Trouser House: A case study of one small arts initiative as it charts a course to legal, financial, and programmatic relevancy

The purpose of this report is to assist Trouser House, a New Orleans contemporary art and urban farming initiative, in determining the best course of action for establishing its legal structure and achieving financial security. To do this, the author provides an analysis of the present operations of Trouser House; outlines several social entrepreneurial structures as models for consideration; presents research on the current role of small arts organizations and the state of arts philanthropy nationwide; and provides recommendations as to how Trouser House can improve and strengthen current practices to maximize its potential as a small community-based arts organization

Reducing inappropriate antibiotics prescribing: The role of online commentary on physical examination findings

Objective: This study investigates the relationship of ‘online commentary’(contemporaneous physician comments about physical examination [PE] findings) with (i) parent questioning of the treatment recommendation and (ii) inappropriate antibiotic prescribing. Methods: A nested cross-sectional study of 522 encounters motivated by upper respiratory symptoms in 27 California pediatric practices (38 pediatricians). Physicians completed a post-visit survey regarding physical examination findings, diagnosis, treatment, and whether they perceived the parent as expecting an antibiotic. Taped encounters were coded for ‘problem’ online commentary (PE findings discussed as significant or clearly abnormal) and ‘no problem’ online commentary (PE findings discussed reassuringly as normal or insignificant). Results: Online commentary during the PE occurred in 73% of visits with viral diagnoses (n = 261). Compared to similar cases with ‘no problem’ online commentary, ‘problem’ comments were associated with a 13% greater probability of parents uestioning a non-antibiotic treatment plan (95% CI 0-26%, p = .05,) and a 27% (95% CI: 2-52%, p < .05) greater probability of an inappropriate antibiotic prescription. Conclusion: With viral illnesses, problematic online comments are associated with more pediatrician-parent conflict over non-antibiotic treatment recommendations. This may increase inappropriate antibiotic prescribing. Practice implications: In viral cases, physicians should consider avoiding the use of problematic online commentary

Solar-powered electric propulsion spacecraft Bimonthly report

Mission analysis and design study of Mars spacecraft solar-powered electric propulsion syste

Solar-powered electric propulsion spacecraft Bimonthly report no. 3, Jul. - Aug. 1965

Solar powered electric propulsion spacecraft - propulsion system and hardware, spacecraft system design, and flyby heliocentric tranfer trajectory analysi

Predicting clinical trial results based on announcements of interim analyses

BACKGROUND: Announcements of interim analyses of a clinical trial convey information about the results beyond the trial’s Data Safety Monitoring Board (DSMB). The amount of information conveyed may be minimal, but the fact that none of the trial’s stopping boundaries has been crossed implies that the experimental therapy is neither extremely effective nor hopeless. Predicting success of the ongoing trial is of interest to the trial’s sponsor, the medical community, pharmaceutical companies, and investors. We determine the probability of trial success by quantifying only the publicly available information from interim analyses of an ongoing trial. We illustrate our method in the context of the National Surgical Adjuvant Breast and Bowel (NSABP) trial, C-08. METHODS: We simulated trials based on the specifics of the NSABP C-08 protocol that were publicly available. We quantified the uncertainty around the treatment effect using prior weights for the various possibilities in light of other colon cancer studies and other studies of the investigational agent, bevacizumab. We considered alternative prior distributions. RESULTS: Subsequent to the trial’s third interim analysis, our predictive probabilities were: that the trial would eventually be successful, 48.0%; would stop for futility, 7.4%; and would continue to completion without statistical significance, 44.5%. The actual trial continued to completion without statistical significance. CONCLUSIONS: Announcements of interim analyses provide information outside the DSMB’s sphere of confidentiality. This information is potentially helpful to clinical trial prognosticators. ‘Information leakage’ from standard interim analyses such as in NSABP C-08 is conventionally viewed as acceptable even though it may be quite revealing. Whether leakage from more aggressive types of adaptations is acceptable should be assessed at the design stage

Deferring the decision point : Treatment assertions in neurology outpatient consultations

Recommendations can be implied by asserting some generalisation about a treatment’s benefit without overtly directing the patient to take it. Focusing on a collection of assertions in UK neurology consultations, this paper shows that these are overwhelmingly receipted as “merely” doing informing and argues that this is made possible by their ambiguous design: their relatively depersonalised formats convey that the neurologist is simply telling the patient what’s available, but the link made between the treatment and the patient’s condition implies that it will be of benefit. Thus, assertions, while stopping short of telling the patient what to do, are hearable as recommendation relevant. This delicates balance leaves it up to the patient to respond either to the implied or on-record action (recommending vs. informing). When treated as “merely” doing informing, assertions defer the decision point until the neurologist has done something more. Three main interactional functions of this are identified as follows: (i) indicating the existence of a solution to a concern, without making a decision relevant next; (ii) orienting to the patient’s right to choose; and (iii) making “cautious” recommendations

How communication affects prescription decisions in consultations for acute illness in children:a systematic review and meta-ethnography

BACKGROUND: Communication within primary care consultations for children with acute illness can be problematic for parents and clinicians, with potential misunderstandings contributing to over–prescription of antibiotics. This review aimed to synthesise the evidence in relation to communication and decision making in consultations for children with common acute illness. METHODS: A systematic search of MEDLINE, EMBASE, CINAHL, PsycINFO, SSCI, SIGLE, Dissertation Express and NHS economic evaluation databases was conducted. Studies of primary care settings in high income countries which made direct observations of consultations and reported qualitative data were included. Included studies were appraised using the process recommended by the Cochrane Qualitative Methods Group. Credibility was assessed as high for most studies but transferability was usually assessed low or unclear. Data were synthesised using a meta–ethnographic approach. RESULTS: Thirty–five papers and 2 theses reporting on 13 studies were included, 7 of these focussed on children with respiratory tract infections (RTI) and the remaining 6 included children with any presenting illness. Parent communication focussed on their concerns and information needs, whereas clinician communication focussed on diagnosis and treatment decisions. During information exchanges, parents often sought to justify the need for the consultation, while clinicians frequently used problem minimising language, resulting in parents and clinicians sometimes talking at cross–purposes. In the context of RTIs, a range of parent communication behaviours were interpreted by clinicians as indicating an expectation for antibiotics; however, most were ambiguous and could also be interpreted as raising concerns or requests for further information. The perceived expectation for antibiotics often changed clinician decision making into clinician–parent negotiation. CONCLUSIONS: Misunderstandings occurred due to parents and clinicians talking at cross purposes about the ‘seriousness’ of the illness and because parents’ expressions of concern or requests for additional information were sometimes perceived as a challenge to the clinicians’ diagnosis or treatment decision. This modifiable problem may be an important contribution to the unnecessary and unwanted prescribing of antibiotics. Primary care clinicians should be offered training to understand parent communication primarily as expressions of concern or attempts at understanding and always to check rather than infer parental expectations

Sequoyah v. TVA, 6th Circuit, Docket No. 79-1633: Required Statement For Rehearing En Banc

Petition for rehearing and suggestion for rehearing en banc under rules 35(B) and 40 of the Federal Rules of Appellate Procedure, submitted by Cherokee groups as part of their lawsuit to prevent the completion of the Tellico Project

Book Reviews

An Estate Planner\u27s Handbook By Mayo Adams Shattuck Boston: Little, Brown & Company, 1948. Pp. 575. $7.50 reviewer: Philip A. Hendrick ================================ Estate Planning and Estate Tax Saving By Edward N. Polisher Philadelphia: George T. Bisel Company. Second Edition, 1948. 2 Volumes. Pp. xxxii, 923.$20.00 reviewer: Charles L.B. Lowndes =============================== Federal Taxes--Corporations and Partnerships, 1948-49 By Robert H. Montgomery, Conrad B. Taylor and Mark E. Richardson Vol. I: Gross Income and Deductions Vol. II: Taxes, Returns and Administration New York: The Ronald Press Company, 1948. Pp. xiii, 1001; pp. iv, 881. $20.00 Federal Taxes--Estates, Trusts and Gifts, 1948-49 By Robert H. Montgomery and James 0. Wynn New York: The Ronald Press Company,1948. Pp. xi, 1263.$10.00 reviewer: Adrian W. DeWind ================================ Wills, Gifts and Estate Planning Under the 1948 Revenue Act By Seymour S. Mintz, Richard C. Flesch and Bernard Soman Washington: The Bureau of National Affairs, Inc., 1948. Pp. 328. $2.00 reviewer: Chas. A. Morehead =============================== Federal Taxation for the Lawyer By Houstin Shockey New York: Prentice-Hall, Inc., Second Edition, 1947. Pp. xiii, 396.$5.00 reviewer: John R. Stiver