Creating and Certifying the Professional Mediator -- Education and Credentialing

Existing and pending law school mediation programs, post-graduate mediator training programs, mentorship programs, credentialing movements, and continuing mediation education were examined by a panel and speakers directly involved in those fields. Are we effectively training new mediators in law schools and post-graduate programs? Should we, and how can we, credential mediators? Do good mediators need to be re-trained? How would continuing mediation educational requirements be implemented

Creating and Certifying the Professional Mediator -- Education and Credentialing

Existing and pending law school mediation programs, post-graduate mediator training programs, mentorship programs, credentialing movements, and continuing mediation education were examined by a panel and speakers directly involved in those fields. Are we effectively training new mediators in law schools and post-graduate programs? Should we, and how can we, credential mediators? Do good mediators need to be re-trained? How would continuing mediation educational requirements be implemented

Investigating Hydrologic Alteration as a Mechanism of Fish Assemblage Shifts in Urbanizing Streams

Stream biota in urban and suburban settings are thought to be impaired by altered hydrology; however, it is unknown what aspects of the hydrograph alter fish assemblage structure and which fishes are most vulnerable to hydrologic alterations in small streams. We quantified hydrologic variables and fish assemblages in 30 small streams and their subcatchments (area 8-20 km 2) in the Etowah River Catchment (Georgia, USA). We stratified streams and their subcatchments into 3 landcover categories based on imperviousness (20% of subcatchment), and then estimated the degree of hydrologic alteration based on synoptic measurements of baseflow yield. We derived hydrologic variables from stage gauges at each study site for 1 y (January 2003-2004). Increased imperviousness was positively correlated with the frequency of storm events and rates of the rising and falling limb of the hydrograph (i.e, storm flashiness ) during most seasons. Increased duration of low flows associated with imperviousness only occurred during the autumn low-flow period, and this measure corresponded with increased richness of lentic tolerant species. Altered storm flows in summer and autumn were related to decreased richness of endemic, cosmopolitan, and sensitive fish species, and decreased abundance of lentic tolerant species. Species predicted to be sensitive to urbanization, based on specific life-history or habitat requirements, also were related to stormflow variables and % fine bed sediment in riffles. Overall, hydrologic variables explained 22 to 66% of the variation in fish assemblage richness and abundance Linkages between hydrologic alteration and fish assemblages were potentially complicated by contrasting effects of elevated flows on sediment delivery and scour, and mediating effects of high stream gradient on sediment delivery from elevated flows. However, stormwater management practices promoting natural hydrologic regimes are likely to reduce the impacts of catchment imperviousness on stream fish assemblages. ?? 2005 by The North American Benthological Societ

Utility of Quantitative Sensory Testing and Screening Tools in Identifying HIV-Associated Peripheral Neuropathy in Western Kenya: Pilot Testing

Neuropathy is the most common neurologic complication of HIV but is widely under-diagnosed in resource-constrained settings. We aimed to identify tools that accurately distinguish individuals with moderate/severe peripheral neuropathy and can be administered by non-physician healthcare workers (HCW) in resource-constrained settings.We enrolled a convenience sample of 30 HIV-infected outpatients from a Kenyan HIV-care clinic. A HCW administered the Neuropathy Severity Score (NSS), Single Question Neuropathy Screen (Single-QNS), Subjective Peripheral Neuropathy Screen (Subjective-PNS), and Brief Peripheral Neuropathy Screen (Brief-PNS). Monofilament, graduated tuning fork, and two-point discrimination examinations were performed. Tools were validated against a neurologist's clinical assessment of moderate/severe neuropathy.The sample was 57% male, mean age 38.6 years, and mean CD4 count 324 cells/µL. Neurologist's assessment identified 20% (6/30) with moderate/severe neuropathy. Diagnostic utilities for moderate/severe neuropathy were: Single-QNS--83% sensitivity, 71% specificity; Subjective-PNS-total--83% sensitivity, 83% specificity; Subjective-PNS-max and NSS--67% sensitivity, 92% specificity; Brief-PNS--0% sensitivity, 92% specificity; monofilament--100% sensitivity, 88% specificity; graduated tuning fork--83% sensitivity, 88% specificity; two-point discrimination--75% sensitivity, 58% specificity.Pilot testing suggests Single-QNS, Subjective-PNS, and monofilament examination accurately identify HIV-infected patients with moderate/severe neuropathy and may be useful diagnostic tools in resource-constrained settings

Is It Time to Rethink How Neuropsychological Tests Are Used to Diagnose Mild Forms of HIV-Associated Neurocognitive Disorders? Impact of False-Positive Rates on Prevalence and Power

BACKGROUND: Between 0–48% of normal HIV-uninfected individuals score below threshold neuropsychological test scores for HIV-associated neurocognitive disorders (HAND), or are false-positives. There has been little effort to understand the effect of varied interpretations of research criteria for HAND on false-positive frequencies, prevalence and analytic estimates. METHODS: The proportion of normal individuals scoring below Z-score thresholds drawn from research criteria for HAND, or false-positive frequencies, was estimated in a normal Kenyan population and a simulated normal population using varied interpretations of research criteria for HAND. We calculated the impact of false-positive frequencies on prevalence estimates and statistical power. RESULTS: False-positive frequencies of 2–74% were observed for Asymptomatic Neurocognitive Impairment/Mild Neurocognitive Disorder and 0–8% for HIV-associated Dementia. False-positive frequencies depended on definition of an abnormal cognitive domain, Z-score thresholds, and neuropsychological battery size. Misclassification led to clinically important overestimation of prevalence and dramatic decreases in power. CONCLUSIONS: Minimizing false-positive frequencies is critical to decrease bias in prevalence estimates and minimize reductions in power in studies of association, particularly for mild forms of HAND. We recommend changing the Z-score threshold to ≤−1.5 for mild impairment, limiting analysis to 3–5 cognitive domains, and using the average Z-score to define an abnormal domain

Multidisciplinary Baseline Assessment of Homosexual Men with and without Human Immunodeficiency Virus Infection. I. Overview of Study Design

Although much is known about the virus believed by most experts to be the cause of the acquired immunodeficiency syndrome and about its pathogenic actions, major areas of ignorance remain. Among these are the reasons for the varying time between infection with human immunodeficiency virus and development of acquired imunodeficiency syndrome, the relationship between neurologic and medical aspects of the disease, the time course of neuropsychological findings, and the prevalence of psychiatric morbidity. We assessed 124 homosexual men who were positive for human immunodeficiency virus and 84 who were negative for the virus. In this article we describe the study design, method of recruitment, and medical and demographic characteristics of the cohort, which will be followed up for 5 years

Characteristics of outdoor falls among older people: A qualitative study

Background Falls are a major threat to older people’s health and wellbeing. Approximately half of falls occur in outdoor environments but little is known about the circumstances in which they occur. We conducted a qualitative study to explore older people’s experiences of outdoor falls to develop understanding of how they may be prevented. Methods We conducted nine focus groups across the UK (England, Wales, and Scotland). Our sample was from urban and rural settings and different environmental landscapes. Participants were aged 65+ and had at least one outdoor fall in the past year. We analysed the data using framework and content analyses. Results Forty-four adults aged 65 – 92 took part and reported their experience of 88 outdoor falls. Outdoor falls occurred in a variety of contexts, though reports suggested the following scenarios may have been more frequent: when crossing a road, in a familiar area, when bystanders were around, and with an unreported or unknown attribution. Most frequently, falls resulted in either minor or moderate injury, feeling embarrassed at the time of the fall, and anxiety about falling again. Ten falls resulted in fracture, but no strong pattern emerged in regard to the contexts of these falls. Anxiety about falling again appeared more prevalent among those that fell in urban settings and who made more visits into their neighbourhood in a typical week. Conclusions This exploratory study has highlighted several aspects of the outdoor environment that may represent risk factors for outdoor falls and associated fear of falling. Health professionals are recommended to consider outdoor environments as well as the home setting when working to prevent falls and increase mobility among older people

Evaluating the GeoSnap 13-μ\mum Cut-Off HgCdTe Detector for mid-IR ground-based astronomy

New mid-infrared HgCdTe (MCT) detector arrays developed in collaboration with Teledyne Imaging Sensors (TIS) have paved the way for improved 10-$\mu$m sensors for space- and ground-based observatories. Building on the successful development of longwave HAWAII-2RGs for space missions such as NEO Surveyor, we characterize the first 13-$\mu$m GeoSnap detector manufactured to overcome the challenges of high background rates inherent in ground-based mid-IR astronomy. This test device merges the longwave HgCdTe photosensitive material with Teledyne's 2048x2048 GeoSnap-18 (18-$\mu$m pixel) focal plane module, which is equipped with a capacitive transimpedance amplifier (CTIA) readout circuit paired with an onboard 14-bit analog-to-digital converter (ADC). The final assembly yields a mid-IR detector with high QE, fast readout (>85 Hz), large well depth (>1.2 million electrons), and linear readout. Longwave GeoSnap arrays would ideally be deployed on existing ground-based telescopes as well as the next generation of extremely large telescopes. While employing advanced adaptive optics (AO) along with state-of-the-art diffraction suppression techniques, instruments utilizing these detectors could attain background- and diffraction-limited imaging at inner working angles <10 $\lambda/D$, providing improved contrast-limited performance compared to JWST MIRI while operating at comparable wavelengths. We describe the performance characteristics of the 13-$\mu$m GeoSnap array operating between 38-45K, including quantum efficiency, well depth, linearity, gain, dark current, and frequency-dependent (1/f) noise profile.Comment: 17 pages, 17 figures. Accepted for publication in special addition of Astronomische Nachrichten / Astronomical Notes as a contribution to SDW202

Cost-Effectiveness Analysis of Four Simulated Colorectal Cancer Screening Interventions, North Carolina

Colorectal cancer (CRC) screening rates are suboptimal, particularly among the uninsured and the under-insured and among rural and African American populations. Little guidance is available for state-level decision makers to use to prioritize investment in evidence-based interventions to improve their population’s health. The objective of this study was to demonstrate use of a simulation model that incorporates synthetic census data and claims-based statistical models to project screening behavior in North Carolina

Planning for Sustainability in Small Municipalities: The Influence of Interest Groups, Growth Patterns, and Institutional Characteristics

How and why small municipalities promote sustainability through planning efforts is poorly understood. We analyzed ordinances in 451 Maine municipalities and tested theories of policy adoption using regression analysis.We found that smaller communities do adopt programs that contribute to sustainability relevant to their scale and context. In line with the political market theory, we found that municipalities with strong environmental interests, higher growth, and more formal governments were more likely to adopt these policies. Consideration of context and capacity in planning for sustainability will help planners better identify and benefit from collaboration, training, and outreach opportunities