Full Text Available The development of alternative dispute resolution procedures raises a number of new problems and questions for jurisprudence and legal practice. Many of these are closely related to the implementation of mediation procedures. Significant attention has been paid in the legal literature to the need for mediators’ legal education. Nowadays a professional lawyer usually performs the functions of a mediator. Nevertheless, in some countries the competence of mediators can be limited. In fact, such persons may be prohibited from providing any legal assistance to the parties. A direct prohibition of this kind exists in Russian legislation. To what degree is this prohibition realistic and reasonable? Different countries enjoy different approaches to the possibility of providing disputing parties with a mediator’s legal assistance in addressing issues requiring legal advice or in the drafting of legal documents. Different approaches to this issue have appeared for various reasons. The absence of consensus is caused by a contradiction between the principle of mediator neutrality in the conflict resolution process and the goals of dispute settlement in which a legally competent intermediary is involved. To ensure the effectiveness of the mediation process, legislators should seek out more flexible ways of regulating procedure. Mandatory regulation itself contradicts the spirit of ‘semi-formal’ alternative (extrajudicial methods for conflict resolution. As such, the presence of direct prohibitions or severe restrictions may not only become challenging in the performance of law but such peremptory norms can also make mediation unattractive and ineffective for some particular types of dispute, such as labor disputes. The principle of preserving a mediator’s neutrality is possible if exercised within the framework of a balanced approach to reasonable limits and discretionary rules for the provision of certain types of legal assistance to disputing
Florentino Ruiz Ruiz
Full Text Available The donating of assistance to those people in grave need presents the case for examining the contents of what is known as humanitarian assistance, for determining its field of application, for looking at those to whom it is addressed and at those who are able to offer it. Also, given that this assistance is capable of being offered in very different situations, of putting both peace and international security in danger or of dealing with events which have nothing to do with it, both the General Assembly of the UN as well as the SecurityCouncil have shown how they are related in determined circumstances. The assistance can be offered by governmental institutions or dependents of international organizations such as through Non-Governmental Organizations putting forward new questions aboutthe principle of non-intervention. Furthermore, in those cases in which assistance cannot be offered with the consent of the territorial State, or, in the case of armed conflict, of the contending sides, its very effectiveness necessarily involves the establishment of some system of protection for those who offer assistance, and to try and assure the arrival of help to those to whom it is destined.Conceived and shaped by the Resolutions of the General Assembly with respect to state sovereignty, the offering of humanitarian assistance does not mean that it does not imply limits to the sovereignty of the States and that the need to make it effective does not impose obligations upon them, which as they regard guaranteeing basic human rights such as the right to life or physical well-being can, for their connection with the latter, constitute obligations erga omnes. In any case, it is a developing institution, as well as with regard to its legal consequences, whose real effectiveness must advance by way of identifying rights which are harmed in the case of the offer for assistance being refused or impeded it and the consequences which such interference carries with it.
Palali, Ali; van Ours, Jan
We investigate the determinants of the support for cannabis legalization finding a causal effect of personal experience with cannabis use. Current and past cannabis users are more in favor of legalization. We relate this finding to self-interest and inside information about potential dangers of
Palali, A. (Ali); J.C. van Ours (Jan)
textabstractWe investigate the determinants of the support for cannabis legalization finding a causal effect of personal experience with cannabis use. Current and past cannabis users are more in favor of legalization. We relate this finding to self-interest and inside information about potential
Erwe, H.; Uhlenberg, K.P.; Vietor, G.
'Whenever right turns to wrong, it is our duty to offer resistance'. More and more people have come to realize that it is not enough to go to the polls every four years or to commit oneself to working in one party. Politics, administration and industry do follow principles of their own, taking shelter behind self-made factual obligations. However, those concerned have started to go for their own interests, standing up against threats in great things as well as against changes in little things. How to offer legal assistance, what to note when in action and which consequences 'violations of law and order' may have is described in this law guide in a manner easy to understand, and is demonstrated by means of numerous working examples to all those who have become active members of citizens action groups and associations. (orig.) [de
Palali, Ali; van Ours, Jan C
textabstractWe investigate the determinants of the support for cannabis legalization finding a causal effect of personal experience with cannabis use. Current and past cannabis users are more in favor of legalization. We relate this finding to self-interest and inside information about potential dangers of cannabis. While the self-interest effect is not very surprising, the effect of inside information suggests that cannabis use is not as harmful as cannabis users originally thought it was be...
The successful economy in a country can be measured by the number of commercializing intellectual property rights (IPR). To pursue IPR growth, triple helix component becomes a backbone to weave academia, business and government to collaborate with each other. Generally, collaborations move from their common interest, but within triple helix the collaboration can be run structurally and sustain. Depart from the arguments; the question arises: How is the condition of Indonesia Innovation System? Through legal approach, this paper will explain current legal condition and legal structure of the Indonesian innovation system. The reason to review the law is to relate with the government’s target to create 1000 digital start-ups alike as in Silicon Valley level size. Therefore, legal framework review becomes useful to explain the condition of the law as a supporting system. In this sense, the legal prescription can be generated to confirm Indonesian laws, whether supported the national innovation system or conversely. Within law perspective, Indonesian government categorizes the innovative industry as a creative industry. However, there is still no resolute concept to follow. Therefore, some of law adjustment is needed to support the government’s plan to pursue commercialized innovation.
Palali, A.; van Ours, J.C.
We investigate the determinants of the support for cannabis legalizationfinding a causal effect of personal experience with cannabis use. Current and past cannabis users are more in favor of legalization. We relate this to self-interest and inside information about potential dangers of cannabis use.
Golden, Marilyn; Zoanni, Tyler
This article is an overview of the problems with the legalization of assisted suicide as public policy. The disability community's opposition to assisted suicide stems in part from factors that directly impact the disability community as well as all of society. These factors include the secrecy in which assisted suicide operates today, in states where it is legal; the lack of robust oversight and the absence of investigation of abuse; the reality of who uses it; the dangerous potential of legalization to further erode the quality of the U.S. health care system; and its potential for other significant harms. Legalizing assisted suicide would augment real dangers that negate genuine choice and self-determination. In view of this reality, we explore many of the disability-related effects of assisted suicide, while also addressing the larger social context that inseparably impacts people with disabilities and the broader public. First, after addressing common misunderstandings, we examine fear and bias toward disability, and the deadly interaction of assisted suicide and our profit-driven health care system. Second, we review the practice of assisted suicide in Oregon, the first U.S. state to legalize it, and debunk the merits of the so-called Oregon model. Third and finally, we explore the ways that so-called "narrow" assisted suicide proposals threaten inevitable expansion. Copyright © 2010 Elsevier Inc. All rights reserved.
Leenes, R.E.; Svensson, Jorgen S.
The legal practitioner is a knowledge worker. Two distinct technologies may be of assistance to this type of professional: legal knowledge‐based system technology and Internet World Wide Web technology. In this paper we investigate the relation between legal knowledge‐based systems and the Internet.
Full Text Available In a world in which IT is developing faster than ever, providing reliable solutions to all problems, regardless the field of interest, the issue of computer-assisted translation systems is more and more complex, offering both advantages and disadvantages. The field of translating legal texts from Romanian into English is deprived of a large number of specialists and this is one of the main reasons why more and more people resort to computer-assisted translations, especially Google translations when dealing with translating various texts (from Romanian into English or vice-versa, in this particular case legal texts. Yet, although this field has immensely thrived recently, and is quite reliable for simple and very easy translations, the average English speaker runs huge risks of falling into traps that can lead to errors and misinterpretations. Thus, this article aims to identify the main theoretical approaches to computer-assisted theories and the major risks and threats that occur in this type of translation, focusing particularly on legal texts. There are important differences, not only of words, but also differences in the legal systems themselves, both theoretical and practical ones, which must be correctly dealt with -something which computer-assisted translation cannot do (yet.
Kiser, Jerry D.
With the shift in Americans' beliefs regarding legalizing physician-assisted suicide for the terminally ill, counselors must be prepared to counsel clients who have decided to end their lives. For counselors to avoid violating the ethical guidelines established by the American Counseling Association (ACA) regarding these clients, a reevaluation of…
McGinty, Emma E; Niederdeppe, Jeff; Heley, Kathryn; Barry, Colleen L
In debates about recreational marijuana legalization, pro-legalization arguments highlighting economic and other potential policy benefits compete with anti-legalization arguments emphasizing public health risks. In 2016, we conducted a national survey using an online panel (N=979) designed to answer two main research questions: (1) How do Americans perceive the relative strength of competing arguments about recreational marijuana legalization? (2) How are perceptions of argument strength associated with public support for recreational marijuana legalization? We examined differences in attitudes among individuals living in states that have/have not legalized recreational marijuana and among Democrats/Independents/Republicans. Ordered logit regression assessed the relationship between perceived argument strength and public support for recreational marijuana legalization. Respondents rated pro-legalization arguments highlighting beneficial economic and criminal justice consequences as more persuasive than anti-legalization arguments emphasizing adverse public health effects. Respondents were more likely to agree with arguments highlighting legalization's potential to increase tax revenue (63.9%) and reduce prison overcrowding (62.8%) than arguments emphasizing negative consequences on motor vehicle crashes (51.8%) and youth health (49.6%). The highest rated anti-legalization arguments highlighted the conflict between state and federal marijuana laws (63.0%) and asserted that legalization will fail to eliminate the black market (57.2%). Respondents who endorsed pro-legalization economic and criminal justice arguments were more likely than other respondents to support legalization. Our findings indicate that, on both side of the recreational marijuana legalization debate, there are arguments that resonate with the American public. However, public health risk messages were viewed as less compelling than pro-legalization economic and criminal justice-oriented arguments
Hill, Lauren M; Maman, Suzanne; Holness, David; Moodley, Dhayendre
The rights of women and people living with HIV (PLHIV) are protected under South African law, yet there is a gap in the application of these laws. While there are numerous systemic and social barriers to women's and PLHIV's exercise of their legal rights and rights to access social services, there has been little effort to document these barriers as well as legal needs and knowledge in this context. 1480 HIV-positive and HIV-negative women recruited from an antenatal clinic in Umlazi Township completed a questionnaire on legal knowledge, experience of legal issues, assistance seeking for legal issues, and barriers to seeking assistance. We compared the legal knowledge and experience of legal issues of HIV-positive and HIV-negative women, and described assistance seeking and barriers to assistance seeking among all women. Both HIV-positive and HIV-negative women had high levels of knowledge of their legal rights. There were few important differences in legal knowledge and experience of legal issues by HIV status. The most common legal issues women experienced were difficulty obtaining employment (11 %) and identification documents (7 %). A minority of women who had ever experienced a legal issue had sought assistance for this issue (38 %), and half (50 %) of assistance sought was from informal sources such as family and friends. Women cited lack of time and government bureaucracy as the major barriers to seeking assistance. These results indicate few differences in legal knowledge and needs between HIV-positive and HIV-negative women in this context, but rather legal needs common among women of reproductive age. Legal knowledge may be a less important barrier to seeking assistance for legal issues than time, convenience, and cost. Expanding the power of customary courts to address routine legal issues, encouragement of pro bono legal assistance, and introduction of legal navigators could help to address these barriers.
This article argues in favour of three related claims: First, suicide is not an immoral act. If people autonomously choose to kill themselves, this ought to be respected. Second, we can deem the desire to die comprehensible, and even rational, when the person contemplating suicide does not see a meaning in her life. This assessment is not based on a metaphysically dubious comparison between the actual life of a person and the supposed state of being dead. Third, from the first two theses it does not automatically follow that we should allow other people to help someone who autonomously and rationally chooses to die to pursue this plan. To argue against indirect legal paternalism, the practice of legally preventing someone else to assist a person to perform a suicide or to be killed on request, needs additional reasons. It is argued that assisted suicide and voluntary active euthanasia can indeed be justified by establishing a claim of persons who want to die but are not able to kill themselves. This mainly means that being really free to die should be interpreted as involving the means to fulfil one's desire to die. Copyright © 2013 Elsevier Ltd. All rights reserved.
Watson, Amy C.; Corrigan, Patrick W.; Angell, Beth
The use of legal coercion to compel individuals to participate in mental health treatment is expanding despite a lack of empirical support for many of its forms. Policies supporting mandated treatment are made by legislators and judges, often based on perceptions of public concern. Using data from the MacArthur Mental Health Module contained in…
Snyder Sulmasy, Lois; Mueller, Paul S
Calls to legalize physician-assisted suicide have increased and public interest in the subject has grown in recent years despite ethical prohibitions. Many people have concerns about how they will die and the emphasis by medicine and society on intervention and cure has sometimes come at the expense of good end-of-life care. Some have advocated strongly, on the basis of autonomy, that physician-assisted suicide should be a legal option at the end of life. As a proponent of patient-centered care, the American College of Physicians (ACP) is attentive to all voices, including those who speak of the desire to control when and how life will end. However, the ACP believes that the ethical arguments against legalizing physician-assisted suicide remain the most compelling. On the basis of substantive ethics, clinical practice, policy, and other concerns articulated in this position paper, the ACP does not support legalization of physician-assisted suicide. It is problematic given the nature of the patient-physician relationship, affects trust in the relationship and in the profession, and fundamentally alters the medical profession's role in society. Furthermore, the principles at stake in this debate also underlie medicine's responsibilities regarding other issues and the physician's duties to provide care based on clinical judgment, evidence, and ethics. Society's focus at the end of life should be on efforts to address suffering and the needs of patients and families, including improving access to effective hospice and palliative care. The ACP remains committed to improving care for patients throughout and at the end of life.
Petersen, Kerry; Baker, H W G; Pitts, Marian; Thorpe, Rachel
The professional and legal regulation of assisted reproductive technologies (ART) in Australia is a vast maze of intersecting laws and guidelines which place restrictions on the provision of services such as infertility treatment, surrogacy, sex selection for social reasons, donor insemination, pre-implantation diagnosis and human embryo research. This study investigated the application of these restrictions on clinical practice in New South Wales, a relatively unregulated State, and Victoria, a relatively highly regulated State. The results of the survey indicate that the range of ART services in Victorian clinics was far more limited than in New South Wales clinics. The Victorian clinics uniformly restricted access of single and lesbian women and did not offer social sex selection procedures. The New South Wales clinics adopted different polices regarding these services. It was found that restrictive laws governing "social" issues have a significant impact on the availability of ART services and some respondents seemed unclear about the nature of restrictions and laws relevant to their work. It was also found that "reproductive tourism" is prevalent and restrictions were circumnavigated by patients with assistance from clinics. It was concluded that more evidence is required to evaluate regulation in this field of medicine.
Spriet, Lawrence L; Perry, Christopher G R; Talanian, Jason L
Physical training and proper nutrition are paramount for success in sport. A key tissue is skeletal muscle, as the metabolic pathways that produce energy or ATP allow the muscles to complete the many activities critical to success in sport. The energy-producing pathways must rapidly respond to the need for ATP during sport and produce energy at a faster rate or for a longer duration through training and proper nutrition which should translate into improved performance in sport activities. There is also continual interest in the possibility that nutritional supplements could further improve muscle metabolism and the provision of energy during sport. Most legal sports supplements do not improve performance following oral ingestion. However, three legal supplements that have received significant attention over the years include creatine, carnitine and sodium bicarbonate. The ingestion of large amounts of creatine for 4-6 days increases skeletal muscle creatine and phosphocreatine contents. The majority of the experimental evidence suggests that creatine supplementation can improve short-term exercise performance, especially in sports that require repeated short-term sprints. It may also augment the accretion of skeletal muscle when taken in combination with a resistance-exercise training programme. Supplementary carnitine has been touted to increase the uptake and oxidation of fat in the mitochondria. However, muscle carnitine levels are not augmented following oral carnitine supplementation and the majority of well-controlled studies have reported no effect of carnitine on enhancing fat oxidation, Vo(2max) or prolonged endurance exercise performance. The ingestion of sodium bicarbonate before intense exercise decreases the blood [H+] to potentially assist the efflux of H+ from the muscle and temper the metabolic acidosis associated with intense exercise. Many studies have reported performance increases in laboratory-based cycling tests and simulated running races in
Marco Antonio Scanavini
Full Text Available Objective: To analyze the attributes and legal implications of the Dentists’ Assistants, both from the aspect of the use of their services and their education/training. Methods: Five hundred questionnaires were distributed to Dentists’ assistants in private clinics in the region of Piracicaba, São Paulo, of which 127 (25.4% returns were received, answered by the assistants themselves.Results: All the professionals researched were women, and 55.9% of them had completed high school. The majority of the assistants were trained by the dentist him/herself, sometimes exceeding, and at other times falling short of the demands of their functions. The majority (18.1% were registered with the Regional Council of Dentistry and 74.8% were registered in the Employment Books. No assistants were sued by or received warning from the Regional Council of Dentistry.Conclusion: Wider publication of the Dental Code of Ethics and consolidation of norms for procedures in the Dentistry councils as regards professionals and assistants is important in order to avoid misuse of their services. Stricter monitoring is required to prevent assistants from performing inadequate activities, as well as those outside of their professional education.
Full Text Available Between the right to defence and assistance and the civil rights a close connection has been identified. Sometimes the realisation and protection of these rights, such as the right to life, to personal dignity, to private life etc., in general are impossible without the right to defence and legal assistance. First, the right to legal assistance allows the individual to comprehend the powers conferred to him by this right. Second, the right to legal assistance allows the protection and enforcement of these personal rights. The subjects of both rights are all the persons who have the right to information about the status of their own rights and liberties and the problems impeding their achievement. The importance of informing citizens and states in all spheres, and in particular about the implementation scope of the right to legal assistance consists in the population’s comprehensive legal information.
Sheryl M Strasser
Full Text Available Introduction: The aging population is a rapidly growing demographic in the United States. Isolation, limited autonomy, and declining physical and mental health render many older adults vulnerable to elder mistreatment (EM. The purpose of this study was to assess the prevalence and correlates of EM among a sample of older adults using legal assistance services in Atlanta, Georgia.Methods: Researchers administered surveys to consenting older adults (aged 60þ in 5 metro Atlanta community centers that hosted legal assistance information sessions as part of the Elderly Legal Assistance Program. The surveys screened for risk factors and prevalence of EM risk using valid and reliable measures and included additional questions regarding demographics characteristics and healthcare use behaviors.Results: Surveys were completed by 112 participants. Findings reveal that 32 (28.6% respondents met the criteria for elder abuse / neglect risk; 17 (15.2% respondents met criteria for depression; and 105 (93.7% had visited a healthcare provider during the past 6 months.Conclusion: The rates of EM risk in this sample were higher than those previously reported in research. Findings support continued examination of unique risks that may be present among older adults who may be possibly facing legal issues. Additionally, the reported frequency of healthcare visits among participants reveals a promising opportunity to examine development of a more widespread EM screening approach to be conducted in non-emergency settings. Interdisciplinary collaboration is required to inform screening approaches that account for complexities that EM cases present. [West J Emerg Med. 2013;14(4:309–315.
Full Text Available National laws represent a combination of customary and ethical, but also political and other opinions in a society. Particularly delicate, are the laws regulating the issue of assisted reproduction. In this area, broad social acceptance of legal solutions is an essential prerequisite for their use, while achieving the consent of the majority, especially the consensus is extremely difficult, almost impossible. As much as the laws seek to implement those views that are predominant, the adopted solutions will always remain incapable of granting wishes to a certain number of people. These persons, in an understandable effort to realize their desire for an offspring at any cost, will not hold back from seeking help at any place, even if it meant going to distant destinations and extracting large sums of money. In fact, many patients go to other countries which set less restrictive rules in the field of assisted reproduction, and it appears that in the near future we could not expect a reduction of this trend. This phenomenon, which is in theory called reproductive tourism, has long been a reality that one can see as a problem, while others view it as an irreplaceable solution. This paper seeks to highlight the main causes of this phenomenon, but also to try and give an answer as to, whether reproductive tourism should be prevented (and how or actually its maintenance in force reduces moral conflict in society through a mechanism that recognizes the right of everyone to a considerable extent of free will in decision making regarding the most significant issues which offspring certainly is.
Belenki, Liudmila; Sterzik, Vera; Bohnert, Michael; Zimmermann, Klaus; Liehr, Andreas W
Reflectance spectrometry is a fast and reliable method for the characterization of human skin if the spectra are analyzed with respect to a physical model describing the optical properties of human skin. For a field study performed at the Institute of Legal Medicine and the Freiburg Materials Research Center of the University of Freiburg, a scientific information repository has been developed, which is a variant of an electronic laboratory notebook and assists in the acquisition, management, and high-throughput analysis of reflectance spectra in heterogeneous research environments. At the core of the repository is a database management system hosting the master data. It is filled with primary data via a graphical user interface (GUI) programmed in Java, which also enables the user to browse the database and access the results of data analysis. The latter is carried out via Matlab, Python, and C programs, which retrieve the primary data from the scientific information repository, perform the analysis, and store the results in the database for further usage.
... accordance with good legal practice and the policies and guidance provided by the Judge Advocate General. (6... other matters requiring an educated ability to relate the general body and philosophy of law to a specified legal problem of a client. Guidance in this matter may be had from various official sources...
Nitta, Katsumi; Shibasaki, Masato; Yasumura, Yoshiaki; Hasegawa, Ryuzo; Fujita, Hiroshi; Koshimura, Miyuki; Inoue, Katsumi; Shirai, Yasuyuki; Komatsu, Hiroshi
We present an overview of a legal negotiation support system, ANS (Argumentation based Negotiation support System). ANS consists of a user interface, three inference engines, a database of old cases, and two decision support modules. The ANS users negotiates or disputes with others via a computer network. The negotiation status is managed in the form of the negotiation diagram. The negotiation diagram is an extension of Toulmin’s argument diagram, and it contains all arguments insisted by participants. The negotiation protocols are defined as operations to the negotiation diagram. By exchanging counter arguments each other, the negotiation diagram grows up. Nonmonotonic reasoning using rule priorities are applied to the negotiation diagram.
Hudson, P.; Hudson, R.; Philip, J.; Boughey, M.; Kelly, B.; Hertogh, C.M.P.M.
Objective: Despite the availability of palliative care in many countries, legalization of euthanasia and physician-assisted suicide (EAS) continues to be debated - particularly around ethical and legal issues - and the surrounding controversy shows no signs of abating. Responding to EAS requests is
... 42 Public Health 1 2010-10-01 2010-10-01 false Solicitation of legal business; negotiation of... § 35.14 Solicitation of legal business; negotiation of release or settlement; assistance prohibited. All employees of the Service and all persons attached in any capacity to a station or hospital...
Administration for Children and Families (DHHS), Washington, DC. Div. of State Legalization and Repatriation.
The State Legalization Impact Assistance Grant (SLIAG) Program, administered by the Administration for Children and Families within the Department of Health and Human Services, provides grants to states to help them pay the costs of providing services to certain aliens legalized under the Immigration Reform and Control Act of 1986 (IRCA). An…
... sufficient legal training to preside over criminal proceedings; affording the defendant the right to... 45 CFR Part 1614 Restrictions on Legal Assistance With Respect to Criminal Proceedings in Tribal... represent eligible persons in any and all criminal proceedings in tribal courts. Previously, the LSC Act and...
Medical-legal partnerships: the role of mental health providers and legal authorities in the development of a coordinated approach to supporting mental health clients' legal needs in regional and rural settings.
Speldewinde, Christopher A; Parsons, Ian
Medical-legal partnerships (MLP) are a model in which medical and legal practitioners are co-located and work together to support the health and wellbeing of individuals by identifying and resolving legal issues that impact patients' health and wellbeing. The aim of this article is to analyse the benefits of this model, which has proliferated in the USA, and its applicability in the context of rural and remote Australia. This review was undertaken with three research questions in mind: What is an MLP? Is service provision for individuals with mental health concerns being adequately addressed by current service models particularly in the rural context? Are MLPs a service delivery channel that would benefit individuals experiencing mental health issues? The combined searches from all EBSCO Host databases resulted in 462 citations. This search aggregated academic journals, newspapers, book reviews, magazines and trade publications. After several reviews 38 papers were selected for the final review based on their relevance to this review question: How do MLPs support mental health providers and legal service providers in the development of a coordinated approach to supporting mental health clients' legal needs in regional and rural Australia? There is considerable merit in pursuing the development of MLPs in rural and remote Australia particularly as individuals living in rural and remote areas have far fewer opportunities to access support services than those people living in regional and metropolitan locations. MLPS are important channels of service delivery to assist in early invention of legal problems that can exacerbate mental health problems.
marital or cohabitation domicile. Sexual relations leading to conception. Maintenance of matrimonial domicile within the state. Possible "in rem...satisfied, superseded, materially amended or set aside. The member may raise that there is a legal impediment to the establishment of an involuntary
Strate, John; Kiska, Timothy; Zalman, Marvin
At the November 1998 general election, Michigan citizens were given the opportunity to vote on Proposal B, an initiative that would have legalized physician-assisted suicide (PAS). PAS initiatives also have been held in Washington State, California, Oregon, and Maine, with only Oregon's passing. We use exit poll data to analyze the vote on Proposal B. Attributes associated with social liberalism -- Democratic Party identification, less frequent church attendance, more education, and greater household income -- led to increased odds of a "yes" vote. Attributes associated with social conservatism -- Republican Party identification and frequent church attendance -- led to decreased odds of a "yes" vote. Similar to the abortion issue, PAS's supporters strongly value personal autonomy, whereas its opponents strongly value the sanctity of life. Voter alignments like those in Michigan will likely appear in other states with the initiative process if PAS reaches their ballots.
Chambaere, Kenneth; Bernheim, Jan L
In 2002, physician-assisted dying was legally regulated in the Netherlands and Belgium, followed in 2009 by Luxembourg. An internationally frequently expressed concern is that such legislation could stunt the development of palliative care (PC) and erode its culture. To study this, we describe changes in PC development 2005-2012 in the permissive Benelux countries and compare them with non-permissive countries. Focusing on the seven European countries with the highest development of PC, which include the three euthanasia-permissive and four non-permissive countries, we compared the structural service indicators for 2005 and 2012 from successive editions of the European Atlas of Palliative Care. As an indicator for output delivery of services to patients, we collected the amounts of governmental funding of PC 2002-2011 in Belgium, the only country where we could find these data. The rate of increase in the number of structural PC provisions among the compared countries was the highest in the Netherlands and Luxembourg, while Belgium stayed on a par with the UK, the benchmark country. Belgian government expenditure for PC doubled between 2002 and 2011. Basic PC expanded much more than endowment-restricted specialised PC. The hypothesis that legal regulation of physician-assisted dying slows development of PC is not supported by the Benelux experience. On the contrary, regulation appears to have promoted the expansion of PC. Continued monitoring of both permissive and non-permissive countries, preferably also including indicators of quantity and quality of delivered care, is needed to evaluate longer-term effects. 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.
Full Text Available In three large, nationally representative surveys of U.S. 12th graders, college students, and adults ('N' = 9 million conducted 1968–2015, Americans became significantly more supportive of legal marijuana (cannabis starting in the mid-1980’s. Hierarchical models using age-period-cohort analysis on the adult (General Social Survey sample showed that the increased support for legalization is primarily a time period effect rather than generational or age effect; thus, Americans of all ages became more supportive of legal marijuana. Among 12th graders, support for marijuana legalization was closely linked to perceptions of marijuana safety.
Full Text Available This paper presents the basic legal instruments of mutual assistance in tax matters in the field of direct and indirect taxation in European union, forms of mutual assistance and its importance in fight against international tax evasion and international double taxation. Namely, processes of globalization and liberalization, in terms of taxation in accordance with the principle of worldwide income, have meant that information that is available to a tax administration is not enough to correctly determine tax liability. In such situations states can rely on mutual assistance which may be manifested as exchange of tax information, collaboration by officials and simultaneous controls.
Jones, David Albert; Paton, David
Several US states have legalized or decriminalized physician-assisted suicide (PAS) while others are considering permitting PAS. Although it has been suggested that legalization could lead to a reduction in total suicides and to a delay in those suicides that do occur, to date no research has tested whether these effects can be identified in practice. The aim of this study was to fill this gap by examining the association between the legalization of PAS and state-level suicide rates in the United States between 1990 and 2013. We used regression analysis to test the change in rates of nonassisted suicides and total suicides (including assisted suicides) before and after the legalization of PAS. Controlling for various socioeconomic factors, unobservable state and year effects, and state-specific linear trends, we found that legalizing PAS was associated with a 6.3% (95% confidence interval 2.70%-9.9%) increase in total suicides (including assisted suicides). This effect was larger in the individuals older than 65 years (14.5%, CI 6.4%-22.7%). Introduction of PAS was neither associated with a reduction in nonassisted suicide rates nor with an increase in the mean age of nonassisted suicide. Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in nonassisted suicides. This suggests either that PAS does not inhibit (nor acts as an alternative to) nonassisted suicide, or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals.
Faundes; Anibal; Shah; Iqbal H.
Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal con...
Gulzhazira A. Ilyasova
Full Text Available The article features the analysis of Kazakhstan’ National Legislation, international conventions (agreements in the area of Ecological Sustainability ratified by the Republic of Kazakhstan. The agreements have been endorsed by Resolutions of Inter-Parliament Assembly of States Members of the Commonwealth of Independent States. Recommended legal act dated November 2, 1996, “Law on Ecological Safety” dated November 15, 2003. The analysis of Kazakhstan’s legislation demonstrates partially effective laws on ecological safety. In this regard, there is a need to systemize the current legislature and adopt legal instrument regulating sustainability of ecological safety in the Republic of Kazakhstan.
McQuoid-Mason, David J
In the recent case of Stransham-Ford v. the Minister of Justice and Correctional Services, the North Gauteng High Court held that a terminally ill patient who was experiencing intractable suffering was entitled to commit suicide with the assistance of his doctor and that the doctor's conduct would not be unlawful. The court was careful to state that it was not making a general rule about doctor-assisted suicide. The latter should be left to the Parliament, the Constitutional Court and 'future courts'. The judge dealt specifically with the facts of the case at hand. In order to understand the basis of the decision it is necessary to consider: (i) the facts of the case; (ii) the question of causation; (iii) the paradox of 'passive' and 'active' euthanasia; (iv) the test for unlawfulness in euthanasia cases; and (v) the meaning of doctor-assisted suicide. It is also necessary to clarify the present legal position regarding doctor-assisted suicide.
Dunlavy, Daniel M.; Bauer, Travis L.; Verzi, Stephen J.; Basilico, Justin Derrick; Shaneyfelt, Wendy
This report describes the Licensing Support Network (LSN) Assistant--a set of tools for categorizing e-mail messages and documents, and investigating and correcting existing archives of categorized e-mail messages and documents. The two main tools in the LSN Assistant are the LSN Archive Assistant (LSNAA) tool for recategorizing manually labeled e-mail messages and documents and the LSN Realtime Assistant (LSNRA) tool for categorizing new e-mail messages and documents. This report focuses on the LSNAA tool. There are two main components of the LSNAA tool. The first is the Sandia Categorization Framework, which is responsible for providing categorizations for documents in an archive and storing them in an appropriate Categorization Database. The second is the actual user interface, which primarily interacts with the Categorization Database, providing a way for finding and correcting categorizations errors in the database. A procedure for applying the LSNAA tool and an example use case of the LSNAA tool applied to a set of e-mail messages are provided. Performance results of the categorization model designed for this example use case are presented.
Van der Roest, Henriëtte G; Wenborn, Jennifer; Pastink, Channah; Dröes, Rose-Marie; Orrell, Martin
The sustained interest in electronic assistive technology in dementia care has been fuelled by the urgent need to develop useful approaches to help support people with dementia at home. Also the low costs and wide availability of electronic devices make it more feasible to use electronic devices for the benefit of disabled persons. Information Communication Technology (ICT) devices designed to support people with dementia are usually referred to as Assistive Technology (AT) or Electronic Assistive Technology (EAT). By using AT in this review we refer to electronic assistive devices. A range of AT devices has been developed to support people with dementia and their carers to manage their daily activities and to enhance safety, for example electronic pill boxes, picture phones, or mobile tracking devices. Many are commercially available. However, the usefulness and user-friendliness of these devices are often poorly evaluated. Although reviews of (electronic) memory aids do exist, a systematic review of studies focusing on the efficacy of AT for memory support in people with dementia is lacking. Such a review would guide people with dementia and their informal and professional carers in selecting appropriate AT devices. Primary objectiveTo assess the efficacy of AT for memory support in people with dementia in terms of daily performance of personal and instrumental activities of daily living (ADL), level of dependency, and admission to long-term care. Secondary objectiveTo assess the impact of AT on: users (autonomy, usefulness and user-friendliness, adoption of AT); cognitive function and neuropsychiatric symptoms; need for informal and formal care; perceived quality of life; informal carer burden, self-esteem and feelings of competence; formal carer work satisfaction, workload and feelings of competence; and adverse events. We searched ALOIS, the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), on 10 November 2016. ALOIS is
Cohn, Amy M; Johnson, Amanda L; Rose, Shyanika W; Rath, Jessica M; Villanti, Andrea C
As of 2015, more than half of U.S. states have legalized, medicalized, or decriminalized marijuana. This study examined the prevalence and correlates of support for marijuana legalization in a national sample of young adults and the intention to use marijuana more frequently if it were legalized. Data were from Wave 7 (weighted N = 3532) of the Truth Initiative Young Adult Cohort, a national sample of men and women aged 18-34. We assessed demographics, past 30-day substance (alcohol, tobacco, marijuana, other drug use), depression and anxiety, social smoking, marijuana harm perceptions (relative to cigarettes), and state-level marijuana policies as correlates of support for marijuana legalization and intentions to use marijuana more often if it were legalized. Multivariable models of correlates of support for legalization and intentions to use marijuana were conducted separately for the full sample and for nonmarijuana users. Weighted estimates showed that 39% of the full sample and 9% of nonmarijuana users supported marijuana legalization. Multivariable models showed that lower marijuana harm perceptions and lifetime and past 30-day tobacco use were common predictors of support for marijuana legalization and intentions to use marijuana among non-users of marijuana. Conclusions/Importance: Over a third of the sample supported marijuana legalization. Tobacco use and perceptions that marijuana is less harmful than cigarettes were robust risk correlates of support for marijuana legalization and intentions to use more frequently among nonusers. Public health campaigns should target these factors to deter marijuana-related harm in susceptible young adults.
Faúndes, Anibal; Shah, Iqbal H
Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal condition for abortion is met. The present article aims to contribute to a better understanding that one can be in favor of greater access to safe abortion services, while at the same time not be "in favor of abortion," by reviewing the evidence that indicates that criminalization of abortion only increases mortality and morbidity without decreasing the incidence of induced abortion, and that decriminalization rapidly reduces abortion-related mortality and does not increase abortion rates. Copyright © 2015. Published by Elsevier Ireland Ltd.
Full Text Available This contribution focuses on the modalities of mutual legal assistance and extradition from a South African perspective. The question is posed whether South Africa has succeeded to establish the required framework as a fully fledged member of the international community to make a positive contribution in the fields of mutual legal assistance and extradition subsequent to its international political isolation during the apartheid era. Although the international community derives substantial benefit from a borderless global world, it has as a result also to deal with the negative impact of globalization on international crime. Physical and/or electronic crimes are increasingly committed across borders and may be described as borderless, but law enforcement (combating, investigation and prosecution of crime is still very much confined to the borders of a state. Criminal networks have taken advantage of the opportunities resulting from the dramatic changes in world politics, business, technology, communications and the explosion in international travel and effectively utilize these opportunities to avoid and hamper law enforcement investigations. As a sovereign state has control over its own territory it also implies that states should not interfere with each other’s domestic affairs. The correct and acceptable procedure would be for a state (requesting state to apply to another state (requested state for co-operation in the form of mutual legal assistance regarding the gathering of evidence and/or extradition of the perpetrator. Co-operation between states are governed by public international law between the requesting and requested state and the domestic law of the requested state. The South African legislature has increasingly provided for extraterritorial jurisdiction of South African courts in respect of organized crime and terrorism. It does however appear that existing criminal justice responses are experiencing challenges to meet the
Burkhardt, S; La Harpe, R; Harding, T W; Sobel, J
The purpose of this paper is to present the legal aspects associated with assisted suicide in Switzerland and compare them with those in other countries. Like euthanasia, assisted suicide is a subject that induces much discussion in many countries. While the law is very liberal in some countries, such as Belgium and the Netherlands (where both euthanasia and assisted suicide take place), these practices are very controversial in other countries, such as France, where they remain taboo subjects. In the United States of America, the laws concerning assisted suicide can differ greatly from one state to another. For example, in Oregon, assisted suicide is allowed if applied by a medical doctor; in others, this act is illegal. In Canada, it is punishable according to the Criminal Code. In Switzerland euthanasia is punishable by law. However, the penal code does not condemn assisted suicide, whether carried out by a medical doctor or another person, provided it is not carried out through selfish motives. The application of these practices has become simplified in recent years and societies for the right to die with dignity based on this principle have come into being (Exit and Dignitas). In the French- and German-speaking parts of Switzerland the association Exit assists individuals living in Switzerland with serious progressive and incurable disease in their engagement to end their life. The association Dignitas, in the German-speaking part of Switzerland, also undertakes--in the same circumstances--to assist individuals coming from foreign countries. Dignitas welcomes several such individuals every year, especially from Germany, where a similar approach does not currently exist.
Subbaraman, Meenakshi Sabina; Kerr, William C
Support for the legalization of recreational marijuana continues to increase across the United States and globally. In 2016, recreational marijuana was legalized in the most populous US state of California, as well as three other states. The primary aim of this study was to examine trends in support for recreational marijuana legalization in Washington, a state which has had legal recreational marijuana for almost four years, using data collected over the four years post-legalization. A secondary aim was to examine trends in support for the cultivation of marijuana for personal use. Data come from geographically representative general population samples of adult (aged 18 and over) Washington residents collected over five timepoints (every six months) between January 2014 and April 2016 (N=4101). Random Digit Dial was used for recruitment. Statistical analyses involved bivariate comparisons of proportions across timepoints and subgroups (defined by age, gender, and marijuana user status), and multivariable logistic regression controlling for timepoint (time) to formally test for trend while controlling for demographic and substance use covariates. All analyses adjusted for probability of selection. Support for legalization in Washington has significantly increased: support was 64.0% (95% CI: 61.2%-67.8%) at timepoint 1 and 77.9% (95% CI: 73.2%-81.9%) at timepoint 5. With each six months' passing, support increased 19% on average. We found no statistically significant change in support for home-growing. Support for marijuana legalization has continued to significantly increase in a state that has experienced the policy change for almost four years. Copyright © 2017. Published by Elsevier B.V.
Full Text Available The study of the legal and penal mechanism by which European Union Member States jointly act for preventing and combating certain categories of crimes, includes the analysis of conventions regarding legal assistance that Member States undertake to grant each other the catching and prosecution of people who commit crimes on their territory, either violating the domestic criminal law or the international criminal law represented by international conventions that require signatory states to incriminate or punish certain categories of crimes, against which they pledged to fight together. Conventions adopted at European Union level concerning international legal assistance in criminal matters, give legal expression to the most complex and most effective form of cooperation between States in the fight against crime, establishing brand new ways of international legal assistance in criminal matters.The importance of the Conventions regarding legal assistance in criminal matters result from the fact that they ensure the correct application of European criminal law relating to combating the worst types of crimes, making possible criminal liability and conviction of various crimes, with the help of other member states of the European conventions.
Vina, Stephen R
.... Reported escalations in criminal activity and illegal immigration, however, have prompted some law makers to reevaluate the extent and type of military support that occurs in the Mexico-United States border region...
Laux, Johannes; Röbel, Andreas; Parzeller, Markus
Under German criminal law, euthanasia assisted by the attending physician involves the risk of criminal prosecution. However, in the absence of clear legal provisions, the law concerning euthanasia has been primarily developed by court rulings and jurisprudential literature in the last 30 years. According to a traditional classification there are four categories of euthanasia: help in the dying process, direct active euthanasia, indirect active euthanasia and passive euthanasia. However, there is still no generally accepted definition for the general term "euthanasia". The development of the law on the permissibility of euthanasia was strongly influenced by the conflict between the right of self-determination of every human being guaranteed by the Constitution and the constitutional mandate of the state to protect and maintain human life. The decisions of the German Federal Court of Justice on euthanasia in the criminal trials "Wittig" (1984), "Kempten" (1994) and "Putz" (2010) as well as the ruling of the 12th Division for Civil Matters of the Federal Court of Justice (2003) are of special importance. Some of these decisions were significantly influenced by the discussions in the jurisprudential literature. However, the German Bundestag became active for the first time as late as in 2009 when it adopted the 3rd Guardianship Amendment Act, which also contains provisions on the legal validity of a living will independent of the nature and stage of an illness. In spite of the new law, an analysis of the "Putz" case makes it especially clear that the criminal aspects of legal issues at the end of a person's life still remain controversial. It is to be expected that this issue will remain the subject of intensive discussion also in the next few years.
There is unanimity among states to protect the continuation of life of the individual as a safeguard against their collective extinction. The right to life is accordingly guaranteed but its antithesis, the right to die is the subject of an unending debate. The controversy over the right to die is deepened by rapid advances in medicine, creating the capability for prolongation of life beyond the span which one's natural strength can endure. Ghana's supreme law explicitly guarantees the right to life but remains ambiguous on right to die, particularly euthanasia and assisted dying. Thus, some of the other rights, such as the right to dignity and not to be tortured, can creatively be exploited to justify some instances of euthanasia. Ghana's criminal code largely proscribes euthanasia. Notwithstanding, proscription of euthanasia and assisted dying by the law, in Ghana's empirical work undertaken in some of the communities in Ghana, suggests that euthanasia is quietly practisedin health facilities and private homes, especially in the rural areas. Contrary to the popular reasons assigned in the literature of the Western world, with respect to the practice or quest for legalization of euthanasia as being a necessity for providing relief from pain or hopeless quality of life, empirical data from social and anthropological studies conducted in Ghana reveal that poverty is the motivation for informal euthanasia practice in Ghana rather than genuine desire on part of patients to die or their relatives to see to their accelerated death. Apart from poverty, traditional cultural values of African societies consider non-natural death as a taboo and ignominy to the victim and his family. Thus, any move by the government to legalize euthanasia will need to be informed by widely held consultations and a possible referendum; otherwise the law may be just a mere transplant of Western models of legislation on euthanasia without reflecting the ethos of the African people.
van der Linden, Michelle; Buckingham, Karen; Farquhar, Cindy; Kremer, Jan Am; Metwally, Mostafa
Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin (hCG), which is produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques (ART) the progesterone or hCG levels, or both, are low and the natural process is insufficient, so the luteal phase is supported with either progesterone, hCG or gonadotropin releasing hormone (GnRH) agonists. Luteal phase support improves implantation rate and thus pregnancy rates but the ideal method is still unclear. This is an update of a Cochrane Review published in 2004 (Daya 2004). To determine the relative effectiveness and safety of methods of luteal phase support in subfertile women undergoing assisted reproductive technology. We searched the Cochrane Menstrual Disorders and Subfertility Group (MDSG) Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL, Database of Abstracts of Reviews of Effects (DARE), LILACS, conference abstracts on the ISI Web of Knowledge, OpenSigle for grey literature from Europe, and ongoing clinical trials registered online. The final search was in February 2011. Randomised controlled trials of luteal phase support in ART investigating progesterone, hCG or GnRH agonist supplementation in in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) cycles. Quasi-randomised trials and trials using frozen transfers or donor oocyte cycles were excluded. We extracted data per women and three review authors independently assessed risk of bias. We contacted the original authors when data were missing or the risk of bias was unclear. We entered all data in six different comparisons. We calculated the Peto odds ratio (Peto OR) for each comparison. Sixty-nine studies with a total of 16,327 women were included. We assessed most of the studies as having an unclear risk of bias, which we interpreted as a high risk
Full Text Available The right to equal recognition before the law, protected by Article 12 of the United Nations (UN Convention on the Rights of Persons with Disabilities (CRPD, mandates the use of supported decision-making practices to enable disabled people, particularly those with intellectual and/or psychosocial disabilities, to enjoy their legal capacity. Finding ways to translate this theoretical mandate into practice poses a number of particularly challenging socio-legal issues, which this research seeks to address. The English Mental Capacity Act 2005 (MCA sets out a right to support with decision-making (s.1(3, underpinned by a presumption of capacity (s.1(2. Qualitative interviews with intellectually disabled people, their supporters, and care and support professionals were undertaken to explore how disabled people make decisions in their everyday lives, the kinds of support they need, and the strategies for supported decision-making used in practice. Analysis of these interviews suggests that a range of supported decision-making techniques have been developed in practice and are effective in supporting everyday preferences and some life choices. Paradoxically, it appears that as decisions become more complex, the support available to disabled people reduces. Specifically, much less support is available for more difficult decisions around finances, healthcare and legal matters. We argue that the reasons for this are due to a web of regulatory, social and policy issues. We conclude that implementing the right to enjoy legal capacity through supported decision-making will require a combination of regulatory reform, social change and policy amendment.
The Legal Counsel works with, and provides legal and strategic advice to, staff throughout the Centre, at all levels. The Legal Counsel assists the Corporate Secretary and General Counsel in advising, and providing support to, Centre management and the Board of Governors on corporate governance matters.
... OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COVERAGE AND CONDITIONS OF ELIGIBILITY IN FINANCIAL ASSISTANCE PROGRAMS... charges are based on rates regulated by a State or Federal governmental body. Support and maintenance...
Linden, M. van der; Buckingham, K.; Farquhar, C.; Kremer, J.A.M.; Metwally, M.
BACKGROUND: Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin(hCG) produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques(ART), progesterone and/or hCG
Linden, M. Van der; Buckingham, K.; Farquhar, C.; Kremer, J.A.M.; Metwally, M.
BACKGROUND: Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin (hCG), which is produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques (ART) the progesterone
Models of support for students with disability and learning difficulties in mainstream classes in Australia rely extensively on teacher assistants (TAs). Current models, however, inadvertently perpetuate low expectations because providing TA support can be one of the most restrictive supports offered in a school [Giangreco, M. F. 2010a.…
Harper, Joyce; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo J; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan
How has the interface between genetics and assisted reproduction technology (ART) evolved since 2005? The interface between ART and genetics has become more entwined as we increase our understanding about the genetics of infertility and we are able to perform more comprehensive genetic testing. In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and ART and published an extended background paper, recommendations and two Editorials. An interdisciplinary workshop was held, involving representatives of both professional societies and experts from the European Union Eurogentest2 Coordination Action Project. In March 2012, a group of experts from the European Society of Human Genetics, the European Society of Human Reproduction and Embryology and the EuroGentest2 Coordination Action Project met to discuss developments at the interface between clinical genetics and ART. As more genetic causes of reproductive failure are now recognized and an increasing number of patients undergo testing of their genome prior to conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and PGD may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from RCTs to substantiate that the technique is both effective and efficient. Whole genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving, but still remains very
Yang, X; Griffiths, I M
This paper has compared the legal frameworks supporting water management in Europe and China, with special focus on integrated river basin management (IRBM) to identify synergies and opportunities in policymaking and implementation. The research shows that China has committed to the efficient management of water resources through various policy tools during the current period. This commitment, however, has often been interrupted and distorted by politics, resulting in the neglect of socioeconomic and environmental priorities. The European legal framework supporting water management underwent a complex and lengthy development, but with the adoption of the Water Framework Directive provides a policy model on which to develop an integrated and sustainable approach to river basin management, elements of which may help to meet the demands of the emerging 21st century Chinese society on these critical natural resources.
Rojas, Sebastian V; Hanke, Jasmin S; Haverich, Axel; Schmitto, Jan D
Ventricular assist device (VAD) therapy is currently one of the fastest-developing fields in cardiac surgery. Consistently improved technology, research, and gain of clinical experience have established VADs as an important option for the treatment of congestive heart failure. During the past year, novel devices and less invasive surgical procedures have been revolutionizing this field. The purpose of this manuscript is to review these innovations with special emphasis on device-related surgery. Device miniaturization has enabled less invasive VAD surgery, excluding the need for full sternotomy. Recent data show that intrahospital survival rates following less invasive VAD implantation are surpassing 90%. Secondly, two new devices, Heartmate 3 and MVAD, are being applied and tested for clinical application. In this context, the Heartmate 3 CE mark study recently concluded with excellent outcomes and without any pump thrombosis or device malfunctions. The first clinical results of the newest generation of VADs are very promising compared with old-generation devices. Furthermore, less invasive surgery is becoming a standard for the implantation, exchange, or explantation of left VADs. The joint venture of improved technology and innovative surgical techniques will push this field forward to even better outcomes and reduced complication rates.
Grosse, Claudia; Grosse, Alexandra
This paper presents three different models of the legal regulation of assisted suicide in European countries. First, the current legal regime governing assisted suicide in the Netherlands is described where both euthanasia and assisted suicide have been legalised. This section also includes some empirical data on euthanasia and assisted-suicide practices in the Netherlands, as well as a comparison with the current legal legislation in Belgium and Luxembourg. Next, Switzerland is presented as a country where euthanasia is punishable by law but assisted suicide is legally allowed, provided it is not carried out with selfish motives. This section also focuses on the assisted-suicide-related case law of the Swiss Federal Supreme Court and the European Court of Human Rights. Last, the current legal situation regarding assisted suicide in Austria and Germany is described. While the Austrian Penal Code explicitly prohibits assisted suicide, assistance with suicide is not specifically regulated by the German Penal Code. However, medical doctors are not allowed to assist suicides according to the professional codes of conduct drawn up by the German medical associations under the supervision of the health authorities. © The Author(s) 2014.
Howie, Laura Odell; Troutman-Jordan, Meredith; Newman, Ann M.
Successful aging has been associated with adequate social support. However, impaired functionality, increased dependence, multiple comorbidities, and reduced social interactions place older assisted living community (ALC) residents at risk for poorer social support and less successful aging. This cross-sectional descriptive study used the revised…
EKSISTENSI BANTUAN HUKUM TERHADAP PRAJURIT TNI SEBAGAI PELAKU TINDAK PIDANA DAN PRAKTIKNYA / The Existence And Practice Of Legal Assistance To Indonesian National Armed Forces Personnel As Criminal Offender
Tumbur Palti D Hutapea
Full Text Available Bantuan Hukum merupakan bantuan yang diberikan oleh seorang ahli di bidang hukum atau penasihat hukum kepada seorang yang terkena masalah hukum di setiap tahapan pemeriksaan baik di luar maupun di dalam pengadilan. Peranan bantuan hukum bagi Prajurit TNI sangat diperlukan dalam menghadapi permasalahan hukum yang dihadapinya. Peraturan perundang-undangan yang mengatur bantuan hukum di lingkungan TNI sepanjang sejarah berdirinya TNI telah mengutamakan bantuan hukum yang berasal dari internal TNI berdasarkan perintah di mana personilnya belum memiliki akreditasi/sertifikasi, sehingga kalangan eksternal sulit memasuki lingkungan hukum militer sebab harus memperoleh izin Perwira Penyerah Perkara (Papera. Perlunya prioritas percepatan RUU tentang Peradilan Militer yang salah satunya merevisi aturan pemberian bantuan hukum kepada Prajurit TNI. Selanjutnya diperlukan kebebasan memilih dan menetapkan layanan bantuan hukum dari advokat profesional atau dengan menggunakan sarana posbakum, khususnya perkara yang diancam pidana mati dan pidana tambahan berupa pemecatan dari dinas militer. Legal assistance is an assistance given by an expertise in law area or legal advisors to those who have legal problems at every stage of investigation both outside and inside the court. The role of legal assistance for Indonesian National Armed Forces personnel is important. The Legislation covering legal assistance in the Indonesian National Armed Forces community throughout the history has prioritized internal legal assistance where the personnel itself does not have certification/ accreditation for it. The external is hard to get involve and have to obtain special permission from the Officers hand the case (Papera. Accelerating the Bill on Military Justice to revise the rules on providing legal assistance to Army personnel is priority. Furthermore, the necessary freedom to choose and establish legal assistance services of a professional advocate or by means POSBAKUM
This study examined predictors of staff-supportive organizational culture in assisted living settings. The sample included 294 staff members in 52 facilities. Organizational culture was assessed according to staff perceptions of teamwork, morale, information flow, involvement, supervision, and meetings. Hierarchical linear modeling was used to examine the effects of organizational factors (i.e., facility size, chain membership, ownership, level of care, level of residents' disability) on staff-supportive organizational culture. More staff-supportive culture was associated with smaller facility size, chain membership, and a higher level of care. These findings point to the importance of organizational factors in shaping a staff-supportive organizational culture.
The study investigated the effect of peer tutoring-assisted instruction, parent supportiveness and students locus of control on achievement in Senior Secondary Mathematics. It adopted a non-randomized pretest posttest control group design in a quasi experimental setting. It involves 300 senior secondary II students from six ...
Bosshard, G; Broeckaert, B; Clark, D; Materstvedt, L J; Gordijn, B; Müller-Busch, H C
To analyse legislation and medical professional positions concerning the doctor's role in assisted dying in western Europe, and to discuss their implications for doctors. This paper is based on country-specific reports by experts from European countries where assisted dying is legalised (Belgium, The Netherlands), or openly practiced (Switzerland), or where it is illegal (Germany, Norway, UK). Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide (but not euthanasia) is not illegal in either Germany or Switzerland, but a doctor's participation in Germany would violate the code of professional medical conduct and might contravene of a doctor's legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not. Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This "neutral" stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a "medical end-of-life decision" since the 1970s. A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions.
... within Indian country. Public Law 113-4, Sec. 904(c), 127 Stat. 122. ``Indian country'' is a term of art... in an Indian tribal court is not a `criminal proceeding.' '' 41 FR 38506, Sept. 10, 1976. Neither the... principal defense asserted involves rights arising from a treaty with Indians. A number of legal services...
Assisted suicide has been an issue for terminally ill patients for many years. This is because patients who suffer from terminal illnesses are forced to make difficult choices at the end of their lives...
Karimov, Jamshid H; Sunagawa, Gengo; Horvath, David; Fukamachi, Kiyotaka; Starling, Randall C; Moazami, Nader
Failure of the right ventricle represents a significant clinical problem and may have different causes, with rates varying between 5% and 50% in patients supported by a left ventricular assist device (LVAD). However, treatment options and device development for right ventricular failure (RVF) have significantly lagged behind those for LVADs. Newer technologies designed or adapted for RV support are needed to provide adequate long-term circulatory support. In this review, we discuss (1) the significance of RVF and its physiologic implications, (2) device constraints affecting treatment options for RVF, and (3) implantable VADs potentially available for RV support. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Full Text Available The main objective of this paper is to explore the potentials of assistive technologies to support seniors’ independent living. The work looks at two salient aspects of utilizing technologies for elderly, namely direct support and empowering technologies. The research undertakes a comprehensive analysis of attempts that have been made through investigation of the literature. For this purpose, a realist review of relevant papers published since 2000 has been conducted. The paper concludes that although much research in this area targets the direct support for older adults, the effective use of technologies to maintain seniors’ physical and cognitive abilities requires further investigations. This can provide avenues of opportunities that would empower seniors for their independent living.
Pesut, Barbara; McLean, Tammy; Reimer-Kirkham, Sheryl; Hartrick-Doane, Gweneth; Hutchings, Deanna; Russell, Lara B
Collaborative education that prepares nursing and healthcare assistant students in supportive care for older adults living at home with advanced chronic illness is an important innovation to prepare the nursing workforce to meet the needs of this growing population. To explore whether a collaborative educational intervention could develop registered nursing and healthcare assistant students' capabilities in supportive care while enhancing care of clients with advanced chronic illness in the community. Mixed method study design. A rural college in Canada. Twenty-one registered nursing and 21 healthcare assistant students completed the collaborative workshop. Eight registered nursing students and 13 healthcare assistant students completed an innovative clinical experience with fifteen clients living with advanced chronic illness. Pre and post-test measures of self-perceived competence and knowledge in supportive care were collected at three time points. Semi-structured interviews were conducted to evaluate the innovative clinical placement. Application of Friedman's test indicated statistically significant changes on all self-perceived competence scores for RN and HCA students with two exceptions: the ethical and legal as well as personal and professional issues domains for HCA students. Application of Friedman's test to self-perceived knowledge scores showed statistically significant changes in all but one domain (interprofessional collaboration and communication) for RN students and all but three domains for HCA students (spiritual needs, ethical and legal issues, and inter-professional collaboration and communication). Not all gains were sustained until T-3. The innovative community placement was evaluated positively by clients and students. Collaborative education for nursing and healthcare assistant students can enhance self-perceived knowledge and competence in supportive care of adults with advanced chronic illness. An innovative clinical experience can
Laux, Johannes; Röbel, Andreas; Parzeller, Markus
In Germany, physician-assisted euthanasia involves numerous risks for the attending physician under criminal and professional law. In the absence of clear legal provisions, four different categories of euthanasia have been developed in legal practice and the relevant literature: help in the dying process, direct active euthanasia, indirect active euthanasia and passive euthanasia. The so-called "help during the dying process" by administering medically indicated analgesic drugs without a life-shortening effect is exempt from punishment if it corresponds to the will of the patient. If the physician omits to give such analgesic drugs although the patient demands them, this is deemed a punishable act of bodily injury. The same applies if the physician administers analgesics against the will of the patient. Medically indicated pain treatment which has a potential or certain life-shortening effect (indirect active euthanasia) is permitted under certain conditions: if there are no alternative and equally suitable treatment options without the risk of shortening the patient's life, if the patient has given his consent to the treatment and if the physician does not act with the intention to kill. The deliberate killing of a dying or terminally ill patient for the purpose of ending his suffering (direct active euthanasia) is prohibited. This includes both deliberately killing a patient against or without his will (by so-called "angels of death") and the killing of a patient who expressly and earnestly demands such an act from his physician (killing on request/on demand). Physician-assisted suicide is generally not liable to punishment in Germany. Nevertheless, the action may be subject to punishment if the physician omits to rescue the life of an unconscious suicide victim. "Palliative sedation" is regarded as a special case. It may become necessary if certain symptoms in the terminal stage of a fatal disease unbearable for the patient cannot be controlled by any other
Full Text Available regimes for multi-use MSP—in this instance the South African legal framework. Although multi-use MSP has not been explicitly adopted as a process within South Africa's broader ICM implementation, existing legislation does reveal support. The department...
Churruca Muguruza, C.; Isa, F. G.; San José, D. G.; Fernández Sánchez, P. A.; Márquez Carrasco, C.; Muñoz Nogal, E.; Nagore Casas, M.; Timmer, Alexandra|info:eu-repo/dai/nl/351098852
This report is devoted to the mapping of legal and policy instruments of the EU for human rights and democracy support. In particular, it highlights the EU´s human rights priorities in terms of themes and vulnerable groups in its external action based on a review of EU policy documents and
Allaire, P.E.; Maslen, E.H. [Univ. of Virginia, Charlottesville, VA (United States); Kim, H.C.; Olsen, D.B.; Bearnson, G.D. [Univ. of Utah, Salt Lake City, UT (United States)
Mechanical artificial hearts are now expected to be used as assist or total replacements for failing human hearts, if a reliable, anatomically appropriate design is developed. Initially, ventricular assist or total replacement devices were pulsatile air driven units containing a flexing polymeric diaphragm and two valves for each ventricle. Many reliability problems were encountered. Recently, attention has been focused on axial or centrifugal continuous flow blood pumps. Magnetic bearings employed in such devices offer the advantages of no required lubrication and large operating clearances. This paper describes a prototype continuous flow pump supported in magnetic bearings. The pump performance was measured in a simulated adult human circulation system. It delivered 6 liters/min of flow at 100 mm Hg differential head operating at 2,400 rpm in water. The pump is totally magnetically supported in four magnetic bearings - two radial and two thrust. The geometry and other properties of the bearings are described. Bearing parameters such as load capacity, current gains, and open loop stiffness are discussed. Bearing coil currents were measured during operation in air and water. The rotor was operated in various orientations to determine the actuator current gains. These values were then used to estimate the radial and thrust forces acting on the rotor in both air and water.
The earthquake that struck the central coast of Peru on 15 August 2007 was a disaster that mobilized international humanitarian assistance to address the needs of the affected people in the regions of Huancavelica, Ica, and Lima. It also was an opportunity to prove the effectiveness of regulations and procedures to facilitate the entry and distribution of donations and medical goods during a major emergency. In the first month after the earthquake, the national government approved new regulations that aimed to reduce waiting time while reducing the number of requisites required by customs. More than 5,500 tons of international donations arrived in Peru in a short period of time. Many donated medicines arrived unsorted, without an international non-proprietary (generic) name on the label, and some medicines did not have any relationship with the diseases that would appear in the aftermath of the event.
Waanders, Tim; Münsterer, T.; Kress, M.
Helicopter operations at low altitude are to this day only performed under VFR conditions in which safe piloting of the aircraft relies on the pilot's visual perception of the outside environment. However, there are situations in which a deterioration of visibility conditions may cause the pilot to lose important visual cues thereby increasing workload and compromising flight safety and mission effectiveness. This paper reports on a pilot assistance system for all phases of flight which is intended to: • Provide navigational support and mission management • Support landings/take-offs in unknown environment and in DVE • Enhance situational awareness in DVE • Provide obstacle and terrain surface detection and warning • Provide upload, sensor based update and download of database information for debriefing and later missions. The system comprises a digital terrain and obstacle database, tactical information, flight plan management combined with an active 3D sensor enabling the above mentioned functionalities. To support pilots during operations in DVE, an intuitive 3D/2D cueing through both head-up and head-down means is proposed to retain situational awareness. This paper further describes the system concept and will elaborate on results of simulator trials in which the functionality was evaluated by operational pilots in realistic and demanding scenarios such as a SAR mission to be performed in mountainous area under different visual conditions. The objective of the simulator trials was to evaluate the functional integration and HMI definition for the NH90 Tactical Transport Helicopter.
Full Text Available Objective. Evaluate the capacity of the federal legal framework to govern financing of health institutions in the public sector through innovative schemes –otherwise known as functional integration–, enabling them to purchase and sell health services to and from other public providers as a strategy to improve their performance. Materials and methods. Based on indicators of normative alignment with respect to functional integration across public health provider and governance institutions, content analysis was undertaken of national health programs and relevant laws and guidelines for financial coordination. Results. Significant progress was identified in the implementation of agreements for the coordination of public institutions. While the legal framework provides for a National Health System and a health sector, gaps and contradictions limit their scope. The General Register of Health is also moving forward, yet it lacks the necessary legal foundation to become a comprehensive tool for integration. The medical service exchange agreements are also moving forward based on tariffs and shared guidelines. However, there is a lack of incentives to promote the expansion of these agreements. Conclusions. It is recommended to update the legal framework for the coordination of the National Health System, ensuring a more harmonious and general focus to provide functional integration with the needed impulse.
Burnside, Elizabeth S
Medical knowledge is growing at an explosive rate. While the availability of pertinent data has the potential to make the task of diagnosis more accurate, it is also increasingly overwhelming for physicians to assimilate. Using artificial intelligence techniques, a computer can process large amounts of data to help physicians manage the growing body of medical knowledge and thereby make better decisions. Computer-assisted diagnosis support is of particular interest to the diagnostic imaging community because radiologists must integrate huge amounts of data in order to diagnose disease. Bayesian networks, among the most promising artificial intelligence techniques available, enable computers to store knowledge and estimate the probability of outcomes based on probability theory. The article describes what a Bayesian network is and how it works using a system in mammography for illustration. A comparison of Bayesian networks with other types of artificial intelligence methods, specifically neural networks and case-based reasoning, clarifies the unique features and the potential of these systems to aid radiologists in the decisions they make every day.
Full Text Available The empirically established decline in law student well-being during the first year of law school is a red-flagged imprimatur for first year curriculum change. This article suggests that by engaging law students with the concept of a positive professional identity, student engagement and intrinsic motivation will increase because they are working towards a career goal that has meaning and purpose. Law school is a time of professional transformation and the legal academy can take steps to ensure that this transformation is inculcated with positive messages. Literature from the fields of law and psychology is analysed in this article, to explain how a positive conception of the legal profession (and a student’s future role within it can increase a student’s psychological well-being – at law school and beyond.
Y. О. Romanenko
Full Text Available The paper studied the legal framework that regulates social relations in the field of internal environmental safety and provides a unified state policy and the exercise of powers by the authorities at all levels. Thus, in the legal field there are the gaps on many issues that are important in solving the tasks, including the powers and responsibilities of the various subjects of law in an extreme situation, as well as management and leadership of emergency rescue activity and other urgent works in disaster areas. It is established that to increase the state’s role in protecting the population from emergency situations of natural character, it is necessary to achieve a qualitative change in the legal status of government, the formation of relevant legislation and conduct regulation. In general, the process of regulation in addressing the problems of population protection from emergency situations of different nature must be carry out through the systematization of the national, regional and local levels regulations that are relevant to the issues of prevention and liquidation of emergency situations; also we must eliminate inconsistencies in current legislation and coordinate the national legislation with international. Based on analysis of existing and unresolved problems of internal environmental safety it is necessity to implement new mechanisms of state influence to prevent environmental degradation, the use of methods and means of protecting the population from current anthropogenic influences; reorganization of the territory, defining the boundaries of zones of sanitary, medical and sanitary survey of the population; ensuring internal environmental safety is realized with the help of legal, operational and rescue, functional and territorial public administration practices; the use of multi-state management controls that are able to simultaneously influence the situation in the sphere of nature.
Tarnow, W J
Physician-assisted suicide is one of the most controversial issues in society today. We live in an age where medical technology has developed so fast and so far that those who would have swiftly succumbed to deadly diseases in the not too distant past are now living, or, rather, being kept alive long past the point of meaningful existence. Although everyone sympathizes with the painful plight of the terminally ill, the specter of physician-assisted suicide gives many pause, and rightfully so: one need only think of the carbon monoxide contraption in the back of Dr. Death's infamous van to realize that society must address the issue of the right to die. Is there any solution to this great debate? In this note, Mr. William Tarnow passionately answers in the affirmative. Mr. Tarnow analyzes the constitutionality of state statutes which either criminalize or legalize physician-assisted suicide under both the Due Process and Equal Protection Clauses of the Constitution of the United States. The note also considers the case law, largely from the federal Ninth Circuit Court of Appeals, invalidating and upholding such statutes under the Constitution. Arguing that there is indeed a constitutional liberty interest in physician-assisted suicide, Mr. Tarnow concludes by suggesting that state legislatures can and must create legislation that legalizes physician-assisted suicide and passes constitutional muster.
provedures used to provide me with nourishment and hydration (including, for example, parenteral feeding, intravenous feedings, misting, and endotracheal or...example, parenteral feeding, intravenous feedings, misting, and endotracheal or nasogastric tube use) be instituted or, if previously instituted, to...die naturally with only the administracion of medication or the performance of any medical procedure deemed necessary to provide me with comfort care
Davidson, Gavin; Brophy, Lisa; Campbell, Jim; Farrell, Susan J; Gooding, Piers; O'Brien, Ann-Marie
There have been important recent developments in law, research, policy and practice relating to supporting people with decision-making impairments, in particular when a person's wishes and preferences are unclear or inaccessible. A driver in this respect is the United Nations Convention on the Rights of Persons with Disabilities (CRPD); the implications of the CRPD for policy and professional practices are currently debated. This article reviews and compares four legal frameworks for supported and substitute decision-making for people whose decision-making ability is impaired. In particular, it explores how these frameworks may apply to people with mental health problems. The four jurisdictions are: Ontario, Canada; Victoria, Australia; England and Wales, United Kingdom (UK); and Northern Ireland, UK. Comparisons and contrasts are made in the key areas of: the legal framework for supported and substitute decision-making; the criteria for intervention; the assessment process; the safeguards; and issues in practice. Thus Ontario has developed a relatively comprehensive, progressive and influential legal framework over the past 30 years but there remain concerns about the standardisation of decision-making ability assessments and how the laws work together. In Australia, the Victorian Law Reform Commission (2012) has recommended that the six different types of substitute decision-making under the three laws in that jurisdiction, need to be simplified, and integrated into a spectrum that includes supported decision-making. In England and Wales the Mental Capacity Act 2005 has a complex interface with mental health law. In Northern Ireland it is proposed to introduce a new Mental Capacity (Health, Welfare and Finance) Bill that will provide a unified structure for all substitute decision-making. The discussion will consider the key strengths and limitations of the approaches in each jurisdiction and identify possible ways that further progress can be made in law, policy
Tighe, Patrick J.; Badiyan, S. J.; Luria, I.; Lampotang, S.; Parekattil, S.
Recent advances in telemedicine and robotically assisted telesurgery may offer advanced surgical care for the geographically remote patient. Similar advances in tele-anesthesia will be necessary to optimize perioperative care for these patients. Although many preliminary investigations into tele-anesthesia are underway, none involves remote performance of anesthesia-related procedures. Here we describe simulated robotically assisted fiberoptic intubations using an airway simulation mannequin. Both oral and nasal approaches to fiberoptic intubation were successful, but presented unique opportunities and challenges inherent to the robot’s design. Robotically assisted airway management is feasible using multipurpose surgical robotic systems. PMID:20870983
Leidenfrost, Jeremy; Prasad, Sunil; Itoh, Akinobu; Lawrance, Christopher P; Bell, Jennifer M; Silvestry, Scott C
Cardiogenic shock from refractory right ventricular (RV) failure during left ventricular assist device placement is associated with high morbidity and mortality. The addition of extracorporeal membrane oxygenation to RV mechanical assistance may help RV recovery and lead to improved outcomes. We retrospectively reviewed all implanted continuous-flow left ventricular assist devices from April 2009 to June 2013. RV mechanical support was utilized for RV failure defined as haemodynamic instability despite vasopressors, pulmonary vascular dilators and inotropic therapy. RV assist devices were utilized with and without in-line membrane oxygenation. During the study period, 267 continuous-flow left ventricular assist devices were implanted. RV mechanical support was utilized in 27 (10%) patients; 12 (46%) had the addition of in-line extracorporeal membrane oxygenation. The mean age of patients with a right ventricular assist device with membrane oxygenation was lower than that in patients with a right ventricular assist device alone (45.6 ± 15.9 vs 64.6 ± 6.5, P = 0.001). Support was weaned in 66% (10 of 15) of patients with right ventricular assist device (RVAD) alone vs 83% (10 of 12) of those with RVAD with membrane oxygenation (P = 0.42). The RVAD was removed after 10.4 ± 9.4 vs 5 ± 2.99 days for patients with a RVAD with membrane oxygenation (P = 0.1). Patients with RVAD with membrane oxygenation had a 30-day mortality rate of 8 vs 47% for those with RVAD alone (P = 0.04). The survival rate after discharge was 86, 63 and 54% at 3, 6 and 12 months for both groups combined. Patients with a RVAD with membrane oxygenation support for acute RV failure after continuous-flow left ventricular assist device implantation had a lower 30-day mortality than those with a RVAD alone. Patients who survive to discharge have a reasonable 1-year survival. Combining membrane oxygenation with RVAD support appears to offer a short-term survival benefit in patients with RV failure
Besharov, Douglas J.
Since its creation, the Supplemental Nutrition Assistance Program (SNAP) has changed from an antihunger program to an income-supplementation program. Because the program (and its predecessor Food Stamp Program) was not designed for this purpose, the result is a program that has many unintended and, many believe, negative effects. The key challenge…
The Legal Counsel assists the Corporate Secretary and General Counsel in advising, and providing support to, Centre management and the Board of Governors on ... This involves providing strategic and tactical advice to, and working as an integral member of, IDRC negotiating teams on particular transactions towards:.
... common experiences of the orphans. Most regard support they receive to deal with their daily challenges as inadequate. It is recommended that orphan support system be re-visited, to enhance the lives of orphaned children. Keywords: AIDS, orphan, paternal orphan, maternal orphan, double orphan, Kinship foster care ...
Kemp, Candace L.
Being married in later life often prevents relocation to long-term care settings, but couples do relocate to these environments. Typically, this transition does not mark the end of support provided by families, especially adult children. Little is known about children's experiences providing support in care settings when both parents are involved.…
provide support targeting high-risk subjects for at-risk students in Mechanical Engineering at WSU. ... and cooperative learning approaches during group sessions and active student engagement to support ... improved study skills, improved time management, and improved communication, problem-solving and presentation ...
assessment will be drawn from a variety of sources, such as checklists prepared by the in-country SAO, in-country surveys, and security assistance re...activity will prepare, coordinate, and execute the lease agreement with industry after HQDA (SAUS-IA- DSE ) obtains ASA(AL&T) approval as appropriate. d
Miller, Randolph A.
This paper presents a brief history of computer-assisted diagnosis, including challenges and future directions. Some ideas presented in this article on computer-assisted diagnostic decision support systems (CDDSS) derive from prior work by the author and his colleagues (see list in Acknowledgments) on the INTERNIST-1 and QMR projects. References…
Examines factors facilitating support giving to members of the social network by elderly Jewish persons residing in assisted-living facilities in Israel. Results reveal that it is principally the perceived support measure along with two personal characteristics that explains the variance in support provision scores. (Author/MKA)
Where x …x is Peer tutoring; o o is Teaching + Peer tutoring; and. ○------○ is Conventional method. Discussion and Conclusion. The main effect of peer tutoring, parent supportiveness locus of control and gender on students' achievement in Mathematics was only significant for the treatment and was not significant for ...
Coursindel, Thibault; Martinez, Jean; Parrot, Isabelle
In this laboratory activity, students are introduced to a three-step synthesis of hydantoin (imidazolidine-2,4-dione), a moiety that is found in many biologically active compounds. Using a microwave oven and solid-support technology, this synthetic experiment is designed for masters-degree candidates working in organic chemistry or upper-level…
Dekker, D.; Buzink, S.N.; Molenbroek, J.F.M.; De Bruin, R.
Improving the toilet environment holds promises for increasing the quality of life for elderly and disabled persons. This is one of the goals of the Friendly Rest Room (FRR) project. The study described in this article explored the preference and use of supports in the toilet environment during the
This paper examines the role that properly constructed school improvement plans, developed by schools, and circuit improvement plans, developed by the Circuit Team, plays in effective district/circuit support to schools. We report on the construction of a theoretical model to assist Circuit Teams to support School ...
Miljkovic, Nadica; Milovanovic, Ivana; Dragin, Aleksandra
The main clinical measures of walking recovery in stroke patients were compared for training assisted by Walkaround® postural support (WPS) and conventional (CON) support by a cane/therapist. OBJECTIVE: We attributed the differences between the trainings to modified muscular synergies that occurr...
O'Rourke, John; West, John
Education assistants (EAs) who support students with disability in general education classrooms often find themselves in difficult situations. Caught in the firing line between their personal sense of duty, expectations of the classroom teachers, and the challenges that inclusion presents, their roles as primary support agents are anything but…
Harper, J.C.; Geraedts, J.; Borry, P.; Cornel, M.C.; Dondorp, W.; Gianaroli, L.; Harton, G.; Milachich, T.; Kaariainen, H.; Liebaers, I.; Morris, M.; Sequeiros, J.; Sermon, K.; Shenfield, F.O.; Skirton, H.; Soini, S.; Spits, C.; Veiga, A.; Vermeesch, J.R.; Viville, S.; de Wert, G.; Macek, M.
In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two
Harper, J.; Geraedts, J.; Borry, P.; Cornel, M.C.; Dondorp, W.J.; Gianaroli, L.; Harton, G.; Milachich, T.; Kaariainen, H.; Liebaers, I.; Morris, M.; Sequeiros, J.; Sermon, K.; Shenfield, F.; Skirton, H.; Soini, S.; Spits, C.; Veiga, A.; Vermeesch, J.R.; Viville, S.; de Wert, G.; Macek, M.
Study question: How has the interface between genetics and assisted reproduction technology (ART) evolved since 2005? Summary answer: The interface between ART and genetics has become more entwined as we increase our understanding about the genetics of infertility and we are able to perform more
Marishet, Mohammed Hamza
The Convention on the Rights of Persons with Disabilities (CRPD) prohibited deprivation legal capacity of persons with disability based on assessment of mental capacity. The assertion is that, persons with disabilities shall exercise their legal capacity in all aspects of life without any restrictions that are based on mental incapacity (such as, unsoundness of mind, deficit in mental capacity, dotage, etc. This approach signifies a shift from substituted decision making, where another person act on behalf of persons with mental disabilities, to supported decision making where the person with mental disability is assisted in decision making. The rationale for the move lies on the recognition that the right to legal capacity embodies the inherent meaning of what it meant to be human. Without legal capacity a person cannot exercise all other rights and entitlements. Accordingly, States parties to CRPD are required to reform domestic legislations that are based on substituted decision making model and recognize full legal capacity of persons with disabilities in line with supported decision making model. As a Sate party to CRPD, Ethiopia assumed the same obligation. Nonetheless, in its initial report to the Committee on CRPD, the country denies existence of legislation that restricts legal capacity on the grounds of mental incapacity. This research found out that there are restrictions imposed on legal capacity of persons with disabilities on the basis of mental incapacity/disability. The research analyzed the approach employed to restrict legal capacity under the existing legal frameworks of Ethiopia vis-à-vis supported decision-making regime under CRPD. The research is doctrinal and, as such, limited to content analysis of general and specific legal capacity laws of the country (such as, marriage, divorce, will, work and employment, political participation, access to justice and others). Copyright © 2017 Elsevier Ltd. All rights reserved.
Dar, Shir; Lazer, Tal; Swanson, Sonja; Silverman, Jan; Wasser, Cindy; Moskovtsev, Sergey I; Sojecki, Agata; Librach, Clifford L
What are the medical, psychosocial and legal aspects of gestational surrogacy (GS), including pregnancy outcomes and complications, in a large series? Meticulous multidisciplinary teamwork, involving medical, legal and psychosocial input for both the intended parent(s) (IP) and the gestational carrier (GC), is critical to achieve a successful GS program. Small case series have described pregnancy rates of 17-50% for GS. There are no large case series and the medical, legal and psychological aspects of GS have not been addressed in most of these studies. To our knowledge, this is the largest reported GS case series. A retrospective cohort study was performed. Data were collected from 333 consecutive GC cycles between 1998 and 2012. There were 178 pregnancies achieved out of 333 stimulation cycles, including fresh and frozen transfers. The indications for a GC were divided into two groups. Those who have 'failed to carry', included women with recurrent implantation failure (RIF), recurrent pregnancy loss (RPL) and previous poor pregnancy outcome (n = 96; 132 cycles, pregnancy rate 50.0%). The second group consisted of those who 'cannot carry' including those with severe Asherman's syndrome, uterine malformations/uterine agenesis and maternal medical diseases (n = 108, 139 cycles, pregnancy rate 54.0%). A third group, of same-sex male couples and single men, were analyzed separately (n = 52, 62 cycles, pregnancy rate 59.7%). In 49.2% of cycles, autologous oocytes were used and 50.8% of cycles involved donor oocytes. The 'failed to carry' group consisted of 96 patients who underwent 132 cycles at a mean age of 40.3 years. There were 66 pregnancies (50.0%) with 17 miscarriages (25.8%) and 46 confirmed births (34.8%). The 'cannot carry pregnancy' group consisted of 108 patients who underwent 139 cycles at a mean age of 35.9 years. There were 75 pregnancies (54.0%) with 15 miscarriages (20.0%) and 56 confirmed births (40.3%). The pregnancy, miscarriage and live birth
Hossain, Shabbir; Valente, Pedro Ricardo da Nova; Hallenborg, Kasper
intelligent technologies to support people with special demands to live longer periods in their proffered environment . The prime challenges of the AAL are recognition of the assisted person’s current activity and providing appropriate support to the person . But these systems need extensive studies......Current research work shows that progress on AI and wireless sensor networks, made it possible to improve the quality of life of the people with disabilities using recent technologies . Ambient Assisted Living (AAL) is one of the well-known research areas that has a goal to use ambient...
Elmer, D.B.; Rogers, K.; Vanston, J.H.; Elmer, D.B.; Gustavson, T.C.; Kreitler, C.W.; Letlow, K.; Lopreato, S.C.; Meriwether, M.; Ramsey, P.; Rogers, K.E.; Williamson, J.K.
The legal issues are discussed in two areas: legal scholarship and legal support. Scholorship is distinguished from support by concentration on abstract analyses of issue that include resource definition, ownership, taxation, and multistate reservoirs. Support is based entirely on those legal tasks called up by the technical work schedule in the areas of Resource Assessment, Advanced Research and Technology, Institutional and Environmental, and Resonance Utilization. The legal section will, in the future, make recommendations and implement procedures designed to assist in the rapid and orderly development of the resource. The PERT (Program Evaluation Review Techniques) chart for sequencing of legal scholarship and support tasks is included. An oral presentation on geothermal resources in Texas, a resource model for the resource utilization section, and some excerpts from legislation pertaining to geothermal energy are provided in an Appendix. (MCW)
Barberger-Gateau, P; Helmer, C; Ouret, S; Gendron, B
The French National Program on Nutrition and Health has defined two specific objectives targeting older persons: (i) to improve their status in calcium and vitamin D and (ii) to prevent undernutrition. Home help provides support in activities of daily living, including meals, to dependent persons. The objective of our study was to evaluate the impact of a nutritional education intervention on knowledge and practices among home support assistants for the elderly. Three facilities providing home support in Gironde (France) selected 132 home support assistants to follow an education program and 134 controls. Nutrition training was conducted in the intervention group by a dietician during two half-day sessions in May-June 2004. A non randomized controlled trial design was used for evaluation. Nutritional knowledge (20 questions) and practice (5 questions) of home support assistants were assessed by questionnaire before (April 2004) and after (September 2004) the training period in each group. Satisfaction of the intervention group was also assessed. The intervention group included 101 participants and the control group 106 persons who answered both questionnaires before and after the education program. The intervention group was significantly younger (p educated (p = 0.01) and had less often participated to previous nutrition training (p intervention for their mean scores of knowledge or practices. The intervention group significantly improved its knowledge score (mean gain 2.5 points, p nutritional education was very significant (p intervention in multivariate analyses. Satisfaction of trained home support assistants was very high. An education program of home support assistants for elderly persons can improve their nutritional knowledge, but this study cannot conclude that the intervention was efficient to improve the nutritional status of older persons.
Frati, Paola; Foldes-Papp, Zeno; Panici, Pierluigi B; Brunelli, Roberto; Zaami, Simona; Busardò, Francesco P; Fineschi, Vittorio
Pregnancy in advanced reproductive age is nowadays part of the social and welfare scenario. The effects and assessment of the risks and complications in women over the age of 43 must still be more specifically defined. The aim of this study is to compare the outcomes between spontaneous pregnancies with those induced by assisted reproductive technology (ART) in women ≥ 43 years. This retrospective observational study enrolled 114 women with an age of ≥ 43 divided as follows: 74 with spontaneous pregnancies and 40 with ART-induced pregnancy. For statistical analysis, a t-test was used to compare the parameters analyzed for quantitative variables and χ2 was used for qualitative variables. A p-value ≤ 0.05 was considered statistically significant. Statistical Analysis was performed using the program SPSS 16.0 for Windows. The statistically significant differences between IVF and spontaneous pregnancy groups were respectively: gestational hypertension (30% vs 6.8%), preeclampsia (17.5% vs 2.7%), preterm delivery (47.5% vs 13.5%), IUGR (17.5% vs 4.1%), caesarian section (95% vs 70.3%), length of recovery (8.6±7.2 vs 5.9±3) and mean birth weight (2641± 695 g vs 3207±496 g). Women in advanced reproductive age (≥ 43 years) who undergo assisted fertilization procedures are at a higher risk of complications compared to women of the same age with spontaneous pregnancies.
Bhayat, Imtiaz; Manuguerra, Maurizio; Baldock, Clive
In this paper, a model and tool is proposed to assist universities and other mission-based organisations to ascertain systematically the optimal portfolio of projects, in any year, meeting the organisations risk tolerances and available funds. The model and tool presented build on previous work on university operations and decision support systems…
Mohammad Taghi Karimian
Discussion: Assistive technologies together with the support of relatives and care services help people to cope with a variety of activities in their daily lives with fewer restrictions. The effectiveness of the aids differs between participants because it depends on several factors such as health, knowledge, and information about aids, as well as the appropriate selection of aids.
Scherer, Petra; Beswick, Kim; DeBlois, Lucie; Healy, Lulu; Opitz, Elisabeth Moser
When looking at teaching and learning processes in mathematics education students with mathematical learning difficulties or disabilities are of great interest. To approach the question of how research can support practice to assist these students one has to clarify the group or groups of students that we are talking about. The following…
... Housing for the Elderly Act of 2010 (Pub. L. 111-372, 124 Stat. 4077, approved January 4, 2011) (2010 Act... Section 202 Supportive Housing for the Elderly program (Section 202 program) in the case of refinancing or... that includes the owner of a project assisted under SPRAC. The SPRAC II includes definitions that are...
Nov 17, 2016 ... If the role of the Education District and Circuit Officers in South Africa is to work collaboratively with schools ... research was to develop a theoretical model to assist. Circuit Teams to support School Management. Teams. This paper builds on work previously ..... At the meeting, the participants sat in groups,.
Paris, Lisa F.; Boston, Julie; Morris, Julia
Australian pre-service teachers (PST) frequently report feeling isolated and vulnerable during the high stakes Assistant Teacher Program (ATP) final practicum. Mentoring and online learning communities have been shown to offer effective support during periods in which pre-service and beginning teachers feel challenged. As social media…
One of the United States Support Program's (USSP) priorities for 2008 is to support the International Atomic Energy Agency's (IAEA) development of an integrated and efficient safeguards information infrastructure, including reliable and maintainable information systems, and effective tools and resources to collect and analyze safeguards-relevant information. The USSP has provided funding in support of this priority for the ISIS Re-engineering Project (IRP), and for human resources support to the design and definition of the enhanced information analysis architecture project (nVision). Assistance for several other information technology efforts is provided. This paper will report on the various ongoing support measures undertaken by the USSP to support the IAEA's information technology enhancements and will provide some insights into activities that the USSP may support in the future.
Kohno, Hiroki; Matsumiya, Goro; Sawa, Yoshiki; Ono, Minoru; Saiki, Yoshikatsu; Shiose, Akira; Yamazaki, Kenji; Matsui, Yoshiro; Niinami, Hiroshi; Matsuda, Hikaru; Kitamura, Soichiro; Nakatani, Takeshi; Kyo, Shunei
The Jarvik 2000 ventricular assist device features a miniaturized intraventricular pump and an intermittent low-speed function that facilitates aortic valve opening. Despite its long history, little is known about the Jarvik device with regard to post-implantation outcomes. Prospectively collected data from 13 participating hospitals were extracted from the Japanese Registry for Mechanically Assisted Circulatory Support database to analyze mortality, morbidity and de-novo aortic regurgitation. Data on 83 patients who underwent implantation of the Jarvik 2000 were reviewed. Median support duration was 191 (maximum 758) days. All recipients underwent implantation as a bridge to transplantation. Overall survival proportions at 1 and 2 years were 85.0% and 79.3%, respectively. Nine patients were in INTERMACS Level 1, and 28 patients were on mechanical circulatory support at the time of implantation. Causes of death included stroke, infection and device malfunction. Three patients had their device removed: 2 at the time of heart transplantation and 1 after recovery of the left ventricle. Common adverse events included major bleeding (27.7%), new infection (31.3%), stroke (20.5%) and device malfunction (20.5%). De-novo aortic regurgitation was observed in 17 patients, 6 of whom developed at least moderate regurgitation during follow-up. Mid-term survival after Jarvik 2000 implantation was satisfactory and comparable to that reported by other national and international registries (INTERMACS and IMACS) for continuous-flow LVADs. De novo aortic regurgitation occurred despite the intermittent low-speed effect of this device, with some recipients experiencing progressive worsening of aortic regurgitation within 2 years post-implantation. Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Fischer, Quentin; Kirsch, Matthias
Refractory right ventricular failure (RVF) after implantation of left ventricular assist device (LVAD) is a dramatic complication. The addition of right ventricular assist device (RVAD) may improve RV recovery and lead to improve outcomes. From February 2012 to September 2014, 44 patients received a HeartMate II. These patients were retrospectively compared in two groups according to early liberal implantation of an extracorporeal membrane oxygenation (ECMO) used as a RVAD established between a femoral vein and the pulmonary artery. Of the 44 patients, 22 required addition of a temporary RVAD (t-RVAD group). Patients are sicker in the t-RVAD group with significantly higher rate of preoperative extracorporeal life support (46% vs. 9%; p = 0.016) or any mechanical circulatory support (55% vs. 14%; p = 0.01), more preoperative hemofiltration (23% vs. 0%; p = 0.048), and more inotrope support by dobutamine (68.2% vs. 27.3%; p = .015). Likewise Michigan risk score was significantly higher in t-RVAD group (2.61 ± 2.2 vs. 1.0 ± 1.6 pts; p = 0.013) and INTERMACS clinical profile (2.1 ± 0.6 vs. 3.4 ± 1.3 pts; p = 0.0001). Despite severity of preimplant conditions in t-RVAD group, clinical outcomes did not differ in both groups with similar survival rate at 6 months (60.4 ± 12 vs. 71.4 ± 9.9 months; p = 0.585). Early and liberal use of temporary RVAD in patients with risk factors of RVF could improve the prognostic after LVAD implantation.
Lebersorger, Karin J
In the western industrial countries more and more couples with an unfulfilled desire for a child use assisted reproductive technology (ART). This focusses on physical processes and doesn't sufficiently provide necessary supportive psychological/psychotherapeutic guidance.Neglecting the psychological dimension causes ART to enhance the risk for negative processes of emotional development of a child.After a brief overview of prevalence and summarizing the legal situation three areas will be discussed which involve a high risk potential and their influences on relationship- and personality development will be described: • The psychological burden for potential parents during the treatment. • Wishes of perfection and high expectations concerning the child which can turn normative crises into severe problems. • The frequent handling of the treatment as a taboo which can become a destructive family secret between parents and child.The paper will conclude with thoughts concerning prevention and treatment.Every person working in the field of childhood and adolescence can contribute to a healthy psychological development of these children. This means acknowledging and working through the emotional burden and the wishes and explaining about the dangers of taboos like in foster care and adoption.
Basile, Eloisa; Russo, Giulio; Leone, Antonio M
It is essential to understand the pathophysiology of cardiogenic shock and the possible deterioration of contractile function during high-risk PCI in order to select those patients who could benefit from mechanical support thus choosing the most suitable device in every situation. Percutaneous Ventricular Assist Devices (pVAD) provide hemodynamic support by improving cardiac output and mean arterial pressure, but their specific features result in different hemodynamic effects and degrees of myocardial ischemic protection and LV unloading. These features, together with ease of use, specific contraindications and individual risk of complications, must be taken into account in the evaluation and selection of the device. Ai of this review is to illustrate the principles of left ventricular mechanic, including the pressure- volume loop analysis, in order to better understand, to quantify the different hemodynamic effects of pVAD supports and to explain the key pathophysiological aspects of assisted PCI.
Tulika S Khanna
Full Text Available Esthetic and functional rehabilitation of completely edentulous maxillary arch with fixed implant supported prosthesis is a challenging task. Newer technologies such as computer assisted design computer assisted manufacturing (CAD CAM and cone beam conventional tomography play an important role in achieving predictable results. Full mouth porcelain fused to metal (PFM individual crowns on CAD CAM milled titanium framework provides positive esthetic and functional outcome. This is a case report of rehabilitation of partially edentulous maxillary arch patient. Staged rehabilitation of this patient was planned. In the first stage, root canal treatment of key abutment teeth was done, nonsalvageable teeth were removed, and immediate interim overdenture was provided. In the second stage, five Nobel Biocare dental implants were placed. After integration impressions were made, CAD CAM milled titanium bar was fabricated. Individual PFM crowns were made and cemented. This method gives better esthetic compared to acrylic fused to metal hybrid prosthesis with the advantage of retrievability just like screw retained prosthesis. Hence, this technique is good for rehabilitation of patients with high esthetic demands.
Liu, Brent J; Law, Maria Y Y; Documet, Jorge; Gertych, Arkadiusz
The need for quantified knowledge and decision-support tools to handle complex radiation therapy (RT) imaging and informatics data is becoming steadily apparent. Lessons can be learned from current CAD applications in radiology. This paper proposes a methodology to develop this quantified knowledge and decision-support tools to facilitate RT treatment planning. The methodology is applied to cancer patient cases treated by intensity modulated radiation therapy (IMRT). The use of the "inverse treatment planning" and imaging intensive nature of IMRT allows for the development of such image-assisted tools for supporting decision-making thus providing better workflow efficiency and more precise dose predictions.
Cowger, Jennifer; Romano, Matthew A; Stulak, John; Pagani, Francis D; Aaronson, Keith D
This review summarizes management strategies to reduce morbidity and mortality in heart failure patients supported chronically with implantable left ventricular assist devices (LVADs). As the population of patients supported with long-term LVADs has grown, patient selection, operative technique, and patient management strategies have been refined, leading to improved outcomes. This review summarizes recent findings on LVAD candidate selection, and discusses outpatient strategies to optimize device performance and heart failure management. It also reviews important device complications that warrant close outpatient monitoring. Managing patients on chronic LVAD support requires regular patient follow-up, multidisciplinary care teams, and frequent laboratory and echocardiographic surveillance to ensure optimal outcomes.
Lubbers, M; Jaspers, E.; Ultee, W.C.
Two years after the legalization of same-sex marriages in the Netherlands, 65% of the Dutch population largely or completely disagrees with the statement “gay marriage should be abolished.” This article shows, by way of multinomial logistic regression analysis of survey data, which socializing
Lubbers, M.; Jaspers, E.; Ultee, W.C.
Two years after the legalization of same-sex marriages in the Netherlands, 65% of the Dutch population largely or completely disagrees with the statement "gay marriage should be abolished." This article shows, by way of multinomial logistic regression analysis of survey data, which socializing
Lubbers, Marcel; Jaspers, Eva; Ultee, Wout
Two years after the legalization of same-sex marriages in the Netherlands, 65% of the Dutch population largely or completely disagrees with the statement "gay marriage should be abolished." This article shows, by way of multinomial logistic regression analysis of survey data, which socializing agents influence one's attitude toward…
Bavinck, M.; Johnson, D.; Amarasinghe, O.; Rubinoff, J.; Southwold-Llewellyn, S.; Thomson, K.T.
This article presents findings on the current state of fisheries governance in South Asia from the perspective of legal pluralism. It is based on ethnographic fieldwork in six coastal districts of India and Sri Lanka and focuses on resource health and allocation. We suggest that interactions between
Lubbers, M.; Jaspers, E.; Ultee, W.C.
Two years after the legalization of same-sex marriages in the Netherlands, 65% of the Dutch population largely or completely disagrees with the statement "gay marriage should be abolished." This article shows, by way of multinomial logistic regression analysis of survey data, which socializing
Full Text Available The Ambient Assisted Living (AAL area is in constant evolution, providing new technologies to users and enhancing the level of security and comfort that is ensured by house platforms. The Ambient Assisted Living for All (AAL4ALL project aims to develop a new AAL concept, supported on a unified ecosystem and certification process that enables a heterogeneous environment. The concepts of Intelligent Environments, Ambient Intelligence, and the foundations of the Ambient Assisted Living are all presented in the framework of this project. In this work, we consider a specific platform developed in the scope of AAL4ALL, called UserAccess. The architecture of the platform and its role within the overall AAL4ALL concept, the implementation of the platform, and the available interfaces are presented. In addition, its feasibility is validated through a series of tests.
Nadarajah, Ravichandran; Rajesh, Hemashree; Wong, Ker Yi; Faisal, Fazlin; Yu, Su Ling
Assisted reproductive techniques (ARTs) result in a deficient luteal phase, requiring the administration of intramuscular, intravaginal or oral exogenous progesterone. Dydrogesterone, an oral retroprogesterone with good bioavailability, has been used in assisted reproductive cycles with outcomes that are comparable to those of vaginal or intramuscular progesterone. However, there are limited reviews on its use for luteal phase support in ARTs, in terms of pregnancy outcomes and associated fetal anomalies. This study aimed to review the live birth rates and associated fetal anomalies of women who were given dydrogesterone for luteal phase support in assisted reproductive cycles at a tertiary hospital in Singapore. This retrospective descriptive study included 1,050 women who underwent in vitro fertilisation/intracytoplasmic sperm injection at the Centre for Assisted Reproduction of Singapore General Hospital between 2000 and 2011. The women were given dydrogesterone for luteal phase support. The main outcome measures were rates of pregnancy, live birth, miscarriage and fetal anomalies. The pregnancy and live birth rates were 34.7% and 27.7%, respectively. Among those who achieved pregnancy, 17.0% miscarried, 0.8% had ectopic pregnancies and 0.3% had molar pregnancies. Fetal anomalies were detected in 1.9% of pregnancies, all of which were terminated by choice. Since the outcomes of dydrogesterone are comparable to those of intramuscular and vaginal progesterone, it is a reasonable option to provide luteal phase support for women who are uncomfortable with injections or vaginal insertions. Randomised controlled studies are needed to determine the optimal dosage of dydrogesterone for luteal phase support in ARTs.
Swinnen, Eva; Baeyens, Jean-Pierre; Knaepen, Kristel; Michielsen, Marc; Hens, Gerrit; Clijsen, Ron; Goossens, Maggie; Buyl, Ronald; Meeusen, Romain; Kerckhofs, Eric
The goal was to assess in healthy participants the three-dimensional kinematics of the pelvis and the trunk during robot-assisted treadmill walking (RATW) at 0%, 30% and 50% body weight support (BWS), compared with treadmill walking (TW). 18 healthy participants walked (2 kmph) on a treadmill with and without robot assistance (Lokomat; 60% guidance force; 0%, 30% and 50% BWS). After an acclimatisation period (four minutes), trunk and pelvis kinematics were registered in each condition (Polhemus Liberty [240 Hz]). The results were analysed using a repeated measures analysis of variance with Bonferroni correction, with the level of suspension as within-subject factor. During RATW with BWS, there were significantly (1) smaller antero-posterior and lateral translations of the trunk and the pelvis; (2) smaller antero-posterior flexion and axial rotation of the trunk; (3) larger lateral flexion of the trunk; and (4) larger antero-posterior tilting of the pelvis compared with TW. There are significant differences in trunk and pelvis kinematics in healthy persons during TW with and without robot assistance. These data are relevant in gait rehabilitation, relating to normal balance regulation. Additional research is recommended to further assess the influence of robot assistance on human gait. The trunk and pelvis moves in a different way during walking with robot assistance. The data suggest that the change in movement is due to the robot device and the harness of the suspension system more than due to the level of suspension itself.
Mazerolle, Stephanie M; Clines, Stephanie; Eason, Christianne M; Pitney, William A
The graduate-assistant position can be a highly influential experience because it is often the first time novice athletic trainers (ATs) are practicing autonomously. To gain an understanding of how graduate-assistant ATs (GAATs) perceive professional socialization and mentorship during their assistantships. Semistructured phone interviews. Graduate-assistant ATs in various clinical settings. Twenty-five GAATs (20 women, 5 men) studying in 1 of 3 academic tracks (postprofessional athletic training = 8, athletic training-based curriculum = 11, non-athletic training-based curriculum = 6). Median age was 24 years. Phone interviews were digitally recorded and transcribed verbatim. Data analysis used principles of the general inductive approach. Credibility was maintained using peer review, field notes, and intercoder reliability. Participants identified peer support throughout their experiences, in both academic and clinical settings. The GAATs frequently relied on other GAATs for support due to shared experiences and understanding of workloads. Participants described difficulty receiving supervisor support from full-time staff ATs due to the supervisors' workload and time constraints, limiting their availability for mentoring. Guidance from academic support personnel occurred only in athletic training-centered academic programs. Communication emerged as helpful for incoming GAATs; the previous GAATs provided formal mentorship via job descriptions highlighting role responsibilities and expectations. Differences between assistantship types were noted only in terms of receiving balanced mentorship between the academic and clinical staffs, such that students studying in postprofessional athletic training programs perceived more balanced support. Our results confirm the literature regarding the GAAT's pursuit of continued formal mentoring. The GAATs perceived less support from full-time AT staff members due to limited availability. Therefore, GAATs leaned on their peers for
... the Secretary fund under technical assistance supported employment projects? The following activities... 34 Education 2 2010-07-01 2010-07-01 false What activities may the Secretary fund under technical assistance supported employment projects? 380.6 Section 380.6 Education Regulations of the Offices of the...
van der Heide, Agnes
Several countries have adopted laws that regulate physician assistance in dying. Such assistance may consist of providing a patient with a prescription of lethal medication that is self-administered by the patient, which is usually referred to as (physician) assistance in suicide, or of administering lethal medication to a patient, which is referred to as euthanasia. The main aim of regulating physician assistance in dying is to bring these practices into the open and to provide physicians with legal certainty. A key condition in all jurisdictions that have regulated either assistance in suicide or euthanasia is that physicians are only allowed to engage in these acts upon the explicit and voluntary request of the patient. All systems that allow physician assistance in dying have also in some way included the notion that physician assistance in dying is only accepted when it is the only means to address severe suffering from an incurable medical condition. Arguments against the legal regulation of physician assistance in dying include principled arguments, such as the wrongness of hastening death, and arguments that emphasize the negative consequences of allowing physician assistance in dying, such as a devaluation of the lives of older people, or people with chronic disease or disabilities. Opinion polls show that some form of accepting and regulating euthanasia and physician assistance in suicide is increasingly supported by the general population in most western countries. Studies in countries where physician assistance in dying is regulated suggest that practices have remained rather stable in most jurisdictions and that physicians adhere to the legal criteria in the vast majority of cases. © 2013 Elsevier B.V. All rights reserved.
Marasco, Silvana F; Lo, Casey; Murphy, Deirdre; Summerhayes, Robyn; Quayle, Margaret; Zimmet, Adam; Bailey, Michael
In patients requiring left ventricular assist device (LVAD) support, it can be difficult to ascertain suitability for long-term mechanical support with LVAD and eventual transplantation. LVAD implantation in a shocked patient is associated with increased morbidity and mortality. Interest is growing in the utilization of extracorporeal life support (ECLS) as a bridge-to-bridge support for these critically unwell patients. Here, we reviewed our experience with ECLS double bridging. We hypothesized that ECLS double bridging would stabilize end-organ dysfunction and reduce ventricular assist device (VAD) implant perioperative mortality. We conducted a retrospective review of prospectively collected data for 58 consecutive patients implanted with a continuous-flow LVAD between January 2010 and December 2013 at The Alfred Hospital, Melbourne, Victoria, Australia. Twenty-three patients required ECLS support pre-LVAD while 35 patients underwent LVAD implantation without an ECLS bridge. Preoperative morbidity in the ECLS bridge group was reflected by increased postoperative intensive care duration, blood loss, blood product use, and postoperative renal failure, but without negative impact upon survival when compared with the no ECLS group. ECLS stabilization improved end-organ function pre-VAD implant with significant improvements in hepatic and renal dysfunction. This series demonstrates that the use of ECLS bridge to VAD stabilizes end-organ dysfunction and reduces VAD implant perioperative mortality from that traditionally reported in these "crash and burn" patients. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Morrison, Julie Q.; Russell, Christine; Dyer, Stephanie; Metcalf, Terri; Rahschulte, Rebecca L.
Despite the national proliferation of technical assistance as a driver for school reform and as a model for embedded and sustained professional development, very little is known about the organizational structures and processes needed to support technical assistance. The purpose of this paper is to describe a structured needs assessment process…
Century, Jeanne Rose
This study explored evaluation of systemic reform. Specifically, it focused on the evaluation of a systemic effort to improve K-8 science, mathematics and technology education. The evaluation was of particular interest because it used both technical assistance and evaluation strategies. Through studying the combination of these roles, this investigation set out to increase understanding of potentially new evaluator roles, distinguish important characteristics of the evaluator/project participant relationship, and identify how these roles and characteristics contribute to effective evaluation of systemic science education reform. This qualitative study used interview, document analysis, and participant observation as methods of data collection. Interviews were conducted with project leaders, project participants, and evaluators and focused on the evaluation strategies and process, the use of the evaluation, and technical assistance. Documents analyzed included transcripts of evaluation team meetings and reports, memoranda and other print materials generated by the project leaders and the evaluators. Data analysis consisted of analytic and interpretive procedures consistent with the qualitative data collected and entailed a combined process of coding transcripts of interviews and meetings, field notes, and other documents; analyzing and organizing findings; writing of reflective and analytic memos; and designing and diagramming conceptual relationships. The data analysis resulted in the development of the Multi-Function Model for Systemic Reform Support. This model organizes systemic reform support into three functions: evaluation, technical assistance, and a third, named here as "systemic perspective." These functions work together to support the project's educational goals as well as a larger goal--building capacity in project participants. This model can now serve as an informed starting point or "blueprint" for strategically supporting systemic reform.
Herrmann, Janne Rothmar
The article discusses the inadequacy of traditional theory on legal personhood in relation to embryos and foetuses. To challenge the somewhat binary view of legal personhood according to which the ‘born alive' criterion is paramount the article demonstrates that the number of legal categories in ...... in which embryos and foetuses are placed are much more complex. These categories are identified using Danish legislation as an example and on that basis the article extracts and identifies the different parameters that play a part in the legal categorisation of the human conceptus....
Herrmann, Janne Rothmar
The article discusses the inadequacy of traditional theory on legal personhood in relation to embryos and foetuses. To challenge the somewhat binary view of legal personhood according to which the ‘born alive' criterion is paramount the article demonstrates that the number of legal categories...... in which embryos and foetuses are placed are much more complex. These categories are identified using Danish legislation as an example and on that basis the article extracts and identifies the different parameters that play a part in the legal categorisation of the human conceptus....
Services Division, North Carolina Department of Human Resources, 325 North Salisbury Street, Raleigh, North Carolina 27611. (Also, request Information...pocketbook. Some models are designed for those whose budget limits them to a lower-cost home. Other models have such higher-priced features as cathedral
Hoogerwerf, Evert-Jan; Solander-Gross, Andrea; Mavrou, Katerina; Traina, Ivan; Hersh, Marion
In order to support schools to assess their performance in supporting children with disabilities in their ICT and ICT-AT needs, a self-assessment framework was developed by a task force of partners and associate partners of the ENTELIS project. The self-assessment tool aims to help educational establishments that welcome learners with disabilities to assess their current outcomes and to plan improvements in supporting these students in increasing digital literacy and developing digital skills. This includes the use of mainstream Information and Communication Technology (ICT) and specially designed digital Assistive Technologies (ICT-AT). This can only successfully happen if schools fully embrace an inclusive approach to education. In this paper the authors describe the development of the framework and the further steps for its use.
Poh, Chin L; Chiletti, Roberto; Zannino, Diana; Brizard, Christian; Konstantinov, Igor E; Horton, Stephen; Millar, Johnny; d'Udekem, Yves
The capacity and limitations of ventricular assist device (VAD) support in single-ventricle physiology remains poorly understood. We aimed to review our experience in the use of VAD support in the single-ventricle circulation to determine its feasibility in this population. We reviewed our experience with VAD support in patients with single ventricles over the past 25 years. Fifty-seven patients received 64 runs of VAD support between 1990 and 2015 at a median age of 13 days [interquartile range (IQR) 4.1-99.4 days], of which 55 were supported for post-cardiotomy failure. The majority of patients received short-term VAD support, while 4 patients were either directly supported (1) or transitioned onto the Berlin Heart EXCOR (3). The median duration of support was 3.5 days (IQR 2.8-5.2 days). Twelve patients suffered significant neurological complications, and thromboembolic events occurred in 8 patients. Twenty-nine of the 55 patients were successfully weaned off support (53%). There were 37 inpatient deaths, with a survival-to-hospital discharge rate of 33% (18 of 55). Of the 4 patients supported after early Fontan failure, 3 died. Having a higher mean arterial blood pressure on initiation of VAD support was the only significant predictor of death (hazards ratio 1.08; 95% confidence interval 1.03-1.14; P = 0.002). Patients who required a second run of support had higher hospital mortality (83% vs 63%; P = 0.84). Of the hospital survivors, 12 patients (63%) remain alive without heart transplantation at median 7.2 years (IQR 3.5-14.0) post VAD support. VAD support in patients with a single ventricle has a high hospital mortality, with 1 of 3 patients surviving to discharge. Systemic VAD support is likely futile in the setting of early Fontan failure or when re-initiation of support is required. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Murray, Lindsay K; González-Costello, Jose; Jonas, Samual N; Sims, Daniel B; Morrison, Kerry A; Colombo, Paolo C; Mancini, Donna M; Restaino, Susan W; Joye, Evan; Horn, Evelyn; Takayama, Hiroo; Marboe, Charles C; Naka, Yoshifumi; Jorde, Ulrich P; Uriel, Nir
Giant cell myocarditis (GCM) carries a poor prognosis and many patients require end-stage therapies. This study sought to determine the outcome of patients bridged with ventricular assist devices (VAD) to orthotopic heart transplantation (OHT). A retrospective data collection of all patients with GCM was performed. Diagnosis was determined by endomyocardial or explanted heart biopsy. Eight patients were found, but two of those patients went directly to OHT and were excluded. The remaining six patients received VADs, and these patients, aged 44 ± 18 years, were included. Five of the six patients were bridged with biventricular support and one patient was supported by left ventricular assist device (LVAD) alone. Two patients died on device support. Four patients were bridged to OHT 77 ± 42 days after device implantation. All four patients bridged with a VAD are alive, with a mean follow-up of 5.7 ± 4.1 years. Two patients were found to have recurrent GCM in the transplanted heart and were treated successfully with immunosuppression. Three patients had high grade (2R) rejection at 66 ± 52 days post-OHT. Cardiac function was preserved in all patients, and only one patient had cardiac allograft vasculopathy. Patients with end-stage GCM can be successfully bridged with VADs to OHT with very good post-OHT survival. The proper immunosuppressive regimen for this group needs further investigation given the frequency of rejection and GCM recurrence.
Full Text Available The Republic of Macedonia (RM has been a part of the Bologna process since 2003. The Ministry of Education, law and policy makers and higher education institutions have actively engaged with its main concepts. In parallel with this, since the adoption of the law on higher education in 2008 and the reform of the Accreditation and Evaluation Board, there have been numerous changes and amendments culminating in the fast-tracked adoption of a new law at the beginning of 2015. Some of its solutions created a huge debate among the academic community, other intellectuals and students themselves, resulting in the postponement of that law and a kind of legal vacuum. In such turbulent circumstances, individual higher education institutions had to consider how and to what extent to adopt and develop relevant standards and guidelines, comply with the legal framework and promote good practice. The aim of this paper is to present how these three aspects, Bologna standards and guidelines for Quality Assurance (QA, a national legal framework and an institutional approach are being reflected, merged and implemented at a relatively young higher education institution. It questions the impact of these three elements on each other and how one institution’s drive for improvement is affected. This is done through a qualitative analysis of the three-fold perspectives. The conclusions and recommendations are expected to be of use to policy makers in the country and region as they evaluate how international trends and good practice fit into the socio-economic and political conditions of RM and similar countries. At the same time, it can demonstrate how far institutional quality assurance and progress can be implemented and recognized in the country itself and by some international stakeholders. It can also prove that the South East European University (SEEU is a national leader in this field as RM has no functioning QA evaluation system, while SEEU has managed to
Alston, Reginald; Lewis, Allen; Loggins, Shondra
Examine the relationship among assistive technology (AT), race, and other demographic characteristics (eg, sex, educational attainment, and employment status), medical coverage, as well as government support for veterans with severe disabilities. Data were analyzed from the Rehabilitation Services Administration-911 dataset collected in the United States in 2012. Descriptive and multivariate analyses were performed. Among veterans with severe disabilities, factors that increased AT usage for European Americans (EAs) and African Americans (AAs) were employment, medical coverage (eg, access to private insurance and Medicare), government support (eg, Supplemental Security Income or Social Security Disability Income), and having a sensory type of disability. Having a mental disability was associated with decreased use of AT for EAs and AAs. Whereas EAs) had more factors associated with a decreased likelihood of using AT, AAs had more factors associated with an increased likelihood. For EA veterans with severe disabilities, receiving Medicaid, veteran benefits, and Workers' Compensation were associated with a decreased likelihood of using AT. AA veterans with severe disabilities were 60% less likely to use AT compared with EAs. Racial differences between AAs and EAs were observed in the use of AT by veterans with severe disabilities based on sex, education, employment status, medical coverage, and government support. AAs were generally less likely to use AT; however, greater exposure to resources such as employment, insurance, and government income support partially explained the differential AT use between EAs and AAs. Future policies and research should address these racial disparities in veterans with severe disabilities to promote equitable AT use and healthy functioning.
Abbott, Lesley; McConkey, Roy; Dobbins, Michael
Under the aegis of inclusion, greater numbers of learning support assistants (LSAs) in mainstream and special schools are increasingly required to assist teachers with pupils who have complex needs across the full age range. Because of the numerous and wide-ranging learning difficulties and learning disabilities in addition to sensory impairment,…
da Silva, Alan Patricio; Bulle Oliveira, Acary Souza; Pinheiro Bezerra, Italla Maria; Pedrozo Campos Antunes, Thaiany; Guerrero Daboin, Blanca Elena; Raimundo, Rodrigo Daminello; Dos Santos, Vagner Rogério; de Abreu, Luiz Carlos
The concept of assistive technology covers several areas of action; one of them is communication with the elaboration of accessible solutions to overcome daily difficulties. It contributes to the resumption of functional abilities, expanding and facilitating inclusion and independent living. To analyze the usability of a low cost prototype device to support educational activities of adolescents with cerebral palsy. A descriptive observational study. The evaluation of a prototype device was made through a validated questionnaire, Quest Version 2.0, on the level of the user's satisfaction with an assistive technology, composed of 12 evaluation items. The questionnaire was filled out by the educator based on the observation of four wheelchair-bound participants diagnosed with cerebral palsy according to the international classification of diseases and health-related problems, ICD-10, who attend a coexistence and teaching institution in the state of São Paulo, Brazil. The device developed was considered an assistive technology, which provided an experience with a positive level of satisfaction for the participants. The tested prototype contributes to communication and interaction allowing adolescents with cerebral palsy to participate in educational activities. Implications for Rehabilitation The device assists the individual in the educational activities and can positively influence their development, observe the individual number 5, who has an important limitation in coordination and fine movements, placing the role of the task in the vertical position offers a new perspective to perform the task, this stimulates him to try to perform the work, so the challenge was adjusted to the demands of each individual which can contribute to its neuromotor development, the amplitude of the distal movements and the manual ability, since it must look for alternatives to complete the task requested.
Zhu, Shidong; Luo, Lin; Yang, Bibo; Li, Xinghui; Wang, Xiaohao
Ventricular assist devices (LVADs) are increasingly recognized for supporting blood circulation in heart failure patients who are non-transplant eligible. Because of its volume, the traditional pulsatile device is not easy to implant intracorporeally. Continuous flow LVADs (CF-LVADs) reduce arterial pulsatility and only offer continuous flow, which is different from physiological flow, and may cause long-term complications in the cardiovascular system. The aim of this study was to design a new pulsatile assist device that overcomes this disadvantage, and to test this device in the cardiovascular system. Firstly, the input and output characteristics of the new device were tested in a simple cardiovascular mock system. A detailed mathematical model was established by fitting the experimental data. Secondly, the model was tested in four pathological cases, and was simulated and coupled with a fifth-order cardiovascular system and a new device model using Matlab software. Using assistance of the new device, we demonstrated that the left ventricle pressure, aortic pressure, and aortic flow of heart failure patients improved to the levels of a healthy individual. Especially, in state IV level heart failure patients, the systolic blood pressure increased from 81.34 mmHg to 132.1 mmHg, whereas the diastolic blood pressure increased from 54.28 mmHg to 78.7 mmHg. Cardiac output increased from 3.21 L/min to 5.16 L/min. The newly-developed assist device not only provided a physiological flow that was similar to healthy individuals, but also effectively improved the ability of the pathological ventricular volume. Finally, the effects of the new device on other hemodynamic parameters are discussed.
Loyaga-Rendon, Renzo Y; Plaisance, Eric P; Arena, Ross; Shah, Keyur
The left ventricular assist device (LVAD) is an accepted treatment alternative for the management of end-stage heart failure. As we move toward implantation of LVADs in less severe cases of HF, scrutiny of functional capacity and quality of life becomes more important. Patients demonstrate improvements in exercise capacity after LVAD implantation, but the effect is less than predicted. Exercise training produces multiple beneficial effects in heart failure patients, which would be expected to improve quality of life. In this review, we describe factors that are thought to participate in the persistent exercise impairment in LVAD-supported patients, summarize current knowledge about the effect of exercise training in LVAD-supported patients, and suggest areas for future research. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Eursch, Andreas A.
The thesis on an immersive assistance system concept with augmented reality for the support of manual activities in radioactive production environments covers the following topics: analysis of the situation: production and use of radioactive materials, problem analysis of the work in the production facilities, necessity of manual activities, automation, prediction in hot cells; status of research and development; assistance system concept, immersive camera system; augmented reality support in hot cells; economic evaluation and generalization.
Jukic P, Nikolina; Gagliardi, Cristina; Fagnani, Donata; Venturini, Claudia; Orlandoni, Paolo
The purpose of this study was to comprehend and describe the views, experiences and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition. The objective was to gather empirical evidence to improve the delivery of Home Enteral Nutrition for old patients taking into account the caregivers' support needs. A qualitative methodology with focus groups as data collection method was used to collect the testimonies of 30 informal and formal caregivers of older patients treated with Home Enteral Nutrition by the Clinical Nutrition Service of INRCA (Ancona) during 2014. Quantitative methodology was used to collect socio-demographic data. Partially modified Silver's "Home Enteral Nutrition Caregiver Task Checklist" was used to identify training needs. The constant comparison method was used to code and categorize data and to develop themes of focus groups. Simple descriptive statistics were used to summarize questionnaires. Five main themes were identified from focus groups: acceptance of the therapy, skill acquisition process, need for psychological and practical support at home from healthcare professionals, lifestyle adaptation, affirmation of life and family. All caregivers testified the initial fear and refusal to manage the nutrition pump and the therapy. They expressed the need to be trained gradually, starting during a patient's hospitalization, and continuing in the community. With reference to their overall QoL, it emerged that informal caregivers suffered mostly from the reduction of their free time while formal caregivers suffered social isolation and psychological burden. For both groups the monthly home visit was the most important element of the HEN service. Informal caregivers highlighted the importance of having their loved ones at home. Unsatisfied training needs were identified by the modified Silver's "Home Enteral Nutrition Caregiver Task Checklist". This qualitative study underlined the challenges and adaptations of
Full Text Available To deal with the rising integration of stochastic renewables and energy intensive distributed energy resources (DER to the electricity network, alternatives to expensive network reinforcements are increasingly needed. An alternative solution often under consideration is integrating flexibility from the consumer side to system management. However, such a solution needs to be contemplated from different angles before it can be implemented in practice. To this end, this article considers a case study of the Amsterdam ArenA stadium and its surrounding network where flexibility is expected to be available to support the network in the future. The article studies the technical aspects of using this flexibility to determine to what extent, despite the different, orthogonal goals, the available flexibility can be used by various stakeholders in scenarios with a large load from electric vehicle charging points. Furthermore, a legal study is performed to determine the feasibility of the technical solutions proposed by analysing current European Union (EU and Dutch law and focusing on the current agreements existing between the parties involved. The article shows that flexibility in the network provided by Amsterdam ArenA is able to significantly increase the number of charging points the network can accommodate. Nonetheless, while several uses of flexibility are feasible under current law, the use of flexibility provided by electric vehicles specifically faces several legal challenges in current arrangements.
T du Plessis
Full Text Available Advances in the information and communication technologies have led to the availability of a range of primary and secondary legal research publications online via the Internet, rather than on other storing devices such as compact discs or publications in the print media. Not only has information and communication technology (ICT impacted on the availability of legal information resources, but its effects are also noticed in various law-related areas such as legal practice management, legal education, corporate governance and the law per se. The question addressed by this article is whether the application of ICTs has an effect on the practice of law, and specifically whether information and knowledge management affects the processes of legal research in modern legal practice. Various issues are considered in this regard, including what the concept of knowledge management (KM entails in a law firm and what the current KM trends in South African law firms are. The article investigates global trends in the application of ICTs for legal research purposes, what the specific applications of KM in support of legal research may be, how information technology applications and KM systems and strategies can support the legal research process, and what the benefits of KM are to legal research. It finally discusses the impact technology has had on the skills required of competitive legal professionals.
Fresiello, Libera; Buys, Roselien; Jacobs, Steven; Van Puyvelde, Joeri; Droogne, Walter; Rega, Filip; Meyns, Bart
Background In the present work, we investigated the exercise capacities of patients with partial flow left ventricular assist devices and its evolution over time. We then compared the exercise capacities of these patients with those of full support ventricular assist device patients. Methods We retrospectively analysed the data of maximal cardiopulmonary exercise tests of ten partial support patients (CircuLite Synergy® Micropump) collected before (PS0), at 3 (PS3) and 6 months (PS6) after implantation. The data were then compared with those of 17 patients (FS6) treated with a full support device (HeartMate II, Thoratec©). For this analysis, we considered the exercise tests performed at 6 months after pump implantation for both groups. Results Peak oxygen uptake evolved in the PS0, PS3 and PS6 groups from 11.5 ± 2.3 to 12.6 ± 2.8 and 12.0 ± 2.7 mL/kg/min, respectively. Heart rate peak increased from PS0 to PS6 (100 ± 17 bpm and 107 ± 22 bpm, p = 0.05). The comparative analysis between PS6 and FS6 groups showed no difference in terms of exercise performance (12.0 ± 2.7 and 13.5 ± 3.0 mL/kg/min, respectively), fatigue perception, ventilation efficiency slope, anaerobic threshold and oxygen uptake efficiency slope. The chronotropic response was also similar in both PS6 and FS6 groups. However, PS6 patients were more often treated with β-blockers and therefore had lower heart rates at rest and at peak exercise than FS6 patients. Conclusions Exercise performance does not change after partial support implantation and stays stable over time. Partial and full support patients show similar exercise performances that attain 41% and 46% of the expected values, respectively.
Aguirre-Bermeo, H; Bottiroli, M; Italiano, S; Roche-Campo, F; Santos, J A; Alonso, M; Mancebo, J
To compare tolerance, duration of mechanical ventilation (MV) and clinical outcomes during weaning from MV in patients subjected to either pressure support ventilation (PSV) or proportional assist ventilation (PAV). A prospective, observational study was carried out. Intensive Care Unit. A total of 40 consecutive subjects were allocated to either the PSV or the PAV group until each group contained 20 patients. Patients were included in the study when they met the criteria to begin weaning and the attending physician decided to initiate the weaning process. The physician selected the modality and set the ventilatory parameters. None. Demographic data, respiratory mechanics, ventilatory parameters, duration of MV, and clinical outcomes (reintubation, tracheostomy, mortality). Baseline characteristics were similar in both groups. No significant differences were observed between the PSV and PAV groups in terms of the total duration of MV (10 [5-18] vs. 9 [7-19] days; P=.85), reintubation (5 [31%] vs. 3 [19%]; P=.69), or mortality (4 [20%] vs. 5 [25%] deaths; P=1). Eight patients (40%) in the PSV group and 6 patients (30%) in the PAV group (P=.74) required a return to volume assist-control ventilation due to clinical deterioration. Tolerance, duration of MV and clinical outcomes during weaning from mechanical ventilation were similar in PSV and PAV. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.
Masood, Anum; Sheng, Bin; Li, Ping; Hou, Xuhong; Wei, Xiaoer; Qin, Jing; Feng, Dagan
Pulmonary cancer is considered as one of the major causes of death worldwide. For the detection of lung cancer, computer-assisted diagnosis (CADx) systems have been designed. Internet-of-Things (IoT) has enabled ubiquitous internet access to biomedical datasets and techniques; in result, the progress in CADx is significant. Unlike the conventional CADx, deep learning techniques have the basic advantage of an automatic exploitation feature as they have the ability to learn mid and high level image representations. We proposed a Computer-Assisted Decision Support System in Pulmonary Cancer by using the novel deep learning based model and metastasis information obtained from MBAN (Medical Body Area Network). The proposed model, DFCNet, is based on the deep fully convolutional neural network (FCNN) which is used for classification of each detected pulmonary nodule into four lung cancer stages. The performance of proposed work is evaluated on different datasets with varying scan conditions. Comparison of proposed classifier is done with the existing CNN techniques. Overall accuracy of CNN and DFCNet was 77.6% and 84.58%, respectively. Experimental results illustrate the effectiveness of proposed method for the detection and classification of lung cancer nodules. These results demonstrate the potential for the proposed technique in helping the radiologists in improving nodule detection accuracy with efficiency. Copyright © 2018 Elsevier Inc. All rights reserved.
Full Text Available The aim of the study was to determine the current practices of nutritional support among hospitalized patients in nonspecialized hospital departments. Materials and Methods. During an observation period of 2 months, a surgeon and a gastroenterologist designated in each of the two departments concerned, not “specialized” in nutritional assistance, have treated patients in which nutritional support seemed necessary. Assessing the degree of malnutrition of the patient, the therapeutic decision and the type of product prescribed by the doctors were secondarily compared to the proposals of a structured computer program according to the criteria and standards established by the institutions currently recognized. Results. The study included 120 patients bearing a surgical disease in 86.7% of cases and 10% of medical cases. 50% of the patients had cancer. Nutritional status was correctly evaluated in 38.3% by the initial doctors’ diagnosis—consistent with the software’s evaluation. The strategy of nutrition was concordant with the proposals of the software in 79.2% of cases. Conclusions. Despite an erroneous assessment of the nutritional status in more than two-thirds of cases the strategy of nutritional management was correct in 80% of cases. Malnutrition and its consequences can be prevented in nonexperienced nutritional teams by adequate nutritional support strategies coming from modern techniques including computerized programs.
Birks, Emma J
Heart failure is associated with remodeling that consists of adverse cellular, structural, and functional changes in the myocardium. Until recently, this was thought to be unidirectional, progressive, and irreversible. However, irreversibility has been shown to be incorrect because complete or partial reversal can occur that can be marked after myocardial unloading with a left ventricular assist device (LVAD). Patients with chronic advanced heart failure can show near-normalization of nearly all structural abnormalities of the myocardium or reverse remodeling after LVAD support. However, reverse remodeling does not always equate with clinical recovery. The molecular changes occurring after LVAD support are reviewed, both those demonstrated with LVAD unloading alone in patients bridged to transplantation and those occurring in the myocardium of patients who have recovered enough myocardial function to have the device removed. Reverse remodeling may be attributable to a reversal of the pathological mechanisms that occur in remodeling or the generation of new pathways. A reduction in cell size occurs after LVAD unloading, which does not necessarily correlate with improved cardiac function. However, some of the changes in both the cardiac myocyte and the matrix after LVAD support are specific to myocardial recovery. In the myocyte, increases in the cytoskeletal proteins and improvements in the Ca²⁺ handling pathway seem to be specifically associated with myocardial recovery. Changes in the matrix are complex, but excessive scarring appears to limit the ability for recovery, and the degree of fibrosis in the myocardium at the time of implantation may predict the ability to recover.
Claudia I. Martínez-Alcalá
Full Text Available The increasing human longevity around the world calls for new attention models in which the primary caregiver plays a crucial role as a source of care supply. However, primary caregivers’ lack of training, along with high levels of stress, depression and anxiety, can have a negative impact on both the caregiver’s health and the development of caregiving duties. Hence, the objective of the present article is to introduce the eCuidador platform, an innovative tool that seeks to provide assistance and support to primary caregivers by means of a variety of services available in the cloud with the aim of improving caregivers’ health and quality of life. Likewise, we present the results obtained from the pilot test validation, in which the evaluation of the following parameters was carried out: Usability (12, Functionality (10, Design (11, Usefulness (12 and Satisfaction (12. The participants of this pilot test were 12 primary caregivers (91.66% women.
René F. Navarro
Full Text Available The cognitive deficits in persons with dementia (PwD can produce significant functional impairment from early stages. Although memory decline is most prominent, impairments in attention, orientation, language, reasoning, and executive functioning are also common. Dementia is also characterized by changes in personality and behavioral functioning that can be very challenging for caregivers and patients. This paper presents results on the use and adoption of an assisted cognition system to support occupational therapy to address psychological and behavioral symptoms of dementia. During 16 weeks, we conducted an in situ evaluation with two caregiver-PwD dyads to assess the adoption and effectiveness of the system to ameliorate challenging behaviors and reducing caregiver burden. Evaluation results indicate that intervention personalization and a touch-based interface encouraged the adoption of the system, helping reduce challenging behaviors in PwD and caregiver burden.
Navarro, René F; Rodríguez, Marcela D; Favela, Jesús
The cognitive deficits in persons with dementia (PwD) can produce significant functional impairment from early stages. Although memory decline is most prominent, impairments in attention, orientation, language, reasoning, and executive functioning are also common. Dementia is also characterized by changes in personality and behavioral functioning that can be very challenging for caregivers and patients. This paper presents results on the use and adoption of an assisted cognition system to support occupational therapy to address psychological and behavioral symptoms of dementia. During 16 weeks, we conducted an in situ evaluation with two caregiver-PwD dyads to assess the adoption and effectiveness of the system to ameliorate challenging behaviors and reducing caregiver burden. Evaluation results indicate that intervention personalization and a touch-based interface encouraged the adoption of the system, helping reduce challenging behaviors in PwD and caregiver burden.
Tsirmpas, Charalampos; Kouris, Ioannis; Anastasiou, Athanasios; Giokas, Kostas; Iliopoulou, Dimitra; Koutsouris, Dimitris
Internet of Things (IoT) is the logical further development of today's Internet, enabling a huge amount of devices to communicate, compute, sense and act. IoT sensors placed in Ambient Assisted Living (AAL) environments, enable the context awareness and allow the support of the elderly in their daily routines, ultimately allowing an independent and safe lifestyle. The vast amount of data that are generated and exchanged between the IoT nodes require innovative context modeling approaches that go beyond currently used models. Current paper presents and evaluates an open interoperable platform architecture in order to utilize the technical characteristics of IoT and handle the large amount of generated data, as a solution to the technical requirements of AAL applications.
Wilding, Lucy; Claridge, Simon
The Emotional Literacy Support Assistant (ELSA) programme is an example of an individualised intervention to support pupils experiencing a range of social and emotional needs. Semi-structured interviews were conducted to explore parents' constructions of several aspects of the programme: its aims and how these are achieved; its impact on children,…
...? (a) Each community-based organization and eligible recipient that desire to participate in this... Assistance for Vocational Education Support Programs by Community-Based Organizations? 403.141 Section 403... Education Support Programs by Community-Based Organizations § 403.141 What are the application requirements...
Miyashita, Ayako; Hasenbush, Amira; Wilson, Bianca DM; Meyer, Ilan; Nezhad, Sheila; Sears, Brad
This report summarizes findings of the Legal Assessment of Needs Study (“LeAN Study”) – an online survey with 387 respondents who identified as people living with HIV/AIDS (“PLWH”). We describe respondents’ legal needs, respondents’ experiences getting assistance for identified legal needs from both legal and non-legal sources, and barriers respondents faced in accessing assistance from both legal and non-legal sources. We describe differences and similarities among subpopulations that are tr...
Ruttmann, Elfriede; Weissenbacher, Annemarie; Ulmer, Hanno; Müller, Ludwig; Höfer, Daniel; Kilo, Juliane; Rabl, Walter; Schwarz, Birgit; Laufer, Günther; Antretter, Herwig; Mair, Peter
Extracorporeal circulation is considered the gold standard in the treatment of hypothermic cardiocirculatory arrest; however, few centers use extracorporeal membrane oxygenation instead of standard extracorporeal circulation for this indication. The aim of this study was to evaluate whether extracorporeal membrane oxygenation-assisted resuscitation improves survival in patients with hypothermic cardiac arrest. A consecutive series of 59 patients with accidental hypothermia in cardiocirculatory arrest between 1987 and 2006 were included. Thirty-four patients (57.6%) were resuscitated by standard extracorporeal circulation, and 25 patients (42.4%) were resuscitated by extracorporeal membrane oxygenation. Accidental hypothermia was caused by avalanche in 22 patients (37.3%), drowning in 22 patients (37.3%), exposure to cold in 8 patients (13.5%), and falling into a crevasse in 7 patients (11.9%). Multivariate logistic regression analysis was used to compare extracorporeal membrane oxygenation with extracorporeal circulation resuscitation, with adjustment for relevant parameters. Restoration of spontaneous circulation was achieved in 32 patients (54.2%). A total of 12 patients (20.3%) survived hypothermia. In the extracorporeal circulation group, 64% of the nonsurviving patients who underwent restoration of spontaneous circulation died of severe pulmonary edema, but none died in the extracorporeal membrane oxygenation group. In multivariate analysis, extracorporeal membrane oxygenation-assisted resuscitation showed a 6.6-fold higher chance for survival (relative risk: 6.6, 95% confidence interval: 1.2-49.3, P = .042). Asphyxia-related hypothermia (avalanche or drowning) was the most predictive adverse factor for survival (relative risk: 0.09, 95% confidence interval: 0.01-0.60, P = .013). Potassium and pH failed to show statistical significance in the multivariate analysis. Extracorporeal rewarming with an extracorporeal membrane oxygenation system allows prolonged
Gossai, Nathan; Brown, Nicholas M; Ameduri, Rebecca; Zantek, Nicole D; Louis, James St; Steiner, Marie E
The balance of hemostasis and anticoagulation is a concern for patients dependent upon ventricular assist devices (VADs). Bleeding is a common complication with both short- and long-term use of these devices. A better understanding of the risk factors and etiologies of bleeding associated with these devices is needed and could improve the overall results. We sought to determine the relationship of mechanical circulatory assist device use with acquired von Willebrand disease (avWD) in children. Data were analyzed retrospectively via review of the medical record of 19 consecutive patients who were supported with the Berlin EXCOR VAD for greater than 24 hours. Laboratory testing for avWD was performed at the discretion of the clinical team, often in association with clinical bleeding. Of 19 pediatric patients, 10 (52.6%) had laboratory testing consistent with avWD. Median time to detection of avWD was 35 days postimplantation of device (range 0-310 days). Both minor mucosal bleeding and bleeding requiring intervention were highly prevalent in patients in whom avWD was identified (10/10 [100%] and 7/10 [70%]). The mean age of all patients was 3.3 years, but patients found to have avWD tended to be older (mean 5.3 years) and supported with larger volume VADs. This experience demonstrates a high prevalence of avWD following EXCOR implantation. Bleeding, older age, and larger VAD size may be associated with avWD. These results should stimulate critical evaluation of individualized anticoagulation regimens in pediatric VAD patients. © The Author(s) 2016.
Boots, Denise Paquette; Heide, Kathleen M; Cochran, John K
The U.S. Supreme Court recently re-examined the constitutionality of the death penalty in the context of two of three special offender populations of murderers (juveniles, mentally retarded, and mentally incompetent). The Court reaffirmed the imposition of the death penalty for juveniles 16 and 17, while reversing itself on the mentally retarded. In reaching its decision, the Court relied on society's "evolving standards of decency." Using Likert-type items, this study is the first to have prospective jurors assess support for the death penalty for these specific offender groups. The public's support for the execution of each of the groups is then compared with existing case law. Descriptive statistics and regression analyses indicate that, as expected, the levels of support for the applicability of capital punishment to the various special offender populations are much lower than that for the general adult offender. Moreover, these findings are congruent with the holdings of the Court with one notable exception: a slight majority of respondents supported executing the mentally incompetent. Reasons for the public's apparent departure from the Supreme Court holding prohibiting the execution of mentally incompetent convicted murderers are discussed. The Court's continued role in protecting marginalized populations from "cruel and unusual punishment" is explored in the context of strong public sentiment demanding justice and finality despite changes in offenders' mental capacity. Copyright 2003 John Wiley & Sons, Ltd.
Costa Ramos, Vânia
The following article gives an overview of legal aid for victims in criminal cases in Portugal. It addresses the issues of a victim’s access to a lawyer, when and how the right is granted (right to legal assistance), and under what circumstances the victim has a right to financial legal aid (right to financial legal aid).
The aim of the chapter is to study the concept of paraphrase developed by Simonnæs for describing textual elements directed at non-experts in court decisions and intended to give insight into the legal argumentation of the court. Following a discussion of the concept of paraphrase I will study two...... texts disseminating legal concepts in different situations (Wikipedia article for general public, article from ministry aimed at children and adolescents) and especially investigate, to what extent the paraphrase concept is applicable also for describing dissemination strategies in such situations....... In the conclusion, hypotheses for further investigation of knowledge dissemination in the field of law are formulated....
The idealised land|water dichotomy is most obviously challenged by ice when ‘land practice’ takes place on ice or when ‘maritime practice’ is obstructed by ice. Both instances represent disparity between the legal codification of space and its social practice. Logically, then, both instances call...... for alternative legal thought and practice; in the following I will emphasise the former and reflect upon the relationship between ice, law and politics. Prior to this workshop I had worked more on the relationship between cartography, geography and boundaries than specifically on ice. Listening to all...
Raimundo Nonato Delgado-Rodrigues
Full Text Available Sleep medicine is a relatively new field among Medical Sciences. Its legal aspects are still obscure, either for lack of knowledge of the biological mechanisms underlying violent behaviour during sleep or the virtual absence of clear legal and uniformly accepted guidelines as to whether to punish or treat those disorders. An updated review of the pertinent literature was performed to determine the most prevalent pathological conditions involving violence and sleep and to identify their most common precipitating factors, attempting to provide some technical support to aid Brazilian medical-experts or assistants in preparing substantial and scientific-based reports in a legal environment.
Delgado-Rodrigues, Raimundo Nonato; Allen, Alexander N; Santos, Leandro Galuzzi dos; Schenck, Carlos H
Sleep medicine is a relatively new field among Medical Sciences. Its legal aspects are still obscure, either for lack of knowledge of the biological mechanisms underlying violent behaviour during sleep or the virtual absence of clear legal and uniformly accepted guidelines as to whether to punish or treat those disorders. An updated review of the pertinent literature was performed to determine the most prevalent pathological conditions involving violence and sleep and to identify their most common precipitating factors, attempting to provide some technical support to aid Brazilian medical-experts or assistants in preparing substantial and scientific-based reports in a legal environment.
Koni, Phillip; Chishinga, Nathaniel; Nyirenda, Lameck; Kasonde, Prisca; Nsakanya, Richard; Welsh, Michael
The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation. Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20-1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24-1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29-7.86) and in both rural and urban settings. QA/QI tools can be used to assess performance at health facilities and determine readiness for
Macleod, Catriona Ida; Hansjee, Jateen
Discursive constructions of abortion are embedded in the social and gendered power relations of a particular socio-historical space. As part of research on public discourses concerning abortion in South Africa where there has been a radical liberalisation of abortion legislation, we collected data from male group discussions about a vignette concerning abortion, and newspaper articles written by men about abortion. Our analysis revealed how discourses of equality, support and rights may be used by men to subtly undermine women's reproductive right to 'choose' an abortion. Within an Equal Partnership discourse, abortion, paired with the assumption of foetal personhood, was equated with violating an equal heterosexual partnership and a man's patriarchal duty to protect a child. A New Man discourse, which positions men as supportive of women, was paired with the assumption of men as rational and women as irrational in decision-making, to allow for the possibility of men dissuading women from terminating a pregnancy. A Rights discourse was invoked to suggest that abortion violates men's paternal rights.
Rossor, Thomas E; Hunt, Katie A; Shetty, Sandeep; Greenough, Anne
Effective synchronisation of infant respiratory effort with mechanical ventilation may allow adequate gas exchange to occur at lower peak airway pressures, potentially reducing barotrauma and volutrauma and development of air leaks and bronchopulmonary dysplasia. During neurally adjusted ventilatory assist ventilation (NAVA), respiratory support is initiated upon detection of an electrical signal from the diaphragm muscle, and pressure is provided in proportion to and synchronous with electrical activity of the diaphragm (EADi). Compared to other modes of triggered ventilation, this may provide advantages in improving synchrony. Primary• To determine whether NAVA, when used as a primary or rescue mode of ventilation, results in reduced rates of bronchopulmonary dysplasia (BPD) or death among term and preterm newborn infants compared to other forms of triggered ventilation• To assess the safety of NAVA by determining whether it leads to greater risk of intraventricular haemorrhage (IVH), periventricular leukomalacia, or air leaks when compared to other forms of triggered ventilation Secondary• To determine whether benefits of NAVA differ by gestational age (term or preterm)• To determine whether outcomes of cross-over trials performed during the first two weeks of life include peak pressure requirements, episodes of hypocarbia or hypercarbia, oxygenation index, and the work of breathing SEARCH METHODS: We performed searches of the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cohrane Library; MEDLINE via Ovid SP (January 1966 to March 2017); Embase via Ovid SP (January 1980 to March 2017); the Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host (1982 to March 2017); and the Web of Science (1985 to 2017). We searched abstracts from annual meetings of the Pediatric Academic Societies (PAS) (2000 to 2016); meetings of the European Society of Pediatric Research (published in Pediatric Research); and meetings of the
Delivering social work services in collaboration with the legal representation for individual clients: An effective, ethical and economical approach to supporting families in child abuse and neglect legal proceedings.
This article discusses the need to improve the quality of helping relationships between families and social workers in the child protection system and the growing body of evidence that teams of social workers and lawyers are effective at improving outcomes in child protection legal proceedings. The author presents an alternative structure of delivering social work services within the child protection systems once a court gets involved with a family, proposing that social workers should focus on individual clients in collaboration with their legal representation, rather than the traditional model of a governmental agency social worker serving the family as a unit as it also determines placement of the children. Pairing the social worker to an individual client in tandem with their legal representative would help resolve the widely observed relationship problems between service users and governmental agency social workers that include the power imbalance created by the agency's authority to determine placement of children, the conflicts of interest that agency workers face when required to manage differing family members' needs, and the lack of protection of the due process right of confidentiality for parties involved in legal proceedings. This alternative structure also impacts the need to use resources more efficiently and has been demonstrated to result in substantial returns on investment. This article concludes that when a family becomes involved in child abuse and neglect legal proceedings, the child welfare agency should shift the delivery of social work services to the individual parties, away from the governmental agency and in conjunction with their legal representation. Copyright © 2017 Elsevier Ltd. All rights reserved.
One disadvantage of the rapid advances in modern dentistry is that treatment options have never been more varied or confusing. Compounded by a more educated population greatly assisted by online information in an increasingly litigious society, a major concern in recent times is increased litigation against health practitioners. The manner in which courts handle disputes is ambiguous and what is considered fair or just may not be reflected in the judicial process. Although legal decisions in Australia follow a doctrine of precedent, the law is not static and is often reflected by community sentiment. In medical litigation, this has seen the rejection of the Bolam principle with a preference towards greater patient rights. Recent court decisions may change the practice of dentistry and it is important that the clinician is not caught unaware. The aim of this article is to discuss legal issues that are pertinent to the practice of modern dentistry through an analysis of legal cases that have shaped health law. Through these discussions, the importance of continuing professional development, professional association and informed consent will be realized as a means to limit the legal complications of dental practice. © 2014 Australian Dental Association.
This research discusses on the analysis of International law on the seizure of assets in South East Asia countries according to UNCAC and AMLAT. Questions posed are (1) how is the implementation of International law principles on the seizure of assets based on UNCAC and AMLAT? (2), what are the forms of International legal instruments on seizure of assets in South East Asia region? The research shows that (1) the implementation of International law principles in seizure of assets in South Ea...
Khan, Nadeem; Husain, Syed Arman; Husain, Syed Iman; Khalaf, Natalia; George, Joggy; Raissi, Farshad; Segura, Ana Maria; Kar, Biswajit; Bogaev, Roberta C; Frazier, O H
We report the case of a patient who had chronic anthracycline-induced cardiomyopathy that was reversed after treatment with a left ventricular assist device. A 29-year-old woman had undergone anthracycline-based chemotherapy as a teenager in 1991 and 1992 and received a diagnosis of dilated cardiomyopathy 10 years later. Optimal medical therapy had initially controlled the symptoms of heart failure. However, in June 2006, the symptoms worsened to New York Heart Association functional class IV status. We implanted a continuous-flow left ventricular assist device as a bridge to cardiac transplantation; of note, a left ventricular core biopsy at that time showed no replacement fibrosis. The patient's clinical status improved thereafter, enabling left ventricular assist device ex-plantation after 17 months. To our knowledge, this is the first report of the use of left ventricular assist device support to reverse chronic anthracycline-induced heart failure.
Full Text Available Having limited legal status has direct negative consequences for Syrian refugees’ access to protection and assistance during their stay in Lebanon. Limited legal status also increases the risks of abuse and exploitation.
Wagner O. de Morais
Full Text Available As an alternative to the existing software architectures that underpin the development of smart homes and ambient assisted living (AAL systems, this work presents a database-centric architecture that takes advantage of active databases and in-database processing. Current platforms supporting AAL systems use database management systems (DBMSs exclusively for data storage. Active databases employ database triggers to detect and react to events taking place inside or outside of the database. DBMSs can be extended with stored procedures and functions that enable in-database processing. This means that the data processing is integrated and performed within the DBMS. The feasibility and flexibility of the proposed approach were demonstrated with the implementation of three distinct AAL services. The active database was used to detect bed-exits and to discover common room transitions and deviations during the night. In-database machine learning methods were used to model early night behaviors. Consequently, active in-database processing avoids transferring sensitive data outside the database, and this improves performance, security and privacy. Furthermore, centralizing the computation into the DBMS facilitates code reuse, adaptation and maintenance. These are important system properties that take into account the evolving heterogeneity of users, their needs and the devices that are characteristic of smart homes and AAL systems. Therefore, DBMSs can provide capabilities to address requirements for scalability, security, privacy, dependability and personalization in applications of smart environments in healthcare.
Choi, Hyung Soo; Lee, Dong Hoon; Kim, Chan Woong; Kim, Sung Eun; Oh, Je Hyeok
The inclusion of cardiopulmonary resuscitation (CPR) in formal education has been a useful approach to providing basic life support (BLS) services. However, because not all students have been able to learn directly from certified instructors, we studied the educational efficacy of the use of peer-assisted learning (PAL) to train high-school students to perform BLS services. This study consisted of 187 high-school students: 68 participants served as a control group and received a 1-hour BLS training from a school nurse, and 119 were included in a PAL group and received a 1-hour CPR training from a PAL leader. Participants' BLS training was preceded by the completion of questionnaires regarding their background. Three months after the training, the participants were asked to respond to questionnaires about their willingness to perform CPR on bystander CPR and their retention of knowledge of BLS. We found no statistically significant difference between the control and PAL groups in their willingness to perform CPR on bystanders (control: 55.2%, PAL: 64.7%, P=0.202). The PAL group was not significantly different from the control group (control: 60.78±39.77, PAL: 61.76±17.80, P=0.848) in retention of knowledge about BLS services. In educating high school students about BLS, there was no significant difference between PAL and traditional education in increasing the willingness to provide CPR to bystanders or the ability to retain knowledge about BLS.
Vu, Phu; Fredrickson, Scott; Meyer, Richard
With a dearth of research on human-robot interaction in education and relatively high non-completion rates of online students, this study was conducted to determine the feasibility of using a virtual assistant (VA) to respond to questions and concerns of students and provide 24/7 online course content support. During a 16 week-long academic…
Information systems supporting the delivery of conservation technical assistance by the United States Department of Agriculture (USDA) to agricultural producers on working lands have become increasingly complex over the past 25 years. They are constrained by inconsistent coordination of domain knowl...
Osborne, Cara; Burton, Sheila
The Educational Psychology Service in this study has responsibility for providing group supervision to Emotional Literacy Support Assistants (ELSAs) working in schools. To date, little research has examined this type of inter-professional supervision arrangement. The current study used a questionnaire to examine ELSAs' views on the supervision…
Stulak, John M; Lee, Dustin; Haft, Jonathon W; Romano, Matthew A; Cowger, Jennifer A; Park, Soon J; Aaronson, Keith D; Pagani, Francis D
Modern left ventricular assist devices (LVAD) require anti-coagulation (AC) with warfarin and anti-platelet therapy to prevent thromboembolic complications in patients. Gastrointestinal bleeding (GI) is a significant adverse event in these patients and treatment typically requires reduction or elimination of AC or anti-platelet therapy. It is not known whether alterations in AC to treat GI bleeding influence subsequent risk of thromboembolic (TE) events during LVAD support. Between July 2003 and September 2011, 389 patients (308 male) underwent implantation of a continuous-flow LVAD at the University of Michigan Health System and the Mayo Clinic. Median age at implant was 60 years (range 18 to 79 years). Outcomes were analyzed for the association of GI bleeding events and subsequent TE events, defined as stroke, transient ischemic attack, hemolysis or suspected or confirmed pump thrombosis. Median survival was 10 months (maximum 7.2 years, total 439 patient-years). TE events occurring within the first 30 days were not counted. Overall survival and freedom from an outcome event were assessed using the Kaplan-Meier method. Associations between GI bleeding and subsequent TE events and survival impact were analyzed as time-dependent covariates. One hundred ninety-nine GI bleeding episodes occurred in 116 of 389 patients (30%) for an event rate of 0.45 GI bleed/patient-year of support. One hundred thirty-eight TE events occurred in 97 of 389 patients (25%) for an event rate of 0.31 TE event/patient-year of support. Median time from LVAD implant to first GI bleed was 5 months (range 1 to 116 months) and to first TE event was 6 months (range 1 to 29 months). For patients who had a TE event after GI bleed, the median interval was 5 months (range 0.5 to 25 months). TE events were 7.4-fold more likely in patients who had a prior GI bleed (range 4.9- to 11.1-fold) (p cause of this relationship is unknown, it suggests that a reduction in anti-coagulation and anti
Bryant, Brian R.; Seok, Soonwha; Ok, Minwook; Bryant, Diane Pedrotty
During a four-year period, from 1988-1992, two significant events occurred that greatly influenced assistive technology (AT) and intellectual disability: the passage by Congress of the Technology-Related Assistance for Individuals with Disabilities Act of 1988 and publication by the American Association on Intellectual and Development Disabilities…
In this study, the researcher aimed to develop a mobile-assisted learning system and to investigate whether it could promote teenage learners' classical Chinese learning through the flipped classroom approach. The researcher first proposed the structure of the Cross-device Mobile-Assisted Classical Chinese (CMACC) system according to the pilot…
Legal and administrative measures to support police enforcement of traffic rules. The "Escape" Project, Deliverable 5. Project funded by the European Commission under the Transport RTD Programme of the 4th Framework Programme.
Goldenbeld, C. Heidstra, J. Christ, R. Mäkinen, T. & Hakkert, A.S.
This report addresses the question of how legal and administrative systems may support the operation or effectiveness of the total system of traffic law enforcement. In this first chapter we present road safety and traffic enforcement as the efforts of several interlinked organisations and
Miura, Kousei; Kadone, Hideki; Koda, Masao; Abe, Tetsuya; Endo, Hirooki; Murakami, Hideki; Doita, Minoru; Kumagai, Hiroshi; Nagashima, Katsuya; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi
An excessive lumbar load with snow-shoveling is a serious problem in snowfall areas. Various exoskeletal robots have been developed to reduce lumbar load in lifting work. However, few studies have reported the attempt of snow-shoveling work using exoskeletal robots. The purpose of the present study was to test the hypothesis that the HAL for Care Support robot would reduce lumbar load in repetitive snow-shoveling movements. Nine healthy male volunteers performed repetitive snow-shoveling movements outdoors in a snowfall area for as long as possible until they were fatigued. The snow-shoveling trial was performed under two conditions: with and without HAL for Care Support. Outcome measures were defined as the lumbar load assessed by the VAS of lumbar fatigue after the snow-shoveling trial and the snow-shoveling performance, including the number of scoops, and snow shoveling time and distance. The mean of VAS of lumbar fatigue, the number of scoops, and snow-shoveling time and distance without HAL for Care Support were 75.4 mm, 50.3, 145 s, and 9.6 m, while with HAL for Care Support were 39.8 mm, 144, 366 s, and 35.4 m. The reduction of lumbar fatigue and improvement of snow-shoveling performance using HAL for Care Support were statistically significant. There was no adverse event during snow-shoveling with HAL for Care Support. In conclusion, the HAL for Care Support can reduce lumbar load in repetitive snow-shoveling movements. Copyright © 2017 Elsevier Ltd. All rights reserved.
AbstractThis research discusses on the analysis of international law on the seizure of assets in South East Asia countries according to UNCAC and AMLAT. Questions posed are (1) how is the implementation of international law principles on the seizure of assets based on UNCAC and AMLAT? (2), what are the forms of international legal instruments on seizure of assets in South East Asia region? The research shows that (1) the implementation of international law principles in seizure of assets in ...
T du Plessis
Full Text Available Since the advent of the latest constitutional dispensation in South Africa, legal researchers have been presented with new opportunities for research into constitutional issues, development and the relationship between constitutional law and other fields. This article investigates how information technology applications can support the legal research process and what the benefits of technology are likely to be to legal research. Furthermore, it investigates the changes and the impact that electronic resources and the digital information environment might have on legal research. This entails a study of the unique characteristics of digital legal research and of the challenges that legal researchers face in a changing information environment.
Full Text Available In my paper I would like to present the origin and the main tasks of the DFAC. In my article I also mention other institutions of family support which might help to improve the functioning of this basic unit of society. The work of those institutions is especially important in case of families having a disorder, in connection with the performance of its basic functions of care and education – in relation to children, the disabled, elderly people and also young people who require preventive actions and rehabilitation. It is essential to know the tasks and the role of DFAC, because of the increasing number of juvenile offenders and the parents' upbringing and caring failure. Such disorders are caused by difficult situation of people under protection of child and family support institutions, in connection with unemployment, poverty, and helplessness. Such families and single units as well should be given care and one should show them the way to solve their problems. Today, the institutions such as DFAC, homes for mothers with infant children or the National Emergency Service for Victims of Domestic Violence are one of the most important and necessary in helping the families. They can help to improve the quality of whole society's life as well as to increase self-esteem of people who feel lost and who are looking for their place in life
Li, Yi; Hashimoto, Minoru
Plasticized polyvinyl chloride (PVC) gel and mesh electrode-based soft actuators have considerable potential to provide new types of artificial muscle, exhibiting similar responsiveness to biological muscle in air, >10% deformation, >90 kPa output stress, variable stiffness, long cycle life (>5 million cycles), and low power consumption. We have designed and fabricated a prototype of walking assist wear using the PVC gel actuator in previous study. The system has several advantages compared with traditional motor-based exoskeletons, including lower weight and power consumption, and no requirement for rigid external structures that constrain the wearer’s joints. In this study, we designed and established a control and power system to making the whole system portable and wearable outdoors. And we designed two control strategies based on the characteristics of the assist wear and the biological kinematics. In a preliminary experimental evaluation, a hemiparetic stroke patient performed a 10 m to-and-fro straight line walking task with and without assist wear on the affected side. We found that the assist wear enabled natural movement, increasing step length and decreasing muscular activity during straight line walking. We demonstrated that the assistance effect could be adjusted by controlling the on-off time of the PVC gel soft actuators. The results show the effectiveness of the proposed system and suggest the feasibility of PVC gel soft actuators for developing practical soft wearable assistive devices, informing the development of future wearable robots and the other soft actuator technologies for human movement assistance and rehabilitation.
The incumbent provides first-level management of the legal operations in the Office of the Secretary and General Counsel, with particular emphasis on supporting the lawyers, monitoring and coordinating the flow of legal information and workload, conducting basic research including through the use of legal databases, and ...
for alternative legal thought and practice; in the following I will emphasise the former and reflect upon the relationship between ice, law and politics. Prior to this workshop I had worked more on the relationship between cartography, geography and boundaries than specifically on ice. Listening to all...... the interesting conversations during the workshop, however, made me think that much of the concern with the Polar Regions in general, and the presence of ice in particular, reverberates around the question of how to accommodate various geographical presences and practices within the regulatory framework that we...
Fosch Villaronga, Eduard; Husty, M.; Hofbaur, M.; Can Dede, M.I.
This paper describes some relevant legal aspects concerning non-social robots. Special attention is drawn to Person Carrier Robots (PCaR) and Physical Assistant Robots (PAR). Although concrete legal binding regulations concerning these two sub-types of Personal Care Robots (PCR) are missing, the
Full Text Available The article begins with the overview of the legal capacity as a general legal qualification recognized by the legal order guaranteeing the right to be a holder of rights and obligations. The article is then focused on the scope of the absolute Constitutional guarantee of the right to legal personality as well as on the Constitutional prohibition of discrimination which gives rise to the general equality before the Constitution and the law. The focus of this article is the moment when the legal capacity, or legal personality, is considered to be acquired. It then moves to the issue whether limiting the access to techniques of assisted reproduction (biomedical conception is contrary to the general rules on legal capacity, and whether this is a genuine form of biomedical discrimination.
Cho, Feifei; Sugimoto, Riku; Noritsugu, Toshiro; Li, Xiangpan
This study focuses on developing a safe, lightweight, power assist device that can be worn by people who like caregivers during lifting or static holding tasks to prevent low back pain (LBP). Therefore in consideration of their flexibility, light weight, and large force to weight ratio we have developed a Wearable Power Assist Wear for caregivers, two types of pneumatic actuators are employed in assisting low back movement for their safety and comfort. The device can be worn directly on the body like normal clothing. Because there is no rigid exoskeleton frame structure, it is lightweight and user friendly. In this paper, we proposed the new type of the wearable power assist wear and improved the controller of control system.
This book "Sound-based Assistive Technology" explains a technology to help speech-, hearing- and sight-impaired people. They might benefit in some way from an enhancement in their ability to recognize and produce speech or to detect sounds in their surroundings. Additionally, it is considered how sound-based assistive technology might be applied to the areas of speech recognition, speech synthesis, environmental recognition, virtual reality and robots. It is the primary focus of this book to provide an understanding of both the methodology and basic concepts of assistive technology rather than listing the variety of assistive devices developed in Japan or other countries. Although this book presents a number of different topics, they are sufficiently independent from one another that the reader may begin at any chapter without experiencing confusion. It should be acknowledged that much of the research quoted in this book was conducted in the author's laboratories both at Hokkaido University and the University...
The utility of personal digital assistant resources in healthcare practice and education presents new challenges for faculty due to changing device capabilities and software availability. Although there is a plethora of personal digital assistant resources available for use by healthcare providers, little is known about the effect on clinical reasoning in nursing students. The complexity of the healthcare arena precludes reliance on memory as a sole resource for problem solving because it can be unreliable. A personal digital assistant provides instant access to information on medical treatment options so reliance on memory alone is avoided. The aims of this study are to assess clinical reasoning when personal digital assistants are used as an information resource for nursing students. These findings have implications for the future nursing work force, including accurate differential diagnosis and diagnostic reasoning, reduction of medication errors, reduction of healthcare costs, and development of effective treatment protocols.
Wang, Jingting; Yao, Nengliang; Wang, Yuanyuan; Zhou, Fen; Liu, Yanyan; Geng, Zhaohui; Yuan, Changrong
Acute lymphoblastic leukaemia (ALL) is the most common childhood malignancy. Caring for children with ALL is an uncommon experience for parents without medical training. They urgently need professional assistance when their children are recovering at home. This paper documents the process of developing an Android application (app) "Care Assistant" for family caregivers of children with ALL. Key informant interviews and focus group studies were used before programming the app. The key informants and focus group members included: caregivers of children with ALL, cancer care physicians and nurses, and software engineers. We found several major challenges faced by caregivers: limited access to evidence-based clinic information, lack of financial and social assistance, deficient communications with doctors or nurses, lack of disease-related knowledge, and inconvenience of tracking treatments and testing results. This feedback was used to develop "Care Assistant". This app has eight modules: personal information, treatment tracking, family care, financial and social assistance, knowledge centre, self-assessment questionnaires, interactive platform, and reminders. We have also developed a web-based administration portal to manage the app. The usability and effectiveness of "Care Assistant" will be evaluated in future studies. © The Author(s) 2015.
Shrestha, Srijana; Judge, Katherine S; Wilson, Nancy L; Moye, Jennifer A; Snow, A Lynn; Kunik, Mark E
Financial and legal services are unique needs of persons with dementia and their caregivers. This study examines their need for legal and financial assistance and the kinds of legal and financial services provided within Partners in Dementia Care, a telephone-based, care coordination and support service intervention delivered through a partnership between Veterans Affairs (VA) medical centers and local Alzheimer's Association chapters. Based on comprehensive assessment, and needs prioritization, care coordinators collaboratively planned action steps (specific behavioral tasks) with each caregiver/person with dementia to address the dyad's identified unmet needs. Results show that 51 (54.8%) of 93 dyads reported a need for legal and financial services. Action steps related to legal and financial need included education or assistance with legal services (27.27%), nonhealth-related financial benefits (32.32%), health-related financial benefits (21.21%), financial management/planning (9.09%), and financial support (10.1%). Comparable numbers of action steps were directed to VA (41.4%) and non-VA (58.6%) services.
Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy. European Society of Human Genetics and European Society of Human Reproduction and Embryology.
Harper, Joyce C; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan
In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation - ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and provide
Schmack, Bastian; Weymann, Alexander; Popov, Aron-Frederik; Patil, Nikhil Prakash; Sabashnikov, Anton; Kremer, Jamila; Farag, Mina; Brcic, Andreas; Lichtenstern, Christoph; Karck, Matthias; Ruhparwar, Arjang
Right ventricular failure (RVF) is an unfortunate complication that continues to limit outcomes following durable left ventricular assist device (LVAD) implantation. Despite several ‘RVF risk scores’ having been proposed, preoperative prediction of post-LVAD RVF remains a guesstimate at best. Current strategies for institution of temporary RVAD support are invasive, necessitate additional re-thoracotomy, restrict postoperative mobilization, and/or entail prolonged retention of prosthetic material in-situ. The authors propose a novel surgical strategy comprising simultaneous implantation of a permanent LVAD and percutaneous TandemHeart® plus ProtekDuo® to provide temporary RVAD support and preempt RVF in patients with impaired RV function. PMID:27145697
Zimmerman, Sheryl; Love, Karen; Cohen, Lauren W; Pinkowitz, Jackie; Nyrop, Kirsten A
As a result of the Centers for Medicare & Medicaid Services (CMS) interest in creating a unifying definition of "community living" for its Medicaid Home and Community Based Services and Support (HCBS) programs, it needed clarifying descriptors of person-centered (PC) practices in assisted living to distinguish them from institutional ones. Additionally, CMS's proposed language defining "community living" had the unintended potential to exclude many assisted living communities and disadvantage residents who receive Medicaid. This manuscript describes the consensus process through which clarifying language for "community living" and a framework for HCBS PC domains, attributes, and indicators specific to assisted living were developed. It examines the validity of those domains based on literature review, surveys, and stakeholder focus groups, and identifies nine domains and 43 indicators that provide a foundation for defining and measuring PC practice in assisted living. Ongoing efforts using community-based participatory research methods are further refining and testing PC indicators for assisted living to advance knowledge, operational policies, practices, and quality outcomes.
Burnfield, Judith M; Irons, Sonya L; Buster, Thad W; Taylor, Adam P; Hildner, Gretchen A; Shu, Yu
Individuals with walking limitations often experience challenges engaging in functionally relevant exercise. An adapted elliptical trainer (motor to assist pedal movement, integrated body weight harness, ramps/stairs, and grab rails) has been developed to help individuals with physical disabilities and chronic conditions regain/retain walking capacity and fitness. However, limited published studies are available to guide therapeutic interventions. This repeated measures study examined the influence of motor-assisted elliptical training speed on lower extremity muscle demands at four body weight support (BWS) levels commonly used therapeutically for walking. Electromyography (EMG) and pedal trajectory data were recorded as ten individuals without known disability used the motor-assisted elliptical trainer at three speeds [20,40, 60 revolutions per minute (RPM)] during each BWS level (0%, 20%, 40%, 60%). Overall, the EMG activity (peak, mean, duration) in key stabilizer muscles (i.e., gluteus medius, gluteus maximus, vastus lateralis, medial gastrocnemius and soleus) recorded at 60 RPM exceeded those at 40 RPM, which were higher than values at 20 RPM in all but three situations (gluteus medius mean at 0% BWS, vastus lateralis mean at 20% BWS, soleus duration at 40% BWS); however, these differences did not always achieve statistical significance. Slower motor-assisted speeds can be used to accommodate weakness of gluteus medius, gluteus maximus, vastus lateralis, medial gastrocnemius and soleus. As strength improves, training at faster motor-assisted speeds may provide a means to progressively challenge key lower extremity stabilizers. Copyright © 2013 Elsevier B.V. All rights reserved.
Łyp, Marek; Stanisławska, Iwona; Witek, Bożena; Olszewska-Żaczek, Ewelina; Czarny-Działak, Małgorzata; Kaczor, Ryszard
This study deals with the use of a robot-assisted body-weight-supported treadmill training in multiple sclerosis (MS) patients with gait dysfunction. Twenty MS patients (10 men and 10 women) of the mean of 46.3 ± 8.5 years were assigned to a six-week-long training period with the use of robot-assisted treadmill training of increasing intensity of the Lokomat type. The outcome measure consisted of the difference in motion-dependent torque of lower extremity joint muscles after training compared with baseline before training. We found that the training uniformly and significantly augmented the torque of both extensors and flexors of the hip and knee joints. The muscle power in the lower limbs of SM patients was improved, leading to corrective changes of disordered walking movements, which enabled the patients to walk with less effort and less assistance of care givers. The torque augmentation could have its role in affecting the function of the lower extremity muscle groups during walking. The results of this pilot study suggest that the robot-assisted body-weight-supported treadmill training may be a potential adjunct measure in the rehabilitation paradigm of 'gait reeducation' in peripheral neuropathies.
Trevino, Roberto A; Richard, Alan J
Research shows that support for legalization of drugs varies significantly among different sociodemographic and political groups. Yet there is little research examining the degree of support for legalization of drugs among drug users. This paper examines how frequency and type of drug use affect the support for legalization of drugs after adjusting for the effects of political affiliation and sociodemographic characteristics. A sample of 188 drug users and non-drug users were asked whether they would support the legalization of marijuana, cocaine, and heroin. Respondents reported their use of marijuana, crack, cocaine, heroin, speedball, and/or methamphetamines during the previous 30 days. Support for legalization of drugs was analyzed by estimating three separate logistic regressions. The results showed that the support for the legalization of drugs depended on the definition of "drug user" and the type of drug. In general, however, the results showed that marijuana users were more likely to support legalizing marijuana, but they were less likely to support the legalization of cocaine and heroin. On the other hand, users of crack, cocaine, heroin, speedball, and/or methamphetamines were more likely to support legalizing all drugs including cocaine and heroin.
Parette, Howard P., Jr.; Brotherson, Mary Jane
This article discusses a family-centered approach to assistive technology assessment for young children with mental retardation or developmental disabilities and their families. After a literature review, legal definitions of assistive technology are examined, and a model is presented for supporting and involving families in technology assessment…
Suwantarathip, Ornprapat; Orawiwatnakul, Wiwat
The use of mobile phones for learning has become well-known and is widely adopted in many language classes. The use of SMS for transmitting short messages is a fast way of helping students to learn vocabulary. To address this issue, this study was conducted to examine the effects of mobile-assisted vocabulary exercises on vocabulary acquisition of…
Castells-Ayuso, Paula; Berenguer-Labaig, Cristina; Sánchez-Martín, Pascual; Sánchez-Martín, Fernando
The aim of this study was to measure how infertility and assisted reproduction treatments (including artificial insemination) could affect the quality of life, and to evaluate how nurses could be helpful in this process, by alleviating anxiety and increasing the quality of life. A cross-sectional observational study was conducted on 48 patients (26 cycles) in an Assisted Reproduction Unit from 2nd December 2013 to 30th April 2014. Socio-demographic data were obtained, with the quality of life being assessed using the FertiQoL questionnaire before and after the treatment, and the consultations with a nurse by telephone or e-mail of these patients were also analyzed. The study results show a decreased quality of life in these patients, which was worse in men and in couples who had no previous children. Patient-centered care improved quality of life and tolerability to the assisted reproduction treatment. Patients frequently telephoned the nurse to solve their doubts and problems. The present study suggests that nurses can play an important role in improving the quality of life of patients undergoing assisted reproduction treatment. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.
Friesen, Lori; Delisle, Esther
Over the last 20 years or so, the popularity of animal-assisted literacy learning programs has gained momentum in schools and libraries around the world (Intermountain Therapy Animals, 2011). To date, such programs are currently running in four Canadian provinces and 43 U.S. states, as well as in Australia, the United Kingdom, Italy, and India…
This descriptive action research experience with case study procedures examined the use of best practices paired with assistive technologies as interventions to individualize fiction reading instruction for a high-functioning elementary student, JB (pseudonym), diagnosed with autistic spectrum disorder. JB's instructional, reading goals were to…
Andersen, Mads; Gustafsson, Finn; Madsen, Per Lav
Functional assessment of continuous-flow left ventricular assist devices (LVADs) is usually performed with the patient at rest. This study compared echocardiographic indices of contraction and filling pressure with invasive measures in 12 ambulatory LVAD patients undergoing symptom-limited bicycle...
Narcis Eduard MITU; Alia Gabriela DUŢĂ
The legal relationship is a patrimonial or non-patrimonial social relationship regulated by a rule of law. Any legal relationship is a social relationship, but not any social relationship is a legal relationship. The law maker has the power to select, of the multitude of human relationships, those who gives importance in terms of legal perspective, encoding them through legal regulations.
... litigation management procedures and cost guidelines. DEAR 931.205-33 requires litigation and other legal... commonplace among businesses. The Legal Management Plan assists Department Counsel in understanding the contractor's internal procedures, litigation protocols and processes to manage costs. Legal Management Plans...
Munthe, Christian; Nielsen, Morten Ebbe Juul
identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to healthcare professionals’ conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment......This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious...... refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for healthcare professionals based on the importance of cultural...
Rhonan Ferreira da Silva
Full Text Available INTRODUÇÃO: o mercado de trabalho tem se mostrado saturado de profissionais atuando nos grandes centros urbanos e, por este motivo, as estratégias de produtividade são imprescindíveis. A delegação de funções aos auxiliares odontológicos tem se tornado vital e corriqueira para aqueles que exercem a Ortodontia. OBJETIVO: conhecer o perfil do cirurgião-dentista especialista nesta área e as funções delegadas por ele à equipe auxiliar. METODOLOGIA: foi aplicado um questionário a todos os especialistas em Ortodontia e Ortopedia Facial inscritos no Conselho Regional de Odontologia de Goiás, com atividade em Goiânia e Aparecida de Goiânia. RESULTADOS E CONCLUSÃO: os resultados demonstraram que os ortodontistas, de um modo geral, aproveitam bem a mão-de-obra auxiliar chegando até a ultrapassar os limites ético-legais.INTRODUCTION: the work market has been shown to be saturated with professionals working at large urban centers and, for this reason, productive strategies are indispensable. The delegation of functions to dental assistants is becoming vital and quite common for those that work with Orthodontics. AIM: to evaluate the profile of the orthodontists and the workload delegated by them to the dental assistant team. METHODS: a questionnaire was given to all specialists in Orthodontics and Dentofacial Orthopedics registered at the Regional Council of Dentistry of Goiás, with practices in Goiânia and Aparecida de Goiânia. RESULTS AND CONCLUSIONS: the results demonstrated that orthodontists, in general, take advantage of the work labor of the dental assistants even surpassing the ethical-legal limits.
Jean D. Hallewell Haslwanter; Geraldine Fitzpatrick
Due to an aging population in Europe, the development of Ambient Assisted Living technologies (AAL) is increasingly the target of research financing. These technologies promise to enable older people to remain in their own homes longer, something many people report wanting and which may also reduce the costs of care. To date however there are few systems on the market. Other studies have tried to understand this by looking at user acceptance. However, by looking only at the user acceptance, w...
not have accomplished this thesis or even advanced far enough in my career to be afforded the opportunity to attend the esteemed Army Command and...in FHA operations by participation in Operation United Assistance. Scope and Delimitations The scope and delimitations are self -imposed boundaries...challenge identified was the need to conduct training exercises to develop relationships and refine processes prior to an actual FHA operation (Keen 2010
Vu, Vi; Wong, Kin; Del Alamo, Juan; Aguilo, Pablo M. L.; May-Newman, Karen; Department of Bioengineering, San Diego State University Collaboration; Department of Mechanical; Aerospace Engineering, University of California San Diego Collaboration; Mechanical Assist Device Program, Sharp Memorial Hospital Collaboration
Left ventricular assist devices (LVADs) are mechanical pumps that are surgically connected to the left ventricle (LV) and aorta to increase aortic flow and end-organ perfusion. Clinical studies have demonstrated that LVADs improve patient health and quality of life and significantly reduce the mortality of cardiac failure. However, In the presence of left ventricular assisted devices (LVAD), abnormal flow patterns and stagnation regions are often linked to thrombosis. The aim of our study is to evaluate the flow patterns in the left ventricle of the LVAD-assisted heart, with a focus on alterations in vortex development and blood stasis. To this aim, we applied color Doppler echocardiography to measure 2D, time resolved velocity fields in patients before and after implantation of LVADs. In agreement with our previous in vitro studies (Wong et al., Journal of Biomechanics 47, 2014), LVAD implantation resulted in decreased flow velocities and increased blood residence time near the outflow tract. The variation of residence time changes with LVAD operational speed was characterized for each patient.
Cícero Pereira Alencar
Full Text Available This article discusses the legal and social impact of the internalization, within the Brazilian law, of the Convention on the Rights of Persons with Disabilities (CRPD, 2008 and its regulations - through the Brazilian Law on the Inclusion of Persons with Disabilities (LBI. The focus of the analysis is the recognition of the legal capacity and the effectiveness of the human rights of persons with disabilities and their impact on legal institutions of guardianship and civil interdiction. To this end, a bibliographical and documentary research was conducted and, based on the theory of social justice, by Martha C. Nussbaum, embedded on the concept of capacity, as well as the critical theory of human rights, by Joaquín Herrera Flores. Our goal was to investigate whether the Brazilian Courts of Appeal had applied the CRPD. In theory, the higher the observance of the Convention, the greater the recognition of the autonomy and legal capacity of persons with disabilities; and thus lower the number of the cases of civil interdiction. The results obtained from the analysis of the data from the Court of Appeal of the state of Minas Gerais, from the period of 2010-2014, indicate findings on the opposite direction.
On the basis on 1) the Danish legal writer A.S.Ørsted (1778-1860) and 2) an enquete among present day Danish legal scholars, the contribution deals with special traits in Danish legal method......On the basis on 1) the Danish legal writer A.S.Ørsted (1778-1860) and 2) an enquete among present day Danish legal scholars, the contribution deals with special traits in Danish legal method...
Bennett, Mosi K; Sweet, Wendy E; Baicker-McKee, Sara; Looney, Elizabeth; Karohl, Kristen; Mountis, Maria; Tang, W H Wilson; Starling, Randall C; Moravec, Christine S
We hypothesized that S100A1 is regulated during human hypertrophy and heart failure and that it may be implicated in remodeling after left ventricular assist device. S100A1 is decreased in animal and human heart failure, and restoration produces functional recovery in animal models and in failing human myocytes. With the potential for gene therapy, it is important to carefully explore human cardiac S100A1 regulation and its role in remodeling. We measured S100A1, the sarcoplasmic endoplasmic reticulum Ca(2+)ATPase, phospholamban, and ryanodine receptor proteins, as well as β-adrenergic receptor density in nonfailing, hypertrophied (left ventricular hypertrophy), failing, and failing left ventricular assist device-supported hearts. We determined functional consequences of protein alterations in isolated contracting muscles from the same hearts. S100A1, sarcoplasmic endoplasmic reticulum Ca(2+)ATPase and phospholamban were normal in left ventricular hypertrophy, but decreased in failing hearts, while ryanodine receptor was unchanged in either group. Baseline muscle contraction was not altered in left ventricular hypertrophy or failing hearts. β-Adrenergic receptor and inotropic response were decreased in failing hearts. In failing left ventricular assist device-supported hearts, S100A1 and sarcoplasmic endoplasmic reticulum Ca(2+)ATPase showed no recovery, while phospholamban, β-adrenergic receptor, and the inotropic response fully recovered. S100A1 and sarcoplasmic endoplasmic reticulum Ca(2+)ATPase, both key Ca(2+)-regulatory proteins, are decreased in human heart failure, and these changes are not reversed after left ventricular assist device. The clinical significance of these findings for cardiac recovery remains to be addressed. © 2014 American Heart Association, Inc.
Yan, Bo; Xu, Hui; Zhang, Ke; Li, Shujin; Wang, Jin; Shi, Yuting; Du, Yukou
Self-supported PdCu alloy nanowires fabricated by a facile one-pot method have been reported, which copper assists in the morphological transformation from graininess to nanowires. The copper incorporated with palladium to form alloy structures cannot only cut down the usage of noble metal but also enhance their catalytic performances. The catalysts with self-supported structure and proper ratio of palladium to copper show great activity and long-term stability for the electrooxidation of ethylene glycol in alkaline solution. Especially for Pd43Cu57, its mass activity reaches to 5570.83 mA mg-1, which is 3.12 times as high as commercial Pd/C. This study highlights an accessible strategy to prepare self-supported PdCu alloy nanowires and their potential applications in renewable energy fields.
In this book, leading authors in the field discuss developments of Ambient Assisted Living. The contributions have been chosen and invited at the 7th AAL congress, Berlin. It presents new technological developments which support the autonomy and independence of individuals with special needs. As the technological innovation raises also social issues, the book addresses micro and macro economical aspects of assistive systems and puts an additional emphasis on the ethical and legal discussion. The presentation is supported by real world examples and applications.
Donohue, Brad; Plant, Christopher P; Loughran, Travis A; Torres, Anali
Contingency management (CM) has extensively been shown to be effective in reducing substance use disorders, but its effects in reducing child maltreatment have yet to be determined. The current study provides preliminary support for the utilization of an innovative family-assisted CM component in 18 mothers who were referred to an evidence-supported behavioral treatment for concurrent child neglect and drug abuse by Child Protective Service caseworkers. In the examined CM, participants were invited to indicate from a list of common actions incompatible with child neglect (i.e. positive parenting actions), the extent to which these actions had been experienced utilizing a 3-point scale (almost never, sometimes, almost always). For each item that was indicated to be almost never or sometimes experienced, the participants were queried to indicate if the neglect incompatible action should be targeted as a therapeutic goal. Contingencies were subsequently established in which the participants were rewarded by involved family members for their completion of therapeutic goals. At baseline, results indicated that there was a negative association between the number of neglect incompatible parenting actions that were infrequently experienced and child abuse potential. A hierarchical multiple regression analysis showed that the number of neglect incompatible actions targeted as therapeutic goals at baseline, but not the number of positive parenting actions experienced infrequently at baseline, predicted reduced child maltreatment potential following treatment. These findings suggest the examined CM may assist evidence supported behavioral treatment specific to child neglect and drug abuse.
Padilla, Romen Herrera; Priecel, Peter; Lin, Ming; Lopez-Sanchez, Jose Antonio; Zhong, Ziyi
This work aims to develop a rapid and efficient strategy for preparing supported metal catalysts for catalytic applications. The sonication-assisted reduction-precipitation method was employed to prepare the heterogeneous mono- and bi-metallic catalysts for photocatalytic degradation of methyl orange (MO) and preferential oxidation (PROX) of CO in H 2 -rich gas. In general, there are three advantages for the sonication-assisted method as compared with the conventional methods, including high dispersion of metal nanoparticles on the catalyst support, the much higher deposition efficiency (DE) than those of the deposition-precipitation (DP) and co-precipitation (CP) methods, and the very fast preparation, which only lasts 10-20s for the deposition. In the AuPd/TiO 2 catalysts series, the AuPd(3:1)/TiO 2 catalyst is the most active for MO photocatalytic degradation; while for PROX reaction, Ru/TiO 2 , Au-Cu/SBA-15 and Pt/γ-Al 2 O 3 catalysts are very active, and the last one showed high stability in the lifetime test. The structural characterization revealed that in the AuPd(3:1)/TiO 2 catalyst, Au-Pd alloy particles were formed and a high percentage of Au atoms was located at the surface. Therefore, this sonication-assisted method is efficient and rapid in the preparation of supported metal catalysts with obvious structural characteristics for various catalytic applications. Copyright © 2016 Elsevier B.V. All rights reserved.
Full Text Available This paper questions some basic assumptions of legal theory, education and practice from the perspective of rural, remote and regional (RRR legal communities beyond the metropolis. Legal ideologies and values fundamental to the legitimacy of the modern state, such as the Rule of Law, are embedded in most law curricula and reinforced at every stage of the educational continuum, and commonly assert that law, legal rights and access to courts of law apply equally regardless of physical location or social status. Despite this, indigenous and other excluded groups living in peripheral communities frequently experience law differently from their urban counterparts, as do legal professionals living and working outside the city. The key issue examined concerns how centre-periphery tension should best be managed in the future regulation of law and lawyers. What kind of policies and strategies may genuinely assist social inclusion and to what extent should law and legal practice accommodate diversity? How and to what extent should lawyers and para-legals represent the interests of communities rather than private individuals in RRR areas of Australia? What kind of training and technological support do they require? The paper aims to set out some choices that confront policymakers while drawing upon international experience that may offer some guidance.
This study addresses the challenges faced by Modern Foreign Language teacher trainees when asked to investigate the potential of a Personal Digital Assistant to support them both in their learning and in their teaching during their training year. Personal Digital Assistants (PDAs) such as the Windows Pocket PCs used in this study have previously…
Rahsepar, Mansour, E-mail: email@example.com [Department of Materials Science and Engineering, School of Engineering, Shiraz University, Zand Boulevard, Shiraz, 7134851154 (Iran, Islamic Republic of); Kim, Hasuck, E-mail: firstname.lastname@example.org [Department of Chemistry, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul, 151-747 (Korea, Republic of); Department of Energy Systems Engineering, Daegu Gyeongbuk Institute of Science & Technology, Daegu, 711-873 (Korea, Republic of)
Multiwalled carbon nanotube (MWCNT) supported PtRu nanoparticles were synthesized by using a microwave-assisted improved impregnation technique. X-ray diffraction, transmission electron microscopy and X-ray photo electron spectroscopy were used to characterize the prepared PtRu/MWCNT nanoparticles. The PtRu nanoparticles with a satisfactory dispersion were formed on the external surface of MWCNTs. The CO stripping experiment was performed to evaluate the poisoning resistance of the prepared PtRu/MWCNT nanoparticles. Results of electrochemical measurements indicate that the prepared PtRu/MWCNTs shows an enhanced performance toward CO poisoning. The results of characterization revealed that microwave-assisted improved impregnation technique have a high yield of alloy phase formation and could be effectively used as a simple, quick and efficient technique for preparation of bimetallic PtRu/MWCNT nanoparticles. - Highlights: • Highly dispersed PtRu/MWCNTs were formed without use of any stabilizing agent. • Microwave irradiation enhances the uniform dispersion of the PtRu nanoparticles. • Microwave-assisted improved impregnation have a high yield of alloy phase formation. • The prepared PtRu/MWCNTs shows an enhanced performance toward CO poisoning.
Speller, Brittany; Stolee, Paul
As the population ages, the demand for long-term care settings is expected to increase. Assisted living is a suitable and favourable residence for older individuals to receive care services specific to their needs while maintaining their independence and privacy. With the growing transition of older individuals into assisted living, facilities need to ensure that safe care is continually maintained. The purpose of this study was to determine the gaps and strengths in care related to safety in assisted living facilities (ALFs). A qualitative descriptive research design was used to provide a comprehensive understanding of client safety from the perspectives of clients, administrative staff and personal support workers. Interviews were conducted with 22 key informants from three ALFs in Toronto, Ontario throughout July 2012. All interviews were semi-structured, audio-recorded and transcribed verbatim. Initial deductive analysis used directed coding based on a prior literature review, followed by inductive analysis to determine themes. Three themes emerged relating to the safety of clients in ALFs: meaning of safety, a multi-faceted approach to providing safe care and perceived areas of improvement. Sub-themes also emerged including physical safety, multiple factors, working as a team, respecting clients' independence, communication and increased education and available resources. The study findings can contribute to the improvement and development of new processes to maintain and continually ensure safe care in ALFs. © 2014 John Wiley & Sons Ltd.
Assisted suicide is now legal in several jurisdictions outside Canada, including the Netherlands, Belgium, Switzerland, Oregon, Washington State and Vermont. In Canada, public support for the decriminalization of assisted suicide is increasing, although assisted suicide remains prohibited under Canada's Criminal Code. That may soon change and, as patients'advocates, nurses need to khow and understand their roles and current laws relevant to treatment and end-of-life care.
Hussain, Shahid; Jamwal, Prashant K; Ghayesh, Mergen H
While body weight support (BWS) intonation is vital during conventional gait training of neurologically challenged subjects, it is important to evaluate its effect during robot assisted gait training. In the present research we have studied the effect of BWS intonation on muscle activities during robotic gait training using dynamic simulations. Two dimensional (2-D) musculoskeletal model of human gait was developed conjointly with another 2-D model of a robotic orthosis capable of actuating hip, knee and ankle joints simultaneously. The musculoskeletal model consists of eight major muscle groups namely; soleus (SOL), gastrocnemius (GAS), tibialis anterior (TA), hamstrings (HAM), vasti (VAS), gluteus maximus (GLU), uniarticular hip flexors (iliopsoas, IP), and Rectus Femoris (RF). BWS was provided at levels of 0, 20, 40 and 60% during the simulations. In order to obtain a feasible set of muscle activities during subsequent gait cycles, an inverse dynamics algorithm along with a quadratic minimization algorithm was implemented. The dynamic parameters of the robot assisted human gait such as joint angle trajectories, ground contact force (GCF), human limb joint torques and robot induced torques at different levels of BWS were derived. The patterns of muscle activities at variable BWS were derived and analysed. For most part of the gait cycle (GC) the muscle activation patterns are quite similar for all levels of BWS as is apparent from the mean of muscle activities for the complete GC. Effect of BWS variation during robot assisted gait on muscle activities was studied by developing dynamic simulation. It is expected that the proposed dynamic simulation approach will provide important inferences and information about the muscle function variations consequent upon a change in BWS during robot assisted gait. This information shall be quite important while investigating the influence of BWS intonation on neuromuscular parameters of interest during robotic gait training.
This collection gathers together a host of the most eminent contemporary legal philosophers, who writes about their take on legal philosophy, its fundamental questions and potential.......This collection gathers together a host of the most eminent contemporary legal philosophers, who writes about their take on legal philosophy, its fundamental questions and potential....
Aitken, Peter; Leggat, Peter; Harley, Hazel; Speare, Richard; Leclercq, Muriel
Background It is likely that calls for disaster medical assistance teams (DMATs) continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support. Methods Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster. Results The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the South East Asian Tsunami affected areas. The DMAT members had significant clinical and international experience. There was unanimous support for dedicated logistic support with 80% (47/59) strongly agreeing. Only one respondent (2%) disagreed with teams being self sufficient for a minimum of 72 hours. Most felt that transport around the site was not a problem (59%; 35/59), however, 34% (20/59) felt that transport to the site itself was problematic. Only 37% (22/59) felt that pre-deployment information was accurate. Communication with local health providers and other agencies was felt to be adequate by 53% (31/59) and 47% (28/59) respectively, while only 28% (17/59) felt that documentation methods were easy to use and reliable. Less than half (47%; 28/59) felt that equipment could be moved easily between areas by team members and 37% (22/59) that packaging enabled materials to be found easily. The maximum safe container weight was felt to be between 20 and 40 kg by 58% (34/59). Conclusions This study emphasises the importance of dedicated logistic support for DMAT and the need for teams to be self sufficient for a minimum period of 72 hours. There is a need for accurate pre deployment information to guide resource prioritisation with clearly labelled pre packaging to assist access on site. Container weights should be restricted to between
Randall, G. Kevin; Martin, Peter; MacDonald, Maurice; Margrett, Jennifer; Bishop, Alex J.; Poon, Leonard W.
We investigated the influence of social relations on health outcomes in very late life by examining the support-efficacy convoy model among older adults who resided in three different residential environments (centenarians in private homes, n = 126; centenarians in assisted living facilities, n = 55; centenarians in nursing homes, n = 105). For each group, path analytic models were employed to test our hypotheses; analyses controlled for sex, mental status, education, perceived economic sufficiency, and activities of daily living. The hypothesized relationships among the models' variables were unique to each of the three groups; three different models fit the data depending upon residential environment. The direct and indirect effects of social relations assessments were positive for the mental and physical health of very old adults, suggesting that participants welcomed the support. However, residential status moderated the associations between the assessments of social relations, self-efficacy, and both outcomes, physical and mental health. PMID:21792391
Inoue, Takafumi; Nishimura, Takashi; Murakami, Arata; Itatani, Keiichi; Takaoka, Tetsuhiro; Kitahori, Kazuo; Umeki, Akihide; Takezoe, Toshiko; Kashiwa, Koichi; Kyo, Shunei; Ono, Minoru
The mid-term and long-term results of left ventricular assist device (LVAD) implantation for small children are still unsatisfactory. There have been few reports of LVAD implantation for more than a month in children weighing under 5 kg. We report the case of a 4-month-old female infant who survived for 2 months after being diagnosed with dilated cardiomyopathy (DCM) with extracorporeal centrifugal pump support. In recent years, although pumps designed for small children have been introduced and are used as a bridge to transplantation or recovery, mid-term or long-term mechanical support for small children with heart failure is still difficult. We managed to successfully provide support for a low-body-weight child with a centrifugal pump over a mid-term period. We achieved acceptable control of thrombosis, but eventually the infant died of sepsis. Autopsy revealed no prominent thrombosis in the perfusion cannula, drainage cannula, the pump, or the left ventricle. This is the first case report of LVAD support with the centrifugal pump, ROTAFLOW(®) (Maquet, Rastatt, Germany), for 2 months in a child weighing under 5 kg. Our method may potentially save severe heart failure children who need mid-term LVAD support.
Bauer, Adrian; Schaarschmidt, Jan; Grosse, F Oliver; Al Alam, Nidal; Hausmann, Harald; Krämer, Klaus; Strüber, Martin; Mohr, Friedrich W
The use of extracorporeal life support systems (ECLS) in patients with postcardiotomy low cardiac output syndrome (LCO) as a bridge to recovery and bridge to implantation of ventricular assist device (VAD) is common nowadays. A 59-year-old patient with acute myocardial infarction received a percutaneous transluminal angioplasty and stenting of the circumflex artery. During catheterization of the left coronary artery (LAD), the patient showed ventricular fibrillation and required defibrillation and cardiopulmonary resuscitation. After implantation of an intra-aortic balloon pump, the patient immediately was transmitted to the operating room. He received emergency coronary artery bypass grafting in a beating heart technique using pump-assisted minimal extracorporeal circulation circuit (MECC). Two bypass grafts were performed to the LAD and the right posterior descending artery. Despite initial successful weaning off cardiopulmonary bypass with high-dose inotropic support, the patient presented postcardiotomy LCO and an ECLS was implanted. The primary setup of the heparin-coated MECC system was modified and used postoperatively. As a result of the absence of an in-house VAD program, the patient was switched to a transportable ECLS the next day and was transferred by helicopter to the nearest VAD center where the patient received a successful insertion of a left VAD 3 days later.
Miyashita, Ayako; Hasenbush, Amira; Sears, Brad
This report summarizes findings of the Legal Assessment of Needs Study (“LeAN Study”) – an online survey with 387 respondents who identified as people living with HIV/AIDS – for transgender women living with HIV in Los Angeles County. We describe respondents’ legal needs, respondents’ experiences getting assistance for identified legal needs from both legal and non-legal sources, and barriers respondents faced in accessing assistance from both legal and non-legal sources. We describe differen...
Rhodes, A M
Adolescent pregnancies have risen in recent years. Options open to the pregnant adolescent are: terminating the pregnancy; giving birth to the child out of wedlock; keeping the baby; giving the baby up for adoption; and marriage before or after the birth of the baby. Each of these options carries certain legal ramifications, since the adolescent patients have not reached the age of majority. The state or the parents usually assume the role of decision making on behalf of the adolescent or assist in the decision making process. Court rulings since the early seventies have legalized abortion and enlarged the rights of minors seeking termination of their pregnancies. Both parents and minors have rights under the certain state laws; parent have the right to notification, minors have the right to privacy. Keeping the child, out of wedlock, might result in legal battles over custody and/or establishing financial support from the father. Some adolescent mothers give up their children for adoption. There are 2 legal procedures that have to be accomplished before a child can be adopted: termination of the rights of the natural parents and adoption proceedings. If the parents marry after the birth of the child, the child is then considered legitimate and the father does not have to go through the process of adopting the child. Other issues requiring parental or individual consent include consent to treatment, contraception, or sterilization. In the case of forcible rape or incest, the physician is required to report incidents to law enforcement officials.
Helmons, Pieter J.; Suijkerbuijk, Bas O.; Nannan Panday, Prashant V.; Kosterink, Jos G. W.
Increased budget constraints and a continuous focus on improved quality require an efficient inpatient drug surveillance process. We describe a hospital-wide drug surveillance strategy consisting of a multidisciplinary evaluation of drug surveillance activities and using clinical decision support to
Baker, Sally; Ramsay, Georgina; Irwin, Evonne; Miles, Lauren
This paper contributes a rich picture of how students from refugee backgrounds navigate their way into and through undergraduate studies in a regional Australian university, paying particular attention to their access to and use of different forms of support. We draw on the conceptualisation of "hot" and "cold" knowledge,…
Jean D. Hallewell Haslwanter
Full Text Available Due to an aging population in Europe, the development of Ambient Assisted Living technologies (AAL is increasingly the target of research financing. These technologies promise to enable older people to remain in their own homes longer, something many people report wanting and which may also reduce the costs of care. To date however there are few systems on the market. Other studies have tried to understand this by looking at user acceptance. However, by looking only at the user acceptance, we may miss important aspects to explain why systems went wrong in the first place, since decisions made during the development may affect the success later. To address this, we report on a study in which we applied qualitative methods, including workshops and an interactive poster, to consult with people who have experience in the development of these technologies. We present the common issues reported across various AAL development projects done in Europe that the participants thought were important to the success or failure of projects. We also describe some ideas from participants for addressing some of these problems. The results demonstrate the importance of issues related to financing with grants for projects but also the need for improved user-centered practice.
El Maatougui, Abdelaziz; Azuaje, Jhonny; Sotelo, Eddy; Caamaño, Olga; Coelho, Alberto
A solution phase protocol that enabled the synthesis of three diverse libraries of pyridazin-3-ones incorporating α,β-unsaturated moieties at position 5 of the heterocyclic core has been developed using silica-supported aluminum trichloride as a heterogeneous and reusable catalyst. This robust procedure has facilitated the hit to lead process for these series of compounds and allowed the identification of new potent derivatives that elicit antiplatelet activity in the low micromolar range.
Sladen, Robert N
The past decade has seen an exponential increase in the application and development of durable long-term as well as nondurable short-term mechanical circulatory support for cardiogenic shock and acute or chronic heart failure. Support has evolved from bridge-to-transplant to destination therapy, bridge to rescue, bridge to decision making, and bridge to a bridge. Notable trends include device miniaturization, minimally invasive and/or percutaneous insertion, and efforts to superimpose pulsatility on continuous flow. We can certainly anticipate that innovation will accelerate in the months and years to come. However, despite-or perhaps because of-the enhanced equipment now available, mechanical circulatory support is an expensive, complex, resource-intensive modality. It requires considerable expertise that should preferably be centralized to highly specialized centers. Formidable challenges remain: systemic inflammatory response syndromes and vasoplegia after device insertion; postoperative sepsis; optimal anticoagulation regimens to prevent device-induced thrombosis and cerebral thromboembolism; wound site, intracranial, and gastrointestinal bleeding; multisystem injury and failure; patient dissatisfaction (even when providers consider the procedure a "success"); and ethical decision making in conditions of futility.
Despite recent progress, the production costs for renewable electricity remain above those for conventional power. Expectations of continuous reductions in production costs, typically underpin governments' policies for financial support. They often draw on the technology-focused versions of the Experience Curve model. This paper discusses how national-contextual factors also have a strong influence on production costs, such as geographic, infrastructural, institutional, and resource factors. As technologies mature, and as they reach significant levels of diffusion nationally, sustained increases in production costs might be recorded, due to these nationally contextual factors, poorly accounted for in policy-making decisions for price support. The paper suggests an analytical framework for a more comprehensive understanding of production costs. Based on this, it recommends that the evolution of specific cost levels and factors be monitored to locate 'sources of changes'. The paper also suggests policy instruments that governments may use to facilitate cost decreases, whenever possible. The application of the framework is illustrated for the diffusion of wind power in Spain during the past three decades. - Highlights: → Models, frameworks for policy-making on price support for renewable electricity production costs. → Policy instruments to help reduce production costs. → Limits to the influence of policies of production costs reductions.
Thaysen, Jens Damgaard
This paper discusses how legal moralism should be defined. It is argued that legal moralism should be defined as the position that “For any X, it is always a pro tanto reason for justifiably imposing legal regulation on X that X is morally wrong (where “morally wrong” is not conceptually equivalent...... to “harmful”)”. Furthermore, a distinction between six types of legal moralism is made. The six types are grouped according to whether they are concerned with the enforcement of positive or critical morality, and whether they are concerned with criminalising, legally restricting, or refraining from legally...... protecting morally wrong behaviour. This is interesting because not all types of legal moralism are equally vulnerable to the different critiques of legal moralism that have been put forth. Indeed, I show that some interesting types of legal moralism have not been criticised at all....
Shaheen M. Sarkar
Full Text Available N-Sulfonyl-1,2-diamine ligands, derived from 1,2-diaminocyclohexane and 1,2-diaminopropane, were immobilized onto mesoporous SBA-15 silica. The SBA-15-supported sulfonyldiamine-Ru complex was prepared in situ under microwave heating at 60 W for 3 min. The prepared sulfonyldiamine-Ru complex was used as an efficient catalyst for the transfer hydrogenation of ketones to the corresponding secondary alcohols. The heterogeneous complex showed extremely high catalytic activity with 99% conversion rate under microwave heating condition. The complexes were regenerated by simple filtration and reused two times without significant loss of activity.
Roč. 7, č. 1 (2017), s. 40-49 ISSN 1805-8396 R&D Projects: GA ČR(CZ) GA16-26910S Institutional support: RVO:68378122 Keywords : biometric data * consumer protection * data protection Subject RIV: AG - Legal Sciences OBOR OECD: Law
[On the improvement of the legal support of the food safety in the conditions of trade and economic integration of states-members of the Customs union and the Russian Federation's accession to the WTO].
Bragina, I V; Aksenova, O I; Bokit'ko, B G; Gorsky, A A
In the article priority activities of The Federal Service for the Oversight of Consumer Protection and Welfare on improvement of standard legal support of safety of foodstuff and control of compliance of foodstuff to legislation requirements are reported. The main documents directed on harmonization of the international requirements with national ones and requirements of the Customs union on safety of foodstuff are submitted. Work within a framework of Russian Federation's accession to the WTO is described. And data on control of quality and safety of foodstuff are provided also.
Doležal, Adam; Doležal, Tomáš
Roč. 10, č. 7 (2014), s. 53-70 ISSN 1857-7881 Institutional support: RVO:68378122 Keywords : causation * tort law * legal liability Subject RIV: AG - Legal Sciences http://www.eujournal.org/index.php/esj/article/view/2968
Voltolini, Alessandra; Minotti, Anna; Verde, Alessandro; Cipriani, Manlio; Garascia, Andrea; Turazza, Fabio; Macera, Francesca; Perna, Enrico; Russo, Claudio F; Fumagalli, Emilia; Frigerio, Maria
Heart disease has an impact on patient's identity and self-perception. Taking into account the wide literature about psychological aspects before and after heart transplant, it clearly emerges that there is a lack of data and results for patients up to implantation of ventricular assist devices (VAD). The aim of the present study was to explore quality of life and factors correlated with psychological adjustment in patients supported with VAD. From February 2013 to August 2014, 18 patients (17 male, mean age 57 years) under clinical evaluation before and after VAD implantation were enrolled. During interviews, patients were assessed with EuroQoL-5D questionnaire to monitor improvement of quality of life before implantation and at 3 and 6 months; critical issues, needs and point of views of patients have been described. A significant improvement in the quality of life score was observed at 3 (score 38 [interquartile range 30-40] vs 75 [60-80], ppsychological state investigated by the test showed a clear and positive trend. All patients need to empower through complete information about the device, related risks and life expectancy. Interdisciplinary approach improved compliance with therapy. Successful treatment and efficient psychological care are closely related to assessment and continuous clinical support. This approach ensures a better selection of patients and improves their compliance. Further data are needed to support our preliminary observations and to explore long-term quality of life.
The paper presents the potential of the Egyptian Nuclear Power Project and its importance to Egypt for electric energy security and diversity as well as the nuclear project role to achieve the economical and social development of the country. The former historical three efforts to implement the project would be presented. The main features of the project Bid Invitation Specifications (BIS) would be highlighted including the nuclear reactor type and the financial issues as well as the challenges especially that regarding public acceptance and local industry participation. The presentation highlights the role of the IAEA in providing the technical assistance in support of the project implementation throughout its history as related to the feasibility study, electric grid requirements, site selection, training, and other aspects. (author)
Grillo, Michael C.; Leist, Cathy W.
This study seeks to examine the relationship between the long-term use of academic support services such as tutoring, learning assistance, and supplemental instruction and retention to graduation. Little research has been devoted to the relationship between academic support and retention to graduation in both the literatures on retention and…
Munthe, Christian; Nielsen, Morten Ebbe Juul
This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for healthcare professionals based on the importance of cultural identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to healthcare professionals' conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment, and this requirement is found to create serious problems for those wishing to defend the idea under consideration. We conclude that the notion of a legal right to conscientious refusal for any profession is either fundamentally incompatible with elementary legal ethical requirements, or implausible because it undermines the functioning of a related professional sector (healthcare) or even of society as a whole.
Schwanbeck, Jan; Weingartner, Rolf
Decision making in flood situations is a difficult task, especially in small to medium-sized mountain catchments (30 - 500 km2) which are usually characterized by complex topography, high drainage density and quick runoff response to rainfall events. Operating hydrological models driven by numerical weather prediction systems, which have a lead-time of several hours up to few even days, would be beneficial in this case as time for prevention could be gained. However, the spatial and quantitative accuracy of such meteorological forecasts usually decrease with increasing lead-time. In addition, the sensitivity of rainfall-runoff models to inaccuracies in estimations of areal rainfall increases with decreasing catchment size. Accordingly, decisions on flood alerts should ideally be based on areal rainfall from high resolution and short-term numerical weather prediction, nowcasts or even real-time measurements, which is transformed into runoff by a hydrological model. In order to benefit from the best possible rainfall data while retaining enough time for alerting and for prevention, the hydrological model should be fast and easily applicable by decision makers within local authorities themselves. The proposed decision support methodology FlooDSuM (Flood Decision Support Methodology) aims to meet those requirements. Applying FlooDSuM, a few successive binary decisions of increasing complexity have to be processed following a flow-chart-like structure. Prepared data and straightforwardly applicable tools are provided for each of these decisions. Maps showing the current flood disposition are used for the first step. While danger of flooding cannot be excluded more and more complex and time consuming methods will be applied. For the final decision, a set of scatter-plots relating areal precipitation to peak flow is provided. These plots take also further decisive parameters into account such as storm duration, distribution of rainfall intensity in time as well as the
Wong, Charlene A; Polsky, Daniel E; Jones, Arthur T; Weiner, Janet; Town, Robert J; Baker, Tom
The design of the Affordable Care Act's online health insurance Marketplaces can improve how consumers make complex health plan choices. We examined the choice environment on the state-based Marketplaces and HealthCare.gov in the third open enrollment period. Compared to previous enrollment periods, we found greater adoption of some decision support tools, such as total cost estimators and integrated provider lookups. Total cost estimators differed in how they generated estimates: In some Marketplaces, consumers categorized their own utilization, while in others, consumers answered detailed questions and were assigned a utilization profile. The tools available before creating an account (in the window-shopping period) and afterward (in the real-shopping period) differed in several Marketplaces. For example, five Marketplaces provided total cost estimators to window shoppers, but only two provided them to real shoppers. Further research is needed on the impact of different choice environments and on which tools are most effective in helping consumers pick optimal plans. Project HOPE—The People-to-People Health Foundation, Inc.
Torres, L.; Villena, H.
The United Nations Convention of the Law of the Sea (UNCLOS) establishes the juridical and legal frameworks which the Coastal States (C S) establish their respective outer limit of the continental shelf in which will exercise sovereignty rights under the resources in the on the seabed and seabed subsurface. The base to reach the delineation of continental shelf outer limit is ruled by the application the criteria which take into consideration mainly data and pieces of information from Geology, Geophysics and Geomorphology employed both lonely or conjunction. In the current presentation were employed both data carried out by Brazilian Continental Shelf Project (Laplace) and data from public domain. As the underwater features do not follow political limits, the goal of this proposal work is to present the integration of both data and pieces of information from geological, geophysical and geomorphologic characteristics in order to reach the harmonization of the Brazil and Uruguay continental shelf outer limit nearby their Maritime Lateral Boundary
... affecting older persons in economic or social need, for example, public benefits, institutionalization and... judicial representation in the areas of law affecting older persons with economic or social need; (3... employees shall: (1) Participate in any public demonstration, picketing, boycott, or strike, except as...
Filaković, Pavo; Petek Erić, Anamarija; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven
The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity – fully or partially. Given ...
A discussion of legal and administrative language, and the necessity for accurate translation of this language in the field of international relations. Topics treated are: characteristic features of legal and administrative terminology; the interpretation of it; and the technique of translating legal and administrative texts. (AMH)
Randall, Lisa H; Curran, Eileen A; Omer, Saad B
Recent years have brought increased focus on the desirability of vaccinating more healthcare workers against influenza. The concern that novel 2009 H1N1 influenza A would spark a particularly severe influenza season in 2009-2010 spurred several institutions and one state to institute mandatory vaccination policies for healthcare workers, and several new mandates have been introduced since then. Some healthcare workers, however, have voiced objections in the media and in legal proceedings. This paper reviews the characteristics of influenza and how it is transmitted in the healthcare setting; surveys possible constitutional, administrative, and common law arguments against mandates; assesses the viability of those arguments; and identifies potential new legal strategies to support influenza vaccine mandates. It is intended to assist those involved in the regulation and administration of public and private healthcare institutions who may be considering approaches to mandates but have concerns about legal challenges. Copyright © 2013 Elsevier Ltd. All rights reserved.
Wilson, Kenneth L; Doswell, Jayfus T; Fashola, Olatokunbo S; Debeatham, Wayne; Darko, Nii; Walker, Travelyan M; Danner, Omar K; Matthews, Leslie R; Weaver, William L
This study was to extrapolate potential roles of augmented reality goggles as a clinical support tool assisting in the reduction of preventable causes of death on the battlefield. Our pilot study was designed to improve medic performance in accurately placing a large bore catheter to release tension pneumothorax (prehospital setting) while using augmented reality goggles. Thirty-four preclinical medical students recruited from Morehouse School of Medicine performed needle decompressions on human cadaver models after hearing a brief training lecture on tension pneumothorax management. Clinical vignettes identifying cadavers as having life-threatening tension pneumothoraces as a consequence of improvised explosive device attacks were used. Study group (n = 13) performed needle decompression using augmented reality goggles whereas the control group (n = 21) relied solely on memory from the lecture. The two groups were compared according to their ability to accurately complete the steps required to decompress a tension pneumothorax. The medical students using augmented reality goggle support were able to treat the tension pneumothorax on the human cadaver models more accurately than the students relying on their memory (p augmented reality group required more time to complete the needle decompression intervention (p = 0.0684), this did not reach statistical significance. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.
Full Text Available In the rehabilitation field, the use of additive manufacturing techniques to realize customized orthoses is increasingly widespread. Obtaining a 3D model for the 3D printing phase can be done following different methodologies. We consider the creation of personalized upper limb orthoses, also including fingers, starting from the acquisition of the hand geometry through accurate 3D scanning. However, hand scanning procedure presents differences between healthy subjects and patients affected by pathologies that compromise upper limb functionality. In this work, we present the concept and design of a 3D printed support to assist hand scanning of such patients. The device, realized with FDM additive manufacturing techniques in ABS material, allows palmar acquisitions, and its design and test are motivated by the following needs: (1 immobilizing the hand of patients during the palmar scanning to reduce involuntary movements affecting the scanning quality and (2 keeping hands open and in a correct position, especially to contrast the high degree of hypertonicity of spastic subjects. The resulting device can be used indifferently for the right and the left hand; it is provided in four-dimensional sizes and may be also suitable as a palmar support for the acquisition of the dorsal side of the hand.
Armour, Danielle; Warren, Elizabeth; Miller, Jodie
Indigenous teacher assistants (ITAs) are often employed in schools to assist in addressing educational issues relating to Indigenous students. While, this practice has occurred for over 40 years in most Australian states, little has been written about their contribution in assisting Indigenous students to learn. This paper explores the influence…
Roč. 8, č. 2 (2014) ISSN 1802-5951 Institutional support: RVO:68378122 Keywords : brain-computer interface * human rights * right to privacy, Subject RIV: AG - Legal Sciences http://mujlt.law.muni.cz/index.php
Vasconcelos, Renata S; Sales, Raquel P; Melo, Luíz H de P; Marinho, Liégina S; Bastos, Vasco Pd; Nogueira, Andréa da Nc; Ferreira, Juliana C; Holanda, Marcelo A
Pressure support ventilation (PSV) is often associated with patient-ventilator asynchrony. Proportional assist ventilation (PAV) offers inspiratory assistance proportional to patient effort, minimizing patient-ventilator asynchrony. The objective of this study was to evaluate the influence of respiratory mechanics and patient effort on patient-ventilator asynchrony during PSV and PAV plus (PAV+). We used a mechanical lung simulator and studied 3 respiratory mechanics profiles (normal, obstructive, and restrictive), with variations in the duration of inspiratory effort: 0.5, 1.0, 1.5, and 2.0 s. The Auto-Trak system was studied in ventilators when available. Outcome measures included inspiratory trigger delay, expiratory trigger asynchrony, and tidal volume (V T ). Inspiratory trigger delay was greater in the obstructive respiratory mechanics profile and greatest with a effort of 2.0 s (160 ms); cycling asynchrony, particularly delayed cycling, was common in the obstructive profile, whereas the restrictive profile was associated with premature cycling. In comparison with PSV, PAV+ improved patient-ventilator synchrony, with a shorter triggering delay (28 ms vs 116 ms) and no cycling asynchrony in the restrictive profile. V T was lower with PAV+ than with PSV (630 mL vs 837 mL), as it was with the single-limb circuit ventilator (570 mL vs 837 mL). PAV+ mode was associated with longer cycling delays than were the other ventilation modes, especially for the obstructive profile and higher effort values. Auto-Trak eliminated automatic triggering. Mechanical ventilation asynchrony was influenced by effort, respiratory mechanics, ventilator type, and ventilation mode. In PSV mode, delayed cycling was associated with shorter effort in obstructive respiratory mechanics profiles, whereas premature cycling was more common with longer effort and a restrictive profile. PAV+ prevented premature cycling but not delayed cycling, especially in obstructive respiratory mechanics
Alkasab, Tarik K; Bizzo, Bernardo C; Berland, Lincoln L; Nair, Sujith; Pandharipande, Pari V; Harvey, H Benjamin
Decreasing unnecessary variation in radiology reporting and producing guideline-concordant reports is fundamental to radiology's success in value-based payment models and good for patient care. In this article, we present an open authoring system for point-of-care clinical decision support tools integrated into the radiologist reporting environment referred to as the computer-assisted reporting and decision support (CAR/DS) framework. The CAR/DS authoring system, described herein, includes: (1) a definition format for representing radiology clinical guidelines as structured, machine-readable Extensible Markup Language documents and (2) a user-friendly reference implementation to test the fidelity of the created definition files with the clinical guideline. The proposed definition format and reference implementation will enable content creators to develop CAR/DS tools that voice recognition software (VRS) vendors can use to extend the commercial tools currently in use. In making the definition format and reference implementation software freely available, we hope to empower individual radiologists, expert groups such as the ACR, and VRS vendors to develop a robust ecosystem of CAR/DS tools that can further improve the quality and efficiency of the patient care that our field provides. We hope that this initial effort can serve as the basis for a community-owned open standard for guideline definition that the imaging informatics and VRS vendor communities will embrace and strengthen. To this end, the ACR Assist™ initiative is intended to make the College's clinical content, including the Incidental Findings Committee White Papers, available for decision support tool creation based upon the herein described CAR/DS framework. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Tseng, Cheyenne C S; Huibers, Manon M H; Gaykema, Lonneke H; Siera-de Koning, Erica; Ramjankhan, Faiz Z; Maisel, Alan S; de Jonge, Nicolaas
The interleukin-33 (IL-33)/suppressor of tumorigenicity 2 (ST2) pathway is suggested to play an important role in fibrosis, remodelling and the progression of heart failure (HF). Increased soluble (sST2) levels are associated with adverse outcome in the average HF population. Less is known about sST2 levels in end-stage HF. Therefore, we studied sST2 levels in end-stage HF and the effect of unloading by left ventricular assist device (LVAD) support on sST2 levels. Serial plasma measurements of sST2 were performed pre-implantation and 1, 3 and 6 months after (LVAD) implantation in 38 patients. sST2 levels were elevated in end-stage HF just prior to LVAD implantation (74.2 ng/mL [IQR 54.7-116.9]; normal end-stage HF patients with variability that suggests multiple inputs to a pro-inflammatory and pro-fibrotic pathway. Cardiogenic shock and increased C-reactive protein levels are associated with higher sST2 levels. LVAD support results in a significant drop in sST2 levels with normalization within 3 months postimplantation. This suggests that LVAD support leads to lessening of fibrosis and inflammation, which might eventually be used to target medical policy: explantation of the LVAD versus permanent use or cardiac transplantation. © 2018 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.
Information on adoption must be given to couples who seek treatment for medically-assisted procreation. But is adoption a real alternative? What are the chances for a couple who consults to see its desire for adoption be achieved according to its own situation, the characteristics of the child he wants, and the general situation of adoption? Can adoption, just like assisted procreation, often described by the couples as a "obstacle course", go parallel? Or should one try adoption once assisted reproduction failed? Is the couple willing to suffer the social and legal control of adoption after having supported the medical control of the ART? In all cases, the reality is that two out of three couples engaged in assisted reproduction will have a child whereas scarcely more than one candidate to adoption will be offered to adopt a child after three or four-years procedure. Copyright © 2010 Elsevier Masson SAS. All rights reserved.
Glennen, Robert E.
In the aftermath of the Watergate scandal, each profession is reviewing its ethical practices. This paper assists in this renewal by citing the code of ethical standards of APGA; reviewing the laws of the State of Nevada regarding privileged communications; and covering the legal aspects which relate to counseling situations. (Author)
Apperson, Ron; Waxman, Everett
This is the latest edition of a handbook designed to assist school administrators in preventing and dealing with school disruptions and certain related legal matters. Because the handbook was prepared specifically for use by administrators in the Los Angeles Unified School District, it is based on laws and regulations that may not apply elsewhere.…
Prange-Lasonder, Gerdienke B; Radder, Bob; Kottink, Anke I R; Melendez-Calderon, Alejandro; Buurke, Jaap H; Rietman, Johan S
Recent technological developments regarding wearable soft-robotic devices extend beyond the current application of rehabilitation robotics and enable unobtrusive support of the arms and hands during daily activities. In this light, the HandinMind (HiM) system was developed, comprising a soft-robotic, grip supporting glove with an added computer gaming environment. The present study aims to gain first insight into the feasibility of clinical application of the HiM system and its potential impact. In order to do so, both the direct influence of the HiM system on hand function as assistive device and its therapeutic potential, of either assistive or therapeutic use, were explored. A pilot randomized clinical trial was combined with a cross-sectional measurement (comparing performance with and without glove) at baseline in 5 chronic stroke patients, to investigate both the direct assistive and potential therapeutic effects of the HiM system. Extended use of the soft-robotic glove as assistive device at home or with dedicated gaming exercises in a clinical setting was applicable and feasible. A positive assistive effect of the soft-robotic glove was proposed for pinch strength and functional task performance 'lifting full cans' in most of the five participants. A potential therapeutic impact was suggested with predominantly improved hand strength in both participants with assistive use, and faster functional task performance in both participants with therapeutic application.
Filaković, Pavo; Erić, Anamarija Petek; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven
The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity - fully or partially. Given the increasing number of persons with dementia, they are often subjects of legal expertise concerning their legal capacity. On the other part, emphasis on the civil rights of mentally ill also demands their maximal protection. Therefore such distinctive issue is approached with particular attention. The approach in determination of legal competency is more focused on gradation of it's particular aspects instead of existing dual concept: legally capable - legally incapable. The main assumption represents how person with dementia is legally capable and should enjoy all the rights, privileges and obligations as other citizens do. The aspects of legal competency for which person with dementia is going to be deprived, due to protection of one's rights and interests, are determined in legal procedure and then passed over to the guardian decided by court. Partial annulment of legal competency is measure applied when there is even one existing aspect of preserved legal capability (pension disposition, salary or pension disposition, ability of concluding contract, making testament, concluding marriage, divorce, choosing whereabouts, independent living, right to vote, right to decide course of treatment ect.). This measure is most often in favour of the patient and rarely for protection of other persons and their interests. Physicians are expected to precisely describe early dementia symptoms which may influence assessment of specific aspects involved in legal capacity (memory loss, impaired task
Jeffrey, Karen; Bourgeois, Sharon
The objective of this review was to determine whether the use of Personal Digital Assistants (PDAs) would provide greater support in developing undergraduate nursing students' clinical reasoning, in comparison to more traditional resources such as textbooks. The search strategy sought to identify published data from five electronic databases: CINAHL, Medline, Cochrane Library, Meditext and Scopus. Unpublished literature was also sought in digital dissertations, conference proceedings, relevant scholarly websites and reference lists. All undergraduate nursing students were considered eligible for inclusion. Types of interventions considered for this review were inclusive of all forms of PDAs and traditional resources. The research setting of this systematic review reflects the diversity of nursing practice, and includes the classroom, clinical or simulated environment. The process of clinical reasoning was defined by four outcome measures; alterations in theoretical nursing knowledge, clinical skills, problem solving and reflection. Studies of potential significance to the review were assessed for methodological quality independently by two reviewers using the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Authorship of the studies was not concealed from the two reviewers. From the nine studies assessed for quality, only data from four studies were included in the review. Four published studies were included in the systematic review of literature. The designs of the studies included a nonrandomised quasi-experimental design, case control study, comparative descriptive design and a pre test post test mixed method study. Four outcomes were identified by the four included studies. These outcomes addressed possible effects of PDA usage on undergraduate nursing students' practice of medication administration, self-efficacy, anticipation to exercise professional nursing judgment and clinical reasoning.This systematic review provides
Høyer, Ellen; Jahnsen, Reidun; Stanghelle, Johan Kvalvik; Strand, Liv Inger
Treadmill training with body weight support (TTBWS) for relearning walking ability after brain damage is an approach under current investigation. Efficiency of this method beyond traditional training is lacking evidence, especially in patients needing walking assistance after stroke. The objective of this study was to investigate change in walking and transfer abilities, comparing TTBWS with traditional walking training. A single-blinded, randomized controlled trial was conducted. Sixty patients referred for multi-disciplinary primary rehabilitation were assigned into one of two intervention groups, one received 30 sessions of TTBWS plus traditional training, the other traditional training alone. Daily training was 1 hr. Outcome measures were Functional Ambulation Categories (FAC), Walking, Functional Independence Measure (FIM); shorter transfer and stairs, 10 m and 6-min walk tests. Substantial improvements in walking and transfer were shown within both groups after 5 and 11 weeks of intervention. Overall no statistical significant differences were found between the groups, but 12 of 17 physical measures tended to show improvements in favour of the treadmill approach. Both training strategies provided significant improvements in the tested activities, suggesting that similar outcomes can be obtained in the two modalities by systematic, intensive and goal directed training.
... (His), the United Negro College Fund Special Programs developed and implemented a comprehensive technical assistance and infrastructure program This program has provided HBCUs, HSIs, TCUs, and MIs...
Sheldon, C T; Aubry, T D; Arboleda-Florez, J; Wasylenki, D; Goering, P N
The following study evaluates the complex association between legal involvement and mental illness. It describes a population of consumers of community mental health programs, comparing those with legal involvement to those without legal involvement, on a number of demographic, clinical and social indicators. It is a secondary analysis of data collected in studies making up the Community Mental Health Evaluation Initiative (CMHEI) in the province of Ontario, Canada. Legal involvement was a significant issue among community mental health program consumers; about one in five consumers had at least some contact with the legal system in the preceding nine months. Legally involved consumers were more likely to be in receipt of social assistance and be unstably housed than those legally uninvolved. However, there were no significant differences between legally involved and uninvolved consumers with respect to severity of symptomatology, current medication use or number of hospitalization days in the past 9 months. A predictive model compared the differential impact of clinical and social determinants upon legal involvement. Analyses failed to uncover a significant relationship between severity of psychiatric symptomatology and legal involvement. Significant predictors of legal involvement included gender, race, drug use as well as housing instability, and receipt of social assistance. Legal involvement was attributable to factors other than the severity of mental illness; these results challenge assumptions that the most symptomatically severe consumers are most at risk of legal involvement. Accordingly, the rate of legal involvement in a sample of community mental health program users must be considered in a broad context, with particular emphasis on social disadvantage.
McMurray, Josephine; Strudwick, Gillian; Forchuk, Cheryl; Morse, Adam; Lachance, Jessica; Baskaran, Arani; Allison, Lauren; Booth, Richard
Intelligent assistive technologies that complement and extend human abilities have proliferated in recent years. Service robots, home automation equipment, and other digital assistant devices possessing artificial intelligence are forms of assistive technologies that have become popular in society. Older adults (>55 years of age) have been identified by industry, government, and researchers as a demographic who can benefit significantly from the use of intelligent assistive technology to support various activities of daily living. The purpose of this scoping review is to summarize the literature on the importance of the concept of "trust" in the adoption of intelligent assistive technologies to assist aging in place by older adults. Using a scoping review methodology, our search strategy will examine the following databases: ACM Digital Library, Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, PsycINFO, Scopus, and Web of Science. Two reviewers will independently screen the initial titles obtained from the search, and these results will be further inspected by other members of the research team for inclusion in the review. This review will provide insights into how the concept of trust is actualized in the adoption of intelligent assistive technology by older adults. Preliminary sensitization to the literature suggests that the concept of trust is fluid, unstable, and intimately tied to the type of intelligent assistive technology being examined. Furthermore, a wide range of theoretical lenses that include elements of trust have been used to examine this concept. This review will describe the concept of trust in the adoption of intelligent assistive technology by older adults, and will provide insights for practitioners, policy makers, and technology vendors for future practice. ©Josephine McMurray, Gillian Strudwick, Cheryl Forchuk, Adam Morse, Jessica Lachance, Arani Baskaran, Lauren
Blume, Peter Erik
This book describes how legal method is used within the Danish legal system. Its target group is foreign lawyers and law students who have an interest in knowing how Danish law commonly is determined and applied. In the first chapters legal method and legal sources in general are defined...... and furthermore a brief account of Danish legal history is provided. The following chapters concern: • Legal institutions, • Statute and Statutory Law • Legal Decisions • Legal Literature and Legal Knowledge • Other National Legal Sources • External Influences on Danish Law...
OBJECTIVE: To compare neurally adjusted ventilatory assist ventilation with pressure-support ventilation. DESIGN: Prospective, crossover comparison study. SETTING: Tertiary care pediatric and neonatal intensive care unit. PATIENTS: Sixteen ventilated infants and children: mean age = 9.7 months (range = 2 days-4 yrs) and mean weight = 6.2 kg (range = 2.4-13.7kg). INTERVENTIONS: A modified nasogastric tube was inserted and correct positioning was confirmed. Patients were ventilated in pressure-support mode with a pneumatic trigger for a 30-min period and then in neurally adjusted ventilatory assist mode for up to 4 hrs. MEASUREMENTS AND MAIN RESULTS: Data collected for comparison included activating trigger (neural vs. pneumatic), peak and mean airway pressures, expired minute and tidal volumes, heart rate, respiratory rate, pulse oximetry, end-tidal CO2 and arterial blood gases. Synchrony was improved in neurally adjusted ventilatory assist mode with 65% (+\\/-21%) of breaths triggered neurally vs. 35% pneumatically (p < .001) and 85% (+\\/-8%) of breaths cycled-off neurally vs. 15% pneumatically (p = .0001). The peak airway pressure in neurally adjusted ventilatory assist mode was significantly lower than in pressure-support mode with a 28% decrease in pressure after 30 mins (p = .003) and 32% decrease after 3 hrs (p < .001). Mean airway pressure was reduced by 11% at 30 mins (p = .13) and 9% at 3 hrs (p = .31) in neurally adjusted ventilatory assist mode although this did not reach statistical significance. Patient hemodynamics and gas exchange remained stable for the study period. No adverse patient events or device effects were noted. CONCLUSIONS: In a neonatal and pediatric intensive care unit population, ventilation in neurally adjusted ventilatory assist mode was associated with improved patient-ventilator synchrony and lower peak airway pressure when compared with pressure-support ventilation with a pneumatic trigger. Ventilating patients in this new mode
Full Text Available In this paper we introduce and apply the method for determination of the glass transition temperature of the sub-100 nm thick freestanding and supported polymer films based on thermally assisted atomic force microscopy (AFM. In proposed approach changes of the phase of an oscillating AFM cantilever are used to determine glass transition temperature. An anomalous decrease of the glass transition temperature for both free-standing and supported azobenzene-functionalized polymer thin films is shown.
Maher, Anthony John; Vickerman, Philip
One outcome of England's Code of Practice' (DfE, 1994) was an increase, first, in the number of learning support assistants (LSAs) working in mainstream schools and, second, the establishment of the role of special educational needs co-ordinator (SENCO). Semi-structured interviews were conducted with SENCOs and LSAs to explore: (i) why they chose…
Robertson, I A
The majority of veterinarians recognise their important role and responsibility to society and animal welfare in the detection and reporting of suspected abuse of animals and humans. In spite of the existing moral, ethical, and legal duties applied to veterinarians, they face substantial barriers that prohibit them from fulfilling their professional role in handling cases of suspected abuse. With increasing public and legal attention on issues of animal welfare, the non-fulfillment of these duties places the profession and its members at considerable risk of public criticism and adverse legal accountability. The issue is raised here that the veterinary profession in New Zealand needs to provide a clear policy statement and take pro-active measures that provide practical enforceable solutions to these existing barriers and legal risks. Such an initiative will assist in ensuring that all registered members consistently fulfil their obligations, and are legally protected while doing so. Veterinary counterparts overseas already provide a legislative immunity for their veterinarians who report suspected abuse as part of a mandated duty to report. Implementation of such a duty has significant benefits for all veterinarians, including the requirement for education and effective support systems. In the absence of such a mandatory duty, intermediary measures can be introduced, demonstrating social responsibility and commitment by the profession to their existing duty of care.
Motshekga, Sarah C.; Ray, Suprakas S.; Onyango, Maurice S.; Momba, Maggie N.B.
Highlights: • A facile, fast and effective method was used for preparing metal–clay composites. • The metal/oxide loaded on clay exhibited narrow size range at nano scale. • The composites deactivate both Gram negative and Gram positive bacteria. • A combination of metal and metal oxide provides the best antibacterial property. -- Abstract: Composites of silver–zinc oxide nanoparticles supported on bentonite clay were synthesized by the microwave-assisted synthesis method for use as an antibacterial material. Silver nitrate was used as the precursor of silver nanoparticles while zinc oxide nanoparticles were commercially sourced. The composites were characterized by powder X-ray diffraction (XRD), transmission electron microscope (TEM), Fourier transform infrared (FTIR) and BET surface area measurements. XRD spectra showed peaks of silver confirming the formation of the silver and not of the silver nitrate or any other impurity of the metal. Meanwhile TEM confirmed the formation of silver and zinc oxide nanoparticles on the clay layers, with particle sizes ranging from 9–30 nm and 15–70 nm, respectively. The antibacterial activities of the composites were evaluated against Gram negative Escherichia coli bacteria and Gram positive Enterococcus faecalis bacteria by the disc diffusion method. Whereas both composites of Ag-clay and ZnO-clay showed good antibacterial activity against bacteria, a better antibacterial activity was observed with Ag/ZnO-clay composite. The results therefore reveal that Ag/ZnO-clay composite is a promising bactericide that can be used for deactivating microbes in water
Motshekga, Sarah C. [DST/CSIR National Centre for Nanostructured Materials, Council for Scientific and Industrial Research, Pretoria 0001 (South Africa); Department of Chemical, Metallurgical and Materials Engineering, Tshwane University of Technology, Pretoria 0001 (South Africa); Ray, Suprakas S. [DST/CSIR National Centre for Nanostructured Materials, Council for Scientific and Industrial Research, Pretoria 0001 (South Africa); Onyango, Maurice S., E-mail: OnyangoMS@tut.ac.za [Department of Chemical, Metallurgical and Materials Engineering, Tshwane University of Technology, Pretoria 0001 (South Africa); Momba, Maggie N.B. [Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Arcadia Campus, Pretoria 0001 (South Africa)
Highlights: • A facile, fast and effective method was used for preparing metal–clay composites. • The metal/oxide loaded on clay exhibited narrow size range at nano scale. • The composites deactivate both Gram negative and Gram positive bacteria. • A combination of metal and metal oxide provides the best antibacterial property. -- Abstract: Composites of silver–zinc oxide nanoparticles supported on bentonite clay were synthesized by the microwave-assisted synthesis method for use as an antibacterial material. Silver nitrate was used as the precursor of silver nanoparticles while zinc oxide nanoparticles were commercially sourced. The composites were characterized by powder X-ray diffraction (XRD), transmission electron microscope (TEM), Fourier transform infrared (FTIR) and BET surface area measurements. XRD spectra showed peaks of silver confirming the formation of the silver and not of the silver nitrate or any other impurity of the metal. Meanwhile TEM confirmed the formation of silver and zinc oxide nanoparticles on the clay layers, with particle sizes ranging from 9–30 nm and 15–70 nm, respectively. The antibacterial activities of the composites were evaluated against Gram negative Escherichia coli bacteria and Gram positive Enterococcus faecalis bacteria by the disc diffusion method. Whereas both composites of Ag-clay and ZnO-clay showed good antibacterial activity against bacteria, a better antibacterial activity was observed with Ag/ZnO-clay composite. The results therefore reveal that Ag/ZnO-clay composite is a promising bactericide that can be used for deactivating microbes in water.
Kadiyala, M D M; Nedumaran, S; Singh, Piara; S, Chukka; Irshad, Mohammad A; Bantilan, M C S
The semi-arid tropical (SAT) regions of India are suffering from low productivity which may be further aggravated by anticipated climate change. The present study analyzes the spatial variability of climate change impacts on groundnut yields in the Anantapur district of India and examines the relative contribution of adaptation strategies. For this purpose, a web based decision support tool that integrates crop simulation model and Geographical Information System (GIS) was developed to assist agronomic decision making and this tool can be scalable to any location and crop. The climate change projections of five global climate models (GCMs) relative to the 1980-2010 baseline for Anantapur district indicates an increase in rainfall activity to the tune of 10.6 to 25% during Mid-century period (2040-69) with RCP 8.5. The GCMs also predict warming exceeding 1.4 to 2.4°C by 2069 in the study region. The spatial crop responses to the projected climate indicate a decrease in groundnut yields with four GCMs (MPI-ESM-MR, MIROC5, CCSM4 and HadGEM2-ES) and a contrasting 6.3% increase with the GCM, GFDL-ESM2M. The simulation studies using CROPGRO-Peanut model reveals that groundnut yields can be increased on average by 1.0%, 5.0%, 14.4%, and 20.2%, by adopting adaptation options of heat tolerance, drought tolerant cultivars, supplemental irrigation and a combination of drought tolerance cultivar and supplemental irrigation respectively. The spatial patterns of relative benefits of adaptation options were geographically different and the greatest benefits can be achieved by adopting new cultivars having drought tolerance and with the application of one supplemental irrigation at 60days after sowing. Copyright © 2015 Elsevier B.V. All rights reserved.
Full Text Available Calcium and phosphate are central for myocardial contractility and energy metabolism, and low levels of the calciotropic hormone 1,25-dihydroxyvitamin D (1,25(OH2D, as well as high levels of the phosphaturic hormone fibroblast growth factor (FGF-23, are independently associated with poor clinical outcome in heart failure (HF patients. We therefore aimed to investigate the postoperative time course of the aforementioned hormones in HF patients supported with a left-ventricular assist device (LVAD implant.For the present study, stored biobank plasma samples of 69 patients, collected before LVAD implantation (t0 and 12 days (t1, 30 days (t2, 83 days (t3, and 300 days (t4 post-intervention, were used to measure circulating FGF-23, parathyroid hormone (PTH, 25-hydroxyvitamin D (25OHD, 1,25(OH2D, and kidney function.Most patients were male and had baseline INTERMACS levels and cardiac index values ≤ 3 and ≤ 2.7 L/min/m2, respectively. There were significant time effects on estimated glomerular filtration rate (eGFR, FGF-23 and 1,25(OH2D, but not on PTH or 25OHD. Notably, eGFR values increased and FGF-23 levels decreased only transiently, whereas 1,25(OH2D increased continuously until t4. The rise in 1,25(OH2D was largely influenced by those patients who survived the first post-implant year, and was not seen in non-survivors. Variations in 1,25(OH2D levels could only partly be explained by eGFR values or FGF-23, 25OHD, and PTH levels (multiple R2 = 0.305;P<0.001.The present study indicates that LVAD implantation has only transient effects on circulating FGF-23 levels, but is associated with a continuous increase in circulating 1,25(OH2D levels, especially in survivors.
Cantillon, Daniel J; Bianco, Christopher; Wazni, Oussama M; Kanj, Mohamed; Smedira, Nicholas G; Wilkoff, Bruce L; Starling, Randall C; Saliba, Walid I
Ventricular tachyarrhythmias (VT) are common among ventricular assist device (VAD) recipients, yet electrophysiologic (EP) characteristics and catheter ablation outcomes remain uncharacterized. To evaluate the EP characteristics and catheter ablation outcomes for VTs among heart failure patients on VAD support. The Cleveland Clinic registry of consecutive patients undergoing VAD placement in 1991-2010 with medically refractory, symptomatic VT referred for EP study and catheter ablation. Among 611 recipients of VAD (mean age 53.3 ± 12.4 years, 80% men), 21 patients (3.4%) were referred for 32 EP procedures, including 11 patients (52%) presenting with implantable cardioverter-defibrillator therapy (13 shocks, 26 antitachycardia pacing). Data from 44 inducible tachycardias (mean cycle length 339 ± 59 ms) demonstrated monomorphic VT (n = 40, 91%; superior axis 52%, right bundle branch block morphology 41%) and polymorphic ventricular tachycardia (PMVT)/ventricular fibrillation (n = 4, 8%). Electroanatomic mapping of 28 tachycardias in 20 patients demonstrated reentrant VT related to intrinsic scar (n = 21 of 28, 75%) more commonly than the apical inflow cannulation site (n = 4 of 28, 14%), focal/microreentry VT (n = 2 of 28, 7%), or bundle branch reentry (n = 1 of 28, 3.5%). Catheter ablation succeeded in 18 of 21 patients (86%). VT recurred in 7 of 21 patients (33%) at a mean of 133 ± 98 days, and 6 patients (29%) required repeat procedures, with subsequent recurrence in 4 of 21 patients (19%). Catheter ablation of VT is effective among recipients of VAD. Intrinsic myocardial scar, rather than the apical device cannulation site, appears to be the dominant substrate. Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Gupta, Sunil; Muthiah, Kavitha; Woldendorp, Kei; Robson, Desiree; Jansz, Paul; Hayward, Christopher S
It is important to accurately monitor residual cardiac function in patients under long-term continuous-flow left ventricular assist device (cfLVAD) support. Two new measures of left ventricular (LV) chamber contractility in the cfLVAD-unloaded ventricle include IQ, a regression coefficient between maximum flow acceleration and flow pulsatility at different pump speeds; and K, a logarithmic relationship between volumes moved in systole and diastole. We sought to optimize these indices. We also propose RIQ, a ratio between maximum flow acceleration and flow pulsatility at baseline pump speed, as an alternative to IQ. Eleven patients (mean age 49 ± 11 years) were studied. The K index was derived at baseline pump speed by defining systolic and diastolic onset as time points at which maximum and minimum volumes move through the pump. IQ across the full range of pump speeds was markedly different between patients. It was unreliable in three patients with underlying atrial fibrillation (coefficient of determination R(2) range: 0.38-0.74) and also when calculated without pump speed manipulation (R(2) range: 0.01-0.74). The K index was within physiological ranges, but poorly correlated to both IQ (P = 0.42) and RIQ (P = 0.92). In four patients there was excellent correspondence between RIQ and IQ, while four other patients showed a poor relationship between these indices. As RIQ does not require pump speed changes, it may be a more clinically appropriate measure. Further studies are required to determine the validity of these indices. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Emanuel, Ezekiel J; Onwuteaka-Philipsen, Bregje D; Urwin, John W; Cohen, Joachim
The increasing legalization of euthanasia and physician-assisted suicide worldwide makes it important to understand related attitudes and practices. To review the legal status of euthanasia and physician-assisted suicide and the available data on attitudes and practices. Polling data and published surveys of the public and physicians, official state and country databases, interview studies with physicians, and death certificate studies (the Netherlands and Belgium) were reviewed for the period 1947 to 2016. Currently, euthanasia or physician-assisted suicide can be legally practiced in the Netherlands, Belgium, Luxembourg, Colombia, and Canada (Quebec since 2014, nationally as of June 2016). Physician-assisted suicide, excluding euthanasia, is legal in 5 US states (Oregon, Washington, Montana, Vermont, and California) and Switzerland. Public support for euthanasia and physician-assisted suicide in the United States has plateaued since the 1990s (range, 47%-69%). In Western Europe, an increasing and strong public support for euthanasia and physician-assisted suicide has been reported; in Central and Eastern Europe, support is decreasing. In the United States, less than 20% of physicians report having received requests for euthanasia or physician-assisted suicide, and 5% or less have complied. In Oregon and Washington state, less than 1% of licensed physicians write prescriptions for physician-assisted suicide per year. In the Netherlands and Belgium, about half or more of physicians reported ever having received a request; 60% of Dutch physicians have ever granted such requests. Between 0.3% to 4.6% of all deaths are reported as euthanasia or physician-assisted suicide in jurisdictions where they are legal. The frequency of these deaths increased after legalization. More than 70% of cases involved patients with cancer. Typical patients are older, white, and well-educated. Pain is mostly not reported as the primary motivation. A large portion of patients receiving
Chambliss, William; Scorza, Thomas
Presents two opposing viewpoints concerning the legalization of drugs. States that control efforts are not cost effective and suggests that legalization with efforts at education is a better course of action (W. Chambliss). The opposing argument contends that the cost in human suffering negates any savings in dollars gained through legalization…
presentation, I will focus on how the group included legal matters in the new letters, and how the pilot project group involved legal advice in their considerations. I will also discuss how and when to introduce legal advice in the letter editing process, drawing on the experiences of the group members......, interviewing central participants in the pilot project, and by carrying out a small questionnaire based survey and a series of interviews with members of the letters’ target group. One of the most prevalent challenges addressed by the group was how to make sure to address legal matters properly. In my...... language changes aimed at. What to learn from the presentation: •How to design a plain language project •How to include legal advice in a plain language project •How to design a study of plain language changes...
Full Text Available The development of biomedicine has led to the birth of the first test-tube baby in 1978, and that event gave enormous impetus for further development of biomedically assisted fertilization, but also for the development of supporting legislation. Biomedically assisted fertilization and its application raises sensitive social and moral issues, so states retain their sovereign rights in this area and enact rules and regulations that reflect their national legislative policy. Comparative studies across Europe show that national legal acts are in force in many countries, but differences exist and states persist on them. Legal regulation of biomedically assisted fertilization provides legal security for individuals who are subjected to it, making easier the legal protection in cases where individual rights are violated. This paper presents two recent judgments of the European Court of Human Rights, the subject matter of which are issues of biomedically assisted fertilization, where legal remedy is sought under Article 8 of the European Convention for the Protection of Human Rights and Fundamental Freedoms. Both judgments are in favor of the states against which complaints are filed by individuals: the Court ruled that national regulations have not violated the right to respect for the individual's private life.
Edelstein, Zoe R; Myers, Julie E; Cutler, Blayne H; Blum, Micheline; Muzzio, Douglas; Tsoi, Benjamin W
In the United States, routine HIV testing is recommended for persons aged 13-64 years. In 2010, New York State passed a law mandating offer of testing in most health-care settings. We report on the consumer perspective in New York City (NYC) shortly after the law's enactment. We analyzed data from a 2011 telephone survey representative of NYC adults aged 18-64 years (n = 1,846). This analysis focused on respondents' report of HIV test offer at last clinical visit and of willingness to test if recommended by their doctor. Offer and willingness were estimated by age, gender, race/ethnicity, education, income, marital status, sexual identity, partner number, and HIV testing history; associations were examined using multivariable regression. Among NYC adults, 35.7% reported an HIV test in the past year and 31.8% had never tested. Among 86.7% with a clinical visit in the past year, 31.4% reported being offered a test at last visit. Offer was associated with younger age, race/ethnicity other than white, non-Hispanic, lower income, and previous testing. Only 6.7% of never-testers were offered a test at last clinical visit. Willingness to test if recommended was high overall (90.2%) and across factors examined. After a new law was enacted in support of routine HIV testing, approximately 1 in 3 New Yorkers aged 18-64 years were offered a test at last clinical visit; 9 in 10 were willing to test if recommended by their doctor. This suggests that patient attitudes will not be a barrier to complete implementation of the law.
Mohite, Prashant N; Sabashnikov, Anton; Simon, Andre Ruediger; Weymann, Alexander; Patil, Nikhil Prakash; Unsoeld, Bernhard; Bireta, Christian; Popov, Aron Frederik
The discrepancy between the number of patients on the waiting list and available donor hearts has led to the successful development of left ventricular assist devices (LVAD) as a bridge to transplantation. The conventional LVADs are designed to provide full hemodynamic support for the end-stage failing heart. However, full-support LVAD implantation requires major surgery, sternotomy and cardiopulmonary bypass in majority of cases. The Synergy Micro-pump is the smallest implantable LVAD and provides partial flow support up to 3 l/min. It was shown that early intervention with this device can provide substantial benefits to patients with severe heart failure not yet sick enough for a full-support LVAD. Due the small dimensions it can be implanted without cardiopulmonary bypass or a sternotomy. The purpose of this article is to review the clinical use of the Synergy Micro-pump as partial hemodynamic support.
IIEC, a division of CERF, has developed an extensive base of experience implementing activities that support climate action by developing USIJI projects in transitional countries within Asia, Latin America, Central and Eastern Europe, and southern Africa. IIEC has been able to provide a range of technical and policy assistance to governments and industry in support of sustainable energy use. IIEC continues to work in key countries with local partners to develop and implement energy efficiency policies and standards, develop site-specific projects, and assist governing bodies to establish national priorities and evaluation criteria for approving GHG-mitigation projects. As part of this project, IIEC focused on promoting a series of activities in Thailand and South Africa in order to identify GHG mitigation projects and work within the national approval process of those countries. The sections of this report outline the activities conducted in each country in order to achieve that goal.
Kaluža, Luděk; Gulková, Daniela; Vít, Zdeněk; Zdražil, Miroslav
Roč. 112, OCT (2013), s. 272-276 ISSN 0016-2361 R&D Projects: GA ČR GAP106/11/0902 Institutional support: RVO:67985858 Keywords : MoO3/SiO2-Al2O3 * CoMo/SiO2-Al2O3 * water-assisted spreading Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 3.406, year: 2013
This article examines the legal position of a nurse who believes that a colleague is performing below the level of competence required, witnesses inappropriate action by a colleague, or who believes that the care environment is putting patients at risk.
Shehab, Sajad; Macdonald, Peter S; Keogh, Anne M; Kotlyar, Eugene; Jabbour, Andrew; Robson, Desiree; Newton, Phillip J; Rao, Sriram; Wang, Louis; Allida, Sabine; Connellan, Mark; Granger, Emily; Dhital, Kumud; Spratt, Phillip; Jansz, Paul C; Hayward, Christopher S
There is limited information on outcomes using the HeartWare ventricular assist device (HVAD; HeartWare, Framington, MA) as a biventricular assist device, especially with respect to site of right ventricular assist device (RVAD) implantation. Outcomes in 13 patients with dilated cardiomyopathy and severe biventricular failure who underwent dual HVAD implantation as bridge to transplantation between August 2011 and October 2014 were reviewed. Of 13 patients, 10 were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Level 1, and 3 were INTERMACS Level 2. Mean age was 45 ± 11 years, and mean body mass index was 26 ± 4 kg/m(2). There were 7 patients on temporary mechanical support pre-operatively (extracorporeal life support, n = 5; intra-aortic balloon pump, n = 2). The median hospital length of stay was 53 days (interquartile range [IQR] 33-70 days) with a median intensive care unit length of stay of 14 days (IQR 8-36 days). The median length of support on device was 269 days (IQR 93-426 days). The right HVAD was implanted in the right ventricular (RV) free wall in 6 patients and in the right atrial (RA) free wall in 7 patients. Transplantation was successfully performed in 5 patients, and overall survival for the entire cohort was 54%. RVAD pump thrombosis occurred in 3 of 6 RV pumps and 1 of 7 RA pumps. No left ventricular assist device pump thrombosis was observed. Bleeding tended to be higher in the RV implantation group (3 of 6 vs 0 of 7). During follow up, 6 patients died (4 of 7 in the RA group vs 2 of 6 in the RV group). Cause of death was multiple-organ failure in 3 patients, sepsis in 2 patients, and intracerebral hemorrhage in 1 patient. Critically ill patients who require biventricular support can be successfully bridged to transplant using 2 HVADs. RA implantation may allow right heart support with lower pump thrombosis and bleeding complications, although this was at the expense of a higher mortality in this cohort. Crown
Frederick Schauer; Barbara A. Spellman
Objective to study the notion and essence of legal judgments calibration the possibilities of using it in the lawenforcement activity to explore the expenses and advantages of using it. Methods dialectic approach to the cognition of social phenomena which enables to analyze them in historical development and functioning in the context of the integrity of objective and subjective factors it determined the choice of the following research methods formallegal comparative legal sociolog...
Hertel, Thomas Klitgaard
This work presents a comprehensive analysis of legal practices and dispute processing in Old Assyrian society c. 1950-1800 B.C. in the ancient Near East.......This work presents a comprehensive analysis of legal practices and dispute processing in Old Assyrian society c. 1950-1800 B.C. in the ancient Near East....
Gomez-Caro, Lilia C.; Sanchez-Sanchez, Mario; Bocanegra-Garcia, Virgilio; Rivera, Gildardo [Universidad Autonoma de Tamaulipas, Reynosa (Mexico). Dept. de Farmacia y Quimica Medicinal; Monge, Antonio [Universidad de Navarra, Pamplona (Spain). Centro de Investigacion en Farmacobiologia Aplicada. Unidad de Investigacion y Desarrollo de Medicamentos
We describe the synthesis of 12 new ethyl and methyl quinoxaline-7-carboxylate 1,4-di-N-oxide derivatives on solid supports with room temperature and microwave-assisted solvent-free procedures. Results show that solid supports have good catalytic activity in the formation of quinoxaline 1,4-di-N-oxide derivatives. We found that florisil and montmorillonite KSF and K10 could be used as new, easily available, inexpensive alternatives of catalysts. Additionally, room temperature and microwave-irradiation solvent-free synthesis was more efficient than a conventional procedure (Beirut reaction), reducing reaction time and increasing yield. (author)
Full Text Available The microwave-assisted conversion of levulinic acid (LA has been studied using low-loaded supported Fe-based catalysts on porous silicates. A very simple, productive, and highly reproducible continuous flow method has been used for the homogeneous deposition of metal oxide nanoparticles on the silicate supports. Formic acid was used as a hydrogen donating agent for the hydrogenation of LA to effectively replace high pressure H2 mostly reported for LA conversion. Moderate LA conversion was achieved in the case of non-noble metal-based iron oxide catalysts, with a significant potential for further improvements to compete with noble metal-based catalysts.
Parton, Steve; Fleming, Hugh
This article begins with an overview of the University’s pioneering Peer Assisted Learning Scheme (PAL) and describes how in 2005/6, the Library became involved, collaborating with the PAL Coordinator to develop materials for use by PAL Leaders. PAL is intended to foster cross-year support between students on the same course. It encourages students to support each other and learn co-operatively under the guidance of trained students from the year above - called PAL Leaders. Two documents were...
Tchantchaleishvili, Vakhtang; Hallinan, William; Schwarz, Karl Q; Massey, Howard Todd
Interest in utilizing long-term mechanical circulatory support for Fontan-type circulation has been high. Unfortunately, so far such attempts have not been successful. Herein, we are presenting the first case of an individual with biventricular heart failure and Fontan-type circulation on long-term mechanical circulatory support with a continuous-flow left ventricular assist device. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
The objective of this article is to: (1) evaluate the rationality and opportunity of this debate; (2) try to establish links with legal drugs; (3) evaluate the available data on the effect of legalization of a drug; and (4) propose an alternative drug police based on clear objectives to be reached; (5) describe how Sweden is dealing with the theme of drugs restriction as a social care. Methodologically the text constitutes in a summary of readings and elaborations of the author, placed to incite a discussion. It is concluded that four aspects need to be taken into consideration when a drug police of a country is analyzed, they are: (1) external factors influence the police: international agreements, health and social assistance police, individual rights, authority and autonomy of physicians and other professionals; (2) the objective established influence formal polices and its implementation; (3) the symbolic influence that excels the implementation. Influent people make declarations that strongly reach the legitimacy and adhesion to actions; (4) formal polices and their implementation receive direct influence to socially perceived damages by the drugs use, which could be independent of the real level of its use in a determined society.
de Graaf, Everlien; Zweers, Daniëlle; Valkenburg, Anna Ch; Uyttewaal, Allegonda; Teunissen, Saskia Ccm
A majority of patients prefer to die at home. Specialist palliative care aims to improve quality of life. Hospice assist at home is a Dutch model of general/specialised palliative care within primary care, collaboratively built by general practitioners and a hospice. The aims of this study are to explore whether hospice assist at home service enables patients at hometo express end-of-life preferences and die in their preferred location. In addition, this study provides insight into symptomburden, stability and early referral. A retrospective cross-sectional evaluation study was performed (December 2014-March 2015), using hospice assist at home patient records and documentation. Primary outcome includes congruence between preferred and actual place of death. Secondary outcomes include symptom burden, (in)stability and early identification. Between June 2012 and December 2014, 130 hospice assist at home patients, living at home with a life expectancy Hospice assist at home, a collaboration between general practitioners, district nurses, trained volunteers and a hospice team, facilitates (1) general practitioner-initiated consultation by Nurse Consultant Hospice, (2) fortnightly interdisciplinary consultations and (3) 24/7 hospice backup for patients, caregivers and professionals. A total of 130 patients (62 (48%) men; mean age, 72 years) were enrolled, of whom 107/130 (82%) died and 5 dropped out. Preferred place of death was known for 101/107 (94%) patients of whom 91% patients died at their preferred place of death. Hospice assist at home service supports patients to die in their preferred place of death. Shared responsibility of proactive care in primary care collaboration enabled patients to express preferences. Hospice care should focus on local teamwork, to contribute to shared responsibilities in providing optimal palliative care. © The Author(s) 2016.
Katushemererwe, Fridah; Nerbonne, John
This study presents the results from a computer-assisted language learning (CALL) system of Runyakitara (RU_CALL). The major objective was to provide an electronic language learning environment that can enable learners with mother tongue deficiencies to enhance their knowledge of grammar and acquire writing skills in Runyakitara. The system…
Bouck, Emily C.; Meyer, Nancy K.; Satsangi, Rajiv; Savage, Melissa N.; Hunley, Megan
Written expression is a neglected but critical component of education; yet, the writing process--from prewriting, to writing, and postwriting--is often an area of struggle for students with disabilities. One strategy to assist students with disabilities struggling with the writing process is the use of computer-based technology. This article…
Katushemererwe, Fridah; Nerbonne, John
This study presents the results from a computer-assisted language learning (CALL) system of Runyakitara (RU_CALL). The major objective was to provide an electronic language learning environment that can enable learners with mother tongue deficiencies to enhance their knowledge of grammar and acquire
Sunstein, Cass Robert
Can computers, or artificial intelligence, reason by analogy? This essay urges that they cannot, because they are unable to engage in the crucial task of identifying the normative principle that links or separates cases. Current claims, about the ability of artificial intelligence to reason analogically, rest on an inadequate picture of what legal reasoning actually is. For the most part, artificial intelligence now operates as a kind of advanced version of LEXIS, offering research assistance...
Gerdts, Caitlin; DePiñeres, Teresa; Hajri, Selma; Harries, Jane; Hossain, Altaf; Puri, Mahesh; Vohra, Divya; Foster, Diana Greene
Factors such as poverty, stigma, lack of knowledge about the legal status of abortion, and geographical distance from a provider may prevent women from accessing safe abortion services, even where abortion is legal. Data on the consequences of abortion denial outside of the US, however, are scarce. In this article we present data from studies among women seeking legal abortion services in four countries (Colombia, Nepal, South Africa and Tunisia) to assess sociodemographic characteristics of legal abortion seekers, as well as the frequency and reasons that women are denied abortion care. The proportion of women denied abortion services and the reasons for which they were denied varied widely by country. In Colombia, 2% of women surveyed did not receive the abortions they were seeking; in South Africa, 45% of women did not receive abortions on the day they were seeking abortion services. In both Tunisia and Nepal, 26% of women were denied their wanted abortions. The denial of legal abortion services may have serious consequences for women's health and wellbeing. Additional evidence on the risk factors for presenting later in pregnancy, predictors of seeking unsafe illegal abortion, and the health consequences of illegal abortion and childbirth after an unwanted pregnancy is needed. Such data would assist the development of programmes and policies aimed at increasing access to and utilisation of safe abortion services where abortion is legal, and harm reduction models for women who are unable to access legal abortion services. 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.
Matters to address prior to introducing new life support technology in Japan: three serious ethical concerns related to the use of left ventricular assist devices as destination therapy and suggested policies to deal with them.
Asai, Atsushi; Masaki, Sakiko; Okita, Taketoshi; Enzo, Aya; Kadooka, Yasuhiro
Destination therapy (DT) is the permanent implantation of a left ventricular assist device (LVAD) in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications. Because of deeply ingrained cultural and religious beliefs regarding death and the sanctity of life, Japanese society may not be ready to make changes needed to enable patients to have LVADs deactivated under certain circumstances to avoid needless suffering. Western ethical views that permit LVAD deactivation based mainly on respect for autonomy and dignity have not been accepted thus far in Japan and are unlikely to be accepted, given the current Japanese culture and traditional values. Some healthcare professionals might regard patients as ineligible for DT unless they have prepared advance directives. If this were to happen, the right to prepare an advance directive would instead become an obligation to do so. Furthermore, patient selection for DT poses another ethical issue. Given the predominant sanctity of life principle and lack of cost-consciousness regarding medical expenses, medically appropriate exclusion criteria would be ignored and DT could be applied to various patients, including very old patients, the demented, or even patients in persistent vegetative states, through on-site judgment. There is an urgent need for Japan to establish and enact a basic act for patient rights. The act should include: respect for a patient's right to self-determination; the right to refuse unwanted treatment; the right to prepare legally binding advance directives; the right to decline to prepare such directives; and access to nationally insured healthcare. It should enable those concerned with
Full Text Available In Salian and Ripuarian Code affatomia represented a bilateral legal transaction that was aimed at changing of the scoped of heirs determined by the customs, at least insofar being applied in the absence of biological descendants only. However, almost all further similarities in the field cease at this point. The form for using affatomia with Ripuarian Franks was much simpler than the one with the Salian Franks. Unlike the Salian Franks, affatomia could by all odds be used by Ripuarian Franks spouses in determining each other for a heir. Legal nature of the Salian Franks affatomia is most similar to the mancipatio familiae type of will in the Roman law (which does not mean it emerged from this law, while its form in the Ripuarian Code is much closer to testamentary adoption. As with Ripuarian Franks, affatomia seems to have definitely produced legal effects only after the death of the disposant, while its legal effects with the Salian Code performed inter vivos. Contemporary authors are trying to designate the legal nature of legal affairs from the early development of human and legal civilization through modern institutes that represent the completion of their evolutionary path. Taking the inheritance contract of the German or Swiss law, or the future assets donation of the French law, for example, and then comparing them to affatomia and thinx is an anachronism. This is evident by the fact that the legal nature of these ancient Germanic institutes can not be viewed unilaterally, but always through a combination of those institutes which we know today as adoption, gift or mixed donation with retention of different modalities for the transferor or the testator (usually usufruct. In this sense, if we are looking for a inheritance agreement in the Middle Ages, the contract in which a person determines other person for his/her universal or singular successor in the modern sense, we will certainly not find one. However, if within this institute we
Geigle, Paula R; Frye, Sara Kate; Perreault, John; Scott, William H; Gorman, Peter H
A 41-year-old man with a history of C6 American Spinal Injury Association (ASIA) Impairment Scale (AIS) C spinal cord injury (SCI), enrolled in an Institutional Review Board (IRB)-approved, robotic-assisted body weight-supported treadmill training (BWSTT), and aquatic exercise research protocol developed asymptomatic autonomic dysreflexia (AD) during training. Little information is available regarding the relationship of robotic-assisted BWSTT and AD. After successfully completing 36 sessions of aquatic exercise, he reported exertional fatigue during his 10th Lokomat intervention and exhibited asymptomatic or silent AD during this and the three subsequent BWSTT sessions. Standard facilitators of AD were assessed and no obvious irritant identified other than the actual physical exertion and positioning required during robotic-assisted BWSTT. Increased awareness of potential silent AD presenting during robotic assisted BWSTT training for individuals with motor incomplete SCI is required as in this case AD clinical signs were not concurrent with occurrence. Frequent vital sign assessment before, during, and at conclusion of each BWSTT session is strongly recommended.
Santana, Raymond A. Nava
A review of the national and state legislation dealing with bilingual education is presented in the context of an introductory history of the bilingual movement in the United States. This history falls into two periods; the first from 1840-1920, and the second from 1960 to the present. The goal of bilingual education, to teach English without…
Compostella, Leonida; Russo, Nicola; Setzu, Tiziana; Compostella, Caterina; Bellotto, Fabio
Axial-flow left ventricular assist devices (LVADs) are increasingly used as destination therapy in end-stage chronic heart failure (CHF), as they improve survival and quality of life. Their effect on exercise tolerance in the early phase after implantation is still unclear. The aim of this study was to evaluate the effect of LVADs on the exercise capacity of a group of CHF patients within 2 months after initiation of circulatory support. Cardiopulmonary exercise test data were collected for 26 consecutive LVAD-implanted CHF patients within 2 months of initiation of assistance; the reference group consisted of 30 CHF patients not supported by LVAD who were evaluated after an episode of acute heart failure. Both LVAD and reference groups showed poor physical performance; LVAD patients achieved lower workload (LVAD: 36.3 ± 9.0 W, reference: 56.6 ± 18.2 W, P assist device. Copyright © 2013 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Legal Advisers from twelve international organizations belonging to the United Nations Organization's family met at the Agency's Headquarters in Vienna on 19 and 20 May to discuss legal problems of common administrative interest. The meeting was held on the initiative of the Agency while the UN Conference on the Law of Treaties was taking place in Vienna during April and May. With Mr. Constantin A. Stavropoulos, Under-Secretary, Legal Counsel of the United Nations, as chairman, this was the second meeting of Legal Advisers since 1954. The following organizations were represented: Food and Agriculture Organization of the United Nations, International Atomic Energy Agency, International Bank for Reconstruction and Development, International Civil Aviation Organization, International Labour Organisation, Inter-Governmental Maritime Consultative Organization, International Monetary Fund, International Telecommunication Union, United Nations, United Nations Educational, Scientific and Cultural Organization, United Nations Industrial Development Organization, World Health Organization. Topics discussed included the recruitment of legal staff and possible exchange of staff between organizations; competence and procedure of internal appeals committees, experience with cases before the Administrative Tribunals and evaluation of their judgments; experience with Staff Credit Unions; privileges and immunities of international organizations; headquarters and host government agreements; and patent policies of international organizations. Consultations will continue through correspondence and further meetings. (author)
Walsh, Simon J
A forensic biologist is usually involved in the criminal justice system process somewhere between the police and the legal system, interacting in a practical context regularly and extensively with both. Forensic DNA research and development commonly involves initiatives that encroach into the neighbouring domains of the law enforcement or legal agencies. Despite this level of association, establishing meaningful cross-disciplinary communication and understanding within the justice system remains a challenge. As an example, there is an abundance of literature relating to forensic DNA profiling in legal and criminological periodicals. Such journals are perhaps outside the regular reading of forensic scientists and much of the legal discussion appears to go unnoticed. This situation is understandable; however, it is also undesirable particularly as forensic DNA developments are intertwined with significant changes in legislation and contentious issues of privacy, civil liberty and social justice. This paper attempts to address this shortcoming directly by summarising - from the viewpoint of a forensic scientist - some of the discussion in the legal literature. In particular the review focuses on discussion raising ideological and ethical concerns. Awareness of these views is of relevance to forensic science. It assists us to accurately place DNA evidence into context and to develop its role in achieving the broader criminal justice system objectives. Understanding the discussion also provides a way to enter the debate and communicate at an appropriate level the true potential of DNA to the legal community.
Euthanasia and physician-assisted suicide (hereafter E/PAS) is a practice with a long history. It was a frequent occurrence in the Ancient World, despite the prohibitions of the Hippocratic Oath (which had no legal standing and was supported by a minority of. Greco-Roman physicians). It was condemned as murder by the ...
Bradbury, J.A.; Leyson, J.; Lester, M.K.
This report revises and updates the 1995 report Financial Assistance to States and Tribes to Support Emergency Preparedness and Response and the Safe Transportation of Hazardous Shipments, PNL-10260 (UC-620). The presentation of data and some of the data reported have been changed; these data supersede those presented in the earlier publication. All data have been updated to fiscal year 1995, with the exception of FEMA data that are updated to fiscal year 1994 only. The report identifies and summarizes existing sources of financial assistance to States and Tribes in preparing and responding to transportation emergencies and ensuring the safe transportation of hazardous shipments through their jurisdictions. It is intended for use as an information resource for the U.S. Department of Energy's Office of Environmental Management (EM), Office of Transportation, Emergency Management, and Analytical Services (EM-76)
Agustín Huete García
Full Text Available At present, there are several alternatives to support daily life of people with disabilities, which require different resources: human, institutional, technical, material, financial, etc. In addition, these alternatives involve different impacts on both the life of people with disabilites and their immediate environment. This paper presents a case study that compares an user of personal assistance services of the Program for Independent Living (PAVI with an user of a residential service. The study method used is based on the approach of Social Return on Investment (SROI. It also specifies the selection of cases, the partners consulted to gather concepts and values, data collection, variables and formulas for calculating and monetization. Despite its limited scope, it is possible to draw conclusions about the social return on investment in a “standard profile” receiving personal assistance services compared with a “standard profile” in a residential service.
Li, Hongliang; Wang, Renzhang; Hong, Qi; Chen, Luwei; Zhong, Ziyi; Koltypin, Yuri; Calderon-Moreno, J; Gedanken, Aharon
Metallic Ru nanoparticles have been successfully produced and incorporated into the pores of SBA-15 in situ employing a simple ultrasound-assisted polyol method. The product has been confirmed by X-ray diffraction, transmission electron microscopy, and X-ray photoelectron spectroscopy, where ultrasound provides both the energy for the reduction of the Ru(III) ion and the driving force for the loading of the Ru(0) nanoparticles into the SBA-15 pores. An ultrasound-assisted insertion mechanism has been proposed based on the microjets and shake-wave effect of the collapsed bubbles. The catalytic properties of the SBA-15-supported Ru nanoparticles have been tested by the partial oxidization of methane and show very high activity and high CO selectivity.
Pope, Thaddeus Mason
This issue's "Legal Briefing" column covers legal developments pertaining to informed consent. Not only has this topic been the subject of recent articles in this journal, but it also been the subject of numerous public and professional discussions over the past several months. Legal developments concerning informed consent can be usefully grouped into nine categories: 1. General disclosure standards in the clinical context; 2. Shared decision making; 3. Staturorily mandated abortion disclosures; 4. Staturorily mandated end-of-life counseling; 5. Other staturorily mandated subject-specific disclosures; 6. U.S. Food and Drug Administration (FDA) labeling and federal pre-emption of state informed consent law; 7. Relaxed informed consent for HIV testing; 8. General disclosure standards in the research context; 9. Issues on the horizon.
Full Text Available The aim of this study was to determine the impact of change dimensions in the legal environment on the quality of each stage of the decision-making process of the senior managers of public institutions. The interest population of this study included all general managers, directors, administrative, financial and support assistants, financial controllers and managers and other executive directors and deputies of Zanjan province that were studied by census method. The data collection toll was a researcher-made questionnaire that its reliability and validity were confirmed (Cronbach's alpha coefficient: 0.87. Data analysis was performed using descriptive statistics and inferential statistics techniques (Chi-square test and Friedman test by SPSS software. The results show that the dimensions of changes in the legal environment factors affect on the two first and third stages of the decision making process of managers (stages of data collection, decision-making and its implementation. However, it has no effect of the data and information analysis stage.
Full Text Available Their social nature encourages people to associate and jointly achieve the goals that they would not be able to achieve individually. Legal entities are created as one of the legal modalities of that association, as separate entities that have their own legal personality independent of the subjectivity of their members. Legal entities are holders of some human rights, depending on the nature of the right, including the right to non-discrimination. All mechanisms envisaged for legal protection against discrimination in the national legislation are available to legal persons. On the other hand, the situation is quite different in terms of access to international forums competent to deal with cases of discrimination. Legal entities do not have access to some international forums, while they may have access to others under the same conditions prescribed for natural persons. Legal entities may be exposed to various forms of direct and indirect discrimination both in the private and in the public sphere of social relations. Phenomenological characteristics of discrimination against legal persons are not substantially different from discrimination against individuals. There are no significant differences regarding the application of discrimination test in cases of discrimination of legal entities as compared to the use of this test in cases involving discrimination of natural persons or groups of persons. Legal entities may be discriminated against on the basis of characteristics of their legal personality, such as those which are objective elements of the legal entity and part of its legal identity. Discrimination of legal entities may be based on personal characteristics of its members (i.e. people who make a personal essence of a legal entity because their characteristics can be 'transferred' to the legal entity and become part of its identity. Legal entities should also be protected from this special form of transferred (associative discrimination.
Darcy, Simon; Green, Jenny; Maxwell, Hazel
The purpose of this article is to examine the use of a mobile technology platform, software customization and technical support services by people with disability. The disability experience is framed through the participants' use of the technology, their social participation. A qualitative and interpretive research design was employed using a three-stage process of observation and semi-structured interviews of people with disability, a significant other and their service provider. Transcripts were analyzed to examine the research questions through the theoretical framework of PHAATE - Policy, Human, Activity, Assistance and Technology and Environment. The analysis revealed three emergent themes: 1. Engagement and activity; 2. Training, support and customization; and 3. Enablers, barriers and attitudes. The findings indicate that for the majority of users, the mobile technology increased the participants' communication and social participation. However, this was not true for all members of the pilot with variations due to disability type, support needs and availability of support services. Most participants, significant others and service providers identified improvements in confidence, security, safety and independence of those involved. Yet, the actions and attitudes of some of the significant others and service providers acted as a constraint to the adoption of the technology. Implications for Rehabilitation Customized mobile technology can operate as assistive technology providing a distinct benefit in terms of promoting disability citizenship. Mobile technology used in conjunction with a supportive call centre can lead to improvements in confidence, safety and independence for people experiencing disability. Training and support are critical in increasing independent use of mobile technology for people with disability. The enjoyment, development of skills and empowerment gained through the use of mobile technology facilitate the social inclusion of people with
Van Der Vort, Geoffrey; Wood, Lesley
The Education District and Circuit Offices in South Africa are mandated by the Department of Basic Education to support schools under their jurisdiction. Reasons for the lack of such support to schools have been highlighted in various reports and research findings. This paper examines the role that properly constructed school improvement plans,…
Haneya, Assad; Philipp, Alois; Puehler, Thomas; Rupprecht, Leopold; Kobuch, Reinhard; Hilker, Michael; Schmid, Christof; Hirt, Stephan W
Acute right ventricular (RV) failure is a life-threatening condition with a poor prognosis, and sometimes the use of mechanical circulatory support is inevitable. In this article, we describe our experience using a centrifugal pump as a temporary percutaneous right ventricular assist device (RVAD) in patients with postoperative acute refractory RV failure after left ventricular assist device (LVAD) implantation. We retrospectively reviewed eight consecutive patients with acute RV failure who underwent temporary percutaneous RVAD implantation using a centrifugal pump after LVAD implantation between April 2008 and February 2011. A Dacron graft was attached to the main pulmonary artery and passed through a subxiphoid exit, where the outflow cannula was inserted. The inflow cannula was percutaneously cannulated using Seldinger's technique in the femoral vein. The chest was definitely closed. The technique allowed bedside removal, avoiding chest re-opening. The median patient age was 52 years (range: 41-58). The median duration of support was 14 days (range: 12-14). RV systolic function improved; central venous pressure and mean pulmonary artery pressure decreased significantly after RVAD support. In three patients, an oxygenator was integrated into the RVAD due to impaired pulmonary function. Six patients were successfully weaned. Five patients survived to hospital discharge. Technical problems or serious complications concerning decannulation were not observed. This report suggests that implantation of temporary percutaneous RVAD using a centrifugal pump is a safe alternative in the treatment of postoperative acute refractory RV failure. Ease of device implantation, weaning, explantation, and limited number of complications justify a liberal use.
White, Jennifer H; Quinn, Martina; Garland, Sheila; Dirkse, Dale; Wiebe, Patricia; Hermann, Madeline; Carlson, Linda E
Animal-assisted therapy (AAT) interventions have been shown to assist in coping and improve patient responses to symptoms. Specifically, the presence of an animal has been found to lower anxiety and motivate participation in therapy. We aimed to explore the acceptability of and experience of AAT during individual breast cancer counseling sessions. Patients undertaking counseling with a therapy dog present were invited to participate in the study. Patients were individually interviewed and asked to reflect on their experiences of AAT. Data generation and analysis were concurrent. Transcripts were analyzed thematically using a process of constant comparison. Our sample included 8 female participants, 39 to 61 years old, at an average of 3 years post-breast cancer diagnosis. The majority of patients reported a positive experience with AAT. Themes that emerged around their counseling experience included benefits in the process of initiating counseling and benefits for greater engagement and personal disclosure. Incorporating AAT into the delivery of counseling for breast cancer patients appears to be feasible and acceptable at a patient level. From a clinical perspective, AAT promoted increased communication with health professionals. This is of clinical importance as a means to improve participation and engagement in therapy-important elements in therapeutic outcomes. However, further evaluation of the impact of AAT on specific patient outcomes and psychological morbidity is required. © The Author(s) 2015.
Full Text Available The majority of the students who enroll at the Walter Sisulu University (WSU in South Africa are not equipped with the necessary academic/learning skills to cope with the university environment, especially in Mechanical Engineering. The Department of Higher Education and Training (2013, p. 17, further states that “students’ support is crucial to ensure that students adapt to the demands of college life and that they can meet the demands of college programmes”. Particularly in South Africa, the school environment might also contribute to poor student performance as a result of insufficient student support, and a lack of facilities and resources. In order to address this gap, a Peer-Assisted Learning (PAL programme was implemented to provide support targeting high-risk subjects for at-risk students in Mechanical Engineering at WSU. The programme therefore is pro-active and student-driven in that senior students assist junior students with their academic work and learning processes. The programme is designed to encourage collaborative and cooperative learning approaches during group sessions and active student engagement to support student learning (Laal & Laal, 2012. The programme requires substantial resources and time commitments. It is important from an operational, learning, and student perspective to understand in what ways the PAL programme assists students (if at all. Eliciting the experiences of students also helps the department to design interventions from a student-centred perspective using the lens of learning theories. This qualitative case study explores the student experience of the Peer-Assisted Learning (PAL programme. Open-ended questionnaires/survey from 20 first-year students elicited their perceptions and experiences of the PAL programme. Responses were analysed thematically. Findings indicated that the students had useful insights that may contribute to revising the programme. Aspects mentioned were improved study
Andersen, Mads; Videbaek, Regitze; Boesgaard, Søren
The incidence of ventricular tachycardia (VT) or ventricular fibrillation (VF) in patients supported with a continuous-flow left ventricular assist device (LVAD) has not been investigated in detail. In 23 consecutive recipients of a HeartMate II, we analyzed the incidence of VT/VF during a total...... of 266 months of follow-up. Sustained VT or VF occurred in 52% of the patients, with the majority of arrhythmias occurring in the first 4 weeks after LVAD implantation. VT/VF requiring implantable cardioverter-defibrillator (ICD) shock or external defibrillation occurred in 8 patients and significant...
Several sections of the Criminal Code of Canada which are relevant to the issue of euthanasia are discussed. In addition, the value placed on the sanctity of life by the law, the failure to recognize motive in cases of euthanasia, and disparate legal and medical definitions of death are also considered. (Author)
This section treats of the following documents and legal texts: 1 - Belgium 29 June 2014 - Act amending the Act of 22 July 1985 on Third-Party Liability in the Field of Nuclear Energy; 2 - Belgium, 7 December 2016. - Act amending the Act of 22 July 1985 on Third-Party Liability in the Field of Nuclear Energy
Taylor, Kelley R.
The 21st century has brought many technological, social, and economic changes--nearly all of which have affected schools and the students, administrators, and faculty members who are in them. Luckily, as some things change, other things remain the same. Such is true with the fundamental legal principles that guide school administrators' actions…
This chapter of "Principles of School Business Management" discusses the implications of several court cases for legal issues affecting the role of the school business official. The issues addressed include civil rights, negligence, contracts, criminal liability, tuition and fees, and student records. The chapter opens with a brief overview of…
What is a commission within the Staff Association (SA)? A commission is a working group of the CERN Staff Council, led by a staff representative. The commission is composed mainly of staff representatives, but interested members of the SA can apply to participate in the work of a commission. What is the commission on legal matters? The commission on legal matters works on texts governing the employment conditions of staff (Employed Members of Personnel and Associated Members of Personnel). This covers legal documents such as the Staff Rules and Regulations, administrative and operational circulars, as well as any other document relating to employment conditions. How is the work organised in this commission? The revision process of the text is generally done along following lines: The HR department, and its legal experts, proposes new texts or modifications to existing texts. A schedule for the study of these texts is established each year and this calendar by the commission to plan its work. The new or modi...
Guttmacher, Alan F.; And Others
A roundtable discussion on legal abortion includes Dr. Alan F. Guttmacher, President of The Planned Parenthood Federation of America, Robert Hall, Associate Professor of Obstetrics and Gynecology at Columbia University College of Physicians and Surgeons, Christopher Tietze, a diretor of The Population Council, and Harriet Pilpel, a lawyer.…
Bellani, Giacomo; Coppadoro, Andrea; Patroniti, Nicolò; Turella, Marta; Arrigoni Marocco, Stefano; Grasselli, Giacomo; Mauri, Tommaso; Pesenti, Antonio
Auto-positive end-expiratory pressure (auto-PEEP) may substantially increase the inspiratory effort during assisted mechanical ventilation. Purpose of this study was to assess whether the electrical activity of the diaphragm (EAdi) signal can be reliably used to estimate auto-PEEP in patients undergoing pressure support ventilation and neurally adjusted ventilatory assist (NAVA) and whether NAVA was beneficial in comparison with pressure support ventilation in patients affected by auto-PEEP. In 10 patients with a clinical suspicion of auto-PEEP, the authors simultaneously recorded EAdi, airway, esophageal pressure, and flow during pressure support and NAVA, whereas external PEEP was increased from 2 to 14 cm H2O. Tracings were analyzed to measure apparent "dynamic" auto-PEEP (decrease in esophageal pressure to generate inspiratory flow), auto-EAdi (EAdi value at the onset of inspiratory flow), and IDEAdi (inspiratory delay between the onset of EAdi and the inspiratory flow). The pressure necessary to overcome auto-PEEP, auto-EAdi, and IDEAdi was significantly lower in NAVA as compared with pressure support ventilation, decreased with increase in external PEEP, although the effect of external PEEP was less pronounced in NAVA. Both auto-EAdi and IDEAdi were tightly correlated with auto-PEEP (r = 0.94 and r = 0.75, respectively). In the presence of auto-PEEP at lower external PEEP levels, NAVA was characterized by a characteristic shape of the airway pressure. In patients with auto-PEEP, NAVA, compared with pressure support ventilation, led to a decrease in the pressure necessary to overcome auto-PEEP, which could be reliably monitored by the electrical activity of the diaphragm before inspiratory flow onset (auto-EAdi).
Jørgensen, Rune Nørgaard
SRA would very much like to support the exchange of best practice between members throughout the year and the Membership Committee is presently looking into the opportunities for a Staff Exchange or Legal Alien Program. However the International Section has already had the chance to provide...
Núñez Vaquero, Álvaro
This paper pursues three goals. First, some traditional concepts of ‘legal science’ will be analysed, and a definition of ‘legal science ampio sensu’, ‘legal science stricto sensu’ and ‘legal dogmatics’ will be proposed. Second, a reconstruction of five models of ‘legal science ampio sensu’ will be presented to show the different methodological alternatives available to legal scholars. Third, I claim that it is necessary (for conceptual reasons) to argue for moral reasons when choosing a lega...
Papers gepresenteerd op de conferentie, 'The Role of Legal Translation in Legal Harmonization', georganiseerd in Amsterdam op 21 januari 2011, door The Amsterdam Circle for Law & Language (ACLL) en the Centre for the Study of European Contract Law (CSECL).
This is a contribution to the scholarly discussion concerning the limited use of the case study qualitative method in support of legal research. It demonstrates the use of the case study qualitative method in the context of an empirical legal research project, which examines stakeholder
Bradbury, J.A.; Jones, M.L.
This report identifies and summarizes existing sources of financial assistance to States and Indian tribes in preparing and responding to transportation emergencies and ensuring the safe transportation of hazardous shipments through their jurisdictions. The report has been prepared as an information resource for the US Department of Energy's Office of Environmental Restoration and Waste Management, Office of Transportation, Emergency Management and Analytical Services. The report discusses funding programs administered by the following Federal agencies: Federal Emergency Management Agency; Department of Transportation; the Environmental Protection Agency; and the Department of Energy. Also included is a summary of fees assessed by some States on carriers of hazardous materials and hazardous waste. The discussion of programs is supplemented by an Appendix that provides a series of tables summarizing funding sources and amounts. The report includes several conclusions concerning the level of funding provided to Indian tribes, the relative ranking of funding sources and the variation among States in overall revenues for emergency response and safe transportation
Jung, Mette Holme; Goetze, Jens Peter; Boesgaard, Soeren
BACKGROUND: Neurohormones play a key role in regulating hemodynamics in heart failure (HF) both at rest and during exercise. In contrast, little is known about the importance of neurohormonal regulation for exercise capacity in continuous-flow left ventricular assist device (CF-LVAD) patients....... The aim of this study was to assess the relation between neurohormonal activation patterns in CF-LVAD patients and exercise capacity. METHODS: Plasma concentrations of the C-terminal portion of pro-arginine vasopressin precursor (copeptin), pro-adrenomedullin (proADM), pro-B-type (proBNP) and pro......-atrial (proANP) natriuretic peptides were measured in 25 CF-LVAD patients (HeartMate II) in the morning prior to maximal cardiopulmonary exercise testing determining peak oxygen uptake (peak VO2). Quality of life (QOL) was determined by questionnaires. RESULTS: Peak VO2 was severely reduced averaging 13...
Saeed, Omar; Jorde, Ulrich P
The purpose of this review is to highlight recent advances and challenges in the clinical implementation of continuous flow left ventricular assist devices (CF LVADs) in patients with advanced heart failure. Post approval studies of CF LVAD therapy continue to show a progressive improvement in survival and reduction in adverse events. Major trials are ongoing to compare outcomes of an axial flow device (Heart Mate II) and smaller centrifugal flow pumps (HeartWare VADs and Heart Mate III). Numerous studies have investigated strategies to reduce major hematologic and neurologic adverse events by evaluating hemolysis, antithrombotic therapy, and blood pressure control. This review will present the current findings that are centered around the impact of CF LVADs on improving survival and reducing adverse events through an evolution in management and design.
Đapović Lasta S.
Full Text Available Rape was identified as a criminal act in the earliest known legal writings, Hamurabi's legal code (cir. 2000 BC. In the Balkans, in the Middle Ages, rape was always punished in one way or another, in the statutes of the Adriatic maritime towns, which were under the rule of the Nemanjić state or the West. All categories of women, even prostitutes and slaves, were protected by law from sexual violence in many statutes. Also in Dušan's legal code the regulation is found, severely punishing rapists. Laws following the Second Serbian Uprising, also provide severe punishment for sexual violence, especially towards women but also male minors. Legal and court practice, following the Second World War, indicate that the protection of women from sexual violence is completely inadequate and this at a time when women had achieved equal rights with men in many spheres of life. World events at the end of the 20th century: collapse of the Soviet Union: as well as the happenings in this region,: war, ethnic and religious conflicts resulted in massive rape of women, opening of brothels, trading women and family violence. Non state organizations, mainly women in expert associations, invest great effort to rectify this very unsatisfactory situation. They exert pressure for change in the law and in court practice, by which women would have more effective defense against sexual violence, as well as organized assistance for women victims of traffic, and warning of the possible danger.
Full Text Available A case brief can be described as a succinct summary of a case which specifies the facts, procedural history, legal issue(s, court decision and legal reasoning supporting the judgment, even though exact formats may vary. Case briefing is a demanding activity which is required from students during their law studies. The goal is to teach students to focus on the essential parts of the case and to obtain a thorough understanding of the case and the reasoning, which means the students need to employ their analytical and critical thinking skills.
Wright, Glen; Rochette, Julien; O'Hagan, Anne Marie; De Groot, Jiska; Leroy, Yannick; Soininen, Niko; Salcido, Rachael; Castelos, Montserrat Abad; Jude, Simon; Kerr, Sandy
Ocean energy is a novel renewable energy resource being developed as part of the push towards a 'Blue Economy'. The literature on ocean energy has focused on technical, environmental, and, increasingly, social and political aspects. Legal and regulatory factors have received less attention, despite their importance in supporting this new technology and ensuring its sustainable development. In this Issue Brief, we set out some key legal challenges for the development of ocean energy technologies, structured around the following core themes of marine governance: (i) international law; (ii) environmental impacts; (iii) rights and ownership; (iv) consenting processes; and (v) management of marine space and resources. (authors)
Full Text Available Abstract Background Computerised cognitive behaviour therapy (cCBT involves standardised, automated, interactive self-help programmes delivered via a computer. Randomised controlled trials (RCTs and observational studies have shown than cCBT reduces depressive symptoms as much as face-to-face therapy and more than waiting lists or treatment as usual. cCBT’s efficacy and acceptability may be influenced by the “human” support offered as an adjunct to it, which can vary in duration and can be offered by people with different levels of training and expertise. Methods/design This is a two-by-two factorial RCT investigating the effectiveness, cost-effectiveness and acceptability of cCBT supplemented with 12 weekly phone support sessions are either brief (5–10 min or extended (20–30 min and are offered by either an expert clinician or an assistant with no clinical training. Adults with non-suicidal depression in primary care can self-refer into the study by completing and posting to the research team a standardised questionnaire. Following an assessment interview, eligible referrals have access to an 8-session cCBT programme called Beating the Blues and are randomised to one of four types of support: brief-assistant, extended-assistant, brief-clinician or extended-clinician. A sample size of 35 per group (total 140 is sufficient to detect a moderate effect size with 90% power on our primary outcome measure (Work and Social Adjustment Scale; assuming a 30% attrition rate, 200 patients will be randomised. Secondary outcome measures include the Beck Depression and Anxiety Inventories and the PHQ-9 and GAD-7. Data on clinical outcomes, treatment usage and patient experiences are collected in three ways: by post via self-report questionnaires at week 0 (randomisation and at weeks 12 and 24 post-randomisation; electronically by the cCBT system every time patients log-in; by phone during assessments, support sessions and exit interviews. Discussion
Lok, Sjoukje I; Nous, Fay M A; van Kuik, Joyce; van der Weide, Petra; Winkens, Bjorn; Kemperman, Hans; Huisman, Andre; Lahpor, Jaap R; de Weger, Roel A; de Jonge, Nicolaas
During support with a left ventricular assist device (LVAD), partial reverse remodelling takes place in which fibrosis plays an important role. In this study, we analysed the histological changes and expression of fibrotic markers in patients with advanced heart failure (HF) during continuous-flow LVAD (cf-LVAD) support. In 25 patients, myocardial tissue at the time of LVAD implantation (pre-LVAD) was compared with tissue from the explanted left ventricle (post-LVAD). Interstitial fibrosis and cardiomyocyte size were analysed pre- and post-LVAD. Plasma was obtained from all patients before and during LVAD support. Plasma levels, cardiac mRNA and protein expression of brain natriuretic peptide (BNP), galectin-3 (Gal-3), connective tissue growth factor (CTGF), osteopontin (OPN) and transforming growth factor β-1 were determined. Fibrosis increased during cf-LVAD unloading (P markers remained elevated in comparison with controls. cf-LVAD support is associated with lengthening of cardiomyocytes, without alterations in diameter size. Remarkably, myocardial fibrosis increased as well as circulating pro-fibrotic markers. Whether the morphological changes are a direct effect of reduced pulsatility during cf-LVAD support or due to HF progression requires further investigation. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Obani, P.; Gupta, J.
This review paper analyzes the legal and non-legal literature on the human right to sanitation (HRS). It shows that despite applying different paradigms in framing the HRS, both literature support the following three main conclusions: (a) state and non-state actors, particularly NGOs and private
Full Text Available Purpose: The purpose of this study is to identify and validate the requirements for new technology supporting wellness, independence and social participation for older people domiciled in residential homes and/or assisted-living communities. Method: This research adopts a stakeholder evaluation approach to requirements elicitation and user interface design. Specifically, the study design combines several qualitative human–machine interaction (HMI design frameworks/methods, including realist ethnography, scenario-based design, persona-based design, and participatory design. Findings: New technology should reflect positive values around ageing and link to psychosocial models of successful ageing, and biopsychosocial models of health and wellbeing. Resident autonomy, wellness and social participation cannot be conceptualized outside an understanding of the relationships older adults have with others. The design remit for this technology is to enable a resident experience that is similar to living at home. New technologies should facilitate wellness and communication/connection, and not simply risk assessment. New technology provides an opportunity to bridge existing information gaps between care planning, care assessments and daily care. Overall this technology needs to be intuitive and uphold the resident’s dignity and rights. Person-to-person interaction is central to care delivery. The introduction of new technology should enhance this interaction, and not threaten it. Conclusions: Future assisted-living (AL technology should be premised by biopsychosocial models of wellness and support relationships between older adults and members of the personal and professional community. New assisted-living technology affords the possibility for improved social relationships, enhanced wellbeing, better quality of care, and independence. Such technologies require careful consideration in relation to adapting to age/condition and managing issues
Dandel, Michael; Krabatsch, Thomas; Falk, Volkmar
Left ventricular assist devices (LVADs) are safer and provide better survival and better quality of life than biventricular assist devices (BVADs) but end-stage heart failure often involves both ventricles, even if its initial cause was left-sided heart disease. Right ventricular failure (RVF) is also a severe complication in about 25% of patients receiving an LVAD, with high perioperative morbidity (renal, hepatic or multi-organ failure) and mortality. Patients who receive an RV assist device (RVAD) only days after LVAD insertion fare much worse than those who receive an RVAD simultaneously with LVAD implantation. Temporary RVAD support in LVAD recipients with high risk for postoperative RVF can avoid permanent BVAD support. Thus, patients who definitely need a BVAD should already be identified preoperatively or at least intra-operatively. However, although the initial biochemical, hemodynamic and echocardiographic patient profiles at admission may suggest the need for a BVAD, many risk factors may be favorably modified by various strategies that may result in avoidance of RVF after LVAD implantation. This article summarizes the knowledge of risk factors for irreversible RVF after LVAD implantation and strategies to optimize RV function (preoperatively, intra-operatively and post-operatively) aimed to reduce the number of BVAD implantations. Special attention is focused on assessment of RV size, geometry and function in relation to loading conditions with the goal of predicting preoperatively the RV changes which might be induced by RV afterload reduction with the LVAD. The review also provides a theoretical and practical basis for clinicians intending to be engaged in this field. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Iizuka, Kei; Nishinaka, Tomohiro; Takewa, Yoshiaki; Yamazaki, Kenji; Tatsumi, Eisuke
Aortic valve regurgitation (AR) is a serious complication under left ventricular assist device (LVAD) support. AR causes LVAD-left ventricular (LV) recirculation, which makes it difficult to continue LVAD support. However, the hemodynamics and myocardial oxygen metabolism of LVAD support with AR have not been clarified, especially, how pump rotation speed influences them. An animal model of LVAD with AR was newly developed, and how pump rotation speed influences hemodynamics and myocardial oxygen metabolism was examined in acute animal experiments. Five goats (55 ± 9.3 kg) underwent centrifugal type LVAD, EVAHEART implantation. The AR model was established by placing a vena cava filter in the aortic valve. Hemodynamic values and the myocardial oxygen consumption, delivery, and oxygen extraction ratio (O 2 ER) were evaluated with changing pump rotation speeds with or without AR (AR+, AR-). AR+ was defined as Sellers classification 3 or greater. AR was successfully induced in five goats. Diastolic aortic pressure was significantly lower in AR+ than AR- (p = 0.026). Central venous pressure, mean left atrial pressure, and diastolic left ventricular pressure were significantly higher in AR+ than AR- (p = 0.010, 0.047, and 0.0083, respectively). Although systemic flow did not improve with increasing pump rotation speed, LVAD pump flow increased over systemic flow in AR+, which meant increasing pump rotation speed increased LVAD-LV recirculation and did not contribute to effective systemic circulation. O 2 ER in AR- decreased with increasing pump rotation speed, but O 2 ER in AR+ was hard to decrease. The O 2 ER in AR+ correlated positively with the flow rate of LVAD-LV recirculation (p = 0.012). AR caused LVAD-LV recirculation that interfered with the cardiac assistance of LVAD support and made it ineffective to manage with high pump rotation speed.
Full Text Available Objective to study the notion and essence of legal judgments calibration the possibilities of using it in the lawenforcement activity to explore the expenses and advantages of using it. Methods dialectic approach to the cognition of social phenomena which enables to analyze them in historical development and functioning in the context of the integrity of objective and subjective factors it determined the choice of the following research methods formallegal comparative legal sociological methods of cognitive psychology and philosophy. Results In ordinary life people who assess other peoplersaquos judgments typically take into account the other judgments of those they are assessing in order to calibrate the judgment presently being assessed. The restaurant and hotel rating website TripAdvisor is exemplary because it facilitates calibration by providing access to a raterrsaquos previous ratings. Such information allows a user to see whether a particular rating comes from a rater who is enthusiastic about every place she patronizes or instead from someone who is incessantly hard to please. And even when less systematized as in assessing a letter of recommendation or college transcript calibration by recourse to the decisional history of those whose judgments are being assessed is ubiquitous. Yet despite the ubiquity and utility of such calibration the legal system seems perversely to reject it. Appellate courts do not openly adjust their standard of review based on the previous judgments of the judge whose decision they are reviewing nor do judges in reviewing legislative or administrative decisions magistrates in evaluating search warrant representations or jurors in assessing witness perception. In most legal domains calibration by reference to the prior decisions of the reviewee is invisible either because it does not exist or because reviewing bodies are unwilling to admit using what they in fact know and employ. Scientific novelty for the first
Badke, Lara K.
A complete discussion of intellectual property (IP), faculty rights, and the public good requires a thorough framing of higher education's legal context, from which the rise of legalistic criteria (or legalization) and current IP regime have grown.
A substantial majority of Canadians favours a change to the Criminal Code which would make it legally permissible, subject to careful regulation, for patients suffering from incurable physical illness to opt for either physician assisted suicide (PAS) or voluntary active euthanasia (VAE). This discussion will focus primarily on the arguments for and against decriminalizing physician assisted suicide, with special reference to the British Columbia case of Lee Carter vs. Attorney General of Canada. The aim is to critique the arguments and at the same time to describe the contours of the current Canadian debate. Both ethical and legal issues raised by PAS are clarified. Empirical evidence available from jurisdictions which have followed the regulatory route is presented and its relevance to the slippery slope argument is considered. The arguments presented by both sides are critically assessed. The conclusion suggested is that evidence of harms to vulnerable individuals or to society, consequent upon legalization, is insufficient to support continued denial of freedom to those competent adults who seek physician assistance in hastening their death. Copyright © 2013 Elsevier Ltd. All rights reserved.
Liu, Shyh-Jiun; Huang, Chia-Hung; Huang, Chun-Kai; Hwang, Weng-Sing
Iron complexes were supported on commercial carbon black and heat treated to create FeO(x)/C catalysts that showed a larger normalized current density and normalized power density than commercial Pt/C catalysts; the coordination number of the iron complexes used affected the formation of the active site for oxygen reduction in PEMFC.
Collet-Klingenberg, Lana; Neitzel, Jen; LaBerge, Julie
Teaching staff at a rural middle school, with support from the National Professional Development Center on Autism Spectrum Disorders (NPDC-ASD), implemented a peer-mediated intervention. This program involved 4 learners with ASD and 18 typical peers divided into three groups that met over a semester as typical peers were taught about social skills…
Wellington, Wendy; Stackhouse, Joy
The majority of children with speech, language and communication needs (SLCN) are educated in mainstream classrooms where they can have difficulties with the language needed for learning. Although visual support in the classroom can help to scaffold children's learning and socialization, many teachers feel ill equipped to use this. They do not…
... VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION STATE VOCATIONAL AND APPLIED TECHNOLOGY EDUCATION... special prevocational education programs. (5) Career intern programs. (6) Model programs for school... 34 Education 3 2010-07-01 2010-07-01 false What activities does the Secretary support under the...
Lin, Lu; Liu, Haiou; Zhang, Xiongfu
Rational design of efficient approaches to fabricate MOFs-coated core-shell composites is promising but challenging. We report here the encapsulation of Pd nanoparticles (Pd NPs) supported flower-like ZnO (F-ZnO) microspheres with ZIF-8 shell through a facile strategy, in which the formation and immobilization of Pd NPs on F-ZnO supports and the subsequent growth of ZIF-8 shells over them are effectively integrated into one-pot synthetic route. Importantly, the utilization of ZnO both as support of Pd NPs and Zn2+ source of ZIF-8 is favorable for the implement of one-pot synthesis, due to its functions in anchoring Pd NPs and inducing ZIF-8 formation. Further insights into the morphological influence of zinc oxide particles on the resulting materials indicate that the flower-like microspheres with 2D nanosheets as subunits also benefit the coating of Pd NPs supported cores with ZIF-8, resulting in a well-defined core-shell catalyst. The achieved catalyst deliveries remarkable performance in terms of selectivity, anti-poisoning and recyclability in the liquid hydrogenations of alkenes.
Brown, Jessica; Wollersheim, Madeline
College students with mild traumatic brain injury (mTBI) may experience chronic cognitive deficits necessitating use of external supports for daily task completion. The purpose of this study was to explore cognitive support system selection and use by students with histories of mTBI when completing novel prospective memory tasks. We implemented a multiple case study, sequential explanatory mixed-methods design with three participants. Participants completed four experimental phases: (1) background history collection, cognitive assessment completion, pre-trial interview, and selection of two external supports for trial phase use; (2) trial Phase 1 (i.e., 10-days); (3) trial Phase 2 (i.e., 10 days); and (4) post-trial exit interview. We examined participants' support type and characteristic preferences and evaluated task execution accuracy when implementing differing supports. Participants expressed both collective and unique cognitive aid preferences before trial completion. Trial phase results revealed that task completion accuracy did not alter substantially between trials; however, personal preferences and perceived usefulness of trialled cognitive aid systems appeared to impact support implementation and effectiveness. Themes emerged from post-trial interview relating to the (a) necessity for differing functions of individual systems and (b) importance of trialling devices prior to selection. Results emphasize the necessity of person-centred approaches to treatment due to the variability of performance accuracy and system preferences. The cognitive aid selection and implementation intervention protocol piloted in this study appears beneficial for understanding unique strengths and challenges for college students following mTBI and may be useful for clinicians working with individuals with mTBI. Implications for rehabilitation College-aged students with mild traumatic brain injury report unique preferences for no- and high-tech cognitive aids; however, similar
Hasegawa, T K; Lange, B; Bower, C F; Purtilo, R B
Perplexing ethical and legal concerns cross health professions and reach into many professions and vocations. Confidentiality is crucial not only to the health professional and the patient, but also to the lawyer and client, and the investigative reporter and the source. Reporting poor work or whistleblowing is a dilemma not only for dentists and other health care professionals, but also for the engineer, architect, and federal employee, among others. This survey of the ethical or legal perceptions of the dental practitioner supports two conclusions: perplexing situations are perceived as predominantly ethical rather than legal problems and the factor of age (number of years in practice) might affect this trend toward the ethical consideration of complicated issues. Understanding the nature of these and other perplexing situations requires that dental practitioners step beyond the confines of their practice and the boundaries of the dental profession to search for more effective ways of dealing with, and therefore living with, the realities of their practice.
Morris, Janet R
Bet Tzedek, Hebrew for the "House of Justice," provides free legal assistance to older adults in Los Angeles County. Their civil attorneys work alongside prosecutors and service providers for the elderly as members of multidisciplinary teams to assist older adults with complicated elder abuse and neglect cases. Case examples demonstrate how civil attorneys collaborate with the Los Angeles County Elder Abuse Forensic Center to address financial abuse, real estate fraud, and self-neglect issues. Cooperation among the courts, Bet Tzedek, and other county agencies has resulted in more user-friendly processes to expedite filing of conservatorships and elder abuse restraining orders.
Reavley, Nicola J; Ross, Anna M; Killackey, Eoin; Jorm, Anthony F
Background. The age at which most young people are in tertiary education is also the age of peak onset for mental illness. Because mental health problems can have adverse effects on students' academic performance and welfare, institutions require guidance how they can best provide support. However, the scientific evidence for how best to do this is relatively limited. Therefore a Delphi expert consensus study was carried out with professional and consumer experts. Methods. A systematic review of websites, books and journal articles was conducted to develop a 172 item survey containing strategies that institutions might use to support students with a mental illness. Two panels of Australian experts (74 professionals and 35 consumers) were recruited and independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines. Results. The overall response rate across three rounds was 83% (80% consumers, 85% professionals). 155 strategies were endorsed as essential or important by at least 80% of panel members. The endorsed strategies provided information on policy, measures to promote support services, service provision, accessibility of support services, relationships between services, other types of support and issues associated with reasonable adjustments. They also provided guidance on the procedures the institutions should have for making staff aware of issues associated with mental illness, mental illness training, support for staff and communicating with a student with a mental illness. They also covered student rights and responsibilities, the procedures the institutions should have for making students aware of issues associated with mental illness, dealing with mental health crises, funding and research and evaluation. Conclusions. The guidelines provide guidance for tertiary institutions to assist them in supporting students with a mental illness. It is hoped that they may be used to inform policy and
Nicola J. Reavley
Full Text Available Background. The age at which most young people are in tertiary education is also the age of peak onset for mental illness. Because mental health problems can have adverse effects on students’ academic performance and welfare, institutions require guidance how they can best provide support. However, the scientific evidence for how best to do this is relatively limited. Therefore a Delphi expert consensus study was carried out with professional and consumer experts.Methods. A systematic review of websites, books and journal articles was conducted to develop a 172 item survey containing strategies that institutions might use to support students with a mental illness. Two panels of Australian experts (74 professionals and 35 consumers were recruited and independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines.Results. The overall response rate across three rounds was 83% (80% consumers, 85% professionals. 155 strategies were endorsed as essential or important by at least 80% of panel members. The endorsed strategies provided information on policy, measures to promote support services, service provision, accessibility of support services, relationships between services, other types of support and issues associated with reasonable adjustments. They also provided guidance on the procedures the institutions should have for making staff aware of issues associated with mental illness, mental illness training, support for staff and communicating with a student with a mental illness. They also covered student rights and responsibilities, the procedures the institutions should have for making students aware of issues associated with mental illness, dealing with mental health crises, funding and research and evaluation.Conclusions. The guidelines provide guidance for tertiary institutions to assist them in supporting students with a mental illness. It is hoped that they may be used to
Berland-Benhaïm, C; Bartoli, C; Karsenty, G; Piercecchi-Marti, M-D
To describe the legal framework of medicine prescription in France in 2013. With the assistance of lawyer and forensic pathologist, consultation (legifrance.gouv.fr), analysis, summary of French laws and rules surrounding drugs prescriptions to humans for medical purpose. Free medicine prescription is an essential feature of a doctor's action. To prescribe involve his responsibility at 3 levels: deontological, civilian and penal. Aim of the rules of medicine prescription is to preserve patient's safety and health. Doctors are encouraged to refer to recommendations and peer-reviewed publication every time the prescriptions go out of the case planned by law. Knowledge and respect of medicine prescription legal rules is essential for a good quality practice. Medical societies have a major role to improve medicine use among practitioners. Copyright © 2013. Published by Elsevier Masson SAS.
Bonios, Michael J; Selzman, Craig H; Gilbert, Edward M; McKellar, Stephen H; Koliopoulou, Antigoni; Strege, Jennifer L; Nativi, Jose N; Fang, James C; Stehlik, Josef; Drakos, Stavros G
We present the case of two patients with idiopathic dilated cardiomyopathy and moderate aortic valve regurgitation that were treated with a bioprosthetic valve at the time of the left ventricular assist device (LVAD) implantation. A few months later, patients revealed partial recovery in the left ventricle systolic function. Both patients, during the LVAD turndown protocol, reported the onset of chest pain. The transthoracic echocardiography revealed the presence of a new transaortic pressure gradient. We confirmed the presence of a fused bioprosthetic valve by further performing a transesophageal echocardiogram and a left and right heart catheterization. Replacement of aortic valve at the time of an LVAD implantation constitutes a challenging case. Although a mechanical valve is contraindicated due to the increased thromboembolic risk, selecting a bioprosthetic valve increases the risk of valve leaflets fusion. The consequences of this phenomenon should be acknowledged in LVAD patients undergoing aortic valve replacement with a bioprosthetic, especially under the view of LVAD explantation for those revealing myocardial recovery under mechanical unloading.
Schmidt, Thomas; Bjarnason-Wehrens, Birna; Mommertz, Stephanie; Hannig, Meike; Schulte-Eistrup, Sebastian; Willemsen, Detlev; Reiss, Nils
Following implantation of a left ventricular assist device (LVAD), acceptable functional performance is now being achieved; however, peak VO 2 and peak work load (watts) remain considerably limited. Maximum physical capacity is essentially dependent on generated cardiac output (CO) and arteriovenous oxygen difference (avDO 2 ). We investigated the changes in CO and avDO 2 during exercise in LVAD patients with an HVAD pump (HeartWare Inc., Framingham, MA, USA). Approximately 6 weeks after implantation, 20 patients (100% male, 60.8 ± 7.3 years old, BMI 25.7 ± 3.3) underwent a six-minute walk test (6MWT), a cardiopulmonary exercise test (CPET), and noninvasive hemodynamic measurement. The mean six-minute walking distance (6MWD) was 403 m (68% of predicted), and mean peak VO 2 was 10.9 mL/kg/min (39% of predicted). Mean total CO improved from 3.8 L at rest to 7.0 L at maximum exercise. The mean avDO 2 increased from 7.4 mL/dL (44% of oxygen content) at rest to 13.2 mL/dL (75% of oxygen content) at maximum exercise. There was a significant increase in both total CO (P parameters. © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
О. О. Пестрецова
Full Text Available One of the promising areas in the work of modern libraries that combine the traditional functions of the library with the functions of industry information centers is legal informing and information support of the law-making process. The globalization of the economy and political integration raise the issue not just about accumulation, processing, storage of national legal information, but also about the importance of literature collections on legal comparativistics, information support of transnational law. The article deals with the experience of foreign and domestic law libraries. Much attention is given to the main tasks and forms of legal libraries work, formation and development of legal funds and literature collections. The libraries that are charged with the functions the accumulation of legal resources suggests the active participation in this informational activity of the two types of libraries: the government libraries with the status of national that provide access to documents of national importance, carry out information support of political and legal processes. Another type of law libraries – academic, which providing the educational process and at the same time are centers of legal information, not only for the university community, but also for professional communities, regional authorities, civil society.
Changes in homicide and arrest rates were compared among cohorts born before and after legalization of abortion and those who were unexposed to legalized abortion. It was found that legalized abortion improved the lives of many women as they could avoid unwanted births.
Minor girls are legally considered as incapable, under the authority of their parents. Difficulties can arise when a minor becomes pregnant. The law takes account of this situation: under certain conditions, she can decide by herself to undertake certain actions, medical or otherwise, without the consent of her parents. These include access to contraception, abortion or anonymous birth. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Full Text Available Legal pluralism calls into question the monopoly of the modern state when it comes to the production and the enforcement of norms. It rests on the assumption that juridical normativity and state organization can be dissociated. From an early modern historian’s perspective, such an assumption makes perfect sense, the plural nature of the legal order being the natural state of affairs in imperial spaces across the globe in the sixteenth and seventeenth centuries. This article will provide a case study of the collaborative nature of the interaction between spiritual and temporal legal orders in Spain and its overseas territories as conceived by Tomás de Mercado (ca. 1520–1575, a major theologian from the School of Salamanca. His treatise on trade and contracts (1571 contained an extended discussion of the government’s attempt to regulate the grain market by imposing a maximum price. It will be argued that Mercado’s view on the bindingness of economic regulations in conscience allowed for the internalization of the regulatory power of the nascent state. He called upon confessors to be strict enforcers of state law, considering them as fathers of the republic as much as fathers of faith. This is illustrative of the »collaborative form of legal pluralism« typical of the osmotic relationship between Church and State in the early modern Spanish empire. It contributed to the moral justification of state jurisdictions, while at the same time, guaranteeing a privileged role for theologians and religious leaders in running the affairs of the state.
In Salian and Ripuarian Code affatomia represented a bilateral legal transaction that was aimed at changing of the scoped of heirs determined by the customs, at least insofar being applied in the absence of biological descendants only. However, almost all further similarities in the field cease at this point. The form for using affatomia with Ripuarian Franks was much simpler than the one with the Salian Franks. Unlike the Salian Franks, affatomia could by all odds be used by Ripuarian Franks...
Grant, Jon E; Odlaug, Brian L; Davis, Andrew A; Kim, Suck Won
Although studies have examined clinical characteristics of kleptomania, no previous studies have examined the legal consequences of kleptomania. From 2001 to 2007, 101 adult subjects (n = 27 [26.7%] males) with DSM-IV kleptomania were assessed on sociodemographics and clinical characteristics including symptom severity, comorbidity, and legal repercussions. Of 101 subjects with kleptomania, 73.3% were female. Mean age of shoplifting onset was 19.4 +/- 12.0 years, and subjects shoplifted a mean of 8.2 +/- 11.0 years prior to meeting full criteria for kleptomania. Co-occurring depressive, substance use, and impulse control disorders were common. Sixty-nine subjects with kleptomania (68.3%) had been arrested, 36.6% had been arrested but not convicted, 20.8% had been convicted and incarcerated after conviction, while only 10.9% had been convicted and not incarcerated after conviction. Kleptomania is associated with significant legal repercussions. The findings emphasize the need for rigorous treatment approaches to target kleptomania symptoms and prevent re-offending.
Arends, J.; Sandusky, William F.
This report represents findings of a design review team that evaluated construction documents (at the 100% level) and operating specifications for a new control tower and support building that will be built in Palm Springs, California by the Federal Aviation Administration (FAA). The focus of the review was to identify measures that could be incorporated into the final design and operating specifications that would result in additional energy savings for the FAA that would not have otherwise occurred.
Mitchell, Bernadette; Armour, Carol; Lee, Mary; Song, Yun Ju; Stewart, Kay; Peterson, Greg; Hughes, Jeff; Smith, Lorraine; Krass, Ines
To evaluate the capacity and effectiveness of trained community pharmacists in delivering the Diabetes Medication Assistance Service (DMAS) via (1) number and types of self-management support interventions (SMSIs); (2) number of goals set and attained by patients and (3) patient outcomes (glycaemic control, medication adherence and satisfaction). Pharmacists (n=109) from 90 community pharmacies in Australia were trained and credentialed to deliver the DMAS. The training focused on developing pharmacists' knowledge and skills in supporting patients' diabetes self-management. A total of 387 patients completed the trial. The mean number of SMSIs per patient was 35 (SD ±31) and the majority (87%) had at least one documented goal that was fully or partially attained. There were significant health benefits for patients including improved glycaemic control and a reduced risk of non-adherence to medications. Over 90% of DMAS patients reported improvements in their knowledge about diabetes self-management. The DMAS provides self management support in the community pharmacy for people with T2DM which may result in improved clinical outcomes. Given appropriate training in diabetes care and behavior change strategies, community pharmacists can offer programs which provide self-management support to their patients with T2DM and improve their health outcomes. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
[email protected] . SUPPLEMENTARY INFORMATION: Section 1007(a)(2) of the Legal Services Corporation Act (``Act...: Authority: Secs. 1006(b)(1), 1007(a)(1) Legal Services Corporation Act of 1974, 42 U.S.C. 2996e(b)(1), 2996f... LEGAL SERVICES CORPORATION 45 CFR Part 1611 Income Level for Individuals Eligible for Assistance...
....gov . SUPPLEMENTARY INFORMATION: Section 1007(a)(2) of the Legal Services Corporation Act (Act), 42 U... continues to read as follows: Authority: Secs. 1006(b)(1), 1007(a)(1) Legal Services Corporation Act of 1974... LEGAL SERVICES CORPORATION 45 CFR Part 1611 Income Level for Individuals Eligible for Assistance...
Bouglé, Adrien; Bombled, Camille; Margetis, Dimitri; Lebreton, Guillaume; Vidal, Charles; Coroir, Marine; Hajage, David; Amour, Julien
Ventilator-associated pneumonia (VAP) is frequent in Intensive Care Unit (ICU) patients. In the specific case of patients treated with Veno-Arterial Extracorporeal Membrane Oxygenation Support (VA-ECMO), VAP treatment failures (VAP-TF) have been incompletely investigated. To investigate the risk factors of treatment failure (VAP-TF) in a large cohort of ICU patients treated with VA-ECMO, we conducted a retrospective study in a Surgical ICU about patients assisted with VA-ECMO between January 1, 2013, and December 31, 2014. Diagnosis of VAP was confirmed by a positive quantitative culture of a respiratory sample. VAP-TF was defined as composite of death attributable to pneumonia and relapse within 28 days of the first episode. In total, 152 patients underwent ECMO support for > 48h. During the VA-ECMO support, 85 (55.9%) patients developed a VAP, for a rate of 60.6 per 1000 ECMO days. The main pathogens identified were Pseudomonas aeruginosa and Enterobacteriaceae. VAP-TF occurred in 37.2% of patients and was associated with an increased 28-day mortality (Hazard Ratio 3.05 [1.66; 5.63], P<0.001), and VA-ECMO assistance duration (HR 1.47 [1.05-2.05], P = 0.025). Risk factors for VAP-TF were renal replacement therapy (HR 13.05 [1.73; 98.56], P = 0.013) and documentation of Pseudomonas aeruginosa (HR 2.36 [1.04; 5.35], P = 0.04). VAP in patients treated with VA-ECMO is associated with an increased morbidity and mortality. RRT and infection by Pseudomonas aeruginosa appear as strong risks factors of treatment failure. Further studies seem necessary to precise the best antibiotic management in these patients.
Peniel Jean Gildo
Full Text Available Recent technological advancements respond to the call to minimize/eliminate emissions to the atmosphere. However, on the average, fuel oils which is one of the major raw materials, is found to increase in sulfur concentration due to a phenomenon called thermal maturation. As such, a deeper desulfurization process is needed to obtain low/ultra-low sulfur fuel oils. In the present study, the ultrasound assisted oxidative desulfurization (UAOD processes using the H2O2 and HPW-AC oxidizing system applied to simulated fuel (~2800 ppm sulfur in the form of dibenzothiophene, benzothiophene, and thiophene dissolved in toluene, were optimized. After the pre-saturation of the HPW-AC with the simulated fuel, H2O2 was added just before the reaction was commenced under ultrasonic irradiation. After the application of both 2k-factorial design of experiment for screening and Face-Centered Design of Experiment for optimization, it was found that 25.52 wt% of H2O2 concentration, 983.9 mg of catalyst dose, 9.52 mL aqueous phase per 10 mL of the organic phase and 76.36 minutes of ultrasonication time would render 94.74% oxidation of the sulfur compounds in the simulated fuel. After the application of the optimized parameters to kerosene and employing a 4-cycle extraction using acetonitrile, 99% of the original sulfur content were removed from the kerosene using the UAOD optimized parameters. The desulfurization process resulted in a low-sulfur kerosene which retained its basic fuel properties such as density, viscosity and calorific value.
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Legal research and preparation of legal... INSTITUTIONAL MANAGEMENT LEGAL MATTERS Inmate Legal Activities § 543.11 Legal research and preparation of legal... program or work assignment), to do legal research and to prepare legal documents. Where practical, the...
den Uil, Corstiaan A; Akin, Sakir; Jewbali, Lucia S; Dos Reis Miranda, Dinis; Brugts, Jasper J; Constantinescu, Alina A; Kappetein, Arie Pieter; Caliskan, Kadir
Short-term mechanical circulatory support (MCS) is increasingly used as a bridge to decision in patients with refractory cardiogenic shock. Subsequently, these patients might be bridged to durable MCS either as a bridge to candidacy/transplantation, or as destination therapy. The aim of this study was to review support duration and clinical outcome of short-term MCS in cardiogenic shock, and to analyse application of this technology as a bridge to long-term cardiac support (left ventricular assist device, LVAD) from 2006 till June 2016. Using Cochrane Register of Trials, Embase and Medline, a systematic review was performed on patients with cardiogenic shock from acute myocardial infarction, end-stage cardiomyopathy, or acute myocarditis, receiving short-term MCS. Studies on periprocedural, post-cardiotomy and cardiopulmonary resuscitation support were excluded. Thirty-nine studies, mainly registries of heterogeneous patient populations (n = 4151 patients), were identified. Depending on the device used (intra-aortic balloon pump, TandemHeart, Impella 2.5, Impella 5.0, CentriMag and peripheral veno-arterial extracorporeal membrane oxygenation), mean support duration was (range) 1.6-25 days and the mean proportion of short-term MCS patients discharged was (range) 45-66%. The mean proportion of bridge to durable LVAD was (range) 3-30%. Bridge to durable LVAD was most frequently performed in patients with end-stage cardiomyopathy (22 [12-35]%). We conclude that temporary MCS can be used to bridge patients with cardiogenic shock towards durable LVAD. Clinicians are encouraged to share their results in a large multicentre registry in order to investigate optimal device selection and best duration of support. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
In this study, a new heterogeneous palladium (II) catalyst that contains O-carboxymethyl chitosan Schiff base has been designed for Suzuki coupling reactions. The chemical structures of the synthesized catalyst were characterized with the FTIR, TG/DTG, ICP-OES, SEM/EDAX, 1H NMR, 13C NMR, GC/MS, XRD, and magnetic moment techniques. The reusability and catalytic behavior of heterogeneous catalyst was tested towards Suzuki reactions. As a result of the tests, excellent selectivity was obtained, and by-products of homo coupling were not seen in the spectra. The biaryls products were identified on a GC/MS. In addition, it was determined in the reusability tests that the catalysts could be used several times (seven runs). More importantly, with very low catalyst loading (6 × 10-3 mol %) in very short reaction time (5 min), chitosan Schiff base supported Pd(II) complex gave high TON and TOF values. These findings showed that Schiff base supported Pd(II) catalyst is suitable for Suzuki cross coupling reactions.
Baran, Talat; Menteş, Ayfer
In this study a new type chitosan-based support has been produced for Pd(II) catalyst and its catalytic performance in Suzuki Csbnd C reactions has been studied under microwave irradiation without using any solvent. The chemical identification of the catalyst was performed using TG/DTG, FTIR, UV-Vis ICP-OES, SEM/EDAX, 13C NMR, molar conductivity, XRD and magnetic moment techniques. The performance of this new Pd(II) catalyst was studied in Suzuki Csbnd C reactions. The Pd(II) catalyst exhibited a good catalytic performance in very short time (4 min) by giving high TONs and TOFs with low amount of the catalyst (0.015 mol%). The catalyst also had reusability and did not lose its activity until six runs.
Walker, Denise D
Eight states and the District of Columbia have legalized the recreational use of cannabis for adults and more are expected to follow suit. After alcohol, cannabis is the most commonly used drug by adolescents. Consumption of this drug during this developmental period poses unique risks. Therefore, attention must be paid both to how legalization affects adolescents and how tailored interventions can effectively address their needs for assistance. This commentary offers considerations for how legalization might be crafted so as to benefit adolescents. It additionally focuses on how services might be designed to reach and intervene with teens who are questioning their use or are experiencing a cannabis use disorder and desire assistance in quitting. Copyright © 2017. Published by Elsevier Inc.
Farahani, R D; Lebel, L L; Therriault, D
Ultraviolet-assisted three-dimensional (3D) printing (UV-3DP) was used to manufacture photopolymer-based microdevices with 3D self-supported and freeform features. The UV-3DP technique consists of the robotized deposition of extruded filaments, which are rapidly photopolymerized under UV illumination during the deposition process. This paper systematically studies the processing parameters of the UV-3DP technique using two photo-curable polymers and their associated nanocomposite materials. The main processing parameters including materials' rheological behavior, deposition speed and extrusion pressure, and UV illumination conditions were thoroughly investigated. A processing map was then defined in order to help choosing the proper parameters for the UV-3DP of microstructures with various geometries. Compared to self-supported features, the accurate fabrication of 3D freeform structures was found to take place in a narrower processing region since a higher rigidity of the extruded filament was required for structural stability. Finally, various 3D self-supported and freeform microstructures with high potential in micro electromechanical systems, micro-systems and organic electronics were fabricated to show the capability of the technique. (paper)
Roč. 152, č. 5 (2013), s. 425-446 ISSN 0231-6625 R&D Projects: GA ČR GAP408/12/2579 Institutional support: RVO:68378122 Keywords : legal origins * law and economics * legal culture Subject RIV: AG - Legal Sciences
Inciardi, James A.; McBride, Duane C.
Analyzes the major proposals for drug legalization and discusses the possible consequences of these efforts if successful. Argues that the legalization of drugs would be an extremely complex undertaking and that most calls for such action do not offer specific proposals. Points out research that supports arguments against legalization of drugs.…
Wyner, A.Z.; Hoekstra, R.J.
The paper provides an OWL ontology for legal cases with an instantiation of the legal case Popov v. Hayashi. The ontology makes explicit the conceptual knowledge of the legal case domain, supports reasoning about the domain, and can be used to annotate the text of cases, which in turn can be used to
Wyner, A.; Hoekstra, R.
The paper provides an OWL ontology for legal cases with an instantiation of the legal case Popov v. Hayashi. The ontology makes explicit the conceptual knowledge of the legal case domain, supports reasoning about the domain, and can be used to annotate the text of cases, which in turn can be used to
Stern, Ralph D., Ed.
Negligence, a tort liability, is defined, discussed, and reviewed in relation to several court decisions involving school principals. The history of liability suits against school principals suggests that a reasonable, prudent principal can avoid legal problems. Ten guidelines are presented to assist principals in avoiding charges of negligence.…
Focuses on the origins of the reasons for the scarcity of books in law libraries and the legal profession in Nigeria. Publishing books locally with government assistance is advocated as a lasting solution, and cooperation and resource sharing among libraries is encouraged. (Contains 26 references.) (EAM)
Mitochondrial transfer: Ethical, legal and social implications in assisted reproduction. ... Mitochondrial transfer has also been closely associated with reproductive cloning, which is regulated differently worldwide. Children born from these techniques might experience an identity crisis. Although three gametes are needed to ...
This article examines how survivors of domestic violence and the institutional authorities to whom they turn for assistance represent verbal aggression in direct quotations and indirect reported speech in legal testimony. Using the theoretical framework proposed by Briggs and Bauman (1992), I suggest that direct quotations and reported speech…
Marina Moya González
Full Text Available This paper analyses the preimplantation genetic diagnosis (PGD in Spain, and the legal aspects. It exposes the technical characteristics, as well as the ethical and social consequences. It compares the different rules of law about assisted human reproduction techniques in Spain, and those in some European countries.
Ray, Gayl M.; Wilson, Nick; Mangini, Rick
This document, which lists core business and legal office management competencies identified by representatives from education and business and industry throughout Ohio, is intended to assist individuals and organizations in developing college tech prep programs that will prepare students from secondary through post-secondary associate degree…
Nadelmann, Ethan A.
Argues that current drug control policies are failing and that new proposals are even more costly and repressive. Contends that legalization would eliminate many drug-related problems and allow the government to redirect its efforts toward assistance and positive inducements. (FMW)
Sampson, James P., Jr.; And Others
This document contains chapter 6 (5 articles) of a collection of 35 articles primarily from American Association for Counseling and Development (AACD) publications on the most important legal and ethical topics about which all school counselors need to be informed. "Ethical Issues Involved With the Use of Computer-Assisted Counseling, Testing, and…
This section treats of the following documents and legal texts: 1 - Brazil: Law No. 13,260 of 16 March 2016 (To regulate the provisions of item XLIII of Article 5 of the Federal Constitution on terrorism, dealing with investigative and procedural provisions and redefining the concept of a terrorist organisation; and amends Laws No. 7,960 of 21 December 1989 and No. 12,850 of 2 August 2013); 2 - India: The Atomic Energy (Amendment) Act, 2015; Department Of Atomic Energy Notification (Civil Liability for Nuclear Damage); 3 - Japan: Act on Subsidisation, etc. for Nuclear Damage Compensation Funds following the implementation of the Convention on Supplementary Compensation for Nuclear Damage
Herod, Jerrell W; Ambardekar, Amrut V
Right ventricular (RV) failure is a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Whether RV function deteriorates with prolonged LVAD support is unknown. Speckle-tracking echocardiography provides a sensitive, noninvasive, reproducible, and quantitative assessment of RV systolic and diastolic function. Echocardiograms were retrospectively reviewed from before and after implantation of a Heartmate II LVAD. Speckle-tracking analysis was performed to measure RV longitudinal systolic strain, strain rate, and diastolic strain rate for each patient at baseline and over discrete time periods after LVAD implantation. Seventeen patients were included in the analysis, with an average follow-up after LVAD implantation of 234 ± 125 days. RV systolic strain improved in 15 patients, decreasing from -7.4 ± 2.3% to -9.7 ± 3.3% after LVAD (P = .026). Systolic strain rate improved in 11 patients, decreasing from -0.67 ± 0.25%/s to -0.96 ± 0.36%/s (P = .011). RV diastolic strain rate improved in 12 patients, increasing from 0.70 ± 0.33%/s to 1.02 ± 0.40%/s (P = .016). Chronic LVAD support improves RV systolic and diastolic function in LVAD patients who did not require an RV assist device. Speckle-tracking echocardiography may offer a noninvasive technique for identifying and monitoring improvements in RV function in LVAD patients. Copyright © 2014 Elsevier Inc. All rights reserved.
Koehler, Tamara; Brown, Andrew
Introduction Understanding how pharmacy technicians and other pharmacy support workforce cadres assist pharmacists in the healthcare system will facilitate developing health systems with the ability to achieve universal health coverage as it is defined in different country contexts. The aim of this paper is to provide an overview of the present global variety in the technician and other pharmacy support workforce cadres considering; their scope, roles, supervision, education and legal framewo...
Luciana Silva Zapparolli
Full Text Available One of the great challenges in distance-learning is to follow the actions of the teachers/tutors and also the actions of students during the process of teaching and learning. This article presents the FAG Tool integrated with the LMS Moodle was developed to help managers of the Distance Education environment to monitor the actions of teachers/tutors and also teachers/tutors in the follow-up of student actions. Through the techniques of Business Intelligence (BI and Learning Analytics (LA, the tool generates analytical reports and dashboards, presenting a holistic and transversal view, being this vision the differential of this tool. The use of FAG allows teachers/tutors to monitor the participation of all their students in all virtual rooms under their responsibility and thus take corrective measures in the teaching and learning process, such as reducing the risk of avoidance. For the managers, it can be considered as a support tool for decision making regarding the faculty, maintaining or not the teacher/tutor in the process of teaching and learning or even be a base to enlarge or reduce their classes depending on their performance in the virtual environment. Through the use of the FAG, this decision-making can happen during the teaching and learning process and not only after the end, as is usual, because the reports are easy to understand and present accurate information in time to ensure the success of the teaching and learning process.
Z. Gonul BALKIR
Full Text Available The necessity of examination of every case within its peculiar conditions in social sciences requires different approaches complying with the spirit and nature of social sciences. Multiple realities require different and various perceptual interpretations. In modern world and social sciences, interpretation of perception of valued and multi-valued have been started to be understood by the principles of fuzziness and fuzzy logic. Having the verbally expressible degrees of truthness such as true, very true, rather true, etc. fuzzy logic provides the opportunity for the interpretation of especially complex and rather vague set of information by flexibility or equivalence of the variables’ of fuzzy limitations. The methods and principles of fuzzy logic can be benefited in examination of the methodological problems of law, especially in the applications of filling the legal loopholes arising from the ambiguities and interpretation problems in order to understand the legal rules in a more comprehensible and applicable way and the efficiency of legal implications. On the other hand, fuzzy logic can be used as a technical legal method in legal education and especially in legal case studies and legal practice applications in order to provide the perception of law as a value and the more comprehensive and more quality perception and interpretation of value of justice, which is the core value of law. In the perception of what happened as it has happened in legal relationships and formations, the understanding of social reality and sociological legal rules with multi valued sense perspective and the their applications in accordance with the fuzzy logic’s methods could create more equivalent and just results. It can be useful for the young lawyers and law students as a facilitating legal method especially in the materialization of the perception and interpretation of multi valued and variables. Using methods and principles of fuzzy logic in legal
Student, Vladimir; Vidlar, Ales; Grepl, Michal; Hartmann, Igor; Buresova, Eva; Student, Vladimir
The advent of robotics has facilitated new surgical techniques for radical prostatectomy. These allow adjustment of pelvic anatomical and functional relationships after removal of the prostate to ameliorate postprostatectomy incontinence (PPI) and reduce the time to complete continence. To describe the results of a new surgical technique for reconstruction of vesicourethral anastomosis using the levator ani muscle for support during robot-assisted radical prostatectomy (RARP). A prospective, randomised, single-blind study among 66 consecutive patients with localised prostate cancer (cT1-2N0M0) undergoing RARP from June to September 2014, 32 using the new technique and 34 using the standard posterior reconstruction according to Rocco. In the advanced reconstruction of vesicourethral support (ARVUS) intervention group, the fibres of the levator ani muscle, Denonvilliers fascia, retrotrigonal layer, and median dorsal raphe were used to form the dorsal support for the urethrovesical anastomosis. Suture of the arcus tendineus to the bladder neck served as the anterior fixation. We compared demographic data and preoperative and postoperative functional and oncologic results for the two groups. The primary endpoint was continence evaluated at different time points (24h, 2, 4, and 8 wk, and 6 and 12 mo). The secondary endpoints were perioperative and postoperative complications and erectile function. Using a continence definition of 0 pads/d, the continence rates for the ARVUS versus the control group were 21.9% versus 5.9% at 24h (p=0.079), 43.8% versus 11.8% at 2 wk (p=0.005), 62.5% versus 14.7% at 4 wk (pInternational Index of Erectile Function questionnaire results at 6 and 12 mo after surgery showed similar potency rates for the control group (40.0% and 73.33%) and the ARVUS group (38.8% and 72.22%). There were four postoperative complications (2 in each group): three haematomas requiring transfusion and one lymphocele that needed drainage. No urinary retention
Bench-Capon, Trevor; Prakken, Henry; Sartor, Giovanni
A popular view of what Artificial Intelligence can do for lawyers is that it can do no more than deduce the consequences from a precisely stated set of facts and legal rules. This immediately makes many lawyers sceptical about the usefulness of such systems: this mechanical approach seems to leave out most of what is important in legal reasoning. A case does not appear as a set of facts, but rather as a story told by a client. For example, a man may come to his lawyer saying that he had developed an innovative product while working for Company A. Now Company B has made him an offer of a job, to develop a similar product for them. Can he do this? The lawyer firstly must interpret this story, in the context, so that it can be made to fit the framework of applicable law. Several interpretations may be possible. In our example it could be seen as being governed by his contract of employment, or as an issue in Trade Secrets law.
Brauer, Susanne; Bolliger, Christian; Strub, Jean-Daniel
In Switzerland, assisted suicide is legal as long as it does not involve self-serving motives. Physician-assisted suicide is regulated by specific guidelines issued by the Swiss Academy of Medical Sciences (SAMS). This article summarises the results of an empirical study of physicians' attitudes to assisted suicide in Switzerland, which was commissioned by the SAMS. The study (in German) is available online at: www.samw.ch. Twelve qualitative interviews and a written survey were conducted, involving a disproportional, stratified random sample of Swiss physicians (4,837 contacted, 1,318 respondents, response rate 27%). Due to the response rate and the wide variation of respondents from one professional speciality to another, the findings and interpretations presented should be regarded as applying only to the group of physicians who are interested in or are particularly affected by the issue of assisted suicide. They cannot be generalised to the whole body of physicians in Switzerland. Of the respondents, 77% considered physician-assisted suicide to be justifiable in principle, while 22% were fundamentally opposed to it. Although 43% could imagine situations where they would personally be prepared to perform assisted suicide, it is clear from the study that this potential readiness does not mean that all respondents would automatically be prepared to perform it in practice as soon as the legal criteria are met. The vast majority of respondents emphasised that there should be no obligation to perform physician-assisted suicide. Opinions differed as to whether physician-assisted suicide should remain restricted to cases where the person concerned is approaching the end of life. While a large majority of respondents considered physician-assisted suicide also to be justifiable in principle in non-end-of-life situations, 74% supported the maintenance of the end-of-life criterion in the SAMS Guidelines as a necessary condition for physician-assisted suicide. Over 50% of
This paper reviews the case for and against mandatory legal capital rules. It is argued that legal capital is no longer an appropriate means of safeguarding creditors' interests. This is most clearly the case as regards mandatory rules. Moreover, it is suggested that even an 'opt in' (or default) legal capital regime is unlikely to be a useful mechanism. However, the advent of regulatory arbitrage in European corporate law will provide a way of gathering information regarding investors' prefe...
Schäfke, Werner; Mayoral, Juan A.; Hvidt, Martine Stagelund
This article provides novel empirical survey evidence on socialization factors leading lecturers to implement interdisciplinary teaching in law. Recent debates on the legal scholarship and higher education legal institutions advocates for the introduction of interdisciplinary approaches to legal...... of the teaching staff in this institution. To explain the adoption of interdisciplinary teaching, we rely on socialization factors connected to their former higher education and socialization in research and multidisciplinary environments....
Oxalate is usually used as a refractory model compound that cannot be effectively removed by ozone and hydroxyl radical oxidation in water. In this study, we found that ceria supported CuO significantly improved oxalate degradation in reaction with ozone. The optimum CuO loading amount was 12%. The molar ratio of oxalate removed/ozone consumption reached 0.84. The catalytic ozonation was most effective in a neutral pH range (6.7-7.9) and became ineffective when the water solution was acidic or alkaline. Moreover, bicarbonate, a ubiquitous hydroxyl radical scavenger in natural waters, significantly improved the catalytic degradation of oxalate. Therefore, the degradation relies on neither hydroxyl radical oxidation nor acid assistance, two pathways usually proposed for catalytic ozonation. These special characters of the catalyst make it suitable to be potentially used for practical degradation of refractory hydrophilic organic matter and compounds in water and wastewater. With in situ characterization, the new surface Cu(II) formed from ozone oxidation of the trace Cu(I) of the catalyst was found to be an active site in coordination with oxalate forming multi-dentate surface complex. It is proposed that the complex can be further oxidized by molecular ozone and then decomposes through intra-molecular electron transfer. The ceria support enhanced the activity of the surface Cu(I)/Cu(II) in this process. © 2012 Elsevier B.V.
Bozkurt, Selim; Safak, Koray K
Dilated cardiomyopathy is the most common type of the heart failure which can be characterized by impaired ventricular contractility. Mechanical circulatory support devices were introduced into practice for the heart failure patients to bridge the time between the decision to transplant and the actual transplantation which is not sufficient due to the state of donor organ supply. In this study, the hemodynamic response of a cardiovascular system that includes a dilated cardiomyopathic heart under support of a newly developed continuous flow left ventricular assist device--Heart Turcica Axial--was evaluated employing computer simulations. For the evaluation, a numerical model which describes the pressure-flow rate relations of Heart Turcica Axial, a cardiovascular system model describing the healthy and pathological hemodynamics, and a baroreflex model regulating the heart rate were used. Heart Turcica Axial was operated between 8000 rpm and 11,000 rpm speeds with 1000 rpm increments for assessing the pump performance and response of the cardiovascular system. The results also give an insight about the range of the possible operating speeds of Heart Turcica Axial in a clinical application. Based on the findings, operating speed of Heart Turcica Axial should be between 10,000 rpm and 11,000 rpm.
Safak, Koray K.
Dilated cardiomyopathy is the most common type of the heart failure which can be characterized by impaired ventricular contractility. Mechanical circulatory support devices were introduced into practice for the heart failure patients to bridge the time between the decision to transplant and the actual transplantation which is not sufficient due to the state of donor organ supply. In this study, the hemodynamic response of a cardiovascular system that includes a dilated cardiomyopathic heart under support of a newly developed continuous flow left ventricular assist device—Heart Turcica Axial—was evaluated employing computer simulations. For the evaluation, a numerical model which describes the pressure-flow rate relations of Heart Turcica Axial, a cardiovascular system model describing the healthy and pathological hemodynamics, and a baroreflex model regulating the heart rate were used. Heart Turcica Axial was operated between 8000 rpm and 11000 rpm speeds with 1000 rpm increments for assessing the pump performance and response of the cardiovascular system. The results also give an insight about the range of the possible operating speeds of Heart Turcica Axial in a clinical application. Based on the findings, operating speed of Heart Turcica Axial should be between 10000 rpm and 11000 rpm. PMID:24363780
The radiograph itself plays a major role in medical malpractice cases. Also, many questions arise concerning the rights to and storage of x-ray films. These issues are addressed in this chapter. To keep the terminology simple, the word radiograph represents all imaging documentation on hard copy film (x-rays, nuclear medicine, computer-assisted studies, ultrasound, and magnetic resonance imaging)
After the events of September 11, the United Nations Security Council adopted Resolution 1373 (2001) which has been called the 'Counter-Terrorism Code' of the world, because it creates legal obligations for all 192 Member States of the United Nations. UN Security Council Resolutions 1373 (2001), 1540 (2004) and 1735 (2006) as well as a defined set of 13 global treaties constitute the universal legal framework against terrorism which must be implemented in a manner consistent with international human rights obligations. Basically, these 13 treaties as well as Resolution 1373 are international criminal law instruments. Within this universal legal framework, the framework against nuclear terrorism is constituted by Resolution 1540, the Convention on the Physical Protection of Nuclear Material (CPPNM) which entered into force in 1987, and the International Convention for the Suppression of Terrorist Bombings which is in force since 2001. These three legal instruments will be supplemented by the International Convention for the Suppression of Acts of Nuclear Terrorism, an amendment to the CPPNM and two Protocols amending the Convention for the Suppression of Unlawful Acts Against the Safety of Maritime Navigation and the Protocol for the Suppression of Unlawful Acts Against the Safety of Fixed Platforms Located on the Continental Shelf, once these instruments, all of which were adopted in 2005, enter into force. The Terrorism Prevention Branch (TPB) of the United Nations Office on Drugs and Crime (UNODC) assists countries which are in need of legislative assistance for the drafting of appropriate counter-terrorism laws that duly take into account the obligations contained in Resolution 1373, the United Nations sanctions against Al-Qaida and the Taliban as well as in the 13 universal conventions for the prevention and the suppression of terrorism, including the CPPNM and the new International Convention for the Suppression of Acts of Nuclear Terrorism. UNODC/TPB has also
data machines may be able to (or are thought to be able to) make a prediction profile, leaving risks for individuals for being excluded from life and health insurances, being targets for computational policing etc. An additional dimension to the prefabricated decisions is the commercial aspect......) decisions which has implications for legal orders, legal actors and legal research, not to mention legal legitimacy as well as personal autonomy and democracy. On the one hand automation may facilitate better, faster, more predictable and more coherent decisions and leave cumbersome and time consuming...
This doctoral thesis presents solutions to some of the legal problems encountered in the interpretation of the various laws and regulations governing nuclear waste disposal, and reveals the legal system supporting the variety of individual regulations. Proposals are made relating to modifications of problematic or not well defined provisions, in order to contribute to improved juridical security, or inambiguity in terms of law. The author also discusses the question of the constitutionality of the laws for nuclear waste disposal. Apart from the responsibility of private enterprise to contribute to safe treatment or recycling, within the framework of the integrated waste management concept, and apart from the Government's responsibility for interim or final storage of radioactive waste, there is a third possibility included in the legal system for waste management, namely voluntary measures taken by private enterprise for radioactive waste disposal. The licence to be applied for in accordance with section 3, sub-section (1) of the Radiation Protection Ordinance is interpreted to pertain to all measures of radioactive waste disposal, thus including final storage of radioactive waste by private companies. Although the terminology and systematic concept of nuclear waste disposal are difficult to understand, there is a functionable system of legal provisions contained therein. This system fits into the overall concept of laws governing technical safety and safety engineering. (orig./HSCH) [de
Júlio César Fontana-Rosa
Full Text Available Os autores discutem o significado ético e jurídico da expressão "responsável legal", questionando seus limites. Demonstram que de fato ela não atende satisfatoriamente o que se denomina responsabilidade legal, pois para tanto teria que encontrar amparo nos códigos e normas legais, o que, de fato, não acontece. Assim, a expressão representante legal pode não possibilitar ao profissional, quando de sua utilização respaldo ético e legal normativo a sua atividade profissional.The authors discuss the legal and ethical meaning of the expression "Third-Party Consent" by questioning its limits. It is indeed shown that it does not satisfactorily meet what is called third-party consent because this would require legal endorsement by legal codes and norms which, in fact does not occur. As such, the expression "third-party consent", whenever used, may not provide the professional with the normative, ethical and legal support needed for professional performance.
Full Text Available This paper is an attempt to analyse the most important grammatical and, specifically, syntactic features and to point out some prominent lexical ones, which aim at accuracy and objectivity of a written legal document, and to discuss how these features influence clarity and transparency of the legal documents. The study covers the analysis of some EU, UK, US legislative acts alongside with some extracts from contract samples. The analysis reveals that written legal English is distinguished by long compound sentences, often with inverted word order and numerous embeddings, passive constructions and nominalisations, specific use of personal pronouns and collocations of synonyms (doublets and triplets, etc. These means allow to achieve the most possible accuracy and objectivity in legal texts but make them complicated and difficult to comprehend at once. Formality, achieved by the mentioned means, makes legal English distant from everyday language and often becomes a reason for criticism. Plain English supporters encourage simplifying legal language; however, long traditions of legal English make changes slow and difficult. Therefore, comprehension and usage of legal English still requires special knowledge of its lexical and grammatical features.
Raisler, K.M.; Gregory, A.M.
This chapter focuses on the legal issues relating to the derivatives market in the USA, and analyses the Commodity Futures Trading Commission's (CFTCs) information on swaps and hybrid instruments. The law and regulation in the USA is examined and the jurisdictional reach of the Securities and Exchange Commission (SEC), CFTC, and the Commodity Exchange Act (CEA) is described. The forward contract exclusion and the case of Transnor (Bermuda) Ltd. versus BP North America Petroleum, state laws, swap policy statement issues by the CFTC, the Futures Trading Practices Act of 1992, swaps exemptions, the exemption of hybrid instruments from the CEA, and energy contract exemption are discussed. Enforceability, derivatives, and issues before regulators are considered
Ovidiu – Horia Maican
Full Text Available The Brexit referendum vote has mainly political implications and no direct legal effect. The article 50 of the Treaty on European Union allows member states to withdraw from the European Union in accordance with its own constitutional requirements. After the referendum is a period of two years from the british notice of intention to withdraw to negotiate terms of exit unless all the other member states agree to extend it. Article 50 put the balance of power firmly in the hands of the 27 other states more than the leaving state. After the time limit in article 50 is expiring, Europen Union in theory law ceases to apply in the United Kingdom. In the same time, separating European law from british national law will be an complicated process.
Gil Carlos Rodrigues Medeiros
Full Text Available The aim of this work is to develop a software tool that provides a user-friendly graphical interface of generic and configurable design in order to ease the researcher’s tasks in data manipulation and analysis. Two primary targets have influenced the design: data preparation for analysis in animal breeding programs and usability increase for those applications that perform important analysis methods, but interact with users only through text files and command lines. The Guaiaca tool was designed as a “utility belt” in the form of two integrated assistants, and it can be combined with multiple analysis applications. This tool offers facilities to: (a collect, manipulate, and reorganize data; (b organize, register, and retrieve analyses through descriptors; and (c prepare and activate analysis processes. Guaiaca’s Execution Assistant module is described in this paper, where is also emphasized the parameters to configure, the main data structures to maintain, and the form of the relationship between its generic interface and combined analysis applications. The generic interface has been customized and validated for the peculiarities of two applications, WOMBAT (mixed models and INTERGEN (Bayesian models. Several data analyses were performed with the interface support to prove its generality and ease of installation, configuration and operation. Data sets from 5,726 quails in a breeding program were used with these applications. Use of the integrated Guaiaca-WOMBAT application is illustrated with an analysis example, prepared and visualized on the Guaiaca tool and executed by WOMBAT. The Beta version of the Guaiaca tool for Windows is available free of charge to the scientific community and can be obtained at http://www.ufpel.edu.br/~gil.medeiros/guaiaca.
Feng, Xin; Qian, Zenghui; Liu, Peng; Zhang, Baorui; Wang, Luyao; Guo, Erkang; Wen, Xiaolong; Xu, Wenjuan; Jiang, Chuhan; Wu, Zhongxue; Li, Youxiang; Liu, Aihua
To compare the rates of recanalization and in-stent stenosis between the Enterprise (EP) and low-profile visualized intraluminal support (LVIS) stent deployments for intracranial aneurysms (IAs), and the factors associated therein. Between June 2014 and July 2016, 142 patients with a total of 161 IAs were treated by LVIS stent-assisted coiling and 111 patients with a total of 142 IAs were treated by EP stent-assisted coiling at our institution. Procedure-related complications, angiographic follow-up results, and clinical outcomes were analyzed statistically. The rates of initially complete and near-complete IA occlusion immediately after the procedure were similar in the LVIS and EP groups (94.3% vs. 89.9%; P = 0.275). On follow-up, complete and near-complete occlusion rates and recanalization rates were also similar in the 2 groups (96.6% vs. 92.1%; P =0.330 and 8.0% vs. 13.5%; P = 0.245, respectively). On logistic regression analysis, a higher size ratio (SR) was significantly associated with the recanalization of aneurysms in the EP group, but not in the LVIS group. The rate of moderate to severe in-stent stenosis was lower in the LVIS group (10.2%) than in the EP group (16.8%), but the difference was not statistically significant (P = 0.198). Our data show acceptable rates of complete and near-complete occlusion with both the LVIS and EP stents. LVIS stents were associated with lower rates of recanalization and in-stent stenosis, but the difference was not significant. Higher SR (≥2) was a significant predictor of recanalization in IAs treated with EP stents, but not in those treated with LVIS stents. Copyright © 2017. Published by Elsevier Inc.
Full Text Available Alumina-supported silver and indium catalysts are investigated for the hydrogen-assisted selective catalytic reduction (SCR of NOx with ammonia. Particularly, we focus on the active phase of the catalyst and the formation of surface species, as a function of the gas environment. Diffuse reflectance ultraviolet-visible (UV-vis spectroscopy was used to follow the oxidation state of the silver and indium phases, and in situ diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS was used to elucidate the formation of surface species during SCR conditions. In addition, the NOx reduction efficiency of the materials was evaluated using H2-assisted NH3-SCR. The DRIFTS results show that the Ag/Al2O3 sample forms NO-containing surface species during SCR conditions to a higher extent compared to the In/Al2O3 sample. The silver sample also appears to be more reduced by H2 than the indium sample, as revealed by UV-vis spectroscopic experiments. Addition of H2, however, may promote the formation of highly dispersed In2O3 clusters, which previously have been suggested to be important for the SCR reaction. The affinity to adsorb NH3 is confirmed by both temperature programmed desorption (NH3-TPD and in situ DRIFTS to be higher for the In/Al2O3 sample compared to Ag/Al2O3. The strong adsorption of NH3 may inhibit (self-poison the NH3 activation, thereby hindering further reaction over this catalyst, which is also shown by the lower SCR activity compared to Ag/Al2O3.
Natasha A Loghmanpour
Full Text Available This study investigated the use of Bayesian Networks (BNs for left ventricular assist device (LVAD therapy; a treatment for end-stage heart failure that has been steadily growing in popularity over the past decade. Despite this growth, the number of LVAD implants performed annually remains a small fraction of the estimated population of patients who might benefit from this treatment. We believe that this demonstrates a need for an accurate stratification tool that can help identify LVAD candidates at the most appropriate point in the course of their disease. We derived BNs to predict mortality at five endpoints utilizing the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS database: containing over 12,000 total enrolled patients from 153 hospital sites, collected since 2006 to the present day, and consisting of approximately 230 pre-implant clinical variables. Synthetic minority oversampling technique (SMOTE was employed to address the uneven proportion of patients with negative outcomes and to improve the performance of the models. The resulting accuracy and area under the ROC curve (% for predicted mortality were 30 day: 94.9 and 92.5; 90 day: 84.2 and 73.9; 6 month: 78.2 and 70.6; 1 year: 73.1 and 70.6; and 2 years: 71.4 and 70.8. To foster the translation of these models to clinical practice, they have been incorporated into a web-based application, the Cardiac Health Risk Stratification System (CHRiSS. As clinical experience with LVAD therapy continues to grow, and additional data is collected, we aim to continually update these BN models to improve their accuracy and maintain their relevance. Ongoing work also aims to extend the BN models to predict the risk of adverse events post-LVAD implant as additional factors for consideration in decision making.
Huschilt, Julie; Clune, Laurie
Innovative solutions for dementia care are required to address the steady rise in adults living with dementia, lack of adequate staffing to provide high-quality dementia care, and the need for family caregivers to provide care for their loved ones in the home. This article provides an overview of the use of socially assistive robots (SARs) to offer support as therapists, companions, and educators for people living with dementia. Social, ethical, and legal challenges associated with the use of robotic technology in patient care and implications for the use of SARs by nurses are discussed. These items considered, the authors conclude that SARs should be considered as a viable way to assist people living with dementia to maintain their highest possible level of independence, enhance their quality of life, and provide support to overburdened family caregivers. Further research is needed to evaluate the merits of this technological approach in the care of adults with dementia. Copyright 2012, SLACK Incorporated.
Гаврилова, Ілона Олександрівна; Університет державної фіскальної служби України
In the article the features of the administrative liability of legal entities in Ukraine; The experience of foreign countries on the administrative liability of legal entities, proposed measures to improve the administrative and tort legislation on administrative liability of legal entities in Ukraine.The problems of liability of legal entities were always relevant and important for administrative and legal science. Legal entities, performing administrative and legal relationships, may commit...
Holley, Christopher T; Fitzpatrick, Megan; Roy, Samit S; Alraies, M Chadi; Cogswell, Rebecca; Souslian, Laura; Eckman, Peter; John, Ranjit
Aortic insufficiency (AI) is a significant long-term complication of continuous-flow left ventricular assist device (CF-LVAD) implantation. We sought to evaluate its impact on clinical outcomes and mortality in CF-LVAD recipients. We retrospectively analyzed 237 patients implanted with HeartMate II CF-LVADs at our institution from June 2005 through June 2013. We evaluated recipients' baseline characteristics and annual echocardiograms, grading AI severity as either none, trace, mild, moderate or severe. Only moderate or severe AI was considered clinically significant. Recipients who underwent concomitant aortic valve surgery or who had undergone previous prosthetic aortic valve implantation were excluded. Moderate or severe AI occurred in 32 (15.2%) patients. Risk factors that significantly affected the development of AI included older age at the time of implantation, female gender, longer duration of LVAD support and destination therapy designation. Freedom from moderate or severe AI was 94%, 76% and 65% of patients at 1, 3 and 5 years, respectively. Overall cohort survival based on Kaplan-Meier analysis was 78%, 59% and 42% at 1, 3 and 5 years, respectively. There was no difference in survival between recipients who developed significant AI and those who did not (log-rank test, p = 0.73). In this large, single-institution study, the overall rate of AI was low, but increased in frequency with longer duration of LVAD support. Although AI development remains a concern for patients on long-term CF-LVAD support, AI development does not appear to impact long-term mortality. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Gribnau, J.L.M.; Soeteman, A.
Instrumentalist legislation usually underestimates the importance of legal principles in modern law. Legal principles are the normative core of a value oriented conception of law. They function as essential criteria of evaluation for lawmaking by the legislator and the executive. In fact,
What is being suggested as the most feasible course now is a standfast position on the legal front; an aggressive, directed research program planned to answer the critical questions about marijuana; and a discouragement policy for adolescents. Legalization is not seen as a tenable solution for many reasons, and it is one that may be irreversible and regretted.
This article discusses the cultural and other turns in relation to legal culture and situates Western legal culture in context. It deals with concepts and their relations to trends and fashions and introduces methodological reflections such as use of interdisciplinary methods, personal experience...
... United States Patent and Trademark Office Legal Processes ACTION: Proposed collection; comment request... Patent and Trademark Office (USPTO). The rules for these legal processes may be found under 37 CFR Part 104, which outlines procedures for service of process, demands for employee testimony and production...
... Patent and Trademark Office Legal Processes ACTION: Proposed collection; comment request. SUMMARY: The... United States Patent and Trademark Office (USPTO). The rules for these legal processes may be found under 37 CFR Part 104, which outlines procedures for service of process, demands for employee testimony and...
Discusses proposals for a new guest worker program with Mexico, reviewing characteristics of U.S. farmworkers, the current federal H-2A program for admitting legal guest workers for farm work, major proposals being debated to turn unauthorized into legal farmworkers, and new considerations after September 11 that may affect the negotiations. (SM)
The book discusses the most typical legal challenges met in the chartering, broker, agent or port management part of the shipping industry. It discusses these issues in both English and Scandinavian law and gives indications on how to best ensure your legal risk management in these parts...
Previous findings suggest that income inequality leads to lower legal quality. This paper argues that voters' tolerance of inequality exerts an additional influence. Empirical findings suggest that inequality leads to lower legal quality due to its effect on trust while the tolerance of inequality...
Abat Ninet, Antoni
The focus of this paper is the question of legitimacy, and how can we consider legitimate an imposed constitution and the subsequent constitutional principles, practices and values that go hand-in-hand with the legal and political acculturation. Constitutional texts around the world are good...... examples of transposition and complicity of theological and juridical thoughts. For the purpose of this paper, imposed constitutions are political and legal norms of a state enacted and enforced without the free and full agreement of the Demos. Legal theology implies the application of religious phenomena......, theories and concepts to achieve undisputed legal legitimacy. Imposed constitutions as rules imposed for salvation for those “Platonic Philosophes” who have seen the “light”, that known the episteme are paramount examples of legal and political theology. The paper has two main sections. The first one...
This brochure provides general information about relocation assistance provided by the Iowa Department of Transportation (DOT) for those individuals who may be required to move as a result of a highway project. It is not intended to be a legal docume...
Background In May 2013 a new Assisted Dying Bill was tabled in the House of Lords and is currently scheduled for a second reading in May 2014. The Bill was informed by the report of the Commission on Assisted Dying which itself was informed by evidence presented by invited experts. This study aims to explore how the experts presenting evidence to the Commission on Assisted Dying conceptualised mental capacity for patients requesting assisted suicide and examine these concepts particularly in relation to the principles of the Mental Capacity Act 2005. Methods This study was a secondary qualitative analysis of 36 transcripts of oral evidence and 12 pieces of written evidence submitted by invited experts to the Commission on Assisted Dying using a framework approach. Results There was agreement on the importance of mental capacity as a central safeguard in proposed assisted dying legislation. Concepts of mental capacity, however, were inconsistent. There was a tendency towards a conceptual and clinical shift toward a presumption of incapacity. This appeared to be based on the belief that assisted suicide should only be open to those with a high degree of mental capacity to make the decision. The ‘boundaries’ around the definition of mental capacity appeared to be on a continuum between a circumscribed legal ‘cognitive’ definition of capacity (in which most applicants would be found to have capacity unless significantly cognitively impaired) and a more inclusive definition which would take into account wider concepts such as autonomy, rationality, voluntariness and decision specific factors such as motivation for decision making. Conclusion Ideas presented to the Commission on Assisted Dying about mental capacity as it relates to assisted suicide were inconsistent and in a number of cases at variance with the principles of the Mental Capacity Act 2005. Further work needs to be done to establish a consensus as to what constitutes capacity for this decision and
Price, Annabel; McCormack, Ruaidhri; Wiseman, Theresa; Hotopf, Matthew
In May 2013 a new Assisted Dying Bill was tabled in the House of Lords and is currently scheduled for a second reading in May 2014. The Bill was informed by the report of the Commission on Assisted Dying which itself was informed by evidence presented by invited experts.This study aims to explore how the experts presenting evidence to the Commission on Assisted Dying conceptualised mental capacity for patients requesting assisted suicide and examine these concepts particularly in relation to the principles of the Mental Capacity Act 2005. This study was a secondary qualitative analysis of 36 transcripts of oral evidence and 12 pieces of written evidence submitted by invited experts to the Commission on Assisted Dying using a framework approach. There was agreement on the importance of mental capacity as a central safeguard in proposed assisted dying legislation. Concepts of mental capacity, however, were inconsistent. There was a tendency towards a conceptual and clinical shift toward a presumption of incapacity. This appeared to be based on the belief that assisted suicide should only be open to those with a high degree of mental capacity to make the decision.The 'boundaries' around the definition of mental capacity appeared to be on a continuum between a circumscribed legal 'cognitive' definition of capacity (in which most applicants would be found to have capacity unless significantly cognitively impaired) and a more inclusive definition which would take into account wider concepts such as autonomy, rationality, voluntariness and decision specific factors such as motivation for decision making. Ideas presented to the Commission on Assisted Dying about mental capacity as it relates to assisted suicide were inconsistent and in a number of cases at variance with the principles of the Mental Capacity Act 2005. Further work needs to be done to establish a consensus as to what constitutes capacity for this decision and whether current legal frameworks are able to
Full Text Available Despite decades of development of formal tools for modelling legal knowledge and reasoning, the creation of a fully fledged legal decision support system remains challenging. Among those challenges, such system requires an enormous amount of commonsense knowledge to derive legal expertise. This paper describes the development of a negotiation decision support system (the Parenting Plan Support System or PPSS to support parents in drafting an agreement (the parenting plan for the exercise of parental custody of minor children after a divorce is granted. The main objective here is to discuss problems of framing an intuitively appealing and computationally efficient knowledge base that can adequately represent the indeterminate legal concept of the well-being of the child in the context of continental legal culture and of Polish law in particular. In addition to commonsense reasoning, interpretation of such a concept demands both legal expertise and significant professional knowledge from other domains.
The case of Ms B throws up some interesting issues regarding the role of the nurse in assisting patients in making and implementing their decisions. The High Court transcript makes it clear who the voices with influence in legal matters were, and why the decisions they took were made. Absent from the myriad voices is that of the profession of nursing. Are nurses silenced by professional boundaries, the legal framework or lack of confidence? The concept of nursing advocacy is once again thrown into relief and critical questions need asking about the limits of professional nursing practice.
Ruiz, Jennifer; Labas, Michele P; Triche, Elizabeth W; Lo, Albert C
The majority of persons with multiple sclerosis (MS) experience problems with gait, which they characterize as highly disabling impairments that adversely impact their quality of life. Thus, it is crucial to develop effective therapies to improve mobility for these individuals. The purpose of this study was to determine whether combination gait training, using robot-assisted treadmill training followed by conventional body-weight-supported treadmill training within the same session, improved gait and balance in individuals with MS. This study tested combination gait training in 7 persons with MS. The participants were randomized into the immediate therapy group (IT group) or the delayed therapy group (DT group). In phase I of the trial, the IT group received treatment while the DT group served as a concurrent comparison group. In phase II of the trial, the DT group received treatment identical to the treatment received by the IT group in phase I. Outcome measures included the 6-Minute Walk Test (6MWT), the Timed 25-Foot Walk Test, velocity, cadence, and the Functional Reach Test (FRT). Nonparametric statistical techniques were used for analysis. Combination gait training resulted in significantly greater improvements in the 6MWT for the IT group (median change = +59 m) compared with Phase I DT group (median change = -8 m) (P = 0.08) and FRT (median change = +3.3 cm in IT vs -0.8 cm in the DT group phase I; P = 0.03). Significant overall pre-post improvements following combination gait training were found in 6MWT (+32 m; P = 0.02) and FRT (+3.3 cm; P = 0.06) for IT and Phase II DT groups combined. Combination of robot with body-weight-supported treadmill training gait training is feasible and improved 6MWT and FRT distances in persons with MS.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A62) for more insights from the authors.
Lick, Scott D; Vaidya, Smita; Kollar, Andras C; Boor, Paul J; Vertrees, Roger A
Patients on a left ventricular assist device (LVAD) often have a high level of panel-reactive antibodies (PRA). Conventional therapy is to await a heart from a negative prospective-crossmatch donor. We transplanted three high-PRA patients with non-crossmatched hearts, using intra- and post-operative plasmapheresis and long-term T-/B-/plasma-cell therapy with alemtuzumab. Three highly sensitized patients (70%, 94% and 96% T-PRA; 63%, 24% and 73% B-PRA) were transplanted after 29, 187 and 94 days LVAD support. The first patient (Case 1) had an erroneous prospective negative crossmatch (due to an outside laboratory's use of the wrong patient's serum) with immediate allograft dysfunction. The correct serum showed a strongly positive crossmatch; plasmapheresis followed by alemtuzumab (20 mg intravenously) shortly after arrival in the ICU resulted in rapid hemodynamic improvement. Encouraged by this success, the next two patients (Cases 2 and 3) underwent LVAD explant and heart transplant with the next available ABO-identical, non-crossmatched donors, using plasmapheresis on bypass immediately before heart implant and alemtuzumab 20 mg intravenously upon ICU arrival, with uneventful courses. All three patients had positive retrospective T- and B-cell crossmatches. Maintenance immunosuppression consisted of cyclosporine and routine prednisone taper, with plasmapheresis as needed (Patient 1, x10; Patient 2, x5) based on diastolic dysfunction. Mycophenolate mofetil was started as a third agent several months post-transplant. Patients are presently New York Heart Association (NYHA) Class I at 26, 16 and 13 months post-transplant. In this small series with follow-up, immediate antibody removal with plasmapheresis, combined with alemtuzumab, a long-acting antibody to CD52 (expressed on T, B and some plasma cells), appears effective in allowing transplantation in sensitized, positive crossmatch recipients. Expanded use of this strategy could shorten LVAD support in many
Dobkin, Bruce H; Duncan, Pamela W
Body weight-supported treadmill training (BWSTT) and robotic-assisted step training (RAST) have not, so far, led to better outcomes than a comparable dose of progressive over-ground training (OGT) for disabled persons with stroke, spinal cord injury, multiple sclerosis, Parkinson's disease, or cerebral palsy. The conceptual bases for these promising rehabilitation interventions had once seemed quite plausible, but the results of well-designed, randomized clinical trials have been disappointing. The authors reassess the underpinning concepts for BWSTT and RAST, which were derived from mammalian studies of treadmill-induced hind-limb stepping associated with central pattern generation after low thoracic spinal cord transection, as well as human studies of the triple crown icons of task-oriented locomotor training, massed practice, and activity-induced neuroplasticity. The authors retrospectively consider where theory and practice may have fallen short in the pilot studies that aimed to produce thoroughbred interventions. Based on these shortcomings, the authors move forward with recommendations for the future development of workhorse interventions for walking. In the absence of evidence for physical therapists to employ these strategies, however, BWSTT and RAST should not be provided routinely to disabled, vulnerable persons in place of OGT outside of a scientifically conducted efficacy trial.
Mondal, Nandan K; Sobieski, Michael A; Pham, Si M; Griffith, Bartley P; Koenig, Steven C; Slaughter, Mark S; Wu, Zhongjun J
The objective of this study was to investigate the changes in oxidative stress (OS) and circulating regulatory T cells (Tregs) of the immune system in patients supported by continuous-flow ventricular assist device (CF-VAD) with or without infection. We recruited 16 CF-VAD patients (5 with infection and 11 without infection) and 7 healthy volunteers. Generation of reactive oxygen species (ROS) from lymphocytes, superoxide dismutase (SOD) in erythrocyte, total antioxidant capacity (TAC), and oxidized low-density lipoprotein (oxLDL) in plasma were measured. Circulating Tregs were evaluated by flow cytometry. Heart failure (HF) patients had elevated OS than healthy volunteers as evident from higher lymphocyte ROS, elevated oxLDL, as well as depleted SOD and TAC levels. At baseline, HF patients had decreased percentage of Tregs (5.12 ± 1.5% vs. 8.14 ± 3.01%, p infection illustrated 35% and 44% rise in ROS and oxLDL, respectively, 31% decrease in TAC, and marked rise in percentage of Tregs (14.27 ± 3.17% vs. 9.38 ± 3.41%, p infection. Elevated OS and rise in Tregs were more prominent in CF-VAD patients with infection. In conclusion, OS and compromised immune system may be important indicators of systemic response of the body to CF-VAD among HF patients with infection.
Ribesse, Nathalie; Bossyns, Paul; Marchal, Bruno; Karemere, Hermes; Burman, Christopher J; Macq, Jean
In the field of development cooperation, interest in systems thinking and complex systems theories as a methodological approach is increasingly recognised. And so it is in health systems research, which informs health development aid interventions. However, practical applications remain scarce to date. The objective of this article is to contribute to the body of knowledge by presenting the tools inspired by systems thinking and complexity theories and methodological lessons learned from their application. These tools were used in a case study. Detailed results of this study are in process for publication in additional articles. Applying a complexity 'lens', the subject of the case study is the role of long-term international technical assistance in supporting health administration reform at the provincial level in the Democratic Republic of Congo. The Methods section presents the guiding principles of systems thinking and complex systems, their relevance and implication for the subject under study, and the existing tools associated with those theories which inspired us in the design of the data collection and analysis process. The tools and their application processes are presented in the results section, and followed in the discussion section by the critical analysis of their innovative potential and emergent challenges. The overall methodology provides a coherent whole, each tool bringing a different and complementary perspective on the system.
Wetherall, Anthony; Robin, Isabelle
The responsible use of nuclear technology requires the safe and environmentally sound management of radioactive waste, for which countries need to have stringent technical, administrative and legal measures in place. The legal aspects of radioactive waste management can be found in a wide variety of legally binding and non-binding international instruments. This overview focuses on the most relevant ones, in particular those on nuclear safety, security, safeguards and civil liability for nuclear damage. It also identifies relevant regional instruments concerning environmental matters, in particular, with regard to strategic environmental assessments (SEAs), environmental impact assessments (EIAs), public access to information and participation in decision-making, as well as access to justice
Feteris, E.; Kloosterhuis, H.
In the past thirty years legal argumentation has become an important interdisciplinary field of interest. The study of legal argumentation draws its data, assumptions and methods from disciplines such as legal theory, legal philosophy, logic, argumentation theory, rhetoric, linguistics, literary
This section treats of the following Documents and legal texts: 1 - Canada: Nuclear Liability and Compensation Act (An Act respecting civil liability and compensation for damage in case of a nuclear incident, repealing the Nuclear Liability Act and making consequential amendments to other acts); 2 - Japan: Act on Compensation for Nuclear Damage (The purpose of this act is to protect persons suffering from nuclear damage and to contribute to the sound development of the nuclear industry by establishing a basic system regarding compensation in case of nuclear damage caused by reactor operation etc.); Act on Indemnity Agreements for Compensation of Nuclear Damage; 3 - Slovak Republic: Act on Civil Liability for Nuclear Damage and on its Financial Coverage and on Changes and Amendments to Certain Laws (This Act regulates: a) The civil liability for nuclear damage incurred in the causation of a nuclear incident, b) The scope of powers of the Nuclear Regulatory Authority (hereinafter only as the 'Authority') in relation to the application of this Act, c) The competence of the National Bank of Slovakia in relation to the supervised financial market entities in the financial coverage of liability for nuclear damage; and d) The penalties for violation of this Act)
This section of the Bulletin presents the recently published documents and legal texts sorted by country: - Brazil: Resolution No. 169 of 30 April 2014. - Japan: Act Concerning Exceptions to Interruption of Prescription Pertaining to Use of Settlement Mediation Procedures by the Dispute Reconciliation Committee for Nuclear Damage Compensation in relation to Nuclear Damage Compensation Disputes Pertaining to the Great East Japan Earthquake (Act No. 32 of 5 June 2013); Act Concerning Measures to Achieve Prompt and Assured Compensation for Nuclear Damage Arising from the Nuclear Plant Accident following the Great East Japan Earthquake and Exceptions to the Extinctive Prescription, etc. of the Right to Claim Compensation for Nuclear Damage (Act No. 97 of 11 December 2013); Fourth Supplement to Interim Guidelines on Determination of the Scope of Nuclear Damage Resulting from the Accident at the Tokyo Electric Power Company Fukushima Daiichi and Daini Nuclear Power Plants (Concerning Damages Associated with the Prolongation of Evacuation Orders, etc.); Outline of 'Fourth Supplement to Interim Guidelines (Concerning Damages Associated with the Prolongation of Evacuation Orders, etc.)'. - OECD Nuclear Energy Agency: Decision and Recommendation of the Steering Committee Concerning the Application of the Paris Convention to Nuclear Installations in the Process of Being Decommissioned; Joint Declaration on the Security of Supply of Medical Radioisotopes. - United Arab Emirates: Federal Decree No. (51) of 2014 Ratifying the Convention on Supplementary Compensation for Nuclear Damage; Ratification of the Federal Supreme Council of Federal Decree No. (51) of 2014 Ratifying the Convention on Supplementary Compensation for Nuclear Damage
Goldman, N; Pebley, A R
religious observance in Colombia, Costa Rica, and Peru. The occurrence of a pregnancy does not substantially increase the frequency of legalization. This may be due to the absence of social disapproval of illegitimate children. In all 4 countries, marriages preceded by a period of cohabitation were less likely to end in separation. The higher age at marriage for couples who lived together before marriage explains some of the greater stability. The results do not support the widely held assumption that legalization occurs to legitimize births. Education and age are factors that account for some difference in frequency. Because the analysis is restricted to rural areas, additional research is needed to illuminate relationships in urban areas.
Maher, Anthony John
Britain's 1981 Education Act stimulated a partial migration of pupils from special to mainstream schools. The onus has since been on teachers to meet the needs and capitalise on the capabilities of pupils with special educational needs and disabilities (SEND) in mainstream school settings. The research analysed learning support assistant (LSA) and…
Jung, Mette Holme; Hansen, Peter Bo; Sander, Kaare
AIMS: Continuous-flow left ventricular assist device (CF-LVAD) implantation is associated with improved quality of life, but the effect on exercise capacity is less well documented. It is uncertain whether a fixed CF-LVAD pump speed, which allows for sufficient circulatory support at rest, remains...
Hale, Kelli; Capra, Sandra; Bauer, Judith
This paper presents an approach to assist health professionals in recommending high quality apps for supporting chronic disease self-management. Most app reviews focus on popularity, aesthetics, functionality, usability, and information quality. There is no doubt these factors are important in selecting trustworthy apps which are appealing to users, but behavioral theory may be also be useful in matching the apps to user needs. The framework developed aims to be methodologically sound, capable of selecting popular apps which include content covered by evidence-based programs, consistent with behavioral theory, as well as a patient-centered approach for matching apps to patients' individual needs. A single disease-type 2 diabetes-was selected to illustrate how the framework can be applied as this was deemed to represent the types of strategies used in many chronic diseases. A systematic approach based on behavioral theory and recommendations from best practice guidelines was developed for matching apps to patients' needs. In March 2014, a series of search strategies was used to identify top-rated iPhone and Android health apps, representing 29 topics from five categories of type 2 diabetes self-management strategies. The topics were chosen from published international guidelines for the management of diabetes. The senior author (KH) assessed the most popular apps found that addressed these topics using the Behavioral Theory Content Survey (BTS), which is based on traditional behavioral theory. A tool to assist decision making when using apps was developed and trialed with health professionals for ease of use and understanding. A total of 14 apps were assessed representing all five topic categories of self-management. Total theoretical scores (BTS scores) were less than 50 on a 100-point scale for all apps. Each app scored less than 50% of the total possible BTS score for all four behavioral theories and for most of the 20 behavioral strategies; however, apps scored
Johnson, Ralph J
This article reports the exploratory development and study efforts regarding the viability of a novel "going-in light" or "Going Light" medical component in support of US Army Pacific (USARPAC) Humanitarian Assistance/Disaster Relief (HA/DR) missions, namely, a BLU-MED ® incremental modular equipment package along with a Rapid Deployment Medical Team (RDMT). The study was conducted to uncover a way for the U.S. Army to: (1) better medically support the greater U.S. military Pacific Command, (2) prepare the Army for Pacific HA/DR contingencies, and (3) imprint a swift presence and positive contribution to Pacific HA/DR operations. The findings were derived from an intensive quasi-Military Decision Making Planning (MDMP) process, specifically, the Oracle Delphi. This process was used to: (1) review a needs assessment on the profile of disasters in general and the Pacific in particular and (2) critically examine the viability and issues surrounding a Pacific HA/DR medical response of going in light and incrementally. The Pacific area of operations contains 9 of 15 countries most at risk for disasters in the most disaster-prone region of the world. So, it is not a matter of whether a major, potentially large-scale lethal disaster will occur but rather when. Solid empirical research has shown that by every outcome measured Joint Forces (Army, Navy, Air Force, and Marines) medical HA/DR operations have been inordinately successful and cost-effective when they employed U.S. Army medical assets inland near disasters' kinetic impact and combined sister services' logistical support and expertise. In this regard, USARPAC has the potential to go in light and successfully fill a vital HA/DR medical response gap with the RDMT and a BLU-MED ® . However, initially going in fast and light and expanding and contracting as the situation dictates comes with subsequent challenges as briefly described herein that must be addressed. The challenges to going in light are not
Brouwer, Marije; Kaczor, Christopher; Battin, Margaret P; Maeckelberghe, Els; Lantos, John D; Verhagen, Eduard
Voluntary active euthanasia for adults at their explicit request has been legal in Belgium and the Netherlands since 2002. In those countries, acceptance of the practice for adults has been followed by acceptance of the practice for children. Opponents of euthanasia see this as a dangerous slippery slope. Proponents argue that euthanasia is sometimes ethically appropriate for minors and that, with proper safeguards, it should be legally available in appropriate circumstances for patients at any age. In this Ethics Rounds, we asked philosophers from the United States and the Netherlands, and a Dutch pediatrician, to discuss the ethics of legalizing euthanasia for children. Copyright © 2018 by the American Academy of Pediatrics.
Full Text Available The aim of this paper is to discuss challenges in legal translation from the view of a teacher who evaluates the work of semi-professional translators in a special setting. Recurrent translation errors may subsequently be used as a pedagogical resource in specialised translator training. The observation of recurrent challenges confronting the candidates in legal translation and the absence of formal translator training programs are the reasons why NHH now offers an on-line course in legal translation, JurDist, focusing i.a. on useful translation strategies.
Hillebrand, Jennifer; Olszewski, Deborah; Sedefov, Roumen
This article describes the findings of a descriptive analysis of 27 online drug retailers selling legal alternatives to illegal drugs, commonly referred to as "herbal highs" and "legal highs" in 2008 . The study attempted to quantify the online availability of drug retailers, to describe common products and characteristics in EU-based retail sales. The findings highlight the concern about the lack of objective information about products offered, including potential risks to health. Systems should be developed to assess the contents of products and the accuracy of information provided on the Internet, alongside continued monitoring of this market for "legal high" substances.
A phenomenon called legal argumentation is analyzed in the dissertation. The aim of the thesis is to identify the prerequisites that allow to consider the legal argumentation to be correct, also to evaluate those prerequisites logically. Legal argumentation is analyzed as a phenomenon per se, without relating it to any particular arguing subject. Other dimensions of the process of making a legal decision, such as legal reasoning, legal discourse, interpretation of law and others are discu...
Altamura, M.; Ferraris, L.; Miozzo, D.; Musso, L.; Siccardi, F.
An exponential improvement of numerical weather prediction (NWP) models was observed during the last decade (Lynch, 2008). Civil Protection (CP) systems exploited Meteo services in order to redeploy their actions towards the prediction and prevention of events rather than towards an exclusively response-oriented mechanism1. Nevertheless, experience tells us that NWP models, even if assisted by real time observations, are far from being deterministic. Complications frequently emerge in medium to long range forecasting, which are subject to sudden modifications. On the other hand, short term forecasts, if seen through the lens of criminal trials2, are to the same extent, scarcely reliable (Molini et al., 2009). One particular episode related with wrong forecasts, in the Italian panorama, has deeply frightened CP operators as the NWP model in force missed a meteorological adversity which, in fact, caused death and dealt severe damage in the province of Vibo Valentia (2006). This event turned into a very discussed trial, lasting over three years, and intended against whom assumed the legal position of guardianship within the CP. A first set of data is now available showing that in concomitance with the trial of Vibo Valentia the number of alerts issued raised almost three folds. We sustain the hypothesis that the beginning of the process of overcriminalization (Husak, 2008) of CPs is currently increasing the number of false alerts with the consequent effect of weakening alert perception and response by the citizenship (Brezntiz, 1984). The common misunderstanding of such an issue, i.e. the inherent uncertainty in weather predictions, mainly by prosecutors and judges, and generally by whom deals with law and justice, is creating the basis for a defensive behaviour3 within CPs. This paper intends, thus, to analyse the social and legal relevance of uncertainty in the process of issuing meteo-hydrological alerts by CPs. Footnotes: 1 The Italian Civil Protection is working
Full Text Available An exponential improvement of numerical weather prediction (NWP models was observed during the last decade (Lynch, 2008. Civil Protection (CP systems exploited Meteo services in order to redeploy their actions towards the prediction and prevention of events rather than towards an exclusively response-oriented mechanism1.
Nevertheless, experience tells us that NWP models, even if assisted by real time observations, are far from being deterministic. Complications frequently emerge in medium to long range forecasting, which are subject to sudden modifications. On the other hand, short term forecasts, if seen through the lens of criminal trials2, are to the same extent, scarcely reliable (Molini et al., 2009.
One particular episode related with wrong forecasts, in the Italian panorama, has deeply frightened CP operators as the NWP model in force missed a meteorological adversity which, in fact, caused death and dealt severe damage in the province of Vibo Valentia (2006. This event turned into a very discussed trial, lasting over three years, and intended against whom assumed the legal position of guardianship within the CP. A first set of data is now available showing that in concomitance with the trial of Vibo Valentia the number of alerts issued raised almost three folds. We sustain the hypothesis that the beginning of the process of overcriminalization (Husak, 2008 of CPs is currently increasing the number of false alerts with the consequent effect of weakening alert perception and response by the citizenship (Brezntiz, 1984.
The common misunderstanding of such an issue, i.e. the inherent uncertainty in weather predictions, mainly by prosecutors and judges, and generally by whom deals with law and justice, is creating the basis for a defensive behaviour3 within CPs. This paper intends, thus, to analyse the social and legal relevance of uncertainty in the process of issuing
a combined health and social sector system response to intimate partner violence, this article provides health professionals with insight into domestic violence and current legal and psychosocial support services. It focuses on how to support and advise abused women about practicalities of obtaining protection orders and ...
Full Text Available In some legal surroundings telepathology is considered a breach of registrational barriers. The recommendation of the G 8 states in Europe for required legislation in telemedicine suggests to recognise that the localization of the remote health care professional defines the site not only of licensure but also of liability. This approach must be considered helpful, since it can solve many problems brought about by the doubtful results of private international law and conventions like the European Union (EU and Lugano Convention. Under today's conditions in private international law it must be considered essential to agree upon a choice of law and stipulate a court of jurisdiction when doing telepathology. However, the opposing aims of insuring the patients claims and avoiding jurisdictions that exceed the local expectations of the medical professional must be reconciled. Data protection and data security are other crucial topics that require attention. Generally speaking, the principles of minimum data exchange, anonymity, pseudonymity and cryptography must be established as a basis for all telepathology procedures. Only when personal data is needed, its use can be legitimated. Written consent of the patient is advised. To guarantee a cross‐border security level the regulations of the EU‐Data Protection Directive need to be transformed into national law. In practise, cross‐border dataflow shall only take place where the security level can be maintained even within the other country. Finally, reimbursement questions must be answered to establish a sound economical basis for telepathology. The spatial distance between the participants may yield the question, whether the service has been rendered to an extent necessary and sufficient for reimbursement. If reimbursement takes place on a cross‐border or cross‐regional level, severe disturbances of the health systems can occur. Regulation schemes or treaties need therefore to be developed to
Riddle, Christopher A
This article explores at least two dominant critiques of assisted dying from a disability rights perspective. In spite of these critiques, I conclude that assisted dying ought to be permissible. I arrive at the conclusion that if we respect and value people with disabilities, we ought to permit assisted dying. I do so in the following manner. First, I examine recent changes in legislation that have occurred since the Royal Society of Canada Expert Panel on End-of-Life Decision-Making report, published in this journal. I suggest that these changes are likely to only strengthen opposition to assisted dying from disability rights activists and people with disabilities. Second, I focus on respect for people with disabilities and in particular, respect for their autonomy and decision-making abilities. Third, I explore the opposition to assisted dying that focuses on risk and the vulnerability of people with disabilities. Here I suggest that this risk ought not to be of special concern. Ultimately, I conclude that upholding respect for the disabled requires the legalization of assisted dying, rather than the denial of access in a misguided effort to protect people with disabilities. © 2017 John Wiley & Sons Ltd.
І. M. Alieksieieva
Full Text Available One of the distinguishing features of man as a biological individual who is able to comprehend meaningfully the reality surrounding him and manage his actions is consciousness. Depending on the scientific-theoretical approaches or applied needs, it is customary to apply a certain differentiation of definitions of the concept of consciousness, for example, everyday or political, individual or mass, the consciousness of school or student youth, and other. One of its varieties, perhaps the most important at the present stage of development of society and statehood, is the legal consciousness of man. The problem of the formation and functioning of the human sense of justice is one of the most popular and constantly developed in a number of scientific fields. The purpose of the work is to study the state of scientific knowledge of the legal consciousness and legal culture of student, future pharmacists in the context of legal education in the university. Materials and methods. According to a specific goal, the research was based on the analysis of international and national legislation, the database of scientific research developments of the National Library of Ukraine V.I. Vernadsky, the study of author's scientific works and professional publications on the formation of consciousness, legal consciousness and legal culture of youth, in particular, student. Methods of research - bibliographic, linguistic, comparative analysis, content-legal analysis. Results. The basic link of society is a person, as a biological individual, to which such mental entities as mind, consciousness and will are inherent. These qualities enable it to critically perceive the surrounding being, to realize and determine its place in the society, to program its perspective and direct its actions according to a specific goal. A specific form of consciousness is legal consciousness (legal awareness - the system of reflecting the legal reality in views, theories, concepts
Department of Transportation — Legal Interpretations and the Chief Counsel's opinions are now available at this site. Your may choose to search by year or by text search. Please note that not all...
Full Text Available At each stage of the resettlement process, the presence of counsel – legal advocates – can help refugees to present their complete cases efficiently and avoid unnecessary rejections. This provides benefits to decision makers as well.
. The married couples subjected to this mobile lifestyle are always in a process of becoming illegal, which is the consequence of ‘overstaying’ in Denmark or ‘understaying’ in Sweden. Besides its legal aspects, a semi-legal status also has significant moral implications that not only restructure marriage......In 2002, the Danish government introduced new legislation on family reunification to restrict the transnational arranged marriages that were occurring among some immigrant groups. Since then, thousands of people have emigrated from Denmark to Sweden where, as citizens of the European Union......, they are entitled to family reunification. In this article, I introduce the concept of semi-legality to describe the situation whereby Pakistani transnational couples commute on a regular basis between their legal residences in Sweden and their places of work or networks of friends and family in Denmark...
Rowthorn, Virginia; Plum, Alexander J; Zervos, John
legal and regulatory standards that encourage the introduction and scalable adoption of successful health care innovations developed outside of the US, particularly innovations that support public health goals and do not have the benefit of a large corporate sponsor to facilitate introduction to the market. Copyright © 2016 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.
The way to an energy transition will be reached with an integration of renewable energies in our energy mix. This development includes a legal transition because the current legal context that applies to green energies is not efficient and does not contribute to this emergency. Changing the legal frame becomes a necessity and particularly the way these energies are governed, planned and supported. It's also important that administrative procedures that regulate the implantation of energies production system are set. At last, this legal transition will have to conciliate imperatives linked to the development of renewable energies with those governing the protection of surroundings, all aiming to a sustainable development. (author) [fr
João Maurício Adeodato
Full Text Available The text aims to lay the foundations of a realistic rhetoric, from the descriptive perspective of how the legal decision actually takes place, without normative considerations. Aristotle's rhetorical idealism and its later prestige reduced rhetoric to the art of persuasion, eliminating important elements of sophistry, especially with regard to legal decision. It concludes with a rhetorical perspective of judicial activism in complex societies.
Ramírez García, Hugo Saúl
This article explores the legal meanings of biopiracy concept, linked to subjects such as intellectual property rights on genetic resources, bioprospecting contracts, right to food, and food security. It overcomes the critical function of biopiracy concept related to world-wide extended tendencies: privatization and technification. Likewise, protectionism shows the opportunity that biopiracy concept represents for the enrichment of the legal interpretation related to the bioethical statue of biotech developments.
Irina V. Mikheeva
Full Text Available Objective to study the state of legal support of the cluster strategies implementation to identify the problems and possible directions for improving the legal support of cluster development in the regions. Methods systemic structuralfunctional induction and deduction analysis and synthesis formal legal. Results the paper formulates the definition of cluster as a form of cooperative interaction of organizations interacting in some economic sphere due to functional dependence complementing each other and reinforcing the competitive advantages of individual companies. The hypothesis is proposed that the organizational and management structure of clusters should be unified and obtain normative fixation so that the same type of bodies including executive bodies and the structure of the different clusters deliberative specialized organizations organizationcoordinator etc. had similar competence and position in the management hierarchy. Scientific novelty following the most general conception of a cluster as interacting institutions in a specific area one can see that the lack of clarity in the legal support of the clusters functioning does not allow to determine the status of authoritative and nonauthoritative subjects of economic activities their organizationallegal forms and the procedure of their interaction. Practical significance the identified problems of legal support of the cluster strategies implementation can help in the improvement of state regulation of cluster relations in the regions and their implementation.
Dalaba, Maxwell Ayindenaba; Akweongo, Patricia; Williams, John; Saronga, Happiness Pius; Tonchev, Pencho; Sauerborn, Rainer; Mensah, Nathan; Blank, Antje; Kaltschmidt, Jens; Loukanova, Svetla
This study analyzed cost of implementing computer-assisted Clinical Decision Support System (CDSS) in selected health care centres in Ghana. A descriptive cross sectional study was conducted in the Kassena-Nankana district (KND). CDSS was deployed in selected health centres in KND as an intervention to manage patients attending antenatal clinics and the labour ward. The CDSS users were mainly nurses who were trained. Activities and associated costs involved in the implementation of CDSS (pre-intervention and intervention) were collected for the period between 2009-2013 from the provider perspective. The ingredients approach was used for the cost analysis. Costs were grouped into personnel, trainings, overheads (recurrent costs) and equipment costs (capital cost). We calculated cost without annualizing capital cost to represent financial cost and cost with annualizing capital costs to represent economic cost. Twenty-two trained CDSS users (at least 2 users per health centre) participated in the study. Between April 2012 and March 2013, users managed 5,595 antenatal clients and 872 labour clients using the CDSS. We observed a decrease in the proportion of complications during delivery (pre-intervention 10.74% versus post-intervention 9.64%) and a reduction in the number of maternal deaths (pre-intervention 4 deaths versus post-intervention 1 death). The overall financial cost of CDSS implementation was US$23,316, approximately US$1,060 per CDSS user trained. Of the total cost of implementation, 48% (US$11,272) was pre-intervention cost and intervention cost was 52% (US$12,044). Equipment costs accounted for the largest proportion of financial cost: 34% (US$7,917). When economic cost was considered, total cost of implementation was US$17,128-lower than the financial cost by 26.5%. The study provides useful information in the implementation of CDSS at health facilities to enhance health workers' adherence to practice guidelines and taking accurate decisions to improve
João Guilherme Sampaio dos Anjos
Full Text Available The social assistance has intrinsic historical, legal and political relationship to social rights. Fundamental rights have assumed a legal-constitutional role since the mid-twentieth century. Through historical and doctrinal review of fundamental rights and social welfare, the identification of legal frameworks and institutional instruments of social assistance that demonstrate their ability to contribute to the realization of social rights and the problem of realization of social rights, social assistance seems to be able to play a prominent role as a public policy that helps to point out a solution to the problem of lack of effectiveness of social rights.
Full Text Available Abstract Background In many rural regions in Germany, the proportion of the elderly population increases rapidly. Simultaneously, about one-third of the presently active GPs will retire until 2010. Often it is difficult to find successors for vacant GP-practices. These regions require innovative concepts to avoid the imminent shortage in primary health care. The AGnES-concept comprises the delegation of GP-home visits to qualified AGnES-practice assistants (AGnES: GP-supporting, community-based, e-health-assisted, systemic intervention. Main objectives were the assessment of the acceptance of the AGnES-concept by the participating GPs, patients, and AGnES-practice assistants, the kind of delegated tasks, and the feasibility of home telecare in a GP-practice. Methods In this paper, we report first results of the implementation of this concept in regular GP-practices, conducted November 2005 – March 2007 on the Island of Rügen, Mecklenburg-Western Pomerania, Germany. This study was meant as a proof of concept. The GP delegated routine home-visits to qualified practice employees (here: registered nurses. Eligible patients were provided with telecare-devices to monitor disease-related physiological values. All delegated tasks, modules conducted and questionnaire responses were documented. The participating patients were asked for their acceptance based on standardized questionnaires. The GPs and AGnES-practice assistants were asked for their judgement about different project components, the quality of health care provision and the competences of the AGnES-practice assistants. Results 550 home visits were conducted. 105 patients, two GPs and three AGnES-practice assistants (all registered nurses participated in the project. 48 patients used telecare-devices to monitor health parameters. 87.4% of the patients accepted AGnES-care as comparable to common GP-care. In the course of the project, the GPs delegated an increasing number of both monitoring
Jan M. Broekman
Full Text Available The work of the great American philosopher Charles Sanders Peirce (1839-1914 becomes more and more appreciated beyond the boundaries of his pragmatism, a philosophical mainstream he founded in the early 20th century. This essay is inspired by five points of interest, all of which focus on law and legal discourse. Firstly, one should acknowledge that his proposal pertaining to a general theory of signs, which he called ‘semeiotics’ around 1860, leads to an untraditional and in-depth understanding of legal discourse: in essence, of law as a system of specific meanings and signs. Semiotics in general became a substantial part of his ‘evolutionary cosmology,’ an all-embracing approach to tackle classical and modern philosophical issues. Secondly, his anthropological intuition based on semiotics, (concentrated in the formula ‘man is a sign’ became important for our understanding of a human subject’s position in law, as author of a legal discourse as well as an individual subjected to law. Thirdly, the tensions between chance and continuity in legal discourse are of focal interest for the creation of legal meaning in law’s practices. Novelty, Peirce suggested in this context, occurs by the grace of chance rather than of continuity and fixed traditions. Fourthly, Roberta Kevelson (1931-1998 explored and expanded the field of legal semiotics on the basis of the works of Peirce. In doing so, she established an American tradition of legal semiotics distinct from a European tradition, which related more to linguists, psychologists and philosophers embracing structuralism. Fifthly, Tyche, the Ancient Goddess of fate and fortune, is because of Peirce’s references more at home in the US legal semiotic tradition. Her fame and influence reaches beyond law and became supported by recent archaeological discoveries, publications and exhibitions, which not only provide information about her background, but also underline her possible influence on
Abbasi, Mahmoud; Shamsi Gooshki, Ehsan; Allahbedashti, Neda
Abortion traditionally means, "to miscarry" and is still known as a problem which societies has been trying to reduce its rate by using legal means. Despite the pregnant women and fetuses have being historically supported; abortion was firstly criminalized in 1926 in Iran, 20 years after establishment of modern legal system. During next 53 years this situation changed dramatically, so in 1979, the time of Islamic Revolution, aborting fetuses before 12 weeks and therapeutic abortion (TA) during all the pregnancy length was legitimate, based on regulations that used medical justification. After 1979 the situation changed into a totally conservative and restrictive approach and new Islamic concepts as "Blood Money" and "Ensoulment" entered the legal debates around abortion. During the next 33 years, again a trend of decriminalization for the act of abortion has been continuing. Reduction of punishments and omitting retaliation for criminal abortions, recognizing fetal and maternal medical indications including some immunologic problems as legitimate reasons for aborting fetuses before 4 months and omitting the fathers' consent as a necessary condition for TA are among these changes. The start point for this decriminalization process was public and professional need, which was responded by religious government, firstly by issuing juristic rulings (Fatwas) as a non-official way, followed by ratification of "Therapeutic Abortion Act" (TAA) and other regulations as an official pathway. Here, we have reviewed this trend of decriminalization, the role of public and professional request in initiating such process and the rule-based language of TAA.
Libassi, F.P.; Donaldson, L.F.
This paper considers the legal, ethical, and economic constraints to developing a comprehensive knowledge of the biological effects of ionizing radiation. These constraints are not fixed and immutable; rather they are determined by the political process. Political issues cannot be evaded. The basic objective of developing a comprehensive knowledge about the biological effects of ionizing radiation exists as an objective not only because we wish to add to the store of human knowledge but also because we have important use for that knowledge. It will assist our decision-makers to make choices that affect us all. These choices require both hard factual information and application of political judgment. Research supplies some of the hard factual information and should be as free as possible from political influence in its execution. At the same time, the political choices that must be made influence the direction and nature of the research program as a whole. Similarly, the legal, ethical, and economic factors that constrain our ability to expand knowledge through research reflect a judgment by political agents that values other than expansion of knowledge should be recognized and given effect
The responsibility for nuclear security rests entirely with each State. There is no single international instrument that addresses nuclear security in a comprehensive manner. The legal foundation for nuclear security comprises international instruments and recognized principles that are implemented by national authorities. Security systems at the national level will contribute to a strengthened and more universal system of nuclear security at the international level. The binding security treaties are; Convention on the Physical Protection of Nuclear Material, the 2005 amendment thereto, Safeguards Agreements between the Agency and states required in Connection with the Treaty on the Non-Proliferation of Nuclear Weapons. Model Protocol additional to agreement(s) between State(s) and the Agency for the application of Safeguards Convention on Early Notification of a Nuclear Accident, Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency, Convention on Nuclear Safety, Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management
Dzyadko N. M.
Full Text Available Russia's oldest human rights organization Center for Prison Reform Facilitation (founded in 1988 presents the results of its publishing activities addressed to professionals working in the field of socio-psychological and legal assistance to minors and adults. This is a series of brochures "Children in Prison", published with the support of the Russian Public Movement "Civil Dignity" in 2014 under the campaign "Youngster: Legal literacy" to rise the competence of experts on the identity of adolescents and replenish their professional and methodical luggage: "Punish conditionally" "The teenager and his rights", "City of the future with and without the prison", "Lessons of law in a juvenile correctional facility. Methodical collection". The booklet series "Know Your Rights!" is addressed to people in distress, potential victims of treasury justice, those who do not have the means to expensive lawyer. The brochures include practical and legal advice, examples of complaints, appeals, petitions, dealing with specific cases. Brochures are distributed free of charge.
Full Text Available In 2008, the Malaysia land code, named the National Land Code 1965 (NLC 1965, was amended to add Part Five (A to deal with the disposal of underground space. In addition, the Circular of the Director General of Lands and Mines No. 1/2008 was issued to assist the application of Part Five (A of the NLC 1965. However, the legislation is still questionable and has instigated many arguments among numerous actors. Therefore, this research was undertaken to examine legal considerations for the development of underground space. The focus is on four legal considerations, namely underground space ownership, the bundle of rights, depth, and underground space utilization. Rooted in qualitative methods, interviews were conducted with respondents involved in the development of underground space in Malaysia. The obtained data were then analyzed descriptively. The findings differentiated the rights of landowners for surface land and underground space, and their liability for damages and the depth. It was indicated that the current legislation in Malaysia, namely Part Five (A of the NLC 1965 and the Circular of the Director General of Lands and Mines No. 1/2008, is adequate to facilitate the development of underground space in terms of legal considerations. However, to further facilitate the development of underground land in the future, based on the research, four enhancements are recommended for legal considerations pertaining to the development of underground space in Malaysia. Keywords: Underground space, Legal consideration, Land right, Urban development
Full Text Available This essay examines manufacture of a legally-relevant symbolic object, "emergency." The examination is carried out in the phenomenological key. For the initial theoretical orientation I take HUSSERL's critique of mathematization of the life-world. Thereby I show that emergency can be conceived of as a temporal mode of constitution. With the help of workplace studies, I export phenomenological insights into a social scientific sphere. From this perspective, legal emergency comes about as a vehicle that assists in minimizing, mechanizing, transforming and reconstituting a life-world original (client's narrative into a law-specific temporal event grounded in legal discourse and its materialities. Thus understood, the law office becomes comparable to a laboratory whose business is epistemic enculturation. In my analysis of the legal emergency as "becoming," I employ data-based materials collected during extensive fieldwork in a law firm in the United States. I conclude by further theorizing social consequences of legal emergency with Gilles DELEUZE, who locates law at the juncture of materials (discourse and forces (actions. URN: urn:nbn:de:0114-fqs0701129
-, č. 16 (2012) ISSN 1028-3625 Institutional support: RVO:68378122 Keywords : global legal order * legal obligation * coercion Subject RIV: AG - Legal Sciences http://cadmus.eui.eu/bitstream/handle/1814/21758/RSCAS_2012_16.pdf?sequence=1
Although the international community derives substantial benefit from a borderless global world, it has as a result also to deal with the negative impact of ... Criminal networks have taken advantage of the opportunities resulting from the dramatic changes in world politics, business, technology, communications and the ...
On the other hand if the UK requests the extradition of a US citizen, it would have to show evidence that the US citizen has committed the ... citizen, who in 2011 threatened to unleash foot-and-mouth disease on British livestock in a biological terror attack unless he was paid $4 million. 76. Roach also threatened to launch a ...
... Act of 2003 (TVPRA), and the Violence Against Women and Department of Justice Reauthorization Act of... representation on matters such as domestic and poverty law, employment, housing, and benefits, so long as such..., as amended, and the Violence Against Women and Department of Justice Reauthorization Act of 2005...
Rodica Diana APAN
Full Text Available The legal evaluation of the penalty interest, meaning the ex lege determination of its level is applicable only in the case of non-fulfillment of a monetary payment obligation. The applicability of the system of legal evaluation of the interest is generally determined by the absence of a document that ascertains the agreement of the parties, such as a contract, through which the parties, following this agreement, evaluate the prejudice caused by the non-fulfillment of a monetary payment obligation, before the prejudice has occurred. The legal evaluation of the penalty interest, as a component of the regulation in the field of legal interest has the purpose to ensure creditor’s protection. Regardless of the prejudice caused to the creditor, the legal penalty interest shall be determined by relating it to a variable benchmark that is the level of the reference interest rate of the National Bank of Romania, which is the monetary policy interest rate of the National Bank of Romania.
Full Text Available The relevance of the topic to the continuing importance of legal regulation of human behavior, the necessity of foreseeing the adverse consequences of social disorders and urgency of the prevention of deconditioning and deviant behavioral manifestations. In this regard, it is important to examine the phenomenon of legal socialization, causing interest among the representatives of the human Sciences and specialists in different branches of psychological knowledge. Taking into account the multidimensional nature of this phenomenon, it is an essential consideration of the trajectories of its occurrence in correlation with different interacting with other determinants. Such determinants include age psychological characteristics, experience crises of mental development, socially conditioned factors, and the influence of the professional environment. In article are characterized by individual patterns of legal socialization of a personality, revealing its essence, on the basis of summarizing opinions of scientists based on their own point of view. On the basis of the theoretical analysis made assumptions about the peculiarities of legal socialization of the individual occurring in different age periods of life; formulated likely areas for further study the phenomenon under research legal psychology.
Albiero, Alberto Maria; Benato, Renato
Complications are frequently reported when combining computer assisted flapless surgery with an immediate loaded prefabricated prosthesis. The authors have combined computer-assisted surgery with the intraoral welding technique to obtain a precise passive fit of the immediate loading prosthesis. An edentulous maxilla was rehabilitated with four computer assisted implants welded together intraorally and immediately loaded with a provisional restoration. A perfect passive fit of the metal framework was obtained that enabled proper osseointegration of implants. Computer assisted preoperative planning has been shown to be effective in reducing the intraoperative time of the intraoral welding technique. No complications were observed at 1 year follow-up. This guided-welded approach is useful to achieve a passive fit of the provisional prosthesis on the inserted implants the same day as the surgery, reducing intraoperative time with respect to the traditional intraoral welding technique. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
.... This report describes the design of an Event Logic Assistant (Elan) that provides powerful automated support for applying event logic to the design and implementation of high-assurance distributed protocols...
This report describes one group of nonprofit organizations that provide free civil legal assistance to qualifying low-income people. Between 1997-2001, legal services programs made significant strides in using technology to improve services. In the mid-1990s, they began using new technologies on an increasingly regular basis. However, few had…
Claxton-Oldfield, Stephen; Miller, Kathryn
The purpose of this study was to examine the attitudes of hospice palliative care (HPC) volunteers who provide in-home support (n = 47) and members of the community (n = 58) toward the issue of physician-assisted suicide (PAS). On the first part of the survey, participants responded to 15 items designed to assess their attitudes toward PAS. An examination of individual items revealed differences in opinions among members of both the groups. Responses to additional questions revealed that the majority of volunteers and community members (1) support legalizing PAS; (2) would choose HPC over PAS for themselves if they were terminally ill; and (3) think Canadians should place more priority on developing HPC rather than on legalizing PAS. The implications of these findings are discussed. © The Author(s) 2014.
Full Text Available Legal assistance to the participants in criminal procedure is represented as a complex phenomenon, including the features of international legal assistance, qualified legal assistance, as well as the activities of public authorities in criminal proceedings and professional lawyers (attorneys, advocates, representatives to assist physical and legal persons to protect, safeguard and realize their rights and interests. Legal assistance in case of threat to life, health, rights of participants in criminal proceedings is considered. The activity of certain subjects of criminal proceedings aimed at explaining the rights of crime victims is analyzed. The grounds for applying security measures are determined. Proposals for improving part 3 of article 11 of the RF Criminal Procedure Code are made: “3. In case there is a threat of causing physical, property, moral damage or other harm prohibited by criminal law to rights and legitimate interests of the victim, witness or other participants in criminal proceedings as well as their close relatives, relatives or close persons, the court (judge, the prosecutor, the head of the investigative agency, the investigator, the preliminary investigation agency take security measures, provided by part 9 of article 166, part 2 of article 186, part 8 of article 193, paragraph 4 of part 2 of article 241 and part 5 of article 278 of this Code as well as other security measures provided by the RF legislation, in respect of those persons within twenty-four hours on the basis of these persons’ written (oral statement or on their own initiative within their competence”.