Accelerating Positive Change In Electronic Recrds Management - An Emprical Toolkit Of Solutions

The AC+erm project aims to investigate and critically explore issues and practical strategies for accelerating positive change in electronic records management. The project’s focus is on designing an organisational-centred architecture from three perspectives: people, process and technology. This paper introduces the project, describes the methodology (a systematic literature review, e-Delphi studies and colloquia) and presents solutions for improving ERM developed from the people and process e-Delphi responses. ERM is particularly challenging and the solutions offered by the Delphi participants are numerous, and range in scale and complexity. The only firm conclusion that one can draw is that the majority of the solutions are people-focussed ones. The Cynefin framework is introduced as one approach for providing a conceptual overview to our findings on ERM. The sample solutions presented in this paper provide a toolkit of ‘probes’ and ‘interventions’ for practical application in organisations

Root canal instrumentation efficacy of non-fused and fused primary molar roots:a micro-computed tomography study

Purpose Pulpectomy may be indicated in restorable primary teeth exhibiting irreversible pulpitis or pulpal necrosis. The purpose of this study was to compare the cleaning and shaping efficacy of NiTi systems (Reciproc(R) Blue and MTwo(R)) with manual stainless-steel instrumentation in primary molars using micro-CT analysis. Methods Fifty-seven maxillary second primary molars were scanned using micro-CT. Teeth with three divergent roots were divided randomly (n = 15) according to instrument type (K file, MTwo (R), and Reciproc (R) Blue). Teeth with root fusion were instrumented manually as a separate group (n = 12). Pre- and post-instrumentation micro-CT images were superimposed, and the instrumentation area (IA) and procedural complications were recorded. Results No statistically significant differences in IA between file systems was observed in the non-fused teeth. The mean IA of fused roots was significantly lower than in the non-fused distobuccal (p = 0.003) and palatal (p 60%) occurred in both non-fused and fused primary teeth with fewer procedural complications observed after manual instrumentation

Crocodiles and grey nomads: a deadly combination?

Increasing numbers of retirees seek individual, extended, unstructured activities in remote, non-commercial locations. Travel is predominantly by self-drive 4WD vehicle towing a caravan/campervan. These ‘grey nomads’ often prefer remote bush camping sites/caravan parks to commercial resorts. The tropics – a popular destination – are inhabited by Australia’s only large semi-terrestrial carnivore, the estuarine crocodile Crocodylus porosus. Conservation programmes of recent decades have resulted in a substantial increase in numbers. With naive grey nomads increasingly encroaching on crocodile territory, attacks are expected to increase. Review of conservation programmes to incorporate awareness education targeting grey nomads is therefore required

Sustained carbon uptake and storage following moderate disturbance in a Great Lakes forest

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/117030/1/eap20132351202.pd

A comparative framework: how broadly applicable is a 'rigorous' critical junctures framework?

The paper tests Hogan and Doyle's (2007, 2008) framework for examining critical junctures. This framework sought to incorporate the concept of ideational change in understanding critical junctures. Until its development, frameworks utilized in identifying critical junctures were subjective, seeking only to identify crisis, and subsequent policy changes, arguing that one invariably led to the other, as both occurred around the same time. Hogan and Doyle (2007, 2008) hypothesized ideational change as an intermediating variable in their framework, determining if, and when, a crisis leads to radical policy change. Here we test this framework on cases similar to, but different from, those employed in developing the exemplar. This will enable us determine whether the framework's relegation of ideational change to a condition of crisis holds, or, if ideational change has more importance than is ascribed to it by this framework. This will also enable us determined if the framework itself is robust, and fit for the purposes it was designed to perform — identifying the nature of policy change

Fertility treatment and cancers—the eternal conundrum: a systematic review and meta-analysis

STUDY QUESTION: Does fertility treatment (FT) significantly increase the incidence of breast, ovarian, endometrial or cervical cancer? SUMMARY ANSWER: Overall, FT does not significantly increase the incidence of breast, ovarian or endometrial cancer and may even reduce the incidence of cervical cancer. WHAT IS KNOWN ALREADY: Infertility affects more than 14% of couples. Infertility and nulliparity are established risk factors for endometrial, ovarian and breast cancer, yet the association with FT is more contentious. STUDY DESIGN, SIZE, DURATION: A literature search was carried out using Cochrane Library, EMBASE, Medline and Google Scholar up to December 2019. Peer-reviewed studies stating cancer incidence (breast, ovarian, endometrial or cervical) in FT and no-FT groups were identified. Out of 128 studies identified, 29 retrospective studies fulfilled the criteria and were included (n = 21 070 337). PARTICIPANTS/MATERIALS, SETTING, METHODS: In the final meta-analysis, 29 studies were included: breast (n = 19), ovarian (n = 19), endometrial (n = 15) and cervical (n = 13), 17 studies involved multiple cancer types and so were included in each individual cancer meta-analysis. Primary outcome of interest was cancer incidence (breast, ovarian, endometrial and cervical) in FT and no-FT groups. Secondary outcome was cancer incidence according to specific fertility drug exposure. Odds ratio (OR) and random effects model were used to demonstrate treatment effect and calculate pooled treatment effect, respectively. A meta-regression and eight sub-group analyses were performed to assess the impact of the following variables, maternal age, infertility, study size, outliers and specific FT sub-types, on cancer incidence. MAIN RESULTS AND THE ROLE OF CHANCE: Cervical cancer incidence was significantly lower in the FT group compared with the no-FT group: OR 0.68 (95% CI 0.46-0.99). The incidences of breast (OR 0.86; 95% CI 0.73-1.01) and endometrial (OR 1.28; 95% CI 0.92-1.79) cancers were not found to be significantly different between the FT and no-FT groups. Whilst overall ovarian cancer incidence was not significantly different between the FT and no-FT groups (OR 1.19; 95% CI 0.98-1.46), separate analysis of borderline ovarian tumours (BOT) revealed a significant association (OR 1.69; 95% CI 1.27-2.25). In further sub-group analyses, ovarian cancer incidence was shown to be significantly higher in the IVF (OR 1.32; 95% CI 1.03-1.69) and clomiphene citrate (CC) treatment group (OR 1.40; 95% CI 1.10-1.77), respectively when compared with the no-FT group. Conversely, the incidences of breast (OR 0.75; 95% CI 0.61-0.92) and cervical cancer (OR 0.58; 95% CI 0.38-0.89) were significantly lower in the IVF treatment sub-group compared to the no-FT group. LIMITATIONS, REASONS FOR CAUTION: The large, varied dataset spanning a wide study period introduced significant clinical heterogeneity. Thus, results have to be interpreted with an element of caution. Exclusion of non-English citations, unpublished work and abstracts, in order to ensure data accuracy and reliability was maintained, may have introduced a degree of selection bias. WIDER IMPLICATIONS OF THE FINDINGS: The results for breast, ovarian, endometrial and cervical cancer are reassuring, in line with previously published meta-analyses for individual cancers but the association between IVF and CC treatment and an increase in ovarian cancer incidence requires additional work to understand the potential mechanism driving this association. In particular, focusing on (i) discriminating specific treatments effects from an inherent risk of malignancy; (ii) differential risk profiles among specific patient sub-groups (refractory treatment and obesity); and (iii) understanding the impact of FT outcomes on cancer incidence. STUDY FUNDING/COMPETING INTEREST(S): This study did not receive any funding. The authors have no financial, personal, intellectual and professional conflicts of interest to declare. PROSPERO REGISTRATION NUMBER: CRD42019153404

Where are the Pots and Pans? Collective Responses in Ireland to Neoliberalization in a Time of Crisis: Learning from Latin America

Since 2008, Ireland has experienced a profound multi-faceted crisis, stemming from the collapse of the financial and property sectors. Despite enduring six years of neoliberal austerity measures in response to this situation, popular protest has been muted. Using Silva's [(2009) Challenging Neoliberalism in Latin America (Cambridge and New York: Cambridge University Press)] framework of analysis of popular responses in Latin America to that region's debt crisis of the 1980s and 1990s, this article seeks to investigate why this has been the case. We assess how the crisis is being framed among popular and civil society groups, and whether increased associational and collective power is developing. In doing so, we look at processes of intra-group cooperation, cross-group cooperation and framing and brokerage mechanisms. We then ask, where such processes exist, if they can lead to a comprehensive challenge to the neoliberal policies currently being implemented, as happened in much of Latin America. We conclude that the crisis has not yet reached sufficient depth or longevity to foster a more robust popular response, but propose that analysis of similar processes in Latin America can help us understand better why this is the case, not just in Ireland, but in other countries of Europe experiencing similar situations

Spain as an emergency air traffic hub during volcanic air fall events? Evidence of past volcanic ash air fall over Europe during the late Pleistocene.

Past volcanic eruptions often leave visible ash layers in the geological record, for example in marine or lake sedimentary sequences. Recent developments, however, have shown that non-visible volcanic ash layers are also commonly preserved in sedimentary deposits. These augment the record of past volcanic events by demonstrating that past ash dispersals have been more numerous and widely disseminated in Europe than previously appreciated. The dispersal ‘footprints’ of some large late Pleistocene European eruptions are examined here in the light of the recent Eyjafjallajökull eruption. For example, the Vedde Ash which was erupted from Iceland around 12 thousand years ago, delivered distal (and non-visible) glass deposits as far south as Switzerland and as far east as the Ural Mountains in Russia, with an overall European distribution remarkably similar to the dominant tracks of the recent Eyjafjallajökull plum