Law at the Speed of Dial Up: The Need for a Clear Standard for Employee Use of Employer-Provided Email Systems That Will Withstand Changing Technology

In 2007, the National Labor Relations Board adopted two clear rules concerning employee use of employer-provided email in Guard Publishing Co.: First, the Board held that employers were not required to allow employees to use employer-provided email to engage in protected activity pursuant to section 7 of the National Labor Relations Act; second, the Board held that if an employer allowed employees to use its email system for non-work purposes, it could still lawfully adopt and enforce nondiscriminatory rules that restricted otherwise protected activity. In 2014, the Board reversed this precedent in Purple Communications, Inc., and held that employees have a presumptive right to use an employer’s email system to engage in protected activity on non-working time if they are provided access to email for work-related purposes. This article analyzes the conflicting guidance provided by Guard Publishing Co. and Purple Communications, Inc. against the broader context of prior precedent concerning employer property rights. By highlighting numerous unanswered questions left open by the Board’s analysis in Purple Communications, Inc., this article advocates for the Board to reevaluate its position on employee use of company technology resources, including email, and to adopt a new framework that can readily and predictably be applied to new and developing technologies

Minimally invasive medial patellofemoral ligament reconstruction for patellar instability using an artificial ligament: A two year follow-up

Introduction: Recurrence of acute patellar dislocation affects approximately 30% of individuals, and up to 75% of those with grade IV instability. The medial patellofemoral ligament (MPFL) is considered to be critical for patella stabilisation. MPFL reconstruction with allografts has been proposed to reduce risk of recurrence, but there is limited evidence about the safety and effectiveness of techniques using synthetic allografts. Method: We present a retrospective case series of 29 individuals who underwent a MPFL reconstruction between 2009 and 2012, using an artificial ligament for patellar instability by a single surgeon. Clinical, radiological and functional outcomes were measured at a minimum of 24 months. Results: 31 knees (29 individuals) were followed up for a median of 43 (range: 24 – 68) months. Using the Crosby and Insall grading system, 21 (68%) were graded as excellent, 9 (29%) were good, 1 (3%) as fair and none as worse at 24 months. The mean improvement in Lysholm knee score for knee instability was 68 points (standard deviation 10). Ligamentous laxity was seen in 17 (55 %) of individuals. In this subset, 12 were graded as excellent, 4 as good and 1 as fair. The mean improvement in patellar height was 11 % at 3 months follow-up. All knees had a stable graft fixation with one re-dislocation following trauma. Conclusions: We propose a minimally invasive technique to reconstruct the MPFL using an artificial ligament allowing early mobilization without bracing. This study indicates the procedure is safe, with a low risk of re-dislocation in all grades of instability

Guidance and Individual Learning Accounts

This report presents the results of a CeGS/NICEC project on the role of formal and informal guidance in support of Individual Learning Accounts. It draws on five casestudies of good/interesting practice in implementing this role, including learner profiles, and supported by a literature review. It concludes that guidance can play a significant role in engaging non-traditional learners; that it needs to be marketed more effectively; that a strategy is needed for funding for in-depth guidance; and that the use of ILAs themselves as a route for such funding should be encouraged

Guidance and Individual Learning Accounts

This report presents the results of a CeGS/NICEC project on the role of formal and informal guidance in support of Individual Learning Accounts. It draws on five casestudies of good/interesting practice in implementing this role, including learner profiles, and supported by a literature review. It concludes that guidance can play a significant role in engaging non-traditional learners; that it needs to be marketed more effectively; that a strategy is needed for funding for in-depth guidance; and that the use of ILAs themselves as a route for such funding should be encouraged

Careers Service Work with Adults: A Survey

This report summarises the findings from a postal survey of all Careers Service Companies in England about their adult guidance services and services to employers. The survey was conducted by the Centre for Guidance Studies (University of Derby) and the National Institute for Careers Education and Counselling (NICEC) for the Department for Education and Employment (DfEE)

Kansas environmental and resource study: A Great Plains model

The author has identified the following significant results. Improvement in the land use classification accuracy of ERTS-1 MSS multi-images over Kansas can be made using two distances between neighboring grey tone N-tuples instead of one distance. Much more information is contained texturally than spectrally on the Kansas image. Ground truth measurements indicate that reflectance ratios of the 545 and 655 nm wavebands provide an index of plant development and possibly physiological stress. Preliminary analysis of MSS 4 and 5 channels substantiate the ground truth interpretation. Results of the land use mapping experiment indicate that ERTS-1 imagery has major potential in regionalization. The ways in which land is utilized within these regions may then be studied more effectively than if no adequate regionalization is available. A model for estimating wheat yield per acre has been applied to acreage estimates derived from ERTS-1 imagery to project the 1973 wheat yields for a ten county area in southwest Kansas. The results are within 3% of the preharvest estimates for the same area prepared by the USDA. Visual identification of winter wheat is readily achieved by using a temporal sequence of images. Identification can be improve by stratifying the project area into subregions having more or less homogeneous agricultural practices and crop mixes

Freezing and chemical preservatives alter the stable isotope values of carbon and nitrogen of the Asiatic clam (Corbicula fluminea)

We tested the impacts of most common sample preservation methods used for aquatic sample materials on the stable isotope ratios of carbon and nitrogen in clams, a typical baseline indicator organism for many aquatic food web studies utilising stable isotope analysis (SIA). In addition to common chemical preservatives ethanol and formalin, we also assessed the potential impacts of freezing on δ¹³C and δ¹⁵N values and compared the preserved samples against freshly dried and analysed samples. All preservation methods, including freezing, had significant impacts on δ¹³C and δ¹⁵N values and the effects in general were greater on the carbon isotope values (1.3-2.2% difference) than on the nitrogen isotope values (0.9-1.0% difference). However, the impacts produced by the preservation were rather consistent within each method during the whole 1 year experiment allowing these to be accounted for, if clams are intended for use in retrospective stable isotope studies

A de novo marker chromosome derived from 9p in a patient with 9p partial duplication syndrome and autism features: genotype-phenotype correlation

<p>Abstract</p> <p>Background</p> <p>Previous studies focusing on candidate genes and chromosomal regions identified several copy number variations (CNVs) associated with increased risk of autism or autism spectrum disorders (ASD).</p> <p>Case Presentation</p> <p>We describe a 17-year-old girl with autism, severe mental retardation, epilepsy, and partial 9p duplication syndrome features in whom GTG-banded chromosome analysis revealed a female karyotype with a marker chromosome in 69% of analyzed metaphases. Array CGH analysis showed that the marker chromosome originated from 9p24.3 to 9p13.1 with a gain of 38.9 Mb. This mosaic 9p duplication was detected only in the proband and not in the parents, her four unaffected siblings, or 258 ethnic controls. Apart from the marker chromosome, no other copy number variations (CNVs) were detected in the patient or her family. Detailed analysis of the duplicated region revealed: i) an area extending from 9p22.3 to 9p22.2 that was previously identified as a critical region for the 9p duplication syndrome; ii) a region extending from 9p22.1 to 9p13.1 that was previously reported to be duplicated in a normal individual; and iii) a potential ASD locus extending from 9p24.3 to 9p23. The ASD candidate locus contained 34 genes that may contribute to the autistic features in this patient.</p> <p>Conclusion</p> <p>We identified a potential ASD locus (9p24.3 to 9p23) that may encompass gene(s) contributing to autism or ASD.</p

The impact of the COVID-19 pandemic on the medical care and health-care behaviour of patients with lupus and other systemic autoimmune diseases: a mixed methods longitudinal study

Objective: The aim was to explore the self-reported impact of the COVID-19 pandemic on changes to care and behaviour in UK patients with systemic autoimmune rheumatic diseases, to help ensure that patient experiences are considered in future pandemic planning. Methods: This was a longitudinal mixed methods study, with a cohort completing baseline surveys in March 2020 and follow-up surveys in June 2020 (n = 111), combined with thematic analysis of the LUPUS UK forum and participant interviews (n = 28). Results: Cancellations of routine care and difficulties in accessing medical support contributed to some participants deteriorating physically, including reports of hospitalizations. The majority of participants reported that fear of COVID-19 and disruptions to their medical care had also adversely impacted their mental health. Feeling medically supported during the pandemic was correlated with multiple measures of mental health and perceptions of care, including the Warwick-Edinburgh mental well-being score (r = 0.44, P = 0.01). Five themes were identified: detrimental reduction in care; disparities in contact and communication (medical security vs abandonment sub-theme); perceived and actual endangerment; the perfect storm of reduced clinician ability to help and increased patient reticence to seek help; and identifying the patients most vulnerable to reduced medical care. Conclusion: The diversion of resources away from chronic disease care was perceived by many participants to have caused adverse outcomes. Fear about increased vulnerability to COVID-19 was high, contributing to health-care-avoidant behaviours. This study also highlights the influence of clinician accessibility and patients feeling medically supported on multiple measures of physical and mental health

The development of a risk-adjustment strategy to benchmark emergency medical service (EMS) performance in relation to out-of-hospital cardiac arrest in Australia and New Zealand

Introduction: The aim of this study was to develop a risk adjustment strategy, including effect modifiers, for benchmarking emergency medical service (EMS) performance for out-of-hospital cardiac arrest (OHCA) in Australia and New Zealand. Method: Using 2017–2019 data from the Australasian Resuscitation Outcomes Consortium (Aus-ROC) OHCA Epistry, we included adults who received an EMS attempted resuscitation for a presumed medical OHCA. Logistic regression was applied to develop risk adjustment models for event survival (return of spontaneous circulation at hospital handover) and survival to hospital discharge/30 days. We examined potential effect modifiers, and assessed model discrimination and validity. Results: Both OHCA survival outcome models included EMS agency and the Utstein variables (age, sex, location of arrest, witnessed arrest, initial rhythm, bystander cardiopulmonary resuscitation, defibrillation prior to EMS arrival, and EMS response time). The model for event survival had good discrimination according to the concordance statistic (0.77) and explained 28% of the variation in survival. The corresponding figures for survival to hospital discharge/30 days were 0.87 and 49%. The addition of effect modifiers did little to improve the performance of either model. Conclusion: The development of risk adjustment models with good discrimination is an important step in benchmarking EMS performance for OHCA. The Utstein variables are important in risk-adjustment, but only explain a small proportion of the variation in survival. Further research is required to understand what factors contribute to the variation in survival between EMS