WorldWideScience

Sample records for high deliberate-practice volume

  1. Cultivating Mathematical Skills: From Drill-and-Practice to Deliberate Practice

    Science.gov (United States)

    Lehtinen, Erno; Hannula-Sormunen, Minna; McMullen, Jake; Gruber, Hans

    2017-01-01

    Contemporary theories of expertise development highlight the crucial role of deliberate practice in the development of high level performance. Deliberate practice is practice that intentionally aims at improving one's skills and competencies. It is not a mechanical or repetitive process of making performance more fluid. Instead, it involves a…

  2. Curricular Deliberation about "Hamlet": An Exercise in the Practical.

    Science.gov (United States)

    Siegel, Judith Susan

    This study attempts to clarify and exploit Joseph Schwab's recent and current work on "practical" and "eclectic" curriculums in a simulated deliberation about a concrete curricular question, How might "Hamlet" be taught to one group of high school juniors? By exemplifying curricular deliberation, it aims to clarify…

  3. The Effect Specialization and Diversification Involvement on Learning of Sports Skills According To Deliberate Practice and Deliberate Play

    Directory of Open Access Journals (Sweden)

    Mahdi Fahimi

    2016-12-01

    Full Text Available Objective: The aim was effect deliberate practice and deliberate play on sports skills with emphasis on specialization and diversification in boys 10-12. Methods: The 120 male students randomly divided into four groups of volleyball, soccer, basketball deliberate practice and deliberate play. Pretest and posttest were AAHPERD volleyball, soccer, and Basketball sports skills. Duration of the project was 16 weeks and 3 sessions per week and 90 minutes each session began. Data obtained from questionnaires and personal details about sports experience and test were adjusted using parametric tests, such as T-dependent test and MANOVA with Tukey post hoc test, and software Statistical SPSS19. Results: The results of the study showed that compared four groups, deliberate plays to other deliberate practices have a better motor skill in volleyball, soccer and Basketball sports skills (P<0.05. Volleyball and soccer deliberate practice group had developed Soccer Dribble Test and Control dribble and Defensive movement basketball skills test. Basketball deliberate practice group had not developed the others soccer and volleyball skills. Conclusion: The results showed that diversification participation in some exercises during the early stages of growth, can facilitate the development of general cognitive and physiological skills and create a rich environment for children.

  4. The effects of deliberate practice in undergraduate medical education

    NARCIS (Netherlands)

    Moulaert, Véronique; Verwijnen, Maarten GM; Rikers, Remy; Scherpbier, Albert JJA

    2004-01-01

    INTRODUCTION: Ericsson and colleagues introduced the term 'deliberate practice' to describe training activities that are especially designed to maximise improvement. They stressed that how much one practises is as important as how one practises. Essential aspects of deliberate practice are the

  5. The role of deliberate practice in the acquisition of clinical skills

    Directory of Open Access Journals (Sweden)

    Duvivier Robbert J

    2011-12-01

    Full Text Available Abstract Background The role of deliberate practice in medical students' development from novice to expert was examined for preclinical skill training. Methods Students in years 1-3 completed 34 Likert type items, adapted from a questionnaire about the use of deliberate practice in cognitive learning. Exploratory factor analysis and reliability analysis were used to validate the questionnaire. Analysis of variance examined differences between years and regression analysis the relationship between deliberate practice and skill test results. Results 875 students participated (90%. Factor analysis yielded four factors: planning, concentration/dedication, repetition/revision, study style/self reflection. Student scores on 'Planning' increased over time, score on sub-scale 'repetition/revision' decreased. Student results on the clinical skill test correlated positively with scores on subscales 'planning' and 'concentration/dedication' in years 1 and 3, and with scores on subscale 'repetition/revision' in year 1. Conclusions The positive effects on test results suggest that the role of deliberate practice in medical education merits further study. The cross-sectional design is a limitation, the large representative sample a strength of the study. The vanishing effect of repetition/revision may be attributable to inadequate feedback. Deliberate practice advocates sustained practice to address weaknesses, identified by (self-assessment and stimulated by feedback. Further studies should use a longitudinal prospective design and extend the scope to expertise development during residency and beyond.

  6. The influence of deliberate practice on musical achievement: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Friedrich ePlatz

    2014-06-01

    Full Text Available Deliberate practice (DP is a task-specific structured training activity that plays a key role in understanding skill acquisition and explaining individual differences in expert performance. Relevant activities that qualify as DP have to be identified in every domain. For example, for training in classical music, solitary practice is a typical training activity during skill acquisition. To date, no meta-analysis on the quantifiable effect size of deliberate practice on attained performance in music has been conducted. Yet the identification of a quantifiable effect size could be relevant for the current discussion on the role of various factors on individual difference in musical achievement. Furthermore, a research synthesis might enable new computational approaches to musical development. Here we present the first meta-analysis on the role of deliberate practice in the domain of musical performance. A final sample size of 13 studies (total N = 788 was carefully extracted to satisfy the following criteria: reported durations of task-specific accumulated practice as predictor variables and objectively assessed musical achievement as the target variable. We identified an aggregated effect size of rc = .61; 95% CI [.54, .67] for the relationship between task-relevant practice (which by definition includes DP and musical achievement. Our results corroborate the central role of long-term (deliberate practice for explaining expert performance in music.

  7. The influence of deliberate practice on musical achievement: a meta-analysis.

    Science.gov (United States)

    Platz, Friedrich; Kopiez, Reinhard; Lehmann, Andreas C; Wolf, Anna

    2014-01-01

    Deliberate practice (DP) is a task-specific structured training activity that plays a key role in understanding skill acquisition and explaining individual differences in expert performance. Relevant activities that qualify as DP have to be identified in every domain. For example, for training in classical music, solitary practice is a typical training activity during skill acquisition. To date, no meta-analysis on the quantifiable effect size of deliberate practice on attained performance in music has been conducted. Yet the identification of a quantifiable effect size could be relevant for the current discussion on the role of various factors on individual difference in musical achievement. Furthermore, a research synthesis might enable new computational approaches to musical development. Here we present the first meta-analysis on the role of deliberate practice in the domain of musical performance. A final sample size of 13 studies (total N = 788) was carefully extracted to satisfy the following criteria: reported durations of task-specific accumulated practice as predictor variables and objectively assessed musical achievement as the target variable. We identified an aggregated effect size of r c = 0.61; 95% CI [0.54, 0.67] for the relationship between task-relevant practice (which by definition includes DP) and musical achievement. Our results corroborate the central role of long-term (deliberate) practice for explaining expert performance in music.

  8. Deliberate practice is necessary but not sufficient to explain individual differences in piano sight-reading skill: the role of working memory capacity.

    Science.gov (United States)

    Meinz, Elizabeth J; Hambrick, David Z

    2010-07-01

    Deliberate practice-that is, engagement in activities specifically designed to improve performance in a domain-is strongly predictive of performance in domains such as music and sports. It has even been suggested that deliberate practice is sufficient to account for expert performance. Less clear is whether basic abilities, such as working memory capacity (WMC), add to the prediction of expert performance, above and beyond deliberate practice. In evaluating participants having a wide range of piano-playing skill (novice to expert), we found that deliberate practice accounted for nearly half of the total variance in piano sight-reading performance. However, there was an incremental positive effect of WMC, and there was no evidence that deliberate practice reduced this effect. Evidence indicates that WMC is highly general, stable, and heritable, and thus our results call into question the view that expert performance is solely a reflection of deliberate practice.

  9. Research opportunities in simulation-based medical education using deliberate practice.

    Science.gov (United States)

    McGaghie, William C

    2008-11-01

    There are many opportunities for the academic emergency medicine (EM) community to engage in simulation-based educational research using deliberate practice (DP). This article begins by defining and giving examples of two key concepts: deliberate practice and mastery learning. The article proceeds to report six lessons learned from a research legacy in simulation-based medical education (SBME). It concludes by listing and amplifying 10 DP research opportunities in academic EM. A coda states that the research agenda is rich and ambitious and should focus on the goal of educating superb, expert clinicians.

  10. Deliberate practice theory: relevance, effort, and inherent enjoyment of music practice.

    Science.gov (United States)

    Hyllegard, Randy; Bories, Tamara L

    2008-10-01

    This study examined three assumptions of the theory of deliberate practice for practice playing music on an electronic keyboard. 40 undergraduate students, divided into two separate groups, practiced one of two music sequences and rated the relevance of practice for improving performance on the sequences, the amount of effort needed to learn the sequences, and the inherent enjoyment of practice sessions. Findings for each assumption were consistent with those suggested by theory but also showed that perceptions are affected by the amount of practice completed and performance of the skill.

  11. Deliberate practice and performance in music, games, sports, education, and professions: a meta-analysis.

    Science.gov (United States)

    Macnamara, Brooke N; Hambrick, David Z; Oswald, Frederick L

    2014-08-01

    More than 20 years ago, researchers proposed that individual differences in performance in such domains as music, sports, and games largely reflect individual differences in amount of deliberate practice, which was defined as engagement in structured activities created specifically to improve performance in a domain. This view is a frequent topic of popular-science writing-but is it supported by empirical evidence? To answer this question, we conducted a meta-analysis covering all major domains in which deliberate practice has been investigated. We found that deliberate practice explained 26% of the variance in performance for games, 21% for music, 18% for sports, 4% for education, and less than 1% for professions. We conclude that deliberate practice is important, but not as important as has been argued. © The Author(s) 2014.

  12. Deliberate practice predicts performance over time in adolescent chess players and drop-outs: a linear mixed models analysis.

    Science.gov (United States)

    de Bruin, Anique B H; Smits, Niels; Rikers, Remy M J P; Schmidt, Henk G

    2008-11-01

    In this study, the longitudinal relation between deliberate practice and performance in chess was examined using a linear mixed models analysis. The practice activities and performance ratings of young elite chess players, who were either in, or had dropped out of the Dutch national chess training, were analysed since they had started playing chess seriously. The results revealed that deliberate practice (i.e. serious chess study alone and serious chess play) strongly contributed to chess performance. The influence of deliberate practice was not only observable in current performance, but also over chess players' careers. Moreover, although the drop-outs' chess ratings developed more slowly over time, both the persistent and drop-out chess players benefited to the same extent from investments in deliberate practice. Finally, the effect of gender on chess performance proved to be much smaller than the effect of deliberate practice. This study provides longitudinal support for the monotonic benefits assumption of deliberate practice, by showing that over chess players' careers, deliberate practice has a significant effect on performance, and to the same extent for chess players of different ultimate performance levels. The results of this study are not in line with critique raised against the deliberate practice theory that the factors deliberate practice and talent could be confounded.

  13. Doctor coach: a deliberate practice approach to teaching and learning clinical skills.

    Science.gov (United States)

    Gifford, Kimberly A; Fall, Leslie H

    2014-02-01

    The rapidly evolving medical education landscape requires restructuring the approach to teaching and learning across the continuum of medical education. The deliberate practice strategies used to coach learners in disciplines beyond medicine can also be used to train medical learners. However, these deliberate practice strategies are not explicitly taught in most medical schools or residencies. The authors designed the Doctor Coach framework and competencies in 2007-2008 to serve as the foundation for new faculty development and resident-as-teacher programs. In addition to teaching deliberate practice strategies, the programs model a deliberate practice approach that promotes the continuous integration of newly developed coaching competencies by participants into their daily teaching practice. Early evaluation demonstrated the feasibility and efficacy of implementing the Doctor Coach framework across the continuum of medical education. Additionally, the Doctor Coach framework has been disseminated through national workshops, which have resulted in additional institutions applying the framework and competencies to develop their own coaching programs. Design of a multisource evaluation tool based on the coaching competencies will enable more rigorous study of the Doctor Coach framework and training programs and provide a richer feedback mechanism for participants. The framework will also facilitate the faculty development needed to implement the milestones and entrustable professional activities in medical education.

  14. Voluntarism and transparent deliberation

    DEFF Research Database (Denmark)

    Steglich-Petersen, Asbjørn

    2006-01-01

    It is widely assumed that doxastic deliberation is transparent to the factual question of the truth of the proposition being considered for belief, and that this sets doxastic deliberation apart from practical deliberation. This feature is frequently invoked in arguments against doxastic voluntar......It is widely assumed that doxastic deliberation is transparent to the factual question of the truth of the proposition being considered for belief, and that this sets doxastic deliberation apart from practical deliberation. This feature is frequently invoked in arguments against doxastic...

  15. A Deliberate Practice Instructional Approach for Upper Division Physics Courses

    Science.gov (United States)

    Jones, David

    2015-05-01

    In upper division physics courses, an overarching educational goal is to have students think about and use the material much as a practicing physicist in the field does. Specifically, this would include knowledge (such as concepts, formalism, and instruments), approaches, and metacognitive skills that physicists use in solving ``typical'' (research context) problems to both understand and predict physical observations and accompanying models. Using an interactive instructional approach known as deliberate practice (described earlier in this session) we will discuss our work on how to provide students with the necessary practice and feedback to achieve these skills in a core DAMOP course of modern optics. We present the results of a direct and explicit comparison between this approach and traditional lecture-based instruction revealing evidence that a significant improvement of the students' mastery of these skills occurs when deliberate practice is employed. Our work was supported by the University of British Columbia through the CWSEI.

  16. Simulation-Based Mastery Learning with Deliberate Practice Improves Clinical Performance in Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Ankeet D. Udani

    2014-01-01

    Full Text Available Introduction. Properly performing a subarachnoid block (SAB is a competency expected of anesthesiology residents. We aimed to determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21 anesthesia residents were enrolled. After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum. Residents were then randomized so that half received additional deliberate practice including repetition and expert-guided, real-time feedback. All residents were then retested for technique. SABs on all residents’ next three patients were evaluated in the operating room (OR. Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance checklist on the task-trainer and this increased to 91% after finishing the base curriculum (P<0.02. The intervention group also increased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed in the control group (P<0.03. The OR time required to perform SAB was not different between groups. Conclusions. The base curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent, incremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear.

  17. Simulation-based mastery learning with deliberate practice improves clinical performance in spinal anesthesia.

    Science.gov (United States)

    Udani, Ankeet D; Macario, Alex; Nandagopal, Kiruthiga; Tanaka, Maria A; Tanaka, Pedro P

    2014-01-01

    Introduction. Properly performing a subarachnoid block (SAB) is a competency expected of anesthesiology residents. We aimed to determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21 anesthesia residents were enrolled. After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum. Residents were then randomized so that half received additional deliberate practice including repetition and expert-guided, real-time feedback. All residents were then retested for technique. SABs on all residents' next three patients were evaluated in the operating room (OR). Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance checklist on the task-trainer and this increased to 91% after finishing the base curriculum (P < 0.02). The intervention group also increased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed in the control group (P < 0.03). The OR time required to perform SAB was not different between groups. Conclusions. The base curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent, incremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear.

  18. The role of emotions in moral case deliberation: theory, practice, and methodology.

    Science.gov (United States)

    Molewijk, Bert; Kleinlugtenbelt, Dick; Widdershoven, Guy

    2011-09-01

    In clinical moral decision making, emotions often play an important role. However, many clinical ethicists are ignorant, suspicious or even critical of the role of emotions in making moral decisions and in reflecting on them. This raises practical and theoretical questions about the understanding and use of emotions in clinical ethics support services. This paper presents an Aristotelian view on emotions and describes its application in the practice of moral case deliberation. According to Aristotle, emotions are an original and integral part of (virtue) ethics. Emotions are an inherent part of our moral reasoning and being, and therefore they should be an inherent part of any moral deliberation. Based on Aristotle's view, we examine five specific aspects of emotions: the description of emotions, the attitude towards emotions, the thoughts present in emotions, the reliability of emotions, and the reasonable principle that guides an emotion. We then discuss three ways of dealing with emotions in the process of moral case deliberation. Finally, we present an Aristotelian conversation method, and present practical experiences using this method. © 2011 Blackwell Publishing Ltd.

  19. Deliberate practice theory: perceived relevance, effort, and inherent enjoyment of music practice: study II.

    Science.gov (United States)

    Hyllegard, Randy; Bories, Tamara L

    2009-10-01

    This study, based on the theory of deliberate practice, examined the practice relevance, effort, and inherent enjoyment aspects of the theory. 25 college undergraduates practiced playing a melody on an electronic keyboard for three 20-min. practice sessions. Following each session, the perceived relevance of the practice for improving performance of the melody, the effort needed to learn the melody, and the inherent enjoyment of the practice were each rated on 10-point scales. Findings were consistent with theory and similar to previous studies also involving music practice and other tasks.

  20. Deliberation at the hub of medical education: beyond virtue ethics and codes of practice.

    Science.gov (United States)

    Barilan, Y M; Brusa, M

    2013-02-01

    Although both codes of practice and virtue ethics are integral to the ethos and history of "medical professionalism", the two trends appear mutually incompatible. Hence, in the first part of the paper we explore and explicate this apparent conflict and seek a direction for medical education. The theoretical and empirical literature indicates that moral deliberation may transcend the incompatibilities between the formal and the virtuous, may enhance moral and other aspects of personal sensitivity, may help design and improve other parts of the curricula, and may foster self-awareness and clarification of the professional role. Not only are these goals essential for good and conscientious doctoring, but they may also reduce physicians' "burn-out". We argue that medical education should focus on the ubiquitous practice of deliberation in contemporary medicine, and especially the practice of moral deliberation.

  1. You can’t teach speed: sprinters falsify the deliberate practice model of expertise

    Directory of Open Access Journals (Sweden)

    Michael P. Lombardo

    2014-06-01

    Full Text Available Many scientists agree that expertise requires both innate talent and proper training. Nevertheless, the highly influential deliberate practice model (DPM of expertise holds that talent does not exist or makes a negligible contribution to performance. It predicts that initial performance will be unrelated to achieving expertise and that 10 years of deliberate practice is necessary. We tested these predictions in the domain of sprinting. In Studies 1 and 2 we reviewed biographies of 15 Olympic champions and the 20 fastest American men in U.S. history. In all documented cases, sprinters were exceptional prior to initiating training, and most reached world class status rapidly (Study 1 median = 3 years; Study 2 = 7.5. In Study 3 we surveyed U.S. national collegiate championships qualifiers in sprinters (n = 20 and throwers (n = 44. Sprinters recalled being faster as youths than did throwers, whereas throwers recalled greater strength and throwing ability. Sprinters’ best performances in their first season of high school, generally the onset of formal training, were consistently faster than 95–99% of their peers. Collectively, these results falsify the DPM for sprinting. Because speed is foundational for many sports, they challenge the DPM generally.

  2. Voluntarism and transparent deliberation

    DEFF Research Database (Denmark)

    Steglich-Petersen, Asbjørn

    2006-01-01

    voluntarism. I argue that transparency to factual questions occurs in practical deliberation in ways parallel to transparency in doxastic deliberation. I argue that this should make us reconsider the appeal to transparency in arguments against doxastic voluntarism, and the wider issue of distinguishing...... theoretical from practical rationality....

  3. Comparative-Effectiveness of Simulation-Based Deliberate Practice Versus Self-Guided Practice on Resident Anesthesiologists' Acquisition of Ultrasound-Guided Regional Anesthesia Skills.

    Science.gov (United States)

    Udani, Ankeet Deepak; Harrison, T Kyle; Mariano, Edward R; Derby, Ryan; Kan, Jack; Ganaway, Toni; Shum, Cynthia; Gaba, David M; Tanaka, Pedro; Kou, Alex; Howard, Steven K

    2016-01-01

    Simulation-based education strategies to teach regional anesthesia have been described, but their efficacy largely has been assumed. We designed this study to determine whether residents trained using the simulation-based strategy of deliberate practice show greater improvement of ultrasound-guided regional anesthesia (UGRA) skills than residents trained using self-guided practice in simulation. Anesthesiology residents new to UGRA were randomized to participate in either simulation-based deliberate practice (intervention) or self-guided practice (control). Participants were recorded and assessed while performing simulated peripheral nerve blocks at baseline, immediately after the experimental condition, and 3 months after enrollment. Subject performance was scored from video by 2 blinded reviewers using a composite tool. The amount of time each participant spent in deliberate or self-guided practice was recorded. Twenty-eight participants completed the study. Both groups showed within-group improvement from baseline scores immediately after the curriculum and 3 months following study enrollment. There was no difference between groups in changed composite scores immediately after the curriculum (P = 0.461) and 3 months following study enrollment (P = 0.927) from baseline. The average time in minutes that subjects spent in simulation practice was 6.8 minutes for the control group compared with 48.5 minutes for the intervention group (P < 0.001). In this comparative effectiveness study, there was no difference in acquisition and retention of skills in UGRA for novice residents taught by either simulation-based deliberate practice or self-guided practice. Both methods increased skill from baseline; however, self-guided practice required less time and faculty resources.

  4. The role of informal dimensions of safety in high-volume organisational routines: an ethnographic study of test results handling in UK general practice.

    Science.gov (United States)

    Grant, Suzanne; Checkland, Katherine; Bowie, Paul; Guthrie, Bruce

    2017-04-27

    improvement interventions should focus on how to maximise practice-level knowledge and understanding of the range of context-specific approaches available and the safeties and risks inherent in each within the context of wider complex system conditions and interactions. This in turn has the potential to inform new kinds of proactive, contextually appropriate approaches to intervention development and implementation focusing on the enhanced deliberation of the safety of existing high-volume routines.

  5. Aims and harvest of moral case deliberation.

    Science.gov (United States)

    Weidema, Froukje C; Molewijk, Bert A C; Kamsteeg, Frans; Widdershoven, Guy A M

    2013-09-01

    Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses' empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members.

  6. Bioethics education in clinical settings: theory and practice of the dilemma method of moral case deliberation.

    Science.gov (United States)

    Stolper, Margreet; Molewijk, Bert; Widdershoven, Guy

    2016-07-22

    Moral Case Deliberation is a specific form of bioethics education fostering professionals' moral competence in order to deal with their moral questions. So far, few studies focus in detail on Moral Case Deliberation methodologies and their didactic principles. The dilemma method is a structured and frequently used method in Moral Case Deliberation that stimulates methodological reflection and reasoning through a systematic dialogue on an ethical issue experienced in practice. In this paper we present a case-study of a Moral Case Deliberation with the dilemma method in a health care institution for people with an intellectual disability, describing the theoretical background and the practical application of the dilemma method. The dilemma method focuses on moral experiences of participants concerning a concrete dilemma in practice. By an in-depth description of each of the steps of the deliberation process, we elucidate the educational value and didactics of this specific method. The didactics and methodical steps of the dilemma method both supported and structured the dialogical reflection process of the participants. The process shows that the participants learned to recognize the moral dimension of the issue at stake and were able to distinguish various perspectives and reasons in a systematic manner. The facilitator played an important role in the learning process of the participants, by assisting them in focusing on and exploring moral aspects of the case. The reflection and learning process, experienced by the participants, shows competency-based characteristics. The role of the facilitator is that of a Socratic teacher with specific knowledge and skills, fostering reflection, inquiry and dialogue. The specific didactics of the dilemma method is well suited for teaching bioethics in clinical settings. The dilemma method follows an inductive learning approach through a dialogical moral inquiry in which participants develop not only knowledge but also skills

  7. Deliberate interventions in the availability and circulation of practice elements

    DEFF Research Database (Denmark)

    Quitzau, Maj-Britt; Hoffmann, Birgitte

    competences in relation to the heating system. Otherwise, the circulating ideas about comfort and the daily practices performed in the house remained unchanged. On the basis of these findings, we highlight how the considerations done by the urban government prior to the project and the negotiations undertaken...... of practices can help to inform policy makers in this regard, there is a need for more detailed insight into how such deliberate interventions are performed in practice and intersect with the availability and circulation of practice elements, among others. The aim of this paper is to explore the considerations...... area by setting up very strict requirements to the energy performance of the new buildings. Through qualitative interviews with the urban government, the building companies and the involved families, we have studied how this intervention hindered the circulation of certain practice elements, while...

  8. Cognitive Functions of the Cerebellum Explain How Ericsson's Deliberate Practice Produces Giftedness

    Science.gov (United States)

    Vandervert, Larry R.

    2007-01-01

    A critical issue for Ericsson et al.'s proposal is the development of a fully adequate description of neurophysiological substrates for deliberate practice. Ericsson et al. do provide two substantial subsections on biological substrates--namely, their subsections, "Acquisition of superior power, control, and speed of motor activities" and…

  9. Developing Emotionally Intelligent Leadership: The Need for Deliberate Practice and Collaboration across Disciplines

    Science.gov (United States)

    Allen, Scott J.; Shankman, Marcy Levy; Haber-Curran, Paige

    2016-01-01

    This chapter continues the discussion of what leadership education is and highlights the importance of emotionally intelligent leadership. The authors assert the need for deliberate practice and better collaboration between student affairs, academic affairs, and academic departments to develop emotionally intelligent leaders.

  10. [Moral case deliberation: time for ethical reflection in the daily practice of mental health care].

    Science.gov (United States)

    Vellinga, A; van Melle-Baaijens, E A H

    2016-01-01

    Nowadays, reflecting on ethics, which we choose to call moral case deliberation, is occurring more and more frequently in psychiatric institutions. We have personal experience of organising and supervising moral case deliberation in a large psychiatric institute and we can confirm the positive effects of moral case deliberation which have been reported in the literature. To describe a structured method for moral case deliberation which enables care-givers in health care and/or addiction care to reflect on moral dilemmas. We refer to the main findings in relevant literature and describe how we developed a structured method for implementing moral case deliberation. Our studies of the literature indicate that systematic reflection about ethical dilemmas can improve the quality of care and make care-givers more satisfied with their work. This is why we have developed our own method which is applicable particularly to psychiatric and/or addition care and which can be used systematically in discussions of moral dilemmas. Our method for discussing ethical issues works well in clinical practice, particularly when it is embedded in a multidisciplinary context. Of course, to ensure the continuity of the system, deliberation about moral and ethical issues needs to be financially safeguarded and embedded in the organisation. Discussion of moral issues improves the quality of care and increases care-givers' satisfaction with their work.

  11. Evaluation and perceived results of moral case deliberation: A mixed methods study.

    Science.gov (United States)

    Janssens, Rien M J P A; van Zadelhoff, Ezra; van Loo, Ger; Widdershoven, Guy A M; Molewijk, Bert A C

    2015-12-01

    Moral case deliberation is increasingly becoming part of various Dutch healthcare organizations. Although some evaluation studies of moral case deliberation have been carried out, research into the results of moral case deliberation within aged care is scarce. How did participants evaluate moral case deliberation? What has moral case deliberation brought to them? What has moral case deliberation contributed to care practice? Should moral case deliberation be further implemented and, if so, how? Quantitative analysis of a questionnaire study among participants of moral case deliberation, both caregivers and team leaders. Qualitative analysis of written answers to open questions, interview study and focus group meetings among caregivers and team leaders. Caregivers and team leaders in a large organization for aged care in the Netherlands. A total of 61 moral case deliberation sessions, carried out on 16 care locations belonging to the organization, were evaluated and perceived results were assessed. Participants gave informed consent and anonymity was guaranteed. In the Netherlands, the law does not prescribe independent ethical review by an Institutional Review Board for this kind of research among healthcare professionals. Moral case deliberation was evaluated positively by the participants. Content and atmosphere of moral case deliberation received high scores, while organizational issues regarding the moral case deliberation sessions scored lower and merit further attention. Respondents indicated that moral case deliberation has the potential to contribute to care practice as relationships among team members improve, more openness is experienced and more understanding for different perspectives is fostered. If moral case deliberation is to be successfully implemented, top-down approaches should go hand in hand with bottom-up approaches. The relevance of moral case deliberation for care practice received wide acknowledgement from the respondents. It can contribute

  12. Deliberate practice predicts performance throughout time in adolescent chess players and dropouts: A linear mixed models analysis.

    NARCIS (Netherlands)

    de Bruin, A.B.H.; Smits, N.; Rikers, R.M.J.P.; Schmidt, H.G.

    2008-01-01

    In this study, the longitudinal relation between deliberate practice and performance in chess was examined using a linear mixed models analysis. The practice activities and performance ratings of young elite chess players, who were either in, or had dropped out of the Dutch national chess training,

  13. Best Practices During Hip Arthroscopy: Aggregate Recommendations of High-Volume Surgeons.

    Science.gov (United States)

    Gupta, Asheesh; Suarez-Ahedo, Carlos; Redmond, John M; Gerhardt, Michael B; Hanypsiak, Bryan; Stake, Christine E; Finch, Nathan A; Domb, Benjamin G

    2015-09-01

    To survey surgeons who perform a high volume of hip arthroscopy procedures regarding their operative technique, type of procedure, and postoperative management. We conducted a cross-sectional survey of 27 high-volume orthopaedic surgeons specializing in hip arthroscopy to report their preferences and practices related to their operative practice and postoperative rehabilitation protocol. All participants completed the survey in person in an anonymous fashion during a meeting of the American Hip Institute. All surgeons perform hip arthroscopy with the patient in the supine position, accessing the central compartment of the hip initially, using intraoperative fluoroscopy. All surgeons perform labral repair (100%), with the majority performing labral reconstructions (77.8%) and gluteus medius repairs (81.5%). There is variability in the type of anchors used during labral repair. Most surgeons perform capsular closure in most cases (88.9%), inject either intra-articular cortisone or platelet-rich plasma at the conclusion of the procedure (59%), and prescribe a postoperative hip brace for some or all patients (59%). There is considerable variability in rehabilitation protocols. All surgeons routinely prescribe postoperative heterotopic ossification prophylaxis to their patients, with most surgeons (88.9%) prescribing a nonsteroidal anti-inflammatory medication for 3 weeks. Forty percent of the respondents use the modified Harris Hip Score as the most important outcome measure. Consistent practices such as use of intraoperative fluoroscopy, heterotopic ossification prophylaxis, and labral repair skills were identified by surveying 27 hip arthroscopy surgeons at high-volume centers. Most of the surgeons performed routine capsular closure unless underlying conditions precluded capsular release or plication. The survey identified higher variability between surgeons regarding postoperative rehabilitation protocols and use of intra-articular pharmacologic injections at the

  14. The effectiveness of the Geritalk communication skills course: a real-time assessment of skill acquisition and deliberate practice.

    Science.gov (United States)

    Gelfman, Laura P; Lindenberger, Elizabeth; Fernandez, Helen; Goldberg, Gabrielle R; Lim, Betty B; Litrivis, Evgenia; O'Neill, Lynn; Smith, Cardinale B; Kelley, Amy S

    2014-10-01

    Communication skills are critical in Geriatrics and Palliative Medicine because these patients confront complex clinical scenarios. We evaluated the effectiveness of the Geritalk communication skills course by comparing pre- and post-course real-time assessment of the participants leading family meetings. We also evaluated the participants' sustained skills practice. We compare the participants' skill acquisition before and after Geritalk using a direct observation Family Meeting Communication Assessment Tool and assess their deliberate practice at follow-up. First-year Geriatrics or Palliative Medicine fellows at Mount Sinai Medical Center and the James J. Peters Bronx VA Medical Center participated in Geritalk. Pre- and post-course family meeting assessments were compared. An average net gain of 6.8 skills represented a greater than 20% improvement in use of applicable skills. At two month follow-up, most participants reported deliberate practice of fundamental and advanced skills. This intensive training and family meeting assessment offers evidence-based communication skills training. Published by Elsevier Inc.

  15. Deliberate Practice in Medicine: The Motivation to Engage in Work-Related Learning and Its Contribution to Expertise

    Science.gov (United States)

    van de Wiel, Margje W. J.; Van den Bossche, Piet

    2013-01-01

    This study examined physicians' motivation to engage in work-related learning and its contribution to expertise development beyond work experience. Based on deliberate practice theory, semi-structured interviews were conducted with 17 residents and 28 experienced physicians in internal medicine, focusing on the activities they engaged in during…

  16. Aristotle on Deliberation:Its Place in Ethics, Politics and Rhetoric

    OpenAIRE

    Kock, Christian Erik J

    2014-01-01

    Aristotle differs from most later philosophers in distinguishing clearly between epistemic reasoning, which aims for truth, and practical reasoning, which does not. How can he posit this distinction and yet not dismiss practical reasoning as flattery and manipulation, as Plato did? The answer lies in the concepts of deliberation (boulē, bouleusis) and deliberate choice (proairesis). They link Aristotle's rhetoric, ethics, and politics together and help provide definitions of all three: Ethics...

  17. Procedures and Methods for Cross-community Online Deliberation

    Directory of Open Access Journals (Sweden)

    Cyril Velikanov

    2010-09-01

    Full Text Available In this paper we introduce our model of self-regulated mass online deliberation, and apply it to a context of cross-border deliberation involving translation of contributions between participating languages, and then to a context of cross-community online deliberation for dispute resolution, e.g. between opposing ethnic or religious communities. In such a cross-border or cross-community context, online deliberation should preferably progress as a sequence of segmented phases each followed by a combining phase. In a segmented phase, each community deliberates separately, and selects their best contributions for being presented to all other communities. Selection is made by using our proposed mechanism of mutual moderation and appraisal of contributions by participants themselves. In the subsequent combining phase, the selected contributions are translated (by volunteering or randomly selected participants among those who have specified appropriate language skills and presented to target segments for further appraisal and commenting. Our arguments in support of the proposed mutual moderation and appraisal procedures remain mostly speculative, as the whole subject of mass online self-regulatory deliberation still remains largely unexplored, and there exist no practical realisation of it .

  18. Deliberate Self Harm Behavior

    Directory of Open Access Journals (Sweden)

    Fatma Gul Helvaci Celik

    2017-06-01

    Full Text Available The deliberate self-harm behaviour which defined as attempting to own body resulting in tisue damage without conscious desire of peolple to die, is a major public health problem worldwide. The causes of deliberate self- harm, risk factors, the relationship between mental disorders and treatment strategies are not fully known. Deliberate self- harm can be observed together with psychiatric disorders such as borderline personality disorder, histrionic personality disorder, eating disorders and mood disorders. Also, deliberate self-harm must be distinguished from suicidal behavior. Psychologi-cal trauma has been suggested as a risk factor for deliberate self- harm behavior. Trauma and traumatic events have long been associated with deliberate self- harm behavior. The aim of this review article is to investigate the etiology and epidemiology of deliberate self-harm behaviour and relationship between psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(2.000: 209-226

  19. Assessing experience in the deliberate practice of running using a fuzzy decision-support system

    Science.gov (United States)

    Roveri, Maria Isabel; Manoel, Edison de Jesus; Onodera, Andrea Naomi; Ortega, Neli R. S.; Tessutti, Vitor Daniel; Vilela, Emerson; Evêncio, Nelson

    2017-01-01

    The judgement of skill experience and its levels is ambiguous though it is crucial for decision-making in sport sciences studies. We developed a fuzzy decision support system to classify experience of non-elite distance runners. Two Mamdani subsystems were developed based on expert running coaches’ knowledge. In the first subsystem, the linguistic variables of training frequency and volume were combined and the output defined the quality of running practice. The second subsystem yielded the level of running experience from the combination of the first subsystem output with the number of competitions and practice time. The model results were highly consistent with the judgment of three expert running coaches (r>0.88, p0.86, p<0.001). From the expert’s knowledge and the fuzzy model, running experience is beyond the so-called "10-year rule" and depends not only on practice time, but on the quality of practice (training volume and frequency) and participation in competitions. The fuzzy rule-based model was very reliable, valid, deals with the marked ambiguities inherent in the judgment of experience and has potential applications in research, sports training, and clinical settings. PMID:28817655

  20. Assessing experience in the deliberate practice of running using a fuzzy decision-support system.

    Directory of Open Access Journals (Sweden)

    Maria Isabel Roveri

    Full Text Available The judgement of skill experience and its levels is ambiguous though it is crucial for decision-making in sport sciences studies. We developed a fuzzy decision support system to classify experience of non-elite distance runners. Two Mamdani subsystems were developed based on expert running coaches' knowledge. In the first subsystem, the linguistic variables of training frequency and volume were combined and the output defined the quality of running practice. The second subsystem yielded the level of running experience from the combination of the first subsystem output with the number of competitions and practice time. The model results were highly consistent with the judgment of three expert running coaches (r>0.88, p0.86, p<0.001. From the expert's knowledge and the fuzzy model, running experience is beyond the so-called "10-year rule" and depends not only on practice time, but on the quality of practice (training volume and frequency and participation in competitions. The fuzzy rule-based model was very reliable, valid, deals with the marked ambiguities inherent in the judgment of experience and has potential applications in research, sports training, and clinical settings.

  1. Teaching ethics in the clinic. The theory and practice of moral case deliberation.

    Science.gov (United States)

    Molewijk, A C; Abma, T; Stolper, M; Widdershoven, G

    2008-02-01

    A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. Within moral case deliberation, healthcare professionals bring in their actual moral questions during a structured dialogue. The ethicist facilitates the learning process by using various conversation methods in order to find answers to the case and to develop moral competencies. The case deliberations are not unique events, but are a structural part of the professional training on the work floor within healthcare institutions. This article presents the underlying theory on (teaching) ethics and illustrates this approach with an example of a moral case deliberation project in a Dutch psychiatric hospital. The project was evaluated using the method of responsive evaluation. This method provided us with rich information about the implementation process and effects the research process itself also lent support to the process of implementation.

  2. Talent identification and deliberate programming in skeleton: ice novice to Winter Olympian in 14 months.

    Science.gov (United States)

    Bullock, Nicola; Gulbin, Jason P; Martin, David T; Ross, Angus; Holland, Terry; Marino, Frank

    2009-02-15

    The aims of this study were to talent transfer, rapidly develop, and qualify an Australian female athlete in the skeleton event at the 2006 Torino Winter Olympic Games and quantify the volume of skeleton-specific training and competition that would enable this to be achieved. Initially, 26 athletes were recruited through a talent identification programme based on their 30-m sprint time. After attending a selection camp, 10 athletes were invited to undertake an intensified skeleton training programme. Four of these athletes were then selected to compete for Australia on the World Cup circuit. All completed runs and simulated push starts were documented over a 14-month period. The athlete who eventually represented Australia at the Torino Winter Olympic Games did so following approximately 300 start simulations and about 220 training/competition runs over a period of 14 months. Using a deliberate programming model, these findings provide a guide to the minimum exposure required for a novice skeleton athlete to reach Olympic representative standard following intensified sport-specific training. The findings of this study are discussed in the context of the deliberate practice theory and offer the term "deliberate programming" as an alternative way of incorporating all aspects of expert development.

  3. The accidental plagiarist: an institutional approach to distinguishing between a deliberate attempt to deceive and poor academic practice

    OpenAIRE

    Robson, Simon; Harvey, Jackie

    2006-01-01

    There is a distinction in the literature between what is regarded as ‘intentional’ plagiarism involving a deliberate attempt to deceive (by the ‘committed’ plagiarist) in order to gain unfair advantage and ‘unintentional’ plagiarism that is associated with poor academic practice stemming from ignorance or misunderstanding of requirements (the ‘accidental’ plagiarist). Clearly, whilst neither should be condoned the former is decidedly less acceptable than the latter. Further, an analysis of ex...

  4. High-Performance Home Technologies: Solar Thermal & Photovoltaic Systems; Volume 6 Building America Best Practices Series

    Energy Technology Data Exchange (ETDEWEB)

    None

    2007-06-01

    The sixth volume of the Building America Best Practices Series presents information that is useful throughout the U.S. for enhancing the energy efficiency practices in the specific climate zones that are presented in each of the volumes.

  5. Informal and Deliberate Learning with New Technologies

    Science.gov (United States)

    Trinder, Ruth

    2017-01-01

    Due to the ready availability of new technologies, opportunities for the incidental as well as deliberate practice of English have multiplied and far exceed what can be done in more formal environments. Yet, despite the sizeable literature on the classroom-based use of specific digital resources, few studies have investigated how students evaluate…

  6. Creating informed public opinion: citizen deliberation about nanotechnologies for human enhancements

    International Nuclear Information System (INIS)

    Cobb, Michael D.

    2011-01-01

    Many people believe that ordinary citizens should influence scientific and technological developments, but the American public is routinely uninformed about these issues. As a solution, some scholars advocate creating informed public opinions by encouraging citizens to deliberate about the issues. Although this idea is currently widely applauded in the science and technology literature, deliberative outcomes are infrequently measured and the practice of deliberation is routinely criticized in other disciplines. This research contributes to our understanding of the effectiveness of citizen deliberation as a method for increasing public engagement with science. I report data measuring results of deliberation in a national citizens’ technology forum (NCTF) about nanotechnologies for human enhancement. The NCTF was a month-long process involving six groups of 9–15 ordinary citizens who deliberated in different locations across the United States with the goal of reaching consensus about policy recommendations within their groups. I find that structured deliberation generated informed opinions, sometimes meaningful shifts in preferences, and increased trust and internal efficacy among the participants. Nevertheless, the NCTF has important shortcomings, and it is not obvious that consensus conferences should be preferred over other mechanisms for creating informed opinions. Future research is needed to corroborate the findings of this study and to systematically compare outcomes of structured citizen deliberation to other less resource intensive forms of engagement.

  7. Engaging Youth and Pre-Service Teachers in Immigration Deliberations

    Science.gov (United States)

    Daniel, Shannon M.

    2015-01-01

    In this report of innovative teacher practice, the author describes an arts-based event which brought together adolescent refugee and immigrant students and pre-service teachers to deliberate about immigration policies and attitudes in the United States.

  8. Impact of a Simulated Clinical Day With Peer Coaching and Deliberate Practice: Promoting a Culture of Safety.

    Science.gov (United States)

    Badowski, Donna M; Oosterhouse, Kimberly J

    Nursing education is challenged to shift from task-based proficiencies to higher level competencies with patient safety as a priority. Using a quasi-experimental pretest/posttest design, a simulation-based, peer-coached, deliberate practice clinical substitution was implemented to compare nursing students' knowledge, skills, and attitudes for promoting safety. Our findings demonstrated improved knowledge and skill acquisition in the intervention and control groups. The former trended toward improved team communication attitudes and enteral medication skill performance. Additional research with larger samples is needed to further investigate this innovative strategy.

  9. Truth in politics : rhetorical approaches to democratic deliberation in Africa and beyond

    NARCIS (Netherlands)

    Salazar, P.J.; Osha, S.; Binsbergen, van W.M.J.

    2004-01-01

    Democracy is about competing "truths". This is why "rhetoric"- the study of public deliberation and the training in public debate and argumentation - is part of democracy in development. This volume acclimatizes "rhetoric" to the philosophical scene in South Africa, and more in general in Africa as

  10. Pragmatism, metaphysics, and bioethics: beyond a theory of moral deliberation.

    Science.gov (United States)

    Pamental, Matthew

    2013-12-01

    Pragmatism has been understood by bioethicists as yet another rival in the "methods wars," as yet another theory of moral deliberation. This has led to criticism of pragmatic bioethics as both theoretically and practically inadequate. Pragmatists' responses to these objections have focused mainly on misunderstandings of pragmatism's epistemology. These responses are insufficient. Pragmatism's commitment to radical empiricism gives it theoretical resources unappreciated by critics and defenders alike. Radical empiricism, unlike its more traditional ancestors, undercuts the gaps between theory and practice, and subjective and objective accounts of experience, and in so doing provides the metaphysical and epistemological basis for a thoroughgoing empirical naturalism in ethics. Pragmatism's strength as an approach to moral problems thus emerges as a result of a much wider array of resources than contemporary interpreters have acknowledged, which makes it a richer, deeper framework for understanding moral deliberation in general and bioethical decision making in particular.

  11. Deliberate Practice Enhances Quality of Laparoscopic Surgical Performance in a Randomized Controlled Trial: from Arrested Development to Expert Performance

    Science.gov (United States)

    Hashimoto, Daniel A.; Sirimanna, Pramudith; Gomez, Ernest D.; Beyer-Berjot, Laura; Ericsson, K. Anders; Williams, Noel N.; Darzi, Ara; Aggarwal, Rajesh

    2014-01-01

    Background This study investigated whether deliberate practice leads to an increase in surgical quality in virtual reality (VR) laparoscopic cholecystectomies (LC). Previous research has suggested that sustained DP is effective in surgical training. Methods Fourteen residents were randomized into deliberate practice (n=7) or control training (n=7). Both groups performed 10 sessions of two VR LCs. Each session, the DP group was assigned 30 minutes of DP activities in between LCs while the control group viewed educational videos or read journal articles. Performance was assessed on speed and dexterity; quality was rated with global (GRS) and procedure-specific (PSRS) rating scales. All participants then performed five porcine LCs. Results Both groups improved over 20 VR LCs in time, dexterity, and global rating scales (all pachieved higher quality of VR surgical performance than control for GRS (26 vs. 20, p=0.001) and PSRS (18 vs. 15, p=0.001). For VR cases, DP subjects plateaued at GRS=25 after 10 cases and control group at GRS=20 after five cases. At completion of VR training, 100% of the DP group reached target quality of performance (GRS≥21) compared to 30% in the control group. There were no significant differences for improvements in time or dexterity over five porcine LCs. Conclusion This study suggests that DP leads to higher quality performance in VR LC than standard training alone. Standard training may leave individuals in a state of “arrested development” compared to DP. PMID:25539697

  12. Client participation in moral case deliberation: a precarious relational balance

    NARCIS (Netherlands)

    Weidema, F.C.; Abma, T.A.; Widdershoven, G.A.M.; Molewijk, A.C.

    2011-01-01

    Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client

  13. Transforming a fourth year modern optics course using a deliberate practice framework

    Directory of Open Access Journals (Sweden)

    David J. Jones

    2015-09-01

    Full Text Available [This paper is part of the Focused Collection on Upper Division Physics Courses.] We present a study of active learning pedagogies in an upper-division physics course. This work was guided by the principle of deliberate practice for the development of expertise, and this principle was used in the design of the materials and the orchestration of the classroom activities of the students. We present our process for efficiently converting a traditional lecture course based on instructor notes into activities for such a course with active learning methods. Ninety percent of the same material was covered and scores on common exam problems showed a 15% improvement with an effect size greater than 1 after the transformation. We observe that the improvement and the associated effect size is sustained after handing off the materials to a second instructor. Because the improvement on exam questions was independent of specific problem topics and because the material tested was so mathematically advanced and broad (including linear algebra, Fourier transforms, partial differential equations, and vector calculus, we expect the transformation process could be applied to most upper-division physics courses having a similar mathematical base.

  14. Transforming a fourth year modern optics course using a deliberate practice framework

    Science.gov (United States)

    Jones, David J.; Madison, Kirk W.; Wieman, Carl E.

    2015-12-01

    [This paper is part of the Focused Collection on Upper Division Physics Courses.] We present a study of active learning pedagogies in an upper-division physics course. This work was guided by the principle of deliberate practice for the development of expertise, and this principle was used in the design of the materials and the orchestration of the classroom activities of the students. We present our process for efficiently converting a traditional lecture course based on instructor notes into activities for such a course with active learning methods. Ninety percent of the same material was covered and scores on common exam problems showed a 15% improvement with an effect size greater than 1 after the transformation. We observe that the improvement and the associated effect size is sustained after handing off the materials to a second instructor. Because the improvement on exam questions was independent of specific problem topics and because the material tested was so mathematically advanced and broad (including linear algebra, Fourier transforms, partial differential equations, and vector calculus), we expect the transformation process could be applied to most upper-division physics courses having a similar mathematical base.

  15. Student-Directed Video Validation of Psychomotor Skills Performance: A Strategy to Facilitate Deliberate Practice, Peer Review, and Team Skill Sets.

    Science.gov (United States)

    DeBourgh, Gregory A; Prion, Susan K

    2017-03-22

    Background Essential nursing skills for safe practice are not limited to technical skills, but include abilities for determining salience among clinical data within dynamic practice environments, demonstrating clinical judgment and reasoning, problem-solving abilities, and teamwork competence. Effective instructional methods are needed to prepare new nurses for entry-to-practice in contemporary healthcare settings. Method This mixed-methods descriptive study explored self-reported perceptions of a process to self-record videos for psychomotor skill performance evaluation in a convenience sample of 102 pre-licensure students. Results Students reported gains in confidence and skill acquisition using team skills to record individual videos of skill performance, and described the importance of teamwork, peer support, and deliberate practice. Conclusion Although time consuming, the production of student-directed video validations of psychomotor skill performance is an authentic task with meaningful accountabilities that is well-received by students as an effective, satisfying learner experience to increase confidence and competence in performing psychomotor skills.

  16. Organizing moral case deliberation experiences in two Dutch nursing homes

    NARCIS (Netherlands)

    van der Dam, S.; Abma, T.A.; Molewijk, A.C.; Kardol, M.J.M.; Schols, J.M.G.A.

    2011-01-01

    Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of

  17. Household Survey of Pesticide Practice, Deliberate Self-Harm, and Suicide in the Sundarban Region of West Bengal, India

    Directory of Open Access Journals (Sweden)

    Sohini Banerjee

    2013-01-01

    Full Text Available The toxicological impact and intentional ingestion of pesticides are major public health concerns globally. This study aimed to estimate the extent of deliberate self-harm (DSH and suicides (suicidal behaviour and document pesticide practices in Namkhana block of the Sundarban region, India. A cross-sectional study was conducted in 1680 households (21 villages following a mixed random and cluster design sampling. The survey questionnaire (Household Information on Pesticide Use and DSH was developed by the research team to elicit qualitative and quantitative information. The Kappa statistic and McNemar’s test were used to assess the level of agreement and association between respondents’ and investigators’ opinions about safe storage of pesticides. Over five years, 1680 households reported 181 incidents of suicidal behaviour. Conflict with family members was the most frequently reported reason for suicidal behaviour (53.6%. The Kappa statistic indicated poor agreement between respondents and investigators about safe storage of pesticides. The pesticide-related annual DSH rate was 158.1 (95% CI 126.2–195.5, and for suicide it was 73.4 (95% CI 52.2–100.3 per 100,000. Unsafe pesticide practice and psychosocial stressors are related to the high rates of suicidal behaviour. An intersectoral approach involving the local governments, agricultural department and the health sector would help to reduce the magnitude of this public health problem.

  18. It's not all about moral reasoning: Understanding the content of Moral Case Deliberation.

    Science.gov (United States)

    Svantesson, Mia; Silén, Marit; James, Inger

    2018-03-01

    Moral Case Deliberation is one form of clinical ethics support described as a facilitator-led collective moral reasoning by healthcare professionals on a concrete moral question connected to their practice. Evaluation research is needed, but, as human interaction is difficult to standardise, there is a need to capture the content beyond moral reasoning. This allows for a better understanding of Moral Case Deliberation, which may contribute to further development of valid outcome criteria and stimulate the normative discussion of what Moral Case Deliberation should contain. To explore and compare the content beyond moral reasoning in the dialogue in Moral Case Deliberation at Swedish workplaces. A mixed-methods approach was applied for analysing audio-recordings of 70 periodic Moral Case Deliberation meetings at 10 Swedish workplaces. Moral Case Deliberation facilitators and various healthcare professions participated, with registered nurses comprising the majority. Ethical considerations: No objection to the study was made by an Ethical Review Board. After oral and written information was provided, consent to be recorded was assumed by virtue of participation. Other than 'moral reasoning' (median (md): 45% of the spoken time), the Moral Case Deliberations consisted of 'reflections on the psychosocial work environment' to a varying extent (md: 29%). Additional content comprised 'assumptions about the patient's psychosocial situation' (md: 6%), 'facts about the patient's situation' (md: 5%), 'concrete problem-solving' (md: 6%) and 'process' (md: 3%). The findings suggest that a restorative function of staff's wellbeing in Moral Case Deliberation is needed, as this might contribute to good patient care. This supports outcome criteria of improved emotional support, which may include relief of moral distress. However, facilitators need a strategy for how to proceed from the participants' own emotional needs and to develop the use of their emotional knowing to focus on

  19. When high-volume PCI operators in high-volume hospitals move to lower volume hospitals-Do they still maintain high volume and quality of outcomes?

    Science.gov (United States)

    Lu, Tsung-Hsueh; Li, Sheng-Tun; Liang, Fu-Wen; Lee, Jo-Chi; Yin, Wei-Hsian

    2017-10-31

    The aim of this quasi-experimental study was to examine whether high-volume percutaneous coronary intervention (PCI) operators still maintain high volume and quality of outcomes when they moved to lower volume hospitals. Systematic reviews have indicated that high-volume PCI operators and hospitals have higher quality outcomes. However, little is known on whether high PCI volume and high quality outcomes are mainly due to operator characteristics (i.e., skill and experience) and is portable across organizations or whether it is due to hospital characteristics (i.e., equipment, team, and management system) and is less portable. We used Taiwan National Health Insurance claims data 2000-2012 to identify 98 high-volume PCI operators, 10 of whom moved from one hospital to another during the study period. We compared the PCI volume, risk-adjusted mortality ratio, and major adverse cardiovascular event (MACE) ratio before and after moving. Of the 10 high-volume operators who moved, 6 moved from high- to moderate- or low-volume hospitals, with median annual PCI volumes (interquartile range) of 130 (117-165) in prior hospitals and 54 (46-84) in subsequent hospitals (the hospital the operator moved to), and the remaining 4 moved from high to high-volume hospitals, with median annual PCI volumes (interquartile range) of 151 (133-162) in prior hospitals and 193 (178-239) in subsequent hospitals. No significant differences were observed in the risk-adjusted mortality ratios and MACE ratios between high-volume operators and matched controls before and after moving. High-volume operators cannot maintain high volume when they moved from high to moderate or low-volume hospitals; however, the quality of care is maintained. High PCI volume and high-quality outcomes are less portable and more hospital bound. © 2017 Wiley Periodicals, Inc.

  20. Deliberation as Communication Instruction: A Study of a Climate Change Deliberation in an Introductory Biology Course

    Science.gov (United States)

    Drury, Sara A. Mehltretter

    2015-01-01

    The author argues that deliberation is an innovative method for teaching communication skills, particularly group communication, in the undergraduate science, technology, engineering, and math (STEM) curriculum. A case study using a deliberation activity on global climate change in an introductory biology course demonstrates how deliberative…

  1. Deliberate honesty

    NARCIS (Netherlands)

    Bereby-Meyer, Y.; Shalvi, S.

    2015-01-01

    Studies on lying, especially on inhibiting honest responses and generating dishonest responses, suggest that honesty is the default behavior and dishonesty requires deliberate effort. Here, we argue that when lying serves self-interest, that is, when lying is tempting and lies are easy to craft,

  2. Don't just do something, stand there! The value and art of deliberate clinical inertia.

    Science.gov (United States)

    Keijzers, Gerben; Cullen, Louise; Egerton-Warburton, Diana; Fatovich, Daniel M

    2018-04-01

    It can be difficult to avoid unnecessary investigations and treatments, which are a form of low-value care. Yet every intervention in medicine has potential harms, which may outweigh the potential benefits. Deliberate clinical inertia is the art of doing nothing as a positive response. This paper provides suggestions on how to incorporate deliberate clinical inertia into our daily clinical practice, and gives an overview of current initiatives such as 'Choosing Wisely' and the 'Right Care Alliance'. The decision to 'do nothing' can be complex due to competing factors, and barriers to implementation are highlighted. Several strategies to promote deliberate clinical inertia are outlined, with an emphasis on shared decision-making. Preventing medical harm must become one of the pillars of modern health care and the art of not intervening, that is, deliberate clinical inertia, can be a novel patient-centred quality indicator to promote harm reduction. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  3. Intuition, deliberation, and the evolution of cooperation.

    Science.gov (United States)

    Bear, Adam; Rand, David G

    2016-01-26

    Humans often cooperate with strangers, despite the costs involved. A long tradition of theoretical modeling has sought ultimate evolutionary explanations for this seemingly altruistic behavior. More recently, an entirely separate body of experimental work has begun to investigate cooperation's proximate cognitive underpinnings using a dual-process framework: Is deliberative self-control necessary to reign in selfish impulses, or does self-interested deliberation restrain an intuitive desire to cooperate? Integrating these ultimate and proximate approaches, we introduce dual-process cognition into a formal game-theoretic model of the evolution of cooperation. Agents play prisoner's dilemma games, some of which are one-shot and others of which involve reciprocity. They can either respond by using a generalized intuition, which is not sensitive to whether the game is one-shot or reciprocal, or pay a (stochastically varying) cost to deliberate and tailor their strategy to the type of game they are facing. We find that, depending on the level of reciprocity and assortment, selection favors one of two strategies: intuitive defectors who never deliberate, or dual-process agents who intuitively cooperate but sometimes use deliberation to defect in one-shot games. Critically, selection never favors agents who use deliberation to override selfish impulses: Deliberation only serves to undermine cooperation with strangers. Thus, by introducing a formal theoretical framework for exploring cooperation through a dual-process lens, we provide a clear answer regarding the role of deliberation in cooperation based on evolutionary modeling, help to organize a growing body of sometimes-conflicting empirical results, and shed light on the nature of human cognition and social decision making.

  4. Identifying practice-related factors for high-volume prescribers of antibiotics in Danish general practice

    DEFF Research Database (Denmark)

    Aabenhus, Rune; Siersma, Volkert Dirk; Sandholdt, Håkon

    2017-01-01

    practice-related factors driving high antibiotic prescribing rates. Results: We included 98% of general practices in Denmark (n = 1962) and identified a 10% group of high prescribers who accounted for 15% of total antibiotic prescriptions and 18% of critically important antibiotic prescriptions. Once case...... prescriptions issued over the phone compared with all antibiotic prescriptions; and a high number of consultations per 1000 patients. We also found that a low number of consultations per 1000 patients was associated with a reduced likelihood of being a high prescriber of antibiotics. Conclusions: An apparent...

  5. [THE FORMS OF DELIBERATION INVOLVED IN THE FIELD OF BIOETHICS: TECHNIQUE DELIBERATION AND ETHICS DELIBERATION].

    Science.gov (United States)

    Neves Pinto, Gerson

    2015-12-01

    In this article the author examines the formulation of the problem of new technologies with their ethical limits and legal. To do this, in a first it is d'assess the contribuitions of the two most important contemporary philosophers who have treated this subject: Jürgen Habermas and Ronald Dworkin, while trying to put them into dialog with the one who has been one of the founders of l'classic ethics: Aristotle. Then, it tries to answer the question of how could we understand this notion that Dworkin nome "moral dislocation" between the random and the choice or well, as the appointed Habermas, "l'extension of the contingency". Finally, we questioned how the Aristotelian distinction between the technical deliberation and deliberative ethical-moral can contribute to a better understanding of the questions on the decisions and choices that will make the moral agents (such as patients or the judges), as well as those relating to the type of deliberation technique chosen by the doctor or by the health professional.

  6. "While you still think, I already type": experienced social power reduces deliberation during e-mail communication.

    Science.gov (United States)

    Scholl, Annika; Sassenberg, Kai

    2014-11-01

    E-mail allows individuals to deliberate on their communication before sending it off. For instance, communication partners can easily take their time to ponder how best to frame a request before they actually send a message. Individuals at times strategically exploit this opportunity to deliberate in order to tailor messages to their communication partner, such as when communicating with a relatively more powerful person. As social power reduces concerns about impression management, we predicted that individuals deliberate more while composing e-mail messages under low (vs. high) power. This assumption was tested with well-established power priming. As such, we expected that experienced power in one context would diminish deliberation times during a subsequent e-mail communication. An experiment manipulating the experience of (low vs. high) power and measuring deliberation times during e-mail composition supported this hypothesis. The findings thus indicate how social power alters deliberation times. More importantly, the results show that individuals not only strategically deliberate during e-mail communication in line with their current situation, but also in line with their social standing in a previous situation (here, their experience of power).

  7. Designing Deliberation Systems

    DEFF Research Database (Denmark)

    Rose, Jeremy; Sæbø, Øystein

    2010-01-01

    the potential to revitalize and transform citizen engagement in democracy.  Although the majority of web 2.0 systems enable these discourses to some extent, government institutions commission and manage specialized deliberation systems (information systems designed to support participative discourse) intended...... to promote citizen engagement.  The most common examples of these are political discussion forums.  Though usually considered trivial adaptations of well-known technologies, these types of deliberative systems are often unsuccessful, and present a distinct set of design and management challenges.......  In this article we analyze the issues involved in establishing political deliberation systems under four headings: stakeholder engagement, web platform design, service management, political process re-shaping and evaluation and improvement.  We review the existing literature and present a longitudinal case study...

  8. High-dose amrinone is required to accelerate rewarming from deliberate mild intraoperative hypothermia for neurosurgical procedures.

    Science.gov (United States)

    Inoue, Satoki; Kawaguchi, Masahiko; Sakamoto, Takanori; Kitaguchi, Katsuyasu; Furuya, Hitoshi; Sakaki, Toshisuke

    2002-07-01

    group were significantly faster and lower, respectively, than in the control group. Systemic vascular resistance in the AMR 15 group was smaller than in the control group throughout the study; on the other hand, only the value after the start of rewarming in the ReAMR group was smaller than in the control group. Amrinone at an infusion rate of 15 or 5 microg x kg(-1) x min(-1) with a reloading at the beginning of rewarming accelerated the rewarming rate of core temperature during deliberate mild hypothermia. This suggests that high-dose amrinone is required to accelerate rewarming from deliberate mild intraoperative hypothermia for neurosurgical procedures.

  9. Homo Ignorans: Deliberately Choosing Not to Know.

    Science.gov (United States)

    Hertwig, Ralph; Engel, Christoph

    2016-05-01

    Western history of thought abounds with claims that knowledge is valued and sought. Yet people often choose not to know. We call the conscious choice not to seek or use knowledge (or information) deliberate ignorance. Using examples from a wide range of domains, we demonstrate that deliberate ignorance has important functions. We systematize types of deliberate ignorance, describe their functions, discuss their normative desirability, and consider how they can be modeled. To date, psychologists have paid relatively little attention to the study of ignorance, let alone the deliberate kind. Yet the desire not to know is no anomaly. It is a choice to seek rather than reduce uncertainty whose reasons require nuanced cognitive and economic theories and whose consequences-for the individual and for society-require analyses of both actor and environment. © The Author(s) 2016.

  10. Deliberate change without hierarchical influence?

    DEFF Research Database (Denmark)

    Nørskov, Sladjana; Kesting, Peter; Ulhøi, John Parm

    2017-01-01

    reveals that deliberate change is indeed achievable in a non-hierarchical collaborative OSS community context. However, it presupposes the presence and active involvement of informal change agents. The paper identifies and specifies four key drivers for change agents’ influence. Originality....../value The findings contribute to organisational analysis by providing a deeper understanding of the importance of leadership in making deliberate change possible in non-hierarchical settings. It points to the importance of “change-by-conviction”, essentially based on voluntary behaviour. This can open the door...

  11. From consultation to deliberation? Tracing deliberative norms in EIA frameworks in Swedish roads planning

    International Nuclear Information System (INIS)

    Isaksson, Karolina; Richardson, Tim; Olsson, Krister

    2009-01-01

    This paper presents the results of an analysis of deliberative norms in the framework for Environmental Impact Assessment (EIA) in roads planning in Sweden. The more specific question is how this framework has responded to the shift towards more deliberative approaches to planning and decision making, advocated in planning theory and policy literature over the last decade. The analysis, which compares the current framework and guidance with an earlier iteration, identifies a shift towards deliberation; deliberative norms are present, and even dominate recent guidance. However, an instrumental norm permeates both the former and the current guidance, suggesting that even as a language of consultation is replaced by one of deliberation, the intention remains to secure and legitimise a smooth development pathway. Evidence from interviews with professionals working in the Swedish EIA system highlights the difficulties of navigating these uncertainties in practice. By opening up critical analysis of deliberative norms as they shape the conditions for practice, this study contributes to the continuous development of planning practice, by supporting a more normatively reflexive approach to framework-design.

  12. Competencies in nursing students for organized forms of clinical moral deliberation and decision-making

    NARCIS (Netherlands)

    dr. Bart Cusveller; Jeanette den Uil-Westerlaken

    2014-01-01

    Bachelor-prepared nurses are expected to be competent in moral deliberation and decision-making (MDD) in clinical practice. It is unclear, however, how this competence develops in nursing students. This study explores the development of nursing students’ competence for participating in organized

  13. 'What the hell is water?' How to use deliberate clinical inertia in common emergency department situations.

    Science.gov (United States)

    Egerton-Warburton, Diana; Cullen, Louise; Keijzers, Gerben; Fatovich, Daniel M

    2018-06-01

    Appropriate deliberate clinical inertia refers to the art of doing nothing as a positive clinical response. It includes shared decision-making to improve patient care with the use of clinical judgement. We discuss common clinical scenarios where the use of deliberate clinical inertia can occur. The insertion of peripheral intravenous cannulae, investigating patients with suspected renal colic and the investigation of low risk chest pain are all opportunities for the thoughtful clinician to 'stand there' and use effective patient communication to avoid low value tests and procedures. Awareness is key to identifying these opportunities to practice deliberate clinical inertia, as many of the situations may be so much a part of our environment that they are hidden in plain view. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  14. Suicide Following Deliberate Self-Harm.

    Science.gov (United States)

    Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Gerhard, Tobias; Blanco, Carlos

    2017-08-01

    The authors sought to identify risk factors for repeat self-harm and completed suicide over the following year among adults with deliberate self-harm. A national cohort of Medicaid-financed adults clinically diagnosed with deliberate self-harm (N=61,297) was followed for up to 1 year. Repeat self-harm per 1,000 person-years and suicide rates per 100,000 person-years (based on cause of death information from the National Death Index) were determined. Hazard ratios of repeat self-harm and suicide were estimated by Cox proportional hazard models. During the 12 months after nonfatal self-harm, the rate of repeat self-harm was 263.2 per 1,000 person-years and the rate of completed suicide was 439.1 per 100,000 person-years, or 37.2 times higher than in a matched general population cohort. The hazard of suicide was higher after initial self-harm events involving violent as compared with nonviolent methods (hazard ratio=7.5, 95% CI=5.5-10.1), especially firearms (hazard ratio=15.86, 95% CI=10.7-23.4; computed with poisoning as reference), and to a lesser extent after events of patients who had recently received outpatient mental health care (hazard ratio=1.6, 95% CI=1.2-2.0). Compared with self-harm patients using nonviolent methods, those who used violent methods were at significantly increased risk of suicide during the first 30 days after the initial event (hazard ratio=17.5, 95% CI=11.2-27.3), but not during the following 335 days. Adults treated for deliberate self-harm frequently repeat self-harm in the following year. Patients who use a violent method for their initial self-harm, especially firearms, have an exceptionally high risk of suicide, particularly right after the initial event, which highlights the importance of careful assessment and close follow-up of this group.

  15. Establishing Political Deliberation Systems

    DEFF Research Database (Denmark)

    Rose, Jeremy; Sæbø, Øystein

    2008-01-01

    The extension and transformation of political participation is dependent on widespread deliberation supported by information and communication technologies.  The most commonly found examples of these eParticipation systems are political discussion forums.  Though much of the discussion...... of these technologies is conducted in the eGovernment and (particularly) the eDemocracy literature, political discussion forums present a distinct set of design and management challenges which relate directly to IS concerns. In this article we analyze problems in establishing political deliberation systems under five...... headings: stakeholder engagement, web platform design, web platform management, political process re-shaping and evaluation and improvement. We review the existing literature and present a longitudinal case study of a political discussion forum: the Norwegian DemokratiTorget (Democracy Square).  We define...

  16. Learning by doing. Training health care professionals to become facilitator of moral case deliberation

    NARCIS (Netherlands)

    Stolper, M.M.; Molewijk, A.C.; Widdershoven, G.

    2015-01-01

    Moral case deliberation (MCD) is a dialogue among health care professionals about moral issues in practice. A trained facilitator moderates the dialogue, using a conversation method. Often, the facilitator is an ethicist. However, because of the growing interest in MCD and the need to connect MCD to

  17. Effective moduli of high volume fraction particulate composites

    International Nuclear Information System (INIS)

    Kwon, P.; Dharan, C.K.H.

    1995-01-01

    Predictions using current micromechanics theories for the effective moduli of particulate-reinforced composites tend to break down at high volume fractions of the reinforcing phase. The predictions are usually well below experimentally measured values of the Young's modulus for volume fractions exceeding about 0.6. In this paper, the concept of contiguity, which is a measure of phase continuity, is applied to Mori-Tanaka micromechanics theory. It is shown that contiguity of the second phase increases with volume fraction, leading eventually to a reversal in the roles of the inclusion and matrix. In powder metallurgy practice, it is well known that at high volume fractions, sintering and consolidation of the reinforcement make it increasingly continuous and more like the matrix phase, while the former matrix tends to become more like the inclusion phase. The concept of contiguity applied to micromechanics theory results in very good agreement between the predicted Young's modulus and experimental data on tungsten carbide particulate-reinforced cobalt

  18. Deliberate Self-Harm within an International Community Sample of Young People: Comparative Findings from the Child & Adolescent Self-Harm in Europe (CASE) Study

    Science.gov (United States)

    Madge, Nicola; Hewitt, Anthea; Hawton, Keith; de Wilde, Erik Jan; Corcoran, Paul; Fekete, Sandor; van Heeringen, Kees; De Leo, Diego; Ystgaard, Mette

    2008-01-01

    Background: Deliberate self-harm among young people is an important focus of policy and practice internationally. Nonetheless, there is little reliable comparative international information on its extent or characteristics. We have conducted a seven-country comparative community study of deliberate self-harm among young people. Method: Over 30,000…

  19. Perspectives on High School Reform. NCREL Viewpoints, Volume 13

    Science.gov (United States)

    Learning Point Associates / North Central Regional Educational Laboratory (NCREL), 2005

    2005-01-01

    Viewpoints is a multimedia package containing two audio CDs and a brief, informative booklet. This volume of Viewpoints focuses on issues related to high school reform. This booklet offers background information explaining the issues surrounding high school reform with perspectives from research, policy, and practice. It also provides a list of…

  20. Neural basis of moral verdict and moral deliberation

    Science.gov (United States)

    Borg, Jana Schaich; Sinnott-Armstrong, Walter; Calhoun, Vince D.; Kiehl, Kent A.

    2011-01-01

    How people judge something to be morally right or wrong is a fundamental question of both the sciences and the humanities. Here we aim to identify the neural processes that underlie the specific conclusion that something is morally wrong. To do this, we introduce a novel distinction between “moral deliberation,” or the weighing of moral considerations, and the formation of a “moral verdict,” or the commitment to one moral conclusion. We predict and identify hemodynamic activity in the bilateral anterior insula and basal ganglia that correlates with committing to the moral verdict “this is morally wrong” as opposed to “this is morally not wrong,” a finding that is consistent with research from economic decision-making. Using comparisons of deliberation-locked vs. verdict-locked analyses, we also demonstrate that hemodynamic activity in high-level cortical regions previously implicated in morality—including the ventromedial prefrontal cortex, posterior cingulate, and temporoparietal junction—correlates primarily with moral deliberation as opposed to moral verdicts. These findings provide new insights into what types of processes comprise the enterprise of moral judgment, and in doing so point to a framework for resolving why some clinical patients, including psychopaths, may have intact moral judgment but impaired moral behavior. PMID:21590588

  1. The epistemic-teleologic model of deliberate self-persuasion.

    Science.gov (United States)

    Maio, Gregory R; Thomas, Geoff

    2007-02-01

    Although past theory and research point to the importance of understanding deliberate self-persuasion (i.e., deliberate self-induced attitude change), there have been no empirical and theoretical efforts to model this process. This article proposes a new model to help understand the process, while comparing the process of deliberate self-persuasion with relevant theory and research. The core feature of this model is a distinction between epistemic processes, which involve attempting to form new valid attitudes, and teleologic processes, which involve self-induced attitude change but with minimal concerns for validity. The epistemic processes employ tactics of reinterpretation, reattribution, reintegration, retesting, changing comparators, and changing dimensions of comparison. The teleologic processes include suppression, preemption, distraction, and concentration. By mapping these processes, this model helps to generate many novel and testable hypotheses about the use of deliberate self-persuasion to cope with ambivalent attitudes.

  2. High Volume Manufacturing and Field Stability of MEMS Products

    Science.gov (United States)

    Martin, Jack

    Low volume MEMS/NEMS production is practical when an attractive concept is implemented with business, manufacturing, packaging, and test support. Moving beyond this to high volume production adds requirements on design, process control, quality, product stability, market size, market maturity, capital investment, and business systems. In a broad sense, this chapter uses a case study approach: It describes and compares the silicon-based MEMS accelerometers, pressure sensors, image projection systems, and gyroscopes that are in high volume production. Although they serve several markets, these businesses have common characteristics. For example, the manufacturing lines use automated semiconductor equipment and standard material sets to make consistent products in large quantities. Standard, well controlled processes are sometimes modified for a MEMS product. However, novel processes that cannot run with standard equipment and material sets are avoided when possible. This reliance on semiconductor tools, as well as the organizational practices required to manufacture clean, particle-free products partially explains why the MEMS market leaders are integrated circuit manufacturers. There are other factors. MEMS and NEMS are enabling technologies, so it can take several years for high volume applications to develop. Indeed, market size is usually a strong function of price. This becomes a vicious circle, because low price requires low cost - a result that is normally achieved only after a product is in high volume production. During the early years, IC companies reduced cost and financial risk by using existing facilities for low volume MEMS production. As a result, product architectures are partially determined by capabilities developed for previous products. This chapter includes a discussion of MEMS product architecture with particular attention to the impact of electronic integration, packaging, and surfaces. Packaging and testing are critical, because they are

  3. Shifting Gear. The daily deliberation between arts and economics in cultural and creative organisations in Utrecht, 2010–2012

    NARCIS (Netherlands)

    Kolsteeg, J

    2014-01-01

    This research analyses strategic practice and discourse in ten cultural and for-profit creative organisations in the Dutch city of Utrecht, between 2010 and 2012. The main question of this research is how deliberations on culture, creativity and business structure strategic discourse and practice in

  4. Deliberating on intersectionality: women’s conferences in Recife

    Directory of Open Access Journals (Sweden)

    Maria-Hélène Sa Vilas Boas

    2015-12-01

    Full Text Available Under what conditions can deliberation include marginalized social groups? Several feminist authors criticize deliberative theory for reproducing power relations between social groups. They defend the explicit recognition of marginalized social groups within deliberative devices. This article aims to analyze the dynamics of deliberation when it gathers a traditionally underrepresented group, women. Based on the study of women’s conferences in Recife, it shows that the combination the politics of recognition and deliberation can lead both to the integration and marginalization of different actors within the group of women, depending on the resources they have available to voice their perspectives.

  5. Decision making uncertainty, imperfection, deliberation and scalability

    CERN Document Server

    Kárný, Miroslav; Wolpert, David

    2015-01-01

    This volume focuses on uncovering the fundamental forces underlying dynamic decision making among multiple interacting, imperfect and selfish decision makers. The chapters are written by leading experts from different disciplines, all considering the many sources of imperfection in decision making, and always with an eye to decreasing the myriad discrepancies between theory and real world human decision making. Topics addressed include uncertainty, deliberation cost and the complexity arising from the inherent large computational scale of decision making in these systems. In particular, analyses and experiments are presented which concern: • task allocation to maximize “the wisdom of the crowd”; • design of a society of “edutainment” robots who account for one anothers’ emotional states; • recognizing and counteracting seemingly non-rational human decision making; • coping with extreme scale when learning causality in networks; • efficiently incorporating expert knowledge in personalized...

  6. Deliberate acquisition of competence in physiological breech birth: A grounded theory study.

    Science.gov (United States)

    Walker, Shawn; Scamell, Mandie; Parker, Pam

    2018-06-01

    Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems. Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool. How professionals learn complex skills contrary to those taught in their local practice settings is unclear. How do professionals develop competence and expertise in physiological breech birth? Nine midwives and five obstetricians with experience facilitating upright physiological breech births participated in semi-structured interviews. Data were analysed iteratively using constructivist grounded theory methods to develop an empirical theory of physiological breech skill acquisition. Among the participants in this research, the deliberate acquisition of competence in physiological breech birth included stages of affinity with physiological birth, critical awareness, intention, identity and responsibility. Expert practitioners operating across local and national boundaries guided less experienced practitioners. The results depict a specialist learning model which could be formalised in sympathetic training programmes, and evaluated. It may also be relevant to developing competence in other specialist/expert roles and innovative practices. Deliberate development of local communities of practice may support professionals to acquire elusive breech skills in a sustainable way. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  7. MANAGING HIGH-END, HIGH-VOLUME INNOVATIVE PRODUCTS

    Directory of Open Access Journals (Sweden)

    Gembong Baskoro

    2008-01-01

    Full Text Available This paper discuses the concept of managing high-end, high-volume innovative products. High-end, high-volume consumer products are products that have considerable influence to the way of life. Characteristic of High-end, high-volume consumer products are (1 short cycle time, (2 quick obsolete time, and (3 rapid price erosion. Beside the disadvantages that they are high risk for manufacturers, if manufacturers are able to understand precisely the consumer needs then they have the potential benefit or success to be the market leader. High innovation implies to high utilization of the user, therefore these products can influence indirectly to the way of people life. The objective of managing them is to achieve sustainability of the products development and innovation. This paper observes the behavior of these products in companies operated in high-end, high-volume consumer product.

  8. Freedom of Expression, Deliberation, Autonomy and Respect

    DEFF Research Database (Denmark)

    Rostbøll, Christian F.

    2011-01-01

    This paper elaborates on the deliberative democracy argument for freedom of expression in terms of its relationship to different dimensions of autonomy. It engages the objection that Enlightenment theories pose a threat to cultures that reject autonomy and argues that autonomy-based democracy...... is not only compatible with but necessary for respect for cultural diversity. On the basis of an intersubjective epistemology, it argues that people cannot know how to live on mutually respectful terms without engaging in public deliberation and develop some degree of personal autonomy. While freedom...... of expression is indispensable for deliberation and autonomy, this does not mean that people have no obligations regarding how they speak to each other. The moral insights provided by deliberation depend on the participants in the process treating one another with respect. The argument is related to the Danish...

  9. Non-Conscious vs. Deliberate Dynamic Decision-Making—A Pilot Experiment

    OpenAIRE

    Andreas Größler; Etiënne Rouwette; Jac Vennix

    2016-01-01

    The purpose of this paper is to explore the effects of non-conscious vs. deliberate ways of making decisions in a dynamic decision-making task. An experimental setting is used to study this question; three experimental groups are distinguished: immediate decision-making (only very limited time for deliberate cognitive processing), considerate decision-making (relatively long time for deliberate cognitive processing), and distracted decision-making (time for non-conscious cognitive processing ...

  10. Non-conscious vs. deliberate dynamic decision-making—a pilot experiment

    OpenAIRE

    Grössler, A.; Rouwette, E.A.J.A.; Vennix, J.A.M.; Größler, A.

    2016-01-01

    The purpose of this paper is to explore the effects of non-conscious vs. deliberate ways of making decisions in a dynamic decision-making task. An experimental setting is used to study this question; three experimental groups are distinguished: immediate decision-making (only very limited time for deliberate cognitive processing), considerate decision-making (relatively long time for deliberate cognitive processing), and distracted decision-making (time for non-conscious cognitive processing ...

  11. Online Public Deliberation in China

    DEFF Research Database (Denmark)

    Medaglia, Rony; Yang, Yang

    2017-01-01

    Internet discussion platforms in China provide a hugely interesting and relevant source for understanding dynamics of online discussions in a unique context. Adopting the theoretical lens of public deliberation, this paper investigates the evolution of patterns of similar-minded and different......-minded interactions over time on a Chinese online discussion forum. We analyse the content and reply networks of 18,000+ messages on four highly debated topics on the Bulletin Board System (BBS) platform Tianya. Findings provide nuanced evidence to the phenomenon of increased network homophily over time, mitigated...... investigation on independent variables for understanding dynamics of online discussions, and for studies comparing cases across different contexts....

  12. Ethics Teaching in Higher Education for Principled Reasoning: A Gateway for Reconciling Scientific Practice with Ethical Deliberation.

    Science.gov (United States)

    Aközer, Mehmet; Aközer, Emel

    2017-06-01

    This paper proposes laying the groundwork for principled moral reasoning as a seminal goal of ethics interventions in higher education, and on this basis, makes a case for educating future specialists and professionals with a foundation in philosophical ethics. Identification of such a seminal goal is warranted by (1) the progressive dissociation of scientific practice and ethical deliberation since the onset of a problematic relationship between science and ethics around the mid-19th century, and (2) the extensive mistrust of integrating ethics in science and engineering curricula beyond its "applied," "practical," or "professional" implications. Although calls by international scientific and educational bodies to strengthen ethics teaching in scientific education over the past quarter century have brought about a notion of combining competence in a certain field with competence in ethics, this is neither entrenched in the academic community, nor fleshed out as regards its core or instruments to realize it. The legitimate goals of ethics teaching in higher education, almost settled since the 1980s, can be subsumed under the proposed seminal goal, and the latter also would safeguard content and methods of ethics interventions against the intrusion of indoctrinative approaches. In this paper, derivation of the proposed seminal goal rests on an interpretation of the Kohlbergian cognitive-developmental conception of moral adulthood consisting in autonomous principled moral reasoning. This interpretation involves, based on Kant's conception of the virtuous person, integrating questions about the "good life" into the domain of principled reasoning.

  13. WORKSHOP: Discussion, debate, deliberation

    NARCIS (Netherlands)

    Jeliazkova, Margarita I.

    2014-01-01

    Discussing, deliberating and debating are a core part of any democratic process. To organise these processes well, a great deal of knowledge and skill is required. It is not simple to find a good balance between a number of elements: appropriate language and terminology; paying attention to solid

  14. Volumizing effects of a smooth, highly cohesive, viscous 20-mg/mL hyaluronic acid volumizing filler: prospective European study

    Directory of Open Access Journals (Sweden)

    Hoffmann Klaus

    2009-08-01

    Full Text Available Abstract Background Facial volume loss contributes significantly to facial aging. The 20-mg/mL hyaluronic acid (HA formulation used in this study is a smooth, highly cohesive, viscous, fully reversible, volumizing filler indicated to restore facial volume. This first prospective study evaluated use in current aesthetic clinical practice. Methods A pan-European evaluation conducted under guidelines of the World Association of Opinion and Marketing Research, the trial comprised a baseline visit (visit 1 and a follow-up (visit 2 at 14 ± 7 days posttreatment. Physicians photographed patients at each visit. Each patient was treated with the 20-mg/mL HA volumizing filler as supplied in standard packaging. Procedural details, aesthetic outcomes, safety, and physician and patient ratings of their experience were recorded. Results Fifteen physicians and 70 patients (91% female; mean age: 50 years participated. Mean volume loss at baseline was 3.7 (moderate on the Facial Volume Loss Scale. Local anesthesia was used in 64.3% of cases. Most injections (85% were administered with needles rather than cannulas. Of the 208 injections, 59% were in the malar region, primarily above the periosteum. Subcutaneous injections were most common for other sites. The mean total injection volume per patient was 4.6 mL. The mean volume loss score declined significantly (P Conclusion The 20-mg/mL smooth, highly cohesive, viscous, volumizing HA filler was effective, well tolerated, and easy to use in current clinical practice. Participants were very likely to recommend this product to colleagues and friends, and patients would be very or quite likely to request this product for future treatments.

  15. Decreased frontal serotonin 5-HT{sub 2a} receptor binding index in deliberate self-harm patients

    Energy Technology Data Exchange (ETDEWEB)

    Audenaert, K. [Dept. of Psychiatry and Medical Psychology, Ghent University Hospital (Belgium); Dept. of Nuclear Medicine, Ghent University Hospital (Belgium); Laere, K. van; Dierckx, R.A. [Dept. of Nuclear Medicine, Ghent University Hospital (Belgium); Dumont, F.; Slegers, G. [Dept. of Radiopharmacy, Ghent Univ. (Belgium); Mertens, J. [VUB-Cyclotron, Brussels (Belgium); Heeringen, C. van [Dept. of Psychiatry and Medical Psychology, Ghent University Hospital (Belgium)

    2001-02-01

    Studies of serotonin metabolites in body fluids in attempted suicide patients and of post-mortem brain tissue of suicide victims have demonstrated the involvement of the serotonergic neurotransmission system in the pathogenesis of suicidal behaviour. Recently developed neuroimaging techniques offer the unique possibility of investigating in vivo the functional characteristics of this system. In this study the 5-HT{sub 2a} receptor population of patients who had recently attempted suicide was studied by means of the highly specific radio-iodinated 5-HT{sub 2a} receptor antagonist 4-amino-N-[1-[3-(4-fluorophenoxy)propyl]-4-methyl-4-piperidinyl]-5-iodo-2-methoxybenzamide or {sup 123}I-5-I-R91150. Nine patients who had recently (1-7 days) attempted suicide and 12 age-matched healthy controls received an intravenous injection of 185 MBq {sup 123}I-5-I-R91150 and were scanned with high-resolution brain single-photon emission tomography (SPET). Stereotactic realigned images were analysed semi-quantitatively using predefined volumes of interest. Serotonin binding capacity was expressed as the ratio of specific to non-specific activity. The cerebellum was used as a measure of non-specific activity. An age-dependent 5-HT{sub 2a} binding index was found, in agreement with previous literature. Deliberate self-harm patients had a significantly reduced mean frontal binding index after correction for age (P=0.002) when compared with controls. The reduction was more pronounced among deliberate self-injury patients (DSI) (P<0.001) than among deliberate self-poisoning patients (DSP). Frontal binding index was significantly lower in DSI patients than in DSP suicide attempters (P<0.001). It is concluded that brain SPET of the 5-HT{sub 2a} serotonin receptor system in attempted suicide patients who are free of drugs influencing the serotonergic system shows in vivo evidence of a decreased frontal binding index of the 5-HT{sub 2a} receptor, indicating a decrease in the number and/or in

  16. Handbook of Parenting. Volume 5: Practical Issues in Parenting. Second Edition.

    Science.gov (United States)

    Bornstein, Marc H., Ed.

    Concerned with practical aspects of meeting children's needs, this volume, the fifth of five on parenting, describes the nuts and bolts of parenting as well as the promotion of positive parenting practices. The volume consists of the following 19 chapters: (1) "The Ethics of Parenting" (Diana Baumrind and Ross A. Thompson; (2) "Parenting and…

  17. Emergency planning and preparedness for the deliberate release of toxic industrial chemicals.

    Science.gov (United States)

    Russell, David; Simpson, John

    2010-03-01

    Society in developed and developing countries is hugely dependent upon chemicals for health, wealth, and economic prosperity, with the chemical industry contributing significantly to the global economy. Many chemicals are synthesized, stored, and transported in vast quantities and classified as high production volume chemicals; some are recognized as being toxic industrial chemicals (TICs). Chemical accidents involving chemical installations and transportation are well recognized. Such chemical accidents occur with relative frequency and may result in large numbers of casualties with acute and chronic health effects as well as fatalities. The large-scale production of TICs, the potential for widespread exposure and significant public health impact, together with their relative ease of acquisition, makes deliberate release an area of potential concern. The large numbers of chemicals, together with the large number of potential release scenarios means that the number of possible forms of chemical incident are almost infinite. Therefore, prior to undertaking emergency planning and preparedness, it is necessary to prioritize risk and subsequently mitigate. This is a multi-faceted process, including implementation of industrial protection layers, substitution of hazardous chemicals, and relocation away from communities. Residual risk provides the basis for subsequent planning. Risk-prioritized emergency planning is a tool for identifying gaps, enhancing communication and collaboration, and for policy development. It also serves to enhance preparedness, a necessary prelude to preventing or mitigating the public health risk to deliberate release. Planning is an iterative and on-going process that requires multi-disciplinary agency input, culminating in the formation of a chemical incident plan complimentary to major incident planning. Preparedness is closely related and reflects a state of readiness. It is comprised of several components, including training and exercising

  18. Deliberate self-harm before psychiatric admission and risk of suicide

    DEFF Research Database (Denmark)

    Madsen, Trine; Agerbo, Esben; Mortensen, Preben Bo

    2013-01-01

    Psychiatric illness and deliberate self-harm (DSH) are major risk factors of suicide. In largely 15 % of psychiatric admissions in Denmark, the patient had an episode of DSH within the last year before admission. This study examined the survival and predictors of suicide in a suicidal high...

  19. Evaluation and perceived results of moral case deliberation: A mixed methods study

    NARCIS (Netherlands)

    Janssens, R.; van Zadelhoff, E.; van Loo, G.; Widdershoven, G.A.; Molewijk, A.C.

    2015-01-01

    Background: Moral case deliberation is increasingly becoming part of various Dutch healthcare organizations. Although some evaluation studies of moral case deliberation have been carried out, research into the results of moral case deliberation within aged care is scarce. Research questions: How did

  20. Deliberation before determination: the definition and evaluation of good decision making.

    Science.gov (United States)

    Elwyn, Glyn; Miron-Shatz, Talya

    2010-06-01

    In this article, we examine definitions of suggested approaches to measure the concept of good decisions, highlight the ways in which they converge, and explain why we have concerns about their emphasis on post-hoc estimations and post-decisional outcomes, their prescriptive concept of knowledge, and their lack of distinction between the process of deliberation, and the act of decision determination. There has been a steady trend to involve patients in decision making tasks in clinical practice, part of a shift away from paternalism towards the concept of informed choice. An increased understanding of the uncertainties that exist in medicine, arising from a weak evidence base and, in addition, the stochastic nature of outcomes at the individual level, have contributed to shifting the responsibility for decision making from physicians to patients. This led to increasing use of decision support and communication methods, with the ultimate aim of improving decision making by patients. Interest has therefore developed in attempting to define good decision making and in the development of measurement approaches. We pose and reflect whether decisions can be judged good or not, and, if so, how this goodness might be evaluated. We hypothesize that decisions cannot be measured by reference to their outcomes and offer an alternative means of assessment, which emphasizes the deliberation process rather than the decision's end results. We propose decision making comprises a pre-decisional process and an act of decision determination and consider how this model of decision making serves to develop a new approach to evaluating what constitutes a good decision making process. We proceed to offer an alternative, which parses decisions into the pre-decisional deliberation process, the act of determination and post-decisional outcomes. Evaluating the deliberation process, we propose, should comprise of a subjective sufficiency of knowledge, as well as emotional processing and

  1. Deliberate self harm in children.

    Science.gov (United States)

    Krishnakumar, P; Geeta, M G; Riyaz, A

    2011-05-01

    To study the nature of deliberate self-harm (DSH) in children and to identify the associated factors. Child Guidance Clinic attached to the Department of Pediatrics of a teaching hospital in South India. Children with history of deliberate self harm who were referred to the CGC for psychological evaluation during a 10 year period. Children and parents were interviewed together and separately and details regarding age, sex, family and school environment, stresses and nature of self harm were documented. Psychiatric diagnosis was made based on DSM IV diagnostic criteria. Among the 30 children included in the study, 21 were boys and 9 were girls. Majority of children were between the ages of 11 and 13 years, the youngest being 6 years old. 76%of children had history of acute stressful life events and 62%of them had chronic ongoing stress. 62%of children had stress in the family and 41%had stress at school. Stress in the family included death of a parent, conflicts with parents or siblings, mental illness in the family, parental alcoholism and parental disharmony. Stress at school included conflicts with classmates, punishment or negative comments by teachers and learning problems. Psychiatric disorders were present in 52%of children, the commonest being depressive disorder. The commonest mode of DSH was self poisoning, and rat poison (zinc phosphide) was the commonest substance used. Deliberate self harm occurs in young children and the risk factors are comparable to those in adolescents.

  2. Deliberate self-harming application of superglue in the nose: case report and literature review.

    Science.gov (United States)

    Tikka, T; Al Abduwani, J; Costello, D

    2015-01-01

    Accidental and non-accidental applications of superglue in the ear, nose and oral cavity have been reported previously. Surgical removal of glue from the nose is the current practice. This paper reports the case of an 18-year-old female, who presented with complete bilateral nasal occlusion due to deliberate self-application of superglue in both nostrils to avoid nasogastric tube insertion. Removal of glue was accomplished with a combination of local anaesthetic cream and acetone-soaked cotton buds, which caused only minimal discomfort to the patient. All traces of glue disappeared within 10 days, without causing damage to the nasal mucosa, nasal blockage or pain. To the best of our knowledge, this is the first case report of deliberate self-application of superglue in the nose. A successful non-surgical management option for the removal of glue from the nose is introduced.

  3. What’s There Not to ‘Like’? Sustainability Deliberations on Facebook

    Directory of Open Access Journals (Sweden)

    Roy Bendor

    2012-10-01

    Full Text Available Social media are considered ideal means to promote inclusive political participation by “reaching citizens where they are” in scalable and cost-effective ways. However, with all the excitement about the new virtual public sphere, little attention is given to the technical mediation itself – the affordances of e-deliberation platforms and the kind of interactions they support. In response, this paper aims to thicken the account of the interrelated political and technological contexts of e-deliberation. Using recent Facebook deliberations on sustainable transportation in Vancouver as our example, we argue that different rationales for public participation in policymaking animate different approaches to discourse, which, in turn, inform and are affected by different design and use strategies for e-deliberation platforms. Our argument suggests that the design affordances of e-deliberation represent opportunities to promote or curtail certain visions of a political culture of sustainability.

  4. Incidence Rates of Deliberate Self-Harm in Denmark 1994–2011

    DEFF Research Database (Denmark)

    Morthorst, Britt Reuter; Soegaard, Bodil; Nordentoft, Merete

    2016-01-01

    Background: The validity and reliability of suicide statistics have been questioned and few nationwide studies of deliberate selfharm have been presented. Aim: To calculate rates of deliberate self-harm in Denmark in order to investigate trends and assess the reliability of hospital records...... incidence of deliberate self-harm among young Danish women was observed, despite detection bias. An improved registration procedure of suicidal behavior is needed....

  5. Ethical case deliberation and decision making.

    Science.gov (United States)

    Gracia, Diego

    2003-01-01

    During the last thirty years different methods have been proposed in order to manage and resolve ethical quandaries, specially in the clinical setting. Some of these methodologies are based on the principles of Decision-making theory. Others looked to other philosophical traditions, like Principlism, Hermeneutics, Narrativism, Casuistry, Pragmatism, etc. This paper defends the view that deliberation is the cornerstone of any adequate methodology. This is due to the fact that moral decisions must take into account not only principles and ideas, but also emotions, values and beliefs. Deliberation is the process in which everyone concerned by the decision is considered a valid moral agent, obliged to give reasons for their own points of view, and to listen to the reasons of others. The goal of this process is not the reaching of a consensus but the enrichment of one's own point of view with that of the others, increasing in this way the maturity of one's own decision, in order to make it more wise or prudent. In many cases the members of a group of deliberation will differ in the final solution of the case, but the confrontation of their reasons will modify the perception of the problem of everyone. This is the profit of the process. Our moral decisions cannot be completely rational, due to the fact that they are influenced by feelings, values, beliefs, etc., but they must be reasonable, that is, wise and prudent. Deliberation is the main procedure to reach this goal. It obliges us to take others into account, respecting their different beliefs and values and prompting them to give reasons for their own points of view. This method has been traditional in Western clinical medicine all over its history, and it should be also the main procedure for clinical ethics.

  6. Sources of bias in clinical ethics case deliberation.

    Science.gov (United States)

    Magelssen, Morten; Pedersen, Reidar; Førde, Reidun

    2014-10-01

    A central task for clinical ethics consultants and committees (CEC) is providing analysis of, and advice on, prospective or retrospective clinical cases. However, several kinds of biases may threaten the integrity, relevance or quality of the CEC's deliberation. Bias should be identified and, if possible, reduced or counteracted. This paper provides a systematic classification of kinds of bias that may be present in a CEC's case deliberation. Six kinds of bias are discussed, with examples, as to their significance and risk factors. Possible remedies are suggested. The potential for bias is greater when the case deliberation is performed by an individual ethics consultant than when an entire clinical ethics committee is involved. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Good Will: Cosmopolitan Education as a Site for Deliberation

    Science.gov (United States)

    Roth, Klas

    2011-01-01

    Why should we deliberate? I discuss a Kantian response to this query and argue that we cannot as rational beings avoid deliberation in principle; and that we have good reasons to consider the value and strength of Kant's philosophical investigations concerning fundamental moral issues and their relevance for the question of why we ought to…

  8. Detecting the Evolution of Deliberate Fertility Control before the Demographic Transition in Germany

    Directory of Open Access Journals (Sweden)

    Aliaksandr Amialchuk

    2012-10-01

    Full Text Available BACKGROUND Pervious literature has established the existence of deliberate non-parity-specific fertility control in pre-transitional populations. However, less focus has been given to the timing of its onset. In addition, previous studies focused on the changes in fertility in response to the local prices of grains, which may be endogenous. OBJECTIVE This paper studies the emergence and evolution of deliberate fertility control by investigating the link between child mortality and economic stress on the one hand and non-parity-specific birth control on the other, in historic German villages between 1700 and 1900. METHODS Birth histories from fourteen German villages (1700-1900 and rye price series are used in a micro-level event history analysis. The fertility response of second and higher-order births to the mortality of children over age two and exogenous fluctuations in rye price are used as measures of the extent of deliberate non-parity-specific birth control. RESULTS Over the course of the demographic transition, the effect of the death of children generally increases after controlling for the effect of the death of children less than two years old. The negative fertility response to high rye prices before and in the year immediately following the price change occurred only after 1800. CONCLUSIONS The replacement and insurance effects associated with child mortality generally increased before the demographic transition. The emergence of the negative effect of high rye prices on fertility after 1800 further supports the presence and evolution of deliberate non-parity-specific fertility control before the demographic transition.

  9. From Protest to Political Parties: Online Deliberation in New Parties in Spain

    Directory of Open Access Journals (Sweden)

    Rosa Borge Bravo

    2016-12-01

    Full Text Available The new parties that emerged following the 15-M movement and against the austerity measures in Spain want to build parties open to the participation and deliberation for all the citizenry. To what extent are these ideals being fulfilled? The aim of this article is to describe and assess some of the main online deliberative processes of the two most important parties, Podemos and Barcelona En Comú, following commonly accepted criteria in the literature for measuring online deliberation. Specifically, we have examined the two most-voted proposals from the online platform Plaza Podemos and the online development of the electoral programme of Barcelona En Comú. Thus, we have conducted a content analysis of 713 (Plaza Podemos and 563 (Barcelona En Comú posts. Both platforms meet the structural and technical criteria for fostering deliberation, but the external impact is high only in the case of Barcelona En Comú. The deliberative quality of the communication is good but not the criteria of reflexivity, inclusion and plurality.

  10. Bringing values and deliberation to science communication.

    Science.gov (United States)

    Dietz, Thomas

    2013-08-20

    Decisions always involve both facts and values, whereas most science communication focuses only on facts. If science communication is intended to inform decisions, it must be competent with regard to both facts and values. Public participation inevitably involves both facts and values. Research on public participation suggests that linking scientific analysis to public deliberation in an iterative process can help decision making deal effectively with both facts and values. Thus, linked analysis and deliberation can be an effective tool for science communication. However, challenges remain in conducting such process at the national and global scales, in enhancing trust, and in reconciling diverse values.

  11. Post Rio Communication Styles for Deliberation

    DEFF Research Database (Denmark)

    Holm, Jesper; Almlund, Pernille

    2015-01-01

    The communicative turn in planning, multi-layered governance and governmentality are analytical concepts from various schools of thought to comprehend the emergence of new types of publicprivate politics when it comes to complex, wicked issues such as sustainability or the 3rd wave of public health......: health promotion. The paper explores a research approach to compare two different policy communication tracks in order to conceive various impacts on deliberation. The tracks are constructed along the narratives individual-collective & consensus-conflictual in the discursive framing of political...... communication. We build on an ANT inspired methodology and look into two simultaneously evolving political agendas during the last two decades - sustainability and health promotion - that have framed communication efforts, campaigns and politics in general. How is public participation and deliberation...

  12. Association of Very Low-Volume Practice With Vascular Surgery Outcomes in New York.

    Science.gov (United States)

    Mao, Jialin; Goodney, Philip; Cronenwett, Jack; Sedrakyan, Art

    2017-08-01

    well as higher charges (OR, 1.28; 95% CI, 1.01-1.62) and increased 30-day readmission (OR, 1.30; 95% CI 1.04-1.62) following CEA. The OAR and CEA procedures performed by very low-volume surgeons resulted in worse postoperative outcomes and greater lengths of stay. Although the percentage of very low-volume surgeons declined from 2000 to 2014, it remains concerning, given ready access to higher-volume surgeons. Future research is needed to understand the existence of this practice pattern in other surgical fields. Efforts to eliminate this practice pattern are warranted to ensure high-quality care for all patients.

  13. Sociopolitical drivers in the development of deliberate carbon storage

    Science.gov (United States)

    Stephens, Jennie C.

    The idea of engineering the storage of carbon released from fossil fuel burning in reservoirs other than the atmosphere has developed in the past 20 years from an obscure idea to an increasingly recognized potential approach that could be an important contributor to stabilizing atmospheric carbon dioxide (CO2) concentrations. Despite the intense application of scientific and technological expertise to the development of options for deliberate carbon storage, nontechnical factors play an important role. This chapter identifies sociopolitical, nontechnical factors that have contributed to the development of ideas and technologies associated with deliberate carbon storage. Broadly, interest in deliberate storage has expanded in response to increasing societal attention to reducing CO2 emissions for climate change mitigation. Specific societal groups, or stakeholders, which have contributed to the recent focus on carbon storage include the fossil fuel industry that has been shifting to a strategy of confronting rather than denying the CO2-climate change connection, a scientific community motivated by an increased sense of urgency of the need to reduce atmospheric CO2 concentrations, the general public with little knowledge about or awareness of carbon storage, and environmental advocacy groups that have demonstrated some divergence in levels of support for deliberate carbon storage. Among the policy mechanisms that have provided incentives for deliberate carbon storage are national accounting of carbon sources and sinks and carbon taxes. Another driver with particular importance in the United States is the political preference of some politicians to support development of advanced technologies for climate change mitigation rather than supporting mandatory CO2 regulations.

  14. Practicing the Test Produces Strength Equivalent to Higher Volume Training.

    Science.gov (United States)

    Mattocks, Kevin T; Buckner, Samuel L; Jessee, Matthew B; Dankel, Scott J; Mouser, J Grant; Loenneke, Jeremy P

    2017-09-01

    To determine if muscle growth is important for increasing muscle strength or if changes in strength can be entirely explained from practicing the strength test. Thirty-eight untrained individuals performed knee extension and chest press exercise for 8 wk. Individuals were randomly assigned to either a high-volume training group (HYPER) or a group just performing the one repetition maximum (1RM) strength test (TEST). The HYPER group performed four sets to volitional failure (~8RM-12RM), whereas the TEST group performed up to five attempts to lift as much weight as possible one time each visit. Data are presented as mean (90% confidence interval). The change in muscle size was greater in the HYPER group for both the upper and lower bodies at most but not all sites. The change in 1RM strength for both the upper body (difference of -1.1 [-4.8, 2.4] kg) and lower body (difference of 1.0 [-0.7, 2.8] kg for dominant leg) was not different between groups (similar for nondominant). Changes in isometric and isokinetic torque were not different between groups. The HYPER group observed a greater change in muscular endurance (difference of 2 [1,4] repetitions) only in the dominant leg. There were no differences in the change between groups in upper body endurance. There were between-group differences for exercise volume (mean [95% confidence interval]) of the dominant (difference of 11,049.3 [9254.6-12,844.0] kg) leg (similar for nondominant) and chest press with the HYPER group completing significantly more total volume (difference of 13259.9 [9632.0-16,887.8] kg). These findings suggest that neither exercise volume nor the change in muscle size from training contributed to greater strength gains compared with just practicing the test.

  15. How Should We Deliberate? Between the Argumentative and the Representative Dimensions of Democratic Deliberation

    Directory of Open Access Journals (Sweden)

    Tutui Viorel

    2012-01-01

    Full Text Available Abstract: My paper focuses on an important subject of the contemporary theory of democracy: what is the relationship between the argumentative and the representative dimensions of deliberative democracy? Using James Fishkin’s account of deliberative democracy and its relations with other democratic models I will argue that there is a severe conflict between these two dimensions: the attempt to enhance the value of argumentation presupposes a decrease in the representative value and the attempt to enhance the representative value results in a decrease in the argumentative value. This conflict is generated by what I call ‘the paradox of democratic deliberation’: the legitimacy of political decisions demands for the ‘raw’ opinion of the citizens, while the epistemic rightness of political decisions demands for a ‘filtered’ public opinion. But we cannot have both. In the final part of this paper I will sustain a moderate conception regarding the role of deliberation in democracy which offers us a way around this paradox but only at the price of significantly reducing the importance of deliberation.

  16. Decreased frontal serotonin 5-HT2a receptor binding index in deliberate self-harm patients

    International Nuclear Information System (INIS)

    Audenaert, K.; Laere, K. van; Dierckx, R.A.; Dumont, F.; Slegers, G.; Mertens, J.; Heeringen, C. van

    2001-01-01

    Studies of serotonin metabolites in body fluids in attempted suicide patients and of post-mortem brain tissue of suicide victims have demonstrated the involvement of the serotonergic neurotransmission system in the pathogenesis of suicidal behaviour. Recently developed neuroimaging techniques offer the unique possibility of investigating in vivo the functional characteristics of this system. In this study the 5-HT 2a receptor population of patients who had recently attempted suicide was studied by means of the highly specific radio-iodinated 5-HT 2a receptor antagonist 4-amino-N-[1-[3-(4-fluorophenoxy)propyl]-4-methyl-4-piperidinyl] -5-iodo-2-methox ybenzamide or 123 I-5-I-R91150. Nine patients who had recently (1-7 days) attempted suicide and 12 age-matched healthy controls received an intravenous injection of 185 MBq 123 I-5-I-R91150 and were scanned with high-resolution brain single-photon emission tomography (SPET). Stereotactic realigned images were analysed semi-quantitatively using predefined volumes of interest. Serotonin binding capacity was expressed as the ratio of specific to non-specific activity. The cerebellum was used as a measure of non-specific activity. An age-dependent 5-HT 2a binding index was found, in agreement with previous literature. Deliberate self-harm patients had a significantly reduced mean frontal binding index after correction for age (P=0.002) when compared with controls. The reduction was more pronounced among deliberate self-injury patients (DSI) (P 2a serotonin receptor system in attempted suicide patients who are free of drugs influencing the serotonergic system shows in vivo evidence of a decreased frontal binding index of the 5-HT 2a receptor, indicating a decrease in the number and/or in the binding affinity of 5-HT 2a receptors. (orig.)

  17. Ethical case deliberation on the ward. A comparison of four methods.

    NARCIS (Netherlands)

    Steinkamp, N.L.; Gordijn, B.

    2003-01-01

    The objective of this article is to analyse and compare four methods of ethical case deliberation. These include Clinical Pragmatism, The Nijmegen Method of ethical case deliberation, Hermeneutic dialogue, and Socratic dialogue. The origin of each method will be briefly sketched. Furthermore, the

  18. Collaborative deliberation: a model for patient care.

    Science.gov (United States)

    Elwyn, Glyn; Lloyd, Amy; May, Carl; van der Weijden, Trudy; Stiggelbout, Anne; Edwards, Adrian; Frosch, Dominick L; Rapley, Tim; Barr, Paul; Walsh, Thom; Grande, Stuart W; Montori, Victor; Epstein, Ronald

    2014-11-01

    Existing theoretical work in decision making and behavior change has focused on how individuals arrive at decisions or form intentions. Less attention has been given to theorizing the requirements that might be necessary for individuals to work collaboratively to address difficult decisions, consider new alternatives, or change behaviors. The goal of this work was to develop, as a forerunner to a middle range theory, a conceptual model that considers the process of supporting patients to consider alternative health care options, in collaboration with clinicians, and others. Theory building among researchers with experience and expertise in clinician-patient communication, using an iterative cycle of discussions. We developed a model composed of five inter-related propositions that serve as a foundation for clinical communication processes that honor the ethical principles of respecting individual agency, autonomy, and an empathic approach to practice. We named the model 'collaborative deliberation.' The propositions describe: (1) constructive interpersonal engagement, (2) recognition of alternative actions, (3) comparative learning, (4) preference construction and elicitation, and (5) preference integration. We believe the model underpins multiple suggested approaches to clinical practice that take the form of patient centered care, motivational interviewing, goal setting, action planning, and shared decision making. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Ethical case deliberation on the ward. A comparison of four methods.

    Science.gov (United States)

    Steinkamp, Norbert; Gordijn, Bert

    2003-01-01

    The objective of this article is to analyse and compare four methods of ethical case deliberation. These include Clinical Pragmatism, The Nijmegen Method of ethical case deliberation, Hermeneutic dialogue, and Socratic dialogue. The origin of each method will be briefly sketched. Furthermore, the methods as well as the related protocols will be presented. Each method will then be evaluated against the background of those situations in which it is being used. The article aims to show that there is not one ideal method of ethical case deliberation, which fits to all possible kinds of moral problems. Rather, as each of the methods highlights a limited number of morally relevant aspects, each method has its strengths and weaknesses as well. These strengths and weaknesses should be evaluated in relation to different types of situations, for instance moral problems in treatment decisions, moral uneasiness and residue, and the like. The suggestion arrived at on the basis of the findings of this paper is a reasonable methodological plurality. This means that a method can be chosen depending on the type of moral problem to be deliberated upon. At the same time it means, that by means of a method, deliberation should be facilitated.

  20. Deliberate Evolution in Multi-Agent Systems

    NARCIS (Netherlands)

    Brazier, F.M.; Jonker, C.M.; Treur, J.; Wijngaards, N.J.E.; Gabbay, D.

    2001-01-01

    Evolution in societies of agents is a challenging phenomenon, both from a fundamental perspective and from an applied perspective. In the literature often genetic programming approaches are used and relatively simple agents are considered, which have no deliberate influence on the direction of the

  1. Socio-Technical Deliberation about Free and Open Source Software: Accounting for the Status of Artifacts in Public Life

    Science.gov (United States)

    Benoit-Barne, Chantal

    2007-01-01

    This essay investigates the rhetorical practices of socio-technical deliberation about free and open source (F/OS) software, providing support for the idea that a public sphere is a socio-technical ensemble that is discursive and fluid, yet tangible and organized because it is enacted by both humans and non-humans. In keeping with the empirical…

  2. Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients.

    Science.gov (United States)

    Naldemirci, Öncel; Wolf, Axel; Elam, Mark; Lydahl, Doris; Moore, Lucy; Britten, Nicky

    2017-08-04

    The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies. This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT). In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication. NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes.

  3. Freedom of Expression, Deliberation, Autonomy, and Respect

    DEFF Research Database (Denmark)

    Rostbøll, Christian Fogh

    for freedom of expression in terms of its relationship to different dimensions of autonomy. In response to the objection that Enlightenment theories pose a threat to cultures that reject autonomy, it is argued that autonomy-based democracy is not only compatible with but necessary for respect for cultural......The strongest versions of the democracy argument for freedom of expression rely on the deliberative conception of democracy. Deliberative democracy entails both an ideal of political autonomy and of autonomous preference formation. This paper elaborates the deliberative democracy argument...... diversity. On the basis of an intersubjective epistemology, I argue that citizens cannot know how to live on mutually respectful terms without engaging in public deliberation. Moreover, to be successful deliberation must foster some degree of personal autonomy, at least the ability to distinguish what...

  4. In the public interest: assessing expert and stakeholder influence in public deliberation about biobanks.

    Science.gov (United States)

    MacLean, Samantha; Burgess, Michael M

    2010-07-01

    Providing technical and experiential information without overwhelming participants' perspectives presents a major challenge to public involvement in policy decisions. This article reports the design and analysis of a case study on incorporating expert and stakeholder knowledge without including them as deliberators, while supporting deliberative participants' ability to introduce and critically assess different perspectives. Analysis of audio-recorded deliberations illustrates how expert and stakeholder knowledge was cited, criticized and incorporated into deliberations. In conclusion, separating experts and stakeholders from deliberations may be an important prima facie principle when the goal is to enhance citizen representation on technical issues and related policy.

  5. Using deliberation to address controversial issues: Developing Holocaust education curriculum.

    Directory of Open Access Journals (Sweden)

    THOMAS MISCO

    2007-10-01

    Full Text Available This paper explores how a cross-cultural project responded to the need for new Holocaust educational materials for the Republic of Latvia through the method of curriculum deliberation. Analysis of interview, observational, and document data drawn from seven curriculum writers and numerous project members suggest that curriculum deliberation helped awaken a controversial and silenced history while attending to a wide range of needs and concerns for a variety of stakeholders. The findings highlight structural features that empowered the curriculum writers as they engaged in protracted rumination, reflected upon competing norms, and considered the nuances of the curriculum problem in relation to implementation. Understanding the process, challenges, and promises of cross-cultural curriculum deliberation holds significance for educators, curricularists, and educational researchers wishing to advance teaching and learning within silenced histories and controversial issues.

  6. Emotions and clinical ethics support. A moral inquiry into emotions in moral case deliberation.

    Science.gov (United States)

    Molewijk, Bert; Kleinlugtenbelt, Dick; Pugh, Scott M; Widdershoven, Guy

    2011-12-01

    Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In a moral case deliberation, the participants are invited to place themselves in the position of the case presenter and to investigate their own emotions in the situation. It is about critically assessing the facts in the case that cause the emotion and the related (moral) thoughts that accompany the emotion. It is also about finding the right emotion in a given situation and finding the right balance in dealing with that emotion. These steps in the moral inquiry give rise to group learning. It is a process of becoming open towards the perspectives of others, leading to new insights into what is an appropriate emotion in the specific situation. We show how this approach works in moral case deliberation. A physician presents a situation in which he is faced with a pregnant woman who is about to deliver multiple extremely premature infants at the threshold of viability. The moral deliberation of the case and the emotions therein leads to the participants' conclusion that "compassion" is a more adequate emotion than "sadness". The emotion "sadness" is pointed towards the tragedy that is happening to the woman. The emotion "compassion" is pointed towards the woman; it combines consideration and professional responsibility. Through the shift towards compassion, participants experienced more creativity and freedom to deal with the sad situation and to support the woman. The paper ends with an analysis and reflection on the deliberation process. In the conclusion we argue for more attention to

  7. How deliberation makes better citizens

    DEFF Research Database (Denmark)

    Hansen, Kasper Møller; Normann Andersen, Vibeke

    2007-01-01

    This article presents results from a Danish national Deliberative Poll on the single European currency. A representative sample of 364 Danish citizens assembled to deliberate on Denmark's participation in the single currency. As a quasi-experiment, the Deliberative Poll is an example of deliberat...... emphasizes the need for further elaboration of the theory of deliberative democracy so that it better reflects these features of ‘real-life' politics....

  8. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence.

    Science.gov (United States)

    McGaghie, William C; Issenberg, S Barry; Cohen, Elaine R; Barsuk, Jeffrey H; Wayne, Diane B

    2011-06-01

    This article presents a comparison of the effectiveness of traditional clinical education toward skill acquisition goals versus simulation-based medical education (SBME) with deliberate practice (DP). This is a quantitative meta-analysis that spans 20 years, 1990 to 2010. A search strategy involving three literature databases, 12 search terms, and four inclusion criteria was used. Four authors independently retrieved and reviewed articles. Main outcome measures were extracted to calculate effect sizes. Of 3,742 articles identified, 14 met inclusion criteria. The overall effect size for the 14 studies evaluating the comparative effectiveness of SBME compared with traditional clinical medical education was 0.71 (95% confidence interval, 0.65-0.76; P medical education in achieving specific clinical skill acquisition goals. SBME is a complex educational intervention that should be introduced thoughtfully and evaluated rigorously at training sites. Further research on incorporating SBME with DP into medical education is needed to amplify its power, utility, and cost-effectiveness.

  9. Just-in-Time Training for High-Risk Low-Volume Therapies: An Approach to Ensure Patient Safety.

    Science.gov (United States)

    Helman, Stephanie; Lisanti, Amy Jo; Adams, Ann; Field, Cynthia; Davis, Katherine Finn

    2016-01-01

    High-risk low-volume therapies are those therapies that are practiced infrequently and yet carry an increased risk to patients because of their complexity. Staff nurses are required to competently manage these therapies to treat patients' unique needs and optimize outcomes; however, maintaining competence is challenging. This article describes implementation of Just-in-Time Training, which requires validation of minimum competency of bedside nurses managing high-risk low-volume therapies through direct observation of a return-demonstration competency checklist.

  10. Tragedy in moral case deliberation.

    Science.gov (United States)

    Spronk, Benita; Stolper, Margreet; Widdershoven, Guy

    2017-09-01

    In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants. A case study design is used by conducting semi-structured interviews (N = 10) with health care professionals who both played a role in the treatment of the patient and attended the MCD. The results show that MCD helps people to deal with tragic situations. An important element of MCD in this respect is making explicit the dilemma and the damage, demonstrating that there is no simple solution. MCD prompts participants to formulate and share personal experiences with one another and thus helps to create a shared perception of the situation as tragic. The article concludes that MCD contributes to the sharing of tragic experiences, and fosters mutual interaction during a tragedy. Its value could be increased through explicit reflection on the aspect of contingency that characterises tragedy.

  11. Psychosocial therapy and causes of death after deliberate self-harm

    DEFF Research Database (Denmark)

    Birkbak, J; Stuart, E A; Lind, B D

    2016-01-01

    BACKGROUND: Psychosocial therapy after deliberate self-harm might be associated with reduced risk of specific causes of death. METHOD: In this matched cohort study, we included patients, who after an episode of deliberate self-harm received psychosocial therapy at a Suicide Prevention Clinic...... in Denmark between 1992 and 2010. We used propensity score matching in a 1:3 ratio to select a comparison group from 59 046 individuals who received standard care. National Danish registers supplied data on specific causes of death over a 20-year follow-up period. RESULTS: At the end of follow-up, 391 (6.......5-448.4) for mental or behavioural disorders as a cause of death, 111.1 (95% CI 79.2-210.5) for alcohol-related causes and 96.8 (95% CI 69.1-161.8) for other diseases and medical conditions. CONCLUSIONS: Our findings indicate that psychosocial therapy after deliberate self-harm might reduce long-term risk of death...

  12. Sustainability and deliberate transition of socio-technical systems

    DEFF Research Database (Denmark)

    Hansen, Ole Erik; Søndergård, Bent; Stærdahl, Jens

    or developing socio-technical systems in order to integrate the concept of sustainability as a driver for the deliberate and purposeful shaping and transition. The article discusses the requirements to effective governance networks and governing of governance networks. Research within innovation systems......The article suggests that deliberate planning for sustainability demands a focus on the transition of socio-technical systems in order to establish robust and more sustainable patterns of production and consumption. This implies the necessity of a new perspective for environmental planning......, transition management and technology systems combined with planning and experimental activities provides both a theoretical and empirical body of knowledge of such governance processes. The article discusses how this perspective can be used in relation to the process of developing bio-fuel systems...

  13. Clinical features of adolescents with deliberate self-harm: A case control study in Lisbon, Portugal

    Directory of Open Access Journals (Sweden)

    Diogo F Guerreiro

    2009-11-01

    Full Text Available Diogo F Guerreiro, Ema L Neves, Rita Navarro, Raquel Mendes, Ana Prioste, Diana Ribeiro, Tiago Lila, António Neves, Mónica Salgado, Nazaré Santos, Daniel SampaioYouth Suicide Study Group (NES, The Hospital Santa Maria, Psychiatry Department, Lisbon Faculty of Medicine, PortugalAbstract: Deliberate self-harm (DSH among adolescents is a high-risk condition for suicide. The aim of the present study is to describe the characteristic clinical features of adolescents with DSH according to our local context (Lisbon, Portugal, using easily available information from clinical settings. A case control study was constructed from a sample of 100 adolescents (aged 12 to 21 years. The sample was divided into two groups: adolescents with and without DSH. Case files were examined and data was completed by clinical interviews. Demographic, psychosocial, and psychopathological data were assessed and compared. Ninety-eight subjects completed the protocol. The DSH group was associated with the following: suicidal ideation or suicidal behavior as consultation motive, emergency room referral, previous follow-up attempts, suicidal ideation, psychosocial difficulties, or lack of therapeutic goals. There was a nonsignificant trend towards diagnosis of depression in the DSH group. These results reflect our clinical practice with adolescents and add data about teenagers who self-harm to the literature. Prevention and early recognition of DSH (and frequently associated depression in adolescents are essential and could be life-saving measures. An integrated approach, which takes into account psychosocial difficulties, family dysfunction, and negative expectations, seems to be of great importance.Keywords: deliberate self-harm, suicide, adolescents, suicide risk, case control

  14. Prostate Brachytherapy Case Volumes by Academic and Nonacademic Practices: Implications for Future Residency Training

    International Nuclear Information System (INIS)

    Orio, Peter F.; Nguyen, Paul L.; Buzurovic, Ivan; Cail, Daniel W.; Chen, Yu-Wei

    2016-01-01

    Purpose: The use of prostate brachytherapy has continued to decline in the United States. We examined the national practice patterns of both academic and nonacademic practices performing prostate brachytherapy by case volume per year to further characterize the decline and postulate the effect this trend might have on training the next generation of residents. Methods and Materials: Men diagnosed with prostate cancer who had undergone radiation therapy in 2004 to 2012 were identified. The annual brachytherapy case volume at each facility was determined and further categorized into ≤12 cases per year (ie, an average of ≤1 cases per month), 13 to 52 cases per year, and ≥53 cases per year (ie, an average of ≥1 cases per week) in academic practices versus nonacademic practices. Results: In 2004 to 2012, academic practices performing an average of ≤1 brachytherapy cases per month increased from 56.4% to 73.7%. In nonacademic practices, this percentage increased from 60.2% to 77.4% (P<.0001 for both). Practices performing an average of ≥1 cases per week decreased among both academic practices (from 6.7% to 1.5%) and nonacademic practices (from 4.5% to 2.7%). Conclusions: Both academic and nonacademic radiation oncology practices have demonstrated a significant reduction in the use of prostate brachytherapy from 2004 to 2012. With the case volume continuing to decline, it is unclear whether we are prepared to train the next generation of residents in this critical modality.

  15. Cognitive-behavioural therapy for deliberate self-harm

    NARCIS (Netherlands)

    Slee, Nadja

    2008-01-01

    This thesis describes the outcomes of a randomized controlled trial of a Cognitive Behavioural Therapy (CBT) intervention for patients who engage in Deliberate Self-Harm (DSH). The CBT intervention was designed to supplement usual care following an episode of DSH. The study involved 90 people (95%

  16. Immigration, Suicidal Ideation and Deliberate Self-Injury in the Boston Youth Survey 2006

    Science.gov (United States)

    Borges, Guilherme; Azrael, Deborah; Almeida, Joanna; Johnson, Renee M.; Molnar, Beth E.; Hemenway, David; Miller, Matthew

    2011-01-01

    The prevalence and immigration-related correlates of deliberate self-injury (DSI) and suicidal ideation (SI) were estimated in a sample of Boston public high school students in 2006. Compared with U.S.-born youth, immigrant youth were not at increased risk for DSI or SI, even if they had experienced discrimination due to their ancestry. By…

  17. Conscious thought beats deliberation without attention in diagnostic decision-making: at least when you are an expert.

    Science.gov (United States)

    Mamede, Sílvia; Schmidt, Henk G; Rikers, Remy M J P; Custers, Eugene J F M; Splinter, Ted A W; van Saase, Jan L C M

    2010-11-01

    Contrary to what common sense makes us believe, deliberation without attention has recently been suggested to produce better decisions in complex situations than deliberation with attention. Based on differences between cognitive processes of experts and novices, we hypothesized that experts make in fact better decisions after consciously thinking about complex problems whereas novices may benefit from deliberation-without-attention. These hypotheses were confirmed in a study among doctors and medical students. They diagnosed complex and routine problems under three conditions, an immediate-decision condition and two delayed conditions: conscious thought and deliberation-without-attention. Doctors did better with conscious deliberation when problems were complex, whereas reasoning mode did not matter in simple problems. In contrast, deliberation-without-attention improved novices' decisions, but only in simple problems. Experts benefit from consciously thinking about complex problems; for novices thinking does not help in those cases.

  18. Deliberate and Crisis Action Planning and Execution Segments Increment 2A (DCAPES Inc 2A)

    Science.gov (United States)

    2016-03-01

    2016 Major Automated Information System Annual Report Deliberate and Crisis Action Planning and Execution Segments Increment 2A (DCAPES Inc 2A...Program Name Deliberate and Crisis Action Planning and Execution Segments Increment 2A (DCAPES Inc 2A) DoD Component Air Force Responsible Office Program...APB) dated March 9, 2015 DCAPES Inc 2A 2016 MAR UNCLASSIFIED 4 Program Description Deliberate and Crisis Action Planning and Execution Segments

  19. Deliberate and Crisis Action Planning and Execution Segments Increment 2B (DCAPES Inc 2B)

    Science.gov (United States)

    2016-03-01

    2016 Major Automated Information System Annual Report Deliberate and Crisis Action Planning and Execution Segments Increment 2B (DCAPES Inc 2B...Information Program Name Deliberate and Crisis Action Planning and Execution Segments Increment 2B (DCAPES Inc 2B) DoD Component Air Force Responsible Office...been established. DCAPES Inc 2B 2016 MAR UNCLASSIFIED 4 Program Description Deliberate and Crisis Action Planning and Execution Segments (DCAPES) is

  20. Non-Conscious vs. Deliberate Dynamic Decision-Making—A Pilot Experiment

    Directory of Open Access Journals (Sweden)

    Andreas Größler

    2016-02-01

    Full Text Available The purpose of this paper is to explore the effects of non-conscious vs. deliberate ways of making decisions in a dynamic decision-making task. An experimental setting is used to study this question; three experimental groups are distinguished: immediate decision-making (only very limited time for deliberate cognitive processing, considerate decision-making (relatively long time for deliberate cognitive processing, and distracted decision-making (time for non-conscious cognitive processing only. As experimental stimulus, a simulator based on the Kaibab Plateau model was employed. With a sample size of more than 100 experimental participants, group differences are not significant for most data examined. Implications comprise the formulation of a framework to guide further research. The value of this paper lies in the fact that it connects to a recent discussion in psychology and transfers it to a domain in the core interest of the system community: decision-making in situations with dynamic complexity. Furthermore, it offers a range of improvement points for potential follow-up studies.

  1. Target volume delineation and field setup. A practical guide for conformal and intensity-modulated radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nancy Y. [Memorial Sloan-Kettering Cancer Center, New York, NY (United States). Radiation Oncology; Lu, Jiade J. (eds.) [National Univ. Health System, Singapore (Singapore). Dept. of Radiation Oncology; National Univ. of Singapore (Singapore). Dept. of Medicine

    2013-03-01

    Practical handbook on selection and delineation of tumor volumes and fields for conformal radiation therapy, including IMRT. Helpful format facilitating use on a step-by-step basis in daily practice. Designed to ensure accurate coverage of commonly encountered tumors along their routes of spread. This handbook is designed to enable radiation oncologists to appropriately and confidently delineate tumor volumes/fields for conformal radiation therapy, including intensity-modulated radiation therapy (IMRT), in patients with commonly encountered cancers. The orientation of this handbook is entirely practical, in that the focus is on the illustration of clinical target volume (CTV) delineation for each major malignancy. Each chapter provides guidelines and concise knowledge on CTV selection for a particular disease, explains how the anatomy of lymphatic drainage shapes the selection of the target volume, and presents detailed illustrations of volumes, slice by slice, on planning CT images. While the emphasis is on target volume delineation for three-dimensional conformal therapy and IMRT, information is also provided on conventional radiation therapy field setup and planning for certain malignancies for which IMRT is not currently suitable.

  2. Relational autonomy in the care of the vulnerable: health care professionals' reasoning in Moral Case Deliberation (MCD).

    Science.gov (United States)

    Heidenreich, Kaja; Bremer, Anders; Materstvedt, Lars Johan; Tidefelt, Ulf; Svantesson, Mia

    2017-12-14

    In Moral Case Deliberation (MCD), healthcare professionals discuss ethically difficult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical reflection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals' moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The moral reasoning centred on how to strike the balance between personal convictions about what constitutes good care, and the perceived dissonant care preferences held by the patient. The healthcare professionals deliberated about good care in relation to demands considered to be unrealistic, justifications for influencing the patient, the incapacitated patient's nebulous interests, and coping with the conflict between using coercion to achieve good while protecting human dignity. Furthermore, as a basis for the reasoning, the healthcare professionals reflected on how to establish a responsible relationship with the vulnerable person. This comprised acknowledging the patient as a susceptible human being, protecting dignity and integrity, defining their own moral responsibility, and having patience to give the patient and family time to come to terms with illness and declining health. The profound struggle to respect the patient's autonomy in clinical practice can be understood through the concept of relational autonomy, to try to secure both patients' influence and at the same time take responsibility for their needs as vulnerable humans.

  3. The prevalence of self-reported deliberate self harm in Irish adolescents.

    LENUS (Irish Health Repository)

    Morey, Carolyn

    2008-01-01

    BACKGROUND: Deliberate self harm is major public health problem, in particular among young people. Although several studies have addressed the prevalence of deliberate self harm among young people in the community, little is known about the extent to which deliberate self harm comes to the attention of medical services, the self harm methods used and the underlying motives. The aim of this study was to determine the prevalence of deliberate self harm in adolescents and the methods, motives and help seeking behaviour associated with this behaviour. METHODS: A cross-sectional survey using an anonymous self-report questionnaire was administered in 39 schools in the Southern area of the Health Service Executive, Ireland. Of the 4,583 adolescents aged 15-17 years who were invited to participate in the survey, 3,881 adolescents took part (response: 85%). RESULTS: A lifetime history of DSH was reported by 9.1% (n = 333) of the adolescents. DSH was more common among females (13.9%) than males (4.3%). Self cutting (66.0%) and overdose (35.2%) were the most common DSH methods. A minority of participants accessed medical services after engaging in DSH (15.3%). CONCLUSION: DSH is a significant problem in Irish adolescents and the vast majority do not come to the attention of health services. Innovative solutions for prevention and intervention are required to tackle DSH in adolescents.

  4. Service expectations from high- and low-volume customers in the alcoholic beverage industry

    Directory of Open Access Journals (Sweden)

    Jacques Beukes

    2013-08-01

    Research purpose: This research study investigated the relationship between the volume a customer buys from an alcoholic beverage supply company and what influence this volume has on their customer service expectations. Motivation for the study: The main purpose of this study was to evaluate what influence the volume an organisation buys from alcoholic beverage suppliers has on their service quality expectations. Research design, approach and method: A non-probability judgement sample method was used, with a sample size of 220 respondents. The questionnaire requested respondents (high- and low-volume to rank their customer service expectations and opinions with reference to Parasuraman’s service delivery dimensions. Ranking was done using a five-point Likert scale. Main findings: The findings of the study indicated that both the high- and low-volume customers felt that alcoholic beverage supply companies had to deliver on all five service delivery dimensions but failed to do so to full satisfaction. Practical and managerial implications: It is recommended that the alcoholic beverage supply companies should address the problem areas identified in this study to avoid defection of customers. Contribution and value add: This may assist alcoholic beverage supply companies to better understand the customers’ demographic profiles. The study also revealed that the satisfaction level experienced by customers in both sections of the study (high- and low-demand, with a considerable gap between expectations and opinions within the empathy dimension.

  5. Scoping studies to reduce ICPP high-level radioactive waste volumes for final disposal

    International Nuclear Information System (INIS)

    Knecht, D.A.; Berreth, J.R.; Chipman, N.A.; Cole, H.S.; Geczi, L.S.; Kerr, W.B.; Staples, B.A.

    1985-08-01

    This report presents the results of scoping studies carried out to determine the feasibility of the following candidate options to reduce high-level waste volume: (1) low-fluoride, low-volume glass, (2) glass-ceramic and ceramic, (3) Modified Zirflex, (4) inerts removal by neutralization, and (5) modified Fluorinel processes. The results of the scoping studies show that the glass-ceramic/ceramic waste forms and neutralization process with potential HLW volume reductions ranging from 60 to 80% appear feasible, based on laboratory-scale tests. The presently used Fluorinel process modified by reducing HF usage also appears to be feasible and could result in up to a 10% potential volume reduction. If the current process start-up tests verify the practicality, reduced HF usage will be implemented. The low-volume glass and Modified Zirflex processes may also be feasible, based on laboratory tests, but would require significantly more process development and/or modifications and could result in only a 20 to 30% potential volume reduction. Based on these scoping studies, it is recommended that (1) the glass-ceramic/ceramic and neutralization processes be developed further, (2) reduced HF use for the Modified Fluorinel process be implemented as soon as practical and other options reducing chemical usage for criticality control be evaluated, (3) basic development for the glass process be continued as a back-up technology, and (4) laboratory-scale radioactive fuel dissolution testing for the Modified Zirflex process be completed with further process development discontinued unless needed in the future

  6. John porter lecture: waves of protest--direct action, deliberation, and diffusion.

    Science.gov (United States)

    Wood, Lesley

    2015-02-01

    The book Direct Action, Deliberation and Diffusion: Collective Action After the WTO Protests in Seattle argues that the process of diffusion is dependent on social processes in the receiving context. The most important in social movements is an egalitarian and reflexive deliberation among diverse actors. The book traces the direct action tactics associated with the Seattle protests against the World Trade Organization in 1999 and how these spread to activists in Toronto and New York City. It shows how the structure of the political field, racial and class inequalities, identity boundaries, and organizational and conversational dynamics limited deliberation among activists, and thus limited the diffusion of the Seattle tactics. By constraining the spread of the Seattle tactics, this slowed the global justice movement's wave of protest. In this paper, I explore the application of and implications of this model of protest tactic diffusion to the recent Idle No More mobilizations. © 2015 Canadian Sociological Association/La Société canadienne de sociologie.

  7. VOLUME STUDY WITH HIGH DENSITY OF PARTICLES BASED ON CONTOUR AND CORRELATION IMAGE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Tatyana Yu. Nikolaeva

    2014-11-01

    Full Text Available The subject of study is the techniques of particle statistics evaluation, in particular, processing methods of particle images obtained by coherent illumination. This paper considers the problem of recognition and statistical accounting for individual images of small scattering particles in an arbitrary section of the volume in case of high concentrations. For automatic recognition of focused particles images, a special algorithm for statistical analysis based on contouring and thresholding was used. By means of the mathematical formalism of the scalar diffraction theory, coherent images of the particles formed by the optical system with high numerical aperture were simulated. Numerical testing of the method proposed for the cases of different concentrations and distributions of particles in the volume was performed. As a result, distributions of density and mass fraction of the particles were obtained, and the efficiency of the method in case of different concentrations of particles was evaluated. At high concentrations, the effect of coherent superposition of the particles from the adjacent planes strengthens, which makes it difficult to recognize images of particles using the algorithm considered in the paper. In this case, we propose to supplement the method with calculating the cross-correlation function of particle images from adjacent segments of the volume, and evaluating the ratio between the height of the correlation peak and the height of the function pedestal in the case of different distribution characters. The method of statistical accounting of particles considered in this paper is of practical importance in the study of volume with particles of different nature, for example, in problems of biology and oceanography. Effective work in the regime of high concentrations expands the limits of applicability of these methods for practically important cases and helps to optimize determination time of the distribution character and

  8. Place and Situated Deliberation in Participatory Planning – A Research Proposal

    DEFF Research Database (Denmark)

    Korn, Matthias

    2011-01-01

    for everyone and everywhere through a mobile augmented reality application that visualizes future, planned buildings on capable mobile phones. I conclude with the central questions and problems for future research that focuses on place and situated deliberation.......Within the domain of participatory urban planning, this position paper argues for a focus on the notion of place in the design of mobile and/or ubiquitous systems that are used in deliberation processes with central spatial references. I discuss (1) leveraging properties of place as a resource...

  9. Deliberative Democracy, Critical Thinking, and the Deliberating Individual: empirical challenges to the reasonability of the citizen

    Directory of Open Access Journals (Sweden)

    Juho Ritola

    2015-01-01

    Full Text Available In this essay, I first discuss the conditions set by theorists of democratic deliberation on proper deliberation. These conditions call for reasoned decisions from mutually acceptable premises. Next, I present the ideal of critical thinking that should guide the citizen in this deliberation. I then examine the empirical literature on human reasoning. Some research results in the empirical literature paint a bleak picture of human rationality: we fall victim to heuristics and biases, persevere in our beliefs in the face of contrary evidence, and justify our moral judgments by post hoc-reasoning. In addition, the deliberating groups have problems of their own. The groups may, for example, amplify errors or fall victim to information cascades.  Though these epistemically detrimental processes can be overcome, they do present a challenge to our rationality. The essay concludes by arguing that the empirical evidence in fact supports an internalistic approach to group deliberation, a claim challenged by Solomon (2006.

  10. Vaginismus and dyspareunia: automatic vs. deliberate disgust responsivity.

    Science.gov (United States)

    Borg, Charmaine; de Jong, Peter J; Schultz, Willibrord Weijmar

    2010-06-01

    The difficulty of penetration experienced in vaginismus and dyspareunia may at least partly be due to a disgust-induced defensive response. To examine if sex stimuli specifically elicit: (i) automatic disgust-related memory associations; (ii) physiological disgust responsivity; and/or (iii) deliberate expression of disgust/threat. Two single target Implicit Association Task (st-IAT) and electromyography (EMG) were conducted on three groups: vaginismus (N = 24), dyspareunia (N = 24), and control (N = 31) group. st-IAT, to index their initial disgust-related associations and facial EMG for the m. levator labii and m. corrugator supercilii regions. Both clinical groups showed enhanced automatic sex-disgust associations. As a unique physiological expression of disgust, the levator activity was specifically enhanced for the vaginismus group, when exposed to a women-friendly SEX video clip. Also at the deliberate level, specifically the vaginismus group showed enhanced subjective disgust toward SEX pictures and the SEX clip, along with higher threat responses. Supporting the view that disgust is involved in vaginismus and dyspareunia, for both, clinical groups' sex stimuli automatically elicited associations with disgust. Particularly for the vaginismus group, these initial disgust associations persisted during subsequent validation processes and were also evident at the level of facial expression and self-report data. Findings are consistent with the notion that uncontrollable activated associations are involved in eliciting defensive reactions at the prospect of penetration seen in both conditions. Whereas deliberate attitudes, usually linked with the desire for having intercourse, possibly generate the distinction (e.g., severity) between these two conditions.

  11. Governance networks as a frame for inter-demoi participation and deliberation

    DEFF Research Database (Denmark)

    Sørensen, Eva

    2012-01-01

    By focusing exclusively on the contributions of political participation and deliberation to the enhancement of democratic regulation within a unitary democratic unit-that is, a demos-traditional liberal theories of democracy overlook the democratic value of political participation and deliberation...... between demoi. The need to find ways to increase the democratic quality of inter-demoi interaction is growing rapidly due to the emergence of a pluricentric political system in which cross-demoi decision-making is more the rule than the exception. There is an urgent call for new theories of democracy able...

  12. Advancing technician practice: Deliberations of a regulatory board.

    Science.gov (United States)

    Adams, Alex J

    2018-01-01

    In 2016, the Idaho State Board of Pharmacy (U.S.) undertook a major rulemaking initiative to advance pharmacy practice by broadening the ability of pharmacists to delegate tasks to pharmacy technicians. The new rules of the Board thus moved the locus of control in technician scope of practice from law to pharmacist delegation. Pharmacist delegation is individualistic and takes into account the individual technician's capabilities, the pharmacist's comfort level, facility policies, and the risk mitigation strategies present at the facility, among other factors. State law limits, by contrast, are rigid and can mean that pharmacists are unable to delegate tasks that are or could otherwise be within the abilities of their technicians. The expanded technician duties are in two domains: 1) medication dispensing support (e.g., tech-check-tech, accepting verbal prescriptions, transferring prescriptions, and performing remote data entry); and 2) technical support for pharmacist clinical services (e.g., administering immunizations). This commentary reviews the evidence behind these expanded duties, as well as the key regulatory decision points for each task. The Board's rules and approach may prove useful to other states and even other governing bodies outside the U.S. as they consider similar issues. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. 'Her choice of course': Negotiating legitimacy of 'choice' in abortion rights deliberations during the 'Repeal the Eighth' movement in Ireland.

    Science.gov (United States)

    Sambaraju, Rahul; Sammon, Myles; Harnett, Frank; Douglas, Emma

    2018-02-01

    Discourses of 'choice' are routinely involved in sexual and reproductive rights' advocacy. In this article, we offer a discursive psychological examination of how 'choice' is oriented to, in online deliberations on the ongoing movement for abortion rights in Ireland. Comment posters treated 'choice' as involving outcomes of and motives for choosing, in negotiating legitimacy of women's rights to choose. These accompanied alternative versions of women, either as independent or as intimately bound up with pregnancy/motherhood, which were flexibly used in negotiation legitimacy of women's rights to 'choice' in abortion practices. Choice advocacy is then situated in particular discursive practices.

  14. The control of deliberate waiting strategies in a stop-signal task

    Directory of Open Access Journals (Sweden)

    R.P. Sylwan

    2004-06-01

    Full Text Available To inhibit an ongoing flow of thoughts or actions has been largely considered to be a crucial executive function, and the stop-signal paradigm makes inhibitory control measurable. Stop-signal tasks usually combine two concurrent tasks, i.e., manual responses to a primary task (go-task are occasionally countermanded by a stimulus which signals participants to inhibit their response in that trial (stop-task. Participants are always instructed not to wait for the stop-signal, since waiting strategies cause the response times to be unstable, invalidating the data. The aim of the present study was to experimentally control the strategies of waiting deliberately for the stop-signal in a stop-task by means of an algorithm that measured the variation in the reaction times to go-stimuli on-line, and displayed a warning legend urging participants to be faster when their reaction times were more than two standard deviations of the mean. Thirty-four university students performed a stop-task with go- and stop-stimuli, both of which were delivered in the visual modality and were lateralized within the visual field. The participants were divided into two groups (group A, without the algorithm, vs group B, with the algorithm. Group B exhibited lower variability of reaction times to go-stimuli, whereas no significant between-group differences were found in any of the measures of inhibitory control, showing that the algorithm succeeded in controlling the deliberate waiting strategies. Differences between deliberate and unintentional waiting strategies, and anxiety as a probable factor responsible for individual differences in deliberate waiting behavior, are discussed.

  15. Public deliberation in municipal planning

    DEFF Research Database (Denmark)

    Bohøj, Morten; Borchorst, Nikolaj Gandrup; Bødker, Susanne

    2011-01-01

    This paper reports on an exploratory participatory design process aimed at supporting citizen deliberation in municipal planning. It presents the main outcomes of this process in terms of selected prototypes and an approach to the use setting. We support and discuss different ways for citizens...... to act and reflect on proposed plans: in-situ, while physically close to the planning object, and ex-situ, when citizens are remote from this. The support of in-situ and ex-situ participation allows citizens to engage in continuous reflection-in and on-action as a collaborative activity with other...

  16. Seeking Deliberation on the Unborn in International Law

    Directory of Open Access Journals (Sweden)

    SA de Freitas

    2011-08-01

    Full Text Available International human rights instruments and jurisprudence radiate an understanding of international law as also serving to protect fundamental rights and the interests of the individual. The idea that human rights provide a credible framework for constructing common norms among nations and across cultures is both powerful and attractive. If the protection of being human serves as the common denominator in human rights discussion, and if human rights are deeply inclusive, despite being culturally and historically diverse, then a failure to deliberate on the legal status and protection of the unborn may be seen as a failure to extend respect where it is due. Such deliberation is required, irrespective of the fact that jurisprudential debate on the unborn and on abortion is complex and controversial. The protection of human life, well-being, and dignity are essential aims of the United Nations Charter and the international system created to implement it. Although there have been collective efforts resulting in substantial development in international human rights law, the international community has not approached the legal status and protection of the unborn as a matter of urgency – this, while much has been accomplished regarding women, children, animals and cloning. This article therefore argues for the development of a deliberative framework so as to further the recognition (not necessarily in an absolute sense of the unborn in international law, bearing in mind that opposition to abortion does not of itself constitute an attack on a woman's right to respect for privacy in her life. The article also sets out what such deliberation on the legal status and protection of the unborn entails, against the background of a procedurally-rational approach.

  17. Assessing the associations among trait and state levels of deliberate and spontaneous mind wandering.

    Science.gov (United States)

    Seli, Paul; Risko, Evan F; Smilek, Daniel

    2016-04-01

    Recent research has demonstrated that mind wandering can be subdivided into spontaneous and deliberate types, and this distinction has been found to hold at both the trait and state levels. However, to date, no attempts have been made to link trait-level spontaneous and deliberate mind wandering with state-level assessments of these two subtypes of mind wandering. Here we evaluated whether trait-level deliberate and spontaneous mind wandering map onto state levels of these subtypes of mind wandering. Results showed correspondence between trait-level reports of spontaneous and deliberate mind wandering and their state-level counterparts, indicating that people's reports on the intentionality of their mind wandering in the laboratory correspond to their reports of the intentionality of mind wandering in everyday life. Thus, the trait- and state-level scales of mind wandering were found to validate each other: Whereas the state-level measures provided some construct validity for the trait-level measures, the trait-level measures indicated that the state-level measures may be generalizable to everyday situations. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Democratic Deliberation Procedures : Theoretical and Practical Issues

    Directory of Open Access Journals (Sweden)

    Tutui Viorel

    2011-01-01

    Full Text Available Abstract : In contemporary political philosophy, the focus of the most important controversies is on the deliberative model of democracy. These controversies concern not only the theoretical problem of providing the best justification for a deliberative model of democratic legitimacy, but also the practical problem of designing the best deliberative procedure that will secure the implementation of deliberative democracy. In this paper I will present and analyze some of the most important deliberative designs: deliberative polls, citizens’ juries, consensus conferences and planning cells. I argue that these deliberative events can have a significant impact on the political behavior of a democratic community. However, I explain that all of them have only a limited influence on the policy-making activities in local and central governing structures. This is the reason why I believe we could only supplement and never fully replace the traditional aggregative procedures of democracy (voting and bargaining with a deliberative design.

  19. The Basic Act for Suicide Prevention: Effects on Longitudinal Trend in Deliberate Self-Harm with Reference to National Suicide Data for 1996–2014

    Directory of Open Access Journals (Sweden)

    Miharu Nakanishi

    2017-01-01

    Full Text Available A suicide prevention strategy was launched in Japan in 2006 to address the high suicide rate, which had increased considerably since 1998. The national strategy from 2007 involved the enhancement of psychiatric treatment services at emergency medical facilities and supportive observation by individuals close to patients. The national suicide rate has decreased gradually since 2008; however, national information regarding the number of patients who had engaged in deliberate self-harm was absent. Therefore, the present study examined the longitudinal trend in hospital admissions due to deliberate self-harm in Japan. Data from the National Patient Survey between 1996 and 2014—a nationally representative cross-sectional survey of inpatient care every 3 years—were used. Data for 13,014 patients were included in the estimation of the number of hospital admissions due to deliberate self-harm. The results show that the estimated number of admissions due to deliberate self-harm increased from 2078 in September 1996 to 3189 in September 2008, when the national number of suicide cases peaked, and decreased to 1783 in 2014. Approximately half of the patients were admitted to hospital because of self-harm via means other than drug poisoning, which had a high mortality rate (5.6%. The proportion of patients receiving public assistance was higher in those who had engaged in deliberate self-harm (8.5% relative to that observed in the general population. Overall, the trend in deliberate self-harm was synchronous with the number of suicide cases over time. As economic poverty has been associated with suicidal ideation and behavior and some recipients of public assistance tend to abuse psychotropic medication, the public assistance program should provide mental health support for recipients of social benefit schemes.

  20. Creating a firestorm: a review of children who deliberately light fires.

    Science.gov (United States)

    Lambie, Ian; Randell, Isabel

    2011-04-01

    Deliberate firesetting is a significant social problem that causes millions of dollars of property damage each year. Of particular concern is that a high proportion of these arson offences are committed by children and adolescents. Youth firesetters are a unique and diverse group, variant in their motivations, needs and behavior and distinct from their adult counterparts. The study of firesetting has been approached in a number of ways and thus the existing body of research lacks a coherent, consistent and comprehensive set of empirical findings. In synthesizing the literature on child and adolescent firesetting, this review considers the potential relationships between firesetting typologies, risk factors, development and treatment. It considers the extent to which firesetting can be considered within the framework of antisocial behavior and what implications such a relationship may have for clinical practice. The review concludes that despite a number of risk factors being repeatedly identified, an understanding of the etiology behind firesetting behavior and potential developmental trajectories remains theoretically rather than empirically based. Existing typological theories do not take sufficient account of the complexities of firesetting behavior and there is not yet a typology and accompanying assessment that has undergone thorough empirical testing and is of significant clinical utility. Despite indications that the relationship between firesetting and antisocial behavior is of a serious nature, there has been a general lack of attention to this in literature and practice. Attention to this relationship is necessary not just in the area of firesetting research and practice, but also amongst those working with youth with behavioral difficulties and conduct problems, as for these individuals firesetting is likely to indicate particularly high risk for severity of behavior and future offending. Because of this relationship and the diversity of firesetting

  1. Comparing group deliberation to other forms of preference aggregation in valuing ecosystem services

    Directory of Open Access Journals (Sweden)

    Mackenzie B. Murphy

    2017-12-01

    Full Text Available Deliberative methods for valuing ecosystem services are hypothesized to yield group preferences that differ systematically from those that would be obtained through calculative aggregation of the preferences of participating individuals. We tested this hypothesis by comparing the group consensus results of structured deliberations against a variety of aggregation methods applied to individual participant preferences that were elicited both before and after the deliberations. Participants were also asked about their perceptions of the deliberative process, which we used to assess their ability to detect preference changes and identify the causes of any changes. For five of the seven groups tested, the group consensus results could not have been predicted from individual predeliberation preferences using any of the aggregation rules. However, individual postdeliberation preferences could be used to reconstruct the group preferences using consensual and rank-based aggregation rules. These results imply that the preferences of participants changed over the course of the deliberation and that the group preferences reflected a broad consensus on overall rankings rather than simply the pairwise preferences of the majority. Changes in individual preferences seem to have gone largely unnoticed by participants, as most stated that they did not believe their preferences had substantially changed. Most participants were satisfied with the outcome of the deliberation, and their degree of satisfaction was correlated with the feeling that their opinion was heard and that they had an influence on the outcome. Based on our results, group deliberation shows promise as a means of generating ecosystem service valuations that reflect a consensus opinion rather than simply a collection of personal preferences.

  2. Best-practices guidelines for L2PSA development and applications. Volume 1 - General

    International Nuclear Information System (INIS)

    Raimond, E.; Pichereau, F.; Durin, T.; Rahni, N.; Loeffler, H.; Roesch, O.; Lajtha, G.; Santamaria, C.S.; Dienstbier, J.; Rydl, A.; Holmberg, J.E.; Lindholm, I.; Maennistoe, I.; Pauli, E.M.; Dirksen, G.; Grindon, L.; Peers, K.; Bassi, C.; Hulqvist, G.; Parozzi, F.; Polidoro, F.; Cazzoli, E.; Vitazkova, J.; Burgazzi, L.; Brinkman, H.; Seidel, A.; Schubert, B.; Wohlstein, R.; Guentay, S.; Oury, L.; Ngatchou, C.; Siltanen, S.; Niemela, I.; Routamo, T.; Vincon, L.; Helstroem, P.

    2010-01-01

    The objective of this coordinated action was to develop best practice guidelines for the performance and application of Level 2 PSA with a view to achieve harmonisation at EU level and to allow a meaningful and practical uncertainty evaluation in a Level 2 PSA. Specific relationships with communities in charge of nuclear reactor safety (utilities, safety authorities, vendors, and research or services companies) have been established in order to define the current needs in terms of guidelines for Level 2 PSA development and application. An international workshop was organised in Hamburg, with the support of VATTENFALL, in November 2008. The Level 2 PSA experts from ASAMPSA2 project partners have proposed some guidelines for the development and application of L2PSA based on their experience, open literature, and on information available from international cooperation (EC Severe Accident network of Excellence - SARNET, IAEA standards, OECD-NEA publications and workshop). There are a large number of technical issues addressed in the guideline which are not all covered with the same level of detail in the first version of the guideline. This version was submitted for external review in November 2010 by severe accident and PSA experts (especially from SARNET and OECD-NEA members). The feedback of the external review will be dis cussed during an international open works hop planned for March 2011 and all outcomes will be taken into consideration in the final version of this guideline (June 2011). The guideline includes 3 volumes: - Volume 1 - General considerations on L2PSA. - Volume 2 - Technical recommendations for Gen II and III reactors. - Volume 3 - Specific considerations for future reactors (Gen IV). The recommendations formulated in the guideline should not be considered as 'mandatory' but should help Level 2 PSA developers to achieve high quality studies with limited time and resources. It may also help Level 2 PSA reviewers by positioning one specific study in

  3. Dewey's Theory of Moral (and Political) Deliberation Unfiltered

    Science.gov (United States)

    Ralston, Shane J.

    2010-01-01

    In this paper, I argue that many recent interpretations of John Dewey's vision of democracy distort that vision by filtering it through the prism of contemporary deliberative democratic theories. An earlier attempt to defend Dewey's theory of moral deliberation is instructive for understanding the nature and function of this filter. In James…

  4. Moral deliberation and nursing ethics cases: elements of a methodological proposal.

    Science.gov (United States)

    Schneider, Dulcinéia Ghizoni; Ramos, Flávia Regina Souza

    2012-11-01

    A qualitative study with an exploratory, descriptive and documentary design that was conducted with the objective of identifying the elements to constitute a method for the analysis of accusations of and proceedings for professional ethics infringements. The method is based on underlying elements identified inductively during analysis of professional ethics hearings judged by and filed in the archives of the Regional Nursing Board of Santa Catarina, Brazil, between 1999 and 2007. The strategies developed were based on the results of an analysis of the findings of fact (occurrences/infractions, causes and outcomes) contained in the records of 128 professional ethics hearings and on the structural elements (statements, rules and practices) identified in five example professional ethics cases. The strategies suggested for evaluating accusations of ethics infringements and the procedures involved in deliberating on ethics hearings constitute a generic proposal that will require adaptation to the context of specific professional ethics accusations.

  5. Tax Salience, Voting, and Deliberation

    DEFF Research Database (Denmark)

    Sausgruber, Rupert; Tyran, Jean-Robert

    Tax incentives can be more or less salient, i.e. noticeable or cognitively easy to process. Our hypothesis is that taxes on consumers are more salient to consumers than equivalent taxes on sellers because consumers underestimate the extent of tax shifting in the market. We show that tax salience...... biases consumers' voting on tax regimes, and that experience is an effective de-biasing mechanism in the experimental laboratory. Pre-vote deliberation makes initially held opinions more extreme rather than correct and does not eliminate the bias in the typical committee. Yet, if voters can discuss...... their experience with the tax regimes they are less likely to be biased....

  6. Machine vision for high-precision volume measurement applied to levitated containerless material processing

    International Nuclear Information System (INIS)

    Bradshaw, R.C.; Schmidt, D.P.; Rogers, J.R.; Kelton, K.F.; Hyers, R.W.

    2005-01-01

    By combining the best practices in optical dilatometry with numerical methods, a high-speed and high-precision technique has been developed to measure the volume of levitated, containerlessly processed samples with subpixel resolution. Containerless processing provides the ability to study highly reactive materials without the possibility of contamination affecting thermophysical properties. Levitation is a common technique used to isolate a sample as it is being processed. Noncontact optical measurement of thermophysical properties is very important as traditional measuring methods cannot be used. Modern, digitally recorded images require advanced numerical routines to recover the subpixel locations of sample edges and, in turn, produce high-precision measurements

  7. Longitudinal relationships between gratitude, deliberate rumination, and posttraumatic growth in adolescents following the Wenchuan earthquake in China.

    Science.gov (United States)

    Zhou, Xiao; Wu, Xinchun

    2015-10-01

    To examine the longitudinal relationship between gratitude, deliberate rumination and posttraumatic growth (PTG) in the adolescent survivors after the Wenchuan earthquake, 217 adolescent survivors were randomly selected from several primary and secondary schools in the county of Wenchuan, and were assessed by questionnaires at three and a half years (T1), four and a half years (T2), five and a half years (T3) after the Wenchuan earthquake, respectively. The results found that there was a one-way predictive relationship of gratitude onto PTG from T1 to T3, and gratitude predicted deliberate rumination from T1 to T2 but not T2 to T3. Deliberate rumination only had a significant positive effect on PTG from T2 to T3, and PTG only predicted deliberate rumination from T1 to T2. These results indicated that gratitude could be a stable predictive factor for the development of PTG, and gratitude could also affect PTG by deliberate rumination. In addition, the predictive effect between deliberate rumination and PTG is unstable with time change. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  8. Intuitive and Deliberate Judgments Are Based on Common Principles

    Science.gov (United States)

    Kruglanski, Arie W.; Gigerenzer, Gerd

    2011-01-01

    A popular distinction in cognitive and social psychology has been between "intuitive" and "deliberate" judgments. This juxtaposition has aligned in dual-process theories of reasoning associative, unconscious, effortless, heuristic, and suboptimal processes (assumed to foster intuitive judgments) versus rule-based, conscious, effortful, analytic,…

  9. Aristotle’s contribution to the deliberation from a bioethical perspective

    Directory of Open Access Journals (Sweden)

    Mario Orlando Parra-Pineda

    2017-10-01

    Full Text Available Deliberation is a basic rational human activity recognized since ancient times due to its role in decision making during daily life activities and in specialized areas of knowledge such as medicine, politics and ethics. The objective of this reflection paper is to study the contribution of Aristotle to the deliberative process through his work the Nicomachean Ethics, where the following aspects of deliberation were identified for analysis: origin, definition, characteristics, and types and conditions for its development. Bioethics defend these aspects, since it finds in Aristotelian phronesis the fundamental axis to guide its actions in search of human self-realization and the analysis and decision making of the clinical bioethical problems. Twenty-four centuries have passed until the importance of this process and the need to educate about it was finally rediscovered.

  10. The roles of talent, physical precocity and practice in the development of soccer expertise.

    Science.gov (United States)

    Helsen, W F; Hodges, N J; Van Winckel, J; Starkes, J L

    2000-09-01

    Here we consider the potential contributions of talent, physical precocity and deliberate practice in the development of soccer expertise. After presenting a working definition of 'talent', we examine how coaches perceive and select potential talent. Our findings suggest that much of what coaches see as early talent may be explained by physical precocity associated with a relative age advantage. Finally, as a test of the model of Deliberate Practice, we review the results of studies that assessed the progress of international, national and provincial players based on accumulated practice, amount of practice per week and relative importance and demands of various practice and everyday activities. A positive linear relationship was found between accumulated individual plus team practice and skill. Various practical suggestions can be made to improve talent detection and selection and to optimize career practice patterns in soccer.

  11. In search of online deliberation : Towards a new method for examining the quality of online discussions

    NARCIS (Netherlands)

    Graham, Todd; Witschge, Tamara

    2003-01-01

    Many advocates of deliberative democracy see in the Internet a new opportunity for the development of public spaces, public spheres, and places where deliberation can take place. An important element of the notion of the public sphere in general and of deliberation specifically, is the quality of

  12. Examining the scope and patterns of deliberate self-injurious cutting content in popular social media.

    Science.gov (United States)

    Miguel, Elizabeth M; Chou, Tommy; Golik, Alejandra; Cornacchio, Danielle; Sanchez, Amanda L; DeSerisy, Mariah; Comer, Jonathan S

    2017-09-01

    Social networking services (SNS) have rapidly become a central platform for adolescents' social interactions and media consumption patterns. The present study examined a representative sample of publicly accessible content related to deliberate self-injurious cutting across three SNS platforms: Twitter, Tumblr, and Instagram. Data collection simulated searches for publicly available deliberate self-injury content on Twitter, Tumblr, and Instagram. Over a six-month period at randomly generated time points, data were obtained by searching "#cutting" on each SNS platform and collecting the first 10 posts generated. Independent evaluators coded posts for presence of the following: (a) graphic content, (b) negative self-evaluations, (c) references to mental health terms, (d) discouragement of deliberate self-injury, and (e) recovery-oriented resources. Differences across platforms were examined. Data collection yielded a sample of 1,155 public posts (770 of which were related to mental health). Roughly 60% of sampled posts depicted graphic content, almost half included negative self-evaluations, only 9.5% discouraged self-injury, and Instagram posts displayed the greatest proportion of graphic content and negative self-evaluations, whereas Twitter exhibited the smallest proportion of each. Findings characterize the graphic nature of online SNS deliberate self-injury content and the relative absence of SNS-posted resources for populations seeking out deliberate self-injurious cutting content. Mental health professionals must recognize the rapidly changing landscape of adolescent media consumption, influences, and social interaction as they may pertain to self-harm patterns. © 2017 Wiley Periodicals, Inc.

  13. Effect of Risk Acceptance for Bundled Care Payments on Clinical Outcomes in a High-Volume Total Joint Arthroplasty Practice After Implementation of a Standardized Clinical Pathway.

    Science.gov (United States)

    Kee, James R; Edwards, Paul K; Barnes, Charles L

    2017-08-01

    The Bundled Payments for Care Improvement (BPCI) initiative and the Arkansas Payment Improvement (API) initiative seek to incentivize reduced costs and improved outcomes compared with the previous fee-for-service model. Before participation, our practice initiated a standardized clinical pathway (CP) to reduce length of stay (LOS), readmissions, and discharge to postacute care facilities. This practice implemented a standardized CP focused on patient education, managing patient expectations, and maximizing cost outcomes. We retrospectively reviewed all primary total joint arthroplasty patients during the initial 2-year "at risk" period for both BPCI and API and determined discharge disposition, LOS, and readmission rate. During the "at risk" period, the average LOS decreased in our total joint arthroplasty patients and our patients discharged home >94%. Patients within the BPCI group had a decreased discharge to home and decreased readmission rates after total hip arthroplasty, but also tended to be older than both API and nonbundled payment patients. While participating in the BPCI and API, continued use of a standardized CP in a high-performing, high-volume total joint practice resulted in maintenance of a low-average LOS. In addition, BPCI patients had similar outcomes after total knee arthroplasty, but had decreased rates of discharge to home and readmission after total hip arthroplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Systematic and deliberate orientation and instruction for dedicated education unit staff.

    Science.gov (United States)

    Smyer, Tish; Tejada, Marianne Bundalian; Tan, Rhigel Alforque

    2015-03-01

    On the basis of increasing complexity of the health care environment and recommended changes in how nurses are educated to meet these challenges, the University of Nevada Las Vegas, School of Nursing established an academic-practice partnership with Summerlin Hospital Medical Center to develop a dedicated education unit (DEU). When the DEU model was implemented, variables that were not discussed in the literature needed to be addressed. One such challenge was how to impart pedagogy related to clinical teaching to the DEU nursing staff who would be acting as clinical dedicated unit instructors (CDIs). Of chief concern was the evaluation and monitoring of the quality of CDI-student interactions to ensure optimal student learning outcomes. This article addresses the development of a deliberate, systematic approach to the orientation and continued education of CDIs in the DEU. This information will assist other nursing programs as they begin to implement DEUs. Copyright 2015, SLACK Incorporated.

  15. Deliberate Learning and Vocabulary Acquisition in a Second Language

    Science.gov (United States)

    Elgort, Irina

    2011-01-01

    This study investigates outcomes of deliberate learning on vocabulary acquisition in a second language (L2). Acquisition of 48 pseudowords was measured using the lexical decision task with visually presented stimuli. The experiments drew on form priming, masked repetition priming, and automatic semantic priming procedures. Data analyses revealed a…

  16. Hierarchy, Dominance, and Deliberation: Egalitarian Values Require Mental Effort.

    Science.gov (United States)

    Van Berkel, Laura; Crandall, Christian S; Eidelman, Scott; Blanchar, John C

    2015-09-01

    Hierarchy and dominance are ubiquitous. Because social hierarchy is early learned and highly rehearsed, the value of hierarchy enjoys relative ease over competing egalitarian values. In six studies, we interfere with deliberate thinking and measure endorsement of hierarchy and egalitarianism. In Study 1, bar patrons' blood alcohol content was correlated with hierarchy preference. In Study 2, cognitive load increased the authority/hierarchy moral foundation. In Study 3, low-effort thought instructions increased hierarchy endorsement and reduced equality endorsement. In Study 4, ego depletion increased hierarchy endorsement and caused a trend toward reduced equality endorsement. In Study 5, low-effort thought instructions increased endorsement of hierarchical attitudes among those with a sense of low personal power. In Study 6, participants' thinking quickly allocated more resources to high-status groups. Across five operationalizations of impaired deliberative thought, hierarchy endorsement increased and egalitarianism receded. These data suggest hierarchy may persist in part because it has a psychological advantage. © 2015 by the Society for Personality and Social Psychology, Inc.

  17. Deliberate total parathyroidectomy: a potentially novel therapy for tumor-induced hypophosphatemic osteomalacia.

    Science.gov (United States)

    Bhadada, Sanjay K; Palnitkar, Saroj; Qiu, Shijing; Parikh, Nayana; Talpos, Gary B; Rao, Sudhaker D

    2013-11-01

    Tumor-induced osteomalacia (TIO) is an acquired hypophosphatemic metabolic bone disorder that can be cured by removing or ablating the offending tumor. However, when the tumor cannot be localized, lifelong therapy with oral phosphate and calcitriol or cinacalcet with close monitoring is required. A 56-year-old man was diagnosed with TIO in 1990. Initial therapy consisted of oral phosphate and calcitriol with symptomatic and biochemical improvement and healing of osteomalacia. Eight years later, hypercalcemic hyperparathyroidism developed, requiring subtotal parathyroidectomy with a transient increase in serum phosphate and normalization of serum calcium and PTH. Recurrent hypercalcemic hyperparathyroidism developed after 10 years of medical therapy. A deliberate total parathyroidectomy produced a prompt rise in serum phosphate into the normal range > 3.0 mg/dL and remained normal during the next 4 years of follow-up, despite continued very high serum fibroblast growth factor-23 levels throughout the 23-year follow-up. We report an unusual case of a TIO patient with long-term follow-up who developed recurrent hypercalcemic hyperparathyroidism on long-term oral phosphate therapy. Deliberate total parathyroidectomy normalized serum phosphate despite persistently elevated fibroblast growth factor-23 levels. Total parathyroidectomy offers a potentially novel therapy in some patients with TIO in whom medical therapy is not feasible or the tumor is unresectable.

  18. The Effects of Practice-Based Training on Graduate Teaching Assistants’ Classroom Practices

    Science.gov (United States)

    Becker, Erin A.; Easlon, Erin J.; Potter, Sarah C.; Guzman-Alvarez, Alberto; Spear, Jensen M.; Facciotti, Marc T.; Igo, Michele M.; Singer, Mitchell; Pagliarulo, Christopher

    2017-01-01

    Evidence-based teaching is a highly complex skill, requiring repeated cycles of deliberate practice and feedback to master. Despite existing well-characterized frameworks for practice-based training in K–12 teacher education, the major principles of these frameworks have not yet been transferred to instructor development in higher educational contexts, including training of graduate teaching assistants (GTAs). We sought to determine whether a practice-based training program could help GTAs learn and use evidence-based teaching methods in their classrooms. We implemented a weekly training program for introductory biology GTAs that included structured drills of techniques selected to enhance student practice, logic development, and accountability and reduce apprehension. These elements were selected based on their previous characterization as dimensions of active learning. GTAs received regular performance feedback based on classroom observations. To quantify use of target techniques and levels of student participation, we collected and coded 160 h of video footage. We investigated the relationship between frequency of GTA implementation of target techniques and student exam scores; however, we observed no significant relationship. Although GTAs adopted and used many of the target techniques with high frequency, techniques that enforced student participation were not stably adopted, and their use was unresponsive to formal feedback. We also found that techniques discussed in training, but not practiced, were not used at quantifiable frequencies, further supporting the importance of practice-based training for influencing instructional practices. PMID:29146664

  19. Dewey's Ethical Justification for Public Deliberation Democracy

    Science.gov (United States)

    Shook, John

    2013-01-01

    Interpretations of John Dewey's political theory grasp his respect for public deliberation, but typically overlook his ethical justification for democracy. Dewey gave two primary reasons why democracy is superior to other forms of government. First, a public educated in the tools of social intelligence can be more effective at managing their…

  20. Reorienting Deliberation: Identity Politics in Multicultural Societies

    Directory of Open Access Journals (Sweden)

    Rebecca Mason

    2010-03-01

    Full Text Available Many political theorists argue that cross-cultural communication within multicultural democracies is not best served by a commitment to identity politics. In response, I argue that identity politics only interfere with democratic participation according to an erroneous interpretation of the relationship between identity and reasoning. I argue that recognizing the importance of identity to the intelligibility of reasons offered in the context of civic deliberation is the first step towards the kind of dialogue that democratic participation requires.

  1. High call volume at poison control centers: identification and implications for communication.

    Science.gov (United States)

    Caravati, E M; Latimer, S; Reblin, M; Bennett, H K W; Cummins, M R; Crouch, B I; Ellington, L

    2012-09-01

    High volume surges in health care are uncommon and unpredictable events. Their impact on health system performance and capacity is difficult to study. To identify time periods that exhibited very busy conditions at a poison control center and to determine whether cases and communication during high volume call periods are different from cases during low volume periods. Call data from a US poison control center over twelve consecutive months was collected via a call logger and an electronic case database (Toxicall®).Variables evaluated for high call volume conditions were: (1) call duration; (2) number of cases; and (3) number of calls per staff member per 30 minute period. Statistical analyses identified peak periods as busier than 99% of all other 30 minute time periods and low volume periods as slower than 70% of all other 30 minute periods. Case and communication characteristics of high volume and low volume calls were compared using logistic regression. A total of 65,364 incoming calls occurred over 12 months. One hundred high call volume and 4885 low call volume 30 minute periods were identified. High volume periods were more common between 1500 and 2300 hours and during the winter months. Coded verbal communication data were evaluated for 42 high volume and 296 low volume calls. The mean (standard deviation) call length of these calls during high volume and low volume periods was 3 minutes 27 seconds (1 minute 46 seconds) and 3 minutes 57 seconds (2 minutes 11 seconds), respectively. Regression analyses revealed a trend for fewer overall verbal statements and fewer staff questions during peak periods, but no other significant differences for staff-caller communication behaviors were found. Peak activity for poison center call volume can be identified by statistical modeling. Calls during high volume periods were similar to low volume calls. Communication was more concise yet staff was able to maintain a good rapport with callers during busy call periods

  2. Suicide attempts by deliberate self-poisoning in children and adolescents

    Czech Academy of Sciences Publication Activity Database

    Zakharov, S.; Navrátil, Tomáš; Pelclová, D.

    2013-01-01

    Roč. 210, č. 1 (2013), s. 302-307 ISSN 0165-1781 Institutional support: RVO:61388955 Keywords : Deliberate suicidal self-poisoning * Suicide attempts in children and adolescents * Czech Toxicological Information Centre Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.682, year: 2013

  3. Enacting Ethics: Bottom-up Involvement in Implementing Moral Case Deliberation

    NARCIS (Netherlands)

    Weidema, F.C.; Molewijk, A.C.; Widdershoven, G.A.M.; Abma, T.A.

    2012-01-01

    In moral case deliberation (MCD), healthcare professionals meet to reflect upon their moral questions supported by a structured conversation method and non-directive conversation facilitator. An increasing number of Dutch healthcare institutions work with MCD to (1) deal with moral questions, (2)

  4. High Production Volume Information System (HPVIS)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The High Production Volume Information System (HPVIS) provides access to select health and environmental effect information on chemicals that are manufactured in...

  5. Between demarcation and discretion: The medical-administrative boundary as a locus of safety in high-volume organisational routines.

    Science.gov (United States)

    Grant, Suzanne; Guthrie, Bruce

    2018-04-01

    Patient safety is an increasing concern for health systems internationally. The majority of administrative work in UK general practice takes place in the context of organisational routines such as repeat prescribing and test results handling, where high workloads and increased clinician dependency on administrative staff have been identified as an emerging safety issue. Despite this trend, most research to date has focused on the redistribution of the clinical workload between doctors, nurses and allied health professionals within individual care settings. Drawing on Strauss's negotiated order perspective, we examine ethnographically the achievement of safety across the medical-administrative boundary in key high-volume routines in UK general practice. We focus on two main issues. First, GPs engaged in strategies of demarcation by defining receptionist work as routine, unspecialised and dependent upon GP clinical knowledge and oversight as the safety net to deal with complexity and risk. Receptionists consented to this 'social closure' when describing their role, thus reinforcing the underlying inter-occupational relationship of medical domination. Second, in everyday practice, GPs and receptionists engaged in informal boundary-blurring to safely accommodate the complexity of everyday high-volume routine work. This comprised additional informal discretionary spaces for receptionist decision-making and action that went beyond the routine safety work formally assigned to them. New restratified intra-occupational hierarchies were also being created between receptionists based on the complexity of the safety work that they were authorised to do at practice level, with specialised roles constituting a new form of administrative 'professional project'. The article advances negotiated order theory by providing an in-depth examination of the ways in which medical-administrative boundary-making and boundary-blurring constitute distinct modes of safety in high-volume

  6. Cognitive and Contextual Correlates of Spontaneous and Deliberate Mind-Wandering

    Science.gov (United States)

    Robison, Matthew K.; Unsworth, Nash

    2018-01-01

    Individuals with greater cognitive abilities generally show reduced rates of mind-wandering when completing relatively demanding tasks (Randall, Oswald, & Beier, 2014). However, it is yet unclear whether elevated rates of mind-wandering among low-ability individuals are manifestations of deliberate, intentional episodes of mind-wandering…

  7. Public Deliberation on Government-managed Social Media

    DEFF Research Database (Denmark)

    Medaglia, Rony; Zhu, Demi

    2017-01-01

    – characterised by exposure to different opinions, mutual understanding, and reasonableness – or hinder them, resulting in increased homophily and polarisation. Using the theoretical lens of public deliberation, this study investigates attitudinal and cognitive aspects of user conversations on government......-managed social media accounts. Drawing on a survey of 417 users of the Chinese social media platform Weibo, our findings show that interactions on social media are mostly non-dialogical and non-creative in nature, and characterised by homophily and polarisation, even though users perceive their interactions...

  8. Speed or deliberation: a comparison of post-disaster recovery in Japan, Turkey, and Chile.

    Science.gov (United States)

    Platt, Stephen; So, Emily

    2017-10-01

    This paper compares recovery in the wake of three recent earthquakes: the Great East Japan Earthquake in March 2011; the Van earthquake in Turkey in October 2011; and the Maule earthquake in Chile in February 2010. The authors visited all three locations approximately 12-18 months after the incidents and interviewed earthquake specialists, disaster managers, urban planners, and local authorities. A key challenge to post-disaster recovery planning is balancing speed and deliberation. While affected communities must rebuild as quickly as possible, they must also seek to maximise the opportunities for improvement that disasters provide. The three case studies bring this dilemma into stark relief, as recovery was respectively slow, fast, and just right in the aftermath of the events: the Government of Japan adopted a deliberate approach to recovery and reconstruction; speed was of the essence in Turkey; and an effective balance between speed and deliberation was achieved in Chile. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

  9. Adolescents' Deliberate Self-Harm, Interpersonal Stress, and the Moderating Effects of Self-Regulation: A Two-Wave Longitudinal Analysis

    Science.gov (United States)

    Jutengren, Goran; Kerr, Margaret; Stattin, Hakan

    2011-01-01

    The predictive effects of peer victimization and harsh parenting on deliberate self-harm were examined. As derived from the experiential avoidance model, the study also tested whether these links were moderated by individual self-regulation approaches. Data were collected at two points in time from 880 junior high school students (mean age =…

  10. Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Lind, Bertel Dam; Stuart, Elizabeth A

    2015-01-01

    BACKGROUND: Although deliberate self-harm is a strong predictor of suicide, evidence for effective interventions is missing. The aim of this study was to examine whether psychosocial therapy after self-harm was linked to lower risks of repeated self-harm, suicide, and general mortality. METHODS......: In this matched cohort study all people who, after deliberate self-harm, received a psychosocial therapy intervention at suicide prevention clinics in Denmark during 1992-2010 were compared with people who did not receive the psychosocial therapy intervention after deliberate self-harm. We applied propensity...... score matching with a 1:3 ratio and 31 matching factors, and calculated odds ratios for 1, 5, 10, and 20 years of follow-up. The primary endpoints were repeated self-harm, death by suicide, and death by any cause. FINDINGS: 5678 recipients of psychosocial therapy (followed up for 42·828 person...

  11. High tidal volume ventilation in infant mice.

    Science.gov (United States)

    Cannizzaro, Vincenzo; Zosky, Graeme R; Hantos, Zoltán; Turner, Debra J; Sly, Peter D

    2008-06-30

    Infant mice were ventilated with either high tidal volume (V(T)) with zero end-expiratory pressure (HVZ), high V(T) with positive end-expiratory pressure (PEEP) (HVP), or low V(T) with PEEP. Thoracic gas volume (TGV) was determined plethysmographically and low-frequency forced oscillations were used to measure the input impedance of the respiratory system. Inflammatory cells, total protein, and cytokines in bronchoalveolar lavage fluid (BALF) and interleukin-6 (IL-6) in serum were measured as markers of pulmonary and systemic inflammatory response, respectively. Coefficients of tissue damping and tissue elastance increased in all ventilated mice, with the largest rise seen in the HVZ group where TGV rapidly decreased. BALF protein levels increased in the HVP group, whereas serum IL-6 rose in the HVZ group. PEEP keeps the lungs open, but provides high volumes to the entire lungs and induces lung injury. Compared to studies in adult and non-neonatal rodents, infant mice demonstrate a different response to similar ventilation strategies underscoring the need for age-specific animal models.

  12. Non-conscious vs. deliberate dynamic decision-making—a pilot experiment

    NARCIS (Netherlands)

    Grössler, A.; Rouwette, E.A.J.A.; Vennix, J.A.M.; Größler, A.

    2016-01-01

    The purpose of this paper is to explore the effects of non-conscious vs. deliberate ways of making decisions in a dynamic decision-making task. An experimental setting is used to study this question; three experimental groups are distinguished: immediate decision-making (only very limited time for

  13. Stress potentiates decision biases: A stress induced deliberation-to-intuition (SIDI model

    Directory of Open Access Journals (Sweden)

    Rongjun Yu

    2016-06-01

    Full Text Available Humans often make decisions in stressful situations, for example when the stakes are high and the potential consequences severe, or when the clock is ticking and the task demand is overwhelming. In response, a whole train of biological responses to stress has evolved to allow organisms to make a fight-or-flight response. When under stress, fast and effortless heuristics may dominate over slow and demanding deliberation in making decisions under uncertainty. Here, I review evidence from behavioral studies and neuroimaging research on decision making under stress and propose that stress elicits a switch from an analytic reasoning system to intuitive processes, and predict that this switch is associated with diminished activity in the prefrontal executive control regions and exaggerated activity in subcortical reactive emotion brain areas. Previous studies have shown that when stressed, individuals tend to make more habitual responses than goal-directed choices, be less likely to adjust their initial judgment, and rely more on gut feelings in social situations. It is possible that stress influences the arbitration between the emotion responses in subcortical regions and deliberative processes in the prefrontal cortex, so that final decisions are based on unexamined innate responses. Future research may further test this ‘stress induced deliberation-to-intuition’ (SIDI model and examine its underlying neural mechanisms.

  14. Handbook of library training practice and development volume 3

    CERN Document Server

    Brine, Alan

    2016-01-01

    Librarians must now work at a different level from that required 20 years ago, but the training available is not always appropriate or accessible to all. The authors of this volume have responded to this significant and continuing change within the profession by offering a much-needed guide to best practice for staff training and development in library and information work. This handbook addresses new aspects of service provision both in the UK and abroad, and provides an up-to-date review of the current developments that are becoming increasingly important to librarians through the influence of the electronic age and the widening of areas of professional involvement. The Handbook of Library Training Practice and Development will be invaluable to those responsible for the development of staff and line managers as well as providing a crucial insight into the information profession for anyone new to this career path or looking to develop their knowledge within it.

  15. Deliberate Self-Harm in Adolescence: A Challenge for Schools

    Science.gov (United States)

    Best, Ron

    2006-01-01

    Acts of deliberate self-harm (DSH) by adolescents are thought to be on the increase. Many of those who self-harm are of school age and it is to be expected that schools (and their teachers) will be aware of the problem and will respond appropriately as part of their pastoral-care provision. However, a recent survey of research in pastoral care and…

  16. Adapting the coping in deliberation (CODE) framework: a multi-method approach in the context of familial ovarian cancer risk management.

    Science.gov (United States)

    Witt, Jana; Elwyn, Glyn; Wood, Fiona; Rogers, Mark T; Menon, Usha; Brain, Kate

    2014-11-01

    To test whether the coping in deliberation (CODE) framework can be adapted to a specific preference-sensitive medical decision: risk-reducing bilateral salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer. We performed a systematic literature search to identify issues important to women during deliberations about RRSO. Three focus groups with patients (most were pre-menopausal and untested for genetic mutations) and 11 interviews with health professionals were conducted to determine which issues mattered in the UK context. Data were used to adapt the generic CODE framework. The literature search yielded 49 relevant studies, which highlighted various issues and coping options important during deliberations, including mutation status, risks of surgery, family obligations, physician recommendation, peer support and reliable information sources. Consultations with UK stakeholders confirmed most of these factors as pertinent influences on deliberations. Questions in the generic framework were adapted to reflect the issues and coping options identified. The generic CODE framework was readily adapted to a specific preference-sensitive medical decision, showing that deliberations and coping are linked during deliberations about RRSO. Adapted versions of the CODE framework may be used to develop tailored decision support methods and materials in order to improve patient-centred care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Contextual Leadership Practices: The Case of a Successful School Principal in Malaysia

    Science.gov (United States)

    Noman, Mohammad; Awang Hashim, Rosna; Shaik Abdullah, Sarimah

    2018-01-01

    The study of context-based leadership practices has gained currency during the last decade. This study aims to complement the recent efforts of researchers in identifying the context-based leadership practices of successful school leaders, and deliberating how these practices are enacted within their own unique contexts. An in-depth case study was…

  18. Software Engineering and Knowledge Engineering Theory and Practice Volume 2

    CERN Document Server

    2012-01-01

    The volume includes a set of selected papers extended and revised from the I2009 Pacific-Asia Conference on Knowledge Engineering and Software Engineering (KESE 2009) was held on December 19~ 20, 2009, Shenzhen, China.   Volume 2 is to provide a forum for researchers, educators, engineers, and government officials involved in the general areas of Knowledge Engineering and Communication Technology to disseminate their latest research results and exchange views on the future research directions of these fields. 135 high-quality papers are included in the volume. Each paper has been peer-reviewed by at least 2 program committee members and selected by the volume editor Prof.Yanwen Wu.   On behalf of the this volume, we would like to express our sincere appreciation to all of authors and referees for their efforts reviewing the papers. Hoping you can find lots of profound research ideas and results on the related fields of Knowledge Engineering and Communication Technology. 

  19. Cooperation, Fast and Slow: Meta-Analytic Evidence for a Theory of Social Heuristics and Self-Interested Deliberation.

    Science.gov (United States)

    Rand, David G

    2016-09-01

    Does cooperating require the inhibition of selfish urges? Or does "rational" self-interest constrain cooperative impulses? I investigated the role of intuition and deliberation in cooperation by meta-analyzing 67 studies in which cognitive-processing manipulations were applied to economic cooperation games (total N = 17,647; no indication of publication bias using Egger's test, Begg's test, or p-curve). My meta-analysis was guided by the social heuristics hypothesis, which proposes that intuition favors behavior that typically maximizes payoffs, whereas deliberation favors behavior that maximizes one's payoff in the current situation. Therefore, this theory predicts that deliberation will undermine pure cooperation (i.e., cooperation in settings where there are few future consequences for one's actions, such that cooperating is not in one's self-interest) but not strategic cooperation (i.e., cooperation in settings where cooperating can maximize one's payoff). As predicted, the meta-analysis revealed 17.3% more pure cooperation when intuition was promoted over deliberation, but no significant difference in strategic cooperation between more intuitive and more deliberative conditions. © The Author(s) 2016.

  20. Peer sexual harassment and deliberate self-injury: longitudinal cross-lag investigations in Canada and Sweden.

    Science.gov (United States)

    Marshall, Sheila K; Faaborg-Andersen, Pernille; Tilton-Weaver, Lauree C; Stattin, Håkan

    2013-12-01

    Although the receipt of peer sexual harassment in schools has been linked to deliberate self-injury, the direction of association over time has not been tested. Two longitudinal studies examined whether receipt of peer sexual harassment within schools predicts engagement in deliberate self-injury or vice versa. Differences between boys and girls were also tested. Surveys were conducted in two countries, Canada and Sweden. Measures of sexual harassment and deliberate self-injury were administered yearly in classrooms. Two waves of data were collected in the Canadian study (N = 161, 59.6% girls, mean age = 13.82 years); three waves of data were collected in Sweden (N = 513, 47% girls, mean age = 13.23 years). In the Canadian study, deliberate self-injury predicted subsequent peer sexual harassment; the converse relationship was not significant. No significant gender differences were found. Across the three waves of the Swedish study, peer sexual harassment predicted self-injury from T1 to T2, and self-injury predicted peer sexual harassment from T2 to T3. However, self-injury did not mediate peer sexual harassment at T1 and T3. Tests of gender differences revealed self-injury predicted sexual harassment from T2 to T3 among Swedish girls but not boys. Adolescents who deliberately self-injure may be vulnerable to sexual harassment by peers at school. Cultural norms may have a role in whether this process applies primarily to girls or to both genders. Sexual harassment by peers may also increase self-injury, but this is not subsequently linked to increases in receipt of sexual harassment. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. Motive Matters! An exploration of the notion ‘deliberate breach of contract’ and its consequences for the application of remedies

    OpenAIRE

    Kogelenberg, Martijn

    2012-01-01

    textabstractThis thesis explores the notion of deliberate breach of contract and its potential remedial consequences. In the major jurisdictions in Europe and in the United States the notion of deliberate breach of contract is generally not coherently and officially defined and acknowledged as an independent legal phenomenon. The ultimate added value of this thesis intends to be a first coherent comparative research on deliberate breach of contract and its potential consequences for the core ...

  2. The significance of internet communication in public deliberation:

    OpenAIRE

    Rasmussen, Terje

    2009-01-01

    The article addresses recent structural changes in the public sphere related to media as platforms for debate and deliberation. New media platforms for communication lead to changes in the communication structure itself. This can easily be seen in the differentiation processes of the public sphere that is now taking place: The differentiation of topics, styles and actors is an astonishing phenomenon, is constantly a topic of debate in itself, often labelled as both decay and democratisation. ...

  3. Practical guidelines for small-volume additions of uninhibited water to waste storage tanks

    International Nuclear Information System (INIS)

    Hsu, T.C.; Wiersma, B.J.; Zapp, P.E.; Pike, J.A.

    1994-01-01

    Allowable volumes of uninhibited water additions to waste tanks are limited to volumes in which hydroxide and nitrite inhibitors reach required concentrations by diffusion from the bulk waste within five days. This diffusion process was modeled conservatively by Fick's second law of diffusion. The solution to the model was applied to all applicable conditions which exist in the waste tanks. Plant engineers adapted and incorporated the results into a practical working procedure for controlling and monitoring the addition of uninhibited water. Research, technical support, and field engineers worked together to produce an effective solution to a potential waste tank corrosion problem

  4. The Quality of Deliberation in Two Committees of the European Parliament: The Neglected Influence of the Situational Context and the Policymaking Stage

    Directory of Open Access Journals (Sweden)

    Léa Roger

    2013-10-01

    Full Text Available In our paper we try to answer two empirical research questions. First, we assess the deliberative quality of discussions in two committees of the EU Parliament. In order to do so, we use a slightly revised version of the DQI. Second, we identify and empirically measure those variables that systematically influence the quality of deliberation in interviews with debate actors. We argue that the quality of deliberation in EU committees is influenced by two normative values: deliberation (common good orientation and responsiveness (particular interest orientation, with the guiding value determined by the particular situation. Using a multidimensional concept of deliberation, we empirically test the impact of situational variables on specific aspects of deliberative quality. In addition, we take into account the temporal dimension of deliberation.

  5. Study on the High Volume Reduction of Radioactive Wastes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki Hong; Sik, Kang Il; Seok, Hong Dae [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Ho, Jeon Gil [RADIN Co. Ltd., Daejeon (Korea, Republic of)

    2013-10-15

    The solidification of radioactive wastes by the mixing method always increases their volume due to the limitation of incorporation ratio (waste/solidification agent). But if the powdered wastes can be compacted as the high density pellets and also the pellets can be filled up in a waste drum as much as possible while solidifying them with a very sticky solidification agent including a void formed in the filling step of pellets, it might be more desirable to reduce the waste volume as compared with the mixing method. So in this study, we designed and manufactured a high volume reduction machine which has the special size and shape of a pellet pocket, which the pellets can be extracted from easily and filled up in a large amount in drum, a pressurizing device to press 2 rolls, and the uniform feeding device of powder to the roll tyre. Some operational parameters which affect the formation of pellets from a powder were investigated, and then the volume reduction of a powder was evaluated. The briquetting machine, popular in general industry, was modified to apply for the volume reduction of the powered radioactive wastes (dried concentrate, sludge, spent ion-exchange resin, ash, depleted uranium powder, and etc.). In this developed high volume reduction machine, the capacity was 25 ∼ 62.5 kg/h at the optimum conditions, and the estimated volume reduction was about 2.95 (2.74/0.93) on the basis of between a powder (bulk density = 0.93 g/cm{sup 3}) and the pellet (2.74 g/cm{sup 3}). But on the basis of 200L drum, the calculated volume reduction was about 1.34 in consideration of a void volume originated in the filling step of the pellets.

  6. Deliberating about race as a variable in biomedical research | van ...

    African Journals Online (AJOL)

    Race as a variable in research ethics is investigated: to what extent is it morally appropriate to regard the race of research subjects as pivotal for research outcomes? The challenges it poses to deliberation in research ethics committees are considered, and it is concluded that race sometimes must be considered, subject to ...

  7. From the shadows into the light: How pretrial publicity and deliberation affect mock jurors' decisions, impressions, and memory.

    Science.gov (United States)

    Ruva, Christine L; Guenther, Christina C

    2015-06-01

    This 2-part study explored how exposure to negative pretrial publicity (Neg-PTP) influences the jury process, as well as possible mechanisms responsible for its biasing effects on decisions. Study Part A explored how PTP and jury deliberations affect juror/jury verdicts, memory, and impressions of the defendant and attorneys. One week before viewing a criminal trial mock-jurors (N = 320 university students) were exposed to Neg-PTP or unrelated crime stories (No-PTP). Two days later deliberating jurors came to a group decision, whereas nondeliberating jurors completed an unrelated task before making an individual decision. Neg-PTP jurors were more likely to vote guilty, make memory errors, and rate the defendant lower in credibility. Deliberation reduced Neg-PTP jurors' memory accuracy and No-PTP jurors' guilty verdicts (leniency bias). Jurors' memory and ratings of the defendant and prosecuting attorney significantly mediated the effect of PTP on guilt ratings. Study Part B content analyzed 30 mock-jury deliberations and explored how PTP influenced deliberations and ultimately jury decisions. Neg-PTP juries were more likely than No-PTP juries to discuss ambiguous trial evidence in a proprosecution manner and less likely to discuss judicial instructions and lack of evidence. All Neg-PTP juries mentioned PTP, after instructed otherwise, and rarely corrected jury members who mentioned PTP. Discussion of ambiguous trial evidence in a proprosecution manner and lack of evidence significantly mediated the effect of PTP on jury-level guilt ratings. Together the findings suggest that judicial admonishments and deliberations may not be sufficient to reduce PTP bias, because of memory errors, biased impressions, and predecisional distortion. (c) 2015 APA, all rights reserved).

  8. Meditation and yoga practice are associated with smaller right amygdala volume: the Rotterdam study

    NARCIS (Netherlands)

    R.A. Gotink (Rinske); M.W. Vernooij (Meike); M.K. Ikram (Kamran); W.J. Niessen (Wiro); Krestin, G.P. (Gabriel P.); A. Hofman (Albert); H.W. Tiemeier (Henning); M.G.M. Hunink (Myriam)

    2018-01-01

    textabstractTo determine the association between meditation and yoga practice, experienced stress, and amygdala and hippocampal volume in a large population-based study. This study was embedded within the population-based Rotterdam Study and included 3742 participants for cross-sectional

  9. Personal Characteristics of Teachers, Situational Variables and Deliberations in Planning Instruction.

    Science.gov (United States)

    Kremer, Lya

    This study reveals possible relationships among teachers' personality traits, situational variables, and deliberation characteristics in planning instruction. Dogmatism and locus of control perceptions were the personality traits studied, and the situations compared student teachers with elementary and secondary school teachers. Both groups were…

  10. Public Deliberation as a Teaching Andragogy: Implications for Adult Student Learning from a Doctoral Higher Education Policy Course

    Science.gov (United States)

    Johnson, Matthew; Partlo, Margaret; Hullender, Tammy; Akanwa, Emmanuel; Burke, Heather; Todd, Jerry; Alwood, Christine

    2014-01-01

    Public deliberation provides an inclusive and robust mechanism for making shared decisions in community and political settings; however, its application to teaching and learning remains underutilized (McMillan & Harriger, 2007). This manuscript reports on a case study of the use of public deliberation as a teaching andragogy in a graduate…

  11. High lung volume increases stress failure in pulmonary capillaries

    Science.gov (United States)

    Fu, Z.; Costello, M. L.; Tsukimoto, K.; Prediletto, R.; Elliott, A. R.; Mathieu-Costello, O.; West, J. B.

    1992-01-01

    We previously showed that when pulmonary capillaries in anesthetized rabbits are exposed to a transmural pressure (Ptm) of approximately 40 mmHg, stress failure of the walls occurs with disruption of the capillary endothelium, alveolar epithelium, or sometimes all layers. The present study was designed to test whether stress failure occurred more frequently at high than at low lung volumes for the same Ptm. Lungs of anesthetized rabbits were inflated to a transpulmonary pressure of 20 cmH2O, perfused with autologous blood at 32.5 or 2.5 cmH2O Ptm, and fixed by intravascular perfusion. Samples were examined by both transmission and scanning electron microscopy. The results were compared with those of a previous study in which the lung was inflated to a transpulmonary pressure of 5 cmH2O. There was a large increase in the frequency of stress failure of the capillary walls at the higher lung volume. For example, at 32.5 cmH2O Ptm, the number of endothelial breaks per millimeter cell lining was 7.1 +/- 2.2 at the high lung volume compared with 0.7 +/- 0.4 at the low lung volume. The corresponding values for epithelium were 8.5 +/- 1.6 and 0.9 +/- 0.6. Both differences were significant (P less than 0.05). At 52.5 cmH2O Ptm, the results for endothelium were 20.7 +/- 7.6 (high volume) and 7.1 +/- 2.1 (low volume), and the corresponding results for epithelium were 32.8 +/- 11.9 and 11.4 +/- 3.7. At 32.5 cmH2O Ptm, the thickness of the blood-gas barrier was greater at the higher lung volume, consistent with the development of more interstitial edema. Ballooning of the epithelium caused by accumulation of edema fluid between the epithelial cell and its basement membrane was seen at 32.5 and 52.5 cmH2O Ptm. At high lung volume, the breaks tended to be narrower and fewer were oriented perpendicular to the axis of the pulmonary capillaries than at low lung volumes. Transmission and scanning electron microscopy measurements agreed well. Our findings provide a physiological

  12. Situated practices of testimony. A rhetorical approach

    Directory of Open Access Journals (Sweden)

    Paula OLMOS

    2008-01-01

    Full Text Available Contrary to most current epistemologists who concentrate on core cases of rather ‘spontaneous’ (deliberately  de-contextualized  trust  and  belief  in the  face  of  assertions,  Classical  rhetoricians  addressed  the study of ‘testimony’ as an (at least two-acts phenomenon: that of the ‘disclosure’ of information and that of the ‘appeal’ to its authority in subsequent discursive practices. Moreover, they primarily focused on this second phase as they assumed that it was such argumentative setting that finally gave ‘testimonial’ relevance to the first act. According to this ‘rhetorical’ model, then, it is the dynamics (by means of an in medias res approach  and  pragmatics  (by means  of  a  deliberate  attention  to  specifically  ‘situated’  practices  of  such complex process that is the core issue regarding ‘testimony’.

  13. Learning Curves of Virtual Mastoidectomy in Distributed and Massed Practice

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts; Konge, Lars; Cayé-Thomasen, Per

    2015-01-01

    IMPORTANCE: Repeated and deliberate practice is crucial in surgical skills training, and virtual reality (VR) simulation can provide self-directed training of basic surgical skills to meet the individual needs of the trainee. Assessment of the learning curves of surgical procedures is pivotal...... in understanding skills acquisition and best-practice implementation and organization of training. OBJECTIVE: To explore the learning curves of VR simulation training of mastoidectomy and the effects of different practice sequences with the aim of proposing the optimal organization of training. DESIGN, SETTING...... plateaued on a score of 16.0 (15.3-16.7) at approximately the ninth repetition, but the individual learning curves were highly variable. CONCLUSIONS AND RELEVANCE: Novices can acquire basic mastoidectomy competencies with self-directed VR simulation training. Training should be organized with distributed...

  14. Islamic bioethical deliberation on the issue of newborns with disorders of sex development.

    Science.gov (United States)

    Mohamed, Mohd Salim; Noor, Siti Nurani Mohd

    2015-04-01

    This article presents the Islamic bioethical deliberation on the issue of sex assignment surgery (SAS) for infants with disorders of sex development (DSD) or intersexed as a case study. The main objective of this study is to present a different approach in assessing a biomedical issue within the medium of the Maqasid al-Shari'ah. Within the framework of the maqasidic scheme of benefits and harms, any practice where benefits are substantial is considered permissible, while those promoting harms are prohibited. The concept of Maqasid al-Shari'ah which is the mechanistic interpretation of Qur'an and Hadith presents the holistic attention of Islam on many life activities, including healthcare. Indeed, this concept encompasses many aspects of worldly life, both for the human individual and collectively for the whole society. In healthcare, the practice of SAS on DSD newborns has presented an assortment of implications on the future livelihood of the affected individual. The process of decision-making seems to be very multifaceted since every element such as the determination of the 'correct' sex and the urgency of early surgery must consider the benefits and harms, as well as the child's rights and best interest. The application of the concept of Maqasid al-Shari'ah, would convey a pragmatic approach that is often disregarded in Western medicine. This approach considers the right of the individual to live life optimally, individually and socially and practice his faith, precisely, in accordance with the assigned gender.

  15. An Experimental Study of High Strength-High Volume Fly Ash Concrete for Sustainable Construction Industry

    Science.gov (United States)

    Kate, Gunavant K.; Thakare, Sunil B., Dr.

    2017-08-01

    Concrete is the most widely used building material in the construction of infrastructures such as buildings, bridges, highways, dams, and many other facilities. This paper reports the development, the basic idea, the main properties of high strength-high volume fly ash with application in concrete associated with the development and implementation of Sustainable Properties of High Volume Fly Ash Concrete (HVFAC) Mixtures and Early Age Shrinkage and mechanical properties of concrete for 7,28,56 and 90days. Another alternative to make environment-friendly concrete is the development of high strength-high-volume fly ash concrete which is an synthesized from materials of geological origin or by-product materials such as fly ash which is rich in silicon and aluminum. In this paper 6 concrete mixtures were produced to evaluate the effect of key parameters on the mechanical properties of concrete and its behavior. The study key parameters are; binder material content, cement replacement ratios, and the steel fibers used to High Volume Fly Ash mixtures for increasing performance of concrete.

  16. To Think or Not to Think:The Effect of Cognitive Deliberation on the Influence of Injunctive Versus Descriptive Social Norms

    NARCIS (Netherlands)

    Melnyk, V.; Herpen, van E.; Fischer, A.R.H.; Trijp, van H.C.M.

    2011-01-01

    Consumers can process information containing social norms at different cognitive deliberation levels. This paper investigates the effect of cognitive deliberation for both descriptive and injunctive norms. The experimental study examines the consequences for attitudes and behavioral intentions of

  17. International Best Practice Basis for Assessing Recovery Operations. Annex II of Technical Volume 5

    International Nuclear Information System (INIS)

    2015-01-01

    This volume seeks to identify lessons learned related to post-accident recovery that may further improve preparedness worldwide. This objective assessment of the recovery programme is made according to international best practice. In the practice and assessment of radiation and nuclear safety, international best practice is a process or technique that is likely to consistently produce superior results. An important principle is that a ‘best’ practice can evolve to become better as improvements are discovered and lessons are learned from past experience. The lessons to be learned from the recovery programme as it unfolds in Japan will feed back into improving international best practice in post-accident recovery worldwide. Best practice is used to maintain quality and is a component of quality management systems and standards, such as ISO 9000. It is generally regarded as being the most efficient and effective way to accomplish desired outcomes. The body of best practice is used as a benchmark and for self assessment

  18. Volume of hospital is important for the prognosis of high-risk patients with nonvariceal upper gastrointestinal bleeding (NVUGIB).

    Science.gov (United States)

    Choi, Jin Woo; Jeon, Seong Woo; Kwon, Jung Gu; Lee, Dong Wook; Ha, Chang Yoon; Cho, Kwang Bum; Jang, Byung Ik; Park, Jung Bae; Park, Youn Sun

    2017-08-01

    Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a potentially life-threatening hospital emergency requiring hemodynamic stabilization and resuscitation. This study is carried out to determine whether hospital volume can influence outcome in patients with NVUGIB. This is a retrospective study with a prospective cohort database (KCT 0000514. cris.nih.go.kr). Eight teaching hospitals were divided into two different groups: high-volume centers (HVC, ≥60 NVUGIB patients/year, four clinics) and low-volume centers (LVC, bleeding after treatment, re-bleeding, necessity for surgical/other retreatments, and death within 30 days. Similar baseline characters for patients were observed in both groups. There was a significant difference in the incidence of poor outcome between the HVC and LVC groups (9.06 vs. 13.69%, P = 0.014). The incidence rate of poor outcome in high-risk patients (Rockall score ≥8) in HVC was lower than that in high-risk patients in LVC (16.07 vs. 26.92%, P = 0.048); however, there was no significant difference in poor outcome in the lower-risk patients in either group (8.72 vs. 10.42%, P = 0.370). Significant correlation between hospital volume and outcome in NVUGIB patients was observed. Referral to HVC for the management of high-risk NVUGIB patients should be considered in clinical practice.

  19. Managers' views on and experiences with moral case deliberation in nursing teams

    NARCIS (Netherlands)

    Weidema, F.C.; Molewijk, A.C.; Kamsteeg, F.; Widdershoven, G.A.M.

    2015-01-01

    Aims: Providing management insights regarding moral case deliberation (MCD) from the experiential perspective of nursing managers. Background: MCD concerns systematic group-wise reflection on ethical issues. Attention to implementing MCD in health care is increasing, and managers' experiences

  20. High volume improves outcomes: The argument for centralization of rectal cancer surgery.

    Science.gov (United States)

    Aquina, Christopher T; Probst, Christian P; Becerra, Adan Z; Iannuzzi, James C; Kelly, Kristin N; Hensley, Bradley J; Rickles, Aaron S; Noyes, Katia; Fleming, Fergal J; Monson, John R T

    2016-03-01

    Centralization of care to "centers of excellence" in Europe has led to improved oncologic outcomes; however, little is known regarding the impact of nonmandated regionalization of rectal cancer care in the United States. The Statewide Planning and Research Cooperative System (SPARCS) was queried for elective abdominoperineal and low anterior resections for rectal cancer from 2000 to 2011 in New York with the use of International Classification of Diseases, Ninth Revision codes. Surgeon volume and hospital volume were grouped into quartiles, and high-volume surgeons (≥ 10 resections/year) and hospitals (≥ 25 resections/year) were defined as the top quartile of annual caseload of rectal cancer resection and compared with the bottom 3 quartiles during analyses. Bivariate and multilevel regression analyses were performed to assess factors associated with restorative procedures, 30-day mortality, and temporal trends in these endpoints. Among 7,798 rectal cancer resections, the overall rate of no-restorative proctectomy and 30-day mortality decreased by 7.7% and 1.2%, respectively, from 2000 to 2011. In addition, there was a linear increase in the proportion of cases performed by both high-volume surgeons and high-volume hospitals and a decrease in the number of surgeons and hospitals performing rectal cancer surgery. High-volume surgeons at high-volume hospitals were associated independently with both less nonrestorative proctectomies (odds ratio 0.65, 95% confidence interval 0.48-0.89) and mortality (odds ratio 0.43, 95% confidence interval 0.21-0.87) rates. No patterns of significant improvement within the volume strata of the surgeon and hospitals were observed over time. This study suggests that the current trend toward regionalization of rectal cancer care to high-volume surgeons and high-volume centers has led to improved outcomes. These findings have implications regarding the policy of health care delivery in the United States, supporting referral to high-volume

  1. Unsupervised Learning Through Randomized Algorithms for High-Volume High-Velocity Data (ULTRA-HV).

    Energy Technology Data Exchange (ETDEWEB)

    Pinar, Ali [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kolda, Tamara G. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Carlberg, Kevin Thomas [Wake Forest Univ., Winston-Salem, MA (United States); Ballard, Grey [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mahoney, Michael [Univ. of California, Berkeley, CA (United States)

    2018-01-01

    Through long-term investments in computing, algorithms, facilities, and instrumentation, DOE is an established leader in massive-scale, high-fidelity simulations, as well as science-leading experimentation. In both cases, DOE is generating more data than it can analyze and the problem is intensifying quickly. The need for advanced algorithms that can automatically convert the abundance of data into a wealth of useful information by discovering hidden structures is well recognized. Such efforts however, are hindered by the massive volume of the data and its high velocity. Here, the challenge is developing unsupervised learning methods to discover hidden structure in high-volume, high-velocity data.

  2. Deliberations of working group 3: stakeholders and the public: who are they?

    International Nuclear Information System (INIS)

    Webster, S.

    2000-01-01

    The working-group deliberations opened with a general discussion centred primarily around the issues introduced in the two papers presented that morning in plenary session: 'Who Are Stakeholders in Environmental Risk Decisions?' and 'Participation of Stakeholders in Waste Management Decisions: The German Experience'. In general, the interventions by the group were open and frank and adequately covered the key issues of the subject. This was followed by a presentation on the views and experience of the current siting debate in Sweden from the perspective of the regulatory bodies and a brief summary by the Chairman of the definition of the public in EU legislation and International Conventions. The majority of the working-group members contributed actively to the debate, and the discussions were conducted in an informal and open-minded manner. Hereinafter are the main observations made during the working group deliberations. (author)

  3. Air Force Leadership Study: The Need for Deliberate Development

    Science.gov (United States)

    2012-02-01

    Abraham Maslow , once the basic needs of survival and security are met, people concern themselves with higher needs like affection, be- longing, the...maintaining the data needed , and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of...Study: The Need for Deliberate Development 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e

  4. Ribbon scanning confocal for high-speed high-resolution volume imaging of brain.

    Directory of Open Access Journals (Sweden)

    Alan M Watson

    Full Text Available Whole-brain imaging is becoming a fundamental means of experimental insight; however, achieving subcellular resolution imagery in a reasonable time window has not been possible. We describe the first application of multicolor ribbon scanning confocal methods to collect high-resolution volume images of chemically cleared brains. We demonstrate that ribbon scanning collects images over ten times faster than conventional high speed confocal systems but with equivalent spectral and spatial resolution. Further, using this technology, we reconstruct large volumes of mouse brain infected with encephalitic alphaviruses and demonstrate that regions of the brain with abundant viral replication were inaccessible to vascular perfusion. This reveals that the destruction or collapse of large regions of brain micro vasculature may contribute to the severe disease caused by Venezuelan equine encephalitis virus. Visualization of this fundamental impact of infection would not be possible without sampling at subcellular resolution within large brain volumes.

  5. Managing deliberate self-harm in young people: An evaluation of a training program developed for school welfare staff using a longitudinal research design

    Directory of Open Access Journals (Sweden)

    McGorry Patrick D

    2008-09-01

    Full Text Available Abstract Background Although deliberate self-harm is prevalent among young people, many who engage in deliberate self-harm receive sub-optimal care. Although schools are a well placed setting to support young people who engage in self-harm there are no specific training packages designed to assist school welfare staff to support these young people. The current study aimed to design, deliver and evaluate a training course specifically for school staff. Methods The study employed a longitudinal design. Two hundred and thirteen people participated in the training and evaluation. A questionnaire was administered at baseline, immediately after the training and at 6-month follow-up in order to determine if the training led to improvements in confidence when working with young people who self-harm, perceived skill, knowledge of, and attitudes towards people who self harm. Results Prior to the course, the majority of participants demonstrated relatively high levels of confidence, perceived skill and knowledge of self-harm and endorsed relatively positive attitudes towards people who engage in self-harm. Despite this, significant improvements were observed in terms of increased confidence, increased perceptions of skill along with increased knowledge of deliberate self-harm. These improvements were sustained over the follow-up period. Conclusion The results demonstrated that the provision of specifically designed training can help school welfare staff to feel better equipped to support young people who are engaging in deliberate self-harm.

  6. A comparative study of self-consolidating concretes incorporating high-volume natural pozzolan or high-volume fly ash

    KAUST Repository

    Celik, Kemal; Meral, Cagla; Mancio, Mauricio; Mehta, P. Kumar; Monteiro, Paulo J.M.

    2014-01-01

    The purpose of this study is to compare the effects of Portland cement replacement on the strength and durability of self-consolidating concretes (SSC). The two replacement materials used are high-volume natural pozzolan (HVNP), a Saudi Arabian aluminum-silica rich basaltic glass and high-volume Class-F fly ash (HVFAF), from Jim Bridger Power Plant, Wyoming, US. As an extension of the study, limestone filler (LF) is also used to replace Portland cement, alongside HVNP or HVFAF, forming ternary blends. Along with compressive strength tests, non-steady state chloride migration and gas permeability tests were performed, as durability indicators, on SCC specimens. The results were compared to two reference concretes; 100% ordinary Portland cement (OPC) and 85% OPC - 15% LF by mass. The HVNP and HVFAF concrete mixes showed strength and durability results comparable to those of the reference concretes; identifying that both can effectively be used to produce low-cost and environmental friendly SCC. © 2013 Elsevier Ltd. All rights reserved.

  7. A comparative study of self-consolidating concretes incorporating high-volume natural pozzolan or high-volume fly ash

    KAUST Repository

    Celik, Kemal

    2014-09-01

    The purpose of this study is to compare the effects of Portland cement replacement on the strength and durability of self-consolidating concretes (SSC). The two replacement materials used are high-volume natural pozzolan (HVNP), a Saudi Arabian aluminum-silica rich basaltic glass and high-volume Class-F fly ash (HVFAF), from Jim Bridger Power Plant, Wyoming, US. As an extension of the study, limestone filler (LF) is also used to replace Portland cement, alongside HVNP or HVFAF, forming ternary blends. Along with compressive strength tests, non-steady state chloride migration and gas permeability tests were performed, as durability indicators, on SCC specimens. The results were compared to two reference concretes; 100% ordinary Portland cement (OPC) and 85% OPC - 15% LF by mass. The HVNP and HVFAF concrete mixes showed strength and durability results comparable to those of the reference concretes; identifying that both can effectively be used to produce low-cost and environmental friendly SCC. © 2013 Elsevier Ltd. All rights reserved.

  8. The Cognitive-Miser Response Model: Testing for Intuitive and Deliberate Reasoning

    Science.gov (United States)

    Bockenholt, Ulf

    2012-01-01

    In a number of psychological studies, answers to reasoning vignettes have been shown to result from both intuitive and deliberate response processes. This paper utilizes a psychometric model to separate these two response tendencies. An experimental application shows that the proposed model facilitates the analysis of dual-process item responses…

  9. Virtue, Practical Wisdom and Character in Teaching

    Science.gov (United States)

    Cooke, Sandra; Carr, David

    2014-01-01

    Recent reflection on the professional knowledge of teachers has been marked by a shift away from more reductive competence and skill-focused models of teaching towards a view of teacher expertise as involving complex context-sensitive deliberation and judgement. Much of this shift has been inspired by an Aristotelian conception of practical wisdom…

  10. Optimization of the convection volume in online post-dilution haemodiafiltration : practical and technical issues

    NARCIS (Netherlands)

    Chapdelaine, Isabelle; de Roij van Zuijdewijn, Camiel L M; Mostovaya, Ira M; Lévesque, Renée; Davenport, Andrew; Blankestijn, P J; Wanner, Christoph; Nubé, Menso J; Grooteman, Muriel P C; Davenport, A; Basile, C; Locatelli, F; Maduell, F; Mitra, S; Ronco, C; Shroff, R; Tattersall, J; Wanner, C

    In post-dilution online haemodiafiltration (ol-HDF), a relationship has been demonstrated between the magnitude of the convection volume and survival. However, to achieve high convection volumes (>22 L per session) detailed notion of its determining factors is highly desirable. This manuscript

  11. Motive Matters! An exploration of the notion ‘deliberate breach of contract’ and its consequences for the application of remedies

    NARCIS (Netherlands)

    M. van Kogelenberg (Martijn)

    2012-01-01

    textabstractThis thesis explores the notion of deliberate breach of contract and its potential remedial consequences. In the major jurisdictions in Europe and in the United States the notion of deliberate breach of contract is generally not coherently and officially defined and acknowledged as an

  12. Effect of alcohol dose on deliberate self-harm in men and women.

    Science.gov (United States)

    Berman, Mitchell E; Fanning, Jennifer R; Guillot, Casey R; Marsic, Angelika; Bullock, Joshua; Nadorff, Michael R; McCloskey, Michael S

    2017-09-01

    Nonexperimental survey and field research support the notion that alcohol use may be associated with deliberate self-harm (DSH) across the spectrum of lethality, from nonsuicidal self-injury (NSSI) through suicide. Nonexperimental studies, however, provide limited information about potential causal relationships between alcohol consumption and DSH. Two previous experiments showed that a relatively high-dose of alcohol increases the likelihood of engaging in DSH in men, with DSH defined by the self-administration of a "painful" shock (the self-aggression paradigm [SAP]; Berman & Walley, 2003; McCloskey & Berman, 2003). In this study, we examined whether (a) lower doses of alcohol also elicit DSH, (b) this effect occurs for women as well as men, and (c) individual differences in past nonsuicidal self-injury (NSSI) moderate alcohol's effects on DSH. Nonalcohol dependent men and women (N = 210) were assigned either to .00%, .05%, .075%, or .100% blood alcohol concentration (BAC) drink conditions and completed a self-rating scale of NSSI (the Deliberate Self-Harm Inventory [DSHI]; Gratz, 2001). As in previous SAP studies, DSH was operationalized by shock setting behavior during a competitive reaction time (RT) game. Overall, a greater proportion of participants in the .075% and .100% (but not .050%) alcohol conditions self-selected a "painful" shock to administer compared to participants in the placebo condition. NSSI predicted self-administration of painful shocks, but did not moderate the alcohol effect. Results provide experimental evidence to support the notion that interventions for self-harm should include processes to monitor and limit alcohol intake. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Prevalence and characteristics of moral case deliberation in Dutch health care

    NARCIS (Netherlands)

    Dauwerse, L.; Stolper, M.M.; Widdershoven, G.; Molewijk, A.C.

    2014-01-01

    The attention for Moral case deliberation (MCD) has increased over the past years. Previous research on MCD is often written from the perspective of MCD experts or MCD participants and we lack a more distant view to the role of MCD in Dutch health care institutions in general. The purpose of this

  14. Paramedics' experiences of financial medicine practices in the pre ...

    African Journals Online (AJOL)

    Examples included Over-servicing, Selective Patient Treatment, Fraudulent Billing Practices, Eliciting of kickbacks, incentives or benefits and Deliberate Time Wasting. Conclusion: The results of this study are concerning as the actions of service providers described by the participants constitute gross violations of the ethical ...

  15. A study on the hydrogen recombination rates of catalytic recombiners and deliberate ignition

    International Nuclear Information System (INIS)

    Fineschi, F.; Bazzichi, M.; Carcassi, M.

    1994-01-01

    A study is being carried out by the Department of Nuclear and Mechanical Constructions (DCMN) at the University of Pisa on catalytic recombiners and on deliberately induced weak deflagration. The recombination rates of different types of catalytic devices were obtained from a thorough analysis of published experimental data. The main parameter that affects the effectiveness of these devices seems to be the molar density of the deficiency reactant rather than its volumetric concentration. The recombination rate of weak deflagrations in vented compartments has been assessed with experimental tests carried out in a small scale glass vessel. Through a computerized system of analysis of video recordings of the deflagrations, the flame surface and the burned gas volume were obtained as functions of time. Although approximations are inevitable, the method adopted to identify the position of the flame during propagation is more reliable than other non-visual methods (thermocouples and ion-probes). It can only easily be applied to vented weak deflagrations, i.e. when the hydrogen concentration is far from stoichiometric conditions and near to flammability limits, because the pressurization has to be limited due to the low mechanical resistance of the glass. The values of flame surface and burned gas volume were used as inputs for a computer code to calculate the recombining rate, the burning velocity and the pressure transient in the experimental test. The code is being validated with a methodology principally based on a comparison of the measurements of pressure with the calculated values. The research gave some very interesting results on a small scale which should in the future be compared with large scale data

  16. Outcomes of moral case deliberation--the development of an evaluation instrument for clinical ethics support (the Euro-MCD).

    Science.gov (United States)

    Svantesson, Mia; Karlsson, Jan; Boitte, Pierre; Schildman, Jan; Dauwerse, Linda; Widdershoven, Guy; Pedersen, Reidar; Huisman, Martijn; Molewijk, Bert

    2014-04-08

    Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers' experiences and perceived importance of outcomes of Moral Case Deliberation. A multi-item instrument for assessing outcomes of Moral Case Deliberation (MCD) was constructed through an iterative process, founded on a literature review and modified through a multistep review by ethicists and health care providers. The instrument measures perceived importance of outcomes before and after MCD, as well as experienced outcomes during MCD and in daily work. A purposeful sample of 86 European participants contributed to a Delphi panel and content validity testing. The Delphi panel (n = 13), consisting of ethicists and ethics researchers, participated in three Delphi-rounds. Health care providers (n = 73) participated in the content validity testing through 'think-aloud' interviews and a method using Content Validity Index. The development process resulted in the European Moral Case Deliberation Outcomes Instrument (Euro-MCD), which consists of two sections, one to be completed before a participant's first MCD and the other after completing multiple MCDs. The instrument contains a few open-ended questions and 26 specific items with a corresponding rating/response scale representing various MCD outcomes. The items were categorised into the following six domains: Enhanced emotional support, Enhanced

  17. Outcomes of Moral Case Deliberation - the development of an evaluation instrument for clinical ethics support (the Euro-MCD)

    Science.gov (United States)

    2014-01-01

    Background Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers’ experiences and perceived importance of outcomes of Moral Case Deliberation. Methods A multi-item instrument for assessing outcomes of Moral Case Deliberation (MCD) was constructed through an iterative process, founded on a literature review and modified through a multistep review by ethicists and health care providers. The instrument measures perceived importance of outcomes before and after MCD, as well as experienced outcomes during MCD and in daily work. A purposeful sample of 86 European participants contributed to a Delphi panel and content validity testing. The Delphi panel (n = 13), consisting of ethicists and ethics researchers, participated in three Delphi-rounds. Health care providers (n = 73) participated in the content validity testing through ‘think-aloud’ interviews and a method using Content Validity Index. Results The development process resulted in the European Moral Case Deliberation Outcomes Instrument (Euro-MCD), which consists of two sections, one to be completed before a participant’s first MCD and the other after completing multiple MCDs. The instrument contains a few open-ended questions and 26 specific items with a corresponding rating/response scale representing various MCD outcomes. The items were categorised into the following six domains: Enhanced

  18. Automatic and deliberate affective associations with sexual stimuli in women with lifelong vaginismus before and after therapist-aided exposure treatment.

    Science.gov (United States)

    Melles, Reinhilde J; ter Kuile, Moniek M; Dewitte, Marieke; van Lankveld, Jacques J D M; Brauer, Marieke; de Jong, Peter J

    2014-03-01

    The intense fear response to vaginal penetration in women with lifelong vaginismus, who have never been able to experience coitus, may reflect negative automatic and deliberate appraisals of vaginal penetration stimuli which might be modified by exposure treatment. The aim of this study is to examine whether (i) sexual stimuli elicit relatively strong automatic and deliberate threat associations in women with vaginismus, as well as relatively negative automatic and deliberate global affective associations, compared with symptom-free women; and (ii) these automatic and more deliberate attitudes can be modified by therapist-aided exposure treatment. A single target Implicit Association Test (st-IAT) was used to index automatic threat associations, and an Affective Simon Task (AST) to index global automatic affective associations. Participants were women with lifelong vaginismus (N = 68) and women without sexual problems (N = 70). The vaginismus group was randomly allocated to treatment (n = 34) and a waiting list control condition (n = 34). Indices of automatic threat were obtained by the st-IAT and automatic global affective associations by the AST, visual analogue scales (VAS) were used to assess deliberate appraisals of the sexual pictures (fear and global positive affect). More deliberate fear and less global positive affective associations with sexual stimuli were found in women with vaginismus. Following therapist-aided exposure treatment, the strength of fear was strongly reduced, whereas global positive affective associations were strengthened. Automatic associations did not differ between women with and without vaginismus and did not change following treatment. Relatively stronger negative (threat or global affect) associations with sexual stimuli in vaginismus appeared restricted to the deliberate level. Therapist-aided exposure treatment was effective in reducing subjective fear of sexual penetration stimuli and led to more global positive affective

  19. High speed analysis of high pressure combustion in a constant volume cell

    NARCIS (Netherlands)

    Frijters, P.J.M.; Klein-Douwel, R.J.H.; Manski, S.S.; Somers, L.M.T.; Baert, R.S.G.; Dias, V.

    2005-01-01

    A combustion process with N2, O2 and C2H4 as fuel used in an opticallyaccessible, high pressure, high temperature, constant volume cell forresearch on diesel fuel spray formation, is studied. The flame frontspeed Vf,HS is determined using high speed imaging. The pressure traceof the combustion

  20. From core belief challenge to posttraumatic growth in para sport athletes: moderated mediation by needs satisfaction and deliberate rumination.

    Science.gov (United States)

    Hammer, Chris; Podlog, Leslie; Wadey, Ross; Galli, Nick; Forber-Pratt, Anjali J; Newton, Maria

    2018-04-25

    To examine how deliberate rumination and psychological need satisfaction interact to facilitate posttraumatic growth for para sport athletes with acquired disability. Utilizing a sample of 70 para sport athletes, the hypothesized mediating role of deliberate rumination was examined via a simple mediation model. The interaction between needs satisfaction and deliberate rumination and their effect on posttraumatic growth was examined utilizing a moderated mediation procedure. Disruption to one's core beliefs was significantly associated with posttraumatic growth. This relationship, was in part, explained by the deliberate rumination engaged in soon after the trauma. Needs satisfaction, while a significant predictor of posttraumatic growth, did not moderate the indirect effect. Although deliberate rumination at both timeframes and needs satisfaction were independently associated with posttraumatic growth, they did not interact in the hypothesized manner to influence posttraumatic growth. There remains a need to better understand how the experience of posttraumatic growth is achieved amongst individuals with acquired disability, and the role that para sport may play in this process. Implications for rehabilitation The disruption to one's core beliefs caused by acquiring a physical disability is not only a natural experience but also a necessary antecedent to posttraumatic growth. As such, rehabilitation practitioners ought to normalize these types of challenges when working with individuals with acquired disability. Practitioners may help to facilitate growth outcomes by encouraging individuals to deliberately ruminate about their acquired disability. That is, practitioners can help those with acquired disability to seek meaning and understanding about their disability or the precipitating event. For those who struggle to deliberately ruminate in the immediate disability aftermath, practitioners may encourage para sport participation to potentially prompt constructive

  1. Accounting practice diversity in the healthcare industry.

    Science.gov (United States)

    Robbins, W A; Turpin, R

    1993-05-01

    A recent study examining accounting practices currently being used to prepare annual hospital financial statements indicates relatively little diversity, regardless of organizational type or size. The study's findings should interest those concerned with healthcare accounting and financial reporting issues, especially healthcare administrators and members of standards setting boards who participate in accounting policy deliberations.

  2. Does delivery volume of family physicians predict maternal and newborn outcome?

    International Nuclear Information System (INIS)

    Klein, M.C.; Spence, A.; Kaczorowski, J.; Kelly, A.; Grzybowski, S.

    2002-01-01

    The number of births attended by individual family physicians who practice intrapartum care varies. We wanted to determine if the practice-volume relations that have been shown in other fields of medical practice also exist in maternity care practice by family doctors. For the period April 1997 to August 1998, we analyzed all singleton births at a major maternity teaching hospital for which the family physician was the responsible physician. Physicians were grouped into 3 categories on the basis of the number of births they attended each year: fewer than 12, 12 to 24, and 25 or more. Physicians with a low volume of deliveries (72 physicians, 549 births), those with a medium volume of deliveries (34 physicians, 871 births) and those with a high volume of deliveries (46 physicians, 3024 births) were compared in terms of maternal and newborn outcomes. The main outcome measures were maternal morbidity, 5-minute Apgar score and admission of the baby to the neonatal intensive care unit or special care unit. Secondary outcomes were obstetric procedures and consultation patterns. There was no difference among the 3 volume cohorts in terms of rates of maternal complications of delivery, 5-minute Apgar scores of less than 7 or admissions to the neonatal intensive care unit or the special care unit, either before or after adjustment for parity, pregnancy-induced hypertension, diabetes, ethnicity, lone parent status, maternal age, gestational age, newborn birth weight and newborn head circumference at birth. High-and medium-volume family physicians consulted with obstetricians less often than low-volume family physicians (adjusted odds ratio [OR] 0.586 [95% confidence interval, CI, 0.479-0.718] and 0.739 [95% Cl 0.583-0.935] respectively). High-and medium-volume family physicians transferred the delivery to an obstetrician less often than low-volume family physicians (adjusted OR 0.668 [95% CI 0.542-0.823] and 0.776 [95% Cl 0.607-0.992] respectively). Inductions were performed

  3. Does delivery volume of family physicians predict maternal and newborn outcome?

    Energy Technology Data Exchange (ETDEWEB)

    Klein, M.C. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Univ. of British Columbia, Dept. of Family Practice, Vancouver, British Columbia (Canada); Spence, A. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Kaczorowski, J. [McMaster Univ., Depts. of Family Medicine and of Clinical Epidemiology and Biostatistics, Hamilton, Ontario (Canada); Kelly, A. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Univ. of British Columbia, Dept. of Health Care and Epidemiology, Vancouver, British Columbia (Canada); Grzybowski, S. [Univ. of British Columbia, Dept. of Family Practice, Vancouver, British Columbia (Canada)

    2002-05-01

    The number of births attended by individual family physicians who practice intrapartum care varies. We wanted to determine if the practice-volume relations that have been shown in other fields of medical practice also exist in maternity care practice by family doctors. For the period April 1997 to August 1998, we analyzed all singleton births at a major maternity teaching hospital for which the family physician was the responsible physician. Physicians were grouped into 3 categories on the basis of the number of births they attended each year: fewer than 12, 12 to 24, and 25 or more. Physicians with a low volume of deliveries (72 physicians, 549 births), those with a medium volume of deliveries (34 physicians, 871 births) and those with a high volume of deliveries (46 physicians, 3024 births) were compared in terms of maternal and newborn outcomes. The main outcome measures were maternal morbidity, 5-minute Apgar score and admission of the baby to the neonatal intensive care unit or special care unit. Secondary outcomes were obstetric procedures and consultation patterns. There was no difference among the 3 volume cohorts in terms of rates of maternal complications of delivery, 5-minute Apgar scores of less than 7 or admissions to the neonatal intensive care unit or the special care unit, either before or after adjustment for parity, pregnancy-induced hypertension, diabetes, ethnicity, lone parent status, maternal age, gestational age, newborn birth weight and newborn head circumference at birth. High-and medium-volume family physicians consulted with obstetricians less often than low-volume family physicians (adjusted odds ratio [OR] 0.586 [95% confidence interval, CI, 0.479-0.718] and 0.739 [95% Cl 0.583-0.935] respectively). High-and medium-volume family physicians transferred the delivery to an obstetrician less often than low-volume family physicians (adjusted OR 0.668 [95% CI 0.542-0.823] and 0.776 [95% Cl 0.607-0.992] respectively). Inductions were performed

  4. Deliberate release of genetically modified plants into the environment in Slovenia

    Directory of Open Access Journals (Sweden)

    Zlata LUTHAR

    2015-11-01

    Full Text Available Deliberate release of genetically modified higher plants (GMHPs into the environment in Slovenia is regulated by the Law on the Management of Genetically Modified Organisms (ZRGSO Ur. l. RS 23/2005 and 21/2010, III chapter. For each deliberate release of GMPs into the environment a license issued by the Ministry of Environment and Spatial Planning (MESP must be acquired. The application or notification should contain a very accurate and complex description of the GMP, of the field where it will be released and of wider surroundings or environment. The application consists of Annex 2 with accessories: 1. Part A (technical data for the authorization of deliberate GMP release into the environment; 2. Part B (environmental risk assessment; 3. Application summary in Slovenian and English language for the release of GMP into environment, which is transmitted to Brussels by MESP; 4. Extract from the Land Cadastre of the field to which the GMP will be released. The release procedure runs (till here under the above mentioned Law, which has been in place for several years and which clearly defines that it is possible to release GMP in Slovenia. In the case of GM rice in 2011, the law applied till the site selection of the experiment. Here, the law was not sufficiently taken into account. It was prevailed by the regulation of Farmland and Forest Fund of the Republic of Slovenia and municipal decision, which was stronger than the national law and prevented the cultivation of GM rice in an area that is legally suitable for release of GMO into the environment. Rice is not grown in Slovenia and does not have wild ancestors or close relatives with whom it might mate. Nearest area of cultivation is in neighboring Italy, which is from potentially selected location in Slovenia more than 70 km away.

  5. Problem solving ability and repetition of deliberate self-harm: a multicentre study.

    NARCIS (Netherlands)

    McAuliffe, C.; Corcoran, P.; Keeley, H.S.; Arensman, E.; Bille Brahe, U.; de Leio, D.; Fekete, S.; Hawton, K.; Hjelmeland, H.; Kelleher, M.; Kerkhof, A.J.F.M.; Lonnqvist, J.; Michel, K.; Salander Renberg, E.; Schmidtke, A.; van Heeringen, K.; Wasserman, D.

    2006-01-01

    Background. While recent studies have found problem-solving impairments in individuals who engage in deliberate self-harm (DSH), few studies have examined repeaters and non-repeaters separately. The aim of the present study was to investigate whether specific types of problem-solving are associated

  6. Adolescent Deliberate Self-Harm: Linkages to Emotion Regulation and Family Emotional Climate

    Science.gov (United States)

    Sim, Leslie; Adrian, Molly; Zeman, Janice; Cassano, Michael; Friedrich, William N.

    2009-01-01

    Parents' responses to their children's emotional expressivity have been shown to significantly influence children's subsequent psychosocial functioning. This study hypothesized that adolescents' deliberate self-harm (DSH) may be an outcome associated with poor emotion regulation as well as an invalidating family environment. The mediational role…

  7. Sophistic Ethics in the Technical Writing Classroom: Teaching "Nomos," Deliberation, and Action.

    Science.gov (United States)

    Scott, J. Blake

    1995-01-01

    Claims that teaching ethics is particularly important to technical writing. Outlines a classical, sophistic approach to ethics based on the theories and pedagogies of Protagoras, Gorgias, and Isocrates, which emphasizes the Greek concept of "nomos," internal and external deliberation, and responsible action. Discusses problems and…

  8. Schizophrenia and Deliberate Self-Harm: A Systematic Review of Risk Factors

    Science.gov (United States)

    Haw, Camilla; Hawton, Keith; Sutton, Lesley; Sinclair, Julia; Deeks, Jonathan

    2005-01-01

    Deliberate self-harm (DSH) is a strong predictor of suicide in schizophrenia. The aim of this review was to identify risk factors for DSH in schizophrenia. This systematic review of the international literature examined cohort and case-control studies of patients with schizophrenia or related diagnoses that reported DSH as an outcome. Studies were…

  9. Impact of clinical trials on neurosurgical practice: an assessment of case volume.

    Science.gov (United States)

    Simon, Scott D; Koyama, Tatsuki; Zacharia, Brad E; Schirmer, Clemens M; Cheng, Joseph S

    2015-04-01

    To evaluate the effect of important trials on the practice of neurosurgery. We hypothesized that evidence from trials addressing the management of intracranial aneurysms (International Subarachnoid Aneurysm Trial [ISAT]) and nontraumatic intracerebral hemorrhages (Surgical Trial in Intracerebral Hemorrhage [STICH]) and vertebral augmentation for osteoporotic vertebral body fractures had a significant impact on the frequency of the corresponding neurosurgical procedures. A Medicare administrative database was queried for corresponding Common Procedural Terminology codes and units billed per calendar year. The effects of ISAT and STICH were evaluated using a generalized linear model. The effect of the vertebral augmentation study was evaluated using a t test. After publication of ISAT in 2002, the rate of increase in proportion of cerebral aneurysms that were treated with embolization (Common Procedural Terminology code 61624) per year increased from 3.9% to 5.5% (P = 0.01). After publication of STICH in 2005, the number of craniotomies performed for intracerebral hematoma decreased from 2341 in 2002 to 1646 in 2011 (P = 0.03). After 2 publications in 2009, performance of vertebral augmentation decreased from a high of 99,961 in 2009 per year to 77,108 in 2013 (P = 0.002). Randomized clinical trials remain the gold standard in the medical community to demonstrate efficacy, but their true impact relies on rapid and extensive assimilation into everyday medical practice. However, the described methodology establishes a temporal relationship only and does not prove causation. Nonetheless, trends in procedural volume suggest that the results of these select randomized clinical trials had a significant effect on neurosurgical practice affecting Medicare patients within an interval of a few years. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Investigation of Groundwater Flow Variations near a Recharge Pond with Repeat Deliberate Tracer Experiments

    Directory of Open Access Journals (Sweden)

    Jordan F Clark

    2014-06-01

    Full Text Available Determining hydraulic connections and travel times between recharge facilities and production wells has become increasingly important for permitting and operating managed aquifer recharge (MAR sites, a water supply strategy that transfers surface water into aquifers for storage and later extraction. This knowledge is critical for examining water quality changes and assessing the potential for future contamination. Deliberate tracer experiments are the best method for determining travel times and identifying preferential flow paths between recharge sites over the time scales of weeks to a few years. This paper compares the results of two deliberate tracer experiments at Kraemer Basin, Orange County, CA, USA. Results from the first experiment, which was conducted in October 1998, showed that a region of highly transmissive sedimentary material extends down gradient from the basin for more than 3 km [1]. Mean groundwater velocities were determined to be approximately 2 km/year in this region based on the arrival time of the tracer center of mass. A second experiment was initiated in January 2008 to determine if travel times from this basin to monitoring and production wells changed during the past decade in response to new recharge conditions. Results indicate that flow near Kraemer Basin was stable, and travel times to most wells determined during both experiments agree within the experimental uncertainty.

  11. Mental Models and Deliberate Manipulation of Data

    DEFF Research Database (Denmark)

    Koester, Thomas; Jakobsen, Jeanette; Brøsted, Jesper Ejdorf

    2015-01-01

    Human factors risk analysis and usability tests in telemedicine contexts primarily seek to investigate how to reduce the likelihood of slips, lapses and mistakes. However, to ensure trustworthiness in e-health data, one must also be aware of more intentional patient actions which could potentially...... compromise patient safety and/or the integrity of the system. The pilot study in this paper set out to explore mental models and deliberate manipulation of data in a Danish telemedicine setting of home monitoring among pregnant women. Results show, that patients construct mental models of the telemedicine...... system, and that the patient can utilize such mental models in attempts to manipulate their data input to get a desired output from the telemedicine system....

  12. Deliberation and Scale in Mekong Region Water Governance

    Science.gov (United States)

    Dore, John; Lebel, Louis

    2010-07-01

    Understanding the politics of deliberation, scales, and levels is crucial to understanding the social complexity of water-related governance. Deliberative processes might complement and inform more conventional representational and bureaucratic approaches to planning and decision-making. However, they are also subject to scale and level politics, which can confound institutionalized decision-making. Scale and level contests arise in dialogues and related arenas because different actors privilege particular temporal or spatial scales and levels in their analysis, arguments, and responses. Scale contests might include whether to privilege administrative, hydrological, ecosystem, or economic boundaries. Level contests might include whether to privilege the subdistrict or the province, the tributary watershed or the international river basin, a river or a biogeographic region, and the local or the regional economy. In the Mekong Region there is a recurrent demand for water resources development projects and major policies proposed by governments and investors to be scrutinized in public. Deliberative forms of engagement are potentially very helpful because they encourage supporters and critics to articulate assumptions and reasoning about the different opportunities and risks associated with alternative options, and in doing so, they often traverse and enable higher-quality conversations within and across scales and within and between levels. Six case studies from the Mekong Region are examined. We find evidence that scale and level politics affects the context, process, content, and outcomes of deliberative engagement in a region where public deliberation is still far from being a norm, particularly where there are sensitive and far-reaching choices to be made about water use and energy production.

  13. Indigenous high volume air sampler

    International Nuclear Information System (INIS)

    Kotrappa, P.; Setty, N.P.N.; Raghunath, B.; Sivasubrahmanyam, P.S.

    1978-01-01

    A high volume air sampler for use in assessing concentrations of low levels of air borne particulates has been fabricated. The sampler will be of use in radioactive installations, conventional industries and environmental pollution analysis. It is comparable in performance with the imported Staplex air samplers. A turbine and motor system similar to the one found in conventional vacuum cleaners is used in its design. The sampler units can be produced in large numbers. (M.G.B.)

  14. Geophagia among female adolescents as a culturally driven practice

    African Journals Online (AJOL)

    Geophagia, the deliberate ingestion of soil, is a culturally sanctioned practice common to the world's more tribally oriented people. Widely reported among pregnant and lactating women, geophagia is also practised by female adolescents (FA). This article presents preliminary findings on the incidence and reasons of ...

  15. Beyond Reactive Planning: Self Adaptive Software and Self Modeling Software in Predictive Deliberation Management

    National Research Council Canada - National Science Library

    Lenahan, Jack; Nash, Michael P; Charles, Phil

    2008-01-01

    .... We present the following hypothesis: predictive deliberation management using self-adapting and self-modeling software will be required to provide mission planning adjustments after the start of a mission...

  16. European public deliberation on brain machine interface technology: five convergence seminars.

    Science.gov (United States)

    Jebari, Karim; Hansson, Sven-Ove

    2013-09-01

    We present a novel procedure to engage the public in ethical deliberations on the potential impacts of brain machine interface technology. We call this procedure a convergence seminar, a form of scenario-based group discussion that is founded on the idea of hypothetical retrospection. The theoretical background of this procedure and the results of five seminars are presented.

  17. SCC with high volume of fly ash content

    Directory of Open Access Journals (Sweden)

    Bakhrakh Anton

    2017-01-01

    Full Text Available Self-compacting concrete is a very perspective building material. It provides great benefits during the construction of heavily reinforced buildings. SCC has outstanding properties such as high flowability, dense structure and high strength due to specific quality of aggregates, fillers, their proportion in mix, use of polycarboxylate-based superplasticizers. Main disadvantages of SCC are high price and the difficulty of obtaining a proper mix. Use of fillers, such as fly ash type F, is a way to make SCC cheaper by replacing part of cement. Fly ash also provides some technological and operating advantages. In this paper the influence of high volume (60% from cement fly ash type F on the properties of concrete mixture and hardened concrete is investigated. The result of the work shows the possibility of reduction the cost of SCC using ordinary fillers and high amount of fly ash. The investigated SCC has low speed of hardening (7-day compressive strength at the range of 41.8 MPa and high volume of entrained air content (3.5%.

  18. High resolution gas volume change sensor

    International Nuclear Information System (INIS)

    Dirckx, Joris J. J.; Aernouts, Jef E. F.; Aerts, Johan R. M.

    2007-01-01

    Changes of gas quantity in a system can be measured either by measuring pressure changes or by measuring volume changes. As sensitive pressure sensors are readily available, pressure change is the commonly used technique. In many physiologic systems, however, buildup of pressure influences the gas exchange mechanisms, thus changing the gas quantity change rate. If one wants to study the gas flow in or out of a biological gas pocket, measurements need to be done at constant pressure. In this article we present a highly sensitive sensor for quantitative measurements of gas volume change at constant pressure. The sensor is based on optical detection of the movement of a droplet of fluid enclosed in a capillary. The device is easy to use and delivers gas volume data at a rate of more than 15 measurements/s and a resolution better than 0.06 μl. At the onset of a gas quantity change the sensor shows a small pressure artifact of less than 15 Pa, and at constant change rates the pressure artifact is smaller than 10 Pa or 0.01% of ambient pressure

  19. Towards high-resolution positron emission tomography for small volumes

    International Nuclear Information System (INIS)

    McKee, B.T.A.

    1982-01-01

    Some arguments are made regarding the medical usefulness of high spatial resolution in positron imaging, even if limited to small imaged volumes. Then the intrinsic limitations to spatial resolution in positron imaging are discussed. The project to build a small-volume, high resolution animal research prototype (SHARP) positron imaging system is described. The components of the system, particularly the detectors, are presented and brief mention is made of data acquisition and image reconstruction methods. Finally, some preliminary imaging results are presented; a pair of isolated point sources and 18 F in the bones of a rabbit. Although the detector system is not fully completed, these first results indicate that the goals of high sensitivity and high resolution (4 mm) have been realized. (Auth.)

  20. Design and usability of heuristic-based deliberation tools for women facing amniocentesis.

    Science.gov (United States)

    Durand, Marie-Anne; Wegwarth, Odette; Boivin, Jacky; Elwyn, Glyn

    2012-03-01

    Evidence suggests that in decision contexts characterized by uncertainty and time constraints (e.g. health-care decisions), fast and frugal decision-making strategies (heuristics) may perform better than complex rules of reasoning. To examine whether it is possible to design deliberation components in decision support interventions using simple models (fast and frugal heuristics). The 'Take The Best' heuristic (i.e. selection of a 'most important reason') and 'The Tallying' integration algorithm (i.e. unitary weighing of pros and cons) were used to develop two deliberation components embedded in a Web-based decision support intervention for women facing amniocentesis testing. Ten researchers (recruited from 15), nine health-care providers (recruited from 28) and ten pregnant women (recruited from 14) who had recently been offered amniocentesis testing appraised evolving versions of 'your most important reason' (Take The Best) and 'weighing it up' (Tallying). Most researchers found the tools useful in facilitating decision making although emphasized the need for simple instructions and clear layouts. Health-care providers however expressed concerns regarding the usability and clarity of the tools. By contrast, 7 out of 10 pregnant women found the tools useful in weighing up the pros and cons of each option, helpful in structuring and clarifying their thoughts and visualizing their decision efforts. Several pregnant women felt that 'weighing it up' and 'your most important reason' were not appropriate when facing such a difficult and emotional decision. Theoretical approaches based on fast and frugal heuristics can be used to develop deliberation tools that provide helpful support to patients facing real-world decisions about amniocentesis. © 2011 Blackwell Publishing Ltd.

  1. Systems Thinking Tools for Improving Evidence-Based Practice: A Cross-Case Analysis of Two High School Leadership Teams

    Science.gov (United States)

    Kensler, Lisa A. W.; Reames, Ellen; Murray, John; Patrick, Lynne

    2012-01-01

    Teachers and administrators have access to large volumes of data but research suggests that they lack the skills to use data effectively for continuous school improvement. This study involved a cross-case analysis of two high school leadership teams' early stages of evidence-based practice development; differing forms of external support were…

  2. TRUTH OR DARE: ONLINE DELIBERATION. A CASE STUDY OF TWO INTERNET BASED DELIBERATIVE PLATFORMS

    Directory of Open Access Journals (Sweden)

    Luana Maria BIDAȘCĂ

    2011-06-01

    Full Text Available In this article, I attempt to discuss how the internet can be used to stimulate an effective communication between citizens and decision-makers. In particular, I will aim to see if it can facilitate a greater degree of deliberation among citizens, if it can make democracy more inclusive and if it can make decision makers more responsible. I will first look at the definition and characteristics of deliberative democracy. Then after looking at what has been written so far about the effect of online discussions on democracy, I shall analyze the role the internet played in two case studies: web based participatory budgeting (PB and domnuleprimar.ro (DearMrMayor.ro. Both of these platforms were designed to create a closer bond between decisionmakers and citizens and will thus prove relevant to the discussion. Finally, I conclude that while the two case studies seem to favor increased inclusiveness, it only partially increases accountability and does not register any significant progress with regard to deliberation. Still, I argue that reasons for optimism exist even with regard to the deliberative aspect. Since the debate regarding the value of online deliberation is far from over, more research is needed in order to perhaps design a framework which will allow us to exploit the democratic value of the internet to its full potential.

  3. Developer Stories: Improving Architecture in Agile Practice

    DEFF Research Database (Denmark)

    Tjørnehøj, Gitte; Jensen, Rolf Njor; Platz, Niels

    2007-01-01

    of viable architectures. To strengthen XP in this regard a new practice: Developer Stories ([2]) was introduced in 2006 - mainly based on a theoretical argumentation. This paper reports from extensive experimentation with, and elaboration of the new practice. Results from this experimentation shows...... that using Developer Stories increases the likelihood of developing a viable architecture through a series of deliberate choices, through creating disciplined and recurring activities that: 1) Facilitate sharing and embodying of knowledge about architectural issues, and 2) heighten visibility of refactorings...

  4. Democracy or war? The communication and deliberation of the climate issue online

    Directory of Open Access Journals (Sweden)

    Tomas Moe Skjølsvold

    2015-06-01

    Full Text Available For years, technology optimists have hoped that the internet might serve as a vehicle for democratization. Meanwhile, many STS-scholars have called for a democratization of scientific practices through increased transparency and inclusion of lay-persons in scientific knowledge production. Many expect this to result in increased scientific quality and more legitimate knowledge claims. In this article, we explore what happens when science related communication moves online. Do climate scientists and climate ‘skeptics’ use the internet to engage lay persons in factual deliberations and debate? Does the rise of the internet as a channel of science communication herald a new, democratic scientific era? Our paper suggests that such claims should be made with caution. Instead we identify two ways that the internet is used by climate scientists. First, it is a tool to fight a cold war with climate skeptics, a dynamic which is hidden from public view. Second, it is a site of education, where ready-made packets of facts should be transported to lay-people to mitigate perceived knowledge deficits. This strategy is mimicked by climate skeptics who attempt to make their communication appear more scientific than the scientists.

  5. Did J. Marion Sims deliberately addict his first fistula patients to opium?

    Science.gov (United States)

    Wall, L Lewis

    2007-07-01

    American surgeon J. Marion Sims (1813-83) is regarded by many modern authors as a controversial figure because he carried out a series of experimental surgeries on enslaved African American women between 1846 and 1849 in an attempt to cure them of vesicovaginal fistulas, which they had all developed as a result of prolonged obstructed labor. He operated on one woman, Anarcha Westcott, thirty times before he successfully closed her fistula. Sims performed these fistula repair operations without benefit of anesthesia but gave these women substantial doses of opium afterwards. Several modern writers have alleged that Sims did this in order to addict them to the drug and thereby to enhance his control over them. This article examines the controversy surrounding Sims' use of postoperative opium in these enslaved surgical patients. The evidence suggests that although these women were probably tolerant to the doses of opium that he used, there is no evidence that he deliberately tried to addict them to this drug. Sims' use of postoperative opium appears to have been well supported by the therapeutic practices of his day, and the regimen that he used was enthusiastically supported by many contemporary surgeons.

  6. Clinical Diagnostic and Sociocultural Dimensions of Deliberate Self-Harm in Mumbai, India

    Science.gov (United States)

    Parkar, Shubhangi R.; Dawani, Varsha; Weiss, Mitchell G.

    2006-01-01

    Patients' accounts complement psychiatric assessment of deliberate self-harm (DSH). In this study we examined psychiatric disorders, and sociocultural and cross-cultural features of DSH. SCID diagnostic interviews and a locally adapted EMIC interview were used to study 196 patients after DSH at a general hospital in Mumbai, India. Major depression…

  7. Research Evidence and School Board Deliberations: Lessons from Three Wisconsin School Districts

    Science.gov (United States)

    Asen, Robert; Gurke, Deb; Conners, Pamela; Solomon, Ryan; Gumm, Elsa

    2013-01-01

    This article analyzes the use of research evidence in school-board deliberations in three school districts in Wisconsin. In these settings, the circulation, meaning, and function of research depended importantly on the interests and backgrounds of advocates, the composition of audiences, and the values and contexts of decision-making. Board…

  8. Stimulus-dependent deliberation process leading to a specific motor action demonstrated via a multi-channel EEG analysis

    Directory of Open Access Journals (Sweden)

    Sonja eHenz

    2015-07-01

    Full Text Available The aim of the study was to determine whether a deliberative process, leading to a motor action, is detectable in high density EEG recordings. Subjects were required to press one of two buttons. In a simple motor task the subject knew which button to press, whilst in a color-word Stroop task subjects had to press the right button with the right index finger when meaning and color coincided, or the left button with the left index finger when meaning and color were disparate.EEG recordings obtained during the simple motor task showed a sequence of positive (P and negative (N cortical potentials (P1-N1-P2 which are assumed to be related to the processing of the movement.The sequence of cortical potentials was similar in EEG recordings of subjects having to deliberate over how to respond, but the above sequence (P1-N1-P2 was preceded by slowly increasing negativity (N0, with N0 being assumed to represent the end of the deliberation process.Our data suggest the existence of neurophysiological correlates of deliberative processes.

  9. Schwab, Bagley, and Dewey: Concerns for the Theoretic and the Practical.

    Science.gov (United States)

    Null, J. Wesley

    2000-01-01

    Outlines the philosophies and theories of Joseph Schwab (deliberation toward decision), William Bagley (disciplined classroom progress), and John Dewey (pragmatism and education through occupations). Suggests elements to guide contemporary curriculum: respect for theory and practice; theory as guide, not determinant; and theoretical principles…

  10. One angry woman: Anger expression increases influence for men, but decreases influence for women, during group deliberation.

    Science.gov (United States)

    Salerno, Jessica M; Peter-Hagene, Liana C

    2015-12-01

    We investigated whether expressing anger increases social influence for men, but diminishes social influence for women, during group deliberation. In a deception paradigm, participants believed they were engaged in a computer-mediated mock jury deliberation about a murder case. In actuality, the interaction was scripted. The script included 5 other mock jurors who provided verdicts and comments in support of the verdicts; 4 agreed with the participant and 1 was a "holdout" dissenter. Holdouts expressed their opinions with no emotion, anger, or fear and had either male or female names. Holdouts exerted no influence on participants' opinions when they expressed no emotion or fear. Participants' confidence in their own verdict dropped significantly, however, after male holdouts expressed anger. Yet, anger expression undermined female holdouts: Participants became significantly more confident in their original verdicts after female holdouts expressed anger-even though they were expressing the exact same opinion and emotion as the male holdouts. Mediation analyses revealed that participants drew different inferences from male versus female anger, which created a gender gap in influence during group deliberation. The current study has implications for group decisions in general, and jury deliberations in particular, by suggesting that expressing anger might lead men to gain influence, but women to lose influence over others (even when making identical arguments). These diverging consequences might result in women potentially having less influence on societally important decisions than men, such as jury verdicts. (c) 2015 APA, all rights reserved).

  11. Effect of high-volume systematic local infiltration analgesia in Caesarean section

    DEFF Research Database (Denmark)

    Larsen, Klaus Richter; Kristensen, B B; Rasmussen, M A

    2015-01-01

    BACKGROUND: Pain after Caesarean section is often treated with opioids with a risk of side effects. Wound infiltration with local anaesthetics is effective and has few side effects, but volume vs. dose concentration has not been examined. METHODS: Ninety patients scheduled for elective Caesarean...... found concerning time spent in the PACU, to first mobilisation or in number of women with nausea/vomiting (P ≥ 0.05). No complications related to ropivacaine were observed. CONCLUSIONS: Systematic infiltration with a high concentration, low volume compared with low concentration, high volume showed...

  12. High-volume infiltration analgesia in bilateral hip arthroplasty

    DEFF Research Database (Denmark)

    Andersen, Lasse Ø; Otte, Niels Kristian Stahl; Husted, Henrik

    2011-01-01

    Background and purpose High-volume infiltration analgesia may be effective in postoperative pain management after hip arthroplasty but methodological problems prevent exact interpretation of previous studies. Methods In a randomized, double-blind placebo-controlled trial in 12 patients undergoing...... bilateral total hip arthroplasty (THA) in a fast-track setting, saline or high-volume (170 mL) ropivacaine (0.2%) with epinephrine (1:100,000) was administered to the wound intraoperatively along with supplementary postoperative injections via an intraarticular epidural catheter. Oral analgesia...... was instituted preoperatively with a multimodal regimen (gabapentin, celecoxib, and acetaminophen). Pain was assessed repeatedly for 48 hours postoperatively, at rest and with 45° hip flexion. Results Pain scores were low and similar between ropivacaine and saline administration. Median hospital stay was 4...

  13. Read-only high accuracy volume holographic optical correlator

    Science.gov (United States)

    Zhao, Tian; Li, Jingming; Cao, Liangcai; He, Qingsheng; Jin, Guofan

    2011-10-01

    A read-only volume holographic correlator (VHC) is proposed. After the recording of all of the correlation database pages by angular multiplexing, a stand-alone read-only high accuracy VHC will be separated from the VHC recording facilities which include the high-power laser and the angular multiplexing system. The stand-alone VHC has its own low power readout laser and very compact and simple structure. Since there are two lasers that are employed for recording and readout, respectively, the optical alignment tolerance of the laser illumination on the SLM is very sensitive. The twodimensional angular tolerance is analyzed based on the theoretical model of the volume holographic correlator. The experimental demonstration of the proposed read-only VHC is introduced and discussed.

  14. High-volume infiltration analgesia in bilateral hip arthroplasty

    DEFF Research Database (Denmark)

    Andersen, Lasse Ø; Otte, Niels Kristian Stahl; Husted, Henrik

    2011-01-01

    bilateral total hip arthroplasty (THA) in a fast-track setting, saline or high-volume (170 mL) ropivacaine (0.2%) with epinephrine (1:100,000) was administered to the wound intraoperatively along with supplementary postoperative injections via an intraarticular epidural catheter. Oral analgesia...... was instituted preoperatively with a multimodal regimen (gabapentin, celecoxib, and acetaminophen). Pain was assessed repeatedly for 48 hours postoperatively, at rest and with 45° hip flexion. Results Pain scores were low and similar between ropivacaine and saline administration. Median hospital stay was 4...... (range 2-7) days. Interpretation Intraoperative high-volume infiltration with 0.2% ropivacaine with repeated intraarticular injections postoperatively may not give a clinically relevant analgesic effect in THA when combined with a multimodal oral analgesic regimen with gabapentin, celecoxib...

  15. Learning by doing. Training health care professionals to become facilitator of moral case deliberation.

    Science.gov (United States)

    Stolper, Margreet; Molewijk, Bert; Widdershoven, Guy

    2015-03-01

    Moral case deliberation (MCD) is a dialogue among health care professionals about moral issues in practice. A trained facilitator moderates the dialogue, using a conversation method. Often, the facilitator is an ethicist. However, because of the growing interest in MCD and the need to connect MCD to practice, healthcare professionals should also become facilitators themselves. In order to transfer the facilitating expertise to health care professionals, a training program has been developed. This program enables professionals in health care institutions to acquire expertise in dealing with moral questions independent of the expertise of an (external) ethicist. Over the past 10 years, we developed a training program with a specific mix of theory and practice, aiming to foster the right attitude, skills and knowledge of the trainee. The content and the didactics of the training developed in line with the philosophy of MCD: pragmatic hermeneutics, dialogical ethics and Socratic epistemology. Central principles are: 'learning by doing', 'reflection instead of ready made knowledge', and 'dialogue on dialogue'. This paper describes the theoretical background and the didactic content of the current training. Furthermore, we present didactic tools which we developed for stimulating active learning. We also go into lessons we learned in developing the training. Next, we provide some preliminary data from evaluation research of the training program by participants. The discussion highlights crucial aspects of educating professionals to become facilitators of MCD. The paper ends with concluding remarks and a plea for more evaluative evidence of the effectiveness and meaning of this training program for doing MCD in institutions.

  16. ACUTE EFFECTS OF STATIC STRETCHING, DYNAMIC EXERCISES, AND HIGH VOLUME UPPER EXTREMITY PLYOMETRIC ACTIVITY ON TENNIS SERVE PERFORMANCE

    Directory of Open Access Journals (Sweden)

    Ertugrul Gelen

    2012-12-01

    Full Text Available The purpose of this study was to compare the acute effects of static stretching; dynamic exercises and high volume upper extremity plyometric activity on tennis serve performance. Twenty-six elite young tennis players (15.1 ± 4.2 years, 167.9 ± 5.8 cm and 61.6 ± 8.1 kg performed 4 different warm-up (WU routines in a random order on non-consecutive days. The WU methods consisted of traditional WU (jogging, rally and serve practice (TRAD; traditional WU and static stretching (TRSS; traditional WU and dynamic exercise (TRDE; and traditional WU and high volume upper extremity plyometric activity (TRPLYP. Following each WU session, subjects were tested on a tennis serve ball speed test. TRAD, TRSS, TRDE and TRPLYO were compared by repeated measurement analyses of variance and post-hoc comparisons. In this study a 1 to 3 percent increase in tennis serve ball speed was recorded in TRDE and TRPLYO when compared to TRAD (p 0.05. ICCs for ball speed showed strong reliability (0.82 to 0.93 for the ball speed measurements.The results of this study indicate that dynamic and high volume upper extremity plyometric WU activities are likely beneficial to serve speed of elite junior tennis players.

  17. Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients presented with few, if any, symptoms. A majority of objects pass spontaneously or remain in situ without complication. Twenty-four patients were discharged following initial evaluation and without specific treatment. Eight of these were reviewed electively and discharged within one week. Twelve patients were admitted for observation, seven of whom were discharged within 48 hrs. Upper gastrointestinal endoscopy was performed in four patients and an intragastric foreign body identified in two cases. Laparotomy was performed in two cases for unresolving mechanical intestinal obstruction. Management should be conservative when possible, with surgery indicated only for complications.

  18. Improved Short-Term Outcomes following Orthognathic Surgery Are Associated with High-Volume Centers.

    Science.gov (United States)

    Berlin, Nicholas L; Tuggle, Charles T; Steinbacher, Derek M

    2016-08-01

    Previous studies assessing outcomes following orthognathic surgery rely primarily on single-center/surgeon experience. In addition to issues of generalizability, these studies are limited in evaluating the effect of operative volume on patient outcomes. Orthognathic procedures were identified in the 1999 to 2011 Healthcare Cost and Utilization Project Nationwide Inpatient Sample. Outcomes included occurrence of any in-hospital complication, extended length of stay (>2 days), and increased costs (>$10,784). High-volume hospitals were defined as the 90th percentile of case volume or higher (>31 cases/year). Univariate and multivariate analyses were conducted to identify independent predictors of outcomes. Trend analyses were performed to assess changes in the annual rate of patients treated at high-volume hospitals over the study period. Among 101,692 orthognathic surgery patients, 19.6 percent underwent concurrent ancillary procedures (i.e., genioplasty, rhinoplasty, or septoplasty), and 37.6 percent underwent double-jaw surgery. Fifty-three percent were treated at high-volume hospitals. High-volume hospitals more often performed ancillary procedures (21.4 percent versus 17.4 percent; p surgery (41.3 percent versus 33.4 percent; p orthognathic cases nationwide are performed at a small number of high-volume hospitals. These hospitals discharge patients earlier, perform more complex procedures, and have fewer complications. Risk, III.

  19. Effect of Systematic Follow-Up by General Practitioners after Deliberate Self-Poisoning: A Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Tine K Grimholt

    Full Text Available To assess whether systematic follow-up by general practitioners (GPs of cases of deliberate self-poisoning (DSP by their patients decreases psychiatric symptoms and suicidal behaviour compared with current practice.Randomised clinical trial with two parallel groups.General practices in Oslo and the eastern part of Akershus County.Patients aged 18-75 years admitted to hospital for DSP. We excluded patients diagnosed with psychoses, without a known GP, those not able to complete a questionnaire, and patients admitted to psychiatric in-patient care or other institutions where their GP could not follow them immediately after discharge.The GPs received a written guideline, contacted the patients and scheduled a consultation within one week after discharge, and then provided regular consultations for six months. We randomised the patients to either intervention (n = 78 or treatment as usual (n = 98.Primary outcome measure was the Beck Scale for Suicide Ideation (SSI. Secondary outcomes were Beck Depression Inventory (BDI and Beck Hopelessness Scale (BHS, self-reported further self-harm and treatment for DSP in a general hospital or an emergency medical agency (EMA. We assessed patients on entry to the trial and at three and six months. We collected data from interviews, self-report questionnaires, and hospital and EMA medical records.There were no significant differences between the groups in SSI, BDI, or BHS mean scores or change from baseline to three or six months. During follow-up, self-reported DSP was 39.5% in the intervention group vs. 15.8% in controls (P = 0.009. Readmissions to general hospitals were similar (13% in both groups (P = 0.963, while DSP episodes treated at EMAs were 17% in the intervention group and 7% in the control group (P = 0.103.Structured follow-up by GPs after an episode of DSP had no significant effect on suicide ideation, depression or hopelessness. There was no significant difference in repeated episodes of DSP in

  20. Enhancing engineering practices for productivity and profits in agro-allied industries

    International Nuclear Information System (INIS)

    Esan, A. A.

    2000-08-01

    The word productivity is a part of everyday vocabulary of industrial engineers and managers. Terms such as optimum utilization of resources, operational efficiency, product competitiveness, maintenance culture, etc., are mentioned with regular frequency. This is healthy, because productivity improvement does not happen by wishing for it or trying harder but by deliberately planning for it. The rewards of higher productivity are immense. At the firm level, such benefit include high production rates, higher profits, better quality products and services, customer satisfaction, higher take home pay for employees and high employee morale. Many of these benefits can be derived through the application of simple potential productivity improvement tools that are hinged on engineering practices

  1. The shared circuits model (SCM): how control, mirroring, and simulation can enable imitation, deliberation, and mindreading.

    Science.gov (United States)

    Hurley, Susan

    2008-02-01

    Imitation, deliberation, and mindreading are characteristically human sociocognitive skills. Research on imitation and its role in social cognition is flourishing across various disciplines. Imitation is surveyed in this target article under headings of behavior, subpersonal mechanisms, and functions of imitation. A model is then advanced within which many of the developments surveyed can be located and explained. The shared circuits model (SCM) explains how imitation, deliberation, and mindreading can be enabled by subpersonal mechanisms of control, mirroring, and simulation. It is cast at a middle, functional level of description, that is, between the level of neural implementation and the level of conscious perceptions and intentional actions. The SCM connects shared informational dynamics for perception and action with shared informational dynamics for self and other, while also showing how the action/perception, self/other, and actual/possible distinctions can be overlaid on these shared informational dynamics. It avoids the common conception of perception and action as separate and peripheral to central cognition. Rather, it contributes to the situated cognition movement by showing how mechanisms for perceiving action can be built on those for active perception.;>;>The SCM is developed heuristically, in five layers that can be combined in various ways to frame specific ontogenetic or phylogenetic hypotheses. The starting point is dynamic online motor control, whereby an organism is closely attuned to its embedding environment through sensorimotor feedback. Onto this are layered functions of prediction and simulation of feedback, mirroring, simulation of mirroring, monitored inhibition of motor output, and monitored simulation of input. Finally, monitored simulation of input specifying possible actions plus inhibited mirroring of such possible actions can generate information about the possible as opposed to actual instrumental actions of others, and the

  2. Low-volume high-intensity swim training is superior to high-volume low-intensity training in relation to insulin sensitivity and glucose control in inactive middle-aged women.

    Science.gov (United States)

    Connolly, Luke J; Nordsborg, Nikolai B; Nyberg, Michael; Weihe, Pál; Krustrup, Peter; Mohr, Magni

    2016-10-01

    We tested the hypothesis that low-volume high-intensity swimming has a larger impact on insulin sensitivity and glucose control than high-volume low-intensity swimming in inactive premenopausal women with mild hypertension. Sixty-two untrained premenopausal women were randomised to an inactive control (n = 20; CON), a high-intensity low-volume (n = 21; HIT) or a low-intensity high-volume (n = 21; LIT) training group. During the 15-week intervention period, HIT performed 3 weekly 6-10 × 30-s all-out swimming intervals (average heart rate (HR) = 86 ± 3 % HRmax) interspersed by 2-min recovery periods and LIT swam continuously for 1 h at low intensity (average HR = 73 ± 3 % HRmax). Fasting blood samples were taken and an oral glucose tolerance test (OGTT) was conducted pre- and post-intervention. After HIT, resting plasma [insulin] was lowered (17 ± 34 %; P high-intensity intermittent swimming is an effective and time-efficient training strategy for improving insulin sensitivity, glucose control and biomarkers of vascular function in inactive, middle-aged mildly hypertensive women.

  3. High volume tidal or current flow harnessing system

    Energy Technology Data Exchange (ETDEWEB)

    Gorlov, A.M.

    1984-08-07

    Apparatus permitting the utilization of large volumes of water in the harnessing and extracting of a portion of the power generated by the rise and fall of ocean tides, ocean currents, or flowing rivers includes the provision of a dam, and a specialized single cavity chamber of limited size as compared with the water head enclosed by the dam, and an extremely high volume gating system in which all or nearly all of the water between the high and low levels on either side of the dam is cyclically gated through the single chamber from one side of the dam to the other so as to alternately provide positive air pressure and a partial vacuum within the single chamber. In one embodiment, the specialized chamber has a barrier at the bottom which divides the bottom of the chamber in half, large ports at the bottom of the chamber to permit inflow and outflow of high volumes of water, and ganged structures having a higher total area than that of corresponding ports, in which the structures form sluice gates to selectively seal off and open different sets of ports. In another embodiment, a single chamber is used without a barrier. In this embodiment, vertical sluice gates are used which may be activated automatically by pressures acting on the sluice gates as a result of ingested and expelled water.

  4. High-level waste borosilicate glass: A compendium of corrosion characteristics. Volume 2

    International Nuclear Information System (INIS)

    Cunnane, J.C.

    1994-03-01

    The objective of this document is to summarize scientific information pertinent to evaluating the extent to which high-level waste borosilicate glass corrosion and the associated radionuclide release processes are understood for the range of environmental conditions to which waste glass may be exposed in service. Alteration processes occurring within the bulk of the glass (e.g., devitrification and radiation-induced changes) are discussed insofar as they affect glass corrosion.This document is organized into three volumes. Volumes I and II represent a tiered set of information intended for somewhat different audiences. Volume I is intended to provide an overview of waste glass corrosion, and Volume 11 is intended to provide additional experimental details on experimental factors that influence waste glass corrosion. Volume III contains a bibliography of glass corrosion studies, including studies that are not cited in Volumes I and II. Volume I is intended for managers, decision makers, and modelers, the combined set of Volumes I, II, and III is intended for scientists and engineers working in the field of high-level waste

  5. High-level waste borosilicate glass: A compendium of corrosion characteristics. Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    Cunnane, J.C. [comp.; Bates, J.K.; Bradley, C.R. [Argonne National Lab., IL (United States)] [and others

    1994-03-01

    The objective of this document is to summarize scientific information pertinent to evaluating the extent to which high-level waste borosilicate glass corrosion and the associated radionuclide release processes are understood for the range of environmental conditions to which waste glass may be exposed in service. Alteration processes occurring within the bulk of the glass (e.g., devitrification and radiation-induced changes) are discussed insofar as they affect glass corrosion.This document is organized into three volumes. Volumes I and II represent a tiered set of information intended for somewhat different audiences. Volume I is intended to provide an overview of waste glass corrosion, and Volume 11 is intended to provide additional experimental details on experimental factors that influence waste glass corrosion. Volume III contains a bibliography of glass corrosion studies, including studies that are not cited in Volumes I and II. Volume I is intended for managers, decision makers, and modelers, the combined set of Volumes I, II, and III is intended for scientists and engineers working in the field of high-level waste.

  6. Participatory Sustainability Approach to Value Capture-Based Urban Rail Financing in India through Deliberated Stakeholder Engagement

    Directory of Open Access Journals (Sweden)

    Satya Sai Kumar Jillella

    2015-06-01

    Full Text Available Increasingly, cities around the world are seeking innovative financial mechanisms to build rail transit projects. Land value capture (VC is a financing mechanism to fund urban rail transit. Often VC mechanisms are viewed only as a financing tool applied in relation to increased land values from the administration and legislation perspectives, without actively involving the community in the process. The lack of such participation has resulted in the under collection of the true value established. The transit beneficiary community and city tax payers are especially important stakeholders in this process as their willingness to participate is really critical to the overall VC success and transport outcome. This paper introduces a participatory sustainability approach to enable a more deliberated stakeholder engagement intervention across the VC life cycle. A four-step “Participatory Strategic Value Capture (PSVC” framework is proposed offering step-by-step guidance toward facilitating a meaningful stakeholder dialogue, deliberation, and collaboration around the stated engagement interests. The PSVC framework, applied to the proposed Bangalore sub-urban rail project in India, has demonstrated the importance of stakeholder engagement using deliberated participatory approaches from a win-win perspective.

  7. A Decision Support Framework For Science-Based, Multi-Stakeholder Deliberation: A Coral Reef Example

    Science.gov (United States)

    We present a decision support framework for science-based assessment and multi-stakeholder deliberation. The framework consists of two parts: a DPSIR (Drivers-Pressures-States-Impacts-Responses) analysis to identify the important causal relationships among anthropogenic environ...

  8. The deflation limb of the pressure-volume relationship in infants during high-frequency ventilation.

    Science.gov (United States)

    Tingay, David G; Mills, John F; Morley, Colin J; Pellicano, Anastasia; Dargaville, Peter A

    2006-02-15

    The importance of applying high-frequency oscillatory ventilation with a high lung volume strategy in infants is well established. Currently, a lack of reliable methods for assessing lung volume limits clinicians' ability to achieve the optimum volume range. To map the pressure-volume relationship of the lung during high-frequency oscillatory ventilation in infants, to determine at what point ventilation is being applied clinically, and to describe the relationship between airway pressure, lung volume, and oxygenation. In 12 infants, a partial inflation limb and the deflation limb of the pressure-volume relationship were mapped using a quasi-static lung volume optimization maneuver. This involved stepwise airway pressure increments to total lung capacity, followed by decrements until the closing pressure of the lung was identified. Lung volume and oxygen saturation were recorded at each airway pressure. Lung volume was measured using respiratory inductive plethysmography. A distinct deflation limb could be mapped in each infant. Overall, oxygenation and lung volume were improved by applying ventilation on the deflation limb. Maximal lung volume and oxygenation occurred on the deflation limb at a mean airway pressure of 3 and 5 cm H(2)O below the airway pressure approximating total lung capacity, respectively. Using current ventilation strategies, all infants were being ventilated near the inflation limb. It is possible to delineate the deflation limb in infants receiving high-frequency oscillatory ventilation; in doing so, greater lung volume and oxygenation can be achieved, often at lower airway pressures.

  9. Deliberate Science, Continuum Magazine: Clean Energy Innovation at NREL, Winter 2012 (Book)

    Energy Technology Data Exchange (ETDEWEB)

    2012-02-01

    This quarterly magazine is dedicated to stepping beyond the technical journals to reveal NREL's vital work in a real-world context for our stakeholders. Continuum provides insights into the latest and most impactful clean energy innovations, while spotlighting those talented researchers and unique facilities that make it all happen. This edition focuses on deliberate science.

  10. Cranial Tumor Surgical Outcomes at a High-Volume Academic Referral Center.

    Science.gov (United States)

    Brown, Desmond A; Himes, Benjamin T; Major, Brittny T; Mundell, Benjamin F; Kumar, Ravi; Kall, Bruce; Meyer, Fredric B; Link, Michael J; Pollock, Bruce E; Atkinson, John D; Van Gompel, Jamie J; Marsh, W Richard; Lanzino, Giuseppe; Bydon, Mohamad; Parney, Ian F

    2018-01-01

    To determine adverse event rates for adult cranial neuro-oncologic surgeries performed at a high-volume quaternary academic center and assess the impact of resident participation on perioperative complication rates. All adult patients undergoing neurosurgical intervention for an intracranial neoplastic lesion between January 1, 2009, and December 31, 2013, were included. Cases were categorized as biopsy, extra-axial/skull base, intra-axial, or transsphenoidal. Complications were categorized as neurologic, medical, wound, mortality, or none and compared for patients managed by a chief resident vs a consultant neurosurgeon. A total of 6277 neurosurgical procedures for intracranial neoplasms were performed. After excluding radiosurgical procedures and pediatric patients, 4151 adult patients who underwent 4423 procedures were available for analysis. Complications were infrequent, with overall rates of 9.8% (435 of 4423 procedures), 1.7% (73 of 4423), and 1.4% (63 of 4423) for neurologic, medical, and wound complications, respectively. The rate of perioperative mortality was 0.3% (14 of 4423 procedures). Case performance and management by a chief resident did not negatively impact outcome. In our large-volume brain tumor practice, rates of complications were low, and management of cases by chief residents in a semiautonomous manner did not negatively impact surgical outcomes. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  11. Training healthcare professionals as moral case deliberation facilitators : evaluation of a Dutch training programme

    NARCIS (Netherlands)

    Plantinga, Mirjam; Molewijk, Bert; de Bree, Menno; Moraal, Marloes; Verkerk, Marian; Widdershoven, Guy A. M.

    2012-01-01

    Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator.

  12. Training healthcare professionals as moral case deliberation facilitators: evaluation of a Dutch training programme

    NARCIS (Netherlands)

    Plantinga, M.; Molewijk, A.C.; de Bree, M.; Moraal, M.; Verkerk, M.; Widdershoven, G.A.

    2012-01-01

    Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator.

  13. Hominin skeletal part abundances and claims of deliberate disposal of corpses in the Middle Pleistocene.

    Science.gov (United States)

    Egeland, Charles P; Domínguez-Rodrigo, Manuel; Pickering, Travis Rayne; Menter, Colin G; Heaton, Jason L

    2018-05-01

    Humans are set apart from other organisms by the realization of their own mortality. Thus, determining the prehistoric emergence of this capacity is of significant interest to understanding the uniqueness of the human animal. Tracing that capacity chronologically is possible through archaeological investigations that focus on physical markers that reflect "mortality salience." Among these markers is the deliberate and culturally mediated disposal of corpses. Some Neandertal bone assemblages are among the earliest reasonable claims for the deliberate disposal of hominins, but even these are vigorously debated. More dramatic assertions center on the Middle Pleistocene sites of Sima de los Huesos (SH, Spain) and the Dinaledi Chamber (DC, South Africa), where the remains of multiple hominin individuals were found in deep caves, and under reported taphonomic circumstances that seem to discount the possibility that nonhominin actors and processes contributed to their formation. These claims, with significant implications for charting the evolution of the "human condition," deserve scrutiny. We test these assertions through machine-learning analyses of hominin skeletal part representation in the SH and DC assemblages. Our results indicate that nonanthropogenic agents and abiotic processes cannot yet be ruled out as significant contributors to the ultimate condition of both collections. This finding does not falsify hypotheses of deliberate disposal for the SH and DC corpses, but does indicate that the data also support partially or completely nonanthropogenic formational histories.

  14. Implementation of Evidence-Based Practice From a Learning Perspective.

    Science.gov (United States)

    Nilsen, Per; Neher, Margit; Ellström, Per-Erik; Gardner, Benjamin

    2017-06-01

    For many nurses and other health care practitioners, implementing evidence-based practice (EBP) presents two interlinked challenges: acquisition of EBP skills and adoption of evidence-based interventions and abandonment of ingrained non-evidence-based practices. The purpose of this study to describe two modes of learning and use these as lenses for analyzing the challenges of implementing EBP in health care. The article is theoretical, drawing on learning and habit theory. Adaptive learning involves a gradual shift from slower, deliberate behaviors to faster, smoother, and more efficient behaviors. Developmental learning is conceptualized as a process in the "opposite" direction, whereby more or less automatically enacted behaviors become deliberate and conscious. Achieving a more EBP depends on both adaptive and developmental learning, which involves both forming EBP-conducive habits and breaking clinical practice habits that do not contribute to realizing the goals of EBP. From a learning perspective, EBP will be best supported by means of adaptive learning that yields a habitual practice of EBP such that it becomes natural and instinctive to instigate EBP in appropriate contexts by means of seeking out, critiquing, and integrating research into everyday clinical practice as well as learning new interventions best supported by empirical evidence. However, the context must also support developmental learning that facilitates disruption of existing habits to ascertain that the execution of the EBP process or the use of evidence-based interventions in routine practice is carefully and consciously considered to arrive at the most appropriate response. © 2017 Sigma Theta Tau International.

  15. Public deliberation in the function of overcoming the democratic deficit, public debate and delineation from public hearing

    Directory of Open Access Journals (Sweden)

    Vukadinović Slobodan

    2016-01-01

    Full Text Available The article analyses forms of direct democracy from its historical forms, in Ancient Greece, to the modern ones, in Switzerland and the USA. Pointing towards the modern flaws of representative democracy, which dominates the present world, the author explores the forms of citizen participation - from participation to influence, which assists the overcoming of the democratic deficit in practice. Besides the traditional (classical ones, the analysis also focuses on the innovative mechanisms, from informal to formal ones, from individual to collective mechanisms. The focus is on the procedures of direct citizen participation such as: elections, referendum (with its modalities, plebiscite and popular veto, citizens' initiatives, the right of legislative initiative, public meetings, as well as seeking new constructive solutions which enable the citizens not only to express their opinions through selecting the option for or against, but to actively participate and express their own opinions, positions, experiences and arguments - to participate in public deliberation. These are: public debate, public hearing, public consultations and public discussions, round tables and public presence in the form of mini-audiences, public opinion polls and participation in surveys, cooperation of state bodies with civil society organisations, public call for submission of proposals, remarks and petitions, public-private dialogue, focus groups, citizen panels, citizen conferences, citizens' advisory committees, town hall meetings, citizens juries, consensus conferences, the world cafe. In particular, the article points out that e-participation is nowadays utilised more often and gains significance, since it enables citizens to submit their proposals and remarks electronically, in the form of discussion and interaction via social networks and on-line dialogue platforms. It points towards the positive effects and advantages of direct involvement of citizens in the

  16. The Transformative Power of Communication: Democratizing Practices for the General Education Classroom

    Science.gov (United States)

    Haynal, Kaitlyn

    2016-01-01

    This article examines the common communication practices of deliberation, discussion, delivery, and debate, for their democratizing potential through their greater inclusion in all general education classrooms. It argues that these tools are underutilized outside of communication classrooms but offer numerous benefits to teachers and students…

  17. Individual differences in preference for epistemic versus teleologic strategies of deliberate self-persuasion.

    Science.gov (United States)

    Taylor, Cheryl A; Lord, Charles G; Morin, Amanda L; Brady, Sara E; Yoke, Kristin; Lu, Tong

    2014-03-01

    People are often dissatisfied with their attitudes (e.g., liking their jobs too little or junk food too much) and would like to evaluate differently. On the basis of theory and research, a scale was developed to measure individual differences in preference for 2 types of cognitive tactics (epistemic or teleologic [E or T]) that people use when they try to change their own attitudes (Maio & Thomas, 2007). For each of 3 attitude objects (my life, a romantic partner, Arabs), the scale items loaded on the 2 intended factors, and E - T scale scores were significantly correlated across the 3 attitude objects (Study 1). Scale scores also displayed satisfactory internal and test-retest reliability and discriminant validity (Study 2). In addition, E - T scores (i.e., mean preference for epistemic vs. teleologic tactics) displayed satisfactory predictive and construct validity by predicting the extent to which individuals would recall negative attributes of their lives (Study 3) and of going to a counseling center (Study 4) after a session of deliberate self-persuasion. The discussion centers on theoretical and practical applications of the new scale. 2014 APA

  18. Applying What Works: A Case for Deliberate Psychological Education in Undergraduate Business Ethics

    Science.gov (United States)

    Schmidt, Christopher Drees; Davidson, Kathleen M.; Adkins, Christopher

    2013-01-01

    The teaching of business ethics continues to be a topic of great concern as both businesses and business schools seek to develop effective approaches for fostering ethical behavior. Responses to this objective have been varied, and consistent empirical evidence for a particular approach has not emerged. One approach, deliberate psychological…

  19. High-volume recycled materials for sustainable pavement construction.

    Science.gov (United States)

    2017-05-01

    The main objective of this research is to evaluate the feasibility of using high-volume recycled materials for concrete production in rigid pavement. The goal was to replace 50% of the solids with recycled materials and industrial by-products. The pe...

  20. Ethnic density and deliberate self harm; a small area study in south east London

    NARCIS (Netherlands)

    Neeleman, J; Wilson-Jones, C; Wessely, S

    Study objective-Relative risks are frequently used to convey how strongly outcomes like mental illness and suicidal behaviour are associated with personal characteristics Like ethnic background. This study examined whether RRs for deliberate self harm (DSH) in ethnic groups vary between small areas

  1. Hydrological simulation approaches for BMPs and LID practices in highly urbanized area and development of hydrological performance indicator system

    Directory of Open Access Journals (Sweden)

    Yan-wei Sun

    2014-04-01

    Full Text Available Urbanization causes hydrological change and increases stormwater runoff volumes, leading to flooding, erosion, and the degradation of instream ecosystem health. Best management practices (BMPs, like detention ponds and infiltration trenches, have been widely used to control flood runoff events for the past decade. However, low impact development (LID options have been proposed as an alternative approach to better mimic the natural flow regime by using decentralized designs to control stormwater runoff at the source, rather than at a centralized location in the watershed. For highly urbanized areas, LID stormwater management practices such as bioretention cells and porous pavements can be used to retrofit existing infrastructure and reduce runoff volumes and peak flows. This paper describes a modeling approach to incorporate these LID practices and the two BMPs of detention ponds and infiltration trenches in an existing hydrological model to estimate the impacts of BMPs and LID practices on the surface runoff. The modeling approach has been used in a parking lot located in Lenexa, Kansas, USA, to predict hydrological performance of BMPs and LID practices. A performance indicator system including the flow duration curve, peak flow frequency exceedance curve, and runoff coefficient have been developed in an attempt to represent impacts of BMPs and LID practices on the entire spectrum of the runoff regime. Results demonstrate that use of these BMPs and LID practices leads to significant stormwater control for small rainfall events and less control for flood events.

  2. Learning Curves of Virtual Mastoidectomy in Distributed and Massed Practice.

    Science.gov (United States)

    Andersen, Steven Arild Wuyts; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

    2015-10-01

    corresponding nontutored sessions (P distributed practice, suggesting a protective effect when acquired skills were consolidated over time. The mean performance of the nontutored participants in the distributed practice group plateaued on a score of 16.0 (15.3-16.7) at approximately the ninth repetition, but the individual learning curves were highly variable. Novices can acquire basic mastoidectomy competencies with self-directed VR simulation training. Training should be organized with distributed practice, and simulator-integrated tutoring can be useful to accelerate the initial learning curve. Practice should be deliberate and toward a standard set level of proficiency that remains to be defined rather than toward the mean learning curve plateau.

  3. Nature, nurture, and capital punishment: How evidence of a genetic-environment interaction, future dangerousness, and deliberation affect sentencing decisions.

    Science.gov (United States)

    Gordon, Natalie; Greene, Edie

    2018-01-01

    Research has shown that the low-activity MAOA genotype in conjunction with a history of childhood maltreatment increases the likelihood of violent behaviors. This genetic-environment (G × E) interaction has been introduced as mitigation during the sentencing phase of capital trials, yet there is scant data on its effectiveness. This study addressed that issue. In a factorial design that varied mitigating evidence offered by the defense [environmental (i.e., childhood maltreatment), genetic, G × E, or none] and the likelihood of the defendant's future dangerousness (low or high), 600 mock jurors read sentencing phase evidence in a capital murder trial, rendered individual verdicts, and half deliberated as members of a jury to decide a sentence of death or life imprisonment. The G × E evidence had little mitigating effect on sentencing preferences: participants who received the G × E evidence were no less likely to sentence the defendant to death than those who received evidence of childhood maltreatment or a control group that received neither genetic nor maltreatment evidence. Participants with evidence of a G × E interaction were more likely to sentence the defendant to death when there was a high risk of future dangerousness than when there was a low risk. Sentencing preferences were more lenient after deliberation than before. We discuss limitations and future directions. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Powder metallurgical high performance materials. Proceedings. Volume 4: late papers

    Energy Technology Data Exchange (ETDEWEB)

    Kneringer, G; Roedhammer, P; Wildner, H [eds.

    2001-07-01

    This is the fourth volume (late papers) of the 15th International Plansee seminar 2001 which general theme was 'Powder metallurgical high performance materials'. The seminar looked beyond the refractory metals and cemented carbides, which remain as its focus, to novel classes of materials, such as intermetallic compounds, with potential for high temperature applications. This volume 4 contains papers dealing with high performance P/M metals (ITER and fusion reactors, solid targets, materials microstructure, novel alloys, etc.), P/M hard materials ( production and characterization, tungsten carbides, titanium carbides, microstructural design, coatings composition and performance, etc.) and general topics. From 37 papers 24 correspond to INIS subject scope and they were indexed separately. (nevyjel)

  5. Powder metallurgical high performance materials. Proceedings. Volume 4: late papers

    International Nuclear Information System (INIS)

    Kneringer, G.; Roedhammer, P.; Wildner, H.

    2001-01-01

    This is the fourth volume (late papers) of the 15th International Plansee seminar 2001 which general theme was 'Powder metallurgical high performance materials'. The seminar looked beyond the refractory metals and cemented carbides, which remain as its focus, to novel classes of materials, such as intermetallic compounds, with potential for high temperature applications. This volume 4 contains papers dealing with high performance P/M metals (ITER and fusion reactors, solid targets, materials microstructure, novel alloys, etc.), P/M hard materials ( production and characterization, tungsten carbides, titanium carbides, microstructural design, coatings composition and performance, etc.) and general topics. From 37 papers 24 correspond to INIS subject scope and they were indexed separately. (nevyjel)

  6. Decision making and coping in healthcare: the Coping in Deliberation (CODE) framework.

    Science.gov (United States)

    Witt, Jana; Elwyn, Glyn; Wood, Fiona; Brain, Kate

    2012-08-01

    To develop a framework of decision making and coping in healthcare that describes the twin processes of appraisal and coping faced by patients making preference-sensitive healthcare decisions. We briefly review the literature for decision making theories and coping theories applicable to preference-sensitive decisions in healthcare settings. We describe first decision making, then coping and finally attempt to integrate these processes by building on current theory. Deliberation in healthcare may be described as a six step process, comprised of the presentation of a health threat, choice, options, preference construction, the decision itself and consolidation post-decision. Coping can be depicted in three stages, beginning with a threat, followed by primary and secondary appraisal and ultimately resulting in a coping effort. Drawing together concepts from prominent decision making theories and coping theories, we propose a multidimensional, interactive framework which integrates both processes and describes coping in deliberation. The proposed framework offers an insight into the complexity of decision making in preference-sensitive healthcare contexts from a patient perspective and may act as theoretical basis for decision support. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  7. PIEZOELECTRIC WAVEGUIDE SENSOR FOR MEASURING PULSE PRESSURE IN CLOSED LIQUID VOLUMES AT HIGH VOLTAGE ELECTRIC DISCHARGE

    Directory of Open Access Journals (Sweden)

    V. G. Zhekul

    2017-10-01

    Full Text Available Purpose. Investigations of the characteristics of pressure waves presuppose the registration of the total profile of the pressure wave at a given point in space. For these purposes, various types of «pressure to the electrical signal» transmitters (sensors are used. Most of the common sensors are unsuitable for measuring the pulse pressure in a closed water volume at high hydrostatic pressures, in particular to study the effect of a powerful high-voltage pulse discharge on increasing the inflow of minerals and drinking water in wells. The purpose of the work was to develop antijamming piezoelectric waveguide sensor for measuring pulse pressure at a close distance from a high-voltage discharge channel in a closed volume of a liquid. Methodology. We have applied the calibration method as used as a secondary standard, the theory of electrical circuits. Results. We have selected the design and the circuit solution of the waveguide pressure sensor. We have developed a waveguide pulse-pressure sensor DTX-1 with a measuring loop. This sensor makes it possible to study the spectral characteristics of pressure waves of high-voltage pulse discharge in closed volumes of liquid at a hydrostatic pressure of up to 20 MPa and a temperature of up to 80 °C. The sensor can be used to study pressure waves with a maximum amplitude value of up to 150 MPa and duration of up to 80 µs. According to the results of the calibration, the sensitivity of the developed sensor DTX-1 with a measuring loop is 0.0346 V/MPa. Originality. We have further developed the theory of designing the waveguide piezoelectric pulse pressure sensors for measuring the pulse pressure at a close distance from a high-voltage discharge channel in a closed fluid volume by controlling the attenuation of the amplitude of the pressure signal. Practical value. We have developed, created, calibrated, used in scientific research waveguide pressure pulse sensors DTX-1. We propose sensors DTX-1 for sale

  8. Dose-volume considerations in stereotaxic brain radiation therapy

    International Nuclear Information System (INIS)

    Houdek, P.V.; Schwade, J.G.; Pisciotta, V.J.; Medina, A.J.; Lewin, A.A.; Abitbol, A.A.; Serago, C.F.

    1988-01-01

    Although brain radiation therapy experience suggests that a gain in the therapeutic ratio may be achieved by optimizing the dose-volume relationship, no practical system for quantitative assessment of dose-volume data has been developed. This presentation describes the rationale for using the integral dose function for this purpose and demonstrates that with the use of a conventional treatment planning computer and a series of computed tomographic scans, first-order optimization of the dose-volume function can be accomplished in two steps: first, high-dose volume is minimized by selecting an appropriate treatment technique and tumor margin, and then dosage is maximized by calculating the brain tolerance dose as a function of the irradiated volume

  9. High-Temperature-High-Volume Lifting for Enhanced Geothermal Systems

    Energy Technology Data Exchange (ETDEWEB)

    Turnquist, Norman [GE Global Research, Munchen (Germany); Qi, Xuele [GE Global Research, Munchen (Germany); Raminosoa, Tsarafidy [GE Global Research, Munchen (Germany); Salas, Ken [GE Global Research, Munchen (Germany); Samudrala, Omprakash [GE Global Research, Munchen (Germany); Shah, Manoj [GE Global Research, Munchen (Germany); Van Dam, Jeremy [GE Global Research, Munchen (Germany); Yin, Weijun [GE Global Research, Munchen (Germany); Zia, Jalal [GE Global Research, Munchen (Germany)

    2013-12-20

    This report summarizes the progress made during the April 01, 2010 – December 30, 2013 period under Cooperative Agreement DE-EE0002752 for the U.S. Department of Energy entitled “High-Temperature-High-Volume Lifting for Enhanced Geothermal Systems.” The overall objective of this program is to advance the technology for well fluids lifting systems to meet the foreseeable pressure, temperature, and longevity needs of the Enhanced Geothermal Systems (EGS) industry for the coming ten years. In this program, lifting system requirements for EGS wells were established via consultation with industry experts and site visits. A number of artificial lift technologies were evaluated with regard to their applicability to EGS applications; it was determined that a system based on electric submersible pump (ESP) technology was best suited to EGS. Technical barriers were identified and a component-level technology development program was undertaken to address each barrier, with the most challenging being the development of a power-dense, small diameter motor that can operate reliably in a 300°C environment for up to three years. Some of the targeted individual component technologies include permanent magnet motor construction, high-temperature insulation, dielectrics, bearings, seals, thrust washers, and pump impellers/diffusers. Advances were also made in thermal management of electric motors. In addition to the overall system design for a full-scale EGS application, a subscale prototype was designed and fabricated. Like the full-scale design, the subscale prototype features a novel “flow-through-the-bore” permanent magnet electric motor that combines the use of high temperature materials with an internal cooling scheme that limits peak internal temperatures to <330°C. While the full-scale high-volume multi-stage pump is designed to lift up to 80 kg/s of process water, the subscale prototype is based on a production design that can pump 20 kg/s and has been modified

  10. Querying Social Practices in Hospital Context

    DEFF Research Database (Denmark)

    Larsen, John Bruntse; Dignum, Virginia; Villadsen, Jørgen

    2018-01-01

    and capabilities. Social practices can therefore simplify deliberation and planning in complex contexts. In the context of patient-centered planning, hospitals seek means to ensure that patients and their families are at the center of decisions and planning of the healthcare processes. This requires on one hand......Understanding the social contexts in which actions and interactions take place is of utmost importance for planning one’s goals and activities. People use social practices as means to make sense of their environment, assessing how that context relates to past, common experiences, culture...... that patients are aware of the practices being in place at the hospital and on the other hand that hospitals have the means to evaluate and adapt current practices to the needs of the patients. In this paper we apply a framework for formalizing social practices of an organization to an emergency department...

  11. Psychometric properties of the Dutch version of the Attitude Towards Deliberate Self-Harm Questionnaire

    NARCIS (Netherlands)

    Kool, N.; van Meijel, B.; van der Bijl, J.; Koekkoek, B.; Kerkhof, A.

    2015-01-01

    The attitude of nurses and treatment staff is crucial in the treatment of patients who self-harm. However, many patients experience that attitude as negative. The aim of this study was to investigate the psychometric properties of the Dutch version of the Attitude Towards Deliberate Self-Harm

  12. Informed decision making about predictive DNA tests: arguments for more public visibility of personal deliberations about the good life.

    Science.gov (United States)

    Boenink, Marianne; van der Burg, Simone

    2010-05-01

    Since its advent, predictive DNA testing has been perceived as a technology that may have considerable impact on the quality of people's life. The decision whether or not to use this technology is up to the individual client. However, to enable well considered decision making both the negative as well as the positive freedom of the individual should be supported. In this paper, we argue that current professional and public discourse on predictive DNA-testing is lacking when it comes to supporting positive freedom, because it is usually framed in terms of risk and risk management. We show how this 'risk discourse' steers thinking on the good life in a particular way. We go on to argue that empirical research into the actual deliberation and decision making processes of individuals and families may be used to enrich the environment of personal deliberation in three ways: (1) it points at a richer set of values that deliberators can take into account, (2) it acknowledges the shared nature of genes, and (3) it shows how one might frame decisions in a non-binary way. We argue that the public sharing and discussing of stories about personal deliberations offers valuable input for others who face similar choices: it fosters their positive freedom to shape their view of the good life in relation to DNA-diagnostics. We conclude by offering some suggestions as to how to realize such public sharing of personal stories.

  13. Symbiotic empirical ethics: a practical methodology.

    Science.gov (United States)

    Frith, Lucy

    2012-05-01

    Like any discipline, bioethics is a developing field of academic inquiry; and recent trends in scholarship have been towards more engagement with empirical research. This 'empirical turn' has provoked extensive debate over how such 'descriptive' research carried out in the social sciences contributes to the distinctively normative aspect of bioethics. This paper will address this issue by developing a practical research methodology for the inclusion of data from social science studies into ethical deliberation. This methodology will be based on a naturalistic conception of ethical theory that sees practice as informing theory just as theory informs practice - the two are symbiotically related. From this engagement with practice, the ways that such theories need to be extended and developed can be determined. This is a practical methodology for integrating theory and practice that can be used in empirical studies, one that uses ethical theory both to explore the data and to draw normative conclusions. © 2010 Blackwell Publishing Ltd.

  14. Going the Extra Mile: Improved Survival for Pancreatic Cancer Patients Traveling to High-volume Centers.

    Science.gov (United States)

    Lidsky, Michael E; Sun, Zhifei; Nussbaum, Daniel P; Adam, Mohamed A; Speicher, Paul J; Blazer, Dan G

    2017-08-01

    This study compares outcomes following pancreaticoduodenectomy (PD) for patients treated at local, low-volume centers and those traveling to high-volume centers. Although outcomes for PD are superior at high-volume institutions, not all patients live in proximity to major medical centers. Theoretical advantages for undergoing surgery locally exist. The 1998 to 2012 National Cancer Data Base was queried for T1-3N0-1M0 pancreatic adenocarcinoma patients who underwent PD. Travel distances to treatment centers were calculated. Overlaying the upper and lower quartiles of travel distance with institutional volume established short travel/low-volume (ST/LV) and long travel/high-volume (LT/HV) cohorts. Overall survival was evaluated. Of 7086 patients, 773 ST/LV patients traveled ≤6.3 (median 3.2) miles to centers performing ≤3.3 PDs yearly, and 758 LT/HV patients traveled ≥45 (median 97.3) miles to centers performing ≥16 PDs yearly. LT/HV patients had higher stage disease (P travel to a high-volume center remained associated with reduced long-term mortality (hazard ratio 0.75, P travel burden, patients treated at high-volume centers had improved perioperative outcomes, short-term mortality, and overall survival. These data support ongoing efforts to centralize care for patients undergoing PD.

  15. Best-practices guidelines for L2PSA development and applications. Volume 2 - Best practices for the Gen II PWR, Gen II BWR L2PSAs. Extension to Gen III reactors

    International Nuclear Information System (INIS)

    Raimond, E.; Durin, T.; Rahni, N.; Meignen, R.; Cranga, M.; Pichereau, F.; Bentaib, A.; Guigueno, Y.; Loeffler, H.; Mildenberger, O.; Lajtha, G.; Santamaria, C.S.; Dienstbier, J.; Rydl, A.; Holmberg, J.E.; Lindholm, I.; Maennistoe, I.; Pauli, E.M.; Dirksen, G.; Grindon, L.; Peers, K.; Hulqvist, G.; Parozzi, F.; Polidoro, F.; Cazzoli, E.; Vitazkova, J.; Burgazzi, L.; Oury, L.; Ngatchou, C.; Siltanen, S.; Niemela, I.; Routamo, T.; Helstroem, P.; Bassi, C.; Brinkman, H.; Seidel, A.; Schubert, B.; Wohlstein, R.; Guentay, S.; Vincon, L.

    2010-01-01

    The objective of this coordinated action was to develop best practice guidelines for the performance of Level 2 PSA methodologies with a view of harmonisation at EU level and to allow meaningful and practical uncertainty evaluations in a Level 2 PSA. Specific relationships with community in charge of nuclear reactor safety (utilities, safety authorities, vendors, and research or services companies) have been established in order to define the current needs in terms of guidelines for level 2 PSA development and applications. An international workshop was organised in Hamburg, with the support of VATTENFALL, in November 2008. The level 2 PSA experts from the ASAMPSA2 project partners have proposed some guidelines for the development and application of L2PSA based on their experience and on information available from international cooperation (EC Severe Accident network of Excellence - SARNET, IAEA standards, OECD-NEA publications and workshop) or open literature. The number of technical issues addressed in the guideline is very large and all are not covered with the same relevancy in the first version of the guideline. This version is submitted for external review in November 2010 by severe accident experts and PSA, especially, from SARNET and OECD-NEA members. The feedback of the external review will be dis cussed during an international open works hop planned in March 2011 and all outcomes will be taken into consideration in the final version of this guideline (June 2011). The guideline includes 3 volumes: - Volume 1 - General considerations on L2PSA. - Volume 2 - Technical recommendations for Gen II and III reactors. - Volume 3 - Specific considerations for future reactor (Gen IV). The recommendations formulated in the guideline should not be considered as 'mandatory' but should help the L2PSA developers to achieve high quality studies with limited time and resources. It may also help the L2PSA reviewers by positioning one specific study in comparison with some

  16. Improving School Leadership. Volume 1: Policy and Practice

    Science.gov (United States)

    OECD Publishing (NJ3), 2008

    2008-01-01

    As countries strive to reform education systems and improve student results, school leadership is high on education policy agendas. But in many countries, the men and women who run schools are overburdened, underpaid and near retirement. And few people are lining up for their jobs. Based on an OECD study of school leadership practices and policies…

  17. The Socialization of Children’s Memory: Linking Maternal Conversational Style to the Development of Children’s Autobiographical and Deliberate Memory Skills

    Science.gov (United States)

    Langley, Hillary A.; Coffman, Jennifer L.; Ornstein, Peter A.

    2017-01-01

    Data from a large-scale, longitudinal research study with an ethnically and socioeconomically diverse sample were utilized to explore linkages between maternal elaborative conversational style and the development of children’s autobiographical and deliberate memory. Assessments were made when the children were 3, 5, and 6 years of age, and the results reveal concurrent and longitudinal linkages between maternal conversational style in a mother-child reminiscing task and children’s autobiographical memory performance. Maternal conversational style while reminiscing was also significantly related to children’s strategic behaviors and recall in two deliberate memory tasks, both concurrently and longitudinally. Results from this examination replicate and extend what is known about the linkages between maternal conversational style, children’s abilities to talk about previous experiences, and children’s deliberate memory skills as they transition from the preschool to early elementary school years. PMID:29270083

  18. Moderator's view: High-volume plasma exchange: pro, con and consensus.

    Science.gov (United States)

    Kaplan, Andre A

    2017-09-01

    I have been asked to comment on the pro and con opinions regarding high-volume plasma exchange. The authors of both positions have provided cogent arguments and a reasonable approach to choosing the exchange volume for any given therapeutic plasma exchange. The major issue of relevance in this discussion is the nature of the toxins targeted for removal. These parameters include molecular weight, the apparent volume of distribution, the degree of protein binding, the biologic and chemical half-life, and the severity and rapidity of its toxicity. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  19. Keep your bias to yourself: How deliberating with differently biased others affects mock-jurors' guilt decisions, perceptions of the defendant, memories, and evidence interpretation.

    Science.gov (United States)

    Ruva, Christine L; Guenther, Christina C

    2017-10-01

    This experiment explored how mock-jurors' (N = 648) guilt decisions, perceptions of the defendant, memories, and evidence interpretation varied as a function of jury type and pretrial publicity (PTP); utilizing a 2 (jury type: pure-PTP vs. mixed-PTP) × 3 (PTP: defendant, victim, and irrelevant) factorial design. Mock-juries (N = 126) were composed of jurors exposed to the same type of PTP (pure-PTP; e.g., defendant-PTP) or different types of PTP (mixed-PTP; e.g., half exposed to defendant-PTP and half to irrelevant-PTP). Before deliberations jurors exposed to defendant-PTP were most likely to vote guilty; while those exposed to victim-PTP were least likely. After deliberations, jury type and PTP affected jurors' guilt decisions. Specifically, jurors deliberating on pure-PTP juries had verdict distributions that closely resembled the predeliberation distributions. The verdict distributions of jurors on mixed-PTP juries suggested that jurors were influenced by those they deliberated with. Jurors not exposed to PTP appeared to incorporate bias from PTP-exposed jurors. Only PTP had significant effects on postdeliberation measures of memory and evidence interpretation. Mediation analyses revealed that evidence interpretation and defendant credibility assessments mediated the effect of PTP on guilt ratings. Taken together these findings suggest that during deliberations PTP bias can spread to jurors not previously exposed to PTP. In addition, juries composed of jurors exposed to different PTP slants, as opposed to a single PTP slant, can result in less biased decisions. Finally, deliberating with others who do not share similar biases may have little, if any, impact on biased evidence interpretation or memory errors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. MENSTRUAL PHASE OF WOMEN AND DEATH DUE TO DELIBERATE SELF HARM: AN AUTOPSY STUDY

    OpenAIRE

    Sujith Sreenivas

    2015-01-01

    The study was conducted by determining the phase of menstruation of women, who committed suicide by subjecting the uterus for gross and histopathological examination. An understanding whether there was an increased incidence of deliberate self - harm during any particular phase of menstruation was made by this study. AIMS: Determination of me...

  1. ESTIMATION OF STAND HEIGHT AND FOREST VOLUME USING HIGH RESOLUTION STEREO PHOTOGRAPHY AND FOREST TYPE MAP

    Directory of Open Access Journals (Sweden)

    K. M. Kim

    2016-06-01

    Full Text Available Traditional field methods for measuring tree heights are often too costly and time consuming. An alternative remote sensing approach is to measure tree heights from digital stereo photographs which is more practical for forest managers and less expensive than LiDAR or synthetic aperture radar. This work proposes an estimation of stand height and forest volume(m3/ha using normalized digital surface model (nDSM from high resolution stereo photography (25cm resolution and forest type map. The study area was located in Mt. Maehwa model forest in Hong Chun-Gun, South Korea. The forest type map has four attributes such as major species, age class, DBH class and crown density class by stand. Overlapping aerial photos were taken in September 2013 and digital surface model (DSM was created by photogrammetric methods(aerial triangulation, digital image matching. Then, digital terrain model (DTM was created by filtering DSM and subtracted DTM from DSM pixel by pixel, resulting in nDSM which represents object heights (buildings, trees, etc.. Two independent variables from nDSM were used to estimate forest stand volume: crown density (% and stand height (m. First, crown density was calculated using canopy segmentation method considering live crown ratio. Next, stand height was produced by averaging individual tree heights in a stand using Esri’s ArcGIS and the USDA Forest Service’s FUSION software. Finally, stand volume was estimated and mapped using aerial photo stand volume equations by species which have two independent variables, crown density and stand height. South Korea has a historical imagery archive which can show forest change in 40 years of successful forest rehabilitation. For a future study, forest volume change map (1970s–present will be produced using this stand volume estimation method and a historical imagery archive.

  2. Case mix-adjusted cost of colectomy at low-, middle-, and high-volume academic centers.

    Science.gov (United States)

    Chang, Alex L; Kim, Young; Ertel, Audrey E; Hoehn, Richard S; Wima, Koffi; Abbott, Daniel E; Shah, Shimul A

    2017-05-01

    Efforts to regionalize surgery based on thresholds in procedure volume may have consequences on the cost of health care delivery. This study aims to delineate the relationship between hospital volume, case mix, and variability in the cost of operative intervention using colectomy as the model. All patients undergoing colectomy (n = 90,583) at 183 academic hospitals from 2009-2012 in The University HealthSystems Consortium Database were studied. Patient and procedure details were used to generate a case mix-adjusted predictive model of total direct costs. Observed to expected costs for each center were evaluated between centers based on overall procedure volume. Patient and procedure characteristics were significantly different between volume tertiles. Observed costs at high-volume centers were less than at middle- and low-volume centers. According to our predictive model, high-volume centers cared for a less expensive case mix than middle- and low-volume centers ($12,786 vs $13,236 and $14,497, P case mix at low-volume centers, which may lead to perceived poor performance at these centers. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. The effect of chronic erythrocytic polycythemia and high altitude upon plasma and blood volumes.

    Science.gov (United States)

    Burton, R. R.; Smith, A. H.

    1972-01-01

    Comparison of two kinds of physiological chronic erythrocytic polycythemias in order to differentiate the specific effect of erythrocytic polycythemia from the general effects of high altitude upon the plasma volume. The two kinds were produced hormonally in female chickens, at sea level, or by protracted high-altitude exposures. It appears that the vascular system of the body may account for an increase in red blood cell mass either by reduction in plasma volume, or by no change in plasma volume, resulting in differential changes in total blood volumes.

  4. Deliberating emission reduction options

    Energy Technology Data Exchange (ETDEWEB)

    Dowd, A.M.; Rodriguez, M.; Jeanneret, T. [Commonwealth Scientific and Industrial Research Organisation CSIRO, 37 Graham Rd, Highett VIC 3190 (Australia); De Best-Waldhober, M.; Straver, K.; Mastop, J.; Paukovic, M. [Energy research Centre of the Netherlands ECN, Policy Studies, Amsterdam (Netherlands)

    2012-06-15

    For more than 20 years there has been a concerted international effort toward addressing climate change. International conventions, such as the United Nations Foreign Convention on Climate Change (UNFCCC; ratified in 1994), have been established by committed nations seeking to address global climate change through the reduction of greenhouse gases emitted into the Earth's atmosphere (Global CCS Institute, 2011). Long recognised as the most crucial of the greenhouse gases to impact global warming, the majority of carbon dioxide's anthropogenic global emissions are directly related to fuel combustion of which both Australia and the Netherlands' energy production is significantly reliant. Both these nations will need to consider many opinions and make hard decisions if alternative energy options are to be implemented at the scale that is required to meet international emission targets. The decisions that are required not only need to consider the many options available but also their consequences. Along with politicians, policy developers and industry, the general public also need to be active participants in deciding which energy options, and their subsequent consequences, are acceptable for implementation at the national level. Access to balanced and factual information is essential in establishing informed opinions on the many policy options available. Past research has used several methods to measure public perceptions and opinions yet for complex issues, such as emission reduction, some of these methods have shown to be problematic. For example, semi structured interviews can provide data that is flexible and context rich yet is does also come with the limitations such as it seldom provides a practical assessment that can be utilised from researcher to researcher, across disciplines and public participation techniques. Surveys on the other hand usually address these limitations but surveys that do not encourage comparison of information or ask

  5. Deliberating emission reduction options

    Energy Technology Data Exchange (ETDEWEB)

    Dowd, A. M.; Rodriguez, M.; Jeanneret, T. [Commonwealth Scientific and Industrial Research Organisation CSIRO, 37 Graham Rd, Highett VIC 3190 (Australia); De Best-Waldhober, M.; Straver, K.; Mastop, J.; Paukovic, M. [Energy research Centre of the Netherlands ECN, Policy Studies, Amsterdam (Netherlands)

    2012-06-15

    For more than 20 years there has been a concerted international effort toward addressing climate change. International conventions, such as the United Nations Foreign Convention on Climate Change (UNFCCC; ratified in 1994), have been established by committed nations seeking to address global climate change through the reduction of greenhouse gases emitted into the Earth's atmosphere (Global CCS Institute, 2011). Long recognised as the most crucial of the greenhouse gases to impact global warming, the majority of carbon dioxide's anthropogenic global emissions are directly related to fuel combustion of which both Australia and the Netherlands' energy production is significantly reliant. Both these nations will need to consider many opinions and make hard decisions if alternative energy options are to be implemented at the scale that is required to meet international emission targets. The decisions that are required not only need to consider the many options available but also their consequences. Along with politicians, policy developers and industry, the general public also need to be active participants in deciding which energy options, and their subsequent consequences, are acceptable for implementation at the national level. Access to balanced and factual information is essential in establishing informed opinions on the many policy options available. Past research has used several methods to measure public perceptions and opinions yet for complex issues, such as emission reduction, some of these methods have shown to be problematic. For example, semi structured interviews can provide data that is flexible and context rich yet is does also come with the limitations such as it seldom provides a practical assessment that can be utilised from researcher to researcher, across disciplines and public participation techniques. Surveys on the other hand usually address these limitations but surveys that do not encourage comparison of information or ask participants to

  6. Grit, Growth Mindset, and Deliberate Practice in Online Learning

    Science.gov (United States)

    McClendon, Cristie; Neugebauer, Robin Massey; King, Amanda

    2017-01-01

    Online education continues to grow in popularity and is an attractive option for individuals of all ages, but particularly for adults who must balance work, family, and school responsibilities. Attrition rates in online courses are high for a variety of personal and institutional reasons. Some of the personal reasons attributed to retention in…

  7. Towards a Tectonic Sustainable Building Practice

    DEFF Research Database (Denmark)

    Bech-Danielsen, Claus

    and environmental problems? The objective of the project is to analyse and develop the tectonic practice based on case studies, in relation to: • Cultural anchoring and identity creation • Building culture and creative processes • Sustainability, lifecycle and resource management The research project is divided...... into a main project and various subprojects, respectively, two levels that mutually feed each other.The main project, which constitutes the general level, seeks to identify a coherent strategy towards a new tectonically sustainable building culture.The subprojects look at partial issues and go into specific......Can a tectonic building practice be strengthened through new creation processes, where resources are used more purposefully, deliberately and systematically? Which new measures are necessary if we are to develop a strong tectonic building practice with due consideration for increasing climate...

  8. Investigating the "self" in deliberate self-harm.

    Science.gov (United States)

    Adams, Joanna; Rodham, Karen; Gavin, Jeff

    2005-12-01

    In this study, the authors explored how a group of young people aged 16 to 26 years (who identified themselves as having engaged in deliberate self-harm) made sense of the self by conducting two online focus groups and four e-mail interviews. They analyzed data using interpretive phenomenological analysis. The concept of validation was the primary means of making sense of the self and concerned the desire to be considered legitimate and of worth. This desire was clearly evident across three realms of conflict: (a) the intrinsic or extrinsic self, which marked the distinction between objective fact and subjective opinion; (b) the accepted or denied self; and (c) the notion of normality. It is possible that having one's denied self validated online might lead to an exacerbation of an individual's self-harming behavior. Further work is needed to explore the effects of online discussion forums on such taboo forms of behavior.

  9. To dispense or not to dispense? Ethical case decision-making in pharmacy practice

    NARCIS (Netherlands)

    Bolt, Ineke; van den Hoven, Mariëtte; Blom, Lyda; Bouvy, Marcel

    2015-01-01

    In daily practice, pharmacists are regularly confronted with moral problems in which deciding what to do is not always a straightforward decision. In this contribution we show how the use of a specific method for moral deliberation can (in retrospect or prospective) aid moral judgements. We use the

  10. Emotion and self-regulation in deliberate personal change: A case study analysis

    OpenAIRE

    Lopes, Paulo Nuno; Coyle, Adrian; Gallie, Jack

    2014-01-01

    Two young adults’ experiences of deliberate personal change in the realms of study habits and social interaction were examined using a qualitative, interview-based case study approach. Both talked about an aspect of their behavior that they had changed and one that they would like to change. Thematic analysis was used to interpret their stories and reach an integrative and contextualized understanding of their individual developmental trajectories. Our analysis explored the use of motivated r...

  11. Influence of Utilization of High-Volumes of Class F Fly Ash on the Abrasion Resistance of Concrete

    Directory of Open Access Journals (Sweden)

    William PRINCE

    2007-01-01

    Full Text Available Utilization of large volumes of fly ash in various concrete applications is a becoming a more general practice in an efforts towards using large quantities of fly ash. Around the world, Class C or Class F or both as available have been used in high volumes in cement-based materials. In India, majority of fly generated is of Class F type as per ASTM C 618. Yearly fly ash generation in India is approximately 95 million tonnes. Out of which around 15-20% is utilized in cement production and cement/concrete related activities. In order to increase its percentage utilization, an investigation was carried out to use it in concrete.In this paper, abrasion resistance of high volume fly ash (HVFA concretes made with 35, 45, 55, and 65% of cement replacement was evaluated in terms of its relation with compressive strength. Comparison was made between ordinary Portland cement and fly ash concrete. Test results indicated that abrasion resistance of concrete having cement replacement up to 35 percent was comparable to the normal concrete mix with out fly ash. Beyond 35% cement replacement, fly ash concretes exhibited slightly lower resistance to abrasion relative to non-fly ash concretes. Test results further indicated that abrasion resistance of concrete is closely related with compressive strength, and had a very good correlation between abrasion resistance and compressive strength (R2 value between 0.9018 and 0.9859 depending upon age.

  12. Aristotle on Deliberation

    DEFF Research Database (Denmark)

    Kock, Christian Erik J

    2014-01-01

    Aristotle differs from most later philosophers in distinguishing clearly between epistemic reasoning, which aims for truth, and practical reasoning, which does not. How can he posit this distinction and yet not dismiss practical reasoning as flattery and manipulation, as Plato did? The answer lies...

  13. Highly Insulating Windows Volume Purchase Program Final Report

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-04-01

    This report documents the development, execution outcomes and lessons learned of the Highly Insulating Windows Volume Purchase (WVP) Program carried out over a three-year period from 2009 through 2012. The primary goals of the program were met: 1) reduce the incremental cost of highly insulating windows compared to ENERGY STAR windows; and 2) raise the public and potential buyers’ awareness of highly insulating windows and their benefits. A key outcome of the program is that the 2013 ENERGY STAR Most Efficient criteria for primary residential windows were adopted from the technical specifications set forth in the WVP program.

  14. Verification and validation guidelines for high integrity systems. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Hecht, H.; Hecht, M.; Dinsmore, G.; Hecht, S.; Tang, D. [SoHaR, Inc., Beverly Hills, CA (United States)

    1995-03-01

    High integrity systems include all protective (safety and mitigation) systems for nuclear power plants, and also systems for which comparable reliability requirements exist in other fields, such as in the process industries, in air traffic control, and in patient monitoring and other medical systems. Verification aims at determining that each stage in the software development completely and correctly implements requirements that were established in a preceding phase, while validation determines that the overall performance of a computer system completely and correctly meets system requirements. Volume I of the report reviews existing classifications for high integrity systems and for the types of errors that may be encountered, and makes recommendations for verification and validation procedures, based on assumptions about the environment in which these procedures will be conducted. The final chapter of Volume I deals with a framework for standards in this field. Volume II contains appendices dealing with specific methodologies for system classification, for dependability evaluation, and for two software tools that can automate otherwise very labor intensive verification and validation activities.

  15. Verification and validation guidelines for high integrity systems. Volume 1

    International Nuclear Information System (INIS)

    Hecht, H.; Hecht, M.; Dinsmore, G.; Hecht, S.; Tang, D.

    1995-03-01

    High integrity systems include all protective (safety and mitigation) systems for nuclear power plants, and also systems for which comparable reliability requirements exist in other fields, such as in the process industries, in air traffic control, and in patient monitoring and other medical systems. Verification aims at determining that each stage in the software development completely and correctly implements requirements that were established in a preceding phase, while validation determines that the overall performance of a computer system completely and correctly meets system requirements. Volume I of the report reviews existing classifications for high integrity systems and for the types of errors that may be encountered, and makes recommendations for verification and validation procedures, based on assumptions about the environment in which these procedures will be conducted. The final chapter of Volume I deals with a framework for standards in this field. Volume II contains appendices dealing with specific methodologies for system classification, for dependability evaluation, and for two software tools that can automate otherwise very labor intensive verification and validation activities

  16. Self compacting concrete incorporating high-volumes of fly ash

    Energy Technology Data Exchange (ETDEWEB)

    Bouzoubaa, N. [Natural Resources Canada, Ottawa, ON (Canada). International Centre for Sustainable Development of Cement and Concrete; Lachemi, M. [Ryerson Polytechnic Univ., Toronto, ON (Canada). Dept. of Civil Engineering

    2004-07-01

    Self-compacting concrete (SCC) is now widely used in reinforced concrete structures. Fine materials such as fly ash ensure that the concrete has the necessary properties of high fluidity and cohesiveness. An experimental study was conducted in which 9 SCC mixtures and one control concrete were produced in order to evaluate SCC made with high-volumes of fly ash. The content of the cementitious materials remained constant at 400 kg/cubic metre, but the ratio of water to cementitious material ranged from 0.35 to 0.45. The viscosity and stability of the fresh concrete was determined for self-compacting mixtures of 40, 50 and 60 per cent Class F fly ash. The compressive strength and drying shrinkage were also determined for the hardened concretes. Results showed that the SCCs developed a 28-day compressive strength ranging from 26 to 48 MPa. It was concluded that high-volumes of Class F fly ash could offer the following advantages to an SCC: reduced construction time and labour cost; eliminate the need for vibration; reduce noise pollution; improve the filling capacity of highly congested structural members; and, ensure good structural performance. 19 refs., 8 tabs., 2 figs.

  17. Is the Distance Worth It? Patients With Rectal Cancer Traveling to High-Volume Centers Experience Improved Outcomes.

    Science.gov (United States)

    Xu, Zhaomin; Becerra, Adan Z; Justiniano, Carla F; Boodry, Courtney I; Aquina, Christopher T; Swanger, Alex A; Temple, Larissa K; Fleming, Fergal J

    2017-12-01

    It is unclear whether traveling long distances to high-volume centers would compensate for travel burden among patients undergoing rectal cancer resection. The purpose of this study was to determine whether operative volume outweighs the advantages of being treated locally by comparing the outcomes of patients with rectal cancer treated at local, low-volume centers versus far, high-volume centers. This was a population-based study. The National Cancer Database was queried for patients with rectal cancer. Patients with stage II or III rectal cancer who underwent surgical resection between 2006 and 2012 were included. The outcomes of interest were margins, lymph node yield, receipt of neoadjuvant chemoradiation, adjuvant chemotherapy, readmission within 30 days, 30-day and 90-day mortality, and 5-year overall survival. A total of 18,605 patients met inclusion criteria; 2067 patients were in the long-distance/high-volume group and 1362 in the short-distance/low-volume group. The median travel distance was 62.6 miles for the long-distance/high-volume group and 2.3 miles for the short-distance/low-volume group. Patients who were younger, white, privately insured, and stage III were more likely to have traveled to a high-volume center. When controlled for patient factors, stage, and hospital factors, patients in the short-distance/low-volume group had lower odds of a lymph node yield ≥12 (OR = 0.51) and neoadjuvant chemoradiation (OR = 0.67) and higher 30-day (OR = 3.38) and 90-day mortality (OR = 2.07) compared with those in the long-distance/high-volume group. The short-distance/low-volume group had a 34% high risk of overall mortality at 5 years compared with the long-distance/high-volume group. We lacked data regarding patient and physician decision making and surgeon-specific factors. Our results indicate that when controlled for patient, tumor, and hospital factors, patients who traveled a long distance to a high-volume center had improved lymph node yield

  18. Young People and Caregivers' Perceptions of an Intervention Program for Children Who Deliberately Light Fires

    Science.gov (United States)

    Lambie, Ian; Seymour, Fred; Popaduk, Tanya

    2012-01-01

    A significant number of children and adolescents engage in deliberate fire setting, beyond the scope of curiosity and experimentation. Interventions developed to respond to the needs of such fire setters generally involve educational and/or psychosocial approaches. Research evaluating the effectiveness of these interventions is dominated by…

  19. High-pressure-assisted synthesis of high-volume ZnGeP2 polycrystalline

    Science.gov (United States)

    Huang, Changbao; Wu, Haixin; Xiao, Ruichun; Chen, Shijing; Ma, Jiaren

    2018-06-01

    The pnictide and chalcogenide semiconductors are promising materials for the applications in the field of photoelectric. High-purity and high-volume polycrystalline required in the real-world applications is hard to be synthesized due to the high vapor pressure of phosphorus and sulfur components at high temperature. A new high-pressure-resisted method was used to investigate the synthesis of the nonlinear-optical semiconductor ZnGeP2. The high-purity ZnGeP2 polycrystalline material of approximately 500 g was synthesized in one run, which enables the preparation of nominally stoichiometric material. Since increasing internal pressure resistance of quartz crucible and reducing the reaction space, the high-pressure-resisted method can be used to rapidly synthesize other pnictide and chalcogenide semiconductors and control the components ratio.

  20. Compression Behavior of Confined Columns with High-Volume Fly Ash Concrete

    Directory of Open Access Journals (Sweden)

    Sung-Won Yoo

    2017-01-01

    Full Text Available The use of fly ash in ordinary concrete provides practical benefits to concrete structures, such as a gain in long-term strength, reduced hydration heat, improved resistance to chloride, and enhanced workability. However, few studies with high-volume fly ash (HVFA concrete have been conducted that focus on the structural applications such as a column. Thus, there is a need to promote field applications of HVFA concrete as a sustainable construction material. To this end, this study investigated the compressive behavior of reinforced concrete columns that contain HVFA with a 50 percent replacement rate. Six columns were fabricated for this study. The study variables were the HVFA replacement rate, tied steel ratio, and tie steel spacing. The computed ultimate strength by the American Concrete Institute (ACI code conservatively predicted the measured values, and, thus, the existing equation in the ACI code is feasible for confined RC columns that contain HVFA. In addition, an analysis model was calibrated based on the experimental results and is recommended for predicting the stress-strain relationship of confined reinforced concrete columns that contain HVFA.

  1. Comparative study of personality disorder associated with deliberate self harm in two different age groups (15?24 years and 45?74 years)

    OpenAIRE

    Nath, Saswati; Patra, Dipak Kumar; Biswas, Srilekha; Mallick, Asim Kumar; Bandyopadhyay, Gautam Kumar; Ghosh, Srijit

    2008-01-01

    Aims: To study the presence of personality disorder in cases of deliberate self harm (DSH) in young (15?24 years) and elderly (45?74 years) and compare. Materials and Methods: Deliberate self harm cases admitted in Medical and surgical departments and cases attending psychiatry department of R.G. Kar Medical College, Kolkata were studied. For diagnosis of personality disorder ICD 10 International Personality Disorder Examination (IPDE) questionnaire was used. Results: Percentage of elderly pa...

  2. An examination of emergency department nurses' attitudes towards deliberate self-harm in an Irish teaching hospital.

    LENUS (Irish Health Repository)

    McCarthy, Linda

    2010-01-01

    The purpose of this study was to examine emergency department (ED) nurses\\' attitudes towards individuals presenting with deliberate self-harm (DSH), including the relationship between attitudes and factors such as age, academic achievements, length of experience, and self-harm education.

  3. Ethical and equity issues in lung transplantation and lung volume reduction surgery.

    Science.gov (United States)

    Glanville, A R

    2006-01-01

    New medical and scientific disciplines are often developed in haste with rampant enthusiasm and scant regard for the balance between action and thoughtful deliberation. Driven by the desire to prolong life and provide a better quality of life for desperately sick individuals, the twin modalities of lung transplantation and lung volume reduction therapy have only just reached their majority. Both are invested with the capacity to help and to harm so it is right to consider carefully their ethical and equitable distribution. Much has been learned in the last 20 years to assist in these deliberations. First, how can we ensure equity of access to transplant services and equality of outcomes? How do we balance resource allocation of a precious and scarce resource with individual recipient needs? Does the concept of distributive justice prevail in our daily work in this field? How do we honour the donor and their family? How do we as practitioners avoid ethical dilemmas related to personal bias and justifiable reward for services rendered? Finally, how do we learn to incorporate ethical forethought and planning guided by experts in the area into everyday behaviour?

  4. High tidal volume decreases adult respiratory distress syndrome, atelectasis, and ventilator days compared with low tidal volume in pediatric burned patients with inhalation injury.

    Science.gov (United States)

    Sousse, Linda E; Herndon, David N; Andersen, Clark R; Ali, Arham; Benjamin, Nicole C; Granchi, Thomas; Suman, Oscar E; Mlcak, Ronald P

    2015-04-01

    Inhalation injury, which is among the causes of acute lung injury and acute respiratory distress syndrome (ARDS), continues to represent a significant source of mortality in burned patients. Inhalation injury often requires mechanical ventilation, but the ideal tidal volume strategy is not clearly defined in burned pediatric patients. The aim of this study was to determine the effects of low and high tidal volume on the number of ventilator days, ventilation pressures, and incidence of atelectasis, pneumonia, and ARDS in pediatric burned patients with inhalation injury within 1 year post burn injury. From 1986 to 2014, inhalation injury was diagnosed by bronchoscopy in pediatric burned patients (n = 932). Patients were divided into 3 groups: unventilated (n = 241), high tidal volume (HTV, 15 ± 3 mL/kg, n = 190), and low tidal volume (LTV, 9 ± 3 mL/kg, n = 501). High tidal volume was associated with significantly decreased ventilator days (p tidal volume significantly decreases ventilator days and the incidence of both atelectasis and ARDS compared with low tidal volume in pediatric burned patients with inhalation injury. Therefore, the use of HTV may interrupt sequences leading to lung injury in our patient population. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Durability properties of high volume fly ash self compacting concretes

    Energy Technology Data Exchange (ETDEWEB)

    P. Dinakar; K.G. Babu; Manu Santhanam [Indian Institute of Technology, Chennai (India). Building Technology Division

    2008-11-15

    This paper presents an experimental study on the durability properties of self compacting concretes (SCCs) with high volume replacements of fly ash. Eight fly ash self compacting concretes of various strength grades were designed at desired fly ash percentages of 0, 10, 30, 50, 70 and 85%, in comparison with five different mixtures of normal vibrated concretes (NCs) at equivalent strength grades. The durability properties were studied through the measurement of permeable voids, water absorption, acid attack and chloride permeation. The results indicated that the SCCs showed higher permeable voids and water absorption than the vibrated normal concretes of the same strength grades. However, in acid attack and chloride diffusion studies the high volume fly ash SCCs had significantly lower weight losses and chloride ion diffusion.

  6. The use of moral deliberation in empirical research in bioethics

    Directory of Open Access Journals (Sweden)

    Elma Zoboli

    2016-10-01

    Full Text Available The article presents an integrated empirical ethics research project that used the moral deliberation, according to the theoretical and philosophical conception, and methodical proposal of Diego Gracia, as a theoretical and methodological framework. The application showed the potential to realize the dynamics of the studied object in real life, making it possible, from the situation presented in the vignettes, for participants to include what they considered for dealing with the conflict of values. It also made the integration of philosophical and empirical approaches in bioethics research possible. The analytical category of prudence allowed the results to be assessed in a critical and comprehensive way.

  7. Volume measurement variability in three-dimensional high-frequency ultrasound images of murine liver metastases

    International Nuclear Information System (INIS)

    Wirtzfeld, L A; Graham, K C; Groom, A C; MacDonald, I C; Chambers, A F; Fenster, A; Lacefield, J C

    2006-01-01

    The identification and quantification of tumour volume measurement variability is imperative for proper study design of longitudinal non-invasive imaging of pre-clinical mouse models of cancer. Measurement variability will dictate the minimum detectable volume change, which in turn influences the scheduling of imaging sessions and the interpretation of observed changes in tumour volume. In this paper, variability is quantified for tumour volume measurements from 3D high-frequency ultrasound images of murine liver metastases. Experimental B16F1 liver metastases were analysed in different size ranges including less than 1 mm 3 , 1-4 mm 3 , 4-8 mm 3 and 8-70 mm 3 . The intra- and inter-observer repeatability was high over a large range of tumour volumes, but the coefficients of variation (COV) varied over the volume ranges. The minimum and maximum intra-observer COV were 4% and 14% for the 1-4 mm 3 and 3 tumours, respectively. For tumour volumes measured by segmenting parallel planes, the maximum inter-slice distance that maintained acceptable measurement variability increased from 100 to 600 μm as tumour volume increased. Comparison of free breathing versus ventilated animals demonstrated that respiratory motion did not significantly change the measured volume. These results enable design of more efficient imaging studies by using the measured variability to estimate the time required to observe a significant change in tumour volume

  8. Comparison of the outcomes for laparoscopic gastrectomy performed by the same surgeon between a low-volume hospital and a high-volume center.

    Science.gov (United States)

    Kim, Min Gyu; Kwon, Sung Joon

    2014-05-01

    The volume-outcome relationship in laparoscopic surgery is controversial. This study was designed to identify differences in laparoscopic gastrectomy outcomes between a low-volume hospital and a high-volume center and to provide guidelines for overcoming the problems associated with a low-volume hospital. From April 2009 to November 2012, one surgeon performed 134 totally laparoscopic distal gastrectomies (TLDGs) at a high-volume center (HVC; ASAN Medical Center) and at a low-volume hospital (LVH; Hanyang University Guri Hospital). All laparoscopically assisted gastrectomies were excluded from this study. During the early period of laparoscopic gastrectomy at the low-volume hospital, TLDG with Roux-en-Y gastrojejunostomy (RYGJ) was performed according to the surgeon's choice. The reconstruction method was classified as gastroduodenostomy (GD) or RYGJ. Early surgical outcomes achieved at the LVH were investigated and compared with those obtained at the HVC. The early surgical outcomes differed significantly between the two hospitals. In particular, the postoperative complication rate for the patients who underwent TLDG RYGJ at the LVH was higher than at the HVC (LVH 15.4 % vs. HVC 0 %; p = 0.037). Furthermore, significant differences were observed in the mean operation time (TLDG GD: LVH 141.0 min vs. HVC 117.4 min, p = 0.001; TLDG RYGJ: LVH 186.3 min vs. HVC 134.6 min, p = 0.009) and length of hospital stay (TLDG GD: LVH 8.1 days vs. HVC 7.2 days, p = 0.044; TLDG RYGJ: LVH 11.5 day vs. HVC 6.8 day, p = 0.009). Although all the operations were performed by one experienced surgeon, the early surgical outcomes differed significantly between the low- and high-volume hospitals. Low-volume hospitals often lack well-trained surgical professionals such as first assistants and scrub nurses. Therefore, the authors recommend that a surgeon who works at an LVH should assess potential personnel shortages and find a solution before operating.

  9. Breast cancer management: is volume related to quality? Clinical Advisory Panel.

    Science.gov (United States)

    Ma, M; Bell, J; Campbell, S; Basnett, I; Pollock, A; Taylor, I

    1997-01-01

    A method of carrying out region-wide audit for breast cancer was developed by collaboration between the cancer registry, providers and purchasers as part of work to fulfill the 'Calman-Hine' recommendations. In order to test the audit method, a retrospective audit in North Thames East compared practice in 1992 against current guidelines. The analysis compared care in specialist and non-specialist centres. A stratified random sample comprising 28% of all breast cancer patients diagnosed in 1992 was selected from the population-based Thames Cancer Registry. The data for 309 patients with stage I-III tumours were analysed by hospital type using local guidelines. No difference between specialist (high volume) and non-specialist centres was detected for factors important in survival. Pathological staging was good with over 70% reporting tumour size and grade. A small number of patients were undertreated; after conservative surgery, 10% (19) of women did not receive radiotherapy, and 15% (8) of node-positive premenopausal women did not receive chemotherapy or ovarian ablation. In contrast, a significant trend with hospital volume was found for several quality of life factors. These included access to a specialist breast surgeon and specialist breast nurses, availability of fine-needle aspiration (FNA), which ranged from 84% in high-volume to 42% in low-volume centres, and quality of surgery (axillary clearance rates ranged from 51% to 8% and sampling of less than three nodes from 3% to 25% for high- and very low-volume centres respectively). Confidential feedback of results to surgeons was welcomed and initiated change. The summary information gave purchasers information relevant to the evaluation of cancer services. While the audit applied present standards to past practice, it provided the impetus for prospective audit of current practice (now being implemented in North Thames).

  10. Democracy and the Internet: Access, Engagement and Deliberation

    Directory of Open Access Journals (Sweden)

    Roman Gerodimos

    2005-12-01

    Full Text Available The internet has the capacity to facilitate the creation of new forms of civic engagement, but the realisation of these opportunities requires institutional and cultural reinforcement. The democratic character of e-citizenship and the equal distribution of online resources to the public require the fulfilment of four conditions: access, engagement (incorporating education, motivation and trust, meaningful deliberation and a link between civic input and public policy output. Furthermore, the gap between the main features of cyberspace and the inherent prerequisites of democracy, such as a finite space and a set of rules, create tensions that need to be negotiated politically. Although the empirical evidence available includes some encouraging signs regarding the future use of the internet for civic engagement, the existing limitations and obstacles mean that the new media will complement, rather than replace, the old media as a democratic public sphere.

  11. Fundamentals of modern mathematics a practical review

    CERN Document Server

    MacNeil, David B

    2013-01-01

    Students and others wishing to know more about the practical side of mathematics will find this volume a highly informative resource. Accessible explanations of important concepts feature worked examples and diagrams. 1963 edition.

  12. Resource depletion promotes automatic processing: implications for distribution of practice.

    Science.gov (United States)

    Scheel, Matthew H

    2010-12-01

    Recent models of cognition include two processing systems: an automatic system that relies on associative learning, intuition, and heuristics, and a controlled system that relies on deliberate consideration. Automatic processing requires fewer resources and is more likely when resources are depleted. This study showed that prolonged practice on a resource-depleting mental arithmetic task promoted automatic processing on a subsequent problem-solving task, as evidenced by faster responding and more errors. Distribution of practice effects (0, 60, 120, or 180 sec. between problems) on rigidity also disappeared when groups had equal time on resource-depleting tasks. These results suggest that distribution of practice effects is reducible to resource availability. The discussion includes implications for interpreting discrepancies in the traditional distribution of practice effect.

  13. Modeling Inhalational Tularemia: Deliberate Release and Public Health Response

    Science.gov (United States)

    Hall, Ian M.; Leach, Steve

    2011-01-01

    Two epidemic modeling studies of inhalational tularemia were identified in the published literature, both demonstrating the high number of potential casualties that could result from a deliberate aerosolized release of the causative agent in an urban setting. However, neither study analyzed the natural history of inhalational tularemia nor modeled the relative merits of different mitigation strategies. We first analyzed publicly available human/primate experimental data and reports of naturally acquired inhalational tularemia cases to better understand the epidemiology of the disease. We then simulated an aerosolized release of the causative agent, using airborne dispersion modeling to demonstrate the potential number of casualties and the extent of their spatial distribution. Finally, we developed a public health intervention model that compares 2 mitigation strategies: targeting antibiotics at symptomatic individuals with or without mass distribution of antibiotics to potentially infected individuals. An antibiotic stockpile that is sufficient to capture all areas where symptomatic individuals were infected is likely to save more lives than treating symptomatic individuals alone, providing antibiotics can be distributed rapidly and their uptake is high. However, with smaller stockpiles, a strategy of treating symptomatic individuals alone is likely to save many more lives than additional mass distribution of antibiotics to potentially infected individuals. The spatial distribution of symptomatic individuals is unlikely to coincide exactly with the path of the dispersion cloud if such individuals are infected near their work locations but then seek treatment close to their homes. The optimal mitigation strategy will depend critically on the size of the release relative to the stockpile level and the effectiveness of treatment relative to the speed at which antibiotics can be distributed. PMID:22044315

  14. The Use of Expressives in Online Political Talk : Impeding or Facilitating the Normative Goals of Deliberation?

    NARCIS (Netherlands)

    Graham, T.S.; Tambouris, E; Macintosh, A; Glassey, O

    2010-01-01

    Net-based public sphere researchers have questioned whether the internet presents the public sphere with a new opportunity for the development of public spaces where free, equal and open deliberation among citizens can flourish. However, much of the research has operationalized a formal notion of

  15. Investigating Grit Variables and Their Relations with Practice and Skill Groups in Developing Sport Experts

    Science.gov (United States)

    Tedesqui, Rafael A. B.; Young, Bradley W.

    2017-01-01

    Grit, the tendency to work hard toward long-term goals, maintaining effort and interest over years despite failure and adversity, has predicted several achievement outcomes. However, minimal work has examined grit within a sport expertise development framework, and specifically its association with deliberate practice (DP) in sport. Participants,…

  16. High-Dimensional Function Approximation With Neural Networks for Large Volumes of Data.

    Science.gov (United States)

    Andras, Peter

    2018-02-01

    Approximation of high-dimensional functions is a challenge for neural networks due to the curse of dimensionality. Often the data for which the approximated function is defined resides on a low-dimensional manifold and in principle the approximation of the function over this manifold should improve the approximation performance. It has been show that projecting the data manifold into a lower dimensional space, followed by the neural network approximation of the function over this space, provides a more precise approximation of the function than the approximation of the function with neural networks in the original data space. However, if the data volume is very large, the projection into the low-dimensional space has to be based on a limited sample of the data. Here, we investigate the nature of the approximation error of neural networks trained over the projection space. We show that such neural networks should have better approximation performance than neural networks trained on high-dimensional data even if the projection is based on a relatively sparse sample of the data manifold. We also find that it is preferable to use a uniformly distributed sparse sample of the data for the purpose of the generation of the low-dimensional projection. We illustrate these results considering the practical neural network approximation of a set of functions defined on high-dimensional data including real world data as well.

  17. Environmental philosophy: from theory to practice.

    Science.gov (United States)

    Sarkar, Sahotra

    2014-03-01

    Environmental philosophy is a hybrid discipline drawing extensively from epistemology, ethics, and philosophy of science and analyzing disciplines such as conservation biology, restoration ecology, sustainability studies, and political ecology. The book being discussed both provides an overview of environmental philosophy and develops an anthropocentric framework for it. That framework treats natural values as deep cultural values. Tradeoffs between natural values are analyzed using decision theory to the extent possible, leaving many interesting question for philosophical deliberation. This framework is supposed to be applicable in practical contexts. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Deliberate Design of TiO2 Nanostructures towards Superior Photovoltaic Cells.

    Science.gov (United States)

    Sun, Ziqi; Liao, Ting; Sheng, Liyuan; Kou, Liangzhi; Kim, Jung Ho; Dou, Shi Xue

    2016-08-01

    TiO2 nanostructures are being sought after as flexibly utilizable building blocks for the fabrication of the mesoporous thin-film photoelectrodes that are the heart of the third-generation photovoltaic devices, such as dye-sensitized solar cells (DSSCs), quantum-dot-sensitized solar cells (QDSSCs), and the recently promoted perovskite-type solar cells. Here, we report deliberate tailoring of TiO2 nanostructures for superior photovoltaic cells. Morphology engineering of TiO2 nanostructures is realized by designing synthetic protocols in which the precursor hydrolysis, crystal growth, and oligomer self-organization are precisely controlled. TiO2 nanostructures in forms varying from isolated nanocubes, nanorods, and cross-linked nanorods to complex hierarchical structures and shape-defined mesoporous micro-/nanostructures were successfully synthesized. The photoanodes made from the shape-defined mesoporous TiO2 microspheres and nanospindles presented superior performances, owing to the well-defined overall shapes and the inner ordered nanochannels, which allow not only a high amount of dye uptake, but also improved visible-light absorption. This study provides a new way to seek an optimal synthetic protocol to meet the required functionality of the nanomaterials. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Server-based enterprise collaboration software improves safety and quality in high-volume PET/CT practice.

    Science.gov (United States)

    McDonald, James E; Kessler, Marcus M; Hightower, Jeremy L; Henry, Susan D; Deloney, Linda A

    2013-12-01

    With increasing volumes of complex imaging cases and rising economic pressure on physician staffing, timely reporting will become progressively challenging. Current and planned iterations of PACS and electronic medical record systems do not offer workflow management tools to coordinate delivery of imaging interpretations with the needs of the patient and ordering physician. The adoption of a server-based enterprise collaboration software system by our Division of Nuclear Medicine has significantly improved our efficiency and quality of service.

  20. Parental Choices and Ethical Dilemmas Involving Disabilities: Special Education and the Problem of Deliberately Chosen Disabilities

    Science.gov (United States)

    Kauffman, James M.; Hallahan, Daniel P.

    2009-01-01

    Ethical issues regarding children with disabilities have long involved their treatment after they are born. These issues remain important, but children may be deliberately created with or without characteristics that are usually thought of as disabilities. Preimplantation genetic diagnosis (PGD) and related technologies that involve human…

  1. Motives and Suicide Intent Underlying Hospital Treated Deliberate Self-Harm and Their Association with Repetition

    Science.gov (United States)

    McAuliffe, Carmel; Arensman, Ella; Keeley, Helen S.; Corcoran, Paul; Fitzgerald, Anthony P.

    2007-01-01

    The association between motives for deliberate self-harm (DSH), level of suicide intent, and history of DSH is poorly understood. As part of the WHO/EURO Multicentre Study on Suicidal Behavior, the Suicide Intent Scale, and the Motives for Parasuicide Questionnaire were administered to 146 patients presenting with DSH in the Cork region in…

  2. Activation volume and interaction of metal particulate media

    Energy Technology Data Exchange (ETDEWEB)

    Tetsukawa, Hiroki [Sony Corporation, 6-7-35 Kitashinagawa, Shinagawa-ku, Tokyo 141-0001 (Japan)]. E-mail: tetsukaw@arc.sony.co.jp; Kondo, Hirofumi [Sony Corporation, 6-7-35 Kitashinagawa, Shinagawa-ku, Tokyo 141-0001 (Japan)

    2005-09-15

    We have investigated the activation volume (V{sub ac}) and magnetostatic interaction of metal particulate (MP) media. The activation volume of MP media decreases with the decrease of physical volume (V{sub phy}) of metal particles. The activation volume and the ratio of V{sub phy}/V{sub ac} of advanced metal particles are 6x10{sup -24}m{sup 3} and 1.5, respectively. It can be predicted that the physical volume of metal particle is about 3x10{sup -24}m{sup 3} when the physical volume is equal to the activation volume. This value is agreement with the practical lower limit of physical volume of metal particle predicted by Sharrock. The negative interaction (demagnetization effect) in MP media decreases with low saturation magnetization of the metal particles, a thin magnetic layer, a high orientation of MP media, and a low packing fraction of metal particles in the MP media. The activation volume of the MP media decreased as the negative interactions decreased. In advanced MP media with low M{sub r}.t (M{sub r}=remanent magnetization and t=thickness), the influence of interaction on the activation volume is reduced.

  3. Activation volume and interaction of metal particulate media

    International Nuclear Information System (INIS)

    Tetsukawa, Hiroki; Kondo, Hirofumi

    2005-01-01

    We have investigated the activation volume (V ac ) and magnetostatic interaction of metal particulate (MP) media. The activation volume of MP media decreases with the decrease of physical volume (V phy ) of metal particles. The activation volume and the ratio of V phy /V ac of advanced metal particles are 6x10 -24 m 3 and 1.5, respectively. It can be predicted that the physical volume of metal particle is about 3x10 -24 m 3 when the physical volume is equal to the activation volume. This value is agreement with the practical lower limit of physical volume of metal particle predicted by Sharrock. The negative interaction (demagnetization effect) in MP media decreases with low saturation magnetization of the metal particles, a thin magnetic layer, a high orientation of MP media, and a low packing fraction of metal particles in the MP media. The activation volume of the MP media decreased as the negative interactions decreased. In advanced MP media with low M r .t (M r =remanent magnetization and t=thickness), the influence of interaction on the activation volume is reduced

  4. Perioperative mortality in cats and dogs undergoing spay or castration at a high-volume clinic.

    Science.gov (United States)

    Levy, J K; Bard, K M; Tucker, S J; Diskant, P D; Dingman, P A

    2017-06-01

    High volume spay-neuter (spay-castration) clinics have been established to improve population control of cats and dogs to reduce the number of animals admitted to and euthanazed in animal shelters. The rise in the number of spay-neuter clinics in the USA has been accompanied by concern about the quality of animal care provided in high volume facilities, which focus on minimally invasive, time saving techniques, high throughput and simultaneous management of multiple animals under various stages of anesthesia. The aim of this study was to determine perioperative mortality for cats and dogs in a high volume spay-neuter clinic in the USA. Electronic medical records and a written mortality log were used to collect data for 71,557 cats and 42,349 dogs undergoing spay-neuter surgery from 2010 to 2016 at a single high volume clinic in Florida. Perioperative mortality was defined as deaths occurring in the 24h period starting with the administration of the first sedation or anesthetic drugs. Perioperative mortality was reported for 34 cats and four dogs for an overall mortality of 3.3 animals/10,000 surgeries (0.03%). The risk of mortality was more than twice as high for females (0.05%) as for males (0.02%) (P=0.008) and five times as high for cats (0.05%) as for dogs (0.009%) (P=0.0007). High volume spay-neuter surgery was associated with a lower mortality rate than that previously reported in low volume clinics, approaching that achieved in human surgery. This is likely to be due to the young, healthy population of dogs and cats, and the continuous refinement of techniques based on experience and the skills and proficiency of teams that specialize in a limited spectrum of procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Low-load high volume resistance exercise stimulates muscle protein synthesis more than high-load low volume resistance exercise in young men.

    Directory of Open Access Journals (Sweden)

    Nicholas A Burd

    Full Text Available BACKGROUND: We aimed to determine the effect of resistance exercise intensity (%1 repetition maximum-1RM and volume on muscle protein synthesis, anabolic signaling, and myogenic gene expression. METHODOLOGY/PRINCIPAL FINDINGS: Fifteen men (21+/-1 years; BMI=24.1+/-0.8 kg/m2 performed 4 sets of unilateral leg extension exercise at different exercise loads and/or volumes: 90% of repetition maximum (1RM until volitional failure (90FAIL, 30% 1RM work-matched to 90%FAIL (30WM, or 30% 1RM performed until volitional failure (30FAIL. Infusion of [ring-13C6] phenylalanine with biopsies was used to measure rates of mixed (MIX, myofibrillar (MYO, and sarcoplasmic (SARC protein synthesis at rest, and 4 h and 24 h after exercise. Exercise at 30WM induced a significant increase above rest in MIX (121% and MYO (87% protein synthesis at 4 h post-exercise and but at 24 h in the MIX only. The increase in the rate of protein synthesis in MIX and MYO at 4 h post-exercise with 90FAIL and 30FAIL was greater than 30WM, with no difference between these conditions; however, MYO remained elevated (199% above rest at 24 h only in 30FAIL. There was a significant increase in AktSer473 at 24h in all conditions (P=0.023 and mTORSer2448 phosphorylation at 4 h post-exercise (P=0.025. Phosporylation of Erk1/2Tyr202/204, p70S6KThr389, and 4E-BP1Thr37/46 increased significantly (P<0.05 only in the 30FAIL condition at 4 h post-exercise, whereas, 4E-BP1Thr37/46 phosphorylation was greater 24 h after exercise than at rest in both 90FAIL (237% and 30FAIL (312% conditions. Pax7 mRNA expression increased at 24 h post-exercise (P=0.02 regardless of condition. The mRNA expression of MyoD and myogenin were consistently elevated in the 30FAIL condition. CONCLUSIONS/SIGNIFICANCE: These results suggest that low-load high volume resistance exercise is more effective in inducing acute muscle anabolism than high-load low volume or work matched resistance exercise modes.

  6. [The shutdown point and the output volume limit (OVL) in the present situation of healthcare in Hungary (or a little economics for practicing physicians)].

    Science.gov (United States)

    Gresz, Miklós

    2008-09-07

    In the present situation of health care, financing has become so complicated that the treating doctor has to know not only his profession but also has to consider the different regulations, laws and book of rules. The work of the physician cannot be carried out only through the fact that he is a master of his art, that is healing. All healing practice, diagnostic abilities, intuition, empathy and other things are in vain: if he is not familiar with the basics of financing he can lead his institution to insolvency. This article tries to give a view of a small part of financing, the output volume limit (OVL) from another aspect. According to the basics of economy and general rules of leadership it tries to show up the practical difficulties of the output volume limit. The study enlightens that by defining the output volume limit one has to consider the shutdown point of the hospital and knowing this, the actual output volume limit should be defined in the way that it does not make the proper activity of the hospital completely impossible.

  7. Big losses lead to irrational decision-making in gambling situations: relationship between deliberation and impulsivity.

    Directory of Open Access Journals (Sweden)

    Yuji Takano

    Full Text Available In gambling situations, we found a paradoxical reinforcing effect of high-risk decision-making after repeated big monetary losses. The computerized version of the Iowa Gambling Task (Bechara et al., 2000, which contained six big loss cards in deck B', was conducted on normal healthy college students. The results indicated that the total number of selections from deck A' and deck B' decreased across trials. However, there was no decrease in selections from deck B'. Detailed analysis of the card selections revealed that some people persisted in selecting from the "risky" deck B' as the number of big losses increased. This tendency was prominent in self-rated deliberative people. However, they were implicitly impulsive, as revealed by the matching familiar figure test. These results suggest that the gap between explicit deliberation and implicit impulsivity drew them into pathological gambling.

  8. A Methodological Approach for Researching National Classroom Practices

    Directory of Open Access Journals (Sweden)

    Meng Yew Tee

    2016-04-01

    Full Text Available Little continues to be known about what actually happens in classrooms, particularly from a national perspective. Descriptions of classroom practices from a national vantage point can provide a bird's eye view of salient patterns and variations within an education system, especially one as centralised as that of Malaysia. With these descriptions, especially if the primary data consists of video recordings, one can also begin to compare movements in classroom practices across time and space; theorise about the nature of practice within the system as well as inform policy deliberations. This paper examines key methodological decisions of conducting a national study to research classroom educational practice within Malaysia's public school system. The case is made for the use of such studies to gain a bird's eye perspective of classroom practices in a national system as well as to lay the foundations for inter-system comparisons. Potential implications and opportunities of these types of studies are also discussed.

  9. US evaluation of volume brain lesions produced by high-intensity focused US

    International Nuclear Information System (INIS)

    Chua, R.V.; Chua, G.T.; Fry, F.J.; Franklin, T.D.; Wills, E.R.; Hastings, J.S.; Sanghui, N.T.

    1987-01-01

    Eighteen volume brain lesions produced by high-intensity focused US in the right cerebral hemispheres of research canines were evaluated by diagnostic US from immediately after ablation up to 62 days later. Animals were killed and perfused for whole-brain recovery. US evaluation of whole-brain specimens was performed. Histologic analysis of brain sections verified lesion placement, size, and tissue response to US. These sections were compared with US studies for correlation data. Correlation data suggest that US visualization may aid in accurate placement of volume brain lesions and in evaluation of effects of high-intensity focuses US in normal brain

  10. Secure data storage by three-dimensional absorbers in highly scattering volume medium

    International Nuclear Information System (INIS)

    Matoba, Osamu; Matsuki, Shinichiro; Nitta, Kouichi

    2008-01-01

    A novel data storage in a volume medium with highly scattering coefficient is proposed for data security application. Three-dimensional absorbers are used as data. These absorbers can not be measured by interferometer when the scattering in a volume medium is strong enough. We present a method to reconstruct three-dimensional absorbers and present numerical results to show the effectiveness of the proposed data storage.

  11. Oxytocin promotes intuitive rather than deliberated cooperation with the in-group.

    Science.gov (United States)

    Ten Velden, Femke S; Daughters, Katie; De Dreu, Carsten K W

    2017-06-01

    A contribution to a special issue on Hormones and Human Competition. In intergroup settings, individuals prefer cooperating with their in-group, and sometimes derogate and punish out-groups. Here we replicate earlier work showing that such in-group bounded cooperation is conditioned by oxytocin and extend it by showing that oxytocin-motivated in-group cooperation is intuitive rather than deliberated. Healthy males (N=65) and females (N=129) self-administered intranasal placebo or 24IU oxytocin in a double-blind placebo-controlled between-subjects design, were assigned to a three-person in-group (that faced a 3-person out-group), and given an endowment from which they could contribute to a within-group pool (benefitting the in-group), and/or to a between-group pool (benefitting the in-group and punishing the out-group). Prior to decision-making, participants performed a Stroop Interference task that was either cognitively taxing, or not. Cognitively taxed individuals kept less to themselves and contributed more to the within-group pool. Furthermore, participants receiving placebo contributed more to the within-group pool when they were cognitively taxed rather than not; those receiving oxytocin contributed to the within-group pool regardless of cognitive taxation. Neither taxation nor treatment influenced contributions to the between-group pool, and no significant sex differences were observed. It follows that in intergroup settings (i) oxytocin increases in-group bounded cooperation, (ii) oxytocin neither reduces nor increases out-group directed spite, and (iii) oxytocin-induced in-group cooperation is independent of cognitive taxation and, therefore, likely to be intuitive rather than consciously deliberated. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Functionality and Performance Visualization of the Distributed High Quality Volume Renderer (HVR)

    KAUST Repository

    Shaheen, Sara

    2012-07-01

    Volume rendering systems are designed to provide means to enable scientists and a variety of experts to interactively explore volume data through 3D views of the volume. However, volume rendering techniques are computationally intensive tasks. Moreover, parallel distributed volume rendering systems and multi-threading architectures were suggested as natural solutions to provide an acceptable volume rendering performance for very large volume data sizes, such as Electron Microscopy data (EM). This in turn adds another level of complexity when developing and manipulating volume rendering systems. Given that distributed parallel volume rendering systems are among the most complex systems to develop, trace and debug, it is obvious that traditional debugging tools do not provide enough support. As a consequence, there is a great demand to provide tools that are able to facilitate the manipulation of such systems. This can be achieved by utilizing the power of compute graphics in designing visual representations that reflect how the system works and that visualize the current performance state of the system.The work presented is categorized within the field of software Visualization, where Visualization is used to serve visualizing and understanding various software. In this thesis, a number of visual representations that reflect a number of functionality and performance aspects of the distributed HVR, a high quality volume renderer system that uses various techniques to visualize large volume sizes interactively. This work is provided to visualize different stages of the parallel volume rendering pipeline of HVR. This is along with means of performance analysis through a number of flexible and dynamic visualizations that reflect the current state of the system and enables manipulation of them at runtime. Those visualization are aimed to facilitate debugging, understanding and analyzing the distributed HVR.

  13. Back-end interconnection. A generic concept for high volume manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Bosman, J.; Budel, T.; De Kok, C.J.G.M.

    2013-10-15

    The general method to realize series connection in thin film PV modules is monolithical interconnection through a sequence of laser scribes (P1, P2 and P3) and layer depositions. This method however implies that the deposition processes are interrupted several times, an undesirable situation in high volume processing. In order to eliminate this drawback we focus our developments on the so called 'back-end interconnection concept' in which series interconnection takes place AFTER the deposition of the functional layers of the thin film PV device. The process of making a back-end interconnection combines laser scribing, curing, sintering and inkjet processes. These different processes interacts with each other and are investigated in order to create processing strategies that are robust to ensure high volume production. The generic approach created a technology base that can be applied to any thin film PV technology.

  14. High performance work practices, innovation and performance

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Newton, Cameron; Johnston, Kim

    2013-01-01

    Research spanning nearly 20 years has provided considerable empirical evidence for relationships between High Performance Work Practices (HPWPs) and various measures of performance including increased productivity, improved customer service, and reduced turnover. What stands out from......, and Africa to examine these various questions relating to the HPWP-innovation-performance relationship. Each paper discusses a practice that has been identified in HPWP literature and potential variables that can facilitate or hinder the effects of these practices of innovation- and performance...

  15. Deliberate utilization of interaction torques brakes elbow extension in a fast throwing motion.

    Science.gov (United States)

    Hore, Jon; Debicki, Derek B; Gribble, Paul L; Watts, Sherry

    2011-05-01

    We tested the hypothesis that in fast arm movements the CNS deliberately utilizes interaction torques to decelerate (brake) joint rotations. Twelve subjects performed fast 2-D overarm throws in which large elbow extension velocities occurred. Joint motions were computed from recordings made with search coils; joint torques were calculated using inverse dynamics. After ball release, a large follow-through shoulder extension acceleration occurred that was initiated by shoulder extensor muscle torque. This shoulder acceleration produced a flexor interaction torque at the elbow that initiated elbow deceleration (braking). An instantaneous mechanical interaction of passive torques then occurred between elbow and shoulder, i.e., elbow extension deceleration produced a large shoulder extensor interaction torque that contributed to the shoulder extension acceleration which, simultaneously, produced a large elbow flexor interaction torque that contributed to elbow extension deceleration, and so on. Late elbow flexor muscle torque also contributed to elbow deceleration. The interaction of passive torques between shoulder and elbow was braked by shoulder flexor muscle torque. In this mechanism, shoulder musculature contributed to braking elbow extension in two ways: shoulder extensors initiated the mechanical interaction of passive torques between shoulder and elbow and shoulder flexors dissipated kinetic energy from elbow braking. It is concluded that, in fast 2-D throws, the CNS deliberately utilizes powerful interaction torques between shoulder and elbow to brake motion at the elbow.

  16. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people

    Directory of Open Access Journals (Sweden)

    Osborn David

    2008-08-01

    dependence: RR 3.50, CI 1.87, 6.53; any substance use disorder RR 3.42, CI 1.97–5.92, while lifetime prevalence of suicide attempt was especially high in gay and bisexual men (RR 4.28, CI 2.32, 7.88. Conclusion LGB people are at higher risk of mental disorder, suicidal ideation, substance misuse, and deliberate self harm than heterosexual people.

  17. If it feels right, do it: Intuitive decision making in a sample of high-level sport coaches

    Directory of Open Access Journals (Sweden)

    Dave eCollins

    2016-04-01

    Full Text Available Comprehensive understanding and application of decision making is important for the professional practice and status of sports coaches. Accordingly, building on a strong work base exploring the use of professional judgement and decision making in sport, we report a preliminary investigation into uses of intuition by high-level coaches. Two contrasting groups of high-level coaches from adventure sports (n = 10 and rugby union (n = 8, were interviewed on their experiences of using intuitive and deliberative decision making styles, the source of these skills, and the interaction between the two. Participants reported similarly high levels of usage to other professions. Interaction between the two styles was apparent to varying degrees, while the role of experience was seen as an important precursor to greater intuitive practice and employment. Initially intuitive then deliberate decision making was a particular feature, offering participants an immediate check on the accuracy and validity of the decision. Integration of these data with the extant literature and implications for practice are discussed.

  18. "If It Feels Right, Do It": Intuitive Decision Making in a Sample of High-Level Sport Coaches.

    Science.gov (United States)

    Collins, Dave; Collins, Loel; Carson, Howie J

    2016-01-01

    Comprehensive understanding and application of decision making is important for the professional practice and status of sports coaches. Accordingly, building on a strong work base exploring the use of professional judgment and decision making (PJDM) in sport, we report a preliminary investigation into uses of intuition by high-level coaches. Two contrasting groups of high-level coaches from adventure sports (n = 10) and rugby union (n = 8), were interviewed on their experiences of using intuitive and deliberative decision making styles, the source of these skills, and the interaction between the two. Participants reported similarly high levels of usage to other professions. Interaction between the two styles was apparent to varying degrees, while the role of experience was seen as an important precursor to greater intuitive practice and employment. Initially intuitive then deliberate decision making was a particular feature, offering participants an immediate check on the accuracy and validity of the decision. Integration of these data with the extant literature and implications for practice are discussed.

  19. High-Performance Management Practices and Employee Outcomes in Denmark

    DEFF Research Database (Denmark)

    Cristini, Annalisa; Eriksson, Tor; Pozzoli, Dario

    High-performance work practices are frequently considered to have positive effects on corporate performance, but what do they do for employees? After showing that organizational innovation is indeed positively associated with firm performance, we investigate whether high-involvement work practices...

  20. Do high-volume hospitals and surgeons provide better care in urologic oncology?

    Science.gov (United States)

    Eastham, James A

    2009-01-01

    Studies focusing primarily on hospital or surgical volume as a surrogate for surgical experience have found substantial variations in outcomes. Increasing surgical experience has been shown to improve outcomes after multiple procedures, including esophagectomy, pancreatectomy, and primary surgery for colon and breast cancer. More recently, evidence has been presented that surgical volume/experience affects quality of life and cancer control outcomes after urologic oncology procedures. Although most of these data pertain to radical prostatectomy, similar conclusions have been reached for radical cystectomy, retroperitoneal lymph node dissection, and management of renal cell carcinoma. This review highlights data indicating that high-volume surgeons and hospitals provide better care for radical prostatectomy.

  1. Low versus high volume of culture medium during embryo transfer: a randomized clinical trial.

    Science.gov (United States)

    Sigalos, George Α; Michalopoulos, Yannis; Kastoras, Athanasios G; Triantafyllidou, Olga; Vlahos, Nikos F

    2018-04-01

    The aim of this prospective randomized control trial was to evaluate if the use of two different volumes (20-25 vs 40-45 μl) of media used for embryo transfer affects the clinical outcomes in fresh in vitro fertilization (IVF) cycles. In total, 236 patients were randomized in two groups, i.e., "low volume" group (n = 118) transferring the embryos with 20-25 μl of medium and "high volume" group (n = 118) transferring the embryos with 40-45 μl of medium. The clinical pregnancy, implantation, and ongoing pregnancy rates were compared between the two groups. No statistically significant differences were observed in clinical pregnancy (46.8 vs 54.3%, p = 0.27), implantation (23.7 vs 27.8%, p = 0.30), and ongoing pregnancy (33.3 vs 40.0%, p = 0.31) rates between low and high volume group, respectively. Higher volume of culture medium to load the embryo into the catheter during embryo transfer does not influence the clinical outcome in fresh IVF cycles. NCT03350646.

  2. Teacher Reflective Practice in Jesuit High Schools

    Science.gov (United States)

    Klug, Joseph H.

    2010-01-01

    Teachers who engage in reflective practice are more effective and may encourage higher student achievement. The purpose of this study is to explore and describe the methods that teachers use in order to engage in reflective practice. Further, it is essential to gain an understanding of how schools, including Jesuit high schools, promote reflective…

  3. Practices to identify and preclude adverse Aircraft-and-Rotorcraft-Pilot Couplings - A design perspective

    Science.gov (United States)

    Pavel, Marilena D.; Masarati, Pierangelo; Gennaretti, Massimo; Jump, Michael; Zaichik, Larisa; Dang-Vu, Binh; Lu, Linghai; Yilmaz, Deniz; Quaranta, Giuseppe; Ionita, Achim; Serafini, Jacopo

    2015-07-01

    Understanding, predicting and supressing the inadvertent aircraft oscillations caused by Aircraft/Rotorcraft Pilot Couplings (A/RPC) is a challenging problem for designers. These are potential instabilities that arise from the effort of controlling aircraft with high response actuation systems. The present paper reviews, updates and discusses desirable practices to be used during the design process for unmasking A/RPC phenomena. These practices are stemming from the European Commission project ARISTOTEL Aircraft and Rotorcraft Pilot Couplings - Tools and Techniques for Alleviation and Detection (2010-2013) and are mainly related to aerodynamic and structural modelling of the aircraft/rotorcraft, pilot modelling and A/RPC prediction criteria. The paper proposes new methodologies for precluding adverse A/RPCs events taking into account the aeroelasticity of the structure and pilot biodynamic interaction. It is demonstrated that high-frequency accelerations due to structural elasticity cause negative effects on pilot control, since they lead to involuntary body and limb-manipulator system displacements and interfere with pilot's deliberate control activity (biodynamic interaction) and, finally, worsen handling quality ratings.

  4. A Mismatch Between Athlete Practice and Current Sports Nutrition Guidelines Among Elite Female and Male Middle- and Long-Distance Athletes.

    Science.gov (United States)

    Heikura, Ida A; Stellingwerff, Trent; Mero, Antti A; Uusitalo, Arja Leena Tuulia; Burke, Louise M

    2017-08-01

    Contemporary nutrition guidelines promote a variety of periodized and time-sensitive recommendations, but current information regarding the knowledge and practice of these strategies among world-class athletes is limited. The aim of this study was to investigate this theme by implementing a questionnaire on dietary periodization practices in national/international level female (n = 27) and male (n = 21) middle- and long-distance runners/race-walkers. The questionnaire aimed to gain information on between and within-day dietary choices, as well as timing of pre- and posttraining meals and practices of training with low or high carbohydrate (CHO) availability. Data are shown as percentage (%) of all athletes, with differences in responses between subgroups (sex or event) shown as Chi-square x 2 when p nutrition recovery recommendations. However, very few athletes deliberately undertake some contemporary dietary periodization approaches, such as training in the fasted state or periodically restricting CHO intake. This study suggests mismatches between athlete practice and current and developing sports nutrition guidelines.

  5. Abstract 20854: A Tale of Self-Fulfilling Prophecies in Out-of-Hospital Cardiac Arrest: Emergency Medical Technicians Deliberately Perform Substandard CPR When Anticipating Poor Prognosis

    DEFF Research Database (Denmark)

    Bødtker, Henrik; Klausen, Troels M; Lauridsen, Kasper G

    2017-01-01

    ) if they believe resuscitation to be futile. Furthermore, to investigate if different patient and resuscitation attempt characteristics result in EMTs deliberately performing substandard CPR.Methods: This was a cross-sectional questionnaire survey study conducted in 2016 through 2017 including EMTs from a Danish...... and compressions). Overall, 22% and 51% would perform substandard CPR if the patient were 80 or 90 years old respectively, 46% if the patient was living in a nursing home and up to 31% due to comorbidity such as cancer. EMTs (51%) would deliberately perform substandard CPR in case of on-going bystander CPR >20...... minutes. EMTs (72%) felt competent to terminate resuscitation, but only 9% knew international termination guidelines.Conclusion: EMTs delay start of resuscitation if they anticipate resuscitation to be futile. Furthermore, they deliberately perform substandard CPR based on controversial patient...

  6. Resistance to Corrosion of Reinforcement of High Volume Fly Ash Concrete

    International Nuclear Information System (INIS)

    Kwon, S. O.; Bae, S. H.; Lee, H. J.; Lee, K. M.; Jung, S. H.

    2014-01-01

    Due to the increasing of interest about the eco-friendly concrete, it is increased to use concretes containing by-products of industry such as fly ash(FA), ground granulated blast furnace slag(GGBFS), silica fume(SF), and etc. Especially, these are well known for improving the resistances to reinforcement corrosion in concrete and decreasing chloride ion penetration. The purpose of this experimental research is to evaluate the resistance against corrosion of reinforcement of high volume fly ash(HVFA) concrete which is replaced with high volume fly ash for cement volume. For this purpose, the concrete test specimens were made for various strength level and replacement ratio of FA, and then the compressive strength and diffusion coefficient for chloride ion of them were measured for 28, 91, and 182 days, respectively. Also, corrosion monitoring by half cell potential method was carried out for the made lollypop concrete test specimens to detect the time of corrosion initiation for reinforcement in concrete. As a result, it was observed from the test results that the compressive strength of HVFA concrete was decreased with increasing replacement ratio of FA but long-term resistances against reinforcement corrosion and chloride ion penetration of that were increased

  7. Protein-bound toxins: added value in their removal with high convective volumes.

    Science.gov (United States)

    Abad, Soraya; Vega, Almudena; Quiroga, Borja; Arroyo, David; Panizo, Nayara; Reque, Javier Eduardo; López-Gómez, Juan Manuel

    Chronic kidney disease is associated with an increased risk of cardiovascular events. In recent years, protein-bound toxins have become more important due to their association with increased morbidity and mortality, characterised by inadequate clearance during dialysis. The purpose of this study is to assess the influence of high convective volumes on postdilution online haemodiafiltration (OL-HDF) on the removal of medium-sized molecules, small molecules and protein-bound molecules. In forty postdilutional OL-HDF sessions, the reduction rates of toxins of different molecular weights were measured in 13 patients, including protein-bound molecules such as p-cresyl sulphate, indoxyl sulphate and homocysteine. Total convective volume was 28.3 (5.1) litres (range 16.3-38.0 litres). Mean reduction rate of protein-bound molecules was 44.4% (15.7%), 48.7% (14.1%) and 58.6% (8.8%) for p-cresyl sulphate, indoxyl sulphate and homocysteine, respectively. Moreover, a statistically significant direct association was found between the reduction rates of all three molecules, the replacement volume and the Kt/V. High convective volumes during postdilution OL-HDF are associated with increased removal of protein-bound uraemic toxins. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Outcomes of moral case deliberation - the development of an evaluation instrument for clinical ethics support (the Euro-MCD)

    NARCIS (Netherlands)

    Svantesson, M.; Karlsson, J.; Boitte, P.; Schildman, J.; Dauwerse, L.; Widdershoven, G.; Pedersen, R.; Huisman, M.; Molewijk, A.C.

    2014-01-01

    Background: Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case

  9. High-volume intensive training course: a new paradigm for video-assisted thoracoscopic surgery education.

    Science.gov (United States)

    Sihoe, Alan D L; Gonzalez-Rivas, Diego; Yang, Timothy Y; Zhu, Yuming; Jiang, Gening

    2018-03-27

    The emergence of ultra-high-volume centres promises new opportunities for thoracic surgical training. The goal of this study was to investigate the effectiveness of a novel observership course in teaching video-assisted thoracoscopic surgery (VATS) at an ultra-high-volume centre. Two-week courses in VATS at a specialist unit now performing >10 000 major lung resections annually (>50 daily on average) were attended by 230 surgeons from around the world from 2013 to 2016. An online survey preserving responder anonymity was completed by 156 attendees (67.8%). Attendees included 37% from Western Europe, 18% from Eastern Europe and 17% from Latin America. Experience with open thoracic surgery for more than 5 years was reported by 67%, but 79% had less than 5 years of VATS lobectomy experience. During the course, 70% observed over 30 uniportal VATS operations (including 38% observing over 50), and 69% attended an animal wet lab. Although 72% of the responders attended the course less than 12 months ago, the number of ports used (P < 0.001), operation times (P < 0.001) and conversion rates (P < 0.001) reported by the responders were reduced significantly after the course. Improvements in the problem areas of tissue retraction, instrumentation, stapler application and coordination with the assistant during VATS were reported by 56%, 57%, 58% and 53%, respectively. Of those who had attended other VATS courses previously, 87% preferred the training from this high-volume course. High-volume intensive observership training at an ultra-high-volume centre may improve VATS proficiency in a short period of time, and may provide a time-efficient modality for future thoracic surgical training.

  10. Risk factors and correlates of deliberate self-harm behavior: a systematic review.

    Science.gov (United States)

    Fliege, Herbert; Lee, Jeong-Ran; Grimm, Anne; Klapp, Burghard F

    2009-06-01

    Deliberate self-harm behavior--without suicidal intent--is a serious health problem and may be studied as a clinical phenomenon in its own right. Empirical studies of sociodemographic and psychological correlates and risk factors are systematically reviewed. We searched Medline, PsycINFO, PSYNDEX (German psychological literature), and reference lists. We targeted self-induced bodily harm without conscious suicidal intent. Studies on suicidal behavior or self-poisoning were only included if they also assessed nonsuicidal self-harm. Fifty-nine original studies met the criteria. Deliberate self-harm may occur at all ages, yet adolescents and young adults are at a higher risk. Evidence on gender is complex. Only 5 studies realize a prospective design (6 months to 10 years) and test predictors. The majority use cross-sectional and retrospective methods. No longitudinal study (separately) examines new incidence. Evidence of correlates encompasses distal/proximal, person/environment, and state/trait factors. Many studies report associations between current self-harm behavior and a history of childhood sexual abuse. Adolescent and adult self-harmers experience more frequent and more negative emotions, such as anxiety, depression, and aggressiveness, than persons who do not self-harm. Two studies yield specific interactions between childhood trauma and current traits and states such as low emotional expressivity, low self-esteem, and dissociation with respect to a vulnerability to self-harm. Evidence of distal, biographical stressors is fairly strong. Proximal stressors have rarely been investigated; protective factors, hardly at all. Despite many findings of correlates, the data do not yet justify terming them risk factors. Longitudinal studies are needed.

  11. Preferential effects of low volume versus high volume replacement with crystalloid fluid in a hemorrhagic shock model in pigs.

    Science.gov (United States)

    Ponschab, Martin; Schöchl, Herbert; Keibl, Claudia; Fischer, Henrik; Redl, Heinz; Schlimp, Christoph J

    2015-10-06

    Fluid resuscitation is a core stone of hemorrhagic shock therapy, and crystalloid fluids seem to be associated with lower mortality compared to colloids. However, as redistribution starts within minutes, it has been suggested to replace blood loss with a minimum of a three-fold amount of crystalloids. The hypothesis was that in comparison to high volume (HV), a lower crystalloid volume (LV) achieves a favorable coagulation profile and exerts sufficient haemodynamics in the acute phase of resuscitation. In 24 anaesthetized pigs, controlled arterial blood loss of 50 % of the estimated blood volume was either (n = 12) replaced with a LV (one-fold) or a HV (three-fold) volume of a balanced, acetated crystalloid solution at room temperature. Hemodynamic parameters, dilution effects and coagulation profile by standard coagulation tests and thromboelastometry at baseline and after resuscitation were determined in both groups. LV resuscitation increased MAP significantly less compared to the HV, 61 ± 7 vs. 82 ± 14 mmHg (p controlled blood loss, a one fold LV crystalloid replacement strategy is sufficient to adequately raise blood pressure up to a mean arterial pressure >50 mm Hg. The concept of damage control resuscitation (DCR) with permissive hypotension may be better met by using LV as compared to a three fold HV resuscitation strategy. High volume administration of an acetated balanced crystalloid does not lead to hyperchloraemic acidosis, but may negatively influence clinical parameters, such as higher blood pressure, lower body temperature and impaired coagulation parameters, which could potentially increase bleeding after trauma. Replacement of acute blood loss with just an equal amount of an acetated balanced crystalloid appears to be the preferential treatment strategy in the acute phase after controlled bleeding.

  12. High Energy Performance Tests of Large Volume LaBr{sub 3}:Ce Detector

    Energy Technology Data Exchange (ETDEWEB)

    Naqvi, A.A.; Gondal, M.A.; Khiari, F.Z.; Dastageer, M.A. [Department of Physics, King Fahd University of Petroleum and Minerals, Dhahran (Saudi Arabia); Maslehuddin, M.M. [Center for Engineering Research, King Fahd University of Petroleum and Minerals, Dhahran (Saudi Arabia); Al-Amoudi, O.S.B. [Department of Civil Engineering, King Fahd University of Petroleum and Minerals, Dhahran (Saudi Arabia)

    2015-07-01

    High energy prompt gamma ray tests of a large volume cylindrical 100 mm x 100 mm (height x diameter) LaBr{sub 3}:Ce detector were carried out using a portable neutron generator-based Prompt Gamma Neutron Activation Analysis (PGNAA) setup. In this study prompt gamma-rays yield were measured from water samples contaminated with toxic elements such nickel, chromium and mercury compounds with gamma ray energies up to 10 MeV. The experimental yield of prompt gamma-rays from toxic elements were compared with the results of Monte Carlo calculations. In spite of its higher intrinsic background due to its larger volume, an excellent agreement between the experimental and calculated yields of high energy gamma-rays from Ni, Cr and Hg samples has been achieved for the large volume LaBr{sub 3}:Ce detector. (authors)

  13. Ultrasound automated volume calculation in reproduction and in pregnancy.

    Science.gov (United States)

    Ata, Baris; Tulandi, Togas

    2011-06-01

    To review studies assessing the application of ultrasound automated volume calculation in reproductive medicine. We performed a literature search using the keywords "SonoAVC, sonography-based automated volume calculation, automated ultrasound, 3D ultrasound, antral follicle, follicle volume, follicle monitoring, follicle tracking, in vitro fertilization, controlled ovarian hyperstimulation, embryo volume, embryonic volume, gestational sac, and fetal volume" and conducted the search in PubMed, Medline, EMBASE, and the Cochrane Database of Systematic Reviews. Reference lists of identified reports were manually searched for other relevant publications. Automated volume measurements are in very good agreement with actual volumes of the assessed structures or with other validated measurement methods. The technique seems to provide reliable and highly reproducible results under a variety of conditions. Automated measurements take less time than manual measurements. Ultrasound automated volume calculation is a promising new technology which is already used in daily practice especially for assisted reproduction. Improvements to the technology will undoubtedly render it more effective and increase its use. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. A reliable and consistent production technology for high volume compacted graphite iron castings

    Directory of Open Access Journals (Sweden)

    Liu Jincheng

    2014-07-01

    Full Text Available The demands for improved engine performance, fuel economy, durability, and lower emissions provide a continual challenge for engine designers. The use of Compacted Graphite Iron (CGI has been established for successful high volume series production in the passenger vehicle, commercial vehicle and industrial power sectors over the last decade. The increased demand for CGI engine components provides new opportunities for the cast iron foundry industry to establish efficient and robust CGI volume production processes, in China and globally. The production window range for stable CGI is narrow and constantly moving. Therefore, any one step single addition of magnesium alloy and the inoculant cannot ensure a reliable and consistent production process for complicated CGI engine castings. The present paper introduces the SinterCast thermal analysis process control system that provides for the consistent production of CGI with low nodularity and reduced porosity, without risking the formation of flake graphite. The technology is currently being used in high volume Chinese foundry production. The Chinese foundry industry can develop complicated high demand CGI engine castings with the proper process control technology.

  15. [Blood volume for biochemistry determinations--laboratory needs and everyday practice].

    Science.gov (United States)

    Sztefko, Krystyna; Mamica, Katarzyna; Bugajska, Jolanta; Maziarz, Barbara; Tomasik, Przemysław

    2014-01-01

    Blood loss due to diagnostic phlebotomy jest a very serious problem, especially for newborn, infants and critically ill patients on intensive care units. Although single blood loss can be easily tolerated in adults, in small babies and in patients who are frequently monitored based on laboratory tests iatrogenic anaemia can occur. To evaluate the blood volume drawn for routine biochemistry tests in relation to patient age and the number of parameters requested. Blood volume drawn for routine biochemistry measurements from patients hospitalized in University Children's Hospital (N = 2980, children age from one day to 18 years) and in University Hospital (N = 859, adults, aged > 1.8 years) in Cracow has been analyzed. Blood volume was calculated based on regular tube diameter and blood heights in the tube. In case of microvettes the blood volume was 0.2 ml. Statistical analysis has been performed by using PRISM 5.0. The statistical significance was set at p nurses and doctors should include the information about current laboratory automation and methods miniaturization; 2) The amount of blood volume needed by laboratory for the requested number of tests should always be taken into account when diagnostic phlebotomy is necessary.

  16. Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching

    DEFF Research Database (Denmark)

    Lind, Bertel; Erlangsen, Anette; Stuart, Elisabeth

    2014-01-01

    Background Although deliberate self-harm is a strong predictor of suicide, evidence for effective interventions is missing. The aim of this study was to examine whether psychosocial therapy after self-harm was linked to lower risks of repeated self-harm, suicide, and general mortality. Methods...... In this matched cohort study all people who, after deliberate self-harm, received a psychosocial therapy intervention at suicide prevention clinics in Denmark during 1992—2010 were compared with people who did not receive the psychosocial therapy intervention after deliberate self-harm. We applied propensity...... score matching with a 1:3 ratio and 31 matching factors, and calculated odds ratios for 1, 5, 10, and 20 years of follow-up. The primary endpoints were repeated self-harm, death by suicide, and death by any cause. Findings 5678 recipients of psychosocial therapy (followed up for 42·828 person...

  17. Brain potentials during mental arithmetic: effects of extensive practice and problem difficulty

    OpenAIRE

    Pauli, Paul; Lutzenberger, W.; Rau, H.; Birbaumer, N.; Rickard, T. C.; Yaroush, R. A.; Bourne, L. E. J.

    2011-01-01

    Recent behavioral investigations indicate that the processes underlying mental arithmetic change systematically with practice from deliberate, conscious calculation to automatic, direct retrieval of answers from memory [Bourne, L.E.Jr. and Rickard, T.C., Mental calculation: The development of a cognitive skill, Paper presented at the Interamerican Congress of Psychology, San Jose, Costa Rica, 1991; Psychol. Rev., 95 (1988) 492-527]. Results reviewed by Moscovitch and Winocur [In: The handbook...

  18. Reduction on high level radioactive waste volume and geological repository footprint with high burn-up and high thermal efficiency of HTGR

    Energy Technology Data Exchange (ETDEWEB)

    Fukaya, Yuji, E-mail: fukaya.yuji@jaea.go.jp; Nishihara, Tetsuo

    2016-10-15

    Highlights: • We evaluate the number of canisters and its footprint for HTGR. • We proposed new waste loading method for direct disposal of HTGR. • HTGR can significantly reduce HLW volume compared with LWR. - Abstract: Reduction on volume of High Level radioactive Waste (HLW) and footprint in a geological repository due to high burn-up and high thermal efficiency of High Temperature Gas-cooled Reactor (HTGR) has been investigated. A helium-cooled and graphite-moderated commercial HTGR was designed as a Gas Turbine High Temperature Reactor (GTHTR300), and that has particular features such as significantly high burn-up of approximately 120 GWd/t, high thermal efficiency around 50%, and pin-in-block type fuel. The pin-in-block type fuel was employed to reduce processed graphite volume in reprocessing. By applying the feature, effective waste loading method for direct disposal is proposed in this study. By taking into account these feature, the number of HLW canister generations and its repository footprint are evaluated by burn-up fuel composition, thermal calculation and criticality calculation in repository. As a result, it is found that the number of canisters and its repository footprint per electricity generation can be reduced by 60% compared with Light Water Reactor (LWR) representative case for direct disposal because of the higher burn-up, higher thermal efficiency, less TRU generation, and effective waste loading proposed in this study for HTGR. But, the reduced ratios change to 20% and 50% if the long term durability of LWR canister is guaranteed. For disposal with reprocessing, the number of canisters and its repository footprint per electricity generation can be reduced by 30% compared with LWR because of the 30% higher thermal efficiency of HTGR.

  19. Trading volume and the number of trades : a comparative study using high frequency data

    OpenAIRE

    Izzeldin, Marwan

    2007-01-01

    Trading volume and the number of trades are both used as proxies for market activity, with disagreement as to which is the better proxy for market activity. This paper investigates this issue using high frequency data for Cisco and Intel in 1997. A number of econometric methods are used, including GARCH augmented with lagged trading volume and number of trades, tests based on moment restrictions, regression analysis of volatility on volume and trades, normality of returns when standardized by...

  20. High-pitch dual-source CT coronary angiography with low volumes of contrast medium

    International Nuclear Information System (INIS)

    Lembcke, Alexander; Hein, Patrick A.; Knobloch, Gesine; Durmus, Tahir; Hamm, Bernd; Schwenke, Carsten; Huppertz, Alexander

    2014-01-01

    To assess the effect of lower volumes of contrast medium (CM) on image quality in high-pitch dual-source computed tomography coronary angiography (CTCA). One-hundred consecutive patients (body weight 65-85 kg, stable heart rate ≤65 bpm, cardiac index ≥2.5 L/min/m 2 ) referred for CTCA were prospectively enrolled. Patients were randomly assigned to one of five groups of different CM volumes (G 30 , 30 mL; G 40 , 40 mL; G 50 , 50 mL; G 60 , 60 mL; G 70 , 70 mL; flow rate 5 mL/s each, iodine content 370 mg/mL). Attenuation within the proximal and distal coronary artery segments was analysed. Mean attenuation for men and women ranged from 345.0 and 399.1 HU in G 30 to 478.2 and 571.8 HU in G 70 . Mean attenuation values were higher in groups with higher CM volumes (P 30 , G 40 , G 50 , G 60 and G 70 were 89 %, 95 %, 98 %, 98 % and 99 %. CM volume of 30 mL in women and 40 mL in men proved to be sufficient to guarantee attenuation of at least 300 HU. In selected patients high-pitch dual-source CTCA can be performed with CM volumes of 40 mL in men or 30 mL in women. (orig.)

  1. Target volume delineation and treatment planning for particle therapy a practical guide

    CERN Document Server

    Leeman, Jonathan E; Cahlon, Oren; Sine, Kevin; Jiang, Guoliang; Lu, Jiade J; Both, Stefan

    2018-01-01

    This handbook is designed to enable radiation oncologists to treat patients appropriately and confidently by means of particle therapy. The orientation and purpose are entirely practical, in that the focus is on the physics essentials of delivery and treatment planning , illustration of the clinical target volume (CTV) and associated treatment planning for each major malignancy when using particle therapy, proton therapy in particular. Disease-specific chapters provide guidelines and concise knowledge on CTV selection and delineation and identify aspects that require the exercise of caution during treatment planning. The treatment planning techniques unique to proton therapy for each disease site are clearly described, covering beam orientation, matching/patching field techniques, robustness planning, robustness plan evaluation, etc. The published data on the use of particle therapy for a given disease site are also concisely reported. In addition to fully meeting the needs of radiation oncologists, this "kn...

  2. The current status of emergency operations at a high-volume cancer center.

    Science.gov (United States)

    Komori, Koji; Kimura, Kenya; Kinoshita, Takashi; Ito, Seiji; Abe, Tetsuya; Senda, Yoshiki; Misawa, Kazunari; Ito, Yuichi; Uemura, Norihisa; Natsume, Seiji; Kawai, Ryosuke; Kawakami, Jiro; Asano, Tomonari; Iwata, Yoshinori; Kurahashi, Shintaro; Tsutsuyama, Masayuki; Shigeyoshi, Itaru; Shimizu, Yasuhiro

    2014-01-01

    This study aimed to assess the pathogenic causes, clinical conditions, surgical procedures, in-hospital mortality, and operative death associated with emergency operations at a high-volume cancer center. Although many reports have described the contents, operative procedures, and prognosis of elective surgeries in high-volume cancer centers, emergency operations have not been studied in sufficient detail. We retrospectively enrolled 28 consecutive patients who underwent emergency surgery. Cases involving operative complications were excluded. The following surgical procedures were performed during emergency operations: closure in 3 cases (10.7%), diversion in 22 cases (78.6%), ileus treatment in 2 cases (7.1%), and hemostasis in 1 case (3.6%). Closure alone was performed only once for peritonitis. Diversion was performed in 17 cases (77.3%) of peritonitis, 4 cases (18.2%) of stenosis of the gastrointestinal tract, and 1 case (4.5%) of bleeding. There was a significant overall difference (P = 0.001). The frequency of emergency operations was very low at a high-volume cancer center. However, the recent shift in treatment approaches toward nonoperative techniques may enhance the status of emergency surgical procedures. The results presented in this study will help prepare for emergency situations and resolve them as quickly and efficiently as possible.

  3. Automated high speed volume computed tomography for inline quality control

    International Nuclear Information System (INIS)

    Hanke, R.; Kugel, A.; Troup, P.

    2004-01-01

    Increasing complexity of innovative products as well as growing requirements on quality and reliability call for more detailed knowledge about internal structures of manufactured components rather by 100 % inspection than just by sampling test. A first-step solution, like radioscopic inline inspection machines, equipped with automated data evaluation software, have become state of the art in the production floor during the last years. However, these machines provide just ordinary two-dimensional information and deliver no volume data e.g. to evaluate exact position or shape of detected defects. One way to solve this problem is the application of X-ray computed tomography (CT). Compared to the performance of the first generation medical scanners (scanning times of many hours), today, modern Volume CT machines for industrial applications need about 5 minutes for a full object scan depending on the object size. Of course, this is still too long to introduce this powerful method into the inline production quality control. In order to gain acceptance, the scanning time including subsequent data evaluation must be decreased significantly and adapted to the manufacturing cycle times. This presentation demonstrates the new technical set up, reconstruction results and the methods for high-speed volume data evaluation of a new fully automated high-speed CT scanner with cycle times below one minute for an object size of less than 15 cm. This will directly create new opportunities in design and construction of more complex objects. (author)

  4. Analysis of the high water wave volume for the Sava River near Zagreb

    Science.gov (United States)

    Trninic, Dusan

    2010-05-01

    The paper analyses volumes of the Sava River high water waves near Zagreb during the period: 1926-2008 (N = 83 years), which is needed for more efficient control of high and flood waters. The primary Sava flood control structures in the City of Zagreb are dikes built on both riverbanks, and the Odra Relief Canal with lateral spillway upstream from the City of Zagreb. Intensive morphological changes in the greater Sava area near Zagreb, and anthropological and climate variations and changes at the Sava catchment up to the Zagreb area require detailed analysis of the water wave characteristics. In one analysis, maximum annual volumes are calculated for high water waves with constant duration of: 10, 20, 30, 40, 50 and 60 days. Such calculations encompass total quantity of water (basic and surface runoff). The log Pearson III distribution is adapted for this series of maximum annual volumes. Based on the results obtained, the interrelations are established between the wave volume as function of duration and occurrence probability. In addition to the analysis of maximum volumes of constant duration, it is interesting to carry out the analyses of maximum volume in excess of the reference discharge since it is very important for the flood control. To determine the reference discharges, a discharge of specific duration is used from an average discharge duration curve. The adopted reference discharges have durations of 50, 40, 30, 20 and 10%. Like in the previous case, log Pearson III distribution is adapted to the maximum wave data series. For reference discharge Q = 604 m3/s (duration 10%), a linear trend is calculated of maximum annual volumes exceeding the reference discharge for the Sava near Zagreb during the analyzed period. The analysis results show a significant decrease trend. A similar analysis is carried out for the following three reference discharges: regular flood control measures at the Sava near Zagreb, which are proclaimed when the water level is 350 cm

  5. Prehospital tidal volume influences hospital tidal volume: A cohort study.

    Science.gov (United States)

    Stoltze, Andrew J; Wong, Terrence S; Harland, Karisa K; Ahmed, Azeemuddin; Fuller, Brian M; Mohr, Nicholas M

    2015-06-01

    The purposes of the study are to describe current practice of ventilation in a modern air medical system and to measure the association of ventilation strategy with subsequent ventilator care and acute respiratory distress syndrome (ARDS). Retrospective observational cohort study of intubated adult patients (n = 235) transported by a university-affiliated air medical transport service to a 711-bed tertiary academic center between July 2011 and May 2013. Low tidal volume ventilation was defined as tidal volumes less than or equal to 8 mL/kg predicted body weight. Multivariable regression was used to measure the association between prehospital tidal volume, hospital ventilation strategy, and ARDS. Most patients (57%) were ventilated solely with bag valve ventilation during transport. Mean tidal volume of mechanically ventilated patients was 8.6 mL/kg predicted body weight (SD, 0.2 mL/kg). Low tidal volume ventilation was used in 13% of patients. Patients receiving low tidal volume ventilation during air medical transport were more likely to receive low tidal volume ventilation in the emergency department (P tidal volume (P = .840). Low tidal volume ventilation was rare during air medical transport. Air transport ventilation strategy influenced subsequent ventilation but was not associated with ARDS. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. A novel correction factor based on extended volume to complement the conformity index.

    Science.gov (United States)

    Jin, F; Wang, Y; Wu, Y-Z

    2012-08-01

    We propose a modified conformity index (MCI), based on extended volume, that improves on existing indices by correcting for the insensitivity of previous conformity indices to reference dose shape to assess the quality of high-precision radiation therapy and present an evaluation of its application. In this paper, the MCI is similar to the conformity index suggested by Paddick (CI(Paddick)), but with a different correction factor. It is shown for three cases: with an extended target volume, with an extended reference dose volume and without an extended volume. Extended volume is generated by expanding the original volume by 0.1-1.1 cm isotropically. Focusing on the simulation model, measurements of MCI employ a sphere target and three types of reference doses: a sphere, an ellipsoid and a cube. We can constrain the potential advantage of the new index by comparing MCI with CI(Paddick). The measurements of MCI in head-neck cancers treated with intensity-modulated radiation therapy and volumetric-modulated arc therapy provide a window on its clinical practice. The results of MCI for a simulation model and clinical practice are presented and the measurements are corrected for limited spatial resolution. The three types of MCI agree with each other, and comparisons between the MCI and CI(Paddick) are also provided. The results from our analysis show that the proposed MCI can provide more objective and accurate conformity measurement for high-precision radiation therapy. In combination with a dose-volume histogram, it will be a more useful conformity index.

  7. In search of joy in practice: a report of 23 high-functioning primary care practices.

    Science.gov (United States)

    Sinsky, Christine A; Willard-Grace, Rachel; Schutzbank, Andrew M; Sinsky, Thomas A; Margolius, David; Bodenheimer, Thomas

    2013-01-01

    We highlight primary care innovations gathered from high-functioning primary care practices, innovations we believe can facilitate joy in practice and mitigate physician burnout. To do so, we made site visits to 23 high-performing primary care practices and focused on how these practices distribute functions among the team, use technology to their advantage, improve outcomes with data, and make the job of primary care feasible and enjoyable as a life's vocation. Innovations identified include (1) proactive planned care, with previsit planning and previsit laboratory tests; (2) sharing clinical care among a team, with expanded rooming protocols, standing orders, and panel management; (3) sharing clerical tasks with collaborative documentation (scribing), nonphysician order entry, and streamlined prescription management; (4) improving communication by verbal messaging and in-box management; and (5) improving team functioning through co-location, team meetings, and work flow mapping. Our observations suggest that a shift from a physician-centric model of work distribution and responsibility to a shared-care model, with a higher level of clinical support staff per physician and frequent forums for communication, can result in high-functioning teams, improved professional satisfaction, and greater joy in practice.

  8. Fetal lung volume measurement by MRI with high-speed imaging systems

    Energy Technology Data Exchange (ETDEWEB)

    Osada, Hisao; Kaku, Kenshi [Chiba Univ. (Japan). Hospital

    2002-08-01

    Although ultrasonography is widely used for fetal morphologic observation, magnetic resonance imaging (MRI) has gained popularity as a new prenatal diagnostic method with recent introduction of high-speed imaging systems. Infants with lung hypoplasia affecting respiratory function require intensive management starting immediately after birth. Therefore, accurate prenatal differential diagnosis and severity evaluation are extremely important for these fetuses. The aim of this study is to measure fetal lung volume using a computer-based, three-dimensional MRI imaging system and to evaluate the possibility of clinical applications of this procedure. A total of 96 fetuses were evaluated, all were morphologically abnormal, and MRI was done for advanced assessment from 24 to 39 weeks gestation. Three-directional views of fetal chest were imaged by Signa Horizon, 1.5 Tesla, version 5.6 (General Electronics) with the following conditions; coil: TORSO coil, sequence: SSFSE (single shot fast spin echo), slice thickness: 5 mm, and imaging speed: 2 seconds/slice. To calculate the lung volume and create three-dimensional image, the lung area in each slice was traced out, then multiplied using computer image processing. Simultaneously, the volumes of all slices were summed to give the volume of each lung. Linear regression analysis and analysis of covariance (ANCOVA) were used for statistical analyses. In all cases, clear images were obtained, and were adequate for three-dimensional evaluation of the fetal lung. Thirty-five fetuses had poor outcomes, such as intrauterine fetal death, neonatal death, and intensive respiratory care. Regression lines of lung volume versus gestational week were calculated for these fetuses with poor outcome and 61 other fetuses with good outcome. ANCOVA, with gestational week as a covariant, revealed a significant intergroup difference in the lung volume (p<0.001). Similarly, regression lines of lung volume versus fetal body weight estimated by

  9. Decision-making in adolescent females who deliberately self-harm

    Directory of Open Access Journals (Sweden)

    Rigler Tristan

    2016-01-01

    Full Text Available Self-harming behaviour most commonly begins in adolescence and is more frequent among adolescent females. We explored the hypothesis that adolescent females who deliberately selfharm were more likely to perform worse on a decision-making task. Previous research in adolescents who self-harm reported impaired decision-making. However, research put little emphasis on older adolescents and the emotional learning. In our research, we presented the Iowa Gambling Task to 35 adolescent females who self-harmed and were treated at a psychiatric clinic, and to 35 healthy female controls. Our results show that in comparison to the control group the adolescents who self-harm took more risky decisions and were less concerned about the outcome. In addition, the clinical group also focused more on immediate gains and showed a reduced ability to learn from poor decisions in the past. Further research is suggested to explore the potential neurological correlates of decision-making and selfharming behaviour.

  10. Investing in deliberation: a definition and classification of decision support interventions for people facing difficult health decisions.

    Science.gov (United States)

    Elwyn, Glyn; Frosch, Dominick; Volandes, Angelo E; Edwards, Adrian; Montori, Victor M

    2010-01-01

    This article provides an analysis of 'decision aids', interventions to support patients facing tough decisions. Interest has increased since the concept of shared decision making has become widely considered to be a means of achieving desirable clinical outcomes. We consider the aims of these interventions and examine assumptions about their use. We propose three categories, interventions that are used in face-to-face encounters, those designed for use outside clinical encounters and those which are mediated, using telephone or other communication media. We propose the following definition: decision support interventions help people think about choices they face; they describe where and why choice exists; they provide information about options, including, where reasonable, the option of taking no action. These interventions help people to deliberate, independently or in collaboration with others, about options, by considering relevantattributes; they support people to forecast how they might feel about short, intermediate and long-term outcomes which have relevant consequences, in ways which help the process of constructing preferences and eventual decision making, appropriate to their individual situation. Although quality standards have been published for these interventions, we are also cautious about premature closure and consider that the need for short versions for use inside clinical encounters and long versions for external use requires further research. More work is also needed on the use of narrative formats and the translation of theory into practical designs. The interest in decision support interventions for patients heralds a transformation in clinical practice although many important areas remain unresolved.

  11. Effect of high and low ultrafiltration volume during hemodialysis on relative blood volume

    NARCIS (Netherlands)

    Dasselaar, JJ; de Jong, PE; Huisman, RM; Franssen, CFM

    2006-01-01

    Achieving an optimal posthemodialysis hydration status may be difficult because objective criteria for dry weight are lacking. Both relative blood volume changes (Delta RBV) at the end of hemodialysis and Delta RBV normalized for ultrafiltration volume (Delta RBV/UF ratio) have been reported to

  12. Lean Production Control at a High-Variety, Low-Volume Parts Manufacturer

    NARCIS (Netherlands)

    Bokhorst, Jos A. C.; Slomp, Jannes

    2010-01-01

    Eaton Electric General Supplies, a parts manufacturing unit that supplies parts for Eaton's electrical business unit, implemented several lean control elements in its high-variety, low-volume production units. These control elements include a constant work-in-process mechanism to limit and control

  13. Brookings supports breastfeeding: using public deliberation as a community-engaged approach to dissemination of research.

    Science.gov (United States)

    Anderson, Jenn; Kuehl, Rebecca A; Mehltretter Drury, Sara A; Tschetter, Lois; Schwaegerl, Mary; Yoder, Julia; Gullickson, Heidi; Lamp, Jamison; Bachman, Charlotte; Hildreth, Marilyn

    2017-12-01

    Empirical evidence demonstrates myriad benefits of breastfeeding for mother and child, along with benefits to businesses that support breastfeeding. Federal and state legislation requires workplace support for pumping and provides protections for public breastfeeding. Yet, many are unaware of these laws, and thus, support systems remain underdeveloped. We used a community-based approach to spread awareness about the evidence-based benefits of breastfeeding and breastfeeding support. We worked to improve breastfeeding support at the local hospital, among local employers, and throughout the broader community. Our coalition representing the hospital, the chamber of commerce, the university, and local lactation consultants used a public deliberation model for dissemination. We held focus groups, hosted a public conversation, spoke to local organizations, and promoted these efforts through local media. The hospital achieved Baby-Friendly status and opened a Baby Café. Breastfeeding support in the community improved through policies, designated pumping spaces, and signage that supports public breastfeeding at local businesses. Community awareness of the benefits of breastfeeding and breastfeeding support increased; the breastfeeding support coalition remains active. The public deliberation process for dissemination engaged the community with evidence-based promotion of breastfeeding support, increased agency, and produced sustainable results tailored to the community's unique needs.

  14. Clinical diagnostic and sociocultural dimensions of deliberate self-harm in Mumbai, India.

    Science.gov (United States)

    Parkar, Shubhangi R; Dawani, Varsha; Weiss, Mitchell G

    2006-04-01

    Patients' accounts complement psychiatric assessment of deliberate self-harm (DSH). In this study we examined psychiatric disorders, and sociocultural and cross-cultural features of DSH. SCID diagnostic interviews and a locally adapted EMIC interview were used to study 196 patients after DSH at a general hospital in Mumbai, India. Major depression was the most common diagnosis (38.8%), followed by substance use disorders (16.8%), but 44.4% of patients did not meet criteria for an enduring Axis-I disorder (no diagnosis, V-code, or adjustment disorder). Psychache arising from patient-identified sociocultural contexts and stressors complements, but does not necessarily fulfill, criteria for explanatory psychiatric disorders.

  15. Challenges in Accommodating Volume Change of Si Anodes for Li-Ion Batteries.

    Science.gov (United States)

    Ko, Minseong; Chae, Sujong; Cho, Jaephil

    2015-11-01

    Si has been considered as a promising alternative anode for next-generation Li-ion batteries (LIBs) because of its high theoretical energy density, relatively low working potential, and abundance in nature. However, Si anodes exhibit rapid capacity decay and an increase in the internal resistance, which are caused by the large volume changes upon Li insertion and extraction. This unfortunately limits their practical applications. Therefore, managing the total volume change remains a critical challenge for effectively alleviating the mechanical fractures and instability of solid-electrolyte-interphase products. In this regard, we review the recent progress in volume-change-accommodating Si electrodes and investigate their ingenious structures with significant improvements in the battery performance, including size-controlled materials, patterned thin films, porous structures, shape-preserving shell designs, and graphene composites. These representative approaches potentially overcome the large morphologic changes in the volume of Si anodes by securing the strain relaxation and structural integrity in the entire electrode. Finally, we propose perspectives and future challenges to realize the practical application of Si anodes in LIB systems.

  16. Summary of discussion points and further deliberations in the special committee on the ITER project in the Atomic Energy Commission

    International Nuclear Information System (INIS)

    Nakamura, H.

    1998-01-01

    Discussion points and further deliberations in the Special Committee, which was established in December 1996 on the ITER Project were: 'Global environment problem and energy problem', 'Promotion of the fusion energy development' and 'ITER Project'

  17. The Campus Environmental Management System Cycle in Practice: 15 Years of Environmental Management, Education and Research at Dalhousie University

    Science.gov (United States)

    Clarke, Amelia

    2006-01-01

    Purpose: To challenge the deliberate strategy approach of the environmental management system (EMS) cycle, and offer a model based on both the practical reality experienced at Dalhousie University and emergent strategy theory. Also, to share some of the lessons learned in the 15 years of environmental management at Dalhousie University.…

  18. Using high-order polynomial basis in 3-D EM forward modeling based on volume integral equation method

    Science.gov (United States)

    Kruglyakov, Mikhail; Kuvshinov, Alexey

    2018-05-01

    3-D interpretation of electromagnetic (EM) data of different origin and scale becomes a common practice worldwide. However, 3-D EM numerical simulations (modeling)—a key part of any 3-D EM data analysis—with realistic levels of complexity, accuracy and spatial detail still remains challenging from the computational point of view. We present a novel, efficient 3-D numerical solver based on a volume integral equation (IE) method. The efficiency is achieved by using a high-order polynomial (HOP) basis instead of the zero-order (piecewise constant) basis that is invoked in all routinely used IE-based solvers. We demonstrate that usage of the HOP basis allows us to decrease substantially the number of unknowns (preserving the same accuracy), with corresponding speed increase and memory saving.

  19. "And I think that we can fix it": mental models used in high-risk surgical decision making.

    Science.gov (United States)

    Kruser, Jacqueline M; Pecanac, Kristen E; Brasel, Karen J; Cooper, Zara; Steffens, Nicole M; McKneally, Martin F; Schwarze, Margaret L

    2015-04-01

    To examine how surgeons use the "fix-it" model to communicate with patients before high-risk operations. The "fix-it" model characterizes disease as an isolated abnormality that can be restored to normal form and function through medical intervention. This mental model is familiar to patients and physicians, but it is ineffective for chronic conditions and treatments that cannot achieve normalcy. Overuse may lead to permissive decision making favoring intervention. Efforts to improve surgical decision making will need to consider how mental models function in clinical practice, including "fix-it." We observed surgeons who routinely perform high-risk surgery during preoperative discussions with patients. We used qualitative content analysis to explore the use of "fix-it" in 48 audio-recorded conversations. Surgeons used the "fix-it" model for 2 separate purposes during preoperative conversations: (1) as an explanatory tool to facilitate patient understanding of disease and surgery, and (2) as a deliberation framework to assist in decision making. Although surgeons commonly used "fix-it" as an explanatory model, surgeons explicitly discussed limitations of the "fix-it" model as an independent rationale for operating as they deliberated about the value of surgery. Although the use of "fix-it" is familiar for explaining medical information to patients, surgeons recognize that the model can be problematic for determining the value of an operation. Whether patients can transition between understanding how their disease is fixed with surgery to a subsequent deliberation about whether they should have surgery is unclear and may have broader implications for surgical decision making.

  20. A flexible and accurate digital volume correlation method applicable to high-resolution volumetric images

    Science.gov (United States)

    Pan, Bing; Wang, Bo

    2017-10-01

    Digital volume correlation (DVC) is a powerful technique for quantifying interior deformation within solid opaque materials and biological tissues. In the last two decades, great efforts have been made to improve the accuracy and efficiency of the DVC algorithm. However, there is still a lack of a flexible, robust and accurate version that can be efficiently implemented in personal computers with limited RAM. This paper proposes an advanced DVC method that can realize accurate full-field internal deformation measurement applicable to high-resolution volume images with up to billions of voxels. Specifically, a novel layer-wise reliability-guided displacement tracking strategy combined with dynamic data management is presented to guide the DVC computation from slice to slice. The displacements at specified calculation points in each layer are computed using the advanced 3D inverse-compositional Gauss-Newton algorithm with the complete initial guess of the deformation vector accurately predicted from the computed calculation points. Since only limited slices of interest in the reference and deformed volume images rather than the whole volume images are required, the DVC calculation can thus be efficiently implemented on personal computers. The flexibility, accuracy and efficiency of the presented DVC approach are demonstrated by analyzing computer-simulated and experimentally obtained high-resolution volume images.

  1. Overseas Chinese Student Agency: Academic norm, Oral Participation and Discursive Practices for Change

    OpenAIRE

    Zeng, Tianjiao

    2011-01-01

    Participatory practice of overseas Asian students has been much deliberated over these two decades. Recent studies on the international higher education have proposed new perspectives and analytical framework in looking at their classroom participation, which put the essentialising notion of culture and ongoing misunderstandings under attack. Among these alternative approaches, the proposal for a view on ―small culture‖ and ―academic transition‖ are useful in the exploration of student agency...

  2. The effect of the September 11 terrorist attacks on suicide and deliberate self-harm : A time trend study

    NARCIS (Netherlands)

    De Lange, AW; Neeleman, J

    2004-01-01

    Suicide rates may be affected by world news. Our objective was to investigate the possible impact of the terrorist attacks of September 11, 2001, on suicidal behavior in the Netherlands. There was evidence of an increase in rates of suicide and deliberate self-harm in the weeks immediately following

  3. Deliberative Communication Goes to College: The "Deliberation Forum" Project as a Democratic Agent of Empowerment for Communication Students

    Science.gov (United States)

    Malka, Vered

    2016-01-01

    A new field of research has developed over the last few decades, called "Deliberative Communication". It focuses on the potential contribution of public deliberations to strengthening the foundations of democracy and the promotion of social-political goals and objectives. The current research focuses on a unique case study, the…

  4. Measuring emergency department nurses' attitudes towards deliberate self-harm using the Self-Harm Antipathy Scale.

    LENUS (Irish Health Repository)

    Conlon, Mary

    2012-01-31

    The emergency department is an important gateway for the treatment of self-harm patients. Nurses\\' attitudes towards patients who self-harm can be negative and often nurses experience frustration, helplessness, ambivalence and antipathy. Patients are often dissatisfied with the care provided, and meeting with positive or negative attitudes greatly influences whether they seek additional help. A quantitative design was utilised to measure emergency department nurses\\' attitudes towards deliberate self-harm. The \\'Self-Harm Antipathy Scale\\

  5. Reliability of Volumetry and Perimetry to Assess Knee Volume.

    Science.gov (United States)

    Nunes, Guilherme S; Yamashitafuji, Igor; Wageck, Bruna; Teixeira, Guilherme Garcia; Karloh, Manuela; de Noronha, Marcos

    2016-08-24

    The treatment of edema after a knee injury is usually 1 of the main objectives during rehabilitation. To assess the success of treatment, 2 methods are commonly used in clinical practice: volumetry and perimetry. To investigate the intra- and interassessor reliability of volumetry and perimetry to assess knee volume. Cross-sectional. Laboratory. 45 healthy participants (26 women) with mean age of 22.4 ± 2.8 y. Knee volume was assessed by 3 assessors (A, B, and C) with 3 methods (lower-limb volumetry [LLV], knee volumetry [KV], and knee perimetry [KP]). Assessor A was the most-experienced assessor, and assessor C, the least experienced. LLV and KV were performed with participants in the orthostatic position, while KP was performed with participants in supine. For the interassessor analysis, the ICC2,1 was high (.82) for KV and very high for LLV (.99) and KP (.99). For the intra-assessor analysis, ICC2,1 ranged from moderate to high for KV (.69-.83) and was very high for LLV (.99) and KP (.97-.99). KV, LLV, and KP are reliable methods, both intra- and interassessor, to measure knee volume.

  6. Dynamics of volume of competition practice and facilities of training of jumpers in length and triple in the process of long-term preparation

    Directory of Open Access Journals (Sweden)

    Sovenko S.P.

    2012-12-01

    Full Text Available Analysed and systematized information in relation to the volume of competition practice and facilities of different primary orientation of jumpers in length and triple in the process of long-term preparation. The expert questioning is conducted 16 trainers. The documents of planning of training process are analysed, the analysis of diaries of sportsmen is carried out (n=22. The volume of competition practice of sportsmen and facilities of training of different primary orientation is certain. The results of analysis in relation to the construction of training process are reflected by the leading trainers of Ukraine on track-and-field. An approach classification of facilities of training taking into account the specific of training process of sportsmen is presented. It is set that the volume of facilities of general preparation is most on the initial stages of long-term perfection, then stabilized on the stages specialized base and preparations to higher achievements and a few diminishes on maximal implementation of individual possibilities and maintainance of higher sporting trade phases. It is related to diminishing of duration of the general preparatory stages of annual preparation.

  7. Development of alkali activated cements and concrete mixture design with high volumes of red mud

    OpenAIRE

    Krivenko, Pavel; Kovalchuk, Oleksandr; Pasko, Anton; Croymans, Tom; Hutt, Mikael; Lutter, Guillaume; Vandevenne, Niels; Schreurs, Sonja; Schroeyers, Wouter

    2017-01-01

    Dedicated cement compositions were formulated to enable the incorporation of large volume fractions of red mud in alkali activated cements, taking into account the role of the aluminosilicate phase in the processes of hydration and hardening. High volume red mud alkali activated cements were synthesized using a proper combination of red mud, low basic aluminosilicate compounds with a glass phase (blast-furnace slag) and additives selected from high-basic Ca-containing cements with a crystalli...

  8. High-volume ovarian cancer care: survival impact and disparities in access for advanced-stage disease.

    Science.gov (United States)

    Bristow, Robert E; Chang, Jenny; Ziogas, Argyrios; Randall, Leslie M; Anton-Culver, Hoda

    2014-02-01

    To characterize the impact of hospital and physician ovarian cancer case volume on survival for advanced-stage disease and investigate socio-demographic variables associated with access to high-volume providers. Consecutive patients with stage IIIC/IV epithelial ovarian cancer (1/1/96-12/31/06) were identified from the California Cancer Registry. Disease-specific survival analysis was performed using Cox-proportional hazards model. Multivariate logistic regression analyses were used to evaluate for differences in access to high-volume hospitals (HVH) (≥20 cases/year), high-volume physicians (HVP) (≥10 cases/year), and cross-tabulations of high- or low-volume hospital (LVH) and physician (LVP) according to socio-demographic variables. A total of 11,865 patients were identified. The median ovarian cancer-specific survival for all patients was 28.2 months, and on multivariate analysis the HVH/HVP provider combination (HR = 1.00) was associated with superior ovarian cancer-specific survival compared to LVH/LVP (HR = 1.31, 95%CI = 1.16-1.49). Overall, 2119 patients (17.9%) were cared for at HVHs, and 1791 patients (15.1%) were treated by HVPs. Only 4.3% of patients received care from HVH/HVP, while 53.1% of patients were treated by LVH/LVP. Both race and socio-demographic characteristics were independently associated with an increased likelihood of being cared for by the LVH/LVP combination and included: Hispanic race (OR = 1.72, 95%CI = 1.22-2.42), Asian/Pacific Islander race (OR = 1.57, 95%CI = 1.07-2.32), Medicaid insurance (OR = 2.51, 95%CI = 1.46-4.30), and low socioeconomic status (OR = 2.84, 95%CI = 1.90-4.23). Among patients with advanced-stage ovarian cancer, the provider combination of HVH/HVP is an independent predictor of improved disease-specific survival. Access to high-volume ovarian cancer providers is limited, and barriers are more pronounced for patients with low socioeconomic status, Medicaid insurance, and racial minorities. Copyright © 2013

  9. Deliberating the risks of nanotechnologies for energy and health applications in the United States and United Kingdom

    Science.gov (United States)

    Pidgeon, Nick; Harthorn, Barbara Herr; Bryant, Karl; Rogers-Hayden, Tee

    2009-02-01

    Emerging nanotechnologies pose a new set of challenges for researchers, governments, industries and citizen organizations that aim to develop effective modes of deliberation and risk communication early in the research and development process. These challenges derive from a number of issues including the wide range of materials and devices covered by the term `nanotechnology', the many different industrial sectors involved, the fact that many areas of nanotechnology are still at a relatively early stage of development, and uncertainty about the environmental, health and safety impacts of nanomaterials. Public surveys have found that people in the United States and Europe currently view the benefits of nanotechnologies as outweighing their risks although, overall, knowledge about nanotechnology remains very low. However, surveys cannot easily uncover the ways that people will interpret and understand the complexities of nanotechnologies (or any other topic about which they know very little) when asked to deliberate about it in more depth, so new approaches to engaging the public are needed. Here, we report the results of the first comparative United States-United Kingdom public engagement experiment. Based upon four concurrent half-day workshops debating energy and health nanotechnologies we find commonalities that were unexpected given the different risk regulatory histories in the two countries. Participants focused on benefits rather than risks and, in general, had a high regard for science and technology. Application context was much more salient than nation as a source of difference, with energy applications viewed in a substantially more positive light than applications in health and human enhancement in both countries. More subtle differences were present in views about the equitable distribution of benefits, corporate and governmental trustworthiness, the risks to realizing benefits, and in consumerist attitudes.

  10. A PRACTICAL MODEL OF LOW-VOLUME HIGH-INTENSITY INTERVAL TRAINING INDUCES PERFORMANCE AND METABOLIC ADAPTATIONS THAT RESEMBLE 'ALL-OUT' SPRINT INTERVAL TRAINING

    Directory of Open Access Journals (Sweden)

    Mahdi Bayati

    2011-09-01

    Full Text Available Recently, a novel type of high-intensity interval training known as sprint interval training has demonstrated increases in aerobic and anaerobic performance with very low time commitment. However, this type of training program is unpractical for general populations. The present study compared the impact of a low-volume high-intensity interval training to a "all-out" sprint interval training. Twenty-four active young males were recruited and randomized into three groups: (G1: 3-5 cycling bouts × 30-s all-out with 4 min recovery; G2: 6- 10 cycling bouts × 125% Pmax with 2 min recovery and a non-trained control group. They all performed a VO2max test, a time to exhaustion at Pmax (Tmax and a Wingate test before and after the intervention. Capillary blood lactate was taken at rest, 3, and 20 min after the Wingate trial. Training was performed 3 sessions per week for 4 weeks. In G1, significant improvements (p < 0.05 following training were found in VO2max (9.6%, power at VO2max (12.8%, Tmax (48.4%, peak power output (10.3% and mean power output (17.1%. In G2, significant improvements following training were found in VO2max (9.7%, power at VO2max (16.1%, Tmax (54.2%, peak power output (7.4%; p < 0.05, but mean power output did not change significantly. Blood lactate recovery (20th min significantly decreased in G1 and G2 when compared with pre-testing and the CON group (p < 0.05. In conclusion, the results of the current study agree with earlier work demonstrating the effectiveness of 30-s all-out training program to aerobic and anaerobic adaptations. Of substantial interest is that the low volume high intensity training provides similar results but involves only half the intensity with double the repetitions

  11. High-level waste borosilicate glass: A compendium of corrosion characteristics. Volume 3

    International Nuclear Information System (INIS)

    Cunnane, J.C.

    1994-03-01

    The objective of this document is to summarize scientific information pertinent to evaluating the extent to which high-level waste borosilicate glass corrosion and the associated radionuclide release processes are understood for the range of environmental conditions to which waste glass may be exposed in service. Alteration processes occurring within the bulk of the glass (e.g., devitrification and radiation-induced changes) are discussed insofar as they affect glass corrosion. Volume III contains a bibliography of glass corrosion studies, including studies that are not cited in Volumes I and II

  12. High-level waste borosilicate glass: A compendium of corrosion characteristics. Volume 3

    Energy Technology Data Exchange (ETDEWEB)

    Cunnane, J.C. [comp.; Bates, J.K.; Bradley, C.R. [Argonne National Lab., IL (United States)] [and others

    1994-03-01

    The objective of this document is to summarize scientific information pertinent to evaluating the extent to which high-level waste borosilicate glass corrosion and the associated radionuclide release processes are understood for the range of environmental conditions to which waste glass may be exposed in service. Alteration processes occurring within the bulk of the glass (e.g., devitrification and radiation-induced changes) are discussed insofar as they affect glass corrosion. Volume III contains a bibliography of glass corrosion studies, including studies that are not cited in Volumes I and II.

  13. Climate Change: From Science to Practice.

    Science.gov (United States)

    Wheeler, Nicola; Watts, Nick

    2018-03-01

    Climate change poses a significant threat to human health. Understanding how climate science can be translated into public health practice is an essential first step in enabling robust adaptation and improving resiliency to climate change. Recent research highlights the importance of iterative approaches to public health adaptation to climate change, enabling uncertainties of health impacts and barriers to adaptation to be accounted for. There are still significant barriers to adaptation, which are context-specific and thus present unique challenges to public health practice. The implementation of flexible adaptation approaches, using frameworks targeted for public health, is key to ensuring robust adaptation to climate change in public health practice. The BRACE framework provides an excellent approach for health adaptation to climate change. Combining this with the insights provided and by the adaptation pathways approach allows for more deliberate accounting of long-term uncertainties. The mainstreaming of climate change adaptation into public health practice and planning is important in facilitating this approach and overcoming the significant barriers to effective adaptation. Yet, the immediate and future limits to adaptation provide clear justification for urgent and accelerated efforts to mitigate climate change.

  14. Diffusion of good practices of care and decline of the association with case volume: the example of breast conserving surgery

    Science.gov (United States)

    Fedeli, Ugo; Alba, Natalia; Schievano, Elena; Visentin, Cristiana; Rosato, Rosalba; Zorzi, Manuel; Ruscitti, Giancarlo; Spolaore, Paolo

    2007-01-01

    Background Several previous studies conducted on cancer registry data and hospital discharge records (HDR) have found an association between hospital volume and the recourse to breast conserving surgery (BCS) for breast cancer. The aim of the current study is to depict concurrent time trends in the recourse to BCS and its association with hospital volume. Methods Admissions of breast cancer patients for BCS or mastectomy in the period 2000–2004 were identified from the discharge database of the Veneto Region (Italy). The role of procedural volume (low 100 breast cancer surgeries/year), and of individual risk factors obtainable from HDR was assessed through a hierarchical log-binomial regression. Results Overall, the recourse to BCS was higher in medium (risk ratio = 1.12, 95% confidence interval 1.07–1.18) and high-volume (1.09, 1.03–1.14) compared to low-volume hospitals. The proportion of patients treated in low-volume hospitals dropped from 22% to 12%, with a concurrent increase in the activity of medium-volume providers. The increase over time in breast conservation (globally from 56% to 67%) was steeper in the categories of low- and medium-volume hospitals with respect to high caseload. Conclusion The growth in the recourse to BCS was accompanied by a decline of the association with hospital volume; larger centers probably acted as early adopters of breast conservation strategies that subsequently spread to smaller providers. PMID:17945000

  15. The economics of plastic surgery practices: trends in income, procedure mix, and volume.

    Science.gov (United States)

    Krieger, Lloyd M; Lee, Gordon K

    2004-07-01

    Anecdotally, plastic surgeons have complained of working harder for the same or less income in recent years. They also complain of falling fees for reconstructive surgery and increasing competition for cosmetic surgery. This study examined these notions using the best available data. To gain a better understanding of the current plastic surgery market, plastic surgeon incomes, fees, volume, and relative mix of cosmetic and reconstructive surgery were analyzed between the years 1992 and 2002. To gain a broader perspective, plastic surgeon income trends were then compared with those of other medical specialties and of nonmedical professions. The data show that in real dollars, plastic surgeon incomes have remained essentially steady in recent years, despite plastic surgeons increasing their surgery load by an average of 41 percent over the past 10 years. The overall income trend is similar to that of members of other medical specialties and other nonmedical professionals. The average practice percentage of cosmetic surgery was calculated and found to have increased from 27 percent in 1992 to 58 percent in 2002. This most likely can be explained by the findings that real dollar fees collected for cosmetic surgery have decreased very slightly, whereas those for reconstructive procedures have experienced sharp declines. This study demonstrates that plastic surgeons have adjusted their practice profiles in recent years. They have increased their case loads and shifted their practices toward cosmetic surgery, most likely with the goal of maintaining their incomes. The strategy appears to have been successful in the short term. However, with increasing competition and falling prices for cosmetic surgery, it may represent a temporary bulwark for plastic surgeon incomes unless other steps are taken.

  16. High-pitch dual-source CT coronary angiography with low volumes of contrast medium

    Energy Technology Data Exchange (ETDEWEB)

    Lembcke, Alexander; Hein, Patrick A.; Knobloch, Gesine; Durmus, Tahir; Hamm, Bernd [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); Schwenke, Carsten [SCO:SSiS - Schwenke Consulting, Berlin (Germany); Huppertz, Alexander [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); ISI - Imaging Science Institute Charite, Berlin (Germany)

    2014-01-15

    To assess the effect of lower volumes of contrast medium (CM) on image quality in high-pitch dual-source computed tomography coronary angiography (CTCA). One-hundred consecutive patients (body weight 65-85 kg, stable heart rate ≤65 bpm, cardiac index ≥2.5 L/min/m{sup 2}) referred for CTCA were prospectively enrolled. Patients were randomly assigned to one of five groups of different CM volumes (G{sub 30}, 30 mL; G{sub 40}, 40 mL; G{sub 50}, 50 mL; G{sub 60}, 60 mL; G{sub 70}, 70 mL; flow rate 5 mL/s each, iodine content 370 mg/mL). Attenuation within the proximal and distal coronary artery segments was analysed. Mean attenuation for men and women ranged from 345.0 and 399.1 HU in G{sub 30} to 478.2 and 571.8 HU in G{sub 70}. Mean attenuation values were higher in groups with higher CM volumes (P < 0.0001) and higher in women than in men (P < 0.0001). The proportions of segments with attenuation of at least 300 HU in G{sub 30}, G{sub 40}, G{sub 50}, G{sub 60} and G{sub 70} were 89 %, 95 %, 98 %, 98 % and 99 %. CM volume of 30 mL in women and 40 mL in men proved to be sufficient to guarantee attenuation of at least 300 HU. In selected patients high-pitch dual-source CTCA can be performed with CM volumes of 40 mL in men or 30 mL in women. (orig.)

  17. Performance enhancement of direct ethanol fuel cell using Nafion composites with high volume fraction of titania

    Science.gov (United States)

    Matos, B. R.; Isidoro, R. A.; Santiago, E. I.; Fonseca, F. C.

    2014-12-01

    The present study reports on the performance enhancement of direct ethanol fuel cell (DEFC) at 130 °C with Nafion-titania composite electrolytes prepared by sol-gel technique and containing high volume fractions of the ceramic phase. It is found that for high volume fractions of titania (>10 vol%) the ethanol uptake of composites is largely reduced while the proton conductivity at high-temperatures is weakly dependent on the titania content. Such tradeoff between alcohol uptake and conductivity resulted in a boost of DEFC performance at high temperatures using Nafion-titania composites with high fraction of the inorganic phase.

  18. Volume and outcome of organ transplantation

    NARCIS (Netherlands)

    Banta, H.D.; Engel, G.L.; Schersten, T.

    1992-01-01

    In general, technically demanding medical procedures are associated with better outcomes when they are carried out in institutions and by physicians with higher volumes of practice. This paper examines the evidence for a volume-outcome relationship in the case of organ transplantation. Although few

  19. Organizing mini-public deliberations: a careful preparation of the background during four deliberative experiments in Geneva

    OpenAIRE

    Deville, Marion

    2015-01-01

    In order to be institutionalized, deliberative democracy needs places were ordinary citizens debate together. Such places should offer the best possible conditions for debating. These conditions are not straightforward to gather. A lot of empirical work has recently been published on this topic. Mini-public deliberations and deliberative polls are at the interface between academic research and public spiritedness stimulation. Our research team in Geneva organized four corpus of debate experim...

  20. Survival rate in nasopharyngeal carcinoma improved by high caseload volume: a nationwide population-based study in Taiwan

    International Nuclear Information System (INIS)

    Lee, Ching-Chih; Hung, Shih-Kai; Huang, Tze-Ta; Lee, Moon-Sing; Su, Yu-Chieh; Chou, Pesus; Hsiao, Shih-Hsuan; Chiou, Wen-Yen; Lin, Hon-Yi; Chien, Sou-Hsin

    2011-01-01

    Positive correlation between caseload and outcome has previously been validated for several procedures and cancer treatments. However, there is no information linking caseload and outcome of nasopharyngeal carcinoma (NPC) treatment. We used nationwide population-based data to examine the association between physician case volume and survival rates of patients with NPC. Between 1998 and 2000, a total of 1225 patients were identified from the Taiwan National Health Insurance Research Database. Survival analysis, the Cox proportional hazards model, and propensity score were used to assess the relationship between 10-year survival rates and physician caseloads. As the caseload of individual physicians increased, unadjusted 10-year survival rates increased (p < 0.001). Using a Cox proportional hazard model, patients with NPC treated by high-volume physicians (caseload ≥ 35) had better survival rates (p = 0.001) after adjusting for comorbidities, hospital, and treatment modality. When analyzed by propensity score, the adjusted 10-year survival rate differed significantly between patients treated by high-volume physicians and patients treated by low/medium-volume physicians (75% vs. 61%; p < 0.001). Our data confirm a positive volume-outcome relationship for NPC. After adjusting for differences in the case mix, our analysis found treatment of NPC by high-volume physicians improved 10-year survival rate

  1. Cardiovascular drugs in anaesthetic practice

    NARCIS (Netherlands)

    Schwarte, Lothar A.; Loer, S.A.; Wietasch, Johann; Scheeren, TWL

    This two-volume work of 91 chapters covers all aspects of practice in anaesthesia. Volume 1 addresses the underpinning sciences of anaesthesia including physiology, pharmacology, physics, anaesthetic equipment, statistics, and evidence-based anaesthesia. Volume 1 also outlines the fundamental

  2. Volume Bragg grating narrowed high-power and highly efficient cladding-pumped Raman fiber laser.

    Science.gov (United States)

    Liu, Jun; Yao, Weichao; Zhao, Chujun; Shen, Deyuan; Fan, Dianyuan

    2014-12-10

    High-power and highly efficient operation of a single-mode cladding-pumped Raman fiber laser with narrow lasing bandwidth is demonstrated. The spectral narrowing was realized by an external cavity containing a volume Bragg grating with a center wavelength of 1658 nm. A maximum output power of 10.4 W at 1658.3 nm with a spectral linewidth (FWHM) of ∼0.1  nm was obtained for the launched pump power of 18.4 W, corresponding to a slope efficiency of 109% with respect to the launched pump power. Lasing characteristics of free-running operation are also evaluated and discussed.

  3. Unbiased estimation of the liver volume by the Cavalieri principle using magnetic resonance images

    International Nuclear Information System (INIS)

    Sahin, Buenyamin; Emirzeoglu, Mehmet; Uzun, Ahmet; Incesu, Luetfi; Bek, Yueksel; Bilgic, Sait; Kaplan, Sueleyman

    2003-01-01

    Objective: It is often useful to know the exact volume of the liver, such as in monitoring the effects of a disease, treatment, dieting regime, training program or surgical application. Some non-invasive methodologies have been previously described which estimate the volume of the liver. However, these preliminary techniques need special software or skilled performers and they are not ideal for daily use in clinical practice. Here, we describe a simple, accurate and practical technique for estimating liver volume without changing the routine magnetic resonance imaging scanning procedure. Materials and methods: In this study, five normal livers, obtained from cadavers, were scanned by 0.5 T MR machine, in horizontal and sagittal planes. The consecutive sections, in 10 mm thickness, were used to estimate the whole volume of the liver by means of the Cavalieri principle. The volume estimations were done by three different performers to evaluate the reproducibility. Results: There are no statistical differences between the performers and real liver volumes (P>0.05). There is also high correlation between the estimates of performers and the real liver volume (r=0.993). Conclusion: We conclude that the combination of MR imaging with the Cavalieri principle is a non-invasive, direct and unbiased technique that can be safely applied to estimate liver volume with a very moderate workload per individual

  4. The nature of excellent clinicians at an academic health science center: a qualitative study.

    Science.gov (United States)

    Mahant, Sanjay; Jovcevska, Vesna; Wadhwa, Anupma

    2012-12-01

    To understand the nature of excellent clinicians at an academic health science center by exploring how and why excellent clinicians achieve high performance. From 2008 to 2010, the authors conducted a qualitative study using a grounded theory approach. Members of the Clinical Advisory Committee in the Department of Pediatrics at the University of Toronto nominated peers whom they saw as excellent clinicians. The authors then conducted in-depth interviews with the most frequently nominated clinicians. They audio-recorded and transcribed the interviews and coded the transcripts to identify emergent themes. From interviews with 13 peer-nominated, excellent clinicians, a model emerged. Dominant themes fell into three categories: (1) core philosophy, (2) deliberate activities, and (3) everyday practice. Excellent clinicians are driven by a core philosophy defined by high intrinsic motivation and passion for patient care and humility. They refine their clinical skills through two deliberate activities-reflective clinical practice and scholarship. Their high performance in everyday practice is characterized by clinical skills and cognitive ability, people skills, engagement, and adaptability. A rich theory emerged explaining how excellent clinicians, driven by a core philosophy and engaged in deliberate activities, achieve high performance in everyday practice. This theory of the nature of excellent clinicians provides a holistic perspective of individual performance, informs medical education, supports faculty career development, and promotes clinical excellence in the culture of academic medicine.

  5. Role of biomarkers of nephrotoxic acute kidney injury in deliberate poisoning and envenomation in less developed countries.

    Science.gov (United States)

    Mohamed, Fahim; Endre, Zoltan H; Buckley, Nicholas A

    2015-07-01

    Acute kidney injury (AKI) has diverse causes and is associated with increased mortality and morbidity. In less developed countries (LDC), nephrotoxic AKI (ToxAKI) is common and mainly due to deliberate ingestion of nephrotoxic pesticides, toxic plants or to snake envenomation. ToxAKI shares some pathophysiological pathways with the much more intensively studied ischaemic AKI, but in contrast to ischaemic AKI, most victims are young, previously healthy adults. Diagnosis of AKI is currently based on a rise in serum creatinine. However this may delay diagnosis because of the kinetics of creatinine. Baseline creatinine values are also rarely available in LDC. Novel renal injury biomarkers offer a way forward because they usually increase more rapidly in AKI and are normally regarded as absent or very low in concentration, thereby reducing the need for a baseline estimate. This should increase sensitivity and speed of diagnosis. Specificity should also be increased for urine biomarkers since many originate from the renal tubular epithelium. Earlier diagnosis of ToxAKI should allow earlier initiation of appropriate therapy. However, translation of novel biomarkers of ToxAKI into clinical practice requires better understanding of non-renal factors in poisoning that alter biomarkers and the influence of dose of nephrotoxin on biomarker performance. Further issues are establishing LDC population-based normal ranges and assessing sampling and analytical parameters for low resource settings. The potential role of renal biomarkers in exploring ToxAKI aetiologies for chronic kidney disease of unknown origin (CKDu) is a high research priority in LDC. Therefore, developing more sensitive biomarkers for early diagnosis of nephrotoxicity is a critical step to making progress against AKI and CKDu in the developing world. © 2015 The British Pharmacological Society.

  6. The Problem of Character Education and Kohlberg's Moral Education: Critique from Dewey's Moral Deliberation

    Science.gov (United States)

    Liu, Xiangdong

    2014-01-01

    In this article, the author examines Dewey's moral deliberation. Liu argues that Dewey's work will enrich both character education and Kohlberg's moral education. Liu focuses on character education and on Kohlberg's moral education because these are the two dominant approaches. Character education seeks to cultivate good…

  7. Enhancing graphical literacy skills in the high school science classroom via authentic, intensive data collection and graphical representation exposure

    Science.gov (United States)

    Palmeri, Anthony

    This research project was developed to provide extensive practice and exposure to data collection and data representation in a high school science classroom. The student population engaged in this study included 40 high school sophomores enrolled in two microbiology classes. Laboratory investigations and activities were deliberately designed to include quantitative data collection that necessitated organization and graphical representation. These activities were embedded into the curriculum and conducted in conjunction with the normal and expected course content, rather than as a separate entity. It was expected that routine practice with graph construction and interpretation would result in improved competency when graphing data and proficiency in analyzing graphs. To objectively test the effectiveness in achieving this goal, a pre-test and post-test that included graph construction, interpretation, interpolation, extrapolation, and analysis was administered. Based on the results of a paired T-Test, graphical literacy was significantly enhanced by extensive practice and exposure to data representation.

  8. Medical review practices for driver licensing volume 2: case studies of medical referrals and licensing outcomes in Maine, Ohio, Oregon, Texas, Washington, and Wisconsin.

    Science.gov (United States)

    2017-03-01

    This is the second of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk : drivers. This volume pre...

  9. Reshaping supervisory practice in home care.

    Science.gov (United States)

    Knollmueller, R N

    1988-06-01

    Reshaping supervisory practice in home care is not an if but a when issue. We need the best wisdom in how to reshape the practice so that it builds on the experience of the individual and the agency. It is time to deliberately plan to change from the paper-shuffling tendency among supervisors toward supporting more people-oriented activity and to rediscover the pivotal role that supervisors have in keeping a community healthy, staff stimulated, and the agency solvent. Some summary points to consider in reshaping supervisory practice include: (1) redefine supervision to reflect what is desired, needed, and possible, (2) recognize the contribution from change theory and apply it, (3) recapture the commitment and philosophy of supervision from the past, (4) reward the supervisor commensurate with the scope of practice expected, (5) reverse selection of supervisors from preservers of territory to manager as idea entrepreneur, (6) respond to varying and dynamic models of supervisory practice, (7) recharge the supervisor through timely in-service programs, continuing education, and formal academic study, (8) require educational content and practice from colleges and universities that stimulate creative supervisory skills and improve job satisfaction, (9) respect the work of the supervisor and provide appropriate support to achieve success, (10) reconsider current supervisory models and expand opportunities for professional growth among staff, and (11) reshape the supervisory role from one of controller to facilitator and innovator.

  10. Adjustable mounting device for high-volume production of beam-shaping systems for high-power diode lasers

    Science.gov (United States)

    Haag, Sebastian; Bernhardt, Henning; Rübenach, Olaf; Haverkamp, Tobias; Müller, Tobias; Zontar, Daniel; Brecher, Christian

    2015-02-01

    In many applications for high-power diode lasers, the production of beam-shaping and homogenizing optical systems experience rising volumes and dynamical market demands. The automation of assembly processes on flexible and reconfigurable machines can contribute to a more responsive and scalable production. The paper presents a flexible mounting device designed for the challenging assembly of side-tab based optical systems. It provides design elements for precisely referencing and fixating two optical elements in a well-defined geometric relation. Side tabs are presented to the machine allowing the application of glue and a rotating mechanism allows the attachment to the optical elements. The device can be adjusted to fit different form factors and it can be used in high-volume assembly machines. The paper shows the utilization of the device for a collimation module consisting of a fast-axis and a slow-axis collimation lens. Results regarding the repeatability and process capability of bonding side tab assemblies as well as estimates from 3D simulation for overall performance indicators achieved such as cycle time and throughput will be discussed.

  11. Radiographic determination of urinary bladder volume and residual urine volume

    International Nuclear Information System (INIS)

    Klumair, J.

    1977-01-01

    In the course of a long study the author has tested most of the methods for determination of urinary bladder volume. A radiographic method which can state bladder volume exactly in cc's is attainable only with great time and effort. In the author's experience, however, it is possible, by means of a pattern in connection with a IVP, to estimate residual urine volume from a post-void picture of the bladder with sufficient accuracy for practical purposes. An account is given of the production of this pattern and of two relatively simple calculations for residual volume based on AP and lateral views of circular- and ellipsoid-shaped bladders. Also discussed is the radiation exposure which varies with the radiographic methods used. In male patients, the radiation exposure appears to be negligible, especially when the testicles are protected by a radiation shield. In female patients - which make up only a small fraction of all patients -, radiation exposure is higher but must be accepted. (orig./MG) [de

  12. Is orbital volume associated with eyeball and visual cortex volume in humans?

    Science.gov (United States)

    Pearce, Eiluned; Bridge, Holly

    2013-01-01

    In humans orbital volume increases linearly with absolute latitude. Scaling across mammals between visual system components suggests that these larger orbits should translate into larger eyes and visual cortices in high latitude humans. Larger eyes at high latitudes may be required to maintain adequate visual acuity and enhance visual sensitivity under lower light levels. To test the assumption that orbital volume can accurately index eyeball and visual cortex volumes specifically in humans. Structural Magnetic Resonance Imaging (MRI) techniques are employed to measure eye and orbit (n = 88) and brain and visual cortex (n = 99) volumes in living humans. Facial dimensions and foramen magnum area (a proxy for body mass) were also measured. A significant positive linear relationship was found between (i) orbital and eyeball volumes, (ii) eyeball and visual cortex grey matter volumes and (iii) different visual cortical areas, independently of overall brain volume. In humans the components of the visual system scale from orbit to eye to visual cortex volume independently of overall brain size. These findings indicate that orbit volume can index eye and visual cortex volume in humans, suggesting that larger high latitude orbits do translate into larger visual cortices.

  13. High Productivity DRIE solutions for 3D-SiP and MEMS Volume Manufacturing

    International Nuclear Information System (INIS)

    Puech, M; Thevenoud, J M; Launay, N; Arnal, N; Godinat, P; Andrieu, B; Gruffat, J M

    2006-01-01

    Emerging 3D-SiP technologies and high volume MEMS applications require high productivity mass production DRIE systems. The Alcatel DRIE product range has recently been optimised to reach the highest process and hardware production performances. A study based on sub-micron high aspect ratio structures encountered in the most stringent 3D-SiP has been carried out. The optimization of the Bosch process parameters has resulted in ultra high silicon etch rates, with unrivalled uniformity and repeatability leading to excellent process. In parallel, most recent hardware and proprietary design optimization including vacuum pumping lines, process chamber, wafer chucks, pressure control system, gas delivery are discussed. These improvements have been monitored in a mass production environment for a mobile phone application. Field data analysis shows a significant reduction of cost of ownership thanks to increased throughput and much lower running costs. These benefits are now available for all 3D-SiP and high volume MEMS applications. The typical etched patterns include tapered trenches for CMOS imagers, through silicon via holes for die stacking, well controlled profile angle for 3D high precision inertial sensors, and large exposed area features for inkjet printer heads and Silicon microphones

  14. The Socialization of Children's Memory: Linking Maternal Conversational Style to the Development of Children's Autobiographical and Deliberate Memory Skills

    Science.gov (United States)

    Langley, Hillary A.; Coffman, Jennifer L.; Ornstein, Peter A.

    2017-01-01

    Data from a large-scale, longitudinal research study with an ethnically and socioeconomically diverse sample were utilized to explore linkages between maternal elaborative conversational style and the development of children's autobiographical and deliberate memory. Assessments were made when the children were aged 3, 5, and 6 years old, and the…

  15. An Investigation of Literacy Practices in High School Science Classrooms

    Science.gov (United States)

    Wexler, Jade; Mitchell, Marisa A.; Clancy, Erin E.; Silverman, Rebecca D.

    2017-01-01

    This study reports findings from an exploration of the literacy practices of 10 high school science teachers. Based on observations of teachers' instruction, we report teachers' use of text, evidence-based vocabulary and comprehension practices, and grouping practices. Based on interviews with teachers, we also report teachers' perceptions…

  16. Automatic and deliberate affective associations with sexual stimuli in women with lifelong vaginismus before and after therapist-aided exposure treatment

    NARCIS (Netherlands)

    Melles, Reinhilde J.; ter Kuile, Moniek M.; Dewitte, Marieke; van Lankveld, Jacques J. D. M.; Brauer, Marieke; de Jong, Peter J.

    2014-01-01

    The intense fear response to vaginal penetration in women with lifelong vaginismus, who have never been able to experience coitus, may reflect negative automatic and deliberate appraisals of vaginal penetration stimuli which might be modified by exposure treatment. The aim of this study is to

  17. Fairness requires deliberation: the primacy of economic over social considerations

    Science.gov (United States)

    Hochman, Guy; Ayal, Shahar; Ariely, Dan

    2015-01-01

    While both economic and social considerations of fairness and equity play an important role in financial decision-making, it is not clear which of these two motives is more primal and immediate and which one is secondary and slow. Here we used variants of the ultimatum game to examine this question. Experiment 1 shows that acceptance rate of unfair offers increases when participants are asked to base their choice on their gut-feelings, as compared to when they thoroughly consider the available information. In line with these results, Experiments 2 and 3 provide process evidence that individuals prefer to first examine economic information about their own utility rather than social information about equity and fairness, even at the price of foregoing such social information. Our results suggest that people are more economically rational at the core, but social considerations (e.g., inequality aversion) require deliberation, which under certain conditions override their self-interested impulses. PMID:26106342

  18. Fairness requires deliberation: the primacy of economic over social considerations.

    Science.gov (United States)

    Hochman, Guy; Ayal, Shahar; Ariely, Dan

    2015-01-01

    While both economic and social considerations of fairness and equity play an important role in financial decision-making, it is not clear which of these two motives is more primal and immediate and which one is secondary and slow. Here we used variants of the ultimatum game to examine this question. Experiment 1 shows that acceptance rate of unfair offers increases when participants are asked to base their choice on their gut-feelings, as compared to when they thoroughly consider the available information. In line with these results, Experiments 2 and 3 provide process evidence that individuals prefer to first examine economic information about their own utility rather than social information about equity and fairness, even at the price of foregoing such social information. Our results suggest that people are more economically rational at the core, but social considerations (e.g., inequality aversion) require deliberation, which under certain conditions override their self-interested impulses.

  19. Fairness requires deliberation: The primacy of economic over social considerations

    Directory of Open Access Journals (Sweden)

    Guy eHochman

    2015-06-01

    Full Text Available While both economic and social considerations of fairness and equity play an important role in financial decision-making, it is not clear which of these two motives is more primal and immediate and which one is secondary and slow. Here we used variants of the ultimatum game to examine this question. Experiment 1 shows that acceptance rate of unfair offers increases when participants are asked to base their choice on their gut-feelings, as compared to when they thoroughly consider the available information. In line with these results, Experiments 2 and 3 provide process evidence that individuals prefer to first examine economic information about their own utility rather than social information about equity and fairness, even at the price of foregoing such social information. Our results suggest that people are more economically rational at the core, but social considerations (e.g., inequality aversion require deliberation, which under certain conditions override their self-interested impulses.

  20. Deliberating Tarceva: A case study of how British NHS managers decide whether to purchase a high-cost drug in the shadow of NICE guidance.

    Science.gov (United States)

    Hughes, David; Doheny, Shane

    2011-11-01

    This paper examines audio-recorded data from meetings in which NHS managers decide whether to fund high-cost drugs for individual patients. It investigates the work of a Welsh individual patient commissioning (IPC) panel responsible for sanctioning the purchase of 'un-commissioned' treatments for exceptional cases. The case study presented highlights the changing rationales used for approving or denying a cancer drug, Tarceva, during a period when NICE first suggested it was not cost effective, but then changed its position in a final technology appraisal recommending use when the cost did not exceed that of an alternative product. Our data show how decisions taken in the shadow of NICE guidance remain complex and subject to local discretion. Guidance that takes time to prepare, is released in stages, and relates to particular disease stages, must be interpreted in the context of particular cases. The case-based IPC panel discourse stands in tension with the standardised population-based recommendations in guidance. Panel members, who based their decisions on the central notions of 'efficacy' and 'exceptionality', often struggled to apply NICE information on cost-effectiveness to their deliberations on efficacy (clinical effectiveness). The case study suggests that the complex nature of decision making makes standardization of outcomes very difficult to achieve, so that local professional judgement is likely to remain central to health care rationing at this level. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Fuzzy Regression Prediction and Application Based on Multi-Dimensional Factors of Freight Volume

    Science.gov (United States)

    Xiao, Mengting; Li, Cheng

    2018-01-01

    Based on the reality of the development of air cargo, the multi-dimensional fuzzy regression method is used to determine the influencing factors, and the three most important influencing factors of GDP, total fixed assets investment and regular flight route mileage are determined. The system’s viewpoints and analogy methods, the use of fuzzy numbers and multiple regression methods to predict the civil aviation cargo volume. In comparison with the 13th Five-Year Plan for China’s Civil Aviation Development (2016-2020), it is proved that this method can effectively improve the accuracy of forecasting and reduce the risk of forecasting. It is proved that this model predicts civil aviation freight volume of the feasibility, has a high practical significance and practical operation.

  2. Sample volume and alignment analysis for an optical particle counter sizer, and other applications

    International Nuclear Information System (INIS)

    Holve, D.J.; Davis, G.W.

    1985-01-01

    Optical methods for particle size distribution measurements in practical high temperature environments are approaching feasibility and offer significant advantages over conventional sampling methods. A key requirement of single particle counting techniques is the need to know features of the sample volume intensity distribution which in general are a function of the particle scattering properties and optical system geometry. In addition, the sample volume intensity distribution is sensitive to system alignment and thus calculations of alignment sensitivity are required for assessment of practical alignment tolerances. To this end, an analysis of sample volume characteristics for single particle counters in general has been developed. Results from the theory are compared with experimental measurements and shown to be in good agreement. A parametric sensitivity analysis is performed and a criterion for allowable optical misalignment is derived for conditions where beam steering caused by fluctuating refractive-index gradients is significant

  3. High-energy molecular lasers self-controlled volume-discharge lasers and applications

    CERN Document Server

    Apollonov, V V

    2016-01-01

    This book displays the physics and design of high-power molecular lasers. The lasers described are self-controlled volume-discharge lasers. The book explains self-sustained discharge lasers, self-initiated discharge lasers and technical approaches to laser design. Important topics discussed are laser efficiency, laser beam quality and electric field homogeneity. The book contains many new innovative applications.

  4. Connecting to Experience: High-Impact Practices for Leadership Development.

    Science.gov (United States)

    Priest, Kerry L; Clegorne, Nicholas A

    2015-01-01

    Leadership educators can leverage high-impact experiences to enhance student leadership development. This chapter describes three key practices--sociocultural conversations with peers, mentoring, and membership in off-campus organizations--as levers of leadership learning. Illustrations of the practice in context and reflections from practitioners and students are also included. The chapter concludes with considerations of context, developmental readiness, and best practices of experiential education. © 2015 Wiley Periodicals, Inc., A Wiley Company.

  5. Transitions in Theory and Practice: Managing Metals in the Circular Economy

    Directory of Open Access Journals (Sweden)

    Melissa Jackson

    2014-07-01

    Full Text Available Transitioning from current resource management practice dominated by linear economic models of consumption and production, to circular models of resource use, will require insights into the stages and processes associated with socio-technical transitions. This paper is concerned with transitions in practice. It explores two frameworks within the transitions literature—the multi-level perspective and transition management theory—for practical guidance to inform a deliberate transition in practice. The critical futures literature is proposed as a source of tools and methods to be used in conjunction with the transition frameworks to influence and enable transitions in practice. This enhanced practical guidance for initiating action is applied to a specific context—transitioning the Australian metals sector towards a circular economy model. This particular transition case study is relevant because the vision of a circular economy model of resource management is gaining traction internationally, Australia is significant globally as a supplier of finite mineral resources and it will also be used in a collaborative research project on Wealth from Waste to investigate possibilities for the circular economy and metals recycling.

  6. Book review: Fowler's zoo and wild animal medicine (volume 8)

    Science.gov (United States)

    Sleeman, Jonathan M.

    2014-01-01

    In the eighth volume of Fowler's Zoo and Wild Animal Medicine, the editors have returned to the original, comprehensive, taxa-based format last used in the fifth volume that was released in 2003. The book consists of 82 chapters, divided into taxonomic classes that include amphibians, reptiles, birds, and mammals, and a general topics section. The editors deliberately selected new senior authors who are expert veterinary advisors for the various taxa. This international assemblage of authors is impressive, although the book would have benefited from a greater diversity of disciplinary expertise. Synthesis of the large and expanding body of knowledge about zoo and wild animal medicine is a Sisyphean task, but one that the editors have accomplished well. The chapters were well written and are beautifully illustrated with high-quality images and generally well referenced. Much of the information is summarized in tabular format, which I found both a blessing and a curse. Tabulation of hematologic variables and anesthetic doses is helpful; however, tabulation of information regarding infectious and parasitic diseases results in a loss of detail. For example, methods of diagnosis for some diseases are omitted from some tables. The need for succinctness results in trade-offs, and statements such as “Batrachochytrium dendrobatidis … is one of the most well described pathogens of anurans” with no further information leaves readers unsated. In addition, the book does not have any chapters on fish or invertebrates, which are notable omissions given the importance of these species. Those quibbles aside, this is a must-have book for all zoo and wild animal medicine students and practitioners. However, perhaps it is time to recognize that, during the 36 years since the first volume was published, this discipline has become too large to be contained in 1 book. This is largely because of the success of this book series, and it is a nice problem to have.

  7. 77 FR 21065 - Certain High Production Volume Chemicals; Test Rule and Significant New Use Rule; Fourth Group of...

    Science.gov (United States)

    2012-04-09

    ... 2070-AJ66 Certain High Production Volume Chemicals; Test Rule and Significant New Use Rule; Fourth... an opportunity to comment on a proposed test rule for 23 high production volume (HPV) chemical... necessary, to prohibit or limit that activity before it occurs. The opportunity to present oral comment was...

  8. Evaluation of moral case deliberation at the Dutch Health Care Inspectorate: a pilot study.

    Science.gov (United States)

    Seekles, Wike; Widdershoven, Guy; Robben, Paul; van Dalfsen, Gonny; Molewijk, Bert

    2016-05-21

    Moral case deliberation (MCD) as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics support on the level of health care regulation, employees of regulatory bodies are regularly confronted with moral challenges. This pilot study describes and evaluates the use of MCD at the Dutch Health Care Inspectorate (IGZ). The objective of this pilot study is to investigate: 1) the current way of dealing with moral issues at the IGZ; 2) experience with and evaluation of MCD as clinical ethics support, and 3) future preferences and (perceived) needs regarding clinical ethics support for dealing with moral questions at the IGZ. We performed an explorative pilot study. The research questions were assessed by means of: 1) interviews with MCD participants during four focus groups; and 2) interviews with six key stakeholders at the IGZ. De qualitative data is illustrated by data from questionnaires on MCD outcomes, perspective taking and MCD evaluation. Professionals do not always recognize moral issues. Employees report a need for regular and structured moral support in health care regulation. The MCD meetings are evaluated positively. The most important outcomes of MCD are feeling secure and learning from others. Additional support is needed to successfully implement MCD at the Inspectorate. We conclude that the respondents perceive moral case deliberation as a useful form of clinical ethics support for dealing with moral questions and issues in health care regulation.

  9. Deliberate Self-Harm (DSH): a follow-up study of Irish children.

    LENUS (Irish Health Repository)

    Cassidy, C

    2012-02-01

    This study aimed to look at rates of repetition in children presenting with Deliberate Self-Harm (DSH) to a paediatric A&E department. Children presenting with DSH to a paediatric A&E between 2000 and 2005 were invited to participate in the study. Telephone interviews collected information on demographic details and mental health functioning, including repetition of DSH. Data was obtained from 39 parents and 10 children (31 girls and 8 boys, mean age 15) 1 in 5 females (20%) had made a repeat attempt of DSH and 1 in 10 (10%) had repeated more than once. No males repeated self-harm. On going parental concern rather than clinician risk assessment at index episode predicted subsequent DSH. Given the poor predictive value of clinician risk assessment, all attempts of DSH must be taken seriously, especially those associated with ongoing parental concern.

  10. Deliberate Self-Harm (DSH): a follow-up study of Irish children.

    LENUS (Irish Health Repository)

    Cassidy, C

    2009-04-01

    This study aimed to look at rates of repetition in children presenting with Deliberate Self-Harm (DSH) to a paediatric A&E department. Children presenting with DSH to a paediatric A&E between 2000 and 2005 were invited to participate in the study. Telephone interviews collected information on demographic details and mental health functioning, including repetition of DSH. Data was obtained from 39 parents and 10 children (31 girls and 8 boys, mean age 15) 1 in 5 females (20%) had made a repeat attempt of DSH and 1 in 10 (10%) had repeated more than once. No males repeated self-harm. On going parental concern rather than clinician risk assessment at index episode predicted subsequent DSH. Given the poor predictive value of clinician risk assessment, all attempts of DSH must be taken seriously, especially those associated with ongoing parental concern.

  11. Evaluation of Peritumoral Edema in the Delineation of Radiotherapy Clinical Target Volumes for Glioblastoma

    International Nuclear Information System (INIS)

    Chang, Eric L.; Akyurek, Serap; Avalos, Tedde C; Rebueno, Neal C; Spicer, Chris C; Garcia, John C; Famiglietti, Robin; Allen, Pamela K.; Chao, K.S. Clifford; Mahajan, Anita; Woo, Shiao Y.; Maor, Moshe H.

    2007-01-01

    Purpose: To evaluate the spatial relationship between peritumoral edema and recurrence pattern in patients with glioblastoma (GBM). Methods and Materials: Forty-eight primary GBM patients received three-dimensional conformal radiotherapy that did not intentionally include peritumoral edema within the clinical target volume between July 2000 and June 2001. All 48 patients have subsequently recurred, and their original treatment planning parameters were used for this study. New theoretical radiation treatment plans were created for the same 48 patients, based on Radiation Therapy Oncology Group (RTOG) target delineation guidelines that specify inclusion of peritumoral edema. Target volume and recurrent tumor coverage, as well as percent volume of normal brain irradiated, were assessed for both methods of target delineation using dose-volume histograms. Results: A comparison between the location of recurrent tumor and peritumoral edema volumes from all 48 cases failed to show correlation by linear regression modeling (r 2 0.0007; p = 0.3). For patients with edema >75 cm 3 , the percent volume of brain irradiated to 46 Gy was significantly greater in treatment plans that intentionally included peritumoral edema compared with those that did not (38% vs. 31%; p = 0.003). The pattern of failure was identical between the two sets of plans (40 central, 3 in-field, 3 marginal, and 2 distant recurrence). Conclusion: Clinical target volume delineation based on a 2-cm margin rather than on peritumoral edema did not seem to alter the central pattern of failure for patients with GBM. For patients with peritumoral edema >75 cm 3 , using a constant 2-cm margin resulted in a smaller median percent volume of brain being irradiated to 30 Gy, 46 Gy, and 50 Gy compared with corresponding theoretical RTOG plans that deliberately included peritumoral edema

  12. Association Between Treatment at a High-Volume Facility and Improved Survival for Radiation-Treated Men With High-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yu-Wei [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Mahal, Brandon A. [Department of Medicine, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Harvard Medical School, Boston, Massachusetts (United States); Muralidhar, Vinayak [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Harvard Medical School, Boston, Massachusetts (United States); Nezolosky, Michelle [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Beard, Clair J. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Harvard Medical School, Boston, Massachusetts (United States); Den, Robert B. [Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Feng, Felix Y. [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Hoffman, Karen E. [Department of Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Martin, Neil E.; Orio, Peter F. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Harvard Medical School, Boston, Massachusetts (United States); Nguyen, Paul L., E-mail: pnguyen@LROC.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Harvard Medical School, Boston, Massachusetts (United States)

    2016-03-15

    Purpose: Although the association between higher hospital volume and improved outcomes has been well-documented in surgery, there is little data about whether this effect exists for radiation-treated patients. We investigated whether treatment at a radiation facility that treats a high volume of prostate cancer patients is associated with improved survival for men with high-risk prostate cancer. Methods and Materials: We used the National Cancer Database (NCDB) to identity patients diagnosed with prostate cancer from 2004 to 2006. The radiation case volume (RCV) of each hospital was based on its number of radiation-treated prostate cancer patients. We used propensity-score based analysis to compare the overall survival (OS) of high-risk prostate cancer patients in high versus low RCV hospitals. Primary endpoint is overall survival. Covariates adjusted for were tumor characteristics, sociodemographic factors, radiation type, and use of androgen deprivation therapy (ADT). Results: A total of 19,565 radiation-treated high-risk patients were identified. Median follow-up was 81.0 months (range: 1-108 months). When RCV was coded as a continuous variable, each increment of 100 radiation-managed patients was associated with improved OS (adjusted hazard ratio [AHR]: 0.97; 95% confidence interval [CI]: 0.95-0.98; P<.0001) after adjusting for known confounders. For illustrative purposes, when RCV was dichotomized at the 80th percentile (43 patients/year), high RCV was associated with improved OS (7-year overall survival 76% vs 74%, log-rank test P=.0005; AHR: 0.91, 95% CI: 0.86-0.96, P=.0005). This association remained significant when RCV was dichotomized at 75th (37 patients/year), 90th (60 patients/year), and 95th (84 patients/year) percentiles but not the 50th (19 patients/year). Conclusions: Our results suggest that treatment at centers with higher prostate cancer radiation case volume is associated with improved OS for radiation-treated men with high-risk prostate

  13. Behind the stage of deliberate self-persuasion: When changes in valence of associations to an attitude object predict attitude change.

    Science.gov (United States)

    Lu, Tong; Lord, Charles G; Yoke, Kristin

    2015-12-01

    Modern theory and research on evaluative processes, combined with a comprehensive review of deliberate self-persuasion (Maio & Thomas, 2007, Pers. Soc. Psychol. Bull., 11, 46), suggest two types of strategies people can use to construct new, more desired attitudes. Epistemic strategies change the perceived valence of associations activated by the attitude object. Teleologic strategies, in contrast, keep undesired associations from being activated in the first place, thus obviating the need to change their perceived valence. Change in perceived valence of associations therefore might predict attitude change better when people pursue epistemic than teleologic strategies for deliberate self-persuasion. This hypothesis gained convergent support from three studies in which use of epistemic versus teleologic strategies was measured as an individual difference (Study 1) and manipulated (studies 2 and 3). The results of these studies supported the theoretical distinction between the two strategies and suggested further research directions. © 2015 The British Psychological Society.

  14. Shiism: What Students Need to Know. Footnotes. Volume 15, Number 2

    Science.gov (United States)

    Calvert, John

    2010-01-01

    This essay is excerpted from the author's book "Divisions within Islam," part of a 10-volume series for middle and high school students on the World of Islam. It provides information on the religious practices and beliefs of Shiism, and its differences with Sunni Islam. It mentions that Shiism is the second-largest denomination of Islam,…

  15. High Center Volume Does Not Mitigate Risk Associated with Using High Donor Risk Organs in Liver Transplantation.

    Science.gov (United States)

    Beal, Eliza W; Black, Sylvester M; Mumtaz, Khalid; Hayes, Don; El-Hinnawi, Ashraf; Washburn, Kenneth; Tumin, Dmitry

    2017-09-01

    High-risk donor allografts increase access to liver transplant, but potentially reduce patient and graft survival. It is unclear whether the risk associated with using marginal donor livers is mitigated by increasing center experience. The United Network for Organ Sharing registry was queried for adult first-time liver transplant recipients between 2/2002 and 12/2015. High donor risk was defined as donor risk index >1.9, and 1-year patient and graft survival were compared according to donor risk index in small and large centers. Multivariable Cox regression estimated the hazard ratio (HR) associated with using high-risk donor organs, according to a continuous measure of annual center volume. The analysis included 51,770 patients. In 67 small and 67 large centers, high donor risk index predicted increased mortality (p = 0.001). In multivariable analysis, high-donor risk index allografts predicted greater mortality hazard at centers performing 20 liver transplants per year (HR 1.35; 95% CI 1.22, 1.49; p donor risk index and center volume was not statistically significant (p = 0.747), confirming that the risk associated with using marginal donor livers was comparable between smaller and larger centers. Results were consistent when examining graft loss. At both small and large centers, high-risk donor allografts were associated with reduced patient and graft survival after liver transplant. Specific strategies to mitigate the risk of liver transplant involving high-risk donors are needed, in addition to accumulation of center expertise.

  16. Anaesthetic and ICU management of aneurysmal subarachnoid haemorrhage: a survey of European practice.

    Science.gov (United States)

    Velly, Lionel J; Bilotta, Federico; Fàbregas, Neus; Soehle, Martin; Bruder, Nicolas J; Nathanson, Michael H

    2015-03-01

    Many aspects of the perioperative management of aneurysmal subarachnoid haemorrhage (SAH) remain controversial. It would be useful to assess differences in the treatment of SAH in Europe to identify areas for improvement. To determine the clinical practice of physicians treating SAH and to evaluate any discrepancy between practice and published evidence. An electronic survey. Physicians identified through each national society of neuroanaesthesiology and neurocritical care. A 31-item online questionnaire was distributed by the ENIG group. Questions were designed to investigate anaesthetic management of SAH and diagnostic and treatment approaches to cerebral vasospasm. The survey was available from early October to the end of November 2012. Completed surveys were received from 268 respondents, of whom 81% replied that aneurysm treatment was conducted early (within 24 h). Sixty-five percent of centres treated more than 60% of SAH by coiling, 19% had high-volume clipping (>60% of aneurysms clipped) and 16% used both methods equally. No clear threshold for arterial blood pressure target was identified during coiling, temporary clipping or in patients without vasospasm after the aneurysm had been secured. Almost all respondents used nimodipine (97%); 21% also used statins and 20% used magnesium for prevention of vasospasm. A quarter of respondents used intra-arterial vasodilators alone, 5% used cerebral angioplasty alone and 48% used both endovascular methods to treat symptomatic vasospasm. In high-volume clipping treatment centres, 58% of respondents used endovascular methods to manage vasospasm compared with 86% at high-volume coiling treatment centres (P practice patterns of European physicians involved in early treatment of SAH. Significant differences were noted among countries and between high and low-volume coiling centres.

  17. Deliberate teaching tools for clinical teaching encounters: A critical scoping review and thematic analysis to establish definitional clarity.

    Science.gov (United States)

    Sidhu, Navdeep S; Edwards, Morgan

    2018-04-27

    We conducted a scoping review of tools designed to add structure to clinical teaching, with a thematic analysis to establish definitional clarity. Six thousand and forty nine citations were screened, 434 reviewed for eligibility, and 230 identified as meeting study inclusion criteria. Eighty-nine names and 51 definitions were identified. Based on a post facto thematic analysis, we propose that these tools be named "deliberate teaching tools" (DTTs) and defined as "frameworks that enable clinicians to have a purposeful and considered approach to teaching encounters by incorporating elements identified with good teaching practice." We identified 46 DTTs in the literature, with 38 (82.6%) originally described for the medical setting. Forty justification articles consisted of 16 feedback surveys, 13 controlled trials, seven pre-post intervention studies with no control group, and four observation studies. Current evidence of efficacy is not entirely conclusive, and many studies contain methodology flaws. Forty-nine clarification articles comprised 12 systematic reviews and 37 narrative reviews. The most number of DTTs described by any review was four. A common design theme was identified in approximately three-quarters of DTTs. Applicability of DTTs to specific alternate settings should be considered in context, and appropriately designed justification studies are warranted to demonstrate efficacy.

  18. High-level waste storage tank farms/242-A evaporator Standards/Requirements Identification Document (S/RID), Volume 4

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    The High-Level Waste Storage Tank Farms/242-A Evaporator Standards/Requirements Identification Document (S/RID) is contained in multiple volumes. This document (Volume 4) presents the standards and requirements for the following sections: Radiation Protection and Operations.

  19. High-level waste storage tank farms/242-A evaporator Standards/Requirements Identification Document (S/RID), Volume 4

    International Nuclear Information System (INIS)

    1994-04-01

    The High-Level Waste Storage Tank Farms/242-A Evaporator Standards/Requirements Identification Document (S/RID) is contained in multiple volumes. This document (Volume 4) presents the standards and requirements for the following sections: Radiation Protection and Operations

  20. Known volume air sampling pump. Final summary report Jun 1975--Nov 1976

    International Nuclear Information System (INIS)

    McCullough, J.E.; Peterson, A.

    1976-11-01

    The purpose of this development program was to design and develop a known volume air sampling pump for use in measuring the amount of radioactive material in the atmosphere of an underground uranium mine. The principal nuclear radiation hazard to underground uranium mines comes from the mine atmosphere. Daughter products of radon-222 are inhaled by the miner resulting in a relatively high lung cancer rate among these workers. Current exposure control practice employs spot sampling in working areas to measure working level values. Currently available personal air sampling pumps fail to deliver known volumes of air under widely changing differential pressures. A unique type of gas pump known as the scroll compressor, developed by Arthur D. Little, Inc., that has no values and few moving parts is expected to provide a practical, efficient, and dependable air pump for use in dosimeters. The three deliverable known volume air sampling pumps resulting from this work incorporate a scroll pump, drive motor, speed control electronics, and battery pack in a container suitable for attachment to a miner's belt

  1. Laboratory Investigations on Mechanical Properties of High Volume Fly Ash Concrete and Composite Sections

    OpenAIRE

    Aravindkumar B. Harwalkar; S. S. Awanti

    2013-01-01

    Use of fly ash as a supplementary cementing material in large volumes can bring both technological and economic benefits for concrete industry. In this investigation mix proportions for high volume fly ash concrete were determined at cement replacement levels of 50%, 55%, 60% and 65% with low calcium fly ash. Flexural and compressive strengths of different mixes were measured at ages of 7, 28 and 90 days. Flexural strength of composite section prepared from pavement quali...

  2. High-level waste storage tank farms/242-A evaporator Standards/Requirements Identification Document (S/RID), Volume 5

    International Nuclear Information System (INIS)

    1994-04-01

    The High-Level Waste Storage Tank Farms/242-A Evaporator Standards/Requirements Identification Document (S/RID) is contained in multiple volumes. This document (Volume 5) outlines the standards and requirements for the Fire Protection and Packaging and Transportation sections

  3. Deliberate play and preparation jointly benefit motor and cognitive development: mediated and moderated effects

    Directory of Open Access Journals (Sweden)

    Caterina ePesce

    2016-03-01

    Full Text Available In light of the interrelation between motor and cognitive development and the predictive value of the former for the latter, the secular decline observed in motor coordination ability as early as preschool urges identification of interventions that may jointly impact motor and cognitive efficiency.The aim of this study was twofold. It (1 explored the outcomes of enriched physical education, centered on deliberate play and cognitively challenging variability of practice, on motor coordination and cognitive processing; (2 examined whether motor coordination outcomes mediate intervention effects on children’s cognition, while controlling for moderation by lifestyle factors as outdoor play habits and weight status. Four hundred and sixty children aged 5-10 years participated in a 6-month group randomized intervention in physical education, with or without playful coordinative and cognitive enrichment. The weight status and spontaneous outdoor play habits of children (parental report of outdoor play were evaluated at baseline. Before and after the intervention, motor developmental level (Movement Assessment Battery for Children was evaluated in all children, who were then assessed either with a test of working memory (Random Number Generation task, or with a test of attention (from the Cognitive Assessment System, CAS.Children assigned to the ‘enriched’ intervention showed more pronounced improvements in all motor coordination assessments (manual dexterity, ball skills, static/dynamic balance. The beneficial effect on ball skills was amplified by the level of spontaneous outdoor play and weight status. Among indices of executive function and attention, only that of inhibition showed a differential effect of intervention type. Moderated mediation showed that the better outcome of the enriched physical education on ball skills mediated the better inhibition outcome, but only when the enrichment intervention was paralleled by a medium-to-high

  4. Deliberation in Multi-Stakeholder Participation: A Heuristic Framework Applied to the Committee on World Food Security

    Directory of Open Access Journals (Sweden)

    Matheus Alves Zanella

    2018-02-01

    Full Text Available Multi-stakeholder participation (MSP has become a central feature in several institutions and processes of global governance. Those who promote them trust that these arrangements can advance the deliberative quality of international institutions, and thereby improve the democratic quality, legitimacy and effectiveness of both the institutional landscape, as well as decisions made within it. This paper employs a heuristic framework to analyze the deliberative quality of MSP. Specifically, it applies Dryzek’s deliberative systems framework to the case of the Committee on World Food Security (CFS. The assessment shows that the CFS improves the deliberative quality of food security governance by including and facilitating the transmission of discourses from the public to the empowered spaces. However, the deliberative quality of CFS could be higher with stronger accountability mechanisms in place, more meta-deliberation and adoption of CFS outcomes at national and local levels. Reflecting on the limitations of using this heuristic framework to assess MSP, we conclude that the analysis would benefit from more explicit consideration of different forms of power that are part of the social relations between actors involved in such settings. By proposing this analytical approach, we expect to advance a heuristic framework for assessing deliberation in an international context of the growing importance of MSP in sustainability and global governance.

  5. Assessment of left ventricular function and volumes by myocardial perfusion scintigraphy - comparison of two algorithms

    International Nuclear Information System (INIS)

    Zajic, T.; Fischer, R.; Brink, I.; Moser, E.; Krause, T.; Saurbier, B.

    2001-01-01

    Aim: Left ventricular volume and function can be computed from gated SPECT myocardial perfusion imaging using emory cardiac toolbox (ECT) or gated SPECT quantification (GS-Quant). The aim of this study was to compare both programs with respect to their practical application, stability and precision on heart-models as well as in clinical use. Methods: The volumes of five cardiac models were calculated by ECT and GS-Quant. 48 patients (13 female, 35 male) underwent a one day stress-rest protocol and gated SPECT. From these 96 gated SPECT images, left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) were estimated by ECT and GS-Quant. For 42 patients LVEF was also determined by echocardiography. Results: For the cardiac models the computed volumes showed high correlation with the model-volumes as well as high correlation between ECT and GS-Quant (r ≥0.99). Both programs underestimated the volume by approximately 20-30% independent of the ventricle-size. Calculating LVEF, EDV and ESV, GS-Quant and ECT correlated well to each other and to the LVEF estimated by echocardiography (r ≥0.86). LVEF values determined with ECT were about 10% higher than values determined with GS-Quant or echocardiography. The incorrect surfaces calculated by the automatic algorithm of GS-Quant for three examinations could not be corrected manually. 34 of the ECT studies were optimized by the operator. Conclusion: GS-Quant and ECT are two reliable programs in estimating LVEF. Both seem to underestimate the cardiac volume. In practical application GS-Quant was faster and easier to use. ECT allows the user to define the contour of the ventricle and thus is less susceptible to artifacts. (orig.) [de

  6. EUV mask defect inspection and defect review strategies for EUV pilot line and high volume manufacturing

    Science.gov (United States)

    Chan, Y. David; Rastegar, Abbas; Yun, Henry; Putna, E. Steve; Wurm, Stefan

    2010-04-01

    Reducing mask blank and patterned mask defects is the number one challenge for extreme ultraviolet lithography. If the industry succeeds in reducing mask blank defects at the required rate of 10X every year for the next 2-3 years to meet high volume manufacturing defect requirements, new inspection and review tool capabilities will soon be needed to support this goal. This paper outlines the defect inspection and review tool technical requirements and suggests development plans to achieve pilot line readiness in 2011/12 and high volume manufacturing readiness in 2013. The technical specifications, tooling scenarios, and development plans were produced by a SEMATECH-led technical working group with broad industry participation from material suppliers, tool suppliers, mask houses, integrated device manufacturers, and consortia. The paper summarizes this technical working group's assessment of existing blank and mask inspection/review infrastructure capabilities to support pilot line introduction and outlines infrastructure development requirements and tooling strategies to support high volume manufacturing.

  7. High Cholesterol and Complementary Health Practices: What the Science Says

    Science.gov (United States)

    ... professionals High Cholesterol and Complementary Health Practices: What the Science Says Share: February 2013 Dietary Supplements Red Yeast ... to exploring complementary health products and practices in the context of rigorous ... health researchers, and disseminating authoritative information ...

  8. Training doctors for primary care in China: Transformation of general practice education.

    Science.gov (United States)

    Li, Donald

    2016-01-01

    China is known for developing a cadre of "Barefoot Doctors" to address her rural healthcare needs in past. The tradition of barefoot doctors has inspired similar developments in several other countries across world. Recently China has embarked upon an ambitious new mission to create a primary care workforce consisting of trained general practitioners having international standard skillsets. This editorial provides an insight into the current status of policy deliberations with regards to training of primary care doctors and a new surge in general practice education in China.

  9. Performance of new automated transthoracic three-dimensional echocardiographic software for left ventricular volumes and function assessment in routine clinical practice: Comparison with 3 Tesla cardiac magnetic resonance.

    Science.gov (United States)

    Levy, Franck; Dan Schouver, Elie; Iacuzio, Laura; Civaia, Filippo; Rusek, Stephane; Dommerc, Carinne; Marechaux, Sylvestre; Dor, Vincent; Tribouilloy, Christophe; Dreyfus, Gilles

    2017-11-01

    Three-dimensional (3D) transthoracic echocardiography (TTE) is superior to two-dimensional Simpson's method for assessment of left ventricular (LV) volumes and LV ejection fraction (LVEF). Nevertheless, 3D TTE is not incorporated into everyday practice, as current LV chamber quantification software products are time-consuming. To evaluate the feasibility, accuracy and reproducibility of new fully automated fast 3D TTE software (HeartModel A.I. ; Philips Healthcare, Andover, MA, USA) for quantification of LV volumes and LVEF in routine practice; to compare the 3D LV volumes and LVEF obtained with a cardiac magnetic resonance (CMR) reference; and to optimize automated default border settings with CMR as reference. Sixty-three consecutive patients, who had comprehensive 3D TTE and CMR examinations within 24hours, were eligible for inclusion. Nine patients (14%) were excluded because of insufficient echogenicity in the 3D TTE. Thus, 54 patients (40 men; mean age 63±13 years) were prospectively included into the study. The inter- and intraobserver reproducibilities of 3D TTE were excellent (coefficient of variation<10%) for end-diastolic volume (EDV), end-systolic volume (ESV) and LVEF. Despite a slight underestimation of EDV using 3D TTE compared with CMR (bias=-22±34mL; P<0.0001), a significant correlation was found between the two measurements (r=0.93; P=0.0001). Enlarging default border detection settings leads to frequent volume overestimation in the general population, but improved agreement with CMR in patients with LVEF≤50%. Correlations between 3D TTE and CMR for ESV and LVEF were excellent (r=0.93 and r=0.91, respectively; P<0.0001). 3D TTE using new-generation fully automated software is a feasible, fast, reproducible and accurate imaging modality for LV volumetric quantification in routine practice. Optimization of border detection settings may increase agreement with CMR for EDV assessment in dilated ventricles. Copyright © 2017 Elsevier Masson

  10. Deliberate Integration of Student Leadership Development in Doctor of Pharmacy Programs

    Science.gov (United States)

    Nelson, Michael H.; Bzowyckyj, Andrew S.; Fuentes, David G.; Rosenberg, Ettie; DiCenzo, Robert

    2016-01-01

    The CAPE 2013 Outcomes answered the call for increased student leadership development (SLD) by identifying leadership as a desired curricular goal. To meet this outcome, colleges and schools of pharmacy are advised to first identify a set of SLD competencies aligned with their institution’s mission and goals and then organize these competencies into a SLD framework/model. Student leadership development should be integrated vertically and horizontally within the curriculum in a deliberate and longitudinal manner. It should include all student pharmacists, begin at the point of admission, and extend beyond extracurricular activities. The school’s assessment plan should be aligned with the identified SLD competencies so student learning related to leadership is assessed. To accomplish these recommendations, a positive environment for SLD should be cultivated within the school, including administrative backing and resources, as well as support among the broader faculty for integrating SLD into the curriculum. PMID:26941428

  11. Deliberate Integration of Student Leadership Development in Doctor of Pharmacy Programs.

    Science.gov (United States)

    Janke, Kristin K; Nelson, Michael H; Bzowyckyj, Andrew S; Fuentes, David G; Rosenberg, Ettie; DiCenzo, Robert

    2016-02-25

    The CAPE 2013 Outcomes answered the call for increased student leadership development (SLD) by identifying leadership as a desired curricular goal. To meet this outcome, colleges and schools of pharmacy are advised to first identify a set of SLD competencies aligned with their institution's mission and goals and then organize these competencies into a SLD framework/model. Student leadership development should be integrated vertically and horizontally within the curriculum in a deliberate and longitudinal manner. It should include all student pharmacists, begin at the point of admission, and extend beyond extracurricular activities. The school's assessment plan should be aligned with the identified SLD competencies so student learning related to leadership is assessed. To accomplish these recommendations, a positive environment for SLD should be cultivated within the school, including administrative backing and resources, as well as support among the broader faculty for integrating SLD into the curriculum.

  12. Comparison of heuristics for an economic lot scheduling problem with deliberated coproduction

    Directory of Open Access Journals (Sweden)

    Pilar I. Vidal-Carreras

    2009-12-01

    Full Text Available We built on the Economic Lot Scheduling Problem Scheduling (ELSP literature by making some modifications in order to introduce new constraints which had not been thoroughly studied with a view to simulating specific real situations. Specifically, our aim is to propose and simulate different scheduling policies for a new ELSP variant: Deliberated Coproduction. This problem comprises a product system in an ELSP environment in which we may choose if more than one product can be produced on the machine at a given time. We expressly consider the option of coproducing two products whose demand is not substitutable. In order to draw conclusions, a simulation model and its results were developed in the article by employing modified Bomberger data which include two items that could be produced simultaneously.

  13. Bare-Hand Volume Cracker for Raw Volume Data Analysis

    Directory of Open Access Journals (Sweden)

    Bireswar Laha

    2016-09-01

    Full Text Available Analysis of raw volume data generated from different scanning technologies faces a variety of challenges, related to search, pattern recognition, spatial understanding, quantitative estimation, and shape description. In a previous study, we found that the Volume Cracker (VC 3D interaction (3DI technique mitigated some of these problems, but this result was from a tethered glove-based system with users analyzing simulated data. Here, we redesigned the VC by using untethered bare-hand interaction with real volume datasets, with a broader aim of adoption of this technique in research labs. We developed symmetric and asymmetric interfaces for the Bare-Hand Volume Cracker (BHVC through design iterations with a biomechanics scientist. We evaluated our asymmetric BHVC technique against standard 2D and widely used 3D interaction techniques with experts analyzing scanned beetle datasets. We found that our BHVC design significantly outperformed the other two techniques. This study contributes a practical 3DI design for scientists, documents lessons learned while redesigning for bare-hand trackers, and provides evidence suggesting that 3D interaction could improve volume data analysis for a variety of visual analysis tasks. Our contribution is in the realm of 3D user interfaces tightly integrated with visualization, for improving the effectiveness of visual analysis of volume datasets. Based on our experience, we also provide some insights into hardware-agnostic principles for design of effective interaction techniques.

  14. Proceedings of the 1984 workshop on high-energy excitations in condensed matter. Volume II

    International Nuclear Information System (INIS)

    Silver, R.N.

    1984-12-01

    This volume covers electronic excitations, momentum distributions, high energy photons, and a wrap-up session. Abstracts of individual items from the conference were prepared separately for the data base

  15. Parenting style and conduct problems in children: Case report of deliberate self poisoning in a Nigerian child

    Directory of Open Access Journals (Sweden)

    M F Tunde-Ayinmode

    2011-06-01

    Full Text Available The correlation between psychosocially unhealthy parenting styles and child psychopathology has been established. This case report describes how chronic harsh and overbearing paternal parenting style tipped a young boy into deliberate self poisoning with the aid of organo-phosphorous chemicals (rat poison. This report is purposed to increase the interest of physicians and psychiatrists in parenting style research and in how potentially its modification could be a therapeutic and preventive tool.

  16. Produced water volumes and management practices in the United States.

    Energy Technology Data Exchange (ETDEWEB)

    Clark, C. E.; Veil, J. A. (Environmental Science Division)

    2009-09-01

    Produced water volume generation and management in the United States are not well characterized at a national level. The U.S. Department of Energy (DOE) asked Argonne National Laboratory to compile data on produced water associated with oil and gas production to better understand the production volumes and management of this water. The purpose of this report is to improve understanding of produced water by providing detailed information on the volume of produced water generated in the United States and the ways in which produced water is disposed or reused. As the demand for fresh water resources increases, with no concomitant increase in surface or ground water supplies, alternate water sources, like produced water, may play an important role. Produced water is water from underground formations that is brought to the surface during oil or gas production. Because the water has been in contact with hydrocarbon-bearing formations, it contains some of the chemical characteristics of the formations and the hydrocarbons. It may include water from the reservoir, water previously injected into the formation, and any chemicals added during the production processes. The physical and chemical properties of produced water vary considerably depending on the geographic location of the field, the geologic formation, and the type of hydrocarbon product being produced. Produced water properties and volume also vary throughout the lifetime of a reservoir. Produced water is the largest volume by-product or waste stream associated with oil and gas exploration and production. Previous national produced water volume estimates are in the range of 15 to 20 billion barrels (bbl; 1 bbl = 42 U.S. gallons) generated each year in the United States (API 1988, 2000; Veil et al. 2004). However, the details on generation and management of produced water are not well understood on a national scale. Argonne National Laboratory developed detailed national-level information on the volume of produced

  17. Reassessment of the atomic bomb radiation dosimetry for Hiroshima and Nagasaki. Dosimetry system 2002. DS02. Volume 1

    International Nuclear Information System (INIS)

    Young, Robert W.; Kerr, George D.

    2005-01-01

    The extensive efforts to review the dosimetry of the atomic-bomb survivors and formulate the new dosimetry system DS02 have been greatly welcomed by the Radiation Effects Research Foundation (RERF). This accomplishment is a fine tribute to the importance of the epidemiological studies being conducted at RERF. No other study is so informative of the effects of radiation on human health. The gracious participation in the RERF program by the atomic-bomb survivors allows us to contribute to the well being of these individuals, and the high quality of the data obtained allows the RERF results to feature so prominently in the formulation of international guidelines for radiation protection. Such a great effort to improve and substantiate the dosimetry would not otherwise have been justified. RERF greatly appreciates the independent work of the U.S. and Japanese Working Groups on the atomic-bomb dosimetry and the review by the Joint Senior Review Group of this overall effort. We are assured that unbiased development of the new dosimetry system will reflect well in its application in the RERF epidemiology study. The documentation included in this report will serve as reference for the many deliberations concluded. The title publications are divided into 2 volumes. This is the first volume. The 8 of the reports in each chapter are indexed individually. (J.P.N.)

  18. Reassessment of the atomic bomb radiation dosimetry for Hiroshima and Nagasaki. Dosimetry system 2002. DS02. Volume 2

    International Nuclear Information System (INIS)

    Young, Robert W.; Kerr, George D.

    2005-01-01

    The extensive efforts to review the dosimetry of the atomic-bomb survivors and formulate the new dosimetry system DS02 have been greatly welcomed by the Radiation Effects Research Foundation (RERF). This accomplishment is a fine tribute to the importance of the epidemiological studies being conducted at RERF. No other study is so informative of the effects of radiation on human health. The gracious participation in the RERF program by the atomic-bomb survivors allows us to contribute to the well being of these individuals, and the high quality of the data obtained allows the RERF results to feature so prominently in the formulation of international guidelines for radiation protection. Such a great effort to improve and substantiate the dosimetry would not otherwise have been justified. RERF greatly appreciates the independent work of the U.S. and Japanese Working Groups on the atomic-bomb dosimetry and the review by the Joint Senior Review Group of this overall effort. We are assured that unbiased development of the new dosimetry system will reflect well in its application in the RERF epidemiology study. The documentation included in this report will serve as reference for the many deliberations concluded. The title publications are divided into 2 volumes. This is the second volume. The 29 of the reports in each chapter are indexed individually. (J.P.N.)

  19. Service provision and outcome for deliberate self-poisoning in adults--results from a six centre descriptive study.

    Science.gov (United States)

    Kapur, Navneet; House, Allan; May, Chris; Creed, Francis

    2003-07-01

    The aim of the study was to compare the hospital management and direct costs of self-poisoning in six United Kingdom hospitals and to investigate whether hospital management influences outcome. This was a prospective descriptive study carried out at three teaching hospitals and three district general hospitals in North West England on adults (aged 16 or over) presenting to the study centres with deliberate self-poisoning over a 5-month period. Data were based on demographic and clinical characteristics, management of the current episode, direct costs and repetition of self-poisoning within 12 weeks of index episode. There were 1778 episodes of self-poisoning during the study period. There were marked differences in management between centres. There was a fivefold difference in the rate of admission to a medical bed (16.5%-81.3%), and a twofold difference in the rate of psychosocial assessment (28.5%-57.7%). These differences remained after adjustment for demographic and clinical factors. Hospital costs per episode varied from pound 228 to pound 422 and repetition rate ranged from 10% to 16%. Psychosocial assessment was associated with a twofold reduction in the risk of repetition. The marked variability of services for self-poisoning continue. It seems likely that this is having a detrimental effect on patient outcomes. Large scale intervention studies are required to inform both clinical practice and service provision.

  20. Basketball training increases striatum volume.

    Science.gov (United States)

    Park, In Sung; Lee, Kea Joo; Han, Jong Woo; Lee, Nam Joon; Lee, Won Teak; Park, Kyung Ah; Rhyu, Im Joo

    2011-02-01

    The striatum is associated with the learning and retention of motor skills. Several studies have shown that motor learning induces neuronal changes in the striatum. We investigated whether macroscopic change in striatum volume occurs in a segment of the human population who learned basketball-related motor skills and practiced them throughout their entire athletic life. Three-dimensional magnetic resonance imaging volumetry was performed in basketball players and healthy controls, and striatum volumes were compared based on basketball proficiency, region and side. We identified morphological enlargement in the striatum of basketball players in comparison with controls. Our results suggest that continued practice and repetitive performance of basketball-related motor skills may induce plastic structural changes in the human striatum. Copyright © 2010 Elsevier B.V. All rights reserved.