Scrutiny

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Scrutiny

  • careful scrutiny
  • close scrutiny
  • closer scrutiny
  • critical scrutiny
  • empirical scrutiny
  • external scrutiny
  • greater scrutiny
  • increased scrutiny
  • intense scrutiny
  • regulatory scrutiny


  • Selected Abstracts


    Democratic Accountability and National Parliaments: Redefining the Impact of Parliamentary Scrutiny in EU Affairs

    EUROPEAN LAW JOURNAL, Issue 4 2007
    Katrin Auel
    Such an evaluation, however, is flawed: Formal mandating rights are usually incompatible with the overall logic of parliamentary systems, which explains why most national parliaments make very little use of them. Even more importantly, it unduly reduces parliamentary functions to the legislative or policy-making function. Drawing on agency theory, it will instead be argued that the functions of public deliberation and of holding the government publicly to account are at least as important and therefore need to be included in a redefined concept of parliamentary strength. In particular, the article proposes a distinction between two different elements of accountability,monitoring and political scrutiny,which recognises parliamentary majority and opposition as two distinct agents of the electorate. [source]


    Intensity of Scrutiny and a Good Eyeful Architecture and Transparency

    JOURNAL OF ARCHITECTURAL EDUCATION, Issue 4 2003
    NIGEL WHITELEY
    During the period of the "new architecture" in the 1910s and 1920s, transparency was remarkable, a sign of modernity and progress that was not just technical, but also aesthetic and ethical. However, it changed with consumer capitalism in the 1950s and 60s, and underwent further transformations in the 1990s. This essay sketches some of the key changes and shows, first, how something initially associated with honesty rapidly became problematic once the power of the gaze was noticed and, second, that ambivalence characterizes our contemporary response to a transparency associated with both scrutiny and voyeurism. [source]


    Age of Onset and Nativelikeness in a Second Language: Listener Perception Versus Linguistic Scrutiny

    LANGUAGE LEARNING, Issue 2 2009
    Niclas Abrahamsson
    The incidence of nativelikeness in adult second language acquisition is a controversial issue in SLA research. Although some researchers claim that any learner, regardless of age of acquisition, can attain nativelike levels of second language (L2) proficiency, others hold that attainment of nativelike proficiency is, in principle, impossible. The discussion has traditionally been framed within the paradigm of a critical period for language acquisition and guided by the question of whether SLA is constrained by the maturation of the brain. The work presented in this article can be positioned among those studies that have focused exclusively on the apparent counterexamples to the critical period. We report on a large-scale study of Spanish/Swedish bilinguals (n,=,195) with differing ages of onset of acquisition (<1,47 years), all of whom identify themselves as potentially nativelike in their L2. Listening sessions with native-speaker judges showed that only a small minority of those bilinguals who had started their L2 acquisition after age 12, but a majority of those with an age of onset below this age, were actually perceived as native speakers of Swedish. However, when a subset (n,=,41) of those participants who did pass for native speakers was scrutinized in linguistic detail with a battery of 10 highly complex, cognitively demanding tasks and detailed measurements of linguistic performance, representation, and processing, none of the late learners performed within the native-speaker range; in fact, the results revealed also that only a few of the early learners exhibited actual nativelike competence and behavior on all measures of L2 proficiency that were employed. Our primary interpretation of the results is that nativelike ultimate attainment of a second language is, in principle, never attained by adult learners and, furthermore, is much less common among child learners than has previously been assumed. [source]


    Classifying the medulloblastoma: insights from morphology and molecular genetics

    NEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 4 2002
    D. Ellison
    Significant advances in the treatment of the medulloblastoma (MB) have been made in the last 30 years, reducing mortality by 2-fold. Further improvements in the cure rate require an increased understanding of the biology of MBs, and this will translate into refinements in their classification. Scrutiny of the cytological variation found among MBs has recently led to the concept of the anaplastic MB, which overlaps the large-cell variant and appears to share its poor prognosis. In contrast, the MB with extensive nodularity, a distinctive nodular/desmoplastic variant occurring in infants, has a better outcome than most MBs in these young patients. Building on cytogenetic studies that have drawn attention to abnormalities on chromosome 17 in over a third of MBs, research shows non-random losses on chromosomes 8, 9, 10, 11 and 16, and gains on chromosomes 1, 7 and 9. Overexpression of ErbB2 receptors and losses on chromosome 17p have been proposed as independent indicators of aggressive behaviour, while high TrkC receptor expression indicates a favourable outcome. There is a strong association between anaplastic/large-cell tumours and MYC amplification, which has previously been linked with aggressive disease, but associations between abnormalities on chromosome 17 and anaplastic/large-cell MBs and between abnormalities in the shh/PTCH pathway and the desmoplastic variant are more controversial. Classification of the MB histopathologically and according to profiles of molecular abnormalities will help both to rationalize approaches to therapy, increasing the cure rate and reducing long-term side-effects, and to suggest novel treatments. [source]


    Is dosage of physiotherapy a critical factor in deciding patterns of recovery from stroke: a pragmatic randomized controlled trial

    PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2000
    Dr Cecily Partridge
    Abstract Background and Purpose The best treatment and management of stroke patients has been shown to be in stroke units by multidisciplinary rehabilitation teams. Since the composition of stroke units differs it is important to know the extent to which the different components contribute to this result. Physiotherapy is one component of most rehabilitation teams and recent systematic reviews have shown that patients with stroke receiving more physiotherapy achieve more recovery from disability. However, information about the actual amounts of physiotherapy needed to achieve this result is not known. Method A pragmatic, randomized, single-blind, controlled trial comparing recovery from disability in subjects receiving the current standard amount of 30 minutes' physiotherapy with those receiving double that amount (60 minutes). The study included measures of physical performance and function, psychological aspects of anxiety and depression, and perceived control over recovery. Results Some 114 subjects were recruited to the study; full six-week data are available for 104 subjects and six-month data for 93 subjects. Comparison of initial to six-week difference scores in the control and intervention groups of the whole sample did not show a significant difference. Scrutiny of the recovery curves of the whole sample showed that, in half the sample, three distinct patterns of recovery were demonstrated. Conclusion These results suggest that doubling the physiotherapy time available for patients in a stroke unit will not provide a measurable benefit for all patients. The subgroup analysis of patterns of recovery must be regarded as speculative, but provides the basis for hypotheses about those likely to respond well to more intensive therapy. Copyright © 2000 Whurr Publishers Ltd. [source]


    Policing the Bargain: Coalition Government and Parliamentary Scrutiny

    AMERICAN JOURNAL OF POLITICAL SCIENCE, Issue 1 2004
    Lanny W. Martin
    Policymaking by coalition governments creates a classic principal-agent problem. Coalitions are comprised of parties with divergent preferences who are forced to delegate important policymaking powers to individual cabinet ministers, thus raising the possibility that ministers will attempt to pursue policies favored by their own party at the expense of their coalition partners. What is going to keep ministers from attempting to move policy in directions they favor rather than sticking to the "coalition deal"? We argue that parties will make use of parliamentary scrutiny of "hostile" ministerial proposals to overcome the potential problems of delegation and enforce the coalition bargain. Statistical analysis of original data on government bills in Germany and the Netherlands supports this argument. Our findings suggest that parliaments play a central role in allowing multiparty governments to solve intracoalition conflicts. [source]


    Democracy, Ambiguity, Scrutiny, and Evidence-Based Medicine

    ACADEMIC EMERGENCY MEDICINE, Issue 5 2009
    Shahriar Zehtabchi MD
    No abstract is available for this article. [source]


    Citizens, Consumers and Courts

    AUSTRALIAN JOURNAL OF PUBLIC ADMINISTRATION, Issue 4 2001
    J.J. Spigelman
    Address by the Honourable JJ Spigelman AC, Chief Justice of New South Wales, to the International Conference on Regulation Reform Management and Scrutiny of Legislation, New South Wales State Parliament House, Sydney, on 9 July 2001. [source]


    Aldosterone Receptor Antagonism: Interface With Hyperkalemia in Heart Failure

    CONGESTIVE HEART FAILURE, Issue 5 2004
    Domenic A. Sica MD
    Aldosterone receptor antagonism (ARA) is an increasingly well-accepted element of heart failure therapy. The experimental underpinnings for the use of ARA in heart failure are strong being linked to a variety of tissue-based cardiac effects characteristic of drugs in this class. However, the benefits of ARA therapy do not come without some risk since drugs in this class are potent inhibitors of renal potassium (K+) elimination. Thus, some increment in serum K+, up to and including the development of overt hyperkalemia (typically defined as a serum K+ value in excess of 6.0 mEq/L), is to be expected whenever they are used. Hyperkalemia attributable to ARA relates to several factors including ARA dose, patient predisposition to hyperkalemia, as in the case of renal failure, and dietary intake of K+. The risk of some change in serum K+ with ARA should not be a deterrent to use of drugs in this class but, rather should prompt careful surveillance for the onset of this potentially life-threatening electrolyte disturbance. The frequency of such scrutiny should be patient-specific and based on the constellation of risk factors for hyperkalemia. [source]


    Corporate environmental disclosures about the effects of climate change

    CORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 6 2008
    Elizabeth Stanny
    Abstract We examine factors associated with the US S&P 500 firms' decisions to disclose information about the current and projected effects of climate change to institutional investors. Through the Carbon Disclosure Project, 315 institutional investors representing 41 trillion USD in assets asked the largest public firms to respond to a questionnaire about climate change. We explore whether firms' disclosures directed specifically to institutional investors are related to factors that have been found to explain voluntary disclosures to investors in general. In particular, we consider factors related to the level of scrutiny, since extant literature predicts that the cost of not disclosing increases with level of scrutiny. We find that size, previous disclosures and foreign sales are related to whether firms disclose information about climate change requested by institutional investors through the Carbon Disclosure Project. Copyright © 2008 John Wiley & Sons, Ltd and ERP Environment. [source]


    The ponderous evolution of corporate environmental reporting in Ireland.

    CORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 2 2003
    Recent evidence from publicly listed companies
    Ireland's recent rapid economic growth has exacerbated pressure on the environment, leading to increased scrutiny of corporate environmental impacts. In order to assess whether external corporate environmental reporting (CER) has evolved in conjunction with this increased scrutiny, this paper reports on the results of a comprehensive analysis of CER practice among all Irish listed companies. The findings are interpreted using the lens of legitimacy theory. The results indicate that, apart from companies whose core activities have an easily observable environmental impact, there is little extensive CER undertaken, in terms of either its quantity or quality. Despite evidence of increasing trends in disclosure, in most instances disclosing companies remain at the very early stages in their consideration of CER. It is argued that this negligible disclosure potentially represents a minimalistic response to pressure from stakeholders whose power to threaten organizations' legitimacy is limited. Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment [source]


    Quality of life for patients with a personality disorder , comparison of patients in two settings: an English special hospital and a Dutch TBS clinic

    CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2001
    Dr Mark Swinton Consultant Forensic Psychiatrist
    Introduction There are differing approaches to the management of people with a severe personality disorder in the UK and The Netherlands. Few comparative studies exist. This study describes the use of an adapted version of the Lancashire Quality of life profile as a patient based-outcome measure. Method A cross-sectional sample of 37 patients was interviewed at each site. Result Patients in the Dutch service reported a significantly higher quality of life which could not be explained by better objective circumstances. Discussion The data collected do not explain why the Dutch patients reported a higher quality of life. It is suggested that this finding was related to more extensive therapeutic activity and greater therapeutic optimism in the Dutch service. There is a need for critical scrutiny of the appropriateness of quality of life measures in offender patients before they are accepted for use as an outcome measure. Copyright © 2001 Whurr Publishers Ltd. [source]


    PROPOSITION 8 AND CRIME RATES IN CALIFORNIA: THE CASE OF THE DISAPPEARING DETERRENT

    CRIMINOLOGY AND PUBLIC POLICY, Issue 3 2006
    CHERYL MARIE WEBSTER
    Research Summary: In 1999, Daniel Kessler and Steven Levitt published an article that purported to provide support for the marginal deterrent effects of harsher sanctions on levels of crime. Specifically, they concluded that sentence enhancements that came into effect in California in June 1982 as a result of Proposition 8 were responsible for a subsequent drop in serious crime in this state. Our article examines the analyses and findings of this article and suggests that their conclusion of a deterrent impact fails to withstand scrutiny when more complete and more detailed crime data are used and the comparability of "control" groups is carefully examined. In particular, the addition of annual crime levels for all years (versus only the odd-numbered years that Kessler and Levitt examine) calls into question the prima facie support for a deterrent effect presented by Kessler and Levitt. Specifically, it demonstrates not only that the crime drop in California began before, rather than after, the passing into law of the sentence enhancements in 1982 but also that the downward slope did not accelerate after the change in law. Furthermore, the comparability of the two "control" groups with the "treatment" group is challenged, rendering suspect any findings based on these comparisons. Policy Implications: Case studies suggesting that crime decreased after the imposition of harsh sentencing policies are often cited as evidence of marginal general deterrence. As has been demonstrated in other contexts, the question that needs to be asked is "Compared with what?" Kessler and Levitt's (1999) article demonstrates that those interested in sentencing policy need to be sensitive not only to the appropriateness of the comparisons that are made, but also to the choice of data that are presented. [source]


    Due Diligence and "Reasonable Man," Offshore

    CULTURAL ANTHROPOLOGY, Issue 4 2005
    Bill Maurer
    In the wake of an international crackdown against preferential tax regimes, Caribbean tax havens and other jurisdictions have adopted "due diligence" procedures to manage financial and reputational risk. Due diligence relies on qualitative forms of evaluation and defers grounded and definitive knowledge claims through continuous peer review. In doing so, it mirrors certain forms of ethnographic practice at a number of levels of scale. This article tracks the shifts in financial regulation from crime to harm and from certainty to scrutiny and reflects on their implications for ethnography,as a limited and open-ended process of evaluation warranted by qualitative forms of judgment. It seeks to complicate our picture of contemporary capitalisms by drawing attention to the nonquantifiable and the ethical that lie "inside" them. Where conventional forms of ethnographic critique might look to expose the political or economic interests behind actions, symbols, or social relationships, this article has a more modest goal: to try to understand the similarity of form between due diligence and anthropology. [source]


    A CRITICAL LOOK AT PAP ADEQUECY: ARE OUR CRITERIA SATISFACTORY?

    CYTOPATHOLOGY, Issue 2006
    D.R. Bolick
    Liquid based Pap (LBP) specimen adequacy is a highly documented, yet poorly understood cornerstone of our GYN cytology practice. Each day, as cytology professionals, we make adequacy assessments and seldom wonder how the criteria we use were established. Are the criteria appropriate? Are they safe? What is the scientific data that support them? Were they clinically and statistically tested or refined to achieve optimal patient care? In this presentation, we will take a fresh look at what we know about Pap specimen adequacy and challenge some of the core assumptions of our daily practice. LBP tests have a consistent, well-defined surface area for screening, facilitating the quantitative estimates of slide cellularity. This provides an unprecedented opportunity to establish reproducible adequacy standards that can be subjected to scientific scrutiny and rigorous statistical analysis. Capitalizing on this opportunity, the TBS2001 took the landmark step to define specimen adequacy quantitatively, and set the threshold for a satisfactory LBP at greater than 5,000 well visualized squamous epithelial cells. To date, few published studies have attempted to evaluate the validity or receiver operator characteristics for this threshold, define an optimal threshold for clinical utility or assess risks of detection failure in ,satisfactory' but relatively hypocellular Pap specimens. Five years of cumulative adequacy and cellularity data of prospectively collected Pap samples from the author's laboratory will be presented, which will serve as a foundation for a discussion on ,Pap failure'. A relationship between cellularity and detection of HSIL will be presented. Risk levels for Pap failure will be presented for Pap samples of different cellularities. The effect of different cellularity criterion on unsatisfactory Pap rates and Pap failure rates will be demonstrated. Results from this data set raise serious questions as to the safety of current TBS2001 adequacy guidelines and suggest that the risk of Pap failure in specimens with 5,000 to 20 000 squamous cells on the slide is significantly higher than those assumed by the current criteria. TBS2001 designated all LBP to have the same adequacy criterion. Up to this point, it has been assumed that ThinPrep, SurePath, or any other LBP would be sufficiently similar that they should have the same adequacy criteria. Data for squamous cellularity and other performance characteristics of ThinPrep and SurePath from the author's laboratory will be compared. Intriguing data involving the recently approved MonoPrep Pap Test will be reviewed. MonoPrep clinical trial data show the unexpected finding of a strong correlation between abundance of endocervical component and the detection of high-grade lesions, provoking an inquiry of a potential new role for a quantitative assessment of the transition zone component. The current science of LBP adequacy criteria is underdeveloped and does not appear to be founded on statistically valid methods. This condition calls us forward as a body of practitioners and scientists to rigorously explore, clarify and define the fundamental nature of cytology adequacy. As we forge this emerging science, we will improve diagnostic performance, guide the development of future technologies, and better serve the patients who give us their trust. Reference:, Birdsong GG: Pap smear adequacy: Is our understanding satisfactory? Diagn Cytopathol. 2001 Feb; 24(2): 79,81. [source]


    Cancer risk from diagnostic radiology in a deliberate self-harm patient

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010
    L. J. Norelli
    Norelli LJ, Coates AD, Kovasznay BM. Cancer risk from diagnostic radiology in a deliberate self-harm patient. Objective:, Patients who engage in recurrent deliberate self-harm (DSH) behaviours have increased morbidity and mortality and use emergency services more than others. Unrecognized iatrogenic injury may play a role. Specifically, we call attention to the potential danger of cumulative radiation exposure. Method:, Case presentation and discussion. Results:, A 29-year-old woman with multiple episodes of deliberate foreign body ingestion received over 400 diagnostic radiology examinations during a 12 year period. The patient's calculated total radiation dose reached an average of 20.5 mSv per year, a dose comparable to atomic bomb survivors and nuclear industry workers, populations in which there is a significant excess cancer risk. Conclusion:, Patients with recurrent self-injurious behaviours, frequent users of healthcare services who often undergo repeated medical assessment and treatment, are likely at higher risk for iatrogenic adverse events. Multiple diagnostic radiology examinations have recently come under scrutiny for causing increased lifetime risk of cancer. Healthcare providers, in particular psychiatrists and emergency department physicians, should consider the cumulative risks of radiological procedures when assessing and treating patients with DSH. [source]


    An investigation of root-fractured permanent incisor teeth in children

    DENTAL TRAUMATOLOGY, Issue 1 2003
    Laura Feely
    Abstract ,,,The aim of this retrospective study was to determine the type of healing which occurred in root-fractured permanent incisor teeth in children. The objectives were to determine whether gender, age, stage of root development or location of the fracture affected the healing type. The method involved careful scrutiny of clinical records and radiographs of children who attended a unit of paediatric dentistry in a dental hospital. Relevant information was entered onto a data collection sheet. The results were tabulated and analysed by the ,2 -tests using the SPSS statistical package. The results are based on 34 root-fractured teeth in 33 children aged 8,15 years. Root development was incomplete in 27 of the root-fractured teeth and complete in seven teeth. A good healing outcome was seen in 27 (79.4%) of the teeth and poor healing in 7 (20.6%). The only factor which was found to be statistically significantly related to healing was the stage of root development. It can be concluded that root-fractured teeth with immature roots have a better chance of showing good healing than teeth with mature roots. [source]


    No Smoking Gun: Findings From a National Survey of Office-Based Cosmetic Surgery Adverse Event Reporting

    DERMATOLOGIC SURGERY, Issue 11 2003
    Rajesh Balkrishnan PhD
    Background. Because of recent press reports of adverse outcomes, office-based cosmetic surgery has come under intense scrutiny and associated legislative regulatory action. Objective. To assess the safety of office-based cosmetic surgery through a national survey of state agencies that collect information on adverse patient outcomes. Methods. Medical boards or other responsible authorities were contacted in 48 states to obtain records on adverse outcomes from cosmetic surgery procedures performed in an office-based setting. Results. Five states were able to provide complete information regarding 13 cases of adverse outcomes that resulted from office-based cosmetic surgery procedures. Thirteen states had incomplete information or were unable to provide information. The remaining states reported no adverse outcomes. Information collected by state agencies varies greatly and is inadequate to define the safety of office-based cosmetic surgery practice. Conclusions. The need to regulate physician office surgery on the basis of hospital privileges and office certification is not supported by current data. Mandatory reporting of adverse outcomes from office-based surgery is warranted to identify modifiable risk factors and to reduce the risk of adverse outcomes. [source]


    State Collapse and Fresh Starts: Some Critical Reflections

    DEVELOPMENT AND CHANGE, Issue 5 2002
    Martin Doornbos
    In examining the incidence of state collapse, two central themes emerge, one concerned with the search for causalities and the other concerned with appropriate responses. There is often a misplaced tendency to look for single causes and explanations of state collapse, and similarly to propose single, preferably ,quick,fix' solutions. Instead, what seems to be called for is a more nuanced scrutiny which differentiates the factors leading to collapse in specific instances, and a reconsideration, in the light of this scrutiny, of responses and possible external actor involvement. This article addresses these two themes. Firstly, it takes a preliminary look into the complex web of conditioning and facilitating factors that may or may not set in motion a chain reaction eventually leading to state collapse, examining the extent to which any emerging patterns can be identified. Secondly, it looks more closely at the response side to incidences of state collapse, specifically external responses. Whilst external actors, notably the ,donor community', are trying to better prepare themselves for the eventualities of crises of governance and state collapse in various countries, and to design more effective strategies and instruments, it remains to be seen to what extent there is a ,fit' between the determinants and dynamics of state collapse and the responses and solutions for restoration which are offered. [source]


    Clinical and Economic Factors Associated with Ambulance Use to the Emergency Department

    ACADEMIC EMERGENCY MEDICINE, Issue 8 2006
    Jennifer Prah Ruger PhD
    Background: Concern about ambulance diversion and emergency department (ED) overcrowding has increased scrutiny of ambulance use. Knowledge is limited, however, about clinical and economic factors associated with ambulance use compared to other arrival methods. Objectives: To compare clinical and economic factors associated with different arrival methods at a large, urban, academic hospital ED. Methods: This was a retrospective, cross-sectional study of all patients seen during 2001 (N= 80,209) at an urban academic hospital ED. Data were obtained from hospital clinical and financial records. Outcomes included acuity and severity level, primary complaint, medical diagnosis, disposition, payment, length of stay, costs, and mode of arrival (bus, car, air-medical transport, walk-in, or ambulance). Multivariate logistic regression identified independent factors associated with ambulance use. Results: In multivariate analysis, factors associated with ambulance use included: triage acuity A (resuscitation) (adjusted odds ratio [OR], 51.3; 95% confidence interval [CI] = 33.1 to 79.6) or B (emergent) (OR, 9.2; 95% CI = 6.1 to 13.7), Diagnosis Related Group severity level 4 (most severe) (OR, 1.4; 95% CI = 1.2 to 1.8), died (OR, 3.8; 95% CI = 1.5 to 9.0), hospital intensive care unit/operating room admission (OR, 1.9; 95% CI = 1.6 to 2.1), motor vehicle crash (OR, 7.1; 95% CI = 6.4 to 7.9), gunshot/stab wound (OR, 2.1; 95% CI = 1.5 to 2.8), fell 0,10 ft (OR, 2.0; 95% CI = 1.8 to 2.3). Medicaid Traditional (OR, 2.0; 95% CI = 1.4 to 2.4), Medicare Traditional (OR, 1.8; 95% CI = 1.7 to 2.1), arrived weekday midnight,8 AM (OR, 2.0; 95% CI = 1.8 to 2.1), and age ,65 years (OR, 1.3; 95% CI = 1.2 to 1.5). Conclusions: Ambulance use was related to severity of injury or illness, age, arrival time, and payer status. Patients arriving by ambulance were more likely to be acutely sick and severely injured and had longer ED length of stay and higher average costs, but they were less likely to have private managed care or to leave the ED against medical advice, compared to patients arriving by independent means. [source]


    Brief interventions: good in theory but weak in practice

    DRUG AND ALCOHOL REVIEW, Issue 1 2004
    Professor ANN M. ROCHE Director
    Abstract A substantial body of research evidence has accumulated in support of the efficacy of brief interventions for a number of alcohol and drug-related problem areas, most notably alcohol and tobacco. This evidence has been used to exhort a range of professional groups such as general practitioners (GPs), and more recently emergency department hospital staff to engage in brief interventions. Internationally, however, these secondary prevention efforts have largely failed. Why have these proven interventions not been embraced by frontline workers? This is a little-asked question as efforts to press-gang unwilling professionals to take up the cudgel continue. This paper examines the characteristics of brief interventions and their principal delivery agents and explores reasons for the failure to move from efficacy to effectiveness. Given the prevention potential that rests with brief intervention, these are crucial questions to address. A key feature of brief intervention delivery also examined is the role of GPs versus the less well-explored option of the practice nurse. It will be proposed that perhaps we have the right vehicle but the wrong driver and that until closer scrutiny is made of this issue efforts in this key prevention area will continue to fail to achieve optimum results. [source]


    Sediment transmission and storage: the implications for reconstructing landform development

    EARTH SURFACE PROCESSES AND LANDFORMS, Issue 1 2010
    R. C. Chiverrell
    Abstract The late Holocene (last 3000 years) development of the lower Ribble valley (northwest England) displays evidence for a complex response to a sediment recharge event forced by land-use change induced increases in erosion and sediment delivery. The deposition of fluvial sediments during the late Holocene was restricted to a series of reaches or depocenters separated by zones with no sediment accumulation constrained by older glacial and fluvial terrain. Apparent reach-wide correlations of fluvial terraces break down under the scrutiny applied by comprehensive and extensive radiocarbon control. Bayesian testing of relative order models show that large-scale geomorphological changes, e.g. the progression from one terrace level to another, were time transgressive between different depocenters. The different histories of sediment delivery and storage are probably a function of local- and process-scale variations in these depocenters, and reflect (dis)connectivity relationships within a reach in propagating a basin-scale change (superslug) in the sediment regime. Disconnectivity in the depositional regime through a fluvial reach limits what we can reconstruct in terms of sediment budgets, but radiocarbon dating of multiple palaeochannels offers considerable potential for landform-based research to uncover rates of change within individual depocenters. Copyright © 2009 John Wiley & Sons, Ltd. [source]


    Invasion success: does size really matter?

    ECOLOGY LETTERS, Issue 2 2002
    A. W. Miller
    The recent paper by Roy et al. (2001) presents a compelling relationship between range limit shifts, climatic fluctuations, and body size for marine bivalves in the fossil record. However, their extension of body size as a correlate for contemporary marine bivalve introductions is problematic and requires further scrutiny. Unlike their analysis of the fossil assemblage, the approach used for contemporary invasions does not adequately control for dispersal mechanism (vector) or source region. First, their analysis included mariculture species, intentionally introduced because of their large size, creating a vector-specific bias. Second, successful invaders from multiple source regions (Northern Hemisphere) were compared with potential invaders from a single source region (north-eastern Pacific), leaving both source and vector as uncontrolled variables. We present an analysis of body size for bivalve introductions from a single vector and source region, indicating no correlation between body size and invasion success when eliminating intentional introduction, source region and transport vector as confounding factors. [source]


    DO WE REALLY NEED CENTRAL BANKS?

    ECONOMIC AFFAIRS, Issue 3 2009
    Roland Vaubel
    An analysis of economic theory and economic history suggests that central banks, with a monopoly of money-issuing services, are not necessary. The often-levelled arguments against private banks issuing money in competition with each other and with central banks do not stand up to close scrutiny. [source]


    Some simple economics of GM food

    ECONOMIC POLICY, Issue 33 2001
    Dietmar Harhoff
    Public opposition to the genetic engineering of food crops (GM food) has not been based solely on concern about biological risks. Economic risks have been widely cited too: the fear that the world's food supply will be concentrated in the hands of a few large firms, the fear that such firms will engage or are already engaging in anti,competitive practices, and the fear of the transfer of ownership rights over genetic resources to the private sector. Are these fears justified? We argue that the GM food industry may be on course for further consolidation, and this could be anti,competitive. In fact, policymakers face a dilemma: a stringent regulatory approval process enhances food safety, but at the cost of increasing market concentration. We argue also that the integration of seed and agri,chemical manufacturers may bias the introduction of GM traits in undesirable directions. Some business practices (such as tie,in contracts between seeds and complementary products such as herbicides) may have an exclusionary motive that warrants scrutiny on anti,competitive grounds, while some other practices (such as the use of terminator genes) appear more benign. Finally, we argue against granting patents on genes or even on gene ,functions'. Doing so may delay the development of socially beneficial applications. [source]


    Do Peer Groups Matter?

    ECONOMICA, Issue 277 2003
    Peer Group versus Schooling Effects on Academic Attainment
    This paper estimates an educational production function. Educational attainment is a function of peer group, parental input and schooling. Conventional measures of school quality are not good predictors for academic attainment, once we control for peer group effects; parental qualities also have strong effects on academic attainment. This academic attainment is a then a key determinant of subsequent labour market success, as measured by earnings. The main methodological innovation in this paper is the nomination of a set of instruments, very broad regions of birth, which, as a whole, pass close scrutiny for validity and permit unbiased estimation of the production function. [source]


    Smoothing It: Some Aristotelian misgivings about the phronesis-praxis perspective on education

    EDUCATIONAL PHILOSOPHY AND THEORY, Issue 4 2005
    KristjŠn KristjŠnssonArticle first published online: 26 JUL 200
    Abstract A kind of ,neo-Aristotelianism' that connects educational reasoning and reflection to phronesis, and education itself to praxis, has gained considerable following in recent educational discourse. The author identifies four cardinal claims of this phronesis-praxis perspective: that a) Aristotle's epistemology and methodology imply a stance that is essentially, with regard to practical philosophy, anti-method and anti-theory; b) ,producing', under the rubric of technť, as opposed to ,acting' under the rubric of phronesis, is an unproblematically codifiable process; c) phronesis must be given a particularist interpretation; and d) teaching is best understood as praxis in the Aristotelian sense, guided by phronesis. The author argues that these claims have insufficient grounding in Aristotle's own writings, and that none of them stands up to scrutiny. [source]


    Regulatory impact on insect biotechnology and pest management

    ENTOMOLOGICAL RESEARCH, Issue 4 2007
    Chris A. WOZNIAK
    Abstract The application of insect biotechnology is promising for the development of environmentally compatible pest management solutions. As we have refined and enhanced genetic engineering techniques in several insect species that cause significant economic loss and public health injury, it has become clear that insect biotechnology will move forward as one of the key tools of pest management in agriculture and in the human environment. Well characterized genetic elements can be manipulated toward specific aims and maintain a viable insect, albeit one with diminished capacity to exchange genetic material, vector a virus or bacterium, or complete its life cycle. Despite this degree of knowledge and precision, there remain unanswered questions regarding environmental fate, release and public acceptance of this technology. The uncertainty surrounding any novel technology inevitably increases the level of regulatory scrutiny associated with its use. Although the term "insect biotechnology" has many connotations, it certainly includes the genetic modification of symbiotic or commensally associated microbes as a means of delivering a trait (e.g. a toxin) to manage plant and human diseases and insect pests. The distinction between this paratransgenic approach and direct genetic modification of insect pests is an important one biologically as well as from a regulatory standpoint. The regulatory framework for microbial applications to agriculture is in many instances in place; however, we must strive to forge the development of guidelines and regulations that will foster deployment of insect biotechnologies. [source]


    Exposure assessment of 17,-ethinylestradiol in surface waters of the United States and Europe,

    ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 12 2009
    Robert Hannah
    Abstract An evaluation of measured and predicted concentrations of 17,-ethinylestradiol in surface waters of the United States and Europe was conducted to develop expected long-term exposure concentrations for this compound. Measured environmental concentrations (MECs) in surface waters were identified from the literature. Predicted environmental concentrations (PECs) were generated for European and U.S. watersheds using the GREAT-ER and PhATE‘ models, respectively. The majority of MECs are nondetect and generally consistent with model PECs and conservative mass balance calculations. However, the highest MECs are not consistent with concentrations derived from conservative (worst-case) mass balance estimates or model PECs. A review of analytical methods suggests that tandem or high-resolution mass spectrometry methods with extract cleanup result in lower detection limits and lower reported concentrations consistent with model predictions and bounding estimates. Based on model results using PhATE and GREAT-ER, the 90th-percentile low-flow PECs in surface water are approximately 0.2 and 0.3 ng/L for the United States and Europe, respectively. These levels represent conservative estimates of long-term exposure that can be used for risk assessment purposes. Our analysis also indicates that average concentrations are one to two orders of magnitude lower than these 90th-percentile estimates. Higher reported concentrations (e.g., greater than the 99th-percentile PEC of ,1 ng/L) could result from methodological problems or unusual environmental circumstances; however, such concentrations are not representative of levels generally found in the environment, warrant special scrutiny, and are not appropriate for use in risk assessments of long-term exposures. [source]


    A continuing education programme for general practitioners

    EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2000
    Status report after 5 years of function
    In 1992, following newly issued university regulations, the board of the School of Dental Medicine of the University of Geneva decided to establish a structured continuing education course programme for practising dentists in an effort to better meet the school's continuing education mandate. The programme started in January 1994 and was structured so that regular courses would be offered in each discipline of dentistry. The course contents were aimed at satisfying the demands of practising dentists, but it was also established that basic science issues and theoretical concepts should be included. Possible course formats were ,conference', ,hands-on', ,clinical' and ,seminar'. The courses were meant as a form of knowledge transfer from the school to the practising community, but also as a means to generate revenue for research and teaching programmes. Operative aspects were supervised by a small staff which was assisted by computer software designed to handle all procedural steps of course administration, participant registration, accounting, communication. The dentists' responses were rewarding in that attendance was very satisfactory. Closer scrutiny of our data, however, indicates that our impact is still low since at best only 20% of the course-hours required by the Swiss dental association are actually taken. Both course and programme evaluations were satisfactory and are discussed using the Harden and Laidlaw CRISIS criteria. [source]