Legal aspects of open disclosure II: Attitudes of health professionals - Findings from a national survey

Objective: To assess the attitudes of health care professionals engaged in open disclosure (OD) to the legal risks and protections that surround this activity. Design and participants: National cross-sectional survey of 51 experienced OD practitioners conducted in mid 2009. Main outcome measures: Perceived barriers to OD; awareness of and attitudes towards medicolegal protections; recommendations for reform. Results: The vast majority of participants rated fears about the medicolegal risks (45/51) and inadequate education and training in OD skills (43/51) as major or moderate barriers to OD. A majority (30/51) of participants viewed qualified privilege laws as having limited or no effect on health professionals' willingness to conduct OD, whereas opinion was divided about the effect of apology laws (state laws protecting expressions of regret from subsequent use in legal proceedings). In four states and territories (Western Australia, South Australia, Tasmania and the Northern Territory), a majority of participants were unaware that their own jurisdiction had apology laws that applied to OD. The most frequent recommendations for legal reform to improve OD were strengthening existing protections (23), improving education and awareness of applicable laws (11), fundamental reform of the medical negligence system (8), and better alignment of the activities of certain legal actors (eg, coroners) with OD practice (6). Conclusions: Concerns about both the medicolegal implications of OD and the skills needed to conduct it effectively are prevalent among health professionals at the leading edge of the OD movement in Australia. The ability of current laws to protect against use of this information in legal proceedings is perceived as inadequate

Water movement into dormant and non-dormant wheat (Triticum aestivum L.) grains

The movement of water into harvest-ripe grains of dormant and non-dormant genotypes of wheat (Triticum aestivum L.) was investigated using Magnetic Resonance Micro-Imaging (MRMI). Images of virtual sections, both longitudinal and transverse, throughout the grain were collected at intervals after the start of imbibition and used to reconstruct a picture of water location within the different grain tissues and changes over time. The observations were supplemented by the weighing measurements of water content and imbibition of grains in water containing I2/KI which stains starch and lipid, thereby acting as a marker for water. In closely related genotypes, with either a dormant or a non-dormant phenotype, neither the rate of increase in water content nor the pattern of water distribution within the grain was significantly different until 18 h, when germination became apparent in the non-dormant genotype. Water entered the embryo and scutellum during the very early stages of imbibition through the micropyle and by 2 h water was clearly evident in the micropyle channel. After 12 h of imbibition, embryo structures such as the coleoptile and radicle were clearly distinguished. Although water accumulated between the inner (seed coat) and outer (pericarp) layers of the coat surrounding the grain, there was no evidence for movement of water directly across the coat and into the underlying starchy endosperm

Universal architecture of bacterial chemoreceptor arrays

Chemoreceptors are key components of the high-performance signal transduction system that controls bacterial chemotaxis. Chemoreceptors are typically localized in a cluster at the cell pole, where interactions among the receptors in the cluster are thought to contribute to the high sensitivity, wide dynamic range, and precise adaptation of the signaling system. Previous structural and genomic studies have produced conflicting models, however, for the arrangement of the chemoreceptors in the clusters. Using whole-cell electron cryo-tomography, here we show that chemoreceptors of different classes and in many different species representing several major bacterial phyla are all arranged into a highly conserved, 12-nm hexagonal array consistent with the proposed “trimer of dimers” organization. The various observed lengths of the receptors confirm current models for the methylation, flexible bundle, signaling, and linker sub-domains in vivo. Our results suggest that the basic mechanism and function of receptor clustering is universal among bacterial species and was thus conserved during evolution

Soil quality assessment based on soil organic matter pools under long‐term tillage systems and following tillage conversion in a semi‐humid region

A field study was conducted to assess the long-term effects of no-tillage (NT) and conventional tillage (CT), and the short-term effects following tillage conversion -from CT to NT (NTn) and from NT to CT (CTn) on soil quality (SQ) indicators in a semi-humid climate. First, plots of a long-term tillage experiment on a Luvic Phaeozem initiated in 1986, were split into two subplots in 2012, yielding four treatments: NT, CT, NTn and CTn. In 2015, composite soil samples were collected from each treatment and from a natural site (Ref) at depths 0-5, 5-10, 10-20 and 0-20 cm. Several indicators were determined: soil organic carbon (SOC) and nitrogen (SON); particulate organic C (POM-C) and N (POM-N); potential N mineralization (PMN) and soil respiration (Rs). Moreover, bulk density was determined in long-term tillage systems. Different ratios between indicators were calculated, with emphasis on its function in the agroecosystem, i.e. functional indicators. Significant differences in SOC, SON and PMN were found between CT and NT at most depths. In contrast, three years after tillage conversion, only a part of the SQ indicators studied were modified mainly at the 0-10 cm depth. The functional indicators showed differences between tillage systems in the long-term and after short-term tillage conversion depending on the depth; however, the PMN/SON ratio demonstrated differences at all depths. Under these conditions, this ratio -related to easily mineralizable N fraction- proved to be a promising indicator for assessing SQ under contrasting tillage systems regardless of the sampling depth.Fil: Martinez, Juan Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; ArgentinaFil: Galantini, Juan Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; Argentina. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas; ArgentinaFil: Duval, Matias Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; Argentina. Universidad Nacional del Sur. Departamento de Agronomía; ArgentinaFil: López, Fernando Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; Argentin

Landscapes of Loss: Responses to Altered Landscapes in an Ex-Industrial textile Community

Geographically located at the heart of Carpetvillage in West Yorkshire, Carpetmakers had once been a thriving manufacturer of fine woven carpets since the late 1880s. From my own experience of growing up there in the 1970s, its inhabitants had held a sense of ‘communal being-ness’ through the shared experience of living there and of making carpets. After the factory was closed, Carpet Mill was demolished in 2002, leaving a void where there had once been a handsome Victorian building. Interested in responses to architectural, spatial, and sensuous change in an ex-industrial landscape, this article asks: what were the subjective consequences for the affective ties that hold together an ex-industrial community? Using sensuous ethnographic mobile methods, the study draws on ex-Carpetmakers employees and local residents. The research found nostalgic memories of Carpetmakers as a paternalistic employer operating in a thriving and largely self-sufficient community. Photographs were collected from respondents, which chart a vast number of social clubs and events that offered an important dimension to the ‘way of life’ offered to workers in this ‘company village’. It found that while the importance of works buildings is acknowledged by writers on de-industrialization, missing from their accounts is an embodied analysis of how people interact in situ with landscapes of demolition. Respondents told of the emotional trauma of the demolition process, the effects of spatial change through the erasure of the village’s architectural past and the almost total decline of a community which, for them, no longer holds a sense of place. The decline in the social structures of an industrial community meant that ageing ex-workers and residents found it difficult to generate communal ties with newcomers to the village

How risky is caring for emergency patients at risk of malpractice litigation: a population based epidemiological study of Taiwan's experiences

<p>Abstract</p> <p>Background</p> <p>Emergency medicine has generally been considered a high risk specialty. The purpose of this study is to assess the risk of being sued in the district courts for caring emergency room (ER) patients from the perspective of epidemiology.</p> <p>Methods</p> <p>This research was designed to be a retrospective population based cohort study. We intended to find out the incidence of litigations arising from ER patients and that of birth inpatients in Taiwan, and computed their relative risks. The inclusion criterion was set to be incidents transpired in the time period of 1998 to 2002. The study materials included the reimbursement claim dataset of the National Health Insurance from 1998 to 2002, and the district court decision database of the Judicial Yuan from 1999 to 2006.</p> <p>Results</p> <p>The average annual incidence rate of becoming a plaintiff for ER patients is 0.86 per million, and for birth patients is 33.5 per million. There is a statistically significant difference between birth patients and ER patients. The relative risk comparing ER patients against birth inpatients is 0.03.</p> <p>Conclusion</p> <p>The findings of this population based study indicate that the patient population emergency physicians are facing in Taiwan have relatively lower risks of developing litigation in comparison with the patients that come to give birth. Due to the large volume of ER patients, malpractice still pose a major threat in the emergency department, and misdiagnosis remains the major complaint of plaintiffs in subsequent litigations.</p

Applied Theatre and Practice as Research: Polyphonic Conversations

Applied theatre practice as research might be perceived as a curious conflation. Not greatly foregrounded in the literature on applied theatre or performance practice as research, this article engages with the particularities of such a pairing. Beginning with identifying why a consideration is timely, ‘the practice as research’ and ‘social’ turns are invoked and analysed as relevant contexts to consider applied theatre practice as research. Two projects are offered, providing specific examples for discussion. Revealed by increased scrutiny, some broader epistemological questions emerge concerning power, hierarchy of knowledge and research ‘authoring’. A metaphor of polyphonic conversations is offered as an amplification of the applied theatre practical research methodological terrain. Encouraging the basis of many sets of voices contributing to research and potentially negotiating concerns about power hierarchies and knowledge production, the metaphor provokes a fluidity of epistemology, including expanding on the now familiar debates around theory and practice particularly relevant for socially engaged performance-related practical research

Recognizing Speech in a Novel Accent: The Motor Theory of Speech Perception Reframed

The motor theory of speech perception holds that we perceive the speech of another in terms of a motor representation of that speech. However, when we have learned to recognize a foreign accent, it seems plausible that recognition of a word rarely involves reconstruction of the speech gestures of the speaker rather than the listener. To better assess the motor theory and this observation, we proceed in three stages. Part 1 places the motor theory of speech perception in a larger framework based on our earlier models of the adaptive formation of mirror neurons for grasping, and for viewing extensions of that mirror system as part of a larger system for neuro-linguistic processing, augmented by the present consideration of recognizing speech in a novel accent. Part 2 then offers a novel computational model of how a listener comes to understand the speech of someone speaking the listener's native language with a foreign accent. The core tenet of the model is that the listener uses hypotheses about the word the speaker is currently uttering to update probabilities linking the sound produced by the speaker to phonemes in the native language repertoire of the listener. This, on average, improves the recognition of later words. This model is neutral regarding the nature of the representations it uses (motor vs. auditory). It serve as a reference point for the discussion in Part 3, which proposes a dual-stream neuro-linguistic architecture to revisits claims for and against the motor theory of speech perception and the relevance of mirror neurons, and extracts some implications for the reframing of the motor theory

Integration of Consonant and Pitch Processing as Revealed by the Absence of Additivity in Mismatch Negativity

Consonants, unlike vowels, are thought to be speech specific and therefore no interactions would be expected between consonants and pitch, a basic element for musical tones. The present study used an electrophysiological approach to investigate whether, contrary to this view, there is integrative processing of consonants and pitch by measuring additivity of changes in the mismatch negativity (MMN) of evoked potentials. The MMN is elicited by discriminable variations occurring in a sequence of repetitive, homogeneous sounds. In the experiment, event-related potentials (ERPs) were recorded while participants heard frequently sung consonant-vowel syllables and rare stimuli deviating in either consonant identity only, pitch only, or in both dimensions. Every type of deviation elicited a reliable MMN. As expected, the two single-deviant MMNs had similar amplitudes, but that of the double-deviant MMN was also not significantly different from them. This absence of additivity in the double-deviant MMN suggests that consonant and pitch variations are processed, at least at a pre-attentive level, in an integrated rather than independent way. Domain-specificity of consonants may depend on higher-level processes in the hierarchy of speech perception