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Purpose To assess, from the student perspective, medical school training in genetics and genomics. Methods In 2019, the Undergraduate Training in Genomics (UTRIG) Working Group developed genetics-related survey and knowledge questions for the RISE-FIRST, an exam administered to postgraduate year 1 (PGY1) pathology residents in the United States during their first months of training. Survey questions focused on perceived knowledge in genetics and the structure and quality of training with responses compared with those in control areas. Results There were 401 PGY1 pathology residents who took the 2019 RISE-FIRST (65% of those in the United States). There was significantly lower perceived understanding of genetics compared with nongenetics topics. Respondents also reported less time spent learning genetics and lower quality training compared with control areas. Only 53% indicated an interaction during medical school with a medical geneticist. Residents also did not perform as well on the UTRIG-developed knowledge questions than those in other areas of pathology. Conclusion The RISE-FIRST is a useful tool in assessing the current state of medical school training in genetics. This needs assessment may serve as a call to action to improve medical school genetics education and promote greater understanding of the role of genetics professionals in patient care.

Politics have a profound influence on the design and administration of nearly all government laws and policies. And the executive branch, a highly political institution, is given significant latitu...

Objectives To assess current pathology resident training in genomic and molecular pathology. Methods The Training Residents in Genomics (TRIG) Working Group has developed survey questions for the pathology Resident In-Service Examination (RISE) since 2012. Responses to these questions, as well as knowledge questions, were analyzed. Results A total of 2,529 residents took the 2019 RISE. Since 2013, there has been an increase in postgraduate year 4 (PGY4) respondents indicating training in genomic medicine (58% to approximately 80%) but still less than almost 100% each year for molecular pathology. In 2019, PGY4 residents indicated less perceived knowledge and ability related to both genomic and traditional molecular pathology topics compared with control areas. Knowledge question results supported this subjective self-appraisal. Conclusions The RISE is a powerful tool for assessing the current state and also trends related to resident training in genomic pathology. The results show progress but also the need for improvement in not only genomic pathology but traditional molecular pathology training as well.

FOI laws are of a category of laws acutely predisposed to internal resistance and erosion. The study seeks to better understand these limitations by examining legal elements of the laws through an exploratory field study, or audit, of nine state FOI laws. Among the study’s findings are two uniquely strong predictors of better FOI results: The existence of an independent FOI advocacy organization in the state and a legislature subject to the law. The findings suggest cultivating a culture of transparency may be as or more important than any of the generally considered legal variables, such as deadlines or penalties.

To assess, from the student perspective, medical school training in genetics and genomics.In 2019, the Undergraduate Training in Genomics (UTRIG) Working Group developed genetics-related survey and knowledge questions for the RISE-FIRST, an exam administered to postgraduate year 1 (PGY1) pathology residents in the United States during their first months of training. Survey questions focused on perceived knowledge in genetics and the structure and quality of training with responses compared with those in control areas.There were 401 PGY1 pathology residents who took the 2019 RISE-FIRST (65% of those in the United States). There was significantly lower perceived understanding of genetics compared with nongenetics topics. Respondents also reported less time spent learning genetics and lower quality training compared with control areas. Only 53% indicated an interaction during medical school with a medical geneticist. Residents also did not perform as well on the UTRIG-developed knowledge questions than those in other areas of pathology.The RISE-FIRST is a useful tool in assessing the current state of medical school training in genetics. This needs assessment may serve as a call to action to improve medical school genetics education and promote greater understanding of the role of genetics professionals in patient care.

The 1986 Freedom of Information Act amendments were passed as a last-minute rider to Reagan-era War on Drugs legislation. The three pieces – a broad restructuring of Exemption 7, the law enforcemen...

The Glomar response to Freedom of Information Act requests – “we can neither confirm nor deny the existence or nonexistence of records responsive to your request” – was the product of extraordinary circumstances, to be applied sparingly by the federal government in withholding national security information. Since 2013, instances of state and local use of the Glomar response have signaled a potentially problematic expansion. Establishment of non-federal agency use of the Glomar response poses the threat of an exponential increase in the practice, making oversight difficult. This article considers the recent use of the Glomar response in four cases in which state or local agencies utilized the reply to withhold law enforcement records. The origin and case law of the Glomar response, methods for compelling disclosure after a Glomar response are considered, before a discussion of potential threats of expansion and productive paths forward.

Objectives: The biannual Fellow In-Service Hematopathology Examination (FISHE) assesses knowledge in five content areas. We examined the relationship between taking the FISHE and performance on it with outcomes on the first attempted American Board of Pathology Hematology subspecialty certifying examination (ABP-HE). Methods: The pass rate between the ABP-HE candidates who took the spring FISHE and those who did not were compared. The likelihood of fellows passing the ABP-HE based on their percentiles on the FISHE was also assessed. Results: ABP-HE candidates who took the spring FISHE had a higher pass rate (96.4%) than those who did not (76.1%, P

Labor influx is not a new phenomenon and can occur in the context of any major project, including in oil and gas, mining and infrastructure developments. The large-scale and often remote and trans-boundary nature of oil and gas projects can make such undertakings particularly vulnerable to such dynamics. A key driver of socio-economic change in any project context can be rapid population growth or influx in response to project labor demand, or perceptions of direct or indirect economic opportunity associated with the project. Whereas labor influx can have positive effects (e.g., increased opportunities for local businesses, increased human capital), more often than not labor influxresults in or contributes to adverse social, economic, and environmental impacts. If not planned for and effectivelymanaged, labor influx can lead to human welfare risks, including gender-based violence and trauma and negatively affect public infrastructure, housing, natural resource management and social dynamics in the project area and region. These impacts, whichoften long outlast the project and investment cycle, canrepresenta significant risk for oil and gasprojects andlead tocommunity anger and social conflict, reputational impacts, investor concerns, cost overruns, delays, and in extreme cases can put at risk the License to Operate. This paper summarizes the results of a recent global portfolio review focused on labor influx and social impacts commissioned by World Bank (WB). The study was carried out in 2017 as part of a series of actions set in motion by serious allegations of social impact related to a transport project in Uganda, which resulted in the ultimate cancellation of the investment by the WB. While drawing on research into infrastructure projects the paperdiscusseskey observations and lessonsrelevant to the oil and gas industry, and provides recommendations for project planners and managers faced with the potential for labor influx. It concludes that influx is a strategic but often overlooked aspect of project risk management, and outlineskey mitigation measures that should be in every project's social risk management toolkit.

Objectives: To determine the current state of pathology resident training in genomic and molecular pathology. Methods: The Training Residents in Genomics (TRIG) Working Group developed survey and knowledge questions for the 2013 pathology Resident In-Service Examination (RISE). Sixteen demographic questions related to amount of training, current and predicted future use, and perceived ability in molecular pathology vs genomic medicine were included, along with five genomic pathology and 19 molecular pathology knowledge questions. Results: A total of 2,506 pathology residents took the 2013 RISE, with approximately 600 individuals per postgraduate year (PGY). For genomic medicine, 42% of PGY-4 respondents stated they had no training, compared with 7% for molecular pathology (P < .001). PGY-4 residents’ perceived ability, comfort in discussing results, and predicted future use as a practicing pathologist were reported to be less in genomic medicine than in molecular pathology (P < .001). Based on PGY, knowledge question scores showed a greater increase in molecular pathology than in genomic pathology. Conclusions: The RISE is a powerful tool for assessing the state of resident training in genomic pathology and current results suggest a significant deficit. The results also provide a baseline to assess future initiatives to improve genomics education for pathology residents such as those developed by the TRIG Working Group.

This paper explores the rationale, process and outcomes of an early-stage, issue identification and management process that was applied to a large-scale onshore oil development in Madagascar and to highlight the benefits of the issues management (IM) process for large-scale resource developments more generally. Oil and gas and mining developments increasingly take place in remote and environmentally and socially sensitive areas. They can have significant environmental, social and economic impacts and, if poorly planned and executed, generate social conflict. Stakeholder-related risks in the extractive sector have risen sharply over the last 20 years, putting a premium on early issue identification and management, as part of non-technical risk management. IM, the continuous process of issue identification, analysis, resolution and reporting is increasingly being used by leading extractive companies as a complement to impact assessment and related processes. The objective is to ensure that issues that have the potential to generate significant reputational, financial, legal, and operational impacts are identified in a timely manner and addressed before they escalate and become crises. While IM has been used for some time, its application in the oil and gas industry is relatively new. With the growing role of project finance, the increasing prevalence of JVs and the need for partnerships to develop complex projects, IM can bring significant value to sustainable project planning, execution and corporate risk management. One of the key conclusions is that IM can help companies improve their approach to impact assessment, reinforce stakeholder engagement, align projects with international project finance requirements and strengthen corporate and project risk management processes.

The Resident In-Service Examination (RISE) addresses 1 area of the Accreditation Council for Graduate Medical Education Outcome Project; RISE results demonstrate progressive attainment of pathology knowledge during training. We compared RISE scores with primary pathology board certification success for residents graduating in 2008 and 2009. Overall RISE and nearly all sectional scores in anatomic and clinical pathology were significantly higher for residents passing all certifying examinations at the first attempt vs residents who failed any examination. The risk of failing increased with each lower quartile of overall RISE score, such that 34% (2009) and 54% (2008) of residents in the lowest quartile failed at least 1 certifying examination. Two thirds of graduating residents with lowest quartile scores had a similar quartile ranking in the previous RISE, identifying them as at risk. Residents passing the American Board of Pathology certifying examinations have a higher level of medical knowledge in general and specific pathology disciplines as assessed by senior RISE scores.

Oil and gas activities raise important socio-economic questions for host governments, local communities and project proponents alike. If not identified and managed in a timely and effective manner, socio-economic issues - such as labour market effects, population influx, revenue management, social investment and socio-cultural change - can result in significant non-technical risk to projects including local opposition, permitting and project delays, inadequate delivery of benefits and reduced scope to prevent and/or mitigate negative impacts. These issues are particularly important where oil and gas projects take place in remote and environmentally and socially sensitive areas. Addressing socio-economic impacts early on can provide companies with timely identification of socio-economic, cultural and environmental issues at strategic and project level, as part of corporate planning, due diligence and risk management. Independent socio-economic impact studies can help resource companies (and host governments) plan projects more effectively, especially in relation to socio-economic impact management, social investment and overall stakeholder engagement. This paper explores the rationale, process and outcomes of an Independent SocioEconomic Impact Study of a proposed offshore oil development in the Falkland Islands. Arguing that the management of socio-economic issues is essential to any project’s approach to non-technical risk (NTR) management, the paper discusses the value of socio-economic impact studies as a means to manage socio-economic impacts. It also discusses key lessons of the Falkland Island study and its relevance to other projects around the world.

Throughout the world energy companies face a complex agenda requiring improved social and environmental performance. Alongside health, safety and environmental (HSE) issues, questions relating to human rights, revenue sharing, biodiversity, ethics, governance, corruption and the social and economic implications of energy activities are rising to the fore. This requires an understanding of the wider social, economic and political context of energy activities. Indeed, social, economic and political factors can play a crucial role in determining whether and at what pace development proceeds; something that traditional ESIA does not always capture given its focus on project-specific issues. The objective of the paper is to outline the purpose and value of high level, strategic impact assessments of the social, cultural, political, economic and environmental impacts of energy projects. The focus is on providing examples of the practical application of these assessment techniques rather than to dwell on theoretical models and to compare them to other forms of "strategic" assessment.

Sustainability and Corporate Social Responsibility (CSR) have becomesignificant issues for industry, in response to widespread internationalconcerns - NGO's and the media have ensured that the subjects have maintained avery high profile. A vast industry of lobbyists, consultants, academics andanalysts has been spawned to pressure and advise interested and affectedparties. A corresponding volume of documentation has been generated, presentinga wide array of opinions, claims and views. To companies, Health, Safety andEnvironmental (HSE) performance is an established priority but other CSR issuesare forcing themselves onto the corporate agenda. This paper addresses thecurrent priorities of society that are important to the upstream oil and gasindustry, now and potentially in the future. Corporate culture and leadership are fundamental to business success. Theyare also crucial in addressing important environmental and social challenges.As investors, regulators and external stakeholders increasingly expect worldclass CSR/HSE performance from industry, it is important to ensure visible andeffective CSR/HSE leadership. This not only supports sustainable growth inshareholder value but also helps to ensure improved stakeholder relations. Yet,while there is growing evidence that successful companies have elevated CSR/HSEinto their mainstream business management processes, there is a lack of clarityregarding the practical aspects of CSR/HSE leadership, about how to promote itand thus effect positive change throughout an organisation. This paper focuses on the rationale for promoting CSR leadership andprovides a brief overview of practical steps to promote leadership in thisarea. It takes into account many aspects of current practice and identifies keycomponents that could go into a detailed toolbox on CSR leadership. Theobjective should be to first provide a high level framework of guidingprinciples to strengthen leadership (e.g. clear policy statement; key CSRbusiness principles; commercial/CSR balance; simple explanation of the businesscase for good CSR; corporate priority areas with background reasons). These canthen be incorporated into more detailed management systems. Senior managementworkshops, properly planned and facilitated, are a valuable tool in identifyingpriorities and developing leadership programmes.

In 1964 Bartemeier (1) expressed concern about the distancing of psychiatry from occupational therapy and emphasized the need for conjoint efforts. At the 1993 Institute on Hospital and Community Psychiatry, psychiatrist Marianne Klugheit (9) challenged occupational therapists "to wake us up." Emphasizing the potential of occupational therapy in community mental health programs, she stressed the need for occupational therapy to demonstrate to the physician the critical value of such service. As each profession matures and clarifies and refines its domain, roles and expectations change. In its youth, occupational therapy was the agent for psychiatry. It relied on and grew from the leadership and support of psychiatry, discovering in the process its own unique identity and potential. Perhaps we can expect the affiliation of the two disciplines to follow the evolution of the child-parent relationship. As the child matures and establishes his or her efficacy and as the onus of parental responsibility diminish...

A series of 116 pantalar arthrodeses has been presented with a critical follow-up two to twenty-two years after operation. A two-stage pantalar arthrodesis was found to have no advantage over a one-stage procedure. When the Kocher approach was used the operative time was somewhat less than that with the anterolateral approach, but the incidence of wound complications was higher. The rate of pseudarthrosis, which occurred almost exclusively at the ankle, was 14.7 per cent. Most of the pseudarthroses occurred in patients with spasticity, the result of cerebral palsy or degenerative disease of the central nervous system. The best results in both male and female patients were found when the ankle was fused in 5 to 10 degrees of plantar flexion with no pronation or supination.