Letter to Ann Fessenden regarding SEAALL membership status, September 7, 1982

A letter from Susan English to Ann Fessenden submitting changes to SEAALL membership status for University of Richmond law librarians

Federal Regulation of Consumer-Creditor Relations

As anyone who has taught or practiced in the area of consumer law knows, there have been no texts written until now which attempt to bring together in a concise manner the many statutes and regulations which govern this rapidly developing area of law. Kenneth R. Redden, Professor of Law at the University of Virginia, and James McClellan, Chief Counsel and Staff Director of the Subcommittee on the Separation of Powers of the United States Senate Judiciary Committee, have taken the first step to fill this gap by providing us with a text in the area of consumer-creditor relations

Process of change in teaching and learning in higher education : integrating information and communication technology

Merged with duplicate record 10026.1/876 on 01.02.2017 by CS (TIS)The focus of this thesis was inspired by a small study investigating the way in which students could learn co-operatively using computer-mediated communication. Lessons learnt about the significance of purpose, context, nature and design of courses involving Information and Communication Technology (ICT) led to the idea that a holistic view, involving the study of all aspects that contribute to the whole context, would be necessary to reach a better understanding of the process of change in teaching and learning. The opportunity to pursue this route materialised by being part of a team on a national, ESRC funded, project to undertake in-depth qualitative research in sixteen UK universities to explore innovations in teaching and learning. Questions regarding motivation for innovation as well as factors that promote or inhibit this process were posed to innovators and managers. Distance Learning methodologies involving ICT and a student-centred learning ethos were beginning to evolve in campus-based universities. As a result of progressive focusing the Open University was included as a case study and this research has formed the largest part of the thesis. The OU allowed further exploration into the emerging issues which included institutional culture, frameworks, policy and strategies employed to initiate and implement change in teaching and learning. The ways in which individuals or groups negotiate and initiate change were also investigated by two in-depth mini-case studies involving course teams in the process of developing new courses. Topdown and bottom-up perspectives from central managers and course team members contributed to this section. Finally, implementation aspects from one of the mini-case studies - an internet-based technology degree course - were explored. This produced some powerful insights into the whole process of change involving new technologies. The speed of internet development and global interest in exploiting the potential of ICT in education and training has resulted in pressure on institutions from national policy, funding bodies, market competition and individual educational innovators to move towards the integration of ICT in higher education provision. The findings, which indicate the need for flexibility, collaboration and continual evaluation and development, could assist institutions who have begun making this move.Stage One was funded by the University of Exeter, as it evolved from an internal research project - 'Computer Supported Cooperative Learning'; Stage Two was funded by an ESRC award as I was a research assistant on the 'Innovations in Teaching and Learning in Higher Education' project; Stage Three was funded by a studentship from the University of Plymouth

The colonialisation of paint films by microorganisms in the UK and Norway

This work was undertaken in order to study the colonisation of paint films by microorganisms. Quantitative data derived from a range of analytical techniques has provided information on surface changes occurring in the paint films during colonisation in the field and during laboratory exposure experiments. Exposure trials, took place at four different sites, two in Norway and two in the UK. The sites were situated in Sandeflord and Bergen and in Preston and Blackley near Manchester, with the panels facing North at an angle of forty-five degrees. The results obtained from these studies indicate that the range of microorganisms found on the panels exposed at the locations were very similar, suggesting that there was no great difference encountered in the airborne flora as indicated by settle plates at the sites investigated. Painted panels made from Spruce were found to be more heavily colonised than those made from calcium silicate or aluminium. The formulation biocide was seen to be effective in the vermiculite bed system against Aureobasidium pullulans. The Scanning Electron Microscope (SEM) and Environmental Scanning Electron Microscope (ESEM) provided visual evidence that in the case of Aureobasidium pullulans, fungal hyphae penetrated the paint film by the dissolution of the paint binder rather than disruption of the paint films by the growth of microorganisms through the paint film from below. Spruce panels that had been gamma irradiated showed a similar surface colonisation pattern to those untreated. Matrix Assisted Laser Desorption Ionisation Time-of-Flight Mass Spectrometry(MALDI TOF MS) showed that the technique was able to distinguish between spectra generated by different genera of fungi and between spectra generated by different species of the same genus. It is considered that the technique may provide evidence to confirm or refute the nominally common taxonomic status of fungal isolates from different sites. The work undertaken using the Talysurf (TM), shows that the technique is suitable for detecting changes in the surface topography of unprotected paint films. The results from work undertaken with films that had been subject to prolonged exposure at the Preston site and within a vermiculite bed system confirm this. Comparisons of the Fourier transform infrared spectroscopy (FTIR) spectra obtained for exposed and non-exposed paint films suggested that the exposure had no effect on the overall composition of the paint film

Incidence and severity of shoulder pain does not increase with the use of circuit class therapy during inpatient stroke rehabilitation: a controlled trial

QuestionsDoes circuit class therapy result in a greater incidence or severity of shoulder pain compared with individual therapy? Is the incidence influenced by the degree of active shoulder control?DesignControlled trial with intention-totreat analysis.ParticipantsSixty-eight people (6 drop-outs) undergoing inpatient rehabilitation after stroke.InterventionParticipants received either individual therapy or group circuit class therapy.Outcome measuresIncidence of shoulder pain over the previous 24 hours was measured as a yes/no response while severity of shoulder pain was measured using a visual analogue scale at admission, Week 4, and discharge.ResultsThere was no greater chance of participants receiving circuit class therapy having shoulder pain at Week 4 (OR 0.95, 95% CI 0.32 to 2.80) or discharge (OR 0.38, 95% CI 0.11 to 1.45) than participants receiving individual therapy. Of those participants who reported pain, there was no difference between groups in the severity of pain at Week 4 (mean difference –0.2 cm, 95% CI –3.2 to 2.7) or discharge (mean difference –2.1 cm, 95% CI –4.8 to 0.6). There was a greater chance of participants who had no active shoulder control having shoulder pain at Week 4 (OR 5.8, 95% CI 1.6 to 20.4) and at discharge (OR 3.8, 95% CI 1.0 to 13.9) than participants who had active shoulder control.ConclusionThe incidence and severity of shoulder pain was influenced by degree of active shoulder control but not by type of physiotherapy service delivery. Concerns regarding shoulder pain should not be a barrier to the implementation of circuit class therapy during inpatient stroke rehabilitation

How Physically Active Are People with Stroke in Physiotherapy Sessions Aimed at Improving Motor Function? A Systematic Review

Background. Targeted physical activity drives functional recovery after stroke. This review aimed to determine the amount of time stroke survivors spend physically active during physiotherapy sessions. Summary of Review. A systematic search was conducted to identify published studies that investigated the use of time by people with stroke during physiotherapy sessions. Seven studies were included; six observational and one randomised controlled trial. People with stroke were found to be physically active for an average of 60 percent of their physiotherapy session duration. The most common activities practiced in a physiotherapy session were walking, sitting, and standing with a mean (SD) practice time of 8.7 (4.3), 4.5 (4.0), and 8.3 (2.6) minutes, respectively. Conclusion. People with stroke were found to spend less than two-thirds of their physiotherapy sessions duration engaged in physical activity. In light of dosage studies, practice time may be insufficient to drive optimal motor recovery

The influence of power and actor relations on priority setting and resource allocation practices at the hospital level in Kenya: a case study

Abstract Background Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya. Methods We used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. We collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. We applied a combination of two frameworks, Norman Long’s actor interface analysis and VeneKlasen and Miller’s expressions of power framework to examine and interpret our findings Results The interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals. Conclusions Designing hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could improve priority setting practices. This should however, be accompanied by measures to empower stakeholders to contribute to decision making. Strengthening soft leadership skills of hospital managers could also contribute to managing the power dynamics among actors in hospital priority setting processes

Chromosome Abnormalities and Repeated Abortion: A Preliminary Report

In view of the increased frequency of chromosome rearrangements demonstrated in these couples and the importance of counseling for future pregnancies, it would be wise to consider cytogenetic evaluation when all other probable causes for recurrent abortion have been ruled out

The role of Magnetic Resonance Images (MRIs) in coping for patients with brain tumours and their parents:a qualitative study

Abstract Background When children and young people (CYP) are diagnosed with a brain tumour, Magnetic Resonance Imaging (MRI) is key to the clinical management of this condition. This can produce hundreds, and often thousands, of Magnetic Resonance Images (MRIs). Methods Semi-structured interviews were undertaken with 14 families (15 parents and 8 patients), and analysed using Grounded Theory. Analysis was supported by the Framework Method. Results Although the focus of the research was whether paediatric patients and their families find viewing MRIs beneficial, all patients and parents discussed difficult times during the illness and using various strategies to cope. This article explores the identified coping strategies that involved MRIs, and the role that MRIs can play in coping. Coping strategies were classified under the aim of the strategy when used: ‘Normalising’; ‘Maintaining hope and a sense of the future’; ‘Dealing with an uncertain future’; and ‘Seeking Support’. Conclusions Coping and finding ways to cope are clearly used by patients and their families and are something that they wish to discuss, as they were raised in conversations that were not necessarily about coping. This suggests clinicians should always allow time and space (in appointments, consultations, or impromptu conversations on the ward) for patient families to discuss ways of coping. MRIs were found to be used in various ways: to maintain or adapt normal; maintain hope and a sense of the future; deal with an uncertain future; and seek support from others. Clinicians should recognise the potential for MRIs to aid coping and if appropriate, suggest that families take copies of scans (MRIs) home. Professional coaches or counsellors may also find MRIs beneficial as a way to remind families that the child is in a more stable or ‘better’ place than they have been previously

Analysis of Hierarchical Routine Data With Covariate Missingness: Effects of Audit & Feedback on Clinicians' Prescribed Pediatric Pneumonia Care in Kenyan Hospitals.

Background: Routine clinical data are widely used in many countries to monitor quality of care. A limitation of routine data is missing information which occurs due to lack of documentation of care processes by health care providers, poor record keeping, or limited health care technology at facility level. Our objective was to address missing covariates while properly accounting for hierarchical structure in routine pediatric pneumonia care. Methods: We analyzed routine data collected during a cluster randomized trial to investigating the effect of audit and feedback (A&F) over time on inpatient pneumonia care among children admitted in 12 Kenyan hospitals between March and November 2016. Six hospitals in the intervention arm received enhance A&F on classification and treatment of pneumonia cases in addition to a standard A&F report on general inpatient pediatric care. The remaining six in control arm received standard A&F alone. We derived and analyzed a composite outcome known as Pediatric Admission Quality of Care (PAQC) score. In our analysis, we adjusted for patients, clinician and hospital level factors. Missing data occurred in patient and clinician level variables. We did multiple imputation of missing covariates within the joint model imputation framework. We fitted proportion odds random effects model and generalized estimating equation (GEE) models to the data before and after multilevel multiple imputation. Results: Overall, 2,299 children aged 2 to 59 months were admitted with childhood pneumonia in 12 hospitals during the trial period. 2,127 (92%) of the children (level 1) were admitted by 378 clinicians across the 12 hospitals. Enhanced A&F led to improved inpatient pediatric pneumonia care over time compared to standard A&F. Female clinicians and hospitals with low admission workload were associated with higher uptake of the new pneumonia guidelines during the trial period. In both random effects and marginal model, parameter estimates were biased and inefficient under complete case analysis. Conclusions: Enhanced A&F improved the uptake of WHO recommended pediatric pneumonia guidelines over time compared to standard audit and feedback. When imputing missing data, it is important to account for the hierarchical structure to ensure compatibility with analysis models of interest to alleviate bias