Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes

Describes in detail eight change concepts as a guide to transforming a practice into a patient-centered medical home, including engaged leadership, quality improvement strategy, continuous and team-based healing relationships, and enhanced access

The Ethical Review of Health Care Quality Improvement Initiatives: Findings From the Field

Based on surveys, examines the review mechanisms of quality improvement initiatives, including frequency; type, such as use of independent review boards; and consideration for ethical issues such as minimal risk and patient privacy and confidentiality

Interrupting Antiretroviral Treatment in HIV Cure Research: Scientific and Ethical Considerations

Over the past several years there has been intense activity directed at the possibility of achieving remission or eradication of HIV infection. Current assays for the measurement of latent HIV are insufficient to demonstrate complete clearance of replication-competent HIV. Therefore, the ultimate test for assessing whether investigational interventions have resulted in HIV remission or eradication is to interrupt standard antiretroviral therapy (ART) in a carefully controlled clinical trial setting. These procedures, known as analytic treatment interruptions (ATIs), raise important scientific and ethical questions. The lack of definitive assays for measuring viral reservoirs not only makes research on HIV remission or cure challenging, it also affects the ability to assess risks from ATIs themselves. In spite of these challenges, basic ethical criteria can be met with careful study design and close monitoring. In this brief report we outline ethical standards for HIV cure research involving ATIs. These criteria should be revisited as the science evolves

Becoming Sociological: Disciplinarity and a Sense of ‘Home’

This short reflective piece uses the concept of ‘home’ to explore sociology as an intellectual and disciplinary pursuit. Drawing on autobiographical reflections and ethnographic study of sociology writing, I consider some of the trajectories of academics into sociology and what these tell us about the discipline itself. In light of increasing incursions by audit culture and marketisation of academia, Holmwood has drawn attention to a lack of clear internal identity as being ‘sociology’s misfortune’ – that sociology loses out, and is weakened by lacking theories and methodologies specific to the discipline. This essay takes a more optimistic view of sociology’s position, and instead argues that it is this very ambiguity which keeps the discipline a lively and vital space for explorations of the social

Self-Adjusting Biofeedback with a Dynamic Feedback Signal Set (DyFSS)

A lack of control over their autonomic nervous system presents a major challenge for many children with Autism Spectrum Disorder (ASD). Autonomic biofeedback training is a promising treatment for managing anxiety and ASD symptoms more generally. We describe software that tunes four autonomic measurements to the best abilities and needs of each individual patient. Using this dynamic feedback signal set (DyFSS), a strength-based, self-customizing algorithm, we aim to address the autonomic heterogeneity of youth with ASD. The DyFSS may improve autonomic biofeedback training for the user by making it more understandable and easier to accomplish. Because it is self-adjusting, it may also ease the integration of autonomic biofeedback training into clinical work. Initial feasibility testing of this algorithm in youth with ASD with a five-session autonomic biofeedback training protocol showed improved behavior in relation to ASD symptoms Initial reactions show that youth with ASD are readily engaged through technological interventions such as autonomic biofeedback. Keywords— autism spectrum disorder; autonomi

Recoil Studies in the Reaction of 12-C Ions with the Enriched Isotope 118-Sn

The recoil properties of the product nuclei from the interaction of 2.2 GeV/nucleon 12-C ions from Nuclotron of the Laboratory of High Energies (LHE), Joint Institute for Nuclear Research (JINR) at Dubna with a 118-Sn target have been studied using catcher foils. The experimental data were analyzed using the mathematical formalism of the standard two-step vector model. The results for 12-C ions are compared with those for deuterons and protons. Three different Los Alamos versions of the Quark-Gluon String Model (LAQGSM) were used for comparison with our experimental data.Comment: 10 pages, 6 figures, submitted to Nucl. Phys.

Paraphrases and summaries: A means of clarification or a vehicle for articulating a preferred version of student accounts?

The use of group discussions as a means to facilitate learning from experiences is well documented in adventure education literature. Priest and Naismith (1993) assert that the use of the circular discussion method, where the leader poses questions to the participants, is the most common form of facilitation in adventure education. This paper draws on transcripts of facilitation sessions to argue that the widely advocated practice of leader summaries or paraphrases of student responses in these sessions functions as a potential mechanism to control and sponsor particular knowledge(s). Using transcripts from recorded facilitation sessions the analysis focuses on how the leader paraphrases the students’ responses and how these paraphrases or ‘formulations’ function to modify or exclude particular aspects of the students’ responses. I assert that paraphrasing is not simply a neutral activity that merely functions to clarify a student response, it is a subtle means by which the leader of the session can, often inadvertently or unknowingly, alter the student’s reply with the consequence of favouring particular knowledge(s). Revealing the subtle work that leader paraphrases perform is of importance for educators who claim to provide genuine opportunities for students to learn from their experience

Systemic epidermal nevus with involvement of the oral mucosa due to FGFR3 mutation

Our results show that activating FGFR3 mutations can also affect the oral mucosa and that extracutaneous manifestations of EN syndrome can be subtle. We highlight the theoretical risk of the patient having an offspring with thanatophoric dysplasia as gonadal mosaicism for the R248C mutation cannot be excluded