Medicine and Health Sciences Commons^™

Ssrn As An Initial Revolution In Academic Knowledge Aggregation And Dissemination, David Bray, Sascha Vitzthum, Benn Konsynski

Sascha Vitzthum

Within this paper we consider our results of using the Social Science Research Network (SSRN) over a period of 18 months to distribute our working papers to the research community. Our experiences have been quite positive, with SSRN serving as a platform both to inform our colleagues about our research as well as inform us about related research (through email and telephoned conversations of colleagues who discovered our paper on SSRN). We then discuss potential future directions for SSRN to consider, and how SSRN might well represent an initial revolution in 21st century academic knowledge aggregation and dissemination. Our paper …

The Differentiation Of Hepatocyte-Like Cells From Monkey Embryonic Stem Cells., Xiaocui Ma, Jian Wu, M Zern

jian duan wu

Embryonic stem cells (ESC) hold great potential for the treatment of liver diseases. Here, we report the differentiation of rhesus macaque ESC along a hepatocyte lineage. The undifferentiated monkey ESC line, ORMES-6, was cultured in an optimal culture condition in an effort to differentiate them into hepatocyte-like cells in vitro. The functional efficacy of the differentiated hepatic cells was evaluated using RT-PCR for the expression of hepatocyte specific genes, and Western blot analysis and immunocytochemistry for hepatic proteins such as alpha-fetoprotein (AFP), albumin and alpha1-antitrypsin (alpha1-AT). Functional assays were performed using the periodic acid schiff (PAS) reaction and ELISA. The …

Towards Self-Organizing, Smart Business Networks: Let’S Create ‘Life’ From Inert Information, David Bray, Benn Konsynski

David A. Bray

We review three different theories that can inform how researchers can determine the performance of smart business networks, to include: (1) the Theory of Evolution, (2) the Knowledge-Based Theory of the Firm, and (3) research insights into computers and cognition. We suggest that each of these theories demonstrate that to be generally perceived as smart, an organism needs to be self-organizing, communicative, and tool-making. Consequentially, to determine the performance of a smart business network, we suggest that researchers need to determine the degree to which it is self-organizing, communicative, and tool-making. We then relate these findings to the Internet and …

Fitness And Action Monitoring: Evidence For Improved Cognitive Flexibility In Young Adults, Jason R. Themanson, Matthew B. Pontifex, Charles H. Hillman

Jason R. Themanson, Ph.D

To improve behavior, one must detect errors and initiate subsequent corrective adaptations. This action monitoring process has been widely studied, but little is known about how one may improve this aspect of cognition. To examine the relationship between cardiorespiratory fitness and action monitoring, we recorded the error-related negativity (ERN), an event-related brain potential believed to index action monitoring, as well as post-error behavioral indices of action monitoring from healthy young adults (18–25 years) who varied in cardiorespiratory fitness. These measures were collected during the execution of flanker tasks emphasizing response accuracy or speed to better assess the specificity of any …

Investigating Bimanual Coordination In Dominant And Non-Dominant Virtual Hands, Gavin Buckingham, David Carey

Gavin Buckingham

A bias in attention towards the dominant hand has been cited as a possible factor in the lateralisation of human bimanual coordination (Peters, 1981). A mirror was placed between the hands of 18 dextral participants performing rhythmic anti-phase movements. This set-up gave the appearance of a reflected virtual hand (moving in time with the un-occluded hand), in the same spatial location as the occluded left or right hand. This asymmetrical conflict between vision and action examined whether the left hand would show higher levels of error when replaced by a virtual right hand than the converse condition. Higher levels of …

Evaluation Of Scrotal Masses, Jeffrey D. Tiemstra Md, S Kapoor

Jeffrey Tiemstra, MD, FAAFP

Rules Of Engagement: Residents' Perceptions Of The In-Training Evaluation Process, Christopher Watling, Cynthia Kenyon, Elaine Zibrowski, Valerie Schulz, Mark Goldszmidt, Indu Singh, Heather Maddocks, Lorelei Lingard

Lorelei Lingard

BACKGROUND: In-training evaluation reports (ITERs) often fall short of their goals of promoting resident learning and development. Efforts to address this problem through faculty development and assessment-instrument modification have been disappointing. The authors explored residents' experiences and perceptions of the ITER process to gain insight into why the process succeeds or fails.

METHOD: Using a grounded theory approach, semistructured interviews were conducted with 20 residents. Constant comparative analysis for emergent themes was conducted.

RESULTS: All residents identified aspects of "engagement" in the ITER process as the dominant influence on the success of ITERs. Both external (evaluator-driven, such as evaluator credibility) …

A Grass-Roots Approach To Develop A Hispanic Wellness Curriculum In Rural Idaho, Dawn Weiler

Dawn Weiler

The Idaho Partnership for Hispanic Health (IPHH) is a community-based participatory research project focused on identifying the health condition of greatest concern to SW Idaho Hispanics and pilot testing an intervention and its effectiveness. The partnership includes two educational institutions, two Hispanic organizations, and a community non-profit organization. Following the completion of the first two phases of the project (community partnership and community advisory board (CAB) development, and quantitative and qualitative community assessment) the IPHH implemented phase three, intervention development and testing.

Interprofessional Communication And Medical Error: A Reframing Of Research Questions And Approaches, Lara Varpio, Pippa Hall, Lorelei Lingard, Catherine Schryer

Lorelei Lingard

Progress toward understanding the links between interprofessional communication and issues of medical error has been slow. Recent research proposes that this delay may result from overlooking the complexities involved in interprofessional care. Medical education initiatives in this domain tend to simplify the complexities of team membership fluidity, rotation, and use of communication tools. A new theoretically informed research approach is required to take into account these complexities. To generate such an approach, we review two theories from the social sciences: Activity Theory and Knotworking. Using these perspectives, we propose that research into interprofessional communication and medical error can develop better …

Point-Of-Care Assessment Of Medical Trainee Competence For Independent Clinical Work, Tara Kennedy, Glenn Regehr, G. Baker, Lorelei Lingard

Lorelei Lingard

BACKGROUND: Clinical supervisors make frequent assessments of medical trainees' competence so they can provide appropriate opportunities for trainees to experience clinical independence. This study explored context-specific assessments of trainees' competence for independent clinical work.

METHOD: In Phase One, 88 teaching team members from internal and emergency medicine were observed during clinical activities (216 hours), and 65 participants completed brief interviews. In Phase Two, 36 in-depth interviews were conducted using video vignettes. Data collection and analysis employed grounded theory methodology.

RESULTS: Supervisors' assessments of trainee trustworthiness for independent clinical work involved consideration of four dimensions: knowledge/skill, discernment of limitations, truthfulness, and …

Family-Based Weight Management With Latino Mothers And Children, Kathy James, Cynthia Connelly, Elaine Rutkowski, Darlene Mcpherson, Luz Garcia, Nicole Mareno, Dorothy Zirkle

Nicole Mareno

Response: Hiv Testing For Whole Populations, Daniel Halperin, Malcolm Potts, Doug Kirby, Jeff Klausner, Richard Wamai, Ann Swidler, Elliot Marseille, Norman Hearst

Richard G. Wamai

No abstract provided.

Grounded Theory, Mixed Methods, And Action Research, Lorelei Lingard, Mathieu Albert, Wendy Levinson

Lorelei Lingard

No abstract provided.

Critically Appraising Qualitative Research, Ayelet Kuper, Lorelei Lingard, Wendy Levinson

Lorelei Lingard

No abstract provided.

The Quality Control System, Tony Badrick

Tony Badrick

Quality Control System: an understanding of analytical error; synthetic QC material; a set of QC rules; a process to follow if the rules signal. Quality Control (QC) Sera: reconstitution - staff trained; stability tested - post reconstitution and frozen. QC Rules: rules documented - basis of adoption; action to follow in case of failure documented; evidence of this procedure being used in place; are QC rules defined for both batch and continuous analysis - how is a 'run' defined for a continuous analytical process; means and standard deviations (SDs) of controls based on sufficient data points and reflects true state …

Assessing Bioterrorism Preparedness And Response Of Rural Veterinarians: Experiences And Training Needs, Chiehwen Ed Hsu, Francisco G. Soto Mas

Chiehwen Ed Hsu

Veterinarians play a unique role in emergency preparedness and response, and as such federal agencies and academic institutions allocated considerable resources to provide training to enhance their readiness. However, the level of preparedness of veterinarians in many rural regions is yet to be improved. This paper reports an assessment of the bioterrorism preparedness, specifically the experience and training needs of rural veterinarians in North Texas. The study employed a cross-sectional design with a study population that included all veterinarians (N=352) in the 37 counties in Texas Department of State Health Services Regions 2 and 3. Data on veterinarians practicing or …

Abiotic Reaction Of Iodate With Sphagnum Peat And Other Natural Organic Matter, S. Steinberg, G. Kimble, G. Schmett, D. Emerson, M. Turner, M. Rudin

Mark J. Rudin

Previous studies have shown that iodine (including 129I) can be strongly retained in organic-rich surface soils and sediment and that a large fraction of soluble iodine may be associated with dissolved humic material. Iodate (IO3 –) reacts with natural organic matter (NOM) producing either hypoiodous acid (HIO) or I2 as an intermediate. This intermediate is subsequently incorporated into the organic matter. Based on reactions of model compounds, we infer that iodine reacts with peat by aromatic substitution of hydrogen on phenolic constituents of the peat. Alternatively, the intermediate, HIO or I2, may be reduced to iodide (I–). The pH (and …

Hepatic Lesion Radiotherapy: A New Option? Interview By Paul Adams., Michael Lock

Michael Lock

No abstract provided.

Doctors As Patients: A Systematic Review Of Doctors' Health Access And The Barriers They Experience, Margaret Kay, Geoffrey Mitchell, Alexandra Clavarino, Jenny Doust

Jenny Doust

Background The need to improve doctors' access to health care by reducing the barriers they experience has been regularly described in the literature, yet the barriers experienced are not well defined, despite the volume of expert opinion in this area. Aim To define what is known about doctors' access to health care from the data within the current literature.Design of study A systematic review of studies of doctors' health access.Method A systematic search of MEDLINE® and CINAHL, supplemented by citation searches and searches of the grey literature, identified both quantitative and qualitative studies. Two reviewers used specific criteria for inclusion …

Immobilization Of Fission Iodine By Reaction With Insoluble Natural Organic Matter, S. Steinberg, G. Schmett, G. Kimble, D. Emerson, M. Turner, M. Rudin

Mark J. Rudin

Iodine-129 is a fission product and highly mobile in the environment. Along with other stable isotopes of iodine, 129I is released during reprocessing of nuclear fuel and must be trapped to prevent the release of radioactivity to the environment. Past studies have provided evidence that iodine can become associated with natural organic matter (NOM). This research explores the use of NOM (sphagnum peat and humic acid) to sequester iodine from the vapor and aqueous phases. NOM-associated iodine may be stable for geological storage. NOM-sequestered iodine can be recovered by pyrolysis to prepare target materials for transmutation. The nature of the …

Know When To Rock The Boat: How Faculty Rationalize Students' Behaviors, Shiphra Ginsburg, Lorelei Lingard, Glenn Regehr, Kathryn Underwood

Lorelei Lingard

BACKGROUND: When faculty evaluate medical students' professionalism, they make judgments based on the observation of behaviors. However, we lack an understanding of why they feel certain behaviors are appropriate (or not).

OBJECTIVE: To explore faculty's reasoning around potential student behaviors in professionally challenging situations.

DESIGN: Guided interviews with faculty who were asked to respond to 5 videotaped scenarios depicting students in professionally challenging situations.

SUBJECTS: Purposive sample of 30 attending Internists and surgeons.

APPROACH: Transcripts were analyzed using modified grounded theory to search for emerging themes and to attempt to validate a previous framework based on student responses.

RESULTS: Faculty's …

Self-Efficacy Effects On Neuroelectric And Behavioral Indices Of Action Monitoring In Older Adults, Jason R. Themanson, Charles H. Hillman, Edward Mcauley, Sarah M. Buck, Shawna E. Doerksen, Katherine S. Morris, Matthew B. Pontifex

Jason R. Themanson, Ph.D

The relationships between self-efficacy (SE), i.e., beliefs in personal capabilities, and behavioral and neuroelectric (i.e., ERN, Pe) indices of action monitoring were investigated in 40 older adults (13 male) during the completion of a flanker paradigm performed under task conditions emphasizing either accuracy or speed. SE relative to task performance during both conditions was assessed prior to each cognitive task. Results indicated that high-SE older adults exhibited larger ERN and Pe amplitudes compared to low-SE older adults under the accuracy instruction condition. Additionally, a moderating effect of SE on the relationship between ERN and post-error response accuracy was revealed in …

Biomedical Scientists' Perception Of The Social Sciences In Health Research, Mathieu Albert, Suzanne Laberge, Brian Hodges, Glenn Regehr, Lorelei Lingard

Lorelei Lingard

The growing interest in interdisciplinary research within the Canadian health sciences sector has been manifested by initiatives aimed at increasing the involvement of the social sciences in this sector. Drawing on Bourdieu's concept of field and Knorr-Cetina's concept of epistemic culture, this study explores the extent to which it is possible for the social sciences to integrate into, and thrive in, a field in which the experimental paradigm occupies a hegemonic position. Thirty-one semi-structured interviews were conducted to explore biomedical scientists' receptiveness toward the social sciences in general and to qualitative research in particular. We found that these respondents exhibited …

Catalyzing And Sustaining Communities Of Collaboration Around Interprofessional Care: An Evaluation Of Four Educational Programs, Eileen Egan-Lee, Elisa Hollenberg, Dale Dematteo, Stasey Tobin, Ivy Oandasan, Mary-Agnes Beduz, Debbie Kwan, Karen Leslie, Jacques Lee, Maria Tassone, Jane Merkley, Lorelei Lingard, Lynne Sinclair, Mandy Lowe, Danny Nashman, Cate Creede, Doreen Day, Ivan Silver, Scott Reeves

Lorelei Lingard

No abstract provided.

Ethical Issues Associated With The Introduction Of New Surgical Devices, Or Just Because We Can, Doesn’T Mean We Should, Sue Ross, Magali Robert, Marie-Andrée Harvey, Scott Farrell, Jane Schulz, David Wilkie, Danny Lovatsis, Annette Epp, Bill Easton, Barry Mcmillan, Joyce Schachter, Chander Gupta, Charles Weijer

Charles Weijer

Surgical devices are often marketed before there is good evidence of their safety and effectiveness. Our paper discusses the ethical issues associated with the early marketing and use of new surgical devices from the perspectives of the six groups most concerned. Health Canada, which is responsible for licensing new surgical devices, should amend their requirements to include rigorous clinical trials that provide data on effectiveness and safety for each new product before it is marketed. Industry should comply with all Health Canada requirements to obtain licenses for new products. Until Health Canada requires effectiveness and safety data, industry should cooperate …

Reassessing Hiv Prevention, Malcolm Potts, Daniel Halperin, Douglas Kirby, Ann Swidler, Elliot Marseille, Jeffrey Klausner, Norman Hearst, Richard Wamai, James Kahn, Julia Walsh

Richard G. Wamai

No abstract provided.

Mira V: An Integrated System For Minimally Invasive Robot-Assisted Lung Brachytherapy, A. Trejos, A. Lin, S. Mohan, H. Bassan, C. Edirisinghe, R. Patel, C. Lewis, E. Yu, A. Fenster, R. Malthaner

Edward Yu

An integrated system for minimally invasive robot-assisted image-guided lung brachytherapy has been developed. The system incorporates an experimental setup for accurate radioactive seed placement with commercially available dosimetry planning software. The end result is a complete system that allows planning and executing a brachytherapy procedure with increased accuracy. The results of the in vitro seed placement evaluation show that seed misplacement has a significant effect on the volume receiving more than 200% of the dose (V200), and the minimum dosage received by 90% of the volume (D90).

Seriously Working Together: Integrated Governance Models To Achieve Sustainable Partnerships Between Health Care Organisations, Claire Jackson, Caroline Nicholson, Jenny Doust, Lily Cheung, John O'Donnell

Jenny Doust

Objective: To identify sustainable governance arrangements for health care organisations undertaking integrated health service delivery based on best available evidence. Method: Systematic review of the literature (1990–2006), supported by key informant interviews as an integrative process. Results: 16 studies met our selection criteria. All described enablers of and barriers to delivering integrated health services. We identified three models for integrated health care governance with a demonstrated ability to be sustained in the medium term. Common themes that emerged as the logical starting point for more ambitious integrated governance arrangements regionally were: the need for a clear separation between governance and …

Comparison Of Sensorimotor Disturbance Between Subjects With Persistent Whiplash Associated Disorder And Subjects With Acoustic Neuromas, Julia Treleaven, Nancy Low Choy, Ross Darnell, Ben Panizza, David Brown-Rothwell, Gwendolen Jull

Nancy Low Choy

Objective
To determine if differences exist in reported symptoms and in outcomes of sensorimotor tests (cervical joint position error [JPE], neck-influenced eye movement control, postural stability) between subjects with persistent whiplash and subjects with unilateral vestibular pathology associated with acoustic neuroma.

Design
Repeated measures, case controlled.

Setting
Tertiary institution and metropolitan hospital.

Participants
Twenty subjects with persistent whiplash, 20 subjects with acoustic neuroma, and 20 control subjects.

Interventions
Not applicable.

Main Outcome Measures
Symptom descriptors, Dizziness Handicap Inventory (short form), measures of cervical JPE, the smooth pursuit neck torsion (SPNT) test, and forceplate measures of postural stability in comfortable and …

Cruciferous Vegetables Reduce Morphological Markers Of Colon Cancer Risk In Dimethylhydrazine-Treated Rats, Andrea Arikawa

Andrea Y Arikawa

Consumption of cruciferous vegetables has been associated with reduced colon cancer risk in human populations. However, little experimental evidence exists to support this association. Here, we report the effects of diets containing cruciferous vegetables on colon cancer risk. In Expt. 1, rats were fed a vegetable-free (basal) diet or diets containing different lyophilized cruciferous vegetables in concentrations between 4 and 10%. In Expt. 2, rats were fed the basal diet or diets containing 10-22.6% fresh cruciferous vegetables. Diets were fed for 2 wk (Expt. 1) or 3 wk (Expt. 2) before and 7 wk (Expt. 1) or 12 wk (Expt. …