417 research outputs found

    Knowledge Cartography for Controversies: The Iraq Debate

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    In analysing controversies and debates—which would include reviewing a literature in order to plan research, or assessing intelligence to formulate policy—there is no one worldview which can be mapped, for instance as a single, coherent concept map. The cartographic challenge is to show which facts are agreed and contested, and the different kinds of narrative links that use facts as evidence to define the nature of the problem, what to do about it, and why. We will use the debate around the invasion of Iraq to demonstrate the methodology of using a knowledge mapping tool to extract key ideas from source materials, in order to classify and connect them within and across a set of perspectives of interest to the analyst. We reflect on the value that this approach adds, and how it relates to other argument mapping approaches

    Are We Missing an Opportunity? Prediabetes in the U.S. Military

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    INTRODUCTION: The prevalence of prediabetes is estimated to be one-third of Americans with approximately 80% of these individuals unaware of the diagnosis. In the active duty military population, the prevalence of prediabetes is largely unexplored. The purpose of this study was to investigate the prevalence of prediabetes in military service members by quantifying those meeting prediabetes screening criteria, those actually being screened, and those being appropriately diagnosed. MATERIALS AND METHODS: Data were analyzed from calendar years 2014 to 2018 for active duty service members 18 years of age or older. Vitals records were collected to obtain body mass index values. Composite Health Care System laboratory data were queried for hemoglobin A1c (HbA1c) results as well as fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) results. The percentage of active duty service members meeting criteria for prediabetes screening was determined by totaling members age 45 and older with members age 18- to 44-year old with a body mass index ≄25.0 kg/m2, then dividing by the total number of members for each respective military branch. The percentage of active duty service members actually screened for prediabetes was determined based on members meeting prediabetes screening criteria who in fact had FPG, OGTT, or HbA1c labs. The total number of labs meeting prediabetes criteria was determined based on those aforementioned labs with results in the prediabetes range (FPG between 100 and 125 mg/dL, OGTT between 140 and 199 mg/dL, or HbA1c range of 5.7%-6.4%). The total number of service members with appropriate prediabetes International Classification of Disease (ICD) code was determined by identifying members with ICD-9 and ICD-10 codes 790.21, 790.22, and R73.01-R73.03 in their medical record. RESULTS: From 2014 to 2018, 53.9% of 332,502, 56% of 543,081, and 47.3% of 531,313 active duty service members in the Air Force, Army and Navy, respectively, met criteria for prediabetes screening. The rates of actually screening for prediabetes were similar across the Air Force (4.8%), Army (6.7%), and Navy (5.5%). The percentage with labs meeting prediabetes criteria ranged from 17.9% to 28.4% in the Air Force, 24.2% to 30.3% in the Army, and 24.2% to 30.9% in the Navy. The rate of ICD coding for prediabetes increased from 2014 to 2018 across all branches (29.8%-65.3% for the Air Force, 24.6%-46.8% for the Army, and 40.0%-45.5% for the Navy). CONCLUSION: Screening for prediabetes in the active duty military population is grossly inadequate, and even of those screened, diagnosing those meeting prediabetes criteria is similarly inadequate. Although this scenario is not unique to the Military Health System, but reflective of a larger national problem, efforts should be made within the Military Health System to increase the screening for this common disorder. Identifying service members with prediabetes enables opportunities for targeted interventions to delay or prevent the progression to diabetes mellitus

    Research Project as Boundary Object: negotiating the conceptual design of a tool for International Development

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    This paper reflects on the relationship between who one designs for and what one designs in the unstructured space of designing for political change; in particular, for supporting “International Development” with ICT. We look at an interdisciplinary research project with goals and funding, but no clearly defined beneficiary group at start, and how amorphousness contributed to impact. The reported project researched a bridging tool to connect producers with consumers across global contexts and show players in the supply chain and their circumstances. We explore how both the nature of the research and the tool’s function became contested as work progressed. To tell this tale, we invoke the idea of boundary objects and the value of tacking back and forth between elastic meanings of the project’s artefacts and processes. We examine the project’s role in India, Chile and other arenas to draw out ways that it functioned as a catalyst and how absence of committed design choices acted as an unexpected strength in reaching its goals

    Visualizing internetworked argumentation

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    In this chapter, we outline a project which traces its source of inspiration back to the grand visions of Vannevar Bush (scholarly trails of linked concepts), Doug Engelbart (highly interactive intellectual tools, particularly for argumentation), and Ted Nelson (large scale internet publishing with recognised intellectual property). In essence, we are tackling the age-old question of how to organise distributed, collective knowledge. Specifically, we pose the following question as a foil: In 2010, will scholarly knowledge still be published solely in prose, or can we imagine a complementary infrastructure that is ‘native’ to the emerging semantic, collaborative web, enabling more effective dissemination and analysis of ideas

    Effect of Military Deployment on Diabetes Mellitus in Air Force Personnel

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    Introduction: Military deployments relocate service members to austere locations with limited medical capabilities, raising uncertainties whether members with diabetes can participate safely. Military regulations require a medical clearance for service members with diabetes prior to deployment, but there is a dearth of data that can guide the provider in this decision. To alleviate the lack of evidence in this area, we analyzed the change in glycated hemoglobin (HbA1c) and body mass index (BMI) before and after a deployment among active duty U.S. Air Force personnel who deployed with diabetes. Materials and Methods: A retrospective analysis was conducted using HbA1c and BMI values obtained within 3 mo before and within 3 mo after repatriation from a deployment of at least 90 d between January 1, 2004 through December 31, 2014. The study population consisted of 103 and 195 subjects who had an available pre- and post-deployment HbA1c and BMI values, respectively. Paired t-tests were conducted to determine significant differences in HbA1C and BMI values. Results: The majority (73.8%) of members had a HbA1c7%. BMI declined for the overall population (28.3 kg/m2 vs. 27.7 kg/m2, p \u3c 0.0001) and for most of the subgroups. Conclusion: Air Force service members who deployed with diabetes, including those with a HbA1c \u3e 7%, experienced a statistically significant improvement in HbA1c and BMI upon repatriation. A prospective study design in the future can better reconcile the effect of a military deployment on a more comprehensive array of diabetes parameters

    Designing electronic collaborative learning environments

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    Electronic collaborative learning environments for learning and working are in vogue. Designers design them according to their own constructivist interpretations of what collaborative learning is and what it should achieve. Educators employ them with different educational approaches and in diverse situations to achieve different ends. Students use them, sometimes very enthusiastically, but often in a perfunctory way. Finally, researchers study them and—as is usually the case when apples and oranges are compared—find no conclusive evidence as to whether or not they work, where they do or do not work, when they do or do not work and, most importantly, why, they do or do not work. This contribution presents an affordance framework for such collaborative learning environments; an interaction design procedure for designing, developing, and implementing them; and an educational affordance approach to the use of tasks in those environments. It also presents the results of three projects dealing with these three issues

    Inelastic diffraction and color-singlet gluon-clusters in high-energy hadron-hadron and lepton-hadron collisions

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    It is proposed, that ``the colorless objects'' which manifest themselves in large-rapidity-gap events are color-singlet gluon-clusters due to self-organized criticality (SOC), and that optical-geometrical concepts and methods are useful in examing the space-time properties of such objects. A simple analytical expression for the tt-dependence of the inelastic single diffractive cross section dσ/dtd\sigma/dt (tt is the four-momentum transfer squared) is derived. Comparison with the existing data and predictions for future experiments are presented. The main differences and similarities between the SOC-approach and the ``Partons in the Pomeron (Pomeron and Reggeon)''-approach are discussed.Comment: 12 pages, 2 figure

    Motivations for innovation in the built environment: new directions for research

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    Innovation in the built environment involves multiple actors with diverse motivations. Policy-makers find it difficult to promote changes that require cooperation from these numerous and dispersed actors and to align their sometimes divergent interests. Established research traditions on the economics and management of innovation pay only limited attention to stakeholder choices, engagement and motivation. This paper reviews the insights that emerge as research in these traditions comes into contact with work on innovation from sociological and political perspectives. It contributes by highlighting growing areas of research on user involvement in complex innovation, collective action, distributed innovation and transition management. To differing extents, these provide approaches to incorporate the motivations of different actors into theoretical understanding. These indicate new directions for research that promise to enrich understanding of innovation

    The Impact of GLP-1 Receptor Agonists on Patients with Diabetes on Insulin Therapy

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    Objective: The clinical benefit of adding a glucagon-like peptide-1 receptor agonist (GLP-1RA) to basal-bolus or very high dose insulin regimens is unclear. This study investigated the impact of adding a GLP-1RA to a spectrum of insulin regimens (basal, basal-bolus, and U-500) to determine the impact on hemoglobin A1c (HbA1c), weight loss, and total daily insulin dose (TDD) over the course of 12 months. Methods: A retrospective chart review was conducted on 113 participants with type 2 diabetes mellitus using insulin therapy. Each participant\u27s HbA1c, body weight, and TDD were recorded prior to initiation of GLP-1RA therapy and at the 3, 6, and 12-month time points while on combination therapy. Results: Across all participants, the HbA1c values decreased significantly from a baseline of 8.9 (74 mmol/mol) ± 0.14% to 8.2 (66 mmol/mol) ± 0.14% (P\u3c.01) in the first 3 months, 8.0 (64 mmol/mol) ± 0.12% (P\u3c.01) at 6 months, to 8.3 (67 mmol/mol) ± 0.14% (P\u3c.01) at 12 months. There was no significant decrease in weight or TDD with the addition of a GLP-1RA overall or in different insulin groups. However, there was a clinically significant decrease in weight over the study duration. Conclusion: The results of this study suggest that adding a GLP-1RA to various insulin regimens may help to achieve glycemic goals while avoiding the less desirable side effects of weight gain and increasing insulin regimens. However, the expected weight loss and decrease in TDD may not be as sizable in the clinical setting. Abbreviations: DCOE = Diabetes Center of Excellence; DM = diabetes mellitus; GLP-1RA = glucagon-like peptide-1 receptor agonist; HbA1c = hemoglobin A1c; RCT = randomized controlled trial; TDD = total daily dose
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