How do early career teachers value different types of support? A scale-adjusted latent class choice model

© 2015 Elsevier Ltd. Using a discrete choice experimental approach and associated Scale-Adjusted Latent Class Model (SALCM), we quantify the relative value early career teachers (ECTs) place on various types of support in the form of affirmation, resources, collegial opportunities, mentoring, and professional development. ECTs with intentions to depart the profession, place greater relative value on the sharing of resources, cooperative teaching and planning, offsite discussions about classroom management and programming with mentors, and having a greater professional voice. In contrast, those with intentions to remain, place greater value on observation from and conversations about teaching with more experienced teachers at their school

Eliciting risk preferences that predict risky health behaviour: A comparison of two approaches

Information on attitudes to risk could increase understanding of and explain risky health behaviors. We investigate two approaches to eliciting risk preferences in the health domain, a novel “indirect” lottery elicitation approach with health states as outcomes and a “direct” approach where respondents are asked directly about their willingness to take risks. We compare the ability of the two approaches to predict health-related risky behaviors in a general adult population. We also investigate a potential framing effect in the indirect lottery elicitation approach. We find that risk preferences elicited using the direct approach can better predict health-related risky behavior than those elicited using the indirect approach. Moreover, a seemingly innocuous change to the framing of the lottery question results in significantly different risk preference estimates, and conflicting conclusions about the ability of the indicators to predict risky health behaviors

Correlates of long-term land-cover change and protected area performance at priority conservation sites in Africa

The loss of natural habitats is a major threat to biodiversity, and protected area designation is one of the standard responses to this threat. However, greater understanding of the drivers of habitat loss and of the circumstances under which protected areas succeed or fail is still needed. We use visual assessment of satellite images to quantify land-cover change over periods of up to 30 years in and around a matched sample of protected and unprotected Important Bird and Biodiversity Areas (IBAs) in Africa. We modelled the annual survival of forests and other natural land covers as a function of a range of environmental and anthropic predictors of plausible drivers. The best-supported model indicated that survival rates of natural land cover were highest in steeper areas, at higher altitudes, in areas with lower human population densities and in areas where the cover of natural habitats was already higher at the start of the period. Survival rates of natural land cover in protected areas were, on average, around twice those in unprotected areas, but the differences between them varied along different environmental gradients. The overall survival rates of both protected and unprotected forests were significantly lower than those of other natural land-cover types, but the net benefit of protection, in terms of the absolute difference in rates of loss between protected and unprotected sites, was higher in forests. Interaction terms indicated that as slope and altitude increased, the natural protection offered by topography increasingly nullified the additional benefits of legislative protection. Furthermore, protected area designation offered reduced additional benefits to the survival of natural land cover in areas where rates of conversion were higher at the start of the observation period. Variation in the impacts of protected area status along different environmental gradients indicates that targets to improve the world's protected area network, such as Aichi Target 11 of the Convention on Biological Diversity, need to look beyond simple area-based metrics. Our methods and results contribute to the development of a protocol for prioritizing places where protection is likely to have the greatest effect.This work was partly supported by the Cambridge Conservation Initiative Collaborative Fund, through the generosity of Arcadia (grant CCI 09/09 009) and by King's College Cambridge (B. Phalan, Zukerman Junior Research Fellowship)

Modelling the potential non-breeding distribution of Spoon-billed Sandpiper Calidris pygmaea

SummaryThe Spoon-billed Sandpiper Calidris pygmaea is a ‘Critically Endangered’ migratory shorebird. The species faces an array of threats in its non-breeding range, making conservation intervention essential. However, conservation efforts are reliant on identifying the species’ key stopover and wintering sites. Using Maximum Entropy models, we predicted Spoon-billed Sandpiper distribution across the non-breeding range, using data from recent field surveys and satellite tracking. Model outputs suggest only a limited number of stopover sites are suitable for migrating birds, with sites in the Yellow Sea and on the Jiangsu coast in China highlighted as particularly important. All the previously known core wintering sites were identified by the model including the Ganges-Brahmaputra Delta, Nan Thar Island and the Gulf of Mottama. In addition, the model highlighted sites subsequently found to be occupied, and pinpointed potential new sites meriting investigation, notably on Borneo and Sulawesi, and in parts of India and the Philippines. A comparison between the areas identified as most likely to be occupied and protected areas showed that very few locations are covered by conservation designations. Known sites must be managed for conservation as a priority, and potential new sites should be surveyed as soon as is feasible to assess occupancy status. Site protection should take place in concert with conservation interventions including habitat management, discouraging hunting, and fostering alternative livelihoods.Field surveys in Russian non-breeding grounds were supported by RSPB, MHS and NABU. Field surveys in Gulf of Mottama partly supported by BBC Wildlife Fund. Satellite tagging data collection partly supported by The Biodiversity Investigation, Observation and Assessment Program (2019 - 2023) of the Ministry of Ecology and Environment of China, RSPB and a private donor. Bangladesh Spoon-billed Sandpiper Conservation Project’s fieldwork in Meghna Estuary (2015 - 2016) supported by RSPB. Data collection by EL partly supported by Basic research program (budgetary funds), projects number АААА-А19-119022190168-8 and АААА-А19-119021990093-8). PT supported by Moscow State University Grant for Leading Scientific Schools "Depository of the Living Systems" in the MSU Development Program framework. TBL was funded by the Natural Environment Research Council UK, and the IAPETUS Doctoral Training Partnership

Dermatitis associated with exposure to a marine cyanobacterium during recreational water exposure

<p>Abstract</p> <p>Background</p> <p>Anecdotal evidence reported an outbreak of symptoms on Fraser Island during the late 1990s similar to those expected from exposure to dermotoxins found in the cyanobacterium <it>L. majuscula</it>. This coincided with the presence of a bloom of <it>L. majuscula</it>.</p> <p>Methods</p> <p>Records from the Fraser Island National Parks First aid station were examined. Information on cyanobacterial blooms at Fraser Island were obtained from Queensland National Parks rangers.</p> <p>Results</p> <p>Examination of first aid records from Fraser Island revealed an outbreak of symptoms predominantly in January and February 1998.</p> <p>Conclusion</p> <p>During a bloom of <it>L. majuscula </it>there were numerous reports of symptoms that could be attributed to dermotoxins found in <it>L. majuscula</it>. The other four years examined had no <it>L. majuscula </it>blooms and the number of <it>L. majuscula </it>symptoms was much reduced. These cases comprised a high percentage of the cases treated at the first aid station.</p

A complex regional intervention to implement advance care planning in one town's nursing homes: Protocol of a controlled inter-regional study

<p>Abstract</p> <p>Background</p> <p>Advance Care Planning (ACP) is an emerging strategy to ensure that well-reflected, meaningful and clearly documented treatment preferences are available and respected when critical decisions about life-sustaining treatment need to be made for patients unable to consent. In Germany, recent legislation confirms that advance directives (AD) have to be followed if they apply to the medical situation, but implementation of ACP has not yet been described.</p> <p>Methods/Design</p> <p>In a longitudinal controlled study, we compare 1 intervention region (4 nursing homes [n/hs], altogether 421 residents) with 2 control regions (10 n/hs, altogether 985 residents). Inclusion went from 01.02.09 to 30.06.09, observation lasted until 30.06.10. Primary endpoint is the prevalence of ADs at follow-up, 17 (12) months after the first (last) possible inclusion. Secondary endpoints compare relevance and validity of ADs, process quality, the rate of life-sustaining interventions and, in deceased residents, location of death and intensity of treatment before death. The regional multifaceted intervention on the basis of the US program Respecting Choices^®comprises training of n/h staff as facilitators, training of General Practitioners, education of hospital and ambulance staff, and development of eligible tools, including Physician Orders for Life-Sustaining Treatment in case of Emergency (POLST-E).</p> <p><it>Participation data: </it>Of 1406 residents reported to live in the 14 n/hs plus an estimated turnover of 176 residents until the last possible inclusion date, 645 (41%) were willing to participate. Response rates were 38% in the intervention region and 42% in the control region. Non-responder analysis shows an equal distribution of sex and age but a bias towards dependency on nursing care in the responder group. <it>Outcome analysis </it>of this study will become available in the course of 2011.</p> <p>Discussion</p> <p>Implementing an ACP program for the n/hs and related health care providers of a region requires a complex community intervention with the effect of nothing less than a cultural shift in this health care sector. This study is to our knowledge the first to develop a strategy for regional implementation of ACP, and to evaluate its feasibility in a controlled design.</p> <p>Trial Registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN99887420">ISRCTN99887420</a></p

Exploring the similarities and differences between medical assessments of competence and criminal responsibility

The medical assessments of criminal responsibility and competence to consent to treatment are performed, developed and debated in distinct domains. In this paper I try to connect these domains by exploring the similarities and differences between both assessments. In my view, in both assessments a decision-making process is evaluated in relation to the possible influence of a mental disorder on this process. I will argue that, in spite of the relevance of the differences, both practices could benefit from the recognition of this similarity. For cooperative research could be developed directed at elucidating exactly how various mental disturbances can affect decision-making processes

An Ethical Façade? Medical Students' Miscomprehensions of Substituted Judgment

Background: We studied how well first-year medical students understand and apply the concept of substituted judgment, following a course on clinical ethics. Method: Students submitted essays on one of three ethically controversial scenarios presented in class. One scenario involved a patient who had lost decisional capacity. Through an iterative process of textual analysis, the essays were studied and coded for patterns in the ways students misunderstood or misapplied the principle of substituted judgment. Results: Students correctly articulated course principles regarding patient autonomy, substituted judgment, and nonimposition of physician values. However, students showed misunderstanding by giving doctors the responsibility of balancing the interests of the patient against the interests of the family, by stating doctors and surrogates should be guided primarily by a best-interest standard, and by suggesting that patient autonomy becomes the guiding principle only when patients can no longer express their wishes. Conclusion: Students did not appear to internalize or correctly apply the substituted judgment standard, even though they could describe it accurately. This suggests the substituted judgment standard may run counter to students ’ moral intuitions

Criterion and Construct Validity of the CogState Schizophrenia Battery in Japanese Patients with Schizophrenia

BACKGROUND: The CogState Schizophrenia Battery (CSB), a computerized cognitive battery, covers all the same cognitive domains as the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery but is briefer to conduct. The aim of the present study was to evaluate the criterion and construct validity of the Japanese language version of the CSB (CSB-J) in Japanese patients with schizophrenia. METHODOLOGY/PRINCIPAL FINDINGS: Forty Japanese patients with schizophrenia and 40 Japanese healthy controls with matching age, gender, and premorbid intelligence quotient were enrolled. The CSB-J and the Brief Assessment of Cognition in Schizophrenia, Japanese-language version (BACS-J) were performed once. The structure of the CSB-J was also evaluated by a factor analysis. Similar to the BACS-J, the CSB-J was sensitive to cognitive impairment in Japanese patients with schizophrenia. Furthermore, there was a significant positive correlation between the CSB-J composite score and the BACS-J composite score. A factor analysis showed a three-factor model consisting of memory, speed, and social cognition factors. CONCLUSIONS/SIGNIFICANCE: This study suggests that the CSB-J is a useful and rapid automatically administered computerized battery for assessing broad cognitive domains in Japanese patients with schizophrenia

Effectiveness of an online curriculum for medical students on genetics, genetic testing and counseling

Background: It is increasingly important that physicians have a thorough understanding of the basic science of human genetics and the ethical, legal and social implications (ELSI) associated with genetic testing and counseling. Methods: The authors developed a series of web-based courses for medical students on these topics. The course modules are interactive, emphasize clinical case studies, and can easily be incorporated into existing medical school curricula. Results: Results of a &#x2018;real world&#x2019; effectiveness trial indicate that the courses have a statistically significant effect on knowledge, attitude, intended behavior and self-efficacy related to genetic testing (p&#60;0.001; N varies between 163 and 596 for each course). Conclusions: The results indicate that this curriculum is an effective tool for educating medical students on the ELSI associated with genetic testing and for promoting positive changes in students&#x0027; confidence, counseling attitudes and behaviors