274 research outputs found
āNot an Exact Scienceā: Medical Approaches to Age and Sexual Offences in England, 1850-1914
This thesis examines medical approaches to sexual offences in England between 1850 and 1914, with particular attention to law-making and judicial processes. It addresses two key research questions. Firstly, what was the place of medicine in shaping the law on sexual consent and in the implementation of laws on sexual crime? Secondly, can the analytical category of age be used to understand such medical roles? In addressing the first research question, the thesis shows that relationships between medicine, the law and wider society can be understood in terms of negotiation and shared pools of knowledge rather than impact. It demonstrates that medical ideas on sexual crime and sexual consent were deemed sufficiently valuable to be drawn upon widely by different groups, but they were not imposed āfrom aboveā by a coherent medical profession. Medical roles thus need to be studied and understood rather than either oversimplified as ādominantā or dismissed as non-existent. In addressing the second research question, the thesis argues that age has been unduly overlooked as a category of analysis in historiography. It shows that ideas about sexual crime shifted in relation to victims of different ages and that age can productively be situated in relation to other analytical categories, particularly class and gender. By moving beyond treating āchildrenā and āadultsā as homogeneous categories, this study opens up new ways of understanding histories of medico-legal relations and sexual crime.AHR
A bibliography of publications by Albert Bates Lord
Note: [at time of printing] All items listed here can be found in Ellis Library at the University of Missouri, Columbia, either in Special Collections (Ellis 401) or in open stacks (see the affixed call numbers below). Many journals are available online to University of Missouri faculty, staff, and students, and of course through other institutions as well. A full collection of article-length items is maintained in hard copy and on CD in Special Collections
Evaluation of a cognitive skills programme for male prisoners ā exploring treatment effectiveness
Aim: The current study provides an evaluation of a cognitive skills programme (Enhanced Thinking Skills) with adult prisoners.
Method: A pre and post treatment-only design with 171 male prisoners, using self-report psychometric measures.
Results: Significant differences were found in the direction expected. Clinical recovery using stringent methods was not indicated, although improvement/partial response was across a number of domains.
Originality: This study represents the first prison study to distinguish between levels of positive change. It questions previous interpretations of treatment outcome.
Implications for practice: Expectations for treatment outcome for short term interventions should be more realistic; Cognitive skills programmes may be best considered as precursors to longer term therapies; Treatment outcome should focus on improvement and not recovery
Report on social, gender, ethical, regional, and national aspects
Due to the economic crisis, the continuing growth of cities and increasing market prices for secondary raw materials it can be expected that the number of people involved in informal waste collection and recycling activities tends to further increase. Therefore, it is time to rethink potential future developments in the context of low-income countries like Brazil and Nicaragua. When new systems to improve solid waste management are introduced and investment decisions are made, a key question often asked is where and how to make those investments to maximize the intended outcomes. The question is whether to use the knowledge and experience of the existing systems where informal actors play a key role or to strive for modernisation excluding this knowledge and to focus more on technology-based solutions. The contribution of informal activities is difficult to estimate as informal waste claimers have no inherent reason, obligations or simply not the capabilities to keep records regarding their work. As "formal" (official) performance data are usually not covering informal systems, official statistics (if even available) do not reflect the complete picture of waste management in low-income countries. As WEEE contains high concentrations of valuable materials, in comparison to other types of waste, the activity of the informal sector in this sector is high
Improvement of CPD Educational Products
This report contains information on the improvements of CPD modules, courses and educational products based on a pilot phase, where the adjusted and new developed educational products were tested in real-life situations. The main target of the WP4 was to create educational products for non-academic CPD course participants in Brazil and Nicaragua. The modules of the CPD includes the following materials: ā¢ CPD Courses: lecture style training materials, based on the materials for academic educations, but reduced in complexity and theory background ā¢ WEEE dismantling videos: for 5 product types, videos have been developed describing and showing the process ā¢ Practical dismantling trainin
Report on the newly developed CPD educational material
Within course of the project āLatin America-European network on Waste Electrical and Electronic Equipment, research, development and analysisā (LaWEEEda) modern and high quality modules, courses and educational products will be developed. These educational products are especially tailored for Nicaragua and Brazil and include both academic education and continuing professional development (CPD) training courses in the area of WEEE management and related entrepreneurial skills. This report focuses on the newly developed CPD educational material. This comprises following elements: ā¢ Dismantling videos: videos demonstrating and explaining the sequence of dismantling for a number of different e-waste products practical ā¢ Dismantling training: specifically for practitioners it is important to understand the sequence of dismantling and the output materials from this treatment step ā¢ Plant layout design: the participants learn to plan and design processes in the recycling of e-waste products ā¢ Entrepreneurship: beside technical knowledge other skills in non-technical areas like cost calculation and business plan development are of importance. Training in these fields is given in connection with the practical dismantling training
Frequent Dietary Multi-Mycotoxin Exposure in UK Children and Its Association with Dietary Intake
Peer reviewe
Making soft intelligence hard: a multi-site qualitative study of challenges relating to voice about safety concerns.
BACKGROUND: Healthcare organisations often fail to harvest and make use of the 'soft intelligence' about safety and quality concerns held by their own personnel. We aimed to examine the role of formal channels in encouraging or inhibiting employee voice about concerns. METHODS: Qualitative study involving personnel from three academic hospitals in two countries. Interviews were conducted with 165 participants from a wide range of occupational and professional backgrounds, including senior leaders and those from the sharp end of care. Data analysis was based on the constant comparative method. RESULTS: Leaders reported that they valued employee voice; they identified formal organisational channels as a key route for the expression of concerns by employees. Formal channels and processes were designed to ensure fairness, account for all available evidence and achieve appropriate resolution. When processed through these formal systems, concerns were destined to become evidenced, formal and tractable to organisational intervention. But the way these systems operated meant that some concerns were never voiced. Participants were anxious about having to process their suspicions and concerns into hard evidentiary facts, and they feared being drawn into official procedures designed to allocate consequence. Anxiety about evidence and process was particularly relevant when the intelligence was especially 'soft'-feelings or intuitions that were difficult to resolve into a coherent, compelling reconstruction of an incident or concern. Efforts to make soft intelligence hard thus risked creating 'forbidden knowledge': dangerous to know or share. CONCLUSIONS: The legal and bureaucratic considerations that govern formal channels for the voicing of concerns may, perversely, inhibit staff from speaking up. Leaders responsible for quality and safety should consider complementing formal mechanisms with alternative, informal opportunities for listening to concerns
Improving completeness of electronic problem lists through clinical decision support: a randomized, controlled trial
Background: Accurate clinical problem lists are critical for patient care, clinical decision support, population reporting, quality improvement, and research. However, problem lists are often incomplete or out of date. Objective: To determine whether a clinical alerting system, which uses inference rules to notify providers of undocumented problems, improves problem list documentation. Study Design and Methods: Inference rules for 17 conditions were constructed and an electronic health record-based intervention was evaluated to improve problem documentation. A cluster randomized trial was conducted of 11 participating clinics affiliated with a large academic medical center, totaling 28 primary care clinical areas, with 14 receiving the intervention and 14 as controls. The intervention was a clinical alert directed to the provider that suggested adding a problem to the electronic problem list based on inference rules. The primary outcome measure was acceptance of the alert. The number of study problems added in each arm as a pre-specified secondary outcome was also assessed. Data were collected during 6-month pre-intervention (11/2009ā5/2010) and intervention (5/2010ā11/2010) periods. Results: 17,043 alerts were presented, of which 41.1% were accepted. In the intervention arm, providers documented significantly more study problems (adjusted OR=3.4, p<0.001), with an absolute difference of 6,277 additional problems. In the intervention group, 70.4% of all study problems were added via the problem list alerts. Significant increases in problem notation were observed for 13 of 17 conditions. Conclusion: Problem inference alerts significantly increase notation of important patient problems in primary care, which in turn has the potential to facilitate quality improvement
A systematic review of the diagnostic accuracy of automated tests for cognitive impairment
Objective
The aim of this review is to determine whether automated computerised tests accurately identify patients with progressive cognitive impairment and, if so, to investigate their role in monitoring disease progression and/or response to treatment.
Methods
Six electronic databases (Medline, Embase, Cochrane, Institute for Scientific Information, PsycINFO, and ProQuest) were searched from January 2005 to August 2015 to identify papers for inclusion. Studies assessing the diagnostic accuracy of automated computerised tests for mild cognitive impairment (MCI) and early dementia against a reference standard were included. Where possible, sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios were calculated. The Quality Assessment of Diagnostic Accuracy Studies tool was used to assess risk of bias.
Results
Sixteen studies assessing 11 diagnostic tools for MCI and early dementia were included. No studies were eligible for inclusion in the review of tools for monitoring progressive disease and response to treatment. The overall quality of the studies was good. However, the wide range of tests assessed and the non-standardised reporting of diagnostic accuracy outcomes meant that statistical analysis was not possible.
Conclusion
Some tests have shown promising results for identifying MCI and early dementia. However, concerns over small sample sizes, lack of replicability of studies, and lack of evidence available make it difficult to make recommendations on the clinical use of the computerised tests for diagnosing, monitoring progression, and treatment response for MCI and early dementia. Research is required to establish stable cut-off points for automated computerised tests used to diagnose patients with MCI or early dementia
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