Constitutional Amendment; Rescission of Ratification; Extension of Ratification Period, State of Idaho v. Freeman

The court\u27s ruling in Freeman is in conflict with both the Supreme Court\u27s apparent trend involving article V issues, and most of the recent scholarly opinion on point. As a result of this departure, and the fact that the ERA failed to be adopted, this decision is likely to have slight precedential value. Nonetheless, the district court\u27s discussion of the ERA in light of recent changes in the political question doctrine has significance in interpreting article V

Torts in Sports - I\u27ll See You In Court!

This comment analyzes violence in the major professional sports of football, hockey, basketball, and baseball and the inability of the internal control systems of the various sports leagues to adequately control incidents of excessive violence. Judicial redress should be available for injuries resulting from acts committed outside of the rules of the game. The possible theories of recovery and applicable defenses to liability will be analyzed. Criminal liability also will be considered along with recently proposed congressional bills which advocate civil and criminal penalties for excessively violent acts in professional sports

Learning from safety events in healthcare: A sensemaking and mental model perspective

Organizational learning from safety relevant events is critical for improvement of healthcare practice. The identification of causes of safety events in hospitals and the design of improvements engage decision making processes that involve a high degree of interpretive activity by various professional groups (physicians, nurses, risk managers, pharmacists, etc.). From a sensemaking perspective (Weick, 1995, Weick, Sutcliffe, & Obstfeld, 2005), we conceptualize the event investigation and action planning processes as driven by cognitive structures that help individuals understand an event from their own perspective, based on their experience, anticipation of what could happen, professional education and situational perceptions. To better understand these processes, we propose an individual-level framework suggesting that the construction of causal scenarios and the design of improvements are influenced by habitual mental models that contain assumptions and knowledge about safety and accident causation as well as by the analysts’ perceived action repertoires in defining corrective actions. Various influences on the individual cognitive processes in event analysis are discussed, such as professional education, cognitive style, organizational tools, culture, and the use of safety theories. As the framework is intended to stimulate future research, potential research questions and methods are discussed

Learning from safety events in healthcare: A sensemaking and mental model perspective

Organizational learning from safety relevant events is critical for improvement of healthcare practice. The identification of causes of safety events in hospitals and the design of improvements engage decision making processes that involve a high degree of interpretive activity by various professional groups (physicians, nurses, risk managers, pharmacists, etc.). From a sensemaking perspective (Weick, 1995, Weick, Sutcliffe, & Obstfeld, 2005), we conceptualize the event investigation and action planning processes as driven by cognitive structures that help individuals understand an event from their own perspective, based on their experience, anticipation of what could happen, professional education and situational perceptions. To better understand these processes, we propose an individual-level framework suggesting that the construction of causal scenarios and the design of improvements are influenced by habitual mental models that contain assumptions and knowledge about safety and accident causation as well as by the analysts’ perceived action repertoires in defining corrective actions. Various influences on the individual cognitive processes in event analysis are discussed, such as professional education, cognitive style, organizational tools, culture, and the use of safety theories. As the framework is intended to stimulate future research, potential research questions and methods are discussed

Misrepresentation of health research in exertion games literature

HCI often requires scholars to build upon research from fields outside their expertise, creating the risk that foundational work is misunderstood and misrepresented. The prevailing goal of “exergames” research towards ameliorating obesity appears to be built on just such a misunderstanding of health research. In this paper, we analyse all citations to a single influential study, which has been extensively cited to justify research on exergames. We categorise the 375 citations based on whether they represent the findings of that study accurately or inaccurately. Our findings suggest that 69% of exergames papers citing this study misrepresent the findings, demonstrating a systematic failure of scholarship in exergames research. We argue that exergaming research should cease focusing on games as treatment for obesity, and that HCI publications should demand more critical and scholarly engagement with research from outside HCI

Measurement of HbA1c in multicentre diabetes trials - should blood samples be tested locally or sent to a central laboratory: an agreement analysis (vol 17, pg 517, 2016)

Background Glycated haemoglobin (HbA1c) is an important outcome measure in diabetes clinical trials. For multicentre designs, HbA1c can be measured locally at participating centres or by sending blood samples to a central laboratory. This study analyses the agreement between local and central measurements, using 1-year follow-up data collected in a multicentre randomised controlled trial (RCT) of newly diagnosed children with type I diabetes. Methods HbA1c measurements were routinely analysed both locally and centrally at baseline and then at 3, 6, 9 and 12 months and the data reported in mmol/mol. Agreement was assessed by calculating the bias and 95 % limits of agreement, using the Bland-Altman analysis method. A predetermined benchmark for clinically acceptable margin of error between measurements was subjectively set as ±10 % for HbA1c. The percentage of pairs of measurements that were classified as clinically acceptable was calculated. Descriptive statistics were used to examine the agreement within centres. Treatment group was not considered. Results Five hundred and ninety pairs of measurement, representing 255 children and 15 trial centres across four follow-up time points, were compared. There was no significant bias: local measurements were an average of 0.16 mmol/mol (SD = 4.5, 95 % CI −0.2 to 0.5) higher than central. The 95 % limits of agreement were −8.6 to 9.0 mmol/mol (local minus central). Eighty percent of local measurements were within ±10 % of corresponding central measurements. Some trial centres were more varied in the differences observed between local and central measurements: IQRs ranging from 3 to 9 mmol/mol; none indicated systematic bias. Conclusions Variation in agreement between HbA1c measurements was greater than had been expected although no overall bias was detected and standard deviations were similar. Discrepancies were present across all participating centres. These findings have implications for the comparison of standards of clinical care between centres, the design of future multicentre RCTs and existing quality assurance processes for HbA1c measurements. We recommend that centralised HbA1c measurement is preferable in the multicentre clinical trial setting

Blue-headed fantail

5 p. : 1 ill ; 24 cm.Includes bibliographical references (p. 5)

Targeting the live market: recovery of Norway lobsters Nephrops norvegicus (L.) from trawl-capture as assessed by stress-related parameters and nucleotide breakdown

The recovery potential of Norway lobsters (Nephrops norvegicus) held in on-board seawater tanks after trawl-capture was assessed at two different times of the year (winter and summer). Survival recorded 24 h after trawl-capture was 84.83 ± 0.93% in the winter compared to 75.35 ± 2.92% in the summer. Stress-related parameters in the muscle (arginine phosphate, glycogen and L-lactate) and in the haemolymph (L-lactate) were measured, together with nucleotide breakdown products in the muscle (yielding the “Adenylate Energy Charge” or AEC ratio). All parameters analysed were responsive to the stress of the trawl-capture and subsequently recovered towards resting values, but did so at different rates. The fact that some measures recovered at a faster rate than others should be taken into account when trying to develop an index of metabolic stress for this species. Animals trawled in the winter recovered to AEC values above 0.8 within 4 h of placing them in on-board seawater tanks, whereas animals trawled in the summer took 24 h to reach these values. Furthermore, at the end of the trials animals trawled in the summer presented significantly higher haemolymph L-lactate and lower muscle glycogen reserves than the animals trawled in the winter, suggesting a faster recovery in the winter compared to the summer. Finally, animals in the winter were better able to endure further stresses (an emersion of 1 h while animals were transported to the commercial handling facilities). Therefore, as a code of practice it is advised that trawled N. norvegicus directed to the live trade should be allowed to recover for at least 4–6 h in on-board tanks, and extra care should be taken especially in the summer, if further stresses such as additional emersion are to be applied within the first 24 h after capture

Continuous subcutaneous insulin infusion versus multiple daily injection regimens in children and young people at diagnosis of type 1 diabetes: pragmatic randomised controlled trial and economic evaluation

ObjectiveTo compare the efficacy, safety, and cost utility of continuous subcutaneous insulin infusion (CSII) with multiple daily injection (MDI) regimens during the first year following diagnosis of type 1 diabetes in children and young people.DesignPragmatic, multicentre, open label, parallel group, randomised controlled trial and economic evaluation.Setting15 paediatric National Health Service (NHS) diabetes services in England and Wales. The study opened to recruitment in May 2011 and closed in January 2017.ParticipantsPatients aged between 7 months and 15 years, with a new diagnosis of type 1 diabetes were eligible to participate. Patients who had a sibling with the disease, and those who took drug treatments or had additional diagnoses that could have affected glycaemic control were ineligible.InterventionsParticipants were randomised, stratified by age and treating centre, to start treatment with CSII or MDI within 14 days of diagnosis. Starting doses of aspart (CSII and MDI) and glargine or detemir (MDI) were calculated according to weight and age, and titrated according to blood glucose measurements and according to local clinical practice.Main outcome measuresPrimary outcome was glycaemic control (as measured by glycated haemoglobin; HbA1c) at 12 months. Secondary outcomes were percentage of patients in each treatment arm with HbA1c within the national target range, incidence of severe hypoglycaemia and diabetic ketoacidosis, change in height and body mass index (as measured by standard deviation scores), insulin requirements (units/kg/day), partial remission rate (insulin dose adjusted HbA1c Results294 participants were randomised and 293 included in intention to treat analyses (CSI, n=144; MDI, n=149). At 12 months, mean HbA1c was comparable with clinically unimportant differences between CSII and MDI participants (60.9 mmol/mol v 58.5 mmol/mol, mean difference 2.4 mmol/mol (95% confidence interval -0.4 to 5.3), P=0.09). Achievement of HbA1c lower than 58 mmol/mol was low among the two groups (66/143 (46%) CSII participants v 78/142 (55%) MDI participants; relative risk 0.84 (95% confidence interval 0.67 to 1.06)). Incidence of severe hypoglycaemia and diabetic ketoacidosis were low in both groups. Fifty four non-serious and 14 serious adverse events were reported during CSII treatment, and 17 non-serious and eight serious adverse events during MDI treatment. Parents (but not children) reported superior PedsQL scores for those patients treated with CSII compared to those treated with MDI. CSII was more expensive than MDI by £1863 (€2179; $2474; 95% confidence interval £1620 to £2137) per patient, with no additional QALY gains (difference -0.006 (95% confidence interval -0.031 to 0.018)).ConclusionDuring the first year following type 1 diabetes diagnosis, no clinical benefit of CSII over MDI was identified in children and young people in the UK setting, and treatment with either regimen was suboptimal in achieving HbA1c thresholds. CSII was not cost effective.Trial registrationCurrent Controlled Trials ISRCTN29255275; European Clinical Trials Database 2010-023792-25