276 research outputs found

    Triumph of the Whistleblower

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    Thesis advisor: Donald FishmanThe whistleblower has emerged as a relevant player in today's shifting economic and corporate landscape. Using a critical-historical methodology, this thesis explores the dimensions and boundaries of the concept of the âwhistleblowerâ. The specific case studies of WorldCom, the Madoff Ponzi scheme, and WikiLeaks are examined. The analysis includes an investigation into the shifting role of the whistleblower in society and whether legislative enactments have been able to support societyâs need to protect current and future whistleblowers. Finally, this thesis examines the whistleblower's implications for a more ethical future.Thesis (BA) — Boston College, 2012.Submitted to: Boston College. College of Arts and Sciences.Discipline: College Honors Program.Discipline: Communication Honors Program.Discipline: Communication

    Connection and coherence between and among European instruments in the private international law of obligations

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    This article considers points of connection and coherence between and among the Rome I Regulation, the Rome II Regulation, and Regulation 1215, and relevant predecessor instruments. The degree of consistency in aim, design and detail of conflict of laws rules is examined, vertically (between/among consecutive instruments) and horizontally (across cognate instruments). Symbiosis between instruments is explored, as is the interrelationship between choice of court and choice of law. Disadvantaged parties, and the cohesiveness of their treatment under the Regulations, receive particular attention

    Obesity-Related Behaviors among Poor Adolescents and Young Adults: Is Social Position Associated with Risk Behaviors?

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    This cross-sectional study examines multiple dimensions of social position in relation to obesity-related behaviors in an adolescent and young adult population. In addition to using conventional measures of social position, including parental education and household expenditures, we explore the usefulness of three youth-specific measures of social position – community and society subjective social status and school dropout status. Data are taken from a 2004 house-to-house survey of urban households within the bottom 20th percentile of income distribution within seven states in Mexico. A total of 5,321 Mexican adolescents, aged 12–22 years, provided information on obesity-related behaviors (e.g., diet, physical activity, sedentary behavior) and indicators of subjective and objective social position. A parent in each household provided information on socioeconomic status of the parent and household. Ordinal logistic regressions are used to estimate the associations of parental, household and adolescent indicators of social position and obesity-related risk behaviors. Those adolescents with the highest odds of adopting obesity risk behaviors were the ones who perceived themselves as lower in social status in reference to their peer community and those who had dropped out of school. We found no significant associations between parental education or household expenditures and obesity-related risk behaviors. Immediate social factors in adolescents’ lives may have a strong influence on their health-related behaviors. This study provides evidence for the usefulness of two particular measures, both of which are youth-specific. Adolescents and young adults who have dropped out of school and those with lower perceived relative social position within their community are more likely to be at-risk for obesity-related behaviors than those with higher relative social position. We conclude that youth-specific measures may be important in identifying the most at-risk among relatively homogeneous populations of youth

    Economic analysis of a transesophageal echocardiography-guided approach to cardioversion of patients with atrial fibrillation The ACUTE economic data at eight weeks

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    AbstractObjectivesThe aim of this study was to compare the relative cost of a transesophageal echocardiography (TEE)-guided strategy versus conventional strategy for patients with atrial fibrillation (AF) >2 days duration undergoing electrical cardioversion over an eight-week period.BackgroundThe Assessment of Cardioversion Using Transesophageal Echocardiography (ACUTE) trial found no difference in embolic rates between the two approaches. However, the TEE-guided strategy had a shorter time to cardioversion and a lower rate of composite bleeding. While similar clinical efficacy was concluded, the relative cost of these two strategies has not been explored.MethodsTwo economic approaches were employed in the ACUTE trial. The first approach was based on hospital charge data from complete hospital Universal Billing Code of 1992 forms, a detailed hospital charge questionnaire, or imputation. Regression analysis was used to investigate the added cost of adverse events. The second economic approach involved the development of an independent analytic model simulating treatment and actual ACUTE outcome costs as a validation of clinically derived data. Sensitivity analysis was performed on the analytic model to investigate the potential range in cost differences between the strategies.ResultsA total of 833 of the 1,222 patients were enrolled from 53 U.S. sites; TEE-guided (n = 420) and conventional (n = 413). At eight-week follow-up, total mean costs did not significantly differ between the two groups, respectively (6,508vs.6,508 vs. 6,239; difference of $269; p = 0.50). Cumulative costs were 24% higher in the conventional group, primarily due to increased incidence of bleeding and hospital costs associated with bleeding. A separate analytic model showed that treatment costs were higher for the TEE-guided strategy, but outcome costs were higher for the conventional strategy. Sensitivity analysis of the analytic model illustrated that varying the incidence and cost of major bleeding and the cost of TEE had the greatest impact on cost differences between the two groups.ConclusionsIn patients with AF >2 days duration undergoing electrical cardioversion, the TEE-guided group showed little difference in patient costs compared with the conventional group. The TEE strategy had higher initial treatment costs but lower outcome-associated costs. Cumulative costs were 24% higher in the conventional group, primarily due to bleeding. The TEE-guided strategy is an economically feasible approach compared with the conventional strategy

    TIA1 Mutations in Amyotrophic Lateral Sclerosis and Frontotemporal Dementia Promote Phase Separation and Alter Stress Granule Dynamics.

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    Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are age-related neurodegenerative disorders with shared genetic etiologies and overlapping clinical and pathological features. Here we studied a novel ALS/FTD family and identified the P362L mutation in the low-complexity domain (LCD) of T cell-restricted intracellular antigen-1 (TIA1). Subsequent genetic association analyses showed an increased burden of TIA1 LCD mutations in ALS patients compared to controls (p = 8.7 Ă— 1

    Inducing behavioural change in society through communication and education in sustainable manufacturing

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    The United Nations considers the mobilization of the broad public to be the essential requirement for achieving a shift towards a more sustainable development. Science can play a vital role in Education for Sustainable Development (ESD) by contributing to ESD-related research and development on the one hand, and by becoming active awareness raisers themselves in education and multiplier networks. Specifically, the use of special Learnstruments, and investment inOpen Educationformats among other educational tools, may pave the way for accelerated apprehension and appreciation of sustainable manufacturing topics among the greater populace

    How Accessible Was Information about H1N1 Flu? Literacy Assessments of CDC Guidance Documents for Different Audiences

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    We assessed the literacy level and readability of online communications about H1N1/09 influenza issued by the Centers for Disease Control and Prevention (CDC) during the first month of outbreak. Documents were classified as targeting one of six audiences ranging in technical expertise. Flesch-Kincaid (FK) measure assessed literacy level for each group of documents. ANOVA models tested for differences in FK scores across target audiences and over time. Readability was assessed for documents targeting non-technical audiences using the Suitability Assessment of Materials (SAM). Overall, there was a main-effect by audience, F(5, 82) = 29.72, P<.001, but FK scores did not vary over time, F(2, 82) = .34, P>.05. A time-by-audience interaction was significant, F(10, 82) = 2.11, P<.05. Documents targeting non-technical audiences were found to be text-heavy and densely-formatted. The vocabulary and writing style were found to adequately reflect audience needs. The reading level of CDC guidance documents about H1N1/09 influenza varied appropriately according to the intended audience; sub-optimal formatting and layout may have rendered some text difficult to comprehend

    Use of prasugrel vs clopidogrel and outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention in contemporary clinical practice: Results from the PROMETHEUS study.

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    BACKGROUND AND OBJECTIVES: We sought to determine the frequency of use and association between prasugrel and outcomes in acute coronary syndrome patients undergoing percutaneous coronary intervention (PCI) in clinical practice. METHODS: PROMETHEUS was a multicenter observational registry of acute coronary syndrome patients undergoing PCI from 8 centers in the United States that maintained a prospective PCI registry for patient outcomes. The primary end points were major adverse cardiovascular events at 90days, a composite of all-cause death, nonfatal myocardial infarction, stroke, or unplanned revascularization. Major bleeding was defined as any bleeding requiring hospitalization or blood transfusion. Hazard ratios (HRs) were generated using multivariable Cox regression and stratified by the propensity to treat with prasugrel. RESULTS: Of 19,914 patients (mean age 64.4years, 32% female), 4,058 received prasugrel (20%) and 15,856 received clopidogrel (80%). Prasugrel-treated patients were younger with fewer comorbid risk factors compared with their counterparts receiving clopidogrel. At 90days, there was a significant association between prasugrel use and lower major adverse cardiovascular event (5.7% vs 9.6%, HR 0.58, 95% CI 0.50-0.67, P<.0001) and bleeding (1.9% vs 2.9%, HR 0.65, 95% CI 0.51-0.83, P<.001). After propensity stratification, associations were attenuated and no longer significant for either outcome. Results remained consistent using different approaches to adjusting for potential confounders. CONCLUSIONS: In contemporary clinical practice, patients receiving prasugrel tend to have a lower-risk profile compared with those receiving clopidogrel. The lower ischemic and bleeding events associated with prasugrel use were no longer evident after accounting for these baseline differences
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