Findings From the 2007 EBRI/Commonwealth Fund Consumerism in Health Survey

Presents findings on the growth of account-based and high-deductible health plans, the health status and demographic profiles of enrollees, and the health plans' impact on consumer behavior, based on an online survey of privately insured adults

Developing Radiotherapy services in Iraq

A 5 year partnership between Sheffield Hallam University and the Iraq Ministry of Health was established to provide education and development for healthcare professionals; including Radiation Therapy Physicists and Technicians (Radiographers) and Doctors. Supported by the UK Government, the Iraqi Ministry of Health requested the planning and delivery of courses to develop their existing staff and train new practitioners to expand their Radiotherapy service following significant investment in equipment and infrastructure. Reported here are the initial stages of the project: The first cohort of 6 students arrived in August 2012 followed by a 2nd in February 2013. All worked in some aspect of healthcare with a first degree (or higher) in Physics. A minimum of International English Language Testing System (IELTS) level 4 in English language ability was required. Many were currently working as Radiotherapy Physicists but students had mixed levels of clinical experience: some being completely new to Radiotherapy. The overall programme of study was divided into 2 parts. The 1st was designed to enable students to develop their English language skills to a minimum of IELTS level 5; whilst also studying fundamental aspects of Radiotherapy, in preparation for a subsequent CPD Radiation Therapy Physics course (Part 2). Course aims: Facilitate the improvement of cancer care in Iraq and help improve radiation safety by increasing the use of evidence based practice Give students opportunities to use, develop and share their subject/profession specific knowledge and skills Develop language for presentation and group discussion Develop awareness of the classroom culture in UK Higher Education Institution

Compassionate response: Intersection of religious faith and public policy

Much of social work practice is rooted in compassion. Addressing compassion as a virtue, this article examines the possibilities for compassion to be more explicitly and purposefully built into actions at community and policy levels. We discuss the definition of compassion, examine the religious roots of compassion, describe some ways in which religion and policy intersect, and provide contemporary examples of compassion at the interface of religion and policy. In the discussion, we conclude with further thoughts about how compassion might be elevated in our collective societal actions and address the role of social work in these efforts

Out there and in here: design for blended scientific inquiry learning

One of the benefits of mobile technologies is to combine ‘the digital’ (e.g., data, information, photos) with ‘field’ experiences in novel ways that are contextualized by people’s current located activities. However, often cost, mobility disabilities and time exclude students from engaging in such peripatetic experiences. The Out There and In Here project, is exploring a combination of mobile and tabletop technologies in support for collaborative learning. A system is being developed for synchronous collaboration between geology students in the field and peers at an indoor location. The overarching goal of this research is to develop technologies that support people working together in a suitable manner for their locations. There are two OTIH project research threads. The first deals with disabled learner access issues: these complex issues are being reviewed in subsequent evaluations and publications. This paper will deal with issues of technology supported learning design for remote and co-located science learners. Several stakeholder evaluations and two field trials have reviewed two research questions: 1. What will enhance the learning experience for those in the field and laboratory? 2. How can learning trajectories and appropriate technologies be designed to support equitable co-located and remote learning collaboration? This paper focuses on describing the iterative linked development of technologies and scientific inquiry pedagogy. Two stages within the research project are presented. The 1st stage details several pilot studies over 3 years with 21 student participants in synchronous collaborations with traditional technology and pedagogical models. Findings revealed that this was an engaging and useful experience although issues of equity in collaboration needed further research. The 2nd stage, in this project, has been to evaluate data from over 25 stakeholders (academics, learning and technology designers) to develop pervasive ambient technological solutions supporting orchestration of mixed levels of pedagogy (i.e. abstract synthesis to specific investigation). Middleware between tabletop ‘surface’ technologies and mobile devices are being designed with Microsoft and OOKL (a mobile software company) to support these developments. Initial findings reveal issues around equity, ownership and professional identity

Bioaugmentation mitigates the impact of estrogen on coliform-grazing protozoa in slow sand filters

Exposure to endocrine-disrupting chemicals (EDCs), such as estrogens, is a growing issue for human and animal health as they have been shown to cause reproductive and developmental abnormalities in wildlife and plants and have been linked to male infertility disorders in humans. Intensive farming and weather events, such as storms, flash flooding, and landslides, contribute estrogen to waterways used to supply drinking water. This paper explores the impact of estrogen exposure on the performance of slow sand filters (SSFs) used for water treatment. The feasibility and efficacy of SSF bioaugmentation with estrogen-degrading bacteria was also investigated, to determine whether removal of natural estrogens (estrone, estradiol, and estriol) and overall SSF performance for drinking water treatment could be improved. Strains for SSF augmentation were isolated from full-scale, municipal SSFs so as to optimize survival in the laboratory-scale SSFs used. Concentrations of the natural estrogens, determined by gas chromatography coupled with mass spectrometry (GC-MS), revealed augmented SSFs reduced the overall estrogenic potency of the supplied water by 25% on average and removed significantly more estrone and estradiol than nonaugmented filters. A negative correlation was found between coliform removal and estrogen concentration in nonaugmented filters. This was due to the toxic inhibition of protozoa, indicating that high estrogen concentrations can have functional implications for SSFs (such as impairing coliform removal). Consequently, we suggest that high estrogen concentrations could impact significantly on water quality production and, in particular, on pathogen removal in biological water filters

Is training patients in self-examination an effective way to screen for melanoma?

No studies demonstrate that training patients to examine their skin decreases mortality from melanoma in the general population. Nor is there any evidence to suggest that teaching patients to monitor their skin for suspicious lesions results in earlier detection of melanoma, better prognosis at diagnosis, or better clinical outcomes. However, patients who have had melanoma and perform self-examination have a lower risk of death from subsequent occurrences than those who do not (strength of recommendation [SOR]: B, based on a case-control study)

Atypical presentation of neuronal ceroid lipofuscinosis type 8 in a sibling pair and review of the eye findings and neurological features.

Purpose:To report atypical presentation of neuronal ceroid lipofuscinoses type 8 (CLN8) to the eye clinic and review clinical features of CLN8. Observations:Detailed eye exam by slit lamp exam, indirect ophthalmoscopy, fundus photography, optical coherence tomography, visual fields and electroretinogram (ERG). Molecular genetic testing using Next Generation Sequencing panel (NGS) and array Comparative Genomic Hybridization (aCGH).The siblings in this study presented to the eye clinic with retinitis pigmentosa and cystoid macular edema, and a history of seizures but no severe neurocognitive deficits or regression. Genetic testing identified a c.200C > T (p.A67V) variant in the CLN8 gene and a deletion encompassing the entire gene. Electron microscopy of lymphocytes revealed fingerprint inclusions in both siblings. Conclusions:and Importance: Pathogenic variants in CLN8 account for the retinitis pigmentosa and seizures in our patients however, currently, they do not have regression or neurocognitive decline. The presentation of NCL can be very diverse and it is important for ophthalmologists to consider this in the differential diagnosis of retinal disorders with seizures or other neurological features. Molecular genetic testing of multiple genes causing isolated and syndromic eye disorders using NGS panels and aCGH along with additional complementary testing may often be required to arrive at a definitive diagnosis