Engaging Ethical Issues Associated with Research and Public Health Interventions During Humanitarian Crises: Review of a Dialogic Workshop

Compte-rendu / ReviewLe 7 novembre 2014, l’atelier intitulé Humanitarian Health Ethics Workshop a été tenu à l’Université McGill, à Montréal. Hébergé conjointement par le Consortium de recherche sur l’équité en santé de Montréal et le Humanitarian Health Ethics Network, l’événement comprenait six présentations et une discussion extensive entre les participants, incluant des chercheurs du Canada, de Haïti, de l’Inde, de la Suisse et des États-Unis. Les participants étaient de diverses disciplines, soit l’anthropologie, la bioéthique, la médecine, l’ergothérapie, la philosophie, la physiothérapie, les sciences politiques, l’administration et la santé publique. L’objectif de l’atelier était de créer un forum de discussion entre experts et praticiens qui s’intéressent à l’éthique dans la prestation de soins de santé, en recherche et dans les interventions de santé publique en cours de crise humanitaire. Ce compte rendu résume les présentations, les thèmes clés qui ont émergé des discussions de la journée et identifie des pistes de recherches futures.On November 7th, 2014 the Humanitarian Health Ethics Workshop was held at McGill University, in Montreal. Co-hosted by the Montreal Health Equity Research Consortium and the Humanitarian Health Ethics Network, the event included six presentations and extensive discussion amongst participants, including researchers from Canada, Haiti, India, Switzerland and the US. Participants had training in disciplines including anthropology, bioethics, medicine, occupational therapy, philosophy, physical therapy, political science, public administration and public health. The objective of the workshop was to create a forum for discussion amongst scholars and practitioners interested in the ethics of healthcare delivery, research and public health interventions during humanitarian crises. This review is a summary of the presentations given, key themes that emerged during the day’s discussions, and avenues for future research that were identified

Combining Functional and Structural Reasoning for Safety Analysis of Electrical Designs

Increasing complexity of design in automotive electrical systems has been paralleled by increased demands for analysis of the safety and reliability aspects of those designs. Such demands can place a great burden on the engineers charged with carrying out the analysis. This paper describes how the intended functions of a circuit design can be combined with a qualitative model of the electrical circuit that ful®ls the functions, and used to analyse the safety of the design. FLAME, an automated failure mode and e€ects analysis system based on these techniques, is described in detail. FLAME has been developed over several years, and is capable of composing an FMEA report for many di€erent electrical subsystems. The paper also addresses the issue of how the use of functional and structural reasoning can be extended to sneak circuit analysis and fault tree analysis.

One Library’s Successful Venture in Providing Comprehensive Streaming Media Services

Thoroughly understanding what professors and instructors needed to accomplish their teaching goals with streaming video was the first step enabling one academic library to successfully manage a rapid increase in demand for streaming media. The second element was incorporating an expert understanding of copyright law and the nature of the video marketplace. This paper will strive to educate librarians and other professional library staff on how they can best integrate media streaming into mainstream library services for their campus faculty, as well as how to provide a full range of streaming services. The paper also will address workflow, communication with faculty, budget and license negotiations, copyright principles, fair use, and content delivery

Exploring multi-objective trade-offs in the design space of a waste heat recovery system

A waste heat recovery system (WHRS) is used to capture waste heat released from an industrial process, and transform the heat into reusable energy. In practice, it can be difficult to identify the optimal form of a WHRS for a particular installation, since this can depend on various design objectives, which are often mutually exclusive. More so when the number of objectives is large. To address this problem, a multi-objective evolutionary algorithm (MOEA) was used to explore and characterise the trade-off surface within the design space of a particular WHRS. A combination of clustering algorithm and parallel coordinates plots was proposed for use in analysing the results. The trade-off surface is first segmented using a clusteringalgorithm and parallel coordinates plots are then used to both visualise and understand the resulting set of Pareto-optimal designs. As a case study, a simulation of a WHRS commonly found in the foodand drinks process industries was developed, comprising of a desuperheater coupled to a hot water reservoir. The system was parameterised, considering typical objectives, and the MOEA used to build a library of alternative Pareto-optimal designs that can be used by installers. The resulting visualisation are used to better understand the sensitivity of the system’s parameters and their trade-offs, providing another source of information for prospective installations

A non-randomised controlled pilot study of clinical pharmacist collaborative intervention for community dwelling patients with COPD

UK, home-based patients with COPD receive specialist care from respiratory physicians, nurses, and general practitioners (GPs), but increasing complexity of therapeutic options and a GP/Nurse workforce crisis suggests merit in testing the role of home visits by a clinical pharmacist. We conducted a non-randomised intervention study with a contemporaneous comparator group, in Glasgow (Scotland). A clinical pharmacist (working closely with a consultant respiratory physician) visited patients with COPD living at home, assessing respiratory and other co-morbid conditions, and medicines then, with patient approval, agreed treatment modifications with a consultant physician. Comparator group-patients were drawn from another hospital out-patient clinic. Main outcomes were exacerbations during 4-months of follow-up and respiratory hospitalisations (number and duration) after 1 year. In the intervention group, 86 patients received a median of three home visits; 87 received usual care (UC). At baseline, patients in the intervention group were similar to those in UC in terms of respiratory hospitalisations although slightly younger, more likely to receive specific maintenance antibiotics/Prednisolone and to have had exacerbations. Sixty-two (72.1%) of the intervention group received dose changes; 45 (52.3%) had medicines stopped/started and 21 (24.4%) received an expedited review at the specialist respiratory consultant clinic; 46 (53.5%) were referred to other healthcare services. Over one-third were referred for bone scans and 11% received additional investigations. At follow-up, 54 (63.5%) of intervention group participants had an exacerbation compared with 75 (86.2%) in the UC group (p = 0.001); fewer had respiratory hospitalisations (39 (45.3%) vs. 66 (76.7%); p < 0.001). Hospitalisations were shorter in the intervention group. Pharmacist-consultant care for community dwelling patients with COPD, changed clinical management and improved outcomes. A randomised controlled trial would establish causality

“True fan = watch match”? In Search of the ‘Authentic’ Soccer Fan.

Academics have created typologies to divide association football (soccer) fans into categories based upon the assumed ‘authenticity’ of their fandom practices. One of the main requirements of ‘authentic’ fandom has been assumed to be match attendance. The goal of this paper was to critically assess this assumption through considering how fans themselves talk about the significance of match attendance as evidence of ‘authentic’ fandom. In light of the fact that the voices of English non-league fans on the ‘authenticity’ debate have so far been overshadowed by the overbearing focus of much previous research on the upper echelons of English soccer, an e-survey was conducted with 151 members of an online community of fans of English Northern League (NL) clubs (a semi-professional / amateur league based in North East England). Findings revealed that opinion was divided on the constituents of ‘authentic’ fandom and match attendance was not deemed to be the core evidence of support for a club by 42% of the sample. Elias (1978) suggested that dichotomous thinking hinders sociological understanding and it is concluded that fan typologies are not sufficient for assessing the ‘authenticity’ of fan activities

Conceptualizing the adventure-sports coach

As a comparatively recent development, the adventure-sports coach struggles for a clear and distinct identity. The generic term ‘instructor’ no longer characterizes the role and function of this subgroup of outdoor professionals. Indeed, although the fields of adventure/outdoor education and leadership are comparatively well researched, the arrival of this ‘new kid on the block’ appears to challenge both the adventure-sports old guard and traditional views of sports coaching. In an attempt to offer clarity and stimulate debate, this paper attempts to conceptualize the adventure-sports coach in the context of the existing roles in the field and current motivations for activity in the outdoors. We identify issues that are specific to the adventure-sports coach while also recognizing those skills and competencies shared with other professionals, both in the adventure sports profession and traditional sports coaching fields. Based on this review, we offer a conceptual model which may be used to focus debate, stimulate research and, at a possible later stage, to underpin accreditation, training and professional development

Myeloid Arginase 1 Insufficiency Exacerbates Amyloid-β Associated Neurodegenerative Pathways and Glial Signatures in a Mouse Model of Alzheimer’s Disease: A Targeted Transcriptome Analysis

Brain myeloid cells, include infiltrating macrophages and resident microglia, play an essential role in responding to and inducing neurodegenerative diseases, such as Alzheimer’s disease (AD). Genome-wide association studies (GWAS) implicate many AD casual and risk genes enriched in brain myeloid cells. Coordinated arginine metabolism through arginase 1 (Arg1) is critical for brain myeloid cells to perform biological functions, whereas dysregulated arginine metabolism disrupts them. Altered arginine metabolism is proposed as a new biomarker pathway for AD. We previously reported Arg1 deficiency in myeloid biased cells using lysozyme M (LysM) promoter-driven deletion worsened amyloidosis-related neuropathology and behavioral impairment. However, it remains unclear how Arg1 deficiency in these cells impacts the whole brain to promote amyloidosis. Herein, we aim to determine how Arg1 deficiency driven by LysM restriction during amyloidosis affects fundamental neurodegenerative pathways at the transcriptome level. By applying several bioinformatic tools and analyses, we found that amyloid-β (Aβ) stimulated transcriptomic signatures in autophagy-related pathways and myeloid cells’ inflammatory response. At the same time, myeloid Arg1 deficiency during amyloidosis promoted gene signatures of lipid metabolism, myelination, and migration of myeloid cells. Focusing on Aβ associated glial transcriptomic signatures, we found myeloid Arg1 deficiency up-regulated glial gene transcripts that positively correlated with Aβ plaque burden. We also observed that Aβ preferentially activated disease-associated microglial signatures to increase phagocytic response, whereas myeloid Arg1 deficiency selectively promoted homeostatic microglial signature that is non-phagocytic. These transcriptomic findings suggest a critical role for proper Arg1 function during normal and pathological challenges associated with amyloidosis. Furthermore, understanding pathways that govern Arg1 metabolism may provide new therapeutic opportunities to rebalance immune function and improve microglia/macrophage fitness