Discovery-led refinement in e-discovery investigations: sensemaking, cognitive ergonomics and system design.

Given the very large numbers of documents involved in e-discovery investigations, lawyers face a considerable challenge of collaborative sensemaking. We report findings from three workplace studies which looked at different aspects of how this challenge was met. From a sociotechnical perspective, the studies aimed to understand how investigators collectively and individually worked with information to support sensemaking and decision making. Here, we focus on discovery-led refinement; specifically, how engaging with the materials of the investigations led to discoveries that supported refinement of the problems and new strategies for addressing them. These refinements were essential for tractability. We begin with observations which show how new lines of enquiry were recursively embedded. We then analyse the conceptual structure of a line of enquiry and consider how reflecting this in e-discovery support systems might support scalability and group collaboration. We then focus on the individual activity of manual document review where refinement corresponded with the inductive identification of classes of irrelevant and relevant documents within a collection. Our observations point to the effects of priming on dealing with these efficiently and to issues of cognitive ergonomics at the human–computer interface. We use these observations to introduce visualisations that might enable reviewers to deal with such refinements more efficiently

Undergraduate medical education: Thoughts on future challenges

BACKGROUND: There is considerable uncertainty about the future of undergraduate medical education in the face of several important challenges. This paper highlights many of the complexities of the challenges facing medical school leadership today. DISCUSSION: A major challenge facing medical education in the United States is the erosion of the clinical environment, the loss of clinical revenues and all its attendant consequences, including pressures for increased faculty productivity in an environment that is increasingly managed. These pressures have squeezed the time for teaching out of the system. Another challenge is how to incorporate all the new and emergent domains of knowledge into the existing curriculum. There is also a need to incorporate technological advancements into the delivery of teaching. SUMMARY: Undergraduate medical education in the United States must respond to a multitude of challenges if it is to remain vibrant in the 21(st) century

Screening, intervention and outcome in autism and other developmental disorders: the role of randomized controlled trials

We draw attention to a number of important considerations in the arguments about screening and outcome of intervention in children with autism and other developmental disorders. Autism screening in itself never provides a final clinical diagnosis, but may well identify developmental deviations indicative of autism—or of other developmental disorders—that should lead to referral for further clinical assessment. Decisions regarding population or clinic screening cannot be allowed to be based on the fact that prospective longitudinal RCT designs over decades could never be performed in complex developmental disorders. We propose an alternative approach. Early screening for autism and other developmental disorders is likely to be of high societal importance and should be promoted and rigorously evaluated

Gyroless Spin-Stabilization Controller and Deorbiting Algorithm for CubeSats

CubeSats are becoming increasingly popular in the scientific community. While they provide a whole new range of opportunities for space exploration, they also come with their own challenges. One of the main concerns is the negative impact which they can have in the space debris problem. Commonly lacking from attitude determination and propulsion capabilities, it has been difficult to provide CubeSats with means for active deorbiting. While electric propulsion technology has been emerging for its application in CubeSats, little or no literature is available on methods to enable it to be used for deorbiting purposes, especially within the tight constraints faced by these nanosatellites. We present a new and simple algorithm for CubeSat deorbiting, which proposes the use of novel electric propulsion technology with minimum sensing and actuation capabilities. The algorithm is divided into two stages: a spin-stabilization control; and a deorbiting-phase detection. The spin-stabilization control is inspired by the B-dot controller. It does not require gyroscopes, but only requires magnetometers and magnetorquers as sensors and actuators, respectively. The deorbiting-phase detection is activated once the satellite is spin-stabilized. The algorithm can be easily implementable as it does not require any attitude information other than the orbital information, e.g., from the Global Positioning System receiver, which could be easily installed in CubeSats. The effectiveness of each part of the algorithms is validated through numerical simulations. The proposed algorithms outperform the existing approaches such as deorbiting sails, inflatable structures, and electrodynamic tethers in terms of deorbiting times. Stability and robustness analysis are also provided. The proposed algorithm is ready to be implemented with minimal effort and provides a robust solution to the space junk mitigation efforts

The Role of Medical Education in Reducing Health Care Disparities: The First Ten Years of the UCLA/Drew Medical Education Program

BACKGROUND: The University of California, Los Angeles (UCLA)/Charles R. Drew University Medical Education Program was developed to train physicians for practice in underserved areas. The UCLA/Drew Medical Education Program students receive basic science instruction at UCLA and complete their required clinical rotations in South Los Angeles, an impoverished urban community. We have previously shown that, in comparison to their UCLA counterparts, students in the Drew program had greater odds of maintaining their commitment to medically disadvantaged populations over the course of medical education. OBJECTIVE: To examine the independent association of graduation from the UCLA/Drew program with subsequent choice of physician practice location. We hypothesized that participation in the UCLA/Drew program predicts future practice in medically disadvantaged areas, controlling for student demographics such as race/ethnicity and gender, indicators of socioeconomic status, and specialty choice. DESIGN: Retrospective cohort study. PARTICIPANTS: Graduates (1,071) of the UCLA School of Medicine and the UCLA/Drew Medical Education Program from 1985–1995, practicing in California in 2003 based on the address listed in the American Medical Association (AMA) Physician Masterfile. MEASUREMENTS: Physician address was geocoded to a California Medical Service Study Area (MSSA). A medically disadvantaged community was defined as meeting any one of the following criteria: (a) federally designated HPSA or MUA; (b) rural area; (c) high minority area; or (d) high poverty area. RESULTS: Fifty-three percent of UCLA/Drew graduates are located in medically disadvantaged areas, in contrast to 26.1% of UCLA graduates. In multivariate analyses, underrepresented minority race/ethnicity (OR: 1.57; 95% CI: 1.10–2.25) and participation in the Drew program (OR: 2.47; 95% CI: 1.59–3.83) were independent predictors of future practice in disadvantaged areas. CONCLUSIONS: Physicians who graduated from the UCLA/Drew Medical Education Program have higher odds of practicing in underserved areas than those who completed the traditional UCLA curriculum, even after controlling for other factors such as race/ethnicity. The association between participation in the UCLA/Drew Medical Education Program and physician practice location suggests that medical education programs may reinforce student goals to practice in disadvantaged communities

Protocol for the Smoking, Nicotine and Pregnancy (SNAP) trial: double-blind, placebo-randomised, controlled trial of nicotine replacement therapy in pregnancy

Background: Smoking in pregnancy remains a public health challenge. Nicotine replacement therapy (NRT) is effective for smoking cessation in non-pregnant people, but because women metabolise nicotine and cotinine much faster in pregnancy, it is unclear whether this will be effective for smoking cessation in pregnancy. The NHS Health Technology Assessment Programme (HTA)-funded smoking, nicotine and pregnancy ( SNAP) trial will investigate whether or not nicotine replacement therapy ( NRT) is effective, cost-effective and safe when used for smoking cessation by pregnant women. Methods/Design: Over two years, in 5 trial centres, 1050 pregnant women who are between 12 and 24 weeks pregnant will be randomised as they attend hospital for ante-natal ultrasound scans. Women will receive either nicotine or placebo transdermal patches with behavioural support. The primary outcome measure is biochemically-validated, self-reported, prolonged and total abstinence from smoking between a quit date ( defined before randomisation and set within two weeks of this) and delivery. At six months after childbirth self-reported maternal smoking status will be ascertained and two years after childbirth, self-reported maternal smoking status and the behaviour, cognitive development and respiratory symptoms of children born in the trial will be compared in both groups. Discussion: This trial is designed to ascertain whether or not standard doses of NRT ( as transdermal patches) are effective and safe when used for smoking cessation during pregnancy

Nigerian foodstuffs with prostate cancer chemopreventive polyphenols

Dietary polyphenols are antioxidants that can scavenge biological free radicals, and chemoprevent diseases with biological oxidation as their main etiological factor. In this paper, we review our laboratory data vis-ὰ-vis available literature on prostate cancer chemopreventive substances in Nigerian foodstuffs. Dacryodes edulis fruit, Moringa oleifera and Syzygium aromaticum contained prostate active polyphenols like ellagic acid, gallate, methylgallate, catechol, kaempferol quercetin and their derivatives. Also Canarium schweinfurthii Engl oil contained ten phenolic compounds and lignans, namely; catechol, p-hydroxybenzaldehyde, dihydroxyphenylacetic acid, tyrosol, p-hydroxybenzoic acid, dihydroxybenzoic acid, vanillic acid, phloretic acid, pinoresinol, secoisolariciresinol. In addition, tomatoes (Lycopersicon esculentum Mill) which contains the powerful antioxidant and anti-prostate cancer agent, lycopene; cabbage (Brassica oleracea) containing indole-3-carbinol; citrus fruits containing pectin; Soursop (Annona muricata) containing annonaceous acetogenins; soya beans (Glycine max) containing isoflavones; chilli pepper (Capsicum annuum) containing capsaicin, and green tea (Camellia sinensis) containing (-) epigallocatechin gallate (EGCG), (-) epicatechin, (-) epicatechin-3-gallate and (-) epigallocatechin -3-gallate which are widely reported to posses prostate cancer chemopreventive compounds are also grown in Nigeria and other African countries. Thus, the high incidence of prostate cancer among males of African extraction can be dramatically reduced, and the age of onset drastically increased, if the population at risk consumes the right kinds of foods in the right proportion, beginning early in life, especially as prostate cancer has a latency period of about 50 years

Seagrass meadows are important sources of reef island-building sediment

This is the final version. Available on open access from Nature Research via the DOI in this recordThe future vulnerability of low-lying atoll nations is inextricably linked to the production of island-building carbonate sediments by organisms living in their adjacent marine environments. Seagrass meadows are commonly found adjacent to reef islands, but their potential role as sources of reef island-building sediments has been overlooked. Here, we quantify rates of sediment production by seagrass epibionts in a reef island sediment supply context. Total seagrass epibiont sediment production at our study site (Huvadhoo Atoll, Maldives) was 853,000 ± 90,000 kg CaCO3 yr-1 over an area of 1.1 km2. Of this total sediment production, 541,000 ± 23,000 kg CaCO3 yr-1 was estimated to be suitable to contribute to reef island building (i.e., sand-sized, post-agitation). Our findings highlight a previously unrecognised and highly valuable ecosystem service provided by tropical seagrass meadows as important potential sources of reef island-building sediment. This study, therefore, presents a new and compelling geomorphic argument for seagrass conservation.British Society for Geomorpholog

Stress in nurses : stress-related affect and its determinants examined over the nursing day

Peer reviewedPostprin

Determinants of response to a parent questionnaire about development and behaviour in 3 year olds: European multicentre study of congenital toxoplasmosis.

Background: We aimed to determine how response to a parent-completed postal questionnaire measuring development, behaviour, impairment, and parental concerns and anxiety, varies in different European centres. Methods: Prospective cohort study of 3 year old children, with and without congenital toxoplasmosis, who were identified by prenatal or neonatal screening for toxoplasmosis in 11 centres in 7 countries. Parents were mailed a questionnaire that comprised all or part of existing validated tools. We determined the effect of characteristics of the centre and child on response, age at questionnaire completion, and response to child drawing tasks. Results: The questionnaire took 21 minutes to complete on average. 67% (714/1058) of parents responded. Few parents (60/1058) refused to participate. The strongest determinants of response were the score for organisational attributes of the study centre (such as direct involvement in follow up and access to an address register), and infection with congenital toxoplasmosis. Age at completion was associated with study centre, presence of neurological abnormalities in early infancy, and duration of prenatal treatment. Completion rates for individual questions exceeded 92% except for child completed drawings of a man (70%), which were completed more by girls, older children, and in certain centres. Conclusion: Differences in response across European centres were predominantly related to the organisation of follow up and access to correct addresses. The questionnaire was acceptable in all six countries and offers a low cost tool for assessing development, behaviour, and parental concerns and anxiety, in multinational studies