The blameworthiness of health and safety rule violations

Man-made disasters usually lead to the tightening of safety regulations, because rule breaking is seen as a major cause of them. This reaction is based on the presumptions that the safety rules are good and that the rule-breakers are wrong. The reasons the personnel of a coke factory gave for breaking rules raise doubt about the tenability of these presumptions. It is unlikely that this result would have been achieved on the basis of a disaster evaluation or High-Reliability Theory. In both approaches, knowledge of the consequences of human conduct hinders an unprejudiced judgement about the blameworthiness of rule breaking

Myogenin Regulates Exercise Capacity but Is Dispensable for Skeletal Muscle Regeneration in Adult mdx Mice

Duchenne muscular dystrophy (DMD) is the most prevalent inherited childhood muscle disorder in humans. mdx mice exhibit a similar pathophysiology to the human disorder allowing for an in-depth investigation of DMD. Myogenin, a myogenic regulatory factor, is best known for its role in embryonic myogenesis, but its role in adult muscle maintenance and regeneration is still poorly understood. Here, we generated an mdx:Myogflox/flox mouse harboring a tamoxifen-inducible Cre recombinase transgene, which was used to conditionally delete Myog during adult life. After tamoxifen treatment, three groups of mice were created to study the effects of Myog deletion: mdx:Myogflox/flox mice (mdx), Myogflox/flox mice (wild-type), and mdx:MyogfloxΔ/floxΔ:Cre-ER mice (mdx:Myog-deleted). mdx:Myog-deleted mice exhibited no adverse phenotype and behaved normally. When run to exhaustion, mdx:Myog-deleted mice demonstrated an enhanced capacity for exercise compared to mdx mice, running nearly as far as wild-type mice. Moreover, these mice showed the same signature characteristics of muscle regeneration as mdx mice. Unexpectedly, we found that myogenin was dispensable for muscle regeneration. Factors associated with muscle fatigue, metabolism, and proteolysis were significantly altered in mdx:Myog-deleted mice, and this might contribute to their increased exercise capacity. Our results reveal novel functions for myogenin in adult muscle and suggest that reducing Myog expression in other muscle disease models may partially restore muscle function

The Rise and Fall of "Respectable" Spanish Liberalism, 1808-1923: An Explanatory Framework

The article focuses on the reasons behind both the consolidation of what I have termed “respectable” liberalism between the 1830s and the 1840s and its subsequent decline and fall between 1900 and 1923. In understanding both processes I study the links established between “respectable” liberals and propertied elites, the monarchy, and the Church. In the first phase these links served to consolidate the liberal polity. However, they also meant that many tenets of liberal ideology were compromised. Free elections were undermined by the operation of caciquismo, monarchs established a powerful position, and despite the Church hierarchy working with liberalism, the doctrine espoused by much of the Church was still shaped by the Counter-Reformation. Hence, “respectable” liberalism failed to achieve a popular social base. And the liberal order was increasingly denigrated as part of the corrupt “oligarchy” that ruled Spain. Worse still, between 1916 and 1923 the Church, monarch, and the propertied elite increasingly abandoned the liberal Monarchist Restoration. Hence when General Primo de Rivera launched his coup the rug was pulled from under the liberals’ feet and there was no one to cushion the fall

Mindfulness in Action: Discovering How U.S. Navy Seals Build Capacity for Mindfulness in High-Reliability Organizations (HROs)

This study of US Navy Sea Air and Land (SEAL) commandos contributes to research investigating mindfulness in High-Reliability Organizations (HROs) by identifying the individual and collective influences that allow SEALs to build capacity for mindful behaviors despite the complexity of their missions, the unpredictability of their operating environments, and the danger inherent in their work. Although the HRO literature identifies a number of hallmarks of reliability, less attention is paid to how mindfulness is operationally achieved in situ by individuals on the frontline working in HROs. This study addresses this gap using a multi-phase, multi-method investigation of US Navy SEALs, identifying new links between individual mindfulness attributes (comfort with uncertainty and chaos) and collective mindfulness influences (a positive orientation towards failure) that combine to co-create a phenomenon we call 'mindfulness in action'. Mindfulness in action occurs when HROs achieve an attentive yet flexible focus capable of incorporating multiple—sometimes competing—realities in order to assess alternative solutions and take action in dynamic situations. By providing a more nuanced conceptualization of the links between individual mindfulness attributes and collective mindfulness influences, this paper opens up new avenues of discovery for a wide range of reliability-seeking organizations.This study of US Navy Sea Air and Land (SEAL) commandos contributes to research investigating mindfulness in High-Reliability Organizations (HROs) by identifying the individual and collective influences that allow SEALs to build capacity for mindful behaviors despite the complexity of their missions, the unpredictability of their operating environments, and the danger inherent in their work. Although the HRO literature identifies a number of hallmarks of reliability, less attention is paid to how mindfulness is operationally achieved in situ by individuals on the frontline working in HROs. This study addresses this gap using a multi-phase, multi-method investigation of US Navy SEALs, identifying new links between individual mindfulness attributes (comfort with uncertainty and chaos) and collective mindfulness influences (a positive orientation towards failure) that combine to co-create a phenomenon we call 'mindfulness in action'. Mindfulness in action occurs when HROs achieve an attentive yet flexible focus capable of incorporating multiple—sometimes competing—realities in order to assess alternative solutions and take action in dynamic situations. By providing a more nuanced conceptualization of the links between individual mindfulness attributes and collective mindfulness influences, this paper opens up new avenues of discovery for a wide range of reliability-seeking organizations

What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis

To identify those characteristics of self-management interventions in patients with heart failure (HF) that are effective in influencing health-related quality of life, mortality, and hospitalizations

Crime reconstruction and the role of trace materials from crime scene to court

Crime reconstruction takes place in a complex ecosystem and needs to be responsive to the context of each case. For accurate, reproducible and transparent crime reconstructions to take place, a holistic approach is needed that considers the different stakeholders, different types of trace material, integral human decision‐making and interconnected nature of the forensic science process. For robust reconstruction, there needs to be a consideration of both the distinctive types of trace material that can contribute to the reconstruction, and an understanding of the interplay of human decision‐making within reconstruction approaches. In addition, it is also necessary to consider source attribution of a trace material in addition to the activities that led to the generation, identification, transfer, and persistence of the trace. This requires explicit and tacit forms of knowledge, and an incorporation of the inherent uncertainty and risk in the reconstruction approach. The communication of conclusions reached in a crime reconstruction that address what the evidence means is also an important consideration given the different requirements of intelligence and evidence. Therefore, undertaking a crime reconstruction within a holistic framework that seeks to incorporate the complexity of the forensic science ecosystem is valuable for achieving a problem solving approach that offers reproducible, transparent reconstructions with a clear articulation of risk and uncertainty that can be of value to investigators and the courts. This article is categorized under: Forensic Science in Action/Crime Scene Investigation > Crime Scene Reconstruction Forensic Science in Action/Crime Scene Investigation > From Traces to Intelligence and Evidenc

Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature

Background: Scedosporium apiospermum is an emerging opportunistic filamentous fungus, which is notorious for its high levels of antifungal ‑resistance. It is able to cause localized cutaneous or subcutaneous infections in both immu‑ nocompromised and immunocompetent persons, pulmonary infections in patients with predisposing pulmonary diseases and invasive mycoses in immunocompromised patients. Subcutaneous infections caused by this fungus frequently show chronic mycetomatous manifestation. Case report: We report the case of a 70 ‑year ‑old immunocompromised man, who developed a fungal mycetoma‑ tous infection on his right leg. There was no history of trauma; the aetiological agent was identified by microscopic examination and ITS sequencing. This is the second reported case of S. apiospermum subcutaneous infections in Hungary, which was successfully treated by surgical excision and terbinafine treatment. After 7 months, the patient remained asymptomatic. Considering the antifungal susceptibility and increasing incidence of the fungus, Sce - dosporium related subcutaneous infections reported in the past quarter of century in European countries were also reviewed. Conclusions: Corticosteroid treatment represents a serious risk factor of S. apiospermum infections, especially if the patient get in touch with manure ‑enriched or polluted soil or water. Such infections have emerged several times in European countries in the past decades. The presented data suggest that besides the commonly applied voricona‑ zole, terbinafine may be an alternative for the therapy of mycetomatous Scedosporium infections

Diseased muscles that lack dystrophin or laminin-α2 have altered compositions and proliferation of mononuclear cell populations

BACKGROUND: Multiple types of mononucleate cells reside among the multinucleate myofibers in skeletal muscles and these mononucleate cells function in muscle maintenance and repair. How neuromuscular disease might affect different types of muscle mononucleate cells had not been determined. In this study, therefore, we examined how two neuromuscular diseases, dystrophin-deficiency and laminin-α2-deficiency, altered the proliferation and composition of different subsets of muscle-derived mononucleate cells. METHODS: We used fluorescence-activated cell sorting combined with bromodeoxyuridine labeling to examine proliferation rates and compositions of mononuclear cells in diseased and healthy mouse skeletal muscle. We prepared mononucleate cells from muscles of mdx (dystrophin-deficient) or Lama2(-/- )(laminin-α2-deficient) mice and compared them to cells from healthy control muscles. We enumerated subsets of resident muscle cells based on Sca-1 and CD45 expression patterns and determined the proliferation of each cell subset in vivo by BrdU incorporation. RESULTS: We found that the proliferation and composition of the mononucleate cells in dystrophin-deficient and laminin-α2-deficient diseased muscles are different than in healthy muscle. The mdx and Lama2(-/- )muscles showed similar significant increases in CD45(+ )cells compared to healthy muscle. Changes in proliferation, however, differed between the two diseases with proliferation increased in mdx and decreased in Lama2(-/- )muscles compared to healthy muscles. In particular, the most abundant Sca-1(-)/CD45(- )subset, which contains muscle precursor cells, had increased proliferation in mdx muscle but decreased proliferation in Lama2(-/- )muscles. CONCLUSION: The similar increases in CD45(+ )cells, but opposite changes in proliferation of muscle precursor cells, may underlie aspects of the distinct pathologies in the two diseases