1,492 research outputs found
Unauthorized Legal Practice Prosecutions and Independent Paralegals in Ontario and the United States
The issue of unauthorized legal practice involves questions of professionalism and market protection. The legal profession, like other professions, is seen a being particularly successful at excluding others from its area of jurisdiction. Disputes over jurisdiction occur at the edge of this jurisdiction, specifically when certain condition arise. The e conditions are characterized by the indetermination/ technicality (I/T) ratio , where I represents the ideological underpinning of the profession and T represents the technical knowledge. If either the knowledge base or the ideological underpinning deteriorates, the occupation will lose control over its spheres of activity....For an occupation or a profession to feel secure, it must maintain a firm knowledge base and imbue its novices with the necessary ideology
Dum Deedle Dee Um : Dumb Dora
Contains advertisements and/or short musical examples of pieces being sold by publisher.https://digitalcommons.library.umaine.edu/mmb-vp/6797/thumbnail.jp
Novel Calixarene-Schiff Bases that Bind Silver(I) Ion
Two novel calix[4]arene-Schiff base receptors have been synthesized. One of the new compounds has two pendant aldimines, while the second has been prepared by two-point attachment of a calixarene-dialdehyde onto a calixarene-diamine to form a “calix-tube”. Preliminary binding studies with AgClO4 show large complexation-induced shifts in 1H NMR positions
Rethinking the difficult patient: Formative qualitative study using participatory theater to improve physician-patient communication in rheumatology
BACKGROUND: Effective physician-patient communication is crucial for positive health outcomes for patients with chronic diseases. However, current methods of physician education in communication are often insufficient to help physicians understand how patients\u27 actions are influenced by the contexts within which they live. An arts-based participatory theater approach can provide the necessary health equity framing to address this deficiency.
OBJECTIVE: The aim of this study was to develop, pilot, and conduct a formative evaluation of an interactive arts-based communication skills intervention for graduate-level medical trainees grounded in a narrative representative of the experience of patients with systemic lupus erythematosus.
METHODS: We hypothesized that the delivery of interactive communication modules through a participatory theater approach would lead to changes in both attitudes and the capacity to act on those attitudes among participants in 4 conceptual categories related to patient communication (understanding social determinants of health, expressing empathy, shared decision-making, and concordance). We developed a participatory, arts-based intervention to pilot this conceptual framework with the intended audience (rheumatology trainees). The intervention was delivered through routine educational conferences at a single institution. We conducted a formative evaluation by collecting qualitative focus group feedback to evaluate the implementation of the modules.
RESULTS: Our formative data suggest that the participatory theater approach and the design of the modules added value to the participants\u27 learning experience by facilitating interconnection of the 4 communication concepts (eg, participants were able to gain insight into both what physicians and patients were thinking about on the same topic). Participants also provided several suggestions for improving the intervention such as ensuring that the didactic material had more active engagement and considering additional ways to acknowledge real-world constraints (eg, limited time with patients) in implementing communication strategies.
CONCLUSIONS: Our findings from this formative evaluation of communication modules suggest that participatory theater is an effective method for framing physician education with a health equity lens, although considerations in the realms of functional demands of health care providers and use of structural competency as a framing concept are needed. The integration of social and structural contexts into the delivery of this communication skills intervention may be important for the uptake of these skills by intervention participants. Participatory theater provided an opportunity for dynamic interactivity among participants and facilitated greater engagement with the communication module content
The impact of Hurricane Sandy on the shoreface and inner shelf of Fire Island, New York : large bedform migration but limited erosion
© The Author(s), 2015. This is the author's version of the work. It is posted here by permission of Elsevier for personal use, not for redistribution.. The definitive version was published in Continental Shelf Research 98 (2015): 13-25, doi:10.1016/j.csr.2015.03.001.We investigate the impact of superstorm Sandy on the lower shoreface and inner shelf
offshore the barrier island system of Fire Island, NY using before-and-after surveys involving
swath bathymetry, backscatter and CHIRP acoustic reflection data. As sea level rises over the
long term, the shoreface and inner shelf are eroded as barrier islands migrate landward; large
storms like Sandy are thought to be a primary driver of this largely evolutionary process. The
“before” data were collected in 2011 by the U.S. Geological Survey as part of a long-term
investigation of the Fire Island barrier system. The “after” data were collected in January, 2013,
~two months after the storm. Surprisingly, no widespread erosional event was observed. Rather,
the primary impact of Sandy on the shoreface and inner shelf was to force migration of major
bedforms (sand ridges and sorted bedforms) 10’s of meters WSW alongshore, decreasing in
migration distance with increasing water depth. Although greater in rate, this migratory behavior
is no different than observations made over the 15-year span prior to the 2011 survey.
Stratigraphic observations of buried, offshore-thinning fluvial channels indicate that long-term
erosion of older sediments is focused in water depths ranging from the base of the shoreface
(~13-16 m) to ~21 m on the inner shelf, which is coincident with the range of depth over which
sand ridges and sorted bedforms migrated in response to Sandy. We hypothesize that bedform
migration regulates erosion over these water depths and controls the formation of a widely
observed transgressive ravinement; focusing erosion of older material occurs at the base of the
stoss (upcurrent) flank of the bedforms. Secondary storm impacts include the formation of
ephemeral hummocky bedforms and the deposition of a mud event layer.This work was funded primarily by a rapid response grant from the Jackson
School of Geosciences, The University of Texas/Austi
Dantrolene for the Prevention and Treatment of Cerebral Vasospasm after Subarachnoid Hemorrhage – a Randomized Placebo-Controlled Trial to assess Safety, Tolerability and Feasibility
Introduction: Dantrolene is neuroprotective in animal models and may attenuate cerebral vasospasm (cVSP) after aneurysmal subarachnoid hemorrhage (aSAH) in humans. We evaluated safety/tolerability and feasibility of intravenous dantrolene (IV-D) after aSAH.
Methods: In this single-center, randomized, double blind, placebo-controlled trial, 31 patients with acute aSAH were randomized to IV-D 1.25 mg IV every 6 hours x 7 days (n=16) or placebo (n=15). Primary endpoint was incidence of hyponatremia (sNa ≤ 134 mmol/L) and liver toxicity (% patients with ALT, AST and AlkPhos \u3e5x upper limit of normal). Secondary safety endpoints included tolerability, systemic hypotension and intracranial hypertension. Efficacy was explored by clinical, transcranial Doppler (TCD) or angiographic cVSP occurrence, delayed cerebral ischemia (DCI) and 3-month modified-Rankin-Scale, Glasgow Outcome Scale and Barthel Index. Statistical analysis was performed using non-parametric tests, generalized estimating equations and mixed models.
Results: Between IV-D vs. placebo, no differences were observed in the primary outcome (hyponatremia: 44% vs. 67% [p=0.29]; liver toxicity 6% vs. 0% [p=1.0]). Numerically more AEs and SAEs were seen in the IV-D group, but did not reach statistical significance (16 vs. 5 AEs, of which 5 vs. 2 were severe; RR 2.2; 95% CI 0.7-6.7; p=0.16). Three IV-D vs. two placebo patients reached stop criteria: one IV-D patient developed liver toxicity; two patients in each group developed brain edema requiring osmotherapy. No differences in angiographic, TCD, clinical cVSP, DCI, or 3-month functional outcomes were seen. Quantitative angiogram analysis revealed a trend towards increased vessel diameters in the IV-D group after the 7-day infusion-period (p=0.05).
Conclusions: In this small trial, IV-Dantrolene after aSAH was feasible, tolerable and safe, but was underpowered to show efficacy or outcome differences
A new multi-zone model for porosity distribution in Al–Si alloy castings
A new multi-zone model is proposed that explains how porosity forms in various regions of a casting under different conditions and leads to distinct zonal differences in pore shape, size and distribution. This model was developed by considering the effect of cooling rate on solidification and distribution of porosity in Al–Si alloys cast as plates in moulds made with silica, ilmenite or zirconia sand cores or steel chills facing the major plate faces. The alloys cast were Al–7 wt.% Si and Al–12.5 wt.% Si in unmodified and modified forms, the latter with either Na or Sr addition. It is found that, regardless of cooling condition, Si content and modification treatment, the microstructure can be divided into three zones of varying size (across the casting thickness) that are determined by the local cooling conditions and the nucleation and growth mode of the Al–Si eutectic. The zones are: (1) an outer shell-like zone where directional columnar dendritic grains and a fine-celled, coherent eutectic form a low-porosity shell at the casting surface; (2) a transitional zone where equiaxed, eutectic cells grow between columnar dendritic grains and irregular pores become trapped in the mush; and finally (3) a central zone where the thermal gradient is low and equiaxed dendritic grains and eutectic cells grow at the centre of the casting and larger, rounded pores tend to form. The paper discusses how Si content, modification type and cooling conditions influence the location and size (i.e. depth) of each of these zones and how the distribution of porosity is thus affected
Target Zones in History and Theory: Lessons from an Austro-Hungarian Experiment (1896-1914)
The first known experiment with an exchange rate band took place in Austria-
Hungary between 1896 and 1914. The rationale for introducing this policy rested
on precisely those intuitions that the modern literature has emphasized: the band
was designed to secure both exchange rate stability and monetary policy
autonomy. However, unlike more recent experiences, such as the ERM, this
policy was not undermined by credibility problems. The episode provides an ideal
testing ground for some important ideas in modern macroeconomics: specifically,
can formal rules, when faithfully adhered to, provide policy makers with some
advantages such as short term autonomy? First, we find that a credible band has a
"microeconomic" influence on exchange rate stability. By reducing uncertainty, a
credible fluctuation band improves the quality of expectations, a channel that has been neglected in the modern literature. Second, we show that the standard test of the basic target zone model is flawed and develop an alternative methodology. We believe that these findings shed a new light on the economics of exchange rate bands
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