269 research outputs found

    The Substantive Elements in the New Special Pleading Laws

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    Recently there have emerged new special pleading standards applicable to discrete substantive law claims or to certain remedial requests. These norms often raise troubling procedure/substance questions in separation of powers and choice of law settings. The questions are especially difficult where the standards are hard to locate; to distinguish from nonpleading laws; and to differentiate by rationale(s). In the separation of powers setting, these questions must be approached only after undertaking a distinct and detailed analysis of each relevant government's allocation of lawmaking duties. American governments differ significantly in these allocations. In the choice of law setting, these questions can arise in circumstances involving Erie, reverse-Erie and choice of state law. The procedure/substance issues here must be approached only after undertaking a close look at functions, not labels; at the possibility of false conflicts; and without a parochial view as to the possible location or designation of the special pleading norms of other interested governments

    Abuse of power in the disciplinary actions of a state psychology licensing board: inequitable outcomes and early career psychologists

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    The field of psychology has established high professional standards which have become a cornerstone of the practice of psychology. However, powerful boards tasked with administering these standards can operate with little oversight, making it difficult to monitor whether these institutions are operating in a fair and impartial way. In particular, early-career psychologists who have less experience and power in their initial years of independent practice may be singularly vulnerable as they have relatively little experience to navigate the profession, including fielding complaints that may be made against them to a licensing board. While it is essential to ensure early-career psychologists are upholding their commitments to the practice, there are risks in policing their activities without orienting toward growth, learning, and professional development. Even the smallest disciplinary action may never be expunged from a psychologist’s record, resulting in long-term implications for insurance coverage, reputation and future professional viability in the field. Overly-punitive approaches can be distressing or even traumatizing. In this paper, we examine disciplinary actions of the Kentucky Board of Examiners of Psychology (KBEP) from the years 2000 to 2020 (N = 65) to determine the methodology by which the Board administers its oversight function. We analyze the nature of the discipline received (fines, suspensions, continuing education, supervision) revealing a two-tiered system of punishments, and provide context regarding the nature of the disciplinary process and its impacts. We report on qualitative interviews of early career psychologists subject to disciplinary actions by the Board, and psychologists who supervised early career psychologists investigated by the Board. We compare legislation governing KBEP and make comparisons to the workings of licensing boards in three other states. Using these findings, we make recommendations for revisions to the applicable legislation and administrative processes of the Board to establish an improved balance between public safety, the well-being of new psychologists, equity considerations such as race, and the development of the practice of psychology in Kentucky. This work brings to light previously unexamined injustices that can knowingly or unknowingly be perpetuated by licensing Boards, and can be used to inform the creation of more just, balanced and inclusive professional Boards

    Development and testing of the capacity of organisations for system practices scale

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    Background: Systems change approaches are increasingly adopted in public health to address complex problems. It is important that measures of systems change be developed so that the effects of systems change on health outcomes can be evaluated. Organisational practices are potential levers for systems change. However, robust measures of organisational capacity to engage in these practices are lacking. Informed by the Theory of Systems Change, we developed and tested the Capacity of Organisations for System Practices (COSP) scale. The COSP scale comprises four inter-related system practices within organisations—adaptation, alignment, collaboration and evidence-driven action and learning. Methods: We applied a three-stage process: (1) Item generation; (2) Scale pre-testing; and (3) Structural analyses. Item response theory tests and semantic review, together with factor analytic techniques, were applied to refine the item set and determine the scale structure. Results: An initial pool of 97 items was generated and pre-tested with six content experts and four target audience representatives. Modifications resulted in 60 items. In total, 126 participants provided data for the structural analysis. A second-order hierarchical four-factor model fit the data better than the more basic correlated factor model (Δχ2 = 1.758, p =.415). The fit indices for the final 31-item model were acceptable (RMSEA =.084, TLI =.819). Conclusions: The COSP scale is ready for further testing to ensure construct validity, stability and utility. So What?: Once validated, the Capacity of Organisations for System Practices (COSP) scale has the potential to advance the theory and practice of systems change approaches

    A Mixed-Method Approach: Virtual Reality to Co-create Future Higher Education Workspaces in a Post COVID-19 Academic Environment

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    The turmoil caused by COVID-19 saw academics and students in Higher Education (HE) institutions across the UK, and worldwide, facing the sudden and unplanned move to online or blended delivery. It left pre-pandemic operational models in need of evolving, leading to an opportunity to develop and test innovative architectural and spatial programming design strategies for ‘knowledge work’ spaces as academic staff and students returned to campus. The aim of this inter-disciplinary longitudinal study was to evaluate and validate a unique mixed-method approach, which combines extended reality, user experience (UX) and psychological research methodologies with architectural design strategies, to understand how people feel at work; how the environment influences their performance, health and wellbeing; and how to maximise spatial usage. Results were obtained by triangulating data collected from co-creation workshops, an ecological momentary assessment (EMA) survey, and a final usability virtual reality (VR) evaluation. Results imply that there is no ideal layout that would fulfil every user’s needs, instead new strategies need to be developed for workspaces to be redesigned creatively following longer-term usability and healthy architecture standards. This includes the mixed-method approach in this study that successfully creates a link between disciplines and user groups: UX and psychological researchers, architects, estates managers and end-user

    Intensive Care to Intermediate Care Bridge Program

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    To deliver the highest quality of care across the continuum, a large academic tertiary medical center envisioned a project that would provide an internal source of cross trained nurses for their medical intensive care unit (SCU2) and their medical intermediate care unit (R4/IMC/AVU). The hope for this program was to improve communication and collaboration between nurses and enhance the care that they provide to patients and their families. A highly qualified team of nurses was established to create a performance improvement project. The overall goal of this endeavor was to build a more collaborative relationship between the units and ultimately improve patient outcomes and experiences. Since this was a new program, there were expectations of challenges with the start-up. In addition, misunderstanding and misconceptions of each other’s workflows and systems would need to be identified and addressed. Several countermeasures were established to address the concerns and challenges. Development of an action plan, role expectations, competency based orientation tool and recruitment of dynamic tenured nurses proved to be critical key to success. Feedback about the bridge program from patients, families, involved nurses, and administrative leaders has been positive. Next steps include refining staff orientation, identifying potential program members with strong clinical attributes and ongoing evaluation of program outcomes

    Is local review of positron emission tomography scans sufficient in diffuse large B-cell lymphoma clinical trials? A CALGB 50303 analysis

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    BACKGROUND: Quantitative methods of Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) interpretation, including the percent change in FDG uptake from baseline (ΔSUV), are under investigation in lymphoma to overcome challenges associated with visual scoring systems (VSS) such as the Deauville 5-point scale (5-PS). METHODS: In CALGB 50303, patients with DLBCL received frontline R-CHOP or DA-EPOCH-R, and although there were no significant associations between interim PET responses assessed centrally after cycle 2 (iPET) using 5-PS with progression-free survival (PFS) or overall survival (OS), there were significant associations between central determinations of iPET ∆SUV with PFS/OS. In this patient cohort, we retrospectively compared local vs central iPET readings and evaluated associations between local imaging data and survival outcomes. RESULTS: Agreement between local and central review was moderate (kappa = 0.53) for VSS and high (kappa = 0.81) for ∆SUV categories (\u3c66% vs. ≄66%). ∆SUV ≄66% at iPET was significantly associated with PFS (p = 0.03) and OS (p = 0.002), but VSS was not. Associations with PFS/OS when applying local review vs central review were comparable. CONCLUSIONS: These data suggest that local PET interpretation for response determination may be acceptable in clinical trials. Our findings also highlight limitations of VSS and call for incorporation of more objective measures of response assessment in clinical trials
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