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Sample records for outcome remains controversial

  1. Still controversial

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1986-10-15

    It is some sixty years since the existence of the neutrino was controversially postulated by the controversial Wolfgang Pauli. Today, the neutrino remains controversial. At the Berkeley Conference, summarizer Steve Weinberg kept the spotlight on these enigmatic particles during a considerable portion of his talk.

  2. Still controversial

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    It is some sixty years since the existence of the neutrino was controversially postulated by the controversial Wolfgang Pauli. Today, the neutrino remains controversial. At the Berkeley Conference, summarizer Steve Weinberg kept the spotlight on these enigmatic particles during a considerable portion of his talk

  3. Introduction: From pathogenesis to therapy, deep endometriosis remains a source of controversy.

    Science.gov (United States)

    Donnez, Jacques

    2017-12-01

    Deep endometriosis remains a source of controversy. A number of theories may explain its pathogenesis and many arguments support the hypothesis that genetic or epigenetic changes are a prerequisite for development of lesions into deep endometriosis. Deep endometriosis is frequently responsible for pelvic pain, dysmenorrhea, and/or deep dyspareunia, but can also cause obstetrical complications. Diagnosis may be improved by high-quality imaging. Therapeutic approaches are a source of contention as well. In this issue's Views and Reviews, medical and surgical strategies are discussed, and it is emphasized that treatment should be designed according to a patient's symptoms and individual needs. It is also vital that referral centers have the knowledge and experience to treat deep endometriosis medically and/or surgically. The debate must continue because emerging trends in therapy need to be followed and investigated for optimal management. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Controversies in gestational diabetes.

    Science.gov (United States)

    Nolan, Christopher J

    2011-02-01

    Gestational diabetes mellitus (GDM) and controversy are old friends. However, several major studies in the field have clarified some of the main issues. There is now no doubt that hyperglycaemia, at levels less than those that occur in overt diabetes, is associated with adverse pregnancy outcomes, such as large-for-gestational age infants, neonatal hyperinsulinism, neonatal hypoglycaemia and pre-eclampsia. We also have evidence now that a standard approach to GDM with diagnosis at 24-28 weeks, dietary advice, self-monitoring of blood glucose and insulin therapy as needed reduces these adverse perinatal outcomes. Unknown, however, is if this same approach is effective at reducing long-term risks of metabolic syndrome, type 2 diabetes and cardiovascular disease in both the mothers and babies. For example, could our management strategies miss critical time points of fuel-mediated injury to the foetus important for the baby's long-term metabolic health? The implications of a recent international consensus statement on new diagnostic criteria for GDM are discussed, as well as issues relating to the timing of diagnosis. The potential place for a risk calculator for adverse outcomes in GDM pregnancy that takes into account glycaemic and non-glycaemic risk factors is considered. Such a tool could help stratify GDM women to different levels of care. Ongoing issues relating to maternal glycaemic and foetal growth targets, and the use of oral hypoglycaemic agents in GDM are discussed. To resolve some of the remaining controversies, further carefully designed randomised controlled trials in GDM with long-term follow-up of both mothers and babies are necessary. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Controversies relating to the management of acromioclavicular joint dislocations.

    Science.gov (United States)

    Modi, C S; Beazley, J; Zywiel, M G; Lawrence, T M; Veillette, C J H

    2013-12-01

    The aim of this review is to address controversies in the management of dislocations of the acromioclavicular joint. Current evidence suggests that operative rather than non-operative treatment of Rockwood grade III dislocations results in better cosmetic and radiological results, similar functional outcomes and longer time off work. Early surgery results in better functional and radiological outcomes with a reduced risk of infection and loss of reduction compared with delayed surgery. Surgical options include acromioclavicular fixation, coracoclavicular fixation and coracoclavicular ligament reconstruction. Although non-controlled studies report promising results for arthroscopic coracoclavicular fixation, there are no comparative studies with open techniques to draw conclusions about the best surgical approach. Non-rigid coracoclavicular fixation with tendon graft or synthetic materials, or rigid acromioclavicular fixation with a hook plate, is preferable to fixation with coracoclavicular screws owing to significant risks of loosening and breakage. The evidence, although limited, also suggests that anatomical ligament reconstruction with autograft or certain synthetic grafts may have better outcomes than non-anatomical transfer of the coracoacromial ligament. It has been suggested that this is due to better restoration horizontal and vertical stability of the joint. Despite the large number of recently published studies, there remains a lack of high-quality evidence, making it difficult to draw firm conclusions regarding these controversial issues.

  6. Obstetric controversies in thyroidology

    Directory of Open Access Journals (Sweden)

    Ambika Gopalakrishnan Unnikrishnan

    2013-01-01

    Full Text Available It is well known that thyroid disorders commonly affect women. The care of pregnant women affected by thyroid disease is an important clinical challenge for endocrinologists. Hypothyroidism is the commonest problem, and maternal hypothyroxinemia has been linked to adverse feto-maternal outcomes. This article would discuss the controversy regarding first-trimester thyroid hormone deficiency and fetal brain development. Certain obstetric controversies in the management of hyperthyroidism in pregnancy, including the indications of TSH receptor antibody measurements and fetal thyroid status monitoring would also be discussed.

  7. Controversies in Persistent (Chronic) Lyme Disease

    Science.gov (United States)

    2016-01-01

    The Centers for Disease Control and Prevention estimates that more than 300 000 new cases of Lyme disease occur each year in the United States and that 10% to 20% of these patients will remain symptomatic despite receiving appropriate antibiotic therapy. Many elements of the disease are poorly understood and have generated considerable controversy. This paper discusses the medical controversies related to posttreatment manifestations and their potential impact on infusion nurses. PMID:27755213

  8. The outcomes and controversies of transplant tourism-Lessons of an 11-year retrospective cohort study from Taiwan

    OpenAIRE

    Tsai, Daniel Fu-Chang; Huang, Shi-Wei; Holm, Soren; Lin, Yi-Ping; Chang, Yu-Kang; Hsu, Chih-Cheng

    2017-01-01

    BACKGROUND: Transplant tourism has increased rapidly in the past two decades, accounting for about 10% of world organ transplants. However it is ethically controversial and discouraged by professional guidelines. We conducted this study to investigate the outcomes and trends of overseas kidney and liver transplantation in Taiwan to provide a sound basis for ethical reflection.METHODS AND FINDINGS: The Taiwanese National Health Insurance Research Database was used to identify 2381 domestic and...

  9. Surgical treatment of dislocated acromioclavicular syndesmolysis remains controversial

    Directory of Open Access Journals (Sweden)

    Slaviša Mihaljevič

    2007-12-01

    Full Text Available Background: Operative treatment of acromioclavicular (AC joint dislocations Allman-Tossy III type is controversial. There are more than 30 types of operative treatments described. At the Department of Traumatology of Celje General and Teaching Hospital (CGTH we operate the AC joint dislocation by the AC joint opened reduction and fixation using two Kirschner wires and additional figure of eight wire loop over the AC joint. The purpose of the analysis is to evaluate the results of acromioclavicular joint complete dislocation Allman-Tossy III type operative treatment.Patients and methods: In the 2-year period from July 1st 1997, to June 31st, 1999, at the Department of Traumatology of CGTH we operatively treated 59 injured persons with the AC joint dislocation. There were 55 men (93 % and 4 women (7 %. The average age was 40 years (from 20 to 72 years. 56 (95 % injured persons had the AC joint injury of Allman-Tossy III type. In first three weeks (early reconstruction we operated 45 injured persons (76.3 %. The applied material was removed after 8 weeks. 47 (79.7 % injured persons were re-examined at least one year after the injury (27 months in average; 14–39 months. The results were evaluated according to University of California at Los Angeles (UCLA scale for the shoulder function evaluation. The impact of factors on a good treatment result was presented by the odds ratio and uni-variant analysis calculation.Results: Out of 47 injured persons re-examined according to the UCLA scale at least one year after the injury there were 17 injured persons (36.2 % rated with an excellent result (UCLA 34– 35, 22 good (46.8 % (UCLA 28–33, 5 satisfactory (10.6 % (UCLA 21–27 and 3 bad (6.4 % (UCLA 0–20. In total we achieved 83 % of excellent and good results. The injured persons age did not significantly affect the treatment result. Complications occurred in 14 (29.8 % injured patients. If no complications were occurred the odds ratio for good

  10. Penetrating abdominal injuries: management controversies

    Science.gov (United States)

    Butt, Muhammad U; Zacharias, Nikolaos; Velmahos, George C

    2009-01-01

    Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries. PMID:19374761

  11. Penetrating abdominal injuries: management controversies

    Directory of Open Access Journals (Sweden)

    Velmahos George C

    2009-04-01

    Full Text Available Abstract Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries.

  12. Varicocele: Management and the continuing controversies

    Directory of Open Access Journals (Sweden)

    P S Agbo

    2010-01-01

    Full Text Available Varicoceles have long been associated with infertility. Despite this long history, there remains much controversy regarding their aetiology and management. The aim of this review is to present the most current information on the management of varicoceles and to highlight some of the management controversies: Association of varicocele with male infertility; Management of varicocele in adolescent; safety and effectiveness of varicocele embolization and management of subclinical varicoceles. It is hoped that this review study will stimulate further research into this condition in order to find a more common ground regarding its management.

  13. Hilar cholangiocarcinoma: controversies on the extent of surgical resection aiming at cure.

    Science.gov (United States)

    Xiang, Shuai; Lau, Wan Yee; Chen, Xiao-ping

    2015-02-01

    Hilar cholangiocarcinoma is the most common malignant tumor affecting the extrahepatic bile duct. Surgical treatment offers the only possibility of cure, and it requires removal of all tumoral tissues with adequate resection margins. The aims of this review are to summarize the findings and to discuss the controversies on the extent of surgical resection aiming at cure for hilar cholangiocarcinoma. The English medical literatures on hilar cholangiocarcinoma were studied to review on the relevance of adequate resection margins, routine caudate lobe resection, extent of liver resection, and combined vascular resection on perioperative and long-term survival outcomes of patients with resectable hilar cholangiocarcinoma. Complete resection of tumor represents the most important prognostic factor of long-term survival for hilar cholangiocarcinoma. The primary aim of surgery is to achieve R0 resection. When R1 resection is shown intraoperatively, further resection is recommended. Combined hepatic resection is now generally accepted as a standard procedure even for Bismuth type I/II tumors. Routine caudate lobe resection is also advocated for cure. The extent of hepatic resection remains controversial. Most surgeons recommend major hepatic resection. However, minor hepatic resection has also been advocated in most patients. The decision to carry out right- or left-sided hepatectomy is made according to the predominant site of the lesion. Portal vein resection should be considered when its involvement by tumor is suspected. The curative treatment of hilar cholangiocarcinoma remains challenging. Advances in hepatobiliary techniques have improved the perioperative and long-term survival outcomes of this tumor.

  14. Sexual Orientation, Controversy, and Science.

    Science.gov (United States)

    Bailey, J Michael; Vasey, Paul L; Diamond, Lisa M; Breedlove, S Marc; Vilain, Eric; Epprecht, Marc

    2016-09-01

    SummaryOngoing political controversies around the world exemplify a long-standing and widespread preoccupation with the acceptability of homosexuality. Nonheterosexual people have seen dramatic surges both in their rights and in positive public opinion in many Western countries. In contrast, in much of Africa, the Middle East, the Caribbean, Oceania, and parts of Asia, homosexual behavior remains illegal and severely punishable, with some countries retaining the death penalty for it. Political controversies about sexual orientation have often overlapped with scientific controversies. That is, participants on both sides of the sociopolitical debates have tended to believe that scientific findings-and scientific truths-about sexual orientation matter a great deal in making political decisions. The most contentious scientific issues have concerned the causes of sexual orientation-that is, why are some people heterosexual, others bisexual, and others homosexual? The actual relevance of these issues to social, political, and ethical decisions is often poorly justified, however. © The Author(s) 2016.

  15. Caffeine controversies.

    Science.gov (United States)

    Gentle, Samuel J; Travers, Colm P; Carlo, Waldemar A

    2018-04-01

    Caffeine use in preterm infants has endured several paradigms: from standard of care to possible neurotoxin to one of the few medications for which there is evidence of bronchopulmonary dysplasia (BPD) risk reduction. The purpose of the review is to analyze this dynamic trajectory and discuss controversies that still remain after decades of caffeine use. Following concerns for caffeine safety in preterm infants, a large randomized controlled trial demonstrated a reduction in BPD and treatment for patent ductus arteriosus. The lower rate of death or neurodevelopmental impairment noted at 18-21 months was not statistically different at later timepoints; however, infants in the caffeine group had lower rates of motor impairment at 11-year follow-up. The time of caffeine therapy initiation is now substantially earlier, and doses used are sometimes higher that previously used, but there are limited data to support these practices. Caffeine therapy for apnea of prematurity (AOP) remains one of the pillars of neonatal care, although more evidence to support dosing and timing of initiation and discontinuation are needed.

  16. Long-term outcome of craniopharyngioma in children. A review

    International Nuclear Information System (INIS)

    Tamiya, Takashi; Okada, Masaki; Miyake, Keisuke; Kawai, Nobuyuki

    2011-01-01

    The treatment for pediatric craniopharyngioma remains challenging and controversial. Although this tumor is histologically benign, the treatments include radical surgery, conservative surgery, radiotherapy, intracystic chemotherapy and multimodality approaches. In addition, the long-term functional outcomes including visual function, endocrine function, cognitive function, hypothalamic function, and quality of life are complex and major problems among survivors. In this paper, we reviewed the recent treatments for pediatric craniopharyngioma and the long-term outcomes after treatment in literatures. (author)

  17. The outcomes and controversies of transplant tourism—Lessons of an 11-year retrospective cohort study from Taiwan

    Science.gov (United States)

    Holm, Soren; Lin, Yi-Ping; Chang, Yu-Kang

    2017-01-01

    Background Transplant tourism has increased rapidly in the past two decades, accounting for about 10% of world organ transplants. However it is ethically controversial and discouraged by professional guidelines. We conducted this study to investigate the outcomes and trends of overseas kidney and liver transplantation in Taiwan to provide a sound basis for ethical reflection. Methods and findings The Taiwanese National Health Insurance Research Database was used to identify 2381 domestic and 2518 overseas kidney transplant (KT) recipients from 1998 to 2009 and 1758 domestic and 540 overseas liver transplantation (LT) recipients from 1999 to 2009. Cox proportional hazards models were used to assess the risks of mortality and graft failure. The numbers of overseas transplantation increased after 2000, reached a peak in 2005 and decreased after 2007. Compared to their domestic counterparts, the overseas KT recipients were older, male predominant, with shorter pre-op dialysis period and more comorbidities. Similarly, the overseas LT recipients were older, male predominant and had more hepatocellular carcinoma cases. The 1-, 5-, and 10-year patient survival rates were 96.9%, 91.7% and 83.0% respectively for domestic KT and 95.8%, 87.8% and 73.1% for overseas KT (ptourism decreased but the practice still persisted surreptitiously. Compulsory registration policies for overseas transplantation with international conventions to sanction organ trafficking and transplant tourism should be considered to stop these controversial practices. PMID:28575014

  18. The outcomes and controversies of transplant tourism-Lessons of an 11-year retrospective cohort study from Taiwan.

    Science.gov (United States)

    Tsai, Daniel Fu-Chang; Huang, Shi-Wei; Holm, Soren; Lin, Yi-Ping; Chang, Yu-Kang; Hsu, Chih-Cheng

    2017-01-01

    Transplant tourism has increased rapidly in the past two decades, accounting for about 10% of world organ transplants. However it is ethically controversial and discouraged by professional guidelines. We conducted this study to investigate the outcomes and trends of overseas kidney and liver transplantation in Taiwan to provide a sound basis for ethical reflection. The Taiwanese National Health Insurance Research Database was used to identify 2381 domestic and 2518 overseas kidney transplant (KT) recipients from 1998 to 2009 and 1758 domestic and 540 overseas liver transplantation (LT) recipients from 1999 to 2009. Cox proportional hazards models were used to assess the risks of mortality and graft failure. The numbers of overseas transplantation increased after 2000, reached a peak in 2005 and decreased after 2007. Compared to their domestic counterparts, the overseas KT recipients were older, male predominant, with shorter pre-op dialysis period and more comorbidities. Similarly, the overseas LT recipients were older, male predominant and had more hepatocellular carcinoma cases. The 1-, 5-, and 10-year patient survival rates were 96.9%, 91.7% and 83.0% respectively for domestic KT and 95.8%, 87.8% and 73.1% for overseas KT (ptourism decreased but the practice still persisted surreptitiously. Compulsory registration policies for overseas transplantation with international conventions to sanction organ trafficking and transplant tourism should be considered to stop these controversial practices.

  19. Computational Controversy

    NARCIS (Netherlands)

    Timmermans, Benjamin; Kuhn, Tobias; Beelen, Kaspar; Aroyo, Lora

    2017-01-01

    Climate change, vaccination, abortion, Trump: Many topics are surrounded by fierce controversies. The nature of such heated debates and their elements have been studied extensively in the social science literature. More recently, various computational approaches to controversy analysis have

  20. Adolescent Controversial Status Brokers: A Double-Edged Sword

    Science.gov (United States)

    Borowski, Sarah; Zeman, Janice; Carboni, Inga; Gilman, Rich; Thrash, Todd

    2017-01-01

    Using a 3-wave longitudinal, multidimensional approach, this study investigated the influence of social network position and social status on the psychosocial outcomes of 440 youth (45.1% girls; M[subscript age] = 16.1 years; 90.9% Caucasian) over 26 months, focusing on the controversial status classification (i.e., youth who are highly liked and…

  1. Gossip in organisations: Contexts, consequences and controversies

    OpenAIRE

    Michelson, G.; van Iverson, A.; Waddington, K.

    2010-01-01

    This article examines the key themes surrounding gossip including its contexts, the various outcomes (positive and negative) of gossip as well as a selection of challenges and controversies. The challenges which are highlighted revolve around definitional issues, methodological approaches, and ethical considerations. Our analysis suggests that the characteristics and features of gossip lend itself to a process-oriented approach whereby the beginning and, particularly, end points of gossip are...

  2. Climatic change science, experience and controversies

    International Nuclear Information System (INIS)

    Le Treut, H.; Van Ypersele, J.P.; Hallegatte, St.; Hourcade, J.Ch.

    2004-01-01

    The international scientific community, gathered in the framework of the inter-governmental group for climate evolution (Giec), has confirmed the influence of human activities on climate and on the global warming. However, this diagnosis is sometimes questioned in the press. This book, published by the institute of sustainable development, gathers a series of articles written by scientists who make comments on the last Giec reports and who outline the knowledge gained, the remaining uncertainties and the controversies. (J.S.)

  3. Subclinical hypothyroidism: Controversies to consensus

    Directory of Open Access Journals (Sweden)

    Syed Abbas Raza

    2013-01-01

    Full Text Available Diagnoses of subclinicaal hypothyroidism (SCH is biochemically made, when serum thyroid stimulating hormone (TSH levels is elevated while free thyroid hormone levels are within normal reference range. SCH is diagnosed after excluding all other causes of elevated TSH levels. Symptoms of SCH may vary from being asymptomatic to having mild nonspecific symptoms. The risk of progression to overt hypothyroidism is related to number of factors including initial serum TSH concentration, presence of auto antibodies, family history and presence goiter. Various screening recommendations for thyroid function assessment are in practice. There are still controversies surrounding SCH and associated risk of various cardiovascular diseases (CVDs, pregnancy outcomes, neuropsychiatric issues, metabolic syndrome, and dyslipidemia. Consensus will require more large randomized clinical studies involving various age groups and medical condition, especially in developing countries. All these efforts will definitely improve our understanding of disease and ultimately patient outcomes.

  4. Computational Controversy

    OpenAIRE

    Timmermans, Benjamin; Kuhn, Tobias; Beelen, Kaspar; Aroyo, Lora

    2017-01-01

    Climate change, vaccination, abortion, Trump: Many topics are surrounded by fierce controversies. The nature of such heated debates and their elements have been studied extensively in the social science literature. More recently, various computational approaches to controversy analysis have appeared, using new data sources such as Wikipedia, which help us now better understand these phenomena. However, compared to what social sciences have discovered about such debates, the existing computati...

  5. Deciding on gender in children with intersex conditions: considerations and controversies.

    Science.gov (United States)

    Thyen, Ute; Richter-Appelt, Hertha; Wiesemann, Claudia; Holterhus, Paul-Martin; Hiort, Olaf

    2005-01-01

    Biologic factors such as genetic and hormonal influences contribute to gender identity, gender role behavior, and sexual orientation in humans, but this relationship is considerably modified by psychologic, social, and cultural factors. The recognition of biologically determined conditions leading to incongruity of genetically determined sex, somatic phenotype, and gender identity has led to growing interest in gender role development and gender identity in individuals with intersex conditions. Sex assignment of children with ambiguous genitalia remains a difficult decision for the families involved and subject to controversial discussion among professionals and self-help groups. Although systematic empirical data on outcomes of functioning and health-related quality of life are sparse, anecdotal evidence from case series and individual patients about their experiences in healthcare suggests traumatic experiences in some. This article reviews the earlier 'optimal gender policy' as well as the more recent 'full consent policy' and reviews published data on both surgical and psychosocial outcomes. The professional debate on deciding on sex assignment in children with intersex conditions is embedded in a much wider public discourse on gender as a social construction. Given that the empirical basis of our knowledge of the causes, treatment options, long-term outcomes, and patient preferences is insufficient, we suggest preliminary recommendations based on clinical experience, study of the literature, and interviews with affected individuals.

  6. Adolescent varicocoele management controversies.

    Science.gov (United States)

    Serefoglu, E C; Saitz, T R; La Nasa, J A; Hellstrom, W J

    2013-01-01

    Varicocoele is defined as excessive dilatation of the pampiniform venous plexus of the spermatic cord. Varicocoele frequently appears during early puberty and is recognized to be the most common surgically correctable cause of male infertility. However, the actual incidence in adolescents, pathophysiology and the association with male factor infertility all remain somewhat controversial. The most accurate diagnostic technique for identifying young men who will benefit from surgical treatment has yet to be established. Observations of testicular asymmetry and deteriorating semen quality helped establish current guidelines and recommendations for surgical treatment. Further studies, comparing observation with surgical intervention, are needed to refine the current indications for varicocoele repair in the adolescent male. © 2012 American Society of Andrology and European Academy of Andrology.

  7. Management of ß-thalassemia – Consensus and controversies!

    Directory of Open Access Journals (Sweden)

    Mamta V. Manglani

    2017-12-01

    Full Text Available The mainstay of treatment of ß-Thalassemia major includes life-long regular packed red cell transfusions and iron chelation. With advances in understanding the molecular biology and its implications in the patients, newer modalities are now being explored to offer a better quality of life to transfusion dependent thalassemic patients. Improved safety of transfusions, newer chelator drugs and combination of chelators have improved outcomes in these patients. Amlodipine along with chelators may be a future option for preventing cardiac iron overload related complications. Drugs which improve HbF levels and thus ameliorate anemia such as hydroxyurea, butyrates azacytidine etc. have also been explored with little relief to transfusion dependent patients. HSCT, which is the only curative treatment available at present, has its own limitations as sibling donors may not be available to many. However, there has been extensive work done on improving outcomes with MUD and Haplo-identical HSCT in the recent times. Gene therapy using lentiviral vectors is also offering great hope to these children. Induced Pluripotent Stem Cells (iPSC is a promising advance in the treatment of thalassemia. Several newer molecules targeting different pathophysiologic aspects are being explored and have met with good success. These include luspatercept, sotatercept, macrophage inhibition, JAK2 inhibition using ruxolitinib etc. Controversies regarding use of wheat grass and ESAs are relatively less worrisome. But use of thalidomide should be done with great caution. Despite its success reported in anecdotal reports, in the absence of adequate data with larger trials, its role in routine management of thalassemia syndromes remains to be ascertained.

  8. The breast implant controversy.

    Science.gov (United States)

    Cook, R R; Harrison, M C; LeVier, R R

    1994-02-01

    The breast implant issue is a "bad news/good news" story. For many women with implants, the controversy has caused a fair degree of anxiety which may or may not be resolved as further information becomes available. It has also taken its toll on Dow Corning. Whole lines of medical products have been eliminated or are being phase out. The development of new medical applications has been terminated. As a consequence, employees have lost their jobs. What the effect will be on the biomedical industry as a whole remains to be seen (11). While silicones have been an important component in various medical devices, it is likely that other materials can be used as replacements. However, suppliers of non-silicone materials are also reevaluating their role in this market. For example, Du Pont, the nation's largest chemical company, has determined that the unpredictable and excessive costs of doing business with manufacturers of implantable medical devices no longer justifies the unrestricted sale of standard raw materials into this industry. Other companies are quietly following suit. On the up side, it is possible that the research being driven by this controversy will result in a greater understanding of the immunologic implications of xenobiotics, of the importance of nonbiased observations, of the need for ready access to valid data sets, and of the opportunity for valid scientific information to guide legal decisions. Only time will tell.

  9. Controversial Issues in Thyroid Cancer Management.

    Science.gov (United States)

    Tuttle, R Michael

    2018-04-13

    The lack of prospective randomized clinical trials for most management topics in differentiated thyroid cancer force us to make management recommendations based on retrospective observational data which is often incomplete, subject to selection bias, and conflicting. Therefore, it is not surprising that many aspects of thyroid cancer management remain controversial and not well defined. This review will examine the controversies surrounding three important topics in thyroid cancer management: (1) the option of thyroid lobectomy as initial therapy for thyroid cancer, (2) the proper use of preoperative neck imaging to optimize the completeness of the initial surgical procedure, and (3) the selective use RAI therapy as remnant ablation, adjuvant treatment or treatment of known persistent/recurrent disease. As thyroid cancer management moves toward a much more risk adapted approach to personalized management recommendations, clinicians and patients must balance the risks and benefits of the potential management options to arrive at a management plan that is optimized based on both patient preferences/values and the philosophy/experience of the local disease management team. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  10. Outcome of Laparoscopic Versus Open Resection for Transverse Colon Cancer.

    Science.gov (United States)

    Zeng, Wei-Gen; Liu, Meng-Jia; Zhou, Zhi-Xiang; Hou, Hui-Rong; Liang, Jian-Wei; Wang, Zheng; Zhang, Xing-Mao; Hu, Jun-Jie

    2015-10-01

    Laparoscopic resection for transverse colon cancer remains controversial. The aim of this study is to investigate the short- and long-term outcomes of laparoscopic surgery for transverse colon cancer. A total of 278 patients with transverse colon cancer from a single institution were included. All patients underwent curative surgery, 156 patients underwent laparoscopic resection (LR), and 122 patients underwent open resection (OR). The short- and long-term results were compared between two groups. Baseline demographic and clinical characteristics were comparable between two groups. Conversions were required in eight (5.1 %) patients. LR group was associated with significantly longer median operating time (180 vs. 140 min; P colon cancer is associated with better short-term outcomes and equivalent long-term oncologic outcomes.

  11. Doctrinal controversies and ecumenical councils | Ogbonnaya ...

    African Journals Online (AJOL)

    This work focused on the doctrinal controversies that have confronted the Church in the course of its development and the accompanying councils that sought to resolve these theological controversies. The paper did this historically, by showing the origin of the problems, the factors and features involved in the controversies ...

  12. Plutonium controversy

    International Nuclear Information System (INIS)

    Richmond, C.R.

    1980-01-01

    The toxicity of plutonium is discussed, particularly in relation to controversies surrounding the setting of radiation protection standards. The sources, amounts of, and exposure pathways of plutonium are given and the public risk estimated

  13. Predictors of patients remaining anovulatory during clomiphene citrate induction of ovulation in normogonadotropic oligoamenorrheic infertility

    NARCIS (Netherlands)

    B. Imani (Babak); M.J.C. Eijkemans (René); E.R. te Velde (Egbert); J.D.F. Habbema (Dik); B.C.J.M. Fauser (Bart)

    1998-01-01

    textabstractThe diagnostic criteria used to identify patients suffering from polycystic ovary syndrome remain controversial. The present prospective longitudinal follow-up study was designed to identify whether certain criteria assessed during standardized initial

  14. Managing Controversies in the Fuzzy Front End

    DEFF Research Database (Denmark)

    Christiansen, John K.; Gasparin, Marta

    2016-01-01

    This research investigates the controversies that emerge in the fuzzy front end (FFE) and how they are closed so the innovation process can move on. The fuzzy front has been characterized in the literature as a very critical phase, but controversies in the FFE have not been studied before....... The analysis investigates the microprocesses around the controversies that emerge during the fuzzy front end of four products. Five different types of controversies are identified: profit, production, design, brand and customers/market. Each controversy represents a threat, but also an opportunity to search...

  15. Plutonium controversy

    Energy Technology Data Exchange (ETDEWEB)

    Richmond, C.R.

    1980-01-01

    The toxicity of plutonium is discussed, particularly in relation to controversies surrounding the setting of radiation protection standards. The sources, amounts of, and exposure pathways of plutonium are given and the public risk estimated. (ACR)

  16. Unicameral bone cysts: general characteristics and management controversies.

    Science.gov (United States)

    Pretell-Mazzini, Juan; Murphy, Robert Francis; Kushare, Indranil; Dormans, John P

    2014-05-01

    Unicameral bone cysts are benign bone lesions that are often asymptomatic and commonly develop in the proximal humerus and femur of skeletally immature patients. The etiology of these lesions remains unknown. Most patients present with a pathologic fracture, but these cysts can be discovered incidentally, as well. Radiographically, a unicameral bone cyst appears as a radiolucent lesion with cortical thinning and is centrally located within the metaphysis. Although diagnosis is frequently straightforward, management remains controversial. Because the results of various management methods are heterogeneous, no single method has emerged as the standard of care. New minimally invasive techniques involve cyst decompression with bone grafting and instrumentation. These techniques have yielded promising results, with low rates of complications and recurrence reported; however, prospective clinical trials are needed to compare these techniques with current evidence-based treatments.

  17. Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues.

    Science.gov (United States)

    Lewis, Tené T; Cogburn, Courtney D; Williams, David R

    2015-01-01

    Over the past two decades, research examining the impact of self-reported experiences of discrimination on mental and physical health has increased dramatically. Studies have found consistent associations between exposure to discrimination and a wide range of Diagnostic and Statistical Manual of Mental Disorders (DSM)-diagnosed mental disorders as well as objective physical health outcomes. Associations are seen in cross-sectional as well as longitudinal studies and persist even after adjustment for confounding variables, including personality characteristics and other threats to validity. However, controversies remain, particularly around the best approach to measuring experiences of discrimination, the significance of racial/ethnic discrimination versus overall mistreatment, the need to account for "intersectionalities," and the importance of comprehensive assessments. These issues are discussed in detail, along with emerging areas of emphasis including cyber discrimination, anticipatory stress or vigilance around discrimination, and interventions with potential to reduce the negative effects of discrimination on health. We also discuss priorities for future research and implications for interventions and policy.

  18. Mourning, Memorials, and Religion: A Psychoanalytic Perspective on the Park51 Controversy

    Directory of Open Access Journals (Sweden)

    Nathan Carlin

    2011-06-01

    Full Text Available This article summarizes a version of the “mourning religion” thesis—derived from the work of Peter Homans and further developed and advanced by William Parsons, Diane Jonte-Pace, and Susan Henking—and then demonstrates how this thesis can shed light on the Park51 controversy. We argue that the Park51 controversy represents a case of incomplete cultural mourning of an aspect of American civil religion that manifests itself in melancholic rage by means of protests, threats to burn the Qur’an (as well as actual burnings of the Qur’an, and vandalism of mosques around the United States. We explore various losses—military, economic, and symbolic—and note that these losses remain ambiguous, therefore preventing closure and productive mourning. The fact that a permanent memorial still has not been built at Ground Zero reflects, and perhaps exacerbates, this incomplete cultural mourning. Also, the fact that Freedom Tower, the building to replace the Twin Towers, is to be 1776 feet tall reflects that the losses related to 9/11 are connected to American civil religion, as 1776 is a sacred year in American history. Setting aside the ethics and the politics related to this controversy, we attempt here to understand this controversy from a psychoanalytic perspective.

  19. Academic Controversy in Macroeconomics: An Active and Collaborative Method to Increase Student Learning

    Science.gov (United States)

    Santicola, Craig F.

    2015-01-01

    The literature indicates that there is a lack of learning outcomes in economics that can be attributed to the reliance on traditional lecture and the failure to adopt innovative instructional techniques. This study sought to investigate the student learning effects of academic controversy, a cooperative learning technique that shows promise in the…

  20. Effects of Synchronicity and Belongingness on Face-to-Face and Computer-Mediated Constructive Controversy

    Science.gov (United States)

    Saltarelli, Andy J.; Roseth, Cary J.

    2014-01-01

    Adapting face-to-face (FTF) pedagogies to online settings raises boundary questions about the contextual conditions in which the same instructional method stimulates different outcomes. We address this issue by examining FTF and computer-mediated communication (CMC) versions of constructive controversy, a cooperative learning procedure involving…

  1. Controversies in the management of tongue base cancer.

    LENUS (Irish Health Repository)

    O'Neill, J P

    2012-01-31

    BACKGROUND: Tongue base cancer is one of the most lethal head and neck cancers. There is considerable controversy in the management of this disease with wide variation of opinion within the literature. METHODS: We discuss the presentation, diagnostic and therapeutic strategies which exist in the literature. Articles were reviewed from 1970 to 2007 within the Medline, Pubmed and Cochrane libraries. CONCLUSIONS: Smokers with a history of persistent unilateral neck pain, even in the absence of clinical signs warrant MRI neck imaging. Tongue base cancer organ preservation therapeutic strategies, radiation and concomitant platinum based chemotherapy, currently optimise oncologic and quality of life outcomes.

  2. Influence of the factor V Leiden mutation on infectious disease susceptibility and outcome

    DEFF Research Database (Denmark)

    Benfield, Thomas L; Dahl, Mortens; Nordestgaard, Borge G

    2005-01-01

    The effect of the coagulation factor V Leiden mutation on infectious disease susceptibility and outcome is controversial.......The effect of the coagulation factor V Leiden mutation on infectious disease susceptibility and outcome is controversial....

  3. Energy, controversies and prospects

    International Nuclear Information System (INIS)

    Bertholet, J.-L.; Garbely, M.; Lachal, B.; Romerio, F.; Weber, W.

    2003-01-01

    The energy debate raises deep controversies, as discussions on climate change or electricity markets' deregulation show. In this context, it is very difficult for the citizen to express himself in referendums and for the decision maker to slice between various options. Experts themselves deliver controversial evaluations and interest groups can benefit from them to suggest their own solution. This book enables to get a better insight and better understand energy-related controversies and the environmental and socio-economic impacts of energy. It deals with topics as complex and politically extreme as the exhaustion of fossil fuels, climate change, ionising radiations, renewable energy sources, energy consumption in Southern countries and the reorganisation of electricity markets. It starts with an article on the precaution principle and it ends with a glance on the future, devoted to education in the field of efficient energy use [fr

  4. Short-Term Outcomes of Simultaneous Laparoscopic Colectomy and Hepatectomy for Primary Colorectal Cancer With Synchronous Liver Metastases

    OpenAIRE

    Inoue, Akira; Uemura, Mamoru; Yamamoto, Hirofumi; Hiraki, Masayuki; Naito, Atsushi; Ogino, Takayuki; Nonaka, Ryoji; Nishimura, Junichi; Wada, Hiroshi; Hata, Taishi; Takemasa, Ichiro; Eguchi, Hidetoshi; Mizushima, Tsunekazu; Nagano, Hiroaki; Doki, Yuichiro

    2014-01-01

    Although simultaneous resection of primary colorectal cancer and synchronous liver metastases is reported to be safe and effective, the feasibility of a laparoscopic approach remains controversial. This study evaluated the safety, feasibility, and short-term outcomes of simultaneous laparoscopic surgery for primary colorectal cancer with synchronous liver metastases. From September 2008 to December 2013, 10 patients underwent simultaneous laparoscopic resection of primary colorectal cancer an...

  5. Teen Addiction. Current Controversies Series.

    Science.gov (United States)

    Winters, Paul A., Ed.

    The Current Controversies series explores social, political, and economic controversies that dominate the national and international scenes today from a variety of perspectives. Recent surveys have shown that, after years of decline, drug use among teenagers has increased during the 1990s, and that alcohol and tobacco use have remained…

  6. Adjunctive use of the diode laser in non-surgical periodontal therapy: exploring the controversy.

    Science.gov (United States)

    Porteous, Mary Sornborger; Rowe, Dorothy J

    2014-04-01

    Despite the controversy regarding clinical efficacy, dental hygienists use the diode laser as an adjunct to non-surgical periodontal therapy. The technique to maximize successful laser therapy outcome is controversial as well. The purpose of this review is to explore the scientific foundation of the controversy surrounding the use of the diode laser as an adjunct to non-surgical periodontal therapy. Further, this paper addresses the weaknesses in study design, the heterogeneity of methodology in the published clinical studies, especially the laser parameters, and how these issues impact the collective clinical and microbial data, and thus conclusions regarding clinical efficacy. Evaluation of the literature identifies possible mechanisms that could contribute to the varied, often conflicting results among laser studies that are the foundation of the controversy surrounding clinical efficacy. These mechanisms include current paradigms of periodontal biofilm behavior, tissue response to laser therapy being dependent on tissue type and health, and that the successful therapeutic treatment window is specific to the target tissue, biofilm composition, laser wavelength, and laser energy delivered. Lastly, this paper discusses laser parameters used in the various clinical studies, and how their diversity contributes to the controversy. Although this review does not establish clinical efficacy, it does reveal the scientific foundation of the controversy and the need for standardized, well designed randomized controlled clinical trials to develop specific guidelines for using the laser as an adjunct to non-surgical periodontal therapy. Using evidence-based laser guidelines would allow dental hygienists to provide more effective non-surgical periodontal care.

  7. Managing Controversies in the Fuzzy Front End

    DEFF Research Database (Denmark)

    Christiansen, John K.; Gasparin, Marta

    2016-01-01

    . The analysis investigates the microprocesses around the controversies that emerge during the fuzzy front end of four products. Five different types of controversies are identified: profit, production, design, brand and customers/market. Each controversy represents a threat, but also an opportunity to search...... for new solutions in the unpredictable non-linear processes. The study uses an ethnographic approach using qualitative data from interviews, company documents, external communication and marketing material, minutes of meetings, informal conversations and observations. The analysis of four FFE processes...... demonstrates how the fuzzy front requires managers to deal with controversies that emerge from many different places and involve both human and non-human actors. Closing the controversies requires managers to take account of the situation, identify the problem that needs to be addressed, and initiate a search...

  8. Predicted supplies of oil: a controversy revisited

    International Nuclear Information System (INIS)

    Mackay, R.M.; Probert, S.D.

    1993-01-01

    This investigation had two objectives. The first was to consider future problems of the oil industry, as envisaged at the time of the impending 1973-74 unit-oil-price crisis. To this end, selected early 1970's pertinent published papers have been analysed and their conclusions now assessed in hindsight. The chosen published articles were considered then to be in part controversial, visionary and simultaneously, often predicting very different outcomes for the future supply, demand and unit cost of crude oil. The second objective was to assess pertinent recent research, and compare what we at present believe to be the status quo for the oil industry, with the perception of how the industry would have developed as portrayed by the early 1970's oil publications. (author)

  9. Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes.

    Science.gov (United States)

    Turton, Mervyn; Africa, Charlene W J

    2017-06-01

    Although there is increasing evidence to suggest an association between periodontal disease and adverse pregnancy outcomes, the issue remains controversial. This study tested the hypothesis that periodontal disease is a risk indicator for preterm delivery of low-birthweight infants. The study sample comprised 443 pregnant women with a mean (± standard deviation) age of 24.13 (±5.30) years. At first visit, maternal oral health status was assessed by the measurement of probing pocket depth and clinical attachment loss, and periodontal status was graded as absent, mild, moderate or severe. An association was sought between pregnancy outcomes and maternal periodontal status. While controlling for other factors, significant associations were found between pregnancy outcomes and maternal periodontal index scores. This study provides further evidence that periodontal disease is a risk indicator for adverse pregnancy outcomes. © 2016 FDI World Dental Federation.

  10. Laparoscopic Nephroureterectomy: Oncologic Outcomes and Management of Distal Ureter; Review of the Literature

    Directory of Open Access Journals (Sweden)

    Andre Berger

    2009-01-01

    Full Text Available Introduction. Laparoscopic radical nephroureterectomy (LNU is being increasingly performed at several centers across the world. We review oncologic outcomes after LNU procedure and the techniques for the management of distal ureter. Materials and Methods. A comprehensive review of the literature was performed on the oncological outcomes and management of distal ureter associated with LNU for upper tract transitional cell carcinoma (TCC. Results and Discussion. LNU for upper tract TCC is performed pure laparoscopically (LNU or hand-assisted (HALNU. The management of the distal ureter is still debated. LNU appears to have superior perioperative outcomes when compared to open surgery. Intermediate term oncologic outcomes after LNU are comparable to open nephroureterectomy (ONU. Conclusions. Excision of the distal ureter and bladder cuff during nephroureterectomy remains controversial. Intermediate term oncologic outcomes for LNU compare well with ONU. Initial long-term oncologic outcomes are encouraging. Prospective randomized comparison between LNU and open surgery is needed to define the role of these modalities in the current context.

  11. How science makes environmental controversies worse

    International Nuclear Information System (INIS)

    Sarewitz, Daniel

    2004-01-01

    I use the example of the 2000 US Presidential election to show that political controversies with technical underpinnings are not resolved by technical means. Then, drawing from examples such as climate change, genetically modified foods, and nuclear waste disposal, I explore the idea that scientific inquiry is inherently and unavoidably subject to becoming politicized in environmental controversies. I discuss three reasons for this. First, science supplies contesting parties with their own bodies of relevant, legitimated facts about nature, chosen in part because they help make sense of, and are made sensible by, particular interests and normative frameworks. Second, competing disciplinary approaches to understanding the scientific bases of an environmental controversy may be causally tied to competing value-based political or ethical positions. The necessity of looking at nature through a variety of disciplinary lenses brings with it a variety of normative lenses, as well. Third, it follows from the foregoing that scientific uncertainty, which so often occupies a central place in environmental controversies, can be understood not as a lack of scientific understanding but as the lack of coherence among competing scientific understandings, amplified by the various political, cultural, and institutional contexts within which science is carried out. In light of these observations, I briefly explore the problem of why some types of political controversies become 'scientized' and others do not, and conclude that the value bases of disputes underlying environmental controversies must be fully articulated and adjudicated through political means before science can play an effective role in resolving environmental problems

  12. Re-examination of the Controversial Coexistence of Traumatic Brain Injury and Posttraumatic Stress Disorder: Misdiagnosis and Self-Report Measures

    OpenAIRE

    Sbordone, Robert J.; Ruff, Ronald M.

    2010-01-01

    The coexistence of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) remains a controversial issue in the literature. To address this controversy, we focused primarily on the civilian-related literature of TBI and PTSD. Some investigators have argued that individuals who had been rendered unconscious or suffered amnesia due to a TBI are unable to develop PTSD because they would be unable to consciously experience the symptoms of fear, helplessness, and horror associated wi...

  13. Spine Trauma-What Are the Current Controversies?

    Science.gov (United States)

    Oner, Cumhur; Rajasekaran, Shanmuganathan; Chapman, Jens R; Fehlings, Michael G; Vaccaro, Alexander R; Schroeder, Gregory D; Sadiqi, Said; Harrop, James

    2017-09-01

    Although less common than other musculoskeletal injuries, spinal trauma may lead to significantly more disability and costs. During the last 2 decades there was substantial improvement in our understanding of the basic patterns of spinal fractures leading to more reliable classification and injury severity assessment systems but also rapid developments in surgical techniques. Despite these advancements, there remain unresolved issues concerning the management of these injuries. At this moment there is persistent controversy within the spinal trauma community, which can be grouped under 6 headings. First of all there is still no unanimity on the role and timing of medical and surgical interventions for patients with associated neurologic injury. The same is also true for type and timing of surgical intervention in multiply injured patients. In some common injury types like odontoid fractures and burst type (A3-A4) fractures in thoracolumbar spine, there is wide variation in practice between operative versus nonoperative management without clear reasons. Also, the role of different surgical approaches and techniques in certain injury types are not clarified yet. Methods of nonoperative management and care of elderly patients with concurrent complex disorders are also areas where there is no consensus. In this overview article the main reasons for these controversies are reviewed and the possible ways for resolutions are discussed.

  14. The nuclear controversy

    International Nuclear Information System (INIS)

    Walske, C.; Dobkin, R.A.

    1984-01-01

    The article deals with the nuclear controversy, especially in the United States. To a certain extent the nuclear debate has become heavily politicised. Public opinion and anti-nuclear groups are mentioned as well as nuclear disarmament

  15. Communication, Psychosocial, and Educational Outcomes of Children with Cochlear Implants and Challenges Remaining for Professionals and Parents

    Directory of Open Access Journals (Sweden)

    Renée Punch

    2011-01-01

    Full Text Available This paper provides an overview and a synthesis of the findings of a large, multifaceted study investigating outcomes from paediatric cochlear implantation. The study included children implanted at several Australian implant clinics and attending a variety of early intervention and educational settings across a range of locations in eastern Australia. It investigated three major aspects of childhood cochlear implantation: (1 parental expectations of their children's implantation, (2 families' decision-making processes, and (3 the communication, social, and educational outcomes of cochlear implantation for deaf children. It employed a mixed-methods approach in which quantitative survey data were gathered from 247 parents and 151 teachers, and qualitative data from semistructured interviews with 27 parents, 15 teachers, and 11 children and adolescents with cochlear implants. The summarised findings highlight several areas where challenges remain for implant clinics, parents, and educators if children with cochlear implants are to reach their full potential personally, educationally, and socially.

  16. Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy.

    Science.gov (United States)

    Chang, Lenisa V

    2018-05-02

    In the wake of strong, although later refuted, claims of a link between autism and the measles-mumps-rubella (MMR) vaccine, I examine whether fewer parents immunized or delayed vaccinations for their children and if there was a differential response by mother's education level. Using various controls and a differencing strategy that compares in MMR take-up with other vaccines, I find that the MMR-autism controversy led to a decline in the immediate years and that there were negative spillovers onto other vaccines. I also find evidence that more highly educated mothers responded more strongly to the controversy either by not immunizing their children altogether or, to a lesser degree, delaying vaccination. Moreover, the educational gap was greater in states where there was greater media attention devoted to the controversy. This is consistent with the health allocative efficiency hypothesis whereby part of the education gradient in health outcomes is due to more-educated individuals absorbing and responding to health information more quickly. However, unlike in the United Kingdom, where previous studies find that the gap was eliminated after the link was refuted, the evidence for the United States suggests that the educational gap persisted. Copyright © 2018 John Wiley & Sons, Ltd.

  17. The Reviewing of Controversial Juvenile Books: A Study.

    Science.gov (United States)

    Crow, Sherry R.

    1986-01-01

    Describes a study which examined reviewers' treatment of controversial juvenile books in Booklist, Bulletin of Center for Children's Books, Horn Book, and School Library Journal. The total number of controversial books reviewed by each journal, promptness of reviews, and extent of discussion of controversial features are discussed. (MBR)

  18. Controversies in hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    A. Baziad

    2001-09-01

    Full Text Available Deficiency of estrogen hormone will result in either long-term or short-term health problems which may reduce the quality of life. There are numerous methods by which the quality of female life can be achieved. Since the problems occuring are due to the deficiency of estrogen hormone, the appropriate method to tackle the problem is by administration of estrogen hormone. The administration of hormone replacement therapy (HRT with estrogen may eliminate climacteric complaints, prevent osteoporosis, coronary heart disease, dementia, and colon cancer. Although HRT has a great deal of advantage, its use is still low and may result in controversies. These controversies are due to fact that both doctor and patient still hold on to the old, outmoded views which are not supported by numerous studies. Currently, the use of HRT is not only based on experience, or temporary observation, but more on evidence based medicine. (Med J Indones 2001; 10: 182-6Keywords: controversies, HRT

  19. Effects of Face-to-Face and Computer-Mediated Constructive Controversy on Social Interdependence, Motivation, and Achievement

    Science.gov (United States)

    Roseth, Cary J.; Saltarelli, Andy J.; Glass, Chris R.

    2011-01-01

    Cooperative learning capitalizes on the relational processes by which peers promote learning, yet it remains unclear whether these processes operate similarly in face-to-face and online settings. This study addresses this issue by comparing face-to-face and computer-mediated versions of "constructive controversy", a cooperative learning procedure…

  20. Impaired Neonatal Outcome after Emergency Cerclage Adds Controversy to Prolongation of Pregnancy.

    Directory of Open Access Journals (Sweden)

    Ruben-J Kuon

    Full Text Available Emergency cervical cerclage is one of the treatment options for the reduction of preterm birth. The aim of this study is to assess neonatal outcome after cerclage with special focus on adverse effects in very low birth weight infants.Retrospective cohort study. Classification of cerclages in history-indicated (HIC, n = 38, ultrasound-indicated (UIC, n = 29 and emergency/ physical examination-indicated (PEIC, n = 33 cerclage. Descriptive analysis of pregnancy and neonatal outcome (admission to NICU, duration of hospitalization, respiratory outcome (intubation, CPAP, FiO2max, neonatal complications (ROP, IVH. Statistical comparison of perinatal parameters and outcome of neonates <1500 g after cerclage with a birth weight matched control group.Neonates <1500 g after PEIC show significantly impaired outcome, i.e. prolonged respiratory support (total ventilation in days, CPAP, FiO2max and higher rates of neonatal complications (IVH ≥ II, ROP ≥ 2. Placental pathologic evaluation revealed a significantly higher rate of chorioamnionitis (CAM after PEIC. Neonates <1500 g after UIC or HIC show no significant difference in neonatal complications or CAM.In our study PEIC is associated with adverse neonatal outcome in infants <1500 g. The high incidence of CAM indicates a potential inflammatory factor in the pathogenesis. Large well-designed RCTs are required to give conclusive answers to the question whether to prolong or to deliver.

  1. Outcomes after endoscopic port surgery for spontaneous intracerebral hematomas.

    Science.gov (United States)

    Ochalski, Pawel; Chivukula, Srinivas; Shin, Samuel; Prevedello, Daniel; Engh, Johnathan

    2014-05-01

    Spontaneous intracerebral hemorrhages (ICHs) cause significant morbidity and mortality. Traditional open surgical management strategies offer limited benefit except for the most superficial hemorrhages in select patients. Recent reports suggest that endoscopic approaches may improve outcomes, particularly for deep subcortical hemorrhages. However, the management of these patients remains controversial. We reviewed our experience using endoscopic port surgery to identify characteristics that may predict acceptable outcomes. We completed a retrospective chart and imaging review of patients who underwent endoscopic port surgery for evacuation of spontaneous ICH at a single center. Data were gathered regarding patient demographics, hemorrhage locations, operative findings, and clinical outcomes. From 2007 to 2011, 18 patients underwent evacuation of spontaneous intracerebral hematomas using an endoscopic port. The mean age in years was 62 years (range, 43-84 years). Six of 18 patients (33%) died before discharge, and 2 others (11%) died after at least 1 month of survival. Of 12 initial survivors, all were discharged to a rehabilitation or nursing facility. Complete hematoma evacuation was achieved in 7 of 18 patients, with the remaining 11 having a partial evacuation. The patients who died (n = 6) before discharge were statistically more likely to have a left-sided hemorrhage, partial evacuation, or older age than the survivors; death at least 1  month after evacuation was additionally associated with greater preoperative hematoma volumes. Our series demonstrates that endoscopic port surgery for acute intracerebral hematoma evacuation has the ability to achieve significant decompression of large and deep-seated hematomas. Patient age, extent of evacuation, laterality, and preoperative hematoma volume appear to influence patient outcome. Most overall outcomes remain poor. Future studies are necessary to determine if surgical evacuation is in fact superior to best

  2. Breast cancer screening controversies: who, when, why, and how?

    Science.gov (United States)

    Chetlen, Alison; Mack, Julie; Chan, Tiffany

    2016-01-01

    Mammographic screening is effective in reducing mortality from breast cancer. The issue is not whether mammography is effective, but whether the false positive rate and false negative rates can be reduced. This review will discuss controversies including the reduction in breast cancer mortality, overdiagnosis, the ideal screening candidate, and the optimal imaging modality for breast cancer screening. The article will compare and contrast screening mammography, tomosynthesis, whole-breast screening ultrasound, magnetic resonance imaging, and molecular breast imaging. Though supplemental imaging modalities are being utilized to improve breast cancer diagnosis, mammography still remains the gold standard for breast cancer screening. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Neuroimaging of nonaccidental head trauma: pitfalls and controversies

    Energy Technology Data Exchange (ETDEWEB)

    Fernando, Sujan [University of Missouri-Kansas School of Medicine, Department of Medicine, Kansas City, MO (United States); Obaldo, Ruby E. [The University of Kansas Medical Center, Department of Radiology, Kansas City, MO (United States); Walsh, Irene R. [The University of Missouri-Kansas City, Children' s Mercy Hospitals and Clinics, Department of Emergency Medicine, Kansas City, MO (United States); Lowe, Lisa H. [The University of Missouri-Kansas City, Children' s Mercy Hospitals and Clinics, Department of Radiology, Kansas City, MO (United States)

    2008-08-15

    Although certain neuroimaging appearances are highly suggestive of abuse, radiological findings are often nonspecific. The objective of this review is to discuss pitfalls, controversies, and mimics occurring in neuroimaging of nonaccidental head trauma in order to allow the reader to establish an increased level of comfort in distinguishing between nonaccidental and accidental head trauma. Specific topics discussed include risk factors, general biomechanics and imaging strategies in nonaccidental head trauma, followed by the characteristics of skull fractures, normal prominent tentorium and falx versus subdural hematoma, birth trauma versus nonaccidental head trauma, hyperacute versus acute on chronic subdural hematomas, expanded subarachnoid space versus subdural hemorrhage, controversy regarding subdural hematomas associated with benign enlarged subarachnoid spaces, controversy regarding hypoxia as a cause of subdural hematoma and/or retinal hemorrhages without trauma, controversy regarding the significance of retinal hemorrhages related to nonaccidental head trauma, controversy regarding the significance of subdural hematomas in general, and pitfalls of glutaric aciduria type 1 and hemophagocytic lymphohistiocytosis mimicking nonaccidental head trauma. (orig.)

  4. KNOW NUKES: a model for teaching controversial issues

    International Nuclear Information System (INIS)

    Thomashow, M.S.

    1986-01-01

    This dissertation articulates elements of an educational strategy derived from the experience of the KNOW NUKES program, a teacher training project designed to introduce the nuclear power controversy in the high school classroom. This strategy can be used as means of furthering the effectiveness of controversial issues education, not only in the area of nuclear power, but in teaching about any environmental issue. This is specifically achieved by (2) placing the KNOW NUKES institute in the broader context of controversial issues education; (2) describing in detail KNOW NUKES project planning; (3) reviewing the structure and content of the various teaching techniques and materials that have been developed for the KNOW NUKES institute; (4) utilizing a particular technique developed by the institute that reveals varying perspectives on controversial issues, in this case, an instrumental for decoding the controversial issues that are explicit and implicit in corporate image advertisements; and (5) qualitatively evaluating the practical implementation of the KNOW NUKES model

  5. Neuroimaging of nonaccidental head trauma: pitfalls and controversies

    International Nuclear Information System (INIS)

    Fernando, Sujan; Obaldo, Ruby E.; Walsh, Irene R.; Lowe, Lisa H.

    2008-01-01

    Although certain neuroimaging appearances are highly suggestive of abuse, radiological findings are often nonspecific. The objective of this review is to discuss pitfalls, controversies, and mimics occurring in neuroimaging of nonaccidental head trauma in order to allow the reader to establish an increased level of comfort in distinguishing between nonaccidental and accidental head trauma. Specific topics discussed include risk factors, general biomechanics and imaging strategies in nonaccidental head trauma, followed by the characteristics of skull fractures, normal prominent tentorium and falx versus subdural hematoma, birth trauma versus nonaccidental head trauma, hyperacute versus acute on chronic subdural hematomas, expanded subarachnoid space versus subdural hemorrhage, controversy regarding subdural hematomas associated with benign enlarged subarachnoid spaces, controversy regarding hypoxia as a cause of subdural hematoma and/or retinal hemorrhages without trauma, controversy regarding the significance of retinal hemorrhages related to nonaccidental head trauma, controversy regarding the significance of subdural hematomas in general, and pitfalls of glutaric aciduria type 1 and hemophagocytic lymphohistiocytosis mimicking nonaccidental head trauma. (orig.)

  6. Understanding Controversies in Urban Climate Change Adaptation

    DEFF Research Database (Denmark)

    Baron, Nina; Petersen, Lars Kjerulf

    2015-01-01

    This article explores the controversies that exist in urban climate change adaptation and how these controversies influence the role of homeowners in urban adaptation planning. A concrete SUDS project in a housing cooperative in Copenhagen has been used as a case study thereby investigating the m...

  7. Malrotation and midgut volvulus: a historical review and current controversies in diagnosis and management

    International Nuclear Information System (INIS)

    Lampl, Brooke; Berdon, Walter E.; Levin, Terry L.; Cowles, Robert A.

    2009-01-01

    The complex and sometimes controversial subject of malrotation and midgut volvulus is reviewed commencing with the 19th-century Bohemian anatomist, Vaclav Treitz, who described the suspensory muscle anchoring of the duodenal-jejunal junction in the left upper quadrant, and continuing with William Ladd, the 20th-century American ''father of pediatric surgery'' who pioneered the surgical treatment of midgut volvulus. In this review, we present the interesting history of malrotation and discuss the current radiologic and surgical controversies surrounding its diagnosis and treatment. In the symptomatic patient with malrotation and possible midgut volvulus, prompt diagnosis is critical. The clinical examination and plain film are often confusing, and delayed diagnosis can lead to significant morbidity and death. Despite recent intense interest in the position of the mesenteric vessels on US and CT scans, the upper gastrointestinal series remains the fastest and most accurate method of demonstrating duodenal obstruction, the position of the ligament of Treitz, and, if the contrast agent is followed distally, cecal malposition. Controversy exists over the management of asymptomatic patients with malrotation in whom the diagnosis is made incidentally during evaluation for nonspecific complaints, prior to reflux surgery, and in those with heterotaxy syndromes. (orig.)

  8. Is there a scientific nuclear controversy

    International Nuclear Information System (INIS)

    Muench, E.; Borsch, P.

    1977-01-01

    In the present rather violent discussion about the introduction of nuclear power into the energy supply system it is often alleged that even experts disagree about many aspects, which is interpreted to prove the existence of a scientific controversy in these points. This study about the existence or in existence of such controversy critically reviews both the different collections of signatures organized by scientists and the statements published in specific areas of science. Important partial aspects are the energy requirement and the ways and means available to meet it, the safety and the risks of nuclear technology, radiation exposure and biological effects, the misuse of plutonium, and reprocessing and the ultimate storage of radioactive waste. The study concludes that there is no scientific controversy about the peaceful uses of nuclear power in the sense of the term used here. (orig.) [de

  9. Controversies in Obesity Treatment

    Directory of Open Access Journals (Sweden)

    Majid Karandish

    2015-06-01

    Full Text Available The markedly high prevalence of obesity contributes to the increased incidence of chronic diseases, such as diabetes, hypertension, sleep apnea, and heart disease. Because of high prevalence of obesity in almost all countries, it has been the focus of many researches throughout the world during the recent decades. Along with increasing researches, new concepts and controversies have been emerged. The existing controversies on the topic are so deep that some researches argue on absolutely philosophical questions such as “Is obesity a disease?” or “Is it correct to treat obesity?” These questions are based on a few theories and real data that explain obesity as a biological adaptation and also the final results of weight loss programs. Many people attempt to lose weight by diet therapy, physical activity and lifestyle modifications. Importantly, weight loss strategies in the long term are ineffective and may have unintended consequences including decreasing energy expenditure, complicated appetite control, eating disorders, reducing self-esteem, increasing the plasma and tissue levels of persistent organic pollutants that promote metabolic complications, and consequently, higher risk of repeated cycles of weight loss and weight regain. In this review, major paradoxes and controversies on obesity including classic obesity paradox, pre-obesity; fat-but-fit theory, and healthy obesity are explained. In addition, the relevant strategies like “Health at Every Size” that emphasize on promotion of global health behaviors rather than weight loss programs are explained.

  10. The words of controversy about climate change

    International Nuclear Information System (INIS)

    Chetouani, Lamria

    2007-01-01

    The author analyses the rhetorical staging of controversies which occur in France about climate change, and more particularly about the greenhouse effect. In a first part, she makes a distinction between four registers of controversy: on responsibilities, on consequences and extent of the phenomenon, on solutions, and on spatio-temporal projections of the greenhouse effect. She shows that debates are structured by an opposition between optimism and pessimism. In a second part, based on a lexicological analysis, she highlights the important oppositions between scientific speeches and political speeches, independent speeches and technocratic speeches, and so on, with unexpected aspects. It appears that controversy goes largely beyond the scientific debate, and incorporates crossed interventions of economic, political and social concern

  11. On the history of the nuclear controversy

    International Nuclear Information System (INIS)

    Muench, E.

    1979-01-01

    For the past ten years or so the introduction and expansion of nuclear power in a number of industrialized countries of the Western world has been accompanied by a sometimes vehement controversy. This controversy has taken many forms and, in almost all countries, has had distinct effects on the utilization of nuclear power for energy supply purposes. It has given rise to considerable delays in the completion of nuclear installations and, in one country, has even resulted in a rejection of nuclear power altogether. The different facets of the picture, i.e. public action groups opposing nuclear power, the nuclear controversy and scientists, political activities, appeals to courts of law and actions bordering on illegality, are described chronologically and their impacts are analyzed. (orig.) [de

  12. Endothelial progenitor cell subsets and preeclampsia: Findings and controversies

    Directory of Open Access Journals (Sweden)

    Armin Attar

    2017-10-01

    Full Text Available Vascular remodeling is an essential component of gestation. Endothelial progenitor cells (EPCs play an important role in the regulation of vascular homeostasis. The results of studies measuring the number of EPCs in normal pregnancies and in preeclampsia have been highly controversial or even contradictory because of some variations in technical issues and different methodologies enumerating three distinct subsets of EPCs: circulating angiogenic cells (CAC, colony forming unit endothelial cells (CFU-ECs, and endothelial colony-forming cells (ECFCs. In general, most studies have shown an increase in the number of CACs in the maternal circulation with a progression in the gestational age in normal pregnancies, while functional capacities measured by CFU-ECs and ECFCs remain intact. In the case of preeclampsia, mobilization of CACs and ECFCs occurs in the peripheral blood of pregnant women, but the functional capacities shown by culture of the derived colony-forming assays (CFU-EC and ECFC assays are altered. Furthermore, the number of all EPC subsets will be reduced in umbilical cord blood in the case of preeclampsia. As EPCs play an important role in the homeostasis of vascular networks, the difference in their frequency and functionality in normal pregnancies and those with preeclampsia can be expected. In this review, there was an attempt to provide a justification for these controversies.

  13. Covering Conflict and Controversy: Measuring Balance, Fairness, Defamation.

    Science.gov (United States)

    Simon, Todd F.; And Others

    1989-01-01

    Measures balance, fairness, and defamation in local stories containing controversy and covering law enforcement, education, local government, and business. Finds that most stories lack balance and that the opposing side of the controversy was not contacted in 28 percent of the instances. (RS)

  14. Six controversial issues on subclinical Cushing's syndrome.

    Science.gov (United States)

    Chiodini, Iacopo; Albani, Adriana; Ambrogio, Alberto Giacinto; Campo, Michela; De Martino, Maria Cristina; Marcelli, Giorgia; Morelli, Valentina; Zampetti, Benedetta; Colao, Annamaria; Pivonello, Rosario

    2017-05-01

    Subclinical Cushing's syndrome is a condition of hypercortisolism in the absence of signs specific of overt cortisol excess, and it is associated with an increased risk of diabetes, hypertension, fragility fractures, cardiovascular events and mortality. The subclinical Cushing's syndrome is not rare, being estimated to be between 0.2-2 % in the adult population. Despite the huge number of studies that have been published in the recent years, several issues remain controversial for the subclinical Cushing's syndrome screening, diagnosis and treatment. The Altogether to Beat Cushing's syndrome Group was founded in 2012 for bringing together the leading Italian experts in the hypercortisolism-related diseases. This document represents the Altogether to Beat Cushing's syndrome viewpoint regarding the following controversial issues on Subclinical Cushing's syndrome (SCS): (1) Who has to be screened for subclinical Cushing's syndrome? (2) How to screen the populations at risk? (3) How to diagnose subclinical Cushing's syndrome in patients with an adrenal incidentaloma? (4) Which consequence of subclinical Cushing's syndrome has to be searched for? (5) How to address the therapy of choice in AI patients with subclinical Cushing's syndrome? (6) How to follow-up adrenal incidentaloma patients with subclinical Cushing's syndrome surgically or conservatively treated? Notwithstanding the fact that most studies that faced these points may have several biases (e.g., retrospective design, small sample size, different criteria for the subclinical Cushing's syndrome diagnosis), we believe that the literature evidence is sufficient to affirm that the subclinical Cushing's syndrome condition is not harmless and that the currently available diagnostic tools are reliable for identifying the majority of individuals with subclinical Cushing's syndrome.

  15. Malrotation and midgut volvulus: a historical review and current controversies in diagnosis and management

    Energy Technology Data Exchange (ETDEWEB)

    Lampl, Brooke; Berdon, Walter E. [Morgan Stanley Children' s Hospital of New York-Presbyterian, Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY (United States); Levin, Terry L. [Montefiore Medical Center, Department of Radiology, Mamaroneck, NY (United States); Cowles, Robert A. [Morgan Stanley Children' s Hospital of New York-Presbyterian, Division of Pediatric Surgery, Columbia University College of Physicians and Surgeons, New York, NY (United States)

    2009-04-15

    The complex and sometimes controversial subject of malrotation and midgut volvulus is reviewed commencing with the 19th-century Bohemian anatomist, Vaclav Treitz, who described the suspensory muscle anchoring of the duodenal-jejunal junction in the left upper quadrant, and continuing with William Ladd, the 20th-century American ''father of pediatric surgery'' who pioneered the surgical treatment of midgut volvulus. In this review, we present the interesting history of malrotation and discuss the current radiologic and surgical controversies surrounding its diagnosis and treatment. In the symptomatic patient with malrotation and possible midgut volvulus, prompt diagnosis is critical. The clinical examination and plain film are often confusing, and delayed diagnosis can lead to significant morbidity and death. Despite recent intense interest in the position of the mesenteric vessels on US and CT scans, the upper gastrointestinal series remains the fastest and most accurate method of demonstrating duodenal obstruction, the position of the ligament of Treitz, and, if the contrast agent is followed distally, cecal malposition. Controversy exists over the management of asymptomatic patients with malrotation in whom the diagnosis is made incidentally during evaluation for nonspecific complaints, prior to reflux surgery, and in those with heterotaxy syndromes. (orig.)

  16. Controversies in faith and health care.

    Science.gov (United States)

    Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon

    2015-10-31

    Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Danish Cartoon Crisis/Controversy

    DEFF Research Database (Denmark)

    Hervik, Peter

    2017-01-01

    The Danish Cartoon Crisis Controversy is one of several terms that refer to the turmoil that associates with the Danish newspaper Morgenavisen Jyllands-Posten’s publication of 12 cartoons on 30 September 2005. “The Muhammad Cartoon Crisis” is an alternative heading used for the violent global rea...

  18. [Prostate cancer patients with lymph node metastasis. Outcome in a consecutive group of 59 patients

    DEFF Research Database (Denmark)

    Roder, M.A.; Reinhardt, S.; Brasso, K.

    2008-01-01

    INTRODUCTION: The optimal management of prostate cancer patients with lymph node metastasis remains controversial. In this article, the outcome in a consecutive group of patients with newly diagnosed lymph node positive prostate cancer is presented. MATERIALS AND METHODS: In 59 patients...... with histological verified lymph node positive disease but without osseous metastasis, outcome is described by time to biochemical progression, time to metastasis and survival. RESULTS: Median age at diagnosis was 62 years. Median pre-treatment PSA was 21 ng/ml. Endocrine treatment was initiated within median 2...... patients died during follow-up, 15 deaths were attributable to prostate cancer. Estimated median survival was 5.5 years. CONCLUSION: Despite early androgen deprivation therapy, patients with lymph node positive prostate cancer have a grave prognosis with a high risk of progression and disease...

  19. Nuclear controversy with many undercurrents

    International Nuclear Information System (INIS)

    Lingjaerde, R.O.

    1979-01-01

    The president of the Norwegian Atomic Energy Society presents, in the form of an interview his opinions on the nature of the nuclear controversy in Norway. He is very critical of the emotional and uninformed nature of much of the criticism of nuclear power, and emphasises that nuclear power must be regarded as an alternative to other, less favourable forms of thermal power, as a supplement to hydroelectric power, or to electricity rationing. While a society using less energy is quite feasible, it would hardly be acceptable. The waste disposal controversy is quite artifical, as perfectly safe methods of disposal are available. Finally he regrets that it is the conclusions only in the Nuclear Power Commission's report which have attracted attention, and mainly the comments of the dissident minority. (JIW)

  20. Recent controversies on comparative effectiveness research investigations: Challenges, opportunities, and pitfalls.

    Science.gov (United States)

    Kirpalani, Haresh; Truog, William E; D'Angio, Carl T; Cotten, Michael

    2016-10-01

    The purpose of comparative effectiveness research (CER) is to improve health outcomes by developing and disseminating evidence-based information about which currently available interventions and practices are most effective for patients. Randomized Controlled Trials (RCT) are the hallmark of scientific proof, and have been used to compare interventions used in variable ways by different clinicians (comparative effectiveness RCTs, CER-RCTs). But such CER-RCTs have at times generated controversy. Usually the background for the CER-RCT is a range of "standard therapy" or "standard of care." This may have been adopted on observational data alone, or pilot data. At times, such prior data may derive from populations that differ from the population in which the widely variable standard approach is being applied. We believe that controversies related to these CER-RCTs result from confusing "accepted" therapies and "rigorously evaluated therapies." We first define evidence-based medicine and consider how well neonatology conforms to that definition. We then contrast the approach of testing new therapies and those already existing and widely adopted, as in CER-RCTs. We next examine a central challenge in incorporating the control arm within CER-RCTs and aspects of the "titrated" trial. We finally briefly consider some ethical issues that have arisen, and discuss the wide range of neonatology practices that could be tested by CER-RCTs or alternative CER-based strategies that might inform practice. Throughout, we emphasize the lack of awareness of the lay community, and indeed many researchers or commentators, in appreciating the wide variation of standard of care. There is a corresponding need to identify the best uses of available resources that will lead to the best outcomes for our patients. We conclude that CER-RCTs are an essential methodology in modern neonatology to address many unanswered questions and test unproven therapies in newborn care. Copyright © 2016

  1. Recent Controversies on Comparative Effectiveness Research Investigations: Challenges, Opportunities and Pitfalls

    Science.gov (United States)

    Kirpalani, Haresh; Truog, William E.; D'Angio, Carl T.; Cotten, M.

    2016-01-01

    The purpose of comparative effectiveness research (CER) is to improve health outcomes by developing and disseminating evidence-based information about which currently available interventions and practices are most effective for patients. While Randomized Controlled Trials (RCT) are the hallmark of scientific proof, when they have been used to compare interventions used in variable ways by different clinicians (Comparative Effectiveness RCTs, CER RCTs) they have at times, generated controversy. Usually the background for the CER RCT is a range of ‘standard therapy’ or ‘standard of care’. This may have been adopted on observational data alone, pilot data. At times, such prior data may derive from populations that differ from the population in which the widely variable standard approach is being applied. We believe controversies related to these CER-RCTs result from confusing ‘accepted’ therapies and ‘rigorously evaluated therapies”. We first define evidence based medicine, and consider how well neonatology conforms to that definition. We then contrast the approach of testing new therapies and those already existing and widely adopted, as in CER-RCTs. We next examine a central challenge in incorporating the control arm within CER, and aspects of the ‘titrated’ trial. We finally briefly consider some ethical issues that have arisen, and briefly discuss the wide range of neonatology practices that could be subject to CER-RCTs or alternative CER-based strategies that might inform practice in the absence of RCTs. Throughout, we emphasize the lack of awareness of the lay community, and indeed many researchers or commentators, in appreciating the wide variation of standard of care. There is a corresponding need to identify the best uses of available resources that will lead to the best outcomes for our patients. We conclude that CER is an essential methodology in modern neonatology to address many unanswered questions and test unproven therapies in

  2. Why Map Issues? On Controversy Analysis as a Digital Method.

    Science.gov (United States)

    Marres, Noortje

    2015-09-01

    This article takes stock of recent efforts to implement controversy analysis as a digital method in the study of science, technology, and society (STS) and beyond and outlines a distinctive approach to address the problem of digital bias. Digital media technologies exert significant influence on the enactment of controversy in online settings, and this risks undermining the substantive focus of controversy analysis conducted by digital means. To address this problem, I propose a shift in thematic focus from controversy analysis to issue mapping. The article begins by distinguishing between three broad frameworks that currently guide the development of controversy analysis as a digital method, namely, demarcationist, discursive, and empiricist. Each has been adopted in STS, but only the last one offers a digital "move beyond impartiality." I demonstrate this approach by analyzing issues of Internet governance with the aid of the social media platform Twitter.

  3. Mapping Controversies with Social Media: The Case for Symmetry

    Directory of Open Access Journals (Sweden)

    Noortje Marres

    2015-09-01

    Full Text Available This article assesses the usefulness for social media research of controversy analysis, an approach developed in Science and Technology Studies (STS and related fields. We propose that this approach can help to address an important methodological problem in social media research, namely, the tension between social media as resource for social research and as an empirical object in its own right. Initially developed for analyzing interactions between science, technology, and society, controversy analysis has in recent decades been implemented digitally to study public debates and issues dynamics online. A key feature of controversy analysis as a digital method, we argue, is that it enables a symmetrical approach to the study of media-technological dynamics and issue dynamics. It allows us to pay equal attention to the ways in which a digital platform like Twitter mediates public issues, and to how controversies mediate “social media” as an object of public attention. To sketch the contours of such a symmetrical approach, the article discusses examples from a recent social media research project in which we mapped issues of “privacy” and “surveillance” in the wake of the National Security Agency (NSA data leak by Edward Snowden in June 2013. Through a discussion of social media research practice, we then outline a symmetrical approach to analyzing controversy with social media. We conclude that the digital implementation of such an approach requires further exchanges between social media researchers and controversy analysts.

  4. The chilling effect: how do researchers react to controversy?

    Directory of Open Access Journals (Sweden)

    Joanna Kempner

    2008-11-01

    Full Text Available BACKGROUND: Can political controversy have a "chilling effect" on the production of new science? This is a timely concern, given how often American politicians are accused of undermining science for political purposes. Yet little is known about how scientists react to these kinds of controversies. METHODS AND FINDINGS: Drawing on interview (n = 30 and survey data (n = 82, this study examines the reactions of scientists whose National Institutes of Health (NIH-funded grants were implicated in a highly publicized political controversy. Critics charged that these grants were "a waste of taxpayer money." The NIH defended each grant and no funding was rescinded. Nevertheless, this study finds that many of the scientists whose grants were criticized now engage in self-censorship. About half of the sample said that they now remove potentially controversial words from their grant and a quarter reported eliminating entire topics from their research agendas. Four researchers reportedly chose to move into more secure positions entirely, either outside academia or in jobs that guaranteed salaries. About 10% of the group reported that this controversy strengthened their commitment to complete their research and disseminate it widely. CONCLUSIONS: These findings provide evidence that political controversies can shape what scientists choose to study. Debates about the politics of science usually focus on the direct suppression, distortion, and manipulation of scientific results. This study suggests that scholars must also examine how scientists may self-censor in response to political events.

  5. The Chilling Effect: How Do Researchers React to Controversy?

    Science.gov (United States)

    Kempner, Joanna

    2008-01-01

    Background Can political controversy have a “chilling effect” on the production of new science? This is a timely concern, given how often American politicians are accused of undermining science for political purposes. Yet little is known about how scientists react to these kinds of controversies. Methods and Findings Drawing on interview (n = 30) and survey data (n = 82), this study examines the reactions of scientists whose National Institutes of Health (NIH)-funded grants were implicated in a highly publicized political controversy. Critics charged that these grants were “a waste of taxpayer money.” The NIH defended each grant and no funding was rescinded. Nevertheless, this study finds that many of the scientists whose grants were criticized now engage in self-censorship. About half of the sample said that they now remove potentially controversial words from their grant and a quarter reported eliminating entire topics from their research agendas. Four researchers reportedly chose to move into more secure positions entirely, either outside academia or in jobs that guaranteed salaries. About 10% of the group reported that this controversy strengthened their commitment to complete their research and disseminate it widely. Conclusions These findings provide evidence that political controversies can shape what scientists choose to study. Debates about the politics of science usually focus on the direct suppression, distortion, and manipulation of scientific results. This study suggests that scholars must also examine how scientists may self-censor in response to political events. PMID:19018657

  6. Studying a Controversy amongst Pashtuns of Torghar, Balochistan, Pakistan

    Directory of Open Access Journals (Sweden)

    Luc Bellon

    2007-10-01

    Full Text Available Much has been written about the political structures of tribal groups. The present article looks at political dynamics amongst Pashtuns of Balochistan, through the prism of a controversy. The sociological interest of studying the arguments used during a controversy has been underlined by Boltanski and Thevenot. A controversy finishes by the establishment, through consensus, of a common agreement upon accepted norms, determined limits, redefinition of social values, etc. The advantage of focusing on the argumentation itself is to avoid taking the agreement as a pre-established social truth, a reference that concerned people would reluctantly challenge. To study a controversy is to study the social realities in the making, to study the archaeology of collective consensus, to reinstate history, contingencies and individual plurality within the social dynamics and to take seriously their performative actions alongside other social determinisms. This article shows that to study controversy is a way not only to set light on political dynamics and structures, but also to discuss the impact and definition of concepts such as segmentarity, equality, rights, interests, and their relevance within the Pashtun society which was observed.

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

    Science.gov (United States)

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

    2015-12-01

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

  8. The Controversy about Education for Citizenship: The Contested Limits of Tolerance in Spain

    Directory of Open Access Journals (Sweden)

    Flora Burchianti

    2016-05-01

    Full Text Available Education is of crucial importance to ensure social cohesion and progress in a given society. Even if the content of citizenship education has been a matter of debate in several European countries, it has taken a singular development in Spain. The important controversy that has been triggered by its introduction in secondary school curriculum is a matter of interrogation: Why did Spain react differently than other European countries? The argument put forward in this article is that education for citizenship reveals the impossibility for Spain to provide a stabilised and consensual definition of national values and identity, precisely because the country is characterised by unresolved questions about its territorial and national diversity, and exemplifies multiple diversity challenges. After providing a European contextualisation of questions of religious and values teaching in Spain, we present a chronology of the controversy and then analyse the public debate in terms of limits to tolerance. We will show that the question of the shared public values highlighted by this conflict is still unsolved and remain non-consensual in the Spanish society.

  9. Gender differences in success at quitting smoking: Short- and long-term outcomes.

    Science.gov (United States)

    Marqueta, Adriana; Nerín, Isabel; Gargallo, Pilar; Beamonte, Asunción

    2016-06-14

    Smoking cessation treatments are effective in men and women. However, possible sex-related differences in the outcome of these treatments remain a controversial topic. This study evaluated whether there were differences between men and women in the success of smoking cessation treatment, including gender-tailored components, in the short and long term (> 1 year). A telephone survey was carried out between September 2008 and June 2009 in smokers attended in a Smoking Cessation Clinic. All patients who have successfully completed treatment (3 months) were surveyed by telephone to determine their long-term abstinence. Those who remained abstinent were requested to attend the Smoking Cessation Clinic for biochemical validation (expired CO ≤10 ppm). The probability of remaining abstinent in the long-term was calculated using a Kaplan-Meier survival analysis. The treatment success rate at 3-months was 41.3% (538/1302) with no differences by sex 89% (479/538) among those located in the telephonic follow-up study and 47.6% (256/479) were abstinent without differences by sex (p = .519); abstinence was validated with CO less than 10 ppm in 191 of the 256 (53.9% men and 46.1% women). In the survival analysis, the probability of men and women remaining abstinent in the long-term was not significant. There are no differences by sex in the outcome of smoking cessation treatment that included gender-tailored components in the short and long term (> 1 year).

  10. Exxon Valdez controversy revived

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    Four years after its occurrence rocked the petroleum industry and revitalized the US environmental movement, the Exxon Valdez tanker oil spill off Alaska continues to stir controversy. Conflicting reports abound over whether there is long term damage to the Prince William Sound ecosystem resulting from the March 24, 1989, spill. Government scientists at recent conferences disclosed studies they contend show long term, significant damage to the sound. Exxon this month launched a counteroffensive, disclosing results of studies it funded that it claims show no credible scientific evidence of long term damage. At the same time, the company blasted as flawed the government's data on assessing environmental damage to the sound and charged that test samples from the sound were mishandled. Meantime, Prince William Sound still shows lingering effects from the Exxon Valdez oil spill. But recovery has been so rapid that there is more controversy over how to use $900 million in natural resource recovery funds that Exxon paid than over how badly species are suffering. The paper describes Exxon's studies; faulty data; lingering damage; and an update on tanker safety

  11. Controversy and consensus nuclear beta decay 1911-1934

    CERN Document Server

    Jensen, Carsten

    2000-01-01

    In 1920s, a long-lasting controversy on the interpretation of nuclear beta spectrum arose between Lise Meitner and Charles Drummond Ellis. This controversy, and the reactions from the contending parties when it was settled, reflect clearly the difference between the scientific communities in Berlin and Cambridge at that time. The Meitner-Ellis controversy ended in 1929, and it left an anomaly that attracted leading theoretical physicists. A new dispute, this time between Niels Bohr and Wolfgang Pauli, broke out. It concerned the explanation of the continuity of the primary beta particles and dominated the discussions for the next five years. Pauli argued for a new particle, and Bohr for a new theory; both suggestions were radical steps, but they reflected two different ways of doing physics.

  12. Controversial Science and the Media

    Science.gov (United States)

    Riordon, James

    2012-03-01

    The possibility that the OPERA collaboration has detected superluminal neutrinos was among the most controversial topics in physics news in decades, and one of the most widely covered stories in all of science in 2011. Word of the research initially reached journalists and the public prior to publication in peer-reviewed journals. Understandably, many physicists are concerned that the significance of controversial science may be exaggerated or distorted when news organizations report on science at such an early stage. I will offer an overview of the ways the story was promoted by the media relations personnel, and outline the rationales that motivate media relations efforts along with the associated benefits and drawbacks that can result. Finally, I will examine the accuracy and completeness of the superluminal neutrino news stories that ultimately were made available to the general public.

  13. Comprehension of Relations among Controversial Texts: Effects of External Strategy Use

    Science.gov (United States)

    Kobayashi, Keiichi

    2009-01-01

    This study examined the effects of external strategy use on the comprehension of relations among controversial texts. About 80 undergraduates read six controversial texts for the purpose of either finding intertextual relations or forming their opinion about the controversial issue. Half of them were permitted to use external strategies, the other…

  14. Mapping intravascular ultrasound controversies in interventional cardiology practice.

    Directory of Open Access Journals (Sweden)

    David Maresca

    Full Text Available Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innovation has been relatively limited. Intravascular ultrasound remains a niche technology; its clinical practice did not vastly expand, except in Japan, where intravascular ultrasound is an appraised tool for guiding percutaneous coronary interventions. In this qualitative research study, we follow scholarship on the sociology of innovation in exploring both the current adoption practices and perspectives on the future of intravascular ultrasound. We conducted a survey of biomedical experts with experience in the technology, the practice, and the commercialization of intravascular ultrasound. The collected information enabled us to map intravascular ultrasound controversies as well as to outline the dynamics of the international network of experts that generates intravascular ultrasound innovations and uses intravascular ultrasound technologies. While the technology is praised for its capacity to measure coronary atherosclerotic plaque morphology and is steadily used in clinical research, the lack of demonstrated benefits of intravascular ultrasound guided coronary interventions emerges as the strongest factor that prevents its expansion. Furthermore, most of the controversies identified were external to intravascular ultrasound technology itself, meaning that decision making at the industrial, financial and regulatory levels are likely to determine the future of intravascular ultrasound. In light of opinions from the responding experts', a wider adoption of intravascular ultrasound as a stand-alone imaging modality seems rather uncertain, but the appeal for this technology may be renewed by improving image quality and through combination with

  15. HPV vaccines: a controversial issue?

    Science.gov (United States)

    Nicol, A F; Andrade, C V; Russomano, F B; Rodrigues, L L S; Oliveira, N S; Provance, D W

    2016-01-01

    Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment of peer-reviewed scientific data related to measurable outcomes from the use of HPV vaccines throughout the world with focused attention on the potential adverse effects. We found that the majority of studies continue to suggest a positive risk-benefit from vaccination against HPV, with minimal documented adverse effects, which is consistent with other vaccines. However, much of the published scientific data regarding the safety of HPV vaccines appears to originate from within the financially competitive HPV vaccine market. We advocate a more independent monitoring system for vaccine immunogenicity and adverse effects to address potential conflicts of interest with regular systematic literature reviews by qualified individuals to vigilantly assess and communicate adverse effects associated with HPV vaccination. Finally, our evaluation suggests that an expanded use of HPV vaccine into more diverse populations, particularly those living in low-resource settings, would provide numerous health and social benefits.

  16. HPV vaccines: a controversial issue?

    Directory of Open Access Journals (Sweden)

    A.F. Nicol

    2016-01-01

    Full Text Available Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment of peer-reviewed scientific data related to measurable outcomes from the use of HPV vaccines throughout the world with focused attention on the potential adverse effects. We found that the majority of studies continue to suggest a positive risk-benefit from vaccination against HPV, with minimal documented adverse effects, which is consistent with other vaccines. However, much of the published scientific data regarding the safety of HPV vaccines appears to originate from within the financially competitive HPV vaccine market. We advocate a more independent monitoring system for vaccine immunogenicity and adverse effects to address potential conflicts of interest with regular systematic literature reviews by qualified individuals to vigilantly assess and communicate adverse effects associated with HPV vaccination. Finally, our evaluation suggests that an expanded use of HPV vaccine into more diverse populations, particularly those living in low-resource settings, would provide numerous health and social benefits.

  17. AMS and controversies in history The Spanish conquest of Peru

    CERN Document Server

    Zoppi, U; Jacobsen, G; Laurencich-Minelli, L; Lawson, E M; Sarkisian, G; Tuniz, C

    2000-01-01

    The quest for understanding the past often contains a subjective component. Legends, myths, traditions and personal beliefs can unconsciously influence the interpretation of the scientific outcomes or, in the worst instances, even lead to forgery. Fortunately, an increasing number of scientific tools are available nowadays and can be combined to discredit such detriments and offer more reliable foundations for an objective analysis. Radiocarbon dating by AMS is a relatively non-invasive method and is particularly useful when valuable historical artefacts are involved. In this paper, we will present controversial cases where AMS is playing an important role in understanding the past. In particular, we will discuss the use of AMS to authenticate historical documents revealing a new version of the conquest of Peru by Pizarro in the early 1530s.

  18. AMS and controversies in history: The Spanish conquest of Peru

    International Nuclear Information System (INIS)

    Zoppi, U.; Hua, Q.; Jacobsen, G.; Sarkissian, G.; Lawson, E.M.; Tuniz, C.; Laurencich Minelli, L.

    2000-01-01

    The quest for understanding the past often contains a subjective component. Legends, myths, traditions and personal beliefs can unconsciously influence the interpretation of the scientific outcomes or, in the worst instances, even lead to forgery. Fortunately, an increasing number of scientific tools are available nowadays and can be combined to discredit such detriments and offer more reliable foundations for an objective analysis. Radiocarbon dating by AMS is a relatively non-invasive method and is particularly useful when valuable historical artefacts are involved. In this paper, we will present controversial cases where AMS is playing an important role in understanding the past. In particular, we will discuss the use of AMS to authenticate historical documents revealing a new version of the conquest of Peru by Pizarro in the early 1530s

  19. Outcomes of microfracture in professional basketball players.

    Science.gov (United States)

    Cerynik, Douglas L; Lewullis, Gabriel E; Joves, Brian C; Palmer, Michael P; Tom, James A

    2009-09-01

    Surgical treatment for chondral defects of the knee in competitive running and jumping athletes remains controversial. This study evaluated the performance outcomes of professional basketball players in the National Basketball Association (NBA) who underwent microfracture. Data from 24 professional basketball players from 1997 to 2006 was obtained and analyzed. NBA player efficiency ratings (PER) were calculated for two seasons before and after injury. A control group of 24 players was used for comparison. Study group and control group demographics including age, NBA experience, and minutes per game demonstrated no statistical difference. Mean time to return to an NBA game was 30.0 weeks from the time of surgery. The first season after returning to competition PER and minutes per game decreased by 3.5 (P 0.05) and 3.0 min (P NBA game. On return to competition player performance and minutes per game are diminished.

  20. Desecuritization as Displacement of Controversy

    DEFF Research Database (Denmark)

    Jacobsen, Marc; Strandsbjerg, Jeppe

    2017-01-01

    By signing the Ilulissat Declaration of May 2008, the five littoral states of the Arctic Ocean pre-emptively desecuritized potential geopolitical controversies in the Arctic Ocean by confirming that international law and geo-science are the defining factors underlying the future delimitation...

  1. A dual role of lipasin (betatrophin) in lipid metabolism and glucose homeostasis: consensus and controversy.

    Science.gov (United States)

    Zhang, Ren; Abou-Samra, Abdul B

    2014-09-13

    Metabolic syndrome includes glucose intolerance and dyslipidemia, both of which are strong risk factors for developing diabetes and atherosclerotic cardiovascular diseases. Recently, multiple groups independently studied a previously uncharacterized gene, officially named C19orf80 (human) and Gm6484 (mouse), but more commonly known as RIFL, Angptl8, betatrophin and lipasin. Both exciting and conflicting results have been obtained, and significant controversy is ongoing. Accumulating evidence from genome wide association studies and mouse genetic studies convincingly shows that lipasin is involved in lipid regulation. However, the mechanism of action, the identity of transcription factors mediating its nutritional regulation, circulating levels, and relationship among lipasin, Angptl3 and Angptl4, remain elusive. Betatrophin represents a promising drug target for replenishing β-cell mass, but current results have not been conclusive regarding its potency and specificity. Here, we summarize the consensus and controversy regarding functions of lipasin/betatrophin based on currently available evidence.

  2. 'Mysticism' in quantum mechanics: the forgotten controversy

    International Nuclear Information System (INIS)

    Marin, Juan Miguel

    2009-01-01

    This paper argues that a European controversy over a 'mystical' hypothesis, one assigning the mind a role to play at the material level of reality, shaped much of the debate over the interpretation of the quantum equations. It traces back the controversy to the past two decades, beginning in the late 1920s-birth of quantum theory-and concluding with Erwin Schroedinger's lectures published as 'Mind and Matter'. Becoming aware of the issues at stake can help us understand the historical, philosophical and cultural background from which today's physics emerged

  3. COOPERATIVE CONTROVERSY TECHNIQUE TO IMPROVE STUDENTS’ MOTIVATION IN ENGLISH DEBATE

    Directory of Open Access Journals (Sweden)

    Suciati Suciati

    2016-03-01

    Full Text Available Many students do not like English debate. They argue that in the debate, they should apply four skills in English and should have appropriate matter, manner, and method. One of the reasons which make them do not like the debate is their lack of motivation. To solve this problem, teacher or lecturer should apply the appropriate technique in the teaching-learning process. Cooperative controversy technique is different with the traditional debate. In this technique, debaters change positions and try to reach a consensus at the end of the debate. By doing it before practicing the real English debate format, the students will get the basic knowledge about the debate so they do not directly practice the complicated one. Cooperative controversy increases the number of ideas, quality of ideas, feelings of stimulation, and enjoyment and originality of expression in creative problem solving. If it is compared to the group which does not use controversy, in controversy, the members get motivation and satisfaction in solving the problems.Keywords: English debate, students’ motivation, cooperative controversy

  4. Glucose administration after traumatic brain injury exerts some benefits and no adverse effects on behavioral and histological outcomes

    Science.gov (United States)

    Shijo, Katsunori; Ghavim, Sima; Harris, Neil G.; Hovda, David A.; Sutton, Richard L.

    2015-01-01

    The impact of hyperglycemia after traumatic brain injury (TBI), and even the administration of glucose–containing solutions to head injured patients, remains controversial. In the current study adult male Sprague-Dawley rats were tested on behavioral tasks and then underwent surgery to induce sham injury or unilateral controlled cortical impact (CCI) injury followed by injections (i.p.) with either a 50% glucose solution (Glc; 2 g/kg) or an equivalent volume of either 0.9% or 8% saline (Sal) at 0, 1, 3 and 6 h post-injury. The type of saline treatment did not significantly affect any outcome measures, so these data were combined. Rats with CCI had significant deficits in beam-walking traversal time and rating scores (p’s glucose may improve some neurological outcomes and, importantly, the induction of hyperglycemia after isolated TBI did not adversely affect any sensorimotor, cognitive or histological outcomes. PMID:25911580

  5. Risk controversies. Concepts - conflicts - communication

    International Nuclear Information System (INIS)

    Jungermann, H.

    1991-01-01

    Common arguments and differences in risk communication in connection with the controversial discussion surrounding the fields of genetic engineering, chemistry, nuclear engineering, information techniques, and climate research are investigated. Presented are comparative analyses on subjects, those becoming active, and strategies of risk communication. (DG) [de

  6. 16 CFR 2.3 - Policy as to private controversies.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Policy as to private controversies. 2.3 Section 2.3 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE... other action when the alleged violation of law is merely a matter of private controversy and does not...

  7. The Popularity of Outcome Measures for Hip and Knee Arthroplasties.

    Science.gov (United States)

    Lovelock, Thomas M; Broughton, Nigel S; Williams, Cylie M

    2018-01-01

    The optimal methods of determining outcomes following hip and knee arthroplasty remain controversial. The objectives of this study were to determine the most frequently used outcome measures in randomized controlled trials (RCT) and study protocols registered with clinical trials registries (CTR) on hip and knee arthroplasty. A systematic search strategy was undertaken to identify the outcome measures used in RCT and CTR following joint arthroplasty. Databases searched included Embase, Ovid MEDLINE (including In-Process), Cochrane Central Register of Controlled Trials, CINAHL Plus, clinicaltrials.gov, ISRCTN registry, and ANZCTR. Differences in the use of outcome measures between RCT and CTR were assessed using logistic regression. There were 291 RCT and 113 CTR on hip arthroplasty and 452 RCT and 184 CTR on knee arthroplasty that met the inclusion criteria. The most popular outcome measures were the Harris Hip Score and the Knee Society Score. Multiple outcome measures were used in greater than 50% of the included studies. The Oxford Hip Score, Oxford Knee Score, EuroQol-5D, and Knee Injury and Osteoarthritis Outcome Score (all P < .001) were used in significantly more CTR than RCT. There is a clear preference for the use of the Harris Hip Score and Knee Society Score, contrary to existing international guidelines and reviews on the topic. Both measures require clinician input, which potentially influences their validity and increases their overall administration cost. Some patient-reported outcome measures, such as the Oxford Hip and Knee Scores, EuroQol-5D, and KOOS, appear to be increasing in popularity. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Epistemic Authority and Genuine Ethical Controversies.

    Science.gov (United States)

    Roberts, Adam James

    2017-05-01

    In 'Professional Hubris and its Consequences', Eric Vogelstein claims that 'that there are no good arguments in favor of professional organizations taking genuinely controversial positions on issues of professional ethics'. In this response, I defend two arguments in favour of organisations taking such positions: that their stance-taking may lead to better public policy, and that it may lead to better practice by medical professionals. If either of those defences succeeds, then Vogelstein's easy path to his conclusion - that professional organisations should not take such stances - is blocked. He or others must instead look to establish that the reasons against stance-taking on genuine ethical controversies are more compelling than those for it: plausibly a more challenging task. © 2017 John Wiley & Sons Ltd.

  9. Controversial Issues in Learning Disability.

    Science.gov (United States)

    Sapir, Selma C.

    The author discusses controversial issues in the field of learning disabilities (LD). Among topics addressed are conflicting definitions of LD and the impact of the operational definition accepted by the US Government; etiological questions concerning the separation of neurological, environmental, and emotional factors; approaches used in training…

  10. Current controversies, is there merit?

    DEFF Research Database (Denmark)

    Twetman, S

    2009-01-01

    Xylitol has become a debated measure in caries prevention. This paper aims to examine and comment on some possible controversies, with emphasis on the most recent literature. A search for clinical trials was conducted through 2007 in PubMed, and papers describing a controlled xylitol intervention...

  11. Effects of Learning Together, Constructive Controversy in Students' Acquisition of Knowledge and Skills in Peace Education Aspect of Social Studies

    Directory of Open Access Journals (Sweden)

    Rasheed Adenrele Adetoro

    2015-04-01

    Full Text Available This study assessed the effects of two cooperative learning strategies (Learning Together and Constructive Controversy on students’ learning outcomes in Peace Education at Ogun State Junior Secondary School (JSS Level in Nigeria. A sample size of 99 students participated in the experiment from three public JSS in the state. Using Analysis of covariance for testing two null hypotheses, it was discovered that there were no significant main effects on the knowledge (F(2,78=1.429,P>0.05 and conflict resolution skills (F(2,78=0.021, P>0.05 of the students in Peace education aspect of Social Studies. However, the Multiple Classification Analysis of the adjusted post-test mean knowledge scores (14.546 of the students treated with constructive controversy was the highest while that of the students treated with learning together (70.76 was the best in conflict resolution skills. It was therefore recommended that cooperative learning strategies (especially learning together and constructive controversy should always be combined with the conventional method for teaching peace education aspect of social studies.

  12. Hydroelectric power is green, although controversial

    International Nuclear Information System (INIS)

    Schulp, A.

    2003-01-01

    Hydroelectric power is worldwide the most important source of renewable energy. Still, it has some controversial aspects, which are briefly discussed in this article, focusing on Belgium and the Netherlands [nl

  13. Surgery for hip fractures: Does surgical delay affect outcomes?

    Directory of Open Access Journals (Sweden)

    Nicole Simunovic

    2011-01-01

    Full Text Available Hip fractures are associated with a high rate of mortality and profound temporary and sometimes permanent impairment of quality of life. Current guidelines indicate that surgeons should perform surgery for a hip fracture within 24 hours of injury because earlier surgery is associated with better functional outcome and lower rates of perioperative complications and mortality. Proponents of early treatment argue that this approach minimizes the length of time a patient is confined to bed rest, thereby reducing the risk for associated complications, such as pressure sores, deep vein thrombosis, and urinary tract infections. Those favoring delaying surgery beyond the guideline recommendations believe that this approach is required to medically optimize patients, and therefore decrease the risk for perioperative complications. Further challenges to resolving this debate is the lack of an accepted definition of what should constitute an "unacceptable delay" for hip fracture surgery and the fact that outcomes associated with surgical delay are based on observational data alone (i.e., not randomized controlled trials. The effect of preoperative timing on mortality and other patient-important outcomes across various age groups remains controversial and warrants a large randomized controlled trial to offer clear insights into the effects associated with early versus delayed surgery among hip fracture patients.

  14. Teaching controversial issues in the secondary school science classroom

    Science.gov (United States)

    van Rooy, Wilhelmina

    1993-12-01

    A sample of fourteen secondary school biology teachers chosen from twelve schools were interviewed. The purpose was to determine their views on how controversial issues in science might be handled in the secondary school science classroom and whether the issues of surrogacy and human embryo experimentation were suitable controversial issues for discussion in schools. In general, teachers indicated that controversial issues deserve a more prominent place in the science curriculum because they have the potential to foster thinking, learning, and interest in science. The issues of surrogacy and human embryo experimentation were seen as appropriate contexts for learning, provided that teachers were well informed and sensitive to both the students and to the school environment.

  15. Women's Athletics: Coping with Controversy.

    Science.gov (United States)

    Hoepner, Barbara J., Ed.

    This book is a collection of papers discussing controversial topics in women's athletics. Section one, "Overview--Women's Rights," includes articles on women's rights and equal opportunities in sports, the emergence of women in sports, and significant events in a century of American women's sports. Section two, "Women's Intercollegiate…

  16. The first Pico-Ficino Controversy

    DEFF Research Database (Denmark)

    Aasdalen, Unn Irene

    2011-01-01

    -scale conflict regarding how to live and die according to Platonic ideals. The themes of the controversy are firstly the interpretation of Plato’s Symposium, in particular Diotima’s speech, and secondly the practical conclusions one should draw from Plato’s fictional banquet. Ficino’s position is presented...

  17. The design of an enzyme: a chronology on the controversy.

    Science.gov (United States)

    Buc, Henri

    2013-05-13

    After the publication of the Monod-Wyman-Changeux model, a controversy arose between Jacques Monod, Francis Crick and Jeffries Wyman about the comparison of the regulatory performances of an oligomer undergoing a concerted transition between two states and a monomer having the same composition and subjected to a similar conformational equilibrium. The controversy took place between September 1965 and March 1966. It gave rise to several unpublished notes. Numerous misunderstandings between the participants were not fully dissipated as the controversy abruptly ended. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. The role of controversy, regulation and engineering in UK biofuel development

    International Nuclear Information System (INIS)

    Boucher, Philip

    2012-01-01

    Biofuels have undergone a controversial resurgence in the UK since the turn of the century. The aim of this article is to consider this development in the context of ongoing interactions between the controversy and regulatory and engineering activities. It is found that the discursive space of the controversy has increasingly narrowed around environmental issues, particularly greenhouse gas emissions. The implications for biofuel development are considered in the context of changing regulatory and engineering visions in response to indirect land-use change. Opposition to the third generation biofuels may be softened, but it may be more difficult to justify the cost of holistic regulation of land-use change. - Highlights: ► The relationships between regulation, engineering and controversy are considered. ► The controversy has reduced, shifted focus and narrowed in scope. ► The narrowed scope may soften opposition to third generation biofuels. ► It may make it difficult to justify the cost of holistic regulation.

  19. Management and controversies of classical Hodgkin lymphoma in pregnancy.

    Science.gov (United States)

    Eyre, Toby A; Lau, I-Jun; Mackillop, Lucy; Collins, Graham P

    2015-06-01

    The goal of managing classical Hodgkin lymphoma (cHL) in pregnancy is to obtain good long-term outcomes for both the mother and fetus. Given the excellent outcomes outside of pregnancy, the goal of treatment should remain curative. There remains a tension and debate regarding the timing of chemotherapy, the curative nature of such treatment and the timing of delivery. Moreover, the aim during pregnancy should be to minimize fetal toxicity and optimize perinatal outcomes. The management of cHL within pregnancy was covered within the excellent recent British Committee for Standards in Haematology guidelines, but with necessary brevity. By reviewing the literature over the last 30 years, herein we discuss the options for management during each trimester. Critical organogenesis occurs between 2 and 8 weeks post-conception; during which time the immature fetus is vulnerable to cytotoxic exposure. We discuss the evidence for using ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) and single agent vinblastine in the first trimester. cHL presenting in pregnancy raises complex and difficult ethical dilemmas that can cause anxiety for patients, families and physicians. Decision-making must be multi-disciplinary and holistic, taking into account the patient's wishes, psycho-social and religious beliefs and personal circumstances. Clear communication between the haemato-oncologist, medical obstetrician, nurse specialists, midwives and neonatologists is paramount to a successful outcome. © 2015 John Wiley & Sons Ltd.

  20. Turkish Social Studies Teachers’ Thoughts About the Teaching of Controversial Issues

    Directory of Open Access Journals (Sweden)

    Ahmet Copur

    2016-06-01

    Full Text Available In today’s world, one of the primary goals of education is to raise individuals as citizens equipped with the skills of communication, high-level thinking, problem solving and questioning as well as with a global viewpoint. Introducing controversial issues into the classroom environment may be among the steps to be taken to achieve these goals. In this context, this study has the primary goal of revealing Social Studies teachers’ thoughts about the teaching of controversial issues in the classroom environment. This study adopted mixed methods. The study participants consisted of Social Studies teachers working in Bursa, which is a large-scale province of Turkey, in the 2014-2015 school year. According to the study findings, while terror was the most controversial issue, faith in creation was the least controversial issue. In addition, teachers mainly preferred to introduce issues related to the Social Studies curriculum and that were appropriate for the students’ preparedness. However, another result is that controversial issues contributed to students’ acquisition of personal critical skills such as high-level thinking and communication. It was also observed that the teaching of controversial issues was related to the Social Studies lesson and was important for the achievement of the goals of the lesson.

  1. Locoregional recurrence after breast-conserving therapy remains an independent prognostic factor even after an event free interval of 10 years in early stage breast cancer

    NARCIS (Netherlands)

    Tanis, E.; van de Velde, C. J. H.; Bartelink, H.; van de Vijver, M. J.; Putter, H.; van der Hage, J. A.

    2012-01-01

    Locoregional recurrence (LRR) after breast-conserving therapy is a well-known independent risk factor associated with unfavourable long-term outcome. Controversy exists concerning the prognostic impact of a LRR after a very long event-free interval. Patients who underwent breast-conserving therapy

  2. Introducing Ethics Using Structured Controversies

    Science.gov (United States)

    Wareham, David; Elefsiniotis, Takis P.; Elms, David

    2006-01-01

    This paper describes a method of introducing ethics to a second-year class of civil engineering students. The method, known as a "structured controversy", takes the form of a workshop where the students assume the identity of stakeholders having an interest in a proposed development in an environmentally sensitive region. The instructor…

  3. Current controversies and future perspectives in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Agustí, Alvar; Vestbo, Jørgen

    2011-01-01

    Over the past decade there has been much research and interest in COPD. As a result, the understanding and management of the disease has improved significantly. Yet, there are many uncertainties and controversies that require further work. This review discusses these controversies and anticipates...

  4. Weak value controversy

    Science.gov (United States)

    Vaidman, L.

    2017-10-01

    Recent controversy regarding the meaning and usefulness of weak values is reviewed. It is argued that in spite of recent statistical arguments by Ferrie and Combes, experiments with anomalous weak values provide useful amplification techniques for precision measurements of small effects in many realistic situations. The statistical nature of weak values is questioned. Although measuring weak values requires an ensemble, it is argued that the weak value, similarly to an eigenvalue, is a property of a single pre- and post-selected quantum system. This article is part of the themed issue `Second quantum revolution: foundational questions'.

  5. Review of the recent carbon dioxide-climate controversy

    International Nuclear Information System (INIS)

    Luther, F.M.; Cess, R.D.

    1992-01-01

    Model calculations of the climatic impact of the increasing atmospheric carbon dioxide (CO 2 ) concentration consistently suggest that a doubling of the CO 2 concentration would lead to a warming of global average surface air temperatures by as much as several degrees Celsius. In this appendix, this controversy about the effect of CO 2 on climate is reviewed. Because the surface energy balance approach to estimating climate sensitivity has been the source of much of the controversy, a review of this approach is presented. It is shown that prior applications of this approach violate the law of conservation of energy (the first law of thermodynamics); therefore, these results are incorrect. Empirical data indicating the relationship between atmospheric emittance and surface vapor pressure and surface air temperature are shown to be consistent with climate model calculations. Consequently, it is not the experimental data that are the basis of the controversy, but rather the analysis and interpretation of these data

  6. The economics of medicines optimization: policy developments, remaining challenges and research priorities

    Science.gov (United States)

    Faria, Rita; Barbieri, Marco; Light, Kate; Elliott, Rachel A.; Sculpher, Mark

    2014-01-01

    Background This review scopes the evidence on the effectiveness and cost-effectiveness of interventions to improve suboptimal use of medicines in order to determine the evidence gaps and help inform research priorities. Sources of data Systematic searches of the National Health Service (NHS) Economic Evaluation Database, the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects. Areas of agreement The majority of the studies evaluated interventions to improve adherence, inappropriate prescribing and prescribing errors. Areas of controversy Interventions tend to be specific to a particular stage of the pathway and/or to a particular disease and have mostly been evaluated for their effect on intermediate or process outcomes. Growing points Medicines optimization offers an opportunity to improve health outcomes and efficiency of healthcare. Areas timely for developing research The available evidence is insufficient to assess the effectiveness and cost-effectiveness of interventions to address suboptimal medicine use in the UK NHS. Decision modelling, evidence synthesis and elicitation have the potential to address the evidence gaps and help prioritize research. PMID:25190760

  7. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report.

    Science.gov (United States)

    Levey, Andrew S; de Jong, Paul E; Coresh, Josef; El Nahas, Meguid; Astor, Brad C; Matsushita, Kunihiro; Gansevoort, Ron T; Kasiske, Bertram L; Eckardt, Kai-Uwe

    2011-07-01

    The definition and classification for chronic kidney disease was proposed by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) in 2002 and endorsed by the Kidney Disease: Improving Global Outcomes (KDIGO) in 2004. This framework promoted increased attention to chronic kidney disease in clinical practice, research and public health, but has also generated debate. It was the position of KDIGO and KDOQI that the definition and classification should reflect patient prognosis and that an analysis of outcomes would answer key questions underlying the debate. KDIGO initiated a collaborative meta-analysis and sponsored a Controversies Conference in October 2009 to examine the relationship of estimated glomerular filtration rate (GFR) and albuminuria to mortality and kidney outcomes. On the basis of analyses in 45 cohorts that included 1,555,332 participants from general, high-risk, and kidney disease populations, conference attendees agreed to retain the current definition for chronic kidney disease of a GFR 30 mg/g, and to modify the classification by adding albuminuria stage, subdivision of stage 3, and emphasizing clinical diagnosis. Prognosis could then be assigned based on the clinical diagnosis, stage, and other key factors relevant to specific outcomes. KDIGO has now convened a workgroup to develop a global clinical practice guideline for the definition, classification, and prognosis of chronic kidney disease.

  8. 42 CFR 405.817 - Principles for determining amount in controversy.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Principles for determining amount in controversy... the Medicare Part B Program § 405.817 Principles for determining amount in controversy. (a) Individual... may assert that the aggregation principles contained in this subpart may be applied to determine the...

  9. Chernobylsk: a 'cloud' crosses... the facts and the controversies

    International Nuclear Information System (INIS)

    Lerouge, B.

    2008-01-01

    Twenty years after the Chernobylsk accident the effects are detailed by specialists, in radiobiology to judge the eventual sanitary injuries. It is a critical analysis that is made in this work, at the light of todays knowledge. The first part treats the question of communication, faults, late, silent. The second part is the time of controversy, the contamination in France, the radiation doses in France, thyroid cancers, the controversy of low doses effects, the controversy of sanitary consequences in USSR. The third part concerns the modernization of the nuclear world, the radiobiology, the public opinion. In annexes are: radioactivity, serious accidents, radiation doses (concepts and units), radiation protection and standards, the scientific bases of radiation protection, the figured conclusions of Chernobylsk forum, the European contamination map. (N.C.)

  10. The Satanic Ritual Abuse Controversy.

    Science.gov (United States)

    Putnam, Frank W.

    1991-01-01

    The issues raised by Jonker and Jonker-Bakker and Young et al (EC 601 187-188) illustrate a major controversy dividing the child abuse community, the alleged existence of a conspiracy of satanic, ritual, sexual abuse of children. No evidence is found to support claims that large numbers of babies and children are being sacrificed or abused in…

  11. Outcomes following prehospital airway management in severe ...

    African Journals Online (AJOL)

    Backgound. Prevention of hypoxia and thus secondary brain injury in traumatic brain injury (TBI) is critical. However there is controversy regarding the role of endotracheal intubation in the prehospital management of TBI. Objective. To describe the outcome of TBI with various airway management methods employed in the ...

  12. Histopathologic characteristics and short-term outcomes of ...

    African Journals Online (AJOL)

    Introduction: Colorectal carcinoma (CRC) is generally a disease of persons older than 40 years. Concerning younger patients, controversies still exist regarding features and prognosis of CRC. We performed this study to characterise CRC in young patients (≤40 years) as well as to evaluate short-term outcome in ...

  13. The cartoon controversy as a case of multiculturalrecognition

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2007-01-01

    The paper considers what ‘recognition' might mean in theory and which policies would in practice qualify as policies of recognition in relation to multicultural conflicts such as the ‘cartoon controversy' sparked by the publication of drawings of the Prophet Mohammad in the Danish Newspaper...... Jyllands-Posten. The paper provides a general theoretical account of recognition as a strictly political concept, including distinctions between different conceptions hereof, and asks whether the cartoon controversy can be described in these terms and what the relevant meaning of recognition might then be...

  14. Perspectives on classical controversies about the motor cortex.

    Science.gov (United States)

    Omrani, Mohsen; Kaufman, Matthew T; Hatsopoulos, Nicholas G; Cheney, Paul D

    2017-09-01

    Primary motor cortex has been studied for more than a century, yet a consensus on its functional contribution to movement control is still out of reach. In particular, there remains controversy as to the level of control produced by motor cortex ("low-level" movement dynamics vs. "high-level" movement kinematics) and the role of sensory feedback. In this review, we present different perspectives on the two following questions: What does activity in motor cortex reflect? and How do planned motor commands interact with incoming sensory feedback during movement? The four authors each present their independent views on how they think the primary motor cortex (M1) controls movement. At the end, we present a dialogue in which the authors synthesize their views and suggest possibilities for moving the field forward. While there is not yet a consensus on the role of M1 or sensory feedback in the control of upper limb movements, such dialogues are essential to take us closer to one. Copyright © 2017 the American Physiological Society.

  15. From Classroom to Controversy: Conflict in the Teaching of Religion

    Science.gov (United States)

    Neal, Lynn S.

    2013-01-01

    What happens when a class assignment becomes a source of controversy? How do we respond? What do we learn? By describing the controversy surrounding an assignment on religion and representation, this article examines conflict's productive role in teaching about New Religious Movements (NRMs) and religion. It suggests that we consider how our…

  16. Breast cancer radiotherapy: controversies and prospectives

    Institute of Scientific and Technical Information of China (English)

    YU Jin-ming; WANG Yong-sheng

    2008-01-01

    @@ Despite consensus on breast cancer radiotherapy, there are still some controversies over post-mastectomy radiotherapy (PMRT) in patients with 1-3 positive lymph nodes, accelerated partial breast irradiation (APBI), appropriate sequence of radiotherapy, chemotherapy and hormonal treatment, and radiotherapy after preoperative systemic therapy.

  17. The controversial role of food allergy in infantile colic: evidence and clinical management.

    Science.gov (United States)

    Nocerino, Rita; Pezzella, Vincenza; Cosenza, Linda; Amoroso, Antonio; Di Scala, Carmen; Amato, Francesco; Iacono, Giuseppe; Canani, Roberto Berni

    2015-03-19

    Food allergies (FAs) are an increasing problem in Western countries, affecting up to 10% of young children. FAs are frequently associated with gastrointestinal manifestations. The role of FAs as a potential causative factor for infantile colic (IC) is still controversial. We report the most recent evidence on the pathogenesis, clinical and diagnostic aspects of FA-induced infantile colic (IC) and suggest a stepwise diagnostic approach. We selected articles on clinical and immunologic features, pathogenesis and management of FAs and IC from of 1981 to 2015. Original and review articles were identified through selective searches performed on PubMed, using the following terms: colic, infantile colic, food allergy and infantile colic, infantile colic treatment. The possible relationship between FAs and IC derives from the presence of dysmotility with visceral hypersensitivity and dysbiosis, demonstrated in both conditions, and the clinical response to dietary interventions. Unfortunately, the design of the studies, poor characterization of atopy and different dietary approaches limit the understanding of the importance of FAs in subjects with IC. The role of FAs in IC subjects without other symptoms of atopy remains controversial. However, where there is a suspicion of FAs, a short trial with an extensively hydrolyzed cow's proteins formula or, if breast fed, with maternal elimination diet may be considered a reasonable option.

  18. Ego Involvement and Topic Controversiality as Related to Attitude Change.

    Science.gov (United States)

    Sledden, Elizabeth A.; Fernandez, Katherine A.

    Attitude change was measured on four different topics before and immediately after a persuasion was presented in order to compare the degree of change with the level of ego involvement as it relates to topic controversiality. Ego involvement was based on self-ratings of concern for each topic. Objective topic controversiality was based on the…

  19. Controversies in the Diagnosis and Management of NAFLD and NASH.

    Science.gov (United States)

    Rinella, Mary E; Loomba, Rohit; Caldwell, Stephen H; Kowdley, Kris; Charlton, Michael; Tetri, Brent; Harrison, Stephen A

    2014-04-01

    Nonalcoholic fatty liver disease (NAFLD) is recognized as the most common cause of chronic liver disease in the United States. Nonalcoholic steatohepatitis (NASH) occurs in a subset of patients with NAFLD and is characterized by the presence of hepa-tocellular injury, which is progressive in a substantial proportion of cases and can lead to cirrhosis and all of its complications. Although the diagnosis of NAFLD can be made through imaging studies or liver biopsy, the diagnosis of NASH still requires histologic confirmation. Liver biopsy should be performed in the presence of risk factors for advanced disease. Measures aimed at promoting weight loss, a healthier lifestyle, and optimization of metabolic risk factors remain the cornerstone of management of NAFLD. Therapeutic agents that are presently considered the most promising in NAFLD are effective in less than 50% of patients. Among patients with biopsy-proven NASH, treatment with pharmacologic agents should be considered; however, the role of specific agents in NASH still needs further study. Despite a wealth of research over the past 15 years, many controversies remain with respect to the diagnosis and management of NAFLD and NASH as well as the influence of alcohol on liver disease progression in these patients.

  20. Nosema ceranae (Microsporidia), a controversial 21st century honey bee pathogen.

    Science.gov (United States)

    Higes, Mariano; Meana, Aránzazu; Bartolomé, Carolina; Botías, Cristina; Martín-Hernández, Raquel

    2013-02-01

    The worldwide beekeeping sector has been facing a grave threat, with losses up to 100-1000 times greater than those previously reported. Despite the scale of this honey bee mortality, the causes underlying this phenomenon remain unclear, yet they are thought to be multifactorial processes. Nosema ceranae, a microsporidium recently detected in the European bee all over the world, has been implicated in the global phenomenon of colony loss, although its role remains controversial. A review of the current knowledge about this pathogen is presented focussing on discussion related with divergent results, trying to analyse the differences specially based on different methodologies applied and divisive aspects on pathology while considering a biological or veterinarian point of view. For authors, the disease produced by N. ceranae infection cannot be considered a regional problem but rather a global one, as indicated by the wide prevalence of this parasite in multiple hosts. Not only does this type of nosemosis causes a clear pathology on honeybees at both the individual and colony levels, but it also has significant effects on the production of honeybee products. © 2012 Society for Applied Microbiology and Blackwell Publishing Ltd.

  1. Short-Term Outcomes of Simultaneous Laparoscopic Colectomy and Hepatectomy for Primary Colorectal Cancer With Synchronous Liver Metastases

    Science.gov (United States)

    Inoue, Akira; Uemura, Mamoru; Yamamoto, Hirofumi; Hiraki, Masayuki; Naito, Atsushi; Ogino, Takayuki; Nonaka, Ryoji; Nishimura, Junichi; Wada, Hiroshi; Hata, Taishi; Takemasa, Ichiro; Eguchi, Hidetoshi; Mizushima, Tsunekazu; Nagano, Hiroaki; Doki, Yuichiro; Mori, Masaki

    2014-01-01

    Although simultaneous resection of primary colorectal cancer and synchronous liver metastases is reported to be safe and effective, the feasibility of a laparoscopic approach remains controversial. This study evaluated the safety, feasibility, and short-term outcomes of simultaneous laparoscopic surgery for primary colorectal cancer with synchronous liver metastases. From September 2008 to December 2013, 10 patients underwent simultaneous laparoscopic resection of primary colorectal cancer and synchronous liver metastases with curative intent at our institute. The median operative time was 452 minutes, and the median estimated blood loss was 245 mL. Median times to discharge from the hospital and adjuvant chemotherapy were 13.5 and 44 postoperative days, respectively. Negative resection margins were achieved in all cases, with no postoperative mortality or major morbidity. Simultaneous laparoscopic colectomy and hepatectomy for primary colorectal cancer with synchronous liver metastases appears feasible with low morbidity and favorable outcomes. PMID:25058762

  2. The Saga of the HIV Controversy

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 14; Issue 5. The Saga of the HIV Controversy - Nobel Prize in Physiology or Medicine - 2008. Udaykumar Ranga. General Article Volume 14 Issue 5 May 2009 pp 472-498. Fulltext. Click here to view fulltext PDF. Permanent link:

  3. Controversies: Optic nerve sheath fenestration versus shunt placement for the treatment of idiopathic intracranial hypertension

    Directory of Open Access Journals (Sweden)

    Arielle Spitze

    2014-01-01

    Full Text Available Background: Idiopathic intracranial hypertension (IIH has been increasing in prevalence in the past decade, following the obesity epidemic. When medical treatment fails, surgical treatment options must be considered. However, controversy remains as to which surgical procedure is the preferred surgical option - optic nerve sheath fenestration (ONSF or cerebrospinal fluid (CSF shunting - for the long-term treatment of this syndrome. Purpose: To provide a clinical update of the pros and cons of ONSF versus shunt placement for the treatment of IIH. Design: This was a retrospective review of the current literature in the English language indexed in PubMed. Methods: The authors conducted a PubMed search using the following terms: Idiopathic IIH, pseudotumor cerebri, ONSF, CSF shunts, vetriculo-peritoneal shunting, and lumbo-peritoneal shunting. The authors included pertinent and significant original articles, review articles, and case reports, which revealed the new aspects and updates in these topics. Results: The treatment of IIH remains controversial and lacks randomized controlled clinical trial data. Treatment of IIH rests with the determination of the severity of IIH-related visual loss and headache. Conclusion: The decision for ONSF versus shunting is somewhat institution and surgeon dependent. ONSF is preferred for patients with visual symptoms whereas shunting is reserved for patients with headache. There are positive and negative aspects of both procedures, and a prospective, randomized, controlled trial is needed (currently underway. This article will hopefully be helpful in allowing the reader to make a more informed decision until that time.

  4. Current controversies and future perspectives in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Agustí, Alvar; Vestbo, Jørgen

    2011-01-01

    Over the past decade there has been much research and interest in COPD. As a result, the understanding and management of the disease has improved significantly. Yet, there are many uncertainties and controversies that require further work. This review discusses these controversies and anticipates...... some of the changes that may occur in the near future in the field of COPD....

  5. Controversies in office based anesthesia: obstructive sleep apnea considerations.

    Science.gov (United States)

    Gupta, Ruchir; Pyati, Srinivas

    2018-05-14

    As the number of procedures being performed in the office based anesthesia (OBA) setting are increasing, so are the number of patients presenting for surgery with obstructive sleep apnea (OSA). There continues to be controversy regarding whether these patients can be safely cared for in the OBA setting. To date, no national guideline has clearly addressed this issue and while some have extrapolated lessons from what has been published for OSA in the ambulatory surgery center (ASC) setting, some argue that there is a significant difference in the availability of resources in the ASC versus the OBA setting. Those opposing OSA patients for OBA setting point to the prevalence of "practice drift," and no federal oversight as overarching reasons why the OBA is not an appropriate setting. Proponents of the OBA setting argue that a well equipped OBA can have similar resources, and therefore similar outcomes, as an OR in the ASC setting. In this paper we explore the divergent views on this topic and present some recommendations based on best evidence.

  6. Evidence to the Windscale Inquiry on the social and political implications of the nuclear controversy

    International Nuclear Information System (INIS)

    Taylor, P.J.

    1977-01-01

    Mr.Taylor's paper has the following section headings: preface; my relevant experience; the problem of controversy; the nature of the nuclear power controversy; the role of argument; paranoia and repression; structural inertia and conflict; the internationalisation of the opposition; the place of THORP in the context of an environmental revolution; the effect on THORP; the disposal controversy; the safety controversy; the psychological aspects of the nuclear controversy; nuclear power and symbolic representation; my own view as a social anthropologist (fledgling). (U.K.)

  7. Consensus or controversy? The classification and treatment decision-making by 491 maxillofacial surgeons from around the world in three cases of a unilateral mandibular condyle fracture

    NARCIS (Netherlands)

    Kommers, S.C.; Boffano, P.; Forouzanfar, T.

    2015-01-01

    Purpose Many studies are available in the literature on both classification and treatment of unilateral mandibular condyle fractures. To date however, controversy regarding the best treatment for unilateral mandibular condyle fractures remains. Material and methods In this study, an attempt was made

  8. Controversy matters: Impacts of topic and solution controversy on the perceived credibility of a scientist who advocates.

    Directory of Open Access Journals (Sweden)

    Lindsey Beall

    Full Text Available In this article, we focus on the potential influence of a scientist's advocacy position on the public's perceived credibility of scientists as a whole. Further, we examine how the scientist's solution position (information only, non-controversial, and controversial affects the public's perception of the scientist's motivation for sharing information about specific issues (flu, marijuana, climate change, severe weather. Finally, we assess how perceived motivations mediate the relationship between solution position and credibility. Using data from a quota sample of American adults obtained by Qualtrics (n = 2,453, we found that in some conditions advocating for a solution positively predicted credibility, while in one condition, it negatively predicted scientist credibility. We also found that the influence of solution position on perceived credibility was mediated by several motivation perceptions; most notably through perception that the scientist was motivated to: (a serve the public and (b persuade the public. Further results and implications are discussed.

  9. Long-term Outcomes of Paclitaxel-Eluting Versus Sirolimus-Eluting Stent for Percutaneous Coronary Intervention: A Meta-Analysis

    International Nuclear Information System (INIS)

    Kong, J.; Liu, P.; Fan, X.; Wen, J.; Zhang, J.; Zhen, Y.; Li, J.; Cui, Y.; Zheng, X.; Ye, Z.

    2017-01-01

    The relative long-term efficacy and safety of sirolimus-eluting stents (SES) compared with paclitaxel-eluting stents (PES) in multiple comparative studies remains controversial. This report evaluates 29 randomized trials with 18,379 patients in whom long-term (more than 1 year) outcomes were evaluated. The primary outcomes were target lesion revascularization (TLR) and the secondary end points were death, cardiac death, myocardial infarction (MI), major adverse cardiac events (MACEs), target vessel revascularization (TVR)and stent thrombosis (ST). In comparison with PES, SES significantly reduced the long-term risk of TLR (RR=0.68; 95% CI=0.57 to 0.80, p<0.001), TVR (RR=0.69; 95% CI= 0.60 to 0.79, p<0.001) and MACE (RR=0.82; 95% CI= 0.77 to 0.88, p<0.001), while there were no significant difference with respect to death, cardiac death, MI and ST between the two groups. SES performance was significantly better for reducing the former three outcomes and comparable for the majority of the secondary end points when compared against PES. (author)

  10. Socio-scientific controversies and beginning teachers’ pedagogical practice

    Directory of Open Access Journals (Sweden)

    Pedro Reis

    2005-08-01

    Full Text Available The current investigation aimed to study the impact of recent socio-scientific controversies, made public through the media, on the concepts and practices of a group of Natural Science teachers at the start of their careers. This study is particularly relevant at a time that is heavily marked by much debate regarding the social and environmental impact of several scientific and technological innovations and by the implementation of new science curricula, that stress the importance of discussing socio-scientific controversies in the context of students’ scientific alphabetisation (namely in their understanding of the nature of science and its relation to society and culture (McComas, 2000. This investigation followed an interpretative approach of a qualitative nature. Through the construction of case studies, it sought to analyse the possible impact of socio-scientific controversies on the teachers’ concepts (about the nature, teaching and learning of science and pedagogic practice. For data collection semi-structured interviews were conducted and classes observed.The controversial issues raised by certain recent technological innovations – namely the environmental, social and cultural impact they may have – did have an impact on the teachers’ concepts about the nature, teaching and learning of science. Besides reinforcing the duality of feelings as regards science and technology, as a source of both progress and concern, they triggered in these teachers the idea of the need for a widespread scientific alphabetisation that empowers the population for understanding and deciding and acting upon these issues. However, the concept of scientific alphabetisation and the best way to achieve it vary among the teachers participating in this study.

  11. Cartography of architectural controversies

    DEFF Research Database (Denmark)

    Lotz, Katrine

    2009-01-01

    on the visual materials and documents produced during the process, and interviews with architects, clients and engineers, I describe the continuous efforts to establish and strengthen architectural motives, and how they eventually gain the ability to align other motives and other actors. I suggest...... that employing the visualising methods of the recent development of Actor-Network-Theory called ‘Cartography of Controversies' might contribute to trans-disciplinary efforts to develop analytic understanding of the conflicting human purposes and power-struggles at stake in the be-coming of architecture....

  12. Global Banning of a Diffused Controversial Practice

    DEFF Research Database (Denmark)

    Gurses, Kerem; Giones, Ferran; Mehta, Kandarpkumar

    2017-01-01

    We study the deinstitutionalization of a controversial practice that had previously reached a level of international diffusion. We draw on international diffusion and deinstitutionalization theory to study the emergence and diffusion of the third-party ownership practice in the soccer industry. We...... use an inductive case study combining archival and interview data to study the determinants of the international diffusion of a controversial practice at a global scale, the contestation, and finally the deinstitutionalization process that resulted from the ban of the practice. We find...... that the opacity of the practice can be a diffusion driver, locally and at the international level, nevertheless the opacity also may lead to different meaning creation attempts and potential discursive battles between actors, and eventually to deinstitutionalization of the practice. This article advances our...

  13. Improving surgical outcomes

    Directory of Open Access Journals (Sweden)

    Tony Walia

    2008-12-01

    Full Text Available Outcomes of cataract surgery are worse than we would like them to be. Community-based studies show that up to 40% of eyes have a postoperative presenting vision of < 6/60. Eyes with intraocular lenses (IOLs do better; however, it has been shown that even in prosperous middle-income countries, such as Venezuela, in 20% of pseudophakic eyes presenting vision was < 6/60 and in 15% best corrected vision was worse than 6/60.Poor outcomes matter. Patients deserve improved vision whenever possible and poor outcomes deter prospective patients from coming for surgery and probably reduce their willingness to pay for their treatment – particularly if they have to pay in advance!In this article, we offer some suggestions for improving the quality of cataract surgery. We admit that there is little evidence base for most of these suggestions and that some of them are controversial. However, we hope to stimulate debate.

  14. Everything in moderation, even hype: learning from vaccine controversies to strike a balance with CRISPR.

    Science.gov (United States)

    Benston, Shawna

    2017-12-01

    The ease and applicability of CRISPR/Cas9--a new and precise gene editing and reproductive technology--have garnered hype and heightened concern about its potential 'unprecedented and horrific consequences' and have led many scientific leaders to call for a moratorium on its research and use. CRISPR appears distinctly more controversial than previous technological innovations (genetic or otherwise), with a greater reach and speed of human treatment and enhancement; however, we have seen similarly inflated hopes and fears in response to other medical innovations for well over a century. One intervention that has both historically and recently incited alarm--vaccines--serves as a pertinent example of what could go wrong if a technology's reach is shortened due to inflated fears. By comparing the vaccine controversy and the CRISPR debate, we can help separate the hype from the realistic potential of these technologies. How our society grapples with such innovations will determine the extent to which their impact on our individual and collective health will be beneficial. We must recognise the need for a tempered approach to CRISPR conversation leading to regulation and ethical application. Although CRISPR's reach will continue expanding with ongoing research, thus requiring continuous evaluation, the lessons we have learned from the vaccine controversy demonstrate that our approach must not be to shut down regulation and application now, but to thoughtfully conjoin productive debate and action so that therapeutic gene editing can alleviate suffering as soon as possible without precipitating social outcomes we would belatedly deplore. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. The use of content analysis in the assessment of medical controversies.

    Science.gov (United States)

    de Villiers, F P

    1991-12-01

    Medicine is fraught with controversies, and several strategies have been developed in order to reach rational conclusions. Examples are using more subjects or an improved research design, developing consensus statements or using meta-analysis. An additional strategy is described in this paper. The language content of scientific papers is examined to establish whether the authors use factual (informational) language or emotional appeals (directive language) to convince the reader. This type of content analysis is then applied to a sample controversy. The paper shows that directive language content analysis can be applied effectively to scientific publications to clarify the basis of and reasoning behind some controversies.

  16. Actor-network Theory and cartography of controversies in Information Science

    OpenAIRE

    LOURENÇO, Ramon Fernandes; TOMAÉL, Maria Inês

    2018-01-01

    Abstract The present study aims to discuss the interactions between the Actor-network Theory and the Cartography of Controversies method in Information Science research. A literature review was conducted on books, scholarly articles, and any other sources addressing the Theory-Actor Network and Cartography of Controversies. The understanding of the theoretical assumptions that guide the Network-Actor Theory allows examining important aspects to Information Science research, seeking to identif...

  17. Neural tube defects – recent advances, unsolved questions and controversies

    Science.gov (United States)

    Copp, Andrew J.; Stanier, Philip; Greene, Nicholas D. E.

    2014-01-01

    Neural tube defects (NTDs) are severe congenital malformations affecting around 1 in every 1000 pregnancies. Here we review recent advances and currently unsolved issues in the NTD field. An innovation in clinical management has come from the demonstration that closure of open spina bifida lesions in utero can diminish neurological dysfunction in children. Primary prevention by folic acid has been enhanced through introduction of mandatory food fortification in some countries, although not yet in UK. Genetic predisposition comprises the majority of NTD risk, and genes that regulate folate one-carbon metabolism and planar cell polarity have been strongly implicated. The sequence of human neural tube closure events remains controversial, but study of mouse NTD models shows that anencephaly, open spina bifida and craniorachischisis result from failure of primary neurulation, while skin-covered spinal dysraphism results from defective secondary neurulation. Other ‘NTD’ malformations, such as encephalocele, are likely to be post-neurulation disorders. PMID:23790957

  18. Framing effectiveness in impact assessment: Discourse accommodation in controversial infrastructure development

    Energy Technology Data Exchange (ETDEWEB)

    Rozema, Jaap G., E-mail: j.rozema@uea.ac.uk [Science, Society and Sustainability (3S) Research Group, School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ (United Kingdom); Department of Development and Planning, Aalborg University, A.C. Meyers Vænge 15, DK-2450 København SV (Denmark); Bond, Alan J. [Science, Society and Sustainability (3S) Research Group, School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ (United Kingdom); School of Geo and Spatial Sciences, Internal Box 375, North West University (Potchefstroom campus) (South Africa)

    2015-01-15

    There is ongoing debate about the effectiveness of impact assessment tools, which matters both because of the threat to future practice of the tools which are frequently perceived to be ineffective, and because of the disillusionment that can ensue, and controversy generated, amongst stakeholders in a decision context where opportunities for meaningful debate have not been provided. In this article we regard debate about the meaning of effectiveness in impact assessment as an inevitable consequence of increased participation in environmental decision-making, and therefore frame effectiveness based on an inclusive democracy role to mean the extent to which impact assessment can accommodate civil society discourse. Our aim is to investigate effectiveness based on this framing by looking at one type of impact assessment – environmental impact assessment (EIA) – in two controversial project proposals: the HS2 rail network in England; and the A4DS motorway in the Netherlands. Documentary analysis and interviews held with key civil society stakeholders have been deployed to identify discourses that were mobilised in the cases. EIA was found to be able to accommodate only one out of four discourses that were identified; for the other three it did not provide the space for the arguments that characterised opposition. The conclusion in relation to debate on framings of effectiveness is that EIA will not be considered effective by the majority of stakeholders. EIA was established to support decision-making through a better understanding of impacts, so its ineffectiveness is unsurprising when its role is perceived to be broader. However, there remains a need to map discourses in different decision contexts and to analyse the extent to which the range of discourses are accommodated throughout the decision process, and the role of impact assessment in those processes, before recommendations can be made to either improve impact assessment effectiveness, or whether it is

  19. Framing effectiveness in impact assessment: Discourse accommodation in controversial infrastructure development

    International Nuclear Information System (INIS)

    Rozema, Jaap G.; Bond, Alan J.

    2015-01-01

    There is ongoing debate about the effectiveness of impact assessment tools, which matters both because of the threat to future practice of the tools which are frequently perceived to be ineffective, and because of the disillusionment that can ensue, and controversy generated, amongst stakeholders in a decision context where opportunities for meaningful debate have not been provided. In this article we regard debate about the meaning of effectiveness in impact assessment as an inevitable consequence of increased participation in environmental decision-making, and therefore frame effectiveness based on an inclusive democracy role to mean the extent to which impact assessment can accommodate civil society discourse. Our aim is to investigate effectiveness based on this framing by looking at one type of impact assessment – environmental impact assessment (EIA) – in two controversial project proposals: the HS2 rail network in England; and the A4DS motorway in the Netherlands. Documentary analysis and interviews held with key civil society stakeholders have been deployed to identify discourses that were mobilised in the cases. EIA was found to be able to accommodate only one out of four discourses that were identified; for the other three it did not provide the space for the arguments that characterised opposition. The conclusion in relation to debate on framings of effectiveness is that EIA will not be considered effective by the majority of stakeholders. EIA was established to support decision-making through a better understanding of impacts, so its ineffectiveness is unsurprising when its role is perceived to be broader. However, there remains a need to map discourses in different decision contexts and to analyse the extent to which the range of discourses are accommodated throughout the decision process, and the role of impact assessment in those processes, before recommendations can be made to either improve impact assessment effectiveness, or whether it is

  20. Heart Failure with Recovered EF and Heart Failure with Mid-Range EF: Current Recommendations and Controversies.

    Science.gov (United States)

    Unkovic, Peter; Basuray, Anupam

    2018-04-03

    This review explores key features and potential management controversies in two emerging populations in heart failure: heart failure with recovered ejection fraction (HF-recovered EF) and heart failure with mid-range ejection fraction (HFmrEF). While HF-recovered EF patients have better outcomes than heart failure with reduced ejection fraction (HFrEF), they continue to have symptoms, persistent biomarker elevations, and abnormal outcomes suggesting a continued disease process. HFmrEF patients appear to have features of HFrEF and heart failure with preserved ejection fraction (HFpEF), but have a high prevalence of ischemic heart disease and may represent a transitory phase between the HFrEF and HFpEF. Management strategies have insufficient data to warrant standardization at this time. HF-recovered EF and HFmrEF represent new populations with unmet needs and expose the pitfalls of an EF basis for heart failure classification.

  1. Pathogenic mechanisms linking periodontal diseases with adverse pregnancy outcomes.

    Science.gov (United States)

    Cetin, I; Pileri, P; Villa, A; Calabrese, S; Ottolenghi, L; Abati, S

    2012-06-01

    In the last 2 decades, a large proportion of studies have focused on the relationship between maternal periodontal disease and poor obstetric outcomes. The aim of the present review is to summarize the current knowledge about human studies on the pathogenetic mechanisms linking periodontal diseases with adverse pregnancy outcomes. A search of the medical literature was conducted using NIH (National Institute of Health) Pubmed through April 2011. Articles were identified with the Medical Subject Heading (MeSH) and free text terms "small for gestational age (SGA)," "preeclampsia," "preterm labor," and "periodontal disease." Experimental human studies have shown that periodontal pathogens may disseminate toward placental and fetal tissues accompanied by an increase in inflammatory mediators in the placenta. As such, new inflammatory reactions within the placental tissues of the pregnant woman may occur, the physiological levels of prostaglandin E(2) (PGE(2)) and tumor necrosis factor-α (TNF-α) in the amniotic fluid may increase and eventually lead to premature delivery. Although many data from clinical trials suggest that periodontal disease may increase the adverse pregnancy outcome, the exact pathogenetic mechanism involved remains controversial. The findings explain the potential link between periodontal infections and adverse pregnancy outcomes. First, periodontal bacteria can directly cause infections both of the uteroplacenta and the fetus; second, systemic inflammatory changes induced by periodontal diseases can activate responses at the maternal-fetal interface. Of note, associative studies have produced different results in different population groups and no conclusive evidence has still been produced for the potential role of preventive periodontal care to reduce the risk factors of preterm birth.

  2. The Adverse Effect of Spasticity on 3-Month Poststroke Outcome Using a Population-Based Model

    Directory of Open Access Journals (Sweden)

    S. R. Belagaje

    2014-01-01

    Full Text Available Several devices and medications have been used to address poststroke spasticity. Yet, spasticity’s impact on outcomes remains controversial. Using data from a cohort of 460 ischemic stroke patients, we previously published a validated multivariable regression model for predicting 3-month modified Rankin Score (mRS as an indicator of functional outcome. Here, we tested whether including spasticity improved model fit and estimated the effect spasticity had on the outcome. Spasticity was defined by a positive response to the question “Did you have spasticity following your stroke?” on direct interview at 3 months from stroke onset. Patients who had expired by 90 days (n=30 or did not have spasticity data available (n=102 were excluded. Spasticity affected the 3-month functional status (β=0.420, 95 CI=0.194 to 0.645 after accounting for age, diabetes, leukoaraiosis, and retrospective NIHSS. Using spasticity as a covariable, the model’s R2 changed from 0.599 to 0.622. In our model, the presence of spasticity in the cohort was associated with a worsened 3-month mRS by an average of 0.4 after adjusting for known covariables. This significant adverse effect on functional outcomes adds predictive value beyond previously established factors.

  3. Apraxia of Speech: Concepts and Controversies

    Science.gov (United States)

    Ziegler, Wolfram; Aichert, Ingrid; Staiger, Anja

    2012-01-01

    Purpose: This article was written as an editorial to a collection of original articles on apraxia of speech (AOS) in which some of the more recent advancements in the understanding of this syndrome are discussed. It covers controversial issues concerning the theoretical foundations of AOS. Our approach was motivated by a change of perspective on…

  4. Remaining childless : Causes and consequences from a life course perspective

    NARCIS (Netherlands)

    Keizer, R.

    2010-01-01

    Little is know about childless individuals in the Netherlands, although currently one out of every five Dutch individuals remains childless. Who are they? How did they end up being childless? How and to what extent are their life outcomes influenced by their childlessness? By focusing on individual

  5. Are the alleged remains of Johann Sebastian Bach authentic?

    Science.gov (United States)

    Zegers, Richard H C; Maas, Mario; Koopman, A Ton G; Maat, George J R

    2009-02-16

    A skeleton alleged to be that of Johann Sebastian Bach (1685-1750) was exhumed from a graveyard in Leipzig, Germany, in 1894, but its authenticity is not established. In 1895, anatomist Wilhelm His concluded from his examination of the skeleton and reconstruction of the face that it most likely belonged to Bach. In 1949, surgeon Wolfgang Rosenthal noticed exostoses on the skeleton and on x-rays of 11 living organists and proposed a condition, Organistenkrankheit, which he interpreted as evidence that the skeleton was Bach's. However, our critical assessment of the remains analysis raises doubts: the localisation of the grave was dubious, and the methods used by His to reconstruct the face are controversial. Also, our study of the pelvic x-rays of 12 living professional organists failed to find evidence for the existence of Organistenkrankheit. We believe it is unlikely that the skeleton is that of Bach; techniques such as DNA analysis might help resolve the question but, to date, church authorities have not approved their use on the skeleton.

  6. Glaciers in Patagonia: Controversy and prospects

    Science.gov (United States)

    Kargel, J. S.; Alho, P.; Buytaert, W.; Célleri, R.; Cogley, J. G.; Dussaillant, A.; Guido, Z.; Haeberli, W.; Harrison, S.; Leonard, G.; Maxwell, A.; Meier, C.; Poveda, G.; Reid, B.; Reynolds, J.; Rodríguez, C. A. Portocarrero; Romero, H.; Schneider, J.

    2012-05-01

    Lately, glaciers have been subjects of unceasing controversy. Current debate about planned hydroelectric facilities—a US7- to 10-billion megaproject—in a pristine glacierized area of Patagonia, Chile [Romero Toledo et al., 2009; Vince, 2010], has raised anew the matter of how glaciologists and global change experts can contribute their knowledge to civic debates on important issues. There has been greater respect for science in this controversy than in some previous debates over projects that pertain to glaciers, although valid economic motivations again could trump science and drive a solution to the energy supply problem before the associated safety and environmental problems are understood. The connection between glaciers and climate change—both anthropogenic and natural—is fundamental to glaciology and to glaciers' practical importance for water and hydropower resources, agriculture, tourism, mining, natural hazards, ecosystem conservation, and sea level [Buytaert et al., 2010; Glasser et al., 2011]. The conflict between conservation and development can be sharper in glacierized regions than almost anywhere else. Glaciers occur in spectacular natural landscapes, but they also supply prodigious exploitable meltwater.

  7. Understanding the agreements and controversies surrounding childhood psychopharmacology

    Directory of Open Access Journals (Sweden)

    Johnston Josephine

    2008-02-01

    Full Text Available Abstract The number of children in the US taking prescription drugs for emotional and behavioral disturbances is growing dramatically. This growth in the use of psychotropic drugs in pediatric populations has given rise to multiple controversies, ranging from concerns over off-label use and long-term safety to debates about the societal value and cultural meaning of pharmacological treatment of childhood behavioral and emotional disorders. This commentary summarizes the authors' eight main findings from the first of five workshops that seek to understand and produce descriptions of these controversies. The workshop series is convened by The Hastings Center, a bioethics research institute located in Garrison, New York, U.S.A.

  8. Mercury, vaccines, and autism: one controversy, three histories.

    Science.gov (United States)

    Baker, Jeffrey P

    2008-02-01

    The controversy regarding the once widely used mercury-containing preservative thimerosal in childhood vaccines has raised many historical questions that have not been adequately explored. Why was this preservative incorporated in the first place? Was there any real evidence that it caused harm? And how did thimerosal become linked in the public mind to the "autism epidemic"? I examine the origins of the thimerosal controversy and their legacy for the debate that has followed. More specifically, I explore the parallel histories of three factors that converged to create the crisis: vaccine preservatives, mercury poisoning, and autism. An understanding of this history provides important lessons for physicians and policymakers seeking to preserve the public's trust in the nation's vaccine system.

  9. Mapping Wind Energy Controversies

    DEFF Research Database (Denmark)

    Munk, Anders Kristian

    As part the Wind2050 project funded by the Danish Council for Strategic Research we have mapped controversies on wind energy as they unfold online. Specifically we have collected two purpose built datasets, a web corpus containing information from 758 wind energy websites in 6 different countries......, and a smaller social media corpus containing information from 14 Danish wind energy pages on Facebook. These datasets have been analyzed to answer questions like: How do wind proponents and opponents organize online? Who are the central actors? And what are their matters of concern? The purpose of this report...

  10. DES the year in review: controversies.

    Science.gov (United States)

    Garg, S; Bourantas, C; Serruys, P W

    2013-04-01

    Drug-eluting stents (DES) have transformed interventional cardiology over the past decade. Whilst their efficacy has rarely been called into question, there have been concerns over the safety of the early devices, which has prompted the development of new coronary stents. Many of these new devices have entered clinical practice, however questions remain as to whether they offer the improvements in clinical outcomes that were originally anticipated. In addition, there is a debate whether the reported high efficacy of these devices enables percutaneous coronary intervention (PCI) to be performed in patient and lesion sub-groups previous entirely the domain of the cardiac surgeon. This review paper addresses these outstanding questions.

  11. Topical therapy of atopic dermatitis: controversies from Hippocrates to topical immunomodulators.

    Science.gov (United States)

    Tilles, Gérard; Wallach, Daniel; Taïeb, Alain

    2007-02-01

    Although atopic dermatitis can be treated efficiently, there is still much controversy about the risk/benefit ratio of both topical corticosteroids and topical immunomodulators. Conflicting data may be found about the usefulness of bathing, diet regulation, and other therapeutic interventions. These controversies result in part from the persistence of Hippocratic doctrines in modern medical thinking. Humoralist and diathetic doctrines, as they pertain to eczema, are reviewed. The paradoxical worsening of oozing and the deadly hazards of hospitalization before the era of antibiotics are brought to mind. We hope that this historical review will improve the understanding of current controversies and help dermatologists to manage patients with atopic dermatitis and other chronic skin diseases.

  12. Pancreatic injury in children: good outcome of nonoperative treatment.

    NARCIS (Netherlands)

    Blaauw, I. de; Winkelhorst, J.T.; Rieu, P.N.M.A.; Staak, F.H.J.M. van der; Wijnen, M.H.W.A.; Severijnen, R.S.V.M.; Vugt, A.B. van; Wijnen, R.M.H.

    2008-01-01

    PURPOSE: Treatment of blunt injury of the pancreas in children remains controversial. Some prefer nonoperative treatment, whereas others prefer operative management in selected cases. This report reviews the treatment of patients with blunt pancreatic trauma admitted to a level I pediatric trauma

  13. Controversy in the classroom: How eighth-grade and undergraduate students reason about tradeoffs of genetically modified food

    Science.gov (United States)

    Seethaler, Sherry Lynn

    Current issues in science provide a rich context for learning because they can involve complex tradeoffs that cut across traditional disciplinary boundaries. Despite this potential benefit, and the need for citizens to make decisions about such issues, science controversy remains rare in the classroom. Consequently, there is much unknown about how students make sense of complex, multidisciplinary science. This research examined eighth-grade (n = 190) and undergraduate (n = 9) students' reasoning about tradeoffs in the genetically modified food controversy (main study). To extend the findings from the main study, undergraduate students' reasoning was followed as they learned about ten additional science controversies (extension). The studies took place in the context of curricula designed on the basis of the Scaffolded Knowledge Integration Framework, which posits a set of design principles that help students form a rich, integrated network of ideas about a topic. Two new methodologies were developed for this work. The Embedded Perspective of Science Controversy was used to study students' integration of content in their written arguments (main study) and oral and written questions (extension). The Perspective views science controversy as a set of nested levels, where tradeoffs are one of the levels, but connecting to other levels (underlying scientific details, bigger picture context, etc.) is important for the weighing of tradeoffs. A scheme based on Toulmin's (1958) work on argumentation provided a way of comparing the structure of students' arguments. As indicated by pre and post test scores, the curriculum helped both eighth-grade students (t = 11.7, p genetically modified food. In their final papers, both eighth-grade and undergraduate students presented evidence for and against their positions, in contrast with prior literature showing individuals have difficulty coming up with evidence against their positions. The students were also moving across the levels

  14. Controversy, Trials, and Crime--Oh My!

    Science.gov (United States)

    Rott, Kim

    2006-01-01

    Teenagers' innate interest with the justice system is one of the reasons that so many high school literary classics teem with criminals, controversial issues, and trials. Novels such as "To Kill a Mockingbird," "A Separate Peace," "The Crucible," and "Twelve Angry Men" feature high-impact trials. In the author's desire to tap into this interest,…

  15. Ethics in science education: responsabilities and commitments with the child's moral development in the discussion of controversial subjects

    Directory of Open Access Journals (Sweden)

    Júlio César Castilho Razera

    2006-03-01

    Full Text Available A review of recent research outcomes presents in a sample of Science Education journals, shows that ethics and moral development issues have been neglected in the Science Education research. Based in theoretical referential directed toward this theme, and in a research carried out on controversial issues in the Science Teaching, such as those related to the debate creationism versus evolutionism, this paper tries to show the necessity and possibilities to take into consideration questions of this nature in classroom, in order to help developing the moral in students.

  16. Measuring biotechnology employees' ethical attitudes towards a controversial transgenic cattle project: the ethical valance matrix.

    Science.gov (United States)

    Small, Bruce H; Fisher, Mark W

    2005-01-01

    What is the relationship between biotechnology employees' beliefs about the moral outcomes of a controversial transgenic research project and their attitudes of acceptance towards the project? To answer this question, employees (n=466) of a New Zealand company, AgResearch Ltd., were surveyed regarding a project to create transgenic cattle containing a synthetic copy of the human myelin basic protein gene (hMBP). Although diversity existed amongst employees' attitudes of acceptance, they were generally: in favor of the project, believed that it should be allowed to proceed to completion, and that it is acceptable to use transgenic cattle to produce medicines for humans. These three items were aggregated to form a project acceptance score. Scales were developed to measure respondents' beliefs about the moral outcomes of the project for identified stakeholders in terms of the four principles of common morality (benefit, non-harm, justice, and autonomy). These data were statistically aggregated into an Ethical Valence Matrix fo the project. The respondents' project Ethical Valence Scores correlated significantly with their project acceptance scores (r=0.64, pethical reasoning could be a central mechanism for the evaluation of the acceptability of a project. We propose that the Ethical Valence Matrix may be used as a tool to measure ethical attitudes towards controversial issues, providing a metric for comparison of perceived ethical consequences for multiple stakeholder groups and for the evaluation and comparison of the ethical consequences of competing alternative issues or projects. The tool could be used to measure both public and special interest groups' ethical attitudes and results used for the development of socially responsible policy or by science organizations as a democratizing decision aid to selection amongst projects competing for scarce research funds.

  17. History of the Belgian nuclear power controversy

    International Nuclear Information System (INIS)

    Laes, E.

    2009-01-01

    Partly because nuclear energy technology continues to provoke profound controversy, the Flemish institute for technology assessment (viWTA) took the initiative to order a study aimed at mapping out the historical dynamics of the societal debate on nuclear energy. This study was carried out by the Belgian Nuclear Research Centre (SCK-CEN, under the research programme PISA) together with the Free university of Brussels (VUB, research group MEKO) in 2004. In 2007, the report was updated and published by Acco (Leuven) under the title Kernenergie (on)besproken. This study had three main objectives: 1) to discuss the societal debate on nuclear energy in Belgium in relation to major events (Chernobyl, TMI, etc.); 2) to elucidate the role of social actors in the controversy on both a national and international level and 3) to discuss possible alternatives for a better structuring of the debate in the future, building on existing approaches

  18. Metaphysics for an enlightened public: The controversy over monads in Germany, 1746-1748.

    Science.gov (United States)

    Broman, Thomas

    2012-03-01

    This essay analyzes the controversy that attended the prize essay question on monads proposed by the Berlin Academy of Sciences in 1746. The controversy was first touched off by an anonymous pamphlet published by the mathematician Leonhard Euler, the academy's most well known member, that attacked the doctrine of monads. It peaked with the awarding of the prize to Johann Heinrich Gottlob Justi, whose winning essay closely followed Euler's arguments. This essay discusses the controversy as one instance in a broader quarrel in the German academic community over the suitability of Christian Wolff's philosophy as the foundation for a broad range of academic disciplines, including natural philosophy. It also analyzes the controversy as displaying the central role of the periodical press in the emergent German public sphere.

  19. Long-term neurocognitive outcomes following surgery and anaesthesia in early life

    DEFF Research Database (Denmark)

    Hansen, Tom G; Engelhardt, Thomas

    2018-01-01

    PURPOSE OF REVIEW: Repeated controversial and alarming statements of the potential dangers of anaesthetic agents on neurological outcomes in children continue to be issued based primarily on preclinical studies. This review assesses the current evidence of laboratory and clinical data...

  20. Controversies in watermanagement : Frames and mental models

    NARCIS (Netherlands)

    Kolkman, Rien; van der Veen, A.; Geurts, Petrus A.T.M.

    2007-01-01

    Controversies in decision and policy-making processes can be analysed using frame reflection and mental model mapping techniques. The purpose of the method presented in this paper is to improve the quality of the information and interpretations available to decision makers, by surfacing and

  1. Debating Diversity: Ethics and Controversial Public Issues

    Science.gov (United States)

    Darr, Christopher R.

    2016-01-01

    Courses: Ethics, Organizational Communication, Political Communication. Objectives: After completing this unit activity, students should be able to (1) apply multiple ethical perspectives to real-world diversity issues in a debate format, and (2) explain the role of informational and social category diversity in current controversies.

  2. What Can We Learn from Taiwanese Teachers about Teaching Controversial Public Issues?

    Science.gov (United States)

    Hung, Yu-Han

    2016-01-01

    This study explores how history teachers in Taiwan make curricular decisions while engaging controversial public issues. The main political controversies discussed in Taiwanese society center on the relationship between Taiwan and the People's Republic of China. This study documents how four social studies teachers formulate their curricular…

  3. Atomic weight versus atomic mass controversy

    International Nuclear Information System (INIS)

    Holden, N.E.

    1985-01-01

    A problem for the Atomic Weights Commission for the past decade has been the controversial battle over the names ''atomic weight'' and ''atomic mass''. The Commission has considered the arguments on both sides over the years and it appears that this meeting will see more of the same discussion taking place. In this paper, I review the situation and offer some alternatives

  4. The Effectiveness of Nursing Education on Clinical Outcomes of Patients With Heart Failure: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Kollia

    2016-04-01

    Full Text Available Context Many nursing educational approaches have been applied on patients with heart failure (HF to improve their outcomes. The results of these approaches on outcomes of patients with HF remain controversial. Evidence Acquisition The aim of this study was to highlight the importance of nursing education to improve the outcomes of patients with HF, such as self-care behaviour, quality of life, mortality, readmission and hospitalization rates. A systematic review was conducted in the MEDLINE database on investigations punished from 2000 to 2012. The search terms used were self-care, heart failure, nursing, and education. A total of 22 studies complied with the eligibility criteria for this review. Results The findings of the reviewed studies showed that self-care behaviour of patients who received nursing education improved significantly. No significant improvement was noticed in the health-related quality of life. Additionally, there was no significant reduction in readmission, hospitalization and mortality rates of patients after implementing this educational process. Conclusions The effectiveness of nursing education on self-care behaviour of HF patients was clearly demonstrated. Methodological differences in development and implementation of education programs, made the comparison between the results of the studies difficult.

  5. Renal function, time in therapeutic range and outcomes in warfarin-treated atrial fibrillation patients

    DEFF Research Database (Denmark)

    Bonde, Anders Nissen; Lip, Gregory Y H; Kamper, Anne-Lise

    2017-01-01

    Patients with severely reduced renal function have been excluded from randomized controlled trials of oral anticoagulation in atrial fibrillation (AF). Warfarin treatment in this population is controversial and data on anticoagulation control and the impact on adverse outcomes are needed. By indi......Patients with severely reduced renal function have been excluded from randomized controlled trials of oral anticoagulation in atrial fibrillation (AF). Warfarin treatment in this population is controversial and data on anticoagulation control and the impact on adverse outcomes are needed......) was calculated using the Rosendaal method. The risk of stroke and bleeding was estimated using multivariable Cox regression analyses with eGFR and TTR estimated time dependently throughout follow-up. We identified 10,423 warfarin-treated AF patients with available international normalized ratio and creatinine...

  6. Teaching global climate change as a controversial issue - Active learning in higher education

    Energy Technology Data Exchange (ETDEWEB)

    Manolas, E.I.

    2007-07-01

    Global climate change is one of the most important controversial issues of our time. If the role of Universities is to create the leaders of tomorrow, then, the duty of teachers in institutions of higher education is to find ways to help students become aware of the problem and understand the complexity of the issue. Following presentation of the definition of controversial issues, the reasons for teaching controversial topics as well as the characteristics of controversial topics, this paper puts forward certain active learning approaches which are in conformity with such considerations without, at the same time, loosing sight of the interdisciplinary nature of the subject. The paper concludes with a discussion of the obstacles which should be overcome so that the methods put forward in this paper can be applied successfully. (orig.)

  7. Empowerment in healthcare policy making: three domains of substantive controversy.

    Science.gov (United States)

    Chiapperino, Luca; Tengland, Per-Anders

    2015-12-01

    This paper distinguishes between the uses of empowerment across different contexts in healthcare policy and health promotion, providing a model for the ethical and political scrutiny of those uses. We argue that the controversies currently engendered by empowerment are better understood by means of a historical distinction between two concepts of empowerment, namely, what we call the radical empowerment approach and the new wave of empowerment. Building on this distinction, we present a research agenda for ethicists and policy makers, highlighting three domains of controversy raised by the new wave of empowerment, namely: (1) the relationship between empowerment and paternalistic interferences on the part of professionals; (2) the evaluative commitment of empowerment strategies to the achievement of health-related goals; and (3) the problems arising from the emphasis on responsibility for health in recent uses of empowerment. Finally, we encourage the explicit theorisation of these moral controversies as a necessary step for the development and implementation of ethically legitimate empowerment processes.

  8. Effect of Malnutrition at Diagnosis on Clinical Outcomes of Children With Acute Lymphoblastic Leukemia.

    Science.gov (United States)

    Yazbeck, Nadine; Samia, Loma; Saab, Raya; Abboud, Miguel R; Solh, Hassan; Muwakkit, Samar

    2016-03-01

    Acute lymphoblastic leukemia (ALL) is the most common malignancy among children. Although studies have shown that malnutrition can negatively affect treatment outcome, results are controversial. This retrospective study aims at determining the prevalence of malnutrition and its association with treatment outcome among children with ALL treated at the Children's Cancer Institute in Lebanon. A total of 103 patients diagnosed with ALL between April 2002 and May 2010 were enrolled. Anthropometric data were collected from medical records upon diagnosis, at 3 and 6 months, and at the end of treatment. Body mass index was calculated for children 2 years of age and older, whereas weight-for-height ratio was used for patients below 2 years. Patients were considered underweight, stunted, or wasted if their Z-scores were children was 25.2% at diagnosis and remained almost the same at the end of treatment. The odds of having a poor outcome (death and relapse) was higher among malnourished children and more so among stunted children with an odds ratios=2.15; 95% confidence interval, 0.5-8.3 and odds ratio=2.63; 95% confidence interval, 0.6-11.5, respectively. Although there was a trend showing worse outcomes in malnourished children with ALL at diagnosis when compared with well-nourished children larger studies using additional tools like arm anthropometry need to be conducted to prove the association.

  9. E-cigarettes: scientific and political controversies

    OpenAIRE

    Yussuf Saloojee

    2018-01-01

    Background and challenges to implementation The e-cigarette is touted as a disruptive technology that could make combustible cigarettes obsolete. The product, its science and politics though are controversial. Intervention or response Published journal articles, reports and conference presentations on e-cigarettes were located using PubMed, plus conference, industry and other websites. These were critically reviewed. Results and lessons learnt A number of contenti...

  10. The controversy about nuclear power

    International Nuclear Information System (INIS)

    Bethe, H.A.

    1977-01-01

    A short review of the events of the past several years in the conflict in the USA between the groups supporting or opposing nuclear power. Reference is made to publications on both sides of the controversy which the author considers to be well reasoned and useful sources of information. Mention is also made of the legal and legislative actions taken by both sides. The arguments against nuclear power are summarized and solutions to the problems which are the source of these arguments are suggested

  11. Electrical stimulation in dysphagia treatment: a justified controversy?

    NARCIS (Netherlands)

    Bogaardt, H. C. A.

    2008-01-01

    Electrical stimulation in dysphagia treatment: a justified controversy? Neuromuscular electrostimulation (LAMES) is a method for stimulating muscles with short electrical pulses. Neuromuscular electrostimulation is frequently used in physiotherapy to strengthen healthy muscles (as in sports

  12. Attitude of medical professionals regarding controversial issues in kidney donation/transplantation

    Directory of Open Access Journals (Sweden)

    N Almeida

    2016-01-01

    Full Text Available There is a dire need to evaluate new strategies to bridge the wide kidney demand-supply gap. The current study examined the attitude of medical professionals regarding controversial issues pertaining to transplantation. A questionnaire, presenting controversial issues related to kidney transplantation, in an agree-disagree format with supporting reasons, was employed. The research was exploratory. Data were analyzed quantitatively and qualitatively. The sample comprised 140 doctors from Mumbai (mean = 38.1 years, standard deviation = 17.95; Males = 44.3%, Females = 55.7%. Whereas 47.1% of the participants felt that live donors should be given incentives for kidney donation, others (52.9% disagreed, fearing commercialization and illegal activities. The eligibility of patients with HIV/hepatitis for a transplant was denied by 52.9% because of poor outcomes, with the others (47.1% maintaining that these individuals too had a right to live. A substantial majority (90.7% of the participants maintained that organ donors should be given priority in the event of a future need for an organ because their previous humane act should be rewarded (47.1%. Most of the participants (91.4% felt that individuals from the higher socioeconomic strata should not receive preference for kidney transplantation. A majority (77.1% of them were also against kidney selling getting legalized. Compulsory possession of a donor card elicited mixed responses, with some accepting (56.4%, but others rejecting (43.6% this idea as donation was perceived to be a voluntary act (33.6%. While compulsory kidney donation found favor with 44.3%, it found disfavor with others (55.7%. This study will benefit transplant healthcare personnel to formulate new policies in relation to kidney donation/transplantation.

  13. The 'Effects of Transfusion Thresholds on Neurocognitive Outcome of Extremely Low Birth-Weight Infants (ETTNO)' Study

    DEFF Research Database (Denmark)

    Reinholdt, Jes; Veiergang, Gitte

    2012-01-01

    Background: Infants with extremely low birth weight uniformly develop anemia of prematurity and frequently require red blood cell transfusions (RBCTs). Although RBCT is widely practiced, the indications remain controversial in the absence of conclusive data on the long-term effects of RBCT....... Objectives: To summarize the current equipoise and to outline the study protocol of the 'Effects of Transfusion Thresholds on Neurocognitive Outcome of extremely low birth-weight infants (ETTNO)' study. Methods: Review of the literature and design of a large pragmatic randomized controlled trial...... of restrictive versus liberal RBCT guidelines enrolling 920 infants with birth weights of 400-999 g with long-term neurodevelopmental follow-up. Results and Conclusions: The results of ETTNO will provide definite data about the efficacy and safety of restrictive versus liberal RBCT guidelines in very preterm...

  14. Understanding and Developing Controversial Issues in College Courses.

    Science.gov (United States)

    Payne, Brian K.; Gainey, Randy R.

    2003-01-01

    Discusses common controversial issues in different college disciplines, such as the death penalty and drug legalization. Also suggests useful methods for encouraging enlightening discussions, such as verbal and physical cues, student-centered activities, and text selection. (SLD)

  15. [Outcomes, controversies and gastric volume after laparoscopic sleeve gastrectomy in the treatment of obesity].

    Science.gov (United States)

    García-Díaz, Juan José; Ferrer-Márquez, Manuel; Moreno-Serrano, Almudena; Barreto-Rios, Rogelio; Alarcón-Rodríguez, Raquel; Ferrer-Ayza, Manuel

    2016-01-01

    Laparoscopic sleeve gastrectomy is a surgical procedure for the treatment of morbid obesity. However, there are still controversies regarding its efficiency in terms of weight reduction and incidence of complications. In this prospective study, the experience is presented of a referral centre for the treatment of morbid obesity with laparoscopic sleeve gastrectomy. A prospective study on 73 patients subjected to laparoscopic sleeve gastrectomy from February 2009 to September 2013. Patients were followed-up for a period of 12 months, evaluating the development of complications, reduction of gastric volume, and the weight loss associated with the surgery, as well as their impact on the improvement of comorbidities present at beginning of the study. There was a statistically a significantly reduction between the preoperative body mass index (BMI) and the BMI at 12 months after laparoscopic sleeve gastrectomy (p < 0.001), despite there being an increase in the gastric volume during follow-up, measured at one month and 12 months after surgery (p < 0.001). Five patients (6.85%) had complications, with none of them serious and with no deaths in the whole series. Laparoscopic sleeve gastrectomy is a safe and effective technique for the treatment of morbid obesity. Its use is associated with a significant reduction in the presence of comorbidities associated with obesity. Multicentre studies with a longer period of monitoring are required to confirm the efficacy and safety of this surgical technique. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  16. Emergence of controversy in technology transitions: Green revolution and Bt cotton in India

    NARCIS (Netherlands)

    Ramani, S.V.; Thutupalli, A.

    2015-01-01

    Technology transitions following radical technological breakthroughs are often marked by controversies and the transitions to Green Revolution (GR) and Genetically Modified (GM) seeds in India were no exceptions to this rule. Controversies can trigger social dilemmas, but in economics we do not yet

  17. The rocky flats controversy on radionuclide soil action levels

    International Nuclear Information System (INIS)

    Earle, T.C.

    2004-01-01

    This report describes the Rocky Flats radionuclide soil action level controversy as a case study for the purpose of understanding the nature and value of stakeholder involvement in the management of radiological hazards. The report consists of three main sections. The first section outlines the Rocky Flats story, including the Cold War era, the post-Cold War era, and the transition between the two. This provides the context necessary to understand the radionuclide soil action level controversy, the main events of which are described in the second section. In the final section, the Rocky Flats case is briefly discussed within the framework of a general model of stakeholder involvement and the lessons learned from the case are identified. (author)

  18. Controversy and consensus on a clinical pharmacist in primary care in the Netherlands

    NARCIS (Netherlands)

    Hazen, Ankie C M; Wal, Aletta W Van Der; Sloeserwij, Vivianne M.; Zwart, Dorien L M; Gier, Johan J De; de Wit, Niek J; Leendertse, Anne J.; Bouvy, Marcel L.; Bont, Antoinette A De

    2016-01-01

    Background Controversy about the introduction of a non-dispensing pharmacist in primary care practice hampers implementation. Objective The aim of this study is to systematically map the debate on this new role for pharmacists amongst all stakeholders to uncover and understand the controversy and

  19. Factors Predicting a Good Symptomatic Outcome After Prostate Artery Embolisation (PAE).

    Science.gov (United States)

    Maclean, D; Harris, M; Drake, T; Maher, B; Modi, S; Dyer, J; Somani, B; Hacking, N; Bryant, T

    2018-02-26

    As prostate artery embolisation (PAE) becomes an established treatment for benign prostatic obstruction, factors predicting good symptomatic outcome remain unclear. Pre-embolisation prostate size as a predictor is controversial with a handful of papers coming to conflicting conclusions. We aimed to investigate if an association existed in our patient cohort between prostate size and clinical benefit, in addition to evaluating percentage volume reduction as a predictor of symptomatic outcome following PAE. Prospective follow-up of 86 PAE patients at a single institution between June 2012 and January 2016 was conducted (mean age 64.9 years, range 54-80 years). Multiple linear regression analysis was performed to assess strength of association between clinical improvement (change in IPSS) and other variables, of any statistical correlation, through Pearson's bivariate analysis. No major procedural complications were identified and clinical success was achieved in 72.1% (n = 62) at 12 months. Initial prostate size and percentage reduction were found to have a significant association with clinical improvement. Multiple linear regression analysis (r 2  = 0.48) demonstrated that percentage volume reduction at 3 months (r = 0.68, p < 0.001) had the strongest correlation with good symptomatic improvement at 12 months after adjusting for confounding factors. Both the initial prostate size and percentage volume reduction at 3 months predict good symptomatic outcome at 12 months. These findings therefore aid patient selection and counselling to achieve optimal outcomes for men undergoing prostate artery embolisation.

  20. Integration of basic controversies in cross-cultural psychology

    NARCIS (Netherlands)

    Poortinga, Y.H.

    2016-01-01

    This article discusses controversies in the field of cross-cultural psychology, including cultural psychology, with a view to possible integration.1 It briefly describes the indigenisation movement as a reaction against Western scientific ethnocentrism and mentions two methodological topics, that

  1. Datasprints as a method for Controversy Mapping

    DEFF Research Database (Denmark)

    Jensen, Torben Elgaard; Munk, Anders Kristian; Bach, Daniel

    2017-01-01

    A datasprint is an intensive 3-5 day workshop that brings together humanistic researchers, data experts, and stakeholders from a selected field. Together, the participants visualize and analyse a collection of data sets, which have been prepared before the datasprint. In the beginning of a datasp......A datasprint is an intensive 3-5 day workshop that brings together humanistic researchers, data experts, and stakeholders from a selected field. Together, the participants visualize and analyse a collection of data sets, which have been prepared before the datasprint. In the beginning...... of a datasprint, stakeholders present their understandings and views of the field in question. Following this, the workshop participants explore how the prepared data may shed new light on the field. The final products of a datasprint are prototypes of analyses or digital products that forms the basis for future...... collaboration between the partners. Since 2015, DIGHUMLAB has sponsored a special interest group in controversy mapping. Datasprints have proved to be a very productive format for controversy making and for creating dialogue and joint projects between humanistic researchers....

  2. The Case of the Danish Cartoons Controversy: The Paradox of Civility

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2014-01-01

    The so-called ‘Danish cartoons controversy’ set in motion by the publication of twelve drawings under the title ‘the face of Mohammed’ by the Danish broadsheet Jyllands-Posten in September 2005 has become one of the iconic controversies surrounding Islam in Europe. But the cartoon controversy...... by interpreting it in terms of the concept of ‘civility’ as a social theoretical concept and analytical category. The introduction of this analytical perspective gives a more complete picture of what was actually at stake in the cartoons controversy. The introduction of the concept of civility makes it possible...... due to the discursive logic of civility claims. This ‘paradox of civility’ is a practical problem facing any attempt by minority groups to raise issues of civility. This discursive phenomenon might have empirical explanatory significance, since the logic of claims of civility might explain some...

  3. Nonoperative management of perforated appendicitis in children: can CT predict outcome?

    International Nuclear Information System (INIS)

    Levin, Terry; Whyte, Christine; Harris, Burton; Borzykowski, Ross; Han, Bokyung; Blitman, Netta

    2007-01-01

    The optimal treatment of perforated appendicitis remains controversial, but there is a trend toward nonoperative management. CT scanning might be helpful in determining which patients could benefit from this treatment option. To determine the value of CT imaging in predicting clinical success or failure in children with nonoperative management of perforated appendicitis. Admission CT scans of 34 children with perforated appendicitis treated nonoperatively between January 2003 and June 2006 were retrospectively reviewed. All children were given intravenous antibiotics. Clinical outcome was correlated with imaging findings including the maximal area, number and complexity of collections, presence of an appendicolith or extraluminal air, and extent of intra-abdominal disease outside the right lower quadrant. Patients with an accessible simple collection were drained if their clinical condition did not improve. Successful nonoperative management was achieved in 20 patients; 14 patients failed nonoperative therapy. The presence of collections in three or more sectors (defined as the pelvis and four abdominal quadrants) correlated strongly with clinical failure (P < 0.05), while there was no correlation found between clinical outcome and the presence of an appendicolith, extraluminal air, distant ascites, and collection size or complexity. In the nonoperative management of children with perforated appendicitis, admission CT findings demonstrating disease beyond the right lower quadrant correlate with treatment failure. (orig.)

  4. Short-term outcome of posterior anorectal myectomy for treatment of ...

    African Journals Online (AJOL)

    Purpose: Many children with idiopathic constipation (IC) fail to improve with bowel management program. The role of surgical treatment in this subset of patients with intractable IC is still controversial. The aim of this study was to assess the outcome of anorectal myectomy in treatment of intractable IC. Patients and methods: ...

  5. Federal Judge Orders Showing of Controversial Film.

    Science.gov (United States)

    Flygare, Thomas J.

    1987-01-01

    Reviews a recent court decision in Nebraska regarding the cancellation of a controversial film on the University of Nebraska campus. The film was cancelled after a state senator threatened to close the theater if the movie was shown. The lawsuit alleged the university violated the First Amendment in cancelling the film; the judge ruled for the…

  6. Controversial Novels and Censorship in the Schools.

    Science.gov (United States)

    Katz, John Stuart

    The legal history of censorship in general in the United States as well as the legal context in particular of the censorship of novels from schools is discussed. This thesis deals with four novels which have aroused substantial controversy when taught in the schools. The novels are: "The Catcher in the Rye," by J. D. Salinger, "The Adventures of…

  7. Siting controversial facilities

    International Nuclear Information System (INIS)

    Baird, R.D.; Blacker, P.B.

    1985-01-01

    There is often significant difficulty involved with siting controversial facilities. The social and political problems are frequently far more difficult to resolve than the technical and economic issues. The tendancy for most developing organizations is to address only technical issues in the search for a technically optimal site, to the exclusion of such weighting considerations as the social and political climate associated with potential sites--an approach which often imperils the success of the project. The site selection processes currently suggested is summarized and two contemporary examples of their application are cited. The difference between developers' real objectives and the objectives they have implicitly assumed by adopting the recommended approaches without augmentation are noted. The resulting morass of public opposition is attributed to the failure to consider the needs of individuals and groups who stand to be negatively impacted by the development. A comprehensive implementation strategy which addresses non-technical consideration in parallel with technical ones is presented and evaluated

  8. Energy consumption and economic growth—New evidence from meta analysis

    International Nuclear Information System (INIS)

    Chen, Ping-Yu; Chen, Sheng-Tung; Chen, Chi-Chung

    2012-01-01

    The causal relationships between energy consumption and economic growth have given rise to much discussion but remain controversial. Alternative data sets based on different time spans, countries, energy policies and econometric approaches result in diverse outcomes. A meta analysis using a multinomial logit model with 174 samples governing the relationships between GDP and energy consumption is applied here to investigate the major factors that affect these controversial outcomes. The empirical results have demonstrated how the time spans, subject selections including GDP and energy consumption, econometric models, and tools for greenhouse gases emission reduction characteristics significantly affect these controversial outcomes. - Highlights: ► The controversial casual relationships between energy consumption and GDP are investigated. ► A meta analysis using a multinomial logit model is adopted. ► 74 studies governing the relationships between GDP and energy consumption was collected. ► The empirical results show how the probability of major factors affects such relationships.

  9. JUDGMENTS CONCERNING THE ACCOUNTING CONTROVERSIAL OVER THE REVALUATION OF ESTATE INVESTMENTS

    OpenAIRE

    Raluca Andreea Trandafir; Nicoleta Asalos

    2009-01-01

    The present work tackles as main theme the bookkeeping controversy, which is met when the two international audit standards are put face to face, especially IAS 16 that it refers to corporal immobilizations versus IAS 40, that it refers to an real investment. This work has as a goal the presentation and the differentiation of the bookkeeping controversy between the two audit international standards. In the first part of the work there are presented the two standards, IAS 16 corporal Immobiliz...

  10. Unconsciously against it. Psychological aspects of the nuclear controversy

    International Nuclear Information System (INIS)

    Wuenschmann, A.

    1980-06-01

    The book deals with the psychological aspects of the nuclear controversy. An attempt is made to describe, in psychological terms, arrange, explain and, in this sense, 'comprehend' the phenomenon of the nuclear controversy in the light of the following facts: - individual and archetypal spectra of associations arising in the minds of many people in combination with the term 'nuclear power plant', the existence of different psychological types; the suggestion and psychological regression in the group. Especially the nuclear opponents, more or less successfully, have used the individual and archetypal association spectrum as an instrument to further their own ends and have thus contributed to the erection of psychological barriers against nuclear power in the minds of many people. (orig./RW) [de

  11. Leptospirosis-associated acute kidney injury: penicillin at the late stage is still controversial.

    Science.gov (United States)

    Daher, E F; Silva, G B; de Abreu, K L S; Mota, R M S; Batista, D V; Rocha, N A; Araújo, S M H A; Libório, A B

    2012-08-01

    Some antimicrobial agents are active in vitro against Leptospiras. The use of penicillins at the late stage of leptospirosis is still controversial. We aimed to evaluate the use of penicillin in patients with leptospirosis-associated acute kidney injury (AKI). A retrospective study was conducted of patients with leptospirosis admitted to two hospitals in Fortaleza city, Brazil, between 1985 and 2008. AKI was defined according to the RIFLE and AKIN classifications. Patients were divided in two groups according to whether they were treated with a penicillin or not. Two hundred and eighty-seven patients were included, with an average age of 36·8±15·6 years and mostly male (80·8%). One hundred and twelve patients (39%) received a penicillin. Patients treated with a penicillin were younger (32±14 years vs. 39±16 years, P=0·0002) and had a shorter hospital stay (8·4±5·0 vs. 11±7·7 days, Ppenicillin group (111±21 vs. 119±22 mmHg, P=0·04). AKI, need of dialysis and renal recovery at the time of hospital discharge were more frequent in patients who did not use a penicillin (Ppenicillin, remains controversial. The main benefit of using penicillin in the present study was a reduction in the length of hospital stay and fewer complications, such as AKI, but its use was not associated with a decrease in mortality. On balance of risks and benefits, we recommend the use of penicillin in late-stage leptospirosis. © 2011 Blackwell Publishing Ltd.

  12. Five major controversial issues about fusion level selection in corrective surgery for adolescent idiopathic scoliosis: a narrative review.

    Science.gov (United States)

    Lee, Choon Sung; Hwang, Chang Ju; Lee, Dong-Ho; Cho, Jae Hwan

    2017-07-01

    Shoulder imbalance, coronal decompensation, and adding-on phenomenon following corrective surgery in patients with adolescent idiopathic scoliosis are known to be related to the fusion level selected. Although many studies have assessed the appropriate selection of the proximal and distal fusion level, no definite conclusions have been drawn thus far. We aimed to assess the problems with fusion level selection for corrective surgery in patients with adolescent idiopathic scoliosis, and to enhance understanding about these problems. This study is a narrative review. We conducted a literature search of fusion level selection in corrective surgery for adolescent idiopathic scoliosis. Accordingly, we selected and reviewed five debatable topics related to fusion level selection: (1) selective thoracic fusion; (2) selective thoracolumbar-lumbar (TL-L) fusion; (3) adding-on phenomenon; (4) distal fusion level selection for major TL-L curves; and (5) proximal fusion level selection and shoulder imbalance. Selective fusion can be chosen in specific curve types, although there is a risk of coronal decompensation or adding-on phenomenon. Generally, wider indications for selective fusions are usually associated with more frequent complications. Despite the determination of several indications for selective fusion to avoid such complications, no clear guidelines have been established. Although authors have suggested various criteria to prevent the adding-on phenomenon, no consensus has been reached on the appropriate selection of lower instrumented vertebra. The fusion level selection for major TL-L curves primarily focuses on whether distal fusion can terminate at L3, a topic that remains unclear. Furthermore, because of the presence of several related factors and complications, proximal level selection and shoulder imbalance has been constantly debated and remains controversial from its etiology to its prevention. Although several difficult problems in the diagnosis and

  13. Controversial Therapies for Young Children with Developmental Disabilities.

    Science.gov (United States)

    Nickel, Robert E.

    1996-01-01

    This article examines reasons parents may choose a controversial alternative treatment for a child with developmental disabilities and reviews a few specific treatments--vitamin B-6 and magnesium, auditory integration training, megavitamins and minerals, Piracetam, intravenous immunoglobulin, and melatonin. Recommendations on talking with families…

  14. Are too many inferior vena cava filters used? Controversial evidences in different clinical settings: a narrative review.

    Science.gov (United States)

    Dalla Vestra, Michele; Grolla, Elisabetta; Bonanni, Luca; Pesavento, Raffaele

    2018-03-01

    The use of inferior vena cava filters to prevent pulmonary embolism is increasing mainly because of indications that appear to be unclearly codified and recommended. The evidence supporting this approach is often heterogeneous, and mainly based on observational studies and consensus opinions, while the insertion of an IVC filter exposes patients to the risk of complications and increases health care costs. Thus, several proposed indications for an IVC filter placement remain controversial. We attempt to review the proof on the efficacy and safety of IVC filters in several "special" clinical settings, and assess the robustness of the available evidence for any specific indication to place an IVC filter.

  15. Allocative inefficiency and the capital-energy controversy

    International Nuclear Information System (INIS)

    Christopoulos, Dimitris K.; Tsionas, Efthymios G.

    2002-01-01

    The purpose of the paper is to estimate a system of input demands for Greek manufacturing deviating from the standard practice of assuming strict cost minimization. The study allows for the presence of price distortions and allocative inefficiency in the decision process. This assumption affects parameter estimates and estimated elasticities materially, and throws new light on the capital-energy controversy in Greek manufacturing

  16. Lack of Associations between Body Mass Index and Clinical Outcomes in Patients with Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Hyemi Kwon

    2015-09-01

    Full Text Available BackgroundObesity is associated with aggressive pathological features and poor clinical outcomes in breast and prostate cancers. In papillary thyroid carcinoma (PTC, these relationships remain still controversial. This study aimed to evaluate the associations between body mass index (BMI and the clinical outcomes of patients with PTC.MethodsThis retrospective study included 1,189 patients who underwent total thyroidectomy for PTCs equal to or larger than 1 cm in size. Clinical outcomes were evaluated and compared based on the BMI quartiles.ResultsThere were no significant associations between BMI quartiles and primary tumor size, extrathyroidal invasion, cervical lymph node metastasis, or distant metastasis. However, an increase in mean age was associated with an increased BMI (P for trend <0.001. Multifocality and advanced tumor-node-metastasis (TNM stage (stage III or IV were significantly associated with increases of BMI (P for trend 0.02 and <0.001, respectively. However, these associations of multifocality and advanced TNM stage with BMI were not significant in multivariate analyses adjusted for age and gender. Moreover, there were no differences in recurrence-free survivals according to BMI quartiles (P=0.26.ConclusionIn the present study, BMI was not associated with the aggressive clinicopathological features or recurrence-free survivals in patients with PTC.

  17. Pension Reform Act 2004 and its Controversies: Repeating or ...

    African Journals Online (AJOL)

    Pension Reform Act 2004 and its Controversies: Repeating or Learning from Past Mistakes? ... Journal of Research in National Development ... and discusses how the present pension reform will affect active employees when they retire.

  18. The World Congress on Controversies in Breast Cancer (CoBRA in Melbourne, Australia

    Directory of Open Access Journals (Sweden)

    Ilana Rabinoff-Sofer

    2015-03-01

    Full Text Available The World Congress on Controversies in Breast Cancer (CoBRA will take place October 22-24, 2015 in Melbourne, Australia.CoBRA is a concept congress dealing with controversial topics in breast cancer in the format of debates and discussions, allowing ample time for speaker-participant interaction.CLICK HERE for more information

  19. 37 CFR 351.3 - Controversy and further proceedings.

    Science.gov (United States)

    2010-07-01

    ..., the contested amount of a claim is $10,000 or less, the Copyright Royalty Judges shall decide the... CONGRESS COPYRIGHT ROYALTY JUDGES RULES AND PROCEDURES PROCEEDINGS § 351.3 Controversy and further... negotiation period, the Copyright Royalty Judges will issue an order declaring that further proceedings are...

  20. Some diagnostic and therapeutic controversies in glaucoma addressed

    NARCIS (Netherlands)

    Müskens, Rogier Peter Hendrik Maria

    2008-01-01

    In the five studies contained in this thesis, several controversies on the diagnosis of and therapy for glaucoma have been addressed. The first part of this thesis consisted of three studies that aimed tot improve existing technologies for diagnosing glaucoma. The latter part consisted of two

  1. Nuclear Deterrence in Cyber-ia: Challenges and Controversies

    Science.gov (United States)

    2016-09-01

    54 | Air & Space Power Journal Nuclear Deterrence in Cyber-ia Challenges and Controversies © Dr. Stephen J. Cimbala* Disclaimer: The views and...into here. 11. Mazanec, “International Order in Cyberspace,” 83. 12. Joel Brenner, Glass Houses: Privacy , Secrecy, and Cyber Insecurity in a Transparent

  2. Behavioural controversy concerning homo economicus: a Humean perspective

    Directory of Open Access Journals (Sweden)

    Khandakar Elahi

    2014-05-01

    Full Text Available In his monumental masterpiece, A Treatise on Human Nature, which explains the methodology of human reasoning concerning matters of fact and describes the roles that passions and morals play in it, Hume arrives at an enormously interesting maxim: An academic controversy cannot continue for long unless the disputants assign different meanings to the major terms employed in the debate. This theory has been applied in this paper to examine the behavioural criticisms about Homo Economicus (HE, the pivotal perception in the neoclassical microeconomic model.To achieve this objective, the paper discusses the origin and evolution of the concept, reviews behavioural criticisms, summarises the main tenets of Hume’s philosophy of human knowledge and finally examines the behavioural opinions from Hume’s perspective. The paper concludes that Hume’s theory convincingly explains the reason why the HE controversy is continuing for over half century- a fact that both the mainstream and behavioural economists are ignoring.

  3. Resolving the controversy over beneficial effects of ionizing radiation

    International Nuclear Information System (INIS)

    Cuttler, J.M.

    1999-01-01

    In spite of the extensive research carried out during the past century, intense controversy continues over the health effects of low-level radiation. This controversy is largely due to political, social and economic issues among scientists and analysts in a variety of disciplines. These issues cloud objectivity and strengthen paradigms. Over the past ten years, in 14 universities and two research institutes, Japanese scientists have conducted exceptional research which clearly demonstrates beneficial effects of low-level radiation and cancer cures following therapy with low doses of radiation. Assessment, replication and extension of this work in North America could lead to greater appreciation of its significance. Cancer patients would demand such treatments, leading to universal acceptance of these bio-positive effects and reducing public fear of nuclear technology. (author)

  4. Long-term outcome of a multidisciplinary concept of spinal dural arteriovenous fistulae treatment

    International Nuclear Information System (INIS)

    Sherif, Camillo; Gruber, Andreas; Bavinzski, Gerhard; Standhardt, Harald; Widhalm, Georg; Knosp, Engelbert; Gibson, Daniel; Richling, Bernd

    2008-01-01

    The optimal treatment of spinal dural arteriovenous fistulae (SDAVF) remains controversial and long-term follow-up data, especially data from multidisciplinary treatment, are rarely available. Thus, long-term outcomes following a multidisciplinary approach to the treatment of SDAVF were investigated. The investigation included 26 patients with SDAVF treated at the authors' department over a 15-year period including a follow-up of more than 2 years. The treatment strategy when occlusion of the draining vein could be achieved was to embolize the fistula with Histoacryl, with surgery reserved for those patients unsuitable for embolization. Posttreatment angiography followed by MRI was performed in all patients. Clinical follow-up was performed using the gait and micturition Aminoff-Logue scale scores and the modified Rankin scale score. Embolization was performed in 19 patients (73.1%), and direct surgery in 7 patients (26.9%). Follow-up angiography (at a mean of 21.7 months) showed occlusion of the SDAVF in 24 patients (92.3%). Of the 19 embolized patients, 2 (10.5%) developed recurrence secondary to insufficient occlusion of the SDAVF draining vein, and one of these two patients underwent re-embolization and one re-operation. No negative effects of SDAVF recurrence on the final clinical outcome were identified in either patient. MRI after angiography (at a mean of 91.5 months) demonstrated occlusion of all SDAVFs. After a mean clinical follow-up of 103.4 months there was a statistically significant improvement in both the modified Rankin scale score and the Aminoff-Logue gait scale score (P < 0.05). The present multidisciplinary study showed for the first time that embolization leads to stable neuroradiological results and favourable clinical outcomes even for very long follow-up times of more than 100 months. Microsurgery remains the treatment of choice when safe embolization of the draining vein cannot be achieved. (orig.)

  5. The 'Ottoman-German Jihad': Lessons for the Contemporary 'Area Studies' Controversy

    DEFF Research Database (Denmark)

    Jung, Dietrich

    2014-01-01

    The 'Arab Spring' added new fuel to the ongoing controversy over the validity of regional or area studies. None of the Middle East 'area experts' predicted the revolutionary events that led to the fall of a number of authoritarian rulers in the Arab world. As a result, scholars, the media and pol....... The article would argue that this historical dispute already reflected some of the core issues of the contemporary controversy of 'area studies' and contained some lessons for us to learn regarding the analysis of Middle Eastern economy, society and politics....

  6. Geographic variation in the surgical management of lumbar spondylolisthesis: characterizing practice patterns and outcomes.

    Science.gov (United States)

    Azad, Tej D; Vail, Daniel; O'Connell, Chloe; Han, Summer S; Veeravagu, Anand; Ratliff, John K

    2018-05-07

    The role of arthrodesis in the surgical management of lumbar spondylolisthesis remains controversial. We hypothesized that practice patterns and outcomes for this patient population may vary widely. To characterize geographic variation in surgical practices and outcomes for patients with lumbar spondylolisthesis. Retrospective analysis on a national longitudinal database between 2007 and 2014. We calculated arthrodesis rates, inpatient and long term costs, and key quality indicators (e.g. reoperation rates). Using linear and logistic regression models, we then calculated expected quality indicator values, adjusting for patient-level demographic factors, and compared these values to the observed values, to assess quality variation apart from differences in patient populations. We identified a cohort of 67,077 patients (60.7% female, mean age of 59.8 years (SD, 12.0) with lumbar spondylolisthesis who received either laminectomy or laminectomy with arthrodesis. The majority of patients received arthrodesis (91.8%). Actual rates of arthrodesis varied from 97.5% in South Dakota to 81.5% in Oregon. Geography remained a significant predictor of arthrodesis even after adjusting for demographic factors (pgeographic variation was also observed in initial costs ($32,485 in Alabama to $78,433 in Colorado), two-year post-operative costs ($15,612 in Arkansas to $34,096 in New Jersey), length of hospital stay (2.6 days in Arkansas to 4.5 in Washington, D.C.), 30-day complication rates (9.5% in South Dakota to 22.4% in Maryland), 30-day readmission rates (2.5% in South Dakota to 13.6% in Connecticut), and reoperation rates (1.8% in Maine to 12.7% in Alabama). There is marked geographic variation in the rates of arthrodesis in treatment of spondylolisthesis within the United States. This variation remains pronounced after accounting for patient-level demographic differences. Costs of surgery and quality outcomes also vary widely. Further study is necessary to understand the drivers

  7. Controversies in water management: Frames and mental models

    International Nuclear Information System (INIS)

    Kolkman, M.J.; Veen, A. van der; Geurts, P.A.T.M.

    2007-01-01

    Controversies in decision and policy-making processes can be analysed using frame reflection and mental model mapping techniques. The purpose of the method presented in this paper is to improve the quality of the information and interpretations available to decision makers, by surfacing and juxtaposing the different frames of decision makers, experts, and special interests groups. The research provides a new method to analyse frames. It defines a frame to consist of perspectives and a mental model, which are in close interaction (through second order learning processes). The mental model acts like a 'filter' through which the problem situation is observed. Five major perspective types guide the construction of meaning out of the information delivered by the mental model, and determine what actors see as their interests. The perspective types are related to an actor's institutional and personal position in the decision making process. The method was applied to a case, in order to test its viability. The case concerns the decision making process and environmental impact assessment procedure for the improvement of dike ring 53 in the Netherlands, which was initiated by the Dutch 'Flood Defences Act 1996'. In this specific case the perspectives and mental models of stakeholders were elicited to explain controversies. The case was analysed with regard to the conflicts emerging between stakeholders, on an individual level. The influence of institutional embedding of individuals on the use of information and the construction of meaning, and the limits of a participatory approach were analysed within the details of controversies that emerged during the case analysis. Complicating factor appeared to be the interaction between national dike safety norms (short term) and local water management problems (long term). Revealed controversies mainly concerned disputes between an organisational and a technical perspective. But also disputes on distribution of responsibilities

  8. Epidemiology and treatment outcome of surgically treated mandibular condyle fractures. A five years retrospective study.

    Science.gov (United States)

    Zrounba, Hugues; Lutz, Jean-Christophe; Zink, Simone; Wilk, Astrid

    2014-09-01

    Surgical management of mandibular condyle fractures is still controversial. Although it provides better outcome than closed treatment questions still remain about the surgical approach and the osteosynthesis devices to be used. Between 2005 and 2010, we managed 168 mandibular condyle fractures with open treatment. Two surgical approaches were used in this study, a pre-auricular and a high submandibular approach (one or the other or as a combined approach). Internal fixation was performed using TCP(®) plates (Medartis, Basel, Switzerland) or with two lag screws (15 and 17 mm). Delta plates were used in 15 cases (8.9%). We report the epidemiology of these fractures and the outcomes of the surgical treatment. We assessed the complications related to the surgical procedure and those related to the osteosynthesis material. The facial nerve related complication rate was very low and the osteosynthesis materials used proved to be strong enough to realize a stable fixation. The two approaches used in this study appeared to be safe with good aesthetic results. Most of the surgical procedure failures occurred in high subcondylar fractures especially when bilateral. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  9. Socio-Scientific Controversial Issues in 1st Cycle of Basic Education

    Directory of Open Access Journals (Sweden)

    Fábio Ribeiro

    2014-12-01

    Full Text Available Assuming the importance of science education, from early years, aiming to educate citizens capable of thinking critically and act in scientific and technological contexts, a study was carried out in order to develop learning situations focused on controversial socio-scientific issues to promote students’ argumentation skills and scientific knowledge building / mobilization. The study was based on a qualitative methodology, following an action research plan. It was conducted with a class of 3th grade, having been addressed controversial socio-scientific issues, framed in science curriculum topics, using strategies of debate, role-play and argumentative essays. Data was collected using an analyzing instrument of student´s oral and written productions. In data analysis the privileged technique was content analysis. The results suggest that students mobilized requested scientific knowledge, showing improvement in the effective use of argumentation skills required. This allows us to conclude that the approach of controversial socio-scientific issues contributes to the promotion students´ argumentation skills as well as for scientific knowledge construction / mobilization.

  10. Long-term outcomes of laparoscopic surgery for advanced transverse colon cancer.

    Science.gov (United States)

    Zhao, Liying; Wang, Yanan; Liu, Hao; Chen, Hao; Deng, Haijun; Yu, Jiang; Xue, Qi; Li, Guoxin

    2014-05-01

    The role of laparoscopic surgery for advanced transverse colon cancer (TCC) remains controversial, especially in terms of long-term oncologic outcomes. This retrospective cohort study enrolled 157 consecutive patients who underwent curable resections for advanced TCC between January 2002 and June 2011 (laparoscopic-assisted colectomy (LAC), n = 74; open colectomy (OC), n = 83). Short-term outcomes and oncologic long-term outcomes were compared between the two groups. Compared to the OC group, patients in the LAC group had less blood loss (LAC vs. OC, 79.6 ± 70.3 vs. 158.4 ± 89.3 ml, p < 0.001), faster return of bowel function (2.6 ± 0.7 vs. 3.8 ± 0.8 days, p < 0.001), and shorter postoperative hospital stay (10.3 ± 3.7 vs. 12.6 ± 6.0 days, p = 0.007). Conversions were required in four (5.4%) patients. Rates of short-term complication, mortality, and long-term complication were comparable between the two groups. The median follow-up time was 54 (26-106) months in the LAC group and 58 (29-113) months in the OC group (p = 0.407). There were no statistical differences in the rates of 5-year overall survival (73.6 vs. 71.1%, p = 0.397) and 5-year disease-free survival (70.5 vs. 66.7%, p = 0.501) between the two groups. Laparoscopic surgery for advanced TCC yield short-term benefits while achieving equivalent long-term oncologic outcomes.

  11. Radiotherapy in prostate cancer. Innovative techniques and current controversies

    International Nuclear Information System (INIS)

    Geinitz, Hans

    2015-01-01

    Examines in detail the role of innovative radiation techniques in the management of prostate cancer, including IMRT, IGRT, BART, and modern brachytherapy. Explores a range of current controversies in patient treatment. Intended for both radiation oncologists and urologists. Radiation treatment is rapidly evolving owing to the coordinated research of physicists, engineers, computer and imaging specialists, and physicians. Today, the arsenal of ''high-precision'' or ''targeted'' radiotherapy includes multimodal imaging, in vivo dosimetry, Monte Carlo techniques for dose planning, patient immobilization techniques, intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), biologically adapted radiotherapy (BART), quality assurance methods, novel methods of brachytherapy, and, at the far end of the scale, particle beam radiotherapy using protons and carbon ions. These approaches are like pieces of a puzzle that need to be put together to provide the prostate cancer patient with high-level optimized radiation treatment. This book examines in detail the role of the above-mentioned innovative radiation techniques in the management of prostate cancer. In addition, a variety of current controversies regarding treatment are carefully explored, including whether prophylactic treatment of the pelvic lymphatics is essential, the magnitude of the effect of dose escalation, whether a benefit accrues from hypofractionation, and what evidence exists for the superiority of protons or heavy ions. Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies is intended for both radiation oncologists and urologists with an interest in the up-to-date capabilities of modern radiation oncology for the treatment of prostate cancer.

  12. Addressing the controversy regarding the association between thimerosal-containing vaccines and autism

    OpenAIRE

    García-Fernández, Lisset; Unidad de Análisis y Generación de Evidencias en Salud Pública (UNAGESP), Instituto Nacional de Salud. Lima, Perú. Médica infectóloga.; Hernández, Adrián V.; Unidad de Análisis y Generación de Evidencias en Salud Pública (UNAGESP), Instituto Nacional de Salud. Lima, Perú. Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland. Ohio, EE. UU. médico epidemiólogo clínico, PhD in Health Science.; Suárez Moreno, Víctor; Unidad de Análisis y Generación de Evidencias en Salud Pública (UNAGESP), Instituto Nacional de Salud. Lima, Perú. médico infectólogo, MPH in Public Health.; Fiestas, Fabián; Unidad de Análisis y Generación de Evidencias en Salud Pública (UNAGESP), Instituto Nacional de Salud. Lima, Perú. médico epidemiólogo.

    2014-01-01

    Vaccination is one of the most important public health interventions in the reduction childhood morbidity and mortality. Thimerosal is an organic mercury compound used as preservante in multi-dose vials. Often in Peru, there are waves of controversy about the safety of this type of vaccines, mainly arguing that there is an association between them and autism. As a result of these controversies, there have been some voices asking for laws banning thimerosal-containing vaccines, which would...

  13. Does Controversial Science Call For Public Participation? The Case Of Gmo Skepticism

    Directory of Open Access Journals (Sweden)

    Andreas Christiansen

    2017-12-01

    Full Text Available Many instances of new and emerging science and technology are controversial. Although a number of people, including scientific experts, welcome these developments, a considerable skepticism exists among members of the public. The use of genetically modified organisms (GMOs is a case in point. In science policy and in science communication, it is widely assumed that such controversial science and technology require public participation in the policy-making process. We examine this view, which we call the Public Participation Paradigm, using the case of GMOs as an example. We suggest that a prominent reason behind the call for public participation is the belief that such participation is required for democratic legitimacy. We then show that the most prominent accounts of democratic legitimacy do not, in fact, entail that public participation is required in cases of controversial science in general, or in the case of GMOs in particular.

  14. Cognitive outcome of surgery.

    Science.gov (United States)

    Gallagher, Anne; Jambaqué, Isabelle; Lassonde, Maryse

    2013-01-01

    Epilepsy surgery is now widely accepted as an effective therapeutic option for carefully selected children with medically refractory epilepsy. The surgical procedure may cause cognitive deficits or exacerbate existing impairments, but it may also improve cognitive abilities by the restoration of functions located in adjacent or contralateral areas that had been secondarily affected by the epilepsy or the underlying pathology. Compared to adults, better cognitive outcome has been reported in children, a finding probably due to the developing state of the brain, which possesses considerable structural and functional plasticity. More extensive and effective surgery such as hemispherectomy is more commonly used in the pediatric population, and this must also influence surgical outcome. However, studies related to cognitive outcome of epilepsy surgery in children are limited, and controversial results are often reported. In this chapter, we provide a current overview of the literature on cognitive outcomes in children who undergo different types of epilepsy surgery, including focal resections as well as corpus callosotomy and hemispherectomy. Early surgical intervention appears to be a rational option for the treatment of childhood epilepsy since many cognitive deficits are linked to the epileptic process and may disappear when seizures are controlled. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Diversity in Information Technology Education: Issues and Controversies

    Science.gov (United States)

    Trajkovski, Goran, Ed.

    2006-01-01

    "Diversity in Information Technology Education: Issues and Controversies" sheds light on the status of diversity in the field of IT education. It identifies a wide range of problems that educators face on a daily basis, and gives practical, applicable solutions, mainly by showcasing successful and replicable examples. The chapters in "Diversity in…

  16. Update on the surgical management of ulcerative colitis and ulcerative proctitis: current controversies and problems.

    Science.gov (United States)

    Sagar, P M; Pemberton, J H

    1995-01-01

    : The surgical management of ulcerative colitis has been revolutionized in recent years by the development of the ileal pouch-anal procedure. Although it is now the operation of choice for most patients, there remain several controversies. A variety of designs of ileal pouch are available each with advantages and disadvantages. The technique used to anastomose the pouch to the anal canal is also open to debate with some surgeons favoring distal mucosectomy with eradication of all disease and others choosing to perform a stapled anastomosis to achieve better functional results. The main concern for gastroenterologists, however, is the risk of development of pouchitis. The etiology, diagnosis, and treatment of this condition will also be discussed in this review as well as the more classical options for the surgical treatment of ulcerative colitis.

  17. Awakening the Sufferers: Reflections on Public Relations, Activism, and Subalternity in Postcolonial Controversies between Taiwan and Japan

    DEFF Research Database (Denmark)

    Sejrup, Jens

    2014-01-01

    and analysing the public relations implications of two politically sensitive and controversial cases, I question the nature of representative relations as reflected in mainstream mass media coverage in these two societies. Doing so, I raise concerns about the critical scope of scholarly interest in activism...... and the representation of other voices in public relations studies and draw on theoretical insights from Spivak, Guha, and others in order to untangle some of the complexities inherent in the mobilization of subaltern groups, here victims of historical abuse and maltreatment. The existence of such complexities in public...... and legal activism, I argue, remains largely ignored in public relations studies, despite the emergence of a new critical or postmodern paradigm....

  18. Hermeneutics versus science in psychoanalysis: a resolution to the controversy over the scientific status of psychoanalysis.

    Science.gov (United States)

    Fusella, Paul

    2014-12-01

    The controversy over the scientific status of psychoanalysis is investigated and a resolution is proposed. The positions held by the hermeneuticists, conveyed through the hermeneutic interpretation of psychoanalysis put forth by Jurgen Habermas and Paul Ricoeur, are reviewed. The views of psychoanalysis as a science held by the philosopher of science Adolf Grünbaum and by American psychoanalyst Robert S. Wallerstein are also considered. Psychoanalysis remains relevant today because it has situated itself among the other disciplines as a hybrid science, not quite a pure hermeneutic on the one hand, and not quite a pure science on the other, while at the same time having proven to be both these things-and in doing so has revolutionized the way we think about human nature.

  19. Darwinian Controversies: An Historiographical Recounting

    Science.gov (United States)

    Depew, David J.

    2010-05-01

    This essay reviews key controversies in the history of the Darwinian research tradition: the Wilberforce-Huxley debate in 1860, early twentieth-century debates about the heritability of acquired characteristics and the consistency of Mendelian genetics with natural selection; the 1925 Scopes trial about teaching evolution; tensions about race, culture, and eugenics at the 1959 centenary celebration Darwin’s Origin of Species; adaptationism and its critics in the Sociobiology debate of 1970s and, more recently, Evolutionary Psychology; and current disputes about Intelligent Design. These controversies, I argue, are etched into public memory because they occur at the emotionally charged boundaries between public-political, technical-scientific, and personal-religious spheres of discourse. Over most of them falls the shadow of eugenics. The main lesson is that the history of Darwinism cannot be told except by showing the mutual influence of the different norms of discourse that obtain in the personal, technical, and public spheres. Nor can evolutionary biology successfully be taught to citizens and citizens-to-be until the fractious intersections between spheres of discourse have been made explicit. In the course of showing why, I take rival evolutionary approaches to be dynamical historical research traditions rather than static theories. Accordingly, I distinguish Darwin’s version of Darwinism from its later transformations. I pay special attention to the role Darwin assigned to development in evolution, which was marginalized by twentieth-century population genetical Darwinism, but has recently resurfaced in new forms. I also show how the disputed phrases “survival of the fittest” and “social Darwinism” have shaped personal anxieties about “Darwinism,” have provoked public opposition to teaching evolution in public schools, and have cast a shadow over efforts to effectively communicate to the public largely successful technical efforts to make

  20. Taking One's Principles Seriously: A Teacher Confronts Controversy

    Science.gov (United States)

    Hare, William

    2010-01-01

    A teacher faces hostility from certain colleagues who view his decision to attend a controversial lecture as tantamount to the repudiation of the principle of inclusive education and the rights of students with disabilities. The teacher sees the proposed boycott of the lecture as a form of censorship threatening freedom of inquiry and critical…

  1. Outcomes of endoscopic repair of cerebrospinal fluid rhinorrhea without lumbar drains.

    Science.gov (United States)

    Adams, Austin S; Russell, Paul T; Duncavage, James A; Chandra, Rakesh K; Turner, Justin H

    2016-11-01

    Lumbar drains (LD) are commonly used during endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea, either to facilitate graft healing or to monitor CSF fluid dynamics. However, the indications and necessity of LD placement remains controversial. The current study sought to evaluate endoscopic CSF leak repair outcomes in the setting of limited LD use. Patients who underwent endoscopic repair of CSF rhinorrhea between 2004 and 2014 were identified by a review of medical records. Demographic and clinical data were extracted and compared between patients who had surgery with and patients who had surgery without a perioperative LD. A univariate analysis was performed to identify factors predictive of recurrence. A total of 107 patients (116 surgical procedures) were identified, with a mean follow-up of 15.8 months. Eighty-eight of 107 patients (82.2%) had surgery without an LD. The mean hospital stay was 4.48 days in the LD group versus 1.03 days in the non-LD group (p CSF leak repair was not associated with reduced recurrence rates, regardless of leak etiology, and resulted in a significant increase in hospital length of stay. Although the use of perioperative LDs to monitor CSF dynamics may have some therapeutic and diagnostic advantages, it may not be associated with clinically significant improvements in patient outcomes or recurrence rates.

  2. Preparing student teachers to address complex learning and controversy with middle grades students

    OpenAIRE

    Smith, Ann Marie; Lennon, Sean

    2011-01-01

    This qualitative study explores pre-service teachers’ perceptions of teaching critical literacy through discussions of controversial issues. Personality questionnaires were given to six classes of pre-student teachers over three semesters in order to gauge interest in teaching methods that incorporate inquiry learning and critical literacy. The results of this study suggest that these pre-service teachers were generally unwilling to discussing controversial issues in their classes. Also some ...

  3. Should We Teach Homosexuality as a Controversial Issue?

    Science.gov (United States)

    Hand, Michael

    2007-01-01

    Philosophers of education disagree on how the question of the moral status of homosexual acts should be tackled in the classroom. Some argue that the question should be taught as a controversial issue, that we should present rival moral positions as even-handedly as possible; others maintain that we should actively promote the view that homosexual…

  4. Radiotherapy in prostate cancer. Innovative techniques and current controversies

    Energy Technology Data Exchange (ETDEWEB)

    Geinitz, Hans [Krankenhaus der Barmherzigen Schwestern, Linz (Austria). Dept. of Radiation Oncology; Linz Univ. (Austria). Medical Faculty; Roach, Mack III [California Univ., San Francisco, CA (United States). Dept. of Radiation Oncology; Van As, Nicholas (ed.) [The Institute of Cancer Research, Sutton Surrey (United Kingdom)

    2015-04-01

    Examines in detail the role of innovative radiation techniques in the management of prostate cancer, including IMRT, IGRT, BART, and modern brachytherapy. Explores a range of current controversies in patient treatment. Intended for both radiation oncologists and urologists. Radiation treatment is rapidly evolving owing to the coordinated research of physicists, engineers, computer and imaging specialists, and physicians. Today, the arsenal of ''high-precision'' or ''targeted'' radiotherapy includes multimodal imaging, in vivo dosimetry, Monte Carlo techniques for dose planning, patient immobilization techniques, intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), biologically adapted radiotherapy (BART), quality assurance methods, novel methods of brachytherapy, and, at the far end of the scale, particle beam radiotherapy using protons and carbon ions. These approaches are like pieces of a puzzle that need to be put together to provide the prostate cancer patient with high-level optimized radiation treatment. This book examines in detail the role of the above-mentioned innovative radiation techniques in the management of prostate cancer. In addition, a variety of current controversies regarding treatment are carefully explored, including whether prophylactic treatment of the pelvic lymphatics is essential, the magnitude of the effect of dose escalation, whether a benefit accrues from hypofractionation, and what evidence exists for the superiority of protons or heavy ions. Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies is intended for both radiation oncologists and urologists with an interest in the up-to-date capabilities of modern radiation oncology for the treatment of prostate cancer.

  5. [Foucault, Derrida, and the history of madness: notes on a controversy].

    Science.gov (United States)

    Pereira Neto, A F

    1998-01-01

    The publication of the book Folie et Déraison. Histoire de la Folie à l'Age Classique (1961), by Michel Foucault, sparked a debate between the author and philosopher Jacques Derrida during the 1960s and 70s. Derrida criticized the methodological proposal and organization of the History of Madness presented by Foucault in the foreword to the first edition. The controversy appears to have motivated the author to withdraw this same foreword from the second edition. The purpose of this article is to analyze some current points in this controversy. It also presents a research agenda for an understanding of the reasons leading Foucault to take this stance.

  6. Imaging Management of Breast Density, a Controversial Risk Factor for Breast Cancer.

    Science.gov (United States)

    Falcon, Shannon; Williams, Angela; Weinfurtner, Jared; Drukteinis, Jennifer S

    2017-04-01

    Breast density is well recognized as an independent risk factor for the development of breast cancer. However, the magnitude of risk is controversial. As the public becomes increasingly aware of breast density as a risk factor, legislation and notification laws in relation to breast density have become common throughout the United States. Awareness of breast density as a risk factor for breast cancer presents new challenges for the clinician in the approach to the management and screening of women with dense breasts. The evidence and controversy surrounding breast density as a risk factor for the development of breast cancer are discussed. Common supplemental screening modalities for breast cancer are also discussed, including tomosynthesis, ultrasonography, and magnetic resonance imaging. A management strategy for screening women with dense breasts is also presented. The American College of Radiology recognizes breast density as a controversial risk factor for breast cancer, whereas the American Congress of Obstetricians and Gynecologists recognizes breast density as a modest risk factor. Neither organization recommends the routine use of supplemental screening in women with dense breasts without considering additional patient-related risk factors. Breast density is a poorly understood and controversial risk factor for the development of breast cancer. Mammography is a screening modality proven to reduce breast cancer-related mortality rates and is the single most appropriate tool for population-based screening. Use of supplemental screening modalities should be tailored to individual risk assessment.

  7. Social reporting, engagements, controversies and conflict in an arena context

    NARCIS (Netherlands)

    Georgakopoulos, G.; Thomson, I.

    2008-01-01

    Purpose - To empirically investigate relationships between engagement activities and social reporting practices in a controversial and environmentally sensitive industry. The interactions investigated were not restricted to stakeholder relationships but included other communications between

  8. The development of mathematics education as seen in mathematics education controversies in Japan

    OpenAIRE

    Makinae , Naomichi

    2016-01-01

    International audience; It can be said that mathematics education in Japan was started in 1872 when the school system was established. Since that establishment era, controversies have emerged time and again in mathematics education in Japan. Through these controversies, debates have been held on views on mathematics education such as how mathematics ought to be taught and what constitutes knowledge concerning numbers, quantities, and shapes that is desirable for students to acquire. In this ...

  9. The Use and Abuse of "Universal Values" in the Danish Cartoon Controversy

    DEFF Research Database (Denmark)

    Rostbøll, Christian Fogh

    's embodiment of these values from the more abstract ideas. To avoid self-contradiction, liberal principles and constitutional norms should not be seen as incontestable aspects of democracy but rather as subject to recursive democratic justification and revision by everyone subject to them. Newcomers should......During the Danish cartoon controversy in 2005-2006 appeals to universal liberal values were often made in ways that marginalized Muslims. An analysis of the controversy shows that referring to "universal values" can be exclusionary when dominant actors fail to distinguish their own culture...

  10. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues

    Science.gov (United States)

    Russo, Ethan B.

    2016-01-01

    This overview covers a wide range of cannabis topics, initially examining issues in dispensaries and self-administration, plus regulatory requirements for production of cannabis-based medicines, particularly the Food and Drug Administration “Botanical Guidance.” The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer, and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions, and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability (DAL) of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety, and public health issues remain. PMID:27683558

  11. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues.

    Directory of Open Access Journals (Sweden)

    Ethan Budd Russo

    2016-09-01

    Full Text Available This overview covers a wide range of cannabis topics, initially examining issue in dispensaries and self-administration, plus regulatory requirement for production of cannabis-based medicines, particularly the Food and Drug Administration Botanical Guidance. The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety and public health issues remain.

  12. De-escalating Antibiotic Use in the Inpatient Setting: Strategies, Controversies, and Challenges.

    Science.gov (United States)

    Daniel Markley, J; Bernard, Shaina; Bearman, Gonzalo; Stevens, Michael P

    2017-04-01

    Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting. A consensus definition of ADE remains elusive at this time. Preliminary studies utilizing rapid diagnostic tests including matrix-assisted laser desorption/ionization time of flight (MALDI-TOF), procalcitonin, and other molecular techniques have demonstrated the potential to support ADE strategies. In the absence of evidence-based, highly specific ADE protocols, the likelihood that individual providers will make consistent, often challenging, decisions to de-escalate antibiotic therapy is low. Antimicrobial stewardship programs should support local physicians with ADE and develop innovative ways to integrate ADE into the broader construct of antimicrobial stewardship programs. The evolving field of rapid diagnostics has significant potential to improve ADE strategies, but more research is needed to fully realize this goal.

  13. Cause for controversy? Infliximab in the treatment of ulcerative colitis: an update

    Directory of Open Access Journals (Sweden)

    Garrett Lawlor

    2009-12-01

    Full Text Available Garrett Lawlor, Alan C MossBeth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USAAbstract: Infliximab is a monoclonal antibody against tumor necrosis factor (TNF which has become an established therapy for Crohn’s disease over the last 10 years. Given the similarities between Crohn’s disease and ulcerative colitis (UC, it is no surprise that gastroenterologists have used infliximab in patients with UC who have failed other therapies. Although the initial controlled trials with infliximab in steroid-refractory disease were unimpressive, subsequent controlled trials have demonstrated the efficacy of infliximab in both moderate to severe disease, and as rescue-therapy to avoid colectomy. The long-term remission rates, colectomy-sparing effects, and the impact of concomitant immunomodulator therapy, remain to be determined in these patients. Whether infliximab is a superior strategy to cyclosporine in patients with steroidrefractory disease is controversial. This review examines the data on the efficacy and safety of infliximab as an induction and maintenance agent for UC.Keywords: ulcerative colitis, infliximab, biologics

  14. Evidence-Based Management and Controversies in Blunt Splenic Trauma

    NARCIS (Netherlands)

    Olthof, D. C.; van der Vlies, C. H.; Goslings, J. C.

    2017-01-01

    The study aims to describe the evidence-based management and controversies in blunt splenic trauma. A shift from operative management to non-operative management (NOM) has occurred over the past decades where NOM has now become the standard of care in haemodynamically stable patients with blunt

  15. Congenital bronchopulmonary foregut malformations: concepts and controversies

    International Nuclear Information System (INIS)

    Newman, Beverley

    2006-01-01

    This article addresses the scope, etiology, important associations and imaging features of congenital bronchopulmonary foregut malformations. Etiologic concepts, including airway obstruction and vascular anomalies, are highlighted. Technical imaging advances, especially CT and MR, have greatly enhanced our diagnostic abilities in evaluating these lesions; however, thorough and careful assessment of all aspects of the malformation is still necessary. Several specific lesions are discussed in more detail, particularly regarding controversial issues in classification, understanding, imaging and management. (orig.)

  16. Congenital bronchopulmonary foregut malformations: concepts and controversies

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [University of Pittsburgh School of Medicine and Children' s Hospital of Pittsburgh, Pittsburgh, PA (United States)

    2006-08-15

    This article addresses the scope, etiology, important associations and imaging features of congenital bronchopulmonary foregut malformations. Etiologic concepts, including airway obstruction and vascular anomalies, are highlighted. Technical imaging advances, especially CT and MR, have greatly enhanced our diagnostic abilities in evaluating these lesions; however, thorough and careful assessment of all aspects of the malformation is still necessary. Several specific lesions are discussed in more detail, particularly regarding controversial issues in classification, understanding, imaging and management. (orig.)

  17. Child injury control: trends, themes, and controversies.

    Science.gov (United States)

    Johnston, Brian D; Ebel, Beth E

    2013-01-01

    Injury is a major cause of morbidity and mortality among US children, and an important driver of health status globally. Despite its enormous burden, injury is preventable. Over the last 10 years, significant progress has been made in the reduction of unintentional injury among US children. However, aggregate trends mask important disparities by age group, region, and injury mechanism. Basic and translation research is needed to develop and test prevention strategies to address these new or recalcitrant problems. Motor vehicle occupant injury has fallen to historic lows, but challenges remain in protecting novice drivers and managing the distraction of new technologies. Injury to pedestrians has also declined, but likely as a result of decreased exposure as fewer children walk. This calls for a broader public health perspective to promote activity while enhancing safety. Deaths due to drowning are common and illustrate the difficulty in measuring and promoting appropriate supervision. Environmental modification and use of protective products may be a more appropriate response. Concussion in sport is another challenging issue: public health laws promote identification and appropriate management of concussed athletes, but less progress has been made on primary prevention of these injuries. Unintentional poisoning is on the rise, attributable to misuse of, and overdose with, prescription opioids. Injury deaths to infants are also increasing. This trend is driven in part by better death investigation that classifies more sleep-related deaths as suffocation events. Finally, we examine a sample of cross-cutting themes and controversies in injury control that might be amenable to empiric evaluation. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. [The controversy of routine articulator mounting in orthodontics].

    Science.gov (United States)

    Wang, Li; Han, Xianglong; Bai, Ding

    2013-06-01

    Articulators have been widely used by clinicians of dentistry. But routine articulator mounting is still controversial in orthodontics. Orthodontists oriented by gnathology approve routine articulator mounting while nongnathologic orthodontists disapprove it. This article reviews the thoughts of orthodontist that they agree or disagree with routine articulator mounting based on the considerations of biting, temporomandibular disorder (TMD), periodontitis, and so on.

  19. Recognized Obstructive Sleep Apnea is Associated With Improved In-Hospital Outcomes After ST Elevation Myocardial Infarction.

    Science.gov (United States)

    Mohananey, Divyanshu; Villablanca, Pedro A; Gupta, Tanush; Agrawal, Sahil; Faulx, Michael; Menon, Venugopal; Kapadia, Samir R; Griffin, Brian P; Ellis, Stephen G; Desai, Milind Y

    2017-07-20

    Obstructive sleep apnea (OSA) is an independent risk factor for many cardiovascular conditions such as coronary artery disease, myocardial infarction, systemic hypertension, pulmonary hypertension, and stroke. However, the association of OSA with outcomes in patients hospitalized for ST-elevation myocardial infarction remains controversial. We used the nation-wide inpatient sample between 2003 and 2011 to identify patients with a primary discharge diagnosis of ST-elevation myocardial infarction and then used the International Classification of Diseases, Clinical Modification code 327.23 to identify a group of patients with OSA. The primary outcome of interest was in-hospital mortality, and secondary outcomes were in-hospital cardiac arrest, length of stay and hospital charges. Our cohort included 1 850 625 patients with ST-elevation myocardial infarction, of which 1.3% (24 623) had documented OSA. OSA patients were younger and more likely to be male, smokers, and have chronic pulmonary disease, depression, hypertension, known history of coronary artery disease, dyslipidemia, obesity, and renal failure ( P ST-elevation myocardial infarction patients with recognized OSA had significantly decreased mortality compared with patients without OSA. Although patients with OSA had longer hospital stays and incurred greater hospital charges, there was no difference in incidence of in-hospital cardiac arrest. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  20. Clinical outcomes of laparoscopic surgery for advanced transverse and descending colon cancer: a single-center experience.

    Science.gov (United States)

    Yamamoto, Masashi; Okuda, Junji; Tanaka, Keitaro; Kondo, Keisaku; Tanigawa, Nobuhiko; Uchiyama, Kazuhisa

    2012-06-01

    The role of laparoscopic surgery in management of transverse and descending colon cancer remains controversial. The aim of the present study is to investigate the short-term and oncologic long-term outcomes associated with laparoscopic surgery for transverse and descending colon cancer. This cohort study analyzed 245 patients (stage II disease, n = 70; stage III disease, n = 63) who underwent resection of transverse and descending colon cancers, including 200 laparoscopic surgeries (LAC) and 45 conventional open surgeries (OC) from December 1996 to December 2010. Short-term and oncologic long-term outcomes were recorded. The operative time was longer in the LAC group than in the OC group. However, intraoperative blood loss was significantly lower and postoperative recovery time was significantly shorter in the LAC group than in the OC group. The 5-year overall and disease-free survival rates for patients with stage II were 84.9% and 84.9% in the OC group and 93.7% and 90.0% in the LAC group, respectively. The 5-year overall and disease-free survival rates for patients with stage III disease were 63.4% and 54.6% in the OC group and 66.7% and 56.9% in the LAC group, respectively. Use of laparoscopic surgery resulted in acceptable short-term and oncologic outcomes in patients with advanced transverse and descending colon cancer.

  1. The nuclear controversy as reflected in the daily newspapers

    International Nuclear Information System (INIS)

    Buire, S. van.

    1980-01-01

    The development and utilization of nuclear energy has led to conflicts of larger dimensions in our society. What has been the role of the mass communication media in this discussion. Did they fulfill their duty to inform the public, did they actively foster discussions about the facts to be considered, and did they play their part in public opinion making by publishing critical analyses. These are questions answered by this book by presenting analyses of newspaper articles on the nuclear controversy, facts and figures on the opinions and information published in the daily newspapers on the subject of nuclear energy utilization, and analyses of tendencies pro or contra nuclear energy as expressed by the various articles. By an evaluation of the history of discussions, the development and modifications of the arguments put forward and the reactions shown by the various social groups involved in the process are illustrated and commented in the light of the controversy becoming more acute. (orig./HP) [de

  2. Nuclear energy: public controversies and the analysis of risks

    International Nuclear Information System (INIS)

    Sills, D.L.

    1984-01-01

    Energy is a social concept, the product of social, economic, and political processes that define certain raw materials as resources and thus convert them into usable energy. Like all social concepts, energy is controversial. Out of a wide range of controversies, three are selected for analysis here: (1) the relationship of nuclear power systems to nuclear weapons proliferation; (2) the risks of terrorism and sabotage associated with the operation of nuclear power facilities, including threats to civil liberties; and (3) the problems associated with the long-term management of radioactive wastes. The final section of the paper describes various modes of analyzing risks and the perception of risks. It is concluded that it may take many decades to learn whether nuclear energy is as natural a source of electrical power as wells are of drinking water, or whether nuclear energy is a horror that mankind in the 1980s or 1990s took a hard look at and then backed away. (author)

  3. Dissociative identity disorder: a controversial diagnosis.

    Science.gov (United States)

    Gillig, Paulette Marie

    2009-03-01

    A brief description of the controversies surrounding the diagnosis of dissociative identity disorder is presented, followed by a discussion of the proposed similarities and differences between dissociative identity disorder and borderline personality disorder. The phenomenon of autohypnosis in the context of early childhood sexual trauma and disordered attachment is discussed, as is the meaning of alters or alternate personalities. The author describes recent neurosciences research that may relate the symptoms of dissociative identity disorder to demonstrable disordered attention and memory processes. A clinical description of a typical patient presentation is included, plus some recommendations for approaches to treatment.

  4. The Life of Stars The Controversial Inception and Emergence of the Theory of Stellar Structure

    CERN Document Server

    Shaviv, Giora

    2009-01-01

    This beautifully illustrated book describes the birth and evolution of the theory of stellar structure through the vehement controversy between biology (as presented by Darwin) and physics (as presented by Kelvin) about the age of the Earth, which culminated with Rutherford suggesting radioactive dating. Shaviv analyzes critically many proclaimed scientific results, showing how and why they were wrong, and explains why it took decades to find the now accepted scientific answers - where there are such - and why there remains much more to be done before we can say we fully understand what happens up there in the heavens. The Life of the Stars provides fascinating reading for all those interested in the stars, in the history of astronomy and in what their story tells us about how science progresses. Moreover, it will bring readers up-to-date on current problems in astrophysics.

  5. Teaching Controversy by Seminar: An Example in Quaternary Geomorphology.

    Science.gov (United States)

    Harwood, Doug

    1987-01-01

    Describes how seminar work can be structured to help students develop skills of critical thinking and expression when discussing controversial issues in their chosen subject. Particular emphasis is given to methods of organizing instructional materials and appropriate roles for seminar leaders. The debate surrounding the existence of a prehistoric…

  6. Early Controversies over Athetosis: I. Clinical Features, Differentiation from other Movement Disorders, Associated Conditions, and Pathology

    Directory of Open Access Journals (Sweden)

    Douglas J. Lanska

    2013-03-01

    Full Text Available Background: Since the description of athetosis in 1871 by American neurologist William Alexander Hammond (1828-1900 the disorder has been a source of controversy, as were many aspects of Hammond’s career.  Methods: Review of controversies in the semi-centennial since the description of athetosis.  Results: Hammond struggled to establish athetosis as a distinct clinic-pathological entity, and had successfully predicted the striatal pathology in his initial case (albeit somewhat serendipitously.  Athetosis was, nevertheless, considered by many neurologists to be a form of post-hemiplegic chorea or part of a continuum between chorea and dystonia. European neurologists, and particularly the French, initially ignored or discounted the concept. Additional controversies arose over whether the movements persisted during sleep, whether athetosis was, or could be, associated with imbecility or insanity, and how it should be treated. Discussion: Some controversies concerning athetosis served to identify areas where knowledge was insufficient to make accurate statements, despite prior self-assured or even dogmatic statements to the contrary.  Other controversies illustrated established prejudices, even if these biases were often only apparent with the greater detachment of hindsight. 

  7. The mesh controversy [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Joshua A. Cohn

    2016-09-01

    Full Text Available Pelvic organ prolapse and stress urinary incontinence are common conditions for which approximately 11% of women will undergo surgical intervention in their lifetime. The use of vaginal mesh for pelvic organ prolapse and stress urinary incontinence rose rapidly in the early 2000s as over 100 mesh products were introduced into the clinical armamentarium with little regulatory oversight for their use. US Food and Drug Administration Public Health Notifications in 2008 and 2011, as well as reclassification of transvaginal mesh for prolapse to class III in early 2016, were a response to debilitating complications associated with transvaginal mesh placement in many women. The midurethral sling has not been subject to the same reclassification and continues to be endorsed as the “gold standard” for surgical management of stress urinary incontinence by subspecialty societies. However, litigators have not differentiated between mesh for prolapse and mesh for incontinence. As such, all mesh, including that placed for stress urinary incontinence, faces continued controversy amidst an uncertain future. In this article, we review the background of the mesh controversy, recent developments, and the anticipated role of mesh in surgery for prolapse and stress urinary incontinence going forward.

  8. The Role of Historical-Philosophical Controversies in Teaching Sciences: The Debate between Biot and Ampere

    Science.gov (United States)

    Braga, Marco; Guerra, Andreia; Reis, Jose Claudio

    2012-01-01

    This paper evaluates the viability of using controversies in teaching. An educational project has been elaborated in which some historical-philosophical clashes were introduced into the classical syllabus of physics. The historical-philosophical controversy dealt with here, took place between the French physicists Biot and Ampere in the 19th…

  9. Neoadjuvant treatment intensification or adjuvant chemotherapy for locally advanced carcinoma rectum: The optimum treatment approach remains unresolved.

    Science.gov (United States)

    Mallick, Supriya; Benson, Rony; Haresh, K P; Rath, G K

    2015-12-01

    Rectal carcinoma [RC] is often managed with preoperative radiotherapy or radio-chemotherapy followed by total mesorectal excision (TME). Efforts are being made to improve outcome by intensifying the preoperative treatment. However, the optimum therapy remains unclear. There is ongoing controversy regarding the optimum radiation dose, chemotherapy regimen and schedule. In addition there exists growing disagreement regarding the role of adjuvant chemotherapy after neoadjuvant radiation or chemoradiation. We reviewed the recent land mark trials to find a road map in the management of locally advanced rectal carcinoma. Preoperative short course radiotherapy has long been proven to improve local disease control. The initial trials with long course chemoradiotherapy, comparing short course radiotherapy have shown to increase local control and pathological complete response rates. Since then treatment intensification of this neoadjuvant schedule has been tried by many researchers. But initial results of these treatment intensification trials, show no significant benefit and are associated with increased toxicity. There is an unmet need to stratify patients depending on risk to assign them to long course chemoradiotherapy or short course radiotherapy. Current evidence does not support the use of adjuvant chemotherapy in patients who were treated with preoperative (chemo)radiotherapy. Preoperative radiotherapy appears to improve disease control with favorable toxicity profile and there is very little to choose between long course chemoradiotherapy and short course radiotherapy. However, long course chemoradiotherapy may be beneficial for patients with high risk features like positive circumferential resection margin [CRM] and extramural spread of >5mm. There is no role for adjuvant chemotherapy in patients who were treated preoperative (chemo)radiotherapy. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  10. Neoadjuvant treatment intensification or adjuvant chemotherapy for locally advanced carcinoma rectum: The optimum treatment approach remains unresolved

    International Nuclear Information System (INIS)

    Mallick, S.; Benson, R.; Haresh, K.P.; Rath, G.K.

    2015-01-01

    Background: Rectal carcinoma [RC] is often managed with preoperative radiotherapy or radio chemotherapy followed by total meso rectal excision (TME). Efforts are being made to improve outcome by intensifying the preoperative treatment. However, the optimum therapy remains unclear. There is ongoing controversy regarding the optimum radiation dose, chemotherapy regimen and schedule. In addition there exists growing disagreement regarding the role of adjuvant chemotherapy after neoadjuvant radiation or chemo radiation. Methodology: We reviewed the recent land mark trials to find a road map in the management of locally advanced rectal carcinoma. Results: Preoperative short course radiotherapy has long been proven to improve local disease con- trol. The initial trials with long course chemoradiotherapy, comparing short course radiotherapy have shown to increase local control and pathological complete response rates. Since then treatment intensification of this neoadjuvant schedule has been tried by many researchers. But initial results of these treatment intensification trials, show no significant benefit and are associated with increased toxicity. There is an unmet need to stratify patients depending on risk to assign them to long course chemoradiotherapy or short course radiotherapy. Current evidence does not support the use of adjuvant chemotherapy in patients who were treated with preoperative (chemo)radiotherapy. Conclusion: Preoperative radiotherapy appears to improve disease control with favorable toxicity profile and there is very little to choose between long course chemoradiotherapy and short course radiotherapy. However, long course chemoradiotherapy may be beneficial for patients with high risk features like positive circumferential resection margin [CRM] and extramural spread of >5 mm. There is no role for adjuvant chemotherapy in patients who were treated preoperative (chemo)radiotherapy

  11. Nuclear critics and nuclear controversy: Lessons for the next 50 years

    International Nuclear Information System (INIS)

    Perkins, B.

    1992-01-01

    For more than a decade, nuclear electric power was at the center of one of the most widespread and passionate controversies in the United States. A combination of local community groups and a sophisticated national opposition seriously delayed nuclear plants being built in state after state, contributing to major cost increases and, in some instances, project cancellations. According to plans of the US government and electric power industry, new nuclear power plants will be ordered by the mid-1990s and will be in operation around the turn of the century. The success of these plans will depend in part on how well the government and industry learned the lessons of the years of controversy - how well they can rally public support despite the inevitable opposition of nuclear critics. This paper is based on a review of the national nuclear controversy of the 1970s and early 1980s. It analyzes the key lessons to be learned from those experiences and projects them onto the new societal and political setting of the 1990s, reflecting more recent research into effective siting procedures, public participation, risk communications, and other disciplines related to the development of public acceptance for nuclear power plants

  12. Comparison of Functional Outcomes Following Bridge Synostosis with Non-Bone-Bridging Transtibial Combat-Related Amputations

    Science.gov (United States)

    2013-05-15

    the robust interdisciplinary team approach to amputee management in the military system may result in achieving more successful outcomes. Controversy...amputation and limb deficiency: epidemiology and recent trends in the United States. South Med J. 2002 Aug;95(8):875-83. 6. Ertl J. Uber amputationsstumpfe

  13. Teacher College Students' Views of Controversial Environmental Issues: Ambivalence and Readiness to Adopt a Stance

    Science.gov (United States)

    Weinberger, Yehudith; Dreyfus, Amos

    2013-01-01

    One of the most important goals of discussing controversial issues in the classroom is to educate students to possess an inclination towards reason, open mindedness and fairness. However, research tends to show that teachers are not adequately trained to lead fruitful discussions about controversial issues and do not possess the necessary skills…

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

    Directory of Open Access Journals (Sweden)

    THOMAS MISCO

    2007-10-01

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

  15. Long-term outcome following medial open reduction in developmental dysplasia of the hip: a retrospective cohort study.

    Science.gov (United States)

    Gardner, Richard O E; Bradley, Catharine S; Sharma, Om P; Feng, Lin; Shin, Michelle EyunJung; Kelley, Simon P; Wedge, J H

    2016-06-01

    Avascular necrosis (AVN) is a serious complication of treatment for developmental dysplasia of the hip. There is ongoing controversy regarding AVN and its influence on hip development following medial open reduction (MOR). The aim of our study was to (1) determine the long-term prevalence of AVN following MOR, (2) evaluate hip development after MOR, and (3) identify predictors of AVN and radiographic outcome at skeletal maturity after MOR. A retrospective cohort analysis of 60 patients (70 hips) who underwent MOR with a mean follow-up of 10.83 years (5.23-16.74) was conducted. AVN was recorded according to Bucholz and Ogden classification and radiographic outcome based on Severin grading. AVN and hip morphology related to length of follow-up were evaluated. Chi-squared and t-tests were used to identify relationships between AVN and other variables. Logistic regression was used to assess predictors of AVN and Severin outcome. The rate of clinically significant AVN (types 2-4) following MOR was 32.9 % with type 2 accounting for 82.6 % of these cases. While early acetabular development was satisfactory, long-term outcome was unsatisfactory in 26 % of cases with AVN (vs 8.7 % of cases without AVN). A higher rate of AVN was identified when hips were immobilized in ≥60° of abduction postoperatively. A higher rate of poor Severin outcome was identified in hips with AVN. Our findings suggest that there is a high rate of AVN and unsatisfactory long-term outcome following MOR. AVN remains a significant concern following MOR surgery for developmental dysplasia of the hip that may not be apparent until long-term evaluation.

  16. Body hair transplantation: Case report of successful outcome

    Directory of Open Access Journals (Sweden)

    Venkataram Mysore

    2013-01-01

    Full Text Available Transplantation of body hair in to scalp has been suggested as an option to treat extensive cases of baldness with poor donor scalp. However, evidence about its long-term efficacy is yet lacking, with very few published reports and the routine use of the technique is still controversial. We report the satisfactory outcome in a case of extensive baldness in whom hairs from different donor areas such as chest, abdomen, arms, thighs were transplanted on to scalp.

  17. Partisan Scholarship in Technoscientific Controversies

    DEFF Research Database (Denmark)

    Galis, Vasilis; Hansson, Anders

    2012-01-01

    of who controls, manipulates, and establishes decisions, facts, and knowledge. With this in mind, it is possible to identify different forms of partisan research including capture by participants, de facto and overt partisanship, and mercenary scholarship. These different forms of partisan scholarship...... are characterised by differences in the motives underlying epistemological choices of research topic and method, personal commitments to the fields studied, use of research findings in controversies, and positioning of results in wider debates. Two examples help to illustrate partisan scholarship: first, a study...... of new technologies for managing climate change (carbon dioxide capture and storage); and second, the construction of the new underground metro system in Athens and its accommodation of accessibility standards. Both cases entail partisan positions and raise similar concerns about the orthodox...

  18. The European Society of Regional Anaesthesia and Pain Therapy and the American Society of Regional Anesthesia and Pain Medicine Joint Committee Practice Advisory on Controversial Topics in Pediatric Regional Anesthesia.

    Science.gov (United States)

    Ivani, Giorgio; Suresh, Santhanam; Ecoffey, Claude; Bosenberg, Adrian; Lonnqvist, Per-Anne; Krane, Elliot; Veyckemans, Francis; Polaner, David M; Van de Velde, Marc; Neal, Joseph M

    2015-01-01

    Some topics in the clinical management of regional anesthesia in children remain controversial. To evaluate and come to a consensus regarding some of these topics, The European Society of Regional Anaesthesia and Pain Therapy (ESRA) and the American Society of Regional Anesthesia and Pain Medicine (ASRA) developed a joint committee practice advisory on pediatric regional anesthesia (PRA). Representatives from both ASRA and ESRA comprised the joint committee practice advisory on PRA. Evidence-based recommendations were based on a systematic search of the literature. In cases where no literature was available, expert opinion was elicited. Experts selected controversial topics in PRA. The performance of PRA under general anesthesia or deep sedation is associated with acceptable safety and should be viewed as the standard of care (Evidence B2 and Evidence B3). Because of the difficulty interpreting a negative test dose, the use of test dosing should remain discretionary (Evidence B4). The use of either air-loss of resistance or saline-loss of resistance techniques is supported by expert opinion, but the literature supporting one technique over the other is sparse and controversial; when used appropriately, each technique may be safely used in children. There are no current evidence-based data that the use of RA increases the risk for acute compartment syndrome or delays its diagnosis in children. High-level evidence is not yet available for the topics evaluated, and most recommendations are based on Evidence B studies. The ESRA/ASRA recommendations intend to provide guidance for the safe practice of regional anesthesia in children.

  19. The Animal Experimentation Controversy: Ethical Views of Prospective Teachers

    Science.gov (United States)

    de Villiers, Rian

    2012-01-01

    Vivisection (live animal experimentation) is a controversial issue for many people. The purpose of this case study is to examine the attitudes of prospective teachers toward vivisection in education and research, to determine if gender has an influence on these attitudes, and to discuss the implications of these attitudes with regard to teaching…

  20. Sirenomelia: A Multi-systemic Polytopic Field Defect with Ongoing Controversies

    NARCIS (Netherlands)

    Boer, L.L.; Morava, E.; Klein, W.M.; Schepens-Franke, A.N.; Oostra, R.J.

    2017-01-01

    The most impressive phenotypic appearance of sirenomelia is the presence of a 180 degrees -rotated, axially positioned, single lower limb. Associated gastrointestinal and genitourinary anomalies are almost always present. This rare anomaly is still the subject of ongoing controversies concerning its

  1. Sirenomelia: A Multi-systemic Polytopic Field Defect with Ongoing Controversies

    NARCIS (Netherlands)

    Boer, Lucas L.; Morava, Eva; Klein, Willemijn M.; Schepens-Franke, Annelieke N.; Oostra, Roelof Jan

    2017-01-01

    The most impressive phenotypic appearance of sirenomelia is the presence of a 180 degrees-rotated, axially positioned, single lower limb. Associated gastrointestinal and genitourinary anomalies are almost always present. This rare anomaly is still the subject of ongoing controversies concerning its

  2. Recent hospital charity care controversies highlight ambiguities and outdated features of government regulations.

    Science.gov (United States)

    MacKelvie, Charles; Apolskis, Michael; Unland, James J

    2005-01-01

    For years the hospital industry has been embroiled in controversies involving pricing, charity care, and collection practices. Unfortunately, Medicare regulations and policies governing hospital charge-setting and collection practices have not helped bring much clarity to the situation, nor has related CMS and OIG guidance. Coordinated effort by hospitals and regulatory bodies can help clarify unclear government regulation of charity care, pricing, and collections and end potentially destructive controversies that sap valuable time, energy, and resources from efforts addressing much graver long-term threats to hospital viability.

  3. Everything You Need To Know To Understand the Current Controversies You Learned from Psychological Research: A Comment on the Rind and Lilienfeld Controversies.

    Science.gov (United States)

    Sternberg, Robert J.

    2002-01-01

    Discusses applications of theories and research in psychology to understand controversies generated by two recent articles, explaining the need to distinguish between rational and intuitive thinking, recognize the power of context, think reflectively, and realize the costs of defying the crowd, and noting steps one can take to be wiser and more…

  4. Before We Were Us, We Were Them: Curating Controversy

    Science.gov (United States)

    Watson, Keri

    2014-01-01

    Prompted by the passage of Alabama House Bill 56, I organized the museum studies course I taught for Auburn University at Montgomery in the 2013 spring semester around an exhibition on immigration. The course offered the opportunity to engage students, faculty, and the community in discussion of an important, timely, and controversial topic.…

  5. Science and controversy a biography of Sir Norman Lockyer

    CERN Document Server

    Meadows, A

    2008-01-01

    Sir Norman Lockyer left Nature, the world''s leading scientific journal, as his lasting memorial. But his life, and controversial theories, are an important part of science history. His ideas were at the forefront of public debate, and ranged from brilliant to perverse. This entertaining book is a fascinating insight into his eventful life

  6. Exploring Sex and Status Differences in Perceptions, Acceptance, and Outcomes in E- Learning

    Science.gov (United States)

    Kamali, Ali

    2016-01-01

    The integration of electronic technologies in teaching and learning has been a top priority in higher education. However, there is a great deal of controversy in the literature regarding its effectiveness. This bears the question, to what extent are the outcomes (e.g., the student success) in an e-learning environment comparable with that of a…

  7. Medical students and controversial ethical issues: results from the multicenter study SBRAME.

    Science.gov (United States)

    Lucchetti, Giancarlo; de Oliveira, Leandro Romani; Leite, José Roberto; Lucchetti, Alessandra Lamas Granero

    2014-12-15

    Medical students(MS) will face ethical issues throughout their lives as doctors. The present study aims to investigate medical students' opinions on controversial ethical issues and factors associated with these opinions. SBRAME (Spirituality and Brazilian Medical Education) is a multicenter study involving 12 Brazilian medical schools with 5950 MS. Participants completed a questionnaire that collected information on socio-demographic data, medical schools characteristics, religious beliefs and opinions on controversial ethical issues. Of all MS, 3630 participated in the survey (61.0%). The sample was 53.8% women and the mean age was 22.5 years. In general, most MS have no objections to prescription of birth control (90.8%), adult stem cell use (87.5%), embryonic stem cell use (82.0%) and abortion for genetic reasons (51.2%). Approximately half of students have no objections to human cloning (47.3%), 45.7% to withdrawal of artificial life support, 41.4% to euthanasia and 23.3% to abortion for failed contraception. Socio-demographic data such as age, gender and income had little influence on MS opinions. On the other hand, medical schools characteristics (number of medical students in the university, year of medical school foundation, location of the university and type of university) and religious aspects (religious affiliation, religious attendance, non-organizational religiousness and intrinsic religiousness) were highly correlated with their opinions. In general, MS with more supportive opinions on controversial ethical issues were less religious and from non-traditional (newer), urban, public and bigger universities. The current study reveals MS have different opinions regarding controversial ethical issues. Noteworthy, these opinions seem to be shaped more by university characteristics and religious beliefs than socio-demographic data.

  8. Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care.

    Science.gov (United States)

    Davison, Sara N; Levin, Adeera; Moss, Alvin H; Jha, Vivekanand; Brown, Edwina A; Brennan, Frank; Murtagh, Fliss E M; Naicker, Saraladevi; Germain, Michael J; O'Donoghue, Donal J; Morton, Rachael L; Obrador, Gregorio T

    2015-09-01

    Patients with advanced chronic kidney disease (CKD) have a high burden of physical and psychosocial symptoms, poor outcomes, and high costs of care. Current paradigms of care for this highly vulnerable population are variable, prognostic and assessment tools are limited, and quality of care, particularly regarding conservative and palliative care, is suboptimal. The KDIGO Controversies Conference on Supportive Care in CKD reviewed the current state of knowledge in order to define a roadmap to guide clinical and research activities focused on improving the outcomes of people living with advanced CKD, including those on dialysis. An international group of multidisciplinary experts in CKD, palliative care, methodology, economics, and education identified the key issues related to palliative care in this population. The conference led to a working plan to address outstanding issues in this arena, and this executive summary serves as an output to guide future work, including the development of globally applicable guidelines.

  9. Patients' perspective on controversial issues in total knee arthroplasty.

    Science.gov (United States)

    Kim, Tae Kyun; Choi, Jinbae; Shin, Kwang Sook; Chang, Chong Bum; Seong, Sang Cheol

    2008-03-01

    We investigated the level of patient knowledge and preferences over the currently controversial issues in TKA. One hundred patients who had decided to undergo TKA for advanced osteoarthritis were asked to complete a questionnaire inquiring their knowledge and preferences over three controversial issues: (1) computer assisted surgery (CAS), (2) minimal invasive surgery (MIS), and (3) ceramic femoral component. The patient preferences over the three issues were questioned again after they had been informed of advantages and disadvantages of each option using an explanatory document. Most (more than 75%) of the patients did not have sufficient knowledge and their knowledge was based on non-professional sources (more than 85%). Before the information was given, most (more than 80%) of the patients preferred a new option. After the information was provided, more patients preferred a standard option in the issues of CAS (60%) and MIS (88%). This study prompts health care providers to become more active in providing accurate information and to consider patients perspective in making decisions which will influence the benefits and risk of the patients.

  10. The nuclear controversy as reflected in the daily press

    International Nuclear Information System (INIS)

    Buiren, S. van.

    1980-01-01

    Based on a content analysis of 2047 journal articles of the years 1974 to 1977 on conflicts over nuclear power plants (Wyhl, Brokdorf), the book intends to analyze the role of the media in present social conflicts. The book presents facts and figures concerning the information and opinions on nuclear power in five newspapers and the bias of these newspapers in favour of nuclear power or against it. According to the author, newspaper journalists have failed at least in one thing: to explain the dimensions of the conflict with regard to social policy and to give background information on their own opinions. On the other hand, the press has proved its independence: It is not an extended arm of industrial PR departments - at least not in the nuclear controversy. The greater part of the articles is in opposition to nuclear power. The development and modifications of the arguments stated by the various groups active in the nuclear controversy are analyzed in dependence of the increasingly aggressive nature of the conflict. (HP) [de

  11. Playful biometrics: controversial technology through the lens of play.

    Science.gov (United States)

    Ellerbrok, Ariane

    2011-01-01

    This article considers the role of play in the context of technological emergence and expansion, particularly as it relates to recently emerging surveillance technologies. As a case study, I consider the trajectory of automated face recognition—a biometric technology of numerous applications, from its more controversial manifestations under the rubric of national security to a clearly emerging orientation toward play. This shift toward “playful” biometrics—or from a technology traditionally coded as “hard” to one now increasingly coded as “soft”—is critical insofar as it renders problematic the traditional modes of critique that have, up until this point, challenged the expansion of biometric systems into increasingly ubiquitous realms of everyday life. In response to this dynamic, I propose theorizing the expansion of face recognition specifically in relation to “play,” a step that allows us to broaden the critical space around newly emerging playful biometrics, as well as playful surveillance more generally. In addition, play may also have relevance for theorizing other forms of controversial technology, particularly given its potential role in processes of obfuscation, normalization, and marginalization.

  12. Elevated Fasting Blood Glucose Is Predictive of Poor Outcome in Non-Diabetic Stroke Patients: A Sub-Group Analysis of SMART.

    Directory of Open Access Journals (Sweden)

    Ming Yao

    Full Text Available Although increasing evidence suggests that hyperglycemia following acute stroke adversely affects clinical outcome, whether the association between glycaemia and functional outcome varies between stroke patients with\\without pre-diagnosed diabetes remains controversial. We aimed to investigate the relationship between the fasting blood glucose (FBG and the 6-month functional outcome in a subgroup of SMART cohort and further to assess whether this association varied based on the status of pre-diagnosed diabetes.Data of 2862 patients with acute ischemic stroke (629 with pre-diagnosed diabetics enrolled from SMART cohort were analyzed. Functional outcome at 6-month post-stroke was measured by modified Rankin Scale (mRS and categorized as favorable (mRS:0-2 or poor (mRS:3-5. Binary logistic regression model, adjusting for age, gender, educational level, history of hypertension and stroke, baseline NIHSS and treatment group, was used in the whole cohort to evaluate the association between admission FBG and functional outcome. Stratified logistic regression analyses were further performed based on the presence/absence of pre-diabetes history.In the whole cohort, multivariable logistical regression showed that poor functional outcome was associated with elevated FBG (OR1.21 (95%CI 1.07-1.37, p = 0.002, older age (OR1.64 (95% CI1.38-1.94, p<0.001, higher NIHSS (OR2.90 (95%CI 2.52-3.33, p<0.001 and hypertension (OR1.42 (95%CI 1.13-1.98, p = 0.04. Stratified logistical regression analysis showed that the association between FBG and functional outcome remained significant only in patients without pre-diagnosed diabetes (OR1.26 (95%CI 1.03-1.55, p = 0.023, but not in those with premorbid diagnosis of diabetes (p = 0.885.The present results demonstrate a significant association between elevated FBG after stroke and poor functional outcome in patients without pre-diagnosed diabetes, but not in diabetics. This finding confirms the importance of glycemic

  13. Factors Affecting the Participation of Social Studies Teacher Candidates in Discussions on Controversial Issues

    Directory of Open Access Journals (Sweden)

    A. Figen ERSOY

    2013-05-01

    Full Text Available Social studies teachers employ discussions about controversial issues in their classrooms as an effective instructional tool in order to improve citizenship education. Therefore, teaching about controversial issues in preservice social studies programs is important for improving pre-service teachers’ understanding of their own abilities to teach about citizenship issues and their skills to teach about controversial issues in their classrooms as well. Preservice teachers ought to be encouraged to participate more in classroom discussions about controversial issues. Therefore, this study aim to understand and explain factors that affect social studies teacher candidates’ participation in classroom discussions about controversial issues and suggest how this process might be more efficient and effective in Turkey. 1957 pre-service social studies teachers from 12 different universities in Turkey participated in this study. A questionaire was used to collect data for this research. The questionaire included likert type 16 items regarding students’ personal information and factors that affect the level of participation in classroom discussions about controversial issues and one open-ended question regarding implications on how discussions can be improved in a way that help the discussions more effective and efficient. Chi-Square, frequency, and percentange tests were used to analyze the quantitative data. Inductive content analysis method was employed to analyze and code the qualitative data. The findings of the study showed that while 92.2 % pre-service social studies teachers stated that they participate in the dicussions on controversial issues when they only find it interested, 79.4 % participant pointed out that they do not participate in the discussions, if they believe they do not have enough knowledge about the topic of the dicussion. In addition, 47.5% of the participants stated that they do not want to participate in the discussions

  14. Relationship of Prior Antidepressant Exposure to Long-Term Prospective Outcome in Bipolar I Disorder Outpatients

    NARCIS (Netherlands)

    Post, Robert M.; Leverich, Gabriele S.; Altshuler, Lori L.; Frye, Mark A.; Suppes, Trisha; McElroy, Susan L.; Keck, Paul E.; Nolen, Willem A.; Rowe, Mike; Kupka, Ralph W.; Grunze, Heinz; Goodwin, Frederick K.

    Objective:The long-term impact of prior antidepressant exposure on the subsequent course of bipolar illness remains controversial. Method: 139 outpatients (mean age, 42 years) with bipolar I disorder diagnosed by DSM-IV criteria had a detailed retrospective examination of their prior course of

  15. Understanding the nuclear controversy: An application of cultural theory

    International Nuclear Information System (INIS)

    Graaff, Shashi van de

    2016-01-01

    The need for a secure and sustainable energy future has become firmly entrenched on the global political agenda. Governments worldwide are seeking solutions that will ensure security of their energy supplies, while reducing carbon emissions in the fight against climate change. Advocates of nuclear power have reframed the technology as the most reliable, cost-effective and immediate solution to both of these policy problems, and predicted the emergence of a 'nuclear renaissance’. However, there is little evidence to date that suggests a nuclear renaissance has actually taken place. Public opinion polling demonstrates that many remain unconvinced of the need for nuclear power. This paper uses Cultural Theory as a heuristic to understand why the arguments for a nuclear renaissance have been largely unsuccessful. It argues that the failure of nuclear advocates to engage with a wider cross-section of world-views has prevented the controversy surrounding nuclear power from being resolved, and the nuclear renaissance from becoming a reality. In doing so, this paper builds upon a growing recognition of the contribution that social science research can make to understanding public acceptance of energy policy choices. - Highlights: • There is little evidence of a nuclear renaissance taking place in Western Europe or North America. • Public opinion on nuclear power continues to be deeply divided. • Pro-nuclear arguments are dominated by a particular cultural rationality. • A broader range of cultural perspectives needs to be recognised for the nuclear debate to progress.

  16. Staggering successes amid controversy in California water management

    Science.gov (United States)

    Lund, J. R.

    2012-12-01

    Water in California has always been important and controversial, and it probably always will be. California has a large, growing economy and population in a semi-arid climate. But California's aridity, hydrologic variability, and water controversies have not precluded considerable economic successes. The successes of California's water system have stemmed from the decentralization of water management with historically punctuated periods of more centralized strategic decision-making. Decentralized management has allowed California's water users to efficiently explore incremental solutions to water problems, ranging from early local development of water systems (such as Hetch Hetchy, Owens Valley, and numerous local irrigation projects) to more contemporary efforts at water conservation, water markets, wastewater reuse, and conjunctive use of surface and groundwater. In the cacophony of local and stakeholder interests, strategic decisions have been more difficult, and consequently occur less frequently. California state water projects and Sacramento Valley flood control are examples where decades of effort, crises, floods and droughts were needed to mobilize local interests to agree to major strategic decisions. Currently, the state is faced with making strategic environmental and water management decisions regarding its deteriorating Sacramento-San Joaquin Delta. Not surprisingly, human uncertainties and physical and fiscal non-stationarities dominate this process.

  17. Sentencing and Other Controversial Issues: Why We Need Rational Debate More Than Ever

    Directory of Open Access Journals (Sweden)

    Ian Gray

    2013-12-01

    Full Text Available The article seeks to demonstrate the importance of rational debate in the community on controversial issues. It focuses on the need for rationalism to prevail in community debates on controversial issues. Issues inclusive of sentencing, climate change, mental health and its prevalence in the prison system and ‘whether courts are out of touch’ with the community. The article recognises the difficulties faced by those engaged in community issues and concludes by promoting the need to maintain a tolerant and harmonious society by engaging in well informed rational debate.

  18. Applying environmental-behaviour concepts to renewable energy siting controversy: Reflections on a longitudinal bioenergy case study

    Energy Technology Data Exchange (ETDEWEB)

    Upham, Paul, E-mail: paul.upham@manchester.ac.u [Tyndall Centre Manchester and Manchester Institute of Innovation Research, Pariser Building, University of Manchester, Manchester M60 1QD (United Kingdom)

    2009-11-15

    To date, studies of energy siting controversy and of environmental psychology have barely informed one another, despite the environmental-behaviour literature potentially having considerable relevance to understanding public opposition to energy projects. This paper points towards this relevance, using the example of a longitudinal study of public objections to a 21.5 MWe bioenergy gasifier proposed for Winkleigh in Devon, England. Local opinion surveys in 2004 and 2007 showed that public opposition to the proposed gasifier remained strong but also revealed some statistically significant change and correlations of wider interest. In the context of the environmental psychology literature, the dominant model of contextualised values, intention and behaviour, as well as other psychological approaches, are found to be helpful, both for making sense of the results and for informing a psychological research agenda on public objection to new energy infrastructure.

  19. Applying environmental-behaviour concepts to renewable energy siting controversy: Reflections on a longitudinal bioenergy case study

    International Nuclear Information System (INIS)

    Upham, Paul

    2009-01-01

    To date, studies of energy siting controversy and of environmental psychology have barely informed one another, despite the environmental-behaviour literature potentially having considerable relevance to understanding public opposition to energy projects. This paper points towards this relevance, using the example of a longitudinal study of public objections to a 21.5 MWe bioenergy gasifier proposed for Winkleigh in Devon, England. Local opinion surveys in 2004 and 2007 showed that public opposition to the proposed gasifier remained strong but also revealed some statistically significant change and correlations of wider interest. In the context of the environmental psychology literature, the dominant model of contextualised values, intention and behaviour, as well as other psychological approaches, are found to be helpful, both for making sense of the results and for informing a psychological research agenda on public objection to new energy infrastructure.

  20. Fetal abuse and neglect: an emerging controversy.

    Science.gov (United States)

    Landwirth, J

    1987-04-01

    Advances in fetal medicine have expanded opportunities for protection of fetal health and intrauterine management of an increasing number of fetal disorders. The legal rights and duties of parents to provide necessary medical treatment for the child may extend to the prenatal period. Resolution of the conflict between the rights of the fetus to be born healthy and the pregnant woman's right of privacy is difficult and controversial. It is suggested that intrusion into a woman's individual fundamental rights for the potential benefit of her fetus should be permissible only in narrowly defined circumstances.

  1. [Controversies regarding distribution, instrumentation, and competence of hemodynamics laboratories].

    Science.gov (United States)

    Olivari, Z; Piccolo, E

    2001-01-01

    In the last few years we have witnessed a substantial growth in the number of catheterization laboratories, especially in the northern regions of Italy, a phenomenon which has met some controversy and has been discussed in a Symposium at the ANMCO National Conference (Florence, May 20-23, 2000). The controversy is essentially between those who believe in the implementation of catheterization laboratories in all cardiology units equipped with a cardiological intensive care unit (and the creation of a functional network with the tutorial centers) and those who refer to the existing guidelines, standards and VRQ which envisage a geographical distribution of laboratories on the basis of a balance between needs of the population and the minimum quantity of procedures performed by each center in order to guarantee the best quality and cost-effectiveness. The aim of the Symposium was to clarify whether the two "innovations" of these last few years, namely the introduction of new portable radiological equipment on the one hand and the effectiveness of primary angioplasty in the treatment of acute myocardial infarction on the other, may influence the redefinition of criteria regarding the distribution of laboratories, taking into account as well the expansion of indications for coronary angioplasty and coronary angiography. After a lively discussion, the proceedings can be summed up as follows: no agreement was reached regarding the role of portable radiological equipment in the decisional process regarding the setting up of a new catheterization laboratory; primary angioplasty should be carried out in centers with an adequate volume of activity and a functioning inter-hospital organizational structure for this demanding activity; otherwise it does not offer any advantages over fibrinolytic therapy; the proposal of a new organizational model is based on the creation of transverse inter-hospital cardiology departments, the size of which is based on the overall size of the

  2. Can we resolve the radiation controversy

    International Nuclear Information System (INIS)

    Webster, E.W.

    1983-01-01

    The past 20 years has seen an intensification of anxieties about potential harm, specifically cancer, from low levels of x or gamma rays. The idea that radiation is more damaging than previously estimated, says the author, is a central theme in current radiation phobia and probably the principal prop of the antinuclear movement. A current law-suit decision in Salt Lake City will settle the issue for the present. Historical data from Japanese A-bomb survivors and other studies are reviewed, the need for further epidemiologic work pointed out, and 20 years more of data collection from the Japanese survivors indicated as the final arbiter of the controversy. 18 references, 8 figures, 11 tables

  3. Status Report: Black Hole Complementarity Controversy

    International Nuclear Information System (INIS)

    Lee, Bum-Hoon; Yeom, Dong-han

    2014-01-01

    Black hole complementarity was a consensus among string theorists for the interpretation of the information loss problem. However, recently some authors find inconsistency of black hole complementarity: large N rescaling and Almheiri, Marolf, Polchinski and Sully (AMPS) argument. According to AMPS, the horizon should be a firewall so that one cannot penetrate there for consistency. There are some controversial discussions on the firewall. Apart from these papers, the authors suggest an assertion using a semi-regular black hole model and we conclude that the firewall, if it exists, should affect to asymptotic observer. In addition, if any opinion does not consider the duplication experiment and the large N rescaling, then the argument is difficult to accept

  4. [On controversies around the Oedipus Complex].

    Science.gov (United States)

    Drwiega, Marek

    2002-01-01

    In the article the author would like to draw the readers' attention to one of the central issues of psychoanalysis, i.e. Oedipus complex. In the development of the psychoanalysis the classical conception of Oedipus complex presented by Freud gave rise to a severe criticism both on the part of some psychoanalysts, especially women such as e.g. Melanie Klein, and on the part of ethnographers such as B. Malinowski. In the paper the author presents the main controversies concerning this interesting discussion. The fact of the matter is that the Oedipus complex is a hotly debated subject, not only from the cultural point of view but also within the psychoanalytical movement.

  5. Two-year home-based nocturnal noninvasive ventilation added to rehabilitation in chronic obstructive pulmonary disease patients : A randomized controlled trial

    NARCIS (Netherlands)

    Duiverman, Marieke L.; Wempe, Johan B.; Bladder, Gerrie; Vonk, Judith M.; Zijlstra, Jan G.; Kerstjens, Huib A. M.; Wijkstra, Peter J.

    2011-01-01

    Background: The use of noninvasive intermittent positive pressure ventilation (NIPPV) in chronic obstructive pulmonary disease (COPD) patients with chronic hypercapnic respiratory failure remains controversial as long-term data are almost lacking. The aim was to compare the outcome of 2-year

  6. The Legitimizing Function of Judicial Rhetoric in the Eugenics Controversy.

    Science.gov (United States)

    Hasian, Marouf, Jr.; Croasmun, Earl

    1992-01-01

    Investigates the possibility that judicial policymaking is responsive to the situational exigencies created in part through public discourse. Investigates the elite and public perspectives regarding the eugenics controversy in the 1920s to explore the emergent relationship between the public and technical spheres of argument. (SR)

  7. Successful outcome of descending necrotizing mediastinitis due to neck trauma

    International Nuclear Information System (INIS)

    Kurowski, K.; Matuszek, I.; Nunez, C. F. M.

    2011-01-01

    Descending necrotizing mediastinitis (DNM) is an uncommon form of mediastinitis that can rapidly progress to septicemia. The optimal surgical approach still remains controversial. In this paper we would like to present a case of descending necrotizing mediastinitis that was treated successfully by means of thoracic drainage through trans-thoracic approach. In our case DNM occurred as a complication of oropharyngeal abscesses and a complication of cervical spine trauma. (authors)

  8. Enhanced Contaminated Human Remains Pouch: initial development and preliminary performance assessments

    Energy Technology Data Exchange (ETDEWEB)

    Iseli, A.M.; Kwen, H.D.; Ul-Alam, M.; Balasubramanian, M.; Rajagopalan, S.

    2011-11-07

    The objective is to produce a proof of concept prototype Enhanced Contaminated Human Remains Pouch (ECHRP) with self-decontamination capability to provide increased protection to emergency response personnel. The key objective was to decrease the concentration of toxic chemicals through the use of an absorbent and reactive nanocellulose liner. Additionally, nanomaterials with biocidal properties were developed and tested as a 'stand-alone' treatment. The setting was a private company research laboratory. The main outcome measures were production of a functional prototype. A functional prototype capable of mitigating the threats due to sulfur mustard, Soman, and a large variety of liquid and vapor toxic industrial chemicals was produced. Stand-alone biocidal treatment efficacy was validated. The ECHRP provides superior protection from both chemical and biological hazards to various emergency response personnel and human remains handlers.

  9. Ethical Perspectives on the Current Controversy Regarding Openness in Adoption.

    Science.gov (United States)

    Tavis, Timothy M.

    This paper outlines current changes in American adoption practice and the controversies surrounding these changes. It includes a discussion of the role that neo-Kantian and utilitarian perspectives have played in American adoption policy and practice, and offers an alternative, the communitarian perspective, described by Sandel (1984). Adoption…

  10. A conservative approach to pediatric mandibular fracture management: Outcome and advantages

    OpenAIRE

    Amit Khatri; Namita Kalra

    2011-01-01

    Pediatric mandibular fractures are rare and their treatment remains controversial. Management is extremely complicated in mixed dentition as it is inherently dynamic and unstable. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. This case report describes and evaluates the conservative technique of acr...

  11. The Role of Art in Emotional-Moral Reflection on Risky and Controversial Technologies : the Case of BNCI

    NARCIS (Netherlands)

    Roeser, S.; Alfano, V.R.; Nevejan, Caroline

    2018-01-01

    In this article, we explore the role that art can play in ethical reflection on risky and controversial technologies. New technologies often give rise to societal controversies about their potential risks and benefits. Over the last decades, social scientists, psychologists, and philosophers have

  12. The London Spikes Controversy: Homelessness, Urban Securitisation and the Question of ‘Hostile Architecture’

    Directory of Open Access Journals (Sweden)

    James Petty

    2016-03-01

    Full Text Available This article examines an ostensibly new feature of the securitised urban landscape: ‘hostile architecture’. Following controversy in 2014 London over ‘anti-homeless spikes’– metal studs implanted at ground level designed to discourage the homeless from sleeping in otherwise unrestricted spaces – certain visible methods of environmental social control were temporarily subject to intense public scrutiny and debate. While contests over public and urban spaces are not new, the spikes controversy emerged in the context of broader socio-political and governmental shifts toward neoliberal arrangements. Using the spikes issue as a case study, I contextualise hostile architecture within these broader processes and in wider patterns of urban securitisation. The article then offers an explanatory framework for understanding the controversy itself. Ultimately the article questions whether the public backlash against the use of spikes indicates genuine resistance to patterns of urban securitisation or, counterintuitively, a broader public distaste for both the homeless and the mechanisms that regulate them. 

  13. Tumors with intrahepatic bile duct differentiation in cirrhosis: implications on outcomes after liver transplantation.

    Science.gov (United States)

    Facciuto, Marcelo E; Singh, Manoj K; Lubezky, Nir; Selim, Motaz A; Robinson, Dorothy; Kim-Schluger, Leona; Florman, Sander; Ward, Stephen C; Thung, Swan N; Fiel, MariaIsabel; Schiano, Thomas D

    2015-01-01

    The role of liver transplantation (LT) in the management of cirrhotic patients with tumors exhibiting intrahepatic bile duct differentiation remains controversial. The objective of this study was to characterize the spectrum of these tumors and analyze post-LT outcomes. Retrospective pathology database search of explant histology analysis of liver transplants between April 1993 and November 2013. Thirty-two patients were analyzed, 75% were men with a mean age of 60 years. Seven patients had nodules demonstrating intrahepatic cholangiocarcinoma (I-CCA), nine had I-CCA nodules occurring concomitantly with hepatocellular carcinoma (HCC), and 16 had mixed HCC-CCA nodules. The median number of tumors was 1 and size was 2.5 cm. Overall patient survival post-LT at 1 and 5 years was 71% and 57%, respectively. Patients within Milan criteria, especially with I-CCA features, showed a 5-year tumor recurrence rate (10%) and 5-year survival rate (78%) comparable with other patients having HCC within Milan criteria. This series showed that patients with CCA within Milan criteria may be able to achieve acceptable long-term post-LT survival.

  14. Lessons learnt from the organ retention controversy

    International Nuclear Information System (INIS)

    Madden, D.

    2009-01-01

    This paper examines the lessons to be learnt from the organ retention controversy in the Republic of Ireland. The paper emphasises the importance of good communication between clinicians and families of deceased persons and a move away from a medical culture based on paternalism to a partnership approach between clinicians and patients based on mutual trust and understanding. A model of authorisation rather than consent is proposed as the way forward for dealing with the difficult and traumatic experience of asking families for permission to carry out a post mortem examination on their deceased child. (authors)

  15. Blood transfusion after percutaneous coronary intervention and risk of subsequent adverse outcomes: a systematic review and meta-analysis.

    Science.gov (United States)

    Kwok, Chun Shing; Sherwood, Matthew W; Watson, Sarah M; Nasir, Samina B; Sperrin, Matt; Nolan, Jim; Kinnaird, Tim; Kiatchoosakun, Songsak; Ludman, Peter F; de Belder, Mark A; Rao, Sunil V; Mamas, Mamas A

    2015-03-01

    This study sought to define the prevalence and prognostic impact of blood transfusions in contemporary percutaneous coronary intervention (PCI) practice. Although the presence of anemia is associated with adverse outcomes in patients undergoing PCI, the optimal use of blood products in patients undergoing PCI remains controversial. A search of EMBASE and MEDLINE was conducted to identify PCI studies that evaluated blood transfusions and their association with major adverse cardiac events (MACE) and mortality. Two independent reviewers screened the studies for inclusion, and data were extracted from relevant studies. Random effects meta-analysis was used to estimate the risk of adverse outcomes with blood transfusions. Statistical heterogeneity was assessed by considering the I(2) statistic. Nineteen studies that included 2,258,711 patients with more than 54,000 transfusion events were identified (prevalence of blood transfusion 2.3%). Crude mortality rate was 6,435 of 50,979 (12.6%, 8 studies) in patients who received a blood transfusion and 27,061 of 2,266,111 (1.2%, 8 studies) in the remaining patients. Crude MACE rates were 17.4% (8,439 of 48,518) in patients who had a blood transfusion and 3.1% (68,062 of 2,212,730) in the remaining cohort. Meta-analysis demonstrated that blood transfusion was independently associated with an increase in mortality (odds ratio: 3.02, 95% confidence interval: 2.16 to 4.21, I(2) = 91%) and MACE (odds ratio: 3.15, 95% confidence interval: 2.59 to 3.82, I(2) = 81%). Similar observations were recorded in studies that adjusted for baseline hematocrit, anemia, and bleeding. Blood transfusion is independently associated with increased risk of mortality and MACE events. Clinicians should minimize the risk for periprocedural transfusion by using available bleeding-avoidance strategies and avoiding liberal transfusion practices. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  16. Physician-patient discussions of controversial cancer screening tests.

    Science.gov (United States)

    Dunn, A S; Shridharani, K V; Lou, W; Bernstein, J; Horowitz, C R

    2001-02-01

    Screening mammography for younger women and prostate-specific antigen (PSA) measurement have controversial benefits and known potential adverse consequences. While providing informed consent and eliciting patient preference have been advocated for these tests, little is known about how often these discussions take place or about barriers to these discussions. We administered a survey to medical house staff and attending physicians practicing primary care. The survey examined physicians' likelihood of discussing screening mammography and PSA testing, and factors influencing the frequency and quality of these discussions. For the three scenarios, 16% to 34% of physicians stated that they do not discuss the screening tests. The likelihood of having a discussion was significantly associated with house staff physicians' belief that PSA screening is advantageous; house staff and attending physicians' intention to order a PSA test, and attending physicians' intention to order a mammogram; and a controversial indication for screening. The most commonly identified barriers to discussions were lack of time, the complexity of the topic, and a language barrier. Physicians report they often do not discuss cancer screening tests with their patients. Our finding that physicians' beliefs and intention to order the tests, and extraneous factors such as time constraints and a language barrier, are associated with discussions indicates that some patients may be inappropriately denied the opportunity to choose whether to screen for breast and prostate cancer.

  17. D. W. Griffith's Controversial Film, "The Birth of a Nation."

    Science.gov (United States)

    Pitcher, Conrad

    1999-01-01

    Presents a lesson plan that enables students to investigate race relations during the Progressive Era by analyzing D. W. Griffith's "The Birth of a Nation" and the controversy surrounding the release of the film. Explores the pros and cons of using motion pictures as teaching tool. Includes two student handouts. (CMK)

  18. The Future Path of Organic Farming - Values, Standards and Controversy!

    DEFF Research Database (Denmark)

    Kjærgård, Bente; Pedersen, Kirsten Bransholm; Land, Birgit

    The study focuses on the recent debate about what is, or what constitutes, organic farming and what is the right path for organic farming in the future. The study is based on a critical discourse analysis of the controversy about suspending the private standard for organic farming adopted by the ...

  19. [Bacterial resistance in acne? A meta-analysis of the controversy].

    Science.gov (United States)

    Alvarez-Sánchez, Mariana; Rodríguez-Ayala, Ernesto; Ponce-Olivera, Rosa María; Tirado-Sánchez, Andrés; Arellano-Mendoza, María Ivonne

    2016-01-01

    Acne is one of the dermatological pathologies with the highest incidence around the world. It is a multifactorial disease and its treatment can be complex. Propionibacterium acnes play a key role in the inflammation of this dermatosis. Topical antibiotics, including mainly erythromycin and clindamycin, have been used, but there is controversy over their use due to the widely documented bacterial resistance. For this reason a meta-analysis of the publications over the past 10 years is presented in order to confirm this hypothesis. A search was made of the publications over the past 10 years that included the results of antibiogams of patients with acne. MeSH type searches were performed with the terms "acne vulgaris", "Propionibacterium acnes", "topical administration", "treatment", "erythromycin", "clindamycin", "nadifloxacin", "antibacterial agent", "bacterial drug resistance" in PubMed, Ovid, EBSCO, Cochrane, ScienceDirect and ClinicalKey meta-searches. A total of 13 articles were found that met the inclusion criteria. The mean odds ratio (OR 1.24, 95% CI) of the articles showed a slight tendency toward resistance of Propionibacterium acnes. An increase in bacterial resistance to topical erythromycin and clindamycin can be confirmed, thus the use of these antibiotics is recommended in selective cases for short periods, and in combination with benzoyl peroxide for the best clinical outcome in patients with acne vulgaris. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  20. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues

    OpenAIRE

    Russo, Ethan B.

    2016-01-01

    This overview covers a wide range of cannabis topics, initially examining issues in dispensaries and self-administration, plus regulatory requirements for production of cannabis-based medicines, particularly the Food and Drug Administration “Botanical Guidance.” The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer, and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanica...

  1. Improving Outcomes Following Penetrating Colon Wounds

    Science.gov (United States)

    Miller, Preston R.; Fabian, Timothy C.; Croce, Martin A.; Magnotti, Louis J.; Elizabeth Pritchard, F.; Minard, Gayle; Stewart, Ronald M.

    2002-01-01

    Introduction During World War II, failure to treat penetrating colon injuries with diversion could result in court martial. Based on this wartime experience, colostomy for civilian colon wounds became the standard of care for the next 4 decades. Previous work from our institution demonstrated that primary repair was the optimal management for nondestructive colon wounds. Optimal management of destructive wounds requiring resection remains controversial. To address this issue, we performed a study that demonstrated risk factors (pre or intraoperative transfusion requirement of more than 6 units of packed red blood cells, significant comorbid diseases) that were associated with a suture line failure rate of 14%, and of whom 33% died. Based on these outcomes, a clinical pathway for management of destructive colon wounds was developed. The results of the implementation of this pathway are the focus of this report. Methods Patients with penetrating colon injury were identified from the registry of a level I trauma center over a 5-year period. Records were reviewed for demographics, injury characteristics, and outcome. Patients with nondestructive injuries underwent primary repair. Patients with destructive wounds but no comorbidities or large transfusion requirement underwent resection and anastomosis, while patients with destructive wounds and significant medical illness or transfusion requirements of more than 6 units/blood received end colostomy. The current patients (CP) were compared to the previous study (PS) to determine the impact of the clinical pathway. Outcomes examined included colon related mortality and morbidity (suture line leak and abscess). Results Over a 5.5-year period, 231 patients had penetrating colon wounds. 209 survived more 24 hours and comprise the study population. Primary repair was performed on 153 (73%) patients, and 56 patients had destructive injuries (27%). Of these, 40 (71%) had resection and anastomosis and 16 (29%) had diversion

  2. Thinking About Education in Human Rights from an Ethical and Controversial Perspective

    Directory of Open Access Journals (Sweden)

    Abraham Magendzo

    2018-05-01

    Full Text Available This paper delves into the relationship between the education in human rights and ethics from a controversial perspective. It is a direction that seeks to help people become active and participatory citizens in a pluralistic democracy. Three fundamental ethical principles are analyzed, and they allow teaching human rights through controversy: Human rights: a global ethics of human rights; human rights: an ethical minimum; human rights and moral pluralism. This article proposes to relate human rights education with the critical-dialogical pedagogy. In this perspective are identified four critical inquiry tools that serve to develop different dimensions for a critical understanding in the social sphere: the approach of the problem, the reflexive skepticism, the multiperspectivity, and systemic thinking.

  3. Safety and functional outcome of thrombolysis in dissection-related ischemic stroke: a meta-analysis of individual patient data

    NARCIS (Netherlands)

    Zinkstok, Sanne M.; Vergouwen, Mervyn D. I.; Engelter, Stefan T.; Lyrer, Philippe A.; Bonati, Leo H.; Arnold, Marcel; Mattle, Heinrich P.; Fischer, Urs; Sarikaya, Hakan; Baumgartner, Ralf W.; Georgiadis, Dimitrios; Odier, Céline; Michel, Patrik; Putaala, Jukka; Griebe, Martin; Wahlgren, Nils; Ahmed, Niaz; van Geloven, Nan; de Haan, Rob J.; Nederkoorn, Paul J.

    2011-01-01

    The safety and efficacy of thrombolysis in cervical artery dissection (CAD) are controversial. The aim of this meta-analysis was to pool all individual patient data and provide a valid estimate of safety and outcome of thrombolysis in CAD. We performed a systematic literature search on intravenous

  4. Automated discovery systems and the inductivist controversy

    Science.gov (United States)

    Giza, Piotr

    2017-09-01

    The paper explores possible influences that some developments in the field of branches of AI, called automated discovery and machine learning systems, might have upon some aspects of the old debate between Francis Bacon's inductivism and Karl Popper's falsificationism. Donald Gillies facetiously calls this controversy 'the duel of two English knights', and claims, after some analysis of historical cases of discovery, that Baconian induction had been used in science very rarely, or not at all, although he argues that the situation has changed with the advent of machine learning systems. (Some clarification of terms machine learning and automated discovery is required here. The key idea of machine learning is that, given data with associated outcomes, software can be trained to make those associations in future cases which typically amounts to inducing some rules from individual cases classified by the experts. Automated discovery (also called machine discovery) deals with uncovering new knowledge that is valuable for human beings, and its key idea is that discovery is like other intellectual tasks and that the general idea of heuristic search in problem spaces applies also to discovery tasks. However, since machine learning systems discover (very low-level) regularities in data, throughout this paper I use the generic term automated discovery for both kinds of systems. I will elaborate on this later on). Gillies's line of argument can be generalised: thanks to automated discovery systems, philosophers of science have at their disposal a new tool for empirically testing their philosophical hypotheses. Accordingly, in the paper, I will address the question, which of the two philosophical conceptions of scientific method is better vindicated in view of the successes and failures of systems developed within three major research programmes in the field: machine learning systems in the Turing tradition, normative theory of scientific discovery formulated by Herbert Simon

  5. Nuclear power. The Windscale controversy

    International Nuclear Information System (INIS)

    Boyle, G.

    1978-01-01

    The aims of this unit are: (1) to provide a basic understanding of nuclear technology and of the associated technical and environmental problems; (2) to provide an understanding of: (a) the historical growth of the nuclear industry; (b) the arguments for the continued development of nuclear power, and the institutions promoting that development; (3) to provide a basic understanding of the mechanisms and institutions which officially regulate the nuclear power programme in the UK; (4) to provide an understanding of the main issues - technical, economic, social and political - involved in the controversy over the proposed expansion of British Nuclear Fuels Ltd's reprocessing facilities at Windscale, and the events leading up to the Public Inquiry on the proposal which began in June 1977; and (5) to examine (a) the reason for the growth in opposition to nuclear power in various countries and the different approaches taken by the opposition groups; (b) the political impact and effectiveness of that opposition. (author)

  6. Antimicrobials and Non-Healing Wounds. Evidence, controversies and suggestions-key messages

    DEFF Research Database (Denmark)

    Gottrup, Finn; Apelqvist, Jan; Bjarnsholt, Thomas

    2014-01-01

    This article constitutes an extraction of key messages originally presented in the Document: Antimicrobials and Non-Healing Wounds. Evidence, controversies and suggestions written by the European Wound Management Association (EWMA), and originally published by the Journal of Wound Care in 2013. All...

  7. 37 CFR 251.72 - Declaration of controversy: Initiation of arbitration proceeding.

    Science.gov (United States)

    2010-07-01

    ... OFFICE, LIBRARY OF CONGRESS COPYRIGHT ARBITRATION ROYALTY PANEL RULES AND PROCEDURES COPYRIGHT ARBITRATION ROYALTY PANEL RULES OF PROCEDURE Royalty Fee Distribution Proceedings § 251.72 Declaration of... royalties, the Librarian shall publish in the Federal Register a declaration of controversy along with a...

  8. Science and Social Studies Teachers’ Beliefs and Practices about Teaching Controversial Issues: Certain Comparisons

    Directory of Open Access Journals (Sweden)

    Zafer Kuş

    2015-09-01

    Full Text Available The current study aims to investigate social studies and science teachers’ attitudes and classroom practices associated with controversial issues. The study is a qualitative research based on data collected through interviews and observation. Social studies and Science teachers participated in the current study which was conducted in Kirsehir, a city in the center of Turkey, during the 2012-2013 academic years. Data were collected through classroom observation and interviews with teachers. In this study, teachers' positioning during controversial issues are determined by Kelly's (1986 positioning classification: Exclusive Neutrality, Exclusive Partiality, Neutral Impartiality, and Committed Impartiality. According to results of the research, violence against women, education system, terrorism and nationalism are the leading issues among the controversial issues that both social studies and science teachers listed in Turkey. In relation to their area, social studies teachers stated that the issues such as Kemalism, democracy, military coups, and deep state, which are associated with recent history of Turkey, were among the important controversial issues. Science teachers on the other hand stated issues such as cancer and anti-toxic foods and global warming among the controversial issues in Turkey. Both social studies and science teachers stated that the most frequently encountered problem in discussions was lack of knowledge by students. Whereas social studies teachers stated that their priority goals were particularly to raise active citizens and to set up a democratic classroom environment, science teachers pointed to raising scientifically thinking students and increasing students’ knowledge as their priority goals. During in-class discussions teachers take some positions. The positions stated by the teachers and in-class observations of them conflict. Whereas the teachers stated that they prefer the 4th and 3rd positions, the in

  9. The role of STAG2 in bladder cancer.

    Science.gov (United States)

    Aquila, Lanni; Ohm, Joyce; Woloszynska-Read, Anna

    2018-05-01

    Stromal Antigen 2 (STAG2) is one of four components of the cohesin complex and predominantly functions in sister chromatid cohesion and segregation. STAG2 is the most frequently mutated cohesin subunit and was recently identified as a gene that is commonly altered in bladder cancer. The significance of these mutations remains controversial. Some studies associate loss of STAG2 expression with low stage and low grade bladder tumors, as well as with improved clinical outcomes. In other cases, STAG2 inactivation has been shown to be a predictor of worse outcome for these patients. The role of STAG2 in aneuploidy also remains controversial. Loss of STAG2 is associated with significant changes in chromosome number in certain cell lines, while in others, aneuploidy is not induced or results remain inconclusive. At this time, little is known about the influence of STAG2 on cellular migration, invasion, proliferation, and cell death, and such studies are required to determine the role of STAG2 in bladder cancer and other malignancies. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. [3rd and 4th generation estroprogestatives French controversy: What effect on women's behavior?].

    Science.gov (United States)

    Torres, Luis; Frapard, Christian; Daumas, Aurélie; Guibert, Nicolas; Lagouanelle-Simeoni, Marie-Claude; Rakoto, Jean-Claude; Villani, Patrick; Sambuc, Roland

    2016-04-01

    The primary objective of this study was to determine the reasons given by women who have changed or suspended their contraceptive method in 2013. What influence had the 3rd and 4th generation estroprogestatives (EP) French controversy and advices from doctors? Did they notice any consequences of the controversy on their lifestyle? Did they feel an impact on their behavior to health professionals? A study was conducted on women of childbearing age. Data collection took place between November 4 and December 16, 2013. The included subjects were between 18 and 55 years old females. Subjects were surveyed through an anonymous self-administered questionnaire distributed through pharmacies. The protocol called for the construction of clusters of subjects by having heard about, or not, of the controversy. Patients reporting having heard about the controversy have formed the "exposed" group while the others have formed the "unexposed" group. We compared two parameters between these two groups: the rate of subjects who reported having modified or suspended their contraceptive method in 2013 on one hand, and the rate of subjects who reported having made a change in their contraceptive method without or against advices from a doctor on the other hand. The sample included 988 subjects. The average age was 34 years. The level of exposure to media debates was 86.5%. Of the respondents, 19.8% were under 3rd or 4th generation EP in 2012, thus directly involved in the discussions and affected by health recommendations. Of the patients, 38.5% reported having changed their contraception in 2013. In these women, when they confirmed having heard about the controversy, 40.1% of them claimed to have conducted this process without or against advices from a doctor. This number dropped to 18.2% for those who had not heard of it. Media coverage of the 3rd and 4th generation EP vascular risk was not mentioned more by patients who suspended all medical contraceptive method than it was by

  11. How did the fracking controversy emerge in the period 2010-2012?

    Science.gov (United States)

    Mazur, Allan

    2016-02-01

    In 2010-2012, the controversy over fracking grew rapidly, first in the United States, and then internationally. An important step was the anti-fracking documentary film Gasland. With help from celebrity sources, the film was produced and won a prize at the Sundance Film Festival by early 2010 and had an Oscar nomination by early 2011, in the meantime popularizing potent images of hazard including tainted aquifers and ignitable water running from kitchen faucets. During this period, major US news organizations paid little attention to the issue. The offshore Deepwater Horizon disaster of April 2010 spurred The New York Times to prolific reporting on potential risks of the new onshore technique for extracting shale gas. With flagship news coverage, the controversy had by 2012 gained wide media attention that evoked public concern and opposition, spreading from the United States to other nations. © The Author(s) 2014.

  12. The trans-Alaska pipeline controversy: Technology, conservation, and the frontier

    International Nuclear Information System (INIS)

    Coates, P.A.

    1991-01-01

    The Trans-Alaska Pipeline was the object of perhaps the most passionately fought conservation battle in the U.S. Although numerous authors documented the pipeline construction during its construction, there is, surprisingly, no previous scholarly treatment of this event written by an historian. Coates is an environmental historian who views the most interesting aspect of the controversy to be open-quote its relationship to earlier engineering projects and technological innovations in Alaska and the debates that accompanied them.close quotes Thus, he describes how the conservationist and environmental ideas arose during numerous earlier major Alaskan projects and controversies, including the Alaska Highway (1938-41), Canol Pipeline (1943-45), exploration of Naval Petroleum Reserve Number Four (Pet 4, 1944-1953), DEWline (1953-57), oil development in the Kenai National Moose Range (1957-58), statehood (1958), the creation of the Arctic Wildlife Refuge (1960), Project Chariot (1958-63), and Rampart Dam (1959-67). The history starts with the acquisition of Alaska in 1867 and finishes about the time of the Valdez oil spill in 1989

  13. Autonomy, Respect, and Arrogance in the Danish Cartoon Controversy

    OpenAIRE

    Rostbøll, Christian F.

    2009-01-01

    Udgivelsesdato: 2009 Autonomy is increasingly rejected as a fundamental principle by liberal political theorists, because it is regarded as incompatible with respect for diversity. This article seeks, via an analysis of the Danish cartoon controversy, to show that the relationship between autonomy and diversity is more complex than often posited. Particularly, it asks whether the autonomy defense of freedom of expression encourages disrespect for religious feelings. Autonomy leads to disre...

  14. Red blood cell transfusion during septic shock in the ICU

    DEFF Research Database (Denmark)

    Perner, A; Smith, S H; Carlsen, S

    2012-01-01

    Transfusion of red blood cells (RBCs) remains controversial in patients with septic shock, but current practice is unknown. Our aim was to evaluate RBC transfusion practice in septic shock in the intensive care unit (ICU), and patient characteristics and outcome associated with RBC transfusion....

  15. The Comparative Risk of Delirium with Different Opioids : A Systematic Review

    NARCIS (Netherlands)

    Swart, Lieke M.; van der Zanden, Vera; Spies, Petra E.; de Rooij, Sophia E.; van Munster, Barbara C.

    Objective There is substantial evidence that the use of opioids increases the risk of adverse outcomes such as delirium, but whether this risk differs between the various opioids remains controversial. In this systematic review, we evaluate and discuss possible differences in the risk of

  16. A literature review on self-care of chronic illness: definition, assessment and related outcomes.

    Science.gov (United States)

    Ausili, Davide; Masotto, Matteo; Dall'Ora, Chiara; Salvini, Lorena; Di Mauro, Stefania

    2014-01-01

    Chronic illnesses care represents a challenging issue for people well-being and future health systems' sustainability. Promotion of self-care is considered a key point for chronically ill patients' care. The aim of this literature was to explore: how self-care of chronic illness has been theoretically defined; how self-care can be assessed in clinical and research settings; what associations exist between self-care and health outcomes of chronically ill patients. A wide range of definitions and terminologies related to self-care of chronic illness has been found in the literature. Although some common elements useful to explain the concept of self-care have been identified, the physical, cognitive, emotional and social processes underlying self-care remain controversial and poorly defined. Valid and reliable disease-specific assessment tools have been developed and used in a growing number of studies; however, the lack of utilization of standardized instruments in clinical practice has been referred by many authors. Significant correlations between self-care of chronic illness and outcome measures e.g. general health status, quality of life and healthcare costs, are reported by a limited number of studies. Supporting patient self-care is recognized as a crucial factor in chronic illness care. A deeper analysis of variables and processes influencing self-care could help for a full description of the phenomenon. A systematic evaluation of self-care in health professionals' everyday clinical practice is strongly recommended. The development of general non-disease-specific assessment tools could facilitate the evaluation of complex patients, especially those with multiple co-morbidities. Although self-care has been recognized as a vital intermediate outcome, further large-scale studies clarifying the association between self-care and patients' and health systems' outcomes are needed.

  17. Remaining questions in the case for balanced harvesting

    DEFF Research Database (Denmark)

    Burgess, Matthew G; Diekert, Florian K; Jacobsen, Nis Sand

    2016-01-01

    are controversial, including its call for extensive harvesting of juveniles and forage fish. Balanced harvesting also calls for targeting species and size-classes that are not currently marketable, possibly at a significant economic cost. Some have argued that this cost is outweighed by the ecological benefits......Balanced harvesting – harvesting all species and sizes in an ecosystem in proportion to their productivity – is a fisheries management strategy that has been suggested recently to increase yields, while reducing overall ecosystem impact. However, some aspects of balanced harvesting...

  18. PET in cancer screening: a controversial imaging

    International Nuclear Information System (INIS)

    Su Minggang; Tan Tianzhi

    2012-01-01

    Malignancy has been one of the most dangerous threats to human health. Early diagnosis and treatment are key factors for improving prognosis. Cancer screening is an important way to detect early stage cancer and precancerous lesion. PET has been used increasingly in cancer screening in accordance with the requirement of the public. Though a great number of data show that PET can find some subclinical malignancy, yet as a cancer screening modality, PET is still controversial in contemporary medical practice. The aim of this article is to review the application status and existing problem of PET in cancer screening, and to offer some recognition and view about cancer srceening. (authors)

  19. New Reproductive Conception Technologies: Bioethics and Controversies

    Directory of Open Access Journals (Sweden)

    Marlene Tamanini

    2004-01-01

    Full Text Available This article concerns some of the multiple ethical-bioethical and gender issues in the field of new reproductive and contraceptive technologies. The literature presented points to the plurality of possible situations and approaches in a multidimensional and controversial field. It presents some ethical-bioethical principals of biomedical action found in the study of heterosexual couples who use assisted reproduction. and of medical specialists in human reproduction in southern Brazil. It presents the ethical-bioethical presumptions that sanction medical behavior and the continuity of the so-called impregnation treatments, and analyzes the mechanisms used to raise the expectations of couples who lack confidence or success.

  20. [Alcohol and work: remaining sober and return to work].

    Science.gov (United States)

    Vittadini, G; Bandirali, M

    2007-01-01

    One of the most complex alcohol-driven problems is the job loss and the subsequent attempts to return to a professional activity. In order to better understand the issue, an epidemiologic investigation was carried out on a group of 162 alcoholics whilst hospitalised in a specialised clinic. The outcome shows the importance of remaining sober to keep or to be returned to one's own job. Unfortunately, local resources at hand, first of all joining an auto-mutual-help group, re still too little known and thus clearly underemployed. Therefore, an informative action within companies is highly desirable. Those alcoholics suffering from serious illnesses, especially mental ones represent a different issue. For these people a higher involvement of public authorities is desirable in creating protected job openings.

  1. Reading "Daddy's Roommate": Preservice Teachers Respond to a Controversial Text.

    Science.gov (United States)

    Williams, Shawyn

    2002-01-01

    Explores the responses of the author's 31 pre-service teachers to a controversial picture book. Begins by searching for a short text geared to elementary age children and suited for read-alouds. Notes that she believes that the majority of pre-service teachers at this stage in the program are still very impressionable and must be given multiple…

  2. Race and Genetics: Controversies in Biomedical, Behavioral, and Forensic Sciences

    Science.gov (United States)

    Ossorio, Pilar; Duster, Troy

    2005-01-01

    Among biomedical scientists, there is a great deal of controversy over the nature of race, the relevance of racial categories for research, and the proper methods of using racial variables. This article argues that researchers and scholars should avoid a binary-type argument, in which the question is whether to use race always or never.…

  3. Discharged from a mental health admission ward: is it safe to go home? A review on the negative outcomes of psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Loch AA

    2014-04-01

    Full Text Available Alexandre Andrade LochLaboratory of Neurosciences, Department and Institute of Psychiatry, University of São Paulo, BrazilAbstract: Before psychiatry emerged as a medical discipline, hospitalizing individuals with mental disorders was more of a social stigmatizing act than a therapeutic act. After the birth of the mental health disciplines, psychiatric hospitalization was legitimized and has proven to be indispensable, preventing suicides and helping individuals in need. However, despite more than a century passing since this legitimization occurred, psychiatric hospitalization remains a controversial issue. There is the question of possible negative outcomes after a psychiatric admission ceases to take its protective effect, and even of whether the psychiatric admission itself is related to a negative setback after discharge. This review aims to summarize some of the most important negative outcomes after discharge from a psychiatric institution. These experiences were organized into two groups: those after a brief psychiatric hospitalization, and those after a long-stay admission. The author further suggests possible ways to minimize these adversities, emphasizing the need of awareness related to this important issue.Keywords: suicide, stigma, rehabilitation, relapse, rehospitalisation

  4. Physician–Patient Discussions of Controversial Cancer Screening Tests

    Science.gov (United States)

    Dunn, Andrew S.; Shridharani, Kanan V.; Lou, Wendy; Bernstein, Jeffrey; Horowitz, Carol R.

    2016-01-01

    Background Screening mammography for younger women and prostate-specific antigen (PSA) measurement have controversial benefits and known potential adverse consequences. While providing informed consent and eliciting patient preference have been advocated for these tests, little is known about how often these discussions take place or about barriers to these discussions. Methods We administered a survey to medical house staff and attending physicians practicing primary care. The survey examined physicians’ likelihood of discussing screening mammography and PSA testing, and factors influencing the frequency and quality of these discussions. Results For the three scenarios, 16% to 34% of physicians stated that they do not discuss the screening tests. The likelihood of having a discussion was significantly associated with house staff physicians’ belief that PSA screening is advantageous; house staff and attending physicians’ intention to order a PSA test, and attending physicians’ intention to order a mammogram; and a controversial indication for screening. The most commonly identified barriers to discussions were lack of time, the complexity of the topic, and a language barrier. Conclusions Physicians report they often do not discuss cancer screening tests with their patients. Our finding that physicians’ beliefs and intention to order the tests, and extraneous factors such as time constraints and a language barrier, are associated with discussions indicates that some patients may be inappropriately denied the opportunity to choose whether to screen for breast and prostate cancer. PMID:11165455

  5. Controversies in breast cancer: adjuvant and neoadjuvant therapy.

    Science.gov (United States)

    Montemurro, Filippo; Redana, Stefania; Valabrega, Giorgio; Aglietta, Massimo

    2005-06-01

    Initial randomised studies of chemotherapy and endocrine therapy showed that systemic treatments had a substantial impact on the survival of women with early breast cancer. The original assumption was that the efficacy of these treatments was limited to those patients presenting with more adverse prognostic features. Subsequently, meta-analyses of randomised trials revealed that the benefits of chemotherapy and endocrine therapy are not mutually exclusive and extend to all the prognostic subgroups. However, the absolute benefit varies according to baseline characteristics such as tumour stage and other biological factors. Over the last 10 years, considerable progress has been made with the introduction of new drugs into the adjuvant and neoadjuvant treatment of women with breast cancer. Taxanes and third-generation aromatase inhibitors are providing proof of additional benefits compared with standard reference treatments. In parallel, research on the biology of breast cancer is establishing novel prognostic and predictive factors, which may allow better treatment tailoring. Currently, however, women with early breast cancer and their doctors face the difficult task of making therapeutic decisions often based on early results from positive studies. In a disease where follow up is crucial to fully assess the benefit and long-term toxicities of an intervention, current knowledge leaves unanswered questions that generate debate and controversy. This review will summarise recent results from randomised trials of adjuvant and neoadjuvant therapy in women with early breast cancer and focus on the current controversies.

  6. The rocky flats controversy on radionuclide soil action levels

    International Nuclear Information System (INIS)

    Earle, T.C.

    2004-01-01

    An account of the Rocky Flats radionuclide soil action level controversy is presented as: a case study for the purpose of understanding the nature and value of stakeholder involvement in the management of radiological hazards. The report consists of three main sections. The first section outlines the Rocky Flats story, including the Cold War era, which was characterised by secrecy and distrust, the post-Cold War era, in which trust and co-operation between risk managers and the public began to develop. This contrast between these two historical periods provides the context necessary to understand the radionuclide soil action level controversy, the main events of which are described in the second section. In the final section, the Rocky Flats case is briefly discussed within the framework of a general model of stakeholder involvement and the lessons learned from the case are identified: (1) without a basis in shared values, collaborative public involvement in the management of radiological hazards is not possible; (2) given a basis in shared values, collaborative public involvement can lead to improved solutions to the management of radiological hazards; and (3) risk managers should therefore seek to understand the values of public stakeholders and to identify ways, through stakeholder involvement, that those values can be incorporated in management practice. (author)

  7. The long-term functional outcome of type II odontoid fractures managed non-operatively.

    LENUS (Irish Health Repository)

    Butler, J S

    2010-10-01

    Odontoid fractures currently account for 9-15% of all adult cervical spine fractures, with type II fractures accounting for the majority of these injuries. Despite recent advances in internal fixation techniques, the management of type II fractures still remains controversial with advocates still supporting non-rigid immobilization as the definitive treatment of these injuries. At the NSIU, over an 11-year period between 1 July 1996 and 30 June 2006, 66 patients (n = 66) were treated by external immobilization for type II odontoid fractures. The medical records, radiographs and CT scans of all patients identified were reviewed. Clinical follow-up evaluation was performed using the Cervical Spine Outcomes Questionnaire (CSOQ). The objectives of this study were to evaluate the long-term functional outcome of patients suffering isolated type II odontoid fractures managed non-operatively and to correlate patient age and device type with clinical and functional outcome. Of the 66 patients, there were 42 males and 24 females (M:F = 1.75:1) managed non-operatively for type II odontoid fractures. The mean follow-up time was 66 months. Advancing age was highly correlated with poorer long-term functional outcomes when assessing neck pain (r = 0.19, P = 0.1219), shoulder and arm pain (r = 0.41, P = 0.0007), physical symptoms (r = 0.25, P = 0.472), functional disability (r = 0.24, P = 0.0476) and psychological distress (r = 0.41, P = 0.0007). Patients >65 years displayed a higher rate of pseudoarthrosis (21.43 vs. 1.92%) and established non-union (7.14 vs. 0%) than patients <65 years. The non-operative management of type II odontoid fractures is an effective and satisfactory method of treating type II odontoid fractures, particularly those of a stable nature. However, patients of advancing age have been demonstrated to have significantly poorer functional outcomes in the long term. This may be linked to higher rates of non-union.

  8. Removing Mill Weirs in France: The Structure and Dynamics of an Environmental Controversy

    Directory of Open Access Journals (Sweden)

    Regis Barraud

    2017-10-01

    Full Text Available In France, as in many other parts of Europe and North America, the vast increase in the number of dam removals in order to restore ecological continuity has led to a large number of local conflicts, resulting in a significant ecological controversy. Most of these hydraulic works were connected to former water mills. This article will suggest new analytical methods to help understand and interpret this controversy through the use of two complementary approaches. The first is based on a geohistorical approach. It allows us to identify the development of the meanings and values associated with mill weirs and also to trace the development, since the 19th century, of state involvement in dealing with their ecological impact. Our second method, based on political ecology, attempts to decipher the current state of the controversy. Taking this as our objective we have undertaken a qualitative analysis of the discourse produced on a national level and also of the network of actors who make up the oppositional base to dam removal. The affective and emotional dimensions of the controversy, and also the attachment to local places, both of which are often crucial in the expression of opposition on the local scale, can be identified in the discourse. Yet, the discourse we have analysed reveals argumentative poles which translate both the opposition based on rational arguments and also an alternative vision of the development of rivers (heritage status, green and local power production. The oppositional argument which has been developed notably includes a discussion of the knowledge and scientific expertise upon which the process of dam removal is based. It also includes a critique of local consultation and decision-making methods.

  9. Successful outcome of sphincterotomy and 7 French pigtail stent insertion in the management of post-cholecystectomy bile leaks.

    LENUS (Irish Health Repository)

    Donnellan, Fergal

    2009-06-01

    BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is widely used to manage post-cholecystectomy bile leaks. However, the best endoscopic intervention remains controversial. We investigated the success of a 7 French double pigtail stent following sphincterotomy in the management of such bile leaks. METHODS: Between July 1998 and June 2008, 48 patients were referred for ERCP for presumed post-cholecystectomy bile leaks. Leaks were confirmed at ERCP and managed by a combination of sphincterotomy and stent insertion unless contraindicated. RESULTS: Bile duct cannulation was successful in 44 (91.7%) patients. A leak of the cystic duct was demonstrated in 19 (43.2%) patients, the duct of Luschka in 11 (25.0%), and the common hepatic duct in 5 (11.4%). Complete transection of the common bile duct occurred in 4 patients. The remaining patients had no cholangiographic evidence of a leak. Sphincterotomy was performed in 34 patients. A 7 French double pigtail plastic stent was placed in all 35 patients with cholangiographic evidence of a bile leak. No bile leaks were demonstrated at a follow-up of 8-16 weeks and all stents were removed successfully. CONCLUSION: The combination of sphincterotomy and insertion of a 7 French double pigtail stent results in excellent outcomes in the management of post-cholecystectomy bile leaks.

  10. The role of FDG-PET imaging as a prognostic marker of outcome in primary mediastinal B-cell lymphoma

    International Nuclear Information System (INIS)

    Nagle, Sarah J; Chong, Elise A; Chekol, Seble; Shah, Nirav N; Nasta, Sunita D; Glatstein, Eli; Plastaras, John P; Torigian, Drew A; Schuster, Stephen J; Svoboda, Jakub

    2015-01-01

    Primary mediastinal B-cell lymphoma (PMBL) is a subtype of diffuse large B-cell lymphoma (DLBCL) that arises in the mediastinum from B-cells of thymic origin. Optimal management of patients with PMBL remains controversial. The present study evaluates outcomes of 27 PMBL patients treated with R-CHOP with or without radiation therapy (RT). It investigates the role of both interim and posttreatment fluorodeoxyglucose-positron emission tomography (FDG-PET) as prognostic markers of outcome. Additionally, it assesses postprogression therapies in the six patients who had progressive disease. At a median follow-up of 41.5 months (range: 6.1–147.2 months), OS was 95.5% (95% CI = 71.9–99.4) and progression-free survival (PFS) was 70.4% (95% CI = 49.4–83.9) for the entire cohort. The negative predictive values of interim and posttreatment FDG-PET scans were both 100%. Patients who failed initial therapy and were treated with salvage regimens and autologous stem cell transplantation (ASCT) all achieved and maintained CR. PMBL patients can achieve excellent outcomes with minimal toxicities when treated with R-CHOP with or without RT. Negative interim and negative posttreatment FDG-PET results identified PMBL patients who achieve long-term remission. However, the significance of both positive interim and positive posttreatment FDG-PET results needs to be better defined. Those who failed initial therapy were successfully treated with salvage regimens and ASCT

  11. Safe but controversial: A study of recent high-visibility spent fuel shipping campaigns

    International Nuclear Information System (INIS)

    Grimm, P.D.; Harmon, L.H.

    1987-01-01

    Since the need to move radioactive materials is at the core of every part of the fuel cycle, it is not surprising that the waste management program also has a critical transportation link. Yet, in spite of a nearly flawless safety record, transportation of spent fuel is an extremely controversial and emotional issue. There are reactions at every political level and pressures from special interest groups across the Nation. In many cases the courts make the final decisions. An example is the DOE program to move spent fuel from Brookhaven National Laboratory which took ten years to accomplish and wound up being decided by the U.S. Supreme Court. Two other DOE shipping campaigns now underway contain all of the same elements of controversy. About 35 - 40 rail shipments are intended to move the damaged Three-Mile Island core to DOE's Idaho facility. In addition, approximately 50 shipments of spent fuel will be made from the VEPCO plant at Surry, Virginia, to Idaho for use in testing above-ground storage methods. This paper traces the background of the campaigns and the controversies generated. Comparisons and contrasts of ''routine'' shipments of recent years with problems of today, including lawsuits to prevent shipment, are given along with implications for the future

  12. Clinical outcomes in children with Henoch-Schönlein purpura nephritis without crescents.

    Science.gov (United States)

    Delbet, Jean Daniel; Hogan, Julien; Aoun, Bilal; Stoica, Iulia; Salomon, Rémi; Decramer, Stéphane; Brocheriou, Isabelle; Deschênes, Georges; Ulinski, Tim

    2017-07-01

    Henoch-Schönlein purpura is the most common vasculitis in children. Its long-term prognosis depends on renal involvement. The management of Henoch-Schönlein purpura nephritis (HSPN) remains controversial. This study reports the prognosis of children with HSPN presenting with class 2 International Study of Kidney Disease in Children (ISKDC) nephritis. All children with HSPN class 2 diagnosed between 1995 and 2015 in four pediatric nephrology centers were included, and clinical and biological data were collected from the medical files. The primary endpoint was proteinuria remission defined as a proteinuria 3 g/L, 52% proteinuria between 1 and 3 g/L, and 18% proteinuria <1 g/L. Forty-seven percent of patients received orally treatment with steroids alone, 37% received methylprednisolone pulses followed by steroids orally, 18% received no steroids. Although 85% reached remission during follow-up, 12% did not maintain complete remission over time so that only 75% remained in complete remission by the end of the follow-up. Univariate analysis found a higher likelihood of remission in patients with higher proteinuria at disease onset (p = 0.009). This trend was not found in the multivariate analysis after adjusting for treatments, as patients with higher proteinuria were most often treated with steroids. Our study shows that one fourth of patients with HSPN class 2 remain proteinuric and thus carry the risk of developing chronic kidney disease over the long term. This finding, together with the better outcome of patients treated with steroids, is in favor of using high-dose steroids orally or IV in these patients.

  13. Perthes Disease, Results of Conservative Management at Soba ...

    African Journals Online (AJOL)

    Ideal way of treatment remains controversial. Objectives: To study patterns of presentations and outcome of management of patients with LCPD treated at Soba University Hospital. Materials and Methods: Records of patients with LCPD who were treated at Soba University Hospital between 2005 and 2013 were reviewed.

  14. Wrestling with Equity: Reauthorization of IDEA.

    Science.gov (United States)

    Mead, Julie Fisher

    1997-01-01

    Explores six proposed changes and the controversies that have stalled Congress's reauthorization of the Individuals with Disabilities Education Act. Although IDEA's fundamental characteristics will remain unchanged, there is likely to be an increased focus on outcomes, an augmented appeals process, and provisions addressing discipline problems.…

  15. 42 CFR 405.740 - Principles for determining the amount in controversy.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Principles for determining the amount in... Reconsiderations and Appeals Under Medicare Part A § 405.740 Principles for determining the amount in controversy... more appellants, the Secretary may assert that the aggregation principles contained in this subpart may...

  16. Thyroid Lobectomy Is Associated with Excellent Clinical Outcomes in Properly Selected Differentiated Thyroid Cancer Patients with Primary Tumors Greater Than 1 cm

    Science.gov (United States)

    Vaisman, Fernanda; Momesso, Denise; Bulzico, Daniel A.; Pessoa, Cencita H. C. N.; da Cruz, Manuel Domingos Gonçalves; Dias, Fernando; Corbo, Rossana; Vaisman, Mario; Tuttle, R. Michael

    2013-01-01

    Background and Objective. An individualized risk-based approach to the treatment of thyroid cancer is being extensively discussed in the recent literature. However, controversies about the ideal surgical approach remain an important issue with regard to the impact on prognosis and follow-up strategies. This study was designed to describe clinical outcomes in a cohort of low and intermediate risk thyroid cancer patients treated with thyroid lobectomy. Methods. Retrospective review of 70 patients who underwent lobectomy. Results. After a median follow-up of 11 years, 5 patients (5/70, 7.1%) recurred and 5 had a completion for benign lesions, while 60 patients (86%) continued to be observed without evidence for disease recurrence. Suspicious ultrasound findings were significantly more common in patients that had structural disease recurrence (100% versus 4.3%, P < 0.001). Furthermore, a rising suppressed Tg value over time was also associated with structural disease recurrence (80% versus 21.5%, P = 0.01). After additional therapy, 99% of the patients had no evidence of disease. Conclusions. Properly selected thyroid cancer patients can be treated with lobectomy with excellent clinical outcomes. PMID:24455413

  17. Thyroid Lobectomy Is Associated with Excellent Clinical Outcomes in Properly Selected Differentiated Thyroid Cancer Patients with Primary Tumors Greater Than 1 cm

    Directory of Open Access Journals (Sweden)

    Fernanda Vaisman

    2013-01-01

    Full Text Available Background and Objective. An individualized risk-based approach to the treatment of thyroid cancer is being extensively discussed in the recent literature. However, controversies about the ideal surgical approach remain an important issue with regard to the impact on prognosis and follow-up strategies. This study was designed to describe clinical outcomes in a cohort of low and intermediate risk thyroid cancer patients treated with thyroid lobectomy. Methods. Retrospective review of 70 patients who underwent lobectomy. Results. After a median follow-up of 11 years, 5 patients (5/70, 7.1% recurred and 5 had a completion for benign lesions, while 60 patients (86% continued to be observed without evidence for disease recurrence. Suspicious ultrasound findings were significantly more common in patients that had structural disease recurrence (100% versus 4.3%, P<0.001. Furthermore, a rising suppressed Tg value over time was also associated with structural disease recurrence (80% versus 21.5%, P=0.01. After additional therapy, 99% of the patients had no evidence of disease. Conclusions. Properly selected thyroid cancer patients can be treated with lobectomy with excellent clinical outcomes.

  18. Behavioral consequences of conflict-oriented health news coverage: the 2009 mammography guideline controversy and online information seeking.

    Science.gov (United States)

    Weeks, Brian E; Friedenberg, Laura M; Southwell, Brian G; Slater, Jonathan S

    2012-01-01

    Building on channel complementarity theory and media-system dependency theory, this study explores the impact of conflict-oriented news coverage of health issues on information seeking online. Using Google search data as a measure of behavior, we demonstrate that controversial news coverage of the U.S. Preventive Services Task Force's November 2009 recommendations for changes in breast cancer screening guidelines strongly predicted the volume of same-day online searches for information about mammograms. We also found that this relationship did not exist 1 year prior to the coverage, during which mammography news coverage did not focus on the guideline controversy, suggesting that the controversy frame may have driven search behavior. We discuss the implications of these results for health communication scholars and practitioners.

  19. Management of endometrial cancer: issues and controversies.

    Science.gov (United States)

    Bogani, G; Dowdy, S C; Cliby, W A; Ghezzi, F; Rossetti, D; Frigerio, L; Mariani, A

    2016-01-01

    Although endometrial cancer (EC) is the most common gynecologic cancer in developed countries, several aspects of its management are still controversial. In particular, the need to perform lymphadenectomy represents an important matter of discussion. Because of the discordant results in the literature, it is still not possible to draft any definitive conclusions regarding the therapeutic value of lymph node dissection. The present review discusses the role of lymphadenectomy in the setting of EC, risk factors for lymphatic spread, identification of patients at risk for lymph node dissemination, and the current evidence for adjuvant therapies in patients with positive nodes. Reasons for the difficulty in demonstrating any therapeutic value of pelvic and para-aortic lymphadenectomy are also discussed.

  20. Drug safety: Pregnancy rating classifications and controversies.

    Science.gov (United States)

    Wilmer, Erin; Chai, Sandy; Kroumpouzos, George

    2016-01-01

    This contribution consolidates data on international pregnancy rating classifications, including the former US Food and Drug Administration (FDA), Swedish, and Australian classification systems, as well as the evidence-based medicine system, and discusses discrepancies among them. It reviews the new Pregnancy and Lactation Labeling Rule (PLLR) that replaced the former FDA labeling system with narrative-based labeling requirements. PLLR emphasizes on human data and highlights pregnancy exposure registry information. In this context, the review discusses important data on the safety of most medications used in the management of skin disease in pregnancy. There are also discussions of controversies relevant to the safety of certain dermatologic medications during gestation. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. The Controversies over Bioenergy in Denmark

    DEFF Research Database (Denmark)

    Jørgensen, Michael Søgaard; Andersen, Bente Hessellund

    2012-01-01

    convert coal fired power plants to biomass in order to sustain the role of these power plants. Their increasing use of imported wood pellets is criticized for increasing greenhouse gas emissions because of fast logging of years of forest growth. A Danish biotech company is developing enzymes...... a prominent role in several Danish climate and energy plans, alongside with wind and solar energy, and energy savings. There are major controversies about targets for bioenergy with respect to acceptable types, sources and amounts of biomass. Strong path dependency is identified. Energy companies in Denmark...... for processing of biomass for biofuels. The alignment with the private car regime is strong, because biofuel enables continuation of fuel-driven vehicles as dominating transportation mode. Danish farmers see manure as important source for biogas while arguing for reduction of climate impact and nuisances from...

  2. An overview of the Hanford controversy

    International Nuclear Information System (INIS)

    Stewart, A.M.; Kneale, G.W.

    1991-01-01

    In 1964, the Atomic Energy Commission agreed to sponsor 'a study of the lifetime health and mortality experiences of all employees of AEC contractors.' The commission put in charge of this study a physician (Thomas Mancuso) who had recently shown how the U.S. Social Security system could be used to identify the dates and causes of death of all insured workers. As director of the AEC project, Mancuso was at liberty to include any or all the postwar offshoots of the Manhattan Project. His master plan included workers from Oak Ridge, Los Alamos, and Hanford, but it soon became apparent that his attempts to link radiation exposures to subsequent events were proving more successful at Hanford than elsewhere. The authors of this paper, who participated in the study, review the controversy surrounding its eventual publication.22 references

  3. Symptoms of an Intrauterine Hematoma Associated with Pregnancy Complications: A Systematic Review

    Science.gov (United States)

    Xiang, Lan; Wei, Zhaolian; Cao, Yunxia

    2014-01-01

    Objective To evaluate the predictive value of the symptoms of an intrauterine hematoma (IUH) for adverse pregnancy outcomes. Methods A literature review was performed with the search terms, including intrauterine/subchorionic/retroplacental/subplacental hematoma/hemorrhage/bleeding/collection/fluid, covering the period from January, 1981 to January, 2014. We just focused on the pregnancy outcomes associated with different symptoms of an IUH. Results It is generally agreed that a retroplacental, posterior or subchorionic in the fundus of uterus, and/or persistent IUH is associated with adverse outcomes in the ongoing pregnancy. However, the prognosis value of both volume and gestational age at diagnosis of IUH still remains controversial. Some researchers argue that a large IUH is associated with an increased risk of adverse events during pregnancy while others refuted. It is believed by some that the earlier an IUH was detected, the higher the risk for adverse outcomes would be, while no or weak association were reported by other studies. The prognostic value of the simultaneous presence of vaginal bleeding on pregnancy outcome is also controversial. Conclusions Both the position relative to the placenta or uterus and duration of IUH have strong predictive value on the prognosis in the ongoing pregnancy. However, the prognostic values of the IUH volume, gestational age at diagnosis and the simultaneous presence of vaginal bleeding remain controversial up to now. Moreover, most of previous reports are small, uncontrolled studies with incomplete information. Prospective, large sample, cohorts studies which take all detailed symptoms of an IUH into consideration are needed when we evaluate its clinical significance in the prognosis of pregnancy. PMID:25369062

  4. Clinical Correlates of Alleged Satanic Abuse and Less Controversial Sexual Molestation.

    Science.gov (United States)

    Leavitt, Frank

    1994-01-01

    This study found that 39 women alleging satanic ritual abuse and 47 women reporting less controversial forms of sexual trauma as children were characterized by high but nondiscriminating levels of psychiatric pathology. Patients alleging satanic ritual abuse reported higher levels of dissociation, in the range often exhibited by patients with…

  5. General Education Today. A Critical Analysis of Controversies, Practices, and Reforms.

    Science.gov (United States)

    Gaff, Jerry G.

    The range of controversies and changes emerging from the current revival of general education are examined, and many ideas, examples, and recommendations for achieving realistic and successful curricular reform are offered. Instead of either offering an apology for general education or advocating any particular approach, the book draws on solid…

  6. Prognostic value of 24-h ABPM in acute ischemic stroke for short-, medium-, and long-term outcome: a systematic review and meta-analysis.

    Science.gov (United States)

    Kakaletsis, Nikolaos; Ntaios, George; Milionis, Haralampos; Haidich, Anna-Bettina; Makaritsis, Konstantinos; Savopoulos, Christos; Berge, Eivind; Hatzitolios, Apostolos I

    2015-10-01

    The association of blood pressure levels during the acute phase of ischemic stroke with outcome remains controversial. The objective of this systematic review is to assess the predictive value for stroke outcome assessed by the modified Rankin scale score of systolic and diastolic blood pressure, measured by ambulatory blood pressure monitoring methods during the acute phase of ischemic stroke, compared with the values of casually derived blood pressure measurement on admission. We searched for studies with patients admitted within 24 h of stroke onset, and who had ambulatory blood pressure monitoring during the first 24 h of admission. We identified studies that reported blood pressure in those with good outcome and in those with poor outcome at end of follow-up, and performed a meta-analysis of the effect of mean blood pressure on outcome. High systolic and diastolic blood pressure levels derived with ambulatory blood pressure monitoring were associated with poor short-, medium-, and long-term outcome, but the same was not found for casual blood pressure measurements. An increase in systolic blood pressure of 9·1 mmHg (95% confidence interval: 6·6-11·6, P < 0·001; I(2)  = 9%) and an increase in diastolic blood pressure of 2·3 mmHg (95% confidence interval: 0·8-3·7, P = 0·002; I(2)  = 0%) were associated with poor outcome. Higher systolic and diastolic blood pressure levels derived with ambulatory blood pressure monitoring were associated with poor outcome. The same was not found for higher casual blood pressure measurements on admission, and it is possible that ambulatory blood pressure monitoring conveys better prognostic information. © 2015 World Stroke Organization.

  7. Androgen replacement therapy in late-onset hypogonadism: current concepts and controversies - a mini-review.

    Science.gov (United States)

    Mäkinen, Juuso I; Huhtaniemi, Ilpo

    2011-01-01

    Normal testicular function is essential for the maintenance of male physical strength and behaviour irrespective of age. A new term of late-onset hypogonadism (LOH) has been coined for the condition of decreased testosterone (T) and hypogonadal symptoms in ageing men. The most important testicular hormone, T, is responsible for the gender-specific androgenic-anabolic effects in men. Testicular T production remains stable until around the age of 40 years after which it declines by 1-2% annually. Despite this age-related decline, serum T levels in most older men remain within the reference range of younger men. The decreasing androgen levels are paralleled by well-defined objective biological and nonspecific subjective signs and symptoms of ageing. Because these symptoms are similar to those observed in young men with documented hypogonadism, androgen replacement therapy (ART) has been considered a logical way to treat them. A thorough review of the existing literature was performed to evaluate the current concepts and controversies related to ageing men and ART. Although it is intuitively logical that the symptoms of LOH are due to the ageing-related deficiency of T, and that they can be reversed by ART, the evidence for this is still variable and often weak. In particular, evidence-based information about long-term benefits and risks of ART in ageing men is largely missing. Despite widespread use, evidence-based proof for the objective benefits and side effects of ART of elderly men is still scanty, and such treatments should be considered experimental. Copyright © 2010 S. Karger AG, Basel.

  8. The Immunology of Neuromyelitis Optica-Current Knowledge, Clinical Implications, Controversies and Future Perspectives.

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-03-02

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%-25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients.

  9. The Immunology of Neuromyelitis Optica—Current Knowledge, Clinical Implications, Controversies and Future Perspectives

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-01-01

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%–25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients. PMID:26950113

  10. TREM-1 expression in craniopharyngioma and Rathke's cleft cyst: its possible implication for controversial pathology.

    Science.gov (United States)

    Liu, Yi; Wang, Chao-Hu; Li, Dan-Ling; Zhang, Shi-Chao; Peng, Yu-Ping; Peng, Jun-Xiang; Song, Ye; Qi, Song-Tao; Pan, Jun

    2016-08-02

    Whether a mixed type of craniopharyngioma (CP) exists and whether papillary craniopharyngioma (pCP) is on a histopathological continuum with Rathke's cleft cyst (RCC) remain controversial. Herein, we examined the expression and localization of β-catenin, BRAF p.V600E (V600E), and triggering receptor expressed on myeloid cells-1 (TREM-1) in 58 samples including 20 pCPs, 26 adamantinomatous craniopharyngiomas (aCP), and 12 RCCs. Five aCPs were diagnosed with mixed type CPs and the remaining 21 cases were pure aCPs. Four of the 12 RCCs presented with significant squamous epithelium (SE). V600E immunoreactivity was observed in all pCPs in the cytoplasm, but not in the nuclei. aCPs and RCCs, including mixed type CP, did not express V600E. Nuclear β-catenin translocation was detected exclusively in aCPs. TREM-1 was expressed in pCPs. Additionally, TREM-1 expression was detected in the SE of 5 "mixed type" CPs, while it was absent in pure aCPs. TREM-1 was expressed in 4 RCCs with SE, but not in the remaining 8 RCCs. TREM-1 mRNA levels were compared in cultured pCP and aCP cells. TREM-1 mRNA level was significantly (p < 0.001; up to 4.045 fold) higher in pCPs than in aCPs. Western blotting revealed a significantly (p < 0.001; up to 7.19 fold) lower level of TREM-1 expression in aCP cells compared to that in pCP cells. Our findings further supported that RCC and pCP may represent two ends of a morphological spectrum. A variant showing overlapping histological features of aCP and pCP should not be considered as a mixed type.

  11. Einstein's opponents the public controversy about the theory of relativity in the 1920s

    CERN Document Server

    Wazeck, Milena

    2014-01-01

    This detailed account of the controversy surrounding the publication of Albert Einstein's theory of relativity explores the ferocious popular and academic opposition which at one time encircled one of the most important scientific breakthroughs of the twentieth century. Based on extensive archival research, this fascinating discourse includes a compelling and entertaining examination of the contemporary literature created by Einstein's detractors. Exploring the arguments and strategies, social contexts, and motivations of Einstein's detractors, and providing unique insights into the dynamics of scientific controversies, this book is ideal for anyone interested in the history and philosophy of physics, popular science, and the public understanding of science.

  12. The Ground Zero Mosque Controversy: Implications for American Islam

    Directory of Open Access Journals (Sweden)

    Liyakat Takim

    2011-06-01

    Full Text Available The controversy surrounding the “ground zero mosque” is part of a larger debate about the place of Islam in U.S. public space. The controversy also reveals the ways in which the boundaries of American identity continue to be debated, often through struggles over who counts as a “real” American. It further demonstrates the extent to which Islam is figured as un-American and militant, and also the extent to which all Muslims are required to account for the actions of those who commit violence under the rubric of Islam. This paper will discuss how, due to the events of September 11, 2001, Muslims have engaged in a process of indigenizing American Islam. It will argue that the Park51 Islamic Community Center (or Ground Zero mosque is a reflection of this indigenization process. It will go on to argue that projects such as the Ground Zero mosque which try to establish Islam as an important part of the American religious landscape and insist on the freedom of worship as stated in the U.S. constitution, illustrate the ideological battlefield over the place of Islam in the U.S. The paper will also examine the possible ramifications of building the Park51 Islamic Community Center including how this will shape the role that Islam plays in the socio-political lives America Muslims.

  13. Controversies Concerning the Canadian Not Criminally Responsible Reform Act.

    Science.gov (United States)

    Lacroix, Robert; O'Shaughnessy, Roy; McNiel, Dale E; Binder, Renée L

    2017-03-01

    In Canada, individuals found not criminally responsible on account of mental disorder are subject to the disposition recommendations of the Provincial or Territorial Review Board of the jurisdiction where the offense was committed. Bill C-14, known as "The Not Criminally Responsible Reform Act" made changes to the postverdict disposition process of these individuals. This legislation was consistent with a broader "tough-on-crime" agenda of the previous federal government. The legislative changes codify that Review Boards take public safety as the "paramount consideration" in making their recommendations. The legislation also creates a new "high-risk" category for certain offenders and imposes limitations on their liberty. Further, Bill C-14 seeks to enhance victim involvement in the disposition process. The passage of this legislation has generated significant controversy in the medical and legal fields. Critics have stated that there is an absence of empirical evidence on which to base the amendments, that the legislation was an overreaction to high-profile cases, and that Bill C-14 is in questionable compliance with the Canadian Charter of Rights and Freedoms. In this review, we explore the potential catalysts involved in the creation of Bill C-14, the controversy surrounding the legislation, and the potential future impact on practicing forensic psychiatrists and on the forensic mental health system in Canada. © 2017 American Academy of Psychiatry and the Law.

  14. Service and Emotional Support Animals on Campus: The Relevance and Controversy

    Science.gov (United States)

    Phillips, Melinda

    2016-01-01

    Service and emotional support animals (ESA) have recently been a topic of conversation on college campuses, despite decades of controversy related to the interpretation of federal law. The distinction between an Emotional Support Animal and Service Animals, and the rights of the student regarding accommodations under FHA and ADA have been debated…

  15. Outcome of radiation therapy for patients with Kasabach-Merritt syndrome

    International Nuclear Information System (INIS)

    Mitsuhashi, Norio; Furuta, Masaya; Sakurai, Hideyuki; Takahashi, Takeo; Kato, Shingo; Nozaki, Miwako; Saito, Yoshihiro; Hayakawa, Kazushige; Niibe, Hideo

    1997-01-01

    Purpose: The efficacy of radiation therapy for Kasabach-Merritt syndrome, which is characterized by a huge hemangioma with consumption coagulopathy, remains controversial. In this study, we retrospectively investigated the treatment outcome of radiation therapy for seven neonates with Kasabach-Merritt syndrome. Methods and Materials: During the past 25 years we have seen seven children with Kasabach-Merritt syndrome who were treated with radiation therapy. Their ages ranged from 1 day to 5 months, with a median age of 1 month. The hemangioma was located in the extremities in four of seven children. Tumor sizes ranged from 70 cm to more than 150 cm in greatest diameter. Initial platelet counts were all less than 40,000/mm 3 except for one patient. In principle, the total dose applied to the hemangioma was 8-10 Gy, with a daily dose of 1 Gy five times a week. Results: Four of seven hemangiomas responded dramatically, with a concomitant rise of the platelet count to radiation therapy. Although the remaining three hemangiomas, all of which were ill circumscribed by widespread overlying shiny, dusky purple skin, became less tense during radiation therapy. Disseminated intravascular coagulopathy was not improved, but they have responded favorably to two or three courses of radiation therapy with an extended radiation field by 1.5 years of age. As a result, all seven patients are now surviving with no evidence of hemangioma or hematological abnormalities. Shortening of the extremity was observed in three patients who received multiple courses of radiation therapy. Conclusions: Radiation therapy appears to be one of the effective treatment options for Kasabach-Merritt syndrome despite the risk of growth delay and malignancy

  16. Is elevated SUA associated with a worse outcome in young Chinese patients with acute cerebral ischemic stroke?

    Directory of Open Access Journals (Sweden)

    Zhang Bin

    2010-09-01

    Full Text Available Abstract Background Elevated serum uric acid (SUA levels can enhance its antioxidant prosperities and reduce the occurrence of cerebral infarction. Significantly elevated SUA levels have been associated with a better prognosis in patients with cerebral infarction; however, the results from some studies on the relationship between SUA and the prognosis of patients with cerebral infarction remain controversial. Methods We analyzed the relationship between SUA and clinical prognosis of 585 young Chinese adults with acute ischemic stroke as determined by the modified Rankin Scale at discharge. Using multivariate logistic regression modeling, we explore the relationship between SUA levels and patient's clinical prognosis. Results Lower SUA levels at time of admission were observed more frequently in the lowest quintile for patients with severe stroke (P = 0.02. Patients with cerebral infarction patients caused by small-vessel blockage had higher SUA concentrations (P = 0.01 and the lower mRS scores (P Conclusion Elevated SUA is an independent predictor for good clinical outcome of acute cerebral infarction among young adults.

  17. Clinical, patient-related, and economic outcomes of home-based high-dose hemodialysis versus conventional in-center hemodialysis

    Directory of Open Access Journals (Sweden)

    Mitsides N

    2016-07-01

    Full Text Available Nicos Mitsides,1,2 Sandip Mitra,1,2 Tom Cornelis3 1Department of Renal Medicine, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Center, Manchester, 2National Institute for Healthcare Research Devices for Dignity Healthcare Co-operative, Sheffield, UK; 3Department of Nephrology, Jessa Hospital, Hasselt, Belgium Abstract: Despite technological advances in renal replacement therapy, the preservation of health and quality of life for individuals on dialysis still remains a challenge. The high morbidity and mortality in dialysis warrant further research and insight into the clinical domains of the technique and practice of this therapy. In the last 20 years, the focus of development in the field of hemodialysis (HD has centered around adequate removal of urea and other associated toxins. High-dose HD offers an opportunity to improve mortality, morbidity, and quality of life of patients with end-stage kidney disease. However, the uptake of this modality is low, and the risk associated with the therapy is not fully understood. Recent studies have highlighted the evidence base and improved our understanding of this technique of dialysis. This article provides a review of high-dose and home HD, its clinical impact on patient outcome, and the controversies that exist. Keywords: hemodialysis, home dialysis, high dose, outcomes

  18. Prevention of sudden cardiac death in young athletes: controversies and conundrums.

    Science.gov (United States)

    Rowland, Thomas

    2011-01-01

    Strategies for preventing sudden cardiac death in young athletes are predicated on the assumption that: (1) these events reflect pre-existing, clinically silent heart disease, and (2) means for detecting these abnormalities on the pre-participation evaluation are both feasible and accurate. Recent controversy has surrounded both of these presumptions. Some evidence suggests that the myocardial hypertrophy accompanying sports training itself might serve as a substrate for fatal arrhythmias. As well, vigorous debate has arisen over the optimal content of the pre-participation evaluation, particularly regarding the inclusion of routine screening electrocardiograms. As the rarity of these fatal events does not lend itself to an experimental approach, such disagreements are not easily resolved. Consequently, it is expected that decisions regarding approaches to prevention of sudden death in athletes will be dictated largely by region-specific financial, political, and cultural factors. This chapter examines the aetiologies of sudden cardiac death in young athletes as well as the controversies surrounding the prevention of these tragedies. Copyright © 2011 S. Karger AG, Basel.

  19. Gender-related differences in outcome after BMS or DES implantation in patients with ST-segment elevation myocardial infarction treated by primary angioplasty

    DEFF Research Database (Denmark)

    De Luca, Giuseppe; Verdoia, Monica; Dirksen, Maurits T

    2013-01-01

    Several studies have found that among patients with ST-segment elevation myocardial infarction (STEMI) treated by thrombolysis, female sex is associated with a worse outcome. However, still controversial is the prognostic impact of gender in primary angioplasty, especially in the era of drug-elut...

  20. Pediatric urinary tract infections: diagnosis and treatment.

    Science.gov (United States)

    Bitsori, Maria; Galanakis, Emmanouil

    2012-10-01

    Urinary tract infection (UTI) is the most common serious bacterial infection in childhood. Prompt diagnosis and treatment are required for the optimal clinical outcome and the prevention of long-term morbidity and sequelae. Diagnosis and treatment of UTI may seem to be easy tasks, but they remain among the most controversial issues in pediatrics. Consequently, children suspected for UTIs are investigated and treated differently in different settings. The absence of typical clinical presentation and the uncertainties in setting the index of suspicion, collecting appropriate urine samples and interpreting results, combined with different antibiotic policies in the face of increasing resistance of uropathogens, contribute to the controversy. Recently issued guidelines have attempted to settle several thorny aspects in diagnosis and treatment, but quite a few issues still remain controversial. In this review, the authors explore the current situation on diagnosis and treatment of childhood UTI in better understanding their pathogenesis and prevalence in different child populations, discuss recently evaluated diagnostic tests and the new management guidelines.

  1. Perspective: Challenges and Controversial Issues in the Dietary Guidelines for Americans, 1980-2015.

    Science.gov (United States)

    Nestle, Marion

    2018-03-01

    Since 1980, every edition of the Dietary Guidelines for Americans (DGAs) has recommended increased consumption of fruits, vegetables, and whole grains, but reduced consumption of saturated fat, sugars, and sodium and, therefore, their primary food sources. Every edition has generated controversy, mainly from producers of foods affected by "eat less" recommendations, particularly meat. Objections to the 2015 DGAs focused on environmental as well as scientific issues, but also on purported conflicts of interest among members of the Dietary Guidelines Advisory Committee. On this basis, critics induced Congress to authorize the National Academy of Medicine (NAM) to review the process of drawing up the guidelines. The NAM's 2017 reports should strengthen the process, but as long as science continues to support advice to reduce consumption of targeted foods, the guidelines will continue to elicit political controversy.

  2. Cooperative Learning, Responsibility, Ambiguity, Controversy and Support in Motivating Students

    Directory of Open Access Journals (Sweden)

    Ronald Brecke, PhD

    2007-08-01

    Full Text Available This paper argues that student motivation is nurtured more by intrinsic rather than extrinsic rewards. Rather than relying on grades alone to stimulate students, this paper explores how engendering a natural critical learning environment can give students a sense of ownership in their own learning and lead to their commitment to that learning. We examine uses of cooperative learning, shared responsibility, ambiguity, controversy and support in student motivation.

  3. Cooperative Learning, Responsibility, Ambiguity, Controversy and Support in Motivating Students

    Directory of Open Access Journals (Sweden)

    Ronald Brecke

    2007-01-01

    Full Text Available This paper argues that student motivation is nurtured more by intrinsic rather than extrinsic rewards. Rather than relying on grades alone to stimulate students, this paper explores how engendering a natural critical learning environment can give students a sense of ownership in their own learning and lead to their commitment to that learning. We examine uses of cooperative learning, shared responsibility, ambiguity, controversy and support in student motivation.

  4. Current Controversies in Newer Therapies to Treat Birth Asphyxia

    Directory of Open Access Journals (Sweden)

    Pia Wintermark

    2011-01-01

    Full Text Available Despite major advances in monitoring technology and knowledge of fetal and neonatal pathophysiology, neonatal hypoxic-ischemic encephalopathy (HIE remains one of the main causes of severe adverse neurological outcome in children. Until recently, there were no therapies other than supportive measures. Over the past several years, mild hypothermia has been proven to be safe to treat HIE. Unfortunately, this neuroprotective strategy seems efficient in preventing brain injury in some asphyxiated newborns, but not in all of them. Thus, there is increasing interest to rapidly understand how to refine hypothermia therapy and add neuroprotective or neurorestorative strategies. Several promising newer treatments to treat birth asphyxia and prevent its devastating neurological consequences are currently being tested. In this paper, the physiopathology behind HIE, the currently available treatment, the potential alternatives, and the next steps before implementation of these other treatments are reviewed.

  5. Psychotherapy for Borderline Personality Disorder: Progress and Remaining Challenges.

    Science.gov (United States)

    Links, Paul S; Shah, Ravi; Eynan, Rahel

    2017-03-01

    The main purpose of this review was to critically evaluate the literature on psychotherapies for borderline personality disorder (BPD) published over the past 5 years to identify the progress with remaining challenges and to determine priority areas for future research. A systematic review of the literature over the last 5 years was undertaken. The review yielded 184 relevant abstracts, and after applying inclusion criteria, 16 articles were fully reviewed based on the articles' implications for future research and/or clinical practice. Our review indicated that patients with various severities benefited from psychotherapy; more intensive therapies were not significantly superior to less intensive therapies; enhancing emotion regulation processes and fostering more coherent self-identity were important mechanisms of change; therapies had been extended to patients with BPD and posttraumatic stress disorder; and more research was needed to be directed at functional outcomes.

  6. Controversies in the Management of Borderline Resectable Proximal Pancreatic Adenocarcinoma with Vascular Involvement

    Directory of Open Access Journals (Sweden)

    Olga N. Tucker

    2008-01-01

    Full Text Available Synchronous major vessel resection during pancreaticoduodenectomy (PD for borderline resectable pancreatic adenocarcinoma remains controversial. In the 1970s, regional pancreatectomy advocated by Fortner was associated with unacceptably high morbidity and mortality rates, with no impact on long-term survival. With the establishment of a multidisciplinary approach, improvements in preoperative staging techniques, surgical expertise, and perioperative care reduced mortality rates and improved 5-year-survival rates are now achieved following resection in high-volume centres. Perioperative morbidity and mortality following PD with portal vein resection are comparable to standard PD, with reported 5-year-survival rates of up to 17%. Segmental resection and reconstruction of the common hepatic artery/proper hepatic artery (CHA/PHA can be performed to achieve an R0 resection in selected patients with limited involvement of the CHA/PHA at the origin of the gastroduodenal artery (GDA. PD with concomitant major vessel resection for borderline resectable tumours should be performed when a margin-negative resection is anticipated at high-volume centres with expertise in complex pancreatic surgery. Where an incomplete (R1 or R2 resection is likely neoadjuvant treatment with systemic chemotherapy followed by chemoradiation as part of a clinical trial should be offered to all patients.

  7. The nuclear controversy: unequal competition in public policy-making

    International Nuclear Information System (INIS)

    Sanderson, I.

    1980-05-01

    The subject is discussed under the headings: introduction; some epistemological problems; energy policy-making and the energy crisis; the nuclear controversy - substantive issues (the need for nuclear power; the desirability of nuclear power (safety of nuclear power; cost of nuclear power; nuclear power and weapons proliferation; nuclear power and civil liberties; some other aspects of nuclear power development); conclusion); the dominance of pro-nuclear thinking; conclusion and prospects. Appendix A describes the structure of the UK nuclear industry and its European connections. (U.K.)

  8. Nuclear controversy and the political organisations and pressure groups

    International Nuclear Information System (INIS)

    Robin, M.

    1983-01-01

    This paper describes the rise of nuclear controversy in France and the organisation of pressure groups in a political context. The author points out that public opinion became alerted to the dangers of nuclear energy much later in France than for example in the United States and highlights the action of ecologist groups. He concludes that contrary to the case in Australia, the FRG and Sweden anti-nuclear pressure groups have not been successful in truly influencing French governmental policy in that area. (NEA) [fr

  9. The Paravascular Pathway for Brain Waste Clearance: Current Understanding, Significance and Controversy

    Directory of Open Access Journals (Sweden)

    Andrew Bacyinski

    2017-11-01

    Full Text Available The paravascular pathway, also known as the “glymphatic” pathway, is a recently described system for waste clearance in the brain. According to this model, cerebrospinal fluid (CSF enters the paravascular spaces surrounding penetrating arteries of the brain, mixes with interstitial fluid (ISF and solutes in the parenchyma, and exits along paravascular spaces of draining veins. Studies have shown that metabolic waste products and solutes, including proteins involved in the pathogenesis of neurodegenerative diseases such as amyloid-beta, may be cleared by this pathway. Consequently, a growing body of research has begun to explore the association between glymphatic dysfunction and various disease states. However, significant controversy exists in the literature regarding both the direction of waste clearance as well as the anatomical space in which the waste-fluid mixture is contained. Some studies have found no evidence of interstitial solute clearance along the paravascular space of veins. Rather, they demonstrate a perivascular pathway in which waste is cleared from the brain along an anatomically distinct perivascular space in a direction opposite to that of paravascular flow. Although possible explanations have been offered, none have been able to fully reconcile the discrepancies in the literature, and many questions remain. Given the therapeutic potential that a comprehensive understanding of brain waste clearance pathways might offer, further research and clarification is highly warranted.

  10. The Paravascular Pathway for Brain Waste Clearance: Current Understanding, Significance and Controversy.

    Science.gov (United States)

    Bacyinski, Andrew; Xu, Maosheng; Wang, Wei; Hu, Jiani

    2017-01-01

    The paravascular pathway, also known as the "glymphatic" pathway, is a recently described system for waste clearance in the brain. According to this model, cerebrospinal fluid (CSF) enters the paravascular spaces surrounding penetrating arteries of the brain, mixes with interstitial fluid (ISF) and solutes in the parenchyma, and exits along paravascular spaces of draining veins. Studies have shown that metabolic waste products and solutes, including proteins involved in the pathogenesis of neurodegenerative diseases such as amyloid-beta, may be cleared by this pathway. Consequently, a growing body of research has begun to explore the association between glymphatic dysfunction and various disease states. However, significant controversy exists in the literature regarding both the direction of waste clearance as well as the anatomical space in which the waste-fluid mixture is contained. Some studies have found no evidence of interstitial solute clearance along the paravascular space of veins. Rather, they demonstrate a perivascular pathway in which waste is cleared from the brain along an anatomically distinct perivascular space in a direction opposite to that of paravascular flow. Although possible explanations have been offered, none have been able to fully reconcile the discrepancies in the literature, and many questions remain. Given the therapeutic potential that a comprehensive understanding of brain waste clearance pathways might offer, further research and clarification is highly warranted.

  11. Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery

    DEFF Research Database (Denmark)

    Kemp, Joanne L; Collins, Natalie J; Roos, Ewa M.

    2013-01-01

    Patient-reported outcomes (PROs) are considered the gold standard when evaluating outcomes in a surgical population. While the psychometric properties of some PROs have been tested, the properties of newer PROs in patients undergoing hip arthroscopic surgery remain somewhat unknown.......Patient-reported outcomes (PROs) are considered the gold standard when evaluating outcomes in a surgical population. While the psychometric properties of some PROs have been tested, the properties of newer PROs in patients undergoing hip arthroscopic surgery remain somewhat unknown....

  12. New paleoradiological investigations of ancient human remains from North West Lombardy archaeological excavations

    Energy Technology Data Exchange (ETDEWEB)

    Licata, Marta; Borgo, Melania; Armocida, Giuseppe; Nicosia, Luca; Ferioli, Elena [University of Insubria (Varese), Department of Biotechnology and Life Sciences, Varese (Italy)

    2016-03-15

    Since its birth in 1895, radiology has been used to study ancient mummies. The purpose of this article is to present paleoradiological investigations conducted on several medieval human remains in Varese province. Anthropological (generic identification) and paleopathological analyses were carried out with the support of diagnostic imaging (X-ray and CT scans). Human remains were discovered during excavations of medieval archaeological sites in northwest Lombardy. Classical physical anthropological methods were used for the macroscopic identification of the human remains. X-ray and CT scans were performed on the same scanner (16-layer Hitachi Eclos 16 X-ray equipment). Radiological analysis permitted investigating (1) the sex, (2) age of death, (3) type of trauma, (4) therapeutic interventions and (5) osteomas in ancient human remains. In particular, X-ray and CT examinations showed dimorphic facial traits on the mummified skull, and the same radiological approaches allowed determining the age at death from a mummified lower limb. CT analyses allow investigating different types of traumatic lesions in skulls and postcranial skeleton portions and reconstructing the gait and functional outcomes of a fractured femur. Moreover, one case of possible Gardner's syndrome (GS) was postulated from observing multiple osteomas in an ancient skull. Among the medical tests available to the clinician, radiology is the most appropriate first-line procedure for a diagnostic approach to ancient human remains because it can be performed without causing any significant damage to the specimen. (orig.)

  13. New paleoradiological investigations of ancient human remains from North West Lombardy archaeological excavations

    International Nuclear Information System (INIS)

    Licata, Marta; Borgo, Melania; Armocida, Giuseppe; Nicosia, Luca; Ferioli, Elena

    2016-01-01

    Since its birth in 1895, radiology has been used to study ancient mummies. The purpose of this article is to present paleoradiological investigations conducted on several medieval human remains in Varese province. Anthropological (generic identification) and paleopathological analyses were carried out with the support of diagnostic imaging (X-ray and CT scans). Human remains were discovered during excavations of medieval archaeological sites in northwest Lombardy. Classical physical anthropological methods were used for the macroscopic identification of the human remains. X-ray and CT scans were performed on the same scanner (16-layer Hitachi Eclos 16 X-ray equipment). Radiological analysis permitted investigating (1) the sex, (2) age of death, (3) type of trauma, (4) therapeutic interventions and (5) osteomas in ancient human remains. In particular, X-ray and CT examinations showed dimorphic facial traits on the mummified skull, and the same radiological approaches allowed determining the age at death from a mummified lower limb. CT analyses allow investigating different types of traumatic lesions in skulls and postcranial skeleton portions and reconstructing the gait and functional outcomes of a fractured femur. Moreover, one case of possible Gardner's syndrome (GS) was postulated from observing multiple osteomas in an ancient skull. Among the medical tests available to the clinician, radiology is the most appropriate first-line procedure for a diagnostic approach to ancient human remains because it can be performed without causing any significant damage to the specimen. (orig.)

  14. Truth in Packaging: Teaching Controversial Topics to Undergraduates in the Human Sciences.

    Science.gov (United States)

    Fredericks, Marcel; Miller, Steven I.

    1993-01-01

    Argues that the behavioral or "human" sciences are fundamentally different in scope and intent from the natural sciences. Describes the use of controversial topics in undergraduate courses and provides a four-step process. Recommends using Karl Popper's falsification theory to help students think critically about issues. (CFR)

  15. Rectal cancer surgery: volume-outcome analysis.

    LENUS (Irish Health Repository)

    Nugent, Emmeline

    2010-12-01

    There is strong evidence supporting the importance of the volume-outcome relationship with respect to lung and pancreatic cancers. This relationship for rectal cancer surgery however remains unclear. We review the currently available literature to assess the evidence base for volume outcome in relation to rectal cancer surgery.

  16. Clinical outcomes after estimated versus calculated activity of radioiodine for the treatment of hyperthyroidism: systematic review and meta-analysis.

    Science.gov (United States)

    de Rooij, A; Vandenbroucke, J P; Smit, J W A; Stokkel, M P M; Dekkers, O M

    2009-11-01

    Despite the long experience with radioiodine for hyperthyroidism, controversy remains regarding the optimal method to determine the activity that is required to achieve long-term euthyroidism. To compare the effect of estimated versus calculated activity of radioiodine in hyperthyroidism. Design Systematic review and meta-analysis. We searched the databases Medline, EMBASE, Web of Science, and Cochrane Library for randomized and nonrandomized studies, comparing the effect of activity estimation methods with dosimetry for hyperthyroidism. The main outcome measure was the frequency of treatment success, defined as persistent euthyroidism after radioiodine treatment at the end of follow-up in the dose estimated and calculated dosimetry group. Furthermore, we assessed the cure rates of hyperthyroidism. Three randomized and five nonrandomized studies, comparing the effect of estimated versus calculated activity of radioiodine on clinical outcomes for the treatment of hyperthyroidism, were included. The weighted mean relative frequency of successful treatment outcome (euthyroidism) was 1.03 (95% confidence interval (CI) 0.91-1.16) for estimated versus calculated activity; the weighted mean relative frequency of cure of hyperthyroidism (eu- or hypothyroidism) was 1.03 (95% CI 0.96-1.10). Subgroup analysis showed a relative frequency of euthyroidism of 1.03 (95% CI 0.84-1.26) for Graves' disease and of 1.05 (95% CI 0.91-1.19) for toxic multinodular goiter. The two main methods used to determine the activity in the treatment of hyperthyroidism with radioiodine, estimated and calculated, resulted in an equally successful treatment outcome. However, the heterogeneity of the included studies is a strong limitation that prevents a definitive conclusion from this meta-analysis.

  17. Current Controversies in the Prediction, Diagnosis, and Management of Cerebral Vasospasm: Where Do We Stand?

    Directory of Open Access Journals (Sweden)

    Young Lee

    2013-01-01

    Full Text Available Aneurysmal subarachnoid hemorrhage occurs in approximately 30,000 persons in the United States each year. Around 30 percent of patients with aneurysmal subarachnoid hemorrhage suffer from cerebral ischemia and infarction due to cerebral vasospasm, a leading cause of treatable death and disability following aneurysmal subarachnoid hemorrhage. Methods used to predict, diagnose, and manage vasospasm are the topic of recent active research. This paper utilizes a comprehensive review of the recent literature to address controversies surrounding these topics. Evidence regarding the effect of age, smoking, and cocaine use on the incidence and outcome of vasospasm is reviewed. The abilities of different computed tomography grading schemes to predict vasospasm in the aftermath of subarachnoid hemorrhage are presented. Additionally, the utility of different diagnostic methods for the detection and visualization of vasospasm, including transcranial Doppler ultrasonography, CT angiography, digital subtraction angiography, and CT perfusion imaging is discussed. Finally, the recent literature regarding interventions for the prophylaxis and treatment of vasospasm, including hyperdynamic therapy, albumin, calcium channel agonists, statins, magnesium sulfate, and endothelin antagonists is summarized. Recent studies regarding each topic were reviewed for consensus recommendations from the literature, which were then presented.

  18. Current controversies in the prediction, diagnosis, and management of cerebral vasospasm: where do we stand?

    Science.gov (United States)

    Lee, Young; Zuckerman, Scott L; Mocco, J

    2013-01-01

    Aneurysmal subarachnoid hemorrhage occurs in approximately 30,000 persons in the United States each year. Around 30 percent of patients with aneurysmal subarachnoid hemorrhage suffer from cerebral ischemia and infarction due to cerebral vasospasm, a leading cause of treatable death and disability following aneurysmal subarachnoid hemorrhage. Methods used to predict, diagnose, and manage vasospasm are the topic of recent active research. This paper utilizes a comprehensive review of the recent literature to address controversies surrounding these topics. Evidence regarding the effect of age, smoking, and cocaine use on the incidence and outcome of vasospasm is reviewed. The abilities of different computed tomography grading schemes to predict vasospasm in the aftermath of subarachnoid hemorrhage are presented. Additionally, the utility of different diagnostic methods for the detection and visualization of vasospasm, including transcranial Doppler ultrasonography, CT angiography, digital subtraction angiography, and CT perfusion imaging is discussed. Finally, the recent literature regarding interventions for the prophylaxis and treatment of vasospasm, including hyperdynamic therapy, albumin, calcium channel agonists, statins, magnesium sulfate, and endothelin antagonists is summarized. Recent studies regarding each topic were reviewed for consensus recommendations from the literature, which were then presented.

  19. The portrayal of J. Marion Sims' controversial surgical legacy.

    Science.gov (United States)

    Spettel, Sara; White, Mark Donald

    2011-06-01

    In the mid 1800s Dr. J. Marion Sims reported the successful repair of vesicovaginal fistulas with a technique he developed by performing multiple operations on female slaves. A venerated physician in his time, the legacy of Dr. Sims is controversial and represents a significant chapter in the mistreatment of African-Americans by the medical establishment. This review compares the modern debate surrounding his legacy with the presentation of his operation in widely consulted urological texts and journals. A literature review was performed of medical, sociological and periodical sources (1851 to the present) regarding J. Marion Sims and vesicovaginal fistula repair. During the last several decades, while the controversy around Dr. Sims' surgical development has produced a steady stream of articles in the historical and popular literature, relatively little mention is found in standard urology textbooks or journals. With increased public attention, some have debated the removal or modification of public tributes to Dr. Sims. This move has been countered by arguments against the validity of judging a 19th century physician by modern standards. While historians, ethicists and the popular press have debated Dr. Sims' legacy, medical sources have continued to portray him unquestionably as a great figure in medical history. This division keeps the medical profession uninformed and detached from the public debate on his legacy and, thus, the larger issues of ethical treatment of surgical patients. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. National Patterns of Care and Outcomes after Combined Modality Therapy for Stage IIIA Non-small Cell Lung Cancer

    Science.gov (United States)

    Patel, Aalok P.; Crabtree, Traves D.; Bell, Jennifer M.; Guthrie, Tracey J.; Robinson, Clifford G.; Morgensztern, Daniel; Colditz, Graham A.; Kreisel, Daniel; Krupnick, A. Sasha; Bradley, Jeffrey D.; Patterson, G. Alexander; Meyers, Bryan F.; Puri, Varun

    2014-01-01

    Introduction The role of surgery in addition to chemotherapy and radiation for stage IIIA non-small cell lung cancer (NSCLC) remains controversial. Since there is limited data on the benefit from surgery in this setting, we evaluated the use of combined modality therapy nationally, and explored the outcomes with and without the addition of surgery. Methods Patient variables and treatment-related outcomes were abstracted for patients with clinical stage IIIA NSCLC from the National Cancer Database. Patients receiving chemotherapy and radiation (CR) were compared to those undergoing chemotherapy, radiation, and surgery in any sequence (CRS). Results Between 1998 and 2010, 61339 patients underwent combined modality treatment for clinical stage IIIA NSCLC. Of these, 51979 (84.7%) received CR while 9360 (15.3%) underwent CRS. Patients in the CRS group were younger, more likely females and Caucasians, had smaller tumors and lower Charlson comorbidity scores. The 30-day surgical mortality was 200/8993 (2.2%). The median overall survival favored the CRS group in both unmatched (32.4 months vs. 15.7 months, p<.001) and matched analysis based on patient characteristics (34.3 months vs. 18.4months, p<.001). Conclusion There is significant heterogeneity in the treatment of stage IIIA NSCLC in the United States. Patients selected for surgery in addition to chemoradiation therapy appear to have better long-term survival. PMID:24722151

  1. The controversy on chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2013-08-01

    Full Text Available The objective of this review is to analyze the actual scientific controversy on chronic cerebrospinal venous insufficiency (CCSVI and its association with both neurodegenerative disorders and multiple sclerosis (MS. We revised all published studies on prevalence of CCSVI in MS patients, including ultrasound and catheter venography series. Furthermore, we take into consideration other publications dealing with the pathophysiologic consequences of CCSVI in the brain, as well as ecent data characterizing the pathology of the venous wall in course of CCSVI. Finally, safety and pilot data on effectiveness of endovascular CCSVI treatment were further updated. Studies of prevalence show a big variability in prevalence of CCSVI in MS patients assessed by established ultrasonographic criteria. This could be related to high operator dependency of ultrasound. However, 12 studies, by the means of more objective catheter venography, show a prevalence >90% of CCSVI in MS. Global hypo-hypoperfusion of the brain, and reduced cerebral spinal fluid dynamics in MS was shown to be related to CCSVI. Postmortem studies and histology corroborate the 2009 International Union of Phlebology (UIP Consensus decision to insert CCSVI among venous malformations. Finally, safety of balloon angioplasty of the extracranial veins was certainly demonstrated, while prospective data on the potential effectiveness of endovascular treatment of CCSVI support to increase the level of evidence by proceeding with a randomized control trial (RCT. Taking into account the current epidemiological data, including studies on catheter venography, the autoptic findings, and the relationship between CCSVI and both hypo-perfusion and cerebro-spinal fluid flow, we conclude that CCSVI can be definitively inserted among the medical entities. Research is still inconclusive in elucidating the CCSVI role in the pathogenesis of neurological disorders. The controversy between the vascular and the

  2. A Controversial Reform in Indigenous Education: The Cape York Aboriginal Australian Academy

    Science.gov (United States)

    McCollow, John

    2012-01-01

    This article examines a controversial initiative in Indigenous education: the establishment of the Cape York Aboriginal Australian Academy (CYAAA). The article provides a brief description of the Academy's three campuses and their communities and considers: the circumstances of its creation, including the role of Noel Pearson and Cape York…

  3. Is there a way to resolve the controversy on low dose effects?

    International Nuclear Information System (INIS)

    Higson, D.J.

    2002-01-01

    The controversy which is addressed in this paper is whether there are risks or benefits to health from exposure to low levels of ionising radiation or, indeed, whether there are any significant health effects at all. The background to this controversy was outlined in 1998 in the report of a Task Group on Low Dose Effects, convened by the International Nuclear Societies Council (INSC). For the purpose of the INSC report, low levels of radiation were defined as acute doses less than 10 mSv and chronic dose rates less than 20 mSv per year. The INSC Task Group itself concluded that, either there is no risk, or there may be health benefits from such exposures. The scientific aspects of the matter were reviewed by the author in 2001 at the IRPA Regional Congress on Radiation Protection in Central Europe, in Dubrovnik, and are summarised in the next section of this paper. In Dubrovnik, the author concluded that there is at least as much evidence of beneficial health effects as harmful effects from low level radiation. Controversy on the biological effects of low level radiation continues to be polarised to an extent which should be considered unacceptable in a rational community, and it is aggravated by the multiplicity of different viewpoints from which to consider the information available on this subject. These viewpoints include not only the scientific and regulatory positions, but also public and political perceptions, and the news media; and they lead to a wide variety of views, each of which is considered to be legitimate by most of those who adopt it

  4. Element 74, the Wolfram Versus Tungsten Controversy

    Energy Technology Data Exchange (ETDEWEB)

    Holden,N.E.

    2008-08-11

    Two and a quarter centuries ago, a heavy mineral ore was found which was thought to contain a new chemical element called heavy stone (or tungsten in Swedish). A few years later, the metal was separated from its oxide and the new element (Z=74) was called wolfram. Over the years since that time, both the names wolfram and tungsten were attached to this element in various countries. Sixty years ago, IUPAC chose wolfram as the official name for the element. A few years later, under pressure from the press in the USA, the alternative name tungsten was also allowed by IUPAC. Now the original, official name 'wolfram' has been deleted by IUPAC as one of the two alternate names for the element. The history of this controversy is described here.

  5. Education and Labor Market Consequences of Teenage Childbearing: Evidence Using the Timing of Pregnancy Outcomes and Community Fixed Effects

    Science.gov (United States)

    Fletcher, Jason M.; Wolfe, Barbara L.

    2009-01-01

    The question of whether giving birth as a teenager has negative economic consequences for the mother remains controversial despite substantial research. In this paper, we build upon existing literature, especially the literature that uses the experience of teenagers who had a miscarriage as the appropriate comparison group. We show that…

  6. Fatal outcome after insufficient spine fixation for pyogenic thoracic spondylodiscitis: an imperative for 360° fusion of the infected spine

    Directory of Open Access Journals (Sweden)

    Moore Ernest E

    2009-02-01

    Full Text Available Abstract Background Pyogenic spondylodiscitis represents a potentially life-threatening condition. Due to the low incidence, evidence-based surgical recommendations in the literature are equivocal, and the treatment modalities remain controversial. Case presentation A 59 year-old patient presented with a history of thoracic spondylodiscitis resistant to antibiotic treatment for 6 weeks, progressive severe back pain, and a new onset of bilateral lower extremity weakness. Clinically, the patient showed a deteriorating spastic paraparesis of her lower extremities. An emergent MRI revealed a kyphotic wedge compression fracture at T7/T8 with significant spinal cord compression, paravertebral and epidural abscess, and signs of myelopathy. The patient underwent surgical debridement with stabilization of the anterior column from T6–T9 using an expandable titanium cage, autologous bone graft, and an anterolateral locking plate. The patient recovered well under adjunctive antibiotic treatment. She presented again to the emergency department 6 months later, secondary to a repeat fall, with acute paraplegia of the lower extremities and radiographic evidence of failure of fixation of the anterior T-spine. She underwent antero-posterior revision fixation with hardware removal, correction of kyphotic malunion, evacuation of a recurrent epidural abscess, decompression of the spinal canal, and 360° fusion from T2–T11. Despite the successful salvage procedure, the patient deteriorated in the postoperative phase, when she developed multiple complications including pneumonia, acute respiratory distress syndrome, bacterial meningitis, abdominal compartment syndrome, followed by septic shock with multiple organ failure and a lethal outcome within two weeks after revision surgery. Conclusion This catastrophic example of a lethal outcome secondary to failure of anterior column fixation for pyogenic thoracic spondylodiscitis underlines the notion that surgical

  7. Influence of diabetes and hyperglycaemia on infectious disease hospitalisation and outcome

    DEFF Research Database (Denmark)

    Benfield, Thomas; Jensen, J S; Nordestgaard, B G

    2007-01-01

    AIMS/HYPOTHESIS: Diabetes mellitus is believed to increase susceptibility to infectious diseases. The effects of hyperglycaemia per se on infectious disease risk are unknown and the influence of diabetes on infectious disease outcome is controversial. MATERIALS AND METHODS: We studied 10......,063 individuals from the Danish general population, who were participants in The Copenhagen City Heart Study, over a follow-up period of 7 years. Risk of hospitalisation caused by any infectious disease, and subsequent risk of disease progression to death were estimated by Cox proportional hazards regression...

  8. Fair and Unfair Strategies in Public Controversies: The Case of Induced Earthquakes

    NARCIS (Netherlands)

    van Laar, Jan Albert; Krabbe, Erik C. W.; Mohammed, Dima; Lewinski, Marcin

    2016-01-01

    Contemporary theory of argumentation offers many insights about fallacies and the ways to react to them. But what if, in a public controversy, it is not a matter of occasional derailments but one party is systematically trivializing the other party’s problems or resorting to pressure in the form of

  9. Justifying the Use of Internet Sources in School Assignments on Controversial Issues

    Science.gov (United States)

    Mikkonen, Teemu

    2018-01-01

    Introduction: This study concerns students' criteria in the evaluation of Internet sources for a school assignment requiring reflections on a controversial issue. The findings are elaborated by analysing students' discursive accounts in justifying the use or non-use of sources. Method: The interview data was collected in a Finnish upper secondary…

  10. Controversy in the Psychology Classroom: Using Hot Topics to Foster Critical Thinking

    Science.gov (United States)

    Dunn, Dana S., Ed.; Gurung, Regan A. R., Ed.; Naufel, Karen Z., Ed.; Wilson, Janie H., Ed.

    2012-01-01

    One of the hallmarks of a quality liberal arts education is providing undergraduates the opportunity to wrestle with controversial issues. Yet many teachers feel ill-equipped when it comes to broaching disagreeable topics, managing the resulting heated debates, or helping students to separate their personal feelings from scientific evidence. This…

  11. Entanglements of Consumption, Cruelty, Privacy, and Fashion: The Social Controversy over Fur.

    Science.gov (United States)

    Olson, Kathryn M.; Goodnight, G. Thomas

    1994-01-01

    Posits a critical approach to the study of contemporary social controversy. Examines objectives to the use of fur as oppositional argument, rhetoric that veers from the goal of persuasion to block conventional associations and refashion communication norms. Shows how pro-fur responses illustrate strategies available to bolster, alter, or abandon…

  12. Media Misrepresentations of a Mascot Controversy: Contested Constructions of Race and Gender

    Science.gov (United States)

    Gerstl-Pepin, Cynthia; Liang, Guodong

    2010-01-01

    This article examines media coverage of a high school Native American mascot controversy. Discourse analysis of media documents and artifacts was utilized to explore how the issue was socially constructed for public consumption. Critical race feminism was used as a framework to examine how media discourses can oversimplify the complex interaction…

  13. From Iconoclasm to Arianism: The Construction of Christian Tradition in the Iconoclast Controversy

    OpenAIRE

    David M. Gwynn

    2010-01-01

    The defenders of icons in the eighth and ninth centuries, especially Photius, significantly reinterpreted the fourth-century Arian controversy and the views of Eusebius in order to link the Iconoclasts to the Arians and themselves to Church fathers like Athanasius.

  14. Genetic genealogy reveals true Y haplogroup of House of Bourbon contradicting recent identification of the presumed remains of two French Kings.

    Science.gov (United States)

    Larmuseau, Maarten H D; Delorme, Philippe; Germain, Patrick; Vanderheyden, Nancy; Gilissen, Anja; Van Geystelen, Anneleen; Cassiman, Jean-Jacques; Decorte, Ronny

    2014-05-01

    Genetic analysis strongly increases the opportunity to identify skeletal remains or other biological samples from historical figures. However, validation of this identification is essential and should be done by DNA typing of living relatives. Based on the similarity of a limited set of Y-STRs, a blood sample and a head were recently identified as those belonging respectively to King Louis XVI and his paternal ancestor King Henry IV. Here, we collected DNA samples from three living males of the House of Bourbon to validate the since then controversial identification of these remains. The three living relatives revealed the Bourbon's Y-chromosomal variant on a high phylogenetic resolution for several members of the lineage between Henry IV and Louis XVI. This 'true' Bourbon's variant is different from the published Y-STR profiles of the blood as well as of the head. The earlier identifications of these samples can therefore not be validated. Moreover, matrilineal genealogical data revealed that the published mtDNA sequence of the head was also different from the one of a series of relatives. This therefore leads to the conclusion that the analyzed samples were not from the French kings. Our study once again demonstrated that in order to realize an accurate genetic identification of historical remains DNA typing of living persons, who are paternally or maternally related with the presumed donor of the samples, is required.

  15. Early Vessels Exploration of Pink Pulseless Hand in Gartland III Supracondylar Fracture Humerus in Children: Facts and Controversies

    Directory of Open Access Journals (Sweden)

    Tunku-Naziha TZ

    2017-03-01

    Full Text Available The management of pink pulseless limbs in supracondylar fractures has remained controversial, especially with regards to the indication for exploration in a clinically well-perfused hand. We reviewed a series of seven patients who underwent surgical exploration of the brachial artery following supracondylar fracture. All patients had a non-palpable radial artery, which was confirmed by Doppler ultrasound. CT angiography revealed complete blockage of the artery with good collateral and distal run-off. Two patients were more complicated with peripheral nerve injuries, one median nerve and one ulnar nerve. Only one patient had persistent arterial constriction which required reverse saphenous graft. The brachial arteries were found to be compressed by fracture fragments, but were in continuity. The vessels were patent after the release of obstruction and the stabilization of the fracture. There was no transection of major nerves. The radial pulse was persistently present after 12 weeks, and the nerve activity returned to full function.

  16. "Make Not Your Prisons Your Prisons": Participant-Percieved Potential Outcomes of a Shakespeare Focussed Alternative to Juvenile Incarceration in the USA

    Science.gov (United States)

    Nicklin, Laura Louise

    2017-01-01

    For over two decades, there has been a progressive emergence of Shakespeare-focussed, performance-based programmes intended for use as criminal rehabilitation in the USA. Prison based criminal retribution, though historically prevalent, remains controversial. Although it is still used as a common method for rehabilitation, evidence demonstrates…

  17. Impact of gender on outcome after coronary artery bypass surgery.

    Science.gov (United States)

    Ennker, Ina C; Albert, Alexander; Pietrowski, Detlef; Bauer, Kerstin; Ennker, Juergen; Florath, Ines

    2009-06-01

    Following recent studies concerning the increased risk of coronary artery bypass surgery for women, the impact of sex is still a controversial issue. Between 1996 and 2006, 9,527 men and 3,079 women underwent isolated coronary artery bypass in our institute. To adjust for dissimilarities in preoperative risk profiles, propensity score-based matching was applied. Before adjustment, clinical outcomes in terms of operative mortality, arrhythmias, intensive care unit stay, and maximum creatine kinase-MB levels were significantly different for men and women. After balancing the preoperative characteristics, including height, no significant differences in clinical outcomes were observed. However, there was decreased use of internal mammary artery, less total arterial revascularization, and increasing creatine kinase-MB levels with decreasing height. This study supports the theory that female sex per se does not increase operative risk, but shorter height, which is more common in women, affects the outcome, probably due to technical difficulties in shorter patients with smaller internal mammary arteries and coronary vessels. Thus women may especially benefit from sequential arterial grafting.

  18. From Iconoclasm to Arianism: The Construction of Christian Tradition in the Iconoclast Controversy

    Directory of Open Access Journals (Sweden)

    David M. Gwynn

    2010-11-01

    Full Text Available The defenders of icons in the eighth and ninth centuries, especially Photius, significantly reinterpreted the fourth-century Arian controversy and the views of Eusebius in order to link the Iconoclasts to the Arians and themselves to Church fathers like Athanasius.

  19. Controversy and consensus on a clinical pharmacist in primary care in the Netherlands

    NARCIS (Netherlands)

    A.C.M. Hazen (Ankie); Wal, A.W.V.D. (Aletta W. Van Der); V.M. Sloeserwij (Vivianne); D.L.M. Zwart (Dorien); Gier, J.J.D. (Johan J. De); Wit, N.J.D. (Niek J. De); A.J. Leendertse (Anne); M.L. Bouvy (Marcel); A.A. de Bont (Antoinette)

    2016-01-01

    textabstractBackground Controversy about the introduction of a non-dispensing pharmacist in primary care practice hampers implementation. Objective The aim of this study is to systematically map the debate on this new role for pharmacists amongst all stakeholders to uncover and understand the

  20. Training Institutions as places of reproduction of official and scientific knowledge on ecological transition. An analysis with mapping controversies tools

    International Nuclear Information System (INIS)

    Bargues, Emilie; Landivar, Diego

    2016-01-01

    Through an exploratory approach mobilizing a 'mapping controversies methodology', this article analyses the role of training institutions in producing, distributing and criticizing knowledge related to ecological transition. The current work deals with the case of biomass production and activity, a central sector in French ecological transition. The analysis of semantic and unstructured data crawled from 3900 web sites highlights the major issues of controversy, the actors of the controversy, the points of agreement/disagreement among actors, and the particular position of training organizations in the knowledge structure. We find that these organizations are strongly correlated to official and scientific knowledge and less related to critical and marginal knowledge

  1. Clavicle hook plate fixation for displaced lateral-third clavicle fractures (Neer type II): a functional outcome study.

    LENUS (Irish Health Repository)

    Good, Daniel W

    2012-08-01

    Controversy exists with the use of the acromioclavicular hook plate for the treatment of lateral-third clavicle fractures (Neer type II). This is thought to stem from problems associated with the hook plate causing impingement symptoms, which can cause long-term limitation of movement and pain. Our aim was to evaluate the functional outcomes of patients with lateral-third clavicle fractures treated with the hook plate.

  2. A confusion of tongues between psychoanalysis and philosophy: is the controversy over drive versus relational theory a philosophical one?

    Science.gov (United States)

    Taub, Gadi

    2009-06-01

    In recent years the controversy over Drive versus Relational models of the psyche has become entangled in a philosophical controversy over epistemology. Some have argued that the Drive model was a relic of an age of positivistic science, while Relational models are a product of a postmodern condition. This paper argues that the controversy need not be a philosophical one, and that Relational views are not, in fact, a product of postmodernism, nor are they necessarily dependent on a postmodern epistemology. Separating the epistemological from the psychological more carefully may help return the debate to its proper, psychoanalytic domain, and perhaps contribute to a more fruitful dialogue across what, at times, seems like an abyss between Relational views and Drive theory.

  3. Abortion in Young Women and Subsequent Mental Health

    Science.gov (United States)

    Fergusson, David M.; Horwood, L. John; Ridder, Elizabeth M.

    2006-01-01

    Background: The extent to which abortion has harmful consequences for mental health remains controversial. We aimed to examine the linkages between having an abortion and mental health outcomes over the interval from age 15-25 years. Methods: Data were gathered as part of the Christchurch Health and Development Study, a 25-year longitudinal study…

  4. Teaching the Philosophical Interpretations of Quantum Mechanics and Quantum Chemistry through Controversies

    Science.gov (United States)

    Garritz, Andoni

    2013-01-01

    This study has the key premise of teaching history and philosophy of physical sciences to illustrate how controversies and rivalries among scientists play a key role in the progress of science and why scientific development is not only founded on the accumulation of experimental data. The author is a defender of teachers who consider…

  5. For a Psycholinguistic Model of Handwriting Production: Testing the Syllable-Bigram Controversy

    Science.gov (United States)

    Kandel, Sonia; Peereman, Ronald; Grosjacques, Geraldine; Fayol, Michel

    2011-01-01

    This study examined the theoretical controversy on the impact of syllables and bigrams in handwriting production. French children and adults wrote words on a digitizer so that we could collect data on the local, online processing of handwriting production. The words differed in the position of the lowest frequency bigram. In one condition, it…

  6. The Samba Controversy between Noel Rosa and Wilson Batista: Intertextuality and the Meanders of Composition

    Directory of Open Access Journals (Sweden)

    Leandro Moreira da Luz

    2015-07-01

    Full Text Available The purpose of this paper is to analyze the meanders of composition and their intertextuality in the samba controversy between Noel Rosa and Wilson Batista. We observe dialogism in the verbal and musical interaction between the samba writers and several texts of the 1930s. When ears are in tune with the "samba controversy," one observes that the compositions reveal inexorable tensions between the festive world of the "malandro" and the limits of the reality of the time. Accordingly, based on studies that address this theme, we aim to present an insight into this musical "duel," which is not restricted to purely aesthetics issues, but certainly disseminated in society.

  7. Denver's airport of doom; the story behind the world's possibly most controversial airport

    NARCIS (Netherlands)

    Stolwijk, J.

    2014-01-01

    Big airport projects have often been prone to controversy. Schiphol’s Polderbaan project, Heathrow’s expansion, and the construction of Berlin’s new airport all suffered from political, financial or technical issues. However, Denver International Airport (often referred to as DIA) caused uproar in

  8. Biopower, Normalization, and HPV: A Foucauldian Analysis of the HPV Vaccine Controversy.

    Science.gov (United States)

    Engels, Kimberly S

    2016-09-01

    This article utilizes the Foucauldian concepts of biopower and normalization to give an analysis of the debate surrounding the controversial administration of the HPV vaccine to adolescents. My intention is not to solve the problem, rather to utilize a Foucauldian framework to bring various facets of the issue to light, specifically the way the vaccine contributes to strategies of power in reference to how young adults develop within relationships of power. To begin, the article provides an overview of the Foucauldian concepts of biopower and normalization, including how these two strategies of power were present in the administration of the smallpox vaccine in the 19th century. Next, information about HPV and the history of the current controversy in the United States is presented. Lastly, the article presents an analysis of the strategies of biopower and normalization present in the debate on HPV, including an emphasis on how the vaccination is similar to, and different from, 19th century smallpox vaccination. It also explores the way that mechanisms of disease control affect and are affected by individual subjects, in this case, adolescents.

  9. Tooth-bleaching procedures and their controversial effects: A literature review

    Science.gov (United States)

    Alqahtani, Mohammed Q.

    2014-01-01

    Aim This review article will help clinicians improve their understanding of the history of bleaching procedures, bleaching types, components, mechanisms, and their effects on soft tissue, tooth structures, resin composite, and bonding. Methods The controversial issues about bleaching procedures and their effects are reviewed. Additionally, the consequences of pre- and post-bleaching on the bonding potential of composite resin restorations to tooth structure are discussed. Conclusion The overall goal of the paper is to help reduce risks for patients. PMID:25408594

  10. Patient-reported outcomes instruments: bridging the gap between international copyright laws and common practice for developers and users--a case example.

    Science.gov (United States)

    Anfray, Caroline

    2009-12-01

    Copyright laws are intended to protect the rights of authors in their literary, scientific, and artistic works. The recent controversy about the standardized version of the Asthma Quality of Life Questionnaire between Elizabeth Juniper and Eirini Grammatopoulou et al. is an example of the difficulties inherent to copyright faced by developers and users of patient-reported outcome (PRO) instruments. This brief communication presents the basics of international copyright laws (i.e., the Berne Convention), the facts behind the controversy, and our analysis of the case based on our experience as a distributing center of PRO instruments. We conclude that better communication between developers and users would prevent most unfortunate complications and misunderstandings.

  11. CONTROVERSIAL ASPECTS REGARDING TAX EVASION

    Directory of Open Access Journals (Sweden)

    Mircea-Constantin SINESCU

    2018-05-01

    Full Text Available Throughout the paper, we have highlighted some controversial aspects regarding the crime of tax evasion, referring to some important decisions of the High Court of Cassation and Justice and also of the Bucharest Court of Appeal. Debating upon the impunity provision stated by art. 10 of Law no. 241/2005, the study also sheds light upon the issue of the perspective of the judicial organs regarding the juridical regime of the tax due for dividends. The main focus of the paper leads to the situations when there is legal ground for the tax due for dividends to be considered part of the damage caused by tax evasion crime. The study includes a short analysis of some relevant provisions of the Romanian Fiscal Code and also some aspects deriving from decisions issued by the Administrative and Tax Litigation Chamber of The High Court of Cassation and Justice concerning the legal regime of dividends. Consequently, the authors are presenting both perspectives of the interpretation of the issue regarding the tax due for dividends to be considered part of the damage caused by tax evasion crime, resulting from two decisions of the two Criminal Sections of The Bucharest Court of Appeal, also arguing in favour of the most solid interpretation among them

  12. Lyme disease: why the controversy?

    Science.gov (United States)

    Beaman, M H

    2016-12-01

    Some Australians have become convinced of the existence of locally acquired Lyme disease (LD). The history of LD, since its recognition in the early 1970s, is reviewed as a model for investigative approaches to unknown syndromes. Australian Management Guidelines for LD include the requirement for diagnostic testing by National Association of Testing Authorities-accredited laboratories using Therapeutic Goods Administration-licensed tests, which result in the efficient diagnosis of LD in overseas travellers. Despite this, patients who have not left Australia pay many thousands of dollars for non-specialist consultations and testing at overseas laboratories. Unproven long-term therapy with multiple antibiotics has resulted in serious complications, including allergies, line sepsis, pancreatitis and pseudomembranous colitis. Studies have shown that LD vectors are not found in Australia, and Lyme Borrelia has not been found in Australian vectors, animals or patients with autochthonous illnesses. I propose that (i) A non-controversial name for the chronic syndrome should be adopted, 'Australian Multisystem Disorder'. (ii) Research funding should enable the development of a consensus case definition and studies of the epidemiology of this syndrome with laboratory investigations to identify an aetiology and surrogate markers of disease. Prospective, randomised treatment studies could then be undertaken using ethical protocols. © 2016 Royal Australasian College of Physicians.

  13. What Should We Teach as Controversial? A Defense of the Epistemic Criterion

    Science.gov (United States)

    Hand, Michael

    2008-01-01

    There is an emerging consensus that to teach something as controversial is to present it as a matter on which different views are or could be held and to expound those different views as impartially as possible. This raises an important normative question that has yet to receive the attention it deserves from educational theorists: how are we to…

  14. Controversial Embodiment: Sport, Masculinity, Dis/Ability

    Directory of Open Access Journals (Sweden)

    Marilena Parlati

    2015-11-01

    Full Text Available This essay is an attempt at investigating visible forms of complex, indeed controversial embodiment, with the specific intention of concentrating on the ways they interrogate delicate issues such as disability, masculinity and prosthetic sport performance. I intend to sound the shifting boundaries between dis-ability and super-ability as manifested in iconic figures such as Stelarc and, in other fields, Oscar Pistorius, whose unsteady position as privileged/disabled bladerunner seems to require – and indeed to gather – particularly intense scrutiny. I shall introduce a few contemporary discourses on corporeality and embodiment, which focus on the ‘troubling’ nature of auxiliary organs Freud refers to in the much contended paragraph I adopt as epigraph and guiding procedural light; I shall move from Butler and Giddens to Jean-Luc Nancy’s work on transplants and/as prostheses to include theoretical debates on disintegrating embodiment and disability studies, in order to proceed towards an analysis of the short-circuiting of allegedly secure practices of (masculine embodiment in sport culture and theory.

  15. The nuclear energy controversy in Austria

    International Nuclear Information System (INIS)

    Oszuszky, F.; Szeless, A.

    1981-01-01

    The sociological aspects of the energy issue have become of overwhelming importance in the last few years. As a result, traditional considerations such as the importance of adequate and cheap energy supplies as the basis for growth, and the necessity, in a time of politically uncertain oil supplies, of energy supply security and diversity, have been equalled in importance, and sometimes replaced, by arguments about the social goals to be achieved. Nuclear energy has been selected as the vehicle for a socio-political debate on the controversial issue of the application of large-scale technology. Beyond that it has acquired a symbolic role in what is really an emotional attack on the political systems, economy and culture of present day civilization. It stands for the concentration of power, the centralization of technology and society, and man's dependence on the products of that centralization. Nuclear power is seen as one of the motors of further economic growth and thus an apparent pioneer of the further destruction of our natural and social environment. (author)

  16. Preparing Student Teachers to Address Complex Learning and Controversy with Middle Grades Students

    Science.gov (United States)

    Smith, Ann Marie; Lennon, Sean

    2011-01-01

    This qualitative study explores pre-service teachers' perceptions of teaching critical literacy through discussions of controversial issues. Personality questionnaires were given to six classes of pre-student teachers over three semesters in order to gauge interest in teaching methods that incorporate inquiry learning and critical literacy. The…

  17. Autism Narratives in Media Coverage of the MMR Vaccine-Autism Controversy under a Crip Futurism Framework.

    Science.gov (United States)

    Mann, Benjamin W

    2018-03-09

    While previous studies in health communication have examined online news media regarding autism, there is a lack of research that critically examines how such media representations may stigmatize autism and seeks to eliminate the condition, particularly in the context of the resurging measles, mumps, and rubella (MMR) vaccine-autism controversy. To address this gap in the literature, this study analyzes 153 articles that engage the MMR vaccine-autism controversy from the top 10 online news sources in the U.S. from September 2015 through July 2017. It draws from Kafer's (2013) work in Feminist, Crip, Queer, using a lens of crip futurism to interpret three major narrative themes: a death and survival narrative that purports autism as a worst-case scenario, a societal problem narrative, and a preventative narrative that seeks to eliminate the condition. These themes suggest that online news media narratives about autism surrounding the autism-MMR controversy play into stereotypes about autism, including stigmatization and prioritization of preventive behaviors and cures over supporting the lived experiences of autistic individuals. Continued research on the impact of online media portrayals of autism specifically, and disability in health contexts generally, is called for.

  18. Cigarette smoking and lung cancer: a continuing controversy.

    Science.gov (United States)

    Burch, P R

    1982-09-01

    During the late 1950s Sir Ronald Fisher questioned the already popular, but in his view precipitate, causal interpretation of the association between smoking and lung cancer. His pungently expressed views began a controversy that has smouldered and sometimes flared ever since. The most recent attack on Fisher's constitutional hypothesis was launched by Reif and in this paper I consider the validity of his criticisms. A range of evidence shows that it is not yet possible to distinguish between constitutional and causal-plus-constitutional interpretations although recent studies indicate that a pure causal hypothesis is incapable of explaining the full association as observed in Western populations. Unfortunately, errors of diagnosis and death certification still impede the rigorous testing of adequately formulated hypotheses.

  19. Promoting the Role of the Personal Narrative in Teaching Controversial Socio-Scientific Issues

    Science.gov (United States)

    Levinson, Ralph

    2008-01-01

    Citizens participating in contemporary socio-scientific issues (SSI) need to draw on local knowledge and personal experience. If curricular developments in the teaching of controversial SSI are to reflect contemporary notions of citizenship then the personal narrative is an indispensable instrument in bridging the gap between the local/personal…

  20. Ibuprofen in paediatrics: pharmacology, prescribing and controversies.

    Science.gov (United States)

    Moriarty, Camilla; Carroll, Will

    2016-12-01

    Ibuprofen, a propionic acid derivative, is a non-steroidal anti-inflammatory drug. The oral formulation is widely used in paediatric practice and after paracetamol it is one of the most common drugs prescribed for children in hospital. The treatment of fever with antipyretics such as ibuprofen is controversial as fever is the normal response of the body to infection and unless the child becomes distressed or symptomatic, fever alone should not be routinely treated. Combined treatment with paracetamol and ibuprofen is commonly undertaken but almost certainly is not helpful. This article aims to describe the indications and mode of action of the drug, outline its pharmacokinetics and highlight the important key messages regarding its use in clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Patient Outcomes in the Operative and Nonoperative Management of High-Grade Spondylolisthesis in Children

    DEFF Research Database (Denmark)

    Lundine, K. M.; Lewis, S. J.; Al-Aubaidi, Zaid

    2014-01-01

    Background:The optimal management of high-grade spondylolisthesis in the growing child is controversial. Some authors have advocated for surgery in all cases regardless of symptoms. Surgical intervention results in a >10% risk of complications with increased risk of neurological injury associated...... with slip reduction maneuvers. There is a paucity of literature regarding nonoperative management in this setting. This study sought to obtain outcome measures in pediatric patients with high-grade spondylolisthesis managed either operatively or nonoperatively.Methods:Database review was performed...

  2. The "Magic Cure" A Review of the Current Controversial Approaches for Treating Learning Disabilities.

    Science.gov (United States)

    Silver, Larry B.

    1987-01-01

    In view of popular press coverage of controversial approaches to treating learning disabilities, the article briefly reviews evidence concerning the following: neurophysiological retraining (patterning, optometric visual training, cerebellar-vestibular remediation, and applied kinesiology); and orthomolecular medicine (concerning megavitamins,…

  3. IVF and ICSI in Male Infertility: Update on Outcomes, Risks, and Costs

    Directory of Open Access Journals (Sweden)

    Edward Karpman

    2005-01-01

    Full Text Available Assisted reproductive technology with intracytoplasmic sperm injection (ICSI is becoming an international panacea for couples struggling with infertility. The increasing popularity of these techniques and the data generated has given us a better understanding of the efficacy, consequences and costs of these procedures. There still remain many unanswered questions and controversies surrounding the use of IVF and ICSI. Increased experience, better refinement of these techniques and clearer indications for IVF and ICSI will inevitably minimize the risks associated with this procedure.

  4. Thyroid dysfunction and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Sima Nazarpour

    2015-07-01

    identified and its long term impact on childhood development is well known, data on the early and late complications of subclinical thyroid dysfunction during pregnancy or thyroid autoimmunity are controversial. Further studies on maternal and neonatal outcomes of subclinical thyroid dysfunction maternal are needed.

  5. Incidental findings of thyroid tissue in cervical lymph nodes: old controversy not yet resolved?

    NARCIS (Netherlands)

    Triantafyllou, A.; Williams, M.D.; Angelos, P.; Shah, J.P.; Westra, W.H.; Hunt, J.L.; Devaney, K.O.; Rinaldo, A.; Slootweg, P.J.; Gnepp, D.R.; Silver, C.; Ferlito, A.

    2016-01-01

    The clinical significance of papillary or follicular thyroid tissue incidentally discovered in cervical lymph nodes during pathological assessment of neck dissections for non-thyroid cancers of the upper aero-digestive tract is critically reviewed. Special emphasis is given to controversies over

  6. CONTROVERSY AND CONFLICTS DUE TO IMPROPER MEDICAL CARE AND LEGAL PRACTICE OF THEIR RESOLVING

    Directory of Open Access Journals (Sweden)

    I. O. Perepechina

    2015-01-01

    Full Text Available The paper presents the analysis of the statistical data on the Russian Federation, showing how often controversy and conflicts due to improper medical care occurs in medical practice, as well as what are the ways to resolve them.

  7. Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life.

    Science.gov (United States)

    Haeny, Angela M

    2014-07-01

    Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association's (APA's) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present paper analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present paper examines ethical issues that a) should be taken into account before psychologists take a public position on a controversial issue, and b) are in conflict with APA's Ethics Code or current research.

  8. Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life

    Science.gov (United States)

    Haeny, Angela M.

    2014-01-01

    Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association’s (APA’s) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present paper analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present paper examines ethical issues that a) should be taken into account before psychologists take a public position on a controversial issue, and b) are in conflict with APA’s Ethics Code or current research. PMID:25342876

  9. Post-operative hemimaxillectomy rehabilitation using prostheses supported by zygoma implants and remaining natural teeth

    Directory of Open Access Journals (Sweden)

    Xing Zhou Qu

    Full Text Available OBJECTIVES: This study aimed to evaluate the stability of prostheses supported by zygoma implants and remaining teeth for subjects who had undergone hemi-maxillectomy. METHODS: Ten patients were included in the study. Oral rehabilitation was performed using a temporary prosthesis that was supported by remaining teeth for the first three months. Then, a zygoma implant was placed to provide support for a final prosthesis in addition to the remaining teeth. Each prosthesis was tailor-made according to biomechanical three-dimensional finite element analysis results. The patients were assessed using the prosthesis functioning scale of the Memorial Sloan-Kettering Cancer Center. In addition, retention and bite force were recorded for both the temporary prosthesis and the final prosthesis. RESULTS: The mean bite force of the prosthetic first molar was increased to 69.2 N. The mean retentive force increased to 13.5 N after zygoma implant insertion. The bite force on the prosthetic first molar was improved to 229.3 N. CONCLUSION: Bite force increased significantly with the support of a zygoma implant. The use of zygoma implants in the restoration of maxillary defects improved functional outcome and patient satisfaction.

  10. [Sampling in qualitative research: basic principles and some controversies].

    Science.gov (United States)

    Martínez-Salgado, Carolina

    2012-03-01

    This paper presents the rationale for the choice of participants in qualitative research in contrast with that of probability sampling principles in epidemiological research. For a better understanding of the differences, concepts of nomothetic and ideographic generalizability, as well as those of transferability and reflexivity, are proposed, Fundamentals of the main types of sampling commonly used in qualitative research, and the meaning of the concept of saturation are mentioned. Finally, some reflections on the controversies that have arisen in recent years on various paradigmatic perspectives from which to conduct qualitative research, their possibilities of combination with epidemiological research, and some implications for the study of health issues are presented.

  11. Sensitive and Controversial Issues in the Classroom: Teaching History in a Divided Society

    Science.gov (United States)

    Kello, Katrin

    2016-01-01

    Teaching sensitive and controversial issues (SCIs) is of growing interest in contemporary, increasingly heterogeneous societies. In democracies, different groups and institutions expect their values and worldviews to be conveyed at school. On one hand, there is the expectation that SCIs should be treated neutrally. On the other hand, there are…

  12. Controversies and Evolving New Mechanisms in Subarachnoid Hemorrhage

    Science.gov (United States)

    Chen, Sheng; Feng, Hua; Sherchan, Prativa; Klebe, Damon; Zhao, Gang; Sun, Xiaochuan; Zhang, Jianmin; Tang, Jiping; Zhang, John H.

    2013-01-01

    Despite decades of study, subarachnoid hemorrhage (SAH) continues to be a serious and significant health problem in the United States and worldwide. The mechanisms contributing to brain injury after SAH remain unclear. Traditionally, most in vivo research has heavily emphasized the basic mechanisms of SAH over the pathophysiological or morphological changes of delayed cerebral vasospasm after SAH. Unfortunately, the results of clinical trials based on this premise have mostly been disappointing, implicating some other pathophysiological factors, independent of vasospasm, as contributors to poor clinical outcomes. Delayed cerebral vasospasm is no longer the only culprit. In this review, we summarize recent data from both experimental and clinical studies of SAH and discuss the vast array of physiological dysfunctions following SAH that ultimately lead to cell death. Based on the progress in neurobiological understanding of SAH, the terms “early brain injury” and “delayed brain injury” are used according to the temporal progression of SAH-induced brain injury. Additionally, a new concept of the vasculo-neuronal-glia triad model for SAH study is highlighted and presents the challenges and opportunities of this model for future SAH applications. PMID:24076160

  13. Controversy about Management of Hydrocephalus - Shunt vs. Endoscopic Third Ventriculostomy.

    Science.gov (United States)

    Kumar, Vikas; Bodeliwala, Shaam; Singh, Daljit

    2017-08-01

    The best management of hydrocephalus is still controversial in the twenty-first century. Shunt treatment for hydrocephalus is the most common procedure performed in neurosurgical practice and is associated with the highest complications rate. But during the last 2 decades, the treatment of hydrocephalus has improved with better shunt devices available today, increased facilities for investigations and newer approaches like endoscopic third ventriculostomy. The recent advances in development of better endoscopes have provided the patient and treating doctor with an option for an alternative surgery for treatment of hydrocephalus.

  14. Clinical and Epidemiological Significance of Carbapenem Resistance in Acinetobacter baumannii Infections.

    Science.gov (United States)

    Tal-Jasper, Ruthy; Katz, David E; Amrami, Nadav; Ravid, Dor; Avivi, Dori; Zaidenstein, Ronit; Lazarovitch, Tsilia; Dadon, Mor; Kaye, Keith S; Marchaim, Dror

    2016-05-01

    Carbapenems are considered the treatment of choice for Acinetobacter baumannii infections. Many facilities implement preventive measures toward only carbapenem-resistant A. baumannii (CRAB). However, the independent role of the carbapenem resistance determinant on patient outcomes remains controversial. In a 6-year analysis of adults with A. baumannii bloodstream infection (BSI), the outcomes of 149 CRAB isolates were compared to those of 91 patients with carbapenem-susceptible A. baumannii In bivariable analyses, CRAB BSIs were significantly associated with worse outcomes and with a delay in the initiation of appropriate antimicrobial therapy (DAAT). However, in multivariable analyses, carbapenem resistance status was no longer associated with poor outcomes, while DAAT remained an independent predictor. The epidemiological significance of A. baumannii should not be determined by its resistance to carbapenems. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  15. Cardiac biomarkers in neonatal hypoxic ischaemia.

    LENUS (Irish Health Repository)

    Sweetman, D

    2012-04-01

    Following a perinatal hypoxic-ischaemic insult, term infants commonly develop cardiovascular dysfunction. Troponin-T, troponin-I and brain natriuretic peptide are sensitive indicators of myocardial compromise. The long-term effects of cardiovascular dysfunction on neurodevelopmental outcome following perinatal hypoxic ischaemia remain controversial. Follow-up studies are warranted to ensure optimal cardiac function in adulthood. CONCLUSION: Cardiac biomarkers may improve the diagnosis of myocardial injury, help guide management, estimate mortality risk and may also aid in longterm neurodevelopmental outcome prediction following neonatal hypoxic-ischaemia.

  16. Multivariate analysis on unilateral cleft lip and palate treatment outcome by EUROCRAN index: A retrospective study.

    Science.gov (United States)

    Yew, Ching Ching; Alam, Mohammad Khursheed; Rahman, Shaifulizan Abdul

    2016-10-01

    This study is to evaluate the dental arch relationship and palatal morphology of unilateral cleft lip and palate patients by using EUROCRAN index, and to assess the factors that affect them using multivariate statistical analysis. A total of one hundred and seven patients from age five to twelve years old with non-syndromic unilateral cleft lip and palate were included in the study. These patients have received cheiloplasty and one stage palatoplasty surgery but yet to receive alveolar bone grafting procedure. Five assessors trained in the use of the EUROCRAN index underwent calibration exercise and ranked the dental arch relationships and palatal morphology of the patients' study models. For intra-rater agreement, the examiners scored the models twice, with two weeks interval in between sessions. Variable factors of the patients were collected and they included gender, site, type and, family history of unilateral cleft lip and palate; absence of lateral incisor on cleft side, cheiloplasty and palatoplasty technique used. Associations between various factors and dental arch relationships were assessed using logistic regression analysis. Dental arch relationship among unilateral cleft lip and palate in local population had relatively worse scoring than other parts of the world. Crude logistics regression analysis did not demonstrate any significant associations among the various socio-demographic factors, cheiloplasty and palatoplasty techniques used with the dental arch relationship outcome. This study has limitations that might have affected the results, example: having multiple operators performing the surgeries and the inability to access the influence of underlying genetic predisposed cranio-facial variability. These may have substantial influence on the treatment outcome. The factors that can affect unilateral cleft lip and palate treatment outcome is multifactorial in nature and remained controversial in general. Copyright © 2016 Elsevier Ireland Ltd. All

  17. Controversies in presacral tumors management

    Directory of Open Access Journals (Sweden)

    Nidal Issa

    2017-10-01

    Full Text Available Presacral tumors are rare lesions of the retrorectal space that can present diagnostic and therapeutic difficulty because of their anatomic location and the different tissue types and etiology. Although the diagnosis and management of these tumors has evolved in recent years, several points still to be addressed in order to improve perioperative diagnosis and treatment. In the upcoming we will try to highlight some controversial points; the pre-operative biopsies, neoadjuvant therapy, the necessity of surgery and the role of minimally invasive surgeries of presacral tumors. Resumo: Tumores pré-sacrais são lesões raras do espaço retrorretal que podem trazer dificuldades diagnósticas e terapêuticas por causa de sua localização anatômica e também pelos diferentes tipos de tecidos e etiologia. Embora nos últimos anos o diagnóstico e tratamento desses tumores tenham evoluído, diversos pontos ainda devem ser estudados com vistas à melhora do diagnóstico e tratamento no perioperatório. Mais adiante, tentaremos esclarecer alguns pontos controversos; biópsias pré-operatórias, terapia neoadjuvante, a necessidade de cirurgia e o papel das cirurgias minimamente invasivas para os tumores pré-sacrais. Keywords: Presacral tumor, Preoperative biopsy, Neoadjuvant therapy, Palavras-chave: Tumor pré-sacral, Biópsia pré-operatória, Terapia neoadjuvante

  18. Everything you need to know to understand the current controversies you learned from psychological research. A comment on the Rind and Lilienfeld controversies.

    Science.gov (United States)

    Sternberg, Robert J

    2002-03-01

    Psychological theory and research can help explain some of the aspects of the controversies that arose over articles written by B. Rind, P. Tromovitch, and R. Bauserman (1998) and by S. O. Lilienfeld (2002). In particular, one needs to distinguish between rational and intuitive thinking, to recognize the power of context, to be reflective in one's own thinking, and to realize the costs of defying the crowd. There are steps one can take to be wiser and more balanced in one's own thinking than one may have been in the past. One such step is to resolve conflicts among psychologists by attempting to defuse rather than to exacerbate or avoid them.

  19. The electric car controversy. A social-constructivist interpretation of the California zero-emission vehicle mandate

    Energy Technology Data Exchange (ETDEWEB)

    Fogelberg, H

    1998-07-01

    This study focuses the socio-technical dynamics of the attempted reintroduction of electric cars in California. The underlying question is whether or not it is possible to open up an entrenched technological area as car technology, and achieve a radical change. With the perspectives of social constructivist approaches to technological change, this study examines how a large technological controversy was initiated by regulatory action of the air agency in California, the California Air Resources Board, how this controversy developed and stabilized, and how it was ended by the air agency and the auto industry. Based on mainly secondary sources, the definitions that were established on electric cars and gasoline cars at the turn of the 20th century are highlighted, thus showing the existence of two types of automobiles: the city car and the endurance car. The city car did not survive, and was not defined as being a real car. Based on mainly primary sources, the recent electric car controversy is examined, suggesting that the air agency could not force the car industry to re-introduce the city car, and consequently the efforts were directed towards the development of more advanced batteries that could give the electric car a performance close to that of the gasoline car. It also display that electric car technology was enhanced due to the mandate. In ending the controversy, the agency, due to political forces, changed from 'command-and-control' to a 'partnership' strategy. The California Air Resources Board postponed the mandate (from 1998 to 2003), due to the fact that large volume production of advanced batteries was not expected to be in place by 1998. This regulatory relief removed the principal obstacle on behalf of auto manufacturers of not to accept mandated markets, and led General Motors to start to market their purpose built electric sports car by late 1996, and Toyota to promote electric- and electric hybrid car technologies. Thus car technology was re-opened.

  20. The electric car controversy. A social-constructivist interpretation of the California zero-emission vehicle mandate

    Energy Technology Data Exchange (ETDEWEB)

    Fogelberg, H.

    1998-07-01

    This study focuses the socio-technical dynamics of the attempted reintroduction of electric cars in California. The underlying question is whether or not it is possible to open up an entrenched technological area as car technology, and achieve a radical change. With the perspectives of social constructivist approaches to technological change, this study examines how a large technological controversy was initiated by regulatory action of the air agency in California, the California Air Resources Board, how this controversy developed and stabilized, and how it was ended by the air agency and the auto industry. Based on mainly secondary sources, the definitions that were established on electric cars and gasoline cars at the turn of the 20th century are highlighted, thus showing the existence of two types of automobiles: the city car and the endurance car. The city car did not survive, and was not defined as being a real car. Based on mainly primary sources, the recent electric car controversy is examined, suggesting that the air agency could not force the car industry to re-introduce the city car, and consequently the efforts were directed towards the development of more advanced batteries that could give the electric car a performance close to that of the gasoline car. It also display that electric car technology was enhanced due to the mandate. In ending the controversy, the agency, due to political forces, changed from 'command-and-control' to a 'partnership' strategy. The California Air Resources Board postponed the mandate (from 1998 to 2003), due to the fact that large volume production of advanced batteries was not expected to be in place by 1998. This regulatory relief removed the principal obstacle on behalf of auto manufacturers of not to accept mandated markets, and led General Motors to start to market their purpose built electric sports car by late 1996, and Toyota to promote electric- and electric hybrid car technologies. Thus car

  1. Creating a Controversial Picturebook: Discussions with the Creators of "And Tango Makes Three"

    Science.gov (United States)

    Young, Craig A.

    2011-01-01

    Censorship is not a new phenomenon in the field of children's literature. Children's and young adult books are often scrutinized for text and illustrations that may be found questionable for use with young readers. If deemed inappropriate, these books become the subjects of controversial debate and may fall victim to censorship. Although numerous…

  2. Ruffled feathers: Costume, gender and authorship in the Black Swan controversy

    OpenAIRE

    Warner, Helen

    2012-01-01

    In 2011, the popular and trade press reported a dispute between costume designer Amy Westcott and creators of fashion label Rodarte, Kate and Laura Mulleavy, following the decision that the fashion designers were only to receive a back-end credit for their work on psychological thriller Black Swan (Aronofsky, 2010). This article traces the coverage of the Black Swan controversy in order to demonstrate that press discourses surrounding the costume designer perform a series of cultural function...

  3. Oncologic PET/CT: current status and controversies

    International Nuclear Information System (INIS)

    Siegel, B.A.; Dehdashti, F.

    2005-01-01

    The introduction of integrated PET/CT has dramatically increased the worldwide rate of growth for PET, predominantly for oncologic imaging with the glucose analog 18 F-fluorodeoxyglucose (FDG). A rapidly expanding body of literature demonstrates that the use FDG-PET/CT and the resultant ability to interpret coregistered and fused PET and CT images lead to improved observer confidence and improved diagnostic performance by comparison with PET alone, CT alone, and visually correlated PET and CT. The value of PET/CT is likely to be even greater with new PET radiopharmaceuticals under development, many of which produce PET images with even fewer anatomical landmarks than FDG images. PET/CT is also likely to lead to the resurrection of 18 F-fluoride as a principal agent for radionuclide bone imaging. There are a number of controversies related to PET/CT, including minimum training and experience requirements for interpreting physicians and defining new models for technical and professional reimbursement. (orig.)

  4. Epistemological depth in a GM crops controversy.

    Science.gov (United States)

    Hicks, Daniel J

    2015-04-01

    This paper examines the scientific controversy over the yields of genetically modified [GM] crops as a case study in epistemologically deep disagreements. Appeals to "the evidence" are inadequate to resolve such disagreements; not because the interlocutors have radically different metaphysical views (as in cases of incommensurability), but instead because they assume rival epistemological frameworks and so have incompatible views about what kinds of research methods and claims count as evidence. Specifically, I show that, in the yield debate, proponents and opponents of GM crops cite two different sets of claims as evidence, which correspond to two rival epistemological frameworks, classical experimental epistemology and Nancy Cartwright's evidence for use. I go on to argue that, even if both sides of the debate accepted Cartwright's view, they might still disagree over what counts as evidence, because evidence for use ties standards of evidence to what is sometimes called the "context of application." Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. The Social Life of Data (Prototyping Controversies)

    DEFF Research Database (Denmark)

    Jørgensen, Tobias Bornakke; Birkbak, Andreas; Petersen, Morten Krogh

    are out, which leaves it to the public to stumble upon the webpages and explore the results. This unspecified public, however, often seems to have more similarities to a void of non-engagement than a receptive social room. In this paper we take two related steps to counter the lack of public engagement...... that makes available a large relational data set on the Danish power elite (Ellersgaard et al. 2015) through an interactive data navigation tool. The tool allows visitors to explore a data set that is potentially controversial but difficult to navigate. Further, Google Analytics and a simple survey allows us...... to examine how visitors to the website were led to the site in the first place, how they made use of the data navigation tool and how customized maps from the webpage travelled into new and unpredictable arenas. The experiment thus explores the tension between publishing and making things public...

  6. Articles and contributions to the nuclear controversy - 1

    International Nuclear Information System (INIS)

    Wethe, P.I.

    1976-08-01

    In the beginning of the 1970s the public interest in nuclear power in Norway was negligible, and an active information campaign might have been interpreted as an attack on the dominant hydroelectric development policy. In 1973 the electricity authorities themselves began to propose concrete nuclear power projects. Over a very short interval of time organised protest groups emerged whose main objective was to hinder the establishment of nuclear power in their own districts. T hese have since developed into agressive national groups and in the period up to the spring of 1975 an intense press debate took place. The staff of Institutt for Atomenergi took an active part in this debate and this collection of articles and contributions gives an impression of the nuclear controversy in Norway from 1973 to 1976. (JIW)

  7. [PALEOPATHOLOGY OF HUMAN REMAINS].

    Science.gov (United States)

    Minozzi, Simona; Fornaciari, Gino

    2015-01-01

    Many diseases induce alterations in the human skeleton, leaving traces of their presence in ancient remains. Paleopathological examination of human remains not only allows the study of the history and evolution of the disease, but also the reconstruction of health conditions in the past populations. This paper describes the most interesting diseases observed in skeletal samples from the Roman Imperial Age necropoles found in urban and suburban areas of Rome during archaeological excavations in the last decades. The diseases observed were grouped into the following categories: articular diseases, traumas, infections, metabolic or nutritional diseases, congenital diseases and tumours, and some examples are reported for each group. Although extensive epidemiological investigation in ancient skeletal records is impossible, the palaeopathological study allowed to highlight the spread of numerous illnesses, many of which can be related to the life and health conditions of the Roman population.

  8. Brokered dialogue: A new research method for controversial health and social issues.

    Science.gov (United States)

    Parsons, Janet A; Lavery, James V

    2012-07-02

    Dialogue is a foundational feature of social life and an important way in which we come to understand one another. In situations of controversy dialogue is often absent because of a range of social barriers. We have developed a new film-based qualitative research method for studying controversial issues in healthcare and social policy. We call this method Brokered Dialogue. Theoretically informed by the traditions in narrative inquiry and visual anthropology, the method is premised on the idea that dialogue possesses features making it unique as a generator of new knowledge and opportunities for social intervention. Film is not only an extraordinarily rich data source, but an excellent medium for knowledge transfer and dissemination. The paper introduces the Brokered Dialogue method. We outline its critical steps, including the procedures for sampling, data collection and data analysis of both textual and visual data. Participants in a Brokered Dialogue engage in filmed interviews that capture their perspectives on a given topic; they then share their perspectives with, and pose questions of, one another through the medium of film. Using a participatory editing process, only footage that participants feel comfortable showing to others is incorporated. This technique offers participants a 'safe' space for respectful interaction. The editing process itself is analytic, and the final assembly of footage approximates a dialogue on the topic at hand. A link to a film produced from a project piloting the method is provided to demonstrate its real world application. Brokered Dialogue is a method for promoting respectful interactions among those with seemingly divergent views on a controversial topic and for discovering critical points of divergence that may represent pathways for improvement. While the end product is a 'film', the goal is to have these films used as catalysts for ongoing respectful dialogue and problem-solving concerning the topic at hand informing

  9. Brokered dialogue: A new research method for controversial health and social issues

    Directory of Open Access Journals (Sweden)

    Parsons Janet A

    2012-07-01

    Full Text Available Abstract Background Dialogue is a foundational feature of social life and an important way in which we come to understand one another. In situations of controversy dialogue is often absent because of a range of social barriers. We have developed a new film-based qualitative research method for studying controversial issues in healthcare and social policy. We call this method Brokered Dialogue. Theoretically informed by the traditions in narrative inquiry and visual anthropology, the method is premised on the idea that dialogue possesses features making it unique as a generator of new knowledge and opportunities for social intervention. Film is not only an extraordinarily rich data source, but an excellent medium for knowledge transfer and dissemination. Discussion The paper introduces the Brokered Dialogue method. We outline its critical steps, including the procedures for sampling, data collection and data analysis of both textual and visual data. Participants in a Brokered Dialogue engage in filmed interviews that capture their perspectives on a given topic; they then share their perspectives with, and pose questions of, one another through the medium of film. Using a participatory editing process, only footage that participants feel comfortable showing to others is incorporated. This technique offers participants a ‘safe’ space for respectful interaction. The editing process itself is analytic, and the final assembly of footage approximates a dialogue on the topic at hand. A link to a film produced from a project piloting the method is provided to demonstrate its real world application. Summary Brokered Dialogue is a method for promoting respectful interactions among those with seemingly divergent views on a controversial topic and for discovering critical points of divergence that may represent pathways for improvement. While the end product is a ‘film’, the goal is to have these films used as catalysts for ongoing respectful

  10. Multidisciplinary Identification of the Controversial Freedom Fighter Jörg Jenatsch, Assassinated 1639 in Chur, Switzerland.

    Directory of Open Access Journals (Sweden)

    Martin Haeusler

    Full Text Available Jörg Jenatsch, a leading freedom fighter during the Thirty Year's War in Graubünden, Switzerland, was assassinated on carnival 1639. Jenatsch's controversial biography and the unclear circumstances of his death inspired the formation of various legends, novels and films. In 1959, a skeleton discovered in the cathedral of Chur with remains of wealthy baroque clothing was tentatively attributed to Jenatsch. Here, we reassess the skeleton based on a new exhumation. Our multidisciplinary analysis and the head injuries are consistent with reports of the eyewitnesses of the crime, demonstrating that Jenatsch was killed from behind with a semi-sharp implement, supposedly an axe, as well as by a blow with a broad-surfaced object. Moreover, our facial reconstruction closely matches an oil portrait of Jenatsch, and the HIrisPlex system applied to DNA-extracts from the femoral bone reveals brown eye and dark brown hair colour, which coincides well with the portrait, too. Finally, isotope analysis of the femoral bone and a molar support Jenatsch's high social status, luxury diet and a high mobility in the last decade of his life. This multidisciplinary approach thus reinforces personal identification and provides additional insight into the life of this important historic person beyond written resources.

  11. Multidisciplinary Identification of the Controversial Freedom Fighter Jörg Jenatsch, Assassinated 1639 in Chur, Switzerland.

    Science.gov (United States)

    Haeusler, Martin; Haas, Cordula; Lösch, Sandra; Moghaddam, Negahnaz; Villa, Igor M; Walsh, Susan; Kayser, Manfred; Seiler, Roger; Ruehli, Frank; Janosa, Manuel; Papageorgopoulou, Christina

    2016-01-01

    Jörg Jenatsch, a leading freedom fighter during the Thirty Year's War in Graubünden, Switzerland, was assassinated on carnival 1639. Jenatsch's controversial biography and the unclear circumstances of his death inspired the formation of various legends, novels and films. In 1959, a skeleton discovered in the cathedral of Chur with remains of wealthy baroque clothing was tentatively attributed to Jenatsch. Here, we reassess the skeleton based on a new exhumation. Our multidisciplinary analysis and the head injuries are consistent with reports of the eyewitnesses of the crime, demonstrating that Jenatsch was killed from behind with a semi-sharp implement, supposedly an axe, as well as by a blow with a broad-surfaced object. Moreover, our facial reconstruction closely matches an oil portrait of Jenatsch, and the HIrisPlex system applied to DNA-extracts from the femoral bone reveals brown eye and dark brown hair colour, which coincides well with the portrait, too. Finally, isotope analysis of the femoral bone and a molar support Jenatsch's high social status, luxury diet and a high mobility in the last decade of his life. This multidisciplinary approach thus reinforces personal identification and provides additional insight into the life of this important historic person beyond written resources.

  12. Lyme disease: diagnostic issues and controversies.

    Science.gov (United States)

    Aguero-Rosenfeld, Maria E; Wormser, Gary P

    2015-01-01

    The diagnosis of Lyme disease is a controversial topic. Most practitioners and scientists recognize that Lyme disease is associated with certain objective clinical manifestations supported by laboratory evidence of infection with Borrelia burgdorferi sensu lato (the etiologic agent). There are others, however, who believe that patients with Lyme disease may have a wide variety of entirely nonspecific symptoms without any objective clinical manifestation and that laboratory evidence of infection by B. burgdorferi is not required to support the diagnosis. In reality, this perspective is not evidence based and would inevitably lead to innumerable misdiagnoses, given the high frequency of medically unexplained symptoms, such as fatigue and musculoskeletal pains, in the general population. Although those espousing this viewpoint do not believe that a positive laboratory test is required, nevertheless, they often seek out and promote alternative, unapproved testing methods that frequently provide false-positive results to justify their diagnosis. Herein, we provide a brief overview of Lyme disease testing, emphasizing current usage and limitations. We also discuss the use of nonvalidated procedures and the prospects for a reduction in such testing practices in the future.

  13. The association of season and temperature with adverse pregnancy outcome in two German states, a time-series analysis.

    Directory of Open Access Journals (Sweden)

    Jennyfer Wolf

    Full Text Available A seasonality of low birth weight (LBW and preterm birth (PTB has been described for most regions and there is evidence that this pattern is caused by ambient outdoor temperature. However, the association as such, the direction of effect and the critical time of exposure remain controversial.Logistic, time-series regression was performed on nearly 300,000 births from two German states to study the association between season and daily mean temperature and changes in daily proportions of term LBW (tLBW or PTB. Analyses were adjusted for time-varying factors. Temperature exposures were examined during different periods of pregnancy.Weak evidence for an association between season of conception, season of birth or ambient outdoor temperature and tLBW or PTB was found. Results of analyses of temperature were not consistent between the two states. Different sources of bias which would have artificially led to stronger findings were detected and are described.No clear evidence for an association between season of conception, season of birth or temperature and tLBW or PTB was found. In the study of pregnancy outcome different sources of bias can be identified which can potentially explain heterogeneous findings of the past.

  14. Pregnancy outcomes and the effect of metformin treatment in women with polycystic ovary syndrome: an overview.

    Science.gov (United States)

    Ghazeeri, Ghina S; Nassar, Anwar H; Younes, Zeina; Awwad, Johnny T

    2012-06-01

    This article is a review of the literature assessing pregnancy outcomes and the effect of metformin treatment among women with polycystic ovary syndrome (PCOS). A review of research published in English was undertaken using PubMed and MEDLINE databases. The weight of the available evidence suggests that pregnant women with PCOS are at an increased risk of developing gestational diabetes, hypertensive disorders of pregnancy, preterm birth and early pregnancy loss. Obesity is a contributory factor for the increased risk of gestational diabetes in this group of women and is estimated to affect 5-40% of pregnant women with PCOS. The prevalence of other obstetric complications is estimated at 10-30% for gestational hypertension, 8-15% for pre-eclampsia and 6-15% for preterm birth. The association between PCOS and early pregnancy loss may not be direct, wherein the presence of PCOS-associated hyperinsulinemia, leading to hyperandrogenemia, has been implicated in the pathophysiology of early pregnancy loss. Apart from the role of metformin in improving the metabolic consequences accompanying PCOS, it has been shown to improve pregnancy rates in women with PCOS who are resistant to clomiphene citrate. In conclusion, pregnancy in women with PCOS is associated with adverse obstetric outcomes (multiple adverse obstetric risk). Whether metformin should be administered throughout pregnancy still remains controversial. Further prospective studies that foster a larger number of participants and adjust for all potentially confounding factors are needed. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Operative Versus Nonoperative Management of Civilian Gunshot Wounds to the Spinal Cord: Novel Use of the Functional Independence Measure for Validated Outcomes.

    Science.gov (United States)

    McCunniff, Peter T; Ramey, James S; Scott, Meredith L; Roach, Mary J; Vallier, Heather A; Moore, Timothy A; Kelly, Michael L

    2017-10-01

    Surgery for patients with gunshot wound spinal cord injury (GSCI) remains controversial. Few recent studies provide standardized follow-up and detailed functional outcomes. To our knowledge, the research we present in this study is unique in that we are the first to incorporate Functional Independence Measure (FIM) scores as an outcomes measure for neurologic recovery in patients with GSCI. Patients with GSCI were divided into surgical and nonsurgical groups. Neurologic function was measured according to the American Spinal Injury Association impairment scale and defined as either complete or incomplete injury. Outcomes were then analyzed separately for complete and incomplete GSCI groups during hospitalization and rehabilitation. Baseline admissions characteristics were similar between surgical and nonsurgical groups except for a greater median injury severity score in the nonsurgical group (34 vs. 27; P = 0.02). For complete GSCI, total length of stay (LOS) was significantly longer in the surgical group (52 vs. 42 days; P = 0.04), and no difference was observed in overall FIM scores (58 vs. 54; P = 0.7). For incomplete GSCI, rehabilitation LOS was longer (35 vs. 21; P = 0.02) and a trend towards longer total LOS was observed in the surgical group (40 vs. 32; P = 0.07). No difference was observed in overall FIM scores (61 vs. 62; P = 0.9). Surgery for patients with GSCI is associated with increased LOS and is not associated with improved FIM scores for patients with either complete or incomplete spinal cord injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Outcomes and long-term survival of coronary artery surgery: The controversial role of opium as risk marker

    Science.gov (United States)

    Najafi, Mahdi; Jahangiry, Leila; Mortazavi, Seyedeh Hamideh; Jalali, Arash; Karimi, Abbasali; Bozorgi, Ali

    2016-01-01

    AIM To study survival in isolated coronary artery bypass graft (CABG) patients and to evaluate the impact of preoperative chronic opium consumption on long-term outcome. METHODS Cohort of 566 isolated CABG patients as Tehran Heart Center cardiac output measurement was conducted. Daily evaluation until discharge as well as 4- and 12-mo and 6.5-year follow-up information for survival status were fulfilled for all patients. Long-term 6.5-year overall and opium-stratified survival, adjusted survival curves based on opium consumption as well as possible predictors of all-cause mortality using multiple cox regression were determined by statistical analysis. RESULTS Six point five-year overall survival was 91.8%; 86.6% in opium consumers and 92.7% in non-opium consumers (P = 0.035). Patients with positive history of opium consumption significantly tended to have lower ejection fraction (EF), higher creatinine level and higher prevalence of myocardial infarction. Multiple predictors of all-cause mortality included age, body mass index, EF, diabetes mellitus and cerebrovascular accident. The hazard ratio (HR) of 2.09 for the risk of mortality in opium addicted patients with a borderline P value (P = 0.052) was calculated in this model. Further adjustment with stratification based on smoking and opium addiction reduced the HR to 1.20 (P = 0.355). CONCLUSION Simultaneous impact of smoking as a confounding variable in most of the patients prevents from definitive judgment on the role of opium as an independent contributing factor in worse long-term survival of CABG patients in addition to advanced age, low EF, diabetes mellitus and cerebrovascular accident. Meanwhile, our findings do not confirm any cardio protective role for opium to improve outcome in coronary patients with the history of smoking. Further studies are needed to clarify pure effect of opium and warrant the aforementioned findings. PMID:27957254

  17. Influence of treatments on prognosis for vulvar lichen sclerosus: facts and controversies.

    Science.gov (United States)

    Brodrick, Brooks; Belkin, Zoe R; Goldstein, Andrew T

    2013-01-01

    Lichen sclerosus (LS) is an inflammatory dermatosis with a predilection for the anogential skin. Vulvar LS can be a debilitating disease, causing pruritus and pain, and it carries the potential for atrophy, scarring, and significant functional impairment. Recently, many advances have been made regarding the etiology and natural history of the disease process; however, much debate still exists regarding the most advantageous medical and surgical management of this disorder. In an effort to provide a comprehensive review on current vulvar LS literature, the following three controversies will be discussed: (1) optimal disease treatment, (2) theories behind LS's oncogenicity and treatments for minimizing malignancy, and (3) the value of surgical treatment for LS. Ultra-potent topical corticosteroids (TCSs) are the first-line treatment for vulvar LS, while topical calcineurin inhibitors (TCIs) remain second-line agents for patients for whom TCS treatment resulted in incomplete resolution of symptoms or adverse events. Due to the relapsing nature of the disease, long-term maintenance therapy is often required. In addition, recent advances have contributed to the understanding of the association between LS and squamous cell carcinoma (SCC). While the exact mechanism responsible for LS-associated SCC is not known, immune dysregulation and inflammation may play an important role; therefore, successful treatment of LS should be directed towards alleviation of symptoms and reversal of the underlying histopathologic changes. Patients with LS-associated malignancy, as well as patients who need correction of functionally restrictive, scarring processes, can successfully undergo surgical intervention with tissue conservation. © 2013 Elsevier Inc. All rights reserved.

  18. Bioethics networks and reproduction technologies: theoretical and methodological controversies - DOI: 10.3395/reciis.v1i2.87en

    Directory of Open Access Journals (Sweden)

    Rosa Maria Leite Pedro

    2007-12-01

    Full Text Available The object of this paper is to discuss some of the theoretical and methodological controversies surrounding the emerging field of bioethics, especially focusing on reproduction biotechnologies, attempting to give some examples of its implications as a network of controversies. Initially, it presents the new reproduction biotechnologies in terms of the effect which they are producing on our understanding about human nature and life, as well as the context of the emergence of bioethics, traditionally conceived of as a critical and analytical example of the relationship between technology and humanity. As an alternative way of explaining these relationships, it outlines the aspect of bioethics as a network effect, in which the technology-society hybrid is shown both in the building of bioethical norms and in the instabilities which challenge these norms. As a way of understanding this heterogeneous and complex network, Controversy Analysis is proposed as a methodological tool. In order to illustrate the richness of such perspective, a brief empirical study is presented, in which an attempt is made to track controversies articulated around the relations between bioethics and reproduction biotechnologies, with a specific focus on stem cell research, as published by the on-line media from January of 2004 until July of 2006, raising questions about subjects such as: life, humanity, artifice and autonomy.

  19. Operative outcomes of adult living donor liver transplantation and deceased donor liver transplantation: a systematic review and meta-analysis.

    Science.gov (United States)

    Wan, Ping; Yu, Xin; Xia, Qiang

    2014-04-01

    Living donor liver transplantation (LDLT) has emerged as an alternative to deceased donor liver transplantation (DDLT) because of the increasing number of patients waiting for liver transplantation (LT). However, whether it can achieve operative outcomes similar to those achieved with DDLT for adult patients remains controversial. We conducted this meta-analysis to compare the operative outcomes of LDLT and DDLT recipients. A literature search was performed to identify clinical controlled studies comparing LDLT and DDLT that were published before October 2013. Four perioperative outcomes [duration of the recipient operation (DRO), red blood cell (RBC) transfusion requirement, length of the hospital stay, and cold ischemia time (CIT)] and 5 postoperative complication outcomes (biliary complications, vascular complications, intra-abdominal bleeding, perioperative death, and retransplantation) were the main outcomes assessed. Nineteen studies with a total of 5450 patients were included in the meta-analysis. In comparison with DDLT, LDLT was associated with a significantly longer DRO and a shorter CIT. We found that biliary complications [odds ratio (OR) = 3.08, 95% confidence interval (CI) = 1.97-4.81, P < 0.001], vascular complications (OR = 2.16, 95% CI = 1.32-3.54, P = 0.002), and retransplantation (OR = 1.76, 95% CI = 1.09-2.83, P = 0.02) occurred more frequently for LDLT recipients, and the subgroup analysis indicated that the biliary complication rate decreased dramatically with greater LDLT experience. No significant difference was observed in RBC transfusion requirements, the lengths of hospital stays, intra-abdominal bleeding rates, or perioperative mortality between LDLT and DDLT recipients. In conclusion, LDLT is associated with a higher rate of surgical complications after transplantation. A reduction of postoperative complication rates can be achieved as centers gain greater experience with LDLT. However, LDLT is still

  20. Benefit and Risk Perceptions of Controversial Facilities: A Comparison between Local Officials and the Public in China

    Directory of Open Access Journals (Sweden)

    Qingduo Mao

    2018-04-01

    Full Text Available This article investigates the perception biases of local government officials and the general public by comparing their benefit and risk perceptions towards controversial facilities. The analysis framework of Social Judgement Theory (SJT—i.e., (a economic benefits, (b environmental health, and (c social and political factors—was used to design the research. SJT is a widely recognized theoretical framework that includes experimental approaches to the study of cognitive conflicts. An experimental survey was conducted to collect data in order to make a comparison of the weight of different elements. Results demonstrate that there are perception differences between the general public and local officials on controversial facilities. Local officials responsible for endorsing and supervising plants attach more significance to environmental factors than the public, while the public focuses more on social and political factors than officials. There is no significant difference in the cognition of economic benefits. Factors such as demolition compensation and legitimacy may provoke these perception gaps. This paper enriches the current understanding of SJT and policy making for controversial facilities by investigating the perception gaps between officials and the general public.

  1. The health outcomes of human offspring conceived by assisted reproductive technologies (ART).

    Science.gov (United States)

    Chen, M; Heilbronn, L K

    2017-08-01

    Concerns have been raised about the health and development of children conceived by assisted reproductive technologies (ART) since 1978. Controversially, ART has been linked with adverse obstetric and perinatal outcomes, an increased risk of birth defects, cancers, and growth and development disorders. Emerging evidence suggests that ART treatment may also predispose individuals to an increased risk of chronic ageing related diseases such as obesity, type 2 diabetes and cardiovascular disease. This review will summarize the available evidence on the short-term and long-term health outcomes of ART singletons, as multiple pregnancies after multiple embryos transfer, are associated with low birth weight and preterm delivery, which can separately increase risk of adverse postnatal outcomes, and impact long-term health. We will also examine the potential factors that may contribute to these health risks, and discuss underlying mechanisms, including epigenetic changes that may occur during the preimplantation period and reprogram development in utero, and adult health, later in life. Lastly, this review will consider the future directions with the view to optimize the long-term health of ART children.

  2. Dialogs on the Yucca Mountain controversy. Special report No. 10

    International Nuclear Information System (INIS)

    Schluter, C.M.; Szymanski, J.S.

    1993-08-01

    In an attempt to resolve the controversial issue of tectonic and hydrologic stability of the Yucca Mountain region, the National Academy of Sciences established a Panel on Coupled Hydrologic/Tectonic/HydrothermaI Systems. The Panel has recently released it's findings in a report entitled Ground Water at Yucca Mountain: How High Can It Rise? The representation of data and the scientific validity of this report was the subject of comprehensive evaluations and reviews which has led to correspondence between Dr. Charles Archarnbeau and Dr. Frank Press, the President of the National Academy of Sciences. All such correspondence prior to April 9, 1993 is covered by TRAC Special Report No. 5, open-quotes Dialogs on the Yucca Mountain Controversy.close quotes The present report represents a continuation of the dialog between Dr. Archambeau and Dr. Press; specifically the letter from Dr. Press to Dr. Archambeau dated April 9, 1993 and Archambeau's response to Press, dated August 19, 1993. In addition to the correspondence between Press and Archambeau, a series of recent reports by other investigators, referred to in the correspondence from Archambeau, are included in this report and document new data and inferences of importance for resolution of the question of suitability of the Yucca Mountain site as a high level nuclear waste repository. These reports also demonstrate that other scientists, not previously associated with the government's program at Yucca Mountain or the National Academy review of an aspect of that program, have arrived at conclusions that are different than those stated by the Academy review and DOE program scientists

  3. Sugars and Health Controversies: What Does the Science Say?123

    Science.gov (United States)

    Rippe, James M; Angelopoulos, Theodore J

    2015-01-01

    The consumption of sugar and its relation to various potential adverse health consequences are the subjects of considerable debate and controversy. This supplement to Advances in Nutrition provides an expanded summary of a symposium held on 26 April 2014 entitled “Sugars and Health Controversies: What Does the Science Say?” as part of the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2014. The articles in the supplement discuss results of current systematic reviews and meta-analyses as well as randomized controlled trials and draw implications for public policy considerations. In addition, future research gaps are identified. Current research trials conducted with commonly consumed sugars [e.g., sucrose and high-fructose corn syrup (HFCS)] do not support a unique relation to obesity, metabolic syndrome, diabetes, risk factors for heart disease, or nonalcoholic fatty liver disease. Neurologic differences in response to studies that used pure fructose compared with pure glucose have not been confirmed using typical sugars that are consumed (i.e., sucrose and HFCS), which contain ∼50% glucose and fructose. We conclude that added sugars consumed in the normal forms in which humans consume them, at amounts typical of the human diet and for the time period studied in randomized controlled trials, do not result in adverse health consequences. Although more research trials are needed in many areas of sugar consumption and health, there is little scientific justification for recommending restricting sugar consumption below the reasonable upper limit recommended by the Dietary Guidelines for Americans, 2010 of no more than 25% of calories.

  4. Triumph & Commemoration: Collective Imagination and the ‘Ground Zero Mosque’ Controversy

    OpenAIRE

    Powell, Julie M.

    2013-01-01

    This study reassesses the meaning of the ‘Ground Zero Mosque’ controversy of 2010 through the lens of urban sociology and collective imagination. It utilizes the imaginative fruits of civic forums, such as “Imagine NY” and “Listening to the City,” to determine New Yorkers’ collective vision for the rehabilitation of Ground Zero and Lower Manhattan in the aftermath of 9/11. Articulated as a clarion call for the manifestation of commemoration and triumph over terrorism in the New York cityscape...

  5. Patently controversial: markets, morals, and the President's proposal for embryonic stem cell research.

    Science.gov (United States)

    Fins, Joseph J; Schachter, Madeleine

    2002-09-01

    This essay considers the implications of President George W. Bush's proposal for human embryonic stem cell research. Through the perspective of patent law, privacy, and informed consent, we elucidate the ongoing controversy about the moral standing of human embryonic stem cells and their derivatives and consider how the inconsistencies in the president's proposal will affect clinical practice and research.

  6. Human Rights Education: A Pedagogical and Didactic (Teaching Strategy Focused in a Controversial Perspective

    Directory of Open Access Journals (Sweden)

    Abraham Magendzo-Kolstrein

    2015-09-01

    Full Text Available The purpose of this article, which can be envision as an essay, is to present a pedagogical-didactic strategy for human rights education focusing on the controversy. Advancements and setbacks faced by human rights education in Latin America are exposed in order to support this strategy. Therefore, it indicates that education has denied the conflict and explains the need for its inclusion under the idea of ‘controversial issue’. Additionally, the existence of conflicts in the interpretation, violation and/or respect for human rights is pointed out. The principal tensions that cross human rights are displayed. Based on the above, the need to support the existence of a human rights education focusing on the conflict and central components of its teaching strategy are described, and it ends by referring to its didactic approach and the role which should be assumed by faculty when teaching human rights including the conflict.

  7. Controversies in external beam and high dose rate brachytherapy of oesophageal cancer

    International Nuclear Information System (INIS)

    Sur, R.K.; Levin, V.C.; Malas, Simon; Donde, Bernard

    1994-01-01

    Various controversies in the treatment of oesophageal carcinoma with external beam radiotherapy and high dose rate intracavitary irradiation have been reviewed. Conflicting results from different parts of the world has made it difficult to optimize the radiation dose that may give the best results. More studies and longer follow-up are needed before a definite conclusion can be made on the optimization of dose. (author). 18 refs., 2 tabs

  8. Advanced Concepts and Controversies in Emergency Department Pain Management.

    Science.gov (United States)

    Motov, Sergey M; Nelson, Lewis S

    2016-06-01

    Pain is the most common complaint for which patients come to the emergency department (ED). Emergency physicians are responsible for pain relief in a timely, efficient, and safe manner in the ED. The improvement in our understanding of the neurobiology of pain has balanced the utilization of nonopioid and opioid analgesia, and simultaneously has led to more rational and safer opioid prescribing practices. This article reviews advances in pain management in the ED for patients with acute and chronic pain as well as describes several newer strategies and controversies. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Journalism, controversy and convincing practices: the words and the training

    Directory of Open Access Journals (Sweden)

    Francisco José Castilhos Karam

    2012-09-01

    Full Text Available Journalism is raised by Greco-RomanRhetoric and Dialectics and comes through thepresent days without ever giving up on its centralpillar: words. Words are to be found everywhere:in writt en texts, static or dynamic images; in infographicsand great, typical journalistic tales. Theyare to be found in chronics, comics, informal talkand social networks. To become a journalist meansto not give up on words that are central when oneacknowledges the importance of the surroundings,of detection methods and narrative models. Wordsare at the core of controversy and convincing practices.They are at the core of becoming a journalist.

  10. Adjuvant treatment and outcomes of stage III endometrial carcinoma

    International Nuclear Information System (INIS)

    Connell, C.; Ludbrook, J.; Davy, M.; Yeoh, E

    2003-01-01

    Surgery with staging using FIGO (1988) classification is accepted management for stage III endometrial carcinoma. The delivery of adjuvant therapy is controversial and tends to be individualised. Retrospective review of stage III endometrial carcinoma patients who underwent radical surgery at the Royal Adelaide and Queen Elizabeth Hospitals from 1984 to 2003 was carried out. Medical records were reviewed for details of patient characteristics, surgery, histopathology, adjuvant therapy and recurrence/survival. Sixty-six patients with a median age of 69 (37-97), had a median follow-up of 26 months (1-188 ). For all stage III patients, the actuarial 5-year disease-free and overall survivals were 50 and 43% respectively. Thirty-five patients received pelvic +/- paraaortic radiotherapy, 5 whole abdominal radiotherapy, 14 vaginal brachytherapy boost, 10 chemotherapy and 13 adjuvant hormones. Forty-six percent of patients recurred in a median time of 13 months (0-95). For these patients, the sites of first recurrence were pelvis in 27%, pelvis and abdomen in 23%, abdomen alone in 13%, distant alone in 27%, distant and abdominal in 7% and all three sites in 3%. On univariate analysis disease-free survival was impacted by; age, grade, parametrial involvement, number of extrauterine sites, lymphovascular invasion, adjuvant radiotherapy to the pelvis alone and postoperative macroscopic residual disease. Lymphovascular invasion, post-operative residual disease and adjuvant pelvic radiotherapy remained significant on multivariate analysis. These outcomes for stage III endometrial carcinoma are comparable to the current literature. Ongoing research is required to establish the most appropriate adjuvant therapy in these high risk patients

  11. 'Fracking' Controversy and Communication: Using National Survey Data to Understand Public Perceptions of Hydraulic Fracturing (Invited)

    Science.gov (United States)

    Boudet, H. S.

    2013-12-01

    The recent push to develop unconventional sources of oil and gas both in the U.S. and abroad via hydraulic fracturing ('fracking') has generated a great deal of controversy. Effectively engaging stakeholders and setting appropriate policies requires insights into current public perceptions of this issue. Using a nationally representative U.S. sample (N=1,061), we examine public perceptions of hydraulic fracturing including: 'top of mind' associations; familiarity with the issue; levels of support/opposition; and predictors of such judgments. Similar to findings on other emerging technologies, our results suggest limited familiarity with the process and its potential impacts and considerable uncertainty about whether to support it. Multiple regression analysis (r2 = 0.49) finds that women, those holding egalitarian worldviews, those who read newspapers more than once a week, those more familiar with hydraulic fracturing, and those who associate the process with environmental impacts are more likely to oppose fracking. In contrast, people more likely to support fracking tend to be older, hold a bachelor's degree or higher, politically conservative, watch TV news more than once a week, and associate the process with positive economic or energy supply outcomes. Based on these findings, we discuss recommendations for future research, risk communication, and energy policy.

  12. Assessing the public's views in research ethics controversies: deliberative democracy and bioethics as natural allies.

    Science.gov (United States)

    Kim, Scott Y H; Wall, Ian F; Stanczyk, Aimee; De Vries, Raymond

    2009-12-01

    In a liberal democracy, policy decisions regarding ethical controversies, including those in research ethics, should incorporate the opinions of its citizens. Eliciting informed and well-considered ethical opinions can be challenging. The issues may not be widely familiar and they may involve complex scientific, legal, historical, and ethical dimensions. Traditional surveys risk eliciting superficial and uninformed opinions that may be of dubious quality for policy formation. We argue that the theory and practice of deliberative democracy (DD) is especially useful in overcoming such inadequacies. We explain DD theory and practice, discuss the rationale for using DD methods in research ethics, and illustrate in depth the use of a DD method for a longstanding research ethics controversy involving research based on surrogate consent. The potential pitfalls of DD and the means of minimizing them as well as future research directions are also discussed.

  13. Prognostic Factors for Peritonitis Outcome

    NARCIS (Netherlands)

    van Esch, Sadie; Krediet, Raymond T.; Struijk, Dirk G.

    2012-01-01

    Despite advances in treatment and prevention, peritonitis remains a major problem in peritoneal dialysis (PD) patients with often technique failure as a consequence. The last decades the focus of PD peritonitis has changed from lowering peritonitis incidence to improvement of peritonitis outcome.

  14. Controversial Issues in the Diagnosis of Narcissistic Personality Disorder: A Review of the Literature.

    Science.gov (United States)

    Rivas, Luis A.

    2001-01-01

    Reviews the literature on some of the issues that have been proposed as controversial with the diagnosis of Narcissistic Personality Disorder. Discusses the issues of comorbidity that questions the validity of the diagnosis; dimensional models of classification and what constitutes a narcissistic personality disorder; and the role that culture…

  15. Colorectal Cancer: Late Presentation and Outcome of Treatment ...

    African Journals Online (AJOL)

    Background: Colorectal cancer remains a major health problem especially in developed countries where it ranks as the third most common cause of cancer in both men and women. Though incidence of colorectal cancer is low in Nigeria and other developing countries, outcome of treatment remains poor due largely to late ...

  16. Consequences of corporal punishment among African Americans: the importance of context and outcome.

    Science.gov (United States)

    Simons, Leslie Gordon; Simons, Ronald L; Su, Xiaoli

    2013-08-01

    Corporal punishment is a controversial practice used by the majority of American parents and is especially prevalent among African Americans. Research regarding its consequences has produced mixed results although it is clear that there is a need for considering the context within which corporal punishment is administered. To assess the impact of spanking, we employed an expanded parenting typology that includes corporal punishment. Longitudinal self-report data from a sample of 683 African American youth (54% female) were utilized to evaluate the relative impact of the resulting eight parenting styles on three outcomes: conduct problems, depressive symptoms, and school engagement. Results from Negative Binomial Regression Models indicate that the effect of corporal punishment depends upon the constellation of parenting behaviors within which it is embedded and upon the type of outcome being considered. While it is never the case that there is any added benefit of adding corporal punishment, it is also the case that using corporal punishment is not always associated with poor outcomes. Overall, however, our findings show that parenting styles that include corporal punishment do not produce outcomes as positive as those associated with authoritative parenting.

  17. Korean Clinic Based Outcome Measure Studies

    OpenAIRE

    Jongbae Park

    2003-01-01

    Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented...

  18. Long-term outcome following medial open reduction in developmental dysplasia of the hip: a retrospective cohort study

    OpenAIRE

    Gardner, Richard O. E.; Bradley, Catharine S.; Sharma, Om P.; Feng, Lin; Shin, Michelle EyunJung; Kelley, Simon P.; Wedge, J. H.

    2016-01-01

    Introduction Avascular necrosis (AVN) is a serious complication of treatment for developmental dysplasia of the hip. There is ongoing controversy regarding AVN and its influence on hip development following medial open reduction (MOR). Purpose The aim of our study was to (1) determine the long-term prevalence of AVN following MOR, (2) evaluate hip development after MOR, and (3) identify predictors of AVN and radiographic outcome at skeletal maturity after MOR. Methods A retrospective cohort a...

  19. Improving outcomes following penetrating colon wounds: application of a clinical pathway.

    Science.gov (United States)

    Miller, Preston R; Fabian, Timothy C; Croce, Martin A; Magnotti, Louis J; Elizabeth Pritchard, F; Minard, Gayle; Stewart, Ronald M

    2002-06-01

    During World War II, failure to treat penetrating colon injuries with diversion could result in court martial. Based on this wartime experience, colostomy for civilian colon wounds became the standard of care for the next 4 decades. Previous work from our institution demonstrated that primary repair was the optimal management for nondestructive colon wounds. Optimal management of destructive wounds requiring resection remains controversial. To address this issue, we performed a study that demonstrated risk factors (pre or intraoperative transfusion requirement of more than 6 units of packed red blood cells, significant comorbid diseases) that were associated with a suture line failure rate of 14%, and of whom 33% died. Based on these outcomes, a clinical pathway for management of destructive colon wounds was developed. The results of the implementation of this pathway are the focus of this report. Patients with penetrating colon injury were identified from the registry of a level I trauma center over a 5-year period. Records were reviewed for demographics, injury characteristics, and outcome. Patients with nondestructive injuries underwent primary repair. Patients with destructive wounds but no comorbidities or large transfusion requirement underwent resection and anastomosis, while patients with destructive wounds and significant medical illness or transfusion requirements of more than 6 units/blood received end colostomy. The current patients (CP) were compared to the previous study (PS) to determine the impact of the clinical pathway. Outcomes examined included colon related mortality and morbidity (suture line leak and abscess). Over a 5.5-year period, 231 patients had penetrating colon wounds. 209 survived more 24 hours and comprise the study population. Primary repair was performed on 153 (73%) patients, and 56 patients had destructive injuries (27%). Of these, 40 (71%) had resection and anastomosis and 16 (29%) had diversion. More destructive injuries were

  20. The effect of limb amputation on standing weight distribution in the remaining three limbs in dogs.

    Science.gov (United States)

    Cole, Grayson Lee; Millis, Darryl

    2017-01-16

    Despite the fact that limb amputation is a commonly performed procedure in veterinary medicine, quantitative data regarding outcomes are lacking. The intention of this study was to evaluate the effect of limb amputation on weight distribution to the remaining three limbs at a stance in dogs. Ten dogs with a prior forelimb amputation and ten dogs with a prior hindlimb amputation; all of which had no history of orthopaedic or neural disease in the remaining three limbs were included in the study. Standing weight bearing was evaluated with a commercial stance analyzer in all dogs. Five valid trials were obtained and a mean percentage of weight bearing was calculated for each remaining limb. The dogs with a previous forelimb amputation, and also those with a previous hindlimb amputation, had the largest mean increase in weight bearing in the contralateral forelimb. In conclusion, proactive monitoring of orthopaedic disease in the contralateral forelimb may be advisable in dogs with a previous limb amputation. In addition, when determining candidacy for a limb amputation, disease of the contralateral forelimb should be thoroughly evaluated.