Ethical issues in the export, storage and reuse of human biological samples in biomedical research: perspectives of key stakeholders in Ghana and Kenya.

PubMed

Tindana, Paulina; Molyneux, Catherine S; Bull, Susan; Parker, Michael

2014-10-18

For many decades, access to human biological samples, such as cells, tissues, organs, blood, and sub-cellular materials such as DNA, for use in biomedical research, has been central in understanding the nature and transmission of diseases across the globe. However, the limitations of current ethical and regulatory frameworks in sub-Saharan Africa to govern the collection, export, storage and reuse of these samples have resulted in inconsistencies in practice and a number of ethical concerns for sample donors, researchers and research ethics committees. This paper examines stakeholders' perspectives of and responses to the ethical issues arising from these research practices. We employed a qualitative strategy of inquiry for this research including in-depth interviews and focus group discussions with key research stakeholders in Kenya (Nairobi and Kilifi), and Ghana (Accra and Navrongo). The stakeholders interviewed emphasised the compelling scientific importance of sample export, storage and reuse, and acknowledged the existence of some structures governing these research practices, but they also highlighted the pressing need for a number of practical ethical concerns to be addressed in order to ensure high standards of practice and to maintain public confidence in international research collaborations. These concerns relate to obtaining culturally appropriate consent for sample export and reuse, understanding cultural sensitivities around the use of blood samples, facilitating a degree of local control of samples and sustainable scientific capacity building. Drawing on these findings and existing literature, we argue that the ethical issues arising in practice need to be understood in the context of the interactions between host research institutions and local communities and between collaborating institutions. We propose a set of 'key points-to-consider' for research institutions, ethics committees and funding agencies to address these issues.

Workplace violence and psychiatric practice.

PubMed

Beck, J C; Schouten, R

2000-01-01

The authors provide an overview of what is known about workplace violence and discuss how to deal with issues of workplace violence that arise in clinical practice. They review myths and facts about workplace violence, including research on prevention. Legal issues relating to the psychiatrist as employer and the Americans with Disability Act are presented. General principles of violence assessment are reviewed and the authors then discuss the psychiatrist as consultant to the workplace and as clinician treating a victim or perpetrator of workplace violence. Three cases illustrate the general principles provided.

Proceedings of the seventh Northern region paediatric colloquium.

PubMed

Barkla, Xanthe; Kaplan, Carole

2014-01-01

Ethical and legal dilemmas frequently arise in paediatric practice. Given the nature of the speciality, these issues are relevant to both the medical and legal professions. To this end, senior figures from the medical and legal professions in the Northern region have met on a regular basis in order to discuss anonymised case material. We report on the proceedings of the seventh such meeting. Six cases are described and key points arising from the subsequent discussion are presented.

Communities of Practice and On-Line Support for Dissemination and Implementation of Innovation.

ERIC Educational Resources Information Center

Stuckey, Bronwyn; Buehring, Anna; Fraser, Sally

New tools, whether developed organizationally, commercially, or within a domain may represent innovation in the workplace and can be part of larger scale reform and change. The focus of this research is on exploring the roster of issues arising as the theory of communities of practice is applied to specific cases of online professional development…

Understanding and Validity in Qualitative Research.

ERIC Educational Resources Information Center

Maxwell, Joseph A.

1992-01-01

Details the philosophical and practical dimensions of five types of validity used in qualitative research: descriptive, interpretive, theoretical, generalizable, and evaluative, with corresponding issues of understanding. Presents this typology as a checklist of the kinds of threats to validity that may arise. (SK)

Laboratory Evaluation of Energy Recovery Ventilators

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

Kosar, D.

Over the years, building scientists have characterized the relationship between building airtightness, exhaust-only appliances airflows, and building depressurization. Now, as the use of deep retrofit measures and new construction practices is growing to realize lower infiltration levels in increasingly tighter envelopes, performance issues can arise with the operation of exhaust-only appliances in a depressurized home. As the depressurization levels climb in tighter homes, many of these exhaust-only appliances see their rated airflows reduced and other related performance issues arise as a result. If sufficiently depressurized, atmospherically vented combustion appliances that may be present in the home can backdraft as well.more » Furthermore, when exhaust-only appliances operate and the tight home becomes depressurized, water vapor intrusion from outdoors can raise additional issues of mold in the building envelope in more humid climates.« less

How Are Schools in England Addressing the Needs of Mathematically Gifted Children in Primary Classrooms? A Review of Practice

ERIC Educational Resources Information Center

Dimitriadis, Christos

2012-01-01

There is a paucity of research investigating aspects of provision for gifted children within primary schools, particularly in mathematics. This study aimed to address this topic by illuminating issues arising from classroom practice and the experience of both teachers and children. Based on in-depth case studies in four primary schools in which…

Theory and practice in interprofessional ethics: a framework for understanding ethical issues in health care teams.

PubMed

Clark, Phillip G; Cott, Cheryl; Drinka, Theresa J K

2007-12-01

Interprofessional teamwork is an essential and expanding form of health care practice. While moral issues arising in teamwork relative to the patient have been explored, the analysis of ethical issues regarding the function of the team itself is limited. This paper develops a conceptual framework for organizing and analyzing the different types of ethical issues in interprofessional teamwork. This framework is a matrix that maps the elements of principles, structures, and processes against individual, team, and organizational levels. A case study is presented that illustrates different dimensions of these topics, based on the application of this framework. Finally, a set of conclusions and recommendations is presented to summarize the integration of theory and practice in interprofessional ethics, including: (i) importance of a framework, (ii) interprofessional ethics discourse, and (iii) interprofessional ethics as an emerging field. The goal of this paper is to begin a dialogue and discussion on the ethical issues confronting interprofessional teams and to lay the foundation for an expanding discourse on interprofessional ethics.

"Journal of Space Economics - theoretical and practical considerations"

NASA Astrophysics Data System (ADS)

Beldavs, VZ; Sommers, J.

2017-09-01

This paper will address theoretical and practical considerations for the emerging field of space economics and propose an editorial policy for a journal of space economics to provide a forum for the discussion of space economics issues. It is anticipated that initially the Journal of Space Economics will operate from two different nodes one offering a European perspective (University of Latvia) and the other a U.S. perspective (University of Wisconsin at Milwaukee). The first edition of the Journal of Space Economics will focus on issues likely to arise during the course of the International Lunar Decade 2020-2030.

Approaching the "smart growth" issue : a look at best practices used by transportation planning organizations.

DOT National Transportation Integrated Search

2000-01-01

A fundamental public policy decision implicitly addressed by agencies responsible for urban transportation planning is the right of the individual versus the goal of the community. This question arises in considering the role that state and local off...

Balancing dual roles in end-of-life research.

PubMed

Martin, Wanda; Grey, Meredith; Webber, Terry; Robinson, Linnea; Hartt, Nancy; Cairns, Moira; Stajduhar, Kelli

2007-01-01

Ethical and practical issues are sure to arise from the majority of research studies done with palliative populations. Whether it is feeling opportunistic, being emotionally available, or struggling with witnessing a gap in service and needs of the participants receiving care, nurses involved in research find a way to balance both roles to meet the needs of the participants as well as the study (McIlfatrick, Sullivan, & McKenna, 2006). This paper highlights some of the practical and ethical issues that arise when frontline nurses also take on the role of research assistant for studies with palliative populations. Specifically, the authors highlight their personal experiences based on their research assistant work on a study examining family caregiver coping in end-of-life cancer care. The authors discuss the "balancing act" of taking on these dual roles and offer recommendations on how to be with and approach people when doing research at the end of life using a framework based on Swanson's Theory of Caring (1991).

Ethical issues faced by field primatologists: asking the relevant questions.

PubMed

Fedigan, Linda Marie

2010-09-01

Field primatologists face unusual ethical issues. We study animals rather than people and receive research approval from animal care rather than ethics committees. However, animal care evaluation forms are developed from concerns about laboratory animal research and are based on the "Three R's" for humane treatment of captive experimental subjects (replacement, reduction and refinement), which are only debatably relevant to field research. Scientists who study wild, free-ranging primates in host countries experience many ethical dilemmas seldom dealt with in animal care forms. This paper reviews the ethical issues many field primatologists say they face and how these might be better addressed by animal care forms. The ethical issues arising for field researchers are divided into three categories: "Presence, Protocols and People" and for each the most frequent issues are described. The most commonly mentioned ethical concern arising from our presence in the field is the possibility of disease transmission. Although most primate field studies employ only observational protocols, the practice of habituating our study animals to close human presence is an ethical concern for many since it can lessen the animals' fear of all humans, thereby facilitating undesirable behaviors (e.g., crop-raiding) and rendering them vulnerable to harm. Field primatologists who work in host countries must observe national laws and local traditions. As conservationists, primatologists must often negotiate between the resource needs and cultural practices of local people and the interests of the nonhuman primates. Many say they face more ethical dilemmas arising from human interactions than from research on the animals per se. This review concludes with suggestions for relevant questions to ask on animal care forms, and actions that field primatologists can take to better inform animal care committees about the common ethical issues we experience as well as how to develop guidelines for addressing them. (c) 2010 Wiley-Liss, Inc.

Revealing Greenwashing: A Consumers' Perspective

ERIC Educational Resources Information Center

Brouwer, Anne

2016-01-01

A significant problem arising in discursive green marketing practices is the growth of greenwashing; companies providing irrelevant, exaggerated or false information regarding a product's sustainable qualities. This has given rise to a number of issues yet has so far fallen short of being rigorously investigated. In this study, focus group…

Environmental Law: Fundamentals for Schools.

ERIC Educational Resources Information Center

Day, David R.

This booklet outlines the environmental problems most likely to arise in schools. An overview provides a fundamental analysis of environmental issues rather than comprehensive analysis and advice. The text examines the concerns that surround superfund cleanups, focusing on the legal framework, and furnishes some practical pointers, such as what to…

Ethics in Science: The Unique Consequences of Chemistry.

PubMed

Kovac, Jeffrey

2015-01-01

This article discusses the ethical issues unique to the science and practice of chemistry. These issues arise from chemistry's position in the middle between the theoretical and the practical, a science concerned with molecules that are of the right size to directly affect human life. Many of the issues are raised by the central activity of chemistry--synthesis. Chemists make thousands of new substances each year. Many are beneficial, but others are threats. Since the development of the chemical industry in the nineteenth century, chemistry has contributed to the deterioration of the environment but has also helped to reduce pollution. Finally, we discuss the role of codes of ethics and whether the current codes of conduct for chemists are adequate for the challenges of today's world.

Critical Issues in Adult Numeracy Practice--Contradictions and Strategies

ERIC Educational Resources Information Center

Kaye, David

2014-01-01

This paper discusses the critical situations I have been asked to "improve" by providing professional development for teams of adult numeracy and functional mathematics teachers in the post-16 sector in London. These situations have not been identified through any research process, but arise from internal management reviews of course…

Analysis of Core Questions in the Theory-Practice Gap.

ERIC Educational Resources Information Center

Hawley, Steve; Branch, Jan

Problems arising from a state mandate that school-based and college- or university-based teacher education programs be cooperatively developed are examined. The following issues raised from the school district perspective are considered: (1) What mechanisms will be established to insure ongoing communication between college and field-based staff?…

IMPACT OF BEST MANAGEMENT PRACTICES ON WATER QUALITY OF TWO SMALL WATERSHEDS IN INDIANA: ROLE OF SPATIAL SCALE

EPA Science Inventory

Transport and fate of sediments and nutrients within watersheds have important implications for water quality and water resources. Water quality issues often arise because sediments serve as carriers for various pollutants such as nutrients, pathogens, and toxic substances. The C...

Open University Staff Development Materials for Tutors of Open Learning.

ERIC Educational Resources Information Center

Langley, Anne; Perkins, Isabel

1999-01-01

Discusses the evolution of staff development and the new Supporting Open Learners' (SOL) materials at the United Kingdom Open University. Outlines objectives of the SOL program. Discusses issues arising from use of SOL materials, including instructional attitudes; modelling good practice; developing the reflective practitioner; perceived value;…

Researching "With", Not "On": Engaging Marginalised Learners in the Research Process

ERIC Educational Resources Information Center

Atkins, Liz

2013-01-01

This paper discusses practical and methodological issues arising from a case study exploring the hopes, aspirations and learning identities of three groups of students undertaking low-level broad vocational programmes in two English general further education colleges. Working within a social justice theoretical framework the paper outlines the…

Science, Technology, Society: Opportunities.

ERIC Educational Resources Information Center

Lux, Donald G., Ed.

1992-01-01

Recognizing the potential pitfalls resulting from a lack of human foresight lies at the heart of the science-technology-society (STS) movement. This issue of "Theory Into Practice" is the second part of a two-part series that examines the educational opportunities arising as educators attempt to develop student understanding of STS. In the first…

Developing Simulations in Multi-User Virtual Environments to Enhance Healthcare Education

ERIC Educational Resources Information Center

Rogers, Luke

2011-01-01

Computer-based clinical simulations are a powerful teaching and learning tool because of their ability to expand healthcare students' clinical experience by providing practice-based learning. Despite the benefits of traditional computer-based clinical simulations, there are significant issues that arise when incorporating them into a flexible,…

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.

Fad diets: facts for dental professionals.

PubMed

Mobley, Connie

2008-01-01

The author examined fad diet practices associated with oral health status and the role of the dental practitioner in addressing relevant issues. The author reviewed the literature regarding overweight and obesity in the United States to interpret issues that might arise in reviewing fad diet practices among dental patients. The author provides suggestions for assisting patients in choosing dietary and lifestyle behaviors that are based on current public health evidence in support of achieving and maintaining a healthy body weight. Dental professionals are well-positioned to guide patients toward dietary choices that support dental health and the attainment of a healthy weight associated with a decreased risk of developing chronic diseases.

Ethics in Science: The Unique Consequences of Chemistry

PubMed Central

Kovac, Jeffrey

2015-01-01

This article discusses the ethical issues unique to the science and practice of chemistry. These issues arise from chemistry’s position in the middle between the theoretical and the practical, a science concerned with molecules that are of the right size to directly affect human life. Many of the issues are raised by the central activity of chemistry––synthesis. Chemists make thousands of new substances each year. Many are beneficial, but others are threats. Since the development of the chemical industry in the nineteenth century, chemistry has contributed to the deterioration of the environment but has also helped to reduce pollution. Finally, we discuss the role of codes of ethics and whether the current codes of conduct for chemists are adequate for the challenges of today’s world. PMID:26155729

Researcher Tales and Research Ethics: The Spaces in Which We Find Ourselves

ERIC Educational Resources Information Center

White, Julie; Fitzgerald, Tanya

2010-01-01

The tales we tell here focus on the ethical issues arising from our research practice with vulnerable young participants and those for whom research has been inextricably linked with European imperialism and colonialism. The importance of relational obligations, temporality and potential for a continuing narrative approach to ethical research…

Locating and Building Knowledges outside of the Academy: Approaches to Engaged Teaching at the University of Sheffield

ERIC Educational Resources Information Center

Udall, Julia; Forrest, David; Stewart, Katie

2015-01-01

This article draws on three case studies, which illuminate a number of practical, ethical and intellectual issues that arise from "engaged" teaching activities within the curriculum. Projects from the disciplines of Architecture, English and Journalism Studies illustrate the possibilities offered by learning and teaching projects which…

Projected Issues in the Practice of Educational Administration: The English Context.

ERIC Educational Resources Information Center

Browning, Peter

Current and incipient problems in educational administration in England can be grouped into two areas: those resulting from reorganization and those arising from social and political factors. Many problems faced by educational administrators result from school reorganization that is a result of an increase in the number of comprehensive schools.…

Spray Coverage, Hedging and Pecan Scab - an Update on Research

USDA-ARS?s Scientific Manuscript database

Pecan scab is caused by the fungus Fusicladium effusum, and is the major disease of pecan in Georgia and elsewhere in the region, causing severe yield loss in some seasons and areas. There are several reasons for hedging, and some issues may arise as a result of the hedging management practice. Thre...

Mindful Education for ADHD Students: Differentiating Curriculum and Instruction Using Multiple Intelligences

ERIC Educational Resources Information Center

Proulx-Schirduan, Victoria; Shearer, C. Branton; Case, Karen I.

2009-01-01

This practical guide describes ways of working with learners diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) by using Multiple Intelligences Theory. Written for all educators as well as parents, it examines curricular, instructional, school partnering, and leadership issues that may arise for these students in grades K-8. Supported…

Letting the Drama into Group Work: Using Conflict Constructively in Performing Arts Group Practice

ERIC Educational Resources Information Center

Crossley, Tracy

2006-01-01

The article examines conflict avoidance in performing arts group work and issues arising in relation to teaching and learning. In group theory, conflict is addressed largely in terms of its detrimental effects on group work, and its constructive potential is often marginalized. Similarly, undergraduate students usually interpret "effective…

The social development of children with severe learning difficulties: a case study of an inclusive education initiative between two primary schools in Oxfordshire, UK.

PubMed

Dew-Hughes, D; Blandford, S

1999-08-01

This case study of primary age children in two linked Oxfordshire schools investigated the contribution of staff attitudes and practices to inequalities in education, and contrasted the socialisation of children with similar learning difficulties in different educational placements. Participant observation of a group of children and carers in a special school suggested areas of more rigorous inquiry. Structured observations compared this group with a matched sample of children with similar learning difficulties in a mainstream setting. Staff on both sites were invited to comment on findings arising from analysed data in order to identify attitudes and policies which might account for the observed differences in practice. The study was engendered by experience of differences arising from educational placement. The theoretical stance arose through reviewing previous work, predominantly the debate on inclusive education, and the wider issues of human rights and equal opportunities embedded in the social development of people with disabilities. The theoretical framework underpinning this study is established in some depth. The project was designed to investigate issues of the wider social perspective, by conducting a micro-study of one model of educational inclusion whose outcomes have direct relevance to those issues.

Some Spatial Politics of Queer-Feminist Research: Personal Reflections From the Field.

PubMed

Misgav, Chen

2016-01-01

This article addresses methodological issues emerging from research conducted with Trans in the Center, an LGBT activist group in Tel Aviv, Israel. It addresses some complex issues related to the politics and ethics of applying queer and feminist methodology to qualitative research in a trans, queer, and feminist community space. The focus is on two issues: the researcher's positionality vis-à-vis the participants and selecting the appropriate methodology in relation to the characteristics of the group under study. Such issues demonstrate how queer and feminist principles are articulated and interwoven in geographical-spatial research in two different dimensions: in the research practice and methodology and in the practices and the spaces created by the activity of the researched group itself. I conclude with insights arising from the attempt to apply feminist and queer paradigms in both theory and research, and I call for their integration into geographical research.

Ethics in oncology: consulting for the investment industry.

PubMed

Berlin, Jordan; Bruinooge, Suanna S; Tannock, Ian F

2007-02-01

As Ethics Committee Chair, I am pleased to introduce the first in an ongoing series of ethics vignettes. These columns, which are based on true-to-life situations that arise in oncology research and practice, are intended to identify and explore important ethical issues and provide commentary that is specific to oncology. Please look for them periodically in both the Journal of Clinical Oncology and the Journal of Oncology Practice. The idea for publishing vignettes evolved through the joint efforts of the Ethics Committee and the Board of Directors. Rather than adopt a single set of ethical principles that applies vaguely to any situation and well to none, the Committee and the Board preferred to tackle ethical dilemmas individually, specifically, and directly. Because the Ethics Committee thought the ethical and legal implications of physician interactions with the investment industry were so important and timely, it chose to address this topic in both a position article, which was previously published in the January 20, 2007, issue of the Journal of Clinical Oncology (J Clin Oncol 25:338-340, 2007) and in its first vignette column. The Ethics Committee hopes this column will be the first of several that ASCO members will find helpful as they grapple with the many ethical issues that arise in daily practice in the field of oncology. Because these columns are intended to address the concerns of ASCO members, the Committee welcomes suggestions for future topics at vignettes@asco.org. Martin D. Abeloff, MD, Chair, Ethics Committee.

Team Physicians, Sports Medicine, and the Law: An Update.

PubMed

Koller, Dionne L

2016-04-01

The recognition of sports medicine and promulgation of practice guidelines for team physicians will push general medical malpractice standards to evolve into a more specialized standard of care for those who practice in this area. To the extent that practicing medicine in the sports context involves calculations that do not arise in typical medical practice, the sports medicine community can help elucidate those issues and create appropriate guidelines that can serve to inform athlete-patients and educate courts. Doing so will help best set the terms by which those who practice sports medicine are judged. Copyright © 2016 Elsevier Inc. All rights reserved.

Issues and Theoretical Constructs Regarding Parent Education for Autism Spectrum Disorders

PubMed Central

Koegel, Lynn K.; Koegel, Robert L.; Ence, Whitney A.

2013-01-01

Participation of parents of children with autism is commonplace in most comprehensive intervention programs, yet, there is limited research relating to the best practices in this area. This article provides an overview of parent education programs for young children with autism and details data-driven procedures which are associated with improved parent and child outcomes. In addition, we provide a troubleshooting guide based on the literature for professionals regarding a variety of complex issues which may arise during parent education. PMID:21336525

Linking Science Education to the Workplace

NASA Astrophysics Data System (ADS)

Hurd, Paul Dehart

1998-12-01

This article examines the issue of linking education in the sciences with the world of work for all students. Traditionally, science teaching has been limited to preparing student for research career in science at the university level. The reform movement in science education is focused on intellectual skills that serve to fortify the human capital of all students and the economic productivity of the nation. The educational issue arises from evolutionary changes that are taking place in the practice of science, the development of a global economy, the nation's entrance into an Information Age, and the changing nature of the workplace. To identify and integrate these factors in the practice of science teaching is the goal of this article.

English Education and Teacher Education in South Korea

ERIC Educational Resources Information Center

Jo, Seongja

2008-01-01

The spread of the English language is a global phenomenon, but it has a particular resonance in South Korea, where English is second only to Korean as a common language. The paper examines the current educational context in South Korea and the policy and practice issues that arise within this context regarding teacher education in English as a…

Policies and Practices of Professional Development in China: What Do Early Childhood Teachers Think?

ERIC Educational Resources Information Center

Guo, Karen Liang; Yong, Yan

2013-01-01

This paper focuses on early childhood teachers' professional development in China. It reports a study which aims to elicit twelve in-service early childhood teachers' perspectives of the values and issues of professional development policies and the learning opportunities they experienced. Two themes arising from the study are addressed, namely…

The Promise of Anonymity: An Investigation of the Practices of ELA Teachers Facilitating Discourse about LGBTQ Topics

ERIC Educational Resources Information Center

Kavanagh, Sarah Schneider

2016-01-01

Background/Context: As states and districts have begun adopting texts inclusive of lesbian, gay, bisexual, transgender, and queer (LGBTQ) people, debates about how LGBTQ issues should be represented in the curricular canon have emerged. While existing research investigates curricular questions that are arising as a result of LGBTQ curricular…

Electronic Assessment Issues and Practices in Pakistan: A Case Study

ERIC Educational Resources Information Center

Sangi, Nazir A.

2008-01-01

Electronic assessment (e-assessment) methods are at an early stage of development at various levels of education in South East Asian region. Until the primary resource requirements of the various educational institutions have been met in terms of providing an effective and efficient e-assessment system, a range of problems will arise for the…

Issues Arising from the Use of University Ilectures: A Case Study of One Australian Campus

ERIC Educational Resources Information Center

Dobinson, Toni J.; Bogachenko, Tatiana

2018-01-01

Australian universities have moved towards greater reliance on technology as a learning tool. The use of podcasts or recorded lectures (sometimes called ilectures) is now common practice in both on-campus and online modes. Using a qualitative approach to data collection which included recorded interviews, an online survey of open-ended questions…

The Spatial Politics of Gender in EAP Classroom Practice

ERIC Educational Resources Information Center

Appleby, Roslyn

2009-01-01

This paper explores some of the challenges faced by EAP teachers as they address gender issues that arise when teaching in a non-Western cultural context. It draws on interviews with four Australian teachers regarding their experiences in delivering EAP programs in East Timor as part of an international aid effort, and focuses on critical…

Travelling Teens: A Parents' Guide to Family Relocation

ERIC Educational Resources Information Center

Linke, Pam

2005-01-01

Moving house is becoming a more common aspect of modern life; but this does not make it any easier to cope with the many issues that arise--from the everyday practicalities, to the social and emotional challenges involved. Families who are required to relocate face the potentially difficult task of settling each family member into the new…

Ethical Issues in Internet Research: International Good Practice and Irish Research Ethics Documents

ERIC Educational Resources Information Center

Felzmann, Heike

2013-01-01

This chapter discusses the main research ethical concerns that arise in internet research and reviews existing research ethical guidance in the Irish context in relation to its application to internet research. The chapter begins with a brief outline of high profile cases in the early history of the internet that highlighted specific emerging…

78 FR 78770 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Snapper-Grouper Fishery Off the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

..., to the extent practicable, the adverse effects on fishers, support industries, and associated... addition, the issue of disproportional effects on small versus large entities does not arise in the present... has no direct effects on the profits of commercial and for-hire vessels, because there are no...

The Effects of Risk and Size of Company on Business Performance in Information Technology Outsourcing

ERIC Educational Resources Information Center

Balogun, Shereef Adewale

2013-01-01

Information technology (IT) outsourcing is a practical way to transfer information technology by industries of different firms. The problem occurs when companies outsource services to domestic and international data centers as network security issues arise. This leads to competition between companies causing the size of the company to become more…

Women's Guide to Overseas Living. Second Edition.

ERIC Educational Resources Information Center

Piet-Pelon, Nancy J.; Hornby, Barbara

This book examines issues critical to women and their families who go abroad to live. In advising how to cope effectively with the problems that arise, the book illuminates the advantages of living overseas and offers practical suggestions and guidelines that help women take advantage of the opportunity to share in another culture. Divided into 13…

Best research practices in psychology: Illustrating epistemological and pragmatic considerations with the case of relationship science.

PubMed

Finkel, Eli J; Eastwick, Paul W; Reis, Harry T

2015-02-01

In recent years, a robust movement has emerged within psychology to increase the evidentiary value of our science. This movement, which has analogs throughout the empirical sciences, is broad and diverse, but its primary emphasis has been on the reduction of statistical false positives. The present article addresses epistemological and pragmatic issues that we, as a field, must consider as we seek to maximize the scientific value of this movement. Regarding epistemology, this article contrasts the false-positives-reduction (FPR) approach with an alternative, the error balance (EB) approach, which argues that any serious consideration of optimal scientific practice must contend simultaneously with both false-positive and false-negative errors. Regarding pragmatics, the movement has devoted a great deal of attention to issues that frequently arise in laboratory experiments and one-shot survey studies, but it has devoted less attention to issues that frequently arise in intensive and/or longitudinal studies. We illustrate these epistemological and pragmatic considerations with the case of relationship science, one of the many research domains that frequently employ intensive and/or longitudinal methods. Specifically, we examine 6 research prescriptions that can help to reduce false-positive rates: preregistration, prepublication sharing of materials, postpublication sharing of data, close replication, avoiding piecemeal publication, and increasing sample size. For each, we offer concrete guidance not only regarding how researchers can improve their research practices and balance the risk of false-positive and false-negative errors, but also how the movement can capitalize upon insights from research practices within relationship science to make the movement stronger and more inclusive. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Stepwise Approach to Accessible MOOC Development.

PubMed

Draffan, E A; Wald, Mike; Dickens, Kate; Zimmermann, Gottfried; Kelle, Sebastian; Miesenberger, Klaus; Petz, Andrea

2015-01-01

Developing resources for online learning in its many guises and more recently for MOOCs has been discussed across the educational sector, usually by individuals working for one institution or organisation. Rarely are there discussions that highlight the issues of collaborative working on content that is delivered over a period of weeks for a wide range of abilities and skills. In particular there is a reluctance to face the issues presented by barriers to access for those with disabilities and even the issues that could arise should an academic be unable to access the development platform to present content. This paper aims to approach these issues by providing guidance in a series of practical steps that highlight an inclusive design approach.

Dare we speak of ethics? Attending to the unsayable amongst nurse leaders.

PubMed

Schick Makaroff, Kara; Storch, Janet; Newton, Lorelei; Fulton, Tom; Stevenson, Lynne

2010-09-01

There is increasing emphasis on the need for collaboration between practice and academic leaders in health care research. However, many problems can arise owing to differences between academic and clinical goals and timelines. In order for research to move forward it is important to name and address these issues early in a project. In this article we use an example of a participatory action research study of ethical practice in nursing to highlight some of the issues that are not frequently discussed and we identify the impact of things not-named. Further, we offer our insights to others who wish to be partners in research between academic and practice settings. These findings have wide implications for ameliorating misunderstandings that may develop between nurse leaders in light of collaborative research, as well as for participatory action research.

South Asian battered women's use of force against intimate male partners: a practice note.

PubMed

Roy, Debjani

2012-09-01

The purpose of this practice note is to explore issues that arise in Manavi's work with South Asian women who use nonfatal force in heterosexual intimate relationships. It provides a nuanced understanding of the contexts within which a South Asian woman uses physical force. It addresses the many barriers a South Asian woman faces in an abusive relationship that ultimately may lead her to use of force. The goal of the practice note is to act as a tool to strengthen advocacy and service provision made available to South Asian female survivors of violence and abuse.

Family physician practice visits arising from the Alberta Physician Achievement Review

PubMed Central

2013-01-01

Background Licensed physicians in Alberta are required to participate in the Physician Achievement Review (PAR) program every 5 years, comprising multi-source feedback questionnaires with confidential feedback, and practice visits for a minority of physicians. We wished to identify and classify issues requiring change or improvement from the family practice visits, and the responses to advice. Methods Retrospective analysis of narrative practice visit reports data using a mixed methods design to study records of visits to 51 family physicians and general practitioners who participated in PAR during the period 2010 to 2011, and whose ratings in one or more major assessment domains were significantly lower than their peer group. Results Reports from visits to the practices of family physicians and general practitioners confirmed opportunities for change and improvement, with two main groupings – practice environment and physician performance. For 40/51 physicians (78%) suggested actions were discussed with physicians and changes were confirmed. Areas of particular concern included problems arising from practice isolation and diagnostic conclusions being reached with incomplete clinical evidence. Conclusion This study provides additional evidence for the construct validity of a regulatory authority educational program in which multi-source performance feedback identifies areas for practice quality improvement, and change is encouraged by supplementary contact for selected physicians. PMID:24010980

Using action research in nursing practice with older people: democratizing knowledge.

PubMed

Reed, Jan

2005-05-01

This paper reports on an action research study which raised some questions about the processes of developing a sense of shared ownership in action research in a research environment which does not always have the appropriate mechanisms to support and sustain action research. Action research has gained popularity in nursing and healthcare research, offering a way of developing practice-based knowledge, which can assist in changing practice and democratizing inquiry. There are other organizational constraints on action research which arise at different levels, and which also require discussion. These can be issues about communication and ownership at a practice level and issues of funding and project management procedures. This paper reports on a study in which these issues came to the fore, and offers some thoughts on how they can affect the processes of action research. While the principles of action research appear to offer much towards the development of a practice-rooted body of knowledge for nursing, unless some of the issues of ownership are resolved, it is unlikely to move beyond academic rhetoric. If nursing is to engage in action research, this must be done critically and reflectively and careful attention paid to developing an inclusive and collaborative approach to knowledge and practice development. Furthermore, to develop in nursing and health care research, it must find ways to meet the requirements of funding bodies.

Training effectiveness assessment: Methodological problems and issues

NASA Technical Reports Server (NTRS)

Cross, Kenneth D.

1992-01-01

The U.S. military uses a large number of simulators to train and sustain the flying skills of helicopter pilots. Despite the enormous resources required to purchase, maintain, and use those simulators, little effort has been expended in assessing their training effectiveness. One reason for this is the lack of an evaluation methodology that yields comprehensive and valid data at a practical cost. Some of these methodological problems and issues that arise in assessing simulator training effectiveness, as well as problems with the classical transfer-of-learning paradigm were discussed.

The Ethics of Doing Ethics.

PubMed

Hansson, Sven Ove

2017-02-01

Ethicists have investigated ethical problems in other disciplines, but there has not been much discussion of the ethics of their own activities. Research in ethics has many ethical problems in common with other areas of research, and it also has problems of its own. The researcher's integrity is more precarious than in most other disciplines, and therefore even stronger procedural checks are needed to protect it. The promotion of some standpoints in ethical issues may be socially harmful, and even our decisions as to which issues we label as "ethical" may have unintended and potentially harmful social consequences. It can be argued that ethicists have an obligation to make positive contributions to society, but the practical implications of such an obligation are not easily identified. This article provides an overview of ethical issues that arise in research into ethics and in the application of such research. It ends with a list of ten practical proposals for how these issues should be dealt with.

Critical thinking: a two-phase framework.

PubMed

Edwards, Sharon L

2007-09-01

This article provides a comprehensive review of how a two-phase framework can promote and engage nurses in the concepts of critical thinking. Nurse education is required to integrate critical thinking in their teaching strategies, as it is widely recognised as an important part of student nurses becoming analytical qualified practitioners. The two-phase framework can be incorporated in the classroom using enquiry-based scenarios or used to investigate situations that arise from practice, for reflection, analysis, theorising or to explore issues. This paper proposes a two-phase framework for incorporation in the classroom and practice to promote critical thinking. Phase 1 attempts to make it easier for nurses to organise and expound often complex and abstract ideas that arise when using critical thinking, identify more than one solution to the problem by using a variety of cues to facilitate action. Phase 2 encourages nurses to be accountable and responsible, to justify a decision, be creative and innovative in implementing change.

The Translation of Cognitive Paradigms for Patient Research

PubMed Central

Luck, Steven J.; Gold, James M.

2008-01-01

Many cognitive tasks have been developed by basic scientists to isolate and measure specific cognitive processes in healthy young adults, and these tasks have the potential to provide important information about cognitive dysfunction in psychiatric disorders, both in psychopathology research and in clinical trials. However, several practical and conceptual challenges arise in translating these tasks for patient research. Here we outline a paradigm development strategy—which involves iteratively testing modifications of the tasks in college students, in older healthy adults, and in patients—that we have used to successfully translate a large number of cognitive tasks for use in schizophrenia patients. This strategy makes it possible to make the tasks patient friendly while maintaining their cognitive precision. We also outline several measurement issues that arise in these tasks, including differences in baseline performance levels and speed-accuracy trade-offs, and we provide suggestions for addressing these issues. Finally, we present examples of 2 experiments, one of which exemplifies our recommendations regarding measurement issues and was a success and one of which was a painful but informative failure. PMID:18487226

School nurse book clubs: an innovative strategy for lifelong learning.

PubMed

Greenawald, Deborah A; Adams, Theresa M

2008-04-01

Recognizing the ongoing need for continuing education for school nurses, the authors discuss the use of school nurse book clubs as an innovative lifelong-learning strategy. Current research supports the use of literature in nursing education. This article discusses the benefits of book club participation for school nurses and includes suggested fiction and nonfiction books that can be used to enhance nursing knowledge and practice. Through reading and discussion, school nurses can increase their knowledge of nursing history and current health care issues, thus becoming better prepared to address challenging issues that arise in practice. In addition, the use of literature as a learning strategy allows school nurses to broaden their understanding of unique cultural factors that influence the health beliefs and practices of students and their families. Book club participation can also assist school nurses in honing leadership and communication skills and becoming energized to become better advocates for children and families.

Managing vulnerabilities and achieving compliance for Oracle databases in a modern ERP environment

NASA Astrophysics Data System (ADS)

Hölzner, Stefan; Kästle, Jan

In this paper we summarize good practices on how to achieve compliance for an Oracle database in combination with an ERP system. We use an integrated approach to cover both the management of vulnerabilities (preventive measures) and the use of logging and auditing features (detective controls). This concise overview focusses on the combination Oracle and SAP and it’s dependencies, but also outlines security issues that arise with other ERP systems. Using practical examples, we demonstrate common vulnerabilities and coutermeasures as well as guidelines for the use of auditing features.

Ethics in the Legal and Business Practices of Radiation Oncology.

PubMed

Wall, Terry J

2017-10-01

Ethical issues arise when a professional endeavor such as medicine, which seeks to place the well-being of others over the self-interest of the practitioner, meets granular business and legal decisions involved in making a livelihood out of a professional calling. The use of restrictive covenants, involvement in self-referral patterns, and maintaining appropriate comity among physicians while engaged in the marketplace are common challenges in radiation oncology practice. A paradigm of analysis is presented to help navigate these management challenges. Copyright © 2017 Elsevier Inc. All rights reserved.

Ethical issues and best practice in clinically based genomic research: Exeter Stakeholders Meeting Report.

PubMed

Carrieri, D; Bewshea, C; Walker, G; Ahmad, T; Bowen, W; Hall, A; Kelly, S

2016-09-27

Current guidelines on consenting individuals to participate in genomic research are diverse. This creates problems for participants and also for researchers, particularly for clinicians who provide both clinical care and research to their patients. A group of 14 stakeholders met on 7 October 2015 in Exeter to discuss the ethical issues and the best practice arising in clinically based genomic research, with particular emphasis on the issue of returning results to study participants/patients in light of research findings affecting research and clinical practices. The group was deliberately multidisciplinary to ensure that a diversity of views was represented. This report outlines the main ethical issues, areas of best practice and principles underlying ethical clinically based genomic research discussed during the meeting. The main point emerging from the discussion is that ethical principles, rather than being formulaic, should guide researchers/clinicians to identify who the main stakeholders are to consult with for a specific project and to incorporate their voices/views strategically throughout the lifecycle of each project. We believe that the mix of principles and practical guidelines outlined in this report can contribute to current debates on how to conduct ethical clinically based genomic research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Contraceptive Method Initiation: Using the Centers for Disease Control and Prevention Selected Practice Guidelines.

PubMed

Wu, Wan-Ju; Edelman, Alison

2015-12-01

The US Selected Practice Recommendations is a companion document to the Medical Eligibility Criteria for Contraceptive Use that focuses on how providers can use contraceptive methods most effectively as well as problem-solve common issues that may arise. These guidelines serve to help clinicians provide contraception safely as well as to decrease barriers that prevent or delay a woman from obtaining a desired method. This article summarizes the Selected Practice Recommendations on timing of contraceptive initiation, examinations, and tests needed prior to starting a method and any necessary follow-up. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

Children's Views of Decisions Made by the Court: Policy and Practice Issues Arising from the "Your Shout Too!" Survey

ERIC Educational Resources Information Center

Timms, Judith E.; Bailey, Sue; Thoburn, June

2008-01-01

"Your Shout Too!" reports on a National Society for the Prevention of Cruelty to Children survey of the views of 141 children and young people involved in private law court proceedings following the separation of their parents. All of the children who responded had either been the subject of a Welfare Report prepared under the provisions…

Smallholder farmers' behavioural intentions towards sustainable agricultural practices.

PubMed

Zeweld, Woldegebrial; Van Huylenbroeck, Guido; Tesfay, Girmay; Speelman, Stijn

2017-02-01

The introduction of sustainable practices is considered a win-win strategy for low-income countries because of its potential to simultaneously improve food security and address environmental issues. Despite the numerous studies that focus on the adoption of technological innovations, little work has been done on the socio-psychological behaviour of farmers with regard to sustainable practices. This study investigates smallholder farmers' intentions towards two practices: minimum tillage and row planting. The decomposed theory of planned behaviour is used as a theoretical framework to analyse the intentions. The findings reveal that attitudes and normative issues positively explain farmers' intentions to adopt both practices. Perceived control also has a positive significant effect on the intention to apply minimum tillage. When the intention is formed, farmers are expected to carry out their intention when opportunities arise. Moreover, perceived usefulness, social capital, and perceived ease of operation are also significant predictors of farmers' attitudes. Furthermore, social capital and training are factors that positively affect the normative issue, which in turn also positively mediates the relationship between training, social capital and intention. Finally, it is shown that neither the perceived resources nor information from the media significantly affect farmers' intentions. This paper thus confirms that social capital, personal efficacy, training and perceived usefulness play significant roles in the decision to adopt sustainable practices. In addition, willingness to adopt seems to be limited by negative attitudes and by weak normative issues. Therefore, to improve adoption of sustainable practices by smallholder farmers, attention should be given to socio-psychological issues. This could lead to improvements in farm productivity and enhance the livelihoods of smallholders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Informed consent: clinical and legal issues in family practice.

PubMed

Searight, H R; Barbarash, R A

1994-04-01

While patient informed consent is an important clinical and legal dimension of specialty medical care, many important issues arise in primary care. Family physicians are in a unique position to implement informed consent discussions in the ethical spirit in which the doctrine was intended. Because of their long-term relationships with patients and sensitivity to psychosocial issues, family physicians can engage patients in collaborative health care decision making. Primary care physicians are optimally suited to assess patients' understanding of medical information and their competence. Instead of viewing the informed consent process simply as a necessary legal requirement, it should be a method for educating patients and allowing them to participate in their health care decision making.

Introduction to the Special Issue: Precarious Solidarity-Preferential Access in Canadian Health Care.

PubMed

Reid, Lynette

2017-06-01

Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration (conceptual, practical, and ethical) call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundaries (the concept of medical need) and on the normative questions raised by complex models of funding and delivery of care, where patients, providers, and services cross system boundaries.

Phronesis: Beyond the Research Ethics Committee-A Crucial Decision-Making Skill for Health Researchers During Community Research.

PubMed

Greeff, Minrie; Rennie, Stuart

2016-04-01

Health researchers conducting research in the community are often faced with unanticipated ethical issues that arise in the course of their research and that go beyond the scope of ethical approval by the research ethics committee. Eight expert researchers were selected through extreme intensity purposive sampling, because they are representative of unusual manifestations of the phenomenon related to their research in the community. They were selected to take part in a semi-structured focus group discussion on whether practical wisdom (phronesis) is used as a decision-making skill to solve unanticipated ethical issues during research in the community. Although the researchers were not familiar with the concept phronesis, it became obvious that it formed an integral part of their everyday existence and decision making during intervention research. They could balance research ethics with practical considerations. The capacity of practical wisdom as a crucial decision-making skill should be assimilated into a researcher's everyday reality, and also into the process of mentoring young researchers to become phronimos. Researchers should be taught this skill to handle unanticipated ethical issues. © The Author(s) 2016.

Information storage for health-care providers: it's not as simple as it seems.

PubMed

Hanauer, David

2004-01-01

As medical practices migrate from paper to computers for record keeping, new issues surrounding the safe storage of such data are arising. These range from choosing an electronic storage format to ensuring that any electronic information stored today will be available and readable years into the future. Privacy and security issues also continue to be important, especially since the HIPAA regulations were instituted. With the rapid advances in technology, finding the right solution may be like trying to hit a moving target, yet some basic principles, outlined in this article, should make this difficult task easier.

Ethical issues and accountability in pressure ulcer prevention.

PubMed

Welsh, Lynn

2014-10-28

Pressure ulcers represent a considerable cost, both in terms of healthcare spending and quality of life. They are increasingly viewed in terms of patient harm. For clinicians involved in pressure ulcer prevention, ethical issues surrounding accountability may arise from both policy and practice perspectives. It may be useful for clinicians to refer to ethical theories and principles to create frameworks when addressing ethical dilemmas. However, such theories and principles have been criticised for their simplicity and over-generalisation. Alternative theories, for example, virtue ethics and experiential learning, can provide more comprehensive guidance and promote a pluralistic approach to tackling ethical dilemmas.

Endourologic management of malignant ureteral obstruction: indications, results, and quality-of-life issues.

PubMed

Sountoulides, Petros; Pardalidis, Nikolaos; Sofikitis, Nikolaos

2010-01-01

Obstruction of the upper urinary tract is a problem commonly faced by practicing urologists. The constant evolution in endourology has effectively facilitated minimally invasive management of upper-tract obstruction. In a case in which malignancy is the cause of obstruction, however, the situation significantly changes. Questions arise regarding the need for relieving the obstruction, the means to accomplish this, and the benefits and drawbacks of each technique regarding both their efficacy and their impact on the patients well-being and the crucial issue of quality of life in the face of malignancy.

Processes and Challenges in Identifying Learning Disabilities among Students Who Are English Language Learners in Three New York State Districts. Issues & Answers. REL 2010-No. 085

ERIC Educational Resources Information Center

Sanchez, Maria Teresa; Parker, Caroline; Akbayin, Bercem; McTigue, Anna

2010-01-01

Using interviews with district and school personnel and documents from state and district web sites in three districts in New York State, the study examines practices for identifying learning disabilities among students who are English language learners and the challenges that arise. Specifically, two research questions guided the project: (1)…

Federal Litigation Arising from Personnel Practices of Southern School Boards from 1970 through 1981 in the Fifth Circuit Court of Appeals Area.

ERIC Educational Resources Information Center

Sistrunk, Walter E.; Guin, Mary Linda

This paper offers administrators, teachers, and school boards an introduction to legal issues surrounding teacher dismissal and school desegregation and summarizes a study of all teacher dismissal cases heard from 1970 through 1981 in the Fifth Circuit Court of Appeals. Most of the report is devoted to an overview of the historical development of…

Rocking & Rolling: Supporting Infants, Toddlers, and Their Families. Understanding the Influence of Culture on Caregiving Practices . . . From the inside out

ERIC Educational Resources Information Center

Im, Janice; Parlakian, Rebecca; Sanchez, Sylvia

2007-01-01

Everyone brings specific values, beliefs, and assumptions about child rearing and child development to their work with infants and toddlers. Even two teachers who share the same ethnic culture may not share the same beliefs about what is best for young children. Conflicts around these issues can arise with colleagues and families in early care and…

A primer on marginal effects-part II: health services research applications.

PubMed

Onukwugha, E; Bergtold, J; Jain, R

2015-02-01

Marginal analysis evaluates changes in a regression function associated with a unit change in a relevant variable. The primary statistic of marginal analysis is the marginal effect (ME). The ME facilitates the examination of outcomes for defined patient profiles or individuals while measuring the change in original units (e.g., costs, probabilities). The ME has a long history in economics; however, it is not widely used in health services research despite its flexibility and ability to provide unique insights. This article, the second in a two-part series, discusses practical issues that arise in the estimation and interpretation of the ME for a variety of regression models often used in health services research. Part one provided an overview of prior studies discussing ME followed by derivation of ME formulas for various regression models relevant for health services research studies examining costs and utilization. The current article illustrates the calculation and interpretation of ME in practice and discusses practical issues that arise during the implementation, including: understanding differences between software packages in terms of functionality available for calculating the ME and its confidence interval, interpretation of average marginal effect versus marginal effect at the mean, and the difference between ME and relative effects (e.g., odds ratio). Programming code to calculate ME using SAS, STATA, LIMDEP, and MATLAB are also provided. The illustration, discussion, and application of ME in this two-part series support the conduct of future studies applying the concept of marginal analysis.

An International Surgical Rotation as a Systems-Based Elective: The Botswana-University of Pennsylvania Surgical Experience.

PubMed

Cintolo-Gonzalez, Jessica A; Bedada, Alemayehu Ginbo; Morris, Jon; Azzie, Georges

2016-01-01

There is a growing need to address the global burden of surgical disease along with increasing interest in international surgical practice, necessitating an understanding of the challenges and issues that arise on a systems level when practicing abroad. This elective is a month-long rotation in which senior surgical residents participate in patient care as part of a surgical team in the main tertiary and teaching hospital in Gaborone, the capital city of Botswana. Clinical experience is combined with formal readings and educational sessions, with the attending surgeon supervising the program to develop a systems-based curriculum that contextualizes the clinical experience. A formal debriefing and written reflections by the residents at the conclusion of the rotation are used to qualitatively assess resident development and insight into systems-based international surgical practice. Princess Marina Hospital, Gaborone, Botswana. General surgery residents in their fourth clinical year of training. Our elective met important requirements outlined in the literature for foreign practice, including adequate supervision of the American trainees and care to not detract from local trainees' educational experience. Residents' debriefing and written reflections demonstrated an increased understanding of systems-based practice and awareness of issues important to successful international surgical practice and collaboration. Our global surgery elective with a focus on systems-based practice sensitizes residents to the challenges and issues they must be aware of when practicing internationally. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Children's rights in pediatrics.

PubMed

Streuli, Jürg C; Michel, Margot; Vayena, Effy

2011-01-01

The United Nations Convention of Children's Rights (UNCRC) introduced in 1989 has generated a global movement for the protection of children's rights and has brought about a paradigm change in how children are perceived. Pediatric healthcare professionals are interacting with children and therefore with children's rights on a daily basis. However, although at least 18 of the 54 articles are relevant for pediatric practice, there is limited systematic training on how pediatricians can support children's rights in the clinical setting. This article discusses the principles and aims of the UNCRC and proposes a comprehensive checklist of rights vis-à-vis issues that arise in clinical practice.

[Current problems arising from not having biosafety level 4 laboratories in Japan--qualitative study of infectious disease experts].

PubMed

Yamamoto, Yuko; Horiguchi, Itsuko; Marui, Eiji

2009-09-01

No public consensus exists yet on handling Biosafety Level 4 agents and no laboratory is operational at BSL4 in Japan. A discussion that includes neighboring residents and experts should be initiated to communicate risks. In this article, we present the current situation and prioritize problems we presently face. A three-stage Delphi survey was conducted. The subjects were twenty-two persons with extensive experience and knowledge of infectious diseases. Seven projections and issues were made with regard to the problems arising from the lack of an operational BSL4 laboratory. These were tabulated by the KJ method. The top seven projections were scored, such that the top received 7 points and the last received 1 point. A total of 51 projections were obtained for the first part of the survey, 39 for the second, and 29 for the last. The projection with the highest score was that it is impossible to cope with newly emerging infectious diseases. The second was that complete diagnoses are impossible without a BSL4 laboratory. All projections and issues were divided into the following four main groups: issues for researchers and laboratory staff, clinical practice and research on BSL4 agents, domestic and global security, and Japan's international position. We clarified possible problem arising from not having BSL4 laboratories in Japan. The identification of projections by the Delphi survey in this study should be considered as one of many attempts to develop effective risk communication strategies.

The role of ethics in information technology decisions: a case-based approach to biomedical informatics education.

PubMed

Anderson, James G

2004-03-18

The purpose of this paper is to propose a case-based approach to instruction regarding ethical issues raised by the use of information technology (IT) in healthcare. These issues are rarely addressed in graduate degree and continuing professional education programs in health informatics. There are important reasons why ethical issues need to be addressed in informatics training. Ethical issues raised by the introduction of information technology affect practice and are ubiquitous. These issues are frequently among the most challenging to young practitioners who are ill prepared to deal with them in practice. First, the paper provides an overview of methods of moral reasoning that can be used to identify and analyze ethical problems in health informatics. Second, we provide a framework for defining cases that involve ethical issues and outline major issues raised by the use of information technology. Specific cases are used as examples of new dilemmas that are posed by the introduction of information technology in healthcare. These cases are used to illustrate how ethics can be integrated with the other elements of informatics training. The cases discussed here reflect day-to-day situations that arise in health settings that require decisions. Third, an approach that can be used to teach ethics in health informatics programs is outlined and illustrated.

Health research involving First Nations, Inuit and Métis children and their communities

PubMed Central

Starkes, Jill M; Baydala, Lola T

2014-01-01

Canadian and international guidelines address the ethical conduct of health research in general and the issues affecting Indigenous populations in particular. This statement summarizes, for clinicians and researchers, relevant ethical and practical considerations for health research involving Aboriginal children and youth. While not intended to duplicate findings arising from lengthy collaborative processes, it does highlight ‘wise practices’ that have successfully generated knowledge relevant to, respectful of and useful for Aboriginal children, youth and their communities. Further research on current health issues and inequities should lead to practical, effective and culturally relevant applications. Expanding our knowledge of ways to address the health disparities facing Canada’s Aboriginal children and youth can inform health policy and the provision of services. Community-based participatory research is proposed as a means to achieve this goal. PMID:24596485

Privacy considerations in the context of an Australian observational database.

PubMed

Duszynski, K M; Beilby, J J; Marley, J E; Walker, D C; Pratt, N L

2001-12-01

Observational databases are increasingly acknowledged for their value in clinical investigation. Australian general practice in particular presents an exciting opportunity to examine treatment in a natural setting. The paper explores issues such as privacy and confidentiality--foremost considerations when conducting this form of pharmacoepidemiological research. Australian legislation is currently addressing these exact issues in order to establish clear directives regarding ethical concerns. The development of a pharmacoepidemiological database arising from the integration of computerized Australian general practice records is described in addition, to the challenges associated with creating a database which considers patient privacy. The database known as 'Medic-GP', presently contains more than 950,000 clinical notes (including consultations, pathology, diagnostic imaging and adverse reactions) over a 5-year time period and relates to 55,000 patients. The paper then details a retrospective study which utilized the database to examine the interaction between antibiotic prescribing and patient outcomes from a community perspective, following a policy intervention. This study illustrates the application of computerized general practice records in research.

On Retirement of Physicians

PubMed Central

Levy, Roy

1986-01-01

This article takes a look at retirement in general, and the implications for physicians in particular. The recent application of the principles in the Canadian Charter of Rights has raised some unresolved issues for those doctors with contractual employment. They may no longer have mandatory retirement at age 65. Problems can and do arise when self-employed physicians defer retirement from active practice indefinitely. The evaluation of older physicians' competence is explored, and some suggestions offered. PMID:21267269

Autoindexing diffraction images with iMosflm

PubMed Central

Powell, Harold R.; Johnson, Owen; Leslie, Andrew G. W.

2013-01-01

An overview of autoindexing diffraction images based on one-­dimensional fast Fourier transforms is presented. The implementation of the algorithm in the Mosflm/iMosflm program suite is described with a discussion of practical issues that may arise and ways of assessing the success or failure of the procedure. Recent developments allow indexing of images that show multiple lattices, and several examples demonstrate the success of this approach in real cases. PMID:23793145

Stakeholder attitudes and needs regarding cell-free fetal DNA testing.

PubMed

Hill, Melissa; Lewis, Celine; Chitty, Lyn S

2016-04-01

To explore stakeholder views on cell-free DNA testing and highlight findings important for successful implementation and the provision of best practice in counseling. Noninvasive tests based on the analysis of cell-free fetal DNA are now widely available in clinical practice and applications are expanding rapidly. It is essential that stakeholder views are considered in order to identify and address any ethical and social issues. We provide an overview of stakeholder viewpoints and then focus on the key issues of informed decision making, test uptake, service delivery and information sources. Stakeholders are positive about the introduction of cell-free fetal DNA testing into clinical practice. They describe both practical and psychological benefits arising from tests that are safe and can potentially be performed earlier in pregnancy. Key concerns, which include the potential for these tests to have a negative impact on informed decision making and increased societal pressure to have testing, can be addressed through careful parent-directed counseling. As applications for these tests expand it is increasingly important to develop innovative approaches to facilitate good understanding for parents who are offered noninvasive prenatal testing.

Research governance: implications for health library and information professionals.

PubMed

Sen, Barbara A

2003-03-01

The Research Governance Framework for Health and Social Care published by the Department of Health in 2001 provides a model of best practice and a framework for research in the health and social care sector. This article reviews the Department of Health Research Governance Framework, discusses the implications of research governance for library and information professionals undertaking research in the health- and social-care sector and recommends strategies for best practice within the information profession relating to research governance. The scope of the Framework document that covers both clinical and non-clinical research is outlined. Any research involving, amongst other issues, patients, NHS staff and use or access to NHS premises may require ethics committee approval. Particular reference is made to the roles, responsibilities and professional conduct and the systems needed to support effective research practice. Issues such as these combine to encourage the development of a quality research culture which supports best practice. Questions arise regarding the training and experience of researchers, and access to the necessary information and support. The use of the Framework to guide research practice complements the quality issues within the evidence-based practice movement and supports the ongoing development of a quality research culture. Recommendations are given in relation to the document's five domains of ethics, science, information, health and safety and finance and intellectual property. Practical recommendations are offered for incorporating research governance into research practice in ways which conform to the Framework's standards and which are particularly relevant for research practitioners in information science. Concluding comments support the use of the Research Governance Framework as a model for best practice.

Walking the line. Palliative sedation for existential distress: still a controversial issue?

PubMed

Schur, Sophie; Radbruch, Lukas; Masel, Eva K; Weixler, Dietmar; Watzke, Herbert H

2015-12-01

Adequate symptom relief is a central aspect of medical care of all patients especially in those with an incurable disease. However, as an illness progresses and the end of life approaches, physical or psychoexistential symptoms may remain uncontrollable requiring palliative sedation. Although palliative sedation has become an increasingly implemented practice in the care of terminally ill patients, sedation in the management of refractory psychological symptoms and existential distress is still a controversial issue and much debated. This case report presents a patient who received palliative sedation for the treatment of existential distress and discusses considerations that may arise from such a therapeutic approach.

Genetic testing: medico-legal issues.

PubMed

Bird, Sara

2014-07-01

The availability and frequency of genetic testing is increasing. Genetic testing poses some unique ethical and legal issues for medical practitioners because of the potential to identify genetic variants that carry implications for the risk of disease in the future for the patient and their relatives. The regulatory framework within which genetic testing is provided in Australia is also changing. This article examines some medico-legal issues associated with genetic testing that general practitioners (GPs) are likely encounter in their practices. There is inevitable involvement of the GP in the long term care of a patient (and possibly their family) following genetic testing, regardless of whether or not the GP has ordered the testing. Cases are presented to illustrate some of the medico-legal issues that may arise from direct-to-consumer genetic testing, information disclosure to genetic relatives and requests for parentage testing.

Object extraction in photogrammetric computer vision

NASA Astrophysics Data System (ADS)

Mayer, Helmut

This paper discusses state and promising directions of automated object extraction in photogrammetric computer vision considering also practical aspects arising for digital photogrammetric workstations (DPW). A review of the state of the art shows that there are only few practically successful systems on the market. Therefore, important issues for a practical success of automated object extraction are identified. A sound and most important powerful theoretical background is the basis. Here, we particularly point to statistical modeling. Testing makes clear which of the approaches are suited best and how useful they are for praxis. A key for commercial success of a practical system is efficient user interaction. As the means for data acquisition are changing, new promising application areas such as extremely detailed three-dimensional (3D) urban models for virtual television or mission rehearsal evolve.

Ethics, policy, and educational issues in genetic testing.

PubMed

Williams, Janet K; Skirton, Heather; Masny, Agnes

2006-01-01

Analyze ethics, public policy, and education issues that arise in the United States (US) and the United Kingdom (UK) when genomic information acquired as a result of genetic testing is introduced into healthcare services. Priorities in the Ethical, Legal, and Social Issues Research Program include privacy, integration of genetic services into clinical health care, and educational preparation of the nursing workforce. These constructs are used to examine health policies in the US and UK, and professional interactions of individuals and families with healthcare providers. Individual, family, and societal goals may conflict with current healthcare practices and policies when genetic testing is done. Current health policies do not fully address these concerns. Unresolved issues include protection of privacy of individuals while considering genetic information needs of family members, determination of appropriate monitoring of genetic tests, addressing genetic healthcare discrepancies, and assuring appropriate nursing workforce preparation. Introduction of genetic testing into health care requires that providers are knowledgeable regarding ethical, policy, and practice issues in order to minimize risk for harm, protect the rights of individuals and families, and consider societal context in the management of genetic test results. Understanding of these issues is a component of genetic nursing competency that must be addressed at all levels of nursing education.

Dental health of children with cerebral palsy

PubMed Central

Jan, Basil M.; Jan, Mohammed M.

2016-01-01

Cerebral palsy (CP) is a common chronic motor disorder with associated cognitive, communicative, and seizure disorders. Children with CP have a higher risk of dental problems creating significant morbidity that can further affect their wellbeing and negatively impact their quality of life. Screening for dental disease should be part of the initial assessment of any child with CP. The objective of this article is to present an updated overview of dental health issues in children with CP and outline important preventative and practical strategies to the management of this common comorbidity. Providing adequate oral care requires adaptation of special dental skills to help families manage the ongoing health issues that may arise. As oral health is increasingly recognized as a foundation for general wellbeing, caregivers for CP patients should be considered an important component of the oral health team and must become knowledgeable and competent in home oral health practices. PMID:27744459

Countertransference and failure to report child abuse and neglect.

PubMed

Pollak, J; Levy, S

1989-01-01

Though every state has laws requiring the report of suspected child abuse and neglect, failure to report remains a significant problem. Review of previous research on failure to report suggests that the reporters' anxieties about disrupting their relationship with the child's family as well as the reporters' gender, experience, and training affect willingness to report. Countertransference fear, guilt, shame, and sympathy are discussed as a basis for understanding the reporter's anxieties. We suggest that countertransference issues should be addressed in the training and ongoing practice of mandated reporters. The following mechanisms are offered to deal with this issue in training and practice: (1) teaching professionals about how countertransference reactions may arise during the reporting process (this training may include the use of risk management groups for private practitioners); (2) identification of a community child abuse expert for consultation; and (3) educating child protection workers about psychodynamics aspects of case management.

Selecting and starting an orthopaedic surgery practice.

PubMed

Mishra, Allan; Urquhart, Andrew G; Anders, Geoffrey T

2008-01-01

Every new surgeon is faced with the same question as their residency or fellowship draws to a close: What is next? Few residents or fellows are as well prepared to answer that question as they could be. Most programs do not teach residents how to choose a practice type and location. After formal orthopaedic training, new surgeons must make decisions about their careers that can be nearly as complex and difficult as the decisions they make in the operating room. Career choices have both significant and long-term effects on the physician's financial situation, career satisfaction, and personal life. The physician should be aware of key non academic issues that arise when completing a residency program or just beginning the practice of orthopaedic surgery.

Fundamental Ethical Principles in Sports Medicine.

PubMed

Devitt, Brian M

2016-04-01

In sports medicine, the practice of ethics presents many unique challenges because of the unusual clinical environment of caring for players within the context of a team whose primary goal is to win. Ethical issues frequently arise because a doctor-patient-team triad often replaces the traditional doctor-patient relationship. Conflict may exist when the team's priority clashes with or even replaces the doctor's obligation to player well-being. Customary ethical norms that govern most forms of clinical practice, such as autonomy and confidentiality, are not easily translated to sports medicine. Ethical principles and examples of how they relate to sports medicine are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Broadening engineering education: bringing the community in : commentary on "social responsibility in French engineering education: a historical and sociological analysis".

PubMed

Conlon, Eddie

2013-12-01

Two issues of particular interest in the Irish context are (1) the motivation for broadening engineering education to include the humanities, and an emphasis on social responsibility and (2) the process by which broadening can take place. Greater community engagement, arising from a socially-driven model of engineering education, is necessary if engineering practice is to move beyond its present captivity by corporate interests.

Employment & Retirement: A Management-Labor Dialogue. Proceedings of an Industry Conference on Employment and Retirement; A Pre-White House Conference on Aging Activity (Annapolis, Maryland, May 18-20, 1980).

ERIC Educational Resources Information Center

Knatz, Hilary Fleming, Ed.

This publication contains proceedings of a pre-White House Conference on Aging Activity held in May, 1980. The meeting was designed to (1) provide a labor/management forum for review and discussion of problems and issues arising out of a progressively aging population and workforce; (2) explore practical matters which can be resolved by employers…

Theory and Theorizing in Nursing Science: Commentary from the Nursing Research Special Issue Editorial Team.

PubMed

Jairath, Nalini N; Peden-McAlpine, Cynthia J; Sullivan, Mary C; Vessey, Judith A; Henly, Susan J

Articles from three landmark symposia on theory for nursing-published in Nursing Research in 1968-1969-served as a key underpinning for the development of nursing as an academic discipline. The current special issue on Theory and Theorizing in Nursing Science celebrates the 50th anniversary of publication of these seminal works in nursing theory. The purpose of this commentary is to consider the future of nursing theory development in light of articles published in the anniversary issue. The Editorial Team for the special issue identified core questions about continued nursing theory development, as related to the nursing metaparadigm, practice theory, big data, and doctoral education. Using a dialogue format, the editors discussed these core questions. The classic nursing metaparadigm (health, person, environment, nursing) was viewed as a continuing unifying element for the discipline but is in need of revision in today's scientific and practice climates. Practice theory and precision healthcare jointly arise from an emphasis on individualization. Big data and the methods of e-science are challenging the assumptions on which nursing theory development was originally based. Doctoral education for nursing scholarship requires changes to ensure that tomorrow's scholars are prepared to steward the discipline by advancing (not reifying) past approaches to nursing theory. Ongoing reexamination of theory is needed to clarify the domain of nursing, guide nursing science and practice, and direct and communicate the unique and essential contributions of nursing science to the broader health research effort and of nursing to healthcare.

Identifying Unique Ethical Challenges of Indigenous Field-Workers: A Commentary on Alexander and Richman's "Ethical Dilemmas in Evaluations Using Indigenous Research Workers"

ERIC Educational Resources Information Center

Smith, Nick L.

2008-01-01

In contrast with nonindigenous workers, to what extent do unique ethical problems arise when indigenous field-workers participate in field studies? Three aspects of study design and operation are considered: data integrity issues, risk issues, and protection issues. Although many of the data quality issues that arise with the use of indigenous…

A review on the current issues and barriers of Industrialised Building System (IBS) adoption in Malaysia’s construction industry

NASA Astrophysics Data System (ADS)

Amin, M. A. Mohd; Abas, N. H.; Shahidan, S.; Rahmat, M. H.; Suhaini, N. A.; Nagapan, S.; Rahim, R. Abdul

2017-11-01

Malaysia considers the construction industry as one of the main contributors to its Gross Domestic Product (GDP). However, there are some unresolved issues arising from the ongoing and widespread adoption of the conventional method of construction such as the resultant fragmentation of the industry itself; delays in production and delivery time of unnecessary wastages and lack of sustainability practice. Malaysian Government has been continuously encouraging the industry to use, partly or if not wholly, the Industrialized Building System (IBS), which is considered to be an important part of sustainable construction initiative. IBS was introduced to Malaysia as the solution to issues related to dependencies of foreign workers, raising demand for affordable accommodations and improving image, quality and productivity of construction industry. However, the IBS adoption in Malaysia remains low. This paper presents the review of the current issues and barriers of IBS adoption in Malaysian construction industry.

Ethical Tensions Related to Systemic Constraints: Occupational Alienation in Occupational Therapy Practice.

PubMed

Durocher, Evelyne; Kinsella, Elizabeth Anne; McCorquodale, Lisa; Phelan, Shanon

2016-09-03

Ethical tensions arise daily in health care practice and are frequently related to health care system structures or policies. Collective case study methodology was adopted to examine ethical tensions reported by occupational therapists practicing in different settings in Southwestern Ontario, Canada. Inductive analysis involving multiple layers of coding was conducted. This article focuses on tensions related to systemic constraints. Participants reported ethical tensions related to balancing client priorities with those of health care services. Four themes related to systemic constraints were identified including imposed practices, ineffective processes, resource limitations, and lack of services. Therapists' aims could be seen to align with an "ethic of care" and were seen to be in tension in light of systemic constraints. The findings raise issues related to occupational justice, particularly related to occupational alienation in occupational therapy practice, and open conversations related to neoliberalist health care agendas. © The Author(s) 2016.

Genetic Test Results and Disclosure to Family Members: Qualitative Interviews of Healthcare Professionals' Perceptions of Ethical and Professional Issues in France.

PubMed

D' Audiffret Van Haecke, Diane; de Montgolfier, Sandrine

2016-06-01

The benefit of disclosing test results to next of kin is to improve prognosis and-in some cases-even prevent death though earlier monitoring or preventive therapies. Research on this subject has explored the question of intra-familial communication from the standpoint of patients and relatives but rarely, from the standpoint of healthcare professionals. The purpose of this study was to interview relevant healthcare professionals in France, where legislation framing the issue was recently passed. A qualitative study consisting of semi-structured interviews was set up to get a clearer picture of the challenges arising from this issue, its consequences in terms of medical care-service practices, and the positions that frontline professionals have taken in response to this new legal framework. The findings from eight interviews with 7 clinical geneticists and 1 genetic counselor highlight very different patterns of practices among care services and among the genetic diseases involved. It is equally crucial to investigate other issues such as the nature of genetic testing and its consequences in terms of disclosing results to kin, the question of the role of genetic counseling in the disclosure process, the question of prescription by non-geneticist clinicians, and practical questions linked to information content, consent and medical follow-up for patients and their relatives.

Conscientious objection to sexual and reproductive health services: international human rights standards and European law and practice.

PubMed

Zampas, Christina; Andión-Ibañez, Ximena

2012-06-01

The practice of conscientious objection often arises in the area of individuals refusing to fulfil compulsory military service requirements and is based on the right to freedom of thought, conscience and religion as protected by national, international and regional human rights law. The practice of conscientious objection also arises in the field of health care, when individual health care providers or institutions refuse to provide certain health services based on religious, moral or philosophical objections. The use of conscientious objection by health care providers to reproductive health care services, including abortion, contraceptive prescriptions, and prenatal tests, among other services is a growing phenomena throughout Europe. However, despite recent progress from the European Court of Human Rights on this issue (RR v. Poland, 2011), countries and international and regional bodies generally have failed to comprehensively and effectively regulate this practice, denying many women reproductive health care services they are legally entitled to receive. The Italian Ministry of Health reported that in 2008 nearly 70% of gynaecologists in Italy refuse to perform abortions on moral grounds. It found that between 2003 and 2007 the number of gynaecologists invoking conscientious objection in their refusal to perform an abortion rose from 58.7 percent to 69.2 percent. Italy is not alone in Europe, for example, the practice is prevalent in Poland, Slovakia, and is growing in the United Kingdom. This article outlines the international and regional human rights obligations and medical standards on this issue, and highlights some of the main gaps in these standards. It illustrates how European countries regulate or fail to regulate conscientious objection and how these regulations are working in practice, including examples of jurisprudence from national level courts and cases before the European Court of Human Rights. Finally, the article will provide recommendations to national governments as well as to international and regional bodies on how to regulate conscientious objection so as to both respect the practice of conscientious objection while protecting individual's right to reproductive health care.

Closing the Guantanamo Detection Center: Legal Issues

DTIC Science & Technology

2009-04-14

issues likely to arise as a result of executive and legislative action to close the Guantanamo detention facility. It discusses legal issues related to...detention or other wartime actions taken by the Executive. The Bush Administration initially believed that Guantanamo was largely beyond the...C. Henning. This report provides an overview of major legal issues that are likely to arise as a result of executive and legislative action to

Comments on: blood product transfusion in emergency department patients: a case control study of practice patterns and impact on outcome.

PubMed

Karami, Manoochehr; Khazaei, Salman

2017-12-06

Clinical decision makings according studies result require the valid and correct data collection, andanalysis. However, there are some common methodological and statistical issues which may ignore by authors. In individual matched case- control design bias arising from the unconditional analysis instead of conditional analysis. Using an unconditional logistic for matched data causes the imposition of a large number of nuisance parameters which may result in seriously biased estimates.

Empathy, genuineness--And the dynamics of power: A feminist responds to Rogers.

PubMed

Brown, Laura S

2007-09-01

In this article, I discuss the points of convergence and divergence between Carl Rogers' core constructs for therapy (Rogers, 1957; see record 2007-14639-002) and the theories and practices of feminist therapy (Brown, 1994, 2007). The value of Rogers' insights about the importance of the relationship in therapy is reviewed, and the lacunae in his model arising from an inattention to issues of power and politics is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Ethical issues for otolaryngology and surgery in the elderly.

PubMed

Seidman, M D; Shapiro, D P; Shirwany, N A

1999-06-01

Clinical ethics is an intrinsic aspect of medical practice. Concerns for ethical conduct arise in the management of medical benefits, patient preferences, quality of life, and the relationship between patient care and its attendant familial, social, economic, and legal circumstances. Ethical concerns in surgical practice are central to the essence of the Hippocratic doctrine, "First do no harm." In caring for our patients, particularly in light of the modern practice of medicine, we often use the risk-benefit calculus. The range of ethical concerns for the otolaryngologist who deals with the elderly and infirm covers many diverse situations. Superimposed over this spectrum is the idea of patient autonomy, which is considered to be a cardinal issue in any ethical discussion. Furthermore, increasing medical care costs have created a debate regarding the rationing of healthcare. Ethicists continue the discussion as to whether age should be a decisive factor in the rationing of this care. Definitions of "heroic" and "extraordinary" assume greater significance, and controversies of language become pivotal when the comprehension and cognitive orientation of the patient are compromised by disease and senescence.

Nurse's Awareness on Ethico-legal Aspects of Nursing Profession.

PubMed

Paudel Subedi, Krishna Kumari; Timalsina, Kalpana; Bhele, Raja Laxmi

2018-03-13

Nursing practice amicably includes practical efficacy and ethics. Now a days legal and ethical problems associated with client care are arising day by day. Therefore, nurses should have adequate understanding of basic legal concepts and issues relevant to nursing profession in order to protect the rights of the clients and the nurses. A cross sectional descriptive design was adopted for the study. 142 nurses were included by using purposive sampling technique. Data was collected with self-administered structured questionnaire. Descriptive statistics was used to reveal demographic information. Kruskal Wallis and Mann Whitney test were used to find out association of selected demographic variables and ethico legal aspects of nursing. Majority of participants were belonging to 20-29 years of age. More than half nurses had complete bachelor's degree and had less than 10 year's experiences. Majority of participants reported that they did not encounter any legal issues in their professional life till date. Similarly, majority of participants had average level knowledge and equate level of practice. Years of experiences and education level did not affect in knowledge level and existing practice related to ethico legal aspect of nursing. There was no significant relationship between level of knowledge and existing practice. Nurses have average knowledge and practice on ethico legal aspects. There is positive relationship between knowledge and practice though it is not statistically significant.

Ethical and research dilemmas arising from a questionnaire study of psychological morbidity among general practice managers.

PubMed

Sheikh, A; Hurwitz, B; Parker, M

2001-01-01

A questionnaire-based research project enquiring into the psychological health of general practice managers found that 5% of managers admitted to suicidal ideas. This paper explores the moral issues raised when research conducted at a distance uncovers information about participants which indicates that they may be at increased risk of harm. It examines whether the authors of such studies have responsibilities towards their research participants beyond those of analysing and properly interpreting the data supplied to them. The paper is an exercise in self-reflection and self-criticism; not all the questions posed and explored by it can be answered definitively. Implications for planning studies of this kind are discussed.

Occupational health practice and exposure to nanoparticles: reconciling scientific evidence, ethical aspects, and legal requirements.

PubMed

Franco, Giuliano

2011-01-01

The paper aims at focusing the relationship between scientific evidence and ethical values' issues of occupational health practice according to the new Italian law 81/2008 stating that the occupational health physician (OHP) is required to act according to the Code of Ethics of the International Commission on Occupational Health. The code itself emphasizes that (i) the practice should be relevant, knowledge-based, sound, and appropriate to the occupational risks and (ii) the objectives and methods of health surveillance must be clearly defined. Because exposure to nanoparticles involves several uncertainties about health effects and may limit the effectiveness of workers' health surveillance, OHPs face a several ethical dilemmas, involving different stakeholders. The dilemmas arising from the practice should be dealt with according to the ethical principles of beneficence, autonomy, and justice in order to take a decision.

Perceptions and practices of medical practitioners towards ethics in medical practice - a study from coastal South India.

PubMed

Unnikrishnan, B; Kanchan, Tanuj; Kulkarni, Vaman; Kumar, Nithin; Papanna, Mohan Kumar; Rekha, T; Mithra, Prasanna

2014-02-01

Ethics is the application of values and moral rules to human activities. Medical practitioners are expected to not only have the skills and knowledge relevant to their field but also with the ethical and legal expectations that arise out of the standard practices. The present research was conducted with an aim to study the perceptions and practices of medical practitioners towards healthcare ethics in Indian scenario and to strengthen the evidence in the field of ethics training. A cross-sectional study was carried out in three associate hospitals of a Medical College in Southern India. Medical practitioners included in the study were administered a pre-tested, semi-structured questionnaire. Data was collected based on their responses on a 5 point Likert scale and analyzed using SPSS version 11.5. The majority of the participants mentioned that their perceptions of ethics in medical practice were based on information obtained during their undergraduate training, followed by experience at work. The medical practitioners had a positive perception on issues relating to consent in medical practice. However, the same degree of perception was not observed for issues related to confidentiality and their dealing with patients during emergency conditions. The majority of the medical practitioners agreed that ethical conduct is important to avoid legal and disciplinary actions. Among the medical practitioners, the responses of specialists and non-specialists were mostly similar with major differences of opinion for a few issues. A highest level of knowledge, awareness and understanding of ethics are expected in medical practice as it is the foundation of sound healthcare delivery system. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Closing the Guantanamo Detention Center: Legal Issues

DTIC Science & Technology

2009-07-20

to arise as a result of executive and legislative action to close the Guantanamo detention facility. It discusses legal issues related to the...combatants could pursue legal challenges regarding their detention or other wartime actions taken by the Executive. The Bush Administration initially...that are likely to arise as a result of executive and legislative action to close the Guantanamo detention facility. It discusses legal issues

Closing the Guantanamo Detention Center: Legal Issues

DTIC Science & Technology

2009-11-17

immigration consequences. This report provides an overview of major legal issues likely to arise as a result of executive and legislative action to...legal challenges regarding their detention or other wartime actions taken by the Executive. The Bush Administration initially believed that Guantanamo...major legal issues that are likely to arise as a result of executive and legislative action to close the Guantanamo detention facility. It discusses

Ethical issues arising from variation in health services utilization at the end of life.

PubMed

Weeks, William Brinson; Nelson, William A

2011-01-01

Research on health services delivery, particularly at the end of life, has demonstrated that more care does not necessarily lead to better technical quality, patient satisfaction, or outcomes. These findings raise three ethical issues: (1) justice in the allocation of scarce resources across health service areas; (2) nonmaleficence in the provision of appropriate amounts of care to patients; and (3) transparency about local healthcare practice so patients can make enlightened decisions about healthcare choices. We conclude that in this era of healthcare accountability, managers and clinicians can use these ethical principles to drive change in the process of providing more efficient, more effective, and more patient-centered care, especially at the end of life.

HIV/AIDS, Reproductive and Sexual Health, and the Law

PubMed Central

Gostin, Lawrence O.; Hodge, James G.

2008-01-01

The law is a frequently overlooked tool for addressing the complex practical and ethical issues that arise from the HIV/AIDS pandemic. The law intersects with reproductive and sexual health issues and HIV/AIDS in many ways. Well-written and rigorously applied laws could benefit persons living with (or at risk of contracting) HIV/AIDS, particularly concerning their reproductive and sexual health. Access to reproductive health services should be a legal right, and discrimination based on HIV status, which undermines access, should be prohibited. Laws against sexual violence and exploitation, which perpetuate the spread of HIV and its negative effects, should be enforced. Finally, a human rights framework should inform the drafting of laws to more effectively protect health. PMID:18703431

HIV/AIDS, reproductive and sexual health, and the law.

PubMed

Gable, Lance; Gostin, Lawrence O; Hodge, James G

2008-10-01

The law is a frequently overlooked tool for addressing the complex practical and ethical issues that arise from the HIV/AIDS pandemic. The law intersects with reproductive and sexual health issues and HIV/AIDS in many ways. Well-written and rigorously applied laws could benefit persons living with (or at risk of contracting) HIV/AIDS, particularly concerning their reproductive and sexual health. Access to reproductive health services should be a legal right, and discrimination based on HIV status, which undermines access, should be prohibited. Laws against sexual violence and exploitation, which perpetuate the spread of HIV and its negative effects, should be enforced. Finally, a human rights framework should inform the drafting of laws to more effectively protect health.

Models of practice organisation using dental therapists: English case studies.

PubMed

Sun, N; Harris, R V

2011-08-12

A new dental remuneration system based on bands of activity has changed the reward system operating in dental practices and influenced practitioner behaviour in relation to the delegation of tasks to English dental therapists (DTs). Since dental practitioners operate as independent contractors they are free to innovate. A variety of models incorporating DTs in general practice teams exist, some of which may overcome the apparent delegation constraints embedded within this system of remuneration. To describe the way different practices are organised to take account of DTs in their teams and identify whether any of these models address delegation disincentives arising from the system of remuneration. A purposive sample of six dental practices was identified, comprising two small, two medium and two large dental practices, including a variety of models of practice organisation. Semi-structured interviews were carried out with principal dentists, associate dentists, DTs, practice managers and dental hygienists (35 participants in total). A thematic analysis was applied to interview transcripts. The six dental practices demonstrated six different models of practice organisation which could be grouped into 'practice payment' and 'dentist payment' models according to whether the salary costs of the DT were met by a central practice fund or from the income of individual dentists in the team. In both of the large practices only some of the dentists in the team referred work to the DT because of reimbursement issues. In two practices the system was perceived to be satisfactory to all parties, one of these being a single-handed practice with two DTs. Although the remuneration system contained some potential disincentives to DT delegation, some practices innovated in their organisations to overcome these issues.

Cardiovascular diseases and periodontology.

PubMed

Seymour, R A; Preshaw, P M; Thomason, J M; Ellis, J S; Steele, J G

2003-04-01

Cardiovascular diseases represent a widespread heterogeneous group of conditions that have significant morbidity and mortality. The various diseases and their treatments can have an impact upon the periodontium and the delivery of periodontal care. In this paper we consider three main topics and explore their relationship to the periodontist and the provision of periodontal treatment. The areas reviewed include the effect of cardiovascular drugs on the periodontium and management of patients with periodontal diseases; the risk of infective endocarditis arising from periodontal procedures; the inter-relationship between periodontal disease and coronary artery disease. Calcium-channel blockers and beta-adrenoceptor blockers cause gingival overgrowth and tooth demineralisation, respectively. Evidence suggests that stopping anticoagulant therapy prior to periodontal procedures is putting patients at a greater risk of thromboembolic disorders compared to the risk of prolonged bleeding. The relationship between dentistry and infective endocarditis remains a controversial issue. It would appear that spontaneous bacteraemia arising from a patient's oral hygiene practices is more likely to be the cause of endocarditis than one-off periodontal procedures. The efficacy of antibiotic prophylaxis is uncertain (and unlikely to be proven), and the risk of death from penicillin appears to be greater than the risk of death arising from infective endocarditis. Finally, the association between periodontal disease and coronary artery disease has been explored and there seem to be many issues with respect to data handling interpretation. Many putative mechanisms have been suggested; however, these only further highlight the need for intervention studies.

Faith-to-faith at the bedside: theological and ethical issues in ecumenical clinical chaplaincy.

PubMed

Mellon, Brad F

2003-04-01

Chaplains who serve in a clinical context often minister to patients representing a wide variety of faiths. In order to offer the best pastoral care possible, the chaplain should first possess a set of personal theological convictions as a foundation for ministry. Second, he or she needs to be sensitive to the beliefs and practices of the patients. Third, it is vital to develop a relationship of acceptance and trust not only with patients under their care, but also with family members and caregivers as well. At times, situations will arise that are purely religious or theological. In a clinical setting, however, the questions and problems that arise more often are both theological and ethical. It is beneficial for the chaplain to be involved in an ethics committee, where the specifics of each case can be discussed, and staff can offer counsel to patients and their families. This study examines issues that chaplains face at the bedside, such as terminal care, life-prolonging treatments, dementia, persistent vegetative state, and euthanasia-assisted suicide. We will discover that those who are involved in clinical pastoral ministry will be called upon to be a comforter, mediator, educator, ethicist, and counselor.

Dealing sensitively with sexuality in a palliative care context.

PubMed

Woodhouse, Jan; Baldwin, Moyra A

2008-01-01

Sexuality is integral to a person's identity and is encompassed in holistic palliative care. Current directives emphasize psychosocial support that is sensitive to a variety of issues, including sexuality, and offer community nurses the mandate to facilitate expressing sexuality. Nurses fail to address sexuality for a variety of reasons. Appreciating patients' individuality and avoiding making assumptions are some of the requirements to enabling expression of sexuality. Nurses need wisdom and determination to discuss such issues, and it is important that they recognize opportunities and cues as they arise. This article provides an examination of the issues surrounding sexuality outlining an approach that captures' constant attention to details. This guides the 'what', 'how' and 'why' sexuality in palliative care can be addressed. Ethics and safety aspects are briefly discussed and implications for practice suggested. Educating staff and focused education for the patient can positively influence sexuality and individuals' quality of life.

Clinical supervision of psychotherapy: essential ethics issues for supervisors and supervisees.

PubMed

Barnett, Jeffrey E; Molzon, Corey H

2014-11-01

Clinical supervision is an essential aspect of every mental health professional's training. The importance of ensuring that supervision is provided competently, ethically, and legally is explained. The elements of the ethical practice of supervision are described and explained. Specific issues addressed include informed consent and the supervision contract, supervisor and supervisee competence, attention to issues of diversity and multicultural competence, boundaries and multiple relationships in the supervision relationship, documentation and record keeping by both supervisor and supervisee, evaluation and feedback, self-care and the ongoing promotion of wellness, emergency coverage, and the ending of the supervision relationship. Additionally, the role of clinical supervisor as mentor, professional role model, and gatekeeper for the profession are discussed. Specific recommendations are provided for ethically and effectively conducting the supervision relationship and for addressing commonly arising dilemmas that supervisors and supervisees may confront. © 2014 Wiley Periodicals, Inc.

Management system to a photovoltaic panel based on the measurement of short-circuit currents

NASA Astrophysics Data System (ADS)

Dordescu, M.

2016-12-01

This article is devoted to fundamental issues arising from operation in terms of increased energy efficiency for photovoltaic panel (PV). By measuring the current from functioning cage determine the current value prescribed amount corresponding to maximum power point results obtained by requiring proof of pregnancy with this method are the maximum energy possible, thus justifying the usefulness of this process very simple and inexpensive to implement in practice. The proposed adjustment method is much simpler and more economical than conventional methods that rely on measuring power cut.

Biliary pain--work-up and management in general practice.

PubMed

Crawford, Michael

2013-07-01

Pain arising from the gallbladder and biliary tree is a common clinical presentation. Differentiation from other causes of abdominal pain can sometimes be difficult. This article discusses the work-up, management and after care of patients with biliary pain. The role for surgery for gallstones and gallbladder polyps is described. Difficulties in the diagnosis and management of gallbladder pain are discussed. Intra- and post-operative complications are described, along with their management. The issue of post-operative pain in particular is examined, focusing on the timing of the pain and the relevant investigations.

Empirical and Face Validity of Software Maintenance Defect Models Used at the Jet Propulsion Laboratory

NASA Technical Reports Server (NTRS)

Taber, William; Port, Dan

2014-01-01

At the Mission Design and Navigation Software Group at the Jet Propulsion Laboratory we make use of finite exponential based defect models to aid in maintenance planning and management for our widely used critical systems. However a number of pragmatic issues arise when applying defect models for a post-release system in continuous use. These include: how to utilize information from problem reports rather than testing to drive defect discovery and removal effort, practical model calibration, and alignment of model assumptions with our environment.

Teaching Psychiatric Trainees to Respond to Sexual and Loving Feelings: The Supervisory Challenge

PubMed Central

Bridges, Nancy A.

1998-01-01

The intimate nature of the psychodynamic psychotherapy process requires that trainees be educated to deal competently with sexual and loving feelings that arise during psychotherapy. The absence of substantive teaching on these complex treatment issues places a responsibility on the psychotherapy supervisor to educate trainees about the erotic aspects of transference/countertransference. A model of supervision addressing sexual feelings in treatment relationships is proposed and discussed with reference to clinical vignettes.(The Journal of Psychotherapy Practice and Research 1998; 7:217–226) PMID:9631343

Metrology in health: a pilot study

NASA Astrophysics Data System (ADS)

Ferreira, M.; Matos, A.

2015-02-01

The purpose of this paper is to identify and analyze some relevant issues which arise when the concept of metrological traceability is applied to health care facilities. Discussion is structured around the results that were obtained through a characterization and comparative description of the practices applied in 45 different Portuguese health entities. Following a qualitative exploratory approach, the information collected was the support for the initial research hypotheses and the development of the questionnaire survey. It was also applied a quantitative methodology that included a descriptive and inferential statistical analysis of the experimental data set.

Ethical Issues in Transnational Eye Banking.

PubMed

Martin, Dominique E; Kelly, Richard; Jones, Gary L A; Machin, Heather; Pollock, Graeme A

2017-02-01

To review ethical issues that may arise in the setting of transnational eye banking activities, such as when exporting or importing corneal tissue for transplantation. A principle-based normative analysis of potential common dilemmas in transnational eye banking activities was performed. Transnational activities in eye banking, like those in other fields involving procurement and use of medical products of human origin, may present a number of ethical issues for policy makers and professionals. Key ethical concerns include the potential impact of export or import activities on self-sufficiency of corneal tissue supply within exporting and importing countries; potential disclosure requirements when obtaining consent or authorization for ocular tissue donation when donations may be exported; and difficulties inherent in assuring equity in the allocation of tissues available for export and in establishing and respecting standards of safety and quality across different jurisdictions. Further analysis of specific ethical issues in eye banking is necessary to inform development of guidelines and other governance tools that will assist policy makers and professionals to support ethical practice.

Information Virtulization in Virtual Environments

NASA Technical Reports Server (NTRS)

Bryson, Steve; Kwak, Dochan (Technical Monitor)

2001-01-01

Virtual Environments provide a natural setting for a wide range of information visualization applications, particularly wlieit the information to be visualized is defined on a three-dimensional domain (Bryson, 1996). This chapter provides an overview of the issues that arise when designing and implementing an information visualization application in a virtual environment. Many design issues that arise, such as, e.g., issues of display, user tracking are common to any application of virtual environments. In this chapter we focus on those issues that are special to information visualization applications, as issues of wider concern are addressed elsewhere in this book.

Controversies in oncologist-patient communication: a nuanced approach to autonomy, culture, and paternalism.

PubMed

Cherny, Nathan I

2012-01-01

Difficult dialogues with patients facing life-changing decisions are an intrinsic part of oncologic practice and a major source of stress. Having a sophisticated approach to the concepts of autonomy, paternalism, and culture can help in addressing difficult dilemmas that arise around the issues of disclosure and decision making. This article addresses some of the most common major challenges in oncologist-patient communication with a nuanced approach to the concepts of autonomy, paternalism, and culture. It introduces the new concept of"voluntary diminished autonomy" and describes the implications this concept has for the consent process. It also attempts to bring clarity to common problems and misconceptions relating to culture, paternalism, and therapeutic privilege as these pertain to the communication practices of oncologists.

Blending quantitative and qualitative methods in language research and intervention.

PubMed

Brinton, Bonnie; Fujiki, Martin

2003-05-01

Best practice in speech-language pathology should be informed by current research findings. Traditional research methods are not always geared to address some of the complex, individual questions that arise in clinical intervention, however. Qualitative research methods may provide useful tools for bridging the gap from research to practice. Combinations of qualitative and quantitative procedures may be particularly helpful in sorting out some of the important issues surrounding language intervention in both clinical and research contexts. Examples of research blending qualitative and quantitative methods, as well as the case study of Sid, an 11-year-old boy with specific language impairment, are presented to illustrate how a combination of procedures can be used to enhance language research and intervention.

Ethical dilemmas in pediatric and adolescent psychogenic nonepileptic seizures.

PubMed

Cole, Cristie M; Falcone, Tatiana; Caplan, Rochelle; Timmons-Mitchell, Jane; Jares, Kristine; Ford, Paul J

2014-08-01

To date, only a very narrow window of ethical dilemmas in psychogenic nonepileptic seizures (PNES) has been explored. Numerous distinct ethical dilemmas arise in diagnosing and treating pediatric and adolescent patients with PNESs. Important ethical values at stake include trust, transparency, confidentiality, professionalism, autonomy of all stakeholders, and justice. In order to further elucidate the ethical challenges in caring for this population, an ethical analysis of the special challenges faced in four specific domains is undertaken: (1) conducting and communicating a diagnosis of PNESs, (2) advising patients about full transparency and disclosure to community including patients' peers, (3) responding to requests to continue antiepileptic drugs, and (4) managing challenges arising from school policy and procedure. An analysis of these ethical issues is essential for the advancement of best care practices that promote the overall well-being of patients and their families. Copyright © 2014 Elsevier Inc. All rights reserved.

Ethical Dilemmas in Pediatric and Adolescent Psychogenic Non-Epileptic Seizures

PubMed Central

Cole, Cristie M.; Falcone, Tatiana; Caplan, Rochelle; Timmons-Mitchell, Jane; Jares, Kristine; Ford, Paul J.

2014-01-01

To date only a very narrow window of ethical dilemmas in psychogenic non-epileptic seizures (PNES) have been explored. Numerous distinct ethical dilemmas arise in diagnosing and treating pediatric and adolescent patients with PNES. Important ethical values at stake include trust, transparency, confidentiality, professionalism, autonomy of all stakeholders and justice. In order to further elucidate the ethical challenges in caring for this population, an ethical analysis of the special challenges faced in four specific domains is undertaken: (1) conducting and communicating a diagnosis of PNES; (2) advising patients about full transparency and disclosure to community including patients’ peers; (3) responding to requests to continue anti-epileptic drugs; and (4) managing challenges arising from school policy and procedure. An analysis of these ethical issues is essential for the advancement of best care practices that promote the overall well-being of patients and their families. PMID:25022823

76 FR 77053 - Proposed Collection; Income, Excise, and Estate and Gift Taxes Effective Dates, etc.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-09

... Estate and Gift Taxes Effective Dates, etc. AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... gift taxes; effective dates and other issues arising under the employee benefit provisions of the tax..., Excise, and Estate and Gift Taxes Effective Dates and Other Issues Arising Under the Employee Benefit...

'Am I covered?': an analysis of a national enquiry database on scope of practice.

PubMed

Brady, Anne-Marie; Fealy, Gerard; Casey, Mary; Hegarty, Josephine; Kennedy, Catriona; McNamara, Martin; O'Reilly, Pauline; Prizeman, Geraldine; Rohde, Daniela

2015-10-01

Analysis of a national database of enquiries to a professional body pertaining to the scope of nursing and midwifery practice. Against a backdrop of healthcare reform is a demand for flexibility in nursing and midwifery roles with unprecedented redefinition of role boundaries and/or expansion. Guidance from professional regulatory bodies is being sought around issues of concern that are arising in practice. Qualitative thematic analysis. The database of telephone enquiries (n = 9818) made by Registered Nurses and midwives to a national regulatory body (2001-2013) was subjected to a cleaning process and examined to detect those concerns that pertained to scope of practice. A total of 978 enquiries were subjected to thematic analysis. Enquiries were concerned with three main areas: medication management, changing and evolving scope of practice and professional role boundaries. The context was service developments, staff shortages and uncertainty about role expansion and professional accountability. Other concerns related to expectations around responsibility and accountability for other support staff. Efforts by employers to maximize the skill mix of their staff and optimally deploy staff to meet service needs and/or address gaps in service represented the primary service context from which many enquiries arose. The greatest concern for nurses arises around medication management but innovation in healthcare delivery and the demands of service are also creating challenges for nurses and midwives. Maintaining and developing competence is a concern among nurses and midwives particularly in an environment of limited resources and where re-deployment is common. © 2015 John Wiley & Sons Ltd.

Unmasking the predicament of cultural voyeurism: a postcolonial analysis of international nursing placements.

PubMed

Racine, Louise; Perron, Amélie

2012-09-01

The growing interest in international nursing placements cannot be left unnoticed. After 11 years into this twenty-first century, violations of human rights and freedom of speech, environmental disasters, and armed conflicts still create dire living conditions for men and women around the world. Nurses have an ethical duty to address issues of social justice and global health as a means to fulfil nursing's social mandate. However, international placements raise some concerns. Drawing on the works of postcolonial theorists in nursing and social sciences, we examine the risk of replicating colonialist practices and discourses of health in international clinical placements. Referring to Bakhtin's notions of dialogism and unfinalizability, we envision a culturally safe nursing practice arising from dialogical encounters between the Self as an Other and with the Other as an Other. We suggest that exploring the intricacies of cultural and race relations in everyday nursing practice are the premises upon which nurses can understand the broader historic, racial, gendered, political and economic contexts of global health issues. Finally, we make suggestions for developing culturally safe learning opportunities at the international level without minimizing the impact of dialogical cultural encounters occurring at the local and community levels. © 2011 Blackwell Publishing Ltd.

Ethical consequences for professionals from the globalization of food, nutrition and health.

PubMed

Solomons, Noel W

2002-01-01

Globalization is the process of increasing interconnections and linkages, within societies and across geography, due to improved communication and expanded world trade. It limits the differentiation wrought by human cultural evolution, and homogenizes health practices, diet and lifestyle. There are both beneficial and adverse consequences of the globalization process. Globalization also presents a challenge to the development of ethics for practice and advocacy by food and nutrition professionals. Among the related terms, 'morals', 'values' and 'ethics', the latter connotes the basic rules of conduct for interactions within society and with the inanimate environment; rules based on recognized principles (ethical principles). The application of these principles is to resolve ethical dilemmas that arise when more than one interest is at play. Recognized ethical principles include autonomy, beneficence, non-maleficence, justice, utility and stewardship. These can be framed in the context of issues that arise during advocacy for material and behavioural changes to improve the nutritional health of populations. Clearly, at the global level, codes of good conduct and the construction of good food governance can be useful in institutionalizing ethical principles in matters of human diets and eating practices. Ethical dilemmas arise in the context of innate diversity among populations (some individuals benefit, whereas others suffer from the same exposures), and due to the polarity of human physiology and metabolism (practices that prevent some diseases will provoke other maladies). Moreover, the autonomy of one individual to exercise independent will in addressing personal health or treatment of the environment may compromise the health of the individual's neighbours. The challenges for the professional in pursuit of ethical advocacy in a globalized era are to learn the fundamentals of ethical principles; to bear in mind a respect for difference and differentiation that continues to exist, and which should exist, among individuals and societies; and to avoid a total homogenization of agriculture and food supplies.

Examining the conflation of multiculturalism, sexism, and religious fundamentalism through Taylor and Bakhtin: expanding post-colonial feminist epistemology.

PubMed

Racine, Louise

2009-01-01

In this post-9/11 era marked by religious and ethnic conflicts and the rise of cultural intolerance, ambiguities arising from the conflation of multiculturalism, sexism, and religious fundamentalism jeopardize the delivery of culturally safe nursing care to non-Western populations. This new social reality requires nurses to develop a heightened awareness of health issues pertaining to racism and ethnocentrism to provide culturally safe care to non-Western immigrants or refugees. Through the lens of post-colonial feminism, this paper explores the challenge of providing culturally safe nursing care in the context of the post-9/11 in Canadian healthcare settings. A critical appraisal of the literature demonstrates that post-colonial feminism, despite some limitations, remains a valuable theoretical perspective to apply in cultural nursing research and develop culturally safe nursing practice. Post-colonial feminism offers the analytical lens to understand how health, social and cultural context, race and gender intersect to impact on non-Western populations' health. However, an uncritical application of post-colonial feminism may not serve racialized men's and women's interests because of its essentialist risk. Post-colonial feminism must expand its epistemological assumptions to integrate Taylor's concept of identity and recognition and Bakhtin's concepts of dialogism and unfinalizability to explore non-Western populations' health issues and the context of nursing practice. This would strengthen the theoretical adequacy of post-colonial feminist approaches in unveiling the process of racialization that arises from the conflation of multiculturalism, sexism, and religious fundamentalism in Western healthcare settings.

Ethical issues in nanomedicine: Tempest in a teapot?

PubMed

Allon, Irit; Ben-Yehudah, Ahmi; Dekel, Raz; Solbakk, Jan-Helge; Weltring, Klaus-Michael; Siegal, Gil

2017-03-01

Nanomedicine offers remarkable options for new therapeutic avenues. As methods in nanomedicine advance, ethical questions conjunctly arise. Nanomedicine is an exceptional niche in several aspects as it reflects risks and uncertainties not encountered in other areas of medical research or practice. Nanomedicine partially overlaps, partially interlocks and partially exceeds other medical disciplines. Some interpreters agree that advances in nanotechnology may pose varied ethical challenges, whilst others argue that these challenges are not new and that nanotechnology basically echoes recurrent bioethical dilemmas. The purpose of this article is to discuss some of the ethical issues related to nanomedicine and to reflect on the question whether nanomedicine generates ethical challenges of new and unique nature. Such a determination should have implications on regulatory processes and professional conducts and protocols in the future.

Addressing the need for staff support among nurses caring for the AIDS population.

PubMed

Pasacreta, J V; Jacobsen, P B

1989-01-01

More and more nurses are caring for individuals with AIDS-spectrum disorders. When nurses become involved in hospital-based AIDS treatment, major psychosocial issues can arise. In settings where nursing personnel have limited or no experience working with patients with AIDS, fear of contagion is a major issue. This fear has both rational and irrational components. In general, providing up-to-date information in a small group setting can effectively reduce irrational fears. Rational fears, which are not as easily dealt with, should be a stimulus for behavior change (e.g., adoption of precautionary guidelines for reducing the possibility of accidental infection). Different issues arise among nurses specializing in AIDS care and include burnout, a sense of professional isolation, and the need to establish personal boundaries in dealing with patients. Guidelines are offered for establishing a group approach to address these concerns and to handle the sensitive issues that may arise.

Ad hoc supervision of general practice registrars as a 'community of practice': analysis, interpretation and re-presentation.

PubMed

Clement, T; Brown, J; Morrison, J; Nestel, D

2016-05-01

General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also provide an opportunity for learning and teaching. Wenger's (Communities of practice: learning, meaning, and identity. Cambridge University Press, New York, 1998) social theory of learning ('communities of practice') guided a secondary analysis of audio-recordings of ad hoc encounters. Data from one encounter is re-presented as an extended sequence to maintain congruence with the theoretical perspective and enhance vicariousness. An interpretive commentary communicates key features of Wenger's theory and highlights the researchers' interpretations. We argue that one encounter can reveal universal understandings of clinical supervision and that the process of naturalistic generalisation allows readers to transfer others' experiences to their own contexts. The paper raises significant analytic, interpretive, and representational issues. We highlight that report writing is an important, but infrequently discussed, part of research design. We discuss the challenges of supporting the learning and teaching that arises from adopting a socio-cultural lens and argue that such a perspective importantly captures the complex range of issues that work-based practitioners have to grapple with. This offers a challenge to how we research and seek to influence work-based learning and teaching in health care settings.

Nurses' use of qualitative research approaches to investigate tobacco use and control.

PubMed

Schultz, Annette S H; Bottorff, Joan L; McKeown, Stephanie Barclay

2009-01-01

Qualitative research methods are increasingly used by nurse scientists to explore a wide variety of topics relevant to practice and/or health policy issues. The purpose of this chapter is to review the contributions of nurse scientists to the field of tobacco control through the use of qualitative research methods. A systematic literature search strategy was used to identify 51 articles published between 1980 and 2008. The majority (84%) of reviewed articles were authored by North American nurse scientists. Cessation was the most commonly (85%) studied aspect of tobacco control. Six qualitative research approaches were used: qualitative descriptive (55%), narrative analysis (8%), phenomenology (6%), grounded theory (14%), ethnography (12%), and case study (6%). Qualitative descriptive methods were primarily one-off studies to address practical problems or issues encountered in practice, and often validated current understandings related to tobacco. Researchers who used other types of qualitative methods and who conducted qualitative studies as part of programs of research were more likely to make more substantive contributions to the evolving field of tobacco control. These contributions related to how smoking intertwines with personal and social identities, the influence of social context on tobacco use, and nurses' involvement in tobacco control (both of their own tobacco use and in assisting others). Nurse scientists interested in exploring tobacco-related issues are encouraged to consider the full range of qualitative research approaches. Qualitative research methods contribute to our understanding of tobacco use arising from nursing practice, health care and policy, along with the field of tobacco control in general.

Ethics in the practice of speech-language pathology in health care settings.

PubMed

Kummer, Ann W; Turner, Jan

2011-11-01

ETHICS refers to a moral philosophy or a set of moral principles that determine appropriate behavior in a society. Medical ethics includes a set of specific values that are considered in determining appropriate conduct in the practice of medicine or health care. Because the practice of medicine and medical speech-language pathology affects the health, well-being, and quality of life of individuals served, adherence to a code of ethical conduct is critically important in the health care environment. When ethical dilemmas arise, consultation with a bioethics committee can be helpful in determining the best course of action. This article will help to define medical ethics and to discuss the six basic values that are commonly considered in discussions of medical ethics. Common ethical mistakes in the practice of speech-language pathology will be described. Finally, the value of a bioethics consultation for help in resolving complex ethical issues will be discussed. © Thieme Medical Publishers.

The ethics of research on stored biological samples: outcomes of a Workshop.

PubMed

Vaz, Manjulika; Sridhar, T S; Pai, Sanjay A

2016-01-01

Research is often conducted using laboratory samples and data. The ethical issues that arise in a study involving residual samples are considerably different from those arising in a prospective study. Some of these ethical issues concern the risks to confidentiality, individual autonomy, trust in and credibility of the researcher or the research, commercialisation and even the nomenclature involved.

Ethics Instruction for Future Geoscientists: Essential for Contributions to Good Public Policy

NASA Astrophysics Data System (ADS)

Leinen, M.; Mogk, D. W.

2016-12-01

Geoscientists work in a world of uncertainty in the complex, dynamic, and chaotic Earth system that is fraught with opportunities to become involved in ethical dilemmas. To be effective contributors to the public discourse on Earth science policy, geoscientists must conduct their work according to the highest personal and professional ethical standards. The geosciences as a discipline relies on the fidelity of geoscience data and their interpretations, geoscience concepts and methodologies must be conveyed to policy makers in ways that allow them to make informed decisions, corporations require a workforce that conducts their affairs according to the highest standards, and the general public expects the highest standards of conduct of geoscientists as they underwrite much of the research supported through tax dollars and the applications of this research impacts personal and societal lives. Geoscientists must have the foundations to identify ethical dilemmas in the first instance, and to have the ethical decision-making skills to either prevent, mitigate or otherwise address ethical issues that arise in professional practice. Awareness of ethical issues arises in many dimensions: Ethics and self (engaging self-monitoring and self-regulating behaviors); Ethics and profession (working according to professional standards); Ethics and society (communicating effectively to policy makers and the general public about the underlying science that informs public policy); and, Ethics and Earth (recognizing the unique responsibilities of geoscientists in the stewardship of Earth). To meet these ethical challenges, training of future geoscientists must be done a) at the introductory level as all students should be aware of ethical implications of geoscience concepts as they impact societal issues; undergraduate geoscience majors need to be explicitly trained in the standards and norms of the geoscience community of practice; graduate students need to be fully prepared to deal with ethical issues in future employment in the academy, government agencies or the industry. We have developed a comprehensive website, Teaching Geoethics Across the Geoscience Curriculum to support instruction in ethics at all levels: http://serc.carleton.edu/geoethics/index.html

Scaling up the global nursing health workforce: contributions of an international organization.

PubMed

Rukholm, Ellen E; Stamler, Lynnette Leeseberg; Talbot, Lise R; Bednash, Geraldine; Raines, Fay; Potempa, Kathleen; Nugent, Pauline; Clark, Dame Jill Macleod; Bernhauser, Sue; Parfitt, Barbara

2009-01-01

In this paper key highlights of the scholarly work presented at the Toronto 2008 Global Alliance for Nursing Education & Scholarship (GANES) conference are summarized, challenges opportunities and issues facing nursing education globally arising from the conference discourse are outlined and initial steps are suggested as a way forward to a shared global view of baccalaureate and graduate nursing education and scholarship. This shared view arises from beginning understandings of the issues and opportunities we face globally starting with and building upon the lessons learned from the literature and from the experiences of nursing educators and nursing education organization locally, regionally, nationally and internationally. The theme of the groundbreaking GANES Toronto conference was "Educating the future nursing and health workforce: A global challenge". One hundred seventy delegates from 17 countries attended the event, with over 80 papers presented. A primary focus of GANES is the contribution of a strategic alliance of national nursing education organizations to contribute to nursing education leading practices and policy that address the scaling up of global nursing and health workforce. The founding members of GANES see a clear link between a strong educational infrastructure and strong scholarship activities in nursing and the ability of a society to be healthy and prosperous. Evidence presented at the recent GANES conference supports that belief. Through the strength of partnerships and other capacity-building efforts, member countries can support each other to address the global nursing education and health challenges while respecting the local issues.

What Medical Writing Means To Me

PubMed Central

Wager, Elizabeth

2007-01-01

This is a personal account based on many years experience as a medical writer. It considers aspects of medical writing with particular focus on the intellectual and ethical dilemmas it can raise. What makes medical writing both so interesting and so challenging is the fact that it often takes place at the border between different disciplines. For example, it straddles both science and art. Ethical issues also arise at the boundaries between academia and commerce. Until recently there have been few guidelines to help navigate such potentially dangerous territory. I have been privileged to be involved in developing two such guidelines and I describe how I hope the Good Publication Practice guidelines for pharmaceutical companies and the European Medical Writers Association guidelines may improve the practice of this fascinating profession, Medical Writing. PMID:22058630

What medical writing means to me.

PubMed

Wager, Elizabeth

2007-01-01

This is a personal account based on many years experience as a medical writer. It considers aspects of medical writing with particular focus on the intellectual and ethical dilemmas it can raise. What makes medical writing both so interesting and so challenging is the fact that it often takes place at the border between different disciplines. For example, it straddles both science and art. Ethical issues also arise at the boundaries between academia and commerce. Until recently there have been few guidelines to help navigate such potentially dangerous territory. I have been privileged to be involved in developing two such guidelines and I describe how I hope the Good Publication Practice guidelines for pharmaceutical companies and the European Medical Writers Association guidelines may improve the practice of this fascinating profession, Medical Writing.

DNR versus DNT: clinical implications of a conceptual ambiguity: a case analysis.

PubMed

Martin, Robert D; Cohen, Mary Ann; Weiss Roberts, Laura; Batista, Sharon M; Hicks, Dan; Bourgeois, James

2007-01-01

Psychiatrists who practice psychosomatic medicine are routinely called upon to help resolve ethical dilemmas that arise in the care of patients near the end of their lives. Psychosomatic-medicine psychiatrists may be of unique value in these situations because of the clinical insights that we bring to the care of the dying patient. In particular, our subspecialty brings expertise related to the evaluation of decisional capacity of patients who are faced with accepting or declining end-of-life clinical interventions, such as resuscitation and intubation. In this first entry in a new bioethics case series in Psychosomatics, we will lay the groundwork for examining a complex patient case and provide an illustrative analysis of the end-of-life care issues that may be addressed by psychiatrists who practice psychosomatic medicine.

Initiatives by the government and physician groups to improve awareness of medical ethics: Challenges in Japan

PubMed Central

MORIOKA, Yasuhiko

2012-01-01

Physicians have been required to possess high ethical standards, as medical practice is directly involved with patients' lives. Although ethics arise out of an individual's consciousness, ethical regulations imposed by the nation/government together with self-regulation by physician groups are important in the practice of ethics, for which reason countries around the world undertake various initiatives. This paper investigates physician licensure, organizations governing physician status, the role of physician groups, and the actual conditions of lifelong learning and ethics education in developed countries worldwide, in contrast with which it throws problems in the situation in Japan into relief. Organizations governing physician status, the form of medical associations, and the improvement of lifelong learning are pointed out as critical issues especially in Japan. PMID:22498978

EM in high-dimensional spaces.

PubMed

Draper, Bruce A; Elliott, Daniel L; Hayes, Jeremy; Baek, Kyungim

2005-06-01

This paper considers fitting a mixture of Gaussians model to high-dimensional data in scenarios where there are fewer data samples than feature dimensions. Issues that arise when using principal component analysis (PCA) to represent Gaussian distributions inside Expectation-Maximization (EM) are addressed, and a practical algorithm results. Unlike other algorithms that have been proposed, this algorithm does not try to compress the data to fit low-dimensional models. Instead, it models Gaussian distributions in the (N - 1)-dimensional space spanned by the N data samples. We are able to show that this algorithm converges on data sets where low-dimensional techniques do not.

Resource allocation and purchasing in the health sector: the English experience.

PubMed

Smith, Peter C

2008-11-01

The United Kingdom of Great Britain and Northern Ireland has extensive experience in allocating health service funds to regions and localities using funding formulae. This paper focuses on England. Special attention is given to recent policy concerns to reduce avoidable health inequalities by broadening the remit of the resource allocation formulae. The paper also examines the issues that arise when seeking to allocate funds to very small organizational units, such as general practices. The English example is relevant to less-developed health systems, especially for those governments seeking to decentralize, to improve accountability and to promote equity.

Sociological Ambivalence and Funeral Consumption

PubMed Central

Canning, Louise

2015-01-01

This article builds on Hillcoat-Nallétamby and Phillips’ (2011) conceptualization of sociological ambivalence within the relational framework to examine a particular consumption practice, the funeral. We develop understanding of social, cultural and relational issues that arise from the experience associated with funeral-arranging. This is not a voluntary behaviour but one engaged with through force of circumstance and which involves commercial and relational decisions. Drawing on data from 10 interviews from a larger UK study, we focus on ambivalence surrounding choice and its impact on relations, showing how sentiments including love, obligation, regret and revenge evolve and transform past and future relationships. PMID:26236046

Quality health care in the European Union thanks to competition law.

PubMed

Fornaciari, Diego

2010-01-01

There are many biases concerning the application of competition law in health care. Quality concerns can however be integrated into competition law analysis. The aim of this paper is to identify the links between the application of competition law in the European Union and the right to quality health care and to point out the problems that arise when integrating quality concerns in competition law analysis. Guidelines must be issued and competition authorities must work together with institutions that have expertise in the field of health care quality measurement in order to integrate these dimensions in competition practice.

Ethical Issues and Practical Challenges in Suicide Research.

PubMed

Hom, Melanie A; Podlogar, Matthew C; Stanley, Ian H; Joiner, Thomas E

2017-03-01

Research with human subjects represents a critical avenue for suicide prevention efforts; however, such research is not without its ethical and practical challenges. Specifically, given the nature of research with individuals at elevated risk for suicide (e.g., increased concerns regarding participant safety, adverse events, liability, difficulties often arise during the institutional review board (IRB) evaluation and approval process. This paper aims to discuss IRB-related issues associated with suicide prevention research, including researcher and IRB panel member responsibilities, suicide risk assessment and management ethics and procedures, informed consent considerations, preparation of study protocols, and education and training. Points to consider and components to potentially include in an IRB application for suicide-related research are additionally provided. Literature relevant to ethics in suicide research and suicide risk assessment and management was reviewed and synthesized. Suicide research can be conducted in accordance with ethical principles while also furthering the science of suicide prevention. Despite the challenging nature of suicide prevention research, empirically informed solutions exist to address difficulties that may emerge in interfacing with IRBs. There remain areas for improvement in the IRB approval process that warrant further investigation and work.

Communication strategies and intensive interaction therapy meet the theology of the body: bioethics in dialogue with people with profound disabilities.

PubMed

Matthews, Pia

2013-01-01

Academic bioethics does not appear to be interested in communication and its ethical concerns unless communication is to do with issues such as capacity, consent, truth telling and confidentiality. In contrast practitioners are interested in actually communicating with their patients and they are often particularly perplexed when it comes to people with profound disabilities where communication appears disrupted. Although some new and not so new communication strategies, and especially intensive interaction, are available, little has been written on either the ethical concerns these may present or the deeper concepts that underpin them. This article explores the practical applications of some of these communication strategies. By engaging these strategies with theology, and specifically Pope John Paul's Theology of the Body, this article identifies and addresses some significant ethical issues that may arise, notably the risk of dualism and of objectifying the human person. Moreover it provides communication strategies with a rationale that goes beyond practicalities to one based on respect for human dignity, justice and solidarity.

Dancing through Cape Coast: ethical and practical considerations for health-related service-learning programs.

PubMed

Saffran, Lise

2013-09-01

Short-term service-learning programs that focus on global health are expanding rapidly, spurred by students' desire to be of service in a world that has been made to seem small by new technology and universities' willingness to embrace the goal of educating global citizens. In this commentary, the author uses experiences from a recent trip she led to Ghana as a backdrop against which to explore some of the ethical and practical issues that arise when U.S. students work in health-related programs in developing countries. At minimum, the author argues, these programs should lead students to consider issues such as which basic services people are entitled to, regardless of where and in what circumstances they live, and how differences in access to social and economic resources contribute to health disparities on a global scale. She also suggests that sponsoring institutions should consider what is owed to the countries and communities in which their students learn. Finally, she underscores the circumstances under which service-learning programs can truly benefit the cause of global health.

Coupling Considerations in Assembly Language

DTIC Science & Technology

2018-01-05

report discusses coupling issues arising in assembly language source code, as contrasted to similar issues arising in high order language (HOL...Warfare Center Weapons Division (NAWCWD) require compliance with DO-178B and DO-178C, which contain guidelines relating to data and control coupling. The...considered unknown, but its effect on development and maintenance will serve as indicators on whether the coupling measure is high or low. Both

Measuring value sensitivity in medicine.

PubMed

Ineichen, Christian; Christen, Markus; Tanner, Carmen

2017-01-28

Value sensitivity - the ability to recognize value-related issues when they arise in practice - is an indispensable competence for medical practitioners to enter decision-making processes related to ethical questions. However, the psychological competence of value sensitivity is seldom an explicit subject in the training of medical professionals. In this contribution, we outline the traditional concept of moral sensitivity in medicine and its revised form conceptualized as value sensitivity and we propose an instrument that measures value sensitivity. We developed an instrument for assessing the sensitivity for three value groups (moral-related values, values related to the principles of biomedical ethics, strategy-related values) in a four step procedure: 1) value identification (n = 317); 2) value representation (n = 317); 3) vignette construction and quality evaluation (n = 37); and 4) instrument validation by comparing nursing professionals with hospital managers (n = 48). We find that nursing professionals recognize and ascribe importance to principle-related issues more than professionals from hospital management. The latter are more likely to recognize and ascribe importance to strategy-related issues. These hypothesis-driven results demonstrate the discriminatory power of our newly developed instrument, which makes it useful not only for health care professionals in practice but for students and people working in the clinical context as well.

Experimental studies of high-accuracy RFID localization with channel impairments

NASA Astrophysics Data System (ADS)

Pauls, Eric; Zhang, Yimin D.

2015-05-01

Radio frequency identification (RFID) systems present an incredibly cost-effective and easy-to-implement solution to close-range localization. One of the important applications of a passive RFID system is to determine the reader position through multilateration based on the estimated distances between the reader and multiple distributed reference tags obtained from, e.g., the received signal strength indicator (RSSI) readings. In practice, the achievable accuracy of passive RFID reader localization suffers from many factors, such as the distorted RSSI reading due to channel impairments in terms of the susceptibility to reader antenna patterns and multipath propagation. Previous studies have shown that the accuracy of passive RFID localization can be significantly improved by properly modeling and compensating for such channel impairments. The objective of this paper is to report experimental study results that validate the effectiveness of such approaches for high-accuracy RFID localization. We also examine a number of practical issues arising in the underlying problem that limit the accuracy of reader-tag distance measurements and, therefore, the estimated reader localization. These issues include the variations in tag radiation characteristics for similar tags, effects of tag orientations, and reader RSS quantization and measurement errors. As such, this paper reveals valuable insights of the issues and solutions toward achieving high-accuracy passive RFID localization.

Ethical and regulatory issues of pragmatic cluster randomized trials in contemporary health systems

PubMed Central

Anderson, Monique L; Califf, Robert M; Sugarman, Jeremy

2015-01-01

Cluster randomized trials (CRTs) randomly assign groups of individuals to examine research questions or test interventions and measure their effects on individuals. Recent emphasis on quality improvement, comparative effectiveness, and learning health systems has prompted expanded use of pragmatic CRTs in routine healthcare settings, which in turn poses practical and ethical challenges that current oversight frameworks may not adequately address. The 2012 Ottawa Statement provides a basis for considering many issues related to pragmatic CRTs but challenges remain, including some arising from the current U.S. research and healthcare regulations. In order to examine the ethical, regulatory, and practical questions facing pragmatic CRTs in healthcare settings, the National Institutes of Health (NIH) Health Care Systems Research Collaboratory convened a workshop in Bethesda, Maryland in July of 2013. Attendees included experts in clinical trials, patient advocacy, research ethics, and research regulations from academia, industry, the NIH, and other federal agencies. Workshop participants identified substantial barriers to implementing these types of CRTs, including issues related to research design, gatekeepers and governance in health systems, consent, institutional review boards, data monitoring, privacy, and special populations. We describe these barriers and suggest means for understanding and overcoming them to facilitate pragmatic CRTs in healthcare settings. PMID:25733677

Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 1--The model.

PubMed

Dawber, Chris

2013-04-01

In the present study, we outline the evolution of a process-focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3-year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group-as-a-whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process-focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

When an adult female seeks ritual genital alteration: ethics, law, and the parameters of participation.

PubMed

Cantor, Julie D

2006-04-01

Ritual genital cutting for women, a common practice in Africa and elsewhere around the world, remains dangerous and controversial. In recent years, a 14-year-old girl living in Sierra Leone exsanguinated and died following a ritualistic genital cutting. Hoping to avoid that fate, women with backgrounds that accept ritual genital cutting may, when they reach majority age, ask plastic surgeons to perform genital alterations for cultural reasons. Although plastic surgeons routinely perform cosmetic procedures, unique ethical and legal concerns arise when an adult female patient asks a surgeon to spare her the tribal elder's knife and alter her genitalia according to tradition and custom. Misinformation and confusion about this issue exist. This article explores the ethical and legal issues relevant to this situation and explains how the thoughtful surgeon should proceed.

Qualitative research with small connected communities: generating new knowledge while upholding research ethics.

PubMed

Damianakis, Thecla; Woodford, Michael R

2012-05-01

Qualitative researchers have a dual mission: to generate knowledge through rigorous research and to uphold ethical standards and principles. Qualitative researchers often conduct studies with small connected communities in which relationships exist among community members. When engaging such communities, researchers might face ethical issues in upholding confidentiality standards while they work to achieve their dual mandate. Qualitative scholars have paid little attention to the ethical challenges that might arise in this context. Drawing on our experiences conducting studies with such communities, we expand the dialogue concerning qualitative research ethics by making explicit conceptual and practical tensions that emerge at various stages of the research process; articulating our respective reflective processes; and exploring issues associated with strategies for upholding confidentiality. We conclude with lessons learned to guide researchers who might face similar challenges.

Applying Antonio Gramsci's philosophy to postcolonial feminist social and political activism in nursing.

PubMed

Racine, Louise

2009-07-01

Through its social and political activism goals, postcolonial feminist theoretical approaches not only focus on individual issues that affect health but encompass the examination of the complex interplay between neocolonialism, neoliberalism, and globalization, in mediating the health of non-Western immigrants and refugees. Postcolonial feminism holds the promise to influence nursing research and practice in the 21st century where health remains a goal to achieve and a commitment for humanity. This is especially relevant for nurses, who act as global citizens and as voices for the voiceless. The commitment of nursing to social justice must be further strengthened by relying on postcolonial theories to address issues of health inequities that arise from marginalization and racialization. In using postcolonial feminist theories, nurse researchers locate the inquiry process within a Gramscian philosophy of praxis that represents knowledge in action.

Lessons Learned from Implementing the Patient-Centered Medical Home

PubMed Central

Green, Ellen P.; Wendland, John; Carver, M. Colette; Hughes Rinker, Cortney; Mun, Seong K.

2012-01-01

The Patient-Centered Medical Home (PCMH) is a primary care model that provides coordinated and comprehensive care to patients to improve health outcomes. This paper addresses practical issues that arise when transitioning a traditional primary care practice into a PCMH recognized by the National Committee for Quality Assurance (NCQA). Individual organizations' experiences with this transition were gathered at a PCMH workshop in Alexandria, Virginia in June 2010. An analysis of their experiences has been used along with a literature review to reveal common challenges that must be addressed in ways that are responsive to the practice and patients' needs. These are: NCQA guidance, promoting provider buy-in, leveraging electronic medical records, changing office culture, and realigning workspace in the practice to accommodate services needed to carry out the intent of PCMH. The NCQA provides a set of standards for implementing the PCMH model, but these standards lack many specifics that will be relied on in location situations. While many researchers and providers have made critiques, we see this vagueness as allowing for greater flexibility in how a practice implements PCMH. PMID:22969797

Lessons learned from implementing the patient-centered medical home.

PubMed

Green, Ellen P; Wendland, John; Carver, M Colette; Hughes Rinker, Cortney; Mun, Seong K

2012-01-01

The Patient-Centered Medical Home (PCMH) is a primary care model that provides coordinated and comprehensive care to patients to improve health outcomes. This paper addresses practical issues that arise when transitioning a traditional primary care practice into a PCMH recognized by the National Committee for Quality Assurance (NCQA). Individual organizations' experiences with this transition were gathered at a PCMH workshop in Alexandria, Virginia in June 2010. An analysis of their experiences has been used along with a literature review to reveal common challenges that must be addressed in ways that are responsive to the practice and patients' needs. These are: NCQA guidance, promoting provider buy-in, leveraging electronic medical records, changing office culture, and realigning workspace in the practice to accommodate services needed to carry out the intent of PCMH. The NCQA provides a set of standards for implementing the PCMH model, but these standards lack many specifics that will be relied on in location situations. While many researchers and providers have made critiques, we see this vagueness as allowing for greater flexibility in how a practice implements PCMH.

Issues and Dilemmas of Biotechnology, A Reference Guide by Bernice Schacter

NASA Astrophysics Data System (ADS)

Sweeting, Linda M.

2000-10-01

I also recommend the book to the readers of this Journal to provide a base for discussing these issues with the biology majors you teach and with your colleagues in molecular biology. Schacter clarified many technical and practical issues for me, such as the potential usefulness of generating embryos by somatic cell nuclear transfer and the difference between this process and true cloning. I particularly appreciated the measured evaluation of the current products of genetic engineering--Bt corn, bovine growth hormone, testing for BRCA-1 and -2, and forensic use of DNA fingerprinting. Schacter has not succumbed to the temptation to exaggerate either the success or the dangers of biotechnology, but has pointed out the strengths and weaknesses of the methods as part of her commitment to provide readers with the technical base to make their own judgments if and when the situation arises. The book should provide a welcome antidote to both the hype and the panic surrounding advances in biotechnology.

Foundations of translational ecology

USGS Publications Warehouse

Enquist, Carolyn A. F.; Jackson, Stephen T.; Garfin, Gregg M.; Davis, Frank W.; Gerber, Leah R.; Littell, Jeremy; Tank, Jennifer L.; Terando, Adam; Wall, Tamara U.; Halpern, Benjamin S.; Morelli, Toni L.; Hiers, J. Kevin; McNie, Elizabeth; Stephenson, Nathan L.; Williamson, Matthew A.; Woodhouse, Connie A.; Yung, Laurie; Brunson, Mark W.; Hall, Kimberly R.; Hallett, Lauren M.; Lawson, Dawn M.; Moritz, Max A.; Nydick, Koren R.; Pairis, Amber; Ray, Andrea J.; Regan, Claudia M.; Safford, Hugh D.; Schwartz, Mark W.; Shaw, M. Rebecca

2017-01-01

Ecologists who specialize in translational ecology (TE) seek to link ecological knowledge to decision making by integrating ecological science with the full complement of social dimensions that underlie today's complex environmental issues. TE is motivated by a search for outcomes that directly serve the needs of natural resource managers and decision makers. This objective distinguishes it from both basic and applied ecological research and, as a practice, it deliberately extends research beyond theory or opportunistic applications. TE is uniquely positioned to address complex issues through interdisciplinary team approaches and integrated scientist–practitioner partnerships. The creativity and context‐specific knowledge of resource managers, practitioners, and decision makers inform and enrich the scientific process and help shape use‐driven, actionable science. Moreover, addressing research questions that arise from on‐the‐ground management issues – as opposed to the top‐down or expert‐oriented perspectives of traditional science – can foster the high levels of trust and commitment that are critical for long‐term, sustained engagement between partners.

Legal and ethical issues of uterus transplantation.

PubMed

Dickens, Bernard M

2016-04-01

The clinically detailed report of a successful uterus transplantation and live birth in Sweden, in which a family friend donated her uterus, provides a basis for expanded practice. Family members and friends can serve as living donors without offending legal or ethical prohibitions of paid organ donation, even though family members and friends often engage in reciprocal gift exchanges. Donations from living unrelated sources are more problematic, and there is a need to monitor donors' genuine altruism and motivation. Donation by deceased women-i.e. cadaveric donation-raises issues of uterus suitability for transplantation, and how death is diagnosed. Organs' suitability for donation is often achieved by ventilation to maintain cardiac function for blood circulation, but laws and cultures could deem that a heartbeat indicates donors' live status. Issues could arise concerning ownership and control of organs between recovery from donors and implantation into recipients, and on removal following childbirth, that require legal resolution. Copyright © 2016. Published by Elsevier Ireland Ltd.

Integrating virtual reality video games into practice: clinicians' experiences.

PubMed

Levac, Danielle E; Miller, Patricia A

2013-10-01

The Nintendo Wii is a popular virtual reality (VR) video gaming system in rehabilitation practice and research. As evidence emerges related to its effectiveness as a physical therapy training method, clinicians require information about the pragmatics of its use in practice. The purpose of this descriptive qualitative study is to explore observations and insights from a sample of physical therapists (PTs) working with children with acquired brain injury regarding practical implications of using the Wii as a physical therapy intervention. Six PTs employed at a children's rehabilitation center participated in semi-structured interviews, which were transcribed and analyzed using content analysis. Two themes summarize the practical implications of Wii use: 1) technology meets clinical practice; and 2) onus is on the therapist. Therapists described both beneficial and challenging implications arising from the intersection of technology and practice, and reported the personal commitment required to orient oneself to the gaming system and capably implement this intervention. Findings include issues that may be relevant to professional development in a broader rehabilitation context, including suggestions for the content of educational initiatives and the need for institutional support from managers in the form of physical resources for VR implementation.

To research (or not) that is the question: ethical issues in research when medical care is disrupted by political action: a case study from Eldoret, Kenya

PubMed Central

House, Darlene R; Marete, Irene; Meslin, Eric M

2016-01-01

While considerable attention has been focused on understanding the myriad of ethical analysis in international research in low and middle income countries, new issues always arise that have not been anticipated in guidelines or studied extensively. The disruption of medical care arising as a direct result of political actions, including strikes, postelection violence and related activities, is one such issue that leaves physician-researchers struggling to manage often conflicting professional responsibilities. This paper discusses the ethical conflicts that arise for physician-researchers, particularly when disruption threatens the completion of a study or completion is possible but at the expense of not addressing unmet medical needs of patients. We review three pragmatic strategies and the ethical issues arising from each: not starting research, stopping research that has already started, and continuing research already initiated. We argue that during episodes of medical care disruption, research that has been started can be continued only if the ethical standards imposed at the beginning of the study can continue to be met; however, studies that have been approved but not yet started should not begin until the disruption has ended and ethical standards can again be assured. PMID:26474601

Illustrating the practice of statistics

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

Hamada, Christina A; Hamada, Michael S

2009-01-01

The practice of statistics involves analyzing data and planning data collection schemes to answer scientific questions. Issues often arise with the data that must be dealt with and can lead to new procedures. In analyzing data, these issues can sometimes be addressed through the statistical models that are developed. Simulation can also be helpful in evaluating a new procedure. Moreover, simulation coupled with optimization can be used to plan a data collection scheme. The practice of statistics as just described is much more than just using a statistical package. In analyzing the data, it involves understanding the scientific problem andmore » incorporating the scientist's knowledge. In modeling the data, it involves understanding how the data were collected and accounting for limitations of the data where possible. Moreover, the modeling is likely to be iterative by considering a series of models and evaluating the fit of these models. Designing a data collection scheme involves understanding the scientist's goal and staying within hislher budget in terms of time and the available resources. Consequently, a practicing statistician is faced with such tasks and requires skills and tools to do them quickly. We have written this article for students to provide a glimpse of the practice of statistics. To illustrate the practice of statistics, we consider a problem motivated by some precipitation data that our relative, Masaru Hamada, collected some years ago. We describe his rain gauge observational study in Section 2. We describe modeling and an initial analysis of the precipitation data in Section 3. In Section 4, we consider alternative analyses that address potential issues with the precipitation data. In Section 5, we consider the impact of incorporating additional infonnation. We design a data collection scheme to illustrate the use of simulation and optimization in Section 6. We conclude this article in Section 7 with a discussion.« less

Professionalism and ethics: A proposed curriculum for undergraduates.

PubMed

Mahajan, Rajiv; Aruldhas, Blessed Winston; Sharma, Monika; Badyal, Dinesh K; Singh, Tejinder

2016-01-01

Professionalism is the attributes, behaviors, commitments, values, and goals that characterize a profession. In medical professional, it encompasses strong societal role and involves emotional component too. On the other hand, ethics is the study of morality - careful and systematic analysis of moral decisions and behaviors and practicing those decisions. Medical ethics focuses primarily on issues arising out of the practice of medicine. It is generally believed that professionalism and ethics are caught by watching your teachers and seniors and not taught formally. Professionalism and ethics are previously diffused passively to the students through "the hidden curriculum," leaving a lot to chance. However, over the time, it has been advocated that graduates need to be formally trained in the concepts of professionalism and ethics. In this paper, we propose a formal curriculum on professionalism and ethics, tailor-made for Indian medical graduates.

Speaking Up: Veterinary Ethical Responsibilities and Animal Welfare Issues in Everyday Practice

PubMed Central

Hernandez, Elein; Fawcett, Anne; Brouwer, Emily; Rau, Jeff

2018-01-01

Simple Summary Veterinarians have an ethical obligation to provide good care for the animals that they see in practice. However, at times, there may be conflicts between the interests of animal caregivers or owners, the interests of veterinarians and the interests of animals. We provide an overview of why and how veterinary ethics is taught to veterinary students, as well as providing a context for thinking about veterinary ethical challenges and animal welfare issues. We argue that veterinarians are ethically obliged to speak up and ask questions when problems arise or are seen and provide a series of clinical case examples in which there is scope for veterinarians to improve animal welfare by ‘speaking up’. Abstract Although expectations for appropriate animal care are present in most developed countries, significant animal welfare challenges continue to be seen on a regular basis in all areas of veterinary practice. Veterinary ethics is a relatively new area of educational focus but is thought to be critically important in helping veterinarians formulate their approach to clinical case management and in determining the overall acceptability of practices towards animals. An overview is provided of how veterinary ethics are taught and how common ethical frameworks and approaches are employed—along with legislation, guidelines and codes of professional conduct—to address animal welfare issues. Insufficiently mature ethical reasoning or a lack of veterinary ethical sensitivity can lead to an inability or difficulty in speaking up about concerns with clients and ultimately, failure in their duty of care to animals, leading to poor animal welfare outcomes. A number of examples are provided to illustrate this point. Ensuring that robust ethical frameworks are employed will ultimately help veterinarians to “speak up” to address animal welfare concerns and prevent future harms. PMID:29361786

[Controversy in the treatment of a critically ill neonate in a rural health service].

PubMed

Márquez-González, Horacio; Valdez-Martínez, Edith

2015-01-01

Cardiopulmonary resuscitation of newborns with perinatal hypoxia faces serious ethical, moral, medical and legal problems, particularly in rural areas. Ethical and moral issues have to do with the medical-parents relationship; with values, preferences and priorities of each of these groups; and with the scarce resources situation. Medical-technical problems are related to asphyxia complications, and their prognostic and therapeutic implications. Legal considerations arising from the fact of killing or letting die. In this article is analyzed the real case of a neonate with severe perinatal hypoxia in order to enhance the understanding of the incorporation of ethics in everyday clinical practice.

Mixed-Methods Design in Biology Education Research: Approach and Uses

PubMed Central

Warfa, Abdi-Rizak M.

2016-01-01

Educational research often requires mixing different research methodologies to strengthen findings, better contextualize or explain results, or minimize the weaknesses of a single method. This article provides practical guidelines on how to conduct such research in biology education, with a focus on mixed-methods research (MMR) that uses both quantitative and qualitative inquiries. Specifically, the paper provides an overview of mixed-methods design typologies most relevant in biology education research. It also discusses common methodological issues that may arise in mixed-methods studies and ways to address them. The paper concludes with recommendations on how to report and write about MMR. PMID:27856556

Arranged matches and mental illness: therapists' dilemmas.

PubMed

Greenberg, David; Buchbinder, Jacob Tuvia; Witztum, Eliezer

2012-01-01

Traditional societies place especial value on marriage and having children, and marriages are often arranged. A series of situations and dilemmas associated with arranged matches and their consequences are described in the course of mental health work with ultra-orthodox Jewish people with severe mental illness. Issues of confidentiality may arise with parents and matchmakers; on the other hand, respectful cooperation with religious authorities, counselors in the community, and family members is important. Information on genetic counseling, contraception, medication during pregnancy, and breastfeeding are considered and interact with communal structures and practices. There is a need for close support and evaluation during the process of marriage, childbearing, and parenthood.

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.

Guest Editorial

PubMed Central

Namineni, Srinivas

2014-01-01

ABSTRACT At the start of this New Year, I would like to draw attention of pediatric dental fraternity at large toward Raven Maria Blanco Foundation, United States. This is a foundation established by parents of a young girl called Maria, who lost her life in pediatric dental Office, which was not prepared to handle an emergency arising from a procedural sedation for dental treatment. This is very heartening for any parent. It was so heart rending that Grammy award singer Michael Crawford popularly known as ‘Magnedo7’ penned a song called Raven’s Song in her memory. This brings the focus on two important issues: sedation and emergency preparedness in our practices.1 PMID:25709311

Ganoderma pfeifferi--A European relative of Ganoderma lucidum.

PubMed

Lindequist, Ulrike; Jülich, Wolf-Dieter; Witt, Sabine

2015-06-01

In contrast to well-studied and broadly used Ganoderma species, such as Ganoderma lucidum and Ganoderma applanatum, knowledge regarding Ganoderma pfeifferi is very limited. Herein is an overview of the phytochemistry, biological activities and possible applications of this mushroom species. In addition to triterpenoids and polysaccharides, G. pfeifferi contains unique sesquiterpenoids and other small molecular weight compounds. Some of these compounds exhibit remarkable antimicrobial activities in vitro and in vivo against multi-resistant bacteria, such as MRSA. Antiviral properties, UV-protection abilities and other activities are also known. Potential issues arising from the conversion of research results into practical applications are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Challenges for Preclinical Investigations of Human Biofield Modalities

PubMed Central

Gronowicz, Gloria; Bengston, William

2015-01-01

Preclinical models for studying the effects of the human biofield have great potential to advance our understanding of human biofield modalities, which include external qigong, Johrei, Reiki, therapeutic touch, healing touch, polarity therapy, pranic healing, and other practices. A short history of Western biofield studies using preclinical models is presented and demonstrates numerous and consistent examples of human biofields significantly affecting biological systems both in vitro and in vivo. Methodological issues arising from these studies and practical solutions in experimental design are presented. Important questions still left unanswered with preclinical models include variable reproducibility, dosing, intentionality of the practitioner, best preclinical systems, and mechanisms. Input from the biofield practitioners in the experimental design is critical to improving experimental outcomes; however, the development of standard criteria for uniformity of practice and for inclusion of multiple practitioners is needed. Research in human biofield studies involving preclinical models promises a better understanding of the mechanisms underlying the efficacy of biofield therapies and will be important in guiding clinical protocols and integrating treatments with conventional medical therapies. PMID:26665042

Poles apart: does the export of mental health expertise from the Global North to the Global South represent a neutral relocation of knowledge and practice?

PubMed

Cox, Nigel; Webb, Lucy

2015-06-01

The World Health Organization's Mental Health Action Plan 2013-2020 identifies actions for all member states to alleviate the global burden of mental ill health, including an obligation for mental healthcare to be delivered in a 'culturally appropriate' manner. In this article we argue that such a requirement is problematic, not least because such pronouncements remain framed by the normative prepositions of Western medical and psychological practice and their associated ethical, legal and institutional standpoints. As such, when striving to export Western mental health expertise, different paradigms for evidence will be necessary to deliver locally meaningful interventions to low and middle income countries. Our discussion highlights a number of philosophical concerns regarding methodologies for future research practice, including those relating to representation and exclusion in the guise of epistemic injury, presumptive methodologies arising from Western notions of selfhood, and related ethical issues. © 2015 Foundation for the Sociology of Health & Illness.

Guidance for Catastrophic Emergency Situations Involving Asbestos

EPA Pesticide Factsheets

This document addresses the types of asbestos issues that may arise during catastrophic events and how EPA has addressed such issues. It replaces the Guidelines for Catastrophic Emergency Situations Involving Asbestos which was issued in 1992.

Consent, competency and ECT: a psychiatrist's view

PubMed Central

Taylor, P J

1983-01-01

Dr Taylor, an English psychiatrist, considers the issue of the symposium in the context of the Mental Health (Amendment) Act 1982. This, she says, gives little guidance on how judgment of a patient's competency or capability to consent to treatment should be made, although it specifies that unless compulsorily detained patients competently consent to ECT a special second medical opinion is required. Although some guidelines from the Department of Health may be offered before implementation of the Act in September 1983 all those working with psychiatric patients will have to consider the issues. After discussing her criteria for informed consent, some practical approaches for obtaining it and problems arising from these, and problems of surrogate consent, Dr Taylor concludes that there is no single or simple solution to the dilemma. She ends by asking: `Can refusal of ECT for severe depression ever be a competent decision?' PMID:6620319

Ethical issues in neonatal intensive care units.

PubMed

Liu, Jing; Chen, Xin-Xin; Wang, Xin-Ling

2016-01-01

On one hand, advances in neonatal care and rescue technology allow for the healthy survival or prolonged survival time of critically ill newborns who, in the past, would have been non-viable. On the other hand, many of the surviving critically ill infants have serious long-term disabilities. If an infant eventually cannot survive or is likely to suffer severe disability after surviving, ethical issues in the treatment process are inevitable, and this problem arises not only in developed countries but is also becoming increasingly prominent in developing countries. In addition, ethical concerns cannot be avoided in medical research. This review article introduces basic ethical guidelines that should be followed in clinical practice, including respecting the autonomy of the parents, giving priority to the best interests of the infant, the principle of doing no harm, and consent and the right to be informed. Furthermore, the major ethical concerns in neonatal intensive care units (NICUs) in China are briefly introduced.

Prescriber-pharmacist collaboration: re-engineering the partnership to optimize pain patient care.

PubMed

Ruble, James H

2013-12-01

The Walgreen Companies recently settled a Drug Enforcement Administration (DEA) administrative action and other investigations arising in connection with a controlled substance distribution facility in Florida and several of its retail pharmacies. These DEA enforcement actions upon a national chain pharmacy have resulted in a series of policies and professional practices that appear to functionally disrupt continuity of patient care. The policy issues transcend the professions and go to the core of our responsibilities to patients. It is unfortunate that regulations intended to prevent diversion also dramatically disrupt interprofessional relations. Based on public statements of professional organizations, unification on this issue seems possible. This presents an opportunity to revisit collaboration among prescribers and pharmacists in legislative and regulatory advocacy. A uniform definition of "legitimate medical purpose" is needed to maximize patient access to needed pharmacotherapy while remaining vigilant for diversion.

Emerging legal concerns with chronic diseases in the Australian workplace: pre-employment medicals, functional capacity evaluations, workers' compensation and disability discrimination.

PubMed

Guthrie, Robert; Westaway, Jennifer

2009-05-01

Although considerable attention is paid to injury and disease sustained or contracted through work causes, by far the most prolific cause of diminished health in the Australian workplace is chronic illness, which is not caused by work but which may have significant effects upon the work environment. Employers' concerns in relation to loss of productivity through poor health are reflected in a number of practices such as pre-employment screening, on-the-job drug testing and other health and safety requirements. In turn, workers' concerns regarding discrimination, workers' compensation and privacy are frequently raised in relation to discussions on workplace fitness for work. This article reflects on the issues of chronic illness and the legal issues which arise through the interaction of employers' obligations for safety and efficiency and workers' concerns with fairness and privacy.

Increasing the amount of payment to research subjects

PubMed Central

Resnick, DB

2014-01-01

This article discusses some ethical issues that can arise when researchers decide to increase the amount of payment offered to research subjects to boost enrollment. Would increasing the amount of payment be unfair to subjects who have already consented to participate in the study? This article considers how five different models of payment—the free market model, the wage payment model, the reimbursement model, the appreciation model, and the fair benefits model—would approach this issue. The article also considers several practical problems related to changing the amount of payment, including determining whether there is enough money in the budget to offer additional payments to subjects who have already enrolled, ascertaining how difficult it will be to re-contact subjects, and developing a plan of action for responding to subjects who find out they are receiving less money and demand an explanation. PMID:18757614

Epistemic uncertainties and natural hazard risk assessment - Part 1: A review of the issues

NASA Astrophysics Data System (ADS)

Beven, K. J.; Aspinall, W. P.; Bates, P. D.; Borgomeo, E.; Goda, K.; Hall, J. W.; Page, T.; Phillips, J. C.; Rougier, J. T.; Simpson, M.; Stephenson, D. B.; Smith, P. J.; Wagener, T.; Watson, M.

2015-12-01

Uncertainties in natural hazard risk assessment are generally dominated by the sources arising from lack of knowledge or understanding of the processes involved. There is a lack of knowledge about frequencies, process representations, parameters, present and future boundary conditions, consequences and impacts, and the meaning of observations in evaluating simulation models. These are the epistemic uncertainties that can be difficult to constrain, especially in terms of event or scenario probabilities, even as elicited probabilities rationalized on the basis of expert judgements. This paper reviews the issues raised by trying to quantify the effects of epistemic uncertainties. Such scientific uncertainties might have significant influence on decisions that are made for risk management, so it is important to communicate the meaning of an uncertainty estimate and to provide an audit trail of the assumptions on which it is based. Some suggestions for good practice in doing so are made.

A Philosophical Perspective on Evolutionary Systems Biology

PubMed Central

Soyer, Orkun S.; Siegal, Mark L.

2015-01-01

Evolutionary systems biology (ESB) is an emerging hybrid approach that integrates methods, models, and data from evolutionary and systems biology. Drawing on themes that arose at a cross-disciplinary meeting on ESB in 2013, we discuss in detail some of the explanatory friction that arises in the interaction between evolutionary and systems biology. These tensions appear because of different modeling approaches, diverse explanatory aims and strategies, and divergent views about the scope of the evolutionary synthesis. We locate these discussions in the context of long-running philosophical deliberations on explanation, modeling, and theoretical synthesis. We show how many of the issues central to ESB’s progress can be understood as general philosophical problems. The benefits of addressing these philosophical issues feed back into philosophy too, because ESB provides excellent examples of scientific practice for the development of philosophy of science and philosophy of biology. PMID:26085823

Emerging issues in paediatric health research consent forms in Canada: working towards best practices.

PubMed

Dove, Edward S; Avard, Denise; Black, Lee; Knoppers, Bartha M

2013-01-30

Obtaining a research participant's voluntary and informed consent is the bedrock of sound ethics practice. Greater inclusion of children in research has led to questions about how paediatric consent operates in practice to accord with current and emerging legal and socio-ethical issues, norms, and requirements. Employing a qualitative thematic content analysis, we examined paediatric consent forms from major academic centres and public organisations across Canada dated from 2008-2011, which were purposively selected to reflect different types of research ethics boards, participants, and studies. The studies included biobanking, longitudinal studies, and gene-environment studies. Our purpose was to explore the following six emerging issues: (1) whether the scope of parental consent allows for a child's assent, dissent, or future consent; (2) whether the concepts of risk and benefit incorporate the child's psychological and social perspective; (3) whether a child's ability to withdraw is respected and to what extent withdrawal is permitted; (4) whether the return of research results includes individual results and/or incidental findings and the processes involved therein; (5) whether privacy and confidentiality concerns adequately address the child's perspective and whether standard data and/or sample identifiability nomenclature is used; and (6) whether retention of and access to paediatric biological samples and associated medical data are addressed. The review suggests gaps and variability in the consent forms with respect to addressing each of the six issues. Many forms did not discuss the possibility of returning research results, be they individual or general/aggregate results. Forms were also divided in terms of the scope of parental consent (specific versus broad), and none discussed a process for resolving disputes that can arise when either the parents or the child wishes to withdraw from the study. The analysis provides valuable insight and evidence into how consent forms address current ethical issues. While we do not thoroughly explore the contexts and reasons behind consent form gaps and variability, we do advocate and formulate the development of best practices for drafting paediatric health research consent forms. This can greatly ameliorate current gaps and facilitate harmonised and yet contextualised approaches to paediatric health research ethics.

Cross-cultural adaptation and translation of a quality of life tool for new mothers: a methodological and experiential account from six countries.

PubMed

Symon, Andrew; Nagpal, Jitender; Maniecka-Bryła, Irena; Nowakowska-Głąb, Agata; Rashidian, Arash; Khabiri, Roghayeh; Mendes, Isabel; Pinheiro, Ana Karina Bezerra; de Oliveira, Mirna Fontenele; Wu, Liping

2013-04-01

To examine the challenges and solutions encountered in the translation and cross-cultural adaptation of an English language quality of life tool in India, China, Iran, Portugal, Brazil, and Poland. Those embarking on research involving translation and cross-cultural adaptation must address certain practical and conceptual issues. These include instrument choice, linguistic factors, and cultural or philosophical differences, which may render an instrument inappropriate, even when expertly translated. Publication bias arises when studies encountering difficulties do not admit to these, or are not published at all. As an educative guide to the potential pitfalls involved in the cross-cultural adaptation process, this article reports the conceptual, linguistic, and methodological experiences of researchers in six countries, who translated and adapted the Mother-Generated Index, a quality of life tool originally developed in English. Principal investigator experience from six stand-alone studies (two published) ranging from postgraduate research to citywide surveys. DISCUSSION/IMPLICATIONS FOR NURSING: This analysis of a series of stand-alone cross-cultural studies provides lessons about how conceptual issues, such as the uniqueness of perceived quality of life and the experience of new motherhood, can be addressed. This original international approach highlights practical lessons relating to instrument choice, and the resources available to researchers with different levels of experience. Although researchers may be confident of effective translation, conceptual and practical difficulties may be more problematic. Instrument choice is crucial. Researchers must negotiate adequate resources for cross-cultural research, including time, translation facilities, and expert advice about conceptual issues. © 2012 Blackwell Publishing Ltd.

Information technology, the internet, and the future of neurology.

PubMed

Maulden, Sarah A

2003-05-01

This review addresses the impact of information technology and the Internet on the current and future practice of neurology. Information technology is influencing medical practice in ways that could be both beneficial and harmful. Scenarios are presented to depict some of the ways in which the practice of neurology is being influenced by the growth of technology. First, the advantages and disadvantages of e-mail as a means of doctor-patient communication are presented. Some of the ethical and legal issues arising in this context are discussed.Second, the Internet is changing neurologists' relationships to other professionals in the health care industry. Geographical isolation is less problematic than in the past. Telemedicine, including remote consulting via the Web, has special implications for neurologists in several areas, including stroke management, movement disorders, and epilepsy.Third, the growing availability of large databases, powerful search engines, and online full-text journals is discussed. Skill in navigating and managing these resources will become increasingly important. New computer-assisted decision support systems will continue to be implemented. Applications exist or are being developed for use by clinicians for many specific neurologic disorders.Finally, some of the problematic issues concerning medical use of the Internet are discussed, including availability, portability, security, quality, and outcomes. Medical information systems, with their attendant advantages and limitations, will become increasingly significant in the practice of neurology. Despite overall improvement in access to information, major barriers still exist to the proper implementation and utilization of truly integrated information systems.

[Recognition of international ethics codes by physicians and biomedical investigators. Are we prepared for the 21st century challenges?].

PubMed

Ponce-de-León, Sergio

2004-01-01

International oaths and declarations (IOD) represent the essence of proposals or promises on a relevant global issue for which a social group stands for. Their appropriate spread is essential in order for them to have a significant impact. The purpose of this study was to determine the frequency of recognition of several medical practice and clinical research related IOD, among medical personnel differentiated by level of clinical experience and closeness to biomedical research. Five groups were surveyed: 35 undergraduate interns, 50 internal medicine residents, 19 graduate (masters and doctoral degrees) students at the outset of courses, 18 veteran graduate students and 70 biomedical investigators. Performance in the recognition of the 6 probed IOD was uniformly poor. Barely just an average of about one declaration per subject was adequately identified. The Declaration of Helsinki was recognized by more than 50% of those belonging to the groups in which theory and practice of medical research joined together. No other IOD was recognized beyond a 40% level in any group. Comparison of university of origin showed no substantial differences. The lack of knowledge of IOD as a framework in the analysis of ethical conflicts arising along medical practice or clinical research is a worrisome issue. Medical schools seem to neglect their role in divulging them. Institutional review boards should also contribute to divulge IOD. The optimal incorporation of the IOD message comes from its acquisition through a process that links theory and practice.

A solid waste management survey in Davao del Sur (school and household waste management survey)

NASA Astrophysics Data System (ADS)

Trondillo, Mark Jude F.; Amaba, Jeneley A.; Paniza, Lyndelle Ann D.; Cubol, John Rhico V.

2018-02-01

Environmental degradation has become a very alarming issue at present. Human activities have been the primary cause of this unfortunate event which has resulted to other complications such as health problems. The resources are limited and people solely depend on it for living. Thus, the necessity to address these concerns arises. Various solid waste management programs have been established however the people's commitment has continued to challenge the local authorities as well as the cooperating agencies. This study was conducted in order to assess the awareness, practice and attitude towards the existing solid waste management programs of the selected students in Davao del Sur. It also aims to measure the effectiveness and current status of these implemented programs. The study used survey method. One hundred sixty eight of 227 students were surveyed using a validated, self-administered instrument. The study revealed that majority of the students is well aware of the existing solid waste management programs, practice them and is willing to learn more about the issue. Others, on the other hand, do the opposite. It is of great importance that all citizens must commit in the implementation of environmental programs so as to be more effective.

Diagnosis and predictive molecular analysis of non-small-cell lung cancer in the Africa-Middle East region: challenges and strategies for improvement.

PubMed

Slavik, Tomas; Asselah, Fatima; Fakhruddin, Najla; El Khodary, Ahmed; Torjman, Fairouz; Anis, Elia; Quinn, Martin; Khankan, Azzam; Kerr, Keith M

2014-11-01

The identification of tumor biomarkers provides information on the prognosis and guides the implementation of appropriate treatment in patients with many different cancer types. In non-small cell lung cancer (NSCLC), targeted treatment plans based on biomarker identification have already been used in the clinic. However, such predictive molecular testing is not currently a universally used practice. This is the case, in particular, in developing countries where lung cancer is increasingly prevalent. In September 2012 and November 2013, a committee of 16 lung cancer experts from Africa and the Middle East met to discuss key issues related to diagnosis and biomarker testing in NSCLC and the implementation of personalized medicine in the region. The committee identified current challenges for effective diagnosis and predictive analysis in Africa and the Middle East. Moreover, strategies to encourage the implementation of biomarker testing were discussed. A practical approach for the effective diagnosis and predictive molecular testing of NSCLC in these regions was derived. We present the key issues and recommendations arising from the meetings. Copyright © 2014 Elsevier Inc. All rights reserved.

Examining our privileges and oppressions: incorporating an intersectionality paradigm into nursing.

PubMed

Van Herk, Kimberley A; Smith, Dawn; Andrew, Caroline

2011-03-01

An intersectionality paradigm is a means by which nurses can attend to issues of oppression and privilege within their practice and profession. Intersectionality is introduced as an essential theory to help debunk the hegemony of the 'white, middle class' perspective that often directs nursing research, practice, and education. The values and benefits of using an intersectionality paradigm in nursing are shown through recent research done with Aboriginal women. These findings contribute to an increased understanding of the importance and necessity of attending to the power relations that dominate nursing care encounters and influence the way nurses provide care. By acknowledging and responding to the presence of privilege and oppression and the associated power dynamics within the therapeutic encounter, nursing can strive further in helping to alleviate social injustices and health disparities that arise from unequal power relations. © 2011 Blackwell Publishing Ltd.

Theoretical and practical issues in the definition of health: insights from Aboriginal Australia.

PubMed

Boddington, Paula; Räisänen, Ulla

2009-02-01

This paper discusses attempts to define health within a public policy arena and practical and conceptual difficulties that arise. An Australian Aboriginal definition of health is examined. Although there are certain difficulties of translation, this definition is prominent in current Australian health policy and discourse about health. The definition can be seen as broadly holistic in comparison to other holistic definitions such as that of the World Health Organization. The nature of this holism and its grounding within the context of Aboriginal Australia is discussed. In particular, its implications for the phenomenon of medicalization, which may be associated with a holistic notion of health, is critically explored, as is the link of notions of health to culture and the question of the possibility of a universal definition of health. The question of to what extent a definition of health is inspirational or operational is also raised.

DENTAL CARE PROFESSIONALS AND CHILD PROTECTION: CASE SCENARIOS AND DISCUSSIONS.

PubMed

Park, Christine

2015-11-01

Any concerns about paediatric patients in general dental practice can be stressful for all involved. Barriers to the reporting of concerns by dental teams are known to exist. Anything that can help ease those situations can only be beneficial. In this article we look at three scenarios that could arise which I am often asked about during teaching and training sessions on safeguarding and child protection for dental teams. They can be discussed at team meetings and training, so that if they are ever to happen for real, everyone will know exactly what to do. This article cannot be completely prescriptive as there will be local variations, but it gives general guidance on issues raised by the scenarios. If you already have a child protection policy in your practice, make sure you know what it says; and if you don't this article will point the way to further resources for developing one.

Data Acquisition and Preprocessing in Studies on Humans: What Is Not Taught in Statistics Classes?

PubMed

Zhu, Yeyi; Hernandez, Ladia M; Mueller, Peter; Dong, Yongquan; Forman, Michele R

2013-01-01

The aim of this paper is to address issues in research that may be missing from statistics classes and important for (bio-)statistics students. In the context of a case study, we discuss data acquisition and preprocessing steps that fill the gap between research questions posed by subject matter scientists and statistical methodology for formal inference. Issues include participant recruitment, data collection training and standardization, variable coding, data review and verification, data cleaning and editing, and documentation. Despite the critical importance of these details in research, most of these issues are rarely discussed in an applied statistics program. One reason for the lack of more formal training is the difficulty in addressing the many challenges that can possibly arise in the course of a study in a systematic way. This article can help to bridge this gap between research questions and formal statistical inference by using an illustrative case study for a discussion. We hope that reading and discussing this paper and practicing data preprocessing exercises will sensitize statistics students to these important issues and achieve optimal conduct, quality control, analysis, and interpretation of a study.

The mind-body relationship in psychotherapy: grounded cognition as an explanatory framework

PubMed Central

Leitan, Nuwan D.; Murray, Greg

2014-01-01

As a discipline, psychology is defined by its location in the ambiguous space between mind and body, but theories underpinning the application of psychology in psychotherapy are largely silent on this fundamental metaphysical issue. This is a remarkable state of affairs, given that psychotherapy is typically a real-time meeting between two embodied agents, with the goal of facilitating behavior change in one party. The overarching aim of this paper is to problematize the mind–body relationship in psychotherapy in the service of encouraging advances in theory and practice. The paper briefly explores various psychotherapeutic approaches to help explicate relationships between mind and body from these perspectives. Themes arising from this analysis include a tendency toward dualism (separation of mind and body from the conceptualization of human functioning), exclusivism (elimination of either mind or body from the conceptualization of human functioning), or mind–body monism (conceptualization of mind and body as a single, holistic system). We conclude that the literature, as a whole, does not demonstrate consensus, regarding the relationship between mind and body in psychotherapy. We then introduce a contemporary, holistic, psychological conceptualization of the relationship between mind and body, and argue for its potential utility as an organizing framework for psychotherapeutic theory and practice. The holistic approach we explore, “grounded cognition,” arises from a long philosophical tradition, is influential in current cognitive science, and presents a coherent empirically testable framework integrating subjective and objective perspectives. Finally, we demonstrate how this “grounded cognition” perspective might lead to advances in the theory and practice of psychotherapy. PMID:24904486

The mind-body relationship in psychotherapy: grounded cognition as an explanatory framework.

PubMed

Leitan, Nuwan D; Murray, Greg

2014-01-01

As a discipline, psychology is defined by its location in the ambiguous space between mind and body, but theories underpinning the application of psychology in psychotherapy are largely silent on this fundamental metaphysical issue. This is a remarkable state of affairs, given that psychotherapy is typically a real-time meeting between two embodied agents, with the goal of facilitating behavior change in one party. The overarching aim of this paper is to problematize the mind-body relationship in psychotherapy in the service of encouraging advances in theory and practice. The paper briefly explores various psychotherapeutic approaches to help explicate relationships between mind and body from these perspectives. Themes arising from this analysis include a tendency toward dualism (separation of mind and body from the conceptualization of human functioning), exclusivism (elimination of either mind or body from the conceptualization of human functioning), or mind-body monism (conceptualization of mind and body as a single, holistic system). We conclude that the literature, as a whole, does not demonstrate consensus, regarding the relationship between mind and body in psychotherapy. We then introduce a contemporary, holistic, psychological conceptualization of the relationship between mind and body, and argue for its potential utility as an organizing framework for psychotherapeutic theory and practice. The holistic approach we explore, "grounded cognition," arises from a long philosophical tradition, is influential in current cognitive science, and presents a coherent empirically testable framework integrating subjective and objective perspectives. Finally, we demonstrate how this "grounded cognition" perspective might lead to advances in the theory and practice of psychotherapy.

Forensic psychiatric evaluations: an overview of methods, ethical issues, and criminal and civil assessments.

PubMed

Sher, Leo

2015-05-01

Forensic psychiatry is frequently defined as the branch of psychiatry that deals with issues arising in the interface between psychiatry and the law. Psychiatrists are called on by the legal system to provide testimony in a wide variety of cases, criminal and civil. In criminal cases, forensic psychiatrists may be asked to comment on the competence of a person to make decisions throughout all the phases of criminal investigation, trial, and punishment. These include the competence to stand trial, to plead guilty, to be sentenced, to waive appeal, and to be executed. In civil cases, forensic psychiatric experts are asked to evaluate a number of civil competences, including competence to make a will or contract or to make decisions about one's person and property. Psychiatrists are also called on to testify about many other issues related to civil cases. Forensic psychiatrists who work with children and adolescents are frequently involved in evaluations and testimonies concerning juvenile delinquency, child custody, termination of parental rights, and other issues. As such, forensic psychiatric experts have now developed into a reputable and well-known group of professionals. Forensic evaluation methods, ethical issues related to forensic psychiatric practice, and some common criminal and civil forensic psychiatric evaluations are discussed in this overview.

"Must do CPR??": strategies to cope with the new College of Physicians and Surgeons of Ontario policy on end-of-life care.

PubMed

Hawryluck, Laura; Oczkowski, Simon J W; Handelman, Mark

2016-08-01

The College of Physicians and Surgeons of Ontario recently released a new policy, Planning for and Providing Quality End-of-Life Care. The revised policy is more accurate in its consideration of the legal framework in which physicians practice and more reflective of ethical issues that arise in end-of-life (EOL) care. It also recognizes valid instances for not offering cardiopulmonary resuscitation (CPR). Nevertheless, the policy poses a significant ethical and legal dilemma-i.e., if disputes over EOL care arise, then physicians must provide CPR even when resuscitation would fall outside this medical standard of care. While the policy applies in Ontario, it is likely to influence other physician colleges across Canada as they review their standards of practice. This paper explores the rationale for the mandated CPR, clarifies the policy's impact on the medical standard of care, and discusses strategies to improve EOL care within the policy. These strategies include understanding the help-hurt line, changing the language used when discussing cardiac arrest, clarifying care plans during the perioperative period, engaging the intensive care unit team early in goals-of-care discussions, mentoring hospital staff to improve skills in goals-of-care discussions, avoiding use of the "slow code", and continuing to advocate for quality EOL care and a more responsive legal adjudication process.

Architects' perspectives on construction waste reduction by design

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

Osmani, M.; Glass, J.; Price, A.D.F.

2008-07-01

The construction, demolition and excavation waste arising in England was estimated at 91 million tonnes in 2003. The current thinking on construction waste minimisation is heavily focussed on several issues relating to physical construction waste and recycling guides. Indeed, much had been published on ways to improve on-site waste management and recycling activities but very few attempts made to address the effect of design practices on waste generation. However, there is a consensus in the literature that the architect has a decisive role to play in helping to reduce waste by focussing on designing out waste. This paper examines previousmore » studies on architects' approach towards construction waste minimisation; and by means of a postal questionnaire, investigates: the origins of waste; waste minimisation design practices in the UK; and responsibilities and barriers within the UK architectural profession. The findings reveal that waste management is not a priority in the design process. Additionally, the architects seemed to take the view that waste is mainly produced during site operations and rarely generated during the design stages; however, about one-third of construction waste could essentially arise from design decisions. Results also indicate that a number of constraints, namely: lack of interest from clients; attitudes towards waste minimisation; and training all act as disincentives to a proactive and sustainable implementation of waste reduction strategies during the design process.« less

Architects' perspectives on construction waste reduction by design.

PubMed

Osmani, M; Glass, J; Price, A D F

2008-01-01

The construction, demolition and excavation waste arising in England was estimated at 91 million tonnes in 2003. The current thinking on construction waste minimisation is heavily focussed on several issues relating to physical construction waste and recycling guides. Indeed, much had been published on ways to improve on-site waste management and recycling activities but very few attempts made to address the effect of design practices on waste generation. However, there is a consensus in the literature that the architect has a decisive role to play in helping to reduce waste by focussing on designing out waste. This paper examines previous studies on architects' approach towards construction waste minimisation; and by means of a postal questionnaire, investigates: the origins of waste; waste minimisation design practices in the UK; and responsibilities and barriers within the UK architectural profession. The findings reveal that waste management is not a priority in the design process. Additionally, the architects seemed to take the view that waste is mainly produced during site operations and rarely generated during the design stages; however, about one-third of construction waste could essentially arise from design decisions. Results also indicate that a number of constraints, namely: lack of interest from clients; attitudes towards waste minimisation; and training all act as disincentives to a proactive and sustainable implementation of waste reduction strategies during the design process.

Illustrative assessment of human health issues arising from the potential release of chemotoxic substances from a generic geological disposal facility for radioactive waste.

PubMed

Wilson, James C; Thorne, Michael C; Towler, George; Norris, Simon

2011-12-01

Many countries have a programme for developing an underground geological disposal facility for radioactive waste. A case study is provided herein on the illustrative assessment of human health issues arising from the potential release of chemotoxic and radioactive substances from a generic geological disposal facility (GDF) for radioactive waste. The illustrative assessment uses a source-pathway-receptor methodology and considers a number of human exposure pathways. Estimated exposures are compared with authoritative toxicological assessment criteria. The possibility of additive and synergistic effects resulting from exposures to mixtures of chemical contaminants or a combination of radiotoxic and chemotoxic substances is considered. The case study provides an illustration of how to assess human health issues arising from chemotoxic species released from a GDF for radioactive waste and highlights potential difficulties associated with a lack of data being available with which to assess synergistic effects. It also highlights how such difficulties can be addressed.

2 CFR 215.41 - Recipient responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NON-PROFIT ORGANIZATIONS (OMB CIRCULAR A-110) Post Award Requirements Procurement Standards § 215.41... contractual responsibilities arising under its contract(s). The recipient is the responsible authority... contractual and administrative issues arising out of procurements entered into in support of an award or other...

Strategies for Limiting Engineers' Potential Liability for Indoor Air Quality Problems.

PubMed

von Oppenfeld, Rolf R; Freeze, Mark E; Sabo, Sean M

1998-10-01

Engineers face indoor air quality (IAQ) issues at the design phase of building construction as well as during the investigation and mitigation of potential indoor air pollution problems during building operation. IAQ issues that can be identified are "building-related illnesses" that may include problems of volatile organic compounds (VOCs). IAQ issues that cannot be identified are termed "sick building syndrome." Frequently, microorganism-caused illnesses are difficult to confirm. Engineers who provide professional services that directly or indirectly impact IAQ face significant potential liability to clients and third parties when performing these duties. Potential theories supporting liability claims for IAQ problems against engineers include breach of contract and various common law tort theories such as negligence and negligent misrepresentation. Furthermore, an increasing number of federal, state, and local regulations affect IAQ issues and can directly increase the potential liability of engineers. A duty to disclose potential or actual air quality concerns to third parties may apply for engineers in given circumstances. Such a duty may arise from judicial precedent, the Model Guide for Professional Conduct for Engineers, or the Code of Ethics for Engineers. Practical strategies engineers can use to protect themselves from liability include regular training and continuing education in relevant regulatory, scientific, and case law developments; detailed documentation and recordkeeping practices; adequate insurance coverage; contractual indemnity clauses; contractual provisions limiting liability to the scope of work performed; and contractual provisions limiting the extent of liability for engineers' negligence. Furthermore, through the proper use of building materials and construction techniques, an engineer or other design professional can effectively limit the potential for IAQ liability.

To research (or not) that is the question: ethical issues in research when medical care is disrupted by political action: a case study from Eldoret, Kenya.

PubMed

House, Darlene R; Marete, Irene; Meslin, Eric M

2016-01-01

While considerable attention has been focused on understanding the myriad of ethical analysis in international research in low and middle income countries, new issues always arise that have not been anticipated in guidelines or studied extensively. The disruption of medical care arising as a direct result of political actions, including strikes, postelection violence and related activities, is one such issue that leaves physician-researchers struggling to manage often conflicting professional responsibilities. This paper discusses the ethical conflicts that arise for physician-researchers, particularly when disruption threatens the completion of a study or completion is possible but at the expense of not addressing unmet medical needs of patients. We review three pragmatic strategies and the ethical issues arising from each: not starting research, stopping research that has already started, and continuing research already initiated. We argue that during episodes of medical care disruption, research that has been started can be continued only if the ethical standards imposed at the beginning of the study can continue to be met; however, studies that have been approved but not yet started should not begin until the disruption has ended and ethical standards can again be assured. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Dealing with pre-exposure prophylaxis-associated condom migration: changing the paradigm for men who have sex with men.

PubMed

Crosby, Richard A

2017-02-01

The behavioural aspects of pre-exposure prophylaxis (PrEP) are challenging, particularly the issue of condom migration. Three vital questions are: (1) at the population-level, will condom migration lead to increases in non-viral sexually transmissible infections?; (2) how can clinic-based counselling best promote the dual use of condoms and PrEP?; and (3) in future PrEP trials, what are the 'best practices' that should be used to avoid type 1 and type 2 errors that arise without accounting for condom use behaviours? This communication piece addresses each question and suggests the risk of a 'PrEP only' focus to widening health disparities.

Internet research and ethics: transformative issues in nursing education research.

PubMed

Mahon, Pamela Young

2014-01-01

As practice in the educational and clinical settings seeks to be evidence based, faculty are increasingly required to conduct research and publish the results to advance the science of our profession. The purpose of this article is to discuss transformative research ethics because Internet use is an increasing component of current research studies. How nurse educators can engage in research-utilizing methodologies inclusive of technology while adhering to ethical standards developed before the advance of the Internet is reviewed. Recommendations are cited to address the new questions that arise at institutional review board meetings resulting from potential ethical implications of using students or research participants in cyber space. © 2014.

Jungle Computing: Distributed Supercomputing Beyond Clusters, Grids, and Clouds

NASA Astrophysics Data System (ADS)

Seinstra, Frank J.; Maassen, Jason; van Nieuwpoort, Rob V.; Drost, Niels; van Kessel, Timo; van Werkhoven, Ben; Urbani, Jacopo; Jacobs, Ceriel; Kielmann, Thilo; Bal, Henri E.

In recent years, the application of high-performance and distributed computing in scientific practice has become increasingly wide spread. Among the most widely available platforms to scientists are clusters, grids, and cloud systems. Such infrastructures currently are undergoing revolutionary change due to the integration of many-core technologies, providing orders-of-magnitude speed improvements for selected compute kernels. With high-performance and distributed computing systems thus becoming more heterogeneous and hierarchical, programming complexity is vastly increased. Further complexities arise because urgent desire for scalability and issues including data distribution, software heterogeneity, and ad hoc hardware availability commonly force scientists into simultaneous use of multiple platforms (e.g., clusters, grids, and clouds used concurrently). A true computing jungle.

Bilinear modeling and nonlinear estimation

NASA Technical Reports Server (NTRS)

Dwyer, Thomas A. W., III; Karray, Fakhreddine; Bennett, William H.

1989-01-01

New methods are illustrated for online nonlinear estimation applied to the lateral deflection of an elastic beam on board measurements of angular rates and angular accelerations. The development of the filter equations, together with practical issues of their numerical solution as developed from global linearization by nonlinear output injection are contrasted with the usual method of the extended Kalman filter (EKF). It is shown how nonlinear estimation due to gyroscopic coupling can be implemented as an adaptive covariance filter using off-the-shelf Kalman filter algorithms. The effect of the global linearization by nonlinear output injection is to introduce a change of coordinates in which only the process noise covariance is to be updated in online implementation. This is in contrast to the computational approach which arises in EKF methods arising by local linearization with respect to the current conditional mean. Processing refinements for nonlinear estimation based on optimal, nonlinear interpolation between observations are also highlighted. In these methods the extrapolation of the process dynamics between measurement updates is obtained by replacing a transition matrix with an operator spline that is optimized off-line from responses to selected test inputs.

Family Issues In the Workplace: Are Students On Track

ERIC Educational Resources Information Center

Waner, Karen K.; Winter, Janet K.; Breshears, Ronald G.

2005-01-01

Employees attempting to balance careers and families have made family issues a major concern in the workplace. Equity issues arise, however, for employees who do not have family responsibilities. In this study, the authors sought to determine whether students' and employees' perceptions of family issues differed in their responses to nine…

The Right to Live and Die. Canadian Critical Issues Series.

ERIC Educational Resources Information Center

Eisenberg, John; Bourne, Paula

One of a series adapted from the Canadian Public Issues Project, this book is designed to stimulate discussion and reflection about controversial issues through case studies. The book is based on high school units originally drawn from cases in newspapers, journals, books, legal documents, and government reports. Conflicts from issues arising over…

Neuroethical issues in pharmacological cognitive enhancement.

PubMed

Mohamed, Ahmed Dahir

2014-09-01

Neuroethics is an emerging field that in general deals with the ethics of neuroscience and the neuroscience of ethics. In particular, it is concerned with the ethical issues in the translation of neuroscience to clinical practice and in the public domain. Numerous ethical issues arise when healthy individuals use pharmacological substances known as pharmacological cognitive enhancers (PCEs) for non-medical purposes in order to boost higher-order cognitive processes such as memory, attention, and executive functions. However, information regarding their actual use, benefits, and harms to healthy individuals is currently lacking. Neuroethical issues that arise from their use include the unknown side effects that are associated with these drugs, concerns about the modification of authenticity and personhood, and as a result of inequality of access to these drugs, the lack of distributive justice and competitive fairness that they may cause in society. Healthy individuals might be coerced by social institutions that force them to take these drugs to function better. These drugs might enable or hinder healthy individuals to gain better moral and self-understanding and autonomy. However, how these drugs might achieve this still remains speculative and unknown. Hence, before concrete policy decisions are made, the cognitive effects of these drugs should be determined. The initiation of accurate surveys to determine the actual usage of these drugs by healthy individuals from different sections of the society is proposed. In addition, robust empirical research need to be conducted to delineate not only whether or not these drugs modify complex higher-order cognitive processes but also how they might alter important human virtues such as empathy, moral reasoning, creativity, and motivation in healthy individuals. WIREs Cogn Sci 2014, 5:533-549. doi: 10.1002/wcs.1306 For further resources related to this article, please visit the WIREs website. The author has declared no conflicts of interest for this article. © 2014 The Authors. WIREs Cognitive Science published by John Wiley & Sons, Ltd.

Ethical Issues in Editing Scholarly Journals.

ERIC Educational Resources Information Center

Stryker, Sheldon

1990-01-01

Discusses ethical issues that arise when serving as an editor of a scholarly journal. Suggests treating these issues using paradigm-based decisions; decisions based on personal sociological predilections and commitments; and reasonable referee-assignment policies. Notes how conflicts of interest inevitably accompanying such a position. (NL)

Assessing Campus Climates for Lesbian, Gay, Bisexual and Transgender (LGBT) Students: Methodological and Political Issues

ERIC Educational Resources Information Center

Brown, Robert D.; Gortmaker, Valerie J.

2009-01-01

Methodological and political issues arise during the designing, conducting, and reporting of campus-climate studies for LGBT students. These issues interact; making a decision about a methodological issue (e.g., sample size) has an impact on a political issue (e.g., how well the findings will be received). Ten key questions that must be addressed…

Governmentality and Social Capital in Tribal/Federal Relations Regarding Heritage Consultation

DTIC Science & Technology

2016-04-08

cultural resource management (CRM) practices for a qualitative study addressing why tensions between tribes and federal agencies arise in heritage... management (CRM) practices for a qualitative study addressing why tensions between tribes and federal agencies arise in heritage discourse, in spite of...Annual Conference, "Collaborative Archaeology and Collections Management on the Stewart Indian School Project", Invited, Nevada Museum Association

Ethical Challenges in Promoting the Implementation of Preventive Interventions: Report of the SPR Task Force.

PubMed

Leadbeater, Bonnie J; Dishion, Tom; Sandler, Irwin; Bradshaw, Catherine P; Dodge, Kenneth; Gottfredson, Denise; Graham, Phillip W; Lindstrom Johnson, Sarah; Maldonado-Molina, Mildred M; Mauricio, Anne M; Smith, Emilie Phillips

2018-06-23

Prevention science researchers and practitioners are increasingly engaged in a wide range of activities and roles to promote evidence-based prevention practices in the community. Ethical concerns invariably arise in these activities and roles that may not be explicitly addressed by university or professional guidelines for ethical conduct. In 2015, the Society for Prevention Research (SPR) Board of Directors commissioned Irwin Sandler and Tom Dishion to organize a series of roundtables and establish a task force to identify salient ethical issues encountered by prevention scientists and community-based practitioners as they collaborate to implement evidence-based prevention practices. This article documents the process and findings of the SPR Ethics Task Force and aims to inform continued efforts to articulate ethical practice. Specifically, the SPR membership and task force identified prevention activities that commonly stemmed from implementation and scale-up efforts. This article presents examples that illustrate typical ethical dilemmas. We present principles and concepts that can be used to frame the discussion of ethical concerns that may be encountered in implementation and scale-up efforts. We summarize value statements that stemmed from our discussion. We also conclude that the field of prevention science in general would benefit from standards and guidelines to promote ethical behavior and social justice in the process of implementing evidence-based prevention practices in community settings. It is our hope that this article serves as an educational resource for students, investigators, and Human Subjects Review Board members regarding some of the complexity of issues of fairness, equality, diversity, and personal rights for implementation of preventive interventions.

E-portfolios and personalized learning: research in practice with two dyslexic learners in UK higher education.

PubMed

Hughes, Julie; Herrington, Margaret; McDonald, Tess; Rhodes, Amy

2011-02-01

This paper analyses the use of an e-portfolio system in contributing to the personalized learning of two dyslexic learners at the University of Wolverhampton, UK. The rationale for this research rests at the intersection of generic findings from e-portfolio (and wider e-learning) research and the still challenging project in higher education (HE) of creating inclusive curricula. A qualitative, ethnographic approach was employed in a piece of collaborative research between academic staff and dyslexic learners. Two retrospective learner narratives were constructed and then reviewed by all co-authors in terms of the 'personalized fit' which they allowed with dyslexic thinking, learning and writing experience. The findings suggest a potential refinement of the general pedagogical claims about e-portfolio-based learning when considering dyslexic learners and thence the value of an enhanced prioritization of e-portfolio learning practices within inclusive HE curricula. The review and analysis also allow a 'critical' discussion of the practical and theoretical issues arising within this work. Copyright © 2010 John Wiley & Sons, Ltd.

The human rights of intersex people: addressing harmful practices and rhetoric of change.

PubMed

Carpenter, Morgan

2016-05-01

Intersex people and bodies have been considered incapable of integration into society. Medical interventions on often healthy bodies remain the norm, addressing perceived familial and cultural demands, despite concerns about necessity, outcomes, conduct and consent. A global and decentralised intersex movement pursues simple core goals: the rights to bodily autonomy and self-determination, and an end to stigmatisation. The international human rights system is responding with an array of new policy statements from human rights institutions and a handful of national governments recognising the rights of intersex people. However, major challenges remain to implement those statements. Human rights violations of intersex individuals persist, deeply embedded in a deliberate history of silencing. Rhetoric of change to clinical practices remain unsubstantiated. Policy disjunctions arise in a framing of intersex issues as matters of sexual orientation and gender identity, rather than innate sex characteristics; this has led to a rhetoric of inclusion that is not matched by the reality. This paper provides an overview of harmful practices on intersex bodies, human rights developments, and rhetorics of change and inclusion. Copyright © 2016 Elsevier Inc. All rights reserved.

Practical wavelength calibration considerations for UV-visible Fourier-transform spectroscopy.

PubMed

Salit, M L; Travis, J C; Winchester, M R

1996-06-01

The intrinsic wavelength scale in a modern reference laser-controlled Michelson interferometer-sometimes referred to as the Connes advantage-offers excellent wavelength accuracy with relative ease. Truly superb wavelength accuracy, with total relative uncertainty in line position of the order of several parts in 10(8), should be within reach with single-point, multiplicative calibration. The need for correction of the wavelength scale arises from two practical effects: the use of a finite aperture, from which off-axis rays propagate through the interferometer, and imperfect geometric alignment of the sample beam with the reference beam and the optical axis of the moving mirror. Although an analytical correction can be made for the finite-aperture effect, calibration with a trusted wavelength standard is typically used to accomplish both corrections. Practical aspects of accurate calibration of an interferometer in the UV-visible region are discussed. Critical issues regarding accurate use of a standard external to the sample source and the evaluation and selection of an appropriate standard are addressed. Anomalous results for two different potential wavelength standards measured by Fabry-Perot interferometry (Ar II and (198)Hg I) are observed.

Ethical Concerns: Negotiating Truth and Trust

ERIC Educational Resources Information Center

McGarvey, Lynn M.; Sterenberg, Gladys

2009-01-01

Few studies in mathematics education explicitly address ethical issues arising from student interactions. The ethical concerns held by students are expressed in their words, actions, and interactions. The purpose of this article is to explore the ethical nature of copying as it arises in a mathematics classroom. We investigate the basis for…

Saviour-sibling and the psychological, ethical and judicial issues that it creates: should English and French legislators close the Pandora's Box?

PubMed

Madanamoothoo, Allane

2011-05-01

Since the advent of test-tube babies, advances in the biomedical field have risen steadily. In parallel, the scientific body has never since ceased to debate the ethical issues that they arise. This is particularly the case regarding saviour-sibling. Saviour-sibling refers to a child who is conceived to cure an older brother or sister suffering from a serious family genetic disease. Therefore, it is meant to give birth to a child who will provide stem-cells taken from the umbilical cord or bone marrow afterwards, to treat an elder sick sibling. In England, this practice has been explicitly allowed by the new Human Fertilisation and Embryology Act 2008 under some strict conditions. In France, this practice, authorized by the Bioethics Law of August 2004 and confirmed by its decree of implementation published in the Official Journal on 23 December 2006, is also strictly regulated. This technique opens up new perspectives and enormous hope. Its legalisation is certainly justified by the suffering of the parents and to avoid that they travel to other States where it is permitted. However, it raises serious psychological ethical and judicial issues. Following an analysis of the English and French laws on saviour siblings, its controversial side will be highlighted, before concluding whether or not this new Pandora's box which is saviour-sibling, should be closed and other alternative methods encouraged.

Genetics objective structured clinical exams at the Maimonides Infants & Children's Hospital of Brooklyn, New York.

PubMed

Altshuler, Lisa; Kachur, Elizabeth; Krinshpun, Shifra; Sullivan, Deborah

2008-11-01

In 2003, the Maimonides Infants & Children's Hospital received a Title VII Residency Training in Primary Care grant to integrate genetic-specific competencies into postgraduate pediatrics education. As part of that endeavor, mandatory yearly genetics objective structured clinical exams (OSCEs) were instituted for third-year residents. This article reports on the first three years of experience with this innovative educational tool.After an overview of genetic concepts, dysmorphology, and communication styles, residents complete a five-station OSCE and receive feedback from standardized patients and from the faculty who observe them. After this clinical exercise, the residents participate in a small-group debriefing session to share strategies for effective communication and clinical case management and to discuss the ethical issues that arise with these genetic cases.In three years, 60 residents have completed the genetics OSCE program. Evaluation data demonstrate that the program has been effective in both introducing genetic-specific challenges and assessing residents' clinical skills. It has helped trainees self-identify both strengths and further training needs. Pre- and postsurveys among the trainees show increased comfort levels in performing 5 of 12 genetic-related clinical tasks.We conclude that genetics OSCEs are an enriching educational tool. Merely providing trainees and practicing physicians with the latest scientific information is unlikely to prepare them for counseling patients about complex genetic issues. Developing proficiency requires focused practice and effective feedback.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

Religion's Return to Higher Education: A Primer

ERIC Educational Resources Information Center

Jacobsen, Douglas; Jacobsen, Rhonda Hustedt

2013-01-01

Board meetings usually focus on nuts-and-bolts issues--action items and financial matters that require immediate discussion and prompt decisions. But larger philosophical issues also sometimes float to the surface--matters having to do with institutional mission, campus ethos, or educational styles--and when these kinds of issues arise, it is…

76 FR 66720 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-27

... Viers, Communications Director, Presidential Commission for the Study of Bioethical Issues, 1425 New... nation's leaders in medicine, science, ethics, religion, law, and engineering. The Commission advises the President on bioethical issues arising from advances in biomedicine and related areas of science and...

78 FR 71615 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-29

... Issues, 1425 New York Avenue NW, Suite C-100, Washington, DC 20005. Telephone: 202-233-3960. Email... bioethics, science, medicine, technology, engineering, law, philosophy, theology, or other areas of the humanities or social sciences. The Commission advises the President on bioethical issues arising from...

Employment Issues in Higher Education: A Legal Compendium.

ERIC Educational Resources Information Center

Sagan, Jean S., Ed.; Rebel, Thomas P., Ed.

This volume contains 32 articles and sample documents treating legal issues in higher education employment focusing on major issues arising in a non-unionized setting. The first of six sections contains seven articles on the employment relationship in general that touch on current legal trends in employee selection procedures, employment…

Some Enduring Issues of Cyberspace Technology: A Medium Theory Perspective.

ERIC Educational Resources Information Center

Gladney, George Albert

1996-01-01

Uses insights from medium theory to show how several issues arising from past communications revolutions apply to the potential impacts of cyberspace technology. Includes these issues: monopoly of knowledge and creation of information elites; threats to cultural stability and homogenization; and harnessing of epistemological strengths and…

The Coverage Issue

ERIC Educational Resources Information Center

Yoshinobu, Stan; Jones, Matthew G.

2012-01-01

A significant issue mathematics instructors face is how to cover all the material. Mathematics teachers of all levels have some external and internal pressures to "get through" all the required material. The authors define "the coverage issue" to be the set of difficulties that arise in attempting to cover a lengthy list of topics. Principal among…

Exploring arising moments and mindfulness in occupational therapists working in diverse clinical practice areas.

PubMed

Reid, Denise; Naseer, Zahid

2012-10-01

An online survey was conducted with 72 Canadian occupational therapists to (1) explore if and how occupational therapists were aware of "arising moments" in clinical practice, which are moments that give rise to emotions, sensations, and thoughts, and (2) to examine therapists' responses to questions related to mindfulness. Participants described arising moments through an open-ended survey question. Framework analysis was used to develop key themes and subthemes. A modified Philadelphia Mindfulness Awareness (PHLMS) subscale with two additional survey questions "understanding of living in the moment and being present, and awareness of mindfulness" (sum = PAM) were used as indicators of mindfulness. There were significant differences in the means of PHLMS mindfulness among therapists working in diverse practice areas (F = 3.63, p = .009). Posthoc analysis revealed that therapists working in mental health had higher mean PHLMS-mindfulness scores than in all other groups. There were no significant differences in PAM mindfulness among the practice areas (ANOVA, F = 2.15, p = .08). However, posthoc tests showed that the participants in the mental health practice area had a significant difference with one group, general physical health. Findings have implications for practice in occupational therapy and education about mindfulness in occupational therapy.

Licensing of Generic Medicines: Are There Any Challenges Left? A Pharmaceutical Regulatory Perspective.

PubMed

Borg, John Joseph; Tomasi, Paolo; Pani, Luca; Aislaitner, George; Pirozynski, Michal; Leufkens, Hubert; Melchiorri, Daniela

2014-01-01

When an innovative product (innovator) is not covered anymore by intellectual property rights, cheaper equivalent medicinal products (generic products) may be marketed and used in clinical practice. The regulation of generic products is well-established, and is primarily based on standard rules for quality, therapeutic equivalence requirements (the latter in most instances proven through a bioequivalence study), and safety data for the innovator. The extensive experience from bringing generic products to the market over the last decades allows the conclusion that they are well-accepted and provide a useful alternative option for cost-effective pharmacotherapy. While supporting this conclusion, there are a number of issues to be considered during the assessment of a generic product application. Six scenarios are described in total, from an efficacy and a safety perspective, where potential concerns with the current regulatory standards could arise in the approval of generic products. We also propose solutions to these scenarios in order to foster debate on these issues.

D Survey in Complex Archaeological Environments: AN Approach by Terrestrial Laser Scanning

NASA Astrophysics Data System (ADS)

Ebolese, D.; Dardanelli, G.; Lo Brutto, M.; Sciortino, R.

2018-05-01

The survey of archaeological sites by appropriate geomatics technologies is an important research topic. In particular, the 3D survey by terrestrial laser scanning has become a common practice for 3D archaeological data collection. Even if terrestrial laser scanning survey is quite well established, due to the complexity of the most archaeological contexts, many issues can arise and make the survey more difficult. The aim of this work is to describe the methodology chosen for a terrestrial laser scanning survey in a complex archaeological environment according to the issues related to the particular structure of the site. The developed approach was used for the terrestrial laser scanning survey and documentation of a part of the archaeological site of Elaiussa Sebaste in Turkey. The proposed technical solutions have allowed providing an accurate and detailed 3D dataset of the study area. In addition, further products useful for archaeological analysis were also obtained from the 3D dataset of the study area.

Rethinking Headache Chronification

PubMed Central

Turner, Dana P.; Smitherman, Todd A.; Penzien, Donald B.; Lipton, Richard B.; Houle, Timothy T.

2013-01-01

The objective of this series is to examine several threats to the interpretation of headache chronification studies that arise from methodological issues. The study of headache chronification has extensively used longitudinal designs with two or more measurement occasions. Unfortunately, application of these designs when combined with the common practice of extreme score selection as well as the extant challenges in measuring headache frequency rates (eg, unreliability, regression to the mean), induces substantive threats to accurate interpretation of findings. Partitioning the amount of observed variance in rates of chronification and remission attributable to regression artifacts is a critical yet previously overlooked step to learning more about headache as a potentially progressive disease. In this series on rethinking headache chronification, we provide an overview of methodological issues in this area (this paper), highlight the influence of rounding error on estimates of headache frequency (second paper), examine the influence of random error and regression artifacts on estimates of chronification and remission (third paper), and consider future directions for this line of research (fourth paper). PMID:23721237

Application of parameter estimation to aircraft stability and control: The output-error approach

NASA Technical Reports Server (NTRS)

Maine, Richard E.; Iliff, Kenneth W.

1986-01-01

The practical application of parameter estimation methodology to the problem of estimating aircraft stability and control derivatives from flight test data is examined. The primary purpose of the document is to present a comprehensive and unified picture of the entire parameter estimation process and its integration into a flight test program. The document concentrates on the output-error method to provide a focus for detailed examination and to allow us to give specific examples of situations that have arisen. The document first derives the aircraft equations of motion in a form suitable for application to estimation of stability and control derivatives. It then discusses the issues that arise in adapting the equations to the limitations of analysis programs, using a specific program for an example. The roles and issues relating to mass distribution data, preflight predictions, maneuver design, flight scheduling, instrumentation sensors, data acquisition systems, and data processing are then addressed. Finally, the document discusses evaluation and the use of the analysis results.

Measuring Racial/Ethnic Disparities in Health Care: Methods and Practical Issues

PubMed Central

Cook, Benjamin Lê; McGuire, Thomas G; Zaslavsky,, Alan M

2012-01-01

Objective To review methods of measuring racial/ethnic health care disparities. Study Design Identification and tracking of racial/ethnic disparities in health care will be advanced by application of a consistent definition and reliable empirical methods. We have proposed a definition of racial/ethnic health care disparities based in the Institute of Medicine's (IOM) Unequal Treatment report, which defines disparities as all differences except those due to clinical need and preferences. After briefly summarizing the strengths and critiques of this definition, we review methods that have been used to implement it. We discuss practical issues that arise during implementation and expand these methods to identify sources of disparities. We also situate the focus on methods to measure racial/ethnic health care disparities (an endeavor predominant in the United States) within a larger international literature in health outcomes and health care inequality. Empirical Application We compare different methods of implementing the IOM definition on measurement of disparities in any use of mental health care and mental health care expenditures using the 2004–2008 Medical Expenditure Panel Survey. Conclusion Disparities analysts should be aware of multiple methods available to measure disparities and their differing assumptions. We prefer a method concordant with the IOM definition. PMID:22353147

Binaural hearing with electrical stimulation.

PubMed

Kan, Alan; Litovsky, Ruth Y

2015-04-01

Bilateral cochlear implantation is becoming a standard of care in many clinics. While much benefit has been shown through bilateral implantation, patients who have bilateral cochlear implants (CIs) still do not perform as well as normal hearing listeners in sound localization and understanding speech in noisy environments. This difference in performance can arise from a number of different factors, including the areas of hardware and engineering, surgical precision and pathology of the auditory system in deaf persons. While surgical precision and individual pathology are factors that are beyond careful control, improvements can be made in the areas of clinical practice and the engineering of binaural speech processors. These improvements should be grounded in a good understanding of the sensitivities of bilateral CI patients to the acoustic binaural cues that are important to normal hearing listeners for sound localization and speech in noise understanding. To this end, we review the current state-of-the-art in the understanding of the sensitivities of bilateral CI patients to binaural cues in electric hearing, and highlight the important issues and challenges as they relate to clinical practice and the development of new binaural processing strategies. This article is part of a Special Issue entitled . Copyright © 2014 Elsevier B.V. All rights reserved.

Emerging issues in paediatric health research consent forms in Canada: working towards best practices

PubMed Central

2013-01-01

Background Obtaining a research participant’s voluntary and informed consent is the bedrock of sound ethics practice. Greater inclusion of children in research has led to questions about how paediatric consent operates in practice to accord with current and emerging legal and socio-ethical issues, norms, and requirements. Methods Employing a qualitative thematic content analysis, we examined paediatric consent forms from major academic centres and public organisations across Canada dated from 2008–2011, which were purposively selected to reflect different types of research ethics boards, participants, and studies. The studies included biobanking, longitudinal studies, and gene-environment studies. Our purpose was to explore the following six emerging issues: (1) whether the scope of parental consent allows for a child’s assent, dissent, or future consent; (2) whether the concepts of risk and benefit incorporate the child’s psychological and social perspective; (3) whether a child’s ability to withdraw is respected and to what extent withdrawal is permitted; (4) whether the return of research results includes individual results and/or incidental findings and the processes involved therein; (5) whether privacy and confidentiality concerns adequately address the child’s perspective and whether standard data and/or sample identifiability nomenclature is used; and (6) whether retention of and access to paediatric biological samples and associated medical data are addressed. Results The review suggests gaps and variability in the consent forms with respect to addressing each of the six issues. Many forms did not discuss the possibility of returning research results, be they individual or general/aggregate results. Forms were also divided in terms of the scope of parental consent (specific versus broad), and none discussed a process for resolving disputes that can arise when either the parents or the child wishes to withdraw from the study. Conclusions The analysis provides valuable insight and evidence into how consent forms address current ethical issues. While we do not thoroughly explore the contexts and reasons behind consent form gaps and variability, we do advocate and formulate the development of best practices for drafting paediatric health research consent forms. This can greatly ameliorate current gaps and facilitate harmonised and yet contextualised approaches to paediatric health research ethics. PMID:23363554

Pursuing an Ethical, Socially Just Classroom: Searching for Community Psychology Pedagogy.

PubMed

Lichty, Lauren F; Palamaro-Munsell, Eylin

2017-12-01

Discussions of community psychology (CP) ethics often examine how we might best uphold CP values in community-based practice. However, for many community psychologists in faculty positions, our main domain of practice is the undergraduate classroom. Teaching is essential to the growth and sustainability of our field as prospective students tend to discover CP during their undergraduate studies. University-based work is also a key site of CP practice. Universities are contested spaces where interlocking forms of oppression manifest in many ways, including teaching (e.g., what is taught, how, by whom, to whom). CP values compel us to treat our classrooms as more than just information transmission spaces; just as there is no value-neutral research, there is no value-neutral course content or classroom practice. This first-person narrative explores ethical issues that arise when we put CP values, specifically social justice, respect for diversity, participation, and wellness, in conversation with pedagogical best practices and course content in higher education. It presents interrelated ethical dilemmas and the authors' conflicted responses. We conclude with a four-part call to the field for dedicated scholarly spaces and supports focused on the development and study of undergraduate CP pedagogy. © Society for Community Research and Action 2017.

Narrowing the gap of personalized medicine in emerging countries: the case of multiple endocrine neoplasias in Brazil.

PubMed

Toledo, Rodrigo A; Sekiya, Tomoko; Longuini, Viviane C; Coutinho, Flavia L; Lourenço, Delmar M; Toledo, Sergio P A

2012-01-01

The finished version of the human genome sequence was completed in 2003, and this event initiated a revolution in medical practice, which is usually referred to as the age of genomic or personalized medicine. Genomic medicine aims to be predictive, personalized, preventive, and also participative (4Ps). It offers a new approach to several pathological conditions, although its impact so far has been more evident in mendelian diseases. This article briefly reviews the potential advantages of this approach, and also some issues that may arise in the attempt to apply the accumulated knowledge from genomic medicine to clinical practice in emerging countries. The advantages of applying genomic medicine into clinical practice are obvious, enabling prediction, prevention, and early diagnosis and treatment of several genetic disorders. However, there are also some issues, such as those related to: (a) the need for approval of a law equivalent to the Genetic Information Nondiscrimination Act, which was approved in 2008 in the USA; (b) the need for private and public funding for genetics and genomics; (c) the need for development of innovative healthcare systems that may substantially cut costs (e.g. costs of periodic medical followup); (d) the need for new graduate and postgraduate curricula in which genomic medicine is emphasized; and (e) the need to adequately inform the population and possible consumers of genetic testing, with reference to the basic aspects of genomic medicine.

Narrowing the gap of personalized medicine in emerging countries: the case of multiple endocrine neoplasias in Brazil

PubMed Central

Toledo, Rodrigo A.; Sekiya, Tomoko; Longuini, Viviane C.; L. Coutinho, Flavia; Lourenço, Delmar M.; Toledo, Sergio P. A.

2012-01-01

The finished version of the human genome sequence was completed in 2003, and this event initiated a revolution in medical practice, which is usually referred to as the age of genomic or personalized medicine. Genomic medicine aims to be predictive, personalized, preventive, and also participative (4Ps). It offers a new approach to several pathological conditions, although its impact so far has been more evident in mendelian diseases. This article briefly reviews the potential advantages of this approach, and also some issues that may arise in the attempt to apply the accumulated knowledge from genomic medicine to clinical practice in emerging countries. The advantages of applying genomic medicine into clinical practice are obvious, enabling prediction, prevention, and early diagnosis and treatment of several genetic disorders. However, there are also some issues, such as those related to: (a) the need for approval of a law equivalent to the Genetic Information Nondiscrimination Act, which was approved in 2008 in the USA; (b) the need for private and public funding for genetics and genomics; (c) the need for development of innovative healthcare systems that may substantially cut costs (e.g. costs of periodic medical follow-up); (d) the need for new graduate and postgraduate curricula in which genomic medicine is emphasized; and (e) the need to adequately inform the population and possible consumers of genetic testing, with reference to the basic aspects of genomic medicine. PMID:22584698

Graduate Ethics Curricula for Future Geospatial Technology Professionals (Invited)

NASA Astrophysics Data System (ADS)

Wright, D. J.; Dibiase, D.; Harvey, F.; Solem, M.

2009-12-01

Professionalism in today's rapidly-growing, multidisciplinary geographic information science field (e.g., geographic information systems or GIS, remote sensing, cartography, quantitative spatial analysis), now involves a commitment to ethical practice as informed by a more sophisticated understanding of the ethical implications of geographic technologies. The lack of privacy introduced by mobile mapping devices, the use of GIS for military and surveillance purposes, the appropriate use of data collected using these technologies for policy decisions (especially for conservation and sustainability) and general consequences of inequities that arise through biased access to geospatial tools and derived data all continue to be challenging issues and topics of deep concern for many. Students and professionals working with GIS and related technologies should develop a sound grasp of these issues and a thorough comprehension of the concerns impacting their use and development in today's world. However, while most people agree that ethics matters for GIS, we often have difficulty putting ethical issues into practice. An ongoing project supported by NSF seeks to bridge this gap by providing a sound basis for future ethical consideration of a variety of issues. A model seminar curriculum is under development by a team of geographic information science and technology (GIS&T) researchers and professional ethicists, along with protocols for course evaluations. In the curricula students first investigate the nature of professions in general and the characteristics of a GIS&T profession in particular. They hone moral reasoning skills through methodical analyses of case studies in relation to various GIS Code of Ethics and Rules of Conduct. They learn to unveil the "moral ecologies" of a profession through actual interviews with real practitioners in the field. Assignments thus far include readings, class discussions, practitioner interviews, and preparations of original case studies. Curricula thus far are freely available via gisprofessionalethics.org.

Ideologies of moral exclusion: a critical discursive reframing of depersonalization, delegitimization and dehumanization.

PubMed

Tileagă, Cristian

2007-12-01

This paper focuses on some of the issues that arise when one treats notions such as depersonalization, delegitimization and dehumanization as social practices. It emphasizes the importance of: (a) understanding depersonalizing, delegitimizing and dehumanizing constructions as embedded in descriptions of located spatial activities and moral standings in the world and (b) invoking and building a socio-moral order linked to notions of lesser humanity or non-humanity, (spatial) transgression and abjection. These concerns are illustrated by taking talk on Romanies as a case in point from interviews with Romanian middle-class professionals. It is argued that a focus on description rather than explanation might be more effective in understanding the dynamics of ideologies of moral exclusion.

Legally speaking: Federal Trade Commission issues positive advisory opinions on antitrust implications of clinical integration.

PubMed

Wright, Robert

2009-10-01

From time to time, groups of physicians in an area may determine that they would benefit from "integrating" their practices into an IPA, PHO, or other joint venture. The anticipated benefits may include economies of scale, the ability to coordinate care between primary care physicians and specialists, providing disease management services for patients with certain conditions, or a myriad of other reasons. A key characteristic of these proposed integrated models is the ability for the group as a whole to negotiate with insurance companies and self-funded health care plans. When a group reaches the point of negotiating collectively for the fees that a pay- or is going to pay for various services throughout the plan, possible antitrust implications arise.

Compensated transnational surrogacy in Australia: time for a comprehensive review.

PubMed

Newson, Ainsley J

2016-01-18

Commercial or compensated surrogacy involves providing payment for a woman to gestate a fetus to term and then hand over the child to commissioning parent(s). Compensated surrogacy is currently restricted by law or regulation in all Australian states and territories. New South Wales, Queensland and the Australian Capital Territory also restrict commissioning transnational compensated surrogacy, although there is evidence that this is not acting as a deterrent. Ethical issues arising in transnational compensated surrogacy include concerns relating to exploitation, commodification and welfare. The current status quo is unsatisfactory on legal, ethical and practical grounds. It is time to openly debate how Australia should balance the desire for childbearing through surrogacy with the limited domestic availability of women willing to act as surrogates.

Treatment implications arising from a qualitative analysis of letters written by the nonoffending partners of men who have perpetrated child sexual abuse.

PubMed

Cahalane, Hilary; Parker, Gemma; Duff, Simon

2013-01-01

There is a dearth of current empirical research exploring the experiences of nonoffending partners, or women whose partners have perpetrated child sexual abuse. Existing literature is dated and focuses disproportionately on intrafamilial abuse. This research explores how nonoffending partners construct and understand their experiences using thematic analysis within a social constructionist framework. Findings indicate that discovery of a partner's sexual offending is a profoundly distressing experience. It can inhibit a woman's ability to process the broader implications of her partner's behavior, including issues of risk, the impact on the victim, and the additional protective responsibilities she must adopt in the future. Implications for future research and clinical practice are discussed.

[Communication and mental health: a discursive analysis of posters of the National Anti-Asylum Campaign Movement in Brazil].

PubMed

Espirito Santo, Wanda; Araujo, Inesita Soares de; Amarante, Paulo

2016-01-26

The article analyzes two posters that with the same slogan - "Asylums nevermore" - promote National Anti-Asylum Day. The analysis was based on principles of the symptomatology of social discourse, articulating analytical concepts and practices arising from the French School and the pragmatic dimension of discourse analysis. The results revealed affirmation strategies of the movement for the qualification and exacerbation of the issues of the enunciation and other enunciators, namely political actors of the anti-asylum movement and their allies. It also reveals the attempt to disqualify competitive discourse, especially that which discloses the serious problems of its institutional models, but also by juxtaposing the positive presence of the issuers and enunciators of the posters.

Activity Systems and Conflict Resolution in an Online Professional Communication Course

ERIC Educational Resources Information Center

Walker, Kristin

2004-01-01

Conflicts often arise in online professional communication class discussions as students discuss sensitive ethical issues relating to the workplace. When conflicts arise in an online class, the activity system of the class has to be kept in balance for the course to continue functioning effectively. Activity theory and distributed learning theory…

Issues of Learning and Knowledge in Technology Education

ERIC Educational Resources Information Center

McCormick, Robert

2004-01-01

This article examines issues that arise from learning and knowledge in technology education. The issues examined are, first, the definition of technological knowledge and what the nature of that knowledge should be, where the concern is with "how" we define and think about that knowledge, especially in the context of how students learn and use…

Engaging Children: Research Issues around Participation and Environmental Learning

ERIC Educational Resources Information Center

Hacking, Elisabeth Barratt; Barratt, Robert; Scott, William

2007-01-01

In this article we explore a number of issues arising from the papers in this special issue of "Environmental Education Research." The papers focus on current examples of childhood environment research in the UK together with research reviews from the UK, the US and Australia. In order to provide a framework for considering and…

77 FR 41789 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-16

... Issues, 1425 New York Avenue NW., Suite C-100, Washington, DC 20005. Telephone: 202-233-3960. Email... leaders in medicine, science, ethics, religion, law, and engineering. The Commission advises the President on bioethical issues arising from advances in biomedicine and related areas of science and technology...

78 FR 20647 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-05

... Bioethical Issues, 1425 New York Avenue NW, Suite C-100, Washington, DC 20005. Telephone: 202-233-3960. Email... Commission. The Bioethics Commission is an advisory panel of the nation's leaders in medicine, science... issues arising from advances in biomedicine and related areas of science and technology. The Bioethics...

The Professional's Last Will and Testament.

ERIC Educational Resources Information Center

Lancaster, James M.

2003-01-01

In this article a case study illustrates the initial issues arising from the sudden death of key personnel, and then offers an outline for the Professional's Last Will and Testament. This document includes attention to logistical issues and planning for organizational change. It begins with short-term transition issues and continues through other,…

Introduction: Religious and Spiritual Issues in Medical Genetics

PubMed Central

Fanning, Joseph B.; Clayton, Ellen Wright

2009-01-01

This article provides an overview of a special issue on the religious and spiritual concerns that arise in the provision of genetic services. It introduces some of the challenges in defining religion and spirituality and provides contexts and summaries for the empirical and normative research that appears in the issue. PMID:19170098

75 FR 51240 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... definition that may be considered in Amendment 15 based on results from the recent stock assessment. If time permits the Committee may discuss other issues. Although non-emergency issues not contained in this agenda... issues arising after publication of this notice that require emergency action under section 305(c) of the...

A sustainable system of systems approach: a new HFE paradigm.

PubMed

Thatcher, Andrew; Yeow, Paul H P

2016-01-01

Sustainability issues such as natural resource depletion, pollution and poor working conditions have no geographical boundaries in our interconnected world. To address these issues requires a paradigm shift within human factors and ergonomics (HFE), to think beyond a bounded, linear model understanding towards a broader systems framework. For this reason, we introduce a sustainable system of systems model that integrates the current hierarchical conceptualisation of possible interventions (i.e., micro-, meso- and macro-ergonomics) with important concepts from the sustainability literature, including the triple bottom line approach and the notion of time frames. Two practical examples from the HFE literature are presented to illustrate the model. The implications of this paradigm shift for HFE researchers and practitioners are discussed and include the long-term sustainability of the HFE community and comprehensive solutions to problems that consider the emergent issues that arise from this interconnected world. A sustainable world requires a broader systems thinking than that which currently exists in ergonomics. This study proposes a sustainable system of systems model that incorporates ideas from the ecological sciences, notably a nested hierarchy of systems and a hierarchical time dimension. The implications for sustainable design and the sustainability of the HFE community are considered.

A juridical review of partnership agreements that have the elements of work agreements in Indonesia

NASA Astrophysics Data System (ADS)

Nugroho, A.; Sulistyowati, E.; Hikmah, N.

2018-01-01

The Partnership Agreements place the parties in an equal position each party has something as the bargaining power. In some cases, employers prefer to use Partnership Agreements to some individuals to complete the work in their company than Work agreements. Practicality and the absence of obligations to fulfil workers’ rights such as the right to join a Union and to get social security are some of the reasons why employers use the Partnership Agreements. Sometimes Partnership Agreement contains jobs, wages and orders which is the characteristic of work agreement. Based on the fact above, the legal issues arise whether the Partnership Agreement can be considered as the Work Agreement or not and which court is authorized to hear in the event of a dispute. To analyze the above legal issues, this research uses normative legal research type with the statute approach. The technique of legal material analysis uses prescriptive techniques to assess the issue and make recommendations. Based on the analysis, it can be concluded that the Partnership Agreement, of which the elements are: wages and orders can be categorized as Work Agreement and therefore in the event of a dispute, the authorized court is Industrial Relations Court.

Highway reservation system design and its application to freight transportation.

DOT National Transportation Integrated Search

2014-05-01

Congestion and safety associated with freight trucks are key issues that arise in the context of highway : transportation, especially in the heavily-traveled commercial corridors. To address these issues, truck-only lanes for freight trucks have been...

"Generality of mis-fit"? The real-life difficulty of matching scales in an interconnected world.

PubMed

Keskitalo, E Carina H; Horstkotte, Tim; Kivinen, Sonja; Forbes, Bruce; Käyhkö, Jukka

2016-10-01

A clear understanding of processes at multiple scales and levels is of special significance when conceiving strategies for human-environment interactions. However, understanding and application of the scale concept often differ between administrative-political and ecological disciplines. These mirror major differences in potential solutions whether and how scales can, at all, be made congruent. As a result, opportunities of seeking "goodness-of-fit" between different concepts of governance should perhaps be reconsidered in the light of a potential "generality of mis-fit." This article reviews the interdisciplinary considerations inherent in the concept of scale in its ecological, as well as administrative-political, significance and argues that issues of how to manage "mis-fit" should be awarded more emphasis in social-ecological research and management practices. These considerations are exemplified by the case of reindeer husbandry in Fennoscandia. Whilst an indigenous small-scale practice, reindeer husbandry involves multi-level ecological and administrative-political complexities-complexities that we argue may arise in any multi-level system.

My genes made me do it? The implications of behavioural genetics for responsibility and blame.

PubMed

Levitt, Mairi; Manson, Neil

2007-03-01

The idea of individual responsibility for action is central to our conception of what it is to be a person. Behavioural genetic research may seem to call into question the idea of individual responsibility with possible implications for the criminal justice system. These implications will depend on the understandings of the various agencies and professional groups involved in responding to violent and anti-social behaviour, and, the result of negotiations between them over resulting practice. The paper considers two kinds of approaches to the question of responsibility and 'criminal genes' arising from a sociological and philosophical perspective respectively. One is to consider the social context and possible practical implications of research into 'criminal genes' which will later be examined through interviews and discussions with a range of experts including lawyers and social workers. A second and different kind of approach is to ask whether the findings of behavioural genetics ought to have implications for attributions of responsibility. Issues of genetic influence are central to both approaches.

Adaptive Designs for Randomized Trials in Public Health

PubMed Central

Brown, C. Hendricks; Have, Thomas R. Ten; Jo, Booil; Dagne, Getachew; Wyman, Peter A.; Muthén, Bengt; Gibbons, Robert D.

2009-01-01

In this article, we present a discussion of two general ways in which the traditional randomized trial can be modified or adapted in response to the data being collected. We use the term adaptive design to refer to a trial in which characteristics of the study itself, such as the proportion assigned to active intervention versus control, change during the trial in response to data being collected. The term adaptive sequence of trials refers to a decision-making process that fundamentally informs the conceptualization and conduct of each new trial with the results of previous trials. Our discussion below investigates the utility of these two types of adaptations for public health evaluations. Examples are provided to illustrate how adaptation can be used in practice. From these case studies, we discuss whether such evaluations can or should be analyzed as if they were formal randomized trials, and we discuss practical as well as ethical issues arising in the conduct of these new-generation trials. PMID:19296774

High-Rise Construction in Densely Dwelled Cities: Requirements for Premises Insolation and Consequences of their Violation in Russian Law and Jurisprudence

NASA Astrophysics Data System (ADS)

Gongalo, Boris; Gudovicheva, Lubov; Gubareva, Anna; Dobrynina, Larisa

2018-03-01

The issues of constructing high-rise, primarily residential, buildings have a great social significance. Not every plot of land, acquired in the Russian Federation is suitable for high-rise construction. Therefore, every construction company that plans to erect a multi-apartment building, a high-rise office building, or a skyscraper must take into account not only technical norms but as well sanitary legislation regulations that set obligatory requirements about insolation of apartments. The article includes a short study of several norms in the Russian legislation regarding insolation of dwellings; analises the problems of judicial interpretation of the statutory limitations. In this aspect it researches the debatable questions arising in practice of state arbitration courts dealing with the lawsuits on allocation of land-plots by the local administration. The analysis of the judicial practice is followed by description of the difficulties facing the developers of land-plots, concerning the project and territorial planning documentation.

Dentistry as a business: in search of the moral high ground.

PubMed

Holt, Vernon P

2010-07-01

This paper has been developed from a version originally submitted as an assignment for the Faculty of General Dental Practice (UK) Certificate in Health Services Leadership and Management Course. It has been revised in the light of the independent review led by Professor Jimmy Steele into National Health Service dental services in England (generally referred to as the Steele Report), which has commented on many of the points dealt with here. The paper addresses issues arising from a moral tension often experienced by dentists between the professional desire to serve patients well and the necessity, as practice owners running a business, to survive financially. The need for honest and open recognition of what is truly achievable from the public purse is stressed. Rights and responsibilities are discussed in relation to professional practitioners, their patients, and society in general, in seeking the moral high ground under different funding arrangements. The paper concludes by stressing the need to offer improved health rather than palliation of disease.

How do clinical genetics consent forms address the familial approach to confidentiality and incidental findings? A mixed-methods study.

PubMed

Dheensa, Sandi; Crawford, Gillian; Salter, Claire; Parker, Michael; Fenwick, Angela; Lucassen, Anneke

2018-01-01

Genetic test results can be relevant to patients and their relatives. Questions thus arise around whether clinicians regard genetic information as confidential to individuals or to families, and about how they broach this and other issues, including the potential for incidental findings, in consent (forms) for genetic testing. We conducted a content analysis of UK-wide genetic testing consent forms and interviewed 128 clinicians/laboratory scientists. We found that almost all genetic services offered patients multiple, sometimes unworkable, choices on forms, including an option to veto the use of familial genetic information to benefit relatives. Participants worried that documented choices were overriding professional judgement and cautioned against any future forms dictating practice around incidental findings. We conclude that 'tick-box' forms, which do little to enhance autonomy, are masking valid consent processes in clinical practice. As genome-wide testing becomes commonplace, we must re-consider consent processes, so that they protects patients'-and relatives'-interests.

Emerging ethical perspectives in the clustered regularly interspaced short palindromic repeats genome-editing debate

PubMed Central

Camporesi, Silvia; Cavaliere, Giulia

2016-01-01

This paper provides an overview of the ethical issues in the international clustered regularly interspaced short palindromic repeats (CRISPR) genome editing debate from March 2015 to September 2016. We present the regulatory framework for embryo research in the UK, and explain why CRISPR is not a significant break with the past. We discuss the ethical issues arising from CRISPR applications beyond human embryos, namely the use of gene drive-engineered mosquitoes to eradicate diseases, engineering nonhuman animals to harvest organs for human transplant and engineering crops. We discuss the experiments that have demonstrated the technical feasibility of cultivating embryos in vitro for up to 14 days, and possibly beyond this limit, and the ethical issues arising from the proposal to extend the limit beyond 14 days. PMID:28757883

Emerging ethical perspectives in the clustered regularly interspaced short palindromic repeats genome-editing debate.

PubMed

Camporesi, Silvia; Cavaliere, Giulia

2016-11-01

This paper provides an overview of the ethical issues in the international clustered regularly interspaced short palindromic repeats (CRISPR) genome editing debate from March 2015 to September 2016. We present the regulatory framework for embryo research in the UK, and explain why CRISPR is not a significant break with the past. We discuss the ethical issues arising from CRISPR applications beyond human embryos, namely the use of gene drive-engineered mosquitoes to eradicate diseases, engineering nonhuman animals to harvest organs for human transplant and engineering crops. We discuss the experiments that have demonstrated the technical feasibility of cultivating embryos in vitro for up to 14 days, and possibly beyond this limit, and the ethical issues arising from the proposal to extend the limit beyond 14 days.

Exchangeability in the case-crossover design

PubMed Central

Mittleman, Murray A; Mostofsky, Elizabeth

2014-01-01

In cohort and case-control studies, confounding that arises as a result of differences in the distribution of determinants of the outcome between exposure groups leading to non-exchangeability are addressed by restriction, matching or with statistical models. In case-only studies, this issue is addressed by comparing each individual with his/herself. Although case-only designs use self-matching and only include individuals who develop the outcome of interest, issues of non-exchangeability are identical to those that arise in traditional case-control and cohort studies. In this review, we describe one type of case-only design, the case-crossover design, and discuss how the concept of exchangeability can be used to understand issues of confounding, carryover effects, period effects and selection bias in case-crossover studies. PMID:24756878

Evidence-Based Ethics for Neurology and Psychiatry Research

PubMed Central

Kim, Scott Y. H.

2004-01-01

Summary: American bioethics, historically arising out of theology and philosophy, has been dominated by the method of normative analysis. Ethics as policy, however, requires in addition a solid evidence base. This paper discusses the background conditions that make neurotherapeutics research particularly challenging. Three key ethical issues are discussed within an evidence-based ethics framework: the ethical challenges arising from changes in the financial incentive structures for academic researchers and their institutions, the challenges of risk-benefit analysis for neurotherapeutics protocols testing innovative interventions, and the evolving issues surrounding impaired decision-making capacity and surrogate consent for research. For each of these issues, selected empirical data are reviewed, areas for further inquiry are noted, and the need for development of novel methods for bioethics policy research is discussed. PMID:15717040

5 CFR 2610.307 - Further proceedings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 2610.307 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES... written submissions or, as to issues other than substantial justification (such as the applicant's... further proceedings shall be held only when necessary for full and fair resolution of the issues arising...

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.

A Sociological Framework to Address Gender Equity in the Geosciences

NASA Astrophysics Data System (ADS)

Holmes, Mary Anne

2017-04-01

Lack of equity in the science workforce is a sociological problem; those wishing to seek its amelioration can benefit by viewing the issue with a sociological lens (and a sociologist). One useful framework that we have used to think strategically about how to lower barriers to equity is Barbara Risman's (2004): this framework views barriers to equity as individual, interpersonal ("interactional"), and institutional. Any given barrier may fit into one or more of these frames. Individual barriers include those intrinsic to an individual and may include: lack of access to vital networks and mentors, lack of preparation, etc. Such barriers can be addressed through mentoring programs and attention to building networks (e.g., through professional society memberships). Interpersonal or "interactional" barriers are those that arise from how we perceive and treat one another. Implicit bias underlies many of these barriers, including whether we perceive women as scientists, as competent, as dedicated (etc) as men. Such barriers can be reduced through implicit bias awareness. Institutional barriers arise from the structure and history of the academy itself, from its policies and procedures. Many such policies and procedures have a differential impact on men or women, generally without that intention. Policies that reduce equity barriers include family leave, childcare facilities, search committee training, clearly articulated practices for evaluation of applications and personnel reviews, equal starting pay and startup packages, equable canvassing for names to consider for nominations for honors and awards, to name a few. By viewing the issue through such a framework, the appropriate response can be generated for a more effective result.

Ethical considerations for biomedical scientists and engineers: issues for the rank and file.

PubMed

Kwarteng, K B

2000-01-01

Biomedical science and engineering is inextricably linked with the fields of medicine and surgery. Yet, while physicians and surgeons, nurses, and other medical professionals receive instruction in ethics during their training and must abide by certain codes of ethics during their practice, those engaged in biomedical science and engineering typically receive no formal training in ethics. In fact, the little contact that many biomedical science and engineering professionals have with ethics occurs either when they participate in government-funded research or submit articles for publication in certain journals. Thus, there is a need for biomedical scientists and engineers as a group to become more aware of ethics. Moreover, recent advances in biomedical technology and the ever-increasing use of new devices virtually guarantee that biomedical science and engineering will become even more important in the future. Although they are rarely in direct contact with patients, biomedical scientists and engineers must become aware of ethics in order to be able to deal with the complex ethical issues that arise from our society's increasing reliance on biomedical technology. In this brief communication, the need for ethical awareness among workers in biomedical science and engineering is discussed in terms of certain conflicts that arise in the workaday world of the biomedical scientist in a complex, modern society. It is also recognized that inasmuch as workers in the many branches of bioengineering are not regulated like their counterparts in medicine and surgery, perhaps academic institutions and professional societies are best equipped to heighten ethical awareness among workers in this important field.

Drowning in Disinfection Byproducts? Swimming Pool Water Quality

EPA Science Inventory

Disinfection is mandatory for swimming pools, because transmission of disease by bacteria, virus and protozoa is the most significant health issue. However another issue arises, and care should be taken to minimize the risks from disinfection by-products (DBPs). Public pools are ...

Sharing of track by transit and freight railroads : liability and insurance issues

DOT National Transportation Integrated Search

2005-09-21

This report explores the issues of liability and insurance that arise in planning and operating track shared between light rail transit and freight railroads. Shared track operations involve some unique risks, and insurance is used to mitigate or man...

Food for thought: how do we respect our learners' right to privacy?

PubMed

DeSilets, Lynore D

2011-01-01

Issues can arise in relation to the privacy rights of continuing nursing education participants. This column explores four of those issues and offers possible solutions so that the privacy of our learners is protected. Copyright 2011, SLACK Incorporated.

'Understanding' as a practical issue in sexual health education for people with intellectual disabilities: a study using two qualitative methods.

PubMed

Finlay, W M L; Rohleder, Poul; Taylor, Natalie; Culfear, Hollie

2015-04-01

Sexual health education is important in addressing the health and social inequalities faced by people with intellectual disabilities. However, provision of health-related advice and education to people with various types and degrees of linguistic and learning difficulties involves addressing complex issues of language and comprehension. This article reports an exploratory study using 2 qualitative methods to examine the delivery of sexual health education to people with intellectual disabilities. Four video-recordings of sexual health education sessions were collected. Conversation analysis was used to examine in detail how such education occurs as a series of interactions between educators and learners. Interviews with 4 educators were carried out and analyzed using thematic analysis. The analysis shows how educators anticipate problems of comprehension and how they respond when there is evidence that a person does not understand the activity or the educational message. This occurs particularly when verbal prompts involve long sentences and abstract concepts. We show a characteristic pattern that arises in these situations, in which both educator and learner jointly produce a superficially correct response. Although interviews allows us some insight into contextual issues, strategy, and aspects of sexual health education that occur outside of the actual teaching sessions, analysis of actual interactions can show us patterns that occur in interactions between educators and learners when comprehension is in question. Addressing how sexual health education is delivered in practice and in detail provides valuable lessons about how such education can be improved. (c) 2015 APA, all rights reserved).

What's gender got to do with it? Examining masculinities, health and safety and return to work in male dominated skilled trades.

PubMed

Stergiou-Kita, Mary; Mansfield, Elizabeth; Colantonio, Angela; Moody, Joel; Mantis, Steve

2016-06-16

Electrical injuries are a common cause of work-related injury in male dominated skilled trades. In this study we explored how issues of gender, masculinities and institutional workplace practices shape expectations of men and their choices when returning to work following a workplace electrical injury. Twelve workers, who suffered an electrical injury, and twelve employer representatives, completed semi-structured interviews. Using thematic analysis we identified key themes related to how masculinities influenced men's health and safety during the return to work process. Strong identification with worker roles can influence injured workers decisions to return to work 'too early'. A desire to be viewed as a strong, responsible, resilient worker may intersect with concerns about job loss, to influence participants' decisions to not report safety issues and workplace accidents, to not disclose post-injury work challenges, and to not request workplace supports. Institutionalized workplace beliefs regarding risk, de-legitimization of the severity of injuries, and the valorization of the "tough" worker can further re-enforce dominant masculine norms and influence return to work processes and health and safety practices. Workplaces are key sites where gender identities are constructed, affirmed and institutionalized. Further research is warranted to examine how established masculine norms and gendered workplace expectations can influence workplace health and safety in male dominated high risk occupations. Future research should also evaluate strategies that encourage men to discuss post-injury work challenges and request supports when work performance or health and safety issues arise during the return to work process.

Intercultural communication in child and family health: insights from postcolonial feminist scholarship and three-body analysis.

PubMed

Grant, Julian; Luxford, Yoni

2008-12-01

Concerns about intercultural communication practices in child and family health were raised during a South Australian ethnographic study. The family partnership model was observed as a universal pedagogic tool introduced into the host organisation in 2003. It has a role in shaping and reshaping cultural production within child health practice. In this study, we draw on insights from postcolonial feminist scholarship together with three-body analysis to critique the theoretical canons of care that inform intercultural communication in the child and family health setting. We contend that although the family partnership model may be very useful, its intended universal application is problematic in the context of multiculture. Issues of race, gender and class were seemingly unattended when using a communication approach based in historical scientific rationalism. Liberal interpretations of discourses of equity and empathy arising out of contemporary models of communication were often adopted by child and family health nurses and protected them from seeing the inherent binaries that constrain practice. Insights from postcolonial feminist thinking enabled us to recognise the problems of applying theory to practice in a linear fashion. We demonstrate the use of three-body analysis as a deconstruction strategy to refigure how theory might be understood and worked with in the multiculture that is Australia.

Assessing the Effect of an Old and New Methodology for Scale Conversion on Examinee Scores

ERIC Educational Resources Information Center

Rizavi, Saba; Smith, Robert; Carey, Jill

2002-01-01

Research has been done to look at the benefits of BILOG over LOGIST as well as the potential issues that can arise if transition from LOGIST to BILOG is desired. A serious concern arises when comparability is required between previously calibrated LOGIST parameter estimates and currently calibrated BILOG estimates. It is imperative to obtain an…

A Framework for Comprehensive Health Terminology Systems in the United States

PubMed Central

Chute, Christopher G.; Cohn, Simon P.; Campbell, James R.

1998-01-01

Health care in the United States has become an information-intensive industry, yet electronic health records represent patient data inconsistently for lack of clinical data standards. Classifications that have achieved common acceptance, such as the ICD-9-CM or ICD, aggregate heterogeneous patients into broad categories, which preclude their practical use in decision support, development of refined guidelines, or detailed comparison of patient outcomes or benchmarks. This document proposes a framework for the integration and maturation of clinical terminologies that would have practical applications in patient care, process management, outcome analysis, and decision support. Arising from the two working groups within the standards community—the ANSI (American National Standards Institute) Healthcare Informatics Standards Board Working Group and the Computer-based Patient Records Institute Working Group on Codes and Structures—it outlines policies regarding 1) functional characteristics of practical terminologies, 2) terminology models that can broaden their applications and contribute to their sustainability, 3) maintenance attributes that will enable terminologies to keep pace with rapidly changing health care knowledge and process, and 4) administrative issues that would facilitate their accessibility, adoption, and application to improve the quality and efficiency of American health care. PMID:9824798

Integrating Bioethics into Clinical and Translational Science Research: A Roadmap

PubMed Central

Shapiro, Robyn S.; Layde, Peter M.

2008-01-01

Abstract Recent initiatives to improve human health emphasize the need to effectively and appropriately translate new knowledge gleaned from basic biomedical and behavioral research to clinical and community application. To maximize the beneficial impact of scientific advances in clinical practice and community health, and to guard against potential deleterious medical and societal consequences of such advances, incorporation of bioethics at each stage of clinical and translational science research is essential. At the earliest stage, bioethics input is critical to address issues such as whether to limit certain areas of scientific inquiry. Subsequently, bioethics input is important to assure not only that human subjects trials are conducted and reported responsibly, but also that results are incorporated into clinical and community practices in a way that promotes and protects bioethical principles. At the final stage of clinical and translational science research, bioethics helps to identify the need and approach for refining clinical practices when safety or other concerns arise. The framework we present depicts how bioethics interfaces with each stage of clinical and translational science research, and suggests an important research agenda for systematically and comprehensively assuring bioethics input into clinical and translational science initiatives. PMID:20443821

Evaluation of an employment program for people with mental illness using the Supported Employment Fidelity Scale.

PubMed

Cocks, Errol; Boaden, Ross

2009-10-01

The Individual Placement and Support (IPS) model aims to achieve open employment for people with mental illness. The Supported Employment Fidelity Scale (SEFS) is a 15-item instrument that evaluates the extent to which a service follows the IPS principles of best practice. This paper describes the IPS model and an evaluation of a specialist employment program for people with mental illness using the SEFS. The SEFS enabled a quantitative assessment of service provision against the criteria of evidence-based practice principles. Data were collected from multiple sources. In addition, a literature review was conducted, and personnel engaged in implementation of the IPS model at other Australian employment programs were consulted. The program achieved a score of 59 of a possible 75 on the SEFS, which is described as fair supported employment. Analysis of the 15-scale items resulted in the identification of strengths, areas for further development, and a set of recommendations. The program was operating substantially in line with evidence-based practice principles and had considerable scope for further development. Issues arising from the evaluation, areas of applicability of the SEFS and the underlying literature, and implications for occupational therapy are highlighted.

16 CFR 3.13 - Adjudicative hearing on issues arising in rulemaking proceedings under the Fair Packaging and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... material to the issues raised by such objections or other issues specified by the Commission. In such case...) Parties. Any person who petitions for issuance, amendment, or repeal of a rule or order, and any person... filed in the proceeding. Upon written application to the Administrative Law Judge and a showing of good...

Ethics in Educational Technology: Towards a Framework for Ethical Decision Making in and for the Discipline

ERIC Educational Resources Information Center

Spector, J. Michael

2016-01-01

This special issue of "ETR&D" is devoted to ethics in the broad domain of educational technology. Many ethical issues arise involving the study and use of educational technologies. A well-known issue involves the digital divide and the degree to which the introduction of new technologies is increasing the digital divide and…

[The role of local government in the development of health policies].

PubMed

Dallari, S G

1991-10-01

Analysing the evidences for local concern with health in the various historical phases of the organization of social life, especially relating to the discussion of the efficacy of the social rights written into some contemporary constitutions, the attempt is made to define the responsibility for the guarantee of the right to health. The possibility of defining the responsibility for the guarantee of social rights arises directly from the legal definition of such rights, practicable at the level of local government. Thus, after a thorough examination of the Brazilian constitutional organization in search of the guarantee of health for all, it is concluded that the promotion of the said responsibility is greatly favored, since Municipal competence regarding issues related to health are listed and discussed there in detail.

Achieving positive outcomes in complex cases: The Admiral Nurse Dementia Helpline (Innovative Practice).

PubMed

Drayton, Susan; Dening, Karen H

2017-01-01

Carer distress is an all too common factor in caring for someone with dementia, whether living with the person with dementia, or trying to maintain their independence when they are living alone. Providing support for families on many day-to-day issues with immediacy as and when they arise can be very difficult to achieve for services on the ground as carer need can be difficult to anticipate as well as the changing status of the person with dementia. This paper discusses the innovative role of managing complexity on a dementia telephone helpline manned by Admiral Nurses, specialist dementia nurses, in expertly supporting a family over a weekend where there were health concerns of a family member with dementia and a high level of carer distress.

Current Jewish perspectives on maternal identity.

PubMed

Wolowelsky, Joel B; Grazi, Richard V

2014-01-01

Infertility counseling is a specialized field that will continue to grow in coming years as the impact of infertility and its treatment is documented more in terms of emotional, physical, social and life consequences. We report here on more recent developments in halakha (Jewish law and ethics) that are of importance to Orthodox Jewish infertile couple considering donor gametes or surrogacy. Counselors should anticipate issues that may arise in the future and assist couples in their efforts to address them. Good medical practice values the importance of understanding the patient's individual concerns and values, including the complex psychological, sociological and cultural context in which they experience their infertility. Good counseling anticipates and addresses future problems about which patients might not currently be aware, and requires up-to-date authoritative information.

Enhancing patient well-being: advocacy or negotiation?

PubMed Central

Bird, A W

1994-01-01

The United Kingdom Central Council for Nursing, Midwifery and Health Visitors (UKCC) document, Exercising Accountability, states that the role of patient's advocate is an essential aspect of good professional nursing practice (1). The author examines the case for and against the nurse being the best person to act as advocate, and critically evaluates the criteria of advocacy. The problematic moral issues arising are discussed, and a case made for negotiation between the members of the multidisciplinary team and the patient/client (or a significant person to the patient) in order to promote the well-being of the patient and to minimise suffering. She concludes that the health care professional's (including the nurse's) role is to help people to assert control over the factors which affect their lives, that is empowerment, rather than advocacy. PMID:7996560

[The application of climatic therapy in the health resorts of the Black Sea coast of the Caucasus: the current state-of-the-art and the prospects for the further development].

PubMed

Pestereva, N M; Khechumyan, A F; Udovenko, I L; Bekhterev, V N

2016-01-01

The present review summarizes the data published in the domestic and foreign literature concerning the history of climatic therapy, the current concepts of the mechanisms of action of the climatic and weather factors on the human body, the modern therapeutic modalities and technologies for health promotion. We consider not only the achievements but also the problems arising from insufficient knowledge of the impacts of current climate and extreme weather conditions on the state of human health and some disputable issues of the new methods and technologies of climatic therapy. the promising areas of further research and developments pertaining to climatic therapy as practiced under conditions of the Black Sea coast resorts.

Medical responsibility in the United Arab Emirates.

PubMed

Benomran, Fawzi

2010-05-01

Medical responsibility in the United Arab Emirates was formerly defined and governed according to Law 7 of 1975 for the practice of medical professions, which had been a part of civil law. The passing of Law 10 of 2008, namely the "Law on Medical Responsibility in UAE", enacted on 16th December 2008 created a new framework to deal with this issue. One of its provisions required medical practitioners to hold insurance policies, so that insurance companies pays damages to the plaintiff (patient) injured as a result of a physicians' negligence. This paper outlines the issue of medical responsibility and medical negligence. The author's translation of the new law into English is included so that its full text is available for the readers, especially expatriate doctors working in the UAE. Where appropriate, a brief comparison between the old law and new laws is also presented. The objective of this paper is to provide medical practitioners with basic information about the subject in general and to this legislation in particular. It is mandatory for doctors to realize inherent risks involved in the course of their practice. A basic knowledge of the law is required to avoid pitfalls and to safeguard oneself against errors arising from ignorance of the duties and rights of the professional person. Copyright (c) 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Ethical principles in the work of nurse educator-A cross-sectional study.

PubMed

Salminen, Leena; Stolt, Minna; Metsämäki, Riikka; Rinne, Jenni; Kasen, Anne; Leino-Kilpi, Helena

2016-01-01

The application of ethical principles within the teaching profession and nursing practice forms the core of the nurse educator's professional ethics. However, research focusing on the professional ethics of nurse educators is scarce. To describe ethical principles and issues relating to the work of nurse educators from the perspectives of both nurse educators themselves and nursing students. A descriptive study using cross-sectional data and content analysis. Nursing education program involving students from nine polytechnics in Finland. Nursing students (n=202) and nurse educators (n=342). Data were derived from an online survey, with two open-ended questions: Nursing students and nurse educators were asked to name the three main ethical principles that guide the work of nurse educators and also to describe ethical issues involved in the work. Students most often named professionalism, justice, and equality as the main ethical principles for a nurse educator. Nurse educators considered justice, equality, and honesty as the main ethical principles. The content analysis showed that professionalism and the relationship between educator and student were the key categories for ethical issues as perceived by nursing students. Nursing students most often identified inequality between the nurse educator and nursing student as the ethical issue faced by the nurse educator. Nursing students and nurse educators differed somewhat both in their views of the ethical principles guiding an educator's work and in the ethical issues arising in the work. Copyright © 2015 Elsevier Ltd. All rights reserved.

Challenges to complete and useful data sharing.

PubMed

Mbuagbaw, Lawrence; Foster, Gary; Cheng, Ji; Thabane, Lehana

2017-02-14

Data sharing from clinical trials is one way of promoting fair and transparent conduct of clinical trials. It would maximise the use of data and permit the exploration of additional hypotheses. On the other hand, the quality of secondary analyses cannot always be ascertained, and it may be unfair to investigators who have expended resources to collect data to bear the additional burden of sharing. As the discussion on the best modalities of sharing data evolves, some of the practical issues that may arise need to be addressed. In this paper, we discuss issues which impede the use of data even when sharing should be possible: (1) multicentre studies requiring consent from all the investigators in each centre; (2) remote access platforms with software limitations and Internet requirements; (3) on-site data analysis when data cannot be moved; (4) governing bodies for data generated in one jurisdiction and analysed in another; (5) using programmatic data collected as part of routine care; (6) data collected in multiple languages; (7) poor data quality. We believe these issues apply to all primary data and cause undue difficulties in conducting analysis even when there is some willingness to share. They can be avoided by anticipating the possibility of sharing any clinical data and pre-emptively removing or addressing restrictions that limit complete sharing. These issues should be part of the data sharing discussion.

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…

School Politics and Conflict in Racially Isolated Schools.

ERIC Educational Resources Information Center

Michel, George J.

1991-01-01

Compares areas and levels of political conflict in racially isolated school districts by surveying six superintendents from racially isolated African-American schools and six superintendents from racially isolated white schools. Similar issues arise at every conflict level with small variations among issues between African-American and white…

Research Issues Arising from the National Assessment of Educational Progress.

ERIC Educational Resources Information Center

Womer, Frank B.

This symposium deals with recent issues in the development of the National Assessment model. General goals are outlined and the following topics are discussed: "Objectives and Exercises" (Jack C. Merwin); "Sampling" (A. Finkner); and "Data Analysis" (John Milholland). (CK) Aspect of National Assessment (NAEP) dealt…

Ethical Issues in the Mental Health Treatment of Gender Dysphoric Adolescents.

ERIC Educational Resources Information Center

Swann, Stephanie; Herbert, Sarah E.

1999-01-01

Examines ethical dilemmas arising when treating adolescents with gender dysphoria, discussing ethical and legal issues pertinent to treating any adolescent and highlighting gender dysphoric adolescents. Reviews legal decisions, existing data on adolescent decision making, and ethical principles for resolving complex situations. Illustrates ethical…

Legal decision-making by people with aphasia: critical incidents for speech pathologists.

PubMed

Ferguson, Alison; Duffield, Gemma; Worrall, Linda

2010-01-01

The assessment and management of a person with aphasia for whom decision-making capacity is queried represents a highly complex clinical issue. In addition, there are few published guidelines and even fewer published accounts of empirical research to assist. The research presented in this paper aimed to identify the main issues for speech pathologists when decision-making capacity for legal and related matters arose for their clients with aphasia, and to describe qualitatively the nature of these issues and the practices of the speech pathologists in these situations. The methodology was informed by the qualitative research paradigm and made use of the semi-structured interview methods developed for the Critical Incident Technique. Nine speech pathologists, with a range of clinical experience between three and 27 years, were interviewed by telephone, with verbatim notes being taken on-line by the interviewer. The speech pathologists described a total of 21 clients (15 male, six female) with acquired neurological communication disorders (including cerebral vascular accident, traumatic brain injury, and tumour) whose care had raised critical incidents for the speech pathologist in relation to legal and related matters. These verbatim notes were qualitatively analysed using NVivo qualitative analysis software. The main incidents related to legal decisions (for example, power of attorney, will-making), as well as decisions involving consent for medical treatment, discharge, accommodation, and business/financial decisions. In all but one of the incidents recounted, the issues centred on a situation of conflict between the person with aphasia and their family, friends or with the multidisciplinary team. The roles taken by the speech pathologists ranged from those expected within a speech pathology scope of practice, such as that of assessor and consultant, to those which arguably present dilemmas and conflict of interest, for example, interpreter, advocate. The assessment practices involved some standardized testing, but this was stressed by all participants to be of lesser importance than informal observations of function. Speech pathologists emphasized the importance of multiple observations, and multimodal means of communication. The findings indicate that speech pathologists are currently playing an active role when questions arise regarding capacity for legal and related decision-making by people with aphasia. At the same time, the findings support the need for further research to develop guidelines for practice and to build educational experiences for students and novice clinicians to assist them when they engage with the complex case management issues in this area. 2010 Royal College of Speech & Language Therapists.

Ethics of the electrified mind: Defining issues and perspectives on the principled use of brain stimulation in medical research and clinical care

PubMed Central

Cabrera, Laura Y.; Evans, Emily L.; Hamilton, Roy H.

2013-01-01

In recent years, non-pharmacologic approaches to modifying human neural activity have gained increasing attention. One of these approaches is brain stimulation, which involves either the direct application of electrical current to structures in the nervous system or the indirect application of current by means of electromagnetic induction. Interventions that manipulate the brain have generally been regarded as having both the potential to alleviate devastating brain-related conditions and the capacity to create unforeseen and unwanted consequences. Hence, although brain stimulation techniques offer considerable benefits to society, they also raise a number of ethical concerns. In this paper we will address various dilemmas related to brain stimulation in the context of clinical practice and biomedical research. We will survey current work involving deep brain stimulation (DBS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). We will reflect upon relevant similarities and differences between them, and consider some potentially problematic issues that may arise within the framework of established principles of medical ethics: nonmaleficence and beneficence, autonomy, and justice. PMID:23733209

Gender Problems in the Practice of Professional Interpreters Assisting Migrant Women in Australia: A Theoretical Case for Feminist Education.

PubMed

Norma, Caroline; Garcia-Caro, Olga

2016-10-01

Professional interpreters in Australia have little opportunity to undertake education on issues of violence against women. This article observes a lack of awareness of gender violence-related issues among community interpreters. It then notes examples of gender-related problems arising in the work of interpreters assisting migrant women. It repeats Maree Pardy's call for interpreter education, but diverges from her 1995 work by explicitly recommending this education be informed by feminist principles. It observes that, although community interpreters are key to migrant women accessing social services in Australia, the profession resists calls for specialized education. This resistance occurs in a country that is recognized internationally for its progressive public service interpreting policies. We question why this is the case, and suggest that adherence to a peculiarly superficial notion of "impartiality" dulls the profession's responsiveness to the reality of male violence. We draw on government and non-governmental organization (NGO) reports, as well as interpreting scholarship using a gender lens, to theorize the need for feminist education of professional community interpreters. © The Author(s) 2016.

The elusive ideal of inclusiveness: lessons from a worldwide survey of neurologists on the ethical issues raised by whole-genome sequencing.

PubMed

Hurlimann, Thierry; Jaitovich Groisman, Iris; Godard, Béatrice

2017-04-11

The anticipation of ethical issues that may arise with the clinical use of genomic technologies is crucial to envision their future implementation in a manner sensitive to local contexts. Yet, populations in low- and middle-income countries are underrepresented in studies that aim to explore stakeholders' perspectives on the use of such technologies. Within the framework of a research project entitled "Personalized medicine in the treatment of epilepsy", we sought to increase inclusiveness by widening the reach of our survey, inviting neurologists from around the world to share their views and practices regarding the use of whole-genome sequencing in clinical neurology and its associated ethics. We discuss herein the compelling scientific and ethical reasons that led us to attempt to recruit neurologists worldwide, despite the lack, in many low- or middle-income countries, of access to genomic technologies. Recruitment procedures and their results are presented and discussed, as well as the barriers we faced. We conclude that inclusive recruitment remains a challenging, albeit necessary and legitimate, endeavour.

Surrogate-based Analysis and Optimization

NASA Technical Reports Server (NTRS)

Queipo, Nestor V.; Haftka, Raphael T.; Shyy, Wei; Goel, Tushar; Vaidyanathan, Raj; Tucker, P. Kevin

2005-01-01

A major challenge to the successful full-scale development of modem aerospace systems is to address competing objectives such as improved performance, reduced costs, and enhanced safety. Accurate, high-fidelity models are typically time consuming and computationally expensive. Furthermore, informed decisions should be made with an understanding of the impact (global sensitivity) of the design variables on the different objectives. In this context, the so-called surrogate-based approach for analysis and optimization can play a very valuable role. The surrogates are constructed using data drawn from high-fidelity models, and provide fast approximations of the objectives and constraints at new design points, thereby making sensitivity and optimization studies feasible. This paper provides a comprehensive discussion of the fundamental issues that arise in surrogate-based analysis and optimization (SBAO), highlighting concepts, methods, techniques, as well as practical implications. The issues addressed include the selection of the loss function and regularization criteria for constructing the surrogates, design of experiments, surrogate selection and construction, sensitivity analysis, convergence, and optimization. The multi-objective optimal design of a liquid rocket injector is presented to highlight the state of the art and to help guide future efforts.

Adaptive control: Myths and realities

NASA Technical Reports Server (NTRS)

Athans, M.; Valavani, L.

1984-01-01

It was found that all currently existing globally stable adaptive algorithms have three basic properties in common: positive realness of the error equation, square-integrability of the parameter adjustment law and, need for sufficient excitation for asymptotic parameter convergence. Of the three, the first property is of primary importance since it satisfies a sufficient condition for stabillity of the overall system, which is a baseline design objective. The second property has been instrumental in the proof of asymptotic error convergence to zero, while the third addresses the issue of parameter convergence. Positive-real error dynamics can be generated only if the relative degree (excess of poles over zeroes) of the process to be controlled is known exactly; this, in turn, implies perfect modeling. This and other assumptions, such as absence of nonminimum phase plant zeros on which the mathematical arguments are based, do not necessarily reflect properties of real systems. As a result, it is natural to inquire what happens to the designs under less than ideal assumptions. The issues arising from violation of the exact modeling assumption which is extremely restrictive in practice and impacts the most important system property, stability, are discussed.

Culturally competent social work research: methodological considerations for research with language minorities.

PubMed

Casado, Banghwa Lee; Negi, Nalini Junko; Hong, Michin

2012-01-01

Despite the growing number of language minorities, foreign-born individuals with limited English proficiency, this population has been largely left out of social work research, often due to methodological challenges involved in conducting research with this population. Whereas the professional standard calls for cultural competence, a discussion of how to implement strategies for culturally competent research with language minorities is regrettably limited in the social work literature. This article is, to the authors' knowledge, one of the first within the field of social work to tie together unique methodological issues that may arise throughout the research conceptualization, development, and implementation process with this population. Strategies for how to overcome such issues are provided by adapting and expanding on a conceptual framework by Meleis. The incorporation of such research practices with language minorities has the potential to enhance trust and, thus, improve the recruitment and retention of this hard-to-reach population. More important, studies that aim to include such culturally responsive criteria may produce results that have improved validity and, thus, contribute to the advancement of knowledge regarding this population.

Ordering competition: the interactional accomplishment of the sale of art and antiques at auction.

PubMed

Heath, Christian; Luff, Paul

2007-03-01

Auctions provide an institutional solution to a social problem; they enable the legitimate pricing and exchange of goods where those goods are of uncertain value. In turn, auctions raise a number of social and organizational issues that are resolved within the interaction that arise in sales by auction. In this paper, we examine sales of fine art, antiques and objets d'art and explore the ways in which auctioneers mediate competition between buyers and establish a value for goods. In particular, we explore how bids are elicited, co-ordinated and revealed so as to rapidly escalate the price of goods in a transparent manner that enables the legitimate valuation and exchange of goods. In directing attention towards the significance of the social interaction, including talk, visual and material conduct, the paper contributes to the growing corpus of ethnographic studies of markets. It suggests that to understand the operation of markets and their outcomes, and to unpack issues of agency, trust and practice, we need to place the 'interaction order' at the heart of analytic agenda.

Collaborating across services to advance evidence-based nursing practice.

PubMed

Kenny, Deborah J; Richard, Maggie L; Ceniceros, Xochitl; Blaize, Kelli

2010-01-01

Military medical treatment facilities offer a unique environment in which to develop a culture of evidence-based practice (EBP). Distinctive issues arise in the context of changed patient care demographics because of a war-injured population. These issues offer an opportunity to enhance the quality of care through the use and adaptation of research findings in this special nursing environment. In addition, the colocation of two military medical centers offers the prospect of collaborative efforts to create a regional culture for nursing EBP. The purposes of this study were to describe the processes of a collaborative project to train nurses in EBP and to share resources in developing and implementing evidence-based clinical nursing guidelines in two large military medical centers in the Northeastern United States and to discuss the collective efforts of nurse researchers, leadership, advanced practice nurses, and staff nurses in each hospital to facilitate the EBP process. A description of the organizational structure and the climate for EBP of each facility is provided followed by discussion of training efforts and the inculcation of an organizational culture for EBP. Contextual barriers and facilitators were encountered throughout the project. The two nurse researchers leading the projects were able to overcome the barriers and capitalize on opportunities to promote EBP. Three evidence-based clinical practice guidelines were developed at each facility and are currently in various stages of implementation. Despite the barriers, EBP continues to be at the forefront of military nursing practice in the U.S. National Capital Region. Clear communication and regular meetings were essential to the success of the collaborative project within and between the two military hospitals. Military-specific barriers to EBP included high team attrition and turnover because of the war mission and the usual high staff turnover at military hospitals. Military facilitators included a common mission of providing high-quality care for war-injured service members. Lessons learned from this project can be generalized to civilian facilities.

Values, Practice, Science, and AAC

ERIC Educational Resources Information Center

Mirenda, Pat

2017-01-01

The evolution of evidence-based practice in augmentative and alternative communication (AAC) has occurred via two different but related routes: the conventional research-to-practice route and the more common practice-to-research route. This article defines both routes with examples of each and discusses potential problems that may arise when…

Business Ethics 101 for the biotech industry.

PubMed

MacDonald, Chris

2004-01-01

Biotechnology companies face ethical challenges of two distinct types: bioethical challenges faced on account of the nature of work in the life sciences, and corporate ethical challenges on account of their nature as commercial entities. The latter set of challenges has received almost no attention at all in the academic literature or media. This paper begins to remedy that lacuna, examining ethical issues that arise specifically on account of the status of biotech companies as commercial entities. The focus here is on three representative issues: product safety, corporate social responsibility, and corporate governance. It is argued that each of these issues poses particular ethical challenges for companies in the biotech sector. In the area of product safety, it is noted that biotech companies face particular challenges in determining what counts as a "safe" product, given the contentious nature of what might count as a "harm" in the biotech field. In the area of corporate social responsibility, the adoption of a "stakeholder approach" and an attempt to manage the social consequences of products pose special challenges for biotech companies. This is due to the enormous range of groups and individuals claiming to have a stake in the doings of such companies, and the trenchant controversies over just what the social consequences of various biotechnologies might be. In the area of corporate governance, biotech companies need to seek out and follow best practices regarding the ways in which information, authority, and influence flow between a company's shareholders, managers, and Board of Directors, if they are to avoid duplicating the ethical and financial scandal that brought down ImClone. An important meta-issue, here--one that renders each of these corporate ethical challenges more vexing--is the difficulty of finding the appropriate benchmarks for ethical corporate behavior in a field as controversial, and as rapidly evolving, as biotechnology. Three programmatic suggestions can be made: Firstly, scholars and others interested in the ethical performance of the biotech sector must seek out and build opportunities for richer interdisciplinary collaboration. Secondly, companies within the biotech sector must seek out expertise and build capacity and competency in dealing with the corporate ethical issues that arise in their sector. Finally, companies in the biotech sector should explore the opportunities for collective problem solving afforded by the existence of local, national, and international industry associations such as the Biotechnology Industry Organization, BIOTECanada, and EuropaBio.

Closing the Guantanamo Detention Center: Legal Issues

DTIC Science & Technology

2009-09-14

immigration law. This report provides an overview of major legal issues likely to arise as a result of executive and legislative action to close the...possibility that suspected enemy combatants could pursue legal challenges regarding their detention or other wartime actions taken by the Executive. The...and legislative action to close the Guantanamo detention facility. It discusses legal issues related to the transfer or release of Guantanamo detainees

Nature of Science, Scientific Inquiry, and Socio-Scientific Issues Arising from Genetics: A Pathway to Developing a Scientifically Literate Citizenry

ERIC Educational Resources Information Center

Lederman, Norman G.; Antink, Allison; Bartos, Stephen

2014-01-01

The primary focus of this article is to illustrate how teachers can use contemporary socio-scientific issues to teach students about nature of scientific knowledge as well as address the science subject matter embedded in the issues. The article provides an initial discussion about the various aspects of nature of scientific knowledge that are…

'It's interesting how few people die from smoking': tobacco industry efforts to minimize risk and discredit health promotion.

PubMed

Smith, Elizabeth A

2007-04-01

It is well known that the tobacco industry has placed articles in scientific literature to maintain controversy over the dangers of tobacco use, while claiming that smokers are well-informed about risk. This study illuminates an industry attempt to directly undermine popular understanding of the hazards of smoking using an industry-created organization called Associates for Research in the Science of Enjoyment (ARISE). Searches of tobacco industry documents contained in the Legacy Tobacco Documents Library, British American Tobacco Documents Library, and British Columbia's Tobacco Industry documents were performed as well as searches of the LexisNexis database for news articles on ARISE published between 1989 and 2005. Qualitative analysis focused on industry motives, media strategies, and rhetorical tactics; quantitative content analysis focused on media coverage. Between 1989 and 2005, at least 846 articles appeared in the European, Australian, and US press mentioning ARISE, its members, or its activities. Many of these articles presented two themes: smoking was a healthful 'pleasure', and health promotion practices, including cessation, were stressful and unhealthy. Few articles included responses from health advocates, questioned ARISE's claims, or mentioned its funding. ARISE successfully planted stories in the press, designed to allay the health concerns of smokers and to discredit health promotion information and practices. ARISE's later interest in food suggests that counterfactual 'health' messages on almost any topic could be promoted similarly, regardless of their implausibility.

Designing Trend-Monitoring Sounds for Helicopters: Methodological Issues and an Application

ERIC Educational Resources Information Center

Edworthy, Judy; Hellier, Elizabeth; Aldrich, Kirsteen; Loxley, Sarah

2004-01-01

This article explores methodological issues in sonification and sound design arising from the design of helicopter monitoring sounds. Six monitoring sounds (each with 5 levels) were tested for similarity and meaning with 3 different techniques: hierarchical cluster analysis, linkage analysis, and multidimensional scaling. In Experiment 1,…

School Transportation Issues, Laws and Concerns: Implications for Future Administrators

ERIC Educational Resources Information Center

Durick, Jody M.

2010-01-01

Nearly all building administrators are confronted with a variety of transportation issues. Challenges, concerns and questions can arise from various aspects, including student misbehaviors, transportation laws and its implications at the school level, to importance and implementation of a school bus safety program. As new and upcoming future…

Florida's Information Policy: Problems and Issues in the Information Age.

ERIC Educational Resources Information Center

Florida State Legislature, Tallahassee.

This report examines the major issues arising from the impact of information technology on the creation of government information and its storage, processing, and recordkeeping, based on information gathered through a literature search, several mailed questionnaires, and three public hearings. An outline of the background of the information policy…

Corporate restructuring--strategic planning and redesign of employee benefits.

PubMed

Macey, S J

1996-12-01

Many intricate legal, actuarial, design and fiduciary issues arise during corporate restructuring. It is critical to create a process approach that clearly defines and evaluates the human resource and benefits issues that are involved, giving consideration to legal and regulatory, operational, administrative, financial and labor-related concerns.

Teaching an Issues-Based Interdisciplinary Course: Diversity in Management and Marketing

ERIC Educational Resources Information Center

Hazen, Mary Ann; Higby, Mary A.

2005-01-01

The authors examine their experiences of coteaching an intensive, interdisciplinary elective course for MBA students: Diversity in Management and Marketing. They address otherness, dialogue, energy, and change within this course and clarify issues that can arise when coteaching interdisciplinary courses. The authors list implications for…

Validity Issues in Clinical Assessment.

ERIC Educational Resources Information Center

Foster, Sharon L.; Cone, John D.

1995-01-01

Validation issues that arise with measures of constructs and behavior are addressed with reference to general reasons for using assessment procedures in clinical psychology. A distinction is made between the representational phase of validity assessment and the elaborative validity phase in which the meaning and utility of scores are examined.…

Perspectives on National Health Insurance and Rehabilitation. Emerging Issues in Rehabilitation.

ERIC Educational Resources Information Center

Dorken, Herbert; LaRocca, Joseph

Major research findings are synthesized and innovations of current concern to vocational rehabilitation professionals are reported in this paper on national health insurance (NHI) and rehabilitation. Discussion covers the following topics: the concept of insurance, forms of health insurance, issues arising from hearings on NHI, perspectives of…

You've Been Served: Surviving a Deposition

ERIC Educational Resources Information Center

Wodarz, Nan

2010-01-01

School business managers are in the unique position of supervising the areas of the operation that present the greatest opportunities for legal issues to arise. New construction and renovation projects are strewn with legal land mines. The possibility of lawsuits hovers like a black cloud over personnel issues. Opportunities for transportation or…

Ethical issues in public health surveillance: a systematic qualitative review.

PubMed

Klingler, Corinna; Silva, Diego Steven; Schuermann, Christopher; Reis, Andreas Alois; Saxena, Abha; Strech, Daniel

2017-04-04

Public health surveillance is not ethically neutral and yet, ethics guidance and training for surveillance programmes is sparse. Development of ethics guidance should be based on comprehensive and transparently derived overviews of ethical issues and arguments. However, existing overviews on surveillance ethics are limited in scope and in how transparently they derived their results. Our objective was accordingly to provide an overview of ethical issues in public health surveillance; in addition, to list the arguments put forward with regards to arguably the most contested issue in surveillance, that is whether to obtain informed consent. Ethical issues were defined based on principlism. We assumed an ethical issue to arise in surveillance when a relevant normative principle is not adequately considered or two principles come into conflict. We searched Pubmed and Google Books for relevant publications. We analysed and synthesized the data using qualitative content analysis. Our search strategy retrieved 525 references of which 83 were included in the analysis. We identified 86 distinct ethical issues arising in the different phases of the surveillance life-cycle. We further identified 20 distinct conditions that make it more or less justifiable to forego informed consent procedures. This is the first systematic qualitative review of ethical issues in public health surveillance resulting in a comprehensive ethics matrix that can inform guidelines, reports, strategy papers, and educational material and raise awareness among practitioners.

OVERVIEW OF TOXICOKINETIC ISSUES

EPA Science Inventory

Perflouroalkyl acids and related chemistries have physical chemical properties arising from the chemistry of the carbon-fluorine bond that differentiate their biological activity, including pharmacokinetics.

Seeking consent to genetic and genomic research in a rural Ghanaian setting: A qualitative study of the MalariaGEN experience

PubMed Central

2012-01-01

Background Seeking consent for genetic and genomic research can be challenging, particularly in populations with low literacy levels, and in emergency situations. All of these factors were relevant to the MalariaGEN study of genetic factors influencing immune responses to malaria in northern rural Ghana. This study sought to identify issues arising in practice during the enrolment of paediatric cases with severe malaria and matched healthy controls into the MalariaGEN study. Methods The study used a rapid assessment incorporating multiple qualitative methods including in depth interviews, focus group discussions and observations of consent processes. Differences between verbal information provided during community engagement processes, and consent processes during the enrolment of cases and controls were identified, as well as the factors influencing the tailoring of such information. Results MalariaGEN participants and field staff seeking consent were generally satisfied with their understanding of the project and were familiar with aspects of the study relating to malaria. Some genetic aspects of the study were also well understood. Participants and staff seeking consent were less aware of the methodologies employed during genomic research and their implications, such as the breadth of data generated and the potential for future secondary research. Moreover, trust in and previous experience with the Navrongo Health Research Centre which was conducting the research influenced beliefs about the benefits of participating in the MalariaGEN study and subsequent decision-making about research participation. Conclusions It is important to recognise that some aspects of complex genomic research may be of less interest to and less well understood by research participants and that such gaps in understanding may not be entirely addressed by best practice in the design and conduct of consent processes. In such circumstances consideration needs to be given to additional protections for participants that may need to be implemented in such research, and how best to provide such protections. Capacity building for research ethics committees with limited familiarity with genetic and genomic research, and appropriate engagement with communities to elicit opinions of the ethical issues arising and acceptability of downstream uses of genome wide association data are likely to be important. PMID:22747883

Using Critical Literacy to Explore Genetics and its Ethical, Legal, and Social Issues with In-Service Secondary Teachers

PubMed Central

Melançon, Megan E.; Kleine, Karynne L. M.

2010-01-01

The described interdisciplinary course helped a mixed population of in-service secondary English and biology teacher-participants increase their genetics content knowledge and awareness of Ethical, Legal, and Social Implications (ELSI) that arose from discoveries and practices associated with the Human Genome Project. This was accomplished by applying a critical literacy approach that allows people develop cognitive skills such that they are able to “read the world” (Wink, 2004). The approach is one that permits readers to go beyond the literal text to examine what is present as well as what is missing as it relates to issues of equity and fairness. Becoming critically literate enabled these teacher-participants to challenge the subtle attitudes, values, and beliefs conveyed by a range of written and oral texts. The teacher-participants in this course improved their critical literacy skills by actively reading, critically writing about, and using evidence to support their conclusions about issues arising from advances in human genetics. A biologist, a linguist, and an educator collaboratively designed and taught the course. The personalized focus on the integration of thoughtful reading and writing in this class enhanced the teacher-participants' (n = 16) professional and intellectual development and will potentially improve learning in their biology and English classrooms in the future. PMID:21123688

Using critical literacy to explore genetics and its ethical, legal, and social issues with in-service secondary teachers.

PubMed

Gleason, Michael L; Melançon, Megan E; Kleine, Karynne L M

2010-01-01

The described interdisciplinary course helped a mixed population of in-service secondary English and biology teacher-participants increase their genetics content knowledge and awareness of Ethical, Legal, and Social Implications (ELSI) that arose from discoveries and practices associated with the Human Genome Project. This was accomplished by applying a critical literacy approach that allows people develop cognitive skills such that they are able to "read the world" (Wink, 2004). The approach is one that permits readers to go beyond the literal text to examine what is present as well as what is missing as it relates to issues of equity and fairness. Becoming critically literate enabled these teacher-participants to challenge the subtle attitudes, values, and beliefs conveyed by a range of written and oral texts. The teacher-participants in this course improved their critical literacy skills by actively reading, critically writing about, and using evidence to support their conclusions about issues arising from advances in human genetics. A biologist, a linguist, and an educator collaboratively designed and taught the course. The personalized focus on the integration of thoughtful reading and writing in this class enhanced the teacher-participants' (n = 16) professional and intellectual development and will potentially improve learning in their biology and English classrooms in the future.

Beyond the Data: Effective Methods for Communicating the Value of Geoscience Research

NASA Astrophysics Data System (ADS)

Lees, J. M.; Parker, M. L.

2017-12-01

The health of Earth Science departments depends critically on effective campus outreach and communication. Where competing narratives across a broad spectrum of intellectual pursuits draws the attention of administrators for resources, geological sciences are positioned, in a unique way, to make a big impact in both public relations within the institution and outward to the community at large. Researchers, by themselves, often make poor advocates for their exciting discoveries, especially when dealing with colleagues who have little or no appreciation for the interdisciplinary nature of Earth Science. Our communication efforts at the University of North Carolina—Chapel Hill have represented the Department of Geological Sciences with spectacular visual content and riveting storytelling. Long-form features, photos, and videos published in science-oriented campus publications (Endeavors), alumni outreach (Carolina Alumni Review) and more general issues (Arts & Sciences magazine) offer glimpses into geophysical research areas such as coastal evolution, active volcanoes, and stratospheric acoustics. A well crafted story can go a long way towards raising the stature of a small department, and increase the exposure of critical environmental issues on campus. This presentation will include the key elements for crafting a compelling geoscience research story, common issues that can arise in science communication, and best practices for utilizing storytelling methods for outreach in both academic and industry settings.

The impact of alternate weekly collections on waste arisings.

PubMed

Williams, I D; Cole, C

2013-02-15

Residual waste is commonly collected separately from recyclable and organic materials. Different forms of collection and disposal are used internationally since regional or municipal authorities have to adapt to their own circumstances. Many authorities have adopted an alternate weekly collection (AWC) of residual waste and recyclables to force/encourage householders to recycle; however, the degree to which they achieve waste reduction has yet to be reliably quantified. This study reports on how the introduction of AWCs affects household waste arisings. The paper evaluates single and dual stream collection methods and compares their performance with the previous system. Household waste collection trials were conducted between March and June 2009 in England (Lichfield). The trials examined changes to frequency of collection, type of container issued, amounts of sorting required of residents, household participation and productivity levels. A survey of households was completed before any changes were implemented. The quantity of recyclates collected was examined for 2008/2009 and 2009/2010. The study showed that the AWC scheme positively impacted on recycling rates and household behaviour, with no adverse impacts on public participation, household waste arisings or the local environment. No public health problems were reported. Both trials saw an increase in the quantities of recyclates collected per household during the trial period compared to the same period of time in the previous year. The dual stream performed better than the single stream, collecting an average of 5.94 kg/hh/week compared to an average of 5.63 kg/hh/week. The single stream system showed a greater increase in the weight of material collected (0.53 kg/hh/week vs. 0.48 kg/hh/week). Participation and set-out rates showed an increase during the trial period. The single stream option (comingled materials in one container) outperformed the dual stream service. The reduction in costs and improved productivity were the principal reasons used for extending the trial and making changes to the district's waste collections. The study clearly demonstrates the benefits of local authorities and universities collaborating and identifies practical logistical and operational issues that need to be anticipated. Copyright © 2012 Elsevier B.V. All rights reserved.

76 FR 69545 - Conditions and Requirements for Relying on Component Part Testing or Certification, or Another...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... to section 14(d) of the CPSA to section 14(i) of the CPSA due to renumbering arising out of H.R. 2715... CPSA to cite section 14(i) of the CPSA, as a result of renumbering arising out of H.R. 2715. 4... INFORMATION: I. Introduction A. What is the purpose of the final rule? Elsewhere in this issue of the Federal...

Sanctified madness: the God-intoxicated saints of Bengal.

PubMed

Morinis, A

1985-01-01

The saintly madman is a familiar character in South Asia. To outer appearances he is no different from a lunatic, but the mad saint comes to be revered because his idiocy is popularly believed to arise from a different cause than ordinary madness. The common psychopath neglects social conventions because his consciousness is dimmed by incapacity; the saintly madman also breaches convention, but does so because his heightened consciousness has liberated him from the bonds of convention that entrap ordinary people. In the terms of Hinduism, he has tasted the divine nectar of God-realization and has returned to the human realm intoxicated by the experience. In this paper two popular God intoxicated saints of Bengal are discussed. The question is posed whether 'God intoxication' can be considered a culture-bound syndrome of Bengal. The concept of 'culture bound syndrome' is found to be too narrow to encompass the most significant issues to arise from reflection on the characteristics of the God intoxicated. These larger issues have to do with the relationship between cultural practices and models and mental states (whether deviant, as implied by the term 'syndrome' although deviance does not always carry the negative connotation implicit in 'syndrome', or normal). It is suggested that all cultures culture a limited range of mental states and thus the questions posed by the notion of culture bound syndromes are subsumed by larger questions about the relationship of all mind-states to the socio-cultural environment which conditions them. The conclusion is that God intoxication is indeed a uniquely Bengali mental condition, with variants throughout South Asia and kinship to other mystical states, but that the concept of 'syndrome' is not useful.

Cultural and hierarchical influences: ethical issues faced by Taiwanese nursing students.

PubMed

Yeh, Mei-Yu; Wu, Shu-Mei; Che, Hui-Lian

2010-05-01

OBJECTIVES Improving nurses' competence in resolving clinical ethical issues must start with ethics education in training and clinical practice. However, many students complain that they cannot apply classroom learning to actual clinical scenarios. This study explored ethical issues and dilemmas, and their impact experienced by student nurses in clinical practice. METHODS Focus groups were conducted with 44 first-year student nurses from a 2-year college course in northern Taiwan. Interviews were tape-recorded and verbatim transcripts were analysed using content analysis. RESULTS Students expressed and discussed their views in eight focus groups. Analysis of interviews revealed five themes: frustration at inability to help some patients; oppression caused by lower status; lack of honesty and ethical courage; powerlessness, and self-encouragement in adversity. CONCLUSIONS Taiwanese nurse ethics training was only recently introduced and the curriculum has not addressed the clinical reality in Taiwan. This reality includes limitations arising from the medical hierarchy and the socio-cultural role of families in medical decision making, which may inhibit ethical judgements and decision making. In clinical dilemmas, the most common problems faced by Taiwanese nursing students involved not knowing how to handle some situations, inability to abide by principles, and a lack of appropriate role models. Hence, we suggest that nursing ethics education should: (i) integrate scenarios involving ethical dilemmas into daily routines; (ii) give students opportunities to discuss their feelings about their experiences; (iii) allow teachers and students to talk about scenarios with ethical implications, and (iv) provide students with opportunities to reflect on clinical scenarios in order to clarify their values and learn how to respect the value of life.

A researcher's journey: Exploring a sensitive topic with vulnerable women.

PubMed

Marsh, Christine A; Browne, Jenny; Taylor, Jan; Davis, Deborah

2017-02-01

The conduct of research regardless of the subject or methods employed brings responsibilities and challenges. These are greater when dealing with sensitive topics and vulnerable groups and therefore researchers must navigate a range of complex issues and make choices in relation to practical, ethical and philosophical concerns. While literature dealing with research methodologies and research design may assist to some degree, it cannot provide a clear pathway or template as each research project must respond to a unique set of circumstances. We can however, also learn from sharing our stories and critical reflections on our research processes. The purpose of this article is to highlight the practical and methodological issues arising from researching a sensitive topic with vulnerable women experiencing an Assumption of Care. Research involving topics that are deeply personal and private combined with a vulnerable population can be complex and challenging for the researcher. Although some issues were anticipated from the literature, others encountered in this study were unexpected. Special considerations and prerequisites were necessary to build mutual trust and share power with women who had experienced an Assumption of Care at birth. Narrative Inquiry was a good methodological fit for this study as it privileged the voices of women and insisted that their experiences be considered within the context of their lives. Although Narrative Inquiry is a suitable choice for researching sensitive topics with vulnerable women specific considerations are still required to ensure the benefits of this research for both participants and researchers. Family and Community Service (FACS) have now replaced the formerly known Department of Community Services (DoCS) and in consideration of the timing of this study this article uses the terminology as DoCS. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Understanding domains of health-related quality of life concerns of Singapore Chinese patients with advanced cancer: a qualitative analysis.

PubMed

Lee, G L; Pang, G S Y; Akhileswaran, R; Ow, M Y L; Fan, G K T; Wong, C C F; Wee, H L; Cheung, Y B

2016-03-01

Quality of life concerns in patients with advanced diseases might be different from other patients and are shaped by sociocultural context. The objective of this qualitative study was to identify domains and themes of health-related quality of life (HRQoL) that Chinese patients with advanced cancer in Singapore considered relevant and important. English- and Chinese-speaking patients with advanced solid cancer were recruited from a tertiary cancer center and a community-based hospice for in-depth interview or focused group discussion. Thematic analysis was used to identify subthemes, themes, and domains from the transcripts. Forty-six ethnic Chinese (aged 26-86, 48% male) participated in the study. Six domains of HRQoL concerns were identified: pain and suffering, physical health, social health, mental health, financial well-being, and spiritual health. Pain and suffering are not limited to the physical domain, reflecting the multidimensional nature of this concept. Pain and suffering must also be understood within the cultural context. Healthcare relations (i.e., social health), existential well-being and religious well-being (i.e., spiritual health), and suffering (i.e., pain and suffering) are not fully captured in the existing HRQoL instruments. In addition, financial issues and the practice of secrecy in interpersonal relationships emerged as unique features possibly arising from our sociocultural context and healthcare financing landscape. Socioculturally specific issues not measured by the existing HRQoL instruments for use in patients with advanced cancers or terminal diseases were found in our study. These are non-physical pain and suffering, meaning of illness, meaning of death, financial issues, and practice of secrecy in interpersonal relationships.

Estimation of conformational entropy in protein-ligand interactions: a computational perspective.

PubMed

Polyansky, Anton A; Zubac, Ruben; Zagrovic, Bojan

2012-01-01

Conformational entropy is an important component of the change in free energy upon binding of a ligand to its target protein. As a consequence, development of computational techniques for reliable estimation of conformational entropies is currently receiving an increased level of attention in the context of computational drug design. Here, we review the most commonly used techniques for conformational entropy estimation from classical molecular dynamics simulations. Although by-and-large still not directly used in practical drug design, these techniques provide a golden standard for developing other, computationally less-demanding methods for such applications, in addition to furthering our understanding of protein-ligand interactions in general. In particular, we focus on the quasi-harmonic approximation and discuss different approaches that can be used to go beyond it, most notably, when it comes to treating anharmonic and/or correlated motions. In addition to reviewing basic theoretical formalisms, we provide a concrete set of steps required to successfully calculate conformational entropy from molecular dynamics simulations, as well as discuss a number of practical issues that may arise in such calculations.

The Nurse Project: an analysis for nurses to take back our work.

PubMed

Rankin, Janet M

2009-12-01

This paper challenges nurses to join together as a collective in order to facilitate ongoing analysis of the issues that arise for nurses and patients when nursing care is harnessed for health care efficiencies. It is a call for nurses to respond with a collective strategy through which we can 'talk back' and 'act back' to the powerful rationality of current thinking and practices. The paper uses examples from an institutional ethnographic (IE) research project to demonstrate how dominant approaches to understanding nursing position nurses to overlook how we activate practices of reform that reorganize how we nurse. The paper then describes two classroom strategies taken from my work with students in undergraduate and graduate programs. The teaching strategies I describe rely on the theoretical framework that underpin the development of an IE analysis. Taken into the classroom (or into other venues of nursing activism) the tools of IE can be adapted to inform a pedagogical approach that supports nurses to develop an alternate analysis to what is happening in our work.

Public health ethics and more-than-human solidarity.

PubMed

Rock, Melanie J; Degeling, Chris

2015-03-01

This article contributes to the literature on One Health and public health ethics by expanding the principle of solidarity. We conceptualise solidarity to encompass not only practices intended to assist other people, but also practices intended to assist non-human others, including animals, plants, or places. To illustrate how manifestations of humanist and more-than-human solidarity may selectively complement one another, or collide, recent responses to Hendra virus in Australia and Rabies virus in Canada serve as case examples. Given that caring relationships are foundational to health promotion, people's efforts to care for non-human others are highly relevant to public health, even when these efforts conflict with edicts issued in the name of public health. In its most optimistic explication, One Health aims to attain optimal health for humans, non-human animals and their shared environments. As a field, public health ethics needs to move beyond an exclusive preoccupation with humans, so as to account for moral complexity arising from people's diverse connections with places, plants, and non-human animals. Copyright © 2014 Elsevier Ltd. All rights reserved.

Scheduling Aircraft Landings under Constrained Position Shifting

NASA Technical Reports Server (NTRS)

Balakrishnan, Hamsa; Chandran, Bala

2006-01-01

Optimal scheduling of airport runway operations can play an important role in improving the safety and efficiency of the National Airspace System (NAS). Methods that compute the optimal landing sequence and landing times of aircraft must accommodate practical issues that affect the implementation of the schedule. One such practical consideration, known as Constrained Position Shifting (CPS), is the restriction that each aircraft must land within a pre-specified number of positions of its place in the First-Come-First-Served (FCFS) sequence. We consider the problem of scheduling landings of aircraft in a CPS environment in order to maximize runway throughput (minimize the completion time of the landing sequence), subject to operational constraints such as FAA-specified minimum inter-arrival spacing restrictions, precedence relationships among aircraft that arise either from airline preferences or air traffic control procedures that prevent overtaking, and time windows (representing possible control actions) during which each aircraft landing can occur. We present a Dynamic Programming-based approach that scales linearly in the number of aircraft, and describe our computational experience with a prototype implementation on realistic data for Denver International Airport.

Binaural hearing with electrical stimulation

PubMed Central

Kan, Alan; Litovsky, Ruth Y.

2014-01-01

Bilateral cochlear implantation is becoming a standard of care in many clinics. While much benefit has been shown through bilateral implantation, patients who have bilateral cochlear implants (CIs) still do not perform as well as normal hearing listeners in sound localization and understanding speech in noisy environments. This difference in performance can arise from a number of different factors, including the areas of hardware and engineering, surgical precision and pathology of the auditory system in deaf persons. While surgical precision and individual pathology are factors that are beyond careful control, improvements can be made in the areas of clinical practice and the engineering of binaural speech processors. These improvements should be grounded in a good understanding of the sensitivities of bilateral CI patients to the acoustic binaural cues that are important to normal hearing listeners for sound localization and speech in noise understanding. To this end, we review the current state-of-the-art in the understanding of the sensitivities of bilateral CI patients to binaural cues in electric hearing, and highlight the important issues and challenges as they relate to clinical practice and the development of new binaural processing strategies. PMID:25193553

Sociolegal and practice implications of caring for LGBT people with dementia.

PubMed

Peel, Elizabeth; Taylor, Helen; Harding, Rosie

2016-11-30

The needs of lesbian, gay, bisexual and trans (LGBT) people with dementia are poorly recognised. This is due partly to assumptions that all older people are heterosexual or asexual. One quarter of gay or bisexual men and half of lesbian or bisexual women have children, compared with 90% of heterosexual women and men, which means LGBT older adults are more likely to reside in care homes. Older LGBT people may be unwilling to express their sexual identities in care settings and this can affect their care. Members of older people's informal care networks must be recognised to ensure their involvement in the lives of residents in care settings continues. However, healthcare professionals may not always realise that many LGBT people rely on their families of choice or wider social networks more than on their families of origin. This article explores sociolegal issues that can arise in the care of older LGBT people with dementia, including enabling autonomy, capacity and applying legal frameworks to support their identities and relationships. It also highlights implications for practice.

The value of using top-down and bottom-up approaches for building trust and transparency in biobanking.

PubMed

Meslin, Eric M

2010-01-01

With the domestic and international proliferation of biobanks and their associated connections to health information databases, scholarly attention has been turning from the ethical issues arising from the construction of biobanks to the ethical issues that emerge in their operation and management. Calls for greater transparency in governance structures, coupled with stern reminders of the value of maintaining public trust, are seen as critical components in the success of these resources. Two different approaches have been adopted for addressing these types of ethical issues: the first is a 'top-down' approach which focuses on developing policy, procedures, regulations and guidelines to aid decision-makers. The second is a 'bottom-up' approach, which begins with those who are most affected by the issues and attempts to inductively develop consensus recommendations and policy. While both approaches have merit, I argue that more work needs to be done on 'bottom-up' strategies if trust and transparency are to be more than mere slogans. Using 2 case examples from Indiana, the paper summarizes data from a set of surveys we recently conducted that address issues arising from biobanks that provide some insight into issues associated with trust and transparency. Copyright 2010 S. Karger AG, Basel.

Identifying viable regulatory and innovation pathways for regenerative medicine: a case study of cultured red blood cells.

PubMed

Mittra, J; Tait, J; Mastroeni, M; Turner, M L; Mountford, J C; Bruce, K

2015-01-25

The creation of red blood cells for the blood transfusion markets represents a highly innovative application of regenerative medicine with a medium term (5-10 year) prospect for first clinical studies. This article describes a case study analysis of a project to derive red blood cells from human embryonic stem cells, including the systemic challenges arising from (i) the selection of appropriate and viable regulatory protocols and (ii) technological constraints related to stem cell manufacture and scale up to clinical Good Manufacturing Practice (GMP) standard. The method used for case study analysis (Analysis of Life Science Innovation Systems (ALSIS)) is also innovative, demonstrating a new approach to social and natural science collaboration to foresight product development pathways. Issues arising along the development pathway include cell manufacture and scale-up challenges, affected by regulatory demands emerging from the innovation ecosystem (preclinical testing and clinical trials). Our discussion reflects on the efforts being made by regulators to adapt the current pharmaceuticals-based regulatory model to an allogeneic regenerative medicine product and the broader lessons from this case study for successful innovation and translation of regenerative medicine therapies, including the role of methodological and regulatory innovation in future development in the field. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Referrals and relationships: in-practice referrals meetings in a general practice.

PubMed

Rowlands, G; Willis, S; Singleton, A

2001-08-01

GP referrals to secondary care are an important factor in the cost of running the NHS. The known variation in referral rates between doctors has the potential to cause tension within primary care which will be exacerbated by the latest reorganization of primary care and the trend towards capitation-based budgets. The importance of postgraduate learning for GPs has been recognized; continuing professional development is moving towards self-directed practice-based learning programmes. Educational interventions have been shown to alter doctors' prescribing behaviour. This, together with the pressure on accounting for referral activity, makes the prospect of improving, and possibly reducing, referral activity through educational interventions very attractive. This study complemented a randomized controlled trial (RCT) which investigated whether an intervention of the type which had reduced prescribing costs would have a similar effect on referral activity. The context of the study, description of the characteristics of the practice and the issues seen as important by the doctors and practice manager were identified through preliminary semi-structured interviews. The practice then held a series of educational in-practice meetings to discuss referrals and issues arising from referrals. The audio- and videotaped transcripts were interpreted using content and group dynamic analysis. Participants commented upon our preliminary findings. In addition, we used dimensional analysis to induce a preliminary theory describing the effect of the intervention on this general practice which enabled us to review the findings of the parallel RCT. The educational value of the meetings and the learning needs of the participants were also assessed. Our complementary study showed no alteration of practice referral rates following the educational intervention. The qualitative study, unencumbered by the assumptions inherent in the development of the hypothesis tested in the RCT, highlighted the complexity of decision making in general practice and the likely impact of historical background and a variety of internal and external pressures on this self-directive educational intervention. The practice members described the individual and group learning needs identified as a result of the meetings. The findings of this study raise important questions for developing practice-based learning. The outcomes of self-directive interventions in practices will be influenced by internal and external events both past and present. Such outcomes may be qualitative and difficult to measure. They are likely to differ from outcomes seen when interventions are applied to groups of doctors who are not all members of the same practice.

Crown fuel spatial variability and predictability of fire spread

Treesearch

Russell A. Parsons; Jeremy Sauer; Rodman R. Linn

2010-01-01

Fire behavior predictions, as well as measures of uncertainty in those predictions, are essential in operational and strategic fire management decisions. While it is becoming common practice to assess uncertainty in fire behavior predictions arising from variability in weather inputs, uncertainty arising from the fire models themselves is difficult to assess. This is...

Resolving Ethical Issues when Conducting Sexuality Education

ERIC Educational Resources Information Center

Bruess, Clint E.; Greenberg, Jerrold S.

2008-01-01

Ethical issues about conducting sexuality education often arise. This paper describes one system of ethics and how the sexuality educator can use that system to determine whether an action is moral or immoral and, therefore, the appropriate action to take for that sexuality educator to be consistent with his or her values. Ethical principles are…

Young People with Cancer: A Handbook for Parents. Revised Edition.

ERIC Educational Resources Information Center

National Cancer Inst. (NIH), Bethesda, MD.

This book informs parents and families of children and young adults with cancer about the most common types of cancer in the young, treatments and their side effects, and common issues that arise with a cancer diagnosis. Aspects of the disease, including characteristics of leukemia and solid tumors, are described. Treatment issues discussed…

Addressing the Context of E-Learning: Using Transactional Distance Theory to Inform Design

ERIC Educational Resources Information Center

Benson, Robyn; Samarawickrema, Gayani

2009-01-01

The rapidly expanding range of options available for innovative e-learning approaches based on emerging technologies has given renewed importance to teaching and learning issues that have long been familiar to distance educators. These issues arise from the separation between learners, and between teacher and learners, which occurs when learning…

77 FR 2298 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

..., 1425 New York Avenue NW., Suite C-100, Washington, DC 20005. Telephone: (202) 233-3960. Email: Hillary... nation's leaders in medicine, science, ethics, religion, law, and engineering. The Commission advises the President on bioethical issues arising from advances in biomedicine and related areas of science and...

77 FR 26012 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... New York Ave. NW., Suite C-100, Washington, DC 20005. Telephone: (202) 233-3960. Email: Hillary.Viers... nation's leaders in medicine, science, ethics, religion, law, and engineering. The Commission advises the President on bioethical issues arising from advances in biomedicine and related areas of science and...

Employment Protection of School Psychologists: A Cautionary Case

ERIC Educational Resources Information Center

Zirkel, Perry A.

2013-01-01

This article addresses legal issues arising from a district's decision not to renew the employment contract of a 61-year-old school psychologist after 9 years of service. The case focuses on the issues of age discrimination and whistleblowing, although it raises other questions of current relevance to school psychologists, such as the…

Review of the Literature on Children with Special Educational Needs

ERIC Educational Resources Information Center

Alkahtani, Mohammed Ali

2016-01-01

This study outlines the literature relevant to the Cross-cultural issues and the politics of SEN and the different perspectives arising from the literature on this widely debated issue are addressed. In addition, the origin of the term "special educational needs" (SEN), its definitions and the types of special education needs are…

Educational Psychologists' Use of Therapeutic Interventions: Issues Arising from Two Exploratory Case Studies

ERIC Educational Resources Information Center

Atkinson, Cathy; Corban, Ian; Templeton, Jenny

2011-01-01

This article considers the evolving role of the educational psychologist (EP) in providing therapeutic support to children and young people. Through two small-scale research studies, EPs' use of therapeutic interventions and issues in delivering them are explored. Findings reveal use of a range of therapeutic interventions in different contexts…

Conflict or Support: Work and Family in Middle and Old Age.

ERIC Educational Resources Information Center

Goodman, Jane; Waters, Elinor B.

1985-01-01

Describes several career and family issues that may arise for adults and suggests possible counseling interventions. Several assumptions are made about the work/family connection: renegotiation of work/family balance continues throughout work life; a variety of demographic variables affect work/family roles; and some issues relate more to roles…

Getting quality in qualitative research: a short introduction to feminist methodology and methods.

PubMed

Landman, Maeve

2006-11-01

The present paper reflects a practical activity undertaken by the Nutrition Society's qualitative research network in October 2005. It reflects the structure of that exercise. First, there is an introduction to feminist methodology and methods. The informing premise is that feminist methodology is of particular interest to practitioners (professional and/or academic) engaged in occupations numerically dominated by women, such as nutritionists. A critical argument is made for a place for feminist methodology in related areas of social research. The discussion points to the differences that exist between various feminist commentators, although the central aims of feminist research are broadly shared. The paper comprises an overview of organizing concepts, discussion and questions posed to stimulate discussion on the design and process of research informed by feminist methodology. Issues arising from that discussion are summarized.

Ethical analysis in public health.

PubMed

Roberts, Marc J; Reich, Michael R

2002-03-23

Public-health regularly encounters serious ethical dilemmas, such as rationing scarce resources, influencing individuals to change their behaviour, and limiting freedom to diminish disease transmission. Yet unlike medical ethics, there is no agreed-upon framework for analysing these difficulties. We offer such a framework. It distinguishes three philosophical views, often invoked in public-health discourse: positions based on outcomes (utilitarianism), positions focused on rights and opportunities (liberalism), and views that emphasise character and virtue (communitarianism). We explore critical variations within each approach, and identify practical problems that arise in addressing the ethical dimensions of health policy. We conclude by examining challenges posed by the feminist argument of ethics-of-care and by postmodern views about the nature of ethics. Health professionals need enhanced skills in applied philosophy to improve the coherence, transparency, and quality of public deliberations over ethical issues inherent in health policy.

Introducing care pathway commissioning to primary dental care: measuring performance.

PubMed

Harris, R; Bridgman, C; Ahmad, M; Bowes, L; Haley, R; Saleem, S; Singh, R; Taylor, S

2011-12-09

Care pathways have been used in a variety of ways: firstly to support quality improvement through standardising clinical processes, but also for secondary purposes, by purchasers of healthcare, to monitor activity and health outcomes and to commission services. This paper focuses on reporting a secondary use of care pathways: to commission and monitor performance of primary dental care services. Findings of a project involving three dental practices implementing a system based on rating patients according to their risk of disease and need for care are outlined. Data from surgery-based clinical databases and interviews from commissioners and providers are reported. The use of both process and outcome key performance indicators in this context is discussed, as well as issues which arise such as attributability of outcome measures and strategic approaches to improving quality of care.

Diagnosis and management of Alzheimer's disease: past, present and future ethical issues.

PubMed

Gauthier, S; Leuzy, A; Racine, E; Rosa-Neto, P

2013-11-01

There is great interest in the ethical issues associated with Alzheimer's disease (AD) and related dementias given the prevalence of AD and the evolving neuroscience landscape in matters of diagnoses and therapeutics. Much of the ethics discussion arises in the tension between the principle of not doing harm (principle of non-maleficence) in this vulnerable population and the development of effective treatments (principle of beneficence). Autonomy and capacity issues are also numerous, wide-ranging, and concern (1) day to day affairs such as driving safely and spending money wisely, (2) life-time events such as designating a legal representative in case of incapacity, making a will, (3) consenting to treatment and diagnostic procedures, (4) participating in research. The latter issue is particularly thorny and illustrates well the complexity of tackling concerns related to capacity. The impetus to protect AD patients has partly led to ethics regulation and policies making research on inapt patients more difficult because of stringent requirements for signed informed consent or for showing the value of the research to this specific patient population. New issues are arising that relate to earlier diagnosis using biomarkers and (possibly soon) the use of drugs that modify disease progression. We here summarize and discuss the different ethical issues associated with AD from a historical perspective, with emphasis on diagnostic and treatments issues. Copyright © 2013 Elsevier Ltd. All rights reserved.

Global financial crisis and surgical practice: the Greek paradigm.

PubMed

Karidis, Nikolaos P; Dimitroulis, Dimitrios; Kouraklis, Gregory

2011-11-01

Apart from the significant implications of recent financial crisis in overall health indices and mortality rates, the direct effect of health resources redistribution in everyday clinical practice is barely recognized. In the case of Greece, health sector reform and health spending cuts have already had a major impact on costly interventions, particularly in surgical practice. An increase in utilization of public health resources, lack of basic and advanced surgical supplies, salary deductions, and emerging issues in patient management have contributed to serious dysfunction of a public health system unable to sustain current needs. In this context, significant implications arise for the surgeons and patients as proper perioperative management is directly affected by reduced public health funding. The surgical community has expressed concerns about the quality of surgical care and the future of surgical progress in the era of the European Union. Greek surgeons are expected to support reform while maintaining a high level of surgical care to the public. The challenge of cost control in surgical practice provides, nevertheless, an excellent opportunity to reconsider health economics while innovation through a more traditional approach to the surgical patient should not be precluded. A Greek case study on the extent of the current situation is presented with reference to health policy reform, serving as an alarming paradigm for the global community under the pressure of a profound financial recession.

Development of the EORTC QLQ-CAX24, A Questionnaire for Cancer Patients With Cachexia.

PubMed

Wheelwright, Sally J; Hopkinson, Jane B; Darlington, Anne-Sophie; Fitzsimmons, Deborah F; Fayers, Peter; Balstad, Trude R; Bredart, Anne; Hammerlid, Eva; Kaasa, Stein; Nicolatou-Galitis, Ourania; Pinto, Monica; Schmidt, Heike; Solheim, Tora S; Strasser, Florian; Tomaszewska, Iwona M; Johnson, Colin D

2017-02-01

Cachexia is commonly found in cancer patients and has profound consequences; yet there is only one questionnaire that examines the patient's perspective. To report a rigorously developed module for patient self-reported impact of cancer cachexia. Module development followed published guidelines. Patients from across the cancer cachexia trajectory were included. In Phase 1, health-related quality of life (HRQOL) issues were generated from a literature review and interviews with patients in four countries. The issues were revised based on patient and health care professional (HCP) input. In Phase 2, questionnaire items were formulated and translated into the languages required for Phase 3, the pilot phase, in which patients from eight countries scored the relevance and importance of each item, and provided qualitative feedback. A total of 39 patients and 12 HCPs took part in Phase 1. The literature review produced 68 HRQOL issues, with 22 new issues arising from the patient interviews. After patient and HCP input, 44 issues were formulated into questionnaire items in Phase 2. One hundred ten patients took part in Phase 3. One item was reworded, and 20 items were deleted as a consequence of patient feedback. The QLQ-CAX24 is a cancer cachexia-specific questionnaire, comprising 24 items, for HRQOL assessment in clinical trials and practice. It contains five multi-item scales (food aversion, eating and weight-loss worry, eating difficulties, loss of control, and physical decline) and four single items. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Obesity prevention in early life: an opportunity to better support the role of Maternal and Child Health Nurses in Australia.

PubMed

Laws, R; Campbell, K J; van der Pligt, P; Ball, K; Lynch, J; Russell, G; Taylor, R; Denney-Wilson, E

2015-01-01

Because parents with young children access primary health care services frequently, a key opportunity arises for Maternal and Child Health (MCH) nurses to actively work with families to support healthy infant feeding practices and lifestyle behaviours. However, little is known regarding the extent to which MCH nurses promote obesity prevention practices and how such practices could be better supported. This mixed methods study involved a survey of 56 MCH nurses (response rate 84.8 %), 16 of whom participated in semi-structured qualitative interviews. Both components aimed to examine the extent to which nurses addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behavior during routine consultations with young children 0-5 years. Key factors influencing such practices and how they could be best supported were also investigated. All data were collected from September to December 2013. Survey data were analysed descriptively and triangulated with qualitative interview findings, the analysis of which was guided by grounded theory principles. Although nurses reported measuring height/length and weight in most consultations, almost one quarter (22.2 %) reported never/rarely using growth charts to identify infants or children at risk of overweight or obesity. This reflected a reluctance to raise the issue of weight with parents and a lack of confidence in how to address it. The majority of nurses reported providing advice on aspects of infant feeding relevant to obesity prevention at most consultations, with around a third (37 %) routinely provided advice on formula preparation. Less than half of nurses routinely promoted active play and only 30 % discussed limiting sedentary behaviour such as TV viewing. Concerns about parental receptiveness and maintaining rapport were key barriers to more effective implementation. While MCH nurses are well placed to address obesity prevention in early life, there is currently a missed public health opportunity. Improving nurse skills in behaviour change counseling will be key to increasing their confidence in raising sensitive lifestyle issues with parents to better integrate obesity prevention practices into normal MCH service delivery.

Entrepreneurship as Everyday Practice: Towards a Personalized Pedagogy of Enterprise Education

ERIC Educational Resources Information Center

Blenker, Per; Frederiksen, Signe Hedeboe; Korsgaard, Steffen; Muller, Sabine; Neergaard, Helle; Thrane, Claus

2012-01-01

Adopting the perspective of "entrepreneurship as an everyday practice" in education, the authors conceptualize opportunities as arising from the everyday practice of individuals. Opportunities are thus seen as emanating from the individual entrepreneur's ability to disclose anomalies and disharmonies in their personal life. The paper illustrates…

Separation from supported employment: a retrospective chart review study.

PubMed

West, Michael; Targett, Pamela; Wehman, Paul; Cifu, Gabriella; Davis, Jacob

2015-01-01

The objective of this study was to examine job separations from supported employment (SE). The aim was to identify the types and nature of separations and precipitating events leading to the separation. A retrospective chart review methodology was utilized. The study was conducted in a metropolitan area in the Southeast United States by a university-based SE program. Participants were 47 SE clients who had been placed into and separated from 67 jobs. Using a coding form, information regarding the type of separation and issues that preceded the separation were recorded. Data were aggregated using descriptive statistics. The largest number of separations was due to termination, followed by resignation and mutual consent of the employer and employee. The mean number of issues leading to the separation was 2.2, ranging from one to five. Only eight positive issues were found (compared to 116 negative and 20 neutral), the most prevalent being entry into an educational or training program. Common negative issues included poor work performance, attendance and punctuality problems, conflicts with the supervisor, and social and behavioral issues. The findings of this study illustrate the need to address job retention issues during the job development process, finding the most appropriate person-job fit and workplace culture for each client. The findings also support the need for vigilant and regular communication between the SE program and employers to intervene quickly when problems arise. Separation from Supported Employment (SE) SE is an evidence-based employment practice that has been shown effective across multiple disability groups. Studying job separations can provide valuable information for improving service. Locating the best person-job fit, as well as frequent contract with employers, can help prevent unnecessary job loss.

Methodological advances in predicting flow-induced dynamics of plants using mechanical-engineering theory.

PubMed

de Langre, Emmanuel

2012-03-15

The modeling of fluid-structure interactions, such as flow-induced vibrations, is a well-developed field of mechanical engineering. Many methods exist, and it seems natural to apply them to model the behavior of plants, and potentially other cantilever-like biological structures, under flow. Overcoming this disciplinary divide, and the application of such models to biological systems, will significantly advance our understanding of ecological patterns and processes and improve our predictive capabilities. Nonetheless, several methodological issues must first be addressed, which I describe here using two practical examples that have strong similarities: one from agricultural sciences and the other from nuclear engineering. Very similar issues arise in both: individual and collective behavior, small and large space and time scales, porous modeling, standard and extreme events, trade-off between the surface of exchange and individual or collective risk of damage, variability, hostile environments and, in some aspects, evolution. The conclusion is that, although similar issues do exist, which need to be exploited in some detail, there is a significant gap that requires new developments. It is obvious that living plants grow in and adapt to their environment, which certainly makes plant biomechanics fundamentally distinct from classical mechanical engineering. Moreover, the selection processes in biology and in human engineering are truly different, making the issue of safety different as well. A thorough understanding of these similarities and differences is needed to work efficiently in the application of a mechanistic approach to ecology.

A review of the issues and challenges involved in using participant-produced photographs in nursing research.

PubMed

Balmer, Claire; Griffiths, Frances; Dunn, Janet

2015-07-01

To discuss the issues and challenges that may occur when using participant-produced photographs in nursing research. The place of visual representation in society is increasingly being recognized and there is a growing discussion on the advantages of implementing visual methods, such as photography, in health and illness research. Integrating photographs has much potential for both nurse researchers and participants but it remains a novel method of gathering qualitative data and many aspects have had little consideration in the nursing and medical literature. This paper presents a discussion of some of the issues that may arise when using photographs as data. It draws on examples of the insights and experiences we had when we asked study participants to produce photographs to complement their interviews designed to explore their experience of living after cancer. Discussion paper This paper is based on our own experiences and supported by literature and theory. Disseminating this research has prompted much interest from nurses and clinical staff. This paper should highlight some of the factors that may need to be addressed before employing such a novel method, thus ensuring the research process is positive and the outcome relevant for all parties. Examples are used here to illustrate practical, ethical and philosophical issues around the research plan, creating and interpreting photographic data, confidentiality and copyright and analysing and disseminating photographs produced for research. © 2015 John Wiley & Sons Ltd.

Ethical issues in psychiatric genetics.

PubMed

Appelbaum, Paul S

2004-11-01

As knowledge grows regarding the genetic bases of psychiatric disorders, a variety of ethical issues will need to be confronted. Current evidence suggests that the etiology of most psychiatric disorders rests on a combination of multiple genes and environmental factors. As tests for the genes involved become more easily available, pressures will arise to use them for prenatal testing, screening of children and adults, selection of potential adoptees, and pre-marital screening. Common problems that will need to be addressed include popular misunderstanding of the consequences of possessing an affected allele, impact of knowledge of one's genetic make-up on one's sense of self, and the discriminatory use of genetic information to deny persons access to insurance and employment. Although most states have some legislation aimed at preventing discrimination, the laws' coverage is spotty and federal rules are lacking. Physicians may find that newly available genetic information creates new duties for them, including warning third parties who may share the patient's genetic endowment. And genetics research itself has raised questions about when to disclose information to subjects and their family members about the genes that are being studied, and how to define the subjects of the research when information is collected about family members other than the proband. Knowledge of these dilemmas is a first step to resolving them, something that the medical profession will need to attend to in the near-term. Neglect will lead others to set the rules that will control medical practice, including the practice of psychiatry, in the new world of genetic medicine.

The perpetual search for parsimony: enhancing the epistemological and practical utility of qualitative research findings.

PubMed

Cutcliffe, John R; Harder, Henry G

2009-10-01

While it appears that the term parsimony has been used in the context of qualitative research and qualitative research methodology, there is a distinct absence of writing that actually explores, seeks to define, understand, critique, apply and/or evaluate the concept in qualitative research literature. This paper explores a number of issues pertaining to parsimony in qualitative research. It is the hope of the authors that this paper might raise awareness of the hitherto unexplored issues, stimulate some further interest in these and prompt other qualitative researchers to contribute to the ensuing debate. While there are currently no definitive criteria for determining the parsimony of qualitative research findings, it would be epistemologically inappropriate and philosophically incongruent to import and translate quantitative notions of parsimony. However, the ideas, principles and epistemological functions that parsimony serves can and should be applied to the qualitative paradigm. The authors suggest that more than one type of qualitative parsimony is required. The authors advance the argument that there is a relationship between the degree of parsimony and the elegance, ease of accessibility and straightforwardness (some might say - beauty) of the writing/findings; the level of expertise of the researcher; and the quality of the data collection interview. The authors also assert that there are a number of practices which, when adhered to, can enhance the parsimony of the findings and that here are a number of major implications arising from qualitative findings that lack parsimony.

A socio-technical approach to improving retail energy efficiency behaviours.

PubMed

Christina, Sian; Waterson, Patrick; Dainty, Andrew; Daniels, Kevin

2015-03-01

In recent years, the UK retail sector has made a significant contribution to societal responses on carbon reduction. We provide a novel and timely examination of environmental sustainability from a systems perspective, exploring how energy-related technologies and strategies are incorporated into organisational life. We use a longitudinal case study approach, looking at behavioural energy efficiency from within one of the UK's leading retailers. Our data covers a two-year period, with qualitative data from a total of 131 participants gathered using phased interviews and focus groups. We introduce an adapted socio-technical framework approach in order to describe an existing organisational behavioural strategy to support retail energy efficiency. Our findings point to crucial socio-technical and goal-setting factors which both impede and/or enable energy efficient behaviours, these include: tensions linked to store level perception of energy management goals; an emphasis on the importance of technology for underpinning change processes; and, the need for feedback and incentives to support the completion of energy-related tasks. We also describe the evolution of a practical operational intervention designed to address issues raised in our findings. Our study provides fresh insights into how sustainable workplace behaviours can be achieved and sustained over time. Secondly, we discuss in detail a set of issues arising from goal conflict in the workplace; these include the development of a practical energy management strategy to facilitate secondary organisational goals through job redesign. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Collecting data on potentially harmful events: a method for monitoring incidents in general practice.

PubMed

Britt, H; Miller, G C; Steven, I D; Howarth, G C; Nicholson, P A; Bhasale, A L; Norton, K J

1997-04-01

The prediction and subsequent prevention of errors, which are an integral element of human behaviour, require an understanding of their cause. The incident monitoring technique was developed in the study of aviation errors in the Second World War and has been applied more recently in the field of anaesthetics. This pilot study represents one of the first attempts to apply the incident monitoring technique in the general practice environment. A total of 297 GPs across Australia anonymously reported details of unintended events which harmed or could have harmed the patient. Reports were contemporaneously recorded on prepared forms which allowed a free text description of the incident, and structured responses for contributing and mitigating factors, immediate and long-term out-comes, additional costs etc. The first 500 reports were analysed using both of qualitative and quantitative methods and a brief overview of results is presented. The methodological issues arising in the application of this technique to such a large, widely spread profession, in which episodes of care are not necessarily confined to a single consultation, are discussed. This study demonstrated that the incident monitoring technique can be successfully applied in general practice and that the resulting information can facilitate the identification of common factors contributing to such events and allow the development of preventive interventions.

[Occupational medicine: practice and ethical requirements of the new law on health and safety in the workplace (legislative decree 81/2008)].

PubMed

Franco, Giuliano; Mora, Erika

2009-01-01

Decisions in occupational health may involve ethical conflicts arising from conflicts between stakeholders' interests. Codes of ethics can provide a practical guide to solve dilemmas. The new law on health and safety in the workplace in Italy (decree 81/2008) states that occupational health practice must comply with the code of ethics of the International Commission on Occupational Health. The universally acknowledged ethical principles of beneficience/nonmaleficience, autonomy and justice, which are the basis of the Charter of fundamental rights of the European Union, inspired this code. Although the code is not a systematic textbook of occupational health ethics and does not cover all possible aspects arising from the practice, making decisions based on it will assure their effectiveness and compliance with ethical principles, besides the formal respect of the law.

Implicit Sequence Learning and Contextual Cueing Do Not Compete for Central Cognitive Resources

ERIC Educational Resources Information Center

Jimenez, Luis; Vazquez, Gustavo A.

2011-01-01

Sequence learning and contextual cueing explore different forms of implicit learning, arising from practice with a structured serial task, or with a search task with informative contexts. We assess whether these two learning effects arise simultaneously when both remain implicit. Experiments 1 and 2 confirm that a cueing effect can be observed…

The Place of Learning Quantum Theory in Physics Teacher Education: Motivational Elements Arising from the Context

ERIC Educational Resources Information Center

Körhasan, Nilüfer Didis

2015-01-01

Quantum theory is one of the most successful theories in physics. Because of its abstract, mathematical, and counter-intuitive nature, many students have problems learning the theory, just as teachers experience difficulty in teaching it. Pedagogical research on quantum theory has mainly focused on cognitive issues. However, affective issues about…

Positive Discipline A to Z: 1001 Solutions to Everyday Parenting Problems.

ERIC Educational Resources Information Center

Nelsen, Jane; And Others

This book is a parenting reference work that offers background on common disciplinary problems and parenting issues, advice on how to handle problems and issues as they arise, and insight into how to avoid disciplinary problems in the future. The book is divided into three sections: Basic Positive Discipline Parenting Tools, Positive Discipline…

26 CFR 1.1244(c)-1 - Section 1244 stock defined.

Code of Federal Regulations, 2014 CFR

2014-04-01

... November 6, 1978. (2) The term post-November 1978 stock means stock issued after November 6, 1978. In order... evidenced by a security, or arises out of the performance of personal services. (2) The following examples... subparagraph (1) of this paragraph: Example 1. A taxpayer owns stock of Corporation X issued to him prior to...

26 CFR 1.1244(c)-1 - Section 1244 stock defined.

Code of Federal Regulations, 2011 CFR

2011-04-01

... November 6, 1978. (2) The term post-November 1978 stock means stock issued after November 6, 1978. In order... evidenced by a security, or arises out of the performance of personal services. (2) The following examples... subparagraph (1) of this paragraph: Example 1. A taxpayer owns stock of Corporation X issued to him prior to...

78 FR 33843 - Request for Comments on Issues Related to Incidental Findings That Arise in the Clinical...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-05

... by email to [email protected]bioethics.gov or by mail to the following address: Public Commentary, Presidential... Study of Bioethical Issues. Telephone: 202-233-3960. E-Mail: [email protected]bioethics.gov . Additional information may be obtained at http://www.bioethics.gov . SUPPLEMENTARY INFORMATION: On November 24, 2009, the...

Rights and Responsibilities in the Digital Age: Problems with Stronger Copyright in an Information Society.

ERIC Educational Resources Information Center

Eisenschitz, Tamara; Turner, Paul

1997-01-01

Discusses three issues: (1) copyright and the effects of technological change and the trend to commodify information; (2) the interests involved; and (3) the "Green Paper," a proposal by the European Commission to address copyright issues arising from digitization of protected works. Safeguarding free information access can be achieved…

Symmetry of the Adiabatic Condition in the Piston Problem

ERIC Educational Resources Information Center

Anacleto, Joaquim; Ferreira, J. M.

2011-01-01

This study addresses a controversial issue in the adiabatic piston problem, namely that of the piston being adiabatic when it is fixed but no longer so when it can move freely. It is shown that this apparent contradiction arises from the usual definition of adiabatic condition. The issue is addressed here by requiring the adiabatic condition to be…

75 FR 30409 - Advisory Committee to the Director (ACD), Centers for Disease Control and Prevention-Ethics...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

... Committee to the Director (ACD), Centers for Disease Control and Prevention--Ethics Subcommittee (ES) In... to the ACD, CDC, regarding a broad range of public health ethics questions and issues arising from... address public health ethics issues and coordination of these efforts with the CDC Office of State, Tribal...

75 FR 72831 - Advisory Committee to the Director (ACD), Centers for Disease Control and Prevention (CDC)-Ethics...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

... Committee to the Director (ACD), Centers for Disease Control and Prevention (CDC)--Ethics Subcommittee (ES... counsel to the ACD, CDC, regarding a broad range of public health ethics questions and issues arising from... strategy for addressing its charge to provide a preliminary overview to the ACD on ethical issues related...

Illustration of a Multilevel Model for Meta-Analysis

ERIC Educational Resources Information Center

de la Torre, Jimmy; Camilli, Gregory; Vargas, Sadako; Vernon, R. Fox

2007-01-01

In this article, the authors present a multilevel (or hierarchical linear) model that illustrates issues in the application of the model to data from meta-analytic studies. In doing so, several issues are discussed that typically arise in the course of a meta-analysis. These include the presence of non-zero between-study variability, how multiple…

28 CFR 68.53 - Review of an interlocutory order of an Administrative Law Judge in cases arising under section...

Code of Federal Regulations, 2014 CFR

2014-07-01

..., within thirty (30) days of the date of an Administrative Law Judge's interlocutory order, issue an order... an Administrative Law Judge's interlocutory order if: (1) An Administrative Law Judge, when issuing... proceedings. Review of an Administrative Law Judge's interlocutory order will not stay the proceeding unless...

28 CFR 68.53 - Review of an interlocutory order of an Administrative Law Judge in cases arising under section...

Code of Federal Regulations, 2011 CFR

2011-07-01

..., within thirty (30) days of the date of an Administrative Law Judge's interlocutory order, issue an order... an Administrative Law Judge's interlocutory order if: (1) An Administrative Law Judge, when issuing... proceedings. Review of an Administrative Law Judge's interlocutory order will not stay the proceeding unless...

28 CFR 68.53 - Review of an interlocutory order of an Administrative Law Judge in cases arising under section...

Code of Federal Regulations, 2012 CFR

2012-07-01

..., within thirty (30) days of the date of an Administrative Law Judge's interlocutory order, issue an order... an Administrative Law Judge's interlocutory order if: (1) An Administrative Law Judge, when issuing... proceedings. Review of an Administrative Law Judge's interlocutory order will not stay the proceeding unless...

28 CFR 68.53 - Review of an interlocutory order of an Administrative Law Judge in cases arising under section...

Code of Federal Regulations, 2013 CFR

2013-07-01

..., within thirty (30) days of the date of an Administrative Law Judge's interlocutory order, issue an order... an Administrative Law Judge's interlocutory order if: (1) An Administrative Law Judge, when issuing... proceedings. Review of an Administrative Law Judge's interlocutory order will not stay the proceeding unless...

Conflict in Multiculturalism Classes: Too Much Heat or Too Little?

ERIC Educational Resources Information Center

Meacham, Jack

1995-01-01

The issues that arise in a college course on multiculturalism can touch students very personally and may be a first opportunity for many students to talk face-to-face about important social issues. Anticipating when students may become defensive, angry, hurt, or when conflict might erupt will help faculty know when to lower or raise the…

Conceptually and Methodologically Vexing Issues in Teacher Knowledge Assessment

ERIC Educational Resources Information Center

Reutzel, D. Ray; Dole, Janice A.; Read, Sylvia; Fawson, Parker; Herman, Kerry; Jones, Cindy D.; Sudweeks, Richard; Fargo, Jamison

2011-01-01

The purpose of this article is to describe the vexing issues that arise as researchers try to define and assess the knowledge teachers need to teach reading and writing effectively in the primary grades. Over the past several years, the authors of this article have developed and tested an assessment system of teacher knowledge under a grant titled…

Mixing Qualitative and Quantitative Methods: Insights into Design and Analysis Issues

ERIC Educational Resources Information Center

Lieber, Eli

2009-01-01

This article describes and discusses issues related to research design and data analysis in the mixing of qualitative and quantitative methods. It is increasingly desirable to use multiple methods in research, but questions arise as to how best to design and analyze the data generated by mixed methods projects. I offer a conceptualization for such…

Testimony in Narrative Educational Research: A Qualitative Interview, Narrative Analysis and Epistemological Evaluation

ERIC Educational Resources Information Center

Christopher, Justin

2017-01-01

The purpose of this study is to assess issues that arise in the context of epistemological claims in narrative educational research by means of narrative analysis and epistemological evaluation. The research questions which guided the study were: 1) To what extent is epistemology considered by narrative educational researchers?; 2) What issues do…

Statistical issues in searches for new phenomena in High Energy Physics

NASA Astrophysics Data System (ADS)

Lyons, Louis; Wardle, Nicholas

2018-03-01

Many analyses of data in High Energy Physics are concerned with searches for New Physics. We review the statistical issues that arise in such searches, and then illustrate these using the specific example of the recent successful search for the Higgs boson, produced in collisions between high energy protons at CERN’s Large Hadron Collider.

Challenges for consent and community engagement in the conduct of cluster randomized trial among school children in low income settings: experiences from Kenya.

PubMed

Okello, George; Jones, Caroline; Bonareri, Maureen; Ndegwa, Sarah N; McHaro, Carlos; Kengo, Juddy; Kinyua, Kevin; Dubeck, Margaret M; Halliday, Katherine E; Jukes, Matthew C H; Molyneux, Sassy; Brooker, Simon J

2013-05-16

There are a number of practical and ethical issues raised in school-based health research, particularly those related to obtaining consent from parents and assent from children. One approach to developing, strengthening, and supporting appropriate consent and assent processes is through community engagement. To date, much of the literature on community engagement in biomedical research has concentrated on community- or hospital-based research, with little documentation, if any, of community engagement in school-based health research. In this paper we discuss our experiences of consent, assent and community engagement in implementing a large school-based cluster randomized trial in rural Kenya. Data collected as part of a qualitative study investigating the acceptability of the main trial, focus group discussions with field staff, observations of practice and authors' experiences are used to: 1) highlight the challenges faced in obtaining assent/consent; and 2) strategies taken to try to both protect participant rights (including to refuse and to withdraw) and ensure the success of the trial. Early meetings with national, district and local level stakeholders were important in establishing their co-operation and support for the project. Despite this support, both practical and ethical challenges were encountered during consenting and assenting procedures. Our strategy for addressing these challenges focused on improving communication and understanding of the trial, and maintaining dialogue with all the relevant stakeholders throughout the study period. A range of stakeholders within and beyond schools play a key role in school based health trials. Community entry and information dissemination strategies need careful planning from the outset, and with on-going consultation and feedback mechanisms established in order to identify and address concerns as they arise. We believe our experiences, and the ethical and practical issues and dilemmas encountered, will be of interest for others planning to conduct school-based research in Africa. National Institute of Health NCT00878007.

Challenges for consent and community engagement in the conduct of cluster randomized trial among school children in low income settings: experiences from Kenya

PubMed Central

2013-01-01

Background There are a number of practical and ethical issues raised in school-based health research, particularly those related to obtaining consent from parents and assent from children. One approach to developing, strengthening, and supporting appropriate consent and assent processes is through community engagement. To date, much of the literature on community engagement in biomedical research has concentrated on community- or hospital-based research, with little documentation, if any, of community engagement in school-based health research. In this paper we discuss our experiences of consent, assent and community engagement in implementing a large school-based cluster randomized trial in rural Kenya. Methods Data collected as part of a qualitative study investigating the acceptability of the main trial, focus group discussions with field staff, observations of practice and authors’ experiences are used to: 1) highlight the challenges faced in obtaining assent/consent; and 2) strategies taken to try to both protect participant rights (including to refuse and to withdraw) and ensure the success of the trial. Results Early meetings with national, district and local level stakeholders were important in establishing their co-operation and support for the project. Despite this support, both practical and ethical challenges were encountered during consenting and assenting procedures. Our strategy for addressing these challenges focused on improving communication and understanding of the trial, and maintaining dialogue with all the relevant stakeholders throughout the study period. Conclusions A range of stakeholders within and beyond schools play a key role in school based health trials. Community entry and information dissemination strategies need careful planning from the outset, and with on-going consultation and feedback mechanisms established in order to identify and address concerns as they arise. We believe our experiences, and the ethical and practical issues and dilemmas encountered, will be of interest for others planning to conduct school-based research in Africa. Trial registration National Institute of Health NCT00878007 PMID:23680181

Clinical Ethics in Gabon: The Spectrum of Clinical Ethical Issues Based on Findings from In-Depth Interviews at Three Public Hospitals.

PubMed

Sippel, Daniel; Marckmann, Georg; Ndzie Atangana, Etienne; Strech, Daniel

2015-01-01

Unlike issues in biomedical research ethics, ethical challenges arising in daily clinical care in Sub-Saharan African countries have not yet been studied in a systematic manner. However this has to be seen as a distinct entity as we argue in this paper. Our aim was to give an overview of the spectrum of clinical ethical issues and to understand what influences clinical ethics in the Sub-Saharan country of Gabon. In-depth interviews with 18 health care professionals were conducted at three hospital sites in Gabon. Interview transcripts were analyzed using a grounded theory approach (open and axial coding), giving a qualitative spectrum of categories for clinical ethical issues. Validity was checked at a meeting with study participants and other health care experts in Gabon after analysis of the data. Twelve main categories (with 28 further-specified subcategories) for clinical ethical issues were identified and grouped under three core categories: A) micro level: "confidentiality and information", "interpersonal, relational and behavioral issues", "psychological strain of individuals", and "scarce resources"; B) meso level: "structural issues of medical institutions", "issues with private clinics", "challenges connected to the family", and "issues of education, training and competence"; and C) macro level: "influence of society, culture, religion and superstition", "applicability of western medicine", "structural issues on the political level", and "legal issues". Interviewees reported a broad spectrum of clinical ethical issues that go beyond challenges related to scarce financial and human resources. Specific socio-cultural, historical and educational backgrounds also played an important role. In fact these influences are central to an understanding of clinical ethics in the studied local context. Further research in the region is necessary to put our study into perspective. As many participants reported a lack of awareness of ethical issues amongst other health care professionals in daily clinical practice, we suggest that international organizations and national medical schools should consider infrastructure and tools to improve context-sensitive capacity building in clinical ethics for Sub-Saharan African countries like Gabon.

Biomedical research and the commercialization agenda: a review of main considerations for neuroscience.

PubMed

Caulfield, Timothy; Ogbogu, Ubaka

2008-01-01

This article reviews a range of issues associated with the commercialization of biomedical research and speculates on how these issues might apply to the neuroscience context. Drawing on existing studies of the impact of research commercialization activities on various areas of biotechnology research, the authors explore normative benchmarks for assessing and resolving issues likely to arise from the commercialization of neuroscientific research, including such topics as patenting, marketing pressures, and representations of research prospects.

Exploring Issues of Quality of Service in a Next Generation Internet Testbed: A Case Study Using PathMaster

PubMed Central

Shifman, Mark A.; Sayward, Frederick G.; Mattie, Mark E.; Miller, Perry L.

2002-01-01

This case study describes a project that explores issues of quality of service (QoS) relevant to the next-generation Internet (NGI), using the PathMaster application in a testbed environment. PathMaster is a prototype computer system that analyzes digitized cell images from cytology specimens and compares those images against an image database, returning a ranked set of “similar” cell images from the database. To perform NGI testbed evaluations, we used a cluster of nine parallel computation workstations configured as three subclusters using Cisco routers. This architecture provides a local “simulated Internet” in which we explored the following QoS strategies: (1) first-in-first-out queuing, (2) priority queuing, (3) weighted fair queuing, (4) weighted random early detection, and (5) traffic shaping. The study describes the results of using these strategies with a distributed version of the PathMaster system in the presence of different amounts of competing network traffic and discusses certain of the issues that arise. The goal of the study is to help introduce NGI QoS issues to the Medical Informatics community and to use the PathMaster NGI testbed to illustrate concretely certain of the QoS issues that arise. PMID:12223501

Community Involvement During Emergency Responses

EPA Pesticide Factsheets

Involvement occurs in different forms, but is always geared towards improving the public's understanding of the presence of hazardous substances in the community, and how to address any issues that may arise.

28 CFR 68.57 - Judicial review of the final agency order of an Administrative Law Judge in cases arising under...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Judicial review of the final agency order of an Administrative Law Judge in cases arising under section 274B. 68.57 Section 68.57 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) RULES OF PRACTICE AND PROCEDURE FOR ADMINISTRATIVE HEARINGS...

The President's Physician: An African Play : Emmanuel Babatunde Omobowale, 2004, All Saints' Publishers (Ibadan, 978-978-37727-3-1, 77 pp.).

PubMed

Mayaki, Joseph Ajagunmolu

2017-12-01

This review examines issues relating to biomedical ethics and literature in the African drama The President's Physician by Emmanuel Babatunde Omobowale. The play investigates the psychological dilemma of Doctor Bituki Warunga, a personal physician to General Kalunga Ntibantunganyah who brutally and inhumanely rules Wavaria, a fictional African country. The doctor is faced with deciding to uphold the ethics of his profession versus terminating the tyrant's life to set the nation free. The play aims to help budding medical doctors rightly inculcate the principles of medical ethics-autonomy, beneficence, competence, and power-by providing a fictional platform to investigate difficult issues that can arise in clinical practice. The play highlights Warunga's complex dilemma as he struggles to uphold the Hippocratic Oath and at the same time satisfy his conscience towards his contribution to his country's freedom. This review explores the difficulties in decision-making when professional duties not only clash with personal preferences but also with the well-being of an entire nation. This discussion is done alongside the ethical concept of utilitarianism and also highlights significant literary concepts such as satire, symbolism, intertextuality, utopian aesthetics, and authorial vision as conveyed in the text.

Child sex tourism: extending the borders of sexual offender legislation.

PubMed

Newman, William J; Holt, Ben W; Rabun, John S; Phillips, Gary; Scott, Charles L

2011-01-01

Child sex tourism, the act of traveling to engage in sexual acts with minors, plagues developing nations worldwide. Several laws have been passed internationally in recent years designed to curtail this practice. Government entities and human rights organizations have driven these efforts. United States citizens represent a significant proportion of participants in child sex tourism. The PROTECT Act of 2003 prohibits United States citizens from participating in sexual acts with minors while traveling, and establishes extraterritorial jurisdiction. The case of Michael Lewis Clark, the first United States citizen convicted under this legislation, is highlighted. Child sex tourism poses unique issues to courts that will require ongoing clarification as challenges arise. This article discusses potential future challenges, describes strategies to address this problem, and relates this issue to psychiatry. Mental health providers may have the role of evaluating both the victims and perpetrators of child sex tourism. The authors propose a classification system for offenses and an initial list of topics to discuss with victims. The authors also describe the proper mechanism for reporting United States citizens suspected of participating in child sex tourism. Copyright © 2011 Elsevier Ltd. All rights reserved.

Evolving Applications, Technological Challenges and Future Opportunities in Neuromodulation: Proceedings of the Fifth Annual Deep Brain Stimulation Think Tank

PubMed Central

Ramirez-Zamora, Adolfo; Giordano, James J.; Gunduz, Aysegul; Brown, Peter; Sanchez, Justin C.; Foote, Kelly D.; Almeida, Leonardo; Starr, Philip A.; Bronte-Stewart, Helen M.; Hu, Wei; McIntyre, Cameron; Goodman, Wayne; Kumsa, Doe; Grill, Warren M.; Walker, Harrison C.; Johnson, Matthew D.; Vitek, Jerrold L.; Greene, David; Rizzuto, Daniel S.; Song, Dong; Berger, Theodore W.; Hampson, Robert E.; Deadwyler, Sam A.; Hochberg, Leigh R.; Schiff, Nicholas D.; Stypulkowski, Paul; Worrell, Greg; Tiruvadi, Vineet; Mayberg, Helen S.; Jimenez-Shahed, Joohi; Nanda, Pranav; Sheth, Sameer A.; Gross, Robert E.; Lempka, Scott F.; Li, Luming; Deeb, Wissam; Okun, Michael S.

2018-01-01

The annual Deep Brain Stimulation (DBS) Think Tank provides a focal opportunity for a multidisciplinary ensemble of experts in the field of neuromodulation to discuss advancements and forthcoming opportunities and challenges in the field. The proceedings of the fifth Think Tank summarize progress in neuromodulation neurotechnology and techniques for the treatment of a range of neuropsychiatric conditions including Parkinson's disease, dystonia, essential tremor, Tourette syndrome, obsessive compulsive disorder, epilepsy and cognitive, and motor disorders. Each section of this overview of the meeting provides insight to the critical elements of discussion, current challenges, and identified future directions of scientific and technological development and application. The report addresses key issues in developing, and emphasizes major innovations that have occurred during the past year. Specifically, this year's meeting focused on technical developments in DBS, design considerations for DBS electrodes, improved sensors, neuronal signal processing, advancements in development and uses of responsive DBS (closed-loop systems), updates on National Institutes of Health and DARPA DBS programs of the BRAIN initiative, and neuroethical and policy issues arising in and from DBS research and applications in practice. PMID:29416498

[Combating poverty and rebuilding social ties: the lessons of Citizens' Action in the Struggle Against Hunger and Destitution and in Defense of Life].

PubMed

Magalhães, Rosana

2002-01-01

To reflect on Citizens' Action in the Struggle Against Hunger and Destitution and in Defense of Life is to seek to approach the dilemmas and challenges involving the consolidation of citizenship and social justice, as well as the forces in action in contemporary Brazilian society. However, many questions remain open in this effort. The intertwining issues of poverty, politics, and solidarity and the concrete shapes and multiple social developments of Brazil's "Campaign Against Hunger" leave room for various possible interpretations. Thus, considering the breadth of the theme on the one hand and the limits of this article on the other, the objective is to explore some relevant issues in the debate on destitution and exclusion and the process of constructing new kinds of public social intervention and civic participation, arising over the course of the study conducted by the "Citizens' Action Committees" in Rio de Janeiro during 1996 and 1997. The basic idea is to focus on volunteer practices to discuss the dilemmas posed for solving impoverishment and social fragmentation through cooperative activities and mutual help in Brazil.

Current Dilemmas in Defining the Boundaries of Disease.

PubMed

Doust, Jenny; Jean Walker, Mary; Rogers, Wendy A

2017-08-01

Boorse's biostatistical theory states that diseases should be defined in ways that reflect disturbances of biological function and that are objective and value free. We use three examples from contemporary medicine that demonstrate the complex issues that arise when defining the boundaries of disease: polycystic ovary syndrome, chronic kidney disease, and myocardial infarction. We argue that the biostatistical theory fails to provide sufficient guidance on where the boundaries of disease should be drawn, contains ambiguities relating to choice of reference class, and is out of step with medical processes for identifying disease boundaries. Although proponents of the biostatistical theory might regard these practical issues as irrelevant to the aim of providing a theoretical account of disease, we take them to indicate the need for a theoretical account that is adequate for current needs-including limiting new forms of medicalization that are driven by the identification of disease based on dysfunction. Our processes for determining the boundaries for disease need to recognize that there is no value-free method for making these decisions. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ethical issues in the prevention of suicide in prison.

PubMed

Bell, D

1999-10-01

The aim of this paper is to discuss ethical issues that arise in the care of suicidal patients within a prison context. Such a discussion provides a suitable framework for exploration of the broader question of how coercion may be exercised by psychiatrists in a morally justifiable, as opposed to abusive, manner. Literature relevant to the abuse of psychiatric power is reviewed. The means for immediate containment of highly suicidal patients in certain prison contexts is described and the paucity of relevant empirical research literature relating to this is identified. A framework is proposed to assist clinicians in making an ethical evaluation of coercive interventions that is applicable not only in the prevention of prisoner suicide, but also in the practice of psychiatry as a whole. Due regard for the moral dimensions of the relationship between psychiatrist and prisoner has the potential to radically transform the way the exercise of power is subjectively experienced by each of them. Coercion can be exercised by psychiatrists within an ethical framework which is not abusive. There will always be a risk that coercion will become an unhealthy habit of life within which the psychiatrist feels too comfortable.

Tackling stress management, addiction, and suicide prevention in a predoctoral dental curriculum.

PubMed

Brondani, Mario A; Ramanula, Dhorea; Pattanaporn, Komkhamn

2014-09-01

Health care professionals, particularly dentists, are subject to high levels of stress. Without proper stress management, problems related to mental health and addiction and, to a lesser extent, deliberate self-harm such as suicide may arise. There is a lack of information on teaching methodologies employed to discuss stress management and suicide prevention in dental education. The purpose of this article is to describe a University of British Columbia Faculty of Dentistry module designed to address stress management and suicide prevention, using students' personal reflections to illustrate the impact of the pedagogies used. The module enrolls more than 200 students per year and has sessions tailored to the discussion of stress management and suicide prevention. The pedagogies include standardized patients, invited guest lectures, in-class activities, video presentation, and self-reflections. More than 500 students' self-reflections collected over the past five years illustrate the seriousness of the issues discussed and the level of discomfort students experience when pondering such issues. The instructors hope to have increased students' awareness of the stressors in their profession. Further studies are needed to unravel the extent to which such pedagogy influences a balanced practice of dentistry.

Intellectual Disability Policy as Developed, Expressed, and Evaluated in AAIDD/The Arc Joint Statements: The Role of Organization Position Statements.

PubMed

Luckasson, Ruth; Ford, Marty E; McMillan, Elise D; Misilo, Frederick M; Nygren, Margaret A

2017-07-01

The American Association on Intellectual and Developmental Disabilities (AAIDD) and The Arc of the United States (The Arc) have a long history of joined efforts to develop, express, and evaluate disability policies. These efforts have resulted in a series of formal statements on critical issues such as education, healthcare, human rights, and criminal justice. Their joint efforts further important policy goals including providing clear strong communication about important policy values and directions, promulgating key principles of high quality supports and services, affirming best professional practices, and emphasizing personal outcomes. In addition, the joint efforts (a) affirm important aspects of organization identity; (b) enhance the organizations' abilities to assure the input of a wide variety of perspectives; (c) engage members' expanded ranges of experiences and talents; (d) multiply staff and leadership resources; (e) increase communication strength and avenues; and (f) establish processes for timely review and revision of policies as critical disability issues arise or change, and new opportunities for policy integration and advancement occur. This article describes the processes used to develop, express, and evaluate the position statements; summarizes the policy content of several joint statements; and discusses the role of these organization position statements.

Evolving Applications, Technological Challenges and Future Opportunities in Neuromodulation: Proceedings of the Fifth Annual Deep Brain Stimulation Think Tank.

PubMed

Ramirez-Zamora, Adolfo; Giordano, James J; Gunduz, Aysegul; Brown, Peter; Sanchez, Justin C; Foote, Kelly D; Almeida, Leonardo; Starr, Philip A; Bronte-Stewart, Helen M; Hu, Wei; McIntyre, Cameron; Goodman, Wayne; Kumsa, Doe; Grill, Warren M; Walker, Harrison C; Johnson, Matthew D; Vitek, Jerrold L; Greene, David; Rizzuto, Daniel S; Song, Dong; Berger, Theodore W; Hampson, Robert E; Deadwyler, Sam A; Hochberg, Leigh R; Schiff, Nicholas D; Stypulkowski, Paul; Worrell, Greg; Tiruvadi, Vineet; Mayberg, Helen S; Jimenez-Shahed, Joohi; Nanda, Pranav; Sheth, Sameer A; Gross, Robert E; Lempka, Scott F; Li, Luming; Deeb, Wissam; Okun, Michael S

2017-01-01

The annual Deep Brain Stimulation (DBS) Think Tank provides a focal opportunity for a multidisciplinary ensemble of experts in the field of neuromodulation to discuss advancements and forthcoming opportunities and challenges in the field. The proceedings of the fifth Think Tank summarize progress in neuromodulation neurotechnology and techniques for the treatment of a range of neuropsychiatric conditions including Parkinson's disease, dystonia, essential tremor, Tourette syndrome, obsessive compulsive disorder, epilepsy and cognitive, and motor disorders. Each section of this overview of the meeting provides insight to the critical elements of discussion, current challenges, and identified future directions of scientific and technological development and application. The report addresses key issues in developing, and emphasizes major innovations that have occurred during the past year. Specifically, this year's meeting focused on technical developments in DBS, design considerations for DBS electrodes, improved sensors, neuronal signal processing, advancements in development and uses of responsive DBS (closed-loop systems), updates on National Institutes of Health and DARPA DBS programs of the BRAIN initiative, and neuroethical and policy issues arising in and from DBS research and applications in practice.

How the Maori community sees the dental-care system.

PubMed

Edward, S J

1992-10-01

This report has addressed the question of how the Maori community sees the system of oral health care by indicating the complex factors influencing the Maori community's attitude toward health issues. These factors preclude the Maori community from many of the perceived benefits of the present oral health-care system. There is a need in this current climate of debate over health policies to re-focus on primary prevention policies that will be relevant to the Maori community of today. No one is seen in the Maori community to be articulating concern for oral health issues. The challenge for the Dental Council of New Zealand is how then to create a focus on oral health issues within the Maori community, and to actively promote oral health care and encourage usage of a system that is affordable, available, accessible, and appropriate. Practical and relevant recommendations arising from Rapuora: Health and Maori Women 1984 and the Hui Hauora Mokopuna, 1990(10) should be considered when planning future health-care systems. Health was one of the four key areas highlighted in the Ka Awatea report, and it will be an important feature of the work of the new Ministry of Maori Development. It is timely that the Dental Council of New Zealand and the Ministry of Maori Development should facilitate oral health-care systems for the future in partnership with the Maori community.

An overlooked alliance: using human factors engineering to reduce patient harm.

PubMed

Perry, Shawna J

2004-08-01

Although human factors engineering (HFE) is considered only in relationship to the design of medical devices or information systems technology, human factors issues arise in many aspects of work in health care organizations. In one scenario, the resuscitation stretcher would not pass through the ED door closest to radiology. Many clinical work spaces were never formally designed for the work currently being performed in them; instead, they were adapted from existing space originally designed for a different use. In a second scenario, infusion pump malfunction was not apparent. The patient experienced a near miss secondary to poor design; users thought that the infusion pump had been turned off when it was not. Health care can significantly benefit from the incorporation of HFE into the workplace. Introductory classes in medical and nursing schools on HFE will assist students in detecting HFE-related issues, making them less likely to suffer with them or overlook them once in clinical practice. More extensive training for patient safety and risk managers, that is, at a minimum, a certificate-level course from an HFE program, would enhance case and root cause analyses since these issues are rarely factored in. Collaboration with HFE experts and use of HFE principles may not make health care fool-proof, but it will make it less dependent on improvisation and ingenuity to protect patients from the system's vulnerabilities.

The importance of an ethics curriculum in surgical education.

PubMed

Keune, Jason D; Kodner, Ira J

2014-07-01

The nature of surgical work provides fertile ground in which ethical problems can grow. The concept of what it means to be a "good surgeon" includes the ability to reason and deliberate about how the surgeon's unique technical capabilities integrate with larger society. Ethics education at the resident level is important for several reasons. It can ensure that care is delivered in a socially and ethically responsible manner through global and emergent effects on institutions and traditions. It will prepare residents for leadership positions. It can allow residents to confront issues, such as the scientific underdetermination of surgical practice, the application of new technologies to trusting patients that have been developed by for-profit companies, and a surgical environment that is becoming increasingly institutionalized. Resident ethics education provides the opportunity for a model of collective deliberation to be developed that can be used to make sense of ethical problems as they arise.

A practical guide to value of information analysis.

PubMed

Wilson, Edward C F

2015-02-01

Value of information analysis is a quantitative method to estimate the return on investment in proposed research projects. It can be used in a number of ways. Funders of research may find it useful to rank projects in terms of the expected return on investment from a variety of competing projects. Alternatively, trialists can use the principles to identify the efficient sample size of a proposed study as an alternative to traditional power calculations, and finally, a value of information analysis can be conducted alongside an economic evaluation as a quantitative adjunct to the 'future research' or 'next steps' section of a study write up. The purpose of this paper is to present a brief introduction to the methods, a step-by-step guide to calculation and a discussion of issues that arise in their application to healthcare decision making. Worked examples are provided in the accompanying online appendices as Microsoft Excel spreadsheets.

Parallel rendering

NASA Technical Reports Server (NTRS)

Crockett, Thomas W.

1995-01-01

This article provides a broad introduction to the subject of parallel rendering, encompassing both hardware and software systems. The focus is on the underlying concepts and the issues which arise in the design of parallel rendering algorithms and systems. We examine the different types of parallelism and how they can be applied in rendering applications. Concepts from parallel computing, such as data decomposition, task granularity, scalability, and load balancing, are considered in relation to the rendering problem. We also explore concepts from computer graphics, such as coherence and projection, which have a significant impact on the structure of parallel rendering algorithms. Our survey covers a number of practical considerations as well, including the choice of architectural platform, communication and memory requirements, and the problem of image assembly and display. We illustrate the discussion with numerous examples from the parallel rendering literature, representing most of the principal rendering methods currently used in computer graphics.

An Inexpensive, Stable, and Accurate Relative Humidity Measurement Method for Challenging Environments

PubMed Central

Zhang, Wei; Ma, Hong; Yang, Simon X.

2016-01-01

In this research, an improved psychrometer is developed to solve practical issues arising in the relative humidity measurement of challenging drying environments for meat manufacturing in agricultural and agri-food industries. The design in this research focused on the structure of the improved psychrometer, signal conversion, and calculation methods. The experimental results showed the effect of varying psychrometer structure on relative humidity measurement accuracy. An industrial application to dry-cured meat products demonstrated the effective performance of the improved psychrometer being used as a relative humidity measurement sensor in meat-drying rooms. In a drying environment for meat manufacturing, the achieved measurement accuracy for relative humidity using the improved psychrometer was ±0.6%. The system test results showed that the improved psychrometer can provide reliable and long-term stable relative humidity measurements with high accuracy in the drying system of meat products. PMID:26999161

[Single or double moral standards? Professional ethics of psychiatrists regarding self-determination, rights of third parties and involuntary treatment].

PubMed

Pollmächer, T

2015-09-01

The current intensive discussion on the legal and moral aspects of involuntary treatment of psychiatric patients raises a number of ethical issues. Physicians are unambiguously obligated to protect patient welfare and autonomy; however, in psychiatric patients disease-related restrictions in the capacity of self-determination and behaviors endangering the rights of third parties can seriously challenge this unambiguity. Therefore, psychiatry is assumed to have a double function and is also obligated to third parties and to society in general. Acceptance of such a kind of double obligation carries the risk of double moral standards, placing the psychiatrist ethically outside the community of physicians and questioning the unrestricted obligation towards the patient. The present article formulates a moral position, which places the psychiatrist, like all other physicians, exclusively on the side of the patient in terms of professional ethics and discusses the practical problems arising from this moral position.

The Interdisciplinary Geriatric/Gerontological Team in the Academic Setting.

PubMed

Mellor, M Joanna; Solomon, Renee

1992-01-01

Geriatric health care requires the services of an interdisciplinary health care team to assess, treat and order the social service needs of the older person, and this concept needs to be included in geriatric social work education. But while the necessity of interdisciplinary team care is recognized, little focus has been placed on the actual process of developing a functional team. The issues that arise-disparate terminologies, organizational and administrative differentials, turf-and the steps needed for a team to become viable are described, using an interdisciplinary team based in academia as a case model. The academic interdisciplinary team may easily become a forum for 'hot air' rather than a catalyst for good practice. This danger is reviewed with reference to stages in the interdisciplinary team development-- goal development group affiliation; team awareness; and goal evaluation. The chapter concludes with a discussion on the impact of the interdisciplinary team on faculty, students and the academic setting.

An Inexpensive, Stable, and Accurate Relative Humidity Measurement Method for Challenging Environments.

PubMed

Zhang, Wei; Ma, Hong; Yang, Simon X

2016-03-18

In this research, an improved psychrometer is developed to solve practical issues arising in the relative humidity measurement of challenging drying environments for meat manufacturing in agricultural and agri-food industries. The design in this research focused on the structure of the improved psychrometer, signal conversion, and calculation methods. The experimental results showed the effect of varying psychrometer structure on relative humidity measurement accuracy. An industrial application to dry-cured meat products demonstrated the effective performance of the improved psychrometer being used as a relative humidity measurement sensor in meat-drying rooms. In a drying environment for meat manufacturing, the achieved measurement accuracy for relative humidity using the improved psychrometer was ±0.6%. The system test results showed that the improved psychrometer can provide reliable and long-term stable relative humidity measurements with high accuracy in the drying system of meat products.

Variable selection and model choice in geoadditive regression models.

PubMed

Kneib, Thomas; Hothorn, Torsten; Tutz, Gerhard

2009-06-01

Model choice and variable selection are issues of major concern in practical regression analyses, arising in many biometric applications such as habitat suitability analyses, where the aim is to identify the influence of potentially many environmental conditions on certain species. We describe regression models for breeding bird communities that facilitate both model choice and variable selection, by a boosting algorithm that works within a class of geoadditive regression models comprising spatial effects, nonparametric effects of continuous covariates, interaction surfaces, and varying coefficients. The major modeling components are penalized splines and their bivariate tensor product extensions. All smooth model terms are represented as the sum of a parametric component and a smooth component with one degree of freedom to obtain a fair comparison between the model terms. A generic representation of the geoadditive model allows us to devise a general boosting algorithm that automatically performs model choice and variable selection.

Superfund manual: Legal and management strategies. 6. edition

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

Hall, R.M. Jr.

1998-12-31

This book is essential for any responsible business seeking to identify and minimize risks arising out of potential CERCLA liability. This new 6th edition brings you up-to-date on the latest Superfund regulations, case law, and implementation policies, and provides you with comprehensive coverage of the entire program. You`ll learn what Superfund does and requires, how it is being implemented, and its impact upon you. In addition, the book provides some practical thoughts on strategic issues for potentially responsible parties and how to respond. Clearly explained in laymen`s terms are: hazardous substance release reporting; the National Contingency Plan and National Prioritiesmore » List; liability; government liability under Superfund; government response authorities and enforcement; response strategies for potentially responsible parties; natural resource damages; uses of Superfund; the role of the states under Superfund, state statutes and the common law; and EPCRA.« less

Regularizing the r-mode Problem for Nonbarotropic Relativistic Stars

NASA Technical Reports Server (NTRS)

Lockitch, Keith H.; Andersson, Nils; Watts, Anna L.

2004-01-01

We present results for r-modes of relativistic nonbarotropic stars. We show that the main differential equation, which is formally singular at lowest order in the slow-rotation expansion, can be regularized if one considers the initial value problem rather than the normal mode problem. However, a more physically motivated way to regularize the problem is to include higher order terms. This allows us to develop a practical approach for solving the problem and we provide results that support earlier conclusions obtained for uniform density stars. In particular, we show that there will exist a single r-mode for each permissible combination of 1 and m. We discuss these results and provide some caveats regarding their usefulness for estimates of gravitational-radiation reaction timescales. The close connection between the seemingly singular relativistic r-mode problem and issues arising because of the presence of co-rotation points in differentially rotating stars is also clarified.

The literature of medical ethics: Bernard Häring

PubMed Central

Soane, Brendan

1977-01-01

To the general reader and watcher of television programmes medical ethics may appear to be something new. This is not so, for hundreds of articles and many books have appeared over the last 10 years or so to discuss and analyse the problems arising from the practice of medicine. In this study of two larger works - Medical Ethics and Manipulation - both by Bernard Häring, a Roman Catholic theologian - Father Brendan Soane analyses these in some detail and sets their ideas in the context of what has already been written on the major issues of medical ethics and what is likely to be foremost in discussion in the near future. Many readers of this Journal already have the particular background of knowledge to see the problems in medicine which are in fact ethical but the general reader may require help and enlightenment and this is now provided for a special field within the field. PMID:874983

Use of dispersion modelling for Environmental Impact Assessment of biological air pollution from composting: Progress, problems and prospects.

PubMed

Douglas, P; Hayes, E T; Williams, W B; Tyrrel, S F; Kinnersley, R P; Walsh, K; O'Driscoll, M; Longhurst, P J; Pollard, S J T; Drew, G H

2017-12-01

With the increase in composting asa sustainable waste management option, biological air pollution (bioaerosols) from composting facilities have become a cause of increasing concern due to their potential health impacts. Estimating community exposure to bioaerosols is problematic due to limitations in current monitoring methods. Atmospheric dispersion modelling can be used to estimate exposure concentrations, however several issues arise from the lack of appropriate bioaerosol data to use as inputs into models, and the complexity of the emission sources at composting facilities. This paper analyses current progress in using dispersion models for bioaerosols, examines the remaining problems and provides recommendations for future prospects in this area. A key finding is the urgent need for guidance for model users to ensure consistent bioaerosol modelling practices. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The use of propofol by gastroenterologists: medico-legal issues.

PubMed

Axon, Andrew E

2010-01-01

The increasing use of non-anesthesiologist-administered propofol for sedation during gastrointestinal endoscopy has both clinical and legal consequences. As medical practices develop, the law of clinical negligence will be applied in the context of such developments. While the law will recognize the desirability of advanced techniques and methods, in circumstances where an injury or adverse outcome occurs, the facts of a particular case will be scrutinized to determine whether or not the duty of care between patient and clinician has been breached. This paper considers a number of specific matters likely to arise in the context of a clinical negligence/malpractice claim resulting from the use of non-anesthesiologist-administered propofol, in particular the role and standard of care expected of gastroenterologist and/or anesthetic provider, the relevance of FDA labeling, the implementation and use of protocols, the importance of patient selection and informed consent. Copyright 2010 S. Karger AG, Basel.

[Moral problems in home health care--a descriptive ethical study].

PubMed

Lauxen, Oliver

2009-12-01

In Germany there is an increasing importance of home health care and nurses that are employed in the home care sector often have to face ethical issues. The purpose of this ethnographic study was to explore moral problems in the daily practice of these nurses. The method used was qualitative interviews with 20 nurses which have been analysed by content analysis. The results showed that the ethical principle of beneficence was the core concept for the participants. Moral problems arise when nurses cannot act in accordance to this principle or when they cannot determine the good in a situation. In particular, there were four types of moral problems: "beneficence vs. autonomy", "beneficence vs. justice", "beneficence vs. loyalty" and "The good cannot be determined". The way nurses in home health care address moral problems should be improved. Some participants lack ethical competencies. Furthermore, appropriate support services for dealing with moral problems have to be designed.

Ethical difficulties in nursing, educational needs and attitudes about using ethics resources.

PubMed

Leuter, Cinzia; Petrucci, Cristina; Mattei, Antonella; Tabassi, Gianpietro; Lancia, Loreto

2013-05-01

Ethical difficulties arise in healthcare practices. However, despite extensive research findings that demonstrate that most nurses are involved in recurrent ethical problems, institutions are not always able to effectively support nursing care professionals. The limited availability of ethics consultation services and traditional nursing training fails to meet the frequent and strong requests by health workers to support their ethical dilemmas. A questionnaire was administered to 374 nurses attending a specialist training and a lifetime learning programme in Italy. The respondents reported a high frequency of ethically sensitive situations, and they described the poor development of ethics support and a scarcity of ethics training programmes. The results suggest the importance of promoting ethics services that include consultation and ethics training. A need for systematic ethics educational activities was identified for improving the capacity of nurses to manage ethical issues in patient care.

FEAST fundamental framework for electronic structure calculations: Reformulation and solution of the muffin-tin problem

NASA Astrophysics Data System (ADS)

Levin, Alan R.; Zhang, Deyin; Polizzi, Eric

2012-11-01

In a recent article Polizzi (2009) [15], the FEAST algorithm has been presented as a general purpose eigenvalue solver which is ideally suited for addressing the numerical challenges in electronic structure calculations. Here, FEAST is presented beyond the “black-box” solver as a fundamental modeling framework which can naturally address the original numerical complexity of the electronic structure problem as formulated by Slater in 1937 [3]. The non-linear eigenvalue problem arising from the muffin-tin decomposition of the real-space domain is first derived and then reformulated to be solved exactly within the FEAST framework. This new framework is presented as a fundamental and practical solution for performing both accurate and scalable electronic structure calculations, bypassing the various issues of using traditional approaches such as linearization and pseudopotential techniques. A finite element implementation of this FEAST framework along with simulation results for various molecular systems is also presented and discussed.

Hyperstaticity for ergonomie design of a wrist exoskeleton.

PubMed

Esmaeili, Mohammad; Jarrassé, Nathanaël; Dailey, Wayne; Burdet, Etienne; Campolo, Domenico

2013-06-01

Increasing the level of transparency in rehabilitation devices has been one of the main goals in robot-aided neurorehabilitation for the past two decades. This issue is particularly important to robotic structures that mimic the human counterpart's morphology and attach directly to the limb. Problems arise for complex joints such as the human wrist, which cannot be accurately matched with a traditional mechanical joint. In such cases, mechanical differences between human and robotic joint cause hyperstaticity (i.e. overconstraint) which, coupled with kinematic misalignments, leads to uncontrolled force/torque at the joint. This paper focuses on the prono-supination (PS) degree of freedom of the forearm. The overall force and torque in the wrist PS rotation is quantified by means of a wrist robot. A practical solution to avoid hyperstaticity and reduce the level of undesired force/torque in the wrist is presented, which is shown to reduce 75% of the force and 68% of the torque.

Legal Issues of Ambient Intelligence in the SERENITY Project

NASA Astrophysics Data System (ADS)

Krausová, Alžběta; Dumortier, Jos

The successful functionality of the solutions proposed by the SERENITY project will only be achieved when they fit into the existing legal framework. Therefore, when developing software and hardware solutions, developers must respect requirements set out by law. The aim of this chapter is to define legal challenges that arise with the advent of the Ambient Intelligence, and to explain how SERENITY deals with the challenge of legal compliance. To do this, we will first describe how the legal requirements are translated into a machinereadable form in the SERENITY project, and introduce the concept of so called legal patterns. The application of relevant legal principles on data protection will be illustrated using two particular scenarios. We will then focus on practical legal problems related to daily operations of SERENITY technical solutions. Finally, we conclude with an evaluation of the SERENITY approach and its outcomes

Does a Therapist's World View Matter?

PubMed

Peteet, John R; Rodriguez, Vithya B; Herschkopf, Marta D; McCarthy, Alyssa; Betts, Jennifer; Romo, Stephanie; Michael Murphy, J

2016-06-01

While past research indicates that mental health professionals are less religious than the public they serve, little is known about the implications of therapists' world views for their practice. In this study, approximately 50 therapists completed surveys that assessed self-identification in relation to spirituality, religion, and/or world view; how relevant they considered their patients' and their own world views; and responses to clinical vignettes involving issues arising in treatment. While a minority considered themselves religious, a majority indicated that they considered themselves moderately or very spiritual. When asked how they would respond to a series of clinical vignettes involving topics such as assisted suicide and encouraging the use of spiritual resources, responses varied significantly by world view. Respondents endorsed several factors limiting the integration of religion/spiritualities/world views into their clinical work. These data raise questions about how to further explore the clinical relevance of the therapist's world view.

Prison prescribing practice: practitioners' perspectives on why prison is different.

PubMed

Bartlett, A; Dholakia, N; England, R; Hales, H; van Horn, E; McGeorge, T; Moss, B; Ovaisi, S; Tukmachi, E; Patel, S

2014-04-01

The current prison population in England and Wales has multiple, complex healthcare needs, presenting unique challenges to those caring for prisoners. Prison numbers have increased dramatically in the last 10 years. There are now approximately 84,000 prisoners in England and Wales and 120,000 new episodes of imprisonment each year . The authors all contribute to prison healthcare. Below, we discuss a key issue arising from first-hand experience of prisoners' health and social care needs, the prescription of psycho-active drugs by primary and secondary care practitioners. This is a core medical task, but beset with difficulties. These difficulties are not necessarily encountered in other areas of prison healthcare. However, they do illustrate how providing healthcare to prisoners is complex, often lacking a research base and can have pitfalls that are not obvious to the outsider. © 2014 John Wiley & Sons Ltd.

Hospital closure: Phoenix, Hydra or Titanic?

PubMed

Dunne, T; Davis, S

1996-01-01

Very little has been published about the effects of hospital closure in terms of the service, financial or management issues of the process. Attempts through a case-study format to redress the balance and as such represents the reflections of practitioners who have recently undergone the experience of hospital closure and the often neglected issues arising both during and after the process.

The Evolution of an Undergraduate Service Course--How To Cope with Success of an Age of Dinosaurs Class.

ERIC Educational Resources Information Center

Montgomery, Homer

2003-01-01

Discusses how to address the issue of a course becoming too popular. Uses as an example the Age of Dinosaurs course at the University of Texas at Dallas. Describes some issues that can arise such as classroom overflow, overwhelmed labs, cheating, testing methods, and asynchronous instruction. Recommends looking to web-based course management…

The Birth of University Affiliated Early Childhood Centres of Excellence: Investing in Children, Families and Communities

ERIC Educational Resources Information Center

Krog, Soezin; Nel, Norma

2015-01-01

The wellbeing of young children is of national and international concern. Urgent action is therefore required to address issues of children's wellbeing, and failure to do so will have adverse consequences for children today and in generations to come. This paper addresses issues arising from recently published literature in the areas of Early…

Research Ethics in Emerging Forms of Online Learning: Issues Arising from a Hypothetical Study on a MOOC

ERIC Educational Resources Information Center

Esposito, Antonella

2012-01-01

This paper is concerned with how research ethics is evolving along with emerging online research methods and settings. In particular, it focuses on ethics issues implied in a hypothetical virtual ethnography study aiming to gain insights on participants' experience in an emergent context of networked learning, namely a MOOC--Massive Online Open…

The transfer of a health insurance/managed care business.

PubMed

Gavin, John N; Goodman, George; Goroff, David B

2007-01-01

The owners of a health insurance/managed care business may want to sell that business for a variety of reasons. Health care provider systems may want to exit that business due to operating losses, difficulty in complying with regulations, the inherent conflict in operating that business as part of a provider system, or the desire to focus on being a health care provider. Health insurers/HMOs may want to sell all or a portion of their business due to operating losses, difficulty in servicing a particular market, or a desire to focus on other markets. No matter what reason prompts a seller to undertake a sale, a sale of health insurance/managed care business can be a complicated transaction involving a multitude of issues. This article will focus first on the ways in which such a sale may be structured. The article will then discuss some transactional issues that may arise in the negotiations for the sale of a health insurance/managed care business. The article will then focus on some particular legal issues that arise in each sale-e.g., antitrust, HIPAA, regulatory approvals, and charitable issues. Finally, this article will provide an overview of tax structuring considerations.

Incontinence and the duty to provide care.

PubMed

Dimond, Bridgit

Bridgit Dimond considers the legal implications of failing to adequately assess the continence needs of vulnerable people. A typical situation is used to illustrate the legal issues that arise (Box 1).

Serum Amyloid A-Positive Hepatocellular Neoplasm: A New Type of Tumor Arising in Patients with Advanced Alcoholic Disease.

PubMed

Sasaki, Motoko; Nakanuma, Yasuni

2015-09-01

This chapter reviews a new type of hepatocellular neoplasm, serum amyloid A-positive hepatocellular neoplasm (SAA-HN), which arises in patients with advanced alcoholic liver disease such as cirrhosis. SAA-HNs share histological and immunohistochemical features with inflammatory hepatocellular adenoma, for example, a strong immunoreactivity for SAA. Clinicopathological features and issues regarding SAA-HN are reviewed with emphasis regarding its potential to develop into hepatocellular carcinoma. © 2015 S. Karger AG, Basel.

Legal implications of monitoring workers for carcinogenic and mutagenic risk.

PubMed

Damme, C J

1982-01-01

Many industries have initiated testing programs designed to identify workers who are especially vulnerable to workplace assaults by carcinogenic or mutagenic agents. This paper examines a number of legal issues attendant on such programs, including disclosure and consent, confidentiality, and other potential liability-producing factors. This paper also briefly looks at the legal issues that might arise if the federal government were to mandate similar programs. Finally, the basic rationale of industrial monitoring programs is discussed within the context of the emerging legal issues.

Prevention, communication and equity in environmental epidemiology: ethical issues.

PubMed

Pagliarani, Giovanna; Botti, Caterina

2011-01-01

In environmental epidemiology research, decisions about when and how to intervene requires adequate ethical reflection. In fact, different kinds of issues may arise about: research methods and knowledge production; management of the results in terms of their overall assessments or for the implementation of preventive actions; reclamation intervention. In this contribution we propose to consider three topics we regard as crucial to this ethical debate: the reporting of conclusive research data; the correct application of the precautionary principle; and the environmental equity issues.

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

Amy Honchar

The contribution of funds from DOE supported publication costs of a special issue of Deep Sea Research arising from presentations at the First U.S. Atlantic Meridional Overturning Circulation (AMOC) Meeting held 4-6 May, 2009 to review the US implementation plan and its coordination with other monitoring activities. The special issue includes a total of 16 papers, including publications from three DOE-supported investigators (ie Sevellec, F., and A.V. Fedorov; Hu et. al., and Wan et. al.,). The special issue addresses DOE interests in understanding and simulation/modeling of abrupt climate change.

Ethical issues in geriatric psychiatry.

PubMed

Rabins, Peter V; Black, Betty S

2010-01-01

The high rates of medical illness in older people, the high prevalence of cognitive disorder in the elderly, and the high prevalence of frailty in late life raise issues that occur infrequently in the care of younger adults. This article discusses the ethical issues that commonly arise in the setting of these medical and psychiatric morbidities, and emphasizes the need for clinicians and researchers to be knowledgeable about the belief systems and values of individual patients, of their carers when relevant, of themselves, and of research participants.

A Qualitative Study of Immigration Policy and Practice Dilemmas for Social Work Students

ERIC Educational Resources Information Center

Furman, Rich; Langer, Carol L.; Sanchez, Thomas Wayne; Negi, Nalini Junko

2007-01-01

Social policy shapes the infrastructure wherein social work is practiced. However, what happens when a particular social policy is seemingly incongruent with the social work code of ethics? How do social work students conceive and resolve potential practice dilemmas that may arise as a consequence? In this study, the authors explored potential…

Clinical Ethics in Gabon: The Spectrum of Clinical Ethical Issues Based on Findings from In-Depth Interviews at Three Public Hospitals

PubMed Central

Sippel, Daniel; Marckmann, Georg; Ndzie Atangana, Etienne; Strech, Daniel

2015-01-01

Introduction Unlike issues in biomedical research ethics, ethical challenges arising in daily clinical care in Sub-Saharan African countries have not yet been studied in a systematic manner. However this has to be seen as a distinct entity as we argue in this paper. Our aim was to give an overview of the spectrum of clinical ethical issues and to understand what influences clinical ethics in the Sub-Saharan country of Gabon. Materials and Methods In-depth interviews with 18 health care professionals were conducted at three hospital sites in Gabon. Interview transcripts were analyzed using a grounded theory approach (open and axial coding), giving a qualitative spectrum of categories for clinical ethical issues. Validity was checked at a meeting with study participants and other health care experts in Gabon after analysis of the data. Results Twelve main categories (with 28 further-specified subcategories) for clinical ethical issues were identified and grouped under three core categories: A) micro level: “confidentiality and information”, “interpersonal, relational and behavioral issues”, “psychological strain of individuals”, and “scarce resources”; B) meso level: “structural issues of medical institutions”, “issues with private clinics”, “challenges connected to the family”, and “issues of education, training and competence”; and C) macro level: “influence of society, culture, religion and superstition”, “applicability of western medicine”, “structural issues on the political level”, and “legal issues”. Discussion Interviewees reported a broad spectrum of clinical ethical issues that go beyond challenges related to scarce financial and human resources. Specific socio-cultural, historical and educational backgrounds also played an important role. In fact these influences are central to an understanding of clinical ethics in the studied local context. Further research in the region is necessary to put our study into perspective. As many participants reported a lack of awareness of ethical issues amongst other health care professionals in daily clinical practice, we suggest that international organizations and national medical schools should consider infrastructure and tools to improve context-sensitive capacity building in clinical ethics for Sub-Saharan African countries like Gabon. PMID:26161655

Negotiated reorienting: a grounded theory of nurses' end-of-life decision-making in the intensive care unit.

PubMed

Gallagher, Ann; Bousso, Regina Szylit; McCarthy, Joan; Kohlen, Helen; Andrews, Tom; Paganini, Maria Cristina; Abu-El-Noor, Nasser Ibrahim; Cox, Anna; Haas, Margit; Arber, Anne; Abu-El-Noor, Mysoon Khalil; Baliza, Michelle Freire; Padilha, Katia Grillo

2015-04-01

Intensive care units (ICUs) focus on treatment for those who are critically ill and interventions to prolong life. Ethical issues arise when decisions have to be made regarding the withdrawal and withholding of life-sustaining treatment and the shift to comfort and palliative care. These issues are particularly challenging for nurses when there are varying degrees of uncertainty regarding prognosis. Little is known about nurses' end-of-life (EoL) decision-making practice across cultures. To understand nurses' EoL decision-making practices in ICUs in different cultural contexts. We collected and analysed qualitative data using Grounded Theory. Interviews were conducted with experienced ICU nurses in university or hospital premises in five countries: Brazil, England, Germany, Ireland and Palestine. Semi-structured interviews were conducted with 51 nurses (10 in Brazil, 9 in England, 10 in Germany, 10 in Ireland and 12 nurses in Palestine). They were purposefully and theoretically selected to include nurses having a variety of characteristics and experiences concerning end-of-life (EoL) decision-making. The study used grounded theory to inform data collection and analysis. Interviews were facilitated by using key questions. The comparative analysis of the data within and across data generated by the different research teams enabled researchers to develop a deeper understanding of EoL decision-making practices in the ICU. Ethical approval was granted in each of the participating countries and voluntary informed consent obtained from each participant. The core category that emerged was 'negotiated reorienting'. Whilst nurses do not make the 'ultimate' EoL decisions, they engage in two core practices: consensus seeking (involving coaxing, information cuing and voice enabling); and emotional holding (creating time-space and comfort giving). There was consensus regarding the core concept and core practices employed by nurses in the ICUs in the five countries. However, there were some discernible differences regarding the power dynamics in nurse-doctor relationships, particularly in relation to the cultural perspectives on death and dying and in the development of palliative care. The research suggests the need for culturally sensitive ethics education and bereavement support in different cultural contexts. Copyright © 2015. Published by Elsevier Ltd.

77 FR 50637 - Schedule of Fees Authorized

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-22

... direct and indirect costs must be taken into account in the computation of these costs. Since we last... thereof; or (4) Raise novel legal or policy issues arising out of legal mandates, the President's...

Understanding Business Models in Pharmacy Schools.

PubMed

Holdford, David A

2017-06-01

The objectives of this article are to define business models, contrast the business models in pharmacy schools, and discuss issues that can arise from misunderstandings about whom pharmacy schools serve and how they do so.

7 CFR 1780.68 - Owner's contractual responsibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of all contractual and administrative issues arising out of procurement entered into in support of a.... Matters concerning violation of laws are to be referred to the applicable local, State, or Federal authority. ...

Motivational interviewing and the clinical science of Carl Rogers.

PubMed

Miller, William R; Moyers, Theresa B

2017-08-01

The clinical method of motivational interviewing (MI) evolved from the person-centered approach of Carl Rogers, maintaining his pioneering commitment to the scientific study of therapeutic processes and outcomes. The development of MI pertains to all 3 of the 125th anniversary themes explored in this special issue. Applications of MI have spread far beyond clinical psychology into fields including health care, rehabilitation, public health, social work, dentistry, corrections, coaching, and education, directly impacting the lives of many people. The public relevance and impact of clinical psychology are illustrated in the similarity of MI processes and outcomes across such diverse fields and the inseparability of human services from the person who provides them, in that both relational and technical elements of MI predict client outcomes. Within the history of clinical psychology MI is a clear product of clinical science, arising from the seminal work of Carl Rogers whose own research grounded clinical practice in empirical science. As with Rogers' work 70 years ago, MI began as an inductive empirical approach, observing clinical practice to develop and test hypotheses about what actually promotes change. Research on MI bridges the current divide between evidence-based practice and the well-established importance of therapeutic relationship. Research on training and learning of MI further questions the current model of continuing professional education through self-study and workshops as a way of improving practice behavior and client outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Proposing an Operational Definition of Science Teacher Beliefs

NASA Astrophysics Data System (ADS)

Hutner, Todd L.; Markman, Arthur B.

2016-10-01

Much research has shown that a science teacher's beliefs are related to their teaching practice. This line of research has often defined "belief" epistemologically. That is, beliefs are often defined relative to other mental constructs, such as knowledge, dispositions, or attitudes. Left unspecified is the role beliefs play in cognition and how they come to influence science teachers' classroom practice. As such, researchers and science teacher educators have relied on an (at times, implicit) assumption that there is a direct causal relationship between teachers' beliefs and classroom practice. In this paper, we propose an operational, as opposed to epistemological, definition of belief. That is, we are explicit about the role a belief plays in science teachers' cognition and how that leads to classroom practice. We define a belief as a mental representation that influences the practice of a teacher if and only if the belief is active in cognition. We then turn our attention to two limitations in the literature on that have arisen via previous definitions and assumptions regarding science teacher beliefs, showing how defining beliefs operationally helps think about these issues in new ways. The two limitations surround: (1) the difficulty in precisely delineating belief from knowledge; and (2) the interconnectedness of beliefs such that they draw meaning from one another. We then show how our definition of beliefs is congruent with other models of teacher cognition reported in the literature. Finally, we provide implications arising from this definition of belief for both science teacher educators and those who conduct research on the beliefs of both preservice and in-service science teachers.

Student experiences of creating and sharing material in online learning.

PubMed

Potts, Henry W W

2011-01-01

User-generated content in an online environment has significant implications in both education and health. Instead of a model of knowledge being something transferred from the expert to the student or to the patient, Web 2.0 technologies offer the hope of making learning, and healthcare delivery, a more collaborative and participative process. However, some evidence suggests that this supposed democratisation of production is not entirely democratic and, in an educational context, many students are uncomfortable about sharing material they create with their peers. To understand students' affective and other experiences of generating content to be shared online with peers (e.g. in online discussions). Online interviews, face-to-face focus groups and further methods with two student groups in medical education, one undergraduate and one postgraduate. Students were broadly positive about creating and sharing material online, but were also quite anxious about doing so. Many practical issues, including around course design, student workload and assessment pressures, were barriers to students creating and sharing material. Group size is also important, with self-sustaining activity less likely in small groups. Successfully introducing user-generated content into medical education requires attention to practical details and an awareness of the student anxiety that can arise.

Catch-and-release science and its application to conservation and management of recreational fisheries

USGS Publications Warehouse

Cooke, S.J.; Schramm, H.L.

2007-01-01

Catch-and-release angling is a well-established practice in recreational angler behaviour and fisheries management. Accompanying this is a growing body of catch-and-release research that can be applied to reduce injury, mortality and sublethal alterations in behaviour and physiology. Here, the status of catch-and-release research from a symposium on the topic is summarised. Several general themes emerged including the need to: (1) better connect sublethal assessments to population-level processes; (2) enhance understanding of the variation in fish, fishing practices and gear and their role in catch and release; (3) better understand animal welfare issues related to catch and release; (4) increase the exchange of information on fishing-induced stress, injury and mortality between the recreational and commercial fishing sectors; and (5) improve procedures for measuring and understanding the effect of catch-and-release angling. Through design of better catch-and-release studies, strategies could be developed to further minimise stress, injury and mortality arising from catch-and-release angling. These strategies, when integrated with other fish population and fishery characteristics, can be used by anglers and managers to sustain or enhance recreational fishing resources. ?? 2007 The Authors. Journal compilation 2007 Blackwell Publishing Ltd.

Mooring in safe harbors. Proposed rules set out what's legal, what's not under Medicare fraud and abuse laws.

PubMed

MacKelvie, C F; Sanborn, A B

1989-04-01

The 1977 Fraud and Abuse Amendments, which prohibit business relationships that increase Medicare utilization, have created uncertainty among healthcare providers as to which commercial arrangements are legal and which are not. In response to this uncertainty, Congress enacted the Medicare and Medicaid Patient and Program Protection Act of 1987, which required the Department of Health and Human Services to develop regulations that would specify allowable practices. The regulations proposed Jan. 23, 1989, specify "safe harbors" from criminal and civil penalties in the following areas: sales of physician practices, rental agreements, investments by providers, and personal services and management contracts. In addition, the Fraud and Abuse Amendments exempted referrals arising out of a bona fide employment relationship, properly disclosed discounts, and group purchasing arrangements. The proposed regulations attempt to clarify these exemptions. Unfortunately, the proposals do little to calm a healthcare industry that is jumpy about which transactions are permitted and which are not. This is partly because the Internal Revenue Service, Health and Human Services, and the Department of Justice often issue conflicting pronouncements regarding prohibited business transactions by tax-exempt providers.

The role of the primary care practitioner in the treatment of eating disorders.

PubMed

Kreipe, Richard E; Yussman, Susan M

2003-02-01

This article addresses practical issues facing the primary care practitioner caring for an adolescent with an eating disorder. It is grounded in the four elements of successful treatment noted by Comerci: (1) recognizing the disorder and restoring physiologic stability early in its course, (2) establishing a trusting, therapeutic partnership with the adolescent, (3) involving the family in treatment, and (4) using an interdisciplinary team approach. Although primary care practitioners often have an established relationship with their patients, adolescents with eating disorders present special challenges. These adolescents tend to be bright, strong-willed, and wary of any recommendations to change their weight-control practices for fear that they will lose control. Their families are often distraught by the conflicts that arise as a result of the disordered eating behaviors and the fear that the condition is associated with significant morbidity and mortality. The article provides primary care clinicians with pragmatic ways to diagnose and initiate treatment and engage the patient and parents as active participants and members of the therapeutic team in the early phases of treatment. In addressing these principles, the authors combine the nurturant-authoritative approach described by Levenkron with the biopsychosocial model proposed by Engel.

Propensity Scores in Pharmacoepidemiology: Beyond the Horizon.

PubMed

Jackson, John W; Schmid, Ian; Stuart, Elizabeth A

2017-12-01

Propensity score methods have become commonplace in pharmacoepidemiology over the past decade. Their adoption has confronted formidable obstacles that arise from pharmacoepidemiology's reliance on large healthcare databases of considerable heterogeneity and complexity. These include identifying clinically meaningful samples, defining treatment comparisons, and measuring covariates in ways that respect sound epidemiologic study design. Additional complexities involve correctly modeling treatment decisions in the face of variation in healthcare practice, and dealing with missing information and unmeasured confounding. In this review, we examine the application of propensity score methods in pharmacoepidemiology with particular attention to these and other issues, with an eye towards standards of practice, recent methodological advances, and opportunities for future progress. Propensity score methods have matured in ways that can advance comparative effectiveness and safety research in pharmacoepidemiology. These include natural extensions for categorical treatments, matching algorithms that can optimize sample size given design constraints, weighting estimators that asymptotically target matched and overlap samples, and the incorporation of machine learning to aid in covariate selection and model building. These recent and encouraging advances should be further evaluated through simulation and empirical studies, but nonetheless represent a bright path ahead for the observational study of treatment benefits and harms.

Support System for Mental Health Professionals*

PubMed Central

Dandekar, Ajit

2015-01-01

This paper talks of support systems for mental health professionals wherein the Bombay Psychiatric Society (BPS) should devote some meetings exclusively to problems pertaining to the profession, e.g., long and odd working hours leading to potentially hazardous practice schedules, unhealthy competitive attitudes and culture. A crash course in self-defence against potentially psychotic patients and drug addicts is advocated as also awareness of the potential hazards in dealing with the litigious paranoid patients, erotomaniacs and some of the difficult hysterical patients. Potential medicolegal problems arise in treating an uncooperative patient without his knowledge and consent on an outpatient department basis, admitting such an uncooperative patient to a nursing home or a hospital, administering electroconvulsive therapies, maintaining detailed clinical records of patients, and legal issues involving smaller psychiatric private nursing homes. This paper stresses on the use of Yoga as a recognised psycho-physiological therapy. Furthermore, it suggests on the need for BPS, as a professional body, to have a cell to guide and help aspiring young professionals in setting up private practice. It points out the need to evolve some concrete programmes that in the long run should help alleviate stresses and strains and promote positive comprehensive health amongst mental health professionals. PMID:25838730

Ethnographic perspectives on global mental health.

PubMed

Jain, Sumeet; Orr, David M R

2016-12-01

The field of Global Mental Health (GMH) aims to influence mental health policy and practice worldwide, with a focus on human rights and access to care. There have been important achievements, but GMH has also been the focus of scholarly controversies arising from political, cultural, and pragmatic critiques. These debates have become increasingly polarized, giving rise to a need for more dialogue and experience-near research to inform theorizing. Ethnography has much to offer in this respect. This paper frames and introduces five articles in this issue of Transcultural Psychiatry that illustrate the role of ethnographic methods in understanding the effects and implications of the field of global mental health on mental health policy and practice. The papers include ethnographies from South Africa, India, and Tonga that show the potential for ethnographic evidence to inform GMH projects. These studies provide nuanced conceptualizations of GMH's varied manifestations across different settings, the diverse ways that GMH's achievements can be evaluated, and the connections that can be drawn between locally observed experiences and wider historical, political, and social phenomena. Ethnography can provide a basis for constructive dialogue between those engaged in developing and implementing GMH interventions and those critical of some of its approaches.

Cultural competence and medical education: many names, many perspectives, one goal.

PubMed

Betancourt, Joseph R

2006-06-01

Two contemporary reports from the Institute of Medicine--Crossing the Quality Chasm and Unequal Treatment--highlighted the importance of patient-centered care and cultural competence training as a means of improving the quality of health care for all and eliminating racial/ethnic disparities in health care. Previous efforts in cultural competence have aimed to teach about the attitudes, values, beliefs, and behavior of certain groups. A more effective approach is to learn a practical framework to guide inquiry with individual patients about how social, cultural, or economic factors influence their health values, beliefs, and behaviors. Rather than learning about individual cultures and their characteristics, this approach focuses on the issues that arise most commonly due to cultural differences, and how they may affect a physician's interaction with any patient. At the end of the day, physicians need a practical set of tools and skills that will enable them to provide quality care to patients everywhere, from anywhere, with whatever differences in background that may exist, in what is likely to be a brief clinical encounter. Call it what you will, the field of cultural competence aims quite simply to assure that health care providers are prepared to provide quality care to diverse populations.

An alternative strategy to teach biomechanics: The long jump

NASA Astrophysics Data System (ADS)

de la Vega, G. J.; Aguilera, J. A.; Puzzella, A. E.; Mallamaci, C. C.

2007-11-01

The work develops an alternative methodology to teach the Physics principles of Parabolic Cannon Shot in the career of Bioengineering using instead the physic-biological relationship of the long jump performed in Athletics. This is a closer-to-reality example for this discipline, and it is a field- and computer laboratory-reproducible practice that is simple to do by using affordable technology, because the practice can be filmed by the students in a real setting for future analysis off classroom hours. The data extracted from the film can be analysed and used to learn the physics of motion of the participating athletes, and to draw conclusions from their hands-on experience. As a main factor of the proposal, this latter characteristic aims at motivating the students to work and participate within a collaborative framework, so as to motivate them to reason and respond the questionnaire issues that stems from a real experience. A significant improvement of knowledge transference is thus attained by promoting teaching (and self-teaching) through reality-based perception, analysis and learning). This work is undergoing its first stage, and its conclusions arise from the observations on team-work dynamics. Quantitative results are expected for the following stages which are under way of execution.

Is there a role for higher education in preparing nurses?

PubMed

Watson, Roger

2006-12-01

Nurse education is now almost wholly situated within universities internationally. However, issues such as the necessity of higher education for what is seen as a practical occupation and the question of whether or not nursing is a profession arise. Newman viewed universities as places where training was given but character was also formed and self-awareness was developed through exposure to a wide range of disciplines and this type of education has helped to shape other professions. If nursing fulfills the criteria for a profession then it requires nurses to be properly educated in higher education. Poor media images of nursing, opposition from within and outside of the profession and poor funding for research, especially in the UK, where most nurses still do not enter the register with a degree, mean that the place of nursing in higher education remains on the periphery. Nurses must be competent to practice and higher education is not incompatible with the development of competent practitioners. However, higher education should take competent practitioners to a higher level whereby they become capable: able to respond appropriately in unfamiliar situations and to unfamiliar events. This paper argues for the role of higher education for nurses in terms of developing capability.

Legal Issues in the Use of Student Test Scores and Value-Added Models (VAM) to Determine Educational Quality

ERIC Educational Resources Information Center

Pullin, Diana

2013-01-01

A growing number of states and local schools across the country have adopted educator evaluation and accountability programs based on the use of student test scores and value-added models (VAM). A wide array of potential legal issues could arise from the implementation of these programs. This article uses legal analysis and social science evidence…

Policy issues in interconnecting networks

NASA Technical Reports Server (NTRS)

Leiner, Barry M.

1989-01-01

To support the activities of the Federal Research Coordinating Committee (FRICC) in creating an interconnected set of networks to serve the research community, two workshops were held to address the technical support of policy issues that arise when interconnecting such networks. The workshops addressed the required and feasible technologies and architectures that could be used to satisfy the desired policies for interconnection. The results of the workshop are documented.

The Academic Administrator and the Law: What Every Dean and Department Chair Needs To Know. ERIC Digest.

ERIC Educational Resources Information Center

Toma, J. Douglas; Palm, Richard L.

This digest summarizes the role of the dean or department chair in dealing with legal issues in higher education. It considers the types of legal issues which might arise for these administrators (such as contract and tort matters for staff and students), the erosion of the legislative and judicial deference given to academic decision making, and…

Some core contested concepts.

PubMed

Chomsky, Noam

2015-02-01

Core concepts of language are highly contested. In some cases this is legitimate: real empirical and conceptual issues arise. In other cases, it seems that controversies are based on misunderstanding. A number of crucial cases are reviewed, and an approach to language is outlined that appears to have strong conceptual and empirical motivation, and to lead to conclusions about a number of significant issues that differ from some conventional beliefs.

Issues in the Medication Management Process in People Who Have Intellectual and Developmental Disabilities: A Qualitative Study of the Caregivers' Perspective

ERIC Educational Resources Information Center

Erickson, Steven R.; Salgado, Teresa M.; Tian, Xi

2016-01-01

People who have intellectual and developmental disabilities (IDD) often rely on caregivers to assist in the medication management process. The aim of this study was to learn from caregivers, who are either family or support staff, what major issues arise throughout the process of managing medication and how these might be addressed. Problems…

Reneging: A Topic to Promote Engaging Discussions about Law and Ethics in a Business Law or Legal Environment Course

ERIC Educational Resources Information Center

Murphy, Tonia Hap

2009-01-01

This article is intended for business law and legal environment instructors who want to help students understand how they might react when presented with an ethical conflict, no matter how big or how small. The article discusses not only the compelling ethical issues that may arise in reneging cases, but also legal issues. The article provides…

Issues of Shared Parenting of LGBTQ Children and Youth in Foster Care: Preparing Foster Parents for New Roles

ERIC Educational Resources Information Center

Craig-Oldsen, Heather; Craig, J. Ann; Morton, Thomas

2006-01-01

Foster parents have increasingly assumed new and challenging roles during the past decade. Meeting the developmental, attachment, and grieving needs of children and youth in out of home care is challenging by itself, but can become even more difficult with the issues that arise when the child is lesbian, gay, bisexual, transgender, or questioning…

Thought for application and application with thought: issues in theoretical thinking and practical wisdom.

PubMed

Jenkins, Sandra K; Thomas, Mary Beth

2005-01-01

Both theoretical thinking and practical wisdom are used by health professionals in their clinical practice. Lately, discussion has centered on the abstract phrase "theory-practice gap." The health profession is not the only discipline that seeks unity in theory and practice issues. Education is also building bridges in this arena. One reoccurring myth is the notion that theory and practice are separate; as a result, this gives a mistaken impression that theory serves no purpose in practice. Discussion of the issues in this paper includes definitions of theoretical thinking and practical wisdom, theoretical and practical knowledge development, and relevance to health professional's education, practice and science. These issues must be communicated to practitioners, educators and theorists. A collective definition to begin communication is proposed and suggestions are offered for addressing key issues.

An Ethical Issue Scale for Community Pharmacy Setting (EISP): Development and Validation.

PubMed

Crnjanski, Tatjana; Krajnovic, Dusanka; Tadic, Ivana; Stojkov, Svetlana; Savic, Mirko

2016-04-01

Many problems that arise when providing pharmacy services may contain some ethical components and the aims of this study were to develop and validate a scale that could assess difficulties of ethical issues, as well as the frequency of those occurrences in everyday practice of community pharmacists. Development and validation of the scale was conducted in three phases: (1) generating items for the initial survey instrument after qualitative analysis; (2) defining the design and format of the instrument; (3) validation of the instrument. The constructed Ethical Issue scale for community pharmacy setting has two parts containing the same 16 items for assessing the difficulty and frequency thereof. The results of the 171 completely filled out scales were analyzed (response rate 74.89%). The Cronbach's α value of the part of the instrument that examines difficulties of the ethical situations was 0.83 and for the part of the instrument that examined frequency of the ethical situations was 0.84. Test-retest reliability for both parts of the instrument was satisfactory with all Interclass correlation coefficient (ICC) values above 0.6, (for the part that examines severity ICC = 0.809, for the part that examines frequency ICC = 0.929). The 16-item scale, as a self assessment tool, demonstrated a high degree of content, criterion, and construct validity and test-retest reliability. The results support its use as a research tool to asses difficulty and frequency of ethical issues in community pharmacy setting. The validated scale needs to be further employed on a larger sample of pharmacists.

Ethics of palliative care in late-stage cancer management and end-of-life issues in a depressed economy.

PubMed

Chukwuneke, F N

2015-12-01

The Hippocratic Oath has often been referred to as the ethical foundation of medical practice with the key restriction "cause no harm" which is also the principle of benevolence in bioethics. In medical profession, the Oath still exemplifies the key virtues of a doctor in its emphasis on the obligations toward the well-being of the individual patient. In management of end-stage cancer in a depressed economy such as Nigeria, we frequently encounter a wide range of ethical issues that arise in the provision of palliative care mostly due to the prevailing economic situation and cultural setting. Since most of these patients came from a lower economic class of the society, with little or no formal education and lived at a subsistence level, they often find it difficult to provide the medications needed. In a poor setting where health inequity is rife, and ignorance and poverty are commonplace, a good understanding of medical ethics with a good model of health care system will contribute to the health professional's decision-making that will be in the best interest of the patients. Physicians must protect the lives of their patients and should never hasten their death. In end-stage cancer management, we have to relieve suffering and pains, promote palliative care, and give psychological support but never abandoning the patient or initiate terminating their life. This presentation is a clinical analysis of the ethical issues regarding the management of end-stage cancer patients in a poor economy with a critical overview of end-of-life issues in African perspective.

The Australasian Resuscitation in Sepsis Evaluation (ARISE) trial statistical analysis plan.

PubMed

Delaney, Anthony P; Peake, Sandra L; Bellomo, Rinaldo; Cameron, Peter; Holdgate, Anna; Howe, Belinda; Higgins, Alisa; Presneill, Jeffrey; Webb, Steve

2013-09-01

The Australasian Resuscitation in Sepsis Evaluation (ARISE) study is an international, multicentre, randomised, controlled trial designed to evaluate the effectiveness of early goal-directed therapy compared with standard care for patients presenting to the emergency department with severe sepsis. In keeping with current practice, and considering aspects of trial design and reporting specific to non-pharmacological interventions, our plan outlines the principles and methods for analysing and reporting the trial results. The document is prepared before completion of recruitment into the ARISE study, without knowledge of the results of the interim analysis conducted by the data safety and monitoring committee and before completion of the two related international studies. Our statistical analysis plan was designed by the ARISE chief investigators, and reviewed and approved by the ARISE steering committee. We reviewed the data collected by the research team as specified in the study protocol and detailed in the study case report form. We describe information related to baseline characteristics, characteristics of delivery of the trial interventions, details of resuscitation, other related therapies and other relevant data with appropriate comparisons between groups. We define the primary, secondary and tertiary outcomes for the study, with description of the planned statistical analyses. We have developed a statistical analysis plan with a trial profile, mock-up tables and figures. We describe a plan for presenting baseline characteristics, microbiological and antibiotic therapy, details of the interventions, processes of care and concomitant therapies and adverse events. We describe the primary, secondary and tertiary outcomes with identification of subgroups to be analysed. We have developed a statistical analysis plan for the ARISE study, available in the public domain, before the completion of recruitment into the study. This will minimise analytical bias and conforms to current best practice in conducting clinical trials.

Does the Discussion of Socio-Scientific Issues require a Paradigm Shift in Science Teachers' Thinking?

NASA Astrophysics Data System (ADS)

Day, Stephen P.; Bryce, Tom G. K.

2011-08-01

The purpose of this study was to characterise secondary school science teachers' conceptual models of discussion, against the background that a number of researchers have found that discussion of socio-scientific issues in science classrooms is rare, somewhat discomforting for teachers and its purpose unclear. Recent research indicates that when science teachers do engage in socio-scientific discussion, the quality is poor and is teacher-centred where pupils' views do not figure prominently (far less be clarified and integrated with their scientific learning). This has led to calls for such dialogue to be conducted by humanities teachers. The question arising from such thinking is: Do science teachers hold different conceptual models of discussion from their humanities colleagues? Using semi-structured interviews, three groups each of six teachers (experienced science teachers, experienced humanities teachers, and newly qualified science teachers) were interviewed in-depth in order to characterise their conceptual understanding of discussion as a teaching strategy. Analysis of the interview transcripts utilised the constant comparison approach of grounded theory. Five conceptual models of discussion emerged from an analysis of the data-discussion: (1) as a teacher-mediated discourse; (2) as open-ended inquiry; (3) for the development of reasoning skills; (4) as mediated transfer of knowledge to real-life contexts; and (5) as practice for democratic citizenship. The results confirmed that the science teachers' emphasis tended to stress practice for democratic citizenship whereas the humanities teachers' emphasis was more towards open-ended inquiry and for the development of reasoning skills.

Towards a sociology of knowledge translation: the importance of being dis-interested in knowledge translation.

PubMed

Kitto, Simon C; Sargeant, Joan; Reeves, Scott; Silver, Ivan

2012-05-01

Over the last 15 years there has been an increasingly energetic search for theories and definitions in the burgeoning area of knowledge translation (KT) in the health care context. The focus has been on the design and evaluation of KT activities with little attention to developing a considered KT theoretical/methodological approach that takes a more distanced critical inquiry to the studying of KT interventions. As such, what has been overlooked in the health professions KT literature to date is a suitably complex conceptualisation of translation that encompasses the multiplicity of KT interventions, the dynamic environments in which they are occurring, and the production of new knowledge which arises from their interactions. Attending to these epistemological issues; i.e. issues of the type of knowledge and how it is produced, is crucial to developing a relational understanding of the production and emergence of context-specific clinical knowledge and practice in KT processes. Such an approach is compared to the traditional KT evaluations by KT practitioners themselves of the compliance or non-compliance of individual and organisational behaviour change. A Sociology of KT (SKT) is proposed to complement the applied and evaluative research practice of implementing planned action KT activities. The purpose of a SKT basic research agenda is to understand both the context-specific nature of KT interventions and the epistemological premises of the activities of KT implementers themselves, in order to advance the science of KT and inform, complement and add to the success of applied and evaluative KT research in the future.

Psychiatrists' relationships with industry: the principal-agent problem.

PubMed

Appelbaum, Paul S; Gold, Azgad

2010-01-01

Psychiatrists' relationships with the pharmaceutical and device industries have been a growing focus of attention, with questions raised about the impact of those relationships on prescribing practices, diagnostic criteria, practice guidelines, continuing education, conduct and reporting of research, and patients' and public trust. Indeed, these concerns exist for the medical profession as a whole, with various remedial measures proposed. We suggest that such relationships can be understood as giving rise to a "principal-agent problem," which occurs when an agent (here, a physician) is engaged to advance the interests of another party, the principal (typically a patient), but also faces incentives to promote other interests. Studies suggest that at least some relationships--which include attending industry-sponsored presentations, meeting with marketing representatives, and accepting samples--can alter psychiatrists' and other physicians' behavior in ways that can compromise patients' interests, and that industry-funded research may create bias in the medical literature. These effects are difficult to detect in specific cases, however, because of asymmetries of information and may not be apparent even to physicians themselves. Principal-agent analysis suggests that the possible responses to such problems, including appeals to ethical principles, monitoring behavior, and managing risk-inducing situations, should include consideration of aligning agents' incentives with principals' interests. This type of analysis underscores the similarity of the issues raised by physicians' relationships with industry to problems that arise more generally in society, thus reducing physicians' potential affective responses to these issues and efforts to address them. Finally, such analysis directs attention to the benefits and costs of each alternative, thereby encouraging reliance on evidence as a basis for policy.

Ethical issues concerning New Zealand sports doctors

PubMed Central

Anderson, L; Gerrard, D

2005-01-01

Success in sport can provide a source of national pride for a society, and vast financial and personal rewards for an individual athlete. It is therefore not surprising that many athletes will go to great lengths in pursuit of success. The provision of healthcare for elite sports people has the potential to create many ethical issues for sports doctors; however there has been little discussion of them to date. This study highlights these issues. Respondents to a questionnaire identified many ethical matters, common to other areas of medicine. However they also raised problems unique to sports medicine. Some of these ethical difficulties arise out of the place of the sports doctor within the hierarchy of sport. Yet others arise out of the special relationship between sports doctors and individual players/athletes. This study raises some important questions regarding the governance of healthcare in sport, and what support and guidance is available to sports doctors. As medical and scientific intervention in sport escalates, there is a risk that demands for enhanced performance may compromise the health of the athlete, and the role the sports doctor plays remains a critical question. PMID:15681672

Launching the Greek forensic DNA database. The legal framework and arising ethical issues.

PubMed

Voultsos, Polychronis; Njau, Samuel; Tairis, Nikolaos; Psaroulis, Dimitrios; Kovatsi, Leda

2011-11-01

Since the creation of the first national DNA database in Europe in 1995, many European countries have legislated laws for initiating and regulating their own databases. The Greek government legislated a law in 2008, by which the National DNA Database of Greece was founded and regulated. According to this law, only DNA profiles from convicted criminals were recorded. Nevertheless, a year later, in 2009, the law was amended to permit the creation of an expanded database including innocent people and children. Unfortunately, the new law is very vague in many aspects and does not respect the principle of proportionality. Therefore, according to our opinion, it will soon need to be re-amended. Furthermore, prior to legislating the new law, there was no debate with the community itself in order to clarify what system would best suit Greece and what the citizens would be willing to accept. We present the current legal framework in Greece, we highlight issues that need to be clarified and we discuss possible ethical issues that may arise. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Interim Enforcement Program Response Guidance to Public Data Access Issues

EPA Pesticide Factsheets

Written to assist EPA and states when the ECHO web site was launched, this document provides guidance on questions that can arise when compliance and enforcement data are made available to the public.

Some Ethical-Moral Concerns in Administration.

ERIC Educational Resources Information Center

Enns, Frederick

1981-01-01

Presents and analyzes moral-ethical issues that arise in administration and concludes that past descriptive, objective, and scientific approaches to administration have failed to take full account of the moral-ethical dimension of human existence. (Author/WD)

Understanding Business Models in Pharmacy Schools

PubMed Central

Holdford, David A.

2017-01-01

The objectives of this article are to define business models, contrast the business models in pharmacy schools, and discuss issues that can arise from misunderstandings about whom pharmacy schools serve and how they do so. PMID:28720910

Institutionalizing Equitable Policies and Practices for Contingent Faculty

ERIC Educational Resources Information Center

Kezar, Adrianna; Sam, Cecile

2013-01-01

This study is a qualitative inquiry into the institutionalization of equitable policies for non-tenure-track faculty. Through the theoretical framework of institutionalization, we examine factors and strategies forwarding various policies and practices and the challenges that arise. The results highlight themes throughout the stages of…

Reconciling Flexible Staffing Models with Inclusive Governance and Management

ERIC Educational Resources Information Center

Whitchurch, Celia; Gordon, George

2013-01-01

Higher education managers are under increasing pressure from governments to reduce costs by adopting more flexible staffing practices and tensions can arise as institutions seek to sustain motivation and morale across a diversifying workforce. This paper considers how institutional management and governance practices facilitate innovative…

Two Routes to Expertise in Mental Rotation

ERIC Educational Resources Information Center

Provost, Alexander; Johnson, Blake; Karayanidis, Frini; Brown, Scott D.; Heathcote, Andrew

2013-01-01

The ability to imagine objects undergoing rotation (mental rotation) improves markedly with practice, but an explanation of this plasticity remains controversial. Some researchers propose that practice speeds up the rate of a general-purpose rotation algorithm. Others maintain that performance improvements arise through the adoption of a new…

Medical tourism in plastic surgery: ethical guidelines and practice standards for perioperative care.

PubMed

Iorio, Matthew L; Verma, Kapil; Ashktorab, Samaneh; Davison, Steven P

2014-06-01

The goal of this review was to identify the safety and medical care issues that surround the management of patients who had previously undergone medical care through tourism medicine. Medical tourism in plastic surgery occurs via three main referral patterns: macrotourism, in which a patient receives treatments abroad; microtourism, in which a patient undergoes a procedure by a distant plastic surgeon but requires postoperative and/or long-term management by a local plastic surgeon; and specialty tourism, in which a patient receives plastic surgery from a non-plastic surgeon. The ethical practice guidelines of the American Medical Association, International Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and American Board of Plastic Surgeons were reviewed with respect to patient care and the practice of medical tourism. Safe and responsible care should start prior to surgery, with communication and postoperative planning between the treating physician and the accepting physician. Complications can arise at any time; however, it is the duty and ethical responsibility of plastic surgeons to prevent unnecessary complications following tourism medicine by adequately counseling patients, defining perioperative treatment protocols, and reporting complications to regional and specialty-specific governing bodies. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Auto-driven Photo Elicitation Interviews in Research with Children: Ethical and Practical Considerations.

PubMed

Ford, Karen; Bray, Lucy; Water, Tineke; Dickinson, Annette; Arnott, Janine; Carter, Bernie

2017-06-01

Children can sometimes find it difficult to articulate their experiences if they have to rely solely on words. Giving children the opportunity to use arts-based research approaches can support their participation in research and create a bridge that enables them to express their perspectives and feelings. This paper focuses on the ethical and practical considerations when using photo elicitation interviews (PEI) in research with children. The discussion and examples provided are drawn from an international study that used auto-driven PEI, where photographs are taken by children themselves, to explore children's experiences of living with a chronic condition and the impact condition management may have on their everyday lives. In this paper we critically explore the issues arising from our use of PEI including children's participation and engagement, balancing power and control, and keeping children safe. The main areas of focus for the paper are how PEI provided a means of shifting control; how setting photographic boundaries influenced our PEI study with children; and how we addressed risks associated with the method. Our experience shows that PEI is an engaging and valuable research method, providing a powerful medium for obtaining rich data with children. However, PEI is challenging and it requires researchers to conscientiously address ethical and practical aspects that extend beyond those inherent to standard (words-alone) interviews.

Barriers and facilitators related to implementation of regulated midwifery in Manitoba: a case study.

PubMed

Thiessen, Kellie; Heaman, Maureen; Mignone, Javier; Martens, Patricia; Robinson, Kristine

2016-03-15

In 2000, midwifery was regulated in the Canadian Province of Manitoba. Since the establishment of the midwifery program, little formal research has analyzed the utilization of regulated midwifery services. In Manitoba, the demand for midwifery services has exceeded the number of midwives in practice. The specific objective of this study was to explore factors influencing the implementation and utilization of regulated midwifery services in Manitoba. The case study design incorporated qualitative exploratory descriptive methods, using data derived from two sources: interviews and public documents. Twenty-four key informants were purposefully selected to participate in semi-structured in-depth interviews. All documents analyzed were in the public domain. Content analysis was employed to analyze the documents and transcripts of the interviews. The results of the study were informed by the Behavioral Model of Health Services Use. Three main topic areas were explored: facilitators, barriers, and future strategies and recommendations. The most common themes arising under facilitators were funding of midwifery services and strategies to integrate the profession. Power and conflict, and lack of a productive education program emerged as the most prominent themes under barriers. Finally, future strategies for sustaining the midwifery profession focused on ensuring avenues for registration and education, improving management strategies and accountability frameworks within the employment model, enhancing the work environment, and evaluating both the practice and employment models. Results of the document analysis supported the themes arising from the interviews. These findings on factors that influenced the implementation and integration of midwifery in Manitoba may provide useful information to key stakeholders in Manitoba, as well as other provinces as they work toward successful implementation of regulated midwifery practice. Funding for new positions and programs was consistently noted as a successful strategy. While barriers such as structures of power within Regional Health Authorities and inter and intra-professional conflict were identified, the lack of a productive midwifery education program emerged as the most prominent barrier. This new knowledge highlights issues that impact the ongoing growth and capacity of the midwifery profession and suggests directions for ensuring its sustainability.

Responding to Terrorism: Challenges for Democracy. Teacher's Resource Book [and Student Text]. Public Policy Debate in the Classroom. Choices for the 21st Century Education Program.

ERIC Educational Resources Information Center

Blackadar, Andy

This curriculum material, part of a continuing series on current and historical international issues, addresses the issues arising from the September 11, 2001, attacks on the World Trade Center and the Pentagon. On the morning of September 11, 2001, as people watched in horror, terrorist attacks were successfully launched against the United…