Empirical Perspectives on Mediation and Malpractice

The use of mediation in the medical malpractice context is examined. The impact of any court-related alternative dispute resolution program is also discussed

Twitter reciprocal reply networks exhibit assortativity with respect to happiness

The advent of social media has provided an extraordinary, if imperfect, 'big data' window into the form and evolution of social networks. Based on nearly 40 million message pairs posted to Twitter between September 2008 and February 2009, we construct and examine the revealed social network structure and dynamics over the time scales of days, weeks, and months. At the level of user behavior, we employ our recently developed hedonometric analysis methods to investigate patterns of sentiment expression. We find users' average happiness scores to be positively and significantly correlated with those of users one, two, and three links away. We strengthen our analysis by proposing and using a null model to test the effect of network topology on the assortativity of happiness. We also find evidence that more well connected users write happier status updates, with a transition occurring around Dunbar's number. More generally, our work provides evidence of a social sub-network structure within Twitter and raises several methodological points of interest with regard to social network reconstructions.Comment: 22 pages, 21 figures, 5 tables, In press at the Journal of Computational Scienc

Possible Néel Orderings of the Kagomé Antiferromagnet

Possible Néel orderings of antiferromagnetically coupled spins on a kagomé lattice are studied using linear-spin-wave theory and high-temperature expansions. Spin-wave analysis, applied to q=0 (three spins per magnetic unit cell) and to √3 × √3 (nine spins per cell) Néel orderings yield identical excitation spectra with twofold-degenerate linear modes and a dispersionless zero-energy mode. This dispersionless mode is equivalent to an excitation localized to an arbitrary hexagon of nearest-neighbor spins. Second- (J2) and third- (J3) neighbor interactions are shown to stabilize the q=0 state for J2\u3eJ3 and the √3 × √3 state for J23. A high-temperature expansion of the spin-spin susceptibility χαβ(q) is performed to order 1/T8, for n-component, classical spins with nearest-neighbor interactions only. To order 1/T7 the largest eigenvalue of the susceptibility matrix is found to be independent of wave vector with an eigenvector that corresponds to the dispersionless mode of the ordered phase. This degeneracy is removed at order 1/T8. For n=0, the q=0 mode is favored; for n=1, the band is flat; and, for n\u3e1, the maximum susceptibility is found for a √3 × √3 excitation. Similar results are found for the three-dimensional pyrochlore lattice. The high-temperature expansion is used to interpret experimental data for the uniform susceptibility and powder-neutron-diffraction spectrum for the kagomé-lattice system SrCr8−xGa4+xO19

Temporal patterns of happiness and information in a global social network: Hedonometrics and Twitter

Individual happiness is a fundamental societal metric. Normally measured through self-report, happiness has often been indirectly characterized and overshadowed by more readily quantifiable economic indicators such as gross domestic product. Here, we examine expressions made on the online, global microblog and social networking service Twitter, uncovering and explaining temporal variations in happiness and information levels over timescales ranging from hours to years. Our data set comprises over 46 billion words contained in nearly 4.6 billion expressions posted over a 33 month span by over 63 million unique users. In measuring happiness, we use a real-time, remote-sensing, non-invasive, text-based approach---a kind of hedonometer. In building our metric, made available with this paper, we conducted a survey to obtain happiness evaluations of over 10,000 individual words, representing a tenfold size improvement over similar existing word sets. Rather than being ad hoc, our word list is chosen solely by frequency of usage and we show how a highly robust metric can be constructed and defended.Comment: 27 pages, 17 figures, 3 tables. Supplementary Information: 1 table, 52 figure

A single-blind, pilot randomised trial of a weight management intervention for adults with intellectual disabilities and obesity: study protocol

Background: The prevalence of obesity in adults with intellectual disabilities has consistently been reported to be higher than the general population. Despite the negative impact of obesity on health, there is little evidence of the effectiveness of weight management interventions for adults with intellectual disabilities and obesity. Preliminary results from a single-stranded feasibility study of a multi-component weight management intervention specifically designed for adults with intellectual disabilities and obesity (TAKE 5) and that satisfied clinical recommendations reported that it was acceptable to adults with intellectual disabilities and their carers. This study aims to determine the feasibility of a full-scale clinical trial of TAKE 5.<p></p> Methods: This study will follow a pilot randomised trial design. Sixty-six obese participants (body mass index (BMI) ≥30 kg/m2) will be randomly allocated to the TAKE 5 multi-component weight management intervention or a health education ‘active’ control intervention (Waist Winners Too (WWToo)). Both interventions will be delivered over a 12-month period. Participants’ anthropometric measures (body weight, BMI, waist circumference, percentage body fat); indicators of activity (levels of physical activity and sedentary behaviour) and well-being will be measured at three time points: baseline, 6 and 12 months. The researcher collecting outcome measures will be blind to study group allocation.<p></p> Conclusions: The data from this study will generate pilot data on the acceptability of randomisation, attrition rates and the estimates of patient-centred outcomes of TAKE 5, which will help inform future research and the development of a full-scale randomised clinical trial

Empirical Perspectives on Mediation and Malpractice

The use of mediation in the medical malpractice context is examined. The impact of any court-related alternative dispute resolution program is also discussed

Empirical Perspectives on Mediation and Malpractice

Rapporten baseras på strukturerade intervjuer och sammanlagt intervjuades 18 personer, med två till 30 års yrkeserfarenhet som aktivt deltagit i prioriteringsarbete med vertikala rangordningslistor. Resultatet av intervjuerna visade både på underlättande och försvårande faktorer för delaktighet i prioriteringsarbete. Sjuksköterskorna uttryckte svårigheter dels med att få gehör för sina synpunkter och dels med att precisera vad som enligt deras uppfattning är omvårdnad ur ett helhetsperspektiv. De framförde också att omvårdnadsåtgärder vare sig hade varit föremål för prioriteringsdiskussioner eller senare inkluderats i rangordningslistan. Bland arbetsterapeuter och sjukgymnaster upplevdes den rangordningslista de själva arbetat fram som en trygghet i kliniskt beslutsfattade och stöd för öppenhet i kommunikation med allmänheten. Representanter för samtliga vårdyrkesgrupper i undersökningen upplevde det svårt att inkludera den egna professionens yrkesspecifika åtgärder i rangordningen. Det framkom också att uppdraget med att ta fram rangordningslistor måste vara tydligt beskrivet och att prioriteringar bör diskuteras utifrån ett brett behovsperspektiv i väl förberedda multiprofessionella grupper. Arbete med öppna prioriteringar och rangordningslistor kräver många olika perspektiv och förutsätter att alla samverkande professioner har likvärdiga förutsättningar. Riktade utbildningsinsatser inom omvårdnad och rehabilitering behövs för att tillämpning av den nationella modellen för öppna vertikala prioriteringar ska få en vidare användning även inom dessa områden.　 When health services cannot meet all care needs we must set priorities. This has always been done, but seldom in a systematic way. In Sweden, the Health Services Act places the responsibility for healthcare priority setting on local governing bodies (mainly the county councils and regions). The task of priority setting is grounded in the ethical platform and must apply across all health services. In 2003, the Östergötland County Council initially decided that specific limitations must be established regarding the supply of health services. However, follow-up of the county-council-wide effort to set priorities reveals that this work has not reached far enough down into the organisation. Earlier reports from the National Centre for Priority Setting in Health Care describe the initial political decision-making process, the extent to which the policy decisions have been implemented in health care, and the progress of the county council’s prioritisation initiative from 2003 to 2006. With this report we aim to increase knowledge regarding how staff groups other than management- level physicians participated in establishing vertical ranking lists during this period and how these lists were used in Östergötland County Council

Risk and reliability modelling for multi-vehicle marine domains

It is well-known that autonomous underwater vehicle (AUV) missions are a challenging, high-risk robotics application. With many parallels to Mars rovers, AUV missions involve operating a vehicle in an inherently uncertain environment of which our prior knowledge is often sparse or low-resolution. The lack of an accurate prior, coupled with poor situational awareness and potentially significant sensor noise, presents substantial engineering challenges in navigation, localisation, state estimation and control. When constructing missions and operating AUVs, it is important to consider the risks involved. Stakeholders need to be reassured that risks of vehicle loss or damage have been minimised where possible, and scientists need to be confident that the mission is likely to produce sufficient high-quality data to meet the aims of the deployment. In this paper, we consider the challenges associated with risk analysis methods and representations for multi-vehicle missions, reviewing the relevant literature and proposing a methodology

High-intensity, unilateral resistance training of a non-paretic muscle group increases active range of motion in a severely paretic upper extremity muscle group after stroke

Limited rehabilitation strategies are available for movement restoration when paresis is too severe following stroke. Previous research has shown that high-intensity resistance training of one muscle group enhances strength of the homologous, contralateral muscle group in neurologically-intact adults. How this cross education phenomenon might be exploited to moderate severe weakness in an upper extremity muscle group after stroke is not well understood. The primary aim of this study was to examine adaptations in force-generating capacity of severely paretic wrist extensors resulting from high-intensity, dynamic contractions of the non-paretic wrist extensors. A secondary, exploratory aim was to probe neural adaptations in a subset of participants from each sample using a single-pulse, transcranial magnetic stimulation protocol. Separate samples of neurologically-intact controls (n=7) and individuals > 4 months post stroke (n=6) underwent 16 sessions of training. Following training, one-repetition maximum of the untrained wrist extensors in the control group and active range of motion of the untrained, paretic wrist extensors in the stroke group were significantly increased. No changes in corticospinal excitability, intracortical inhibition or interhemispheric inhibition were observed in control participants. Both stroke participants who underwent TMS testing, however, exhibited increased voluntary muscle activation following the intervention. In addition, motor-evoked potentials that were unobtainable prior to the intervention were readily elicited afterwards in a stroke participant. Results of this study demonstrate that high-intensity resistance training of a non-paretic upper extremity muscle group can enhance voluntary muscle activation and force-generating capacity of a severely paretic muscle group after stroke. There is also preliminary evidence that corticospinal adaptations may accompany these gains