Expert Answer Research Articles

Reactions From the Experts: Implications of Open-Source ActiGraph Counts for Analyzing Accelerometer Data

In 2022, it became possible to produce ActiGraph counts from raw accelerometer data without use of ActiLife software. This supports the availability and use of transparent, open-source methods for producing physical behavior outcomes from accelerometer data. However, questions remain regarding the implications of the availability of open-source ActiGraph counts. This Expert Question and Answer paper solicited and summarized feedback from several noted physical behavior measurement experts on five questions related to open-source counts. The experts agreed that open-source, transparent, and translatable methods help with harmonization of accelerometer methods. However, there were mixed views as to the importance of open-source counts and their place in the field moving forward. This Expert Question and Answer provides initial feedback, but more research both within this special issue and to be conducted moving forward will help to inform whether and how open-source counts will be accepted and adopted for use for device-based physical behavior assessments.

International Collaboration on Digital Marketing Materials for the Social Entrepreneurship MSME Community Group of Tri Alam Lestari Waste Bank

International Cooperation between STIE Indonesia Banking School and Khon Kaen Business School Thailand in Waste Bank Management and Digital Marketing for MSMEs Tri Alam Lestari Waste Bank Community. The purpose of this service is to create awareness about waste management and digital marketing skills among MSMEs. This process includes the discussion stage, identification of needs, preparation of materials, and implementation of seminars. The implementation methods include finding expert speakers, presenting material, and question and answer sessions. This activity was carried out in South Jakarta, located at Tri Alam Lestari Waste Bank. As a result, MSMEs' understanding of digital marketing and environmental awareness increased, which has the potential to impact business growth and environmental sustainability.

Novel Framework for Improving the Correctness of Reference Answers to Enhance Results of ASAG Systems.

Usage of online learning platforms increases day by day and henceforth, there emerges the need for automated grading systems to assess the learner's performance. Evaluating these answers demands for a well-grounded reference answer which aids a strong foundation for better grading. Since reference answers impacts the exactness of grading answers of learners, its correctness remains a great concern. A framework that addresses the reference answer exactness in Automated Short Answer Grading (ASAG) systems was developed. This framework includes material content acquisition, clustering collective content, expert answer as key components which was later fed to a zero-shot classifier for a strong reference answer generation. Then, the computed reference answers along with student answers and questions from Mohler dataset were fed to an ensemble of transformers to produce relevant grades. The aforementioned models' RMSE and correlation values were compared against the past values of the dataset. Based on the observations made, this model outperforms the previous approaches.

5612969 INSIGHTS FROM AN ENGAGEMENT EVENT TO SUPPORT COLLABORATION BETWEEN CHILDREN WITH SICKLE CELL DISORDER, THEIR FAMILIES AND HEALTH SERVICES

Introduction: The APPG inquiry into sickle cell disorder (SCD) services found “serious care failings,” detailing SCD patients avoiding hospitals due to fear and lack of trust.1 It is often said that patients and families ‘do not engage’ or are ‘hard to reach,’ reflecting that services are not always accessible. Aims: In response, we organised a collaborative event reaching out to children and young people (CYP) with SCD and their families in a fun, accessible way. This aimed to test the theory that in an alternative and informal environment, there would be significant uptake of health promotion opportunities. Methods: The organising committee invited patient and parent representation, working closely with targeted charities. Three NHS trust charities contributed to funding and Tottenham Hotspur provided the venue. The event was widely advertised through health services via mailing lists, flyers and social media. Health promotion activities included Expert Panel Question and Answer session, myth busting and research stalls, transition workshops and complementary therapies. Performances from the B positive choir, celebrity DJing, arts and crafts, outdoor games and dance ensured the event was entertaining. Additionally, there was a session on career advice, as suggested by one of the patient representatives. Volunteers collected written feedback with open questions aiming to identify what attendees enjoyed, learnt, and improvement suggestions. Results: The event proved popular with 212 people cared for by 24 trusts (across London, Bedfordshire, Bristol, Cambridgeshire, Essex, Hertfordshire and Kent) registered in addition to their friends and family members. Despite train strikes on the day, 123 adults and 153 CYP across a range of ages (15% 1-4 y/o, 29% 5-10, 39% 11-15, 20% 16-18) attended. 64 submitted event feedback. We asked carers and CYP what was most valued about the event. Responses demonstrated: 61% said education about SCD, particularly learning about general management and emerging treatments such as gene therapy. 44% stated Fun and Enjoyment encouraged positive engagement for children and families rather than solely focused on health education. 16% valued the Sense of Community through connecting with other families as well as professionals in an informal setting. Conclusion: This demonstrates the feasibility of large-scale public health events through collaboration with stakeholders. There is demand for accessible, inclusive, and fun educational events in non-clinical settings. The high proportion of attendees learning more about SCD shows this does not detract from educational gain, but can strengthen care in an empowering way. It is important that the event feedback shapes further work. Attendees including families with newly diagnosed children were invited to peer support groups and people signed up to be informed of future events. Future plans include: Hosting similar events with interested networks. Event development to include more interactive workshops, events for young adults and opportunities for CYP and families to connect and form supportive communities. Deep Dive Event into the Experience of Care to investigate and guide what improvements can be made to SCD services. Reference 1. All Party Parlimentary Group (APPG) and the Sickle Cell Society, No One’s Listening: An Inquiry into the Avoidable Deaths and Failures of Care for Sickle Cell Patients in Secondary Care 2021 https://www.sicklecellsociety.org/wp-content/uploads/2021/11/No-Ones-Listening-PDF-Final.pdf

Права та обов’язки експертів з економічних питань у профільному і процесуальному законодавстві

The article considers the rights and obligations of experts on economic affairs in the relevant legislation (the Law of Ukraine "On Forensic Expertise"; the Instruction on the Appointment and Conduct of Forensic Examinations and Expert Studies and the Scientific and Methodological Recommendations on the Preparation and Appointment of Forensic Examinations and Expert Studies; the Instruction on the Peculiarities of Forensic Expert Activity by Certified Forensic Experts who do not work in state specialised expert institutions) and procedural legislation (the Criminal Procedure Code, the Civil Procedure Code, the Commercial Procedure Code and the Code of Administrative Procedure). The purpose of the article (to study the rights and obligations of forensic experts on economic affairs in accordance with the requirements of relevant and procedural legislation) is achieved by using the following general scientific and special research methods: abstract-logical, dialectical, generalization, grouping, and graphical. The study revealed that in conducting forensic examinations and expert studies on economic affairs, there are examinations of documents: accounting, taxation and reporting; economic activities of enterprises and organisations; and financial and credit transactions. At the same time, there is an inconsistency in the names of the types of forensic economic examinations in the relevant legislation. It is determined that the relevant legislation on the rights of experts, including those on economic affairs, provides for 6 of them in the Law of Ukraine "On Forensic Expertise", 8 in the relevant Instructions (only five are similar); the procedural codes establish 8 rights in the Criminal Procedure Code and 6 each in the Civil Procedure Code, the Code of Civil Procedure and the Code of Administrative Procedure (five are also similar). All types of relevant and procedural legislation provide two essentially identical duties of forensic experts (to perform the task and provide an expert opinion and answer questions, if necessary). The Code of Civil Procedure, the Code of Economic Procedure and the Code of Administrative Court Procedure declare only 2 duties each, the Law of Ukraine "On Forensic Expertise" - 3, the Code of Criminal Procedure - 5, and the Instructions - 8. At the same time, the relevant legislation and the Criminal Procedure Code of Ukraine add a general obligation to recuse an expert.

How Well Does the Biochemistry Authentic Scientific Inquiry Lab (BASIL) Promote Expert Understanding of Michaelis‐Menten Kinetics by Undergraduate Students?

BASIL is a course‐based undergraduate research experience (CURE) that focuses on enzyme function prediction. The Protein Data Bank (PDB) contains the structures of over 4000 proteins of unknown function and BASIL provides a basis to assign functions by combining in silico and in vitro analyses. The final BASIL module focuses on a kinetic analysis of the purified protein. In this study we investigate if the BASIL CURE promotes the development of student understanding of Michaelis‐Menten kinetics. Through content analysis of the written BASIL modules and inductive analysis of instructor interview transcripts, we have determined an “expert answer” that has been categorized into three overarching themes: the function of an enzyme is to convert a substrate to a product; the conversion of substrate to product can be tested with experimental assays; and data from assays can be visualized with a graph to characterize the kinetics of enzyme function. These ideal answer subthemes then were aligned with the course‐based undergraduate research abilities (CURAs) identified by Irby et al. (2018). We analyzed student research posters and coded semi‐structured interviews with students who have participated in BASIL at Ursinus College in order to compare them with the “expert answer”. Results suggest that students appear to understand the function of an enzyme and can interpret findings from an activity assay, yet they are lacking in a full understanding of the required data manipulation or underlying meaning of a graphical analysis of kinetics data. In the longer term, this research is aimed at informing improvements in the teaching, learning, and assessment of this area of the BASIL CURE. In particular, the findings will focus on addressing the various identified student difficulties so that the BASIL CURE can come closer to achieving its main goal of developing students as research scientists.Support or Funding InformationThis work was supported by the National Science Foundation under grants #1503811 & 1709805 for the Biochemistry Authentic Scientific Inquiry Lab (BASIL) CURE and #1346567 for the Advancing Competencies in Experimentation ‐ Biology (ACE‐Bio) Network. Any opinions, findings, and conclusions or recommendations expressed in this workshop are those of the authors and do not necessarily reflect the views of the National Science Foundation.Biochemistry Authentic Scientific Inquiry LabFigure 1

Alin: improving interactive ontology matching by interactively revising mapping suggestions

Abstract Ontology matching aims at discovering mappings between the entities of two ontologies. It plays an important role in the integration of heterogeneous data sources that are described by ontologies. Interactive ontology matching involves domain experts in the matching process. In some approaches, the expert provides feedback about mappings between ontology entities, that is, these approaches select mappings to present to the expert who replies which of them should be accepted or rejected, so taking advantage of the knowledge of domain experts towards finding an alignment. In this paper, we present Alin, an interactive ontology matching approach which uses expert feedback not only to approve or reject selected mappings but also to dynamically improve the set of selected mappings, that is, to interactively include and to exclude mappings from it. This additional use for expert answers aims at increasing in the benefit brought by each expert answer. For this purpose, Alin uses four techniques. Two techniques were used in the previous versions of Alin to dynamically select concept and attribute mappings. Two new techniques are introduced in this paper: one to dynamically select relationship mappings and another one to dynamically reject inconsistent selected mappings using anti-patterns. We compared Alin with state-of-the-art tools, showing that it generates alignment of comparable quality.

Social Media Network Utility in Disease Education: Experience from a CML-Disease Awareness Medical Education Program

Background: Digital platforms designed for medical specialists have potential to enhance the delivery of continued education for healthcare professionals (HCPs). Chronic myeloid leukemia (CML) is a relatively rare disease: some HCPs may treat only a handful of patients per year, but nonetheless need to be up-to-date with the latest advances in therapy and treatment recommendations. Achievement of sustained deep molecular response with tyrosine kinase inhibitors (TKIs) is associated with improved long-term clinical outcomes, and potentially provides patients with the option of treatment discontinuation/treatment-free remission (TFR). Monitoring of molecular response - and adjusting treatment or initiating TFR - is an increasingly important part of CML management. The aim of this digital medical education program was to educate an online community of HCPs on CML using an interactive, case-based, on-demand approach to medical education. Here we report the uptake and impact of this program. Methods: The program comprised three components. Two hypothetical case studies were developed based on typical challenges in CML management (Case study 1, molecular monitoring; Case study 2, TFR). These were shared with a digital community of HCPs who were invited by email to engage with these cases. This network included medical oncologists, hematologists, pathologists, internists, cardiologists, medical residents, nurse practitioners and advanced practice registered nurses, physician assistants, and medical students. Each case study included 3 multiple choice questions designed to assess the educational impact of the content. When an incorrect answer was selected, a detailed explanation of the correct answer was provided, ensuring that the educational gap was addressed. The third component of the CML digital education program was an expert question and answer (Q&A) session with a CML specialist. In place of a live Q&A, members of the network were invited to post questions for the specialist at any time prior to or during a scheduled Q&A. These were addressed during a 1-hour virtual event that could be followed for a real-time discussion on CML-related topics such as mutation testing, risk scores, molecular monitoring, the International Scale (IS), and sensitivity of BCR-ABL1 testing for monitoring. Results: Case study engagement was high: 3202 recipients interacted with the cases and 2144 HCPs responded to the 6 questions relating to those 2 case studies. Overall, 41% of respondents did not know that patients with CML should be monitored every 3 months. Only 30% of respondents knew that when starting therapy, polymerase chain reaction (PCR) testing should use a threshold of at least MR4.5 (BCR-ABL1IS ≤0.0032%). Over two thirds of respondents did not know that MR3.0 (BCR-ABL1IS ≤0.01%) was the BCR-ABL1 level at which TKI therapy should be restarted in patients in TFR, and only 16% of respondents knew that BCR-ABL1 level should be assessed monthly in this population. Over half of respondents were not familiar with the eligibility criteria (MR4.5 for ≥2 years with sensitivity of PCR test at least MR4.5) that indicate a patient can discontinue TKI therapy. A total of 2844 HCPs engaged in the expert virtual Q&A forum 5989 times. Participants included medical students (46%), nursing professionals (22%), physician assistants (14%), medical residents (11%), other target physicians (6%) and hematologists/oncologists (1%). HCPs posed 17 questions/comments to the expert, including 8 questions from hematologists/medical oncologists. The expert posted 22 responses, thereby increasing the educational material shared with the participants. Conclusions: During this medical education program, over 2100 HCPs accessed and interacted with the on-demand CML education. The proportion of correct responses to the questions about each case study indicates a gap in HCP knowledge around molecular monitoring and TFR. This digital medical education pilot supported a need for further education in these topics and provided a new approach via medical network learning, using interactive case studies and expert discussion. It illustrates the potential utility of such resources in the continuing education of HCPs on a larger scale. Further study may improve audience targeting and educational yield. Disclosures Atallah: Helsinn: Consultancy; Helsinn: Consultancy; Novartis: Consultancy; Pfizer: Consultancy; Jazz: Consultancy; Takeda: Consultancy, Research Funding; Jazz: Consultancy. Kota:Novartis: Honoraria; Amgen: Honoraria; Pfizer: Honoraria; Xcenda: Honoraria; Takeda: Honoraria. Sadek:Novartis: Employment. Damon:Novartis: Employment, Other: Stock. Jen:Novartis: Employment. Landy:Figure 1: Employment, Other: Shareholder and co-founder; Novartis: Research Funding. Vorona:Incyte Corporation: Research Funding; Tolero Pharmaceuticals: Research Funding; Takeda Oncology: Research Funding; Novartis: Research Funding. Radich:TwinStrand Biosciences: Research Funding; Novartis: Other: RNA Sequencing.

Obstacles to the spread of unintuitive beliefs.

Many socially significant beliefs are unintuitive, from the harmlessness of GMOs to the efficacy of vaccination, and they are acquired via deference toward individuals who are more confident, more competent or a majority. In the two-step flow model of communication, a first group of individuals acquires some beliefs through deference and then spreads these beliefs more broadly. Ideally, these individuals should be able to explain why they deferred to a given source - to provide arguments from expertise - and others should find these arguments convincing. We test these requirements using a perceptual task with participants from the US and Japan. In Experiment 1, participants were provided with first-hand evidence that they should defer to an expert, leading a majority of participants to adopt the expert's answer. However, when attempting to pass on this answer, only a minority of those participants used arguments from expertise. In Experiment 2, participants receive an argument from expertise describing the expert's competence, instead of witnessing it first-hand. This leads to a significant drop in deference compared with Experiment 1. These experiments highlight significant obstacles to the transmission of unintuitive beliefs.

Upgrading Development and Application of Agricultural Information Service System Based on WeChat Public Platform— —A Case of WeChat Public Platform of 12396 Beijing new rural sci-tech service hotline

The WeChat public platform is a new service platform based on WeChat applications that provides business services and user management for individuals, businesses and organizations. It provides a new solution to the lag of agricultural information dissem-ination in the traditional media. However, services based on Tencent's backend can only meet the basic needs of users and reduce the user's experience in agricultural science and technology consulting process. In order to provide efficient and convenient service to users and solve existing problems in consultation process, the platform-related API were used to upgrade the 12396 hotline WeChat public platform to an integrated agricultural information interactive service system. It mainly carries out the following three aspects to upgrade development. Firstly, 12396 hotline WeChat public platform added two sub-menu items, “use ask” and “expert answer” to push the user’s question to expert directly, reducing the backend customer service’s works and improving the efficiency of problem solving. Secondly, 12396 WeChat public platform upgraded and developed an integrated "one-stop" micro-site to allow users know the agriculture market timely, releasing supply and demand information, etc. Thirdly, the 12396 WeChat public platform combined initiative push information with the user's automatic acquisition of information by sending keywords which increased user selectivity. The upgraded platform has obtained a good preliminary application achievement and recognized and welcomed by users. Finally, we concluded and looked forward to the future development direction of agricultural mobile consulting.

Identifying Characteristics of Dissemination Success Using an Expert Panel

ABSTRACTAlthough considerable work has been done to develop new educational innovations, few have found widespread acceptance in the classroom. To improve the likelihood of adoption of educational innovations, researchers need to understand why some innovations are adopted and routinely used, while others are not. An initial aspect of the diffusion of innovations, as defined in the classical sociological literature, involves the communication of ideas and concepts related to innovations between individuals. This article presents an expert panel's answer to the following question: “What are the most important characteristics that relate to the dissemination of educational innovations?” As dissemination is a critical facet of the diffusion of an innovation, 45 researchers who received technology and engineering grants from the National Science Foundation (NSF) participated in a Delphi study designed to address this research question. In three rounds, the experts identified and ranked 11 characteristics of educational innovations, 6 characteristics of students, 13 characteristics of faculty members, and 5 characteristics of administrators that can relate to the successful dissemination of educational innovations. The results of this study led to the formation of a Characteristics of Dissemination Success (CODS) framework. This framework offers useful guidance for educational innovators seeking a better understanding of the influences on the dissemination of educational innovations.

The Design of “The Use and Maintenance of Common Digital Products” Popular Science Website

With the development of technology and the improvement of people’s living standard, more and more people purchase digital products, a multimedia website becomes an important way for people to learn how to use and maintain the digital products. The demand for knowledge about digital products use and maintenance was identified by questionnaire and interview, and then the popular science website was designed and made. From the paper, you can learn the design principles of the popular science website: properly selecting contents, using multimedia technology, clear navigation and easy to be used. This website contains the modules of computer, mobile phone, camera, DV, MP4, expert answer and forum, you can learn the basic modules and functions design, and the technical key points of implementation of the popular science website in the paper.

Anesthesia Management: Subdural Hemorrhage and Difficult Airway: A Flat-Screen Simulation and Interactive Debriefing

OPEN ACCESSJanuary 14, 2010Anesthesia Management: Subdural Hemorrhage and Difficult Airway: A Flat-Screen Simulation and Interactive Debriefing Leonard Pott, MBBCh FCA(SA), Arne Budde, MD Leonard Pott, MBBCh FCA(SA) Pennsylvania State University College of Medicine Google Scholar More articles by this author , Arne Budde, MD Penn State Hershey Medical Center Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.7891 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail Abstract Introduction: In this resource anesthesiology residents, who have previously been taught to use a screen-based anesthesia simulator, are instructed to manage a simulated case of a patient with a subdural hemorrhage and a difficult airway. Learners work individually and anonymously. Once the simulation has been completed, the residents are debriefed. The debriefing consists of a presentation which includes a number of clinical management decisions. The learners are asked to respond to the management questions using an audience response system. The anonymous responses are shared with the group; the instructor then discusses the correct, and incorrect, answers. Methods: The educational philosophy is based on experiential learning. First the learner is stressed to make management decisions in the simulation. Then the learner again has to make specific decisions, and the learner's response is compared to that of other members of the audience, and finally the learner gets the expert answer. Because the experience is anonymous, learner embarrassment is minimized. This format can be scaled up to any class size. This material is designed primarily for formative assessment but may be used for summative assessment as part of an objective structured clinical exam. Results: This simulation has been used repeatedly for residents in the department of anesthesiology at Penn State Hershey Medical Center, with very good satisfaction scores. No formal assessment of knowledge retention, or knowledge application, has been performed. Discussion: The significance of this submission is that it includes not only the simulation, but also a structured debriefing. The authors hope that other teachers will be able to use this model of instruction effectively, and will prepare different debriefings to share. Educational Objectives By the end of this resource, learners will be able to: Demonstrate the ability to develop an adequate anesthetic management plan for a patient with a subdural hematoma.Demonstrate the ability to develop an adequate anesthetic management plan for a patient with a full stomach and a potentially difficult intubation. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Instructor's Guide.docx Subdural.pptx To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. CitationPott L, Budde A. Anesthesia Management: Subdural Hemorrhage and Difficult Airway: A Flat-Screen Simulation and Interactive Debriefing. MedEdPORTAL. 2010;6:7891. https://doi.org/10.15766/mep_2374-8265.7891 Copyright & Permissions© 2010 Pott and Budde. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike license.KeywordsDifficult IntubationTraumatic Brain InjuriesAnesthesia ManagementSubdural HematomaAirway Management Disclosures None to report. Funding/Support None to report. Loading ...

Development a Consensus Conference-Based Discussion Teaching Model on Xenotransplantation for Practice

The purpose of this study was to develop a consensus conference-based discussion teaching model on xenotransplantation for practice and then verifying its effects. The participants of this study were 93 university students in Gwangju city. The consensus conference-based discussion teaching model was developed through literature review and expert seminars, and the degree of completion was enhanced through the application of the model to the 69 subjects in two times. The developed model consisted of five steps, ‘web-based citizen panel question step', ‘web-based preparing for expert panel answer step', ‘all panel discussion step', ‘citizen panel discussion step', and ‘web-based individually decision and evaluation step'. The results of the application of the model to actual classes were as follows. First, the new model overcame several shortcomings of previous discussion class models. For example, students’ participation was improved considerably at the step of expert panel exploration. Second, the model led the students to in-depth understanding of themes. Third, students’ satisfaction with the new model was very positive.

Child Guidance and Mental Health in the Netherlands

In the Netherlands, as in the United States, the introduction of the concept of ‘mental health’ in education is closely related to the development of a network of child guidance clinics. The first of these was established in Amsterdam in 1928. However, a substantial movement to actively promote mental health did not come into existence until after the Second World War. Unlike in the USA, at the time in the Netherlands the school was considered of only little importance in the crusade for the prevention of mental illness. Teachers and school physicians alike were at the same time recognized as helping forces in the promotion of mental strength and conceived of as inadequately equipped to diagnose problem children. The tradition of labelling the school as a sick‐making institution appears to have been an important asset for the child guidance clinics’ lobby to successfully discredit the institution. Parents’ educational competence was likewise undermined by the infiltration of child‐psychiatric theory, concepts and categories of discourse. The mental health movement promoted an attitude towards the family that was even more disturbingly ambiguous. On the one hand the family was considered a most powerful medicine against what was consistently diagnosed as the moral crisis of society. On the other hand contemporary child‐psychiatric theory pointed at parenting as the prime seedbed of neurosis. Inspired by Sol Cohen’s new cultural history of education the author traces the origins and the initial success of the child guidance approach as part of a larger process of ‘medicalization’, accompanied by ‘neurotization’ as an effect of the growing influence of psychoanalysis. She argues that these processes created the conditions for the Dutch child guidance clinics to monopolize the care, treatment and knowledge of problem children. After discussing the growing ambiguity as to parents’ and the school’s competence in preventing mental illness, the establishment and early development of the Dutch child guidance clinics are described. Finally, an analysis is given of the clinics’ diagnoses and treatment of ‘difficult’ children at the height of the mental health movement’s success, immediately after the war. The child guidance clinics’ work was presented as a blessing for individuals, for society and for the public purse. The self‐image of the institution emphasized its role in the prevention of adult crime and psychiatric treatment. Moreover, the clinics were supposed to prevent much more expensive hospitalization of children in reformatories and children’s homes. In reality, however, they selected for treatment primarily those cases that fitted their approach. In doing so, they could further promote the belief in the mental health movement’s central idea of mental illness as a widespread disease. The child guidance clinics’ lobby succeeded in providing itself with a key role in the theatre of children’s mental health, the expert answer to what was conceived of as a serious crisis in society. Moreover, the lobby claimed to be the solution to the existing ambiguities as to the family and the school as child‐rearing milieux. Therefore, the way the child guidance clinics succeeded in promoting their own approach at the expense of the status and competence of other educational professions and institutions was both enabled by medicalization and neurotization and was itself another step in these processes.

Nurse practitioner knowledge of chronic venous disease: a randomized survey of nurse practitioners in Missouri.

Adult nurse practitioners (NPs) and family practice NPs were randomly sampled (N = 411) from the Missouri 2002 list of certified advanced practice nurses. These practitioners were sent a cover letter and the Diseases of Veins Explanation Survey, which was originally developed for assessing patients' explanatory model of the disease. The Diseases of Veins Explanation Survey was tested and revised with professionals (experts) to determine adequate knowledge of the disease. The survey has 5 sections focusing on chronic venous disease: causes, signs, results, treatments, and efficacy of treatments. Section scores and a total score for the participants were calculated by using the expert panel answer model. A total of 138 practitioners responded, with an additional 37 letters returned with an incorrect address, for a total usable response rate of 34%. Demographics of the participants are presented, as well as comparisons between the expert mean section scores and the mean section scores of the NPs. The section scores of the NPs were not significantly different than the section scores of the expert panel; however, the total score of the NPs was significantly different from that of the expert panel ( P =.05). This, plus individual item differences, has implications for NP education and practice.

Vascular Brachytherapy Boon or Bust?

In the present issue of Circulation , Drs Teirstein and King1 and Waksman and Weinberger2 provide a chronology for the evolution in concept and practice of vascular brachytherapy (VBT). The documentation for durable efficacy of VBT in suppressing recurrent in-stent restenosis (ISR) has been provided by multiple randomized controlled clinical trials. The importance of extending the length of radiated arterial segments well beyond the zone of procedural endoluminal injury has become evident. Similarly, the relative clinical and angiographic safety of VBT (versus conventional therapies for ISR) has been demonstrated, and specific procedural as well as adjunctive pharmacological protocol modifications have evolved. These have included the avoidance of restenting and the prolonged administration of clopidogrel therapy, which have collectively effectively eliminated the previously alarming issue of late thrombosis after VBT. Finally, an effective …

Yet More Maths Problems

This article considers several key problems facing the teaching and learning of mathematics at secondary level. In particular, it studies the need for better defined aims for mathematics teaching; the standards currently being attained by students viewed from an international perspective; the validity of many of the assessment procedures on which the government places such emphasis; and the underlying problem, that of an insufficiency of well-qualified mathematics teachers — a problem that, for several decades, governments have chosen to ignore. Suggestions are made on how the various aims of mathematics education might be better met.‘Does “Mathematics for all” mean “No mathematics for all”?’ Title of a lecture given by J. de Lange in 1983.‘A calculator, …, a friend or an independent financial advisor can substitute for an education in mathematics for instrumental purposes’ (Bramall, 2000).‘Q. I would like to know the rate of inflation for the years since 1987 to the present time to work out the true value of my savings. Can you help?A. Certainly. Since 1987 the cost of living has gone up by 70 per cent. So £1 today is worth the equivalent of only 30p then.’ Reader's question and financial expert's answer in ‘Your money’, Saga Magazine, April 2001.

Treatment of Fox-Fordyce disease.

To the Editor.— I read with great interest Dr. Alfred J. Shapiro's question on treatment of Fox-Fordyce disease (222:1069, 1972) and Dr. Walter B. Shelley's expert answer. I would like to add to his advice a form of therapy, which I learned from my father, Felix Pinkus, MD, and which I found successful in several cases of this tormenting affection. Erythema doses of ultraviolet rays from a hot quartz ultraviolet lamp are given once a week to produce repeated exfoliation of the affected skin. The patient is advised to use talc freely for relief of the sunburn, but not to use ointments or creams or any deodorants or other applications. Improvement usually follows the first or second treatment, and four to six treatments may produce a long-lasting remission. The rationale of this formerly quite empirical therapy is given in Dr. Shelley's own investigations, which established obstruction of the apocrine duct

I131 Levels in Milk

<h3>To the Editor:</h3> —In the Aug 17, 1963, issue ofThe Journal(<b>185</b>:615), a physician from Delaware inquires about the significance of I¹³¹levels in milk. Your expert's answer contains errors and misleading statements. These require correction because the problem of fallout is becoming more widely discussed by laymen. Reference to "maximum permissible concentration" (MPC) is out of date in connection with radiation protection standards. The permissible concentration concept was based on the assumption that below certain radiation exposures no biological damage occurs. This is almost certainly not true for genetic effects of radiation. Whether a threshold exists for somatic effects has not been proved or disproved, but most authorities now agree that the threshold assumption cannot be safely used in the development of radiation standards. Hence, the Federal Radiation Council (FRC) in its first report of May, 1960, clearly stated the need for balancing risks and benefits