Mediation: developing a theoretical framework for understanding alternative dispute resolution

The perceived failure and repeal of the 2004 Disciplinary and Grievance Regulations has triggered interest in mediation techniques. This paper examines alternative approaches to conflict resolution by developing a theoretical framework that relates dispute resolution practice to philosophical assumptions about authority and knowledge. The dominant approach is rooted in top-down authority that legitimises disciplinary and grievance processes. Research findings from the US suggest that higher levels of satisfaction can be achieved through mediation processes. Mediation is driven by a commitment to developing both individual and collective conflict resolution skills in order to develop equitable relationships. This assumes acceptance of plurality indetermining both the process and outcome of dispute resolution posing a fundamental challenge at the philosophical level to dominant assumptions in the employer-employee relationship. By investigating the assumptions underpinning mediation, its link to direct democracy, and challenge to managerial authority, are revealed at the level of theory and practice

Hacking your way to the next level : creating an affordable game controller for your accessible needs

My father, Tony Duff, the hero of my life, is physically and mentally disabled. He is a proud, disciplined man who retired from a thirty-year career in nursing—twenty of whom were on active-duty military service. Since having a stroke, he has been forced to adapt to his environment because of his limited abilities. Frustrated with his situation, he needed something more therapeutic than traditional physical therapy to help him thrive. So, I started to search for answers. There are many rehabilitation therapy techniques used that are effective for stroke patients, such as gaming. In the article Rehabilitation of the Upper Arm Early After Stroke: Video Games Versus Conventional Repair, author Isabelle Laffont et al. concluded that “playing video games thirty days after a stroke was more efficient than conventional rehabilitation on both sensorimotor recovery and gross grasping function.” Additionally, an article titled Video Games Effective Treatment for Stroke Patients states, “Patients who played video games…were up to five times more likely to show improvements in arm motor function than those who had standard therapy.” I wanted to know more, especially since my father has had several strokes. I noticed he was guarding his right arm instead of using it (Tony is right-handed). Dr. Gustavo Saposnik, the Stroke Outcomes Research Unit director at St Michael’s Hospital and lead author of this study, says, “It (video gaming) provides an affordable, enjoyable, and effective alternative to intensify treatment and promote motor recovery after a stroke. However, only some disabled individuals can use a standard gaming controller; other, more adaptive controllers can cost hundreds of dollars. By framing insights through research, development, and analysis, I began looking for ways video games could help improve stroke patients' motor function. I crafted different controller designs through iterative prototyping and testing processes that disabled individuals, such as stroke patients, can utilize to improve their motor function. This thesis report will present the analytical research, creative concepts, and prototyping that went into designing an inexpensive, accessible, and adaptable controller.Desig

Self-management education for cystic fibrosis

Background: Self-management education may help patients with cystic fibrosis and their families to choose, monitor and adjust treatment requirements for their illness, and also to manage the effects of illness on their lives. Although self-management education interventions have been developed for cystic fibrosis, no previous systematic review of the evidence of effectiveness of these interventions has been conducted. Objectives: To assess the effects of self-management education interventions on improving health outcomes for patients with cystic fibrosis and their caregivers. Search methods: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register (date of the last search: 22 August 2013). We also searched databases through EBSCO (CINAHL; Psychological and Behavioural Sciences Collection; PsychInfo; SocINDEX) and Elsevier (Embase) and handsearched relevant journals and conference proceedings (date of the last searches: 01 February 2014 ). Selection criteria: Randomised controlled trials, quasi-randomised controlled trials or controlled clinical trials comparing different types of self-management education for cystic fibrosis or comparing self-management education with standard care or no intervention. Data collection and analysis: Two authors assessed trial eligibility and risk of bias. Three authors extracted data. Main results: Four trials (involving a total of 269 participants) were included. The participants were children with cystic fibrosis and their parents or caregivers in three trials and adults with cystic fibrosis in one trial. The trials compared four different self-management education interventions versus standard treatment: (1) a training programme for managing cystic fibrosis in general; (2) education specific to aerosol and airway clearance treatments; (3) disease-specific nutrition education; and (4) general and disease-specific nutrition education. Training children to manage cystic fibrosis in general had no statistically significant effects on weight after six to eight weeks, mean difference -7.74 lb (i.e. 3.51 kg) (95% confidence interval -35.18 to 19.70). General and disease-specific nutrition education for adults had no statistically significant effects on: pulmonary function (forced expiratory volume at one second), mean difference -5.00 % (95% confidence interval -18.10 to 8.10) at six months and mean difference -5.50 % (95% confidence interval -18.46 to 7.46) at 12 months; or weight, mean difference - 0.70 kg (95% confidence interval -6.58 to 5.18) at six months and mean difference -0.70 kg (95% confidence interval -6.62 to 5.22) at 12 months; or dietary fat intake scores, mean difference 1.60 (85% confidence interval -2.90 to 6.10) at six months and mean difference 0.20 (95% confidence interval -4.08 to 4.48) at 12 months. There is some limited evidence to suggest that self-management education may improve knowledge in patients with cystic fibrosis but not in parents or caregivers. There is also some limited evidence to suggest that self-management education may result in positively changing a small number of behaviours in both patients and caregivers. Authors' conclusions: The available evidence from this review is of insufficient quantity and quality to draw any firm conclusions about the effects of self-management education for cystic fibrosis. Further trials are needed to investigate the effects of self-management education on a range of clinical and behavioural outcomes in children, adolescents and adults with cystic fibrosis and their caregivers

Self-management education for cystic fibrosis

Self-management education may help patients with cystic fibrosis and their families to choose, monitor and adjust treatment requirements for their illness, and also to manage the effects of illness on their lives. Although self-management education interventions have been developed for cystic fibrosis, no previous systematic review of the evidence of effectiveness of these interventions has been conducted

Investigation of polycystic ovarian syndrome: variation in practice and impact on the speed of diagnosis

Objective Accurate diagnosis of polycystic ovarian syndrome (PCOS) enables clinical interventions/cardiometabolic risk factor management. Diagnosis can take over 2 years and multiple clinician contacts. We examined patterns of PCOS-associated biochemical investigations following initial consultation prior to pelvic ultrasound scan (USS). Methods We determined in 206 women (i) the range of different biochemical test panels used in the diagnosis of PCOS in primary/secondary care prior to USS relative to national guidance in the UK and (ii) the relation between testing patterns and time to USS to highlight potential delays introduced by inappropriate testing. Results In these 206 women, 47 different test combinations were requested at initial venepuncture; only 7 (3%) had the test panel suggested in UK guidance (follicle-stimulating hormone/luteinizing hormone/testosterone/sex hormone-binding globulin/prolactin). The number of tests performed prior to USS varied from one test to all seven tests. There was an inverse relation between the number of biochemistry tests requested at initial venepuncture episode and ‘time to scan’. Those who had <3 tests had a significantly longer time from first request to USS (median 70 days) than those with 3–7 tests (median 40 days; P = 0.002). One venepuncture episode prior to USS was associated with shorter ‘time to scan’ (median 29 days) than those with 2–4 episodes (median 255 days; P < 0.001). Conclusion There was no identifiable pattern to biochemical investigations requested as part of the initial diagnostic evaluation in women with suspected PCOS. We recommend standardization of the initial biochemical panel of analytes for PCOS workup, with incorporation into hospital/general practice ordering software systems

Comparaison d'estimateurs de fréquence à complexité algorithmique réduite

De nombreux algorithmes, basés sur une modélisation Auto Régressive du signal, ont été proposés pour des problèmes d'estimation de fréquence de signaux périodiques. Nous nous intéressons ici aux performances statistiques de tels estimateurs, et proposons des formules approchées du biais et de la variance des estimées. Les résultats obtenus permettent de mettre en évidence l'influence de la fréquence recherchée, du rapport signal sur bruit et du nombre de points sur les performances de l'estimateur

Salience network and parahippocampal dopamine dysfunction in memory-impaired Parkinson disease

Objective: Patients with Parkinson disease (PD) and mild cognitive impairment (MCI) are vulnerable to dementia and frequently experience memory deficits. This could be the result of dopamine dysfunction in corticostriatal networks (salience, central executive networks, and striatum) and/or the medial temporal lobe. Our aim was to investigate whether dopamine dysfunction in these regions contributes to memory impairment in PD. Methods: We used positron emission tomography imaging to compare D2 receptor availability in the cortex and striatal (limbic and associative) dopamine neuron integrity in 4 groups: memory‐impaired PD (amnestic MCI; n = 9), PD with nonamnestic MCI (n = 10), PD without MCI (n = 11), and healthy controls (n = 14). Subjects were administered a full neuropsychological test battery for cognitive performance. Results: Memory‐impaired patients demonstrated more significant reductions in D2 receptor binding in the salience network (insular cortex and anterior cingulate cortex [ACC] and the right parahippocampal gyrus [PHG]) compared to healthy controls and patients with no MCI. They also presented reductions in the right insula and right ACC compared to nonamnestic MCI patients. D2 levels were correlated with memory performance in the right PHG and left insula of amnestic patients and with executive performance in the bilateral insula and left ACC of all MCI patients. Associative striatal dopamine denervation was significant in all PD patients. Interpretation: Dopaminergic differences in the salience network and the medial temporal lobe contribute to memory impairment in PD. Furthermore, these findings indicate the vulnerability of the salience network in PD and its potential role in memory and executive dysfunction