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Misunderstanding
Kinds of Misunderstanding Selected AbstractsAcknowledging communication: a milieu-therapeutic approach in mental health careJOURNAL OF ADVANCED NURSING, Issue 6 2008Solfrid Vatne Abstract Title.,Acknowledging communication: a milieu-therapeutic approach in mental health care Aim., This paper is a report of a study to develop milieu therapists' acknowledging communication in their relationships with patients. Background., Gunderson's therapeutic processes in milieu therapy have come into use in a broad range of mental health contexts in many countries. Research in nursing indicates that validation needs a more concrete development for use in clinical work. Methods., Schibbye's theory, ,Intersubjective relational understanding', formed the theoretical foundation for a participatory action research project in 2004,2005. The data comprised the researcher's process notes written during participation in the group of group leaders every second week over a period of 18 months, clinical narratives presented by participants in the same group, and eight qualitative interviews of members of the reflection group. Findings., The core concept in acknowledging communication, mutuality, was described as inter-subjective sharing of feelings and beliefs in a respectful way. Participants presented their process of development as a movement from knowing what was best for the patient (acknowledging patients as competent persons, a milieu-therapy culture based on conformity), to appreciating diversity and stubborn talk, to reflective wondering questions. Misunderstanding of acknowledgement occurred, for instance, in the form of always being supportive and affirmative towards patients. Conclusion., The concrete approaches in acknowledging communication presented in this article could be a fruitful basis for educating in and developing milieu therapy, both for nursing and in a multi-professional approach in clinical practice and educational institutions. Future research should focus on broader development of various areas of acknowledging communication in practice, and should also include patients' experiences of such approaches. [source] Mutual Misunderstanding in ContractAMERICAN BUSINESS LAW JOURNAL, Issue 4 2009Benjamin Alarie First page of article [source] Misunderstanding standardized language in research interviewsAPPLIED COGNITIVE PSYCHOLOGY, Issue 2 2004Michael F. Schober Leaving the interpretation of words up to participants in standardized survey interviews, aptitude tests, and experiment instructions can lead to unintended interpretation; more collaborative interviewing methods can promote uniform understanding. In two laboratory studies (a factorial experiment and a more naturalistic investigation), respondents interpreted ordinary survey concepts like ,household furniture' and ,living in a house' quite differently than intended in strictly standardized interviews, when the interpretation was left entirely up to them. Comprehension was more accurate when interviewers responded to requests for clarification with non-standardized paraphrased definitions, and most accurate when interviewers also provided clarification whenever they suspected respondents needed it. Copyright © 2004 John Wiley & Sons, Ltd. [source] Longitudinal tooth fractures: findings that contribute to complex endodontic diagnosesENDODONTIC TOPICS, Issue 1 2007ERIC M. RIVERA The purpose of this review is to describe and discuss the diagnostic and treatment challenges related to tooth fractures primarily in the vertical plane, that is, the long axis of the crown and/or root. This includes when and how to identify and determine the extent of the fracture, when a coronal restoration should be placed, when root canal treatment is needed, and when a tooth or root should be extracted based on the location and extent of the fracture. The term ,longitudinal fractures' is used because they usually represent vertical extensions of fractures over distance and time. These fractures often present problems with diagnosis and treatment, but should be considered as findings only. They are not to be considered as pulpal or periapical diagnoses, but as pathways for bacteria that may induce pulpal and/or periapical inflammation or disease. Longitudinal fractures are divided into five definitive classifications, generally from least to most severe: (1) craze lines; (2) fractured cusp; (3) cracked tooth; (4) split tooth; and (5) vertical root fracture. These differ but have frequently been confused or combined in clinical articles, creating misunderstanding and resulting in incorrect diagnosis and inappropriate treatment. These classifications have been devised to provide global definitions that researchers and clinicians can use to eliminate this confusion. This review is subdivided into these five classifications as to incidence, pathogenesis, clinical features, etiologies, diagnosis, treatment, prognosis, and prevention. [source] Entrepreneurial and Business Growth and the Quest for a "Comprehensive Theory": Tilting at Windmills?ENTREPRENEURSHIP THEORY AND PRACTICE, Issue 2 2010Claire Leitch Even though there has been sustained interest in growth for almost 50 years, relatively little is known about this phenomenon and much confusion and misunderstanding surrounds it. Based on a literature review and the articles in this special issue we make three recommendations that we believe will allow theory to advance and be applicable in practice. First, that discourse between key stakeholders is encouraged in order to achieve greater understanding. Second, that focus is placed on "growth as a process," rather than as a "change in amount." Third, that knowledge production requires inclusivity and pluralism in research perspectives and approaches. [source] National Judges, Community Judges: Invitation to a Journey through the Looking-glass,On the Need for Jurisdictions to Rethink the Inter-systemic Relations beyond the Hierarchical PrincipleEUROPEAN LAW JOURNAL, Issue 6 2008Florence Giorgi The historical conflict between the European Court of Justice (ECJ) and the national constitutional courts regarding primacy is a misunderstanding. In going through the looking-glass, we can understand that, on the contrary, the ECJ and the national constitutional courts adopt comparable solutions in their treatment of legal pluralism, and that they see the negation of pluralism as essential for the survival of their own legal orders. Therefore, these judges must be offered a new theoretical context to help them reconcile their role as supreme guardian with the taking into account of the pluralist context. Finally, practical proposals must be made to give judges the instruments and techniques that are capable of reflecting this plural structure. [source] Pan Evaporation Trends and the Terrestrial Water Balance.GEOGRAPHY COMPASS (ELECTRONIC), Issue 2 2009Declines in pan evaporation have been reported across the USA, former Soviet Union, India, China, Australia, New Zealand and Canada, among other places. The trend is large , approximately an order of magnitude larger than model-based estimates of top of the atmosphere radiative forcing. The pan evaporation trend also has a different sign (i.e. decline) from commonly held conceptions. These are a remarkably interesting set of observations. In the first article of this two-part series, we discussed the measurements themselves and then presented summaries of the worldwide observations. In this, the second article, we outline the use of energy balance methods to attribute the observed changes in pan evaporation to changes in the underlying physical variables, namely, radiation, temperature, vapour pressure deficit and wind speed. We find that much of the decline in pan evaporation can be attributed to declines in radiation (i.e. dimming) and/or wind speed (i.e. stilling). We then discuss the interpretation of changes in the terrestrial water balance. This has been an area of much misunderstanding and confusion, most of which can be rectified through use of the familiar and longstanding supply/demand framework. The key in using the pan evaporation data to make inferences about changes in the terrestrial water balance is to distinguish between water- and energy-limited conditions where different interpretations apply. [source] Sociolinguistic inference and intercultural coorientation.HUMAN COMMUNICATION RESEARCH, Issue 3 2001A Bayesian model of communicative competence in intercultural interaction We present a model that examines the effects of cultural differences on coorientation (the ability of communicators to accurately encode and interpret the referential and relational meanings of messages). Intercultural coorientation is made problematic by the absence of certain shared communication system knowledge, which in same-culture interactions is used in the dynamic sociolinguistic negotiation of relational rights and obligations. We propose that the process of sociolinguistic negotiation of meanings relies fundamentally on probabilistic inference and have constructed a model based on Bayes' theorem. The model predicts the effects of the communication situation, communicator stereotypes and prejudice, and some other-culture speaker errors on conclusions the receiver draws about the message. Using the model, we distinguish between the ethnocentric error of interpreting a communication in terms of one's own culture and the error of not seeing the communication as diagnostic. Among our predictions are: (a) the less diagnostic the communication, the more impact cultural stereotypes will have on attributions; (b) although evidence of sociolinguistic incompetence sometimes causes misunderstanding, it sometimes prevents misunderstanding; (c) multiple consistent features make intentions clearer than would a single cue, but multiple features violating co-occurrence norms often lead to the attribution of incompetence. [source] What do we know about dementia?: a survey on knowledge about dementia in the general public of JapanINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2008Yumiko Arai Abstract Objective The importance of early detection of dementia has been highlighted in recent years by the medical and scientific community; however, delays often occur between the recognition of signs or symptoms and a decision by the patient or family to seek professional help. Such delays may be caused by a lack of knowledge about dementia among patients and family members. The aim of this study was to determine the understanding of dementia among the general public. Methods We conducted a survey in Japan that asked 11 questions regarding knowledge of ,general' information, ,symptoms', and ,biomedical' issues related to dementia. A quota sampling method was used to select 2,500 participants, 2,115 of who were eligible for the analyses. Results The average number of correct responses among females was significantly greater than that among the males. A multiple comparisons test demonstrated that middle-aged women were more knowledgeable than younger and older respondents. It was revealed that there was a lack of knowledge on biomedical aspects of dementia, i.e. cause, treatment, and prognosis along with a misunderstanding of dementia as senescence forgetfulness among the general public. Conclusions There appeared to be gaps in knowledge on dementia among the general public, which may prevent caregivers from planning upcoming social and financial challenges. Correct information needs to be given by health professionals and care staff. Educational initiatives planned for the general public could be useful, and should target those groups, men and non-middle aged women who have lower knowledge. Copyright © 2008 John Wiley & Sons, Ltd. [source] Reconciling situational social psychology with virtue ethicsINTERNATIONAL JOURNAL OF MANAGEMENT REVIEWS, Issue 3 2008Surendra Arjoon For the past four decades, debate has occurred in respect of situational social psychology and virtue ethics. This paper attempts to reconcile this debate. Situationists propose a fragmentation theory of character (each person has a whole range of dispositions, each of which has a restricted situational application) and do not subscribe to a regularity theory of character (behaviour is regulated by long-term dispositions). In order to support this view, they cite a number of experiments. It is proposed that the substantive claims made by situationist social psychologists, for the most part, do not undermine or disagree with an Aristotelian virtue ethics perspective, but stem from a misunderstanding of concepts of moral character, faulty conclusions and generalizations in respect of experimental results. Situationists take a narrow view of character and morality. Evidence from organizational behaviour and managerial research literature supports the view that both situational (organizational) features and inner characteristics (including virtues) are powerful influences and determinants of morally upright and morally deviant behaviour. The role of practical judgement in bridging these views is discussed. As a way forward in reconciling situational social psychology with virtue ethics, the paper proposes an Aristotelian,Thomistic framework to overcome some of the problems associated with inadequate regulative ideals in building a normative moral theory. [source] Evidence-based practice: A framework for clinical practice and research designINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2006Matthew J Leach PhD BN(Hons) ND RN The evidence-based practice (EBP) framework emerged in the early 1970s as a means of improving clinical practice. This shift towards EBP allowed health professionals to move from a culture of delivering care based on tradition, intuition and authority, to a situation where decisions were guided and justified by the best available evidence. Despite the many advantages of EBP, many practitioners remain cautious about embracing the model. Part of this opposition is due to a misunderstanding of EBP, which this paper aims to address. [source] The lognormal distribution is not an appropriate null hypothesis for the species,abundance distributionJOURNAL OF ANIMAL ECOLOGY, Issue 3 2005MARK WILLIAMSON Summary 1Of the many models for species,abundance distributions (SADs), the lognormal has been the most popular and has been put forward as an appropriate null model for testing against theoretical SADs. In this paper we explore a number of reasons why the lognormal is not an appropriate null model, or indeed an appropriate model of any sort, for a SAD. 2We use three empirical examples, based on published data sets, to illustrate features of SADs in general and of the lognormal in particular: the abundance of British breeding birds, the number of trees > 1 cm diameter at breast height (d.b.h.) on a 50 ha Panamanian plot, and the abundance of certain butterflies trapped at Jatun Sacha, Ecuador. The first two are complete enumerations and show left skew under logarithmic transformation, the third is an incomplete enumeration and shows right skew. 3Fitting SADs by ,2 test is less efficient and less informative than fitting probability plots. The left skewness of complete enumerations seems to arise from a lack of extremely abundant species rather than from a surplus of rare ones. One consequence is that the logit-normal, which stretches the right-hand end of the distribution, consistently gives a slightly better fit. 4The central limit theorem predicts lognormality of abundances within species but not between them, and so is not a basis for the lognormal SAD. Niche breakage and population dynamical models can predict a lognormal SAD but equally can predict many other SADs. 5The lognormal sits uncomfortably between distributions with infinite variance and the log-binomial. The latter removes the absurdity of the invisible highly abundant half of the individuals abundance curve predicted by the lognormal SAD. The veil line is a misunderstanding of the sampling properties of the SAD and fitting the Poisson lognormal is not satisfactory. A satisfactory SAD should have a thinner right-hand tail than the lognormal, as is observed empirically. 6The SAD for logarithmic abundance cannot be Gaussian. [source] Understanding the multiple meanings of ,inbreeding' and ,effective size' for genetic management of African rhinoceros populationsAFRICAN JOURNAL OF ECOLOGY, Issue 4 2009Stanton Braude Abstract Although some African rhinoceros populations are currently increasing, others are critically endangered. Even healthy populations are extensively managed in the wild and in captivity. While political and demographic considerations are of primary concern, many decisions are made in the name of genetic management. Such decisions should be informed by a full understanding of the multiple meanings of inbreeding and effective population size. In this essay, we examine inbreeding and effective size of wild and captive populations of African rhinoceroses. We conclude by showing how misunderstanding of effective size and Franklin's 50/500 rule can make a crucial difference in informing management decisions. Résumé Bien que certaines populations de rhinocéros africains soient actuellement en augmentation, d'autres sont en danger critique. Même les populations saines sont gérées très activement dans la nature et en captivité. Alors que les considérations politiques et démographiques soient les principaux motifs d'inquiétude, de nombreuses décisions sont prises au nom de la gestion génétique. Ces décisions devraient se faire en pleine connaissance des multiples implications de l'inbreeding et de ce qu'est une taille de population nécessaire. Dans cet essai, nous examinons l'inbreeding et la taille nécessaire des populations sauvages et captives de rhinocéros africains. Nous concluons en montrant comment une mauvaise compréhension de la taille nécessaire et de la règle 50/500 de Franklin peut entraîner une différence cruciale lorsqu'il s'agit de prendre, en connaissance de cause, les décisions opportunes. [source] Psychotherapy in Brunei DarussalamJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2007N. Kumaraswamy Clinical psychologists face unique challenges in developing Southeast Asian countries because mental health care has not received the kind of attention it deserves. In part, this has been the result of lack of knowledge or misunderstanding about mental health and adherence to various religious and traditional beliefs. In this article, the practice of psychotherapy in Brunei Darussalam is reviewed and then illustrated with a typical case, Mrs. A Asian psychotherapists need more comprehensive knowledge of prevailing cultural beliefs and religious practices among multiethnic population groups. © 2007 Wiley Periodicals, Inc. J Clin Psychol: In Session 63: 735,744, 2007. [source] The Failure of Organizational Learning from Crisis , A Matter of Life and Death?JOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 3 2009Dominic Elliott The continuing failure of organizations to learn from crisis has many costs, social, political, financial and individual and may be attributable to a misunderstanding of learning processes. This paper maps out contributions to learning from crisis from a number of fields. Central to the paper's argument is that the separation of policy development from practice, in theory and action, has contributed to a failure to learn. The paper considers two cases where the failure of child protection services resulted in the deaths of the children concerned. These two cases, separated by seven years, were connected by the failure of the same local authorities and agencies. The paper concludes with a number of observations concerning the public inquiry process. [source] The formal Darwinism project: a mid-term reportJOURNAL OF EVOLUTIONARY BIOLOGY, Issue 4 2007A. GRAFEN Abstract For 8 years I have been pursuing in print an ambitious and at times highly technical programme of work, the ,Formal Darwinism Project', whose essence is to underpin and formalize the fitness optimization ideas used by behavioural ecologists, using a new kind of argument linking the mathematics of motion and the mathematics of optimization. The value of the project is to give stronger support to current practices, and at the same time sharpening theoretical ideas and suggesting principled resolutions of some untidy areas, for example, how to define fitness. The aim is also to unify existing free-standing theoretical structures, such as inclusive fitness theory, Evolutionary Stable Strategy (ESS) theory and bet-hedging theory. The 40-year-old misunderstanding over the meaning of fitness optimization between mathematicians and biologists is explained. Most of the elements required for a general theory have now been implemented, but not together in the same framework, and ,general time' remains to be developed and integrated with the other elements to produce a final unified theory of neo-Darwinian natural selection. [source] The evolution of trade-offs: where are we?JOURNAL OF EVOLUTIONARY BIOLOGY, Issue 2 2007D. A. ROFF Abstract Trade-offs are a core component of many evolutionary models, particularly those dealing with the evolution of life histories. In the present paper, we identify four topics of key importance for studies of the evolutionary biology of trade-offs. First, we consider the underlying concept of ,constraint'. We conclude that this term is typically used too vaguely and suggest that ,constraint' in the sense of a bias should be clearly distinguished from ,constraint' in the sense of proscribed combinations of traits or evolutionary trajectories. Secondly, we address the utility of the acquisition,allocation model (the ,Y-model'). We find that, whereas this model and its derivatives have provided new insights, a misunderstanding of the pivotal equation has led to incorrect predictions and faulty tests. Thirdly, we ask how trade-offs are expected to evolve under directional selection. A quantitative genetic model predicts that, under weak or short-term selection, the intercept will change but the slope will remain constant. Two empirical tests support this prediction but these are based on comparisons of geographic populations: more direct tests will come from artificial selection experiments. Finally, we discuss what maintains variation in trade-offs noting that at present little attention has been given to this question. We distinguish between phenotypic and genetic variation and suggest that the latter is most in need of explanation. We suggest that four factors deserving investigation are mutation-selection balance, antagonistic pleiotropy, correlational selection and spatio-temporal variation, but as in the other areas of research on trade-offs, empirical generalizations are impeded by lack of data. Although this lack is discouraging, we suggest that it provides a rich ground for further study and the integration of many disciplines, including the emerging field of genomics. [source] Managing the risks of physical intervention: developing a more inclusive approachJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2010L. HOLLINS bsc physiotherapy Accessible summary ,,It is imperative that the use of physical interventions be reduced. However, when they are used the safety of recipients must be maximized. ,,A focus on the ,prone restraint position' has led to a narrowed understanding of the risks associated with the application of force during restraints. ,,The ,transitional stabilizing position' offers a platform upon which to consider the broader risks arising during restraints. ,,Training staff to manage such situational risks, using a variation on the existing ABC safety check could be instrumental in reducing the likelihood of adverse outcomes associated with restraints. Abstract Since psychiatry evolved as a professional discipline, mental healthcare professionals have had to, as a last resort, physically intervene to manage physically aggressive patients. In the United Kingdom, physical intervention techniques migrated from the prison service in the mid 1980s where there was extensive use of two particularly controversial practices; ,pain compliance' and the ,prone restraint position'. This paper examines how the classification of the ,prone restraint position' has led to a narrowed focus on one technique and a resultant misunderstanding around the wider risks associated with the applying force and managing restraints. The paper goes on to propose the ,transitional stabilizing position' (TSP) as an alternative concept and puts forward a dynamic risk assessment model. It explores how a shift in staff training away from developing pure competence in the performance of tightly specified techniques to managing the patient in TSPs could conceivably reduce the relatively low risk of death or serious injury associated with the application of restraint techniques to an even lower level. [source] Learning from and responding to students' questions: The authoritative and dialogic tensionJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 2 2010Orlando G. Aguiar Abstract In this study we present an analysis of classroom interactions initiated by students' wonderment questions. Our interest in such events arises from their potential to stimulate active intellectual engagement in classrooms, which can impact upon the subsequent development of the classroom discourse. In investigating this issue we shall address the following research question: How do student questions impact upon the teaching explanatory structure and modify the form of the ongoing classroom discourse, in selected science lessons? From data collected in a Brazilian secondary school we have selected three classroom episodes, with large differences in both the context in which the student's question emerges and in the communicative approach developed in response to it. The analysis, based on the framework proposed by Mortimer and Scott [Mortimer and Scott (2003). Meaning making in secondary science classrooms. Maidenhead: Open University Press], shows that questions made by students are important in providing feedback from students to the teacher, enabling adjustments to the teaching explanatory structure. These adjustments sometimes occur smoothly, at other times with major changes to the features of the classroom discourse, and elsewhere with misunderstanding and disagreement. The data also suggest the need to consider students' intentions and their active participation in the negotiation of both the content and structure of classroom discourse. © 2009 Wiley Periodicals, Inc. J Res Sci Teach 47:174,193, 2010 [source] Methotrexate in psoriasis: 26 years' experience with low-dose long-term treatmentJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2000U-F. Haustein Abstract Objective,To evaluate the efficacy, safety and side-effects of methotrexate (MTX) in psoriasis. Design,A 26-year retrospective study. Setting,Department of Dermatology, Leipzig University, Leipzig, Germany. Patients,One hundred and fifty-seven patients with extensive plaque psoriasis, erythrodermic, pustular and arthropathic forms, were treated with low-dose methotrexate (15,20 mg maximum weekly dosage [Weinstein schedule]), the majority for long-term periods. The mean cumulative dose was 3394 mg, the mean duration 237 weeks. Results,The effect of MTX treatment was good in 76%, moderate in 18% and poor in 6% of subjects; 61% experienced side-effects, most frequently due to liver function abnormalities, bone marrow suppression, nausea, gastric complaints and hair loss. In 20% of cases the subjects were forced to discontinue therapy; 9% refused therapy due to physical and psychological discomfort, 2% wanted to become pregnant, 16% were lost to follow-up, 6% died from multimorbidity and old age. Three subjects (2%) developed cancer of the lung, breast or cervix uteri, possibly in relation to long-term MTX treatment. Altogether there were no deaths or life-threatening side-effects attributable to MTX treatment, and no cases of progressive liver cirrhosis apart from two extensive skin necroses due to overdosage (misunderstanding, suicidal attempt) that were treated successfully with citrovorum factor. Conclusion,Low-dose MTX (<15,20 mg/week) is an effective therapy for extensive and severe forms of psoriasis if patients are selected carefully and monitored regularly, particularly with respect to liver and bone marrow toxicity. This helps to reduce severe side-effects even during long-term treatment. Drug interactions must be avoided. MTX therapy according to the guidelines is relatively safe and still has a place in the systemic treatment of psoriasis with 40 years of experience and an acceptable safety record. [source] Communication and Miscommunication in Informed Consent to ResearchMEDICAL ANTHROPOLOGY QUARTERLY, Issue 4 2004PAMELA SANKAR Biomedical ethics require that research subjects be aware that the drugs they take or procedures they undergo are designed to fulfill the conditions of the experiment and not to benefit a subject's health. This apparently straightforward distinction between research and treatment is a source of much controversy and misunderstanding. Ethicists have labeled this problem the "therapeutic misconception." This misconception and, more broadly, informed consent have been studied extensively. Nonetheless, the therapeutic misconception persists among research subjects. This paper argues that one factor overlooked in the persistence of the therapeutic misconception is the effect of the theoretical paradigm that guides the practice and analysis of informed consent. The paradigm poses an idealized model of communication that ignores social context. This paper examines informed consent practices associated with a cancer research trial to demonstrate an alternative approach to studying informed consent to research. Through analysis of informed consent session transcripts, it demonstrates the importance of taking account of not only what is said, but how and by whom it is said. [source] Co-Constructing Representations of Culture in ESL and EFL Classrooms: Discursive Faultlines in Chile and CaliforniaMODERN LANGUAGE JOURNAL, Issue 1 2009JULIA MENARD, WARWICK Based on qualitative research conducted in 3 university English as a foreign language classrooms in Chile and 3 community college English as a second language classrooms in California, this article examines the approaches used in teaching culture in these classrooms, the differences in how particular cultures (usually national cultures) were represented depending on teaching context, the processes by which these representations of culture were co-constructed by teachers and students, and the extent to which the observed cultural pedagogies seemed to cultivate interculturality. In particular, this article focuses on discursive faultlines (Kramsch, 1993), areas of cultural difference or misunderstanding that became manifest in classroom talk. Although teaching culture was not the primary goal in any of these classes, the teachers generally provided space for students to problematize cultural issues; however, this problematization did not necessarily lead to interculturality. The article concludes with implications for cultural pedagogies based on the observed interactions. [source] Patients' conceptions of the cause of their rheumatoid arthritis: A qualitative studyMUSCULOSKELETAL CARE, Issue 4 2009MScN, Ulrika Bergsten RN Abstract Background:,Patients' perspective of the causes and consequences of rheumatoid arthritis (RA) can conflict with that of healthcare professionals and lead to misunderstanding, difficulties in management and a poorer outcome. Objectives:,The aim of this study was to describe the variation in how patients' conceive the cause of their RA. Methods:,An open written question from the Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study, aimed at patients recently diagnosed with RA, was answered by 38 strategically selected patients during 2003 and analysed using the phenomenographic approach. Results:,Two descriptive categories and six concepts emerged: the category ,consequences beyond personal control' comprised not having a clue, being exposed to climatic change, being genetically exposed and unexpected effects of events; the category ,overloaded circumstances' involved work and family-related strain. Consequences beyond personal control implied that the patients could not prevent the disease and expressed their lack of understanding as to why they contracted it. Overloaded circumstances were described as strained situations that were both work and family related and could be influenced by the patient. Conclusions:,The patient's perspective of the cause of their RA includes aspects that complement the current pathogenetic models and should therefore be considered in the management of the disease. When dealing with rheumatic diseases, it is necessary to be aware of the patient's perspectives in order to new management strategies. In addition to epidemiological studies, further studies of patients' own experience are needed in order to achieve a more tailored care model. Copyright © 2009 John Wiley & Sons, Ltd [source] Civilians Versus Police: Mediation Can Help to Bridge the DivideNEGOTIATION JOURNAL, Issue 3 2000Vivian Berger The increasing frequency of notorious cases of conflicts between police officers and members of the general public (which in New York City has led to incidents of death, battery, and sexual assault) is cause for alarm. At the root of many police-community conflicts are an incomplete understanding of the work of the police, poor communication on the part of the police and the public, or simple misunderstanding. A number of communities, including New York City, are turning to mediation to provide a forum for the potential resolution of complaints made against police by citizens. After a brief survey of the work of such programs nationally, the author focuses on three New York cases in which she served as a mediator, using them to illustrate the pitfalls and special rewards of mediating in this context. The author believes that the mediation process itself can work in a transformative way, improving strained relations between police and the general population [source] On the relationship between population differentiation and sampling effort: is more always better?OIKOS, Issue 8 2009Mats Björklund Given the relative ease by which genotypic data now can be obtained, studies of population differentiation can attain high statistical power provided the number of individuals and loci scored are sufficiently high. This has led to a misunderstanding of the concept of power, and studies with a low number of individuals and loci are dismissed despite highly significant results. This raises statistical, biological and ethical concerns, which we discuss in this note. We suggest that authors should routinely report the number of additional non-significant loci as a measure of the robustness of the results. [source] Healing History's Wounds: Reconciliation Communication Efforts to Build Community Between Minnesota Dakota (Sioux) and Non-Dakota PeoplesPEACE & CHANGE, Issue 3 2002Sheryl L. Dowlin This article describes the moral conflict involved when two incompatible social worlds collided on America's Frontier in Minnesota in 1862. The result was the bloodiest and costliest Indian war and the largest mass execution in our history. The residue of hatred and misunderstanding persist to this day but is being ameliorated by long-term efforts toward reconciliation. These relationship building efforts are illustrated by a model and with examples of dialogue, collaboration, and communally shared experiences between the dominant culture and the Dakota people. It is believed that these efforts are gradually having an impact in healing the deep wounds between these estranged cultures. [source] Characteristics of participants with self-reported hemochromatosis or iron overload at HEIRS study initial screeningAMERICAN JOURNAL OF HEMATOLOGY, Issue 2 2008James C. Barton There are few descriptions of young adults with self-reported hemochromatosis or iron overload (H/IO). We analyzed initial screening data in 7,343 HEmochromatosis and IRon Overload Screening (HEIRS) Study participants ages 25,29 years, including race/ethnicity and health information; transferrin saturation (TS) and ferritin (SF) measurements; and HFE C282Y and H63D genotypes. We used denaturing high-pressure liquid chromatography and sequencing to detect mutations in HJV, TFR2, HAMP, SLC40A1, and FTL. Fifty-one participants reported previous H/IO; 23 (45%) reported medical conditions associated with H/IO. Prevalences of reports of arthritis, diabetes, liver disease or liver cancer, heart failure, fertility problems or impotence, and blood relatives with H/IO were significantly greater in participants with previous H/IO reports than in those without. Only 7.8% of the 51 participants with previous H/IO reports had elevated TS; 13.7% had elevated SF. Only one participant had C282Y homozygosity. Three participants aged 25,29 years were heterozygous for potentially deleterious mutations in HFE2, TFR2, and HAMP promoter, respectively. Prevalences of self-reported conditions, screening iron phenotypes, and C282Y homozygosity were similar in 1,165 participants aged 30 years or greater who reported previous H/IO. We conclude that persons who report previous H/IO diagnoses in screening programs are unlikely to have H/IO phenotypes or genotypes. Previous H/IO reports in some participants could be explained by treatment that induced iron depletion before initial screening, misdiagnosis, or participant misunderstanding of their physician or the initial screening questionnaire. Am. J. Hematol., 2008. © 2007 Wiley-Liss, Inc. [source] Strengthening the understanding of the relationship between survival designs and test statisticsPHARMACEUTICAL STATISTICS: THE JOURNAL OF APPLIED STATISTICS IN THE PHARMACEUTICAL INDUSTRY, Issue 2 2010Guoguang Ma Abstract In the planning of randomized survival trials, the role of follow-up time of trial participants introduces a level of complexity not encountered in non-survival trials. Of the two commonly used survival designs, one design fixes the follow-up time whereas the other allows it to vary. When the follow-up time is fixed the number of events varies. Conversely, when the number of events is fixed, the follow-up time varies. These two designs influence test statistics in ways that have not been fully explored resulting in a misunderstanding of the design,test statistic relationship. We use examples from the literature to strengthen the understanding of this relationship. Group sequential trials are briefly discussed. When the number of events is fixed, we demonstrate why a two-sample risk difference test statistic reduces to a one-sample test statistic which is nearly equal to the risk ratio test statistic. Some aspects of fixed event designs that need further consideration are also discussed. Copyright © 2009 John Wiley & Sons, Ltd. [source] How can Political Liberals be Environmentalists?POLITICAL STUDIES, Issue 4 2002Derek Bell It is often assumed that neutralist liberalism and environmentalism are incompatible because promoting environmentally friendly policies involves endorsing a particular conception of the good life. This paper questions that assumption by showing that one important version of neutralist liberalism, John Rawls's ,justice as fairness', can allow two kinds of justification for environmental policies. First, public reason arguments can be used to justify conceptions of sustainability and environmental justice. Second, comprehensive ideals (including non-anthropocentric ideals) can be used to justify more ambitious environmental policies when two conditions are met, namely, the issue under discussion does not concern constitutional essentials or matters of basic justice; and the policy is endorsed by a majority of citizens. Rawls's willingness to allow this second kind of justification for environmental (and other) policies is defended against two objections, which claim that Rawls's ,democratic liberalism' is incoherent. The first objection , the ,justice' objection , is that to spend public money promoting comprehensive (environmental) ideals is inconsistent with the ,difference principle'. The ,justice' objection depends on a common misunderstanding of the difference principle. The second objection , the ,neutrality' objection , claims that ,democratic liberalism' is inconsistent with Rawls's commitment to neutrality. The ,neutrality' objection is unconvincing because ,democratic liberalism' is ,fundamentally neutral' whereas the leading alternative is not. [source] Random, systematic, and common cause failure: How do you manage them?,PROCESS SAFETY PROGRESS, Issue 4 2006Michela Gentile Abstract A safety instrumented system (SIS) may fail to operate as desired when one or more of its devices fail due to random, systematic, and common cause events. IEC 61511 (ANSI/ISA 84.00.01,2004) stresses the importance of minimizing the propagation of device failure into system failure through design, operating, inspection, and maintenance practices. To fully understand the lifecycle requirements, it is first necessary to understand the types of failures and their potential effects on the SIS. Although several technical standards and other specialized literature address the topic, it is still a "fuzzy" matter, subject to misunderstanding and discussion. IEC 61511 Clause 11.9 requires that the SIL be verified using quantitative analysis, such as reliability block diagrams, fault tree analysis, and Markov modeling. This analysis includes only those dangerous failures that are random in nature. Common cause failures may or may not be included in the verification calculation depending on whether they exhibit random or systematic behavior. Any personnel assigned responsibility for verifying the SIL should understand each failure type and the strategies that can be used against it. Consequently, this article provides an overview of random, systematic, and common cause failures and clarifies the differences in their management within IEC 61511. © 2006 American Institute of Chemical Engineers Process Saf Prog, 2006 [source] | ||||||||||||||||||||||||||||||||||