1,875 research outputs found
Landowners' liability? is perception of the risk of liability for visitors accidents a barrier to countryside access?
The study seeks to analyse both the perception and reality of liability risk for owners of countryside land for injuries suffered by recreational visitors. The study starts by evaluating the relevant legislation and case law in England, Wales, Scotland and Northern Ireland on countryside access and liability in tort for injury suffered by visitors to such places. In doing so it reviews legislation such as Health & Safety at Work Act 1974, Countryside & Rights of Way Act 2000, Land Reform (Scotland) Act 2003, Occupiers' Liability Acts 1957 & 1984, Animals Act 1971 and the Compensation Act 2006. Through appraisal of this legislation and key cases such as Tomlinson -v- Congleton Borough Council (2004) the actual level of liability risk is assessed to be low.
The study then investigates the rise of a pervasive discourse amongst policy makers, judiciary and senior business figures asserting the need to avoid further development of a risk adverse culture within the UK and/or to tackle a growth in the perceived "compensation culture". A link to deregulation and pro-entrepreneurship interests is shown. The reality of compensation claim rates and associated behaviours is then examined. Issues of liability risk perception are then addressed by reviewing in detail the limited available UK literature on liability perception by landowners and comparing this with evidence from the United States and New Zealand. Case studies of alleged risk adverse land management are then examined to test the evidence base for common assertions of excess regulation and/or withdrawal of access to land or facilities through fear of liability. Finally, the study explores (via interviews of 21 land managers and representative bodies) how liability risks are actually perceived by land owners and the extent of awareness of recent changes in discourse and case law regarding public safety issues. In doing so the study reveals the ways in which land managers in large pro-access agencies and utilities develop common standards and understandings around the level of "reasonably practicable" safety provision. The study concludes with recommendations for further research to investigate the way in which liability risk perceptions are formed by smaller landowners who are more remote from such "interpretive communities" (Fish 1980).</p
Diabetes Type II Quality Improvement Using the My Own Health Report
Diabetes Mellitus Type II Quality Improvement Using the My Own Health Report
Lynn Bennett McMorrow
Rationale: To maintain Primary Care Medical Home status, Cold Hollow Family Practice (CHFP) is mandated to perform continuous quality improvement for chronically ill patients. To achieve this goal at CHFP, a formal quality improvement (QI) process using a validated health risk assessment tool, My Own Health Report (MOHR) was used to engage patients with Type 2 Diabetes (T2D) in dialogue regarding self change behaviors. The goal was to improve patient self-care management as evidenced by decreased HbA1c readings or weight as compared to non-participating patients, over a six-month period.
From 1980 through 2012, the number of adults with diagnosed diabetes in the United States nearly quadrupled, from 5.5 million to 21.3 million and 1.7 million more persons over 20 years of age are diagnosed each year. The estimated direct medical costs in 2012 were 176 billion and the indirect costs (lost wages, disability and death) for the same time frame were 69 billion. Individualized patient care, as the corner stone of evidence based practice, is vital to improve self-management in patients who have Type 2 Diabetes (T2D).
Methods: The QI process began with 27 patients. We had 10 patients who did not participate and 17 who did the MOHR as administered by the medical assistant. The provider reviewed the MOHR summary and used motivational interviewing to discuss the results with each patient scheduled for a T2D visit, for willingness to discuss or change modifiable life styles.
Quantitative analysis was done with Fisher’s Exact Test comparing those who were in the MOHR group to those not participating. Qualitative analysis was not done secondary to time and EHR constraints.
Results: Comparison of the MOHR group to the non-MOHR group, 47% improved both weight and HbA1c whereas the non-MOHR group had 0% improvement (P=0.01). Using the same comparison in HbA1c only, the MOHR group decreased by 58% compared to 10% for the non-MOHR group (P= 0.02).
Conclusions: Generalizability is limited by a number of factors: a small group study of 27 patients and provider use of motivational interviewing and historical patient/provider relationships. Furthermore, it was a self-selected group that may have been ready to change. Without randomization, motivational interviewing, and requiring that the MOHR be completed we cannot absolutely determine the impact of the MOHR on T2D disease marker improvements. Further study using the MOHR report with motivational interviewing is needed to support these findings.
Keywords: Diabetes Type 2, MOHR, HbA1
Review of 'The Complete Stories' and 'Ransom' by David Malouf.
Review of David Malouf's 'Complete Stories' and his novel 'Ransom'
A Multisite Case Study of High-Performing Charter School Boards in Florida
The purpose of this multisite case study was to describe the practices and behaviors of high-performing charter school boards. Through description of the practices and behaviors of high-performing charter school boards, the impact of charter school board governance on charter school closures in Florida can be better understood. The theory guiding this study was Coleman’s social capital theory, suggesting that the social capital of members of an organization working towards a common goal through bridging and bonding results in productivity and a positive impact on the organization; in this case study, the organization was the charter school governing board. The central research question for this study addressed the practices and behaviors of high-performing charter school governing board members. Additional subquestions addressed how bonding practices impact charter school governance; how bridging practices impact charter school governance; and how governance training of board members impact charter school governance. A multisite case study design was used to collect data including documents, interviews, and observations. The targeted participants of the study were 16 members from three different high-performing charter school boards in Florida. The case study data were analyzed using Stake’s approach to organization of data, data analysis and representation. Findings indicated common practices and behaviors were present among high-performing charter school boards in the areas of their characteristics and board and member role and responsibility. Further research on high-performing charter schools beyond central Florida and on boards of closed charter schools will help solve the problem of charter school closures in Florida
SURFACE MODIFICATION OF PLGA BIOMATERIALS FOR SITE-DIRECTED IMMOBILIZATION OF GROWTH FACTORS
Biodegradable polymer materials, specifically poly(lactic-co-glycolide) (PLGA) can be used as bone replacements for bone regeneration. Scaffolds can be prepared to be porous to induce bone growth into a scaffold so that it is replaced with natural tissue as the polymer degrades. However, simply using PLGA will result in formation of scar tissue rather than regeneration of natural bone. Therefore focus has turned to attaching growth factors to the PLGA molecules to elicit a specific cellular response when the implant is placed in the body. Site-directed immobilization utilizes specific groups on both the biomaterial and biomolecule so that growth factors can be oriented in a specific manner for increased cellular response. In this research, exposed carboxyl groups on a non end-capped PLGA were modified with bishydrazide spacer molecules of varying length for the eventual attachment of a biomolecule via carbodiimide chemistry. The number of hydrazide groups attached to the surface could be controlled to investigate the effects of the spacer length on protein immobilization. Both vascular endothelial growth factor (VEGF) and parathyroid hormone (PTH) were used in these studies. These two molecules have different target cells and actions, although both can play a role in bone formation. Both molecules have carbohydrate residues that were oxidized with periodate to form aldehyde moieties that were able to react with the hydrazide spacers to form a stable bond between the spacer and protein. The use of a spacer enhanced the binding accessibility of the protein as compared to randomly adsorbed protein. The shortest and longest of the spacers resulted in the highest amount of protein, with corresponding results for antibody binding. The modification of PLGA functional groups with a spacer molecule indicates that this material could be used for site-directed immobilization for any application, simply by tailoring the reaction between the biomaterial and biomolecule
Facebook and Teenagers: Investigating Changes of Perceived Peer Pressures for Romantic Relationship Involvement Based on Facebook Attachment
Although youth aged 12-17 years old constitute a growing segment of Facebook users, the impact social networking websites may have on their psyche has not been well-studied. Additionally, researchers have not investigated peer pressure as a mediator between individuals overall attachment to Facebook and the desire to be involved in a romantic relationship among teens or adults. The purpose of this quantitative study was to examine the connection between Facebook attachment and perceived peer pressure, specifically with regard to romantic relationships in individuals aged 14-17 years. Impression management theory served as the theoretical framework. A survey design was used to examine whether study variables (Facebook attachment, perceived peer pressure, and romantic relationship desires) were correlated with one another and whether Facebook attachment served as a mediating variable. Participants (N = 42) completed online surveys comprised of three established surveys that measure levels of perceived peer pressure, interest in romantic relationships, and overall Facebook attachment. Data were examined using correlational analysis. No significant correlations were found between any study variables. Because of the lack of statistical significance, no decisive conclusions can be rendered. Recommendations for future research include the use of different recruitment methods and the updating of assent and consent regulations for psychological research involving minors. The study provides a starting point for future researchers to evaluate the role of social media in adolescent development. Implications for positive social change include a greater awareness of the role of social media in the psychological development of young teens
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A value chain analysis of interventions to control production diseases in the intensive pig production sector
Value chain analysis (VCA) calculated the financial effects on food chain actors of interventions to improve animal health and welfare in the intensive pig sector. Two interventions to reduce production diseases were studied. A generic chain diagram of linkages between stakeholders and value-added dimensions was designed. Data on structure and financial performance were collected for the sector. The production parameters and financial effects of the interventions were then described to illustrate impact on the supply chain. The effects of the interventions were also assessed at market level using economic welfare analysis. The sectors in Finland and the UK are small in farm numbers and few companies produced much of the output in a largely vertically-integrated structure. The most beneficial intervention in financial terms to farmers was improved hygiene in pig fattening (around +50% in gross margin). It was calculated to reduce the consumer price for pig meat by up to 5% when applied at large, whereas for improved management measures, it would reduce consumer price by less than 0.5%. However, the latter added value also through food quality attributes. We show that good hygiene and animal care can add value. However, evaluation of the financial and social viability of the interventions is needed to decide what interventions are adopted. The structure of supply chains influences which policy measures could be applied. Of the two interventions, improved pig hygiene had the largest potential to improve efficiency and reduce costs. The studied interventions can also provide new business opportunities to farms, slaughterhouses and food sector companies. More evidence is needed to support public policies and business decision-making in the sector. For this, evidence on consumer attitudes to production diseases is needed. Nevertheless, the study makes an important contribution by showing how improvements in health and welfare benefit the whole chain
Social Capital, Health and Mental Health in African American Women
Cultural and social influences on mental and physical health are increasingly recognized by social science researchers. Researchers have found that specific, Afrocultural factors are related to the functioning of African Americans. The current research considered whether interdependence is especially salient for African American women since women and African Americans tend to define themselves within the context of social relationships. The study outlines processes affecting the mental and physical health of African American women including communalism, collective efficacy, and social capital. The also study examined the relationship between socioeconomic status and both mental and physical health among African American women in a low-income residential area. The effect of social capital and collective efficacy on mental and physical health above income was analyzed using hierarchical regression. One-hundred-thirty African-American women in a low-income area of Richmond, Virginia completed surveys between October 2002 and October 2004 measuring social capital, collective efficacy and general health and mental health. Level of education served as a proxy for socioeconomic status. The study\u27s central hypothesis was that social capital and collective efficacy, an indicator of social capital, would moderate rather than mediate the association between socioeconomic status and the outcome variables in this population due to the importance of relationships in the African American culture and in the lives of women. Both moderation and mediation models were tested. Significant relationships were found between income and both physical health and mental health. There were no significant relationships found between social capital and physical health, mental health, or socioeconomic status and mediation was not established. The results also did not establish social capital as a moderator between socio-economic status and the outcome variables. This lack of relationship may be related to several factors including the homogeneity of the sample in terms of socioeconomic status and challenges associated with the use of a new measure for social capital. Meaningful comparisons of social capital between socioeconomic levels could not be made
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