Attitudes on Medical Ethics of Criminal Neurointerventional Treatment

As contemporary scientific advancements offer the opportunity to manipulate processes of the human body at a higher degree of invasiveness than ever before, a number of bioethical concerns are raised. One significant concern is how to discern the acceptable integration of advancements in neurologically-based interventions into the criminal justice system. Past literature supports the idea that there are several variables that interact to form a global conversation on the ethics of compromising a criminal’s freedom of mind for the purposes of sentencing or rehabilitation. Attitudes toward the current criminal justice system and the current uses of neurointerventions are significantly influential, and the public attitudes of such topics have been well-recorded through the literature. An experienced physician was interviewed in order to gain the perspective of a professional who regularly implements neurologically-based treatments. The results of the interview suggested that professionals have a moderate level of confidence that the current relationship between the criminal justice system and neurointerventional methods has generally remained within ethical boundaries. The results also suggested that medical practitioners are tasked with balancing the dignity and the safety patients, which can cause frequent ethical dilemmas. The varying responsibilities of medical professionals keep them equipped to implement expert-level care while simultaneously considering the ethical ramifications of their decisions

People on Drugs: Credibility of User Statements in Health Communities

Online health communities are a valuable source of information for patients and physicians. However, such user-generated resources are often plagued by inaccuracies and misinformation. In this work we propose a method for automatically establishing the credibility of user-generated medical statements and the trustworthiness of their authors by exploiting linguistic cues and distant supervision from expert sources. To this end we introduce a probabilistic graphical model that jointly learns user trustworthiness, statement credibility, and language objectivity. We apply this methodology to the task of extracting rare or unknown side-effects of medical drugs --- this being one of the problems where large scale non-expert data has the potential to complement expert medical knowledge. We show that our method can reliably extract side-effects and filter out false statements, while identifying trustworthy users that are likely to contribute valuable medical information

Community Health Centers: The Challenge of Growing to Meet the Need for Primary Care in Medically Underserved Communities

Provides an overview of community health centers, their patients, and recent federal and state funding cuts, as well as funding prospects for the centers' expansion to meet greater demand among patients newly eligible for Medicaid or private coverage

An Analysis of Technical Leadership in Radiology Technology

The purpose of this study is to determine whether administrators and supervisors in the field of radiology technology receive leadership training as part of their job and whether there is a significant difference for those who do not receive training. If no training is received, does promotion to a leadership position based on technical proficiency or longevity relate to successful leadership characteristics? Currently, no leadership courses are offered in undergraduate or graduate degrees focused on Radiology Technology. Radiologic technologists are required to choose between advanced degrees in imaging to become more technically proficient or advanced degrees in management or business not specific to radiology in order to gain leadership education. The study also focuses on the demographics of radiological managers who recognize their need for leadership training and perceived barriers to leadership development within the radiology technology field. Leaders who are not prepared to lead result in increased employee attrition, which directly affects patient care. Four primary research questions guide this quantitative study, which seeks to establish the need for formal and continued education in leadership development at the collegiate level as well as the organizational level. The results of this study reveal significant differences in leadership characteristics of administrators and supervisors who received formal education and those who did not. The research also showed no relationship with organizations that offer leadership development and voluntary resignations. Demographic characteristics were seen that were significant to radiologic technologists who exhibit high need for leadership development. Implications of this research could include introducing leadership courses within the graduate level degrees specific for radiology technology. A recommendation would be to target the organizations and to offer leadership development training, which was indicated from demographics of the participants who responded with high need for leadership characteristic development

The Guide for Occupational Alliance (GOAL) in pediatric rehabilitation: a shared decision-making and measurement tool

The plan of care in occupational therapy for caregivers of children with acquired brain injury (ABI), created through goal setting, is the foundation for providing services in a pediatric neurorehabilitation setting. During the first year after the injury, caregivers often experience gaps in education, feelings of decreased competence, and decreased understanding of the recovery process. These factors can make developing goals a challenge for caregivers and service providers alike. Although a number of goal-setting mechanisms exist, they currently lack options sensitive to this population’s unique needs. This project set out to explore the clinical barriers involved in goal setting in pediatric rehabilitation and to develop a relevant solution that guides the process. The results identified two theoretical models to use as “lenses” by which the problem was explored and understood. An explanatory model was developed to highlight relationships among contributing factors. A thorough review of evidence was conducted and synthesized to support the explanatory model, and existing solutions explored. Shared-decision making in healthcare through the use of decision aids was identified and investigated as a promising direction for solution development. The Guide for Occupational ALliance (GOAL) in Pediatric Rehabilitation is a shared decision-making and measurement tool designed to facilitate collaborative goal setting with caregivers of children with ABI. The GOAL fosters a family-centered approach that provides education while facilitating discussion around caregiver preferences. Additionally, it gathers helpful outcome data on caregivers’ comfort and satisfaction with goal setting in order to gauge change over time. The GOAL implementation will involve gathering insights, testing the tool, and disseminating the findings. It will be evaluated in three phases: Phase 1, a needs-assessment process involving collection of caregiver and clinician data; Phase 2, a pilot test of the GOAL to explore its effectiveness, content relevance, validity, and benefits; and Phase 3, a repeated measure-outcomes study to understand its reliability, validity, and effectiveness. The GOAL provides an opportunity to enhance collaboration during goal setting with caregivers of children with ABI and their occupational therapy service providers for optimal outcomes

Emergency Management Training and Exercises for Transportation Agency Operations, MTI Report 09-17

Training and exercises are an important part of emergency management. Plans are developed based on threat assessment, but they are not useful unless staff members are trained on how to use the plan, and then practice that training. Exercises are also essential for ensuring that the plan is effective, and outcomes from exercises are used to improve the plan. Exercises have been an important part of gauging the preparedness of response organizations since Civil Defense days when full-scale exercises often included the community. Today there are various types of exercises that can be used to evaluate the preparedness of public agencies and communities: seminars, drills, tabletop exercises, functional exercises, facilitated exercises and full-scale exercises. Police and fire agencies have long used drills and full-scale exercises to evaluate the ability of staff to use equipment, protocols and plans. Transit and transportation agencies have seldom been included in these plans, and have little guidance for their participation in the exercises. A research plan was designed to determine whether urban transit systems are holding exercises, and whether they have the training and guidance documents that they need to be successful. The main research question was whether there was a need for a practical handbook to guide the development of transit system exercises

Sports concussion management using Facebook: A feasibility study of an innovative adjunct "iCon

Context: Sports concussion is currently the focus of much international attention. Innovative methods of facilitating management following this injury need to be investigated to assist athletic trainers. Objective: The objective of this study was to investigate the feasibility of using a Facebook concussion management program termed "iCon" ("interactive concussion management") to facilitate the safe return to play (RTP) of young persons following a sports concussion. Design: This qualitative study was designed as a single-group observational feasibility study using programme evaluation methodology, with the focus on gauging the suitability of the Facebook management strategy for a potential larger study. Setting: iCon involved a Facebook group containing interactive elements, with moderation and support from trained healthcare professionals. Patients or Other Participants: Eleven participants completed the study (n=9 males, n=2 females), and ranged from 18 to 28 years old. Data Collection and Analysis: The study was conducted over a three-month period, with participant questionnaires administered pre- and post-intervention. The primary focus was on the qualitative experiences of the participants in the study, and the effect of iCon on their RTP. Usage data was also collected during the study. Results: At the completion of the study, all participants (100%) stated that they would recommend an intervention such as iCon to others, with their supporting quotes all indicating that iCon has the potential to improve the management of concussion amongst this cohort. The majority of participants (n=9 or 82%) stated they were better informed with regards to their RTP because of participating in iCon. Conclusions: This interactive adjunct to traditional concussion management was appreciated amongst this particular participant group and indicated feasibility for a future, larger study of iCon. Athletic trainers should consider the role that multimedia technologies may play in assisting with the management of sports concussion

Authorized Generic Entry prior to Patent Expiry: Reassessing Incentives for Independent Generic Entry

Patent holders frequently attempt to mitigate the loss of monopoly power by authorizing generic entry prior to patent expiry (early entry). Competition in off-patent pharmaceutical markets may be adversely affected if early entry substantially impairs the attractiveness of subsequent market entry. I examine generic entry decisions made in the course of recent patent expiries to quantify the impact of early entry on incentives for generic entry. Using unique micro data and accounting for the endogeneity of early entry, I estimate recursive bivariate probit models of entry. Drug markets' pre-entry revenues largely determine both independent generic entry and early entry decisions. Early entry in turn has no significant impact on the likelihood of generic entry. Original drug producers appear to authorize generic entry prior to loss of exclusivity primarily fueled by rent-seeking rather than strategic entry-deterrence motives

Motivational Influences of Using Peer Evaluation in Problem-Based Learning in Medical Education

This study investigates the ways in which medical students’ achievement goal orientations (AGO) affect their perceptions of learning and actual learning from an online problem-based learning environment, Calibrated Peer ReviewTM. First, the tenability of a four-factor model (Elliot & McGregor, 2001) of AGO was tested with data collected from medical students (N = 137). Then, a structural regression model relating the factors of AGO to students’ perceptions of grading fairness, judgments of learning, and scoring accuracy was tested. The results indicate that student engagement and success in diagnosing a patient’s presentation using a peer feedback-rich web-based PBL environment is somewhat dependent on student motivation. Theoretical and practical implications, in terms of problem-based learning environments in medical education, are discussed