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Expert intuition is increasingly considered to be a valid form of knowledge, and research has proven its effectiveness in judgment and decision making in various fields. Theorists seem to recognize the contributions of intuition within evaluative practice, but it has never been well-documented. This article presents a study on expert intuition, addressing the manner in which intuition is developed, as well as how it contributes to producing judgments in the specific context of program evaluation. In-depth, in-person interviews were conducted with eight novice evaluators and eight experienced evaluators in order to assess the contributions of experience and expertise. Two key observations emerged from interview analyses. The first was that intuition is developed through a long, complex, and demanding process in which reflective analysis of experiments, successes, and failures play an essential role; the second was that the development of intuition is fostered by expertise and experience.

Introduction: This trial evaluates whether daily low-dose aspirin initiated before 16 weeks of gestation can reduce preeclampsia and fetal growth restriction in nulliparous women identified by first-trimester uterine artery Dopplers as at high risk of preeclampsia. Methods: This randomized, blinded, placebo-controlled, parallel-group trial took place in 17 French obstetric departments providing antenatal care. Pregnant nulliparous women aged ≥ 18 years with a singleton pregnancy at a gestational age < 16 weeks of gestation with a lowest pulsatility index ≥ 1.7 or a bilateral protodiastolic notching for both uterine arteries on an ultrasound performed between 11+0 and 13+6 weeks by a certified sonographer were randomized at a 1:1 ratio to 160 mg of low-dose aspirin or to placebo to be taken daily from inclusion to their 34th week of gestation. The main outcome was preeclampsia or a birthweight ≤ 5th percentile. Other outcomes included preeclampsia, severe preeclampsia, preterm preeclampsia, preterm delivery before 34 weeks, mode of delivery, type of anesthesia, birthweight ≤ 5th percentile and perinatal death. Results: The trial was interrupted due to recruiting difficulties. Between June 2012 and June 2016, 1104 women were randomized, two withdrew consent, and two had terminations of pregnancies. Preeclampsia or a birthweight ≤ 5th percentile occurred in 88 (16.0%) women in the low-dose aspirin group and in 79 (14.4%) in the placebo group (proportion difference 1.6 [-2.6; 5.9] p = 0.45). The two groups did not differ significantly for the secondary outcomes. Conclusion: Low-dose aspirin was not associated with a lower rate of either preeclampsia or birthweight ≤ 5th percentile in women identified by their first-trimester uterine artery Doppler as at high risk of preeclampsia. Trial registration: (NCT0172946). [ABSTRACT FROM AUTHOR]

Every human being will at some point be exposed to some degree of suffering. One segment of the population, people experiencing homelessness, will be much more likely to experience death, illness and bereavement. In Quebec, they are four times more likely to develop cancer and their life expectancy is between 42 and 52 years. The high mortality and morbidity of the homeless population raises the following question: do these individuals have equitable access to palliative care resources? The arrival of Bill 2 in 2015, allowed for the regulation of end-oflife care in Quebec. At the heart of this law is the right of patients at the end of life to have access to palliative care to prevent and ease their suffering. Several issues influence the accessibility of palliative care for the homeless population. Individual factors such as mental illness and substance abuse complicate access to care. The distrust of individuals with multiple traumatic experiences adds another barrier. In addition, these individuals are too busy surviving to navigate the health care system. Structural factors, such as the lack of affordable housing or the impact of a siloed system less suited to complex social situations, contribute to a lack of accessibility. Prejudice is widespread, contributing to the symbolic and institutional exclusion of this population. The objective of this article is therefore to deepen our understanding of the issues of access to palliative care for the homeless population in Quebec. [ABSTRACT FROM AUTHOR]

'Foot-in-the-door' is a well-known compliance technique which increases compliance to a request. Many investigations with this paradigm have generally used prosocial requests to test its effect. Evaluation of the effect of foot-in-the-door was carried out with a courtship request. 360 young women were solicited in the street to accept having a drink with a young male confederate. In the foot-in-the-door condition, before being solicited to have a drink, the young woman was asked to give directions to the confederate or to give him a light for his cigarette. Analysis showed foot-in-the-door was associated with greater compliance to the second request. The theoretical implication of such results with this nonprosocial request are discussed.

Review of the development of French telematics--a union of telecommunications and computer technology--from 1970 to the present discusses: (1) research, political decisions, and field testing; (2) extension of the electronic directory service to the entire country; and (3) services available through the telematic system. (MES)

Byline: Louis Raymond, Josee St-Pierre, Marie Marchand In this paper, we propose a taxonomic approach to organisational performance, that is, a holistic, multidimensional and integrated approach for a deeper understanding of the performance management task faced by SME owner-managers. The first research objective is to identify performance configurations or gestalts that allow one to characterise manufacturing SMEs in a meaningful and eloquent manner with regard to their organisational performance. The second objective is to determine the extent to which these configurations are conditioned by the environmental and organisational context in which performance is managed. To answer these questions, the results of an empirical study of 205 Canadian manufacturing SMEs are presented. Three configurations are found, that is, global performers, gazelles, and mature performers. These configurations are characterised and contextualised, the key finding being that a holistic perspective on performance is particularly useful in apprehending the behaviour of SMEs.

The deployment of electronic health record systems is deemed to play a decisive role in the transformations currently being implemented in primary care medical practices. This study aims to characterize electronic health record systems from the perspective of family physicians. To achieve this goal, we conducted a survey of physicians practising in private clinics located in Quebec, Canada. We used valid responses from 331 respondents who were found to be representative of the larger population. Data provided by the physicians using the top three electronic health record software products were analysed in order to obtain statistically adequate sub-sample sizes. Significant differences were observed among the three products with regard to their functional capability. The extent to which each of the electronic health record functionalities are used by physicians also varied significantly. Our results confirm that the electronic health record artefact 'does matter', its clinical functionalities explaining why certain physicians make more extended use of their system than others. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Program Evaluation is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Program Evaluation is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Program Evaluation is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Renal toxicity induced by cisplatin (CisPt) is a clinical issue in patients with or without chronic kidney disease (CKD). Proximal tubular injury can result in acute kidney injury (AKI), which may compromise the course of chemotherapy and the prognosis. The purpose of this study was to investigate the time course of urinary markers of acute tubulotoxicity and to assess the usefulness of such monitoring in a routine clinical setting. Methods: This work is an open prospective pilot study carried out among 23 patients receiving a platinum-based chemotherapy. Individual comorbidities, plasma parameters of kidney function (urea, creatinine) and estimated glomerular filtration rate were registered. Urinary excretion of leucine aminopeptidase, neutrophil gelatinase-associated lipocalin, cystatin C, liver fatty acid-binding protein and interleukin-18 were monitored during successive chemotherapy cycles. Episodes of AKI were identified according to KDIGO (Kidney Disease Improving Global Outcomes) 2012 guidelines. Results: A total of 28 patients were recruited; among them 23 agreed to be part of the study, of whom 18 received CisPt and 5 carbo- or oxaliplatin. Of the 18 CisPt patients, 12 had a preexisting CKD. Sixteen AKI episodes were observed in 13 patients receiving CisPt with a pejorative evolution in seven cases (partial recovery of the renal function); a transient but dramatic increase in urinary biomarkers was observed 3h after chemotherapy initiation, whereas plasma creatinine rise appeared 72h after the end of CisPt treatment. Identified precipitating factors included: dehydration due to lack of fluid intake or diuretic use, exposure to high CisPt doses, regular use of nonsteroidal anti-inflammatory drugs and/or iodinated contrast agents and sepsis. Conclusion: Even if numerous precipitating factors could be avoided, the monitoring of urinary markers seemed helpful for the early detection of subclinical AKI induced during CisPt chemotherapy. [ABSTRACT FROM AUTHOR]

Copyright of Material Culture Review is the property of Cape Breton University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

MAKING ART GLOBAL (PART 2): 'MAGICIENS DE LA TERRE' 1989, LUCY STEEDS ET AL. London: Walther Koenig and Afterall Books (2013), 304 pp., Paperback, ISBN: 978-3-86335-258-5, $27.50 CHANNELING THE PAST: POLITICIZING HISTORY IN POSTWAR AMERICA, ERIK CHRISTIANSEN Madison: University of Wisconsin Press (2013), 318 pp., Paperback, ISBN: 978-0-29928-904-1, $29.95 EXHIBITING PATRIOTISM: CREATING AND CONTESTING INTERPRETATIONS OF AMERICAN HISTORIC SITES, TERESA BERGMAN Walnut Creek, CA: Left Coast Press (2013), 256 pp., Paperback, ISBN: 978-1-59874-597-9, $29.95 HOW WE FORGOT THE COLD WAR: A HISTORICAL JOURNEY ACROSS AMERICA, JON WIENER Berkeley: University of California Press (2012), 384 pp., Hardcover, ISBN: 978-0-52027-141-8, $34.95 INTERPRETING ART IN MUSEUMS AND GALLERIES, CHRISTOPHER WHITEHEAD London and New York: Routledge (2012), 196 pp., Paperback, ISBN 978-0-41541-922-2, $38.95 DEFINING THE MODERN MUSEUM: A CASE STUDY OF THE CHALLENGES OF EXCHANGE, LIANNE McTAVISH Toronto: University of Toronto Press (2013), 226 pp., Hardcover, ISBN: 978-1-44264-443-4, $50.00 COLLECTING AS MODERNIST PRACTICE, JEREMY BRADDOCK Baltimore: Johns Hopkins University Press (2012), 322 pp., Hardcover, ISBN: 978-1-42140-364-9, $39.95 HE NAMED HER AMBER, IRIS HÄUSSLER Toronto: Art Gallery of Ontario (2011), 176 pp., Hardcover, ISBN: 978-1-89424-368-1, $40.00 [ABSTRACT FROM AUTHOR]

Owner-managers make decisions and manage their firm as governed by the manner in which they conceptualize or ‘conceive’ performance for themselves and their firm, rather than being governed by researchers' and experts' conceptualizations of small business performance. On the basis of survey data obtained from 433 Canadian small businesses, this study aims at a deeper understanding of what owner-managers conceive performance to be, and to what extent this conception is determined by their objectives and social influences. [ABSTRACT FROM AUTHOR]

This paper explores the relevance of Paulo Freire's Pedagogy of the Oppressed to the human services classroom and the worker-client relationship. When the teacher-student relationship follows Freire's problem-posing model of egalitarian education, it can shape and inform students' future worker-client relationships, thereby empowering clients while preventing a colonizer/colonized dynamic from developing. It is not enough to offer compassion to suffering people, Freire submits; educators and professionals must also work to change the systems that reinforce suffering. This task of dual purpose requires two strategies of human service intervention: direct service and systems change. In Freirean terms, this is praxis. [ABSTRACT FROM AUTHOR]

Coregonine fish represent the most successful evolutionary lineage of salmonids with Coregonus as the most speciose salmonid genus inhabiting numerous postglacial lakes across the northern hemisphere. We isolated and characterized 31 polymorphic microsatellite loci in Coregonus clupeaformis with an average number of 5.3 alleles per locus (range three to eight) and an overall expected heterozygosity of 0.74 ± 0.11. Two loci revealed significant linkage associations through analyses of mapping families. Six additional salmonid taxa assessed for cross-species amplification revealed between 18 and 26 positive amplifications and between two and 12 polymorphic loci per species. [ABSTRACT FROM AUTHOR]

The commitment/consistency principle for compliance implies that people act in ways consistent with their previous behavior. Cialdini and Sagarin (2005) have stated that, according to this principle, asking individuals questions to which they would be expected to say "yes" could be associated with achieving greater compliance with a subsequent request. However, this procedure, referred to as the four walls technique, has never been tested experimentally. In this study, we conducted an experiment in which participants were first asked to answer several questions that required "yes" or "no" responses. Then, the participants were asked to comply with an additional request. It was found that saying "yes" several times beforehand is associated with greater compliance with a subsequent request than is saying "no" beforehand or when no first request was made. [ABSTRACT FROM AUTHOR]

The deployment of electronic health record systems is deemed to play a decisive role in the transformations currently being implemented in primary care medical practices. This study aims to characterize electronic health record systems from the perspective of family physicians. To achieve this goal, we conducted a survey of physicians practising in private clinics located in Quebec, Canada. We used valid responses from 331 respondents who were found to be representative of the larger population. Data provided by the physicians using the top three electronic health record software products were analysed in order to obtain statistically adequate sub-sample sizes. Significant differences were observed among the three products with regard to their functional capability. The extent to which each of the electronic health record functionalities are used by physicians also varied significantly. Our results confirm that the electronic health record artefact 'does matter', its clinical functionalities explaining why certain physicians make more extended use of their system than others.

Melanoma patients were injected with various vaccines containing a MAGE-A3 peptide presented by HLA-DP4. Anti-MAGE-A3.DP4 T cells were not detectable in the blood before vaccination, but their frequencies after vaccination ranged from 2 x 10(-6) to 2 x 10(-3) among the CD4(+) blood T lymphocytes of the patients. The CD4(+) blood T lymphocytes that stained ex vivo with HLA-DP4 tetramers folded with the MAGE-A3 peptide were selected by flow cytometry and amplified under clonal conditions. About 5% of the CD4(+) T-cell clones that recognized the MAGE-A3.DP4 antigen had a CD25(+) phenotype in the resting state. These CD25(+) clones had a high capacity to suppress the proliferation of another T-cell clone after peptide stimulation in vitro. Most of them had high FOXP3 expression in the resting state and an unmethylated FOXP3 intron 1. They produced active transforming growth factor-beta but none of cytokines IFN-gamma, interleukin-2 (IL-2), IL-4, IL-5, and IL-10. About 20% of CD25(-) clones had a significant but lower suppressive activity. Most of the CD25(-) clonal populations contained cells that expressed FOXP3 in the resting state, but FOXP3 demethylation was not observed. We conclude that MAGE-A3.DP4 vaccination can produce CD4(+) T cells that may exert regulatory T-cell function in vivo.

Quantitative evaluation of T cell responses of patients receiving antitumoral vaccination with a protein is difficult because of the large number of possible HLA-peptide combinations that could be targeted by the response. To evaluate the responses of patients vaccinated with protein MAGE-3, we have developed an approach that involves overnight stimulation of blood T cells with autologous dendritic cells loaded with the protein, sorting by flow cytometry of the T cells that produce IFN-gamma, cloning of these cells, and evaluation of the number of T cell clones that secrete IFN-gamma upon stimulation with the Ag. An important criterion is that T cell clones must recognize not only stimulator cells loaded with the protein, but also stimulator cells transduced with the MAGE-3 gene, so as to exclude the T cells that recognize contaminants generated by the protein production system. Using this approach it is possible to measure T cell frequencies as low as 10(-6). We analyzed the frequencies of anti-vaccine CD4 T cells in five metastatic melanoma patients who had been injected with a MAGE-3 protein without adjuvant and showed evidence of tumor regression. Anti-MAGE-3 CD4 T cells were detected in one of the five patients. The frequency of the anti-MAGE-3 CD4 T cells was estimated at 1/60,000 of the CD4 T cells in postvaccination blood samples, representing at least an 80-fold increase in the frequency found before immunization. The frequencies of one anti-MAGE-3 CD4 T cell clonotype were confirmed by PCR analysis on blood lymphocytes. The 13 anti-MAGE-3 clones, which corresponded to five different TCR clonotypes, recognized the same peptide presented by HLA-DR1.

The purpose of this study was to test melanoma vaccines consisting of peptides and immunological adjuvants for optimal immunogenicity and to evaluate laboratory immune monitoring for in vivo relevance. Forty-nine HLA-A2 positive patients with Melan-A positive melanoma were repeatedly vaccinated with Melan-A peptide, with or without immune adjuvant AS02B (QS21 and MPL) or IFA. Peptide-specific CD8 T cells in PBLs were analyzed ex vivo using fluorescent HLA-A2/Melan-A multimers and IFN-gamma ELISPOT assays. The vaccines were well tolerated. In vivo expansion of Melan-A-specific CD8 T cells was observed in 13 patients (1/12 after vaccination with peptide in AS02B and 12/17 after vaccination with peptide in IFA). The T cells produced IFN-gamma and downregulated CD45RA and CD28. T-cell responses correlated with inflammatory skin reactions at vaccine injection sites (P < 0.001) and with DTH reaction to Melan-A peptide (P < 0.01). Twenty-six of 32 evaluable patients showed progressive disease, whereas 4 patients had stable disease. The two patients with the strongest Melan-A-specific T-cell responses experienced regression of metastases in skin, lymph nodes, and lung. We conclude that repeated vaccination with Melan-A peptide in IFA frequently leads to sustained responses of specific CD8 T cells that are detectable ex vivo and correlate with inflammatory skin reactions.