The Case for Legal Regulation of Physicians’ Off-Label Prescribing

Deafness has been associated with poor abilities to deal with digits in the context of arithmetic and memory, and language modality-specific differences in the phonological similarity of digits have been shown to influence short-term memory (STM). Therefore, the overall aim of the present thesis was to find out whether language modality-specific differences in phonological processing between sign and speech can explain why deaf signers perform at lower levels than hearing peers when dealing with digits. To explore this aim, the role of phonological processing in digit-based arithmetic and memory tasks was investigated, using both behavioural and neuroimaging methods, in adult deaf signers and hearing non-signers, carefully matched on age, sex, education and non-verbal intelligence. To make task demands as equal as possible for both groups, and to control for material effects, arithmetic, phonological processing, STM and working memory (WM) were all assessed using the same presentation and response mode for both groups. The results suggested that in digit-based STM, phonological similarity of manual numerals causes deaf signers to perform more poorly than hearing non-signers. However, for  digit-based WM there was no difference between the groups, possibly due to differences in allocation of resources during WM. This indicates that similar WM for the two groups can be generalized from lexical items to digits. Further, we found that in the present work deaf signers performed better than expected and on a par with hearing peers on all arithmetic tasks, except for multiplication, possibly because the groups studied here were very carefully matched. However, the neural networks recruited for arithmetic and phonology differed between groups. During multiplication tasks, deaf signers showed an increased  reliance on cortex of the right parietal lobe complemented by the left inferior frontal gyrus. In contrast, hearing non-signers relied on cortex of the left frontal and parietal lobes during multiplication. This suggests that while hearing non-signers recruit phonology-dependent arithmetic fact retrieval processes for multiplication, deaf signers recruit non-verbal magnitude manipulation processes. For phonology, the hearing non-signers engaged left lateralized frontal and parietal areas within the classical perisylvian language network. In deaf signers, however, phonological processing was limited to cortex of the left occipital lobe, suggesting that sign-based phonological processing does not necessarily activate the classical language network. In conclusion, the findings of the present thesis suggest that language modality-specific differences between sign and speech in different ways can explain why deaf signers perform at lower levels than hearing non-signers on tasks that include dealing with digits.Dövhet har kopplats till bristande förmåga att hantera siffror inom områdena aritmetik och minne. Särskilt har språkmodalitetsspecifika skillnader i fonologisk likhet för siffror visat sig påverka korttidsminnet. Det övergripande syftet med den här avhandlingen var därför att undersöka om språkmodalitetsspecifika skillnader i fonologisk bearbetning mellan teckenoch talspråk kan förklara varför döva presterar sämre än hörande på sifferuppgifter. För att utforska det området undersöktes fonologisk bearbetning i sifferbaserade minnesuppgifter och aritmetik med hjälp av både beteendevetenskapliga metoder och hjärnavbildning hos grupper av teckenspråkiga döva och talspråkiga hörande som matchats noggrant på ålder, kön, utbildning och icke-verbal intelligens. För att testförhållandena skulle bli så likartade som möjligt för de båda grupperna, och för att förebygga materialeffekter, användes samma presentations- och svarssätt för båda grupperna. Resultaten visade att vid sifferbaserat korttidsminne påverkas de dövas prestation av de tecknade siffrornas fonologiska likhet. Däremot fanns det ingen skillnad mellan grupperna gällande sifferbaserat arbetsminne, vilket kan bero på att de båda grupperna fördelar sina kognitiva resurser på olika sätt. Dessutom fann vi att den grupp teckenspråkiga döva som deltog i studien presterade bättre på aritmetik än vad tidigare forskning visat och de skiljde sig bara från hörande på multiplikationsuppgifter, vilket kan bero på att grupperna var så noggrant matchade. Däremot fanns det skillnader mellan grupperna i vilka neurobiologiska nätverk som aktiverades vid aritmetik och fonologi. Vid multiplikationsuppgifter aktiverades cortex i höger parietallob och vänster frontallob för de teckenspråkiga döva, medan cortex i vänster frontal- och parietallob aktiverades för de talspråkiga hörande. Detta indikerar att de talspråkiga hörande förlitar sig på fonologiberoende minnesstrategier medan de teckenspråkiga döva förlitar sig på ickeverbal magnitudmanipulering och artikulatoriska processer. Under den fonologiska uppgiften aktiverade de talspråkiga hörande vänsterlateraliserade frontala och parietala områden inom det klassiska språknätverket. För de teckenspråkiga döva var fonologibearbetningen begränsad till cortex i vänster occipitallob, vilket tyder på att teckenspråksbaserad fonologi inte behöver aktivera det klassiska språknätverket. Sammanfattningsvis visar fynden i den här avhandlingen att språkmodalitetsspecifika skillnader mellan tecken- och talspråk på olika sätt kan förklara varför döva presterar sämre än hörande på vissa sifferbaserade uppgifter

M&V in ESPC: The U.S. Federal Experience and Implications for Developing ESPC Markets

The United States Federal Government has been conducting guaranteed savings energy savings performance contracts for over 20 years and now relies on ESPC for the majority of its energy efficiency work. Along with a related financed project type, these deals resulted in $4.2 billion of project investment in the five years ending in 2016, a pace that has even accelerated since. Measurement and verification (M&V) on the projects is the key to assuring savings realization and persistence. Perceived as a weakness or burdensome added cost in the early years of the program, M&V has become a strength. All energy conservation measures (ECMs) have some form of measurement – defined as a measured baseline establishment followed by at least one measurement of the main energy-saving parameter taken in the performance period for each ECM. The government’s in-house energy consulting office, the Federal Energy Management Program (FEMP), now recommends measurement of these “Option A” M&V ECMs throughout the contract term, usually annually. Moreover, a significantly higher percentage of projects are now characterized by more ambitious M&V, including Option B (all parameter measurement) for most generation (including renewable) and some efficiency measures, and more frequent Option C (whole facility utility bill analysis) for “deep retrofit” projects with multiple, interactive ECMs. Coincident with this progress in M&V has been a much greater embracing of ESPC by the federal agencies, resulting in the enormous rate of projects now executed. This paper traces the evolution of M&V in federal ESPC and argues that the heightened credibility of the savings has contributed significantly to the procurement vehicle’s long-term viability. This focus on savings integrity via M&V has been learned over two decades for U.S. federal ESPC, but countries with developing ESPC markets would be wise to emphasize it as their markets emerge, allowing them to avoid some of the “growing pains” experienced in the U.S

Teachers’ Perceptions of the Impact of Principal Leadership Style on Teacher Transfers in International Schools in South Korea

This qualitative study determined the perceptions of international school teachers regarding leadership and how these perceptions influenced their turnover decisions. Research completed largely in the United States shows that principals are a major factor in teachers’ decisions to stay or leave their schools, primarily due to teachers rating their principals highly in communication and support. Over the last 25 years, international schools have experienced a boom in growth, yet research into international schools has lagged. This study sought to build on previous research to find if teacher perceptions in international schools in South Korea mirror those of teachers in previous studies. This action research-based qualitative study used a teacher questionnaire, semistructured teacher interviews, and semistructured administrator interviews to collect data. Teacher participants were foreign-licensed teachers at accredited international schools in South Korea. Administrators were current leaders at the same schools. Teachers at participating schools received an email asking them to complete a questionnaire, at the end of which was a link to participate in an interview to delve deeper into the topic. Administrators at participating schools received an email asking for their participation in the interview. Coding of transcripts made from the audio-recorded interviews allowed for analysis using a general inductive approach. Results showed that teachers and administrators hold very similar opinions about the importance of various factors relating to what teachers need and what influences teachers to stay at their schools. These similarities included the importance of presence, positive feedback, relationships, and approachability. Similarity of perspective should encourage school leaders, as these seem intuitive to lead to positive perceptions of leaders from teachers, which research shows to decrease turnover

Relationships between characteristics of soybean production in Tennessee : the number of contacts the producers had with extension, their farming operation, and their use of production practices

The main purpose of this study was to obtain information that might be useful in developing Extension plans and programs for the soybean producers in Tennessee, characterize soybean production in Tennessee, and identify variables related to the use of soybean production practices. A total of 787 soybean producers located in Tennessee provided survey data in 1986. Tennessee County Extension agents conducted personal interviews with the producers. The nth number method of sampling was used to select the producers to be surveyed. According to the guidelines of the survey, producers interviewed must have grown at least 25 acres of soybeans in 1986. Information was obtained regarding the general production practices and the number of contacts the producers had with Extension agents over a 12 month period. The data was coded and computations were made by the University of Tennessee Computing Center. Chi square and analysis of variance F tests were used to determine the relationships between the dependent and independent variables. Chi square and f values of .05 were accepted as significant. Major findings include the following: Over 76 percent of the soybean producers were characterized as full-time farmers in 1986, over 64 percent were 41 years of age and over, and over 66 percent reported row crop as major source of farm income. Over 50 percent of the producers reported size of operation of under 200 acres. The mean size of operation was 341 acres. Full-time producers had more Extension contacts than part-time producers. Younger producers had more Extension contacts than older producers. Row crop farmers received more farm visits than other producers. Yields produced by soybean farmers were significantly related to 8 of the 12 production practices. Soybean producers who fertilized or limed by soil test, applied fungicide to seed, used crop rotation to control disease, applied inoculant to seed, and used crop rotation to control weeds had significantly higher yields than those that did not. Producers who planted resistant varieties to control cyst nematode or disease produced significantly lower yields than those who did not. Full-time farmers were more likely than part-time farmers to lime land by soil test or use crop rotation to control weeds. Younger producers were no more likely than older producers to use the 12 production practices. Row crop farmers were more likely than other producers to apply molybdenum to seed, apply fungicide to seed, plant disease resistant varieties, plant resistant varieties to control cyst nematode and to check harvesting loss. Larger producers were more likely than smaller producers to apply inoculant, molybdenum, or fungicide to seed, plant disease resistant varieties, plant resistant varieties to control cyst nematode, check harvesting loss, and fertilize or lime land by soil test. Soybean producers who had a higher number of Extension contacts were more likely than producers who had a smaller number of Extension contacts to apply inoculant or molybdenum to seed, and to fertilize or lime by soil test, to apply fungicide to seed, use crop rotation to control disease, cyst nematode and weeds, plant disease resistant varieties to control cyst nematode. Row crop farmers and larger producers used a significantly higher number of the 12 production practices than other farmers and smaller producers. Soybean producers who attended meetings, made office visits, made telephone calls, received farm visits or contacted their Extension agent used a significantly higher number of the 12 production practices. Implication and recommendations also were made

What Becomes of Global Color

The recent demise of certain global unbroken symmetry generators in the presence of a grand unified magnetic monopole leads us to consider more carefully the notion of charges associated with gauge symmetries. It turns out that global transformations associated with the generators of the gauge group, and their charges, make sense only for extended systems which are sufficiently localized. GUT monopoles fail this criterion. Detailed consideration of the monopole-antimonopole system helps remove apparent paradoxes related to the chromodyon excitations of a single monopole and agrees with the previous result that some, but not all, of the states naively expected do exist. The remaining states ns needed to fill out color multiplets are spread throughout space; they are recovered as long-lived excitations when an antimonopole is brought in from infinity