Ways of going on:An analysis of skill applied to medical practice

Humans do two types of actions, polimorphic actions and mimeomorphic actions. The ability to carry out polimorphic actions cannot be mastered outside of socialization. Mimeomorphic actions, however, can be learned in other ways; sometimes, they can be learned away from the context of practice. Polimorphic actions cannot be mimicked by machines, but some mimeomorphic actions can. Other mimeomorphic actions are too complex to mechanize. Actions that cannot be mechanized because they are physically complicated should not be confused with actions that cannot be mechanized because socialization is needed to master them. The analysis has implications for recent debates concerning the differences and similarities between humans and machines. The implica tion of the analysis is that much more can be understood about the relationship between humans and machines if the difference is treated as being a consequence of the unique properties of human societies. In this article, the analysis is applied to cardiac catheteriza tion, pacemaker implantation, simulation of bodies, and work in a medical "SkillsLab.

Groups and individuals: conformity and diversity in the performance of gendered identities

The nature and role of social groups is a central tension in sociology. On the one hand, the idea of a group enables sociologists to locate and describe individuals in terms of characteristics that are shared with others. On the other, emphasizing the fluidity of categories such as gender or ethnicity undermines their legitimacy as ways of classifying people and, by extension, the legitimacy of categorization as a goal of sociological research. In this paper, we use a new research method known as the Imitation Game to defend the social group as a sociological concept. We show that, despite the diversity of practices that may be consistent with self‐identified membership of a group, there are also shared normative expectations – typically narrower in nature than the diversity displayed by individual group members – that shape the ways in which category membership can be discussed with, and performed to, others. Two claims follow from this. First, the Imitation Game provides a way of simultaneously revealing both the diversity and ‘groupishness’ of social groups. Second, that the social group, in the quasi‐Durkheimian sense of something that transcends the individual, remains an important concept for sociology

The Third Wave of science studies: studies of expertise and experience

Science studies has shown us why science and technology cannot always solve technical problems in the public domain. In particular, the speed of political decision-making is faster than the speed of scientific consensus formation. A predominant motif over recent years has been the need to extend the domain of technical decision-making beyond the technically qualified elite so as to enhance political legitimacy. We argue, however, that the `Problem of Legitimacy' has been replaced the `Problem of Extension.' This is a tendency to dissolve the boundary between experts and the public so that there are no longer any grounds for limiting the indefinite extension of technical decision-making rights. We argue that a Third Wave of science studies -- Studies of Expertise and Experience (SEE) -- is needed to solve the Problem of Extension. SEE will include a normative theory of expertise and will disentangle expertise from political rights in technical decision-making. The theory builds categories of expertise starting with the key distinction between interactive expertise and contributory expertise. A new categorisation of types of science is also needed. We illustrate the potential of the approach by re-examining existing case studies including Wynne's study of Cumbrian sheep farmers. Sometimes the new theory argues for more public involvement, sometimes for less. An Appendix describes existing contributions to the problem of technical decision-making in the public domain

Growth, functional capacities and motivation for achievement and competitiveness in youth basketball: An interdisciplinary approach

The interaction of multiple influences on the path to sport success is not yet fully understood by sport scientists. In this study, we examined variation in body size, functional capacities and motivation for achievement, competitiveness and deliberate practice of youth basketball players associated with differences in biological maturity status and chronological age. Reflecting the importance of interactive effects, we examined the relationships between the psychological variables and functional capacities. Fifty-eight male basketball players aged 9.5 to 15.5 years were considered. Variables included chronological age, estimated age at PHV, stature, body mass and sitting height by anthropometry; the Work and Family Orientation and Deliberate Practice Motivation Questionnaires were also used. Finally, the Line Drill test and Yo-Yo Intermittent Recovery level 1 (Yo-Yo IR1) tests were used as functional capacities indicators for basketball. Variance components models derived from series of multilevel linear regression models revealed a significant variation by maturity status for body size, functional capacities indicators, mastery and will to excel. The influence of estimated maturity status on mastery and will to excel was independent of chronological age. Furthermore, after controlling for age, an influence of estimated maturity on competitiveness was apparent. In contrast, no relationships were observed between psychological variables and functional capacities indicators. We conclude that growth-related changes are relevant to understanding players´ motivations for achievement, competitiveness and deliberate practice. This should be of interest to those involved in the selection and development of youth basketball players

Prenatal development is linked to bronchial reactivity: epidemiological and animal model evidence

Chronic cardiorespiratory disease is associated with low birthweight suggesting the importance of the developmental environment. Prenatal factors affecting fetal growth are believed important, but the underlying mechanisms are unknown. The influence of developmental programming on bronchial hyperreactivity is investigated in an animal model and evidence for comparable associations is sought in humans. Pregnant Wistar rats were fed either control or protein-restricted diets throughout pregnancy. Bronchoconstrictor responses were recorded from offspring bronchial segments. Morphometric analysis of paraffin-embedded lung sections was conducted. In a human mother-child cohort ultrasound measurements of fetal growth were related to bronchial hyperreactivity, measured at age six years using methacholine. Protein-restricted rats' offspring demonstrated greater bronchoconstriction than controls. Airway structure was not altered. Children with lesser abdominal circumference growth during 11-19 weeks' gestation had greater bronchial hyperreactivity than those with more rapid abdominal growth. Imbalanced maternal nutrition during pregnancy results in offspring bronchial hyperreactivity. Prenatal environmental influences might play a comparable role in humans

Core Alzheimer’s disease cerebrospinal fluid biomarker assays are not affected by aspiration or gravity drip extraction methods

Background CSF biomarkers are well-established for routine clinical use, yet a paucity of comparative assessment exists regarding CSF extraction methods during lumbar puncture. Here, we compare in detail biomarker profiles in CSF extracted using either gravity drip or aspiration. Methods Biomarkers for β-amyloidopathy (Aβ1–42, Aβ1–40), tauopathy (total tau), or synapse pathology (BACE1, Neurogranin Trunc-p75, α-synuclein) were assessed between gravity or aspiration extraction methods in a sub-population of the Australian Imaging, Biomarkers and Lifestyle (AIBL) study (cognitively normal, N = 36; mild cognitive impairment, N = 8; Alzheimer’s disease, N = 6). Results High biomarker concordance between extraction methods was seen (concordance correlation > 0.85). Passing Bablock regression defined low beta coefficients indicating high scalability. Conclusions Levels of these commonly assessed CSF biomarkers are not influenced by extraction method. Results of this study should be incorporated into new consensus guidelines for CSF collection, storage, and analysis of biomarkers

Recommendations for a standardised educational program in robot assisted gynaecological surgery: consensus from the Society of European Robotic Gynaecological Surgery (SERGS)

Background: the Society of European Robotic Gynaecological Surgery (SERGS) aims at developing a European consensus on core components of a curriculum for training and assessment in robot assisted gynaecological surgery. Methods: a Delphi process was initiated among a panel of 12 experts in robot assisted surgery invited through the SERGS. An online questionnaire survey was based on a literature search for standards in education in gynaecological robot assisted surgery. The survey was performed in three consecutive rounds to reach optimal consensus. The results of this survey were discussed by the panel and led to consensus recommendations on 39 issues, adhering to general principles of medical education. Results: on review there appeared to be no accredited training programs in Europe, and few in the USA. Recommendations for requirements of training centres, educational tools and assessment of proficiency varied widely. Stepwise and structured training together with validated assessment based on competencies rather than on volume emerged as prerequisites for adequate and safe learning. An appropriate educational environment and tools for training were defined. Although certification should be competence based, the panel recommended additional volume based criteria for both accreditation of training centres and certification of individual surgeons. Conclusions: consensus was reached on minimum criteria for training in robot assisted gynaecological surgery. To transfer results into clinical practice, experts recommended a curriculum and guidelines that have now been endorsed by SERGS to be used to establish training programmes for robot assisted surgery

Exploring skewed parton distributions with two body models on the light front II: covariant Bethe-Salpeter approach

We explore skewed parton distributions for two-body, light-front wave functions. In order to access all kinematical regimes, we adopt a covariant Bethe-Salpeter approach, which makes use of the underlying equation of motion (here the Weinberg equation) and its Green's function. Such an approach allows for the consistent treatment of the non-wave function vertex (but rules out the case of phenomenological wave functions derived from ad hoc potentials). Our investigation centers around checking internal consistency by demonstrating time-reversal invariance and continuity between valence and non-valence regimes. We derive our expressions by assuming the effective qq potential is independent of the mass squared, and verify the sum rule in a non-relativistic approximation in which the potential is energy independent. We consider bare-coupling as well as interacting skewed parton distributions and develop approximations for the Green's function which preserve the general properties of these distributions. Lastly we apply our approach to time-like form factors and find similar expressions for the related generalized distribution amplitudes.Comment: 25 pages, 12 figures, revised (minor changes but essential to consistency

Differential Cross Section for Higgs Boson Production Including All-Orders Soft Gluon Resummation

The transverse momentum $Q_T$ distribution is computed for inclusive Higgs boson production at the energy of the CERN Large Hadron Collider. We focus on the dominant gluon-gluon subprocess in perturbative quantum chromodynamics and incorporate contributions from the quark-gluon and quark-antiquark channels. Using an impact-parameter $b$-space formalism, we include all-orders resummation of large logarithms associated with emission of soft gluons. Our resummed results merge smoothly at large $Q_T$ with the fixed-order expectations in perturbative quantum chromodynamics, as they should, with no need for a matching procedure. They show a high degree of stability with respect to variation of parameters associated with the non-perturbative input at low $Q_T$. We provide distributions $d\sigma/dy dQ_T$ for Higgs boson masses from $M_Z$ to 200 GeV. The average transverse momentum at zero rapidity $y$ grows approximately linearly with mass of the Higgs boson over the range $M_Z < m_h \simeq 0.18 m_h + 18$~GeV. We provide analogous results for $Z$ boson production, for which we compute $\simeq 25$ GeV. The harder transverse momentum distribution for the Higgs boson arises because there is more soft gluon radiation in Higgs boson production than in $Z$ production.Comment: 42 pages, latex, 26 figures. All figures replaced. Some changes in wording. Published in Phys. Rev. D67, 034026 (2003