119 research outputs found

    Working With Research Ethics: The Role of Advisory Committees in Community-Based Research

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    Research confirms that the university ethics review process, the only formal ethics review process that most community-based researchers in Nova Scotia have experienced, is neither appropriate nor desirable for most community-based researchers. Instead, most community-based researchers conduct their own informal ethics review using an Advisory Committee. These committees facilitate and implement ethical considerations as they emerge out of the specific dynamics as the research progresses. This paper outlines how Advisory Committees are set up, how they attempt to include in decision-making as many voices as possible, especially those of the research participants, and how they monitor what researchers take from and give back to communities, including making sure that research participants' words are returned to them in an accessible form.La recherche confirme que le processus de l'examen de I'dthique mene par les universitds, le seul processus formel de l'examen del'ethique que la plupart des recherchistes de la Nouvelle-Ecosse connaissent, n'est ni approprie ni desirable pour la majorite desrecherchistes qui travaillent dans la communaute. Au contraire, la plupart des recherchistes qui travaillent dans la communaute menent de facon informelle leur propre examen de I'dthique en se servant d'un comite consultatif. Ces comitis facilitent et implantent les considdrations dthiques au fur et a mesure qu'elles surgissent des dynamiques particulieres au cours de la recherche. Cet article expose les grandes lignes de la facon dont on met sur pied les comites consultatifs, et comment ils essaient d'inclure dans la prise de decisions autant de voix que possible, surtout celles des participants a la recherche et comment ils surveillent ce que les recherchistes retirent des communautes et ce qu'ils leur redonnent, y compris s'assurer que ce que les participants a la recherche ont dit, leur soit retourne dans un format qui leur soit accessible

    Autism and the Crisis of Meaning

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    Wisconsin’s Disaggregated Development and the Study of the Midwest

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    Understanding Wisconsin’s decentralized and greatly localized early development offers important clues for historians of later eras who are attempting to come to terms with the history of the Midwest as a region. The Fox River Valley is but one example of the divisions – economic and otherwise – that make the Midwestern states a patchwork of regions centered on places that might have little bearing to other locations within even their own state. This is both a challenge and an opportunity for historians of the Midwest, typically accustomed to state-based histories, to consider both the global and the intensely local in their work

    IMPACT OF TEAMSTEPPS ON RN-TO-RN INTERACTION

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    Background: The performance of a nursing team is a key component of hospital quality and safety. Baseline data at this practice site was below the national benchmark for RN-to-RN Interaction on the National Database of Nursing Quality Indicators (NDNQI) Job Satisfaction Scale. Findings from the literature demonstrate TeamSTEPPS and interactive learning is one method to address teamwork and support among a healthcare team. Purpose: The purpose of this Doctor of Nursing Practice evidence-based practice project was to increase teamwork among nurses after implementation of TeamSTEPPS. Methods: Registered nurses on a medical-surgical unit completed escape room sessions to learn about TeamSTEPPS concepts. The primary outcome measure included NDNQI RN-to-RN Interaction scores. Additional data was gathered on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Nurse Communication scores and TeamSTEPPS rounding observations. Results: The primary outcome data measuring NDNQI RN-to-RN Interaction demonstrated an overall increase from baseline. Secondary outcome data measuring HCAHPS Communication with Nurses showed a positive influence on scores after intervention. The third outcome measure of TeamSTEPPS rounding observations demonstrated very good to excellent understanding and skill on how to apply the appropriate learned techniques. Conclusions: Integration of TeamSTEPPS tools and strategies in an escape room session is a fun, interactive way to learn while providing an effective team-building activity. Implications for Nursing: The integration of TeamSTEPPS had overall practical significance on the impact of RN-to-RN Interaction when delivered in an escape room setting. This has the potential to help organizations needing to improve teamwork and communication among nurses.No embarg

    Batch and median neural gas

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    Neural Gas (NG) constitutes a very robust clustering algorithm given euclidian data which does not suffer from the problem of local minima like simple vector quantization, or topological restrictions like the self-organizing map. Based on the cost function of NG, we introduce a batch variant of NG which shows much faster convergence and which can be interpreted as an optimization of the cost function by the Newton method. This formulation has the additional benefit that, based on the notion of the generalized median in analogy to Median SOM, a variant for non-vectorial proximity data can be introduced. We prove convergence of batch and median versions of NG, SOM, and k-means in a unified formulation, and we investigate the behavior of the algorithms in several experiments.Comment: In Special Issue after WSOM 05 Conference, 5-8 september, 2005, Pari

    Optometry independent prescribing during COVID lockdown in Wales

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    Introduction: During the COVID‐19 lockdown, primary care optometry services in Wales moved to a hub model of provision. Three independent prescribing models were available in different areas: a commissioned Independent Prescribing Optometry Service (IPOS), independent prescribers that were not commissioned and no independent prescribers available. This allowed a unique opportunity for comparison. Method: Optometry practices completed an online survey for each patient episode. Analysis of the data gave insight into patient presentation to urgent eye services and the drugs prescribed by optometrists. Medicines prescribed, sold or given and onward referral were compared between areas with an IPOS service (n = 2), those with prescribers but no commissioned service (n = 2) and those with no prescribers (n = 2). Results: Data from 22,434 reported patient episodes from 81 optometry practices in six health boards between 14 April 2020 and 30 June 2020 were analysed. Urgent care accounted for 10,997 (49.02%) first appointments and 1777 (7.92%) follow‐ups. Most (18,006, 80.26%) patients self‐referred. The most common presenting symptom was ‘Eye pain/discomfort’ (4818, 43.81% of urgent attendances). Anterior segment pathology was the most reported finding at first (6078, 55.27%) and follow‐up (1316, 74.06%) urgent care appointments. Topical steroids (373, 25.99% of prescriptions) were the most prescribed medications. More medications were prescribed in areas with an IPOS service (1136, 79.16% of prescriptions) than areas with prescribers but no commissioned service. There were more follow‐up appointments in optometric practice and fewer urgent referrals to ophthalmology in IPOS areas. Conclusion: Urgent care services were most utilised by patients with discomfort caused by anterior eye conditions. IPOS services enabled optometrists to manage conditions to resolution without referral and without reduction in medications sold or given. Commissioners should recognise the value in reducing burden in urgent ophthalmology and the need for follow‐up as part of a commissioned independent prescribing service

    Characterisation of faecal protease activity in irritable bowel syndrome with diarrhoea: origin and effect of gut transit

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    OBJECTIVES: Faecal serine proteases (FSPs) may play a role in irritable bowel syndrome with diarrhoea (IBS-D), but their origin is unclear. We aimed to structurally characterise them and define the impact of colonic cleansing and transit time. DESIGN: Faecal samples were obtained from 30 healthy volunteers (HV) and 79 patients with IBS-D participating in a trial of ondansetron versus placebo. Colonic transit was measured using radio-opaque markers. Samples were also obtained from 24 HV before and after colonic cleansing with the osmotic laxative MoviPrep. FSPs were purified from faecal extracts using benzamidine-Sepharose affinity chromatography. SDS-PAGE profiled components were identified using trypsinolysis and tandem mass spectrometry. Functional protease activity in faecal extracts was measured using a colorimetric assay based on the proteolysis of azo-casein. RESULTS: Protein analysis identified the most abundant FSPs as being of human origin and probably derived from pancreatic juice. Functional assays showed increased faecal protease (FP) and amylase in patients with IBS-D compared with HV. Those with higher amylase had significantly higher FP and greater anxiety. FP activity correlated negatively with whole gut transit in patients with IBS-D (Spearman r=−0.32, p=0.005) and HV (r=−0.55, p=0.014). Colon cleansing caused a significant rise in FP activity in HV from a baseline of median (IQR) 253 (140–426) to 1031 (435–2296), levels similar to those seen in patients with IBS-D. FSP activity correlated positively with days/week with urgency. CONCLUSIONS: The most abundant FSPs are of human origin. Rapid transit through the colon and/or decreased (possibly bacterial) proteolytic degradation increases their faecal concentration and could contribute to visceral hypersensitivity in patients with IBS-D. CLINICALTRIALS.GOV: NCT00745004

    Extensive study of HD 25558, a long-period double-lined binary with two SPB components

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    We carried out an extensive observational study of the Slowly Pulsating B (SPB) star, HD 25558. The ≈2000 spectra obtained at different observatories, the ground-based and MOST satellite light curves revealed that this object is a double-lined spectroscopic binary with an orbital period of about nine years. The observations do not allow the inference of an orbital solution. We determined the physical parameters of the components, and found that both lie within the SPB instability strip. Accordingly, both show line-profile variations due to stellar pulsations. 11 independent frequencies were identified in the data. All the frequencies were attributed to one of the two components based on pixel-by-pixel variability analysis of the line profiles. Spectroscopic and photometric mode identification was also performed for the frequencies of both stars. These results suggest that the inclination and rotation of the two components are rather different. The primary is a slow rotator with ≈6 d period, seen at ≈60° inclination, while the secondary rotates fast with ≈1.2 d period, and is seen at ≈20° inclination. Spectropolarimetric measurements revealed that the secondary component has a magnetic field with at least a few hundred Gauss strength, while no magnetic field can be detected in the primary

    Sustaining rare marine microorganisms: macroorganisms as repositories and dispersal agents of microbial diversity

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    Recent analyses revealed that most of the biodiversity observed in marine microbial communities is represented by organisms with low abundance but, nonetheless essential for ecosystem dynamics and processes across both temporal and spatial scales. Surprisingly, few studies have considered the effect of macroorganism-microbe interactions on the ecology and distribution dynamics of rare microbial taxa. In this review, we synthesize several lines of evidence that these relationships cannot be neglected any longer. First, we provide empirical support that the microbiota of macroorganisms represents a significant part of marine bacterial biodiversity and that host-microbe interactions benefit to certain microbial populations which are part of the rare biosphere (i.e., opportunistic copiotrophic organisms). Second, we reveal the major role that macroorganisms may have on the dispersal and the geographic distribution of microbes. Third, we introduce an innovative and integrated view of the interactions between microbes and macroorganisms, namely sustaining the rares, which suggests that macroorganisms favor the maintenance of marine microbial diversity and are involved in the regulation of its richness and dynamics. Finally, we show how this hypothesis complements existing theories in microbial ecology and offers new perspectives about the importance of macroorganisms for the microbial biosphere, particularly the rare members
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