Should Trial by Jury Be Eliminated in Complex Cases

One way in which the public participates in the management of Risk is as jurors. Here, the function of juries in civil litigation is discussed and the argument is made that problems with juries in complex cases may be solved by means short of eliminating juries altogether

Phenotypic pattern over centric fusion clinal variation in the water-hyacinth grasshopper, Cornops aquaticum (Orthoptera: Acrididae)

The water-hyacinth grasshopper, Cornops aquaticum, occurs in freshwater environments in the New World between latitudes 23°N and 35°S. At the southernmost margin of this distribution the populations are polymorphic for three centric fusions (Robertsonian translocations). The frequencies of these chromosome rearrangements increase southwards and the recombination in structural homozygotes and heterozygotes diminishes both along the middle and lower courses of the Paraná River. In the present paper we report a similar cline along the southward flowing Uruguay River. In addition, we report the morphological effects of two of these centric fusion polymorphisms, namely the fusions between chromosomes 2 and 5 of the standard complement (fusion 2/5) and chromosomes 3 and 4 (fusion 3/4) and extend this study to the Uruguay River. There is a strong inverse correlation of fusion frequency with temperature, which indicates that these polymorphisms may be related to increased tolerance of colder climates in this originally tropical species, or some other correlated variable. This study is a further example of chromosomal clines correlated with latitude and is one of a few examples of chromosome polymorphisms associated with phenotypic effects. Finally, it indicates ways of using this species for controlling pests.Fil: Colombo, Pablo Cesar. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Ecología, Genética y Evolución de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Ecología, Genética y Evolución de Buenos Aires; ArgentinaFil: Remis, Maria Isabel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Ecología, Genética y Evolución de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Ecología, Genética y Evolución de Buenos Aires; Argentin

Exploring Clinical Instructors’ Perceptions of Competencies Required for Their Role in a Baccalaureate Nursing Program

The purpose of this research was to conduct an exploratory study to identify Clinical Instructors’ (CI) perceptions of the importance of the WHO competency domains and the importance of these competency domains to their current clinical teaching role in a baccalaureate nursing program in a southwestern Ontario university. A sample of 27 CIs participated in the study to evaluate the importance and implementation of the WHO competencies. The results were analyzed using Wilcoxan Signed Ranks. The findings suggest that 36 out of 37 of the competencies were considered important to the CI role and they implemented these competencies in their practice, but they need to be adapted to the CI-specific role

Mechanisms of habitat segregation between an invasive (Mytilus galloprovincialis) and an indigenous (Perna perna) mussel: adult growth and mortality

The invasive mussel Mytilus galloprovincialis and the indigenous mussel Perna perna coexist intertidally on the south coast of South Africa through partial vertical habitat segregation: M. galloprovincialis dominates the upper shore and P. perna the lower shore. Recruitment patterns can explain the zonation of P. perna, but not the invasive species. We examined the role of post-recruitment interactions by measuring spatial and temporal differences in adult growth and mortality rates of the two species. Specifically, we tested the hypothesis that interspecific differences in growth and mortality reflect adult distribution patterns. The two study locations, Plettenberg Bay and Tsitsikamma, are 70 km apart with two sites (separated by 300–400 m) per location, each divided into three vertical zones. Growth was measured seasonally using different marking methods in 2001 and 2003. Cumulative adult mortality was measured through summer in 2003/2004. Both species generally grew more slowly upshore, but they showed different effects of season. For P. perna, growth was significantly reduced in winter in the low zone, but unaffected by season in the high zone. For M. galloprovincialis, growth was either unaffected by season or increased in winter, even in the high zone. Thus, growth of P. perna and M. galloprovincialis was reduced under cool winter and warm summer temperatures, respectively; and while growth was more similar between species in summer, M. galloprovincialis grew much faster than P. perna in winter. Mortality of P. perna increased upshore. For M. galloprovincialis, mortality was not zone-dependent and was significantly greater than for P. perna on the low-shore and (generally) across the shore in Tsitsikamma. Both species had higher growth and mortality rates in Plettenberg Bay than in Tsitsikamma. Thus, P. perna seems able to maintain spatial dominance on the low-shore and at certain sites because of higher mortality of M. galloprovincialis. We conclude that seasonality in growth of the two species reflects their biogeographic affinities and that coexistence is possible through pre-recruitment effects that limit the vertical distribution of P. perna and post-recruitment effects that limit M. galloprovincialis

Clinical Nurse Instructor Competencies: An Exploratory Study of Role Requirements

Background: Baccalaureate nursing education consists of theoretical and practical training that prepares students for the role of competent nursing care providers. The practical application of knowledge and skills is vital in nursing curricula worldwide. Nursing programs have changed over the last few decades and have become increasingly dependent on part-time Clinical Instructors (CIs) to teach the clinical components of the curricula. However, CIs receive minimal instruction to prepare for this complex role. It has been acknowledged in Canada that there is limited research to inform CI specific competencies. Purpose: The purpose of this research was to conduct an exploratory study to identify the CIs perceptions of the importance of the World Health Organization’s (WHO) nurse educator core competencies and their importance to the clinical teaching role. Methodology: This was an exploratory quantitative study. A self-report survey was developed guided by the WHOs Nurse Educator Core Competencies (NECC). Donabedian’s structure-process-outcome conceptual framework guided this study. Sample and setting: Convenience sampling of participants employed as CIs in a baccalaureate in nursing program in an Ontario university. CIs who taught theory courses were excluded. The survey response rate was 23.9% (n=27). Results: The study results confirm that all the NECC have merit but need to be adapted to a CI-specific role. This is a multi-phased research project and the findings of the study have implications for all stakeholders, including schools of nursing and CIs. Ongoing research is required to inform the policy direction as it pertains to the CI-specific role and competencies in Canada. Implications for nursing programs, research and policy will be shared. Conclusions: Clinical Instruction is an area of nursing which deserves to be acknowledged as a specialty. National standardized CI-specific competencies will provide a strong foundation for CI preparation in Canada. Contexte : Le baccalauréat en sciences infirmières comprend des cours théoriques et pratiques préparant les étudiantes au rôle de professionnelles compétentes en soins de santé. Dans les programmes d’études en sciences infirmières partout dans le monde, l’application pratique des connaissances et habiletés est essentielle. Les programmes de sciences infirmières se sont transformés au cours des dernières décennies, dépendant de plus en plus des enseignantes de clinique (Clinical Instructors; CI), à temps partiel, pour le volet pratique du programme d’études. Ces enseignantes reçoivent toutefois très peu de soutien pour les préparer à jouer ce rôle complexe. Au Canada, il a été reconnu que peu de recherches renseignent sur les compétences spécifiques des enseignantes de cliniques. Objectif : Cette étude exploratoire avait pour but d’identifier les perceptions des enseignantes de clinique quant à l’importance des Compétences essentielles des infirmières enseignantes (Nurse Educator Core Competencies; NECC) décrites par l’Organisation mondiale de la Santé (OMS) ainsi qu’à leur importance pour le rôle d’enseignante de clinique. Méthode : Il s’agissait d’une étude quantitative exploratoire. Un sondage a été élaboré en s’appuyant sur les compétences essentielles des infirmières enseignantes de l’OMS. Le cadre conceptuel « structure-processus-résultats » de Donabedian a guidé cette étude. Échantillon et milieu : Un échantillonnage de convenance a été constitué de participantes volontaires employées comme enseignantes de clinique dans un programme de baccalauréat en sciences infirmières d’une université en Ontario. Les enseignantes qui donnaient des cours théoriques étaient exclues. Le taux de réponse au sondage a été de 23,9 % (n=27). Résultats : Les résultats de l’étude confirment que toutes les compétences sont pertinentes, mais qu’elles doivent être adaptées au rôle spécifique propre aux enseignantes de clinique. Ce projet de recherche comporte plusieurs étapes, et les résultats de cette étude ont des retombées pour toutes les parties prenantes, y compris les écoles de sciences infirmières et les enseignantes de clinique. Les travaux devront se poursuivre afin d’orienter la politique en ce qui concerne le rôle et les compétences spécifiques des enseignantes de clinique au Canada. Les retombées pour les programmes de sciences infirmières, la recherche et les politique seront présentées. Conclusions : L’enseignement clinique constitue un domaine des sciences infirmières méritant d’être reconnu comme une spécialité. Des normes nationales de compétences spécifiques aux enseignantes de clinique serviront de base solide pour la préparation de ces enseignantes au Canada

Will the invasive mussel Mytilus galloprovincialis Lamarck replace the indigenous Perna perna L. on the south coast of South Africa?

The mussel Mytilus galloprovincialis is invasive worldwide, has displaced indigenous species on the west coast of South Africa and now threatens Perna perna on the south coast. We tested the hypothesis that Mytilus will replace Perna by examining changes in their distribution on shores where they co-exist. Total cover, adult density, recruit density, recruit/adult correlations and mean maximum lengths of both species were measured in 2001 at two contrasting sites (Plettenberg Bay and Tsitsikamma) 70 km apart, each including two locations 100 m apart. Cover and density were measured again in 2004. Total mussel abundance was significantly lower in Tsitsikamma, and recruit density was only 17% that of Plettenberg Bay. Abundance and cover increased upshore for Mytilus, but decreased for Perna, giving Mytilus higher adult and recruit density and total cover than Perna in the upper zones. Low shore densities of recruits and adults were similar between species but cover was lower for Mytilus, reflecting its smaller size, and presumably slower growth or higher mortality there. Thus, mechanisms excluding species differed among zones. Recruitment limitation delays invasion at Tsitsikamma and excludes Perna from the high shore, while Mytilus is excluded from the low shore by post-recruitment effects. Recruitment limitation also shapes population structure. Recruit/adult correlations were significant only where adult densities were low, and this effect was species-specific. Thus, at low densities, larvae settle or survive better near adult conspecifics. After 3 years, these patterns remained strongly evident, suggesting Mytilus will not eliminate Perna and that co-existence is possible through partial habitat segregation driven by recruitment limitation of Perna on the high shore and post-settlement effects on Mytilus on the low shore

e-Delphi Technique in Postgraduate Registered Nursing Education and Competency Development: A Scoping Review

Background: It is common for nursing programs in Canada to hire part-time clinical instructors (CIs) to teach the practical components of curricula. Although experts in their field, these Registered Nurses (RNs) don’t have any formal preparation in education. Additionally, there are no current established competencies for CIs in Canada. This void in the Canadian literature warrants a search of competency development using the e-Delphi technique. The e-Delphi technique is a commonly used surveying technique for competency development in healthcare. Objective: To understand the extent, range, and nature of evidence of the use of the e-Delphi technique and critically appraise its use in postgraduate nursing education and nursing competency development to establish the feasibility of application to clinical nurse educator competency (CNEC) development in Canada. Methods: Two independent researchers conducted a scoping review to determine the extent, range, and nature of evidence of the use of the e-Delphi technique and critically appraise its use in postgraduate nursing education and nursing competency development. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute Reviewers’ Manual were used to guide the review. Results: The main components of e-Delphi that were extracted from the literature for review included the purposes of the studies, background of expert panel members, methods of e-Delphi used, reported level of consensus, number of rounds to meet consensus, time between rounds of questions, number of participants and changing participants. The purposes of the reviewed studies demonstrated that e-Delphi is a preferred method for developing or revising competencies for post baccalaureate programs. However, the other key components that were extracted revealed much variation in the use of e-Delphi by researchers. Most importantly, researchers need to ensure they report on the backgrounds of the expert panel members, decrease the time between the survey rounds and avoid introducing new participants in later rounds of the surveys to ensure consistency and methodological rigour of e-Delphi. Conclusion: There are variations in how e-Delphi is used in the literature for competency development, but if the authors are transparent with all phases of the method used, it is evident that it can significantly contribute to the advancement of future CNEC development in Canada. Résumé Contexte : Il est courant pour les programmes de formation en sciences infirmières au Canada d’embaucher des formatrices et formateurs cliniques à temps partiel pour enseigner les composantes pratiques des programmes d’études. Bien que spécialistes dans leur domaine, ces infirmières et infirmiers ne détiennent aucune formation formelle en enseignement. De plus, il n’existe actuellement aucun référentiel de compétences établi pour les formatrices et formateurs cliniques au Canada. Ce vide dans les écrits canadiens justifie une recherche sur l’élaboration des compétences liées à la formation clinique à l’aide de la méthode e-Delphi, une technique de sondage en ligne fréquemment utilisée pour nommer et clarifier les compétences dans le domaine de la santé. Objectif : Comprendre l’étendue, la portée et la nature des données probantes de l’utilisation de la méthode e-Delphi et évaluer de manière critique son utilisation dans la formation après l’obtention du grade en sciences infirmières ainsi que le développement des compétences infirmières afin d’établir la faisabilité de l’application pour l’élaboration des compétences des formatrices et formateurs cliniques au Canada. Méthodes : Deux chercheuses indépendantes ont mené une revue de la portée pour déterminer l’étendue, l’éventail et la nature des données probantes de l’utilisation de la méthode e-Delphi et évaluer de manière critique son utilisation dans la formation après l’obtention du grade en sciences infirmières et le développement des compétences infirmières. Le Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR]) et le Joanna Briggs Institute Reviewers’ Manual ont été utilisés pour guider cette revue. Résultats : Les principales composantes de la méthode e-Delphi qui ont été extraites de la littérature pour la revue comprenaient les objectifs des études, les antécédents des membres du groupe d’experts, les méthodes e-Delphi utilisées, le niveau de consensus rapporté, le nombre de tours pour atteindre le consensus, le temps entre les tours de questions, ainsi que le nombre et les changements de participants. Les objectifs des études examinées ont démontré que la méthode e-Delphi est privilégiée pour développer ou réviser des compétences pour les programmes post-baccalauréat. Cependant, les autres composantes clés extraites ont révélé une grande variation dans l’utilisation de la méthode e-Delphi par les groupes de recherche. Plus important encore, ces derniers doivent s’assurer de rapporter les antécédents des membres du panel d’experts, de réduire le temps entre les cycles de sondage et d’éviter d’introduire de nouveaux participants dans les cycles ultérieurs des sondages afin d’assurer la cohérence et la rigueur méthodologique de la méthode e-Delphi. Conclusion : Il existe des variations dans la façon dont la méthode e-Delphi est utilisée et rapportée dans la littérature pour le développement des compétences, mais si il y a transparence à toutes les phases de l’utilisation de la méthode, il est évident qu’elle peut contribuer de manière significative à l’élaboration du futur référentiel des compétences des formatrices et formateurs cliniques au Canada

Evaluating the utility of gene expression data from patient-matched samples for studying breast cancer

Breast cancer is a heterogeneous disease with distinct subtypes and many different clinical presentations. Neoadjuvant therapy of breast cancer offers a window of opportunity to study translational changes in tumours as a result of treatment alone and may help to identify tumour response status. Pairs of samples collected from different sites or sequentially from the same individual can potentially provide additional prognostic information for the risk stratification of breast cancer. Here, we seek to aggregate multiple studies of valuable, multi-sampled, patient-matched cohorts for meta-analysis to check for an enhanced ability to make new and significant findings about the underlying mechanisms of tumour treatment response. Multiple sequentially-matched datasets of pre- and on-treatment matched primary tumour and lymph node samples were collected and examined for differentially expressed genes and pathways indicative of pathological response. Machine learning methods were applied to identify biomarkers of response from the on-treatment samples, and profiling comparisons were made to assess the additional value of matched patient samples to accurately predict risk. Lastly, five sequentially sampled datasets were aggregated for meta-analysis by combining the normalised pre- to on-treatment expression level differences to identify commonalities in the response to therapy across both endocrine and chemotherapy treatment strategies. The gene, AAGAB, was identified through iterative differential analysis, and was found to be 78% accurate in validation for the prediction of pathological complete response in neoadjuvant chemotherapy treated breast cancer. AAGAB demonstrated significant separation of patient survival curves (log rank p = 0.0036), and the on-treatment samples more accurately reflected the patient risk than the pretreatment samples. Matched lymph node tissue of primary breast cancer was more successful at capturing the patient’s risk of recurrence than the primary biopsy, correctly identifying 83% (10/12) of the recurring patients compared to 25% (3/12) in the primary. Underlying differential expression analysis also showed a considerable number of high profile breast cancer genes over-represented in the lymph node. Aggregation of multiple sequential studies resulted in low post integration concordance values with the reference patient data (<30% profiling agreement), and is not recommended for this type of analysis. However, combining the pairwise change values for gene expression level data was successful, and resulted in the creation of highly accurate models for predicting patient response (F1 accuracy score, 0.92) as well as the identification of potential common escape pathways to breast cancer therapies. Analysis of the matched pre- and on-treatment samples revealed the intrinsic value of multiple on-treatment biopsies. These samples offer valuable new targets for biomarker identification that show significant increases in accuracy for the prediction of response and long term outcome in neoadjuvant chemotherapy. Additional sampling of involved metastatic lymph node also improves the prognostic capabilities for clinicians by providing a potentially more accurate view of the per-patient risk profile. Lastly, the pairwise expression change values show the direction of tumour change, which can be used to create new models for the prediction and classification of patient risk and for furthering our understanding of the mechanisms behind patient non-response