ten when adopting the Arroll item (EPDS ≥ 10: sensitivity 9.1 %, specificity 98.2 %; ≥ 13: sensitivity 9.5 %, specificity 97.1 %). Women's accounts indicated that under-disclosure relates to the context of assessment and perceived relevance of depression to maternity services. Depression symptoms are under-identified in current local practice. While validated tools are needed that can be readily applied in routine maternity care, psychometric properties will be influenced by the context of disclosure when implemented in practice.

Medical Malpractice in Bariatric Surgery: a Review of 140 Medicolegal Claims.

PubMed

Choudhry, Asad J; Haddad, Nadeem N; Martin, Matthew; Thiels, Cornelius A; Habermann, Elizabeth B; Zielinski, Martin D

2017-01-01

Given the current rate of obesity in the USA, it has been estimated that close to half of the US adult population could be obese by 2030, resulting in greater demand for bariatric procedures. Our objective was to analyze malpractice litigation related to bariatric surgery. We conducted a retrospective review of Westlaw (Thompson Reuters) of all bariatric operations that resulted in the filing of a malpractice claim. Each case was reviewed for pertinent medicolegal information related to the procedure, claim, and trial. The search criteria yielded 298 case briefs, of which 140 met inclusion criteria. Thirty-two percent (n = 49) of cases involved male plaintiffs (patients). Mean patient age with standard deviation (SD) was 43 (10) years. The most common procedure litigated was the Roux-en-Y gastric bypass (76 %, n = 107). Overall, the most common alleged reason for a malpractice claim was delay in diagnosis or management of a complication in the postoperative period (n = 66, 47 %), the most common of which was an anastomotic leak (45 %, n = 34). Death was reported in 74 (52 %) cases. Fifty-seven cases (47 %) were decided in favor of the plaintiff (patient), with a median award payout of $1,090,000 (interquartile range [IQR] $412,500 to $2,550,000). Delay in diagnosing or managing complications in the postoperative setting, most commonly an anastomotic leak, accounted for the majority of malpractice claims. Measures taken to identify and address anastomotic leaks and other complications early in the postoperative period could potentially reduce the amount of filed malpractice claims related to bariatric surgery. III.

Medicolegal characteristics of firearm homicides in Belgrade, Serbia: before, during, and after the war in the Former Yugoslavia.

PubMed

Rancic, Nemanja; Erceg, Milena; Radojevic, Nemanja; Savic, Slobodan

2013-11-01

A comparative analysis of firearm homicides committed in Belgrade was performed including four representative years: 1987 (before the civil war in the Former Yugoslavia), 1991 (beginning of the war), 1997 (end of the war), and 2007 (period of social stabilization). The increase in the number of homicides was established in 1991 and 1997 compared with 1987, with the decrease in 2007, but with the continuous increase in the percentage of firearm homicides in the total number of homicides, from 12% in 1987 up to 56% in 2007. The significant increase in firearm homicides during the last decade of the 20th century can be explained by the social disturbances and the high availability of firearms, while their reduction in 2007 could be linked to the gradual stabilization of social circumstances. The results showed that the actual social, political, and economical changes strongly influenced medicolegal characteristics of homicides and particularly firearm homicides. © 2013 American Academy of Forensic Sciences.

Six questions about translational due diligence.

PubMed

Selinger, Evan

2010-04-28

To maintain stable respect and support, translational research must be guided by appropriate ethical, social, legal, and political concerns and carry out culturally competent practices. Considering six key questions concerning due diligence will enable the translational research community to examine critically how it approaches these endeavors.

Implications of the law on video recording in clinical practice.

PubMed

Henken, Kirsten R; Jansen, Frank Willem; Klein, Jan; Stassen, Laurents P S; Dankelman, Jenny; van den Dobbelsteen, John J

2012-10-01

Technological developments allow for a variety of applications of video recording in health care, including endoscopic procedures. Although the value of video registration is recognized, medicolegal concerns regarding the privacy of patients and professionals are growing. A clear understanding of the legal framework is lacking. Therefore, this research aims to provide insight into the juridical position of patients and professionals regarding video recording in health care practice. Jurisprudence was searched to exemplify legislation on video recording in health care. In addition, legislation was translated for different applications of video in health care found in the literature. Three principles in Western law are relevant for video recording in health care practice: (1) regulations on privacy regarding personal data, which apply to the gathering and processing of video data in health care settings; (2) the patient record, in which video data can be stored; and (3) professional secrecy, which protects the privacy of patients including video data. Practical implementation of these principles in video recording in health care does not exist. Practical regulations on video recording in health care for different specifically defined purposes are needed. Innovations in video capture technology that enable video data to be made anonymous automatically can contribute to protection for the privacy of all the people involved.

Working with Second Language Learners: Answers to Teachers' Top Ten Questions.

ERIC Educational Resources Information Center

Cary, Stephen

This book aims to provide practical, research-informed answers to the questions most frequently asked by teachers of second language learners. Every question targets one of the key instructional issues teachers must address to ensure success for their second language students. Included among the questions are: How do I assess a student's English?…

The Use of Questions within In-the-Moment Coaching in Initial Mathematics Teacher Education: Enhancing Participation, Reflection, and Co-Construction in Rehearsals of Practice

ERIC Educational Resources Information Center

Averill, Robin; Drake, Michael; Anderson, Dayle; Anthony, Glenda

2016-01-01

Managing mathematical discussion is known to be challenging for novice teachers. Coaching within student teacher rehearsals of teaching has been shown to develop mathematics teaching practice, but can be time consuming. To examine how coaching using questions could assist novice teachers to promote mathematical thinking and discussions within…

Preceptor questioning and student critical thinking.

PubMed

Myrick, Florence; Yonge, Olive

2002-01-01

Questioning is fundamental to student learning. Not only does it enable students to elevate their level of thinking, but in the process it also affords them the opportunity to deal with their world intelligently. The practice setting is an environment rich in opportunity for enabling critical thinking through the use of questioning. In the preceptorship experience, preceptors are in a prime position to use questioning behaviors that can challenge the way preceptees think, encourage them to justify or clarify their assertions, promote the generation of original ideas, explanations, or solutions to patient problems, provide mental and emotional tools to help resolve dilemmas, promote discussion, and evaluate learning. This article discusses the importance of preceptor questioning for the development and promotion of student critical thinking. Contextually, the authors draw on the findings of a recent study in which preceptor questioning of the knowledge base, decision making, and actions of the preceptee were found to directly bring about or trigger their critical thinking. This article allows for some further reflection on that process and its contribution to the enhancement of the preceptorship experience. Copyright 2002, Elsevier Science (USA). All rights reserved.

An Examination of the Questioning Interactions of Prospective Teachers during Mathematical Discussions

ERIC Educational Resources Information Center

Darke, Kelly Marie

2010-01-01

Questioning is an essential and generative studying practice for prospective teachers (PTs) as they develop their mathematical content knowledge needed for teaching. This study examines PTs' questioning interactions by describing the types of questions they ask during small group discussions in a required mathematics content course and how their…

Structured methods and striking moments: using question sequences in "living" ways.

PubMed

Lowe, Roger

2005-03-01

This article draws together two seemingly incompatible practices in social constructionist therapies: the use of structured questioning methods (associated with solution-focused and narrative therapies) and the poetic elaboration of "striking moments" (associated with conversational therapies). To what extent can we value and use both styles of practice? Beginning with practitioners' concerns about the use of structured question sequences, I explore possibilities for resituating these methods in different conceptual and metaphorical frames, selectively drawing on ideas from the philosophy of striking moments. The aim is not to reduce one therapeutic style to another, but to encourage the teaching and practice of structured methods in more creative, improvisational, and "living" ways.

Medico-legal issues in cardiology.

PubMed

Abbott, Ryan; Cohen, Michael

2013-01-01

The aim of this article is to educate physicians about the current litigation climate in cardiology and cardiac surgery, with a focus on the most frequently litigated areas of practice, including failure to diagnose and treat myocardial infarction, coronary artery bypass graft surgery, percutaneous coronary intervention, and the use of tissue plasminogen activator. Empirical research on cardiology malpractice is presented, along with a sampling of up-to-date cases designed to illustrate common issues and important themes. The principles for reducing legal liability are also discussed, including the informed consent process, spoliation of records, and the role of documentation. Finally, practical recommendations are provided for cardiologists and cardiac surgeons to limit their legal liability.

Association between EMS Question Bank Completion and Passing Rates on the EMS Certification Examination.

PubMed

Clemency, Brian; Martin-Gill, Christian; Rall, Nicole; May, Paul; Lubin, Jeffrey; Cooley, Craig; Van Dillen, Christine; Silvestri, Salvatore; Portela, Roberto; Cooney, Derek; Knutsen, Christian; March, Juan

2017-01-01

A board review question bank was created to assist candidates in their preparation for the 2015 EMS certification examination. We aimed to describe the development of this question bank and evaluate its successes in preparing candidates to obtain EMS subspecialty board certification. An online question bank was developed by 13 subject matter experts who participated as item writers, representing eight different EMS fellowship programs. The online question bank consisted of four practice tests, with each of the tests comprised of 100 questions. The number of candidates who participated in and completed the question bank was calculated. The passing rate among candidates who completed the question bank was calculated and compared to the publicly reported statistics for all candidates. The relationship between candidates' performance on the question bank and subspecialty exam pass rates was determined. A total of 252 candidates took at least one practice test and, of those, 225 candidates completed all four 100-question practice tests. The pass rate on the 2015 EMS certification exam was 79% (95%CI 74-85%) among candidates who completed the question bank, which is 12% higher than the overall pass rate (p = 0.003). Candidates' performance on the question bank was positively associated with overall success on the exam (X 2 = 75.8, p < 0.0001). Achieving a score of ≥ 70% on the question bank was associated with a higher likelihood of passing the exam (OR = 17.8; 95% CI: 8.0-39.6). Completing the question bank program was associated with improved pass rates on the EMS certification exam. Strong performance on the question bank correlated with success on the exam.

Remaking the medico-legal scene: a social history of the late-Victorian coroner in Oxford.

PubMed

Hurren, Elizabeth T

2010-04-01

There have been wide-ranging debates about medicine and the law encapsulated in the figure of the coroner in Victorian England. Recently the historical literature on coroners has been enriched by macro-studies. Despite this important research, the social lives of coroners and their daily interactions remain relatively neglected in standard historical accounts. This article redresses that issue by examining the working life of the coroner for Oxford during the late-Victorian era. Edward Law Hussey kept very detailed records of his time in office as coroner. New research material makes it feasible to trace his professional background, from doctor of the sick poor, to hospital house surgeon and then busy coroner. His career trajectory, personal interactions, and professional disputes, provide an important historical prism illuminating contemporary debates that occupied coroners in their working lives. Hussey tried to improve his medico-legal reach and the public image of his coroner's office by reducing infanticide rates, converting a public mortuary, and acquiring a proper coroner's court. His campaigns had limited success because the social scene in which he worked was complicated by the dominance of health and welfare agencies that resented his role as an expanding arm of the Victorian information state.

ALAT-2014 Chronic Obstructive Pulmonary Disease (COPD) Clinical Practice Guidelines: questions and answers.

PubMed

Montes de Oca, María; López Varela, María Victorina; Acuña, Agustín; Schiavi, Eduardo; Rey, María Alejandra; Jardim, José; Casas, Alejandro; Tokumoto, Antonio; Torres Duque, Carlos A; Ramírez-Venegas, Alejandra; García, Gabriel; Stirbulov, Roberto; Camelier, Aquiles; Bergna, Miguel; Cohen, Mark; Guzmán, Santiago; Sánchez, Efraín

2015-08-01

ALAT-2014 COPD Clinical Practice Guidelines used clinical questions in PICO format to compile evidence related to risk factors, COPD screening, disease prognosis, treatment and exacerbations. Evidence reveals the existence of risk factors for COPD other than tobacco, as well as gender differences in disease presentation. It shows the benefit of screening in an at-risk population, and the predictive value use of multidimensional prognostic indexes. In stable COPD, similar benefits in dyspnea, pulmonary function and quality of life are achieved with LAMA or LABA long-acting bronchodilators, whereas LAMA is more effective in preventing exacerbations. Dual bronchodilator therapy has more benefits than monotherapy. LAMA and combination LABA/IC are similarly effective, but there is an increased risk of pneumonia with LABA/IC. Data on the efficacy and safety of triple therapy are scarce. Evidence supports influenza vaccination in all patients and anti-pneumococcal vaccination in patients <65years of age and/or with severe airflow limitation. Antibiotic prophylaxis may decrease exacerbation frequency in patients at risk. The use of systemic corticosteroids and antibiotics are justified in exacerbations requiring hospitalization and in some patients managed in an outpatient setting. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Question analysis for Indonesian comparative question

NASA Astrophysics Data System (ADS)

Saelan, A.; Purwarianti, A.; Widyantoro, D. H.

2017-01-01

Information seeking is one of human needs today. Comparing things using search engine surely take more times than search only one thing. In this paper, we analyzed comparative questions for comparative question answering system. Comparative question is a question that comparing two or more entities. We grouped comparative questions into 5 types: selection between mentioned entities, selection between unmentioned entities, selection between any entity, comparison, and yes or no question. Then we extracted 4 types of information from comparative questions: entity, aspect, comparison, and constraint. We built classifiers for classification task and information extraction task. Features used for classification task are bag of words, whether for information extraction, we used lexical, 2 previous and following words lexical, and previous label as features. We tried 2 scenarios: classification first and extraction first. For classification first, we used classification result as a feature for extraction. Otherwise, for extraction first, we used extraction result as features for classification. We found that the result would be better if we do extraction first before classification. For the extraction task, classification using SMO gave the best result (88.78%), while for classification, it is better to use naïve bayes (82.35%).

Asking good clinical research questions and choosing the right study design.

PubMed

Bragge, P

2010-07-01

Clinicians and researchers seek answers to clinical research questions, primarily by accessing the results of clinical research studies. This paper moves the focus of research enquiry from getting answers to developing good clinical research questions. Using worked examples, the steps involved in refining questions drawn from various sources to create 'answerable' clinical research questions using the 'PICO' principle are described. Issues to consider in prioritising clinical research questions are also identified. Theoretical and practical considerations involved in choosing the right study design for a clinical research question are then discussed using the worked examples. These include: Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Child deaths with persistent neglected experiences from medico-legal documents in Japan.

PubMed

Yamaoka, Yui; Tamiya, Nanako; Fujiwara, Takeo; Yamasaki, Yukie; Matsuzawa, Akemi; Miyaishi, Satoru

2015-06-01

Few studies have examined the actual conditions of fatal neglect in Japan. The aims of this study were to investigate persistent neglect among child fatalities using medico-legal documents, and to describe the characteristics of the socio-familial background and biological data. The current study analyzed the documents of all postmortem external examinations and autopsies in children <2 years old carried out in one prefecture in Japan from 2006 to 2011. After examining 59 autopsy cases using modified the Maltreatment Classification System, we identified six children who experienced persistent neglect as study samples. Three children were found in unsanitary rooms and one was left alone inside a car. In two cases, age of mother at delivery was <21 years old. Three victims had 1 year older sibling. With regard to history of use of health services, three mothers missed some prenatal care visits, and two refused to receive neonatal home visits. With regard to biological data the average weight Z score of six children was -2.22 after being adjusted to average weight for age (in months) and sex. Three children had acute or chronic undernutrition. Three victims had thymic involution considered as being due to chronic child maltreatment. The present collaboration between public health and legal medicine has enabled investigation of the background and biological impact of experiences of persistent neglect. A multidisciplinary system of evaluating child death is needed to identify preventable factors in order to intervene in the case of neglected children in a timely manner. © 2014 The Authors. Pediatrics International published by Wiley Publishing Asia Pty Ltd on behalf of Japan Pediatric Society.

Power and practices: questions concerning the legislation of health professions in Brazil.

PubMed

Velloso, Isabela S C; Ceci, Christine

2015-07-01

Developments in professional practice can be related to ongoing changes in relations of power among professionals, which often lead to changes in the boundaries of practices. The differing contexts of practices also influence these changing relations among health professionals. Legislation governing professional practice also differs from country to country. In Brazil, over the past 12 years, in a climate of deep disagreement, a new law to regulate medical practice has been discussed. It was sanctioned, or made into law, but with some notable changes, in July 2013. Of interest to us in this paper are the ways the proposed legislation, by setting out the boundaries and scope of medical practice, 'interfered' in the practices of other health professions, undermining many 'independent' practices that have developed over time. However, even taking into account the multiple routes through which practices are established and developed, the role of legislation that seems able to contradict and deny the historical realities of multiple, intersecting practices should be critically interrogated. In this paper, we use the theoretical resources of poststructuralist thinking to explore gaps, ambiguities, and power relations implicit in the discourses that constituted this law. We argue that although the new law can be understood as a social and political device that will interfere in the organization of other health professions' practices, such legislation is only part of what constitutes change in a consolidated professional practice. And while it is important to understand the effects of such legislation, healthcare practices are also realized or 'made real' through ongoing relations of knowledge and power, including, as we will see in this case, activities of resistance. The problem, then, is to understand the practical arrangements, including legislation, traditions and routines, values and knowledge that come to shape the practices of nursing in a particular context. �

Review or True? Using Higher-Level Thinking Questions in Social Studies Instruction

ERIC Educational Resources Information Center

Kracl, Carrie L.

2012-01-01

Asking surface-level questions is a common practice among educators. Delva Daines's (1986) pilot study indicated that 93 percent of the questions asked during lessons were at the literal level of comprehension and that it was very common for the teachers to restate, rephrase, or answer their own questions before the student had an opportunity to…

European Council of Legal Medicine (ECLM) principles for on-site forensic and medico-legal scene and corpse investigation.

PubMed

Cusack, D; Ferrara, S D; Keller, E; Ludes, B; Mangin, P; Väli, M; Vieira, N

2017-07-01

Forensic medical practitioners need to define the general principles governing procedures to be used for the on-site examination of a body where the death has occurred in unnatural, violent or suspicious circumstances. These principles should be followed whenever a medical expert is required to perform an on-site corpse inspection and should be utilised as a set of general guidelines to be adapted to the specific situation in hand and interpreted using common sense and scientific knowledge of the relevant procedures and facts of the case. The aim of these principles is to ensure that forensic evidence at the scene of a death is properly observed and assessed and all necessary relevant evidence gathered in order to ensure that a comprehensive report is available to the judicial authority (investigating judge or coroner) in the justice system. The on-site corpse inspection by a forensic practitioner is a mandatory and essential stage of the forensic and medico-legal autopsy, as it may provide important information for subsequent investigation stages.

Questions, Questioning Techniques, and Effective Teaching.

ERIC Educational Resources Information Center

Wilen, William W., Ed.

This book focuses on questioning techniques and strategies teachers may employ to make the difference between active and passive learning in the classroom. There are nine chapters: (1) Why Questions? (Ambrose A. Clegg, Jr.); (2) Review of Research on Questioning Techniques (Meredith D. Gall and Tom Rhody); (3) The Multidisciplinary World of…

Doctors' perspectives on the viability of rural practice.

PubMed

Jones, J A; Humphreys, J S; Adena, M A

2004-01-01

Private practitioners play a vital role in meeting the health needs of rural communities. However, the prospect of operating a private practice business in rural Australia seems to be increasingly unattractive, because many communities are forced to recruit salaried or overseas-trained doctors. This study focuses on rural practices as businesses whose viability influences their attractiveness for the recruitment and retention of practitioners. The specific objectives are to ascertain which factors contribute to or threaten practice viability in rural areas, and whether they vary according to the degree of rurality or geographical remoteness. This study is based on data collected from a national study into the viability of rural general practice undertaken jointly by the Rural Doctors Association of Australia and Monash University School of Rural Health Bendigo. The Rural Remote and Metropolitan Area (RRMA) classification was used as the indicator of rurality. The study surveyed all general practitioners practising in rural or remote regions of Australia (RRMAs 3 to 7). Only practitioners with some financial interest in the practice were selected for this analysis. Free-text responses to the two questions 'What are the key factors contributing to the viability of your practice?' and 'What factors would put the viability of your practice at risk?' were analysed using qualitative content analysis. Factors were derived iteratively through higher-level aggregation of responses. Chi-square tests were used to make comparisons across the RRMA categories. The national survey achieved a response rate of 35% of the entire population of GPs practising in RRMA 3 to 7 regions. Of these, 1050 respondents were relevant to this analysis. Seven major factors were identified by practitioners as the main contributors to practice viability. 'Practice characteristics' was nominated by 59% of respondents, followed by 'Income' (31%), 'Personal circumstances', 'Workforce' and 'Community

More Questions than Answers: A Response to Stephens, Reeder, and Elder.

ERIC Educational Resources Information Center

Bhaerman, Robert D.

1992-01-01

Responds to the three main articles in this issue with questions concerning the development and use of policy-impact codes (rural-urban classification systems) for specific purposes in policymaking, research, and practice. Questions the necessity for policy-impact codes to ensure equity, adequacy, responsiveness, and appropriateness of rural…

[Giving medico-legal opinions in cases with suspicion of medical mistake.part 1. between medicine and justice.

PubMed

Chowaniec, Czesław; Chowaniec, Małgorzata; Wilk, Mateusz

2017-01-01

Creating medico-legal opinion is a sophisticated investigative, analytical, decision-making and creative process. Forensic medicine specialist in cooperation with clinical medicine consultants, on the basis of evidence analysis, which was gathered during procedures and contained in the acts has to create an objective and essential opinion. This opinion is a vital, very important and irreplaceable proof in every case. Judicial body consults with forensic medicine specialist or specialists if there are circumstances for settlement of which there is a need of classified informations - art. 193 of Penalty Code. Forensic medicine specialists face many difficulties which may have effect on quality, positiveness of opinion, compliance with the deadline, increasing expectancy of judicial body or sides. It is very difficult to find clinical specialists which except their clinical knowledge have basic knowledge about law, the role and duties of an court expert. In this article we discuss creating-opinion problems, role and position of court expert in confrontation with expectations of judicial body and the Justice with particular emphasis on medical mistakes and assessment of medical proceedings. We show the complexity of creating of medical opinions, especially these institutional.

Fertility concerns in men with genitourinary malignancies: Treatment dilemmas, fertility options, and medicolegal considerations.

PubMed

Polland, Allison; Berookhim, Boback M

2016-09-01

With increasing genitourinary cancer survivorship in patients of reproductive age, fertility preservation has become a greater focus in the management of these patients. We performed a review of articles pertaining to male infertility, fertility preservation, and genitourinary cancers. The aim was to review causes of infertility in patients with cancer, current options for fertility preservation, research that may expand preservation options, and ethical as well as medicolegal considerations. There are multiple causes of infertility in male patients with cancer, including the malignancy itself, and the treatments required to achieve a potential cure. Surgery can affect the normal pathways for erection, emission, and ejaculation. Chemotherapy can have a profound negative effect on spermatogenesis by causing chromosomal aberrations, maturation arrest, mutagenesis, and impaired spermatozoa motility. Radiation can cause cellular apoptosis with resultant reduction in spermatogonial stem cells. There are numerous methods to secure fertility before cancer treatment with the aid of cryopreservation ranging from simple patient-provided semen samples to complex sperm retrieval techniques. Research in the field of spermatogenic stem cells may lead to improved treatment options such as autotransplant of stem cells for repopulation of the testes after cancer treatment. Early discussion of possible fertility effects in patients undergoing genitourinary cancer treatment is critical in this era of increasing survivorship. Although current cancer treatments can cause infertility, there are well-established options for fertility preservation and current research will likely lead to improved treatment options. Copyright © 2016 Elsevier Inc. All rights reserved.

Insects and associated arthropods analyzed during medicolegal death investigations in Harris County, Texas, USA: January 2013- April 2016

PubMed Central

2017-01-01

The application of insect and arthropod information to medicolegal death investigations is one of the more exacting applications of entomology. Historically limited to homicide investigations, the integration of full time forensic entomology services to the medical examiner’s office in Harris County has opened up the opportunity to apply entomology to a wide variety of manner of death classifications and types of scenes to make observations on a number of different geographical and species-level trends in Harris County, Texas, USA. In this study, a retrospective analysis was made of 203 forensic entomology cases analyzed during the course of medicolegal death investigations performed by the Harris County Institute of Forensic Sciences in Houston, TX, USA from January 2013 through April 2016. These cases included all manner of death classifications, stages of decomposition and a variety of different scene types that were classified into decedents transported from the hospital (typically associated with myiasis or sting allergy; 3.0%), outdoor scenes (32.0%) or indoor scenes (65.0%). Ambient scene air temperature at the time scene investigation was the only significantly different factor observed between indoor and outdoor scenes with average indoor scene temperature being slightly cooler (25.2°C) than that observed outdoors (28.0°C). Relative humidity was not found to be significantly different between scene types. Most of the indoor scenes were classified as natural (43.3%) whereas most of the outdoor scenes were classified as homicides (12.3%). All other manner of death classifications came from both indoor and outdoor scenes. Several species were found to be significantly associated with indoor scenes as indicated by a binomial test, including Blaesoxipha plinthopyga (Wiedemann) (Diptera: Sarcophagidae), all Sarcophagidae (including B. plinthopyga), Megaselia scalaris Loew (Diptera: Phoridae), Synthesiomyia nudiseta Wulp (Diptera: Muscidae) and Lucilia

Insects and associated arthropods analyzed during medicolegal death investigations in Harris County, Texas, USA: January 2013- April 2016.

PubMed

Sanford, Michelle R

2017-01-01

The application of insect and arthropod information to medicolegal death investigations is one of the more exacting applications of entomology. Historically limited to homicide investigations, the integration of full time forensic entomology services to the medical examiner's office in Harris County has opened up the opportunity to apply entomology to a wide variety of manner of death classifications and types of scenes to make observations on a number of different geographical and species-level trends in Harris County, Texas, USA. In this study, a retrospective analysis was made of 203 forensic entomology cases analyzed during the course of medicolegal death investigations performed by the Harris County Institute of Forensic Sciences in Houston, TX, USA from January 2013 through April 2016. These cases included all manner of death classifications, stages of decomposition and a variety of different scene types that were classified into decedents transported from the hospital (typically associated with myiasis or sting allergy; 3.0%), outdoor scenes (32.0%) or indoor scenes (65.0%). Ambient scene air temperature at the time scene investigation was the only significantly different factor observed between indoor and outdoor scenes with average indoor scene temperature being slightly cooler (25.2°C) than that observed outdoors (28.0°C). Relative humidity was not found to be significantly different between scene types. Most of the indoor scenes were classified as natural (43.3%) whereas most of the outdoor scenes were classified as homicides (12.3%). All other manner of death classifications came from both indoor and outdoor scenes. Several species were found to be significantly associated with indoor scenes as indicated by a binomial test, including Blaesoxipha plinthopyga (Wiedemann) (Diptera: Sarcophagidae), all Sarcophagidae (including B. plinthopyga), Megaselia scalaris Loew (Diptera: Phoridae), Synthesiomyia nudiseta Wulp (Diptera: Muscidae) and Lucilia cuprina

Questions Frequently Asked about Vocational Education. Special Publication Series No. 57.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This document offers the best available answers to questions frequently asked about vocational education by policymakers in vocational education at the state and local level. It is divided into two sections. The first section contains 15 frequently asked questions about vocational education effects and practices, each of which is followed by a…

Service-Learning Projects Developed from Institutional Research Questions

ERIC Educational Resources Information Center

Zack, Maria; Crow, Greg

2013-01-01

Institutional research questions provide an excellent source of interesting problems for service-learning projects for undergraduates in mathematics. This paper discusses how this model has been implemented at Point Loma Nazarene University and provides both examples and practical details. (Contains 6 figures.)

The AP Descriptive Chemistry Question: Student Errors

ERIC Educational Resources Information Center

Crippen, Kent; Brooks, David W.

2005-01-01

For over a decade, the authors have been involved in a design theory experiment providing software for high school students preparing for the descriptive question on the Advanced Placement (AP) chemistry examination. Since 1997, the software has been available as a Web site offering repeatable practice. This study describes a 4-year project during…

Imaging of drug smuggling by body packing.

PubMed

Sica, Giacomo; Guida, Franco; Bocchini, Giorgio; Iaselli, Francesco; Iadevito, Isabella; Scaglione, Mariano

2015-02-01

Body packing, pushing, and stuffing are hazardous practices with complex medicolegal and social implications. A radiologist plays both a social and a medicolegal role in their assessment, and it should not be limited only to the identification of the packages but must also provide accurate information about their number and their exact location so as to prevent any package remains in the body packer. Radiologists must also be able to recognize the complications associated with these risky practices. Imaging assessment of body packing is performed essentially through plain abdominal X-ray and computed tomography scans. Ultrasound and magnetic resonance imaging, although with some advantages, actually have a limited use. Copyright © 2014 Elsevier Inc. All rights reserved.

Complexity Theory, School Leadership and Management: Questions for Theory and Practice

ERIC Educational Resources Information Center

Morrison, Keith

2010-01-01

Complexity theory (CT) has had a meteoric rise in management literature and the social sciences. Its fledgling importation into school leadership and management raises several questions and concerns. This article takes one view of CT and argues that, though its key elements have much to offer school leadership and management, caution has to be…

Can we share questions? Performance of questions from different question banks in a single medical school.

PubMed

Freeman, Adrian; Nicholls, Anthony; Ricketts, Chris; Coombes, Lee

2010-01-01

To use progress testing, a large bank of questions is required, particularly when planning to deliver tests over a long period of time. The questions need not only to be of good quality but also balanced in subject coverage across the curriculum to allow appropriate sampling. Hence as well as creating its own questions, an institution could share questions. Both methods allow ownership and structuring of the test appropriate to the educational requirements of the institution. Peninsula Medical School (PMS) has developed a mechanism to validate questions written in house. That mechanism can be adapted to utilise questions from an International question bank International Digital Electronic Access Library (IDEAL) and another UK-based question bank Universities Medical Assessment Partnership (UMAP). These questions have been used in our progress tests and analysed for relative performance. Data are presented to show that questions from differing sources can have comparable performance in a progress testing format. There are difficulties in transferring questions from one institution to another. These include problems of curricula and cultural differences. Whilst many of these difficulties exist, our experience suggests that it only requires a relatively small amount of work to adapt questions from external question banks for effective use. The longitudinal aspect of progress testing (albeit summatively) may allow more flexibility in question usage than single high stakes exams.

Questioning for Controversial and Critical Thinking Dialogues in the Social Studies Classroom

ERIC Educational Resources Information Center

Lennon, Sean

2017-01-01

The design and implementation of questioning, specifically in regards towards a higher level of thinking, is a common practice in many secondary social science classrooms (Bickmore & Parker, 2012). Questioning can help the teacher develop critical thinking concepts, scaffold discussions, and prod students towards an elevated level of cognition…

Teaching and evaluating point of care learning with an Internet-based clinical-question portfolio.

PubMed

Green, Michael L; Reddy, Siddharta G; Holmboe, Eric

2009-01-01

Diplomates in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program satisfy the self-evaluation of medical knowledge requirement by completing open-book multiple-choice exams. However, this method remains unlikely to affect practice change and often covers content areas not relevant to diplomates' practices. We developed and evaluated an Internet-based point of care (POC) learning portfolio to serve as an alternative. Participants enter information about their clinical questions, including characteristics, information pursuit, application, and practice change. After documenting 20 questions, they reflect upon a summary report and write commitment-to-change statements about their learning strategies. They can link to help screens and medical information resources. We report on the beta test evaluation of the module, completed by 23 internists and 4 internal medicine residents. Participants found the instructions clear and navigated the module without difficulty. The majority preferred the POC portfolio to multiple-choice examinations, citing greater relevance to their practice, guidance in expanding their palette of information resources, opportunity to reflect on their learning needs, and "credit" for self-directed learning related to their patients. Participants entered a total of 543 clinical questions, of which 250 (46%) resulted in a planned practice change. After completing the module, 14 of 27 (52%) participants committed to at least 1 change in their POC learning strategies. Internists found the portfolio valuable, preferred it to multiple-choice examinations, often changed their practice after pursuing clinical questions, and productively reflected on their learning strategies. The ABIM will offer this portfolio as an elective option in MOC.

Five questiouns dentists should ask about their money. Question 4: how do the communities (family, practice, profession, culture, neighborhood, etc.) in which I live affect my financial decisions?

PubMed

Jones, Troy E

2006-11-01

Communities, and the personal value you place on them, affect all your spending, both business and personal. Once you begin questioning and analyzing how they affect your financial decisions, you will begin making more complete choices - the better-informed, the greater chance of success. Society has attached many financial expectations to dentists - both good and bad. By participating in this part of the Five Questions process, you will be able to separate the business of dentistry from the practice of dentistry and your persona beliefs from the beliefs of your communities'.

[Pharmacological, toxicological, deontologic, and medico-legal aspects of the use of appetite suppressant agents in "weight-loss cures"].

PubMed

Carolei, L; Ermio, G; Accorinti, N; Meo, G; Lamberti, V; De Sarro, G

1997-01-01

The pharmacological, deontologic and medico-legal aspects in the use of appetite suppressant drugs have been evaluated. Appetite suppressant drugs used in the treatment of obesity are divided into 2 broad pharmacological categories: those acting via brain catecholamine pathways and those acting via serotonin pathways. Of the former group, amphetamines and phenimetrazines are no longer used because of their stimulant properties and addictive potential. The remaining drugs of this group have some sympathomimetic and stimulant properties. Anorectic drugs which promote serotonin neurotransmission have no such stimulant or sympathomimetic properties. They reduce appetite and food intake and are effective in the treatment of obesity. If they are not used appropriately, appetite suppressants can be of no therapeutic benefit and cause marked health risks. As regards to anorectic drugs, the 13/4/1995 act "Rules and limits in preparing drugs containing anorectic substances", precisely defines rules about selling and use of those substances. Behavior of health care personnel neglecting observance of the rule, could be interpreted as "imprudence", "negligence" and "inexpertness" in designing and managing a fat-reducing diet, that may imply, in case of damage to the patient, a professional fault.

The principles and best practice of question writing for postgraduate examinations.

PubMed

Hayes, Kevin; McCrorie, Peter

2010-12-01

Postgraduate medical education has changed enormously in the last 10 years presenting huge logistical challenges for local, regional and national organisations. Assessment is under change in line with major revisions of postgraduate curricula. Old methods of assessment are changing to newer evidence-based methods supported by ongoing research into good practice. This review examines the purpose and practical considerations of written assessment, the pros and cons of different assessment methods and how good practice can be evaluated and quality assured. Good quality assessment comes at a cost in terms of time and money, and organisations need to invest in their assessment strategies to ensure the highest possible standards. Copyright © 2010 Elsevier Ltd. All rights reserved.

Studying Teacher Preparation: The Questions That Drive Research

ERIC Educational Resources Information Center

Cochran-Smith, Marilyn; Maria Villegas, Ana

2015-01-01

This article argues that research on teacher preparation over the last 100 years can be understood in terms of the major questions that researchers examined. The analysis is guided by the framework of "research as historically situated social practice," which emphasizes that researchers' interests, commitments, and social experiences…

Primary care validation of a single screening question for drinkers.

PubMed

Seale, J Paul; Boltri, John M; Shellenberger, Sylvia; Velasquez, Mary M; Cornelius, Monica; Guyinn, Monique; Okosun, Ike; Sumner, Heather

2006-09-01

The aim of this study was to conduct a primary care validation study of a single screening question for alcohol misuse ("When was the last time you had more than X drinks in 1 day?," where X was four for women and X was five for men), which was previously validated in a study conducted in emergency departments. This cross-sectional study was accomplished by interviewing 625 male and female adult drinkers who presented to five southeastern primary care practices. Patients answered the single question (coded as within 3 months, within 12 months, ever, or never), Alcohol Use Disorders Identification Test (AUDIT), and AUDIT consumption questions (AUDIT-C). Alcohol misuse was defined as either at-risk drinking, identified by a 29-day Timeline Followback interview or a current (past-year) alcohol-use disorder by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, or both. Among 625 drinkers interviewed, 25.6% were at-risk drinkers, 21.7% had a current alcohol- use disorder, and 35.2% had either or both conditions. Considering "within the last 3 months" as positive, the sensitivity of the single question was 80% and the specificity was 74%. Chi-square analyses revealed similar sensitivity across ethnic and gender groups; however, specificity was higher in women and whites (p = .0187 and .0421, respectively). Considering "within the last 12 months" as positive increased the question's sensitivity, especially for those with alcohol-use disorders. The area under the receiver operating characteristic curve of the single alcohol screening question (0.79) was slightly lower than for the AUDIT and AUDIT-C, but sensitivity and specificity were similar. A single question about the last episode of heavy drinking is a sensitive, time-efficient screening instrument that shows promise for increasing alcohol screening in primary care practices.

Recommendations for the pharmacological treatment of COPD: questions and answers.

PubMed

Fernandes, Frederico Leon Arrabal; Cukier, Alberto; Camelier, Aquiles Assunção; Fritscher, Carlos Cezar; Costa, Cláudia Henrique da; Pereira, Eanes Delgado Barros; Godoy, Irma; Cançado, José Eduardo Delfini; Romaldini, José Gustavo; Chatkin, Jose Miguel; Jardim, José Roberto; Rabahi, Marcelo Fouad; Nucci, Maria Cecília Nieves Maiorano de; Sales, Maria da Penha Uchoa; Castellano, Maria Vera Cruz de Oliveira; Aidé, Miguel Abidon; Teixeira, Paulo José Zimermann; Maciel, Renato; Corrêa, Ricardo de Amorim; Stirbulov, Roberto; Athanazio, Rodrigo Abensur; Russo, Rodrigo; Minamoto, Suzana Tanni; Lundgren, Fernando Luiz Cavalcanti

2017-01-01

The treatment of COPD has become increasingly effective. Measures that range from behavioral changes, reduction in exposure to risk factors, education about the disease and its course, rehabilitation, oxygen therapy, management of comorbidities, and surgical and pharmacological treatments to end-of-life care allow health professionals to provide a personalized and effective therapy. The pharmacological treatment of COPD is one of the cornerstones of COPD management, and there have been many advances in this area in recent years. Given the greater availability of drugs and therapeutic combinations, it has become increasingly challenging to know the indications for, limitations of, and potential risks and benefits of each treatment modality. In order to critically evaluate recent evidence and systematize the major questions regarding the pharmacological treatment of COPD, 24 specialists from all over Brazil gathered to develop the present recommendations. A visual guide was developed for the classification and treatment of COPD, both of which were adapted to fit the situation in Brazil. Ten questions were selected on the basis of their relevance in clinical practice. They address the classification, definitions, treatment, and evidence available for each drug or drug combination. Each question was answered by two specialists, and then the answers were consolidated in two phases: review and consensus by all participants. The questions answered are practical questions and help select from among the many options the best treatment for each patient and his/her peculiarities.

Begging the Question: Performativity and Studio-Based Research

ERIC Educational Resources Information Center

Petelin, George

2014-01-01

The requirement that candidates in studio-based or practice-led higher degrees by research should formulate a research question has been found to be problematic by some writers. The present article argues that this stance, particularly as it is articulated by proponents of the influential category of "performative research" (Haseman,…

Mathematics Teachers' Use of Questions: Is There a Change of Practice after the Curriculum Change?

ERIC Educational Resources Information Center

Delice, Ali; Aydin, Emin; Cevik, K. Seda

2013-01-01

The aim of this study is to investigate the questions that are used by teachers. In broader sense the intention is to focus on questions as part of teachers' formal as well as informal assessments. We will mainly concentrate on how students are assessed and how the questions in the assessments are formed and marked. The research is mainly…

Rewards and challenges of family practice

PubMed Central

Manca, Donna P.; Varnhagen, Stanley; Brett-MacLean, Pamela; Allan, G. Michael; Szafran, Olga; Ausford, Allen; Rowntree, Carol; Rumzan, Ismael; Turner, Diana

2007-01-01

OBJECTIVE To identify and describe the important rewards and challenges that affect family physicians in Alberta. DESIGN Web-based qualitative study using the Delphi method. SETTING Province of Alberta. PARTICIPANTS Twenty-eight family physicians practising in Alberta. METHODS The study website presented a description of the project, ethical information, a calendar of events, and contact information. Delphi surveys and demographic questionnaires were password protected. Five rounds of surveys were conducted between May 2004 and January 2005. Participants were notified of each round of surveys and prompted by e–mail ifthey did not respond. FINDINGS Participants identified 8 key rewards and 9 key challenges. The research team identified 2 additional challenges that were validated by participants. In order of perceived importance, key rewards were providing diverse and comprehensive care; providing preventive care; having relationships with patients and their families; being an immersed witness to the human condition; providing continuity of care and receiving ongoing feedback; having flexibility and control of practice and job security; maintaining and acquiring skills and knowledge; teaching and sharing knowledge and gaining experience and mentoring. The challenges, in order of perceived need to be addressed, were workload and time pressures and meeting demands; the need to promote the rewards of family practice to those considering joining the profession; overhead and income inequities; getting respect from specialists; the need to ensure that the rewards identified are not adversely affected by primary care reform; lack of availability of specialists, procedures, tests, and other resources; running a practice as a small business; paperwork, telephone calls, and forms; maintaining and acquiring skills and knowledge; patients’ expectations; and medicolegal issues, insurance paperwork, and dealing with medical claims related to motor vehicle accidents. CONCLUSION

Medico-legal aspects of alleged rape victims in Lahore.

PubMed

Manzoor, Iram; Hashmi, Noreen Rahat; Mukhtar, Fatima

2010-12-01

To describe the socio-demographic along with the medico-legal characteristics of rape victims reporting to a female police station of Lahore. Observational study. Female Police Station in Shadman, Lahore, from, June 1995 to January 2009. A total of 74 cases of alleged rape victims were identified while reviewing all available police files concerning reported rapes and attempted rapes from 1995 to 2008. The data was gathered on preformed questionnaires after conducting the pilot study. All information about victims and alleged offenders were extracted from the police files including socio-demographic profile of the accused and victim both. Use of weapon, evidence of physical and genital trauma, assailant identification and his relationship with the victim, number of accused persons and location of rape was noted in each case. Examination by doctor and obtaining the specimens were also identified and was related to the outcome of the court case. Chi-square test was applied to determine the association of rape with age and educational status of the victim and the accused. A total of 74 cases of alleged rape were reported in the study period at Shadman Female Police Station. Maximum number of victims was reported in the age group 10-19 years (n=46, 62.2%). Majority of the accused belonged to 20-39 years' age group constituting 64.8% of the total. Regarding educational status 45 (60.8%) of the victims and 51 (68.9%) of the accused were illiterate. Significant association was found between the educational status of rape victims and accused (p = 0.016) but not between their ages (p = 0.862). The maximum incidence of rape was reported in unmarried (n = 55, 74.3%) and unemployed (n =61, 82.4%) women. In 14 cases (19%) use of weapon was reported. Physical trauma was reported in 29 (39%) and genital trauma in 14 (19%) cases. The accused were identified as family friends (25%) and neighbours (23%) respectively. Only 21% of the victims were examined by doctor and specimens were

Problem-based learning: Using students' questions to drive knowledge construction

NASA Astrophysics Data System (ADS)

Chin, Christine; Chia, Li-Gek

2004-09-01

This study employed problem-based learning for project work in a year 9 biology class. The purpose of the study was to investigate (a) students' inspirations for their self-generated problems and questions, (b) the kinds of questions that students asked individually and collaboratively, and (c) how students' questions guided them in knowledge construction. Data sources included observation and field notes, students' written documents, audiotapes and videotapes of students working in groups, and student interviews. Sources of inspiration for students' problems and questions included cultural beliefs and folklore; wonderment about information propagated by advertisements and the media; curiosity arising from personal encounters, family members' concerns, or observations of others; and issues arising from previous lessons in the school curriculum. Questions asked individually pertained to validation of common beliefs and misconceptions, basic information, explanations, and imagined scenarios. The findings regarding questions asked collaboratively are presented as two assertions. Assertion 1 maintained that students' course of learning were driven by their questions. Assertion 2 was that the ability to ask the right'' questions and the extent to which these could be answered, were important in sustaining students' interest in the project. Implications of the findings for instructional practice are discussed.

Protecting the Elderly: Federal Agencies’ Role Concerning Questionable Marketing Practices.

DTIC Science & Technology

1987-08-26

1986, the Commission conducted studies of and investigated both health -related and nonhealth-related activities affecting older Americans. For example...ADft-RS s?6 PROTECTING THE ELDERLY : FEDERAL AGENCIES’ ROLE 1’ CONCERNING QUESTIONABLE M. . (U) GENERAL ACCOUNTING OFFICE NASHINGTON DC HUMAN...the Chairman, SelectCommittee on Aging , House of Representatives August 1987 P O E T N pPROTECTING THE NELDERLY 00 Federal Agencies’ Role Concerning

Mind Map Our Way into Effective Student Questioning: a Principle-Based Scenario

NASA Astrophysics Data System (ADS)

Stokhof, Harry; de Vries, Bregje; Bastiaens, Theo; Martens, Rob

2017-07-01

Student questioning is an important self-regulative strategy and has multiple benefits for teaching and learning science. Teachers, however, need support to align student questioning to curricular goals. This study tests a prototype of a principle-based scenario that supports teachers in guiding effective student questioning. In the scenario, mind mapping is used to provide both curricular structure as well as support for student questioning. The fidelity of structure and the process of implementation were verified by interviews, video data and a product collection. Results show that the scenario was relevant for teachers, practical in use and effective for guiding student questioning. Results also suggest that shared responsibility for classroom mind maps contributed to more intensive collective knowledge construction.

Beyond Questioning: Inquiry Strategies and Cognitive and Affective Elements of Jewish Education

ERIC Educational Resources Information Center

Sigel, Irving E.; Kress, Jeffrey S.; Elias, Maurice J.

2007-01-01

Questioning-asking has not only long been seen as a central component of Jewish educational practice but has also been thought to be part of a broader culture of Judaism. In this article, we apply cognitive-developmental theories to advance the discussion of the use of questioning in Jewish education. Such theories allow Jewish educators to more…

Commercial Airline In-Flight Emergency: Medical Student Response and Review of Medicolegal Issues.

PubMed

Bukowski, Josh H; Richards, John R

2016-01-01

As the prevalence of air travel increases, in-flight medical emergencies occur more frequently. A significant percentage of these emergencies occur when there is no certified physician, nurse, or paramedic onboard. During these situations, flight crews might enlist the help of noncertified passengers, such as medical students, dentists, or emergency medical technicians in training. Although Good Samaritan laws exist, many health care providers are unfamiliar with the limited legal protections and resources provided to them after responding to an in-flight emergency. A 78-year-old woman lost consciousness and became pulseless onboard a commercial aircraft. No physician was available. A medical student responded and coordinated care with the flight crew, ground support physician, and other passengers. After receiving a packet (4 g) of sublingual sucrose and 1 L i.v. crystalloid, the patient regained pulses and consciousness. The medical student made the decision not to divert the aircraft based on the patient's initial response to therapy and, 45 min later, the patient had normal vital signs. Upon landing, she was met and taken by paramedics to the nearest emergency department for evaluation of her collapse. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians are the most qualified to assist in-flight emergencies, but they might not be aware of the medicolegal risks involved with in-flight care, the resources available, and the role of the flight crew in liability and decision making. This case, which involved a medical student who was not given explicit protection under Good Samaritan laws, illustrates the authority of the flight crew during these events and highlights areas of uncertainty in the legislation for volunteer medical professionals. Copyright © 2016 Elsevier Inc. All rights reserved.

Simple Texts, Complex Questions: Helping Young Children Generate Questions

ERIC Educational Resources Information Center

Ness, Molly

2017-01-01

As they are naturally curious about the world around them, young children ask lots and lots of questions. In classrooms today, however, there seems to be little space for these student-generated questions as teachers are more likely to pose the questions. Research indicates that question generation is an effective strategy to motivate young…

Theorizing the Entrepreneurial University: Open Questions and Possible Answers

ERIC Educational Resources Information Center

Sotiris, Panagiotis

2012-01-01

This article attempts to address theoretical questions regarding the transition towards an entrepreneurial university and the changes associated with this process, namely the increased commodification, the competitive quest for private funding and the introduction of business management practices. The important theoretical advances made in the…

Question Popularity Analysis and Prediction in Community Question Answering Services

PubMed Central

Liu, Ting; Zhang, Wei-Nan; Cao, Liujuan; Zhang, Yu

2014-01-01

With the blooming of online social media applications, Community Question Answering (CQA) services have become one of the most important online resources for information and knowledge seekers. A large number of high quality question and answer pairs have been accumulated, which allow users to not only share their knowledge with others, but also interact with each other. Accordingly, volumes of efforts have been taken to explore the questions and answers retrieval in CQA services so as to help users to finding the similar questions or the right answers. However, to our knowledge, less attention has been paid so far to question popularity in CQA. Question popularity can reflect the attention and interest of users. Hence, predicting question popularity can better capture the users’ interest so as to improve the users’ experience. Meanwhile, it can also promote the development of the community. In this paper, we investigate the problem of predicting question popularity in CQA. We first explore the factors that have impact on question popularity by employing statistical analysis. We then propose a supervised machine learning approach to model these factors for question popularity prediction. The experimental results show that our proposed approach can effectively distinguish the popular questions from unpopular ones in the Yahoo! Answers question and answer repository. PMID:24837851

Question popularity analysis and prediction in community question answering services.

PubMed

Liu, Ting; Zhang, Wei-Nan; Cao, Liujuan; Zhang, Yu

2014-01-01

With the blooming of online social media applications, Community Question Answering (CQA) services have become one of the most important online resources for information and knowledge seekers. A large number of high quality question and answer pairs have been accumulated, which allow users to not only share their knowledge with others, but also interact with each other. Accordingly, volumes of efforts have been taken to explore the questions and answers retrieval in CQA services so as to help users to finding the similar questions or the right answers. However, to our knowledge, less attention has been paid so far to question popularity in CQA. Question popularity can reflect the attention and interest of users. Hence, predicting question popularity can better capture the users' interest so as to improve the users' experience. Meanwhile, it can also promote the development of the community. In this paper, we investigate the problem of predicting question popularity in CQA. We first explore the factors that have impact on question popularity by employing statistical analysis. We then propose a supervised machine learning approach to model these factors for question popularity prediction. The experimental results show that our proposed approach can effectively distinguish the popular questions from unpopular ones in the Yahoo! Answers question and answer repository.

Questioning in Tongan Science Classrooms: A Pilot Study to Identify Current Practice, Barriers and Facilitators

ERIC Educational Resources Information Center

Bay, Jacquie L.; Fohoko, Fehi; La'Akulu, Mumui; Leota, Ofa; Pulotu, Lesieli; Tu'Ipuloto, Sina; Tutoe, Salesi; Tovo, Oliveti; Vekoso, Ana; Pouvalu, Emeli H.

2016-01-01

Questioning is central to the development of scientific and health literacies. In exploring this concept, Tongan science teachers hypothesized that their ability to use and encourage questioning presented challenges in the context of Tongan social and cultural norms. This study set out to develop a peer-to-peer protocol to enable teachers to…

Two-Year-Old Children Differentiate Test Questions from Genuine Questions

ERIC Educational Resources Information Center

Grosse, Gerlind; Tomasello, Michael

2012-01-01

Children are frequently confronted with so-called "test questions". While genuine questions are requests for missing information, test questions ask for information obviously already known to the questioner. In this study we explored whether two-year-old children respond differentially to one and the same question used as either a genuine question…

Posing Einstein's Question: Questioning Einstein's Pose.

ERIC Educational Resources Information Center

Topper, David; Vincent, Dwight E.

2000-01-01

Discusses the events surrounding a famous picture of Albert Einstein in which he poses near a blackboard containing a tensor form of his 10 field equations for pure gravity with a question mark after it. Speculates as to the content of Einstein's lecture and the questions he might have had about the equation. (Contains over 30 references.) (WRM)

Medicolegal aspects of complex behaviours arising from the sleep period: a review and guide for the practising sleep physician.

PubMed

Morrison, Ian; Rumbold, John M M; Riha, Renata L

2014-06-01

This review is aimed at summarizing the current state of knowledge regarding parasomnias, which have been implicated in medicolegal cases as well as providing guidance to those working within common-law jurisdictions regarding the technical aspects of the law. Sleepwalking and sexsomnia as a defence are being raised more frequently in criminal cases and there has been public debate on their validity. Unfortunately, expert evidence on forensic sleep disorders continues to be heavily opinion-based with the potential for miscarriages of justice seen in recent highly publicized cases. There is an apparent inertia in research into violent sleep disorders. We review the current state of forensic sleep science in the United Kingdom (UK) and abroad and discuss the need to formulate guidelines based on available evidence. We also highlight the pressing necessity for more research in this area as well as the need to reform the law, which is the subject of a recent Criminal Law Commission report in the United Kingdom. In time, this will facilitate the efficient, proportionate, and just disposal of violence arising from sleep, thus benefitting both society and the individual sufferer. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sudden perinatal death due to rupture of congenital cardiac diverticulum. Pathological findings and medico-legal investigations in malpractice charge.

PubMed

Marchesi, Matteo; Boracchi, Michele; Gentile, Guendalina; Maghin, Francesca; Zoja, Riccardo

2017-09-01

Congenital diverticula of the left ventricle, very rare malformations, are determined by an abnormal embryonic development of the ventricular wall and can be isolated or associated to other cardiac anomalies. In most of the cases, these pathologies are not symptomatic and in some patients can be associated to ventricular arrhythmia, cardiac rupture with tamponade and sudden death. Authors are presenting the case of a sudden death in an 8-weeks-old newborn due to rupture of a cardiac congenital diverticulum of the left ventricle, discovered only at the moment of the autopsic examination. The parents of the victim pressed charges against the medical staff that was appointed to the cares, blaming them with malpractice. The missed diagnosis of a cardiac congenital diverticulum of the left ventricle, a rare pathology, reflects the trickiness of the medical management that can lead to medico-legal controversies and, even though such rare conditions must be always taken into consideration when investigating possible dysfunction causing the death, diagnostic difficulties, in the case in exam, justify the missed diagnosis intra-vitam of cardiac ventricular diverticulum. Copyright © 2017 Elsevier B.V. All rights reserved.

Using Mobile Devices to Facilitate Student Questioning in a Large Undergraduate Science Class

ERIC Educational Resources Information Center

Crompton, Helen; Burgin, Stephen R.; De Paor, Declan G.; Gregory, Kristen

2018-01-01

Asking scientific questions is the first practice of science and engineering listed in the Next Generation Science Standards. However, getting students to ask unsolicited questions in a large class can be difficult. In this qualitative study, undergraduate students sent SMS text messages to the instructor who received them on his mobile phone and…

Medical practice, procedure manuals and the standardisation of hospital death.

PubMed

Hadders, Hans

2009-03-01

This paper examines how death is managed in a larger regional hospital within the Norwegian health-care. The central focus of my paper concerns variations in how healthcare personnel enact death and handle the dead patient. Over several decades, modern standardised hospital death has come under critique in the western world. Such critique has resulted in changes in the standardisation of hospital deaths within Norwegian health-care. In the wake of the hospice movement and with greater focus on palliative care, doors have gradually been opened and relatives of the deceased are now more often invited to participate. I explore how the medical practice around death along with the procedure manual of post-mortem care at Trondheim University Hospital has changed. I argue that in the late-modern context, standardisation of hospital death is a multidimensional affair, embedded in a far more comprehensive framework than the depersonalized medico-legal. In the late-modern Norwegian hospital, interdisciplinary negotiation and co-operation has allowed a number of different agendas to co-exist, without any ensuing loss of the medical power holder's authority to broker death. I follow Mol's notion of praxiographic orientation of the actor-network approach while exploring this medical practice.

[Medicolegal problems of "dyadic death"].

PubMed

Kunz, Jerzy; Bolechała, Filip; Kaliszczak, Paweł

2002-01-01

The authors present 9 cases of homicide followed by suicide of the perpetrator--so called dyadic death from the practice of the Cracow Forensic Medicine Chair. The circumstances of the event, medico legal and psychiatric problems were discussed in view of the literature. A typical picture of the perpetrator is male of the average age 49, killing his spouse or children. The major reasons of dyadic death are: breakdown in a relationship, mental and somatic diseases, financial stress. Very uncommon in dyadic death are cases of murder of people from outside the closest family.

Using Clinical Questions Asked by Primary Care Providers Through eConsults to Inform Continuing Professional Development.

PubMed

Archibald, Douglas; Liddy, Clare; Lochnan, Heather A; Hendry, Paul J; Keely, Erin J

2018-01-01

Continuing professional development (CPD) offerings should address the educational needs of health care providers. Innovative programs, such as electronic consultations (eConsults), provide unique educational opportunities for practice-based needs assessment. The purpose of this study is to assess whether CPD offerings match the needs of physicians by coding and comparing session content to clinical questions asked through eConsults. This study analyzes questions asked by primary care providers between July 2011 and January 2015 using a service that allows specialists to provide consultation over a secure web-based server. The content of these questions was compared with the CPD courses offered in the area in which these primary care providers are practicing over a similar period (2012-2014). The clinical questions were categorized by the content area. The percentage of questions asked about each content area was calculated for each of the 12 specialties consulted. CPD course offerings were categorized using the same list of content areas. Percentage of minutes dedicated to each content area was calculated for each specialty. The percentage of questions asked and the percentage of CPD course minutes for each content area were compared. There were numerous congruencies and discrepancies between the proportion of questions asked about a given content area and the CPD minutes dedicated to it. Traditional needs assessment may underestimate the need to address topics that are frequently the subject of eConsults. Planners should recognize eConsult questions as a valuable source of practice-associated challenges that can identify professional development needs of physicians.

Home Schooling: Answers to Questions Parents Most Often Ask.

ERIC Educational Resources Information Center

McIntire, Deborah; Windham, Robert

This resource for parents draws upon research findings and the experience of home schooling parents to answer common questions about home schooling in the United States and Canada. Included is information on home schooling instructional approaches and curricula, record keeping, organizational tools, and practical tips. Chapter 1, "Initial…

Exploring Undergraduates' Understanding of Photosynthesis Using Diagnostic Question Clusters

ERIC Educational Resources Information Center

Parker, Joyce M.; Anderson, Charles W.; Heidemann, Merle; Merrill, John; Merritt, Brett; Richmond, Gail; Urban-Lurain, Mark

2012-01-01

We present a diagnostic question cluster (DQC) that assesses undergraduates' thinking about photosynthesis. This assessment tool is not designed to identify individual misconceptions. Rather, it is focused on students' abilities to apply basic concepts about photosynthesis by reasoning with a coordinated set of practices based on a few scientific…

The function of questions in Omani fourth grade inquiry-based science classrooms: A sociocultural perspective

NASA Astrophysics Data System (ADS)

Al-Shaibani, Madiha Ahmed

2005-11-01

Studies indicate that science education reforms are globally converging. Many countries are adopting the globally advocated science education reforms for the purpose of obtaining the competitive edge in science education and technology that are viewed as the driving forces of modern economies. Globally, science education reforms are emphasizing paradigm shifts in which constructivist instructional are foregrounded. Many science education curricular documents advocate teaching science through engaging students in scientific inquiry. As a result, science classrooms are becoming more student-centered where students are typically actively engaged in inquiry learning. Even though inquiry instruction has become the common approach in teaching science, the actual implementation of inquiry in classrooms indicates that there is a big gap between the intended inquiry advocated in curricula documents and the actual practices in classroom settings. One of the main features of inquiry instruction is student questions. Authentic student questions are essential for the initiating and main scientific inquiry. However, studies have also illustrated the rarity of student questions in classrooms. This dearth in student questions has been attributed to the discursive practices in classrooms. Classrooms that implement the traditional IRE discourse structure tend to have less student questions. On the other hand, reflective questioning is considered a more appropriate classroom discourse structure because it intentionally invites student questions and engages students in classroom discussions. This qualitative study addresses the issue of questioning in fourth grade inquiry-based science classrooms of the Omani Basic Education system. Methods employed in this study included: participant observation, individual interviews, focus group interviews and the collection of artifacts. Findings of this study illustrated the rarity of student questions in the classrooms. However this

Indirect questioning method reveals hidden support for female genital cutting in South Central Ethiopia.

PubMed

Gibson, Mhairi A; Gurmu, Eshetu; Cobo, Beatriz; Rueda, María M; Scott, Isabel M

2018-01-01

Female genital cutting (FGC) has major implications for women's physical, sexual and psychological health, and eliminating the practice is a key target for public health policy-makers. To date one of the main barriers to achieving this has been an inability to infer privately-held views on FGC within communities where it is prevalent. As a sensitive (and often illegal) topic, people are anticipated to hide their true support for the practice when questioned directly. Here we use an indirect questioning method (unmatched count technique) to identify hidden support for FGC in a rural South Central Ethiopian community where the practice is common, but thought to be in decline. Employing a socio-demographic household survey of 1620 Arsi Oromo adults, which incorporated both direct and indirect direct response (unmatched count) techniques we compare directly-stated versus privately-held views in support of FGC, and individual variation in responses by age, gender and education and target female (daughters versus daughters-in-law). Both genders express low support for FGC when questioned directly, while indirect methods reveal substantially higher acceptance (of cutting both daughters and daughters-in-law). Educated adults (those who have attended school) are privately more supportive of the practice than they are prepared to admit openly to an interviewer, indicating that education may heighten secrecy rather than decrease support for FGC. Older individuals hold the strongest views in favour of FGC (particularly educated older males), but they are also more inclined to conceal their support for FGC when questioned directly. As these elders represent the most influential members of society, their hidden support for FGC may constitute a pivotal barrier to eliminating the practice in this community. Our results demonstrate the great potential for indirect questioning methods to advance knowledge and inform policy on culturally-sensitive topics like FGC; providing more

History, research and practice of forensic anthropology in Thailand.

PubMed

Traithepchanapai, Pongpon; Mahakkanukrauh, Pasuk; Kranioti, Elena F

2016-04-01

Forensic anthropology is an increasingly developing discipline born about a century ago in the United States with the objective to contribute the knowledge of bone biology and physical anthropology to the emerging needs of the court of law. The development of research in biological and forensic anthropology has made rapid progress worldwide in the past few years, however, in most countries--with the exception of the United States--forensic anthropology work is still considered within the duties of the forensic pathologist. This paper attempts to summarise the history and development of forensic anthropology in Thailand by providing information on past and current research and practice that can help forensic practitioners to apply existing methods in forensic cases and mass disasters. It is hoped that the lessons learned from the tsunami catastrophe and the emerging need for positive identification in medicolegal settings will lead to rapid advances in education, training and professional engagement of anthropologists from the forensic departments and the law enforcement agencies in Thailand. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Competence-Based Education and Training--About Frequently Asked Questions

ERIC Educational Resources Information Center

Mulder, Martin

2012-01-01

This article follows the author's previous piece on practical guidelines for the development of comprehensive competence-based education and training (Mulder, 2012). It is about the questions that have been and are still frequently asked in presentations, workshops and classes about the introduction of competence-based education. Here, the author…

Explanation, motivation and question posing routines in university mathematics teachers' pedagogical discourse: a commognitive analysis

NASA Astrophysics Data System (ADS)

Viirman, Olov

2015-11-01

This paper investigates the teaching practices used by university mathematics teachers when lecturing, a topic within university mathematics education research which is gaining an increasing interest. In the study, a view of mathematics teaching as a discursive practice is taken, and Sfard's commognitive framework is used to investigate the teaching practices of seven Swedish university mathematics teachers on the topic of functions. The present paper looks at the discourse of mathematics teaching, presenting a categorization of the didactical routines into three categories - explanation, motivation and question posing routines. All of these are present in the discourses of all seven teachers, but within these general categories, a number of different sub-categories of routines are found, used in different ways and to different extent by the various teachers. The explanation routines include known mathematical facts, summary and repetition, different representations, everyday language, and concretization and metaphor; the motivation routines include reference to utility, the nature of mathematics, humour and result focus; and the question posing routines include control questions, asking for facts, enquiries and rhetorical questions. This categorization of question posing routines, for instance, complements those already found in the literature. In addition to providing a valuable insight into the teaching of functions at the university level, the categorizations presented in the study can also be useful for investigating the teaching of other mathematical topics.

Four Questions

ERIC Educational Resources Information Center

Hark-Weber, Amara G., Ed.

2013-01-01

The author is pleased to introduce a new section in "TAJ," Four Questions. The structure is simple: four questions are asked to teaching artists working in various media and locations. The questions are always the same, but because each teaching artist's approach is unique, their answers will provide an insight into particular methodologies that…

Improving youth question-asking and provider education during pediatric asthma visits.

PubMed

Sleath, Betsy; Carpenter, Delesha M; Davis, Scott A; Watson, Claire Hayes; Lee, Charles; Loughlin, Ceila E; Garcia, Nacire; Reuland, Daniel S; Tudor, Gail

2018-06-01

We conducted a pragmatic randomized controlled trial to test the effectiveness of an asthma question prompt list with video intervention to increase youth question-asking and provider education during visits. English or Spanish-speaking youth ages 11-17 with persistent asthma and their parents were enrolled from four rural and suburban pediatric clinics. Youth were randomized to the intervention or usual care groups. Intervention group adolescents watched the video on an iPad and then completed an asthma question prompt list before their visits. Generalized estimating equations were used to analyze the data. Forty providers and 359 patients participated. Intervention group youth were significantly more likely to ask one or more questions about medications, triggers, and environmental control than usual care youth. Providers were significantly more likely to educate intervention group youth about rescue medications, triggers, and environmental control. Intervention group caregivers were not significantly more likely to ask questions. The intervention increased youth question-asking and provider education about medications, triggers, and environmental control. The intervention did not impact caregiver question-asking. Providers/practices should consider having youth complete question prompt lists and watch the video with their parents before visits to increase youth question-asking during visits. Copyright © 2018 Elsevier B.V. All rights reserved.

Doing Science and Asking Questions II: An Exercise That Generates Questions

NASA Astrophysics Data System (ADS)

Hurt Middlecamp, Catherine; Nickel, Anne-Marie L.

2005-08-01

Given the importance of questions in science, it is critical that students learn to ask questions as well as learning to answer them. This paper describes a classroom exercise to help students better ask their own questions. It has been classroom-tested in multiple formats and has also been used for curriculum development workshops for faculty. This exercise in creating questions can be easily customized to suit different instructional contexts; some variations are outlined. More broadly, this paper also discusses the pedagogical significance of questioning, raising four salient points: (1) learners are more likely to have a personal interest in the questions they raise; (2) questions can serve as entry points for issues relating to ethnicity and gender; (3) questions give control to the person who asks them; and (4) questions can challenge existing structures, categories, and norms.

Medicolegal affairs. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

PubMed

Frable, W J; Austin, R M; Greening, S E; Collins, R J; Hillman, R L; Kobler, T P; Koss, L G; Mitchell, H; Perey, R; Rosenthal, D L; Sidoti, M S; Somrak, T M

1998-01-01

technology. The profession should develop "process guidelines" for review of CC smears in the context of possible litigation, including standardized methods for blind slide review of smears that reduce or eliminate context and outcome bias. It is suggested that review panels be anonymous, that the process be standardized and that there be limitations on liability for participating organizations. Professional cytopathology and pathology societies should formulate acceptable guidelines for expert witnesses. The standards should be applicable to both defendant and plaintiff experts. All materials to the extent practical, including consultant opinions, should be available for peer review. Professional cytopathology and pathology societies should monitor expert testimony for objectivity and scientific accuracy. For the near future, litigation will continue to focus on false negative CC smears on a case-by-case basis. Laboratories and individuals can reduce the risk of malpractice liability by directing their attention to proactive quality control and quality assurance methods. In the final analysis, consumer education about the benefits and limitations of the test is key to limiting malpractice claims. To stem the tide of continued medicolegal challenges to the integrity of cytology practice, the cytology community has now focused its efforts on developing and utilizing standards that convey to patients, attorneys and cytologists the contemporary status of and reasonable expectations for the practice of cytology. Guidelines such as those for uniform reporting terminology and clinical management of cervical abnormalities form the basis of cytology practice standards on which legal standards of practice can be based. Consensus conference reports, clinical management trials and scientifically valid studies of false negative rates that analyze the type, frequency and cause of missed cases represent sounder methods of establishing defensible

One hundred questions of importance to the conservation of global biological diversity.

PubMed

Sutherland, W J; Adams, W M; Aronson, R B; Aveling, R; Blackburn, T M; Broad, S; Ceballos, G; Côté, I M; Cowling, R M; Da Fonseca, G A B; Dinerstein, E; Ferraro, P J; Fleishman, E; Gascon, C; Hunter, M; Hutton, J; Kareiva, P; Kuria, A; Macdonald, D W; Mackinnon, K; Madgwick, F J; Mascia, M B; McNeely, J; Milner-Gulland, E J; Moon, S; Morley, C G; Nelson, S; Osborn, D; Pai, M; Parsons, E C M; Peck, L S; Possingham, H; Prior, S V; Pullin, A S; Rands, M R W; Ranganathan, J; Redford, K H; Rodriguez, J P; Seymour, F; Sobel, J; Sodhi, N S; Stott, A; Vance-Borland, K; Watkinson, A R

2009-06-01

We identified 100 scientific questions that, if answered, would have the greatest impact on conservation practice and policy. Representatives from 21 international organizations, regional sections and working groups of the Society for Conservation Biology, and 12 academics, from all continents except Antarctica, compiled 2291 questions of relevance to conservation of biological diversity worldwide. The questions were gathered from 761 individuals through workshops, email requests, and discussions. Voting by email to short-list questions, followed by a 2-day workshop, was used to derive the final list of 100 questions. Most of the final questions were derived through a process of modification and combination as the workshop progressed. The questions are divided into 12 sections: ecosystem functions and services, climate change, technological change, protected areas, ecosystem management and restoration, terrestrial ecosystems, marine ecosystems, freshwater ecosystems, species management, organizational systems and processes, societal context and change, and impacts of conservation interventions. We anticipate that these questions will help identify new directions for researchers and assist funders in directing funds. ©2009 Society for Conservation Biology.

What Makes a Scientific Research Question Worth Investigating? Students' Epistemic Criteria and Considerations of Contribution

NASA Astrophysics Data System (ADS)

Berson, Eric Bruckner

This dissertation introduces the construct of worthwhileness as an important aspect of students' practical epistemologies of science (Sandoval, 2005). Specifically, it examines how students conceptualize what makes a scientific research question worthwhile, through a close analysis of the criteria they use for evaluating scientific research questions. Elementary (n=21) and high school students (n=21) participated in this study. As part of semi-structured interviews, students engaged in three novel tasks designed to elicit the epistemic criteria they use to evaluate scientific research questions in a variety of contexts. Findings indicate that elementary and high school students alike could engage in the practice of evaluating the worth of scientific questions. The criteria they employed included degree of interest, difficulty, and the contribution of questions to knowledge or to solving a problem. The criteria students considered varied by context. Several key differences emerged between the reasoning of the two grade cohorts. High school students tended to place more weight on the contribution of the research question. Also, the criteria reflected in the high school students' judgments of the scientific value of individual questions more closely accorded with the criteria they identified retrospectively as the basis of their judgments. Furthermore, the older cohort more often rationalized the selection and sequence of research questions within a single domain on the basis of epistemic contingency between questions. How students conceptualize what makes a scientific research question worthwhile constitutes a key aspect of students' epistemic reasoning. It is particularly important to understand how students judge the worthwhilness of scientific research questions given the central epistemic role of research questions in scientific inquiry.

Using the Weighted Keyword Model to Improve Information Retrieval for Answering Biomedical Questions

PubMed Central

Yu, Hong; Cao, Yong-gang

2009-01-01

Physicians ask many complex questions during the patient encounter. Information retrieval systems that can provide immediate and relevant answers to these questions can be invaluable aids to the practice of evidence-based medicine. In this study, we first automatically identify topic keywords from ad hoc clinical questions with a Condition Random Field model that is trained over thousands of manually annotated clinical questions. We then report on a linear model that assigns query weights based on their automatically identified semantic roles: topic keywords, domain specific terms, and their synonyms. Our evaluation shows that this weighted keyword model improves information retrieval from the Text Retrieval Conference Genomics track data. PMID:21347188

Using the weighted keyword model to improve information retrieval for answering biomedical questions.

PubMed

Yu, Hong; Cao, Yong-Gang

2009-03-01

Physicians ask many complex questions during the patient encounter. Information retrieval systems that can provide immediate and relevant answers to these questions can be invaluable aids to the practice of evidence-based medicine. In this study, we first automatically identify topic keywords from ad hoc clinical questions with a Condition Random Field model that is trained over thousands of manually annotated clinical questions. We then report on a linear model that assigns query weights based on their automatically identified semantic roles: topic keywords, domain specific terms, and their synonyms. Our evaluation shows that this weighted keyword model improves information retrieval from the Text Retrieval Conference Genomics track data.

Changes in Reference Question Complexity Following the Implementation of a Proactive Chat System: Implications for Practice

ERIC Educational Resources Information Center

Maloney, Krisellen; Kemp, Jan H.

2015-01-01

There has been longstanding debate about whether the level of complexity of questions received at reference desks and via online chat services requires a librarian's expertise. Continued decreases in the number and complexity of reference questions have all but ended the debate; many academic libraries no longer staff service points with…

Practical question-and-answer guide on VDTS (video display terminals) for BEES (base bioenvironmental engineer). Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Olson, B.M.

1985-01-01

The USAF OEHL conducted an extensive literature review of Video Display Terminals (VDTs) and the health problems commonly associated with them. The report is presented in a question-and-answer format in an attempt to paraphrase the most commonly asked questions about VDTs that are forwarded to USAF OEHL/RZN. The questions and answers have been divided into several topic areas: Ionizing Radiation; Nonionizing Radiation; Optical Radiation; Ultrasound; Static Electricity; Health Complaints/Ergonomics; Pregnancy.

Knowledge translation at the macro level: legal and ethical considerations.

PubMed

Larkin, Gregory Luke; Hamann, Cara J; Monico, Edward P; Degutis, Linda; Schuur, Jeremiah; Kantor, Walter; Graffeo, Charles S

2007-11-01

Macro-level legal and ethical issues play a significant role in the successful translation of knowledge into practice. The medicolegal milieu, in particular, can promote clinical inertia and stifle innovation. Embracing new clinical practice guidelines and best practice models has not protected physicians from superfluous torts; in some cases, emerging evidence has been used as the dagger of trial lawyers rather than the scalpel of physicians. Beyond the legal challenges are overarching justice issues that frame the broad goals of knowledge translation (KT) and technology diffusion. Optimal implementation of the latest evidence requires attention to be paid to the context of the candidate community and the key opinion leaders therein, characterized by the "8Ps" (public, patients, press, physicians, policy makers, private sector, payers, and public health). Ethical and equitable KT also accounts for the global burdens and benefits of implementing innovation such that disparities and gaps in health experienced by the least advantaged are prioritized. Researchers and thought leaders must attend to questions of fairness, economics, and legal risk when investigating ways to promote equity-oriented KT.

Virtual Communities of Practice: Bridging Research and Practice Using Web 2.0

ERIC Educational Resources Information Center

Lewis, Laura A.; Koston, Zoe; Quartley, Marjorie; Adsit, Jason

2011-01-01

A significant dilemma for the health and human service professions continues to be the question of how best to bridge the divide between academic research and practice. Communities of practice have traditionally been a vehicle for collaborative research and for information exchange (Moore, 2008). Through collaboration, communities of practice have…

Validity of parent's self-reported responses to home safety questions.

PubMed

Osborne, Jodie M; Shibl, Rania; Cameron, Cate M; Kendrick, Denise; Lyons, Ronan A; Spinks, Anneliese B; Sipe, Neil; McClure, Roderick J

2016-09-01

The aim of the study was to describe the validity of parent's self-reported responses to questions on home safety practices for children of 2-4 years. A cross-sectional validation study compared parent's self-administered responses to items in the Home Injury Prevention Survey with home observations undertaken by trained researchers. The relationship between the questionnaire and observation results was assessed using percentage agreement, sensitivity, specificity, positive predictive value, negative predictive value and intraclass correlation coefficients. Percentage agreements ranged from 44% to 100% with 40 of the total 45 items scoring higher than 70%. Sensitivities ranged from 0% to 100%, with 27 items scoring at least 70%. Specificities also ranged from 0% to 100%, with 33 items scoring at least 70%. As such, the study identified a series of self-administered home safety questions that have sensitivities, specificities and predictive values sufficiently high to allow the information to be useful in research and injury prevention practice.

The Quality of Questions and Use of Resources in Self-Directed Learning: Personal Learning Projects in the Maintenance of Certification

ERIC Educational Resources Information Center

Horsley, T.; O'Neill, J.; Campbell, C.

2009-01-01

Introduction: To engage effectively and efficiently in self-directed learning and knowledge-seeking practices, it is important that physicians construct well-formulated questions; yet, little is known about the quality of good questions and their relationship to self-directed learning or to change in practice behavior. Methods: Personal learning…

Randomized controlled trials in evidence-based mental health care: getting the right answer to the right question.

PubMed

Essock, Susan M; Drake, Robert E; Frank, Richard G; McGuire, Thomas G

2003-01-01

The purpose of clinical research is to answer this question: Would a new treatment, when added to the existing range of treatment options available in practice, help patients? Randomized controlled trials (RCTs)--in particular, double-blind RCTs--have important methodological advantages over observational studies for addressing this question. These advantages, however, come at a price. RCTs compare treatments using a particular allocation rule for assigning patients to treatments (random assignment) that does not mimic real-world practice. "Favorable" results from an RCT indicating that a new treatment is superior to existing treatments are neither necessary nor sufficient for establishing a "yes" answer to the question posed above. Modeled on an experimental design, RCTs are expensive in time and money and must compare simple differences in treatments. Findings have a high internal validity but may not address the needs of the field, particularly where treatment is complex and rapidly evolving. Design of clinical research needs to take account of the way treatments are allocated in actual practice and include flexible designs to answer important questions most effectively.

Impact of medico-legal findings on charge filing in cases of rape in adult women.

PubMed

Hagemann, Cecilie T; Stene, Lise E; Myhre, Arne K; Ormstad, Kari; Schei, Berit

2011-11-01

To assess the impact of the medical documentation and biological trace evidence in rape cases on the legal process. Retrospective descriptive study. Police-reported cases of rape of women ≥16 years old in the Norwegian county of Sør-Trøndelag from January 1997 to June 2003. Police data were merged with data from the Sexual Assault Center at St Olav's Hospital. Charged and non-charged cases were compared. Medico-legal findings and legal outcome. A total of 185 police-reported cases were identified. Of the 101 cases examined at Sexual Assault Center, charges were filed in 18 cases. Extragenital injuries were documented in 49 women; five were life threatening. Anogenital injuries were documented in 14 women; eight had multiple anogenital injuries. Documentation of injuries was not associated with charge filing. In only 33% of the cases were swabs collected from women's genitals used as trace evidence by the police. When used, this increased the likelihood for charge filing. A DNA profile matching the suspect was identified in four of the 18 charged cases and in only one among the 54 non-charged cases. Half of the women had one or more documented injury. Only one-third of the trace evidence kits collected from the women's anogenital area were analyzed. The analysis of swabs was associated with charge filing, regardless of test results. Increased use of such medical evidence, especially in cases of stranger rape, may ensure women's rights and increase available information to the legal system. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

Music therapy with disorders of consciousness: current evidence and emergent evidence-based practice.

PubMed

Magee, Wendy L; O'Kelly, Julian

2015-03-01

Patients with prolonged disorders of consciousness (PDOC) stemming from acquired brain injury present one of the most challenging clinical populations in neurological rehabilitation. Because of the complex clinical presentation of PDOC patients, treatment teams are confronted with many medicolegal, ethical, philosophical, moral, and religious issues in day-to-day care. Accurate diagnosis is of central concern, relying on creative approaches from skilled clinical professionals using combined behavioral and neurophysiological measures. This paper presents the latest evidence for using music as a diagnostic tool with PDOC, including recent developments in music therapy interventions and measurement. We outline standardized clinical protocols and behavioral measures to produce diagnostic outcomes and examine recent research illustrating a range of benefits of music-based methods at behavioral, cardiorespiratory, and cortical levels using video, electrocardiography, and electroencephalography methods. These latest developments are discussed in the context of evidence-based practice in rehabilitation with clinical populations. © 2014 New York Academy of Sciences.

The artful dodger: answering the wrong question the right way.

PubMed

Rogers, Todd; Norton, Michael I

2011-06-01

What happens when speakers try to "dodge" a question they would rather not answer by answering a different question? In 4 studies, we show that listeners can fail to detect dodges when speakers answer similar-but objectively incorrect-questions (the "artful dodge"), a detection failure that goes hand-in-hand with a failure to rate dodgers more negatively. We propose that dodges go undetected because listeners' attention is not usually directed toward a goal of dodge detection (i.e., Is this person answering the question?) but rather toward a goal of social evaluation (i.e., Do I like this person?). Listeners were not blind to all dodge attempts, however. Dodge detection increased when listeners' attention was diverted from social goals toward determining the relevance of the speaker's answers (Study 1), when speakers answered a question egregiously dissimilar to the one asked (Study 2), and when listeners' attention was directed to the question asked by keeping it visible during speakers' answers (Study 4). We also examined the interpersonal consequences of dodge attempts: When listeners were guided to detect dodges, they rated speakers more negatively (Study 2), and listeners rated speakers who answered a similar question in a fluent manner more positively than speakers who answered the actual question but disfluently (Study 3). These results add to the literatures on both Gricean conversational norms and goal-directed attention. We discuss the practical implications of our findings in the contexts of interpersonal communication and public debates.

Surveying Parental Mediation: Connections, Challenges and Questions for Media Literacy

ERIC Educational Resources Information Center

Mendoza, Kelly

2009-01-01

This paper examines three strategies of parental mediation--coviewing, restrictive mediation, and active mediation--in order to make connections, challenge, and raise questions for media literacy. Coviewing, whether it is intentional practice, or whether it functions to promote media literacy, is explored. Restrictive mediation, how it connects to…

Can the study of ethics enhance nursing practice?

PubMed

Allmark, Peter

2005-09-01

The aim of this paper is to suggest that the study of ethics and ethical theories can enhance nursing practice. Knowledge of ethical theories can be of practical use to nurses in at least three ways. First, it can help nurses uncover to what extent a problem is an ethical one. The questions faced in practice can be empirical, formal or philosophical. Very often, a practical decision requires us to tackle all three types. In the example of a 'Do not attempt resuscitation' order, deciding on whether such an order is appropriate requires us to answer empirical questions such as how likely any attempt is to achieve success. It also requires us to answer formal questions such as whether the law permits such an order in the present circumstance. Finally, it requires us to answer ethical/philosophical questions, such as how we should weigh up quality of life against quantity. Second, it can enable practitioners to develop skills and tools to tackle ethical/philosophical questions. In this paper I describe two such tools: Socratic questioning and Aristotelian dialectic. Third, it can help practitioners to develop the soundness of their ethical values and beliefs. All ethical reasoning requires us to use our values and beliefs, and attending to them enhances the quality of our reasoning. The study of ethics can enhance nursing practice.

[The death of Kaspar Hauser (17 Dec 1833)--assassination, suicide or self-inflicted injury?].

PubMed

Risse, Manfred; Bartsch, Christine; Dreyer, Thomas; Weiler, Günter

2005-01-01

The death of Kaspar Hauser is described taking present medicolegal and criminological knowledge into account, the main question being whether the injury was self-inflicted, homicidal or suicidal. In spite of a critical retrospective analysis this question cannot be answered with sufficient certainty even from our modern perspective. It seems unlikely that the stab to the chest was inflicted exclusively for the purpose of self-damage, but both a suicidal stab and a homicidal act (assassination) cannot be definitely ruled out.

Preparing practicing dentists to engage in practice-based research

PubMed Central

DeRouen, Timothy A.; Hujoel, Philippe; Leroux, Brian; Mancl, Lloyd; Sherman, Jeffrey; Hilton, Thomas; Berg, Joel; Ferracane, Jack

2013-01-01

Background The authors describe an educational program designed to prepare practicing dentists to engage in practice-based research in their practices—a trend receiving more emphasis and funding from the National Institute of Dental and Craniofacial Research (NIDCR). Methods The Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT), an NIDCR-funded network of which the authors are members, developed a one-day educational program to educate practitioners in principles of good clinical research. The program has four components built around the following questions: “What is the question?”; “What are the options?”; “How do you evaluate the evidence?”; and “How do you conduct a study?” Results The intensive one-day program initially offered in early 2006, which concluded with applications of research principles to research topics of interest to practitioners, was well-received. Despite their admission that the research methodology by itself was not of great interest, the dentists recognized the importance of the background material in equipping them to conduct quality studies in their practices. Conclusions Dentists interested in participating in practice-based research view training in research methodology as helpful to becoming better practitioner-investigators. The PRECEDENT training program seemed to reinforce their interest. Practice Implications As dentistry evolves to become more evidence-based, more and more of the evidence will come from practice-based research. This training program prepares practicing dentists to become engaged in this trend. PMID:18310739

Does It Say That? Tensions in Teacher Questions When the Text Has the Final Say

ERIC Educational Resources Information Center

Boelé, Amy L.

2017-01-01

Using sociocultural concepts of authoritative and dialogic discourse, I sought to examine 5th-grade teachers' questioning practices during small-group reading instruction to understand the differences between groups reading text on grade level and groups reading texts below grade level. The purpose was also to examine how questions functioned for…

Big Questions Facing Vocational Psychology: A Cognitive Information Processing Perspective

ERIC Educational Resources Information Center

Reardon, Robert C.; Lenz, Janet G.; Sampson, James P., Jr.; Peterson, Gary W.

2011-01-01

This article draws upon the authors' experience in developing cognitive information processing theory in order to examine three important questions facing vocational psychology and assessment: (a) Where should new knowledge for vocational psychology come from? (b) How do career theories and research find their way into practice? and (c) What is…

Have the Answers to Common Legal Questions Concerning Nutrition Support Changed Over the Past Decade? 10 Questions for 10 Years.

PubMed

Barrocas, Albert; Cohen, Michael L

2016-06-01

Clinical nutrition specialists (CNSs) are often confronted with technological, ethical, and legal questions, that is, what can be done technologically, what should be done ethically, and what must be done legally, which conflict at times. The conflict represents a "troubling trichotomy" as discussed in the lead article of this issue of Nutrition in Clinical Practice (NCP). During Clinical Nutrition Week in 2006, a symposium covering these 3 topics was presented, and later that year, an article covering the same topic was published in NCP In this article, we revisit several legal questions/issues that were raised 10 years ago and discuss current answers and approaches. Some of the answers remain unchanged. Other answers have been modified by additional legislation, court decisions, or regulations. In addition, new questions/issues have arisen. Some of the most common questions regarding nutrition support involve the following: liability, informed consent, medical decisional incapacity vs legal competence, advance directive specificity, surrogate decision making, physician orders for life-sustaining treatment and electronic medical orders for life-sustaining treatment, legal definition of death, patient vs family decision making, the noncompliant patient, and elder abuse obligations. In the current healthcare environment, these questions and issues are best addressed via a transdisciplinary team that focuses on function rather than form. The CNS can play a pivotal role in dealing with these challenges by applying the acronym ACT: being Accountable and Communicating with all stakeholders while actively participating as an integral part of the transdisciplinary Team. © 2016 American Society for Parenteral and Enteral Nutrition.

Frequently Asked Questions

EPA Pesticide Factsheets

The Local Government Solar Project Portal's Frequently Asked Questions page provides a forum for cities and towns to ask specific questions of experts and for EPA to share answers to commonly asked questions.

How staff pursue questions to adults with intellectual disabilities.

PubMed

Finlay, W M L; Antaki, C

2012-04-01

When support staff use questions to instruct, advise or guide adults with intellectual disabilities (ID), or to solicit information from them, the interaction does not always proceed smoothly, particularly when replies are ambiguous, absent or not obviously relevant. That can lead to interactional trouble and dissatisfaction, or worse. We report on the ways in which staff members transform their questions over a series of conversational turns in order to solicit an adequate reply, and thereby to fulfil the interactional goal of the question. Our data come from approximately 30 h of recordings of natural conversation between staff members and adults with ID in two residential and one outdoor activities settings. We identify seven practices by which staff attempt to resolve the dilemma between undue direction and premature closure. These include: expansion of the original question, simplifying its format, changing its content in various ways and realising its alternatives in physical form. We highlight strategies which produce answers satisfactory to both parties, and improve the quality of interaction between staff and people with ID. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

Comparing Species Composition of Passive Trapping of Adult Flies with Larval Collections from the Body during Scene-Based Medicolegal Death Investigations

PubMed Central

Sanford, Michelle R.

2017-01-01

Collection of insects at the scene is one of the most important aspects of forensic entomology and proper collection is one of the biggest challenges for any investigator. Adult flies are highly mobile and ubiquitous at scenes, yet their link to the body and the time of colonization (TOC) and post-mortem interval (PMI) estimates is not well established. Collection of adults is widely recommended for casework but has yet to be rigorously evaluated during medicolegal death investigations for its value to the investigation. In this study, sticky card traps and immature collections were compared for 22 cases investigated by the Harris County Institute of Forensic Sciences, Houston, TX, USA. Cases included all manner of death classifications and a range of decomposition stages from indoor and outdoor scenes. Overall, the two methods successfully collected at least one species in common only 65% of the time, with at least one species unique to one of the methods 95% of the time. These results suggest that rearing of immature specimens collected from the body should be emphasized during training to ensure specimens directly associated with the colonization of the body can be identified using adult stages if necessary. PMID:28338605

The questioned p value: clinical, practical and statistical significance.

PubMed

Jiménez-Paneque, Rosa

2016-09-09

The use of p-value and statistical significance have been questioned since the early 80s in the last century until today. Much has been discussed about it in the field of statistics and its applications, especially in Epidemiology and Public Health. As a matter of fact, the p-value and its equivalent, statistical significance, are difficult concepts to grasp for the many health professionals some way involved in research applied to their work areas. However, its meaning should be clear in intuitive terms although it is based on theoretical concepts of the field of Statistics. This paper attempts to present the p-value as a concept that applies to everyday life and therefore intuitively simple but whose proper use cannot be separated from theoretical and methodological elements of inherent complexity. The reasons behind the criticism received by the p-value and its isolated use are intuitively explained, mainly the need to demarcate statistical significance from clinical significance and some of the recommended remedies for these problems are approached as well. It finally refers to the current trend to vindicate the p-value appealing to the convenience of its use in certain situations and the recent statement of the American Statistical Association in this regard.

When Is a Question a Question for Children and Adults?

ERIC Educational Resources Information Center

Saindon, Mathieu R.; Trehub, Sandra E.; Schellenberg, E. Glenn; van Lieshout, Pascal H. H. M.

2017-01-01

Terminal changes in fundamental frequency provide the most salient acoustic cues to declarative questions, but adults sometimes identify such questions from pre-terminal cues. In the present study, adults and 7- to 10-year-old children judged a single speaker's adult- and child-directed utterances as questions or statements in a gating task with…

Teacher Questioning and Invitations to Participate in Advanced Mathematics Lectures

ERIC Educational Resources Information Center

Paoletti, Teo; Krupnik, Victoria; Papadopoulos, Dimitrios; Olsen, Joseph; Fukawa-Connelly, Tim; Weber, Keith

2018-01-01

We were interested in exploring the extent to which advanced mathematics lecturers provide students with opportunities to play a role in considering or generating course content. To do this, we examined the questioning practices of 11 lecturers who taught advanced mathematics courses at the university level. Because we are unaware of other studies…

Evaluating critical thinking in clinical practice.

PubMed

Oermann, M H

1997-01-01

Although much has been written about measurement instruments for evaluating critical thinking in nursing, this article describes clinical evaluation strategies for critical thinking. Five methods are discussed: 1) observation of students in practice; 2) questions for critical thinking, including Socratic questioning; 3) conferences; 4) problem-solving strategies; and 5) written assignments. These methods provide a means of evaluating students' critical thinking within the context of clinical practice.

A Question of Questions.

ERIC Educational Resources Information Center

Fenwick, John; McMillan, Rod

In a conventional teaching situation, a lecturer may use a wide range of questioning techniques aimed at helping students to become active learners. In distance learning, students are often isolated and have limited opportunities for interaction in a social learning environment. Hence, learning strategies in distance learning need to be structured…

To Break it Down or Not Break it Down: That is the Question!

ERIC Educational Resources Information Center

Coker, Cheryl A.

2006-01-01

Learning a new skill, even a seemingly simple one, can be an overwhelming task for a beginner. A question often faced by the practitioner as a result is whether or not to break the skill into parts for initial practice. Skill complexity and skill organization interact to provide direction as to whether whole or part practice should be employed in…

Non-face-to-face consultations and communications in primary care: the role and perspective of general practice managers in Scotland.

PubMed

Hanna, Lisa; May, Carl; Fairhurst, Karen

2011-01-01

Practice managers play an important role in the organisation and delivery of primary care, including uptake and implementation of technologies. Little is currently known about practice managers' attitudes to the use of information and communication technologies, such as email or text messaging, to communicate or consult with patients. To investigate practice managers' attitudes to non-face-to-face consultation/communication technologies in the routine delivery of primary care and their role in the introduction and normalisation of these technologies. We carried out a mixed-methods study in Scotland, UK. We invited all practice managers in Scotland to take part in a postal questionnaire survey. A maximum variation sample of 20 survey respondents participated subsequently in in-depth qualitative interviews. Practice managers supported the use of new technologies for routine tasks to manage workload and maximise convenience for patients, but a range of contextual factors such as practice list size, practice deprivation area and geographical location affected whether managers would pursue the introduction of these technologies in the immediate future. The most common objections were medico-legal concerns and lack of perceived patient demand. Practice managers are likely to play a central role in the introduction of new consultation/communication technologies within general practice. They hold varying views on the appropriateness of these technologies, influenced by a complex mix of contextual characteristics. Managers from areas in which the ethos of the practice prioritises personalised care in service delivery are less enthusiastic about the adoption of remote consultation/communication technologies.

Exam Question Exchange.

ERIC Educational Resources Information Center

Alexander, John J., Ed.

1983-01-01

Acceptable answers are provided for two chemistry questions. The first question is related to the prediction of the appearance of non-first-order proton nuclear magnetic resonance (NMR) spectra. The second question is related to extraterrestrial kinetic theory of gases. (JN)

[The use of the stereomicroscopy in the forensic medicine practice].

PubMed

Valent, D

2010-10-01

In everyday medico-legal practice the situations occur when it is necessary to magnify something and bring it up to the level of magnifying glass and closer to the eye of the examiner, and this way to determine the character of wounds, the way and angle of the attack, vicinity of the instrument of assault and where necessary also to determine the option of other person being present and causing the injury mentioned above. One of the options which enables the forensic pathologist to evaluate the case is the stereomicroscopic examination. It can be done at the place of the autopsy being performed (in vivo) and also in a laboratory (in vitro) after taking samples. The objective of the work is to present methodically quite simple, for time, space and finances not too demanding a method, the results of which is possible to apply in medico-legal practice. The work provides the inside of the cases selected by the author in which the stereomicroscopy has been used as one of the examination methods. The clothing of the victim was examined where the victim suffered thoracic injury caused by gunshot in one case, and the skin and parietal bone in the second case of gunshot injury of the head. Furthermore the appearance of stabbing wounds to the skin was investigated with the identification of angles, of the residue of the paint of a motor vehicle on the clothing of a female pedestrian; and the plant seeds obtained from the crime scene which were found on the body of the victim namely in the head wounds. By further investigations into these cases other options were discovered as to the next more detailed examinations of the cases and the confirmation of the diagnosis. There is a certain value in the photo documentation which was made with every case. Stereomicroscopic examination is a suitable method by means of which it is possible to follow all the morphological findings which the forensic pathologist has to deal with in his work. It significantly broadens the knowledge

[Permanent essential defacement--remarks on the possibilities of verification of the accepted criteria in medico-legal certification in criminal and civil law proceedings].

PubMed

Chowaniec, Czesław; Nowak, Agnieszka; Jabłoński, Christian; Neniczka, Stanisława

2007-01-01

Despite the fact that some criteria of medico-legal certification in criminal and civil proceedings have been established, there are still some topics which are controversial and thus require modification. This is also true of the notion of "permanent essential defacement". In the opinion of the authors, changes in social conventions that are occurring nowadays, as well as a highly diversified, subjective perception of esthetic values indicate the need for discussing a possible modification of the presently obligatory criteria. Apart from the assessment of posttraumatic changes, an important problem is posed by defining the notion of "a part of the body customarily open to the view ". Additionally, the authors bring up for discussion the issue of experts taking into consideration the age and sex of the victims while assessing damages. A separate problem lies in difficulties in assessing the degree of detriment to health because of defacement due to the fact that official tables for evaluating permanent or long-term detriment to health do not include relevant information.

Developing an evidence-based practice protocol: implications for midwifery practice.

PubMed

Carr, K C

2000-01-01

Evidence-based practice is defined and its importance to midwifery practice is presented. Guidelines are provided for the development of an evidence-based practice protocol. These include: identifying the clinical question, obtaining the evidence, evaluating the validity and importance of the evidence, synthesizing the evidence and applying it to the development of a protocol or clinical algorithm, and, finally, developing an evaluation plan or measurement strategy to see if the new protocol is effective.

Unproven (questionable) cancer therapies.

PubMed Central

Brigden, M L

1995-01-01

More than half of all cancer patients use some form of alternative treatment during the course of their illness. Alternative therapies are often started early in patients' illness, and their use is frequently not acknowledged to health care professionals. Some alternative therapies are harmful, and their promoters may be fraudulent. Persons who try alternative cancer therapies may not be poorly educated but may ultimately abandon conventional treatment. Recent attention has focused on aspects of questionable therapies that make these treatments attractive to patients and that may be perceived as being deficient in the practice of conventional health care professionals. Physicians with patients with cancer should always make sure that unproven therapies are discussed early in the therapeutic relationship. They should also attempt to be aware of alternative therapies that are in vogue in their particular geographic area. PMID:8533410

Intermittent auscultation of fetal heart rate during labour - a widely accepted technique for low risk pregnancies: but are the current national guidelines robust and practical?

PubMed

Sholapurkar, S L

2010-01-01

Intermittent auscultation of fetal heart rate is an accepted practice in low risk labours in many countries. National guidelines on intrapartum fetal monitoring were critically reviewed regarding timing and frequency of intermittent auscultation. Hypothetical but plausible examples are presented to illustrate that it may be possible to miss significant fetal distress with strict adherence to current guidelines. Opinion is forwarded that intermittent auscultation should be performed for 60 seconds before and after three contractions over about 10 min every half an hour in the first stage of labour. Reasons are put forward to show how this could be more practical and patient friendly and at the same time could improve detection of fetal distress. The current recommendation of intermittent auscultation every 15 min in the first stage is associated with poor compliance and leads to unnecessary burden, stress and medicolegal liability for birth attendants. Modification of current national guidelines would be desirable.

Learning to Ask Naive Questions with IT Product Design Students

ERIC Educational Resources Information Center

Gunn, Wendy

2008-01-01

What does it mean to use, or do, theory in the scholarship of teaching and learning? The article approaches the question by considering the role of design anthropology in developing studio-based engineering programmes. Central to my discussion within situated contexts of learning is the idea of practice-based exploration conceived as a way of…

Using mixed methods to identify and answer clinically relevant research questions.

PubMed

Shneerson, Catherine L; Gale, Nicola K

2015-06-01

The need for mixed methods research in answering health care questions is becoming increasingly recognized because of the complexity of factors that affect health outcomes. In this article, we argue for the value of using a qualitatively driven mixed method approach for identifying and answering clinically relevant research questions. This argument is illustrated by findings from a study on the self-management practices of cancer survivors and the exploration of one particular clinically relevant finding about higher uptake of self-management in cancer survivors who had received chemotherapy treatment compared with those who have not. A cross-sectional study generated findings that formed the basis for the qualitative study, by informing the purposive sampling strategy and generating new qualitative research questions. Using a quantitative research component to supplement a qualitative study can enhance the generalizability and clinical relevance of the findings and produce detailed, contextualized, and rich answers to research questions that would be unachievable through quantitative or qualitative methods alone. © The Author(s) 2015.

[The certificate of aptitude for sport].

PubMed

Ouchinsky, M

2013-09-01

The medical certificate of no contraindication to the practice of sport, requires prudence during the exam preceding its writing for medicals and medico-legal reasons. It needs a careful questioning on important points relative to the risk of health problems during a sportive effort, especially to seek for the prodoms which can be found in 7 to 50% of cases. This questioning can sometimes be specific to certain specialities of sport. Actually, even if the concept of mass screening identify for sports people, amateurs or not, is still much debated, we can consider as a reasonable attitude, in consulting with the general medicine, to practice a careful cardiovascular examination and an ECG whose the interpretation, done with the expertise required, could help to detect about 60% of the possible lethal abnormalities to the physical effort. In case of doubt during the exam, the complementary investigations are needed in some cases (echocardiogram, stress testing, myocardial perfusion, electrophysiological endocavitary exploration). After that, the used advices can be given to the sportive candidate to minimize the risks. Despite these precautions, a subit death because of the effort can non totally be avoided. Finally, it must be remembered that the behaviour to have for kid and for elderly person involves certain specificities to know.

Exam Question Exchange.

ERIC Educational Resources Information Center

Alexander, John J., Ed.

1987-01-01

Contains two articles relating to chemistry examination questions. One provides examples of how to sequence multiple choice questions so that partial credit may be given for some responses. The second includes a question and solution dealing with stereoisomerism as a result of free radical chlorination of a nonstereoisometic substance. (TW)

[Report on medico-legal data from the mass-investigation performed by the Medico-Legal Society of Japan (XIV). Autopsy cases of traffic accidents in Japan (1990-1994). Planning and Development Committee of The Medico-Legal Society of Japan].

PubMed

1997-04-01

Autopsy findings in 3, 185 cases of death due to traffic accidents obtained from all institutions belong to the Medico-Legal Society of Japan between 1990 and 1994 were analyzed statistically. The results are summarized as follows: 1) The annual number of autopsy cases related to traffic accidents was stable and accounted for 10% of all autopsy cases examined. The autopsy cases also accounted for only 6% of all deaths due to traffic accidents. Cases requiring judicial autopsy are few despite the fact that deaths due to traffic accidents are considered deaths resulting from professional negligence. 2) The purposes of autopsy were, in a decreasing order of frequency, (1) to examine whether the accident was a hit-and-run case, (2) to examine whether the case was multiple accidents, and (3) to clarify the relationship of death with the accident. 3) According to the age, those who were involved in accidents while they were on foot overwhelmingly aged 70 years or above, and those who were involved in accidents while they were riding motorcycles were predominantly in their teens to the 20's. Concerning the situation of the accident, run-over cases, were frequently those in their 40's, and collision cases were predominantly those in their 70's. Among those who died in cars, the drivers were most frequently those in their 50's, followed by those in their 20's. 4) The degree of external and internal injuries was compared. About half the victims sustained severe injuries both internally and externally, and the remaining half sustained mild external injuries and severe internal injuries. Run-over cases generally had severe injuries both internally and externally, but collision cases tended to have mild external injuries and severe internal injuries. 5) The most frequent cause of death was brain injury, followed by loss of blood and traumatic shock. 6) Tire marks were observed in 23% of the run-over cases, and they were observed in the head, face, neck, and thoracoabdominal

Iranian Students' Performance on the IELTS: A Question of Achievement

ERIC Educational Resources Information Center

Ghaemi, Farid; Daftarifard, Parisa; Shirkhani, Servat

2011-01-01

Reading comprehension has won much effort on the part of teachers, testers, and researchers in Iran due to the fact that the immediate need of Iranian students at different university levels is the ability to read in order to get new information on the topic they are studying. The question raised is how much reading practice can move learners…

The effects of cumulative practice on mathematics problem solving.

PubMed

Mayfield, Kristin H; Chase, Philip N

2002-01-01

This study compared three different methods of teaching five basic algebra rules to college students. All methods used the same procedures to teach the rules and included four 50-question review sessions interspersed among the training of the individual rules. The differences among methods involved the kinds of practice provided during the four review sessions. Participants who received cumulative practice answered 50 questions covering a mix of the rules learned prior to each review session. Participants who received a simple review answered 50 questions on one previously trained rule. Participants who received extra practice answered 50 extra questions on the rule they had just learned. Tests administered after each review included new questions for applying each rule (application items) and problems that required novel combinations of the rules (problem-solving items). On the final test, the cumulative group outscored the other groups on application and problem-solving items. In addition, the cumulative group solved the problem-solving items significantly faster than the other groups. These results suggest that cumulative practice of component skills is an effective method of training problem solving.

The effects of cumulative practice on mathematics problem solving.

PubMed Central

Mayfield, Kristin H; Chase, Philip N

2002-01-01

This study compared three different methods of teaching five basic algebra rules to college students. All methods used the same procedures to teach the rules and included four 50-question review sessions interspersed among the training of the individual rules. The differences among methods involved the kinds of practice provided during the four review sessions. Participants who received cumulative practice answered 50 questions covering a mix of the rules learned prior to each review session. Participants who received a simple review answered 50 questions on one previously trained rule. Participants who received extra practice answered 50 extra questions on the rule they had just learned. Tests administered after each review included new questions for applying each rule (application items) and problems that required novel combinations of the rules (problem-solving items). On the final test, the cumulative group outscored the other groups on application and problem-solving items. In addition, the cumulative group solved the problem-solving items significantly faster than the other groups. These results suggest that cumulative practice of component skills is an effective method of training problem solving. PMID:12102132

Development of a Web-based question database for students' self-assessment.

PubMed

Hammoud, Maya M; Barclay, Mel L

2002-09-01

Computer-based testing (CBT) for the purpose of the national licensure examination has increased interest among medical students in this modality of testing. The advent of Web-based question-delivery systems for self-assessment and learning has made it possible for students to practice this technology and participate in self-directed learning. Test Pilot(TM) is a Web-based program that provides a fast and easy tool for the development and deployment of online testing. Our objectives for introducing the program were to (1) develop a large database of questions for students' practice and self-assessment; (2) include multimedia tools such as illustrations and short videos to enhance learning; (3) provide a feedback tool for clerkship and site directors regarding student performance; and (4) evaluate this tool in terms of students' frequency of use, students' satisfaction, and its potential effectiveness in enhancing learning. The Obstetrics and Gynecology clerkship at the University of Michigan is held at four different sites. In the past, students have been provided with access to floppy disks that contain about 500 self-assessment questions. These questions have been reformatted, updated, and transferred to Test Pilot. Visual illustrations have been added to the questions along with more varied formats, including extended matching, fill-in, and essay questions. The questions are divided into ten-question quizzes. The students get immediate feedback after answering each question and a summary of performance at the end of each quiz. Security, access, and analysis are facilitated because the questions and responses are stored centrally. In addition, Test Pilot captures information regarding individual and collective students' performances. At the end of the rotation, students fill out a form evaluating the Test Pilot program and comparing it with the quiz disks. In addition, we are collecting data regarding the actual use of Test Pilot, which will be compared with the

From Principles to Practice: Collegial Observation for Teacher Development

ERIC Educational Resources Information Center

Gray, Susan M.

2012-01-01

Teachers constantly question their own practice. Often, their questions remain unexplored. Collegial observation provides one way to see teaching differently and understand the tensions involved in incorporating new theoretical understandings into practice. Gebhard (1999) argues that conversations preceding and following such observations are…

"This is a question we have to ask everyone": asking young people about self-harm and suicide.

PubMed

O'Reilly, M; Kiyimba, N; Karim, K

2016-10-01

WHAT IS KNOWN ON THE SUBJECT?: An essential part of the mental health assessment is to evaluate the risk of harm to self. Fundamentally this involves asking directly about self-harming behaviour and suicidal thoughts or urges, but practitioners often find it difficult to open up these conversations. This evaluation of risk is particularly important as self-harm and suicidal thoughts are frequently found in young people who attend mental health services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Young people are not always routinely asked directly about self-harm or suicidal thoughts when they are assessed. There are two ways that mental health practitioners introduce this topic: first, by building up to it by initially asking about general feelings, and second by stating that it is a requirement to ask everyone. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: These questions should not be avoided by mental health practitioners just because they are difficult. We offer suggestions as to how to ask questions about self-harm and suicide based on real-world practice. Introduction Questions about self-harm and suicide are essential in risk assessments with children and young people, yet little is known about how mental health practitioners do this. Aim The core aim was to examine how questions about self-harm and suicidal ideation are asked in real-world practice. Method A qualitative design was employed to analyse 28 video-recorded naturally occurring mental health assessments in a child and adolescent mental health service. Data were analysed using conversation analysis (CA). Results In 13 cases young people were asked about self-harm and suicide, but 15 were not. Analysis revealed how practitioners asked these questions. Two main styles were revealed. First was an incremental approach, beginning with inquiries about emotions and behaviours, building to asking about self-harm and suicidal intent. Second was to externalize the question as being required by outside agencies

Training Design Conception and Reflexive Practice: How to Answer Teachers' Questions?

ERIC Educational Resources Information Center

Clottu, Régine

2017-01-01

This research studies the practices related to the conception of training "on demand" in the field of continuous training of teachers. Training "on demand" adapts itself to the problems of professionals. The analysis of the demand faces the complexity of the different contexts as well as the diversity of professionals'…

Formative student-authored question bank: perceptions, question quality and association with summative performance

PubMed Central

Walsh, Jason L; Harris, Benjamin H L; Denny, Paul; Smith, Phil

2018-01-01

Purpose of the study There are few studies on the value of authoring questions as a study method, the quality of the questions produced by students and student perceptions of student-authored question banks. Here we evaluate PeerWise, a widely used and free online resource that allows students to author, answer and discuss multiple-choice questions. Study design We introduced two undergraduate medical student cohorts to PeerWise (n=603). We looked at their patterns of PeerWise usage; identified associations between student engagement and summative exam performance; and used focus groups to assess student perceptions of the value of PeerWise for learning. We undertook item analysis to assess question difficulty and quality. Results Over two academic years, the two cohorts wrote 4671 questions, answered questions 606 658 times and posted 7735 comments. Question writing frequency correlated most strongly with summative performance (Spearman’s rank: 0.24, p=<0.001). Student focus groups found that: (1) students valued curriculum specificity; and (2) students were concerned about student-authored question quality. Only two questions of the 300 ’most-answered' questions analysed had an unacceptable discriminatory value (point-biserial correlation <0.2). Conclusions Item analysis suggested acceptable question quality despite student concerns. Quantitative and qualitative methods indicated that PeerWise is a valuable study tool. PMID:28866607

Exploring undergraduates' understanding of photosynthesis using diagnostic question clusters.

PubMed

Parker, Joyce M; Anderson, Charles W; Heidemann, Merle; Merrill, John; Merritt, Brett; Richmond, Gail; Urban-Lurain, Mark

2012-01-01

We present a diagnostic question cluster (DQC) that assesses undergraduates' thinking about photosynthesis. This assessment tool is not designed to identify individual misconceptions. Rather, it is focused on students' abilities to apply basic concepts about photosynthesis by reasoning with a coordinated set of practices based on a few scientific principles: conservation of matter, conservation of energy, and the hierarchical nature of biological systems. Data on students' responses to the cluster items and uses of some of the questions in multiple-choice, multiple-true/false, and essay formats are compared. A cross-over study indicates that the multiple-true/false format shows promise as a machine-gradable format that identifies students who have a mixture of accurate and inaccurate ideas. In addition, interviews with students about their choices on three multiple-choice questions reveal the fragility of students' understanding. Collectively, the data show that many undergraduates lack both a basic understanding of the role of photosynthesis in plant metabolism and the ability to reason with scientific principles when learning new content. Implications for instruction are discussed.

Exploring Undergraduates' Understanding of Photosynthesis Using Diagnostic Question Clusters

PubMed Central

Parker, Joyce M.; Anderson, Charles W.; Heidemann, Merle; Merrill, John; Merritt, Brett; Richmond, Gail; Urban-Lurain, Mark

2012-01-01

We present a diagnostic question cluster (DQC) that assesses undergraduates' thinking about photosynthesis. This assessment tool is not designed to identify individual misconceptions. Rather, it is focused on students' abilities to apply basic concepts about photosynthesis by reasoning with a coordinated set of practices based on a few scientific principles: conservation of matter, conservation of energy, and the hierarchical nature of biological systems. Data on students' responses to the cluster items and uses of some of the questions in multiple-choice, multiple-true/false, and essay formats are compared. A cross-over study indicates that the multiple-true/false format shows promise as a machine-gradable format that identifies students who have a mixture of accurate and inaccurate ideas. In addition, interviews with students about their choices on three multiple-choice questions reveal the fragility of students' understanding. Collectively, the data show that many undergraduates lack both a basic understanding of the role of photosynthesis in plant metabolism and the ability to reason with scientific principles when learning new content. Implications for instruction are discussed. PMID:22383617

Developing Open-Ended Questions for Surface Area and Volume of Beam

ERIC Educational Resources Information Center

Kurniawan, Henry; Putri, Ratu Ilma Indra; Hartono, Yusuf

2018-01-01

The purpose of this research was to show open-ended questions about surface area and beam volume which valid and practice, have potential effect. This research is research development which consists of two main phases: preliminary phase (preparation phase and problem design) and formative evaluation phase (evaluation and revision phases). The…

The Effects of Adjunct Questions and Feedback on Improving the Reading Comprehension Skills of Learning-Disabled Adolescents.

PubMed

Peverly, Stephen T.; Wood, Rhea

2001-01-01

Adjunct question research has typically focused on the effects of adjunct questions on improving the learning of college students. This study investigated the effects of inserted and massed postquestions (inference, main idea, and detail), with and without feedback, on improving the comprehension skills of adolescents labeled as reading disabled. Students practiced using adjunct questions for 6 weeks. The results suggested that inserted questions (and to a lesser extent massed postquestions) were beneficial in improving the comprehension of texts that did not contain adjunct questions. Specifically, the results indicated that (a) inserted questions were more effective than massed postquestions or no questions, (b) massed postquestions were more effective than no questions, and (c) the effects of inserted questions on comprehension increased over the time of treatment. The beneficial effects of feedback were limited to inference and main idea questions. Copyright 2001 Academic Press.

Current usage and future trends in gross digital photography in Canada.

PubMed

Horn, Christopher L; DeKoning, Lawrence; Klonowski, Paul; Naugler, Christopher

2014-01-14

The purpose of this study was to assess the current usage, utilization and future direction of digital photography of gross surgical specimens in pathology laboratories across Canada. An online survey consisting of 23 multiple choice and free-text questions regarding gross digital photography was sent out to via email to laboratory staff across Canada involved in gross dissection of surgical specimens. Sixty surveys were returned with representation from most of the provinces. Results showed that gross digital photography is utilized at most institutions (90.0%) and the primary users of the technology are Pathologists (88.0%), Pathologists' Assistants (54.0%) and Pathology residents (50.0%). Most respondents felt that there is a definite need for routine digital imaging of gross surgical specimens in their practice (80.0%). The top two applications for gross digital photography are for documentation of interesting/ complex cases (98.0%) and for teaching purposes (84.0%). The main limitations identified by the survey group are storage space (42.5%) and security issues (40.0%). Respondents indicated that future applications of gross digital photography mostly include teaching (96.6%), presentation at tumour boards/ clinical rounds (89.8%), medico-legal documentation (72.9%) and usage for consultation purposes (69.5%). The results of this survey indicate that pathology staff across Canada currently utilizes gross digital images for regular documentation and educational reasons. They also show that the technology will be needed for future applications in teaching, consultation and medico-legal purposes.

Formative student-authored question bank: perceptions, question quality and association with summative performance.

PubMed

Walsh, Jason L; Harris, Benjamin H L; Denny, Paul; Smith, Phil

2018-02-01

There are few studies on the value of authoring questions as a study method, the quality of the questions produced by students and student perceptions of student-authored question banks. Here we evaluate PeerWise, a widely used and free online resource that allows students to author, answer and discuss multiple-choice questions. We introduced two undergraduate medical student cohorts to PeerWise (n=603). We looked at their patterns of PeerWise usage; identified associations between student engagement and summative exam performance; and used focus groups to assess student perceptions of the value of PeerWise for learning. We undertook item analysis to assess question difficulty and quality. Over two academic years, the two cohorts wrote 4671 questions, answered questions 606 658 times and posted 7735 comments. Question writing frequency correlated most strongly with summative performance (Spearman's rank: 0.24, p=<0.001). Student focus groups found that: (1) students valued curriculum specificity; and (2) students were concerned about student-authored question quality. Only two questions of the 300 'most-answered' questions analysed had an unacceptable discriminatory value (point-biserial correlation <0.2). Item analysis suggested acceptable question quality despite student concerns. Quantitative and qualitative methods indicated that PeerWise is a valuable study tool. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Essential Questions

ERIC Educational Resources Information Center

Wilhelm, Jeffrey D.

2012-01-01

The secret to teaching may be as simple as asking students good questions--and then giving them the opportunity to find the answers. The author shares how he uses essential questions that set the class off on an inquiry. Rather than consuming information that he distributes and then repeating it on a test, students carry out their own…

Questioned document workflow for handwriting with automated tools

NASA Astrophysics Data System (ADS)

Das, Krishnanand; Srihari, Sargur N.; Srinivasan, Harish

2012-01-01

During the last few years many document recognition methods have been developed to determine whether a handwriting specimen can be attributed to a known writer. However, in practice, the work-flow of the document examiner continues to be manual-intensive. Before a systematic or computational, approach can be developed, an articulation of the steps involved in handwriting comparison is needed. We describe the work flow of handwritten questioned document examination, as described in a standards manual, and the steps where existing automation tools can be used. A well-known ransom note case is considered as an example, where one encounters testing for multiple writers of the same document, determining whether the writing is disguised, known writing is formal while questioned writing is informal, etc. The findings for the particular ransom note case using the tools are given. Also observations are made for developing a more fully automated approach to handwriting examination.

Questioning ORACLE: An Assessment of ORACLE's Analysis of Teachers' Questions and [A Comment on "Questioning ORACLE"].

ERIC Educational Resources Information Center

Scarth, John; And Others

1986-01-01

Analysis of teachers' questions, part of the ORACLE (Observation Research and Classroom Learning Evaluation) project research, is examined in detail. Scarth and Hammersley argue that the rules ORACLE uses for identifying different types of questions involve levels of ambiguity and inference that threaten reliability and validity of the study's…

Fixing past mistakes. Answers to questions about reviews, refunds, disclosures.

PubMed

Fitzgerald, T Jeffrey

2003-10-01

A medical group must address practical and legal issues when it discovers improper payments, billing mistakes or alleged misconduct. Its response has a significant impact on how the charges are resolved. A group and its providers can come under fraud and abuse investigations, whistle-blower allegations and Medicare payment reviews. Many questions arise in response to billing errors or allegations of misconduct.

Conceptualising Information Literacy as Social Practice: A Study of Pregnant Women's Information Practices

ERIC Educational Resources Information Center

Papen, Uta

2013-01-01

Introduction: The present study presents a view of information literacy not primarily as skill but as different practices, situated within specific social and institutional contexts. It suggests that questions of authority of knowledge are central to understanding people's information practices. Method: First, the concept of information practices…

High time for a change: psychometric analysis of multiple-choice questions in nursing.

PubMed

Redmond, Sandra P; Hartigan-Rogers, Jackie A; Cobbett, Shelley

2012-11-26

Nurse educators teach students to develop an informed nursing practice but can educators claim the same grounding in the available evidence when formulating multiple-choice assessment tools to evaluate student learning? Multiple-choice questions are a popular assessment format within nursing education. While widely accepted as a credible format to assess student knowledge across disciplines, debate exists among educators regarding the number of options necessary to adequately test cognitive reasoning and optimal discrimination between student abilities. The purpose of this quasi-experimental between groups study was to examine the psychometric properties of three option multiple-choice questions when compared to the more traditional four option questions. Data analysis revealed that there were no statistically significant differences in the item discrimination, difficulty or the mean examination scores when multiple-choice test questions were administered with three versus four option answer choices. This study provides additional guidance for nurse educators to assist in improving multiple-choice question writing and test design.

What do primary care practitioners want to know? A content analysis of questions asked at the point of care.

PubMed

Bjerre, Lise M; Paterson, Nicholas R; McGowan, Jessie; Hogg, William; Campbell, Craig M; Viner, Gary; Archibald, Douglas

2013-01-01

Assessing physician needs to develop continuing medical education (CME) activities is an integral part of CME curriculum development. The purpose of the present study was to demonstrate the feasibility of identifying areas of perceived greatest needs for continuing medical education (CME) by using questions collected electronically at the point of care. This study is a secondary analysis of the "Just-in-Time" (JIT) information librarian consultation service database of questions using quantitative content analysis methods. The original JIT project demonstrated the feasibility of a real-time librarian service for answering questions asked by primary care clinicians at the point of care using a Web-based platform or handheld device. Data were collected from 88 primary care practitioners in Ontario, Canada, from October 2005 to April 2006. Questions were answered in less than 15 minutes, enabling clinicians to use the answer during patient encounters. Description of type and frequency of questions asked, including the organ system on which the questions focused, was produced using 2 classification systems, the "taxonomy of generic clinical questions" (TGCQ), and the International Classification for Primary Care version 2 (ICPC-2). Of the original 1889 questions, 1871 (99.0%) were suitable for analysis. A total of 970 (52%) of questions related to therapy; of these, 671 (69.2%) addressed questions about drug therapy, representing 36% of all questions. Questions related to diagnosis (24.8%) and epidemiology (13.5%) were also common. Organ systems questions concerning musculoskeletal, endocrine, skin, cardiac, and digestive systems were asked more than other categories. Questions collected at the point of care provide a valuable and unique source of information on the true learning needs of practicing clinicians. The TGCQ classification allowed us to show that a majority of questions had to do with treatment, particularly drug treatment, whereas the use of the ICPC-2

Asking Questions in the Classroom: An Exploration of Tools and Techniques Used in the Library Instruction Classroom

ERIC Educational Resources Information Center

Whitver, Sara Maurice; Lo, Leo S.

2017-01-01

This study explores the tools and techniques used within the library instruction classroom to facilitate a conversation about teaching practices. Researchers focused on the questioning methods employed by librarians, specifically the number of questions asked by librarians and students. This study was comprised of classroom observations of a team…

Selected nutrition practices of women on hemodialysis and peritoneal dialysis: observations from the NKF-CRN Second National Research Question Collaborative Study.

PubMed

Luttrell, Kathy J; Beto, Judith A; Tangney, Christine C

2014-03-01

The objective of this study was to report selected nutrition behavior practices (type and amount of fat, fiber, and beverage intake) collected by self-administered validated food frequency questionnaires (FFQs) as part of the 1998 to 1999 NKF-CRN Second National Research Question Collaborative Study Group. This study was conducted on a prospective randomized cohort of 264 adult women 18 years of age or older that were on hemodialysis (HD) or peritoneal dialysis for more than 3 months and were receiving treatment in 116 U.S. dialysis centers. These women completed the same self-administered validated FFQ used in the Women's Health Initiative Dietary Modification Trial. Main outcome measures included tabulated FFQ data and selected nutrition practices using descriptive statistics (frequency, percentage). Associations with selected demographic and geographic region variables were examined, and nutrition practice differences by age, registered dietitian full-time equivalents, years on dialysis, and body mass index (BMI) categories were investigated using analyses of variance. Demographics (mean ± standard deviation) were age (56.1 ± 15.3 years), years on dialysis (5.3 ± 4.6 years), and race/ethnicity (62% White, 30% Black) with 86% on HD. The nutrition behavior of taking the skin off of chicken was more prevalent in White women (P < .0005) whereas adding fat to cooking was higher in Black women (P < .0005). Differences in other selected nutrition practices were also observed. Low-fat intake behaviors were reported in 30% to 50% of the sample; fiber intake was minimal (mean 10 g/day). Self-administered FFQs may have limitations in calculating actual intake, but this is the first report of dietary patterns specifically in women undergoing maintenance dialysis from 1998 to 1999. These data could be used to increase fruit and vegetable intake within renal diet parameters and support awareness of healthier food choices. Copyright © 2014 National Kidney Foundation, Inc

Unpark Those Questions

ERIC Educational Resources Information Center

Ness, Molly

2013-01-01

Whenever Mr. Henderson's 3rd grade students had a question that he couldn't immediately answer or that seemed off-topic, he asked them to write the question on a sticky note and place it on a poster dubbed the "Parking Lot." His intention was to find time later to answer those questions, but too often, he said, the parking lot…

Curiosity Questions

ERIC Educational Resources Information Center

Nelsen, Jane; DeLorenzo, Chip

2010-01-01

Have you ever found yourself lecturing a child, with the best of intentions, in an attempt to help him or her learn a lesson or process a situation in a manner that you feel will be productive? Curiosity questions, which the authors also call What and How questions, help children process an experience, event, or natural consequence so that they…

Question Classification Taxonomies as Guides to Formulating Questions for Use in Chemistry Classrooms

ERIC Educational Resources Information Center

Festo, Kayima

2016-01-01

Teacher questions play an important role in facilitating classroom discourse. Using appropriate question types and proper questioning techniques help to create reflective-active learners. Teacher questions can elicit students' explanations, elaboration of their ideas and thinking, and they can be used to disclose students' misconceptions. Despite…

To pray or not to pray: a question of ethics.

PubMed

French, Charlotte; Narayanasamy, Aru

There is a widespread belief that nurses have a duty to provide spiritual care. However, many feel there is still a need for debate surrounding the ethical use of prayer in both nursing research and practice. By using critical reflections and evidence-based literature, this paper develops a discourse on the ethics of prayer as a spiritual intervention in nursing and health care practice. Several key ethical issues are highlighted. In regards to research, lack of informed consent is a major concern in both research and nursing practice. Key ethical issues in practice include questions around intention and authority, e.g. despite the religious beliefs of the nurse, intentions to proselytize must be avoided to protect patient autonomy and avoid abuse of the nurse's authority. Furthermore, prayer has unknown side effects and implications. This paper concludes that, in practice, nurses must reconcile their personal, spiritual beliefs with their professional duties, and while this may be a delicate balance, it is not yet appropriate to encourage or dissuade a patient from their beliefs until appropriate research evidence is produced.

Disability Discrimination and Obesity: The Big Questions?

PubMed

Flint, Stuart W; Snook, Jeremé

2015-12-01

Obesity discrimination in employment and recruitment has become a topic of focus for research examination with increasing reports of discrimination by colleagues and managers. Whilst a limited number of legal cases have emerged, disability law is consulted in line with the expectation of anti-discriminatory practices at work. In line with disability law, whether obesity is defined as a disability or not has an impact on the outcome of a court ruling. Ambiguity when defining obesity through either the medical or social model means there are many questions that remain unanswered which might lead to inconsistency in court rulings.

Question-Asking and Question-Exploring

ERIC Educational Resources Information Center

Sands, Lorraine; Carr, Margaret; Lee, Wendy

2012-01-01

The Centre of Innovation Research at Greerton Early Childhood Centre was characterised as a dispositional milieu where working theories were explored through a narrative research methodology. As the research progressed, the teachers at Greerton strengthened the way we were listening to, and watching out for young children's questions to enable…

A practical approach to warts in the emergency department.

PubMed

Herman, Bruce E; Corneli, Howard M

2008-04-01

Although cutaneous warts are one of the most common skin conditions affecting children, their management can be challenging, especially in complex cases and even more so during a single emergency department encounter. Anogenital warts require particular attention because of their possible but nonspecific association with sexual abuse. This review will focus on cutaneous warts and anogenital warts, with a discussion of their recognition and treatment, especially in the emergency department. The medicolegal implications of anogenital warts in children are also reviewed.

Approaches to answering critical CER questions.

PubMed

Kinnier, Christine V; Chung, Jeanette W; Bilimoria, Karl Y

2015-01-01

While randomized controlled trials (RCTs) are the gold standard for research, many research questions cannot be ethically and practically answered using an RCT. Comparative effectiveness research (CER) techniques are often better suited than RCTs to address the effects of an intervention under routine care conditions, an outcome otherwise known as effectiveness. CER research techniques covered in this section include: effectiveness-oriented experimental studies such as pragmatic trials and cluster randomized trials, treatment response heterogeneity, observational and database studies including adjustment techniques such as sensitivity analysis and propensity score analysis, systematic reviews and meta-analysis, decision analysis, and cost effectiveness analysis. Each section describes the technique and covers the strengths and weaknesses of the approach.

Education Practices and Maturation

ERIC Educational Resources Information Center

Froumin, I. D.

2018-01-01

The article briefly discusses the question of how we should establish special educational practices that could help students mature. In identifying such practices, the author looks to a number of empirical studies that allow us to understand what significance the concept of "maturation" has for children and teenagers. In conclusion, the…

Correlation between Question Intonation and Focus of Interrogation--Evidence from French Dislocated Questions.

ERIC Educational Resources Information Center

Shen, Xiao-nan

This study explores the relationship between question intonation patterns in French using dislocated questions and question-focus (Q- focus). A dislocated question is defined as an interrogative sentence whose sequence is interrupted by the topicalization of a constituent at the left ("Toi, tu viens?"), at the right (Tu viens,…

Differential Changes with Extended Practice.

DTIC Science & Technology

1983-06-01

This project was designed to answer a series of questions involving extended practice on motor skills tasks. The tasks employed were video games , and principal interest was focused on whether: (1) performance late in practice involves fewer underlying factors than early in practice; (2) video games coverge or diverge differentially upon one another; and (3) factorial content of

Critical Questions and Argument Stratagems: A Framework for Enhancing and Analyzing Students' Reasoning Practices

ERIC Educational Resources Information Center

Nussbaum, E. Michael; Edwards, Ordene V.

2011-01-01

This article explores the concepts of "critical questions" (from D. N. Walton, 1996) and "integrative" and "refutational argument stratagems" as an approach for teaching argumentation and critical thinking. A study was conducted for 6 months in 3 sections of a 7th-grade social studies classroom in which 30 students discussed and wrote about…

Barriers to optimal care between physicians and lesbian, gay, bisexual, transgender, and questioning adolescent patients.

PubMed

Kitts, Robert Li

2010-01-01

The objective of this article was to identify barriers to optimal care between physicians and LGBTQ (lesbian, gay, bisexual, transgender, and questioning) adolescents. To this end, 464 anonymous, self-administered surveys were distributed in 2003 to residents and attending physicians in pediatrics, internal medicine, obstetrics-gynecology, psychiatry, emergency medicine, and family practice at Upstate Medical University. The survey included questions pertaining to practice, knowledge, and attitude pertaining to lesbian, gay, transgender, or questioning (LGBTQ) adolescents. One hundred eight four surveys were returned. The majority of physicians would not regularly discuss sexual orientation, sexual attraction, or gender identity while taking a sexual history from a sexually active adolescent. As well, the majority of physicians would not ask patients about sexual orientation if an adolescent presented with depression, suicidal thoughts, or had attempted suicide. If an adolescent stated that he or she was not sexually active, 41% of physicians reported that they would not ask additional sexual health-related questions. Only 57% agreed to an association between being a LGBTQ adolescent and suicide. The majority of physicians did not believe that they had all the skills they needed to address issues of sexual orientation with adolescents, and that sexual orientation should be addressed more often with these patients and in the course of training. This study concludes that barriers in providing optimal care for LGBTQ adolescents can be found with regard to practice, knowledge, and attitude regardless of medical field and other demographics collected. Opportunities exist to enhance care for LGBTQ adolescents.

Rapid Response Teams: Is it Time to Reframe the Questions of Rapid Response Team Measurement?

PubMed

Salvatierra, Gail G; Bindler, Ruth C; Daratha, Kenn B

2016-11-01

The purpose of this article is to present an overview of rapid response team (RRT) history in the United States, provide a review of prior RRT effectiveness research, and propose the reframing of four new questions of RRT measurement that are designed to better understand RRTs in the context of contemporary nursing practice as well as patient outcomes. RRTs were adopted in the United States because of their intuitive appeal, and despite a lack of evidence for their effectiveness. Subsequent studies used mortality and cardiac arrest rates to measure whether or not RRTs "work." Few studies have thoroughly examined the effect of RRTs on nurses and on nursing practice. An extensive literature review provided the background. Suppositions and four critical, unanswered questions arising from the literature are suggested. The results of RRT effectiveness, which have focused on patient-oriented outcomes, have been ambiguous, contradictory, and difficult to interpret. Additionally, they have not taken into account the multiple ways in which these teams have impacted nurses and nursing practice as well as patient outcomes. What happens in terms of RRT process and utilization is likely to have a major impact on nurses and nursing care on general medical and surgical wards. What that impact will be depends on what we can learn from measuring with an expanded yardstick, in order to answer the question, "Do RRTs work?" Evidence for the benefits of RRTs depends on proper framing of questions relating to their effectiveness, including the multiple ways RRTs contribute to nursing efficacy. © 2016 Sigma Theta Tau International.

Adding question answering to an e-tutor for programming languages

NASA Astrophysics Data System (ADS)

Taylor, Kate; Moore, Simon

Control over a closed domain of textual material removes many question answering issues, as does an ontology that is closely intertwined with its sources. This pragmatic, shallow approach to many challenging areas of research in adaptive hypermedia, question answering, intelligent tutoring and humancomputer interaction has been put into practice at Cambridge in the Computer Science undergraduate course to teach the hardware description language Veri/og. This language itself poses many challenges as it crosses the interdisciplinary boundary between hardware and software engineers, giving rise to severalhuman ontologies as well as theprogramming language itself We present further results from ourformal and informal surveys. We look at further work to increase the dialogue between studentand tutor and export our knowledge to the Semantic Web.

Pushing Critical Thinking Skills With Multiple-Choice Questions: Does Bloom's Taxonomy Work?

PubMed

Zaidi, Nikki L Bibler; Grob, Karri L; Monrad, Seetha M; Kurtz, Joshua B; Tai, Andrew; Ahmed, Asra Z; Gruppen, Larry D; Santen, Sally A

2018-06-01

Medical school assessments should foster the development of higher-order thinking skills to support clinical reasoning and a solid foundation of knowledge. Multiple-choice questions (MCQs) are commonly used to assess student learning, and well-written MCQs can support learner engagement in higher levels of cognitive reasoning such as application or synthesis of knowledge. Bloom's taxonomy has been used to identify MCQs that assess students' critical thinking skills, with evidence suggesting that higher-order MCQs support a deeper conceptual understanding of scientific process skills. Similarly, clinical practice also requires learners to develop higher-order thinking skills that include all of Bloom's levels. Faculty question writers and examinees may approach the same material differently based on varying levels of knowledge and expertise, and these differences can influence the cognitive levels being measured by MCQs. Consequently, faculty question writers may perceive that certain MCQs require higher-order thinking skills to process the question, whereas examinees may only need to employ lower-order thinking skills to render a correct response. Likewise, seemingly lower-order questions may actually require higher-order thinking skills to respond correctly. In this Perspective, the authors describe some of the cognitive processes examinees use to respond to MCQs. The authors propose that various factors affect both the question writer and examinee's interaction with test material and subsequent cognitive processes necessary to answer a question.

Revisiting the Authoritative-Dialogic Tension in Inquiry-Based Elementary Science Teacher Questioning

NASA Astrophysics Data System (ADS)

Van Booven, Christopher D.

2015-05-01

Building on the 'questioning-based discourse analytical' framework developed by Singapore-based science educator and discourse analyst, Christine Chin, this study investigated the extent to which fifth-grade science teachers' use of questions with either an authoritative or dialogic orientation differentially restricted or expanded the quality and complexity of student responses in the USA. The author analyzed approximately 10 hours of classroom discourse from elementary science classrooms organized around inquiry-based science curricula and texts. Teacher questions and feedback were classified according to their dialogic orientation and contextually inferred structural purpose, while student understanding was operationalized as a dynamic interaction between cognitive process, syntacto-semantic complexity, and science knowledge type. The results of this study closely mirror Chin's and other scholars' findings that the fixed nature of authoritatively oriented questioning can dramatically limit students' opportunities to demonstrate higher order scientific understanding, while dialogically oriented questions, by contrast, often grant students the discursive space to demonstrate a greater breadth and depth of both canonical and self-generated knowledge. However, certain teacher questioning sequences occupying the 'middle ground' between maximal authoritativeness and dialogicity revealed patterns of meaningful, if isolated, instances of higher order thinking. Implications for classroom practice are discussed along with recommendations for future research.

Estimation of postmortem interval through albumin in CSF by simple dye binding method.

PubMed

Parmar, Ankita K; Menon, Shobhana K

2015-12-01

Estimation of postmortem interval is a very important question in some medicolegal investigations. For the precise estimation of postmortem interval, there is a need of a method which can give accurate estimation. Bromocresol green (BCG) is a simple dye binding method and widely used in routine practice. Application of this method in forensic practice may bring revolutionary changes. In this study, cerebrospinal fluid was aspirated from cisternal puncture from 100 autopsies. A study was carried out on concentration of albumin with respect to postmortem interval. After death, albumin present in CSF undergoes changes, after 72 h of death, concentration of albumin has become 0.012 mM, and this decrease was linear from 2 h to 72 h. An important relationship was found between albumin concentration and postmortem interval with an error of ± 1-4h. The study concludes that CSF albumin can be a useful and significant parameter in estimation of postmortem interval. Copyright © 2015 The Chartered Society of Forensic Sciences. Published by Elsevier Ireland Ltd. All rights reserved.

Validity testing and neuropsychology practice in the VA healthcare system: results from recent practitioner survey (.).

PubMed

Young, J Christopher; Roper, Brad L; Arentsen, Timothy J

2016-05-01

A survey of neuropsychologists in the Veterans Health Administration examined symptom/performance validity test (SPVT) practices and estimated base rates for patient response bias. Invitations were emailed to 387 psychologists employed within the Veterans Affairs (VA), identified as likely practicing neuropsychologists, resulting in 172 respondents (44.4% response rate). Practice areas varied, with 72% at least partially practicing in general neuropsychology clinics and 43% conducting VA disability exams. Mean estimated failure rates were 23.0% for clinical outpatient, 12.9% for inpatient, and 39.4% for disability exams. Failure rates were the highest for mTBI and PTSD referrals. Failure rates were positively correlated with the number of cases seen and frequency and number of SPVT use. Respondents disagreed regarding whether one (45%) or two (47%) failures are required to establish patient response bias, with those administering more measures employing the more stringent criterion. Frequency of the use of specific SPVTs is reported. Base rate estimates for SPVT failure in VA disability exams are comparable to those in other medicolegal settings. However, failure in routine clinical exams is much higher in the VA than in other settings, possibly reflecting the hybrid nature of the VA's role in both healthcare and disability determination. Generally speaking, VA neuropsychologists use SPVTs frequently and eschew pejorative terms to describe their failure. Practitioners who require only one SPVT failure to establish response bias may overclassify patients. Those who use few or no SPVTs may fail to identify response bias. Additional clinical and theoretical implications are discussed.

A topic clustering approach to finding similar questions from large question and answer archives.

PubMed

Zhang, Wei-Nan; Liu, Ting; Yang, Yang; Cao, Liujuan; Zhang, Yu; Ji, Rongrong

2014-01-01

With the blooming of Web 2.0, Community Question Answering (CQA) services such as Yahoo! Answers (http://answers.yahoo.com), WikiAnswer (http://wiki.answers.com), and Baidu Zhidao (http://zhidao.baidu.com), etc., have emerged as alternatives for knowledge and information acquisition. Over time, a large number of question and answer (Q&A) pairs with high quality devoted by human intelligence have been accumulated as a comprehensive knowledge base. Unlike the search engines, which return long lists of results, searching in the CQA services can obtain the correct answers to the question queries by automatically finding similar questions that have already been answered by other users. Hence, it greatly improves the efficiency of the online information retrieval. However, given a question query, finding the similar and well-answered questions is a non-trivial task. The main challenge is the word mismatch between question query (query) and candidate question for retrieval (question). To investigate this problem, in this study, we capture the word semantic similarity between query and question by introducing the topic modeling approach. We then propose an unsupervised machine-learning approach to finding similar questions on CQA Q&A archives. The experimental results show that our proposed approach significantly outperforms the state-of-the-art methods.

Air, water, and surface bacterial contamination in a university-hospital autopsy room.

PubMed

Maujean, Géraldine; Malicier, Daniel; Fanton, Laurent

2012-03-01

Today, little is known about the bacteriological environment of the autopsy room and its potential interest for medico-legal practices. Seven hundred fifty microbiological samples were taken from surface (n = 660), air (n = 48), and water (n = 42) to evaluate it in a French University Forensic Department. Median bacterial counts were compared before and during autopsy for air samples, and before and after autopsy for surface samples, using Wilcoxon matched pairs signed ranks test. Bacterial identification relied on traditional phenotypic methods. Bacterial counts in the air were low before autopsy, increased significantly during procedure, and seemed more linked to the number of people in the room than to an important production of aerosol-containing bacteria. Despite cleaning, human fecal flora was omnipresent on surfaces, which revealed insufficient disinfection. Bacteriological sampling is an easy way to monitor cleaning practices in postmortem rooms, but chiefly a way to improve the reliability of medico-legal proofs of infectious deaths. © 2012 American Academy of Forensic Sciences.

The Practice of Transformative Pedagogy

ERIC Educational Resources Information Center

Ukpokodu, Omiunota

2009-01-01

The author examined the practice of transformative pedagogy in an undergraduate teacher education program. The research was guided by two questions: What is the impact of transformative pedagogy on fostering preservice teachers' transformative learning? and What practices of transformative pedagogy impact student transformative learning?…

Testing for Questionable Research Practices in a Meta-Analysis: An Example from Experimental Parapsychology

PubMed Central

Bierman, Dick J.; Spottiswoode, James P.; Bijl, Aron

2016-01-01

We describe a method of quantifying the effect of Questionable Research Practices (QRPs) on the results of meta-analyses. As an example we simulated a meta-analysis of a controversial telepathy protocol to assess the extent to which these experimental results could be explained by QRPs. Our simulations used the same numbers of studies and trials as the original meta-analysis and the frequencies with which various QRPs were applied in the simulated experiments were based on surveys of experimental psychologists. Results of both the meta-analysis and simulations were characterized by 4 metrics, two describing the trial and mean experiment hit rates (HR) of around 31%, where 25% is expected by chance, one the correlation between sample-size and hit-rate, and one the complete P-value distribution of the database. A genetic algorithm optimized the parameters describing the QRPs, and the fitness of the simulated meta-analysis was defined as the sum of the squares of Z-scores for the 4 metrics. Assuming no anomalous effect a good fit to the empirical meta-analysis was found only by using QRPs with unrealistic parameter-values. Restricting the parameter space to ranges observed in studies of QRP occurrence, under the untested assumption that parapsychologists use comparable QRPs, the fit to the published Ganzfeld meta-analysis with no anomalous effect was poor. We allowed for a real anomalous effect, be it unidentified QRPs or a paranormal effect, where the HR ranged from 25% (chance) to 31%. With an anomalous HR of 27% the fitness became F = 1.8 (p = 0.47 where F = 0 is a perfect fit). We conclude that the very significant probability cited by the Ganzfeld meta-analysis is likely inflated by QRPs, though results are still significant (p = 0.003) with QRPs. Our study demonstrates that quantitative simulations of QRPs can assess their impact. Since meta-analyses in general might be polluted by QRPs, this method has wide applicability outside the domain of experimental

Testing for Questionable Research Practices in a Meta-Analysis: An Example from Experimental Parapsychology.

PubMed

Bierman, Dick J; Spottiswoode, James P; Bijl, Aron

2016-01-01

We describe a method of quantifying the effect of Questionable Research Practices (QRPs) on the results of meta-analyses. As an example we simulated a meta-analysis of a controversial telepathy protocol to assess the extent to which these experimental results could be explained by QRPs. Our simulations used the same numbers of studies and trials as the original meta-analysis and the frequencies with which various QRPs were applied in the simulated experiments were based on surveys of experimental psychologists. Results of both the meta-analysis and simulations were characterized by 4 metrics, two describing the trial and mean experiment hit rates (HR) of around 31%, where 25% is expected by chance, one the correlation between sample-size and hit-rate, and one the complete P-value distribution of the database. A genetic algorithm optimized the parameters describing the QRPs, and the fitness of the simulated meta-analysis was defined as the sum of the squares of Z-scores for the 4 metrics. Assuming no anomalous effect a good fit to the empirical meta-analysis was found only by using QRPs with unrealistic parameter-values. Restricting the parameter space to ranges observed in studies of QRP occurrence, under the untested assumption that parapsychologists use comparable QRPs, the fit to the published Ganzfeld meta-analysis with no anomalous effect was poor. We allowed for a real anomalous effect, be it unidentified QRPs or a paranormal effect, where the HR ranged from 25% (chance) to 31%. With an anomalous HR of 27% the fitness became F = 1.8 (p = 0.47 where F = 0 is a perfect fit). We conclude that the very significant probability cited by the Ganzfeld meta-analysis is likely inflated by QRPs, though results are still significant (p = 0.003) with QRPs. Our study demonstrates that quantitative simulations of QRPs can assess their impact. Since meta-analyses in general might be polluted by QRPs, this method has wide applicability outside the domain of experimental

A Machine Learning-based Method for Question Type Classification in Biomedical Question Answering.

PubMed

Sarrouti, Mourad; Ouatik El Alaoui, Said

2017-05-18

Biomedical question type classification is one of the important components of an automatic biomedical question answering system. The performance of the latter depends directly on the performance of its biomedical question type classification system, which consists of assigning a category to each question in order to determine the appropriate answer extraction algorithm. This study aims to automatically classify biomedical questions into one of the four categories: (1) yes/no, (2) factoid, (3) list, and (4) summary. In this paper, we propose a biomedical question type classification method based on machine learning approaches to automatically assign a category to a biomedical question. First, we extract features from biomedical questions using the proposed handcrafted lexico-syntactic patterns. Then, we feed these features for machine-learning algorithms. Finally, the class label is predicted using the trained classifiers. Experimental evaluations performed on large standard annotated datasets of biomedical questions, provided by the BioASQ challenge, demonstrated that our method exhibits significant improved performance when compared to four baseline systems. The proposed method achieves a roughly 10-point increase over the best baseline in terms of accuracy. Moreover, the obtained results show that using handcrafted lexico-syntactic patterns as features' provider of support vector machine (SVM) lead to the highest accuracy of 89.40 %. The proposed method can automatically classify BioASQ questions into one of the four categories: yes/no, factoid, list, and summary. Furthermore, the results demonstrated that our method produced the best classification performance compared to four baseline systems.

The Effects of Question Generation, Question Answering and Reading on Prose Learning.

ERIC Educational Resources Information Center

Owens, Anthony Mathew

Eighty-seven students took part in a study (using three experimental conditions) of the effect of question generation, question answering, and rereading on an immediate posttest and on a delayed test of knowledge of a text passage. In condition G, subjects generated multiple-choice questions that would test knowledge of each of the six content…

Virtue-Epistemology and the Chagos Unknown: Questioning the Indictment of Knowledge Transmission

ERIC Educational Resources Information Center

Papastephanou, Marianna

2015-01-01

Though concerned with knowledge, this article begins with unknown political events that are ignored by the culture and educational practices of the societies in whose name the events took place. The questions that these events raise indicate a relation of epistemology with ethics and education that complicates some theoretical and managerial…

Evaluative Conditioning: The “How” Question

PubMed Central

Jones, Christopher R.; Olson, Michael A.; Fazio, Russell H.

2011-01-01

Evaluative conditioning (EC) refers to attitude formation or change toward an object due to that object's mere co-occurrence with another valenced object or objects. This chapter focuses on the “how” question, that is, the question of what cognitive processes intervene between mere co-occurrence and attitude formation or change. Though EC has typically been thought of as occurring through a single, albeit contentious, mechanism, we begin by pointing out that both the heterogeneity of EC methodologies and the abundance of inconsistent results suggest that multiple processes with different characteristics can produce EC. We describe how the earliest posited process of EC, Pavlovian conditioning or signal learning, is a valid mechanism of EC that appears to have operated in some experiments but is unlikely to have operated in others and also cannot account for various EC findings. We describe other mechanisms of EC, when they can be expected to occur, and what characteristics they have. We particularly focus our attention on a process model of EC we have recently introduced, the implicit misattribution model. Finally, we describe the implications of a multi-process view of EC, which we argue can help resolve theoretical controversies and further the application of EC as a practical intervention for influencing attitudes in various domains. PMID:22241936

Class-Wide Access to a Commercial Step 1 Question Bank During Preclinical Organ-Based Modules: A Pilot Project.

PubMed

Baños, James H; Pepin, Mark E; Van Wagoner, Nicholas

2018-03-01

The authors examined the usefulness of a commercially available Step 1 question bank as a formative academic support tool throughout organ-based modules in an integrated preclinical medical curriculum. The authors also determined the extent to which correlation between question bank utilization and academic metrics varied with Medical College Admission Test (MCAT) scores. In 2015, a cohort of 185 first-year medical students at University of Alabama School of Medicine were provided with 18-month full access to a commercially available Step 1 question bank of over 2,100 items throughout organ-based modules, although there were no requirements for use. Data on student use of the question bank were collected via an online administrative portal. Relationships between question bank utilization and academic outcomes including exams, module grades, and United States Medical Licensing Examination (USMLE) Step 1 were determined using multiple linear regression. MCAT scores and number of items attempted in the question bank significantly predicted all academic measures, with question bank utilization as the stronger predictor. The association between question bank utilization and academic outcome was stronger for individuals with lower MCAT scores. The findings elucidate a novel academic support mechanism that, for some programs, may help bridge the gap between holistic and mission-based admissions practices and a residency match process that places a premium on USMLE exam scores. Distributed formative use of USMLE Step 1 practice questions may be of value as an academic support tool that benefits all students, but particularly those entering with lower MCAT scores.

Recommended Screening Practices for Launch Collision Aviodance

NASA Technical Reports Server (NTRS)

Beaver, Brian A.; Hametz, Mark E.; Ollivierre, Jarmaine C.; Newman, Lauri K.; Hejduk, Matthew D.

2015-01-01

The objective of this document is to assess the value of launch collision avoidance (COLA) practices and provide recommendations regarding its implementation for NASA robotic missions. The scope of this effort is limited to launch COLA screens against catalog objects that are either spacecraft or debris. No modifications to manned safety COLA practices are considered in this effort. An assessment of the value of launch COLA can be broken down into two fundamental questions: 1) Does collision during launch represent a significant risk to either the payload being launched or the space environment? 2) Can launch collision mitigation be performed in a manner that provides meaningful risk reduction at an acceptable level of operational impact? While it has been possible to piece together partial answers to these questions for some time, the first attempt to comprehensively address them is documented in reference (a), Launch COLA Operations: an Examination of Data Products, Procedures, and Thresholds, Revision A. This report is the product of an extensive study that addressed fundamental technical questions surrounding launch collision avoidance analysis and practice. The results provided in reference (a) will be cited throughout this document as these two questions are addressed. The premise of this assessment is that in order to conclude that launch COLA is a value-added activity, the answer to both of these questions must be affirmative. A "no" answer to either of these questions points toward the conclusion that launch COLA provides little or no risk mitigation benefit. The remainder of this assessment will focus on addressing these two questions.

Surgeons' opinions and practice of informed consent in Nigeria.

PubMed

Ogundiran, Temidayo O; Adebamowo, Clement A

2010-12-01

Informed consent is perhaps more relevant to surgical specialties than to other clinical disciplines. Fundamental to this concept is the provision of relevant information for the patient to make an informed choice about a surgical intervention. The opinions of surgeons in Nigeria about informed consent in their practice were surveyed. A cross-sectional survey of surgeons in Nigeria was undertaken in 2004/5 using self-administered semistructured questionnaires. There were 102 respondents, 85.3% of whom were men and 58.8% were aged 31-40 years. 43.1% were consultants and 54.0% were surgical trainees. 27.4% were in surgical subspecialties, 26.5% in general surgery and 21.6% were obstetricians and gynaecologists. 54.9% agreed that sufficient information is not provided to patients while obtaining their consent for surgical procedures. They listed medicolegal reasons (70.6%), informing patients about benefits, risks and alternatives (64.7%) and hospital policy (50.0%) as some reasons for obtaining consent for surgical procedures. When patients decline to give consent for surgery, 84.3% of them thought that poor communication between surgeons and patients may be contributory. They identified taking a course in bioethics during surgical training and compulsory communication skills course as some ways to improve communication between surgeons and patients. Most Nigerian surgeons seemed to have a good knowledge of the informed consent requirements and process but fall short in practice. There is a need to improve the surgeon-patient relationship in line with modern exigencies to provide interactive environments for fruitful patient communication and involvement.

Student Moderators in Asynchronous Online Discussion: A Question of Questions

ERIC Educational Resources Information Center

Zingaro, Daniel

2012-01-01

Much current research exalts the benefits of having students facilitate weekly discussions in asynchronous online courses. This study seeks to add to what is known about student moderation through an analysis of the types of questions students use to spur each discussion. Prior experimental work has demonstrated that the types of questions posed…

Improving Student Question Classification

ERIC Educational Resources Information Center

Heiner, Cecily; Zachary, Joseph L.

2009-01-01

Students in introductory programming classes often articulate their questions and information needs incompletely. Consequently, the automatic classification of student questions to provide automated tutorial responses is a challenging problem. This paper analyzes 411 questions from an introductory Java programming course by reducing the natural…

FAQ Question Submission

Science.gov Websites

, fax, or phone. Use this area to send us your question. Your name: Your E-Mail address: Your Phone Number (voice): Please include area code. Your Fax Number: Please include area code. Send Your Question

Americans with Disabilities Act (ADA). Title 1--Employment. Questions & Answers for Employees.

ERIC Educational Resources Information Center

American Association of Retired Persons, Washington, DC.

This guide provides information on Title I of the Americans with Disabilities Act (ADA) in a question-and-answer format for employees. The guide covers such topics as the following: which employers must comply; what employment practices and activities are covered; who is protected against employment discrimination; definitions of a person with a…

How to Improve Your Impact Factor: Questioning the Quantification of Academic Quality

ERIC Educational Resources Information Center

Smeyers, Paul; Burbules, Nicholas C.

2011-01-01

A broad-scale quantification of the measure of quality for scholarship is under way. This trend has fundamental implications for the future of academic publishing and employment. In this essay we want to raise questions about these burgeoning practices, particularly how they affect philosophy of education and similar sub-disciplines. First,…

Asking the Right Questions.

ERIC Educational Resources Information Center

O'Malley, Jeffrey J.

1990-01-01

Contends that knowing the right questions to ask is crucial to making an analytical and informative examination of a topic. Presents a question framework for country studies in geography. Includes questions on physical, political, cultural, economic and population geography, transportation, communications, natural resources, and technology. (RW)

Decoding the Disciplines as a Hermeneutic Practice

ERIC Educational Resources Information Center

Yeo, Michelle

2017-01-01

This chapter argues that expert practice is an inquiry that surfaces a hermeneutic relationship between theory, practice, and the world, with implications for new lines of questioning in the Decoding interview.

Cancer in pregnancy: Motherisk on-line question and answer forum.

PubMed

Grupp, Sandy; Einarson, Adrienne; Koren, Gideon

2007-11-01

It seems to me that cancer is occurring or being diagnosed more frequently among young women who are or might become pregnant. In the past year, I have seen several such women in my practice and I have had difficulty finding appropriate information in order to counsel them. Is there somewhere I can go for information about cancer during pregnancy so that I can better educate and inform these patients? The Motherisk Program at the Hospital for Sick Children supports an on-line Cancer in Pregnancy Forum where physicians and other health care professionals can submit questions or details of experiences that they have had with patients who had cancer during pregnancy. Questions about the safety of chemotherapeutic drugs before and during pregnancy and about possible exacerbation of previous cancer by pregnancy are most common.

The Influence of Life Experiences on Educational Leadership Practice and Evolution of That Practice: An Autoethnography

ERIC Educational Resources Information Center

Alwin, Lance

2009-01-01

To address complexity and ongoing change in educational leadership, the literature suggests employing transformational and reflective practices. The literature calls for contextually detailed, longitudinal, varied forms of research that legitimize these leadership practices. As such, this autoethnography addresses these research questions: (1)…

The 150 most important questions in cancer research and clinical oncology series: questions 40-49.

PubMed

2017-07-13

Since the beginning of 2017, Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology, which sparkle diverse thoughts, interesting communications, and potential collaborations among researchers all over the world. In this article, 10 more questions are presented as followed. Question 40. Why do mice being used as tumorigenesis models raised in different places or different conditions possess different tumor formation rate? Question 41. How could we generate more effective anti-metastasis drugs? Question 42. What is the molecular mechanism underlying heterogeneity of cancer cachexia in patients with the same pathologic type? Question 43. Will patients with oligo-metastatic disease be curable by immunotherapy plus stereotactic body radiotherapy? Question 44. Can the Warburg effect regulation be targeted for cancer treatment? Question 45. Why do adenocarcinomas seldom occur in the small intestine? Question 46. Is Epstein-Barr virus infection a causal factor for nasal natural killer/T cell lymphoma formation? Question 47. Why will not all but very few human papillomavirus-infected patients eventually develop cervical cancer? Question 48. Why do cervical carcinomas induced by human papilloma virus have a low mutation rate in tumor suppressor genes? Question 49. Can viral infection trigger lung cancer relapse?

How To Make Innovations Practical

ERIC Educational Resources Information Center

Janssen, Fred; Westbroek, Hanna; Doyle, Walter; van Driel, Jan

2013-01-01

Background/Context: A fundamental tension has long existed between school reform proposals and actual teaching practice. Despite a large literature on teacher change, the discontinuity between innovation and practice continues and many attempts to reform teaching fail to be enacted in most classrooms. Purpose/Objective/Research Question/Focus of…

The Value of Literacy Practices

ERIC Educational Resources Information Center

Esposito, Lucio; Kebede, Bereket; Maddox, Bryan

2015-01-01

The concepts of literacy events and practices have received considerable attention in educational research and policy. In comparison, the question of value, that is, "which literacy practices do people most value?" has been neglected. With the current trend of cross-cultural adult literacy assessment, it is increasingly important to…

`Question Moments': A Rolling Programme of Question Opportunities in Classroom Science

NASA Astrophysics Data System (ADS)

Pedrosa-de-Jesus, Helena; Leite, Sara; Watts, Mike

2016-06-01

This naturalistic study integrates specific `question moments' into lesson plans to increase pupils' classroom interactions. A range of tools explored students' ideas by providing students with opportunities to ask and write questions. Their oral and written outcomes provide data on individual and group misunderstandings. Changes to the schedule of lessons were introduced to explore these questions and address disparities. Flexible lesson planning over 14 lessons across a 4-week period of high school chemistry accommodated students' contributions and increased student participation, promoted inquiring and individualised teaching, with each teaching strategy feeding forward into the next.

Reflective questions in health counseling.

PubMed

Poskiparta, M; Kettunen, T; Liimatainen, L

1998-09-01

This study explores questions that nurses ask patients in order to awaken reflection on their health behavior in health counseling. Thirty-eight counseling situations were videotaped in a hospital. The data were analyzed using conversation analysis which was adapted for the purpose of this study. Nonverbal communication supported speech and was interpreted alongside it. This study found that nurses used only a few reflective questions, most of which were future-oriented or introduced hypotheses. In a nonreflective discussion, nurses used only check-up and alternative questions to get information about patients' illnesses and health care measures. Findings indicated that reflective conversation began with check-up questions about patients' immediate situation, followed by questions about patients' feelings in the past, present, or future. On the third level of questioning, the structure might vary between embedded questions, check-up, alternative, or feeling questions. Nonverbal communication supported the discussion. Reflective questions tended to ensure patient-centered conversation and might improve the effectiveness of health counselling.

Medical school 2.0: How we developed a student-generated question bank using small group learning.

PubMed

Gooi, Adrian C C; Sommerfeld, Connor S

2015-01-01

The multiple-choice question (MCQ) is one of the most common methods for formative and summative assessment in medical school. Common challenges with this format include (1) creating vetted questions and (2) involving students in higher-order learning activities. Involving medical students in the creation of MCQs may ameliorate both of these challenges. What we did: We used a small group learning structure to develop a student-generated question bank. Students created their own MCQ based on self-study materials, and then reviewed each other's questions within small groups. Selected questions were reviewed with the class as a whole. All questions were later vetted by the instructor and incorporated into a question bank that students could access for formative learning. Post-session survey indicated that 91% of the students felt that the class-created MCQ question bank was a valuable resource, and 86% of students would be interested in collaborating with the class for creating practice questions in future sessions. Developing a student-generated question bank can improve the depth and interactivity of student learning, increase session enjoyment and provide a potential resource for student assessment.

Experiential curriculum improves medical students' ability to answer clinical questions using the internet.

PubMed

Alper, Brian S; Vinson, Daniel C

2005-09-01

Teaching about evidence-based medicine (EBM) is widespread, yet physicians still use rapid references preferentially over EBM techniques such as literature searching and appraisal of original research. The Internet now provides rapid access to preappraised evidence. We provided clinically integrated teaching of using the Internet to answer clinical questions for third-year medical students and assessed the change in their search skills. The curriculum included two 90-minute computer lab sessions with teaching of search skills related to clinical questions. Immediately before the first and after the second session, students recorded sites searched, time needed for searching, and answers found for three standardized questions. Pretest and posttest questions were matched and reversed with each block. Eighty-six students completed pretests and posttests. For two questions about conventional medical care, posttest answer quality was significantly higher, and posttest search times were significantly shorter, by 1.6 minutes for question 1 (mean pretest search time 6.3 minutes, mean posttest search time 4.7 minutes) and 1.9 minutes for question 2 (mean pretest search time 8 minutes, mean posttest search time 6.1 minutes). For a question about herbal medicine, results were similar, but there were smaller differences that did not reach statistical significance. Students used or found significantly fewer sites on the posttest than on the pretest to find answers for all three question types (absolute difference=0.3 sites for each question). CONCLUSIONS Introducing students to useful Web sites, practicing answering clinical questions, and integrating this process with clinical rotation experiences can reduce the effort that students need to find answers and improve the quality of answers they find.

Six Questions for Well-Child Care Redesign.

PubMed

Freeman, Brandi K; Coker, Tumaini R

2018-05-29

In the United States, well-child care has the goal of providing comprehensive care to children by addressing developmental, behavioral, psychosocial, and health issues through visits at recommended intervals. The preventive care needs of families can outpace the capacity of clinics and practices to provide it, thus necessitating a redesign of our well-child care system that aligns the structure of preventive care delivery with the needs of families. In this Perspectives article, we focus on six questions (the what, when, who, why, how, and where) for well-child care redesign for infants and young children; by addressing these key questions and providing recommendations for advancing well-child care redesign in the clinical and research arenas, we hope to accelerate the process of well-child care redesign. In the current political and socio-economic environment, continuing with well-child care "as usual" will mean that many families will find that their well-child care visits do not fully address the most pressing needs impacting child health and well-being. It's time to stop tinkering around the edges, and implement and sustain real change in our system for preventive care. Copyright © 2018 Elsevier Ltd. All rights reserved.

To adopt, to adapt, or to contextualise? The big question in clinical practice guideline development.

PubMed

Dizon, Janine Margarita; Machingaidze, Shingai; Grimmer, Karen

2016-09-13

Developing new clinical practice guidelines (CPGs) can be time-consuming and expensive. A more efficient approach could be to adopt, adapt or contextualise recommendations from existing good quality CPGs so that the resultant guidance is tailored to the local context. The first steps are to search for international CPGs that have a similar purpose, end-users and patients to your situation. The second step is to critically appraise the methodological quality of the CPGs to ensure that your guidance is based on credible evidence. Then the decisions begin. Can you simply 'adopt' this (parent) clinical practice guidelines, and implement the recommendations in their entirety, without any changes, in your setting? If so, then no further work is required. However this situation is rare. What is more likely, is that even if recommendations from the parent clinical practice guidelines can be adopted, how they are implemented needs to address local issues. Thus you may need to 'contextualise' the guidance, by addressing implementation issues such as local workforce, training, health systems, equipment and/or access to services. Generally this means that additional information is required (Practice/Context Points) to support effective implementation of the clinical practice guidelines recommendations. In some cases, you may need to 'adapt' the guidance, where you will make changes to the recommendations so that care is relevant to your local environments. This may involve additional work to search for local research, or obtain local consensus, regarding how best to adapt recommendations. For example, adaptation might reflect substituting one drug for another (drugs have similar effects, but the alternative drug to the recommended one may be cheaper, more easily obtained or more culturally acceptable). There is lack of standardisation of clinical practice guidelines terminology, leading clinical practice guideline activities often being poorly conceptualised or reported. We

Analysis of the origin and importance of acetone and isopropanol levels in the blood of the deceased for medico-legal testimony.

PubMed

Borowska-Solonynko, A; Siwińska-Ziółkowska, A; Piotrkowicz, M; Wysmołek, M; Demkow, M

2014-01-01

The aim of the study was to analyze the incidence of acetone and isopropanol in the blood of the deceased, and to assess cases in which the compounds have been detected with a focus on their origin and usefulness for medico-legal testimony. The study material consisted of results of tests detecting ethyl alcohol and reports of autopsies performed at the Department of Forensic Medicine, Medical University of Warsaw, from January 2008 to April 2009 - a total of 2,475 cases. The test group proper (group B) comprised only those cases in which acetone was detected in blood, either with or without isopropanol [n = 202 (8.2%)]. The blood levels of isopropanol varied depending on the cause of death. The need for differentiating the origin of isopropanol in the case of its presence in the blood of the deceased was pointed out. The results of the present study show that the differentiation should be based on the isopropanol and acetone concentration ratio, as isopropanol concentration alone is not sufficient for preparing expert opinions. Even high concentrations of isopropanol, when accompanied by even higher concentrations of acetone, imply that isopropanol could have been formed as a result of acetone transformations. Isopropanol concentrations exceeding acetone levels strongly point to the exogenous origin of isopropanol, particularly when high levels of ethanol are concurrently detected.

The Priority of the Question: Focus Questions for Sustained Reasoning in Science

NASA Astrophysics Data System (ADS)

Lustick, David

2010-08-01

Science education standards place a high priority on promoting the skills and dispositions associated with inquiry at all levels of learning. Yet, the questions teachers employ to foster sustained reasoning are most likely borrowed from a textbook, lab manual, or worksheet. Such generic questions generated for a mass audience, lack authenticity and contextual cues that allow learners to immediately appreciate a question’s relevance. Teacher queries intended to motivate, guide, and foster learning through inquiry are known as focus questions. This theoretical article draws upon science education research to present a typology and conceptual framework intended to support science teacher educators as they identify, develop, and evaluate focus questions with their students.

Research Making Its Way into Classroom Practice

ERIC Educational Resources Information Center

Johnston, Peter; Goatley, Virginia

2015-01-01

Identifying researchers whose work has influenced classroom practice, raises questions about the nature of research and its relationship with practice, and the means through which knowledge is distributed. We argue that normally, influence arises through lines of research more than individuals, that knowing-in-practice distribution systems should…

The value of 100% retrospective peer review in a forensic pathology practice.

PubMed

Obenson, Ken; Wright, Claire M

2013-11-01

Peer review in forensic pathology practice has become an important cornerstone of continuous quality improvement. Although there are several components to an effective and transparent peer review process, one of the most essential is the review of completed reports. The autopsy report may be reviewed prospectively (report reviewed before sign out) or retrospectively (report reviewed after sign out). Prospective reviews are more likely to be performed on criminal or criminally suspicious cases, pediatric and SIDS deaths and high profile cases. Retrospective reviews on the other hand are performed on a proportion of all other signed-out routine medico-legal cases. The actual percentage varies by jurisdiction since there are no agreed minimum standards. Manpower and workload factors appear to be critical to determining what percentage of cases are reviewed retrospectively. The objective of this report is to present a mechanism by which a 100% retrospective review policy has been implemented, how it integrates with quality management protocols, the outcomes of the reviews and what challenges remain to improve compliance with key quality indicators especially turn around time (TAT) statistics. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

"Question Moments": A Rolling Programme of Question Opportunities in Classroom Science

ERIC Educational Resources Information Center

Pedrosa-de-Jesus, Helena; Leite, Sara; Watts, Mike

2016-01-01

This naturalistic study integrates specific "question moments" into lesson plans to increase pupils' classroom interactions. A range of tools explored students' ideas by providing students with opportunities to ask and write questions. Their oral and written outcomes provide data on individual and group misunderstandings. Changes to the…

78 FR 37242 - Draft Report and Recommendations Prepared by the Research Committee of the Scientific Working...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... Recommendations Prepared by the Research Committee of the Scientific Working Group on Medicolegal Death... Justice Programs, National Institute of Justice, Scientific Working Group for Medicolegal Death.../Medicolegal Death Investigation''. The opportunity to provide comments on this document is open to coroner...

A Comparison between the Effectiveness of PBL and LBL on Improving Problem-Solving Abilities of Medical Students Using Questioning

ERIC Educational Resources Information Center

He, Yunfeng; Du, Xiangyun; Toft, Egon; Zhang, Xingli; Qu, Bo; Shi, Jiannong; Zhang, Huan; Zhang, Hui

2018-01-01

In daily patient-history taking and diagnosis practice, doctors ask questions to gather information from patients and narrow down diagnostic hypotheses. Training medical students to be efficient problem solvers through the use of questioning is therefore important. In this study, the effectiveness of problem-based learning (PBL) and lecture-based…

Teacher Training for Effective Questioning.

ERIC Educational Resources Information Center

Godbold, John V.

This paper reviews research studies concerning the effectiveness of varying strategies for teaching questioning skills and groups them into the following organizational scheme: (a) study of question classification systems as a strategy for teaching questioning skills, (b) use of laboratory experiences as a strategy for teaching questioning skills,…

Automatic Chinese Factual Question Generation

ERIC Educational Resources Information Center

Liu, Ming; Rus, Vasile; Liu, Li

2017-01-01

Question generation is an emerging research area of artificial intelligence in education. Question authoring tools are important in educational technologies, e.g., intelligent tutoring systems, as well as in dialogue systems. Approaches to generate factual questions, i.e., questions that have concrete answers, mainly make use of the syntactical…

Conceptual Questions and Challenge Problems

NASA Astrophysics Data System (ADS)

Nurrenbern, Susan C.; Robinson, William R.

1998-11-01

The JCE Internet Conceptual Question and Challenge Problem Web site is a source of questions and problems that can be used in teaching and assessing conceptual understanding and problem solving in chemistry. Here you can find a library of free-response and multiple-choice conceptual questions and challenge problems, tips for writing these questions and problems, and a discussion of types of conceptual questions. This site is intended to be a means of sharing conceptual questions and challenge problems among chemical educators. This is a living site that will grow as you share conceptual questions and challenge problems and as we find new sources of information. We would like to make this site as inclusive as possible. Please share your questions and problems with us and alert us to references or Web sites that could be included on the site. You can use email, fax, or regular mail. Email: nurrenbern@purdue.edu or wrrobin@purdue.edu Fax: 765/494-0239 Mailing address: Susan C. Nurrenbern or William R. Robinson; Department of Chemistry; Purdue University; 1393 Brown Building; West Lafayette, IN 47907-1393. The Conceptual Questions and Challenge Problems Web site can be found here.

Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach.

PubMed

Jackson, Ben; Marshall, Michelle; Schofield, Susie

2017-11-01

Physician associates (PAs) are described as one solution to workforce capacity in primary care in the UK. Despite new investment in the role, how effective this will be in addressing unmet primary care needs is unclear. To investigate the barriers and facilitators to the integration of PAs into the general practice workforce. A modified grounded theory study in a region unfamiliar with the PA role. No a priori themes were assumed. Themes generated from stakeholder interviews informed a literature review and theoretical framework, and were then tested in focus groups with GPs, advanced nurse practitioners (ANPs), and patients. Recorded data were transcribed verbatim, and organised using NVivo version 10.2.2, with iterative analysis of emergent themes. A reflexive diary and independent verification of coding and analysis were included. There were 51 participants (30 GPs, 11 ANPs, and 10 patients) in eight focus groups. GPs, ANPs, and patients recognised that support for general practice was needed to improve access. GPs expressed concerns regarding PAs around managing medical complexity and supervision burden, non-prescriber status, and medicolegal implications in routine practice. Patients were less concerned about specific competencies as long as there was effective supervision, and were accepting of a PA role. ANPs highlighted their own negative experiences entering advanced clinical practice, and the need for support to counteract stereotypical and prejudicial attitudes CONCLUSION: This study highlights the complex factors that may impede the introduction of PAs into UK primary care. A conceptual model is proposed to help regulators and educationalists support this integration, which has relevance to other proposed new roles in primary care. © British Journal of General Practice 2017.

Teaching with the Mathematical Practices in Mind

ERIC Educational Resources Information Center

Billings, Esther M. H.; Coffey, David C.; Golden, John; Wells, Pamela J.

2013-01-01

How can the use of the Standards for Mathematical Practice in the classroom be supported? Professional developers and teacher educators strive to support teachers as they seek to answer this question. When teachers personally and intentionally experience the practices and reflect on how the practices support and promote mathematical understanding,…

Problem of Questioning

ScienceCinema

None

2017-12-09

Le Prof.Leprince-Ringuet, chercheur sur le plan scientifique, artistique et humain, parle de la remise en question des hommes et la remise en question scientifique fondamentale ou exemplaire- plusieurs personnes prennent la parole p.ex Jeanmairet, Adam, Gregory. Le Prof.Gregory clot la soirée en remerciant le Prof.Leprince-Ringuet

Social isolation and delayed discovery of bodies in houses: the value of forensic pathology, anthropology, odontology and entomology in the medico-legal investigation.

PubMed

Archer, M S; Bassed, R B; Briggs, C A; Lynch, M J

2005-07-16

The bodies of socially isolated people may remain undiscovered in their own houses for prolonged periods. Occasionally the body is in situ for sufficient time to become skeletonised, or partially so. Medico-legal investigation of these cases is complicated by degradation and contamination of evidence. Thus, a multidisciplinary forensic investigation is recommended. The potential contributions of forensic pathology, anthropology, odontology and entomology are outlined here with reference to two cases that occurred in Victoria, Australia, in 2003. Forensic pathologists are often unable to determine the cause of death in skeletonised bodies, however, they may find evidence to support either a natural or unnatural mode of death, and they may describe skeletal pathology or trauma, and identify skeletal features to support radiological identification of the deceased. Anthropologists can provide supplementary evidence of skeletal trauma. Additionally, they can assess age, sex, stature and racial affiliation from skeletal remains. Odontologists can identify individuals through comparison with ante-mortem dental records; however, potential difficulties exist in identifying the treating dentist of a socially isolated person. Odontologists may also examine the teeth and oro-facial skeleton for trauma. Entomologists may estimate minimum death time and/or season of death. Entomological examination of insect remains may also confirm that a body has lain in situ for a considerable period.

Medico-legal considerations of canine leishmaniosis in Italy: an overview of an emerging disease with reference to the buying and selling of dogs.

PubMed

Passantino, A

2006-12-01

Leishmaniosis is a common infection in the canine population. Domestic dogs are the main reservoir hosts for zoonotic human visceral leishmaniosis in both the Old and New Worlds. In fact, canine leishmaniosis is not just a veterinary problem. In the light of some recent advances in the field of diagnosis, the author evaluated the medico-legal aspects of buying and selling dogs that are potentially affected by leishmaniosis. This paper clarifies why it is impossible to attribute redhibitory vice (an essential defect in a product which renders it useless or so diminishes its usefulness or value that it must be presumed that, if he had been aware of it, the buyer would not have bought it, or would have paid a lesser price) to this disease and highlights the necessity to improve Sicilian regional law no. 15 of 3 July 2000 concerning the creation of a dog register by giving every animal a health book. With this aim in mind, the author suggests that leishmaniosis be included in the list of notifiable diseases that appears in article 1 of the Italian Veterinary Police Regulations so as to reduce the possibilities of fraudulent trade in dogs known to be infected before purchase.

Asking a Great Question: A Librarian Teaches Questioning Skills to First-Year Medical Students.

PubMed

Adams, Nancy E

2015-01-01

In a single one-hour session, first-year medical students were taught a framework for differentiating between lower-order questions that lead to knowledge of facts and higher-order questions that lead to integration of concepts and deeper learning, thereby preparing them for problem-based learning (PBL). Students generated lists of questions in response to an assertion prompt and categorized them according to Bloom's Taxonomy. These data were analyzed in addition to data from the course exam, which asked them to formulate a higher-level question in response to a prompt. Categorizing questions according to Bloom's Taxonomy was a more difficult task for students than was formulating higher-order questions. Students reported that the skills that they learned were used in subsequent PBL sessions to formulate higher-order learning objectives that integrated new and previously-learned concepts.

Cross-domain question classification in community question answering via kernel mapping

NASA Astrophysics Data System (ADS)

Su, Lei; Hu, Zuoliang; Yang, Bin; Li, Yiyang; Chen, Jun

2015-10-01

An increasingly popular method for retrieving information is via the community question answering (CQA) systems such as Yahoo! Answers and Baidu Knows. In CQA, question classification plays an important role to find the answers. However, the labeled training examples for statistical question classifier are fairly expensive to obtain, as they require the experienced human efforts. Meanwhile, unlabeled data are readily available. This paper employs the method of domain adaptation via kernel mapping to solve this problem. In detail, the kernel approach is utilized to map the target-domain data and the source-domain data into a common space, where the question classifiers are trained under the closer conditional probabilities. The kernel mapping function is constructed by domain knowledge. Therefore, domain knowledge could be transferred from the labeled examples in the source domain to the unlabeled ones in the targeted domain. The statistical training model can be improved by using a large number of unlabeled data. Meanwhile, the Hadoop Platform is used to construct the mapping mechanism to reduce the time complexity. Map/Reduce enable kernel mapping for domain adaptation in parallel in the Hadoop Platform. Experimental results show that the accuracy of question classification could be improved by the method of kernel mapping. Furthermore, the parallel method in the Hadoop Platform could effective schedule the computing resources to reduce the running time.

Assessing Question Quality Using NLP

ERIC Educational Resources Information Center

Kopp, Kristopher J.; Johnson, Amy M.; Crossley, Scott A.; McNamara, Danielle S.

2017-01-01

An NLP algorithm was developed to assess question quality to inform feedback on questions generated by students within iSTART (an intelligent tutoring system that teaches reading strategies). A corpus of 4575 questions was coded using a four-level taxonomy. NLP indices were calculated for each question and machine learning was used to predict…

What is a Question?

NASA Technical Reports Server (NTRS)

Knuth, Kevin H.; Clancy, Daniel (Technical Monitor)

2002-01-01

A given question can be defined in terms of the set of statements or assertions that answer it. Application of the logic of inference to this set of assertions allows one to derive the logic of inquiry among questions. There are interesting symmetries between the logics of inference and inquiry; where probability describes the degree to which a premise implies an assertion, there exists an analogous quantity that describes the bearing or relevance that a question has on an outstanding issue. These have been extended to suggest that the logic of inquiry results in functional relationships analogous to, although more general than, those found in information theory. Employing lattice theory, I examine in greater detail the structure of the space of assertions and questions demonstrating that the symmetries between the logical relations in each of the spaces derive directly from the lattice structure. Furthermore, I show that while symmetries between the spaces exist, the two lattices are not isomorphic. The lattice of assertions is described by a Boolean lattice 2(sup N) whereas the lattice of real questions is shown to be a sublattice of the free distributive lattice FD(N) = 2(sup 2(sup N)). Thus there does not exist a one-to-one mapping of assertions to questions, there is no reflection symmetry between the two spaces, and questions in general do not possess unique complements. Last, with these lattice structures in mind, I discuss the relationship between probability, relevance and entropy.

Clinical guidelines: proliferation and medicolegal significance.

PubMed Central

Hurwitz, B

1994-01-01

Guidelines seeking to influence and regulate clinical activity are currently gaining a new cultural ascendancy on both sides of the Atlantic. Statutory agencies may be charged with developing clinical guidelines, and civil courts, in deciding actions in negligence, could be influenced by standards of care expressed in guideline statements. Clinical guidelines are not accorded unchallengeable status: they have been subject to careful scrutiny by British and American courts to establish their authenticity and relevance. In the United States, compliance with clinical guidelines cannot be used as a defence against liability if a physician's conduct is held to have been negligent, and third party organisations can be held liable if their clinical guidelines are found to be a contributory cause of patient harm. Guidelines have not usurped the role of the expert witness in court. The importance the law attaches to customary practice means that atypical or bizarre guidelines are unlikely to be accepted as embodying a legally required standard of clinical care. PMID:10136259

The Knowledge, Awareness, and Practices of Portuguese General Practitioners Regarding Multimorbidity and its Management: Qualitative Perspectives from Open-Ended Questions.

PubMed

Prazeres, Filipe; Santiago, Luiz

2016-11-08

Multimorbidity's high prevalence and negative impact has made it a subject of worldwide interest. The main aim of this study was to access the Portuguese knowledge, awareness, and practices of general practitioners (GPs) regarding multimorbidity and its management, in order to aid in the development of interventions for improving outcomes in multimorbid patients in primary care. A web-based qualitative descriptive study was carried out in the first trimester of 2016 with primary care physicians working in two districts of the Centre region of Portugal. Open-ended questions were analysed via inductive thematic content analysis. GPs pointed out several difficulties and challenges while managing multimorbidity. Extrinsic factors were associated with the healthcare system logistics' management (consultation time, organization of care teams, clinical information) and society (media pressure, social/family support). Intrinsic factors related to the GP, patient, and physician-patient relationship were also stated. The most significant conclusion to emerge from this study is that although GPs perceived difficulties and challenges towards multimorbidity, they also have the tools to deal with them: the fundamental characteristics of family medicine. Also, the complex care required by multimorbid patients needs adequate consultation time, multidisciplinary teamwork, and more education/training.

Legal challenges in neurological practice.

PubMed

Jayalakshmi, Sita; Vooturi, Sudhindra

2016-10-01

Clinical neuroscience has made tremendous advances over the last century. Neurology as a discipline is still considered challenging and at times risky due to the natural history and progressive course of few of the neurological diseases. Encouragingly, the patient and their caregivers are now increasingly willing to be actively involved in making decisions. The patients' relationship with the doctor is a reflection of the society. A society that is orienting itself toward "rating" and "feedback" has made this doctor-patient relationship, a consumer-service provider relationship. This perhaps is due to commercialization of health that usually accompanies globalization. Moreover, a rapid influx of information from potential erroneous sources such as the Internet has also made patient and caregivers not being hesitant to taking legal course in the case of adverse events during treatment or simply because of dissatisfaction. The purpose of the legal process initiated by patients with neurological ailments is more often to compensate for the income lost, physical and psychological anguish that accompanies disease and its treatment, and to fund treatment or rehabilitation requirements. However, it is not clearly established if monetary benefits acquired lead to better opportunities for recovery of the patient. The consumer protection act and commercialization of medical services may well have an adverse effect on the doctor and patient relationship. Hence, there is a great need for all medical professionals to mutually complement and update each other. This review examines legal (litigation) processes with special interest on medicolegal system in patients with neurological ailments and the challenges faced by the neurologist during day-to-day clinical practice.

Parenting Practices in Cultural Context: An Ecological Perspective

ERIC Educational Resources Information Center

Zarnegar, Zohreh

2015-01-01

Despite general consensus that parenting practices influence the developmental processes of children, many questions about the impacts of parenting practices on child development within the cultural context remain unanswered. This article presents how cultural templates influence parenting practices and developmental processes of young children.…

Best practices for population genetic analyses

USDA-ARS?s Scientific Manuscript database

This review will attempt to address many of these practical questions that are often not readily answered from reading books or reviews on the topic, but emerge from discussions with colleagues and from practical experience. A further complication for microbial or pathogen populations is the frequen...

Toward Question-Asking Machines: The Logic of Questions and the Inquiry Calculus

NASA Technical Reports Server (NTRS)

Knuth,Kevin H.

2005-01-01

For over a century, the study of logic has focused on the algebra of logical statements. This work, first performed by George Boole, has led to the development of modern computers, and was shown by Richard T. Cox to be the foundation of Bayesian inference. Meanwhile the logic of questions has been much neglected. For our computing machines to be truly intelligent, they need to be able to ask relevant questions. In this paper I will show how the Boolean lattice of logical statements gives rise to the free distributive lattice of questions thus defining their algebra. Furthermore, there exists a quantity analogous to probability, called relevance, which quantifies the degree to which one question answers another. I will show that relevance is not only a natural generalization of information theory, but also forms its foundation.

Good practice statements on safe laboratory testing: A mixed methods study by the LINNEAUS collaboration on patient safety in primary care.

PubMed

Bowie, Paul; Forrest, Eleanor; Price, Julie; Verstappen, Wim; Cunningham, David; Halley, Lyn; Grant, Suzanne; Kelly, Moya; Mckay, John

2015-09-01

The systems-based management of laboratory test ordering and results handling is a known source of error in primary care settings worldwide. The consequences are wide-ranging for patients (e.g. avoidable harm or poor care experience), general practitioners (e.g. delayed clinical decision making and potential medico-legal implications) and the primary care organization (e.g. increased allocation of resources to problem-solve and dealing with complaints). Guidance is required to assist care teams to minimize associated risks and improve patient safety. To identify, develop and build expert consensus on 'good practice' guidance statements to inform the implementation of safe systems for ordering laboratory tests and managing results in European primary care settings. Mixed methods studies were undertaken in the UK and Ireland, and the findings were triangulated to develop 'good practice' statements. Expert consensus was then sought on the findings at the wider European level via a Delphi group meeting during 2013. We based consensus on 10 safety domains and developed 77 related 'good practice' statements (≥ 80% agreement levels) judged to be essential to creating safety and minimizing risks in laboratory test ordering and subsequent results handling systems in international primary care. Guidance was developed for improving patient safety in this important area of primary care practice. We need to consider how this guidance can be made accessible to frontline care teams, utilized by clinical educators and improvement advisers, implemented by decision makers and evaluated to determine acceptability, feasibility and impacts on patient safety.

The Power of the Practical

ERIC Educational Resources Information Center

Hern, Nicola

2013-01-01

Whether it is a rapid-fire Twitter event as part of #ASEchat, or BBC Radio 4's "Inside Science," the discussion of practical work generates powerful debate. While it is right that the best use of practical work is continually discussed, its value in science teaching is without question. The level of discussion is being further heightened…

Teacher Roles of Questioning in Early Elementary Science Classrooms: A Framework Promoting Student Cognitive Complexities in Argumentation

NASA Astrophysics Data System (ADS)

Chen, Ying-Chih; Hand, Brian; Norton-Meier, Lori

2017-04-01

The purpose of this study was to investigate the various roles that early elementary teachers adopt when questioning, to scaffold dialogic interaction and students' cognitive responses for argumentative practices over time. Teacher questioning is a pivotal contributing factor that shapes the role teachers play in promoting dialogic interaction in argumentative practice and that different roles serve different functions for promoting students' conceptual understanding. The multiple-case study was designed as a follow-up study after a 4-year professional development program that emphasized an argument-based inquiry approach. Data sources included 30 lessons focusing on whole class discussion from three early elementary teachers' classes. Data were analyzed through two approaches: (1) constant comparative method and (2) enumerative approach. This study conceptualized four critical roles of teacher questioning—dispenser, moderator, coach, and participant—in light of the ownership of ideas and activities. The findings revealed two salient changes in teachers' use of questions and the relationships between teachers' question-asking and students' cognitive responses: (1) teachers increasingly used multiple roles in establishing argumentative discourse as they persistently implemented an argument-based inquiry approach, and (2) as teachers used multiple roles in establishing patterns of questioning and framing classroom interactions, higher levels of student cognitive responses were promoted. This study suggests that an essential component of teacher professional development should include the study of the various roles that teachers can play when questioning for establishing dialogic interaction in argumentation and that this development should consist of ongoing training with systematic support.

Puzzling practice: a strategy for working with clinical practice issues.

PubMed

Walsh, Kenneth; Moss, Cheryle; Lawless, Jane; McKelvie, Rhonda; Duncan, Lindsay

2008-04-01

In this paper we aim to share the evolution of innovative ways to explore, 'unpack' and reframe clinical issues that exist in everyday practice. The elements of these processes, which we call 'puzzling practice', and the techniques associated with them, were delineated over a two year period by the four authors using action theory based processes. The authors have evolved several different frameworks for 'puzzling practice' which we draw on and use in our practice development work and in our research practice. This paper pays attention to a particular form of puzzling practice that we have found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. The paper uses a semi-fictitious example of 'Puzzling Practice' gleaned from our experience as practice development facilitators. In this example 'puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle exploring the heart of out practice; formulating the puzzle question; visualizing the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored.

Queer(ed) risks: life insurance, HIV/AIDS, and the "gay question".

PubMed

Cobb, Neil

2010-01-01

In 2004 the Association of British Insurers (ABI) issued its second Statement of Best Practice on HIV and Insurance. This prohibited use of the "gay question" (employed by some underwriters in application forms for life insurance to identify heightened risk of infection with HIV), in response to growing criticism that the practice was actuarially unreliable, unfair to gay men, and unnecessary, given the availability of alternative "behaviour-based" risk criteria. While the overhaul of this controversial practice is clearly a victory for gay (male) identity politics, this paper argues that the interests of gay men seem to have dominated at the expense of a more far-reaching critique of the industry's evaluation of infection risk. It contends that a more radical (or "queerer") challenge is needed which can better understand and address the injustices created by criteria for appraising risk of infection that still remain in place.

The role of questions in the science classroom - how girls and boys respond to teachers' questions

NASA Astrophysics Data System (ADS)

Eliasson, Nina; Karlsson, Karl Göran; Sørensen, Helene

2017-03-01

The purpose of this study was to explore (a) to what extent male and female science teachers pose different types of questions and (b) if the type of science question posed influences the extent to which boys or girls respond to them. Transcripts of the teacher-student interaction in a whole-class situation were analysed, with attention paid to interactions that involved science questions. Closed and open questions were used. Results revealed that the percentage of closed questions posed corresponded to 87%. Results show that teachers mainly use closed questions, and responses from boys to closed questions are in the majority regardless of if the question is posed by a female teacher (56%) or a male teacher (64%). Both categories of closed questions are mainly considered lower order questions that do not facilitate higher cognitive levels in students. Thus, a direct consequence of an excessive use of this type of questions may be that both boys and girls will be given less opportunities to practise their ability to talk about science. Less access to general classroom interaction may also affect girls' attitudes to science in a negative way which could ultimately hamper the recruitment of girls to higher scientific studies.

Young Children and E-Reading: Research to Date and Questions for the Future

ERIC Educational Resources Information Center

Miller, Elizabeth B.; Warschauer, Mark

2014-01-01

The practice of reading is rapidly moving from print to screen. Young children are not immune from this trend; indeed, many children's principal literacy experiences occur using iPads and other handheld digital devices. This transition raises important questions about how the emergence and development of literacy might change in these new…

Backward Dependencies and in-Situ wh-Questions as Test Cases on How to Approach Experimental Linguistics Research That Pursues Theoretical Linguistics Questions

PubMed Central

Pablos, Leticia; Doetjes, Jenny; Cheng, Lisa L.-S.

2018-01-01

The empirical study of language is a young field in contemporary linguistics. This being the case, and following a natural development process, the field is currently at a stage where different research methods and experimental approaches are being put into question in terms of their validity. Without pretending to provide an answer with respect to the best way to conduct linguistics related experimental research, in this article we aim at examining the process that researchers follow in the design and implementation of experimental linguistics research with a goal to validate specific theoretical linguistic analyses. First, we discuss the general challenges that experimental work faces in finding a compromise between addressing theoretically relevant questions and being able to implement these questions in a specific controlled experimental paradigm. We discuss the Granularity Mismatch Problem (Poeppel and Embick, 2005) which addresses the challenges that research that is trying to bridge the representations and computations of language and their psycholinguistic/neurolinguistic evidence faces, and the basic assumptions that interdisciplinary research needs to consider due to the different conceptual granularity of the objects under study. To illustrate the practical implications of the points addressed, we compare two approaches to perform linguistic experimental research by reviewing a number of our own studies strongly grounded on theoretically informed questions. First, we show how linguistic phenomena similar at a conceptual level can be tested within the same language using measurement of event-related potentials (ERP) by discussing results from two ERP experiments on the processing of long-distance backward dependencies that involve coreference and negative polarity items respectively in Dutch. Second, we examine how the same linguistic phenomenon can be tested in different languages using reading time measures by discussing the outcome of four self

Backward Dependencies and in-Situ wh-Questions as Test Cases on How to Approach Experimental Linguistics Research That Pursues Theoretical Linguistics Questions.

PubMed

Pablos, Leticia; Doetjes, Jenny; Cheng, Lisa L-S

2017-01-01

The empirical study of language is a young field in contemporary linguistics. This being the case, and following a natural development process, the field is currently at a stage where different research methods and experimental approaches are being put into question in terms of their validity. Without pretending to provide an answer with respect to the best way to conduct linguistics related experimental research, in this article we aim at examining the process that researchers follow in the design and implementation of experimental linguistics research with a goal to validate specific theoretical linguistic analyses. First, we discuss the general challenges that experimental work faces in finding a compromise between addressing theoretically relevant questions and being able to implement these questions in a specific controlled experimental paradigm. We discuss the Granularity Mismatch Problem (Poeppel and Embick, 2005) which addresses the challenges that research that is trying to bridge the representations and computations of language and their psycholinguistic/neurolinguistic evidence faces, and the basic assumptions that interdisciplinary research needs to consider due to the different conceptual granularity of the objects under study. To illustrate the practical implications of the points addressed, we compare two approaches to perform linguistic experimental research by reviewing a number of our own studies strongly grounded on theoretically informed questions. First, we show how linguistic phenomena similar at a conceptual level can be tested within the same language using measurement of event-related potentials (ERP) by discussing results from two ERP experiments on the processing of long-distance backward dependencies that involve coreference and negative polarity items respectively in Dutch. Second, we examine how the same linguistic phenomenon can be tested in different languages using reading time measures by discussing the outcome of four self

Human Correlates of Provocative Questions in Pancreatic Pathology

PubMed Central

McDonald, Oliver G.; Maitra, Anirban; Hruban, Ralph H.

2012-01-01

Studies of cell lines and of animal models of pancreatic cancer have raised a number of provocative questions about the nature and origins of human pancreatic cancer and have provided several leads into exciting new approaches for the treatment of this deadly cancer. In addition, clinicians with little or no contact with human pathology have challenged the way that pancreatic pathology is practiced, suggesting that “genetic signals” may be more accurate than today’s multi-modal approach to diagnoses. In this review we consider eight provocative issues in pancreas pathology, with an emphasis on “the evidence derived from man.” PMID:23060061

Questioning and reading goals: information-seeking questions asked on scientific texts read under different task conditions.

PubMed

Ishiwa, Koto; Sanjosé, Vicente; Otero, José

2013-09-01

A number of studies report that few questions are asked in classrooms and that many of them are shallow questions. This study investigates the way in which reading goals determine questioning on scientific texts. Reading goals were manipulated through two different tasks: reading for understanding versus reading to solve a problem. A total of 183 university students. In the first and third questioning experiments, the participants read two short texts. Students in one condition were instructed to understand the texts, whereas in the alternative condition they had to read texts to solve a problem. Students were instructed to write down any questions they might have about the texts. The questions were categorized according to the type of underlying obstacle: associative, explanatory, or predictive. The second experiment used a think-aloud methodology to identify the mental representations generated by the students. The two questioning experiments show that the questions asked depend on the reading goals. Significantly more explanation questions were asked in the understanding condition than in the problem-solving condition. Also, the two conditions were found to have a different influence on the generation of association and explanation questions. Very few prediction questions were asked in either condition. The think-aloud experiment revealed that the mental representations attempted by readers under the two conditions were indeed different. In conclusion, the experiments showed that, given a certain textual input, readers' questions depend on the reading goals associated with tasks. © 2012 The British Psychological Society.

Semantic annotation of consumer health questions.

PubMed

Kilicoglu, Halil; Ben Abacha, Asma; Mrabet, Yassine; Shooshan, Sonya E; Rodriguez, Laritza; Masterton, Kate; Demner-Fushman, Dina

2018-02-06

Consumers increasingly use online resources for their health information needs. While current search engines can address these needs to some extent, they generally do not take into account that most health information needs are complex and can only fully be expressed in natural language. Consumer health question answering (QA) systems aim to fill this gap. A major challenge in developing consumer health QA systems is extracting relevant semantic content from the natural language questions (question understanding). To develop effective question understanding tools, question corpora semantically annotated for relevant question elements are needed. In this paper, we present a two-part consumer health question corpus annotated with several semantic categories: named entities, question triggers/types, question frames, and question topic. The first part (CHQA-email) consists of relatively long email requests received by the U.S. National Library of Medicine (NLM) customer service, while the second part (CHQA-web) consists of shorter questions posed to MedlinePlus search engine as queries. Each question has been annotated by two annotators. The annotation methodology is largely the same between the two parts of the corpus; however, we also explain and justify the differences between them. Additionally, we provide information about corpus characteristics, inter-annotator agreement, and our attempts to measure annotation confidence in the absence of adjudication of annotations. The resulting corpus consists of 2614 questions (CHQA-email: 1740, CHQA-web: 874). Problems are the most frequent named entities, while treatment and general information questions are the most common question types. Inter-annotator agreement was generally modest: question types and topics yielded highest agreement, while the agreement for more complex frame annotations was lower. Agreement in CHQA-web was consistently higher than that in CHQA-email. Pairwise inter-annotator agreement proved most

Validation of good agricultural practices (GAP) on Minnesota vegetable farms.

PubMed

Hamilton, Karin E; Umber, Jamie; Hultberg, Annalisa; Tong, Cindy; Schermann, Michele; Diez-Gonzalez, Francisco; Bender, Jeff B

2015-02-01

The United States Food and Drug Administration and the Department of Agriculture jointly published the "Guide to Minimize Microbial Food Safety Hazards for Fresh Fruits and Vegetables," which is used as a basis for Good Agricultural Practices (GAP) audits. To understand barriers to incorporation of GAP by Minnesota vegetable farmers, a mail survey completed in 2008 was validated with visits to a subset of the farms. This was done to determine the extent to which actual practices matched perceived practices. Two hundred forty-six producers completed the mail survey, and 27 participated in the on-farm survey. Over 75% of the on-farm survey respondents produced vegetables on 10 acres or less and had 10 or fewer employees. Of 14 questions, excellent agreement between on-farm interviews and mail survey responses was observed on two questions, four questions had poor or slight agreement, and eight questions had no agreement. Ninety-two percent of respondents by mail said "they took measures to keep animals and pests out of packing and storage buildings." However, with the on-site visit only 45% met this requirement. Similarly, 81% of respondents by mail said "measures were taken to reduce the risk of wild and/or domestic animals entering into fruit and vegetable growing areas." With direct observation, 70% of farms actually had taken measures to keep animals out of the growing areas. Additional, on-farm assessments were done regarding employee hygiene, training, presence of animals, water sources, and composting practices. This validation study demonstrated the challenge of creating nonleading and concise questions that are not open to broad interpretation from the respondents. If mail surveys are used to assess GAP, they should include open-ended questions and ranking systems to better assess farm practices. To provide the most accurate survey data for educational purposes or GAP audits, on-farm visits are recommended.

Pesticide Labeling Questions & Answers

EPA Pesticide Factsheets

Pesticide manufacturers, applicators, state regulatory agencies, and other stakeholders raise questions or issues about pesticide labels. The questions on this page are those that apply to multiple products or address inconsistencies among product labels.

Teachers' Practices of Inquiry When Teaching Investigations: A Case Study

ERIC Educational Resources Information Center

Dudu, Washington T.; Vhurumuku, Elaosi

2012-01-01

Teacher practices are essential for supporting learners in scientific inquiry practices of framing research questions, designing and conducting investigations, collecting data, and drawing conclusions. This study examines instructional practices of two Grade 11 Physical Science teachers engaged in teaching practical investigations. Data were…

Evidence, Engagement, and Technology: Themes of and the State of Primary Care Practice-based Network Research.

PubMed

Nease, Donald E

2016-01-01

Practice-based research supported by practice-based research network (PBRN) infrastructure has historically provided an important method for challenging guidelines and evidence arising from secondary and tertiary care settings. This sample of current practice-based research in this issue of the JABFM provides an opportunity to ask whether practice-based research continues to address questions relevant to primary care practices and clinicians and whether a PBRN infrastructure is instrumental to maintaining the relevance and feasibility of practice-based research. Based on this issue's articles, the current state of practice-based research seems to be good, at face value addressing relevant issues for primary care practices. Less clear is the degree to which PBRN infrastructures and relationships informed the questions asked and facilitated the implementation of the studies presented. Practice-based research-related articles that routinely report about how study questions arose-from practices and their clinicians, staff and communities, or elsewhere-could help directly answer questions of relevance. In addition, reporting how practices are recruited to practice-based research studies could inform the degree to which ongoing relationships central to PBRNs facilitate the recruitment and conduct of practice-based research. © Copyright 2016 by the American Board of Family Medicine.

Using medico-legal data to investigate fatal older road user crash circumstances and risk factors.

PubMed

Koppel, Sjaan; Bugeja, Lyndal; Smith, Daisy; Lamb, Ashne; Dwyer, Jeremy; Fitzharris, Michael; Newstead, Stuart; D'Elia, Angelo; Charlton, Judith

2018-02-17

This study used medico-legal data to investigate fatal older road user (ORU, aged 65 years and older) crash circumstances and risk factors relating to 4 key components of the Safe System approach (e.g., roads and roadsides, vehicles, road users, and speeds) to identify areas of priority for targeted prevention activity. The Coroners' Court of Victoria's (CCOV) Surveillance Database was searched to identify and describe the frequency and rate per 100,000 population of fatal ORU crashes in the Australian state of Victoria for 2013-2014. Information relating to the deceased ORU, crash characteristics and circumstances, and risk factors was extracted and analyzed. One hundred and thirty-eight unintentional fatal ORU crashes were identified in the CCOV Surveillance Database. Of these fatal ORU crashes, most involved older drivers (44%), followed by older pedestrians (32%), older passengers (17%), older pedal cyclists (4%), older motorcyclists (1%), and older mobility scooter users (1%). The average annual rate of fatal ORU crashes per 100,000 population was 8.1 (95% confidence interval [CI], 6.0-10.2). In terms of the crash characteristics and circumstances, most fatal ORU crashes involved a counterpart (98%), of which the majority were passenger cars (50%) or fixed/stationary objects (25%), including trees (46%) or embankments (23%). In addition, most fatal ORU crashes occurred close to home (73%), on-road (87%), on roads that were paved (94%), on roads with light traffic volume (37%), and during low-risk conditions: between 12 p.m. and 6 p.m. (44%), on weekdays (80%), during daylight (75%), and under dry/clear conditions (81%). Road user (RU) error was identified by the police and/or the coroner for the majority of fatal crashes (55%), with a significant proportion of deceased ORUs deemed to have failed to yield (54%) or misjudged (41%). RU error was the most significant factor identified in fatal ORU crashes, which suggests that there is a limited capacity of the

Undergraduate teaching of forensic medicine in Saudi Arabia.

PubMed

Madadin, Mohammed; Al-Saif, Dalia M; Khamis, Amar Hassan; Taha, Attia Z; Kharoshah, Magdy A; Alsayyah, Ahmed; Alfehaid, Suha; Yaghmour, Khalid; Hakami, Ahmad Yahia; Bamousa, Manal S; Menezes, Ritesh G; Almadani, Osama M

2016-07-01

Medico-legal tasks are not exclusive to forensic medical experts -any physician may face medico-legal issues in his career. Hence, the practice of medicine requires education in legal issues. In Saudi Arabia, there are 30 universities with medical colleges, but we do not know how they teach undergraduate forensic medicine and medico-legal issues. The aim of this study was to discover undergraduate training courses in forensic medicine in Saudi universities. We conducted a cross-sectional study involving all colleges of medicine in Saudi Arabia. A structured, self-administered questionnaire containing 13 items relating to the undergraduate forensic medicine course was distributed. Out of a total of 30 universities, 27 universities responded. Of these 27 universities, 16 (59.26%) teach forensic medicine to undergraduate medical students, and 11 (40.74%) do not teach forensic medicine in their undergraduate curriculum. Of the 27 universities that responded, none has a department of forensic medicine. Eleven universities that do not teach forensic medicine have no forensic medicine unit/division or faculty at all. Forensic medicine belongs to the pathology department in 11 universities, while it belongs to different departments in five universities. There is variation in teaching methods, years where the course is taught and length of the course. Practical and morgue visits take place in 7/16 (43.8%) universities, while 9/16 (56.3%) universities only teach the theoretical aspects of forensic medicine. All 16 universities teach forensic medicine only to medical students and do not teach it to students in other colleges such as dentistry and nursing. © The Author(s) 2016.

Appraisal by Year Six French medical students of the teaching of forensic medicine and health law.

PubMed

Franchitto, Nicolas; Rougé, Daniel

2010-10-01

Legal medicine is a cross-sectional specialty in which medico-legal situations very frequently combine with routine medical practice. A total of 132 students in the last year of the second cycle of medical studies (Year 6) replied anonymously and voluntarily to a questionnaire corresponding to the topics in the curriculum for the national ranking examination: law relating to death and the dying, examination of assault victims, medical malpractice liability rules, writing death certificates, respect of medical confidentiality and the principles of medical deontology. The most frequently cited activities of the forensic physician were autopsy (87.9%), writing certificates (75.8%) and consultations with victims of violence (60.6%). Students did not often come into contact with a medico-legal situation during Years 2-6 of medical studies. Assiduity in attending lectures was low. Students preferred the standard textbooks available in specialized bookshops. They were severe in their appraisal of their own competence at the end of the second cycle, and did not feel ready to examine a corpse (95.5%) or to examine victims of assault (92.4%). Knowledge of the law and of the risks of medical practice was felt to be inadequate by 60.5% of students, and of the writing of a medical certificate by 56.8%. Training medical students in this field is a major challenge in view of the limited number of teaching hours and the need to acquire increasingly specialized knowledge. Complementary initiatives appear to be necessary, such as partnership with other clinical specialties which are frequently confronted with medico-legal situations.

How Do SPJC Administrative and Support Systems and Procedures Need To Change in Order To Overcome Organizational Obstacles to E-Learning Access? Project Eagle Evaluation Question #2. Benchmarking St. Petersburg Junior College: A Report to Leadership.

ERIC Educational Resources Information Center

Burkhart, Joyce

St. Petersburg Junior College (SPJC), Florida, identified critical issues in e-learning practices and posed six questions in order to formulate an evaluation process. SPJC considered one question per quarter for 18 months. The questions were reviewed using the following steps: (1) examine best e-learning practices related to that question, using…

The 150 most important questions in cancer research and clinical oncology series: questions 50-56.

PubMed

2017-08-29

Since the beginning of 2017, Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology, which sparkle diverse thoughts, interesting communications, and potential collaborations among researchers all over the world. In this article, seven more questions are presented as followed. Question 50. When tumor cells spread from primary site to distant sites, are they required to be "trained" or "armed" in the bone marrow niche prior to colonizing soft tissues? Question 51. Are there tipping points during cancer progression which can be identified for manipulation? Question 52. Can we replace molecular biomarkers by network biomarkers? Question 53. Are conventional inhibitors of key cellular processes such as cell proliferation and differentiation more effective than targeted chemotherapeutics that antagonize the downstream cell signaling network via cell-surface receptors such as epidermal growth factor receptor (EGFR), vascular endothelial growth factor receptor (VEGFR) and c-Met, or intracellular receptors such as androgen receptor (AR) and estrogen receptor (ER), by drugs like erlotinib, sunitinib and cabozantinib, or enzalutamide and tomoxifen? Question 54. How can we robustly identify the candidate causal event of somatic genome alteration (SGA) by using computational approach? Question 55. How can we systematically reveal the immune evasion mechanism exploited by each tumor and utilize such information to guide targeted therapy to restore immune sensitivity? Question 56. Can the nasopharyngeal carcinoma (NPC) patients with sarcomatoid carcinoma (SC) subtype benefit from more specific targeted therapy?

Retrieval practice with short-answer, multiple-choice, and hybrid tests.

PubMed

Smith, Megan A; Karpicke, Jeffrey D

2014-01-01

Retrieval practice improves meaningful learning, and the most frequent way of implementing retrieval practice in classrooms is to have students answer questions. In four experiments (N=372) we investigated the effects of different question formats on learning. Students read educational texts and practised retrieval by answering short-answer, multiple-choice, or hybrid questions. In hybrid conditions students first attempted to recall answers in short-answer format, then identified answers in multiple-choice format. We measured learning 1 week later using a final assessment with two types of questions: those that could be answered by recalling information verbatim from the texts and those that required inferences. Practising retrieval in all format conditions enhanced retention, relative to a study-only control condition, on both verbatim and inference questions. However, there were little or no advantages of answering short-answer or hybrid format questions over multiple-choice questions in three experiments. In Experiment 4, when retrieval success was improved under initial short-answer conditions, there was an advantage of answering short-answer or hybrid questions over multiple-choice questions. The results challenge the simple conclusion that short-answer questions always produce the best learning, due to increased retrieval effort or difficulty, and demonstrate the importance of retrieval success for retrieval-based learning activities.

Effective Practice in Inclusive and Special Needs Education

ERIC Educational Resources Information Center

Buli-Holmberg, Jorun; Jeyaprathaban, Sujathamalini

2016-01-01

The present study attempts to evaluate the effective teaching practice for children with special learning needs. The research question framed in the present study for investigation is which practice will be effective in different inclusive classroom settings and what are the factors that contribute for effective practices? Qualitative research was…

Sociomaterial Texts, Spaces and Devices: Questioning "Digital Dualism" in Library and Study Practices

ERIC Educational Resources Information Center

Gourlay, Lesley; Lanclos, Donna M.; Oliver, Martin

2015-01-01

Work on students' study practices posits the digital and material as separate domains, with the "digital" assumed to be disembodied, decontextualised and free-floating, and spaces in the material campus positioned as prototypically "traditional" and analogue. Libraries in particular are often characterised as symbolic of…

Validity and Reliability of Scores Obtained on Multiple-Choice Questions: Why Functioning Distractors Matter

ERIC Educational Resources Information Center

Ali, Syed Haris; Carr, Patrick A.; Ruit, Kenneth G.

2016-01-01

Plausible distractors are important for accurate measurement of knowledge via multiple-choice questions (MCQs). This study demonstrates the impact of higher distractor functioning on validity and reliability of scores obtained on MCQs. Freeresponse (FR) and MCQ versions of a neurohistology practice exam were given to four cohorts of Year 1 medical…

Comparison of injuries due to lethal weapons during and after civil strife in Sri Lanka: A medico-legal study.

PubMed

Vidanapathirana, Muditha; Ruwanpura, Rohan P; Amararatne, Sriyantha Rrg; Ratnaweera, Ajith Rhi

2016-01-01

"Injuries due to lethal weapons" has emerged as a subject of public discussion in Sri Lanka. This study was conducted to describe the nature and characteristics of injuries due to lethal weapons during civil strife and to compare those with injuries after civil strife. A cross-sectional study was conducted on patients reported with injuries caused by lethal weapons from 2004 to 2014. Periods before and after May 19, 2009 were considered as during and after civil strife periods, respectively. A total of 21,210 medico-legal examination forms were studied. There were 358 (1.7%) injuries caused by lethal weapons. Of them, 41% (n = 148) were during and 59% (n = 210) were after the civil strife. During civil strife, 63% occurred during daytime (P < 0.05). Types of lethal weapons that caused injuries were sharp weapons (n = 282), explosives (n = 49), and firearms (n = 27). Of them, 32% of during and 01% of after civil strife were explosive injuries (P < 0.01). Regarding severity, 73% of during and 57% of after civil strife injuries were severe (P < 0.05). During civil strife, 34% injuries were in lower limbs (P < 0.01) and after civil strife, 37% were in upper limbs (P < 0.05). The presence of many similarities indicated that both groups learnt their basis in a society that breeds violence. During civil strife, more injuries occurred during daytime, to lower limbs by explosive weapons and after the civil strife during nighttime, to upper limbs by nonexplosive weapons. Nonexplosive lethal weapon use after civil strife needs further investigation to develop evidence-based interventions.

Comparison of injuries due to lethal weapons during and after civil strife in Sri Lanka: A medico-legal study

PubMed Central

Vidanapathirana, Muditha; Ruwanpura, Rohan P; Amararatne, Sriyantha RRG; Ratnaweera, Ajith RHI

2016-01-01

Background and Aims: “Injuries due to lethal weapons” has emerged as a subject of public discussion in Sri Lanka. This study was conducted to describe the nature and characteristics of injuries due to lethal weapons during civil strife and to compare those with injuries after civil strife. Methods: A cross-sectional study was conducted on patients reported with injuries caused by lethal weapons from 2004 to 2014. Periods before and after May 19, 2009 were considered as during and after civil strife periods, respectively. A total of 21,210 medico-legal examination forms were studied. Results: There were 358 (1.7%) injuries caused by lethal weapons. Of them, 41% (n = 148) were during and 59% (n = 210) were after the civil strife. During civil strife, 63% occurred during daytime (P < 0.05). Types of lethal weapons that caused injuries were sharp weapons (n = 282), explosives (n = 49), and firearms (n = 27). Of them, 32% of during and 01% of after civil strife were explosive injuries (P < 0.01). Regarding severity, 73% of during and 57% of after civil strife injuries were severe (P < 0.05). During civil strife, 34% injuries were in lower limbs (P < 0.01) and after civil strife, 37% were in upper limbs (P < 0.05). Conclusions: The presence of many similarities indicated that both groups learnt their basis in a society that breeds violence. During civil strife, more injuries occurred during daytime, to lower limbs by explosive weapons and after the civil strife during nighttime, to upper limbs by nonexplosive weapons. Nonexplosive lethal weapon use after civil strife needs further investigation to develop evidence-based interventions. PMID:27127743

Ethical checklist for dental practice.

PubMed

Rinchuse, D J; Rinchuse, D J; Deluzio, C

1995-01-01

A checklist for verification of unethical business practices, originally formulated by Drs. Blanchard and Peale, is adapted to dental practice. A scenario is used as a model to demonstrate the applicability of this instrument to dental practice. The instrument asks three questions in regards to an ethical dilemma: 1) Is it legal? 2) Is it fair? 3) How does it make you feel? The paper concludes the giving of gifts to general dentists by dental specialists for the referral of patients is unethical.

The wicked question answered: positive deviance delivers patient-centered care.

PubMed

Gary, Jodie C

2014-01-01

How nurses respond when faced with the dilemma of providing patient-centered care in the absence of patient-centered practice guidelines remains relatively unreported. Standards may not be available to guide nurses or may not be realistic for implementation at the point of care. Nurses may be forced to react creatively to meet the needs of their patients. The purpose was to understand nursing care when standard practice guidelines did not meet patient-specific care needs and to develop various viewpoints related to the use of positive deviance in providing patient-centered care. Complexity theory and the framework of a wicked question were used to guide a 3-round online national Delphi study from November 2011 to February 2012. The panel was accessed through the American Association of Critical Care Nurses to expose the care provided when standard practice guidelines were lacking. Findings support the presence of positive deviance and expose care provided by nurses when standard practice guidelines lacked the ability to provide patient-centered care. Dominant themes of positive deviance are recommended as priorities for future research. Better guidelines are needed that work for nurses, instead of against them, that would not force a nurse into actions that are not patient centered. Guidelines should guide practice and assist in allowing nurses to provide care that is centered on the best needs of the patient in the specific care situation.

Balancing Certainty and Uncertainty in Clinical Practice

ERIC Educational Resources Information Center

Kamhi, Alan G.

2011-01-01

Purpose: In this article, I question how practitioners can balance the certainty and confidence that they can help their patients with the uncertainty that makes them continually question their beliefs and assumptions. Method: I compare the mechanisms of science and models of clinical practice that may help practitioners achieve the right balance…

Measuring Victimization inside Prisons: Questioning the Questions

ERIC Educational Resources Information Center

Wolff, Nancy; Shi, Jing; Bachman, Ronet

2008-01-01

Violence and victimization inside the prison setting are accepted as facts, although the facts about their prevalence remain uncertain. Variation in the methods used to estimate rates of sexual and physical victimization contribute to the wide range in estimates appearing in the prison literature. This article focuses on the questions used in the…

The Priority of the Question: Focus Questions for Sustained Reasoning in Science

ERIC Educational Resources Information Center

Lustick, David

2010-01-01

Science education standards place a high priority on promoting the skills and dispositions associated with inquiry at all levels of learning. Yet, the questions teachers employ to foster sustained reasoning are most likely borrowed from a textbook, lab manual, or worksheet. Such generic questions generated for a mass audience, lack authenticity…

How do primary care physicians seek answers to clinical questions? A literature review.

PubMed

Coumou, Herma C H; Meijman, Frans J

2006-01-01

The authors investigated the extent to which changes occurred between 1992 and 2005 in the ways that primary care physicians seek answers to clinical problems. What search strategies are used? How much time is spent on them? How do primary care physicians evaluate various search activities and information sources? Can a clinical librarian be useful to a primary care physician? Twenty-one original research papers and three literature reviews were examined. No systematic reviews were identified. Primary care physicians seek answers to only a limited number of questions about which they first consult colleagues and paper sources. This practice has basically not changed over the years despite the enormous increase in and better accessibility to electronic information sources. One of the major obstacles is the time it takes to search for information. Other difficulties primary care physicians experience are related to formulating an appropriate search question, finding an optimal search strategy, and interpreting the evidence found. Some studies have been done on the supporting role of a clinical librarian in general practice. However, the effects on professional behavior of the primary care physician and on patient outcome have not been studied. A small group of primary care physicians prefer this support to developing their own search skills. Primary care physicians have several options for finding quick answers: building a question-and-answer database, consulting filtered information sources, or using an intermediary such as a clinical librarian.

How do primary care physicians seek answers to clinical questions? A literature review

PubMed Central

Coumou, Herma C. H.; Meijman, Frans J.

2006-01-01

Objectives: The authors investigated the extent to which changes occurred between 1992 and 2005 in the ways that primary care physicians seek answers to clinical problems. What search strategies are used? How much time is spent on them? How do primary care physicians evaluate various search activities and information sources? Can a clinical librarian be useful to a primary care physician? Methods: Twenty-one original research papers and three literature reviews were examined. No systematic reviews were identified. Results: Primary care physicians seek answers to only a limited number of questions about which they first consult colleagues and paper sources. This practice has basically not changed over the years despite the enormous increase in and better accessibility to electronic information sources. One of the major obstacles is the time it takes to search for information. Other difficulties primary care physicians experience are related to formulating an appropriate search question, finding an optimal search strategy, and interpreting the evidence found. Some studies have been done on the supporting role of a clinical librarian in general practice. However, the effects on professional behavior of the primary care physician and on patient outcome have not been studied. A small group of primary care physicians prefer this support to developing their own search skills. Discussion: Primary care physicians have several options for finding quick answers: building a question-and-answer database, consulting filtered information sources, or using an intermediary such as a clinical librarian. PMID:16404470

Pacific Northwest residential energy survey. Volume 3. Question-by-question results

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1980-07-01

Tabulations are presented of responses to approximately 105 questions. Results are tabulated by 9 geographic regions: the four states of Idaho, Montana, Oregon, and Washington; four climate zones in the region; and a weighted Pacific Northwest total. A description of the tabulated data is given in the Introduction. Tabulated data deal with questions on dwelling characteristics; heating and air-conditioning systems; water heating; appliances; demographic and swelling characteristics; and insulation.

Management of hyperthyroidism due to Graves' disease: frequently asked questions and answers (if any).

PubMed

Bartalena, L; Chiovato, L; Vitti, P

2016-10-01

Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Although progress has been made in our understanding of the pathogenesis of the disease, no treatment targeting pathogenic mechanisms of the disease is presently available. Therapies for Graves' hyperthyroidism are largely imperfect because they are bound to either a high rate of relapsing hyperthyroidism (antithyroid drugs) or lifelong hypothyroidism (radioiodine treatment or thyroidectomy). Aim of the present article is to offer a practical guidance to the reader by providing evidence-based answers to frequently asked questions in clinical practice.

Frequent Questions on Recycling

EPA Pesticide Factsheets

This is a list of frequent questions on recycling, broken down into five categories. These are answers to common questions that EPA has received from press and web inquiries. This list is located on the Reduce, Reuse, Recycle website.

Evaluating Digital Health Interventions: Key Questions and Approaches.

PubMed

Murray, Elizabeth; Hekler, Eric B; Andersson, Gerhard; Collins, Linda M; Doherty, Aiden; Hollis, Chris; Rivera, Daniel E; West, Robert; Wyatt, Jeremy C

2016-11-01

Digital health interventions have enormous potential as scalable tools to improve health and healthcare delivery by improving effectiveness, efficiency, accessibility, safety, and personalization. Achieving these improvements requires a cumulative knowledge base to inform development and deployment of digital health interventions. However, evaluations of digital health interventions present special challenges. This paper aims to examine these challenges and outline an evaluation strategy in terms of the research questions needed to appraise such interventions. As they are at the intersection of biomedical, behavioral, computing, and engineering research, methods drawn from all of these disciplines are required. Relevant research questions include defining the problem and the likely benefit of the digital health intervention, which in turn requires establishing the likely reach and uptake of the intervention, the causal model describing how the intervention will achieve its intended benefit, key components, and how they interact with one another, and estimating overall benefit in terms of effectiveness, cost effectiveness, and harms. Although RCTs are important for evaluation of effectiveness and cost effectiveness, they are best undertaken only when: (1) the intervention and its delivery package are stable; (2) these can be implemented with high fidelity; and (3) there is a reasonable likelihood that the overall benefits will be clinically meaningful (improved outcomes or equivalent outcomes at lower cost). Broadening the portfolio of research questions and evaluation methods will help with developing the necessary knowledge base to inform decisions on policy, practice, and research. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.