Persecution on Account of Political Opinion: Refugee Status after \u3ci\u3eINS v. Elias-Zacarias\u3c/i\u3e, 112 S. Ct. 812 (1992)

In INS v. Elias-Zacarias, the Supreme Court examined the definition of refugee under the Refugee Act of 1980 and found that harm from refusing to join a guerrilla organization is not persecution on account of political opinion as defined under that Act. This decision is incompatible with the intent of the Refugee Act of 1980 and creates onerous burdens of proof for aliens seeking asylum. This Note analyzes the Court\u27s reasoning and concludes that Congress should enact legislation nullifying the Court\u27s decision

Choosing which ear to implant in adult candidates with functional residual hearing

This study examined whether audiologists consider the potential benefits of contralateral hearing aid use following cochlear implantation when recommending which ear to implant in UK adult candidates with residual hearing. Thirty-four audiologists from providers of adult implantation services completed a decision-choice experiment. Clinicians were willing to consider recommending that the poorer ear be implanted, provided it had been aided continuously, suggesting that their decision making seeks to preserve access to residual hearing in the non-implanted ear where possible. Future approaches to determining candidacy should therefore consider that a sub-set of patients may obtain additional benefit from this residual hearing following implantation

Beyond solvent exclusion: i-Motif detecting capability and an alternative DNA light-switching mechanism in a ruthenium(II) polypyridyl complex

Cytosine-rich DNA can fold into secondary structures known as i-motifs. Mounting experimental evidence suggests that these non-canonical nucleic acid structures form in vivo and play biological roles. However, to date, there are no optical probes able to identify i-motif in the presence of other types of DNA. Herein, we report for the first time the interactions between the three isomers of [Ru(bqp)2]2+ with i-motif, G-quadruplex, and double-stranded DNA. Each isomer has vastly different light-switching properties: mer is “on”, trans is “off”, and cis switches from “off” to “on” in the presence of all types of DNA. Using emission lifetime measurements, we show the potential of cis to light up and identify i-motif, even when other DNA structures are present using a sequence from the promoter region of the death-associated protein (DAP). Moreover, separated cis enantiomers revealed Λ-cis to have a preference for the i-motif, whereas Δ-cis has a preference for double-helical DNA. Finally, we propose a previously unreported light-switching mechanism that originates from steric compression and electronic effects in a tight binding site, as opposed to solvent exclusion. Our work suggests that many published non-emissive Ru complexes could potentially switch on in the presence biological targets with suitable binding sites, opening up a plethora of opportunity in the detection of biological molecules

The Cost-Effectiveness of Bimodal Stimulation Compared to Unilateral and Bilateral Cochlear Implant Use in Adults with Bilateral Severe to Profound Deafness

Objectives: An increasing number of severe-profoundly deaf adult unilateral cochlear implant (CI) users receive bimodal stimulation; that is, they use a conventional acoustic hearing aid (HA) in their non-implanted ear. The combination of electric and contralateral acoustic hearing provides additional benefits to hearing and also to general health-related quality of life compared to unilateral CI use. Bilateral CI is a treatment alternative to both unilateral CI and bimodal stimulation in some healthcare systems. The objective of this study was to conduct an economic evaluation of bimodal stimulation compared to other management options for adults with bilateral severe to profound deafness.Design: The economic evaluation took the form of a cost-utility analysis and compared bimodal stimulation (CI+HA) to two treatment alternatives: unilateral and bilateral CI. The analysis used a public healthcare system perspective based on data from the United Kingdom (UK) and the United States (US). Costs and health benefits were identified for both alternatives and estimated across a patient’s lifetime using Markov state transition models. Utilities were based on Health Utilities Index (HUI3) estimates and health outcomes were expressed in Quality Adjusted Life Years (QALYs). The results were presented using the Incremental Cost-Effectiveness Ratio (ICER) and the Net Monetary Benefit approach to determine the cost-effectiveness of bimodal stimulation. Probabilistic sensitivity analyses explored the degree of overall uncertainty using Monte Carlo simulation. Deterministic sensitivity analyses and Analysis of Covariance identified parameters to which the model was most sensitive; i.e. whose values had a strong influence on the intervention that was determined to be most cost-effective. A Value Of Information analysis was performed to determine the potential value to be gained from additional research on bimodal stimulation.Results: The base case model showed that bimodal stimulation was the most cost-effective treatment option with a decision certainty of 72% and 67% in the UK and US, respectively. Despite producing more QALYs than either unilateral CI or bimodal stimulation, bilateral CI was found not to be cost-effective because it was associated with excessive costs. Compared to unilateral CI, the increased costs of bimodal stimulation were outweighed by the gain in quality of life. Bimodal stimulation was found to cost an extra £174 per person in the UK ($937 in the US) and yielded an additional 0.114 QALYs compared to unilateral CI, resulting in an ICER of £1,521 per QALY gained in the UK ($8,192/QALY in the US). The most influential variable was the utility gained from the simultaneous use of both devices (CI+HA) compared to Unilateral CI. The value of further research was £4,383,922 at £20,000/QALY ($86,955,460 at$50,000/QALY in the US).Conclusions: This study provides evidence of the most cost-effective treatment alternative for adults with bilateral severe to profound deafness from publicly-funded healthcare perspectives of the UK and US. Bimodal stimulation was found to be more cost-effective than unilateral and bilateral CI across a wide range of willingness-to-pay thresholds. If there is scope for future research, conducting interventional designs to obtain utilities for bimodal stimulation compared to unilateral CI would reduce decision uncertainty considerably

Low temperature/short duration steaming as a sustainable method of soil disinfection

This report was presented at the UK Organic Research 2002 Conference. Soil samples containing resting structures of fungal crop pathogens (Verticillium dahliae, Sclerotinia sclerotiorum, Sclerotium cepivorum, Pythium ultimum), potato cyst nematodes (Globodera rostochiensis and Globodera pallida) and weeds (Chenopodium album and Agropyron repens) were treated with aerated steam in the laboratory at temperatures ranging from 50–80oC in a specially constructed apparatus. Steaming at 50 or 60oC for three minutes, followed by an eight-minute resting period in the steamed soil and immediate removal from the soil thereafter, resulted in 100% kill of all weeds, fungi and nematodes. Low temperature/ short duration soil steaming could become a sustainable alternative to chemical or high-temperature steam soil disinfestation

Contralateral acoustic hearing aid use in adult unilateral cochlear implant recipients: current provision, practice, and clinical experience in the UK

Objectives: The study surveyed practising cochlear implant audiologists with the aim of: (1) characterising UK clinical practice around the management and fitting of a contralateral hearing aid in adult unilateral cochlear implant users (‘bimodal aiding’); (2) identifying factors that may limit the provision of bimodal aiding; and (3) ascertaining the views of audiologists on bimodal aiding. Methods: An online survey was distributed to audiologists working at the 20 centres providing implantation services to adults in the UK. Results: Responses were received from 19 of the 20 centres. The majority of centres reported evaluating hearing aids as part of the candidacy assessment for cochlear implantation. However, a majority also indicated that they do not take responsibility for the contralateral hearing aid following implantation, despite identifying few practical limiting factors. Bimodal aiding was viewed as more beneficial than wearing the implant alone, with most respondents actively encouraging bimodal listening where possible. Respondents reported that fitting bimodal devices to take account of each other’s settings was potentially more beneficial than independently-fit devices, but such sympathetic fitting was not routine practice in any centre. Discussion: The results highlight some potential inconsistencies in the provision of bimodal aiding across the UK as reported by practising audiologists. The views of audiologists about what is best practice appear to be at odds with the nature and structure of the services currently offered. Conclusion: Stronger evidence that bimodal aiding can be beneficial for UK patients would be required in order for service providers to justify the routine provision of bimodal aiding and to inform guidelines to shape routine clinical practice

Access to aidable residual hearing in adult candidates for cochlear implantation in the UK

Guidance from the National Institute for Health and Care Excellence (NICE) permits candidates to receive a cochlear implant provided they only hear sounds louder than 90 dB HL at 2 and 4 kHz. In some patients, their level of residual hearing may be sufficient to warrant the use of a hearing aid in their non-implanted ear. A survey of unilaterally-implanted adults indicated that those implanted since the publication of NICE guidance were almost seven times more likely to use a hearing aid than those implanted prior to this. If contralateral hearing aid use provides additional benefits over implant use alone, it may be appropriate to consider the capacity to use residual hearing following implantation when determining candidacy

Not Exactly Dragon\u27s Den: Enterprise Challenges can Enhance Psychological Literacy.

Enterprise challenges are teaching activities that allow students to develop and pitch a creative idea in response to a real-life challenge, usually posed by a charitable organisation. Students work in teams to develop their ideas and draw on their subject knowledge, as well as entrepreneurial processes, to articulate their product or service that addresses the challenge. These activities have the potential to enhance psychological literacy as they provide an opportunity to utilise psychological knowledge and skills in novel and unfamiliar ways and urges students to find creative solutions to societal problems. This article presents the rationale and structure to design an enterprise challenge in psychology teaching and uses two case studies to show diverse ways of delivering these teaching events. Evaluation data from six previous challenges show that students self-rate their perceived psychological literacy and entrepreneurial orientation higher after having participated in an enterprise challenge. These teaching activities present a propitious way of enhancing psychological literacy in the curriculum and supporting students on their journey to develop as global citizens