Physiotherapy practices and third party payers: issues in professional ethics in the Northern territories

During a 4-month period, July 2nd 2014 to November 1st 2014, Canadian physiotherapy (PT) professionals were solicited for participation in an empirical cross-sectional online survey questionnaire. Our research team was interested in exploring the ethical challenges encountered in the interactions between PT professionals and third party payers. Analysis of the survey will be disseminated through scientific publications. The purpose of this report is to give detailed results relevant to your provincial association.

Physiotherapy practices and third party payers: issues in professional ethics in Quebec

During a 4-month period, July 2nd 2014 to November 1st 2014, Canadian physiotherapy (PT) professionals were solicited for participation in an empirical cross-sectional online survey questionnaire. Our research team was interested in exploring the ethical challenges encountered in the interactions between PT professionals and third party payers. Analysis of the survey will be disseminated through scientific publications. The purpose of this report is to give detailed results relevant to your provincial association.

Aerodynamic Testing of Variable Message Signs

The increasing nationwide interest in intelligent transportation systems (ITS) and the need for more efficient transportation have led to the expanding use of variable message sign (VMS) technology. VMS panels are substantially heavier than flat panel aluminum signs and have a larger depth (dimension parallel to the direction of traffic). The additional weight and depth can have a significant effect on the aerodynamic forces and inertial loads transmitted to the support structure. The wind induced drag forces and the response of VMS structures is not well understood. Minimum design requirements for VMS structures are contained in the American Association of State Highway Transportation Officials Standard Specification for Structural Support for Highway Signs, Luminaires, and Traffic Signals (AASHTO Specification). However the Specification does not take into account the prismatic geometry of VMS and the complex interaction of the applied aerodynamic forces to the support structure. In view of the lack of code guidance and the limited number research performed so far, targeted experimentation and large scale testing was conducted at the Florida International University (FIU) Wall of Wind (WOW) to provide reliable drag coefficients and investigate the aerodynamic instability of VMS. A comprehensive range of VMS geometries was tested in turbulence representative of the high frequency end of the spectrum in a simulated suburban atmospheric boundary layer. The mean normal, lateral and vertical lift force coefficients, in addition to the twisting moment coefficient and eccentricity ratio, were determined using the measured data for each model. Wind tunnel testing confirmed that drag on a prismatic VMS is smaller than the 1.7 suggested value in the current AASHTO Specification (2013). An alternative to the AASHTO Specification code value is presented in the form of a design matrix. Testing and analysis also indicated that vortex shedding oscillations and galloping instability could be significant for VMS signs with a large depth ratio attached to a structure with a low natural frequency. The effect of corner modification was investigated by testing models with chamfered and rounded corners. Results demonstrated an additional decrease in the drag coefficient but a possible Reynolds number dependency for the rounded corner configuration.

Focused molecular analysis of small cell lung cancer: feasibility in routine clinical practice.

Background: There is an urgent need to identify molecular signatures in small cell lung cancer (SCLC) that may select patients who are likely to respond to molecularly targeted therapies. In this study, we investigate the feasibility of undertaking focused molecular analyses on routine diagnostic biopsies in patients with SCLC.

Methods: A series of histopathologically confirmed formalin-fixed, paraffin-embedded SCLC specimens were analysed for epidermal growth factor receptors (EGFR), KRAS, NRAS and BRAF mutations, ALK gene rearrangements and MET amplification. EGFR and KRAS mutation testing was evaluated using real time polymerase chain reaction (RT-PCR cobas®), BRAF and NRAS mutations using multiplex PCR and capillary electrophoresis-single strand conformation analysis, and ALK and MET aberrations with fluorescent in situ hybridization. All genetic aberrations detected were validated independently.

Results: A total of 105 patients diagnosed with SCLC between July 1990 and September 2006 were included. 60 (57 %) patients had suitable tumour tissue for molecular testing. 25 patients were successfully evaluated for all six pre-defined molecular aberrations. Eleven patients failed all molecular analysis. No mutations in EGFR, KRAS and NRAS were detected, and no ALK gene rearrangements or MET gene amplifications were identified. A V600E substitution in BRAF was detected in a Caucasian male smoker diagnosed with SCLC with squamoid and glandular features.

Conclusion: The paucity of patients with sufficient tumour tissue, quality of DNA extracted and low frequency of aberrations detected indicate that alternative molecular characterisation approaches are necessary, such as the use of circulating plasma DNA in patients with SCLC.

Navigating uncertain waters: a critical review of inferring foraging behaviour from location and dive data in pinnipeds

In the last thirty years, the emergence and progression of biologging technology has led to great advances in marine predator ecology. Large databases of location and dive observations from biologging devices have been compiled for an increasing number of diving predator species (such as pinnipeds, sea turtles, seabirds and cetaceans), enabling complex questions about animal activity budgets and habitat use to be addressed. Central to answering these questions is our ability to correctly identify and quantify the frequency of essential behaviours, such as foraging. Despite technological advances that have increased the quality and resolution of location and dive data, accurately interpreting behaviour from such data remains a challenge, and analytical methods are only beginning to unlock the full potential of existing datasets. This review evaluates both traditional and emerging methods and presents a starting platform of options for future studies of marine predator foraging ecology, particularly from location and two-dimensional (time-depth) dive data. We outline the different devices and data types available, discuss the limitations and advantages of commonly-used analytical techniques, and highlight key areas for future research. We focus our review on pinnipeds - one of the most studied taxa of marine predators - but offer insights that will be applicable to other air-breathing marine predator tracking studies. We highlight that traditionally-used methods for inferring foraging from location and dive data, such as first-passage time and dive shape analysis, have important caveats and limitations depending on the nature of the data and the research question. We suggest that more holistic statistical techniques, such as state-space models, which can synthesise multiple track, dive and environmental metrics whilst simultaneously accounting for measurement error, offer more robust alternatives. Finally, we identify a need for more research to elucidate the role of physical oceanography, device effects, study animal selection, and developmental stages in predator behaviour and data interpretation.

Alternative media for public pedagogy: "Chief" concerns and human agency

To demonstrate how the growing influence of alternative media in civil society correlates with the rise of social movements and their influence on contemporary manifestations of resistance, this research uses critical ethnographic methodologies to document the narratives of alternative media producers in the pro-Indigenous and anti-“Chief” campaigns at the University of Illinois at Urbana-Champaign during the 2006-2007 school year. These narratives demonstrate not only the ways alternative media help transmit dissent by distributing information to diverse populations, but also the manner they facilitate contexts that influence identity formations and strengthen counter-cultural communal practices. Particular lineages of critical social theory are used to situate knowledge construction and social relationships within specific socio-historic contexts to approach issues of subjectivity, human agency, and resistance. These include the Frankfurt School for Social Research, the Birmingham Centre for Contemporary Cultural Studies, and the Brazilian education philosopher Paulo Freire, who emphasize criticality based on the engagement of ideological analysis, as well as developing capacities to critique and resist oppressive social and political relationships. Thus, this study argues for expanding traditional notions of literacy to include the ability to decode and produce media as a critical element of meaningful democratic participation.

Ageing in a non-heterosexual context.

There is increasing recognition of the importance of social and cultural differences in shaping the diversity of the ageing experience in contemporary Britain. Various social and cultural factors, such as those associated with class, ethnicity, gender and disability, influence people’s living circumstances and sources of support in later life. While they have been the subject of considerable speculation, ageing in a non-heterosexual context remains remarkably under-studied. This paper examines the difference that being non-heterosexual makes to how people experience ageing and later life. It draws on quantitative and qualitative data gathered for a British study of the living circumstances of non-heterosexuals aged between the fifties and the eighties. Previous work has overwhelmingly emphasised how individuals manage their sexual identities, but this paper focuses on the factors that shape the non-heterosexual experience of ageing and later life. Particular attention is paid to the relational and community contexts in which non-heterosexuals negotiate personal ageing. This not only provides insights into the specific challenges that ageing presents for non-heterosexuals, but also offers insights into the challenges faced by ageing non-heterosexuals and heterosexuals in ‘ detraditionalised ’ settings.

Feasibility study to inform the design of a UK multi-centre randomised controlled trial of prophylactic antibiotics for the prevention of recurrent cellulitis of the leg

Background: This paper describes the results of a feasibility study for a randomised controlled trial (RCT). Methods: Twenty-nine members of the UK Dermatology Clinical Trials Network (UK DCTN) expressed an interest in recruiting for this study. Of these, 17 obtained full ethics and Research & Development (R&D) approval, and 15 successfully recruited patients into the study. A total of 70 participants with a diagnosis of cellulitis of the leg were enrolled over a 5-month period. These participants were largely recruited from medical admissions wards, although some were identified from dermatology, orthopaedic, geriatric and general surgery wards. Data were collected on patient demographics, clinical features and willingness to take part in a future RCT. Results: Despite being a relatively common condition, cellulitis patients were difficult to locate through our network of UK DCTN clinicians. This was largely because patients were rarely seen by dermatologists, and admissions were not co-ordinated centrally. In addition, the impact of the proposed exclusion criteria was high; only 26 (37%) of those enrolled in the study fulfilled all of the inclusion criteria for the subsequent RCT, and were willing to be randomised to treatment. Of the 70 participants identified during the study as having cellulitis of the leg (as confirmed by a dermatologist), only 59 (84%) had all 3 of the defining features of: i) erythema, ii) oedema, and iii) warmth with acute pain/tenderness upon examination. Twenty-two (32%) patients experienced a previous episode of cellulitis within the last 3 years. The median time to recurrence (estimated as the time since the most recent previous attack) was 205 days (95% CI 102 to 308). Service users were generally supportive of the trial, although several expressed concerns about taking antibiotics for lengthy periods, and felt that multiple morbidity/old age would limit entry into a 3-year study. Conclusion: This pilot study has been crucial in highlighting some key issues for the conduct of a future RCT. As a result of these findings, changes have been made to i) the planned recruitment strategy, ii) the proposed inclusion criteria and ii) the definition of cellulitis for use in the future trial.

Physiotherapy practices and third party payers: issues in professional ethics in British Columbia

[À l'origine dans / Was originally part of : ESPUM - Dép. médecine sociale et préventive - Travaux et publications]

Physiotherapy practices and third party payers: issues in professional ethics in the Prairie provinces

[À l'origine dans / Was originally part of : ESPUM - Dép. médecine sociale et préventive - Travaux et publications]

Physiotherapy practices and third party payers: issues in professional ethics in Ontario

[À l'origine dans / Was originally part of : ESPUM - Dép. médecine sociale et préventive - Travaux et publications]

Physiotherapy practices and third party payers: issues in professional ethics in the Atlantic provinces

[À l'origine dans / Was originally part of : ESPUM - Dép. médecine sociale et préventive - Travaux et publications]

Physiotherapy practices and third party payers: issues in professional ethics in the Northern territories

[À l'origine dans / Was originally part of : ESPUM - Dép. médecine sociale et préventive - Travaux et publications]

Physiotherapy practices and third party payers: issues in professional ethics in Quebec

[À l'origine dans / Was originally part of : ESPUM - Dép. médecine sociale et préventive - Travaux et publications]

Effects of the 2005 reforms on legal responses to women who kill intimate partners

2015 marks a decade since the release of the Victorian Law Reform Commission's Defences to Homicide: Final Report. The Commission's Final Report recommended major changes to the law of homicide in Victoria and in 2005, the Victorian government responded to the 56 recommendations by implementing the largest package of homicide law reforms since the abolition of the death penalty. This book brings together leading scholars, legal practitioners and the former Victorian Attorney-General to provide a comprehensive examination of the Victorian experience of reform, including its perceived successes and failures. This is a controversial area of the law that continues to present challenges in practice. Since the 2005 reforms further reform of the law has occurred in Victoria and a range of divergent approaches to homicide law reform have been introduced and animated debate across Australia and internationally. With such a high level of law reform activity nationally this book provides a timely analysis of the extent to which the Victorian reforms have improved legal responses to lethal violence and with what effect in practice. To enhance this analysis the book also looks internationally to consider the operation of homicide law in England and Wales, Canada and New Zealand and what lessons could be gained from an Australian perspective from differing approaches to reform.

This book explores a number of issues concerning the operation of the law of homicide, sentencing practices, the role of the media, evidence reforms, legal culture, political influences and future reform challenges for Victoria and other Australian jurisdictions. In examining all aspects of the 2005 homicide law reforms, the book draws on the views of those who were involved in reviewing the law of homicide in Victoria, those who recommended and implemented reform, and those who have played a key role in the monitoring and evaluation of the law post-reform in Victoria but also more widely in Australia and internationally. The resulting analysis will be of great interest to law, criminology and socio-legal scholars as well as legal practitioners and law reformers in Australia and comparative international jurisdictions.