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Near the land this bank appears tolerably free from danger, but a little further out it is thickly studded with coral-shoals, which do not generally rise quite to the surface; some of them are very steep-to, and others have a fringe of shoal-water round them. I should have thought that these shoals had level surfaces, had it not been for the statement made by Horsburgh "that most of the shoals hereabouts are formed of a belt of coral." But, perhaps that expression was more particularly applied to the shoals further in the offing. If these reefs of coral have a lagoon-like structure, they should have been coloured blue, and they would have formed an imperfect barrier in front of Palawan and the northern part of Borneo. But, as the water is not very deep, these reefs may have grown up from inequalities on the bank: I have not coloured them.--The coast of CHINA, TONQUIN, and COCHIN-CHINA, forming the western boundary of the China Sea, appear to be without reefs: with regard to the two last-mentioned coasts, I speak after examining the charts on a large scale in the "Atlas of the Voyage of the 'Favourite'." INDIAN OCEAN. SOUTH KEELING atoll has been specially described. Nine miles north of it lies North Keeling, a very small atoll, surveyed by the "Beagle," the lagoon of which is dry at low water.--CHRISTMAS Island, lying to the east, is a high island, without, as I have been informed by a person who passed it, any reefs at all.--CEYLON: a space about eighty miles in length of the south-western and southern shores of these islands has been described by Mr. Twynam ("Naut. Mag." 1836, pages 365 and 518); parts of this space appear to be very regularly fringed by coral-reefs, which extend from a quarter to half a mile from the shore. These reefs are in places breached, and afford safe anchorage for the small trading craft. Outside, the sea gradually deepens; there is forty fathoms about six miles off shore: this part I have coloured red. In the published charts of Ceylon there appear to be fringing-reefs in several parts of the south-eastern shores, which I have also coloured red.--At Venloos Bay the shore is likewise fringed. North of Trincomalee there are also reefs of the same kind. The sea off the northern part of Ceylon is exceedingly shallow; and therefore I have not coloured the reefs which fringe portions of its shores, and the adjoining islets, as well as the Indian promontory of MADURA. CHAGOS, MALDIVA, AND LACCADIVE ARCHIPELAGOES. These three great groups which have already been often noticed, are now well-known from the admirable surveys of Captain Moresby and Lieutenant Powell. The published charts, which are worthy of the most attentive examination, at once show that the CHAGOS and MALDIVA groups are entirely formed of great atolls, or lagoon-formed reefs, surmounted by islets. In the LACCADIVE group, this structure is less evident; the islets are low, not exceeding the usual height of coral-formations (see Lieutenant Wood's account, "Geographical Journal", volume vi., page 29), and most of the reefs are circular, as may be seen in the published charts; and within several of them, as I am informed by Captain Moresby, there is deepish water; these, therefore, have been coloured blue. Directly north, and almost forming part of this group, there is a long, narrow, slightly curved bank, rising out of the depths of the ocean, composed of sand, shells, and decayed coral, with from twenty-three to thirty fathoms on it. I have no doubt that it has had the same origin with the other Laccadive banks; but as it does not deepen towards the centre I have not coloured it. I might have referred to other authorities regarding these three archipelagoes; but after the publication of the charts by Captain Moresby, to whose personal kindness in giving me much information I am exceedingly indebted, it would have been superfluous. SAHIA DE MALHA bank consists of a series of narrow banks, with from eight to sixteen fathoms on them; they are arranged in a semicircular manner, round a space about forty fathoms deep, which slopes on the S.E.

https://charles-darwin.classic-literature.co.uk/coral-reefs/ebook-page-105.asp

The anatomist process is the common group of steps that designers use to create companies processes which might be functional. Each step works toward 1 common objective: making the merchandise or procedure function as expected. This process is utilized to create whatever from mechanised components to entire devices. Once the architectural process is completed, a product or perhaps process is preparing to be implemented in the market. The next phase in the executive process can be testing. With this step, the team studies the product or process to be sure it complies with requirements. The testing method should be reported and include considerable results. Any problems that had been identified during testing need to be identified and analyzed by the team. The method should be repeated until the merchandise or process meets design and style requirements. The engineering procedure involves the usage of technology to fulfill a specific issue. Engineers must consider all of the constraints and resources that you can get to solve the problem. After brainstorming several solutions, engineers build prototypes to test out the alternatives. They also test these representative models rigorously with all the end users to determine which one will continue to work best. This iterative engineering process process is the hallmark of the engineering style process, and it is how innovative products were created. Once the architectural process is done, the design is certainly marketed to the different stakeholders active in the project. These kinds of stakeholders may include the engineering team, managers, investors, and local residential areas. State governments could also be involved depending on regulatory requirements and mortgage approvals required for the project.

https://isukiigreens.com/the-engineering-process/

Guidelines have the potential to affect a wide range of people and organisations by influencing behaviour, changing practice and impacting policy, legal or funding frameworks. Stakeholders are individuals or groups who are affected by or can influence a guideline’s development and implementation (IOM 2011), including: - government agencies - professional societies and the members they represent - people affected by the condition (as individuals and collectively in consumer organisations) - healthcare and academic centres - quality improvement organisations - relevant commercial companies - other end users. Stakeholders include ‘expected users’—those who you might expect or intend to apply, implement, or be otherwise directly affected by your guideline recommendations. In this module, stakeholders are classified as anyone with a legitimate interest in your guideline or anyone affected by its recommendations (see Table 1 for examples). A compelling reason to engage stakeholders is that it can enhance the implementation of your guideline (Grol, Dalhuijsen et al. 1998). First, a guideline developed with input from stakeholders is more likely to be relevant to the needs of its expected users, which improves its implementability. Second, early involvement by organisations that oversee the administration and funding of services that will use your guideline can lead to greater support for its implementation. These benefits are more likely to happen if stakeholders are engaged early in the development process using a consultative approach (Jones 2011). Table 1. Examples of types of stakeholders in guideline development | | Type | | Description | | Expected users | | People intended or expected to apply, implement or be directly affected by the guideline recommendations (e.g. health care providers, policy makers or the public who may use the guideline recommendations to help with decision making). | | Government agencies | | Government agencies involved in the funding or administration of health care, regulatory and policy activities, such as the Department of Health, state and territory health departments, the Department of Veterans’ Affairs, the Australian Commission for Safety and Quality in Health Care and NHMRC. | | Professional bodies | | Professional and industrial bodies, such as medical and nursing colleges, specialty societies, industrial groups, scientific networks and public health groups. | | Insurers | | Private and public insurance companies such as the National Disability Insurance Agency and other payment and reimbursement agencies. | | Industry | | Industry groups and commercial companies involved in manufacturing, supply or service delivery in health and other relevant sectors. | | Condition groups | | Groups that focus on a specific disease, health issue or physical state of being (e.g. pregnancy) that support research, represent relevant professionals or advocate for patients or other populations of interest (see also Consumer involvement). | | Researchers | | Health and medical researchers, institutes and research collaborations. | | Service providers | | Hospitals, healthcare centres and other relevant service providers including professionals who work within these organisations (e.g. educators). | | Advocacy groups | | Groups that attempt to influence or lobby legislators and other decision makers on behalf of a particular cause or interest. You should engage stakeholders at critical points during the development process, such as when the guideline is scoped and when the outcomes are prioritised. While a variety of engagement methods can be used, evidence of their benefits and limitations in guideline development comes from case studies of the experience of developers rather than comparative evaluations. As with all aspects of guideline development, your choice of methods and how you apply them should be balanced with available resources and other constraints (Institute of Medicine 2011) . The following principles (adapted from Department of Health, 2015) can be used to plan authentic stakeholder engagement: - plan in advance for when and how to engage stakeholders - involve stakeholders from the start - set clear expectations by explaining what their role is and how their contribution will inform the guideline - make it easy for stakeholders to be involved, particularly those who may find participation more difficult because of language, culture, age, disability or financial and other barriers - be aware of stakeholder objectives, expertise and level of influence - acknowledge and respect stakeholder views - treat stakeholders equitably. Some stakeholders, such as consumers, should be involved throughout all stages of guideline development—this advice is discussed in other modules (see Consumer involvement, Guideline Development Group and Public Consultation). The focus of this module is on the general methods of engaging stakeholders throughout guideline development. What to do 1. Plan for early and repeated stakeholder involvement Stakeholder perspectives can be considered at different steps in the guideline development process and should be planned in advance. Some agencies use topics suggested by stakeholders to commission and prioritise new guidelines (NICE 2014; Shin 2014; SIGN 2015). Early involvement might include: - proposing or commenting on guideline topics - the relative importance of outcomes - the settings and expected users of the guideline (see Guideline Development Group, Scoping the guideline and Considering purpose and context). You should provide clear opportunities for the involvement of appropriate stakeholders. These may include reviewing recommendations and derivative products to ensure clear and actionable messaging and planning for implementation (Cluzeau, Wedzicha et al. 2012). It is important that developers of Australian guidelines involve Aboriginal and Torres Strait Islander Peoples as members of the guideline development group wherever possible, particularly if key outcomes differ in these populations. If this is not possible then you will need to consider and document alternative ways to seek their views as stakeholders. For example, developers of the NHMRC Borderline Personality Disorder guidelines wrote: Although the Guideline Development Committee membership did not include representation from Aboriginal and Torres Strait Islander peoples, the views of this community were canvassed early in the process through consultation with the Department of Health and Ageing’s Aboriginal and Torres Strait Islander Committee. Once your guideline has been implemented, stakeholders might contact you with feedback about its usability and relevance. They may also let you know when updates are needed, such as when new evidence becomes available, or when changes in practice or policy occur (SIGN 2015). While involving stakeholders can boost the relevance and use of your guideline, it can also add to the overall development time and may increase your administrative burden depending on the engagement methods you choose to use (Cluzeau, Wedzicha et al. 2012). This will present a particular challenge if you are developing guidelines with a volunteer workforce, or if you need to develop guidelines quickly, so you should plan accordingly based on your available resources and deadlines (see the Project planning module). 2. Identify local and international stakeholders Begin this process by conducting a stakeholder analysis. This will help you to determine who should be considered when developing your guideline by systematically gathering and evaluating qualitative information (Schmeer 2001). First define the expected users of your guideline by thinking about who might use or be affected by its recommendations (Canadian Taskforce on Preventive Health Care, 2017). For example, a guideline on the treatment of muscle strains may be developed for physiotherapists, but other expected users might include general practitioners, primary care nurses and people with muscle strains. Expected users are only a subset of stakeholders. Other interested parties in guideline development that can also be considered stakeholders include funding bodies and industry groups. Understanding this distinction will help you later when planning how to involve different stakeholders, for instance when deciding which groups should be involved in decisions about your guideline and which others should simply be informed about its development and progress. It is important to identify not only local stakeholders but also international groups that are developing or publishing advice on similar guideline topics. Searching government websites such as Australian Clinical Practice Guidelines, National Institute for Health and Care Excellence (NICE) Guidance (UK) and Centers for Disease Control and Prevention (CDC) (USA) may help you find guidelines in development or published and it may be helpful to contact their developers for advice on your guideline’s scope and selection of topics. It is better to be non-selective at this stage to ensure that you identify stakeholders across a wide range of relevant groups, regardless of their interests (see Table 1 for examples of types of stakeholders). 3. Consider levels of involvement for different stakeholders Once you have identified relevant stakeholders, consider setting up a database and recording stakeholder details such as their: - name - organisation - position - contact details - location. It is also useful to record their type—for example, whether they are from the government or private sector, or represent a condition group or professional society. An important step in determining appropriate levels of involvement is to list all possible stakeholders and consider their degree of relevance to the guideline (Table 2). Relevance in this case refers to how great an impact the guideline may have on them. It can also refer to their capacity to affect, positively or negatively, the development or implementation of the guideline. For example, if you are developing public and environmental health guidelines you should contact and stay in touch with relevant government jurisdictions. You should also align with their advice, since they will likely be ultimately responsible for implementing your guideline. While not all stakeholders need to be directly engaged, it is important that you consider: - who might be interested in your guideline - what their views might be - what influence they might have on different stages of development. While the degree of relevance can be a useful measure when determining levels of involvement, it is also important that you consider the interests of all stakeholders and whether these might preclude them from particular engagement activities. These are important decisions for you to make as the content and implementation of guidelines may change as a result of stakeholder perspectives and whether they are convergent or contrasting (Green and Aarons 2011). Table 2. Examples of different levels of stakeholder involvement (adapted from Department of Health, 2015). | | Level of involvement | | Nature of involvement | | Example | | Collaborate | | Partner with stakeholders for the development of mutually agreed solutions and a joint plan of action (two-way or multi-way communication where learning, negotiation and decision making occur on both sides). | | This is an option for stakeholders who will be affected by and could influence guideline development and implementation (e.g. organisations that should be involved in implementing the guideline). | | Involve | | Work directly with stakeholders throughout the process to ensure that issues and concerns are understood and considered (two-way or multi-way communication where learning takes place on both sides). | | This is an option for stakeholders who will be affected by the guideline but would not otherwise affect its development (e.g. people who should be targeted to help prioritise outcomes). | | Consult | | Gain information and feedback from stakeholders to inform decisions made internally (limited two-way communication whereby developers ask questions for the stakeholder to answer). | | This is an option for stakeholders who are unlikely to be affected by the guideline but whose activities may influence its development or implementation (e.g. other guideline developers who could help provide evidence tables on related topics). | | Inform | | Inform or educate stakeholders in one-way communication (there is no invitation to respond). | | This is an option for stakeholders who are unlikely to be affected by the guideline or influence its development or implementation (e.g. people who should be sent an email to inform them when public consultation will occur). 4. Decide how and when to engage stakeholders When you are deciding the timing and methods for involving stakeholders you should consider at which stages of development it will be most important to seek their input and plan for distinct engagement activities (Cottrell, Whitlock et al. 2014). You should: - decide on an appropriate level of engagement (see Section 3) - let the focus and desired outcome of the engagement inform the method of choice - avoid tokenistic involvement - develop a communications plan which specifies the aim, method and logistics of each engagement activity (see Table 3 for examples of methods). For all methods it is important that you clearly define which aspects of the guideline are the focus of engagement. Prospective participants should also be informed of how the information they provide will be disseminated and used—for example, if it will be published in the guideline or made available to other stakeholders on request. Contact a range of stakeholders by widely advertising opportunities for them to contribute. For example, consider email (including asking relevant organisations to use existing email lists), social media (e.g. Facebook, Twitter, LinkedIn), online newspapers and magazines, advertising through conferences and using the websites of organisations involved in the guideline’s funding and development. It may be worth setting up a system such as an electronic mailing list or online portal for individuals and organisations to register their interest in being involved. You should ensure that all efforts are made to contact relevant stakeholder groups, including those that may be difficult to reach as not all stakeholders will have the same opportunity to give feedback. You can consider working differently with these stakeholders to help them contribute, or offer alternative ways of engagement to ensure their views are treated equitably. For example, if a stakeholder has limited resources (time, people and money), it might be necessary for you to offer more flexible options in the timing and method of involvement (Department of Prime Minister and Cabinet 2013). Methods to ensure all relevant stakeholders have an opportunity to be involved are discussed further elsewhere (see Equity and Consumer involvement). Finally, consider your own monetary, time and other resource costs of involving stakeholders in different ways (e.g. people, meeting locations, outreach tools, travel) (see the Project planning module). Try to balance the methods and timing chosen with the funding or existing resources available to the development group (IOM 2011). Table 3. Methods of stakeholder engagement | | Method | | Description | | Examples of use | | Stakeholder advisory groups | | These structural groups are not involved in developing the recommendations or drafting the guideline but their advice could be sought on a range of issues at any time during development. | | These should be formed at the beginning of guideline development with defined terms of reference, e.g. the James Lind Alliance Priority Setting Partnerships enable clinicians, patients and carers to work together to set priority questions for review. They can also be formed during the guideline development process as required to provide input addressing unanticipated topics. The Implementability module also discusses the use of advisory groups to consider implementation issues. | | Surveys: | | These can be used to seek specific advice using structured, straightforward questions. Written surveys are relatively inexpensive and can be used to retrieve feedback from a large population or geographical area, but response rates can be low. | | These could be used at any stage of guideline development. Using them early may help to identify individuals and groups who should be consulted in more depth later in the process. E.g. developers of the NHMRC Guidelines for the Management of Overweight and Obesity surveyed consumers and expected users to identify barriers and facilitators to implementation. | | In-depth interviews: | | These can be used to seek detailed information from selected stakeholders, but they can be expensive, difficult to arrange and may need skilled interviewers and analysts. Note also that depending on how these are used, the selection of stakeholders may be divisive if it introduces a hierarchy of importance. | | These could be used to seek individual patient preferences or values related to specific treatment options. E.g. developers of the Australian Clinical practice guidelines for antenatal care conducted face-to-face meetings with Aboriginal health workers. | | Focus or discussion groups | | These can be used to explore specific issues, but they require a skilled facilitator and analyst and it can be difficult to retrieve a variety of different views from participants. | | These could be used to explore perceptions within specific groups. E.g. conducting a series of discussion groups in different regions may be useful for the development of national guidelines. | | Public meetings and forums | | These are opportunities to share information and invite views on a broad range of issues. There might be a risk that discussion is dominated by particular individuals or groups rather than be representative of the whole population. It takes a skilled facilitator to make sure a range of views are presented and to remain focused on particular topics. | | These could be used to bring different disciplines together to discuss a topic, e.g. a national public forum was used to develop definitions and principles of care for NHMRC’s National Guidance on Collaborative Maternity Care. | | Citizen juries | | These can be used to explore values and preferences through well informed and structured discussion. They can be useful for sensitive topics where discussion of values and preferences may be divisive. | | These could be used to prioritise outcomes and explore different values and preferences on sensitive topics. Depending on the topic, this method may require particular expertise, e.g. health economics to be effective. | | Workshops | | These can bring together diverse groups to explore a specific issue or work towards a specific goal. Participants should be carefully recruited depending on the aims of the workshop. | | These could be used to bring together implementation experts and expected users to discuss implementation strategies and formulate a plan, e.g. developers of the Australian Guidelines for the Prevention and Control of Infection used workshops to pilot recommendations using the GuideLine Implementability Appraisal (GLIA) tool. 5. Consider and respond to stakeholder feedback Unlike public consultation, it can be relatively straightforward to predict the volume of feedback you will receive from stakeholder engagement. This is because you and the guideline development team have shaped the engagement activity to your needs and targeted a specific audience. Since they have taken the time to respond to your requests you need to make sure that: - all stakeholder feedback is documented - all feedback is taken into consideration - the participants are acknowledged. Participants should also have access to documentation on how you handled their comments and any resulting changes. This information could be published with the guideline, provided participants have given permission to do so and were informed of how their feedback will be used before commencing the engagement activity. You should also consider any new evidence submitted by stakeholders, provided it meets the inclusion criteria used in the evidence review process. If this evidence was published outside the timeframe of the search parameters, the development group may still wish to consider its potential impact and decide if it should be included in the review or elsewhere in your guideline. NHMRC requirements Guidelines approved by NHMRC must meet all requirements as outlined in the Procedures and requirements for meeting the NHMRC standard. The following requirements are relevant to involving stakeholders: F.4 The developer has identified and consulted with key professional organisations (such as specialty colleges) and consumer organisations that will be involved in, or affected by, the implementation of the clinical recommendations of the guideline. NHMRC Standards The following Standards apply to the Engaging stakeholders module: 1. To be relevant and useful for decision making guidelines will: 1.1 Address a health issue of importance. 1.2 Clearly state the purpose of the guideline and the context in which it will be applied. 1.3 Be informed by public consultation. 1.4 Be feasible to implement. 5. To be focused on health and related outcomes guidelines will: 5.1. Be developed around explicitly defined clinical or public health questions. 5.2. Address outcomes that are relevant to the guideline’s expected end users. 5.3 Clearly define the outcomes considered to be important to the person/s who will be affected by the decision, and prioritise these outcomes. Useful resources Existing guidance to help identify other developers: Australian Clinical Practice Guidelines Centers for Disease Control and Prevention (USA) NICE Guidance (UK) Resources on methods of stakeholder involvement: Department of Health Stakeholder engagement framework James Lind Alliance Priority Setting Partnerships References Canadian Task Force on Preventive Health Care (2017). CTFPHC Patient Engagement Protocol. Cluzeau, F., J. A. Wedzicha, et al. (2012). Stakeholder involvement: how to do it right: article 9 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report. Proceedings of the American Thoracic Society 9(5): 269-273. Cottrell, E., E. Whitlock, et al. (2014). Defining the Benefits of Stakeholder Engagement in Systematic Reviews. Agency for Healthcare Research and Quality, US Department of Health and Human Services. Department of Health (2015). Stakeholder engagement framework, Australian Government. Department of Prime Minister and Cabinet (2013). Cabinet Implementation Toolkit, Australian Government. Green, A. E. and G. A. Aarons (2011). A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping. Implementation Science 6: 104. Grol, R., J. Dalhuijsen, et al. (1998). Attributes of clinical guidelines that influence use of guidelines in general practice: observational study. British Medical Journal 317(7162): 858-861. Institute of Medicine (2011). Clinical practice guidelines we can trust. Committee on Standards for Developing Trustworthy Clinical Practice Guidelines, National Academies of Science. Jones, C. R. (2011). Using the IRPA Guiding Principles on Stakeholder Engagement: putting theory into practice. Health Physics 101(5): 601-605. National Institute for Health and Care Excellence (NICE) (2014). Developing NICE guidelines: the manual. Schmeer, K. (2001). Stakeholder Analysis Guidelines, Policy Toolkit for Strengthening Health Sector Reform, World Health Organisation. Scottish Intercollegiate Guidelines Network (SIGN) (2015). SIGN 50: a guideline developer’s handbook. Shin, J. J. (2014). Involving Stakeholders in the Development of Clinical Practice Guidelines. Otolaryngology - Head and Neck Surgery 150(6): 907-909. Acknowledgments NHMRC would like to acknowledge and thank Professor Sally Green from Cochrane Australia for her contribution to the development of this module as editor. Version 5.1. Last updated 22/11/2018. Suggested citation: NHMRC. Guidelines for Guidelines: Engaging stakeholders. https://nhmrc.gov.au/guidelinesforguidelines/plan/engaging-stakeholders. Last published 22/11/2018.

https://www.nhmrc.gov.au/guidelinesforguidelines/plan/engaging-stakeholders

Former SpaceX engineer breaks down the code to successful hardware engineering Passion, a shared mission and collaboration skills are essential for engineers to be successful, according to Duro Co-founder, Kellan O’Connor. Kellan got his start as a mechanical engineer in space tech. He was drawn to the industry after attending the International Aerospace conference in DC and seeing some of the pioneers of the commercial space industry, such as Elon Musk and Burt Rutan, talk about the future. After grad school, he spent five years in the Propulsion department at SpaceX designing booster engines. This article discusses what life was like in the early days working as a mechanical engineer in space tech. It reviews how hardware engineering has changed with technical advancements and a changing work environment. The early days as a space tech engineer were fast-paced and experimental Kellan began his career as a mechanical engineer working on experimental rocket engine hardware at Exquadrum before joining SpaceX. Arriving at the company before SpaceX was as renowned as it is today, Kellan entered an environment that was very entrepreneurial. Everyone was focused on the singular mission of getting a rocket to orbit for the first time. Unlike the aerospace organizations of the past, SpaceX was set up differently; everything was designed, built and tested internally. This structure enabled the engineering teams to iterate much faster and avoid many of the delays that were inherent in a system built on third-party vendor participation. Day-to-day life at SpaceX primarily involved designing various aspects (e.g. parts, system layout, etc.) of the Falcon 9 booster engine, called Merlin. The startup environment allowed Kellan to gain exposure to different roles across many different disciplines, from design and manufacturing engineering to fluid control systems and structural analysis. While the work was exciting, it also involved a high level of stress. A slight miscalculation could result in mission failures and program setbacks. After a few such setbacks, in 2008, the Falcon 1 rocket became the first privately-developed fully liquid-fueled launch vehicle to go into orbit around the Earth. Collaboration was, and still is, king At the time, the Propulsion department at SpaceX comprised 20 – 30 engineers. As a Design Engineer, Kellan collaborated closely with analysis and development engineers. Designs were analyzed in a digital environment which replicated the real world stresses the rocket would be exposed to on its ascent to space. This iterated process eventually transitioned to producing the part or building the assembly before being shipped to the manufacturing team and tested at the SpaceX Testing Facility in Texas. A tight feedback loop, supported by strong partnerships across the various engineering disciplines, helped reduce development timeframes and remove risk. While the engineering design process overall was efficient, one major inefficiency early on involved the engineering change process. Engineering Change Orders had to be listed out on paper, shared in-person with multiple approvers, and approval signatures had to be written out in order to release any new design revisions. Once SpaceX transitioned to a PLM solution this process improved dramatically, removing the in-person steps and digitizing the paper-based process. Old inspires the new Aside from the obvious advancements in collaboration tools, such as messaging and video conferencing, the biggest developments impacting space technology have been the advances in materials science and software. Higher tensile strength steels, new ceramics and carbon fibers allow rockets to be built lighter and stronger. While mechanical engineering techniques are rooted in static principles, these new materials are changing the way engineers approach their job. Greater computing power and memory allow for enhanced systems intelligence, precise tracking of launch and landing sequences, as well as monitoring of the health of the vehicle. The rapid advancements at SpaceX were largely helped by studying previous design methods and manufacturing processes. Kellan and other SpaceX engineers reviewed old rocket design books describing designs used during the Apollo program. Building on these original ideas with new materials, methods, and software-driven systems allowed for significant improvements. Future focused hardware organizations should embrace new technologies While communications tools and materials have evolved since Kellan began his career, many of the fundamentals of engineering remain the same. Collaboration across departments and maintaining a tight feedback loop between design, test and manufacturing teams will always be essential for success. The difference is that now information sharing is even easier with modern software, such as out-of-the-box cloud-native PLM. Engineers in any location can access the latest revision or BOM and don’t have to worry about sending documents back and forth. Organizations should embrace new cloud tools to help hardware engineers be more agile while also learning from the past by reusing designs. Finally, they should follow SpaceX’s example and clearly define their vision for employees to align to.

https://www.durolabs.co/blog/former-spacex-engineer-breaks-down-the-code-to-successful-hardware-engineering/

This paper describes Statistical Process Control (SPC) and experimental design (DOE), two tools used by industrial engineers to detect, analyze, and solve problems. The goal was to minimize the interruptions in the packing process at a tuna canning plant. The factors identified as probable assignable causes for process interruptions included: (1) the weight of the tuna in the can, (2) the height of the operators, (3) the speed of the packers, and (4) the rpm of the can sealer. Four hundred observations were made for the study, and the order of the experimental conditions measured was randomized in order to protect the design against the influence of unidentified factors. Daniel's method (described by Montgomery, 1989) was used to analyze the data and create a graph showing the estimates of the effects. The following actions were necessary to control the packing line process: (1) The results of the DOE were put into effect; (2) Operators were re-trained; (3) inspections provided the mechanism for operator and process feedback; (4) manufacturing engineers became more involved in the packing process; (5) films were produced to train operators in an improved method of cleaning the fish; (6) the quality of the product was defined as the answer to the problem; and (7) employees learned to prepare and use control charts. These measures, together with strong management support, resulted in substantial improvements and a potential monthly savings of $88,335.

http://asq.org/qic/display-item/index.html?item=9864

Manufacturing engineers are involved in the process of manufacturing from planning to finished product. Manufacturing engineers work on design and operation of integrated systems for production of things. They work to produce high quality goods efficiently and with less wastage and low impact on environment. Manufacturing engineers work on flow of manufacturing, automation, designing the most efficient manufacturing process, assignment of machines and equipments to various lines of manufacture, material handling and layout of the manufacturing area. They begin by making a prototype of the manufacturing process electronically and then translate it into a cost effective and efficient system of manufacturing. Know if Manufacturing Engineer is the RIGHT Career for you? Are your Aptitudes and Personality suitable for becoming a good Manufacturing Engineer ?

http://www.mapmytalent.in/career/manufacturing-engineer

Callaway Golf Company is a leader in total performance, premium golf equipment and active lifestyle products while also being a great place to work! We are passionate and push the limits of innovation. We dare to be great while acting with integrity and respect. We stay hungry, yet humble. All while having fun and making golf enjoyable for everyone! Our company is a blend of experience and diverse backgrounds, and our leaders have a strong history of building and selling successful initiatives. We are working to build a truly groundbreaking company, and we want top-notch people to join us in that mission. JOB OVERVIEW This position is responsible for assisting with technical projects related to new process implementation, process improvements, and cost savings while assisting the manufacturing operation with administrative and technical support. The incumbent is responsible for the daily execution of experiments, data organization and analysis, report generation, and general production support. As a secondary function, the employee will assist in basic administrative tasks related to manufacturing as determined by the Engineering Manager and Plant Manager. ROLES AND RESPONSIBILITIES Manufacturing Quality Systems Support - Continually seek process and system improvements to increase process capability, production yields, and productivity - Under the guidance of senior engineers, assist in the execution of capability improvements and cost-savings/avoidance opportunities - Use sound scientific methods and principles to assist in troubleshooting and also the execution of both small and large scale pilots - Track and document all projects, detailing methods used, critical parameters, and detailed observations and conclusions. - Track engineering equipment related inventory and place orders for spare parts and materials - Communicate effectively with users to identify needs and evaluate alternative solutions - Regularly drive the audit of systems and processes to provide feedback/direction on improvement - Research and evaluate new documentation tools, methods, and systems; implementing improvements to processes and troubleshooting issues - Ensure standardization of systems and processes across teams and regions Project Management - Plan, execute, and track projects - Work with stakeholders to define scope, goals, budget, deliverables, required resources, and timeline - Prepare and present project status during regularly scheduled and ad hoc project review meetings - Work with management to ensure project changes are understood and approved - Evaluate all key project deliverables, as well as final product, to ensure traceability of requirements, high quality, and user acceptance Production Support - Provide necessary feedback to Production Supervisors regarding best practices and training opportunities - Help to establish and document manufacturing instructions, where appropriate - Act as the primary backup for Production Supervisors for production coverage; This may include other operational tasks as determined by the Engineering Manager and Plant Manager TECHNICAL COMPETENCIES (Knowledge, Skills & Abilities) - Must be able to read, write and understand English - Competency with Microsoft Works programs including Excel, Word and Access - Use and understand a wide variety of manufacturing equipment and programs to enhance and support manufacturing processes - Ability to manage various projects, multi-task, and assign tasks when required. - Excellent process identification, evaluation, and problem solving skills. - Ability to elicit cooperation from management and other departments. - Ability to work independently and rapidly adapt and respond to priority changes based on business needs. - Work extended hours and travel in critical situations. - Strong interpersonal skills and professional demeanor. - Ability to maintain professional customer relations and to deal responsively with management and peers. - Demonstrate excellent attention to detail. - Strong written and verbal communication skills. EDUCATION AND EXPERIENCE - Associate’s degree in a related field preferred - 2 years experience in a manufacturing environment PHYSICAL REQUIREMENTS / WORK ENVIRONMENT (if applicable) - Extensive use of office equipment and other business related machines and software.

https://golf-jobs.com/job/facilities/technician/7292188/process-engineering-technician-finishing

The new normal of lower oil prices has led to a simple conclusion—drilling costs must be lowered in order for many projects to be economic. It is not enough to slash big-ticket expenses like cement, mud, and casing, which often lead to potential problems, now and in the future. Operational expenses must be systematically lowered and become much more predictable and repeatable. This requires an approach not dissimilar from LEAN methodologies which are widely used in other industries. Structured and sustainable reductions in drilling costs requires an iterative DMAIC (Define-Measure-Analyze-Improve-Control) methodology. In drilling, the define phase has been imposed by commodity prices. Many have also spent considerable time and effort pursuing analysis and improvement under the assumption that the measurements being used therein are sufficient in type and quality. However, recent evaluation of the data provided by drilling rigs clearly demonstrates that the data provided by drilling rigs is neither complete or of sufficient quality for these purposes. To properly analyze drilling performance and created sustainable, practical, engineering solutions, the industry must begin with a foundation of quality measurements. These are critical to all aspects of drilling optimization, mechanization, automation, and real-time operations and analysis. This paper serves as the foundation for the specification of these measurements as well as the genesis of a body of work—which will be published by a collaborative group of operating companies over the next year—to clearly state the requirements for drilling measurements. Prologue “Sit down before fact with an open mind. Be prepared to give up every preconceived notion. Follow humbly wherever and to whatever abyss Nature leads, or you learn nothing” –Hyman Rickover The new paradigm of ‘drilling as manufacturing’—with a focus on standardization, optimization, and automation, combined with the co-incident rise of real-time operations and monitoring centers, and significant downward pressure on CAPEX clearly illustrate the need for better and/or new measurements and instruments. The majority of drilling rig machines, tools, and instruments, particularly those used on land rigs, were developed for use by rig-based personnel. The main purpose of measurements provided has been driven by safety and failure prevention and is largely supplemented by a very advanced collection of organic sensors—the driller. That is to say that the ability of a human to collect and interpret vast amounts of aural, visual, olfactory, environmental, vibration and other information has allowed us to complete (though with variable and sometimes unpredictable results) our work routinely without complex or even well-specifies sensor networks. Additionally, high profit margins in the past have allowed even uncontrolled or inefficient processes to generate acceptable returns. Thus, as long as the rig reaches total depth in a reasonable timeframe without too much trouble, specifications for the sensitivity, accuracy, repeatability, and reliability of rig equipment have been relatively non-existent. Common practice has been for operating companies and drilling engineers to specify general rig capabilities such as total horsepower, hoisting capacity, pump rate, and pump pressure—leaving the details to the drilling contractor. This has led to wide variations in actual process capabilities and a large number of processes that are out-of-control from a statistical perspective. It is useful, therefore, to remind the engineer of several axioms - A process that is not measured cannot be understood - A process that is not understood cannot be controlled - A process that is not controlled cannot be optimized - A process that is not standardized is difficult to automate - Optimization precedes automation Though this paper focuses on instrument and sensor specifications, the same approach can be followed for machine specification as well. Operations Driven Specifications A thorough process of specification can be well-defined using simple, iterative, eight-step procedure as follows: - Identify all stakeholders While the operations group (drilling) is primary stakeholder, it is unlikely that that they are the only stakeholder. More often, the process is becoming more refined and is influenced by professionals from other disciplines including: a. Rig Personnel and Drilling Contractors The person at the brake handle, shale shakers, slips, or mud pits is the most important stakeholder to consider when specifying any new process, machine, tool, or instrument. If it does not serve him/her well, it should be revised until it does so. This is well reflected in the LEAN concept called ‘genba’ which is a Japanese word that translates to ‘the real place’ or the place where the work is being performed. Any proposed improvement should include (and ideally begin with) a conversation on the rig floor with the people doing the work. Further conversations should regularly include those who will be most responsible for implementation and use. While this will primarily be drilling contractor employees, it may also include other rig-centric suppliers such as directional drillers, fishing hands, and managed pressure personnel. b. Management Management should communicate their process goals through well-chosen KPIs and cost targets. Without these, it is possible that reasonable selections based on key stake-holders may lead to sub-economic solutions or requirements that do not serve the needs of the business as whole. c. Safety and Risk Though many safety and risk considerations have already been addressed in this domain, it is very likely that, if they are required, they will supersede most others and must be included as soon as possible. d. Equipment, Automation, Controls, and Fuel and Power Systems Current automation has yet to mature to the level of robotics and most rig automation systems can be developed to work with existing data as long as specifications containing uncertainty are well defined and communicated. When specifying sensor capability, it is also useful to consider how an industrial engineer could use the data to evaluate machine reliability and performance. e. Regulatory BSEE, BLM, and other regulatory agencies have developed or are considering standards for remote monitoring and operations centers. It is wise to consult them and to develop mutually beneficial standards. f. External Operations The operational needs of data provided by instruments extends beyond drilling. This is particularly true of survey-related data; but, the value of other data to completions and production engineers, as well as geologist, geophysicists and other petro-technical professionals, should not be discounted. g. IT and Analytics On-site personnel benefit from a variety of sensory inputs that are not readily available using existing instruments. However, certain behaviors or events may be more easily detected with data that has the proper resolution and confidence. Moreover, the advent of ‘big data’ tools may lead to additional value creation through large scale data-mining and analytics. h. Geosciences Historically, rig data aggregation systems have been provided by mud-logging companies. This is because of their need to integrate sensor data with geophysical and geologic data. Until the last decade, the mud logger was frequently on of the most influential persons on drilling optimization and well control. As a result, geoscience professionals have a long history of using sensor data and should be consulted early and often. i. Supply Chain The impact of a mature supply chain organization on development of and enforcement specifications cannot be understated. If staffed with professionals with experience in manufacturing (especially automotive, aerospace, and semiconductor), supply chain can provide advice, references, and examples which can significantly expedite and simplify the process. Moreover, supply chain teams typically have one or more quality professional embedded within them and can leverage those skills and resources. j. Quality If the organization has an independent quality department (in oil and gas these are often incorporated in to the safety department) they should be included in the specifications at very early stages to ensure consistency and continuity with internal and external (industry standard/required) specifications. It is not sufficient to simply identify all the stakeholders and invite them to a meeting. In many organizations, it may be unclear who the appropriate stakeholder might be (or if one currently exists) and the engineer is responsible for ensuring that the person qualified for the technical specifications for each discipline is represented. Stakeholders should be actively sought out and encouraged to participate. - Define Defects Based on Process Goals After stakeholders (or groups thereof) have been identified, they must independently define their process goals. Most technical and operations stakeholders have goals that can be easily derived from the needs of their particular work. Management, however, must state their goals as a function of the business as a whole, and a host of externalities such as market forces, debt timelines, joint-ventures and partnerships, and other non-operational considerations. It is also important for managers to note that when KPIs are chosen, behavior adapts to meet those criteria. For example, if ROP (rate of penetration) is chosen as the primary KPI for drilling, employees will modify their actions to meet the goal of high ROP—up to and including sacrificing borehole quality and safety. Thus, one cannot understate the importance of appropriate KPIs in the process of specifying process capabilities at all levels. It should also be evident, to the various stakeholders involved, how their particular interest can be skewed by management KPIs. Each stakeholder should then determine what constitutes a defect in the context of those goals. A defect is not necessarily a mistake or a failure, rather it is a result of an activity or process that falls outside the stated goals(s) of the stakeholder of business. A process goal for safety might be to prevent (or minimize within HSE targets) the probability of a material failure to minimize a material failure that could expose person, property, or the environment to unnecessary risk. This is especially true of pressure and hookload. For example, the safety department might require 0.5% accuracy on hookload to reach an acceptable level of risk for such an event. However, drilling operations process goal might be to have sensor capability such that the probability of a NPT (non-productive time) is minimized. A defect to that process would be that the risk of NPT that is higher than desired or actual resultant NPT—which may only require 2% accuracy. It is clear, in this scenario, that different stakeholders will have different levels of required capability for the same defect (or failure mode). Stakeholders can then work backwards from the amount of desired risk and the probability of defect due to an errant sensor to derive required process capability. An example of this approach is presented in SPE 178776-MS - Perform FMEA for each stakeholder Each stakeholder must determine not only the types of defects that may be present but also the probability of each. Then, they may be able to calculate (or estimate) the probability that a sensor error will contribute to the defect. In many situations, if sensors have not been specified properly in the past, data to calculate this may not be readily available. In this case, stakeholders must rely on simulations, expert interviews, and, sometimes, intuition. It is important to remember that this is an iterative engineering process. Over time, data and experience will reveal if sensor capability specifications should be revised. However, lack of information should not be an excuse for lack of specifications or a deterrent to creating them. The most common approach to this problem is to perform interviews and ask a large number (practically speaking) of professionals what the accuracy, and other process capability requirements, should be—even though they may not be experts in sensor specifications or the like. It is very likely that this will lead to a specification that is sufficiently close to the true requirement that is can be used as a starting point. The reader may think that such guessing is dangerous and not a sound engineering practice. However, it is instructive to recall the experience of the French mathematician Francis Galton—who was determined to demonstrate how non-experts could not be trusted to reach the simplest conclusions. He asked thousands of people to estimate the weight of a cow at a state fair and offered the cow as a prize to anyone who could guess the correct weight within a pound. No one correctly guessed the weight of the cow and the range of guesses was wide. However, the average of all the guesses was within one pound of the true weight. This type of crowd-wisdom has been observed many times and is well documented by James Surowiecki in his book “The Wisdom of Crowds: Why the Many Are Smarter Than the Few and How Collective Wisdom Shapes Businesses, Economies, Societies and Nations.” - Analyze Risk and Probability After probability has been determined, stakeholders should calculate the risked cost of defect(s) in the process. It is at this point that specifications from all stakeholders can be compared on an apples-to-apples basis. For instance, if Stakeholder A has a defect that will occur 10% of the time a sensor is out of spec and the expected cost of that defect is $100,000, the risked cost of an out of spec sensor is $10,000. If Stakeholder B has a defect that will occur 1% of the time but the cost of the defect is $1,500,000, the risked cost is $15,000. In this case, the specifications of Stakeholder B would dominate subject to Step 5. It may be useful to use more advance probabilistic methods, such as monte-carlo simulations, to examine distributions of possibilities as well. - Calculate DPMO (Defects Per Million Opportunities) Another consideration is allowable defect (error) rate of a sensor. Even though a sensor is properly specified and operating in accordingly, the laws of probability tell us that it will eventually have a defect (error). Stakeholders can then determine what level of exposure to such error they will tolerate. If a process occurs only once per well, the allowable DPMO might be 1000—or expecting that there is a 0.1% chance it will occur on any give well (assuming errors are mutually exclusive). However, some safety critical processes, or processes that occur many times per well, might have much lower DPMO. For instance, in an over-pressured, sour reservoir where influx management is critical and common, the allowable DPMO might approach zero to reflect the value of human life. This could indicate a need for very high spec and/or redundant sensors. In the case of iron roughnecks, it was stated that the probability of a single tool-joint being under or over torqued should be much less than 1 per well and was proposed at 0.05. Assuming 3000 connections per well, that meant that an allowable DPMO for the process was 1,000,000/(3000/.05)=16.67. - Specify Sensor Capability Sensor capability is as much about accuracy as it is about precision (variance), and reliability. In the previous example, DPMO was determined to be 16.67. This yields a process sigma (where sigma is the Greek letter used to denote standard deviation) of 5.6. That is to say that, if the error of the sensor were plotted in a histogram, the error would be distributed normally about the true value such that it did not exceed specifications until 5.6 standard deviations (sigmas); or, that the sensor would be accurate, within spec, ~99.999999% of the time. Other parameters that should be considered are: - Double-sided (non-normal) distributions—in some instances, allowable error on the low end might be acceptable but no on the high then (or vice-versa) - Up-time and reliability—If a sensor is critical, it might require uptime of 99.999% or more (this is common for most level 1 web-servers for instance). However, if the rig can perform well without the sensor for a short period of time, such robustness may not be required if it is costly. - Shift and Drift—All sensor specifications should account for shift and drift (typically +/- 1.5 standard deviations). However, some types of measurement are especially sensitive to environmental interference and may or may not be corrected for this. Specification of sensors should include the operation conditions and environment including ranges for: temperature, humidity, barometric pressure, background radiation, gravity, vibration, etc. - Evaluation Sensor Options It is incumbent upon the stakeholders to choose sensors that meet their specifications in the most practical and economic way to minimize waste. Often times, this means choosing a commercially available sensor. However, there are times—particularly in oil and gas—where existing sensors fall short. This was evident in our development of advance gyroscopic and inertial guidance systems for MWD/LWD in the last 30 years. In the event that a sensor is not available, there are two approaches that may be taken. - Revise the process and add controls that can use a lower-spec sensor This is a common process when the cost/time to develop a new sensor is high and requires collaboration from all stakeholders to be successful. - Develop a new sensor for the process. In today’s age of rapid prototyping, advanced materials and manufacturing, and the typical economics of oil and gas projects, this is an attractive option if internal resources are available to help direct the work of suppliers. - Issue Sensor Specifications After the technical work of specification is complete, it must be issued to suppliers. It is important to have a structured approach to this in contract. Specifications should conform to NIST standards and, when possible, refer to API, ASME, ASCE, or other ANSI standards. When standards do not exist, it is wise to collaborate with peer organizations to develop them and disseminate them widely. Manufacturing Process Control for Non-Manufacturers A key difference between oil and gas and traditional manufacturing operations is that operators typically do not own the factory (the rig) nor do the directly engage in the manufacturing (drilling) process. There are exceptions to this general statement in that some operators own a drilling contractor; however, the contractor typically maintains independence. The operator, however, does not forfeit responsibility for properly communicating quality and other specifications to manufacturers and suppliers. It is argued regularly that the difference between drilling and manufacturing is sufficiently large that the examples, and best operational and management practices do not apply to drilling. Fortunately, there are historical examples that clearly demonstrate otherwise. A valuable example is the leadership of Admiral Hyman G. Rickover in the development of the nuclear navy, particularly reactor design and construction, in the 1950’s and 1960’s. In this case, the navy was solely responsible for the design, testing and operation of nuclear reactors but contracted all of the manufacturing to others. Rickover famously (or perhaps infamously depending on whom you ask) developed practices and philosophies that fundamentally changed the landscape of manufacturing in America and are examples that provide valuable insights, even today. Of the lessons learned, several stand out: - It cannot be assumed that a manufacturers and/or suppliers follow basic manufacturing and quality processes. A basic assumption made by most engineers is that a supplier is qualified to provide a product or service by virtue of being a provider of that product or service. This logic is circular and easily disproven but is all too often accepted as true. This is largely due to lack of technical knowledge of the engineer. This is not a problem that is unique to drilling as even in his time Rickover stated that a “…lack of first hand evaluation results in poorly designed and manufactured equipment, late delivery or both” and that “…if this is to be done wisely, persons in authority must possess an unusually high degree of general and technical knowledge and competence.” This lesson precipitates all of the lessons that follow. - Engineers must develop considerable technical skill in fundamental systems and must be intimately involved in the development and deployment of new technology In many cases, during the design and construction of the first reactors, the machines, tools, instruments, products and services that existed were insufficient or they did not exist at all. The team of engineers had to spend considerable time developing, improving, and creating new things, and, at times, entire industries. Such an endeavor is not trivial and requires dedication to developing partners, continuous and rigorous education, and persistent quality control and auditing. Consider the example of the zirconium industry. Before reactor development, the industry barely existed and could not manufacture products to the specifications required by engineers. Moreover, many believed it was not possible to manufacture zirconium to those specifications. Not only did the team promote the advancement of the industry and deliver zirconium to specification, they reduced the cost of the material by 99% in less than 5 years. A similar, though much less technically complex, example can be found in drilling. In the spring of 2014, an independent operator noted that there was no instrument to calibrate the make-up torque of an iron roughneck nor was there a method to record the makeup torque applied to drill pipe. They collaborated with an instrument manufacturer and developed, tested and deployed a new tool for that purpose. In the year that followed, thousands of tests were performed on dozens of iron roughnecks and it was determined that there was significant improvement required to meet process requirements. Without an innovative approach led by an engineer and a manufacturing partner, this process would not be measured, let alone have the ability to be controlled. - Quality control must be recognized as an essential tool to enable management to meet today’s technological imperatives. An interesting example of this in the nuclear navy relates to welding rods. Welders were required to use a special rod developed specifically for welding high-pressure vessels for the reactor. All workers were directed and encouraged to report anything unusual when working on the reactor. As a welder attempted to weld a tight corner of a pressure vessel, his welding rod snapped—which was uncommon give the type of rod he was supposed to be using. Investigation showed that the manufacturer had mixed two different types of rods in the container and that all of the containers of welding rods had the same problem. Instead of passing the buck to the manufacturer, the engineering team took ownership of the problem, visited every manufacturer of welding rods, and helped them implement factory systems to prevent similar mistakes in the future. In drilling, a recent development has come to pass regarding BOP testing that reinforces this approach. A large independent operator noticed troubling discrepancies in BOP tests. They undertook a project to evaluate the root cause of the errors and noted the following: - BOP testers did not have sufficient calibration and quality practices to ensure accurate and precise testing. - Even with proper calibration, BOP testing equipment (recorders) were not accurate and enough to confidently ensure proper BOP performance. - BOP testing practices were susceptible to human and environmentally induces errors which were difficult or impossible to detect post-test. - Drilling rig maintenance, repair, and rigup practices do not support BOP best practices. To further attack the root, the operator, in conjunction with BOP testing companies, developed improved calibration and testing practices, and a designed and tested new BOP testing system that was significantly more accurate and precise than existing systems and prevented or minimized environmental and human induced errors. - Specifications and standards must be clearly communicated by operators Led by Admiral Hyram G. Rickover, the navy developed quality and safety standards in collaboration with the Atomic Energy Commission (AEC). It is important to note that the navy did not shrink from the task of developing these standards but considered them critical to effective communication, economic contracts, and quality manufacturing. These standards were often at odds with manufacturers but were critical to safe and efficient operation of reactors. Had this task been delegated to contractors, the standards would have surely been much lower and would have not supported the goals of the navy and later civilian power systems. This has been widely referred to as the ‘Rickover Effect’ and dramatically changed the American manufacturing landscape for decades. It has been widely recognized that drilling oil wells is significantly different from other long-term, fixed manufacturing efforts such specifications and quality standards are notoriously difficult to manage from the operators’ perspective. This is in large part due to the transient nature of the industry—especially drilling. The problem is, therefore, best addressed using a collaborative approach. That is, if operators join together to develop common specifications, it economically and operationally beneficial for contractors, suppliers and manufacturers to adopt these standards. Thus, a consortium of operators has been formed to collaborative draft, disseminate, and promote such work. - Third party inspection is critical According to Rickover: “Audits and inspections are an important part of your job as a leader…. We cannot assume that all is going well. We must have control measures in place to assure things are being done right. This is not micro-management — it is called doing your job. If you do not have the audits (formal and informal) in place, you will not know about problems until they become consequences, and then you are in the domain of lawyers. That is too late for action, as all you can do then is address the consequences.” Epilogue This paper was written to address a technical gap identified in drilling; but, its broader purpose is to promote a philosophy of excellence, quality, responsibility and professionalism that is a predicate for sustained and future success. Admiral Hyram G. Rickover was the standard bearer of this philosophy for his generation and detailed it thoroughly in a number of essays. Among his many powerful and provocative insights, he noted, “since the engineer deals with metals and fuels of which the earth has but a limited supply, it will make a great difference to future generations whether or not he is fully conscious that every ounce of metal or fossil fuel he uses means a dimunition of our national patrimony which we bequeath to our descendants. Engineers build structures with alter man’s supply of pure air and water, or food and soil. A poorly designed factory may poison air and water; a dam or highway may needlessly rob our grandchildren of good farm land which may well be in short supply. Almost everything the engineer does has an effect of our materials base. His work is seldom purely and engineering task, though he sometimes acts as if it were.” He also stated that engineering “…ceases to be professional if it has in any way been dictated by the client or employer. The role of the professional man in society is to lend his special knowledge, his well-trained intellect, and his dispassionate habit of visualizing problems in terms of fundamental principles to whatever specific task is entrusted to him. Professional independence is not a privilege but rather an inner necessity for the professional man, and a safeguard for his employers and the general public. Without it, he negates everything that makes him a professional person and becomes at best a routing technician or hired hand, at worst a hack.” Perhaps, most importantly, he correctly noted that, “responsibility is a unique concept; it can only reside and inhere within a single individual. You may delegate it but it is still with you. You may share it with others but your portion is not diminished. You many disclaim it but you cannot divest yourself of it. Even if you do not recognize it or admit its presence, you cannot escape it. If the responsibility is rightfully yours, no evasion or ignorance or passing the blame can shift the burden to someone else.” Herein, the drilling engineer is encouraged and challenged to become an expert in the systems upon which he depends and manages and to wholly and assume the responsibility for the success and continuous improvement of the drilling process. Moreover, the engineer is emboldened to adopt a systems approach to drilling and consider professional obligations to clients, other engineers, and the public. Specifications used herein refer to engineering requirements of machines, tools, instruments, products or services and not to general industrial specifications such as those provided by API or other ANSI recognized bodies.

http://www.drillingcontractor.org/drilling-limit-ghost-hyman-g-rickover-39255

Following the success of the 18th Annual International RAPDASA conference, held in Durban in November 2017, we are pleased to announce the 2018 conference jointly hosted by the University of Johannesburg (UJ) and Resolution Circle, on behalf of RAPDASA which will be held from 7 to 9 November 2018 at Resolution Circle Towers in Johannesburg, South Africa. The organising committee, on behalf of RAPDASA, invites SMME’s, entrepreneurs, inventors, engineers, product designers, toolmakers, production staff, technical directors and managers from industry involved in design, development and manufacturing of products and components to participate or simply attend the conference. In addition, participants from international product development communities, academia, national R&D and educational institutions are also invited to attend and participate in the conference. Additive Manufacturing (AM), alternatively referred to as 3D printing, is a layer-based process used to manufacture physical objects. Using AM technology enables the manufacturing of geometrically complex parts, which require a high degree of customisation. AM technologies are currently used in a wide variety of manufacturing sectors, which include Aerospace, Medical, Bio-medical, Dentistry, R&D, Automotive and many more. Throughout the years, AM has demonstrated its value, is of a disruptive nature and can be considered a technology that can be used improve quality of life. The theme for the conference will be: Additive Manufacturing as a key driver of the 4th industrial revolution With respect to the conference theme, papers can be submitted under any of the following topics: - Additive Manufacturing business development / New Additive Manufacturing applications - Impact of Additive Manufacturing on the intellectual property environment - Design for Additive Manufacturing - Reverse engineering - Internet of things - Simulation and modelling - Process monitoring and control - Material evaluation and selection - Post processing and qualification - Material / Process development - Product development The timelines for the submission of papers are as follows: - Submission of Extended Abstracts – 31 May - Notification of acceptance of abstracts – 5 June - Submission of full paper – 30 June - Feedback for paper review – 1 September - Selection of papers for journal – 30 September The conference will run from Wednesday, November the 7th to Friday, November the 9th 2018. Click here to submit a paper on the conference site. A pre-conference seminar will be hosted on Tuesday, November the 6th 2018. Click here for more details.

https://am-hub.dk/events/rapdasa-2018-conference-and-exhibition/

Design is an iterative process that’s increasingly becoming more collaborative and cross-functional. Designers used to live in the world of “creative,” tucked into a cramped back office, with processes that were largely subjective and rarely codified. That world is gone. We've grown up a lot. While our teams and our toolkits have expanded, we’re still facing a common workflow bottleneck that looks something like this: - Design teams are working on multiple different file versions. - Files get exported from one tool and imported into another, duplicated, and renamed. 🏓 - Work is lost. 😩 - Feedback isn’t gathered on the design file, and doesn’t get incorporated. - Engineers and other stakeholders don’t know what’s changed from one version to the next, and why. - Time is wasted. Hair pulling ensues. 🤯 - The project ends 📕 and with it, all past work history, decision-making, and commentary is lost. What would we gain if we reimagined our workflow? Time, creativity, collaboration, increased quality of output, shared institutional knowledge, and more. These are just a few of the reasons why we need version control for design—one place to manage and collaborate on files— and why we’ve made it our mission to redesign the design process. Version control is the foundation of a modern design workflow As our design teams grow, we need a predictable workflow to ship great products. Yet, the design tools that were created to make our lives easier still leave us jumping through hoops. We spend countless hours trying to identify which design files are the most recent, which have been approved, what changes were last made, and why. When designers can’t collaborate on the same file, work ends up fragmented, often accidentally getting overwritten. Feedback gets lost as we try to consolidate it across disparate tools and stakeholders have little insight into when or where to chime in. There’s no clarity, transparency, or consensus. All modern work hangs in the balance of timing and context. To deliver a great customer experience, design, marketing, and engineering have to be able to speak the same language, in one place. As things stand today, the communication flow between design and other stakeholders can be improved dramatically. In the last few years, the design tool space has expanded faster than most of us imagined. New tools for screen design, prototyping, generating code, wireframing, and more, have given us the ability to create more things, faster. But this proliferation of tools has actually increased the complexity of cross-functional work, in a time when the creative process is becoming more collaborative. What would a better design workflow look like? We think it would: - Allow designers to work collaboratively on the same files, without fear of overwriting or losing work. - Allow designers to view teammates’ work in progress and explore new ideas from those ideas, without the fear of overwriting the original designer’s work. - Allow engineers to view and export design specifications directly from approved design files. - Give designers, engineers, and other stakeholders insight into what’s changed from one version of the design to the next, and why. - Let designers organize and share designs with stakeholders to gather feedback directly on the design files when they need it, so they can keep working. - Give designers, engineers, and other stakeholders full access to view and comment on design work in progress. - Give organizations the ability to onboard new team members faster by reviewing all past work history, decision-making, and commentary in a single location. - Empower organizations to maintain institutional knowledge as employees leave and teams change, allowing them to remain agile in the face of market demands. On a very fundamental level, it would allow designers to work together in parallel while maintaining a centralized source of truth that anyone in the organization can access. Version control lets us preserve contextual feedback and surface what’s important, making it easier for us to collaborate with business stakeholders, and ultimately, scale our design process. Version control for design is collaborative by default Design requires talent. But it isn’t magic. By introducing transparency and a predictable workflow, we can bring others into our process, helping them understand the intentionality that goes into designing a great product. This requires a major cultural shift for you, me, and every designer you’ve ever worked with. Adopting a version-controlled workflow turns “my files” into “our files.” It’s a “we not me” way of working. And we all have so much to gain from it. Giving stakeholders more insight and context into our work will make review cycles more efficient. Collaboratively working on the same files with other designers can increase the quality of our output, not to mention, increase consensus and decrease potential blame. Maintaining a centralized, version-controlled source of truth for our work will propel us into a new age of design—one that leaves room for both creativity and productivity.

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Real estate development is the process of altering the built environment for the purpose of human habitation. It involves the demolition, reconstruction, and transformation of existing properties. This process is ongoing and is designed to meet the changing needs of space in society. Development projects are typically complex, requiring adequate financing, careful site selection, and a thorough analysis of the properties in question. They must also consider possible changes to the same property in the future. Process The process of real estate development involves various stages in the building process. Developers work with a variety of counterparts to develop projects, including architects, city planners, engineers, surveyors, inspectors, contractors, leasing agents, and others. In addition, they must obtain the required financing and public approval before construction can begin. The finished structures are then leased to tenants. During this stage, a developer’s job is to market and finance the project. He/she then assembles a team of specialists and manages them to make the project a reality. The process is complex and requires a great deal of planning. Without careful planning, mistakes could cost a developer a significant amount of money. Therefore, it is best to enlist the help of a real estate development company to help reduce the risk and ensure the best possible result. Stakeholders There Bill Bhangal are a variety of external stakeholders involved in real estate development projects. These include economic, legal, and social stakeholders. These parties may not have a direct stake in the project, and therefore have a significant influence on the success of the project. The project’s decision-making processes may also be subject to frictions with these stakeholders. Real estate development involves the constant interaction between a variety of different agencies and individuals. The process of building, selling, and maintaining a residential or commercial property involves a variety of stakeholders. The state sector is involved in zoning regulation, public interest, and labor laws, as well as public infrastructure. The public sector is also involved in acquiring land for development. Skills required Real estate developers must have a strong grasp of the law, including land use laws, and must be able to manage budgets, schedules, personnel, and standards. They must also be able to work with clients and stakeholders to meet their goals. Another skill that real estate developers need is asset management. Asset management includes maintaining properties to increase value and assessing the risks involved. One of the most important soft skills in this field is communication. Effective communication includes understanding others’ body language, uncovering problems, and respecting their time. A person with strong communication skills can be a great asset in real estate development. Career opportunities Real estate development is a field that offers many job opportunities for individuals with a passion for the field. From purchasing raw land and persuading zoning officials to securing permits, developers are involved in every aspect of commercial real estate. They are also responsible for managing projects, overseeing budgets and hiring employees. Before entering the real estate industry, you should consider obtaining an undergraduate degree in the field. A real estate degree can help you gain practical experience and try various niches. Taking courses in information technology is also essential as it will help you use databases and spreadsheets to analyze data. Moreover, you should have good communication and sales skills. Getting involved in extracurricular activities will help you hone your oral presentation skills.

http://www.bluecatslive.com/real-estate-development-is-the-process-of-altering/

Mechanical engineering is essentially concerned with anything that moves and mechanical engineers use the fundamental principles of force, energy and motion to design and produce the mechanical processes that are behind the machines we use every day. Mechanical Engineering is one of the broadest subjects in engineering so after graduating as a mechanical engineer you'll find a huge range of career opportunities available to you - you could end up designing car engines, developing high-performance sports equipment or using the latest 3D printing techniques to improve manufacturing processes. Dilan Paranavithana Dilan moved from Sri Lanka to Sheffield to study Mechanical Engineering with Industrial Management. He now works for Rolls-Royce as a Composites Manufacturing Engineer. During my penultimate year of university I attended a friend’s graduation project presentation at Rolls-Royce, Derby. Inspired, I successfully applied for Rolls-Royce’s engineering graduate scheme, after which I pursued several short placements in the company for 18 months. In my current permanent role I develop composites manufacturing capabilities in the external supply chain to enable delivery of new engine projects. Working at the cutting edge of manufacturing technology, understanding the complexities of a jet engine and influencing its future design with some of the best professionals in the country makes it a challenging and enjoyable role. My degree in Mechanical Engineering has enabled me to build up a logical thinking process that helps me day to day in my current role of introducing and exploiting new technology. My job requires key skills such as problem solving, applying engineering judgement and communicating with a number of internal and external stakeholders, all of which I developed through the varied project work in my degree. In 2011 I secured a secondment to a brand new Rolls-Royce facility in Virginia, USA, where I spent six months validating the manufacturing processes for a critical engine component. Living and working there gave me experience of important technical skills involved with site transition, as well as the opportunity to travel in America, from New York to the Grand Canyon and Los Angeles! Jessica Venn Jessica graduated with a degree in Mechanical Engineering and now works as a graduate design engineer for international engineering firm, Assystem. My favourite subjects at school were maths and physics, because I enjoyed the challenge of solving problems and being able to understand if it was right or wrong. I wanted a career where I could apply these subjects and someone suggested engineering. To help me decide which discipline to apply for, I went on a HeadStart course at Surrey University which gave me experience of chemical, civil, aerospace, electrical and mechanical engineering. Mechanical was the most appealing, not only after playing with k'nex but because I understood that it covers a broad range of careers and would keep my options open. In the summer between my third and fourth years, I had a placement at local engineering company Siemens VAI (metal technologies). This gave me a better idea of what engineers actually do on a daily basis, and also made me realise that steel was not an industry I wanted to enter! It definitely helps if you can get some industry experience while you are at university - it is easier to get a job at this point as you are not expected to have prior experience, whereas many graduate employers will look for it. It shows you are serious about having a career in engineering by making the effort to gain experience. During my final year I used gradcracker.com to find engineering graduate schemes and Assystem was one of the many for which I applied. I was required to send a CV and cover letter, and after this stage I had a personal and technical interview. After this I was offered the job. At the moment I'm involved with producing a solution to a design problem on a gas turbine. This involves modelling, contacting stakeholders for buy-in, justifying the solution to seniors at design reviews and creating reports to show that all considerations and issues have been addressed.

http://www.stemexplore.co.uk/about-engineering/mechanical/

In a previous article, I discussed the causes of lymphedema, their origins and treatment. Lymphatic drainage is also known as lymphatic hydrotherapy, or massage, is a treatment that removes excess water from the tissue. Although there are other benefits to lymphatic drainage, the primary purpose of this post is on the causes and signs of lymphedema. This article can help you identify if lymphatic drainage is the right choice for you. Lymphedema is an accumulation of lymphatic fluid that can cause a reduction in circulation and lower the number of lymphocytes. Studies show mixed results regarding the efficacy of this technique in the treatment of lymphedema. This is due to its fact that it fails to take away the entirety of the amount of fluid. Although there is swelling in the lymph nodes and the bulk of fluid is eliminated through lymphatic vessels, the majority of it isn’t. A 2021 review of the systematic review of lymphatic hydrotherapy in relation to breast cancer tumors found no evidence that this treatment was effective in preventing tumors in terms of growth, survival and. Patients who had only one tumor removed were in comparison to those with no cancer removed, and received treatment for lymphadhaematologic reasons. The comparison of condition of lymphatics prior to and after the treatment was carried out. The lymphatic drain can be simple (also known as inspiravitations) or more complex techniques such as radiofrequency ablation as well as infraredcoagulation may be employed to cleanse the body. (OTH), a type of lymphatic drainage simple (SLE) is accomplished by a series of sittings in warm water and applying a small amount of pressure to the affected area or by adding a little warm olive oil into the water. Sweatband: Another simple SLE method is to take a deep breath, then inhale quickly when your head is submerged in the water. A OTH injection is usually the use of a catheter under the skin, either under the armpit or direct into the lymphatic system. There are times when local anesthesia isn’t needed for lymphatic drainage that is simple. Manual lymph drainage is among of the most sought-after methods for treating patients suffering from lymphoma and various other kinds of tumor growths. The lymphatic massage technique can be used on other parts of your body like the breasts, neck, the abdomen, and legs. However, lymphatic massage has shown significant clinical benefits in the treatment of people suffering from widespread cellulite. The lymphatic system can be able to boost lymph flow that results in the elimination of lymph and extra fluids. Increased lymph flow could decrease visible signs of cellulite, as well as the degree of its severity. In general, when lymph nodes are affected due to lymphedema, the lymph fluid removal reduces swelling. The result is a decrease in the compression of these defected vessels. The discomfort caused by swelling of the lymphatic system can be eased with manual lymph drainage, which lets patients concentrate on the relief of the problem. The most common cause of lymphedema is an damage to the lymphatic system. Usually, this happens due to surgical or cancer. A thorough examination with test results, a medical history of complete medical history are necessary to determine if you have lymphedema. A thorough examination typically detects an excess accumulation of lymph fluid in the lower legs. Lymphedema is characterized by swelling due to excessive fluid accumulation. Initial treatments for lymphedema involve expanding the amount of fluid consumed and increasing the circulation of blood to the lower legs. These measures may only provide temporary relief, however, and more severe strategies are often required to eradicate the disease the body. A specialized type of massage therapy known as lymph-massage is one method to treat lymphedema. The skilled therapist will be in a position to know if patients require this form treatment and then do it on any location which is affected by lymphatic drainage, like the neck or the back. The technique can be performed with care, yet effectively for patients suffering from lymphedema. If you are interested in exploring a self-massage therapy make contact with the therapist in your area. They’re specialists in how to deliver the most effective methods of massage therapy and can guide you to decide if it is right for you. The treatment can be provided as part of the larger program of therapy. Contact the therapist in your area to find out more about this possibility. If you cherished this post and you would like to acquire extra info pertaining to 용인출장마사지 kindly pay a visit to our own website.

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Lymphedema disorder is caused by the accumulation of lymphatic fluid in the intercellular tissue, causing swelling in the arms, legs and trunk. What are the types of lymphedema? Primary Lymphedema; It occurs due to structural deficiency or impairment of lymph vessels. Secondary Lymphedema; Lymphatic system is caused by surgery, radiotherapy, infection, or damage. Causes of Lymphedema Disorder? Congenital, Taking lymph nodes by surgery, Trauma or injury, Infection caused by insect bites or abrasions, Blocking of lymph flow by tumor, Radiotherapy applications. Symptoms of Lymphedema Disorder Feeling of weight in the arms / legs, Limitation of joint movements, Skin dryness, tension, Drowsiness and hardening, Sensory disorders, Joint stiffness in hand / foot, Susceptibility to infection, Decrease in the mobility of the fingers / toes, Accessories such as rings and watches are narrow. Purpose of the Treatment of Lymphedema Disorder Preventing the formation of lymphedema, Preventing the increase of swelling, To reduce the swelling, Increased lymphatic circulation in edematous limb and leg and distribution of accumulated protein, Prevent the occurrence and recurrence of infection. What is the treatment? Skin Care, Manual Lymph Drainage (Lymphedema Massage), Compression Bandage (Lymphedema Bandage), Exercise, Kinesio Tape Taping.

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Lymphedema involves blockage of the lymph vessels, with a resulting accumulation of lymphatic fluid in the interstitial tissues of the body. The lymphatic system consists of lymph vessels and lymph nodes throughout the body. The lymph vessels collect lymphatic fluid, which consists of protein, water, fats, and wastes from cells. The lymph vessels transport the fluid to the lymph nodes, where waste materials and foreign materials are filtered out from the fluid. The fluid is then returned to the blood. When the vessels are damaged or missing, the lymph fluid cannot move freely throughout the system but accumulates. This accumulation of fluid results in abnormal swelling of the arm(s) or leg(s), and occasionally swelling in other parts of the body. Lymphedema is a very serious condition. There is no cure for lymphedema and once it develops, it can be a long-term, uncomfortable, and sometimes painful condition requiring daily treatment. When lymphedema is not treated, the protein-rich fluid continues to accumulate, leading to even more swelling and hardening (referred to as fibrosis) of the tissues. This fluid is a good culture medium for bacteria, thus resulting in reoccurring infections when there are injuries to the skin, decrease or loss of functioning of the affected limbs, and skin breakdown. Infections, referred to lymphangitis, can affect the connective tissue under the skin. Repeated infections may result in scarring, which in turn makes the tissue susceptible to more swelling and infection. Over time, these infections result in tissue hardening (i.e., fibrosis), which is a characteristic of advanced chronic lymphedema. In very severe cases, untreated lymphedema may even result in a rare form of lymphatic cancer called lymphangiosarcoma. Lymphedema affects approximately 100 million people worldwide, including at least 3 million people in the United States. tight fitting of a ring, wristwatch, or bracelet, without a gain in weight. In 90% of the cases, lymphedema is diagnosed through observations, measurements, and symptoms. The remaining 10% require the use of more complex diagnostic tests such as lymphoscintigraphy. Lymphoscintigraphy is a technique in which a radioactive substance that concentrates in the lymphatic vessels is injected into the affected tissue and is mapped using a gamma camera, which images the location of the radioactive tracer. Magnetic resonance imaging (MRI), computed tomography (CT) scanning, and duplex ultrasound are imaging techniques that are also sometimes used as diagnostic tools for lymphedema. Stage 3 (lymphostatic elephantiasis)—swelling is irreversible and the affected areas are very swollen. The skin hardens and begins to break down, fibrosis is more extensive, and patients may need surgery to remove some of the swollen tissues. Primary lymphedema is an inherited condition, where the patient is born without lymph vessels and nodes. The swelling associated with primary lymphedema usually occurs during adolescence and affects the foot or calf. A rare form of primary lymphedema, called Milroy's Disease, occurs in pregnancy. However, secondary lymphedema, or acquired lymphedema, develops as a result of an injury to the lymph system. Specific causes include surgical treatments for certain types of cancers, especially those cancers that currently require the removal of lymph nodes. Radiation treatment for cancer or for some AIDs-related diseases such as Kaposi-Sarcoma may also result in lymphedema, as radiation may damage or destroy lymph nodes or cause the formation of scar tissue that can interrupt the normal flow of the lymphatic fluid. Specific cancers and their treatment that may result in lymphedema include malignant melanoma, breast (in both women and men), gynecological, head and neck, prostate, testicular, bladder, and colon cancer. Other causes of lymphedema include trauma to the lymphatic system from burns, liposuction, tattooing, injuries, surgery, radiation, obesity, heart or circulatory disease, and multiple sclerosis. Lymphedema in people at risk may not develop the condition immediately, but develop the condition weeks, months, or even years later. Aircraft travel has been linked to the development of lymphedema in patients after cancer surgery, possible due to the decreased cabin pressure. In Western countries, one of the most common causes of lymphedema is mastectomy with axillary dissection (removal of the breast and underarm lymph tissue for treatment of breast cancer), which may result in lymphedema of the breast, underarm, or arm on the side of the surgery in 10-20% of patients. This occurs because the lymphatic drainage of the arm passes through the axilla (armpit), and tissue in the axilla is removed during the mastectomy. To reduce the risk of developing lymphedema after breast cancer treatment, there is an alternative treatment that avoids axillary lymph node dissection. Sentinel lymph node biopsy is a new diagnostic procedure used to determine whether the breast cancer has spread (metastasized) to axillary lymph nodes. A sentinel lymph node biopsy requires the removal of only one to three lymph nodes for close review by a pathologist. If the sentinel nodes do not contain tumor (cancer) cells, this may eliminate the need to remove additional lymph nodes in the axillary area. Early research on this technique indicates that sentinel lymph node biopsy may be associated with less pain and fewer complications than standard axillary dissection. Because the procedure is so new, long term data are not yet available. However, there is still a risk for developing lymphedema because of follow-up radiation treatments or chemotherapy, which may also damage the lymph nodes. Persons who have developed lymphedema after cancer treatment should be checked for a possible reoccurrence of cancer if they experience a sudden increase of swelling, for the tumor growth may be responsible for blocking lymphatic flow. improve the overall health of the patient. However, some lymphedema specialists feel that lymphedema patients with metastatic cancer should not be treated with CDT, to prevent the spreading of the cancer. MLD was developed in 1932 in Denmark by a doctor and his wife. It was widely used in Europe and now is accepted as a therapy for lymphedema patients in the United States. In MLD a series of rhythmic, light strokes are made in a specific sequence along the lymphatic vessels and the adjoining tissues. These movements remove the lymph fluids from the tissues and return them to the circulatory system, thus reducing swelling in the affected area. Compression techniques include the use of compression garments, compression aids, and compression bandages. These techniques encourage natural drainage and prevent swelling by supporting tissues in a way that aids in drainage. Compression garments are knit, stretch sleeves or stockings. Compression aids are custom-fitted sleeves, stockings, or pads made of fabric-covered foam. Bandages are an effective and flexible means of compression. They work when the patient is active or is resting and can easily be adjusted to fit changing limb sizes. However, the bandage should be a special type of short-stretch bandage and not the long-stretch bandage that is commonly known as Ace bandages. Only persons who are trained in lymphedema therapy should tape or wrap swollen areas. Self-care techniques are practiced by the patient or his or her caregiver at home, between visits to the therapist. Self-care techniques include self-massage, skin care to maintain healthy tissue, nutritious diet, and exercise to increase lymph flow, increase mobility, and to improve the patient's general health. Exposure to extreme heat has the potential to increase lymphedema swelling, so an affected person or a person at risk of developing lymphedema should avoid hot tubs, saunas, and steam rooms. To keep the affected extremities as healthy as possible, a person with lymphedema should keep the swollen areas clean and avoid heavy lifting and pulling as well as avoid any type of trauma, such as cuts, bruises, sunburn or other burns, injections, sports injuries, insect bites, or cat scratches. Some doctors and lymphedema therapists recommend that a person with lymphedema use a preventative course of antibiotics when having dental treatment, that is, starting antibiotics several days before the appointment and continuing several days afterwards. A person at risk of developing lymphedema (for example, a woman who has been treated for breast cancer) should also observe the same type of precautions to prevent the development of the condition. If infections occur, then all treatments for lymphedema should be discontinued while the infection is present, and the infection treated with antibiotics. Surgery is sometimes used to remove excess tissue ("debulking") if the swollen limb becomes so large and heavy as to interfere with movement. Exercise is important for a person with lymphedema, but only in moderation. If the extremity starts to ache, the person should lie down and elevate the swollen limb. Recommended exercises include walking, swimming, light aerobics, bike riding, and yoga. Persons with lymphedema should wear a lymphedema alert bracelet or necklace for safety during a medical emergency, explaining the risk of infections. They may also benefit from counseling and membership in support groups to deal with the psychological impact of the disease. Sometimes patients with lymphedema will be denied insurance coverage for treatment; as a result patient advocacy groups in 2005 are attempting to get a law passed through the U.S. Congress guaranteeing insurance coverage for lymphedema. The use of clinical aromatherapy in conjunction with CDT may improve the quality of life for persons with lymphedema. Clinical aromatherapy involves the use of essential oils to improve the functioning of the immune system, for the immune system is closely associated with the lymphatic system. Also a massage oil comprised of a blend of frankincense, grapefruit, hyssop, and lavender, may be used to soften scarred and fibrotic tissues. Radiation treatments can cause skin contractures, which can be helped by massage with a blend of cajeput, frankincense, hyssop, lavender, sage, and tea tree. Radiation can also have adverse effects on the bowel, resulting in poor bowel functioning, scarring, and activity restrictions. Massaging the abdomen with a blend of grapefruit, fennel, helichrysum, lavender, myrrh, and sage may improve intestinal functions. When compression techniques are used, the underlying skin can be treated with a blend of bay laurel, chamomile, geranium, helchrysum, lavender, patchouli, and vetiver in a combination of castor oil, safflower oil, and grapeseed oil as carrier oils. Good skin care is important in preventing infections. Body oils that contain cajeput, cypress, lavender, marjoram, and rosewood can be applied after bathing to keep the skin moist and healthy. Finger nail beds can be a portal of entry for infections, so can be kept moist with an essential oil blend of chamomile, geranium, lavender, lemon, sage, tea tree, and ylang ylang. Burt, Jeannie, and White, Gwen. Lymphedema: A Breast Cancer Patient's Guide to Prevention and Healing. Berkeley, CA: Publisher's Group West, 1999. French, Ramona Moody. Milady's Guide to Lymph Drainage Massage. Clifton Park, NY: Milady Publishing, 2003. Kelly, Deborah G. A Primer on Lymphedema. Essex, United Kingdom: Pearson Education, 2001. Parker, James N. and Parker, Philip M.. San Diego, CA: Icon Health Publications, 2004. Axillary nodes — Lymph nodes found in the armpit that drain the lymph channels from the breast. Clinical aromatherapy — Aromatherapy is the therapeutic use of plant-derived, aromatic essential oils to promote physical and psychological well-being. It is sometimes used in combination with massage and other therapeutic techniques as part of a holistic treatment approach. Debulking — General term used for surgeries in which subcutaneous tissue is removed from lymphodemous limb. Fibrosis — Formation of fibrous tissue as a reaction or as a repair process; may occur due to treatment and/or disease. in lymphedema condition known as hardening of the limb with resulting restriction of circulatory flow, increased infection, and weeping sores. Fibrotic — Pertaining to or characterized by fibrosis. In dermatological description, "fibrotic" would be used to describe leathery, bound-down, or thickened, scarred skin. Interstitial fluid — The fluid between cells in tissues. Referred to as the liquid subtance of the body. Interstitial space — The fluid filled areas that surround the cells of a given tissue; also known as tissue space. Long-stretch bandages — Specialized bandages, similar to an Ace bandage, that have 100 to 200% stretch. Low-stretch bandage — Specialized bandages, with 30 to 90% stretch, that are used to obtain the correct compression during the treatment of lymphedema; also known as short-stretch bandages. Lymph — The almost colourless fluid that bathes body tissues and is found in the lymphatic vessels that drain the tissues of the fluid that filters across the blood vessel walls from blood. Lymph carries antibodies and lymphocytes (white blood cells that help fight infection) that have entered the lymph nodes from the blood. Lymph nodes — Small bean-shaped organs of the immune system, distributed widely throughout the body and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immune cells. Lymph System — When sickness or infection invades the body, the immune system is the first line of defense. A big part of that defense is the lymph system. Lymph is carried through the body by lymph vessels that have valves and muscles to help move the fluid. Along the route are lymph nodes that serve as filters for harmful substances. This network of vessels and nodes together is called the lymph system. Lymphatic fluid — The clear fluid found outside the cells which bathes the tissues. It is collected, filtered, and transported by the lymphatic system from around the tissues to the blood circulatory system. Fluid that collects as a result of lymphedema. Nail beds — The underlying connective tissue that nourishes the finger and toenails. Pitting edema — When a swollen area is pressed, the pressure leaves an indentation (pit) that takes time to fill back in. Sentinel node biopsy — A newer procedure performed in order to determine whether breast cancer has spread to auxiliary (underarm) lymph nodes. A blue radioactive tracer and/or blue dye is injected into the area of the breast tumor. The lymphatic vessels carry the dye or radioactive material, to a "sentinel node". This sentinel node is thought to be the first lymph node receiving fluid from the tumor and the one most likely to contain cancer cells if the cancer has spread. Only if the sentinel node contains cancer cells are more lymph nodes removed. Skin contracture — A permanent tightening of the skin that prevents normal movement of the associated body part and that can cause permanent deformity. A contracture develops when the normally elastic connective tissues are replaced by inelastic fibrous tissue. This makes the affected area resistant to stretching and prevents normal movement. chronic swelling of a part due to accumulation of interstitial fluid (edema) secondary to obstruction of lymphatic vessels or lymph nodes. primary lymphedema lymphedema that appears spontaneously without known cause. See table. Swelling (especially in subcutaneous tissues) as a result of obstruction of lymphatic vessels or lymph nodes and the accumulation of large amounts of lymph in the affected region. /lym·phe·de·ma/ (lim″fah-de´mah) chronic swelling of a part due to accumulation of interstitial fluid (edema) secondary to obstruction of lymphatic vessels or lymph nodes. a primary or secondary condition characterized by the accumulation of lymph in soft tissue and the resultant swelling caused by inflammation, obstruction, or removal of lymph channels. Congenital lymphedema (Milroy's disease) is a hereditary disorder characterized by chronic lymphatic obstruction. Lymphedema praecox occurs in adolescence, chiefly in females, and causes puffiness and swelling of the lower limbs, apparently because of hyperplastic development of lymph vessels. Secondary lymphedema may follow surgical removal of lymph channels in mastectomy, obstruction of lymph drainage caused by malignant tumors, or the infestation of lymph vessels with adult filarial parasites. Lymphedema of the lower extremities begins with mild swelling of the foot, gradually extends to the entire limb, and is aggravated by prolonged standing, pregnancy, obesity, warm weather, and the menstrual period. The disorder has no cure, but lymph drainage from the extremity can be improved if the patient sleeps with the foot of the bed elevated 4 to 8 inches, wears elastic stockings, and takes moderate exercise regularly. Light massage in the direction of the lymph flow and thiazide diuretics may be prescribed. Constricting clothing and salty or spicy foods that increase thirst are contraindicated. Surgery may be performed to remove hypertrophied lymph channels and disfiguring tissue. lymphedematose, lymphedematous, adj. Lymphedema occurs in four stages (0 to 3): 0. Subclinical stage in which lymph transport is known to be impaired, but no signs or symptoms are obvious (may last for years); 1. Tissue is soft with pitting edema; swelling decreases with elevation; 2. Tissue is swollen but firmer and thus may not show pitting; edema does not resolve completely with elevation; and 3. The affected limb is grossly enlarged and misshapen; skin breakdown and infection often occur. Symptoms of lymphedema may include a feeling of heaviness, tiredness, aching, weakness, and fullness in a limb that impairs flexibility or interfers with the wearing of jewelry, watches, or clothing. Treatment goals include maintaining use of the affected limb and preventing complications. A combination of manual lymphatic drainage, compression devices, and protection of the affected limb can make a positive difference in a patient’s quality of life. Patient management by physiatrists, other physicians experienced in lymphedema care, certified nurses, and therapists is crucial. Careful measurement of the affected limb with comparison to its opposite and diagnostic testing help to rule out other causes. If necessary, lymphangioscintigraphy can be used to examine the anatomy and functioning of the lymph system. Patients and their partners can be taught effective techniques to use at home. Compression devices are fitted over the affected limb to help maintain or reduce swelling. Compression pumps use air or fluid pressure to mimic massage’s beneficial effects. They are designed to move lymphatic fluid back toward functional nodes by providing sequential, even pressure from the distal to the proximal portions of the affected limb. Compression sleeves or stockings should be fitted by a professional, as an improperly fitted device may irritate skin and other tissues, resulting in additional swelling. Sensible weight reduction programs based on mild caloric restriction and gentle exercise help to alleviate symptoms. Overexertion of affected limbs should be avoided. Using the affected limb for activities of daily living (bathing, hair-brushing) helps to drain lymph fluid. Supporting the arm on the back of a chair or couch provides helpful elevation for lymph drainage. In acute care settings, the affected limb should be identified by the patient and by health care providers using a loose-fitting, colored (bright pink) armband to ensure that blood drawings, injections, and blood pressure readings are not done on that limb. Skin should be kept clean and moisturized to limit chapping or chafing leading to breakdown. The patient is taught to avoid cuts and abrasions, as when using kitchen knives or other implements, to wear gloves when gardening and to wash and inspect skin after such activities, and to clean any skin breaks that occur, treating them with an antibacterial cream or ointment and a sterile dry dressing. In cases of lower extremity edema, sitting with the legs in a dependent position, crossing the legs, or standing for prolonged periods should be avoided. Extremes of heat and cold exposure should be avoided. The health care provider should be notified if the limb develops a rash or itching or pain or if the patient develops fever or flulike symptoms. Local support groups can assist patients in dealing with body image issues, and fitting clothing to asymmetrical limbs. Resources for further information on lymphedema management include The National Lymphedema Network and other support organizations such as the American Cancer Society. Obstruction of the lymphatic channels, producing edema and occurring mostly in women between the ages of 10 and 25. Its cause is unknown. The interstitial fluid that accumulates first appears in the feet but can travel proximally to the trunk and continues to accumulate throughout life. When the edema becomes severe, it predisposes the patient to chronic ulcers and superimposed infections of the legs. Swelling (especially in subcutaneous tissues) due to obstruction of lymphatic vessels or lymph nodes and accumulation of large amounts of lymph in affected region. acute or chronic aggregation of lymph fluid in local tissues caused by obstruction to flow in lymphatic vessels or through lymph nodes; common causes of obstruction are aplasia, hyperplasia or hypoplasia of lymphatics or nodes due to inflammation, trauma or neoplasia, or secondary due to compression of these by adjoining organ enlargement. Aplasia of lymph nodes is an inherited disorder in cattle, dogs and possibly pigs. The diagnosis of lymphedema was generated based on patients' medical history, physical examination, and indirect radionuclide lymphoscintigraphy. Impact of community-based lymphedema management on perceived disability among patients with lymphatic filariasis in Orissa State, India. In the Physical Activity and Lymphedema trial, Shayna L. Primary lymphedema associated with systemic or visceral involvement. Subsequently lymphangioma develops in long standing lymphedema due to proliferation of lymphatic vessels. This patient's remarkable swelling in the thigh, not associated with any particular erythema or warmth, resolved quickly with lymphedema treatment. There are also reported cases of angiosarcoma of congenital nature and other causes of chronic secondary lymphedema, such as posttraumatic or post radiation lymphedema and also cases of upper limb angiosarcoma after breast-conserving therapy [2-4]. In the past, the role of exercise in preventing and treating lymphedema was unclear, but a recent study found that a strength-training exercise program helped relieve symptoms or lymphedema and provided additional benefits to patients. First in the year of 1997 Rasim SarybaE- found himself as struggling with this illness in left part of his right leg, which began to swell up and then he took a series of treatment from lymphedema a kind of elephantiasis and partially recovered.

http://medical-dictionary.thefreedictionary.com/Lymphedema

The lymphatic system is a body system responsible for draining fluid from the body's tissues. Milroy disease is a genetic condition that usually runs in families. It is characterized by the lymphatic system failing in either one or both of the legs, which results in swelling. When the system fails, it does not drain and this is where the swelling comes from. The incidence of this condition is not known due to how rare this condition is. This condition occurs due to a mutation in the FLT4 gene. This gene is responsible for giving the instructions necessary for the production of the vascular endothelial growth factor receptor 3 (VEGFR-3) protein. This protein is necessary for regulating the maintenance and development of the lymphatic system. When the FLT4 gene mutates, the mutation interferes with the movement, survival and growth of lymphatic cells. The mutations result in absent or small lymphatic vessels. If the lymphatic system cannot transport fluid properly, lymphedema develops due to fluid buildup in the tissues of the body. Whether or not FLT4 gene mutations cause the other symptoms of this condition is unknown. Many people with this condition do not have an FLT4 mutation. When this is the case, the cause of the condition is not known. An autosomal dominant pattern is responsible for this condition. With this pattern, all that is required is a single copy of the mutated gene in each cell. Many people with this condition inherit the mutation from one of their affected parents. Other cases stem from a spontaneous FLT4 gene mutation. Approximately 10 to 15 percent of those with an FLT4 gene mutation will not go on to develop the features of this condition. Under normal circumstances, the lymphatic system makes and sends immune cells and fluids throughout the body. With Milroy disease, the transport of these substances is abnormal and lymph fluid accumulates in the extremities. With this condition, the swelling is generally in the feet and legs shortly after birth. Both sides of the body are usually affected and over time the condition does not tend to get worse. In addition to lymphedema, other features occur with this condition. Males may be born with urethra abnormalities or accumulation of fluid in their scrotums. Both genders may experience deep creases in their toes, prominent leg veins, upslanting toenails and wart-like growths. Cellulitis may also occur. Males are affected more often than females with cellulitis; this may cause the lower limbs to become more swollen. Imaging studies may be done as part of the diagnostic process. Performing an ultrasound of the leg can be done to exclude other possible causes of the symptoms, such as vascular abnormalities like arteriovenous fistula. Regular X-rays can be done to exclude bone abnormalities. MRI, while more useful for lymph trunk anatomy, may be used. Lymphangiography with a subcutaneous dye injection and fluorescence microlymphography may also be helpful. To look for an absence of lymphatic vessels, a doctor will order lymphoscintigraphy with the use of technetium-labeled colloid injected subcutaneously. A standard biopsy may also be done. The primary goal of treatment is to control the complications of the swollen limbs and to prevent infection. While there are no medications to treat this condition specifically, complications, such as bacteremia, cellulitis and chylothorax may be treated with medications as required. Benzopyrones, such as diosmin and coumarin, may help in stimulating proteolysis of proteins. Recurrent cellulitis may benefit from an antistreptococcal antibiotic. In low doses, benzathine penicillin or another type of prophylactic antibiotic therapy may be beneficial in preventing intermittent cellulitis. To help with the lymphedema, elevating the affected leg, pneumatic compression or gentle massage, and elastic bandages or stockings may be beneficial. After the affected leg or foot has been given graded support, exercise should be encouraged as long as the patient is healthy enough. Along with elevation, exercise may help promote the movement of fluid away from the leg or foot. A variety of surgical treatments have been tried, but none have been beneficial long-term.

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If you have Lymphedema, or an accumulation of lymphatic fluid that causes swelling in the arms and legs, Good Shepherd can help. Level of care: The cause of Primary Lymphedema is unknown, but with early detection, there are treatments available to help ease your pain and discomfort. Secondary Lymphedema can be the result of cancer or its treatments, including mastectomy or radiation therapy. Whenever lymph nodes have been removed, damaged or challenged by an infection, lymphedema can occur. Designed to help treat and relieve lymphedema symptoms, Good Shepherd's Lymphedema Management Program focuses on Manual Lymph Drainage (MLD), a gentle yet precise massage technique that mobilizes excess tissue fluid and promotes normal functioning of the lymphatic system. MLD is combined with a program of compression bandaging, remedial exercise and patient education for self-care after discharge. Early detection and treatment are crucial to a more favorable outcome. Early treatment can also prevent life-threatening infections associated with lymphedema. Manual Lymph Drainage can be used to treat the following:

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Lymphatic drainage refers to the process in which lymph fluids are drained by a sick individual's lymphatic system. This procedure occurs in response to stress, causing swelling of lymph nodes in the lower extremities. Lymphatic drainage also helps to remove waste products, such as excess fluid in the lungs and accumulated waste products in blood. While lymphatic drainage is not a reaction to illness, it does help to protect tissues from infection. Lymphatic drainage can happen in several of ways. In its simplest type, blood circulation is really a natural, self-pacing procedure whereby fluid is drained from the body by the circulatory system to allow it to become reabsorbed into the blood stream. This procedure, while normal, is only successful if the lymph circulation is sufficient to begin with. In addition, lymphatic drainage can be stimulated by various treatments to raise the total amount of lymph being pumped through the body. There are many types of conditions that could excite or worsen the lymph circulation in the body, including surgery, injury, diseases of the immune system, and many different conditions and occasions. In these situations, doctors may use many different treatments to”excite” the lymph flow within the body, such as: blood transfusions, medications, physical therapy, or operation. Every one of these methods can be quite helpful in increasing cardiovascular drainage. Unfortunately, many of these same methods can also cause swelling or edema at the treatment area. Among the most common kinds of swelling which can occur after mastectomy is known as post-mastectomy lymphedema. This may occur due to swelling which occurs as a result of the operation or after swelling occurs because of other causes, like after radiation therapy. Frequently, swelling begins immediately after the operation, usually following a process where lymph nodes were removed. This swelling usually responds very well to therapy. Sometimes, lymphatic drainage can happen due to a buildup of uric acid. This can occur for a lot of different reasons, such as therapy for cancer, disease, or even tumors. Sometimes, the fluid build-up can be as a direct consequence of the cancer or infection, as opposed to as a consequence of the treatment. But, sometimes treatment may have an impact on how much fluid accumulates in your system, causing lymphedema. Cancer therapy, particularly treatment for melanoma, is understood to create a build-up of particular compounds in the skin. Muscle relaxants or muscular analgesics, as they are often known, can also have an impact on lymphatic drainage in addition to on lymphedema. The pain which accompanies wasting could be raised due to the effects of the drugs on the muscles. Thus, doctors generally prescribe muscle relaxants for individuals who have lymphatic drainage connected with lymphedema. Some patients who choose immune suppressants (such as prednisone) may also experience an increase in swelling because of side effect. In this situation, physicians generally advise reducing the dose or discontinuing use. Another frequent reason for lymphedema is chronic venous insufficiency, also called deep vein thrombosis. If there is inadequate blood circulation through the legs, the muscles aren't able to supply sufficient support, and the absence of circulation may cause tissue swelling. Lymphedema may be secondary, meaning that it was caused by another medical condition (as an instance, severe leg syndrome), or it might be main, meaning there has been an abnormality at the flow of veins. 출장안마 Either way, when the condition is known, physicians can treat it, preventing the possibility of lymphedema. Because of its link to venous insufficiency, leg cramps, swelling, and pain are common symptoms of chronic venous insufficiency. There are a variety of different methods to treat lymphedema. The most significant is to avoid taking medications that might raise lymphedema, such as steroidal and immunosuppressant drugs. Patients who are prescribed these medications should avoid heavy, strenuous activity, particularly when performing exercises. It's also advisable to have a daily walk. To protect against worsening of lymphedema, lymphatic drainage massage has been discovered to be an effective treatment approach.

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Elephantiasis is characterized by an abnormal swelling and inflammation of certain parts of the body. The causes, as well as the treatment options for this rare disease are discussed in this HealthHearty article. Elephantiasis is the condition characterized by the obstruction of the lymphatic vessels, which results in gross swelling of the affected areas. The lymphatic system is responsible for maintaining fluid balance in the body, and removing interstitial fluid from the tissues. Therefore, any kind of obstruction in the lymph vessels can cause an accumulation of fluid, that can manifest in swelling of the surrounding tissues. Elephantiasis causes extreme swelling and thickening of the skin. It more commonly affects the lower trunk, limbs, external genitalia, and the breasts. There are mainly two types of elephantiasis, lymphatic filariasis and non-filarial elephantiasis or podoconiosis. Lymphatic filariasis is caused by parasitic worms, while podoconiosis is a non-parasitic disease. » As has been mentioned already, Elephantiasis is mainly of two types, lymphatic filariasis and non-filarial elephantiasis. The term lymphatic filariasis and elephantiasis are sometimes used interchangeably in the medical literature. Sometimes, it is also termed as the ‘true elephantiasis’. Lymphatic filariasis is more common in tropical areas, and it is caused byparasitic worms like, Brugia malayi, Wuchereria bancrofti, and Brugia Timori. » These parasites are transmitted by mosquitoes. When a mosquito carrying any of these parasitic worms bites a human, it injects the tiny larvae of the worms (microfilariae) into the bloodstream. The larvae usually have a incubation period of 7 to 21 days. They keep circulating in the bloodstream, and eventually invade and block the lymphatic system. » The other type of elephantiasis, i.e., non-filarial elephantiasis is prevalent in some African nations, and is not caused by parasitic worms. Rather, this kind of elephantiasis is believed to be caused by a long-term exposure to certain irritants, and alkali metals, like sodium and potassium found in the soils. These particles may enter the skin through the feet, and then get lodged in the lymphatic tissues, if someone walks barefoot on such high alkaline soils. » Sometimes, severe primary and secondary lymphedema can also cause elephantiasis. Primary lymphedema is inherited, while secondary lymphedema is caused by an injury to the lymphatic vessels. Factors that can cause secondary lymphedema include surgery, lymph node dissection, parasitic infection, and radiation therapy. Elephantiasis nostras is a very rare condition that can also produce symptoms similar to lymphatic filariasis. This disease is a complication of chronic lymphedema, and is not caused by helminths or parasitic worms. » Abnormal swelling and enlargement of certain parts of the body, along with ulceration and thickening of the skin are the most common symptoms of this condition. The swelling results from an accumulation of fluid in the tissues. Elephantiasis mainly causes extreme swelling in the legs, and external genitalia (the scrotum and vulva). » Apart from swelling, this condition can sometimes produce a few other symptoms, such as fever, chills, and malaise. It may take several years for the infection to produce the clinical symptoms. Sometimes, an infection can be asymptomatic, without any external signs or symptoms. But even the asymptomatic infections can cause considerable damage to the kidneys and the lymphatic system, besides altering the immune system. Medications The most commonly used drugs for the treatment of lymphatic filariasis are: ✦ Albendazole ✦ Diethylcarbamazine ✦ Ivermectin » Albendazole and diethylcarbamazine have been found to be effective in killing the microfilariae, and also the adult worms. However, in the sub-Saharan Africa, albendazole is usually used along with ivermectin. Ivermectin can kill the microfilariae, though its effects on the adult worms are not very clear. The most common side effects associated with this medication are, fever, myalgia, and headache. » Diethylcarbamazine is often regarded as a better option than ivermectin for killing adult worms. This medicine is also effective in reducing the size of enlarged lymph nodes considerably. However, this medicine can sometimes produce an allergic reaction, which can necessitate the use of antihistamines and steroids. This side effect is generally attributed to the destruction of the parasites. As the parasitic worms die, they release certain chemicals that can produce the allergic reaction. » Antibiotics such as doxycycline has also shown some promising results in treating lymphatic filariasis. The parasitic worms that cause elephantiasis have a population of symbiotic bacteria, known as Wolbachia, without which they cannot survive. Antibiotics help destroy these symbiotic bacteria, and thus wipe out the parasitic worms as well. » Along with medications, regular cleaning of the affected area can also help control the symptoms of elephantiasis to a great extent. This is probably due to the fact that, many times secondary skin infections play a very important role in aggravating the symptoms of elephantiasis. Daily cleaning can help prevent secondary infections. Surgery When elephantiasis causes gross enlargement of the scrotum, then surgery may be required to address this condition. However, surgery is usually ineffective in resolving the swelling of the limbs or trunk. Treatment for non-filarial elephantiasis include, wearing shoes that can help prevent further exposure to the irritants. Compression bandage and elastic stocking can also help manage the swelling and inflammation caused by this condition. Physicians often suggest cleaning the affected area with soap and water, as well as soaking the area in a mixture of water and antiseptic, for the management of non-filarial elephantiasis. Lastly, surgery can also be performed to reduce this condition, especially when it causes extreme swelling of the scrotum. Lymphedema is usually managed with elastic compression garments, sequential gradient pump therapy, compression bandaging, and manual lymph drainage. Surgery is another treatment option that is employed to provide a long-term solution to patients. Though tissue damage is permanent, the swelling associated with elephantiasis can be managed with appropriate treatment. The non-parasitic form of the diseases can be prevented by reducing the exposure to irritants found in the soil. Lymphatic filariasis can be prevented by controlling the vector that transmit the disease, and the levels of microfilariae in the population. Insecticides can be used for controlling the population of vectors like mosquitoes, while screen around the houses and bed nets can help avoid mosquito bites. Drugs that can reduce the level of microfilariae in the blood can also be administered to the affected people, in order to prevent the transmission of the disease, besides helping them to manage the debilitating symptoms.

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A dog's body is made up of various systems which connect to allow their organism to stay alive. The circulatory system is made of the blood and lymphatic systems which interrelate to carry out various functions. When one part of the body is affected, its connectivity means symptoms can appear in various areas. This differs whether the problem is localized or systemic, i.e. affecting one body part or a range at once. When we see our dog has legs swollen with fluid, we might think it is a localized problem. However, since the legs contain lymph nodes, it is also possibly a more systemic problem. This is often the case with lymphedema in dogs. AnimalWised looks at the the main reason why a dog's leg is swollen with fluid. We do this by looking at the causes, symptoms and treatment of lymphedema in dogs. What is lymphedema in dogs? An edema is a term for various types of fluid retention in the tissue of a dog's body. When this fluid accumulates in the subcutaneous tissue of the lymphatic system, we refer to it as a lymphedema. This is due to some type of malfunctioning of the lymphatic system, something we explore further below. The lymphatic system consists of a network of nodes, lymphatic vessels and lymphoid organs. The latter include the thymus and the spleen. These components work together to collect and transport lymph fluid through various tissues in the body. When this system does not function properly, the lymphatic fluid collects in the tissue under the skin, resulting in the swelling. Since the lymphatic system extends over their body, the fluid accumulation can be almost anywhere. However, we often see the lymphedema present in areas near the lymph nodes. This is why we see the dog's legs often swell with fluid. It is also important to note that there are other types of swelling on a dog's legs. Tumors, skin diseases and allergic reactions can cause localized inflammation. However, not all will be swelling due to fluid accumulation, i.e. an edema. Canine breeds predisposed to lymphedema In the case of dogs, the most frequently affected areas are the hind limbs. There does not appear to be a predilection for the appearance of the disease according to sex, but breed does appear to play a part.. Among the breeds most affected by lymphedema, we can see the Bulldog, German Shepherd, Labrador Retriever, Great Dane and the Dachshund. Types of lymphedema in dogs Canine lymphedema can be classified into two groups: - Primary: when it is caused by a primary defect in the lymphatic system itself, specifically in the nodes and/or lymphatic vessels. - Secondary: when it appears secondary to other pathological processes or as a result of surgical intervention, trauma, etc. Causes of lymphedema in dogs Now we know the two types of canine lymphedema, we explain the main underlying causes of both these categories: - Primary lymphedema: is caused by congenital anomalies. Specifically, primary-type lymphedema in dogs can be caused by lymphatic hypoplasia or by lymphatic hyperplasia and dilatation. - Secondary lymphedema: secondary lymphedema in dogs can be produced by a range of pathological processes. These include malignant cancers (primary or metastatic), inflammation, trauma, chronic infections, parasitic infestations or immune mediated disease. It can also occur as a result of surgery. Symptoms of lymphedema in dogs The main clinical sign associated with canine lymphedema is swelling of the affected area. As we have explained, lymphedema in dogs is more frequent in the legs, especially in the hind limbs. However, the forelimbs, abdomen, genital area and ears can also be affected. It can be unilateral if only one side of the body is affected, or bilateral if both sides are affected simultaneously. As well as legs being swollen with fluid, we may see certain other symptoms which include: - When it affects the legs, the swelling generally begins in the distal area of the extremity, i.e. the area farthest from the animal's body. As it progresses, it spreads towards the proximal area, i.e. the area closest the body. - Pressing the affected tissue firmly with the finger produces a depression (known as a pit) that persists for a few seconds after the finger is removed. - The skin of the affected area is usually thinner and spongy in appearance. - It is usually painless unless there is massive swelling or it is accompanied by cellulite. - The area is usually neither hotter nor colder than normal. - Regional lymph nodes may not be palpable. - The patient may be less active than usual due to the additional weight of the limb. Some of these clinical signs are common with edema caused by abnormalities of the venous system (such as venous stasis), heart failure, renal failure, cirrhosis, or hypoproteinemia. It will be important to differentiate both alterations during the diagnostic process. Diagnosis of lymphedema in dogs When we see a dog's leg or legs swollen with fluid, we need to take them to a veterinarian. While some may require minimal treatment, others are potentially life threatening. The diagnosis of canine lymphedema is based on the following factors: - Clinical history and general examination: the clinical signs described in the previous section allow us to guide the diagnosis of canine lymphedema. - Laboratory tests: including blood tests, urinalysis and other complementary tests. They are necessary to differentiate between lymphedema and other types of swelling, as well as to identify the cause of secondary type lymphedema. - Skin biopsy and histopathology: allows visualizing the microscopic lesions associated with lymphedema. In the case of primary lymphedema, it will allow the detection of the specific type of congenital alteration (hypoplasia or hyperplasia) that causes the lymphedema. Varying degrees of dermal or subdermal edema are commonly seen, with dilated or hyperplastic lymphatic vessels. In chronic cases, it can be accompanied by fibrosis of the tissue. In this case, the swelling won't feel as fluid as before. - Direct lymphangiography: consists of a contrast X-ray of the lymph nodes and vessels. To obtain the radiographic image, the water-based contrast medium must be injected into a lymphatic vessel. - Magnetic resonance imaging (MRI): can be performed as an advanced imaging test, since it allows us to see the structural changes caused by lymphedema and offers relevant information on the presence, architecture and size of the lymph nodes. Treatment of lymphedema in dogs The success of the treatment of canine lymphedema depends to a great extent on its progress and chronicity. The early stages are generally reversible and resolve spontaneously or with supportive treatment. However, when the process becomes chronic, tissue fibrosis usually occurs, complicating treatment. We must emphasize that there is no curative treatment for lymphedema in dogs. However, there are various therapeutic options, both medical and surgical, which may help control the process. Next, we collect the main therapeutic alternatives or supportive therapies for canine lymphedema: - Robert Jones-type compression bandage: it is especially useful in the early stages of lymphedema, as it helps reduce swelling and provides relief to the patient. It is especially useful on the leg swelling. - Rigid bandages: with splints and/or plaster. - Pharmacological treatment: although there are few studies on the matter, tocopherol nicotinate and sodium sulfonate hydrate may be effective in controlling some clinical signs. Long-term treatment with diuretics (such as furosemide) is contraindicated. - Surgical treatment: when conservative treatment is not effective, it is necessary to resort to surgical treatment. Options include removal of edematous tissue, reconstructive surgery, and, in very severe cases, amputation of the affected limb. In addition, in cases of secondary lymphedema in which the primary disease is known, it is also necessary to establish a specific treatment for said primary cause. For the above reasons, it is essential to go to a veterinary center when the first symptoms are observed, since it is important to find the cause to treat lymphedema in dogs. This article is purely informative. AnimalWised does not have the authority to prescribe any veterinary treatment or create a diagnosis. We invite you to take your pet to the veterinarian if they are suffering from any condition or pain. If you want to read similar articles to My Dog's Leg Is Swollen With Fluid, we recommend you visit our Other health problems category. - Dlujnewsky, J., Quintero, V., & Rodrigues, G. (2015). Clinical case report: canine primary lymphedema. Journal of the College of Veterinary Doctors of the Lara State, 10. - Fossum, T. W., & Miller, M. W. (1992). Lymphedema ethiopathogenesis. J Vet Inter Med, 6:238. - Fossum, T. W., King, L. A., Miller, M. W., & Butler, L. M. (1992). Lymphedema clinical signs, diagnosis and treatment. J. Vet Intern Med Assoc, 6:312.

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1. What is lymphedema? Lymphedema is a condition in which excess lymphatic fluid collects in the interstitial tissue and causes swelling in specific areas of the body, usually in the arms or legs. Swelling can also occur in other parts of the body, such as the breast or chest wall. 2. What causes Lymphedema? Lymphedema can develop as a result of cancer, cancer treatment (e.g., surgery, radiation), infection, trauma, scar tissue, or anything that changes, blocks or interrupts the flow of lymph through the lymphatic system. While it is most often associated with breast cancer, lymphedema can result from treatment for other cancers, such as prostate cancer, gynecological cancers, lymphoma and melanoma. The greater the number of lymph nodes removed, the higher the risk for developing lymphedema. Early diagnosis and treatment for lymphedema is important to help reduce symptoms and prevent the condition from progressing. Untreated lymphedema can lead to decreased function and mobility in the affected limb, skin breakdown, infection and other complications. 3. Lymphedema prevention and treatment With proper care and treatment, lymphedema may be prevented or controlled. Lymphedema treatments vary from person to person, depending on the severity and cause. Treatment may include skin care, manual lymph drainage, gentle massage and light exercises to help stimulate the lymphatic system. You may also use compression bandages, pumps, or garments (e.g., sleeves, stockings) to help prevent additional fluid from accumulating in the tissue. In addition, medications can help reduce inflammation, prevent blood clots, and treat infections. You may also use surgical options for the treatment of lymphedema. I am a cancer survivor. After the Surgery, Chemo & Radiation, I have developed a severe Lymphedema. After I did a lot of research & visited a few doctors & specialists, I have decided that I do not want to wear a compression bandage as all the doctors recommended. Therefore, I have done the following steps to limit the inflammation & improve the blood flood & improve Lymphatic fluid to flow. 1. Massage everyday 100 counts per each part of my leg, arm upward direction. 2. Exercise at least 1 hour to improve the fluid movement to the legs & arms. 3. Less Protein Intake. Since Lymphatic fluid likes Liquid Fat staying under the skin. The damaged lymphatic fluid cannot pump back to the lymphatic system, therefore the skin becomes thicker & thicker. Reduction of red meat intake is a must. Use TLS Shakes (2 Scoops) With Complete Green(2 Scoops) Or Whey Protein Shake (1 Package). You may get them from Global.shop.com 4. Eat a lot of fruit and vegetables. 5. Low Sodium Food, Soup or any dishes. 6. Drink hot water with lemon 7. Drink Isotonix Essential Kit twice per day. OPC3 three capful per day reduce inflammation. Use 2 capful of B Complex twice per day, Use Calcium 1 capful twice per day & multivitamin 1 capful once per day. Note: Lymphedema is an inflammation symptom. It can cause kidney damage, infection in lungs and many other part of the body. Therefore, to control inflammation is the key. 8. Skincare To avoid infection, it’s very important not to scratch the itching skin. Apply some anti-itching cream and moisturizer. 9. Drink a lot of Ultimate Aloe Juice. If financially possible, Drink 1-2 bottles of Aloe Juice in Original Flavor Everyday. Ultimate Aloe Juice contains over 200 different vitamins & nutritious with over 20 different Amino Acids. 10. Use Vitamin D 1 capful per day 11. Co Q 10, two gel per day (May get them from global.shop.com) 12. Fish Oil 2 Gels twice per day. 13. Astaxanthine 1 Gel twice per day (may get it from global.shop.com) 14. Use Isotonix Digestives Enzymes at least 3 times per day after each meal. You may use it as many as possible to make sure the food will not stay stomach for so long. Make sure you go to bathroom regularly, at least twice per day. 15. Go to Chinese Store or any grocery store to buy Barley Kernels & Green Beens to boil soup. Drink hot soup after massage every day. The soup can force your system to release more water from your body. 16. Lift your legs, feet or arms high when you sleep or sit. 17. Wear Compression Bandages This is the last option. I prefer not to do so if it is possible. The reason is very simple: Once you put on the badage, your muscle will not work hard as before; You will not exercise enough to make your body fluid move; your cells will not be as active as before. The most important, the fluid will push up and accumate aroud your belly or hip area. If the water can not go out fast enough, eventually you will be out of shape. I would like to activate my cells & move the body fluid by exercise more & massage more. That’s my philosophy. 18. Soak Arms or legs in warm water to stimulate blood flow.

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Chronic Progressive Lymphedema (CPL) is a condition that describes impaired lymph flow in the lower legs. Primarily observed in draft horse breeds, CPL causes swelling and skin inflammation on affected legs. Horses with the condition are also at risk of lesions and secondary bacterial and parasitic infections developing on their legs because of poor lymph flow. A veterinarian can typically diagnose CPL based on a clinical examination. There is no cure for CPL. However, intensive management strategies can slow the progression of the disease and improve the quality of life of affected horses. CPL was recognized in 2003, although skin lesions associated with the condition were initially reported in the early 20th century. CPL is believed to be caused by a combination of genetic and environmental factors. What is Chronic Progressive Lymphedema? A systemic disease of the lymphatic system, CPL occurs due to the accumulation of lymph fluid in the lower legs of affected horses. CPL is a debilitating condition that causes secondary recurrent bacterial and parasitic infections due to poor lymphatic drainage and blood circulation. Recurrent infections promote the development of skin lesions that can extend up the leg to the knees or hocks. These infections typically increase the amount of lymphedema in the affected legs. Decreased lymph flow in the legs of horses with CPL may initially go unnoticed if heavy hair (feathering) is present on the legs. The tissue damage caused by CPL is progressive and can result in lameness, severe disability, disfigurement, and potentially premature death. Chronic progressive lymphedema differs from chronic pastern dermatitis, a condition that occurs due to primary infection with microorganisms. Treatments of skin infections do not resolve the underlying lymphedema associated with CPL. Lymphatic System Dysfunction and CPL The role of the equine lymphatic system is to maintain fluid balance in the tissues, support immune function in the skin, and remove cellular waste products. Protein-rich lymph fluid circulates throughout the body through lymph vessels and lymph nodes. Elastin, an extracellular matrix protein, is necessary to move lymph fluid throughout the body. Abnormal elastin metabolism and impaired elastin quality in the skin are believed to be associated with CPL. If lymph flow is compromised, oxygen supply to tissues decreases and metabolic waste products accumulate within the body. Poor lymph flow (lymph stasis) impairs the skin’s immune response to pathogens and jeopardizes the integrity of the skin barrier. In advanced cases of CPL, there may be complete lymph stasis due to lymphatic dysfunction, lymph vessel dilatation, and the formation of excess fibrous connective tissue (fibrosis). Prevalence of CPL Horses that develop CPL typically don’t show detectible signs of the disease before the age of two. CPL affects breeds including: - Belgian draft horses - German draft horses - Shires - Clydesdales - Gypsy Vanners - English Cobs - Friesians - Percherons The number of horses affected by CPL is unknown. However, a study of 161 Belgian draft horses found that 82% had CPL. Another study involving 912 horses of six different breeds of German draft horses older than 2.5 years determined a prevalence of CPL ranging from 47.5 to 96.1%. Signs of CPL The severity of CPL correlates with how severely lymphatic clearance is delayed. Early signs of CPL include: - Swelling in the lower legs - Soft pitting edema Advanced signs of CPL include: - Firm swelling in the legs - Folds in the skin due to swelling and tissue damage - Lesions (ulcers) - Fibrosis that results in nodule formation - Poor hoof growth - Thrush - Scaling skin - Granulation tissue - Discharge of exudate (pus) due to secondary bacterial overgrowth from the crevices of skin folds - Loss of shape of the lower leg - Skin folds on the neck and the trunk - Impaired movement due to nodule development and skin folds on the limbs Secondary Infections Horses with CPL are prone to the following types of recurring infections due to reduced lymph flow which disrupts the normal barrier function of the skin. Bacterial Infections: Skin infections in horses with CPL may involve bacteria including various species of Staphylococcus and Dermatophilus congolensis. Heavy feathering traps moisture and bacteria that propagate infection. Parasitic Infections:chorioptic mange, is common in horses with CPL. Feathered horses with CPL are prone to overproducing keratin (hyperkeratosis) in their skin. This abnormal thickening of the outer layer of the skin is associated with the development of skin crusts that feather mites feed on. Mites are a trigger for CPL as they can cause scarring and damage to the skin and superficial lymph vessels. Causes of CPL The cause of CPL is currently unknown. However, a combination of the following factors is believed to be involved in the development of the condition. Biological Abnormalities Reduced and or Poor-Quality Elastin: Organized in a three-dimensional network in the skin, elastin surrounds lymphatic vessels and functions like an elastic sponge to facilitate lymph transport throughout the body. Horses with CPL have an abnormal quantity and/or quality of elastin in their skin which results in impaired lymph uptake and clearance from the tissues. A study that compared skin samples from horses with CPL and those without the condition determined that affected horses had increased amounts of dermal elastin in their lower legs and neck, whereas the non-affected horses of a susceptible breed had decreased amounts. Antibodies to elastin have been noted in the blood serum of horses with CPL. Although the quantity of dermal elastin increases in the neck and leg skin of horses with CPL, the architectural structure of this elastin is less organized compared to horses without the condition. It has been proposed that the body forms new elastin to compensate for a lack of elastic support from the original elastin. Abnormal Desmosine: An amino acid that cross-links elastin fibers, desmosine is reduced in the skin of the neck and lower legs of horses with CPL. However, desmosine levels have been found to increase when lesions develop. Genetic Influence No specific genetic markers or mutations are known to be present in horses with CPL, although research sections of DNA sequences may be associated with the condition. Genetics are believed to play a role in the development of CPL in certain breeds of draft horses. The high rate of occurrence in some breeds suggests a genetic predisposition for the condition. CPL is known to occur in Belgian draft horses after continuous selected breeding aimed at producing offspring with dense feathering and heavier legs. A study of 28 Friesian horses found that affected horses had a significantly increased gaskin length, thus suggesting a genetic phenotype may be associated with the development of CPL. Environmental Triggers The environmental conditions in which horses with CPL live affect the progression of their disease. Sandy and muddy environments are believed to promote the development of lesions, whereas clean rubber surfaces do not. Lesions occur more often in horses used for breeding and food production compared to those that are used for work or riding. Diagnosis A veterinary diagnosis of CPL is typically based on clinical presentation and consideration of breed disposition for the disease. Diagnosis typically involves a physical examination and diagnostic testing. The early stages of the disease are typically evident when palpating the lower limbs. Clipping of the feathers is often required to identify lesions. The following diagnostic testing strategies are less commonly used to diagnose CPL: Lymphoscintigraphy: An imaging technology, lymphoscintigraphy is useful for distinguishing lymphedema from other causes of lower limb swelling. This technology can determine how impaired lymph drainage is by identifying dilated and distorted lymph vessels. Skin Biopsy: A biopsy can be used to identify lesions of dilated lymphatic vessels and changes in the underlying elastin fiber network of the skin. However, a loss of elastin may only be present in deep tissues and may not be noted on a regular skin biopsy. Enzyme-Linked Immunosorbent Assay (ELISA): This test was developed to aid in diagnosing CPL by detecting serum anti-elastin antibodies in horses. However, it is not used as a routine test to diagnose CPL. Prognosis: Diligent management can improve the quality of life for horses with CPL, although there is no cure for the condition. Some affected horses may have a reasonable quality of life, whereas severely affected horses are often euthanized. Treatment No treatment currently exists for Chronic Progressive Lymphedema. Therapy for CPL focuses on management strategies to help improve the comfort of affected horses. Grooming: Keeping feathers/excess hair on the legs clipped allows the skin to be observed more easily to treat any lesions promptly. Short hair also provides access to the skin surface to apply topical treatments, prevents moisture from being trapped in the hair, and allows the skin to dry quickly. Skin Cleansing: Affected areas of skin should be gently washed using non-irritating sulfur-based shampoos. After washing, the skin should be thoroughly dried. Antibiotics: Oral and or topical antibiotics may be required to treat secondary skin infections involving bacterial organisms. To avoid the development of microbial resistance, different antimicrobial medications may need to be used on a rotating basis. Antiparasitic Treatments: Topical or oral medications may be used to treat parasite infections involving chorioptes. Treatments for these mite infestations include the topical application of Fipronil spray and lime sulfur. Topical or systemic treatments using macrocyclic lactone drugs including eprinomectin and ivermectin are also used. Compression Bandaging: Multiple layers of specialized compression bandages are applied over carefully padded limbs. Compression bandages create a pressure gradient up the leg. These bandages must be applied correctly to avoid causing injury or further damage to the affected legs. Environmental Management: Horses with CPL should be kept in a dry environment to avoid exposure to wet and muddy conditions that can promote skin infections. Pesticide applications in barns may help to prevent infestation and reinfestation with mites. Daily Exercise: Horses with CPL benefit from regular exercise to increase circulation and lymph flow in their legs. Hoof Care: Regular farrier care is critical for horses with CPL as their hoof quality may be compromised due to the lymphedema involved. Cleaning the hooves daily is important to check for the development of thrush. Combined Decongestive therapy (CDT): CDT treatment involves manual lymph drainage (MLD) and compression bandaging to stimulate the lymph system. This treatment is typically performed by a professional. The goal of CBT is to move lymph from dysfunctional to functional areas of the lymphatic system and to break down fibrotic tissue. Prevention At present, there is no way to prevent CPL in susceptible horses. Because some horses are affected by CPL at a later age, they may have already passed on a genetic predisposition to the disease if they have been bred. Strategies to aid in delaying the onset or progression of CPL include: - House affected horses in a clean and dry environment (rubber matted surfaces) - Use turnout boots to protect the skin from the elements - Apply a barrier cream to help protect the skin from moisture damage - Treat leg bacterial or parasitic infections promptly to prevent their spread - Provide daily exercise to stimulate blood and lymph flow - Use compression bandages to encourage lymph flow - Ensure regular farrier care - Feed a balanced diet to support overall health and skin - Performing repeated clinical examinations prior to breeding to help reduce CPL occurrence If your horse has CPL, consult with our nutritionists for feeding and management recommendations. You can submit your horse’s information online for a free analysis. Is Your Horse's Diet Missing Anything? Identify gaps in your horse's nutrition program to optimize their well-being. References - Affolter, V.K. et al. Chronic Progressive Lymphoedema in Friesian Horses: Suggestive Phenotype of Affected Horses and Genome-Wide Association Study. Vet Dermatol. 2020. - De Keyser, K. et al. Genetic parameters for chronic progressive lymphedema in Belgian Draught Horses. J Anim Breed Genet. 2014. - Affolter, V.K. et al. Chronic progressive lymphedema in draft horses. Vet Clin North Am Equine Pract. 2013. - De Keyser, K. et al. Chronic progressive lymphedema in the Belgian draft horse in Belgium: Clinical phenotyping, prevalence and risk factor analysis. Vlaams Diergeneeskundig Tijdschrift. 2014. - De Cock, H. et al. Quantitative and qualitative evaluation of dermal elastin of draught horses with chronic progressive lymphoedema. J Comp Pathol. 2009. - Brantegem, L.V. et al. Antibodies to elastin peptides in sera of Belgian Draught horses with chronic progressive lymphoedema. Equine Vet J. 2007. - Mittmann, E.H. et al. Whole-genome scan identifies quantitative trait loci for chronic pastern dermatitis in German draft horses. Mamm Genome. 2010.

https://madbarn.com/chronic-progressive-lymphedema-in-horses/

What is Lymphedema? An accumulation of tissue fluid (lymph) caused by structural impairment of the lymphatic system. Swelling is the main symptom, although many people also experience aching, numbness or tingling, and/or a feeling of heaviness. Lymphedema can affect mobility, body image, and general functioning. It is a chronic but Manageable condition that can worsen if left untreated. True lymphedema is a chronic, progressive disease and affects about 2 million people in the U.S. Its incidence is on the rise due to many lifesaving cancer related treatments. Primary Lymphedema Lymphatic system is abnormal from birth, but swelling may not develop until later stages of life. It may be hereditary, or a random genetic problem. Secondary Lymephdema Lymphatic system has been impaired by injury, surgery, or radiation. Symptoms may develop at any time following this injury, sometimes years late.

https://lakecitypt.com/lymphedema-physical-therapy/

Hereditary lymphedema is a genetic developmental disorder affecting the lymphatic system. It is characterized by swelling (edema) of certain parts of the body. The lymphatic system is a circulatory network of vessels, ducts, and nodes that filter and distribute certain protein-rich fluid (lymph) and blood cells throughout the body. Feb 09, · Hereditary lymphedema type II is a primary lymphedema that results from abnormal transport of lymph fluid. Individuals with this condition usually develop swelling in the lower legs and feet during puberty. Excerpted from the GeneReview: Milroy Disease Milroy disease is characterized by lower-limb lymphedema, present as pedal edema at (or before) birth or developing soon after. Occasionally it develops later in life. The severity of edema shows both inter- and intrafamilial variability. May 26, · FOXC2 was the second lymphedema gene found, and was first identified in by Fang et al. FOXC2 is responsible for causing the lymphedema-distichiasis syndrome (LD). Individuals with LD have lymphedema of pubertal or adult onset as well as distichiasis, which is the presence of extra eyelashes. Lipedema is an under-recognized condition, often misdiagnosed as lymphedema or dismissed as simple obesity. We present a series of pedigrees and propose that lipedema is a genetic condition with either X-linked dominant inheritance or more likely, autosomal dominant inheritance with sex limitation. Mutations in the FOXC2 gene cause the Lymphedema-Distichiasis (LD) Syndrome, which consists of lymphedema and distichiasis (double rows of eyelashes). The lymphedema is often confined to the lower extremities, is asymmetric, and has a variable age of onset. Lymphatic filariasis is a parasitic disease caused by three species of microscopic, thread-like worms. The adult worms only live in the human lymph system. The lymph system maintains the body’s fluid balance and fights infections.

http://wifexx.xyz/adult/adult-genetic-pedal-lymphedema-38.php

Lymphedema is a specific type of edema (swelling) that most commonly occurs following cancer treatment, radiation or surgery that damages the lymphatic system. This is a particularly difficult type of edema to treat as it does not respond to elevation or the use of diuretics. The most effective form of treatment and management of lymphedema is known as Complete Decongestive Therapy (CDT) carried out by a Certified Lymphedema Therapist (CLT). When the acute and maintenance phase are performed correctly there is a significant decrease in limb size that can be maintained long term with proper compression garments. The Lymphatic System: A Basic Overview of Fluid Movement:The lymphatic system works closely with our circulatory system to transport fluid, nutrients and protein from the tissue in the body. Unlike the circulatory system, the lymphatic system does not contain a central pump. Instead, the fluid is moved by tiny pulses created within the vessel as well as the pressure created by muscle contractions. The lymphaticcapillaries collect fluid, protein and cellular waste from the cellular space. This is then transported to larger Precollectors and collectors that move the lymphatic fluid to the regional lymph nodes. After the lymph nodes filter the fluid it is sent to Larger Trunks and then lymphatic Ducts that return the lymphatic fluid to the Right and Left venous angle, at the base of the neck. The fluid that is returned to the circulatory system will then be filtered by the liver and kidneys. Excess fluid will be removed from the body as urine. The lymphatic system plays a vital role in the body’s immune function because it transports lymphocytes that work to fight infection. What is Lymphedema? Lymphedema is an accumulation of fluid and protein in an area of the body where the lymphatic system’s transport capacity is insufficient. The characteristics include a slow but progressive onset that may take years to reach a noticeable level of swelling. The progression will almost always start distally and progress proximally. There will be a loss of contours, bony landmarks and wrinkles in the skin as the fluid accumulates and the limb takes on a columnar shape. Lymphedema is rarely painful, but often associated with feeling dull, aching, heavy and tight. When more than one limb is involved the presentation will often be asymmetrical as the different quadrants will not accumulate fluid at the same rate. A history of cellulitis in the area is common because of the decreased immune function associated with lymphatic insufficiency. The presence of necrotic ulcerations is not associated with pure lymphedema because blood supply remains intact, however ulcers can be present in a patient with comorbid lymphedema and venous insufficiency. When left untreated the protein buildup caused by lymphedema will cause skin inflammation and the development of fibrosis, hyperkeratosis, papillomas, Peau D’orange and fluid reflux. -Stemmer Sign: pinch and lift the skin on the tops of the fingers and toes. If the skin is fibrotic, squared off or resistant to lifting the stemmer sign is positive. What is a Certified Lymphedema Therapist? A CLT has prior training as a Physical Therapist, Occupational Therapist, Nurse or Massage Therapist. They then go through an intensive training in the anatomy, physiology, pathology and treatment of lymphatic disorders and edema. Each CLT is able to create a customized multistep program to bring the patient through the acute (decongestive phase) to the maintenance phase of lymphedema management. The CLT is able to measure the patient for an off the shelf or custom compression garment based on their needs. This treatment protocol can also be appropriate for other forms of edema when medically indicated. Understanding the condition of Lymphedema is the first step to proper management. These videos contain great information on what causes the condition and how to best manage it. Watch these videos regularly to refresh your understanding of the condition. -Primary Lymphedema- A collection of protein rich fluid due to a congenital lack of proper lymphatic system structures in the body. The onset of symptoms can be from birth to early adulthood. -Secondary Lymphedema- A collection of protein rich fluid due to damage or removal of part of the lymphatic system. The most common cause is surgery or radiation for cancer treatment. Lymphedema can also be caused by trauma to the body that overloads the lymphatic system’s transport capacity. -Filariasis- A type of secondary lymphedema caused by infection with the philarial worm parasite. This is a mosquito born parasite found in tropical areas and is the most common cause of lymphedema worldwide. It is very uncommon in developed countries but can be seen in individuals that traveled to tropical areas and were infected. Symptoms may take years to develop following infection. -Lipedema- this condition is diagnosed mainly in women as it is an estrogen related collection of fat cells. The patient will present with a large collection of adipose tissue from the pelvic crests to the ankles in a symmetrical distribution. There is a noted band around the ankles and the feet are spared the collection of adipose tissue. The upper body may be noticeably thinner than the lower body and the patient often expresses frustration that exercise has had no effect on decreasing the size of the lower body. The tissue has a very soft texture but exhibits little or no pitting. There is no history of cellulitis but the skin may be sensitive to palpation and bruise easily. Lipolymphedema- This is a combination of Lymphedema and Lipedema. When left untreated lipedema strains the lymphatic system. Over time this strain can cause damage and lymphedema will be present with the lipedema. Malignant Lymphedema- the presence of a tumor can put pressure on the lymphatic system to a point where fluid movement is restricted and lymphedema results. The tumor must be medically managed before treatment of the lymphedema can be considered. o Venous Edema: the most common cause of edema in the lower extremities that arises from vascular damage. This is a low-protein, water rich edema. The collection of fluid and the associated gaiter distribution of darkened skin (hemosiderin staining) is present from the ankle to the upper calf with little to no pitting. The skin becomes dry, tight, shiny and inelastic. Necrotic ulcerations are common as the condition progresses. When left untreated the excess fluid in the cellular space will put stress on the lymphatic system and cause a co-morbid lymphedema (phlebo -lymphostatic edema). CDT is indicated as an appropriate treatment for mild to moderate venous disease if no other contraindication are present. o Cardiac Edema: A collection of fluid in the legs from Congestive Heart Failure that creates hypertension in the venous limb. Right sided heart failure causes a distal collection of low-protein, water rich edema that is increased by gravity. There is a bilateral symmetrical presentation of fluid collection that pits easily with pressure. The edema may resolve partially or completely with elevation of the limb, but will return when in a dependent position. When left untreated the excess fluid will tax the lymphatic system and cause a co-morbid lymphedema. Modified CDT can only be performed on patients that are medically stable and will be closely monitored during treatment. o Myxedema: (pretibial myxedema)- a collection of fluid that begins on the anterior calf caused by hypothyroidism. The lymphatic vessels are compressed by changes caused by hypothyroidism and the resulting damage will cause lymphedema. CDT is indicated as a treatment to remove the collection of fluid. Stages of Lymphedema: All patients that have undergone lymph node removal or radiation treatment are considered to be in the latency phase of lymphedema because their transport capacity is decreased. Not all patients in the latency stage will progress to having an active form of lymphedema, however Any patient that progresses to stage I of lymphedema will eventually progress to stage 3 if left untreated. 3. The limb is wrapped daily with short stretch bandages that create a compression gradient to move fluid from the congested area. The use of multi-layer short stretch bandages creates an environment of low resting pressure and high working pressure. This creates the necessary environment for the muscle pump exercise sequence to move fluid from the area while still allowing for adequate circulation to reach the area. 4. Muscle Pump Exercises: A specific sequence of movements and exercises are performed to contract and relax the muscles to create a pumping effect. The low exertion, slow, rhythmic movements are emphasized by the high working pressure created by the multi-layer short stretch compression wrap. 2. A daily exercise program is performed to improve circulation, activate the muscle pump and encourage fluid movement. Manual Lymphatic Drainage: (MLD)Also known as the Vodder Technique, MLD is a process of establishing collateral circulation and drainage for the lymphatic system. The lymphatic system drains the body by designated quadrants so damage to the regional lymph nodes will cause a buildup of fluid in that quadrant. Light stretch and pull stimulation is performed on the skin to stimulate the lymphatic capillaries to take up fluid. The direction of the stretch and pull movements will direct the fluid away from the congested area to the closest intact lymph nodes. When used in combination with compression garments and muscle pump exercises this is an effective way to direct fluid removal from the area of lymphedema. Complete Decongestive Therapy can be used as an effective treatment program for lymphedema and other forms of edema when no contraindications are present. -Kidney insufficiency (must be stable and able to handle the fluid being moved in the body during wrapping. - Mechanical or pneumatic Pumps are not seen as a practical treatment for swelling caused by lymphedema. This is due to the fact that lymphedema is a collection of both fluid and protein in the interstitial space. The pump will remove the water content from the tissue while the protein remains. Over time the increased concentration of protein will cause greater inflammation and fibrosis of the tissue. The high concentration of proteins in the area will also continue to draw fluid to the area. The external pressure of the pump and the pull of fluid to the area will further tax the lymphatic system and can cause additional damage over time. There is also an increased incidence of developing genital or truncal lymphedema following long term use of a pneumatic compression pump. CDT is a more effective treatment and does not cause additional damage to the lymphatic system. - Diuretics are not effective in treating pure lymphedema for the same reasons. Diuretic medications will decrease some of the fluid content while leaving the protein at a higher concentration. This will cause increased skin inflammation and fibrosis over time. Diuretic medication may be indicated for patients that have lymphedema as well as another condition that would benefit from such medication. - Debulking surgery- the surgical removal of excess fibrotic and adipose tissue is very rarely needed if the patient undergoes proper Complete Decongestive Therapy. The performance of a debulking procedure leaves the patient with excessive scar tissue that further impedes or completely blocks the movement of lymphatic fluid. The pt. will still need to wear compression garments for life following this procedure. Extensive CDT should always be performed as the primary treatment for lymphedema and debulking surgery is reserved as a last resort for severely involved patients. - The only way to encourage movement of protein out of the tissue affected by lymphedema is to perform Manual Lymphatic Drainage. The stretch stimulation created on the skin during MLD stimulates the lymphatic capillaries to draw in both fluid and protein to be directed away from the area.

http://www.bodyinbalancerehab.com/Physical-Therapy/Lymphedema-Treatment/a~7859--c~358308/article.html

Lymphedema, lymphostasis, or “elephantiasis”, based on a violation of the outflow of fluid (lymph) from tissues, clinically manifested by edema, is a chronic disease. The swelling of the limb is due to either hypoplasia of the lymphatic vessels (primary lymphedema) or obstruction or rupture of the vessels (secondary lymphedema). Mostly it has a one-sided nature of the lesion, less often both arms or both legs can be involved in the process. Some patients may have edema of the genitals, chest, and head. Lymphostasis is often the result of surgical removal of lymph nodes in the armpit/groin area, or damage after radiation/chemotherapy. That is, normal drainage of lymph is difficult. Also, the disease can be caused by the growth of a tumor, which directly presses on the lymphatic vessels. Lymphedema can occur in all places where lymph is formed, and thus its drainage may be disrupted. However, the most common locality is the limbs. Symptoms Swelling of either part or all of the leg or arm is often the most pronounced symptom. The severity of the edema may vary. Sometimes the swelling is pronounced. But, often, it all starts with fingers and toes, hands, feet. Some patients note the inability to wear jewelry, watches, certain styles of clothing or shoes, as they become cramped by the end of the day. Symptoms are listed below; - Swelling of either or all of the limbs - Sometimes swelling of the neck and head. - Feeling of heaviness in the limbs. - Feeling of “tightness” in the arms and legs. - Limited range of motion in the affected limb (part of the mobility is lost). - Feeling of discomfort in the affected limb. - Sometimes pain in the affected limb. - Tingling sensation in the affected limb. - Recurrent skin infections in the affected limb. - Trophic changes in the skin (it becomes hard, there may be blisters with lymphatic contents, growths).

https://entirelyhealth.com/conditions/body/lymphedema-signs-symptoms/

Lymphoedema is a long-term (chronic) condition that causes swelling in the body’s tissues. It can affect any part of the body but usually develops in the arms or legs. Lymphedema develops when the lymphatic system doesn’t work properly. The lymphatic system is a network of channels and glands throughout the body that helps fight infection and remove excess fluid. It’s important that lymphoedema is identified and treated as soon as possible. If it isn’t treated, it can get worse. Types of Lymphedema There are two types of lymphedema – primary lymphedema and secondary lymphedema. Both types relate to lymph vessels or lymph nodes that are missing, damaged, removed or otherwise impaired. Primary Lymphedema Primary lymphedema occurs when the lymph system is damaged due to a developmental defect. Primary lymphedema can be classified according to the age of onset. - Congenital: The lymphedema is noticeable at birth - Praecox: Lymphedema occurs after birth, but before age 35 - Tardum: Lymphedema presents after age 35 Primary lymphedema can present as a variety of abnormalities: - Lymphatic Aplasia: Rare condition where portions of the lymph system never develop and are missing - Lymphatic Hypoplasia: This is the most common malformation, and refers to incomplete development of lymph vessels and/or nodes. The number of lymph vessels and/or nodes is reduced, or they can be smaller than normal. - Lymphatic Hyperplasia: Structural malformation of lymph vessels and/or nodes with enlarged dilated lymph vessels which can cause malfunction of lymph valves and compromise lymphatic flow. Secondary Lymphedema Secondary lymphedema occurs due to an outside factor damaging or impairing the lymph system. Causes of secondary lymphedema include: - Cancer surgery/radiation: Removal of lymph nodes from cancer surgery disrupts lymph flow. Radiation treatment can damage the fragile lymphatic vessels and cause lymphedema. - Tumors: Tumors can grow and press on the lymph vessels, blocking flow and causing lymphedema. Tumors often cause lymphedema which differs in that it starts in the upper part of the limb. Other causes of lymphedema usually result in swelling that starts in the lower parts of the limb first. - Trauma: Injury to the body can damage fragile lymphatics and lead to the development of lymphedema. - Infection: Infections can cause inflammation and permanent damage to the fragile lymphatic vessels. - Chronic Venous Insufficiency: Severe chronic venous insufficiency can overwhelm the lymphatics, leading to the development of phlebolymphedema (a venous disease with secondary lymphedema). Often the CVI is exacerbated by other medical conditions. Phlebolymphedema can develop in patients with normal lymphatics, or in patients with damaged lymphatics. Contributing factors include heart failure, renal failure, liver disease, untreated sleep apnea, obesity, paralysis/paresis, pulmonary hypertension, and certain medications. - Obesity: Obesity is an independent risk factor for lymphedema, particularly in cancer survivors. Morbidly obese patients with a BMI > 59 are high risk for spontaneous development of lower limb lymphedema. - Filariasis: A parasitic disease that is found mostly in third-world countries and impairs the lymphatic system. It is the most common cause of lymphedema worldwide. Pathophysiology In a diseased state, the lymphatic transport capacity is reduced. Consequently, the normal volume of interstitial fluid formation exceeds the rate of lymphatic return, resulting in the stagnation of high-molecular-weight proteins in the interstitium. This usually occurs after the flow has been reduced by 80% or more. The result, as compared with forms of edema that have much lower concentrations of protein, is high-protein edema, or lymphedema, with protein concentrations of 1.0-5.5 g/mL. This high oncotic pressure in the interstitium favors the accumulation of additional water. Accumulation of interstitial fluid leads to massive dilatation of the remaining outflow tracts and valvular incompetence that causes a reversal of flow from subcutaneous tissues into the dermal plexus. The lymphatic walls undergo fibrosis, and fibrinoid thrombi accumulate within the lumen, obliterating much of the remaining lymph channels. Spontaneous lymphovenous shunts may form. Lymph nodes harden and shrink, losing their normal architecture. In the interstitium, protein and fluid accumulation initiates a marked inflammatory reaction. Macrophage activity is increased, resulting in the destruction of elastic fibers and production of fibrosclerotic tissue. Fibroblasts migrate into the interstitium and deposit collagen. The result of this inflammatory reaction is a change from the initial pitting edema to the brawny nonpitting edema characteristic of lymphedema. Consequently, local immunologic surveillance is suppressed, and chronic infections, as well as malignant degeneration to lymphangiosarcoma, may occur What causes Lymphedema? If your lymphatic system is damaged or a blockage exists, the fluid can build up in the soft tissue beneath your skin. There are two types of lymphedema: Secondary lymphedema is caused by another condition or disease that damages your lymph vessels or nodes. Secondary lymphedema may be caused by: - An infection in your lymph nodes - Parasites - Cancer or radiation treatment for cancer - Surgery - Lymph node removal - Injury Primary lymphedema is much less common. It’s a genetic problem that happens because your lymph nodes or vessels either aren’t adequately developed or are missing altogether. What are the risks to cause Lymphedema? Risk factors for lymphedema include: - Having more lymph nodes removed: Research shows that having more underarm lymph nodes removed increases lymphedema risk. - Having multiple surgeries to the chest, or more extensive surgery: It’s thought that the more surgical procedures you’ve had to the chest — whether to treat the breast cancer or some other unrelated condition, or to reconstruct the breast — the greater the chance of disruption to the lymphatic system and the greater the lymphedema risk. - Radiation therapy: The greater the area of the chest and/or underarm that needs to be treated with radiation, the greater the risk. Radiation directly to the underarm area, where lymph nodes are clustered, tends to be associated with the highest risk. - Chemotherapy: Research has not yet determined whether chemotherapy itself increases lymphedema risk. However, we know that chemotherapy sometimes leads to weight gain, which is a risk factor. - Being overweight or obese: People who are overweight or obese are more likely to develop lymphedema after breast cancer treatment. - Infection or injury affecting the arm, hand, or upper body on the same side of the body as your surgery: Infection and injury can lead to inflammation of the body’s tissues, which in turn makes the lymphatic system work harder. When an area of the body is inflamed, blood flow increases and so does the fluid load. If your lymphatic system can’t keep up, this can trigger lymphedema. Clinical presentations of Lymphedema If lymphedema does develop, it’s important to recognize it early so you can start treatment right away. Common signs and symptoms you should watch for include: - Swelling - Part of your body (like your arm, leg, belly, or genitals) feeling full or heavy - Skin changing texture, feeling tight or hard or looking red - New aching, tingling, numbness, or other discomforts in the area - Less movement or flexibility in nearby joints (like your hand, wrist, or ankle) or your eyelid(s), throat, or lips - Trouble fitting into clothes in one area, such as a sleeve, pant leg, or shoe being tight - Collars, rings, watches, and/or bracelets feeling tight even though you haven’t gained weight At first, the skin usually stays soft, and raising the affected body part might relieve the swelling. But over time, the swollen area may become hot and red and the skin hard and stiff. If untreated, movement and use of the affected part may become limited. What will be the effects after Lymphedema? Lymphedema is a health condition with a number of distressing symptoms, in addition to several complications that may affect some patients. These include cellulitis, musculoskeletal pain, psychological stress and an increased risk of malignancy. Each of these complications can be managed or prevented with different techniques, as outlined in more detail below. Cellulitis Cellulitis is a bacterial infection of the dermis and subcutaneous tissues underneath the skin and is the most common complication associated with lymphedema. It can both cause and result from lymphedema and may cause repeated episodes of discomfort, referred to as erysipelas, in individuals with the health condition. Musculoskeletal Pain It is common for people with chronic lymphedema to suffer from secondary musculoskeletal problems as a result of the condition, such as back and joint pain. This discomfort can lead to a reduction in the patient’s quality of life. Often excess weight is involved as a causative factor for musculoskeletal complications. Psychological Distress Lymphedema is a chronic condition that has a significant effect on the physical appearance of the individual. This can make an impact on the self-confidence of the individual and may affect the relationships they have with others and lead to periods of depression. It is important for patients with lymphedema to be aware of this risk and have a strong support network to reach out to when feeling down. Malignancy Risk Rare cases have been reported of cutaneous malignancy associated with lymphedema. This is thought to arise as a result of altered immune surveillance in the area affected by lymphedema. Lymphangiosarcoma is the most common form of cancer linked to the disease but other cases have also been reported, including basal cell carcinoma, squamous cell carcinoma, lymphoma, malignancy melanoma, and Kaposi’s sarcoma. How do you Diagnose Lymphedema? When lymphedema is in the advanced stage, the diagnosis is accurate due to the clear clinical symptoms involved. In the early phases of the disease, due to intermittent edema or swelling, it is difficult to establish the diagnosis of lymphedema. The basic diagnostic process involves a medical examination, imaging of the lymph vessels and nodes, imaging of the soft tissues, measuring the changes in electric conductance, measurement of the volume of edema, genetic tests, and imaging of the blood vessels. Medical Examination A family health care provider examines the patient with suspected lymphedema. The history of the patient includes the location of the swelling, the cause of the swelling, the age of the patient, pain, medications that may cause the swelling, family history, among others. Imaging Indirect lymphangiography – This technique uses iodinated contrast materials that are water-soluble. They are introduced between the layers of the skin (intradermally) and can enter the lymphatic system. This technique is useful to visualize simple as well as complex cases of lymphedema. Xeroradiography and mammography films help in visualizing the lymphatic system. Isotopic lymphoscintigraphy – This technique is the most reliable method to assess the integrity of the lymphatic system. It can also detect the peripheral lymphatic system, large lymph vessels, lymph nodes, and the main lymph vessels. However, it is unable to detect the internal transport vessels. Isotopic lymphoscintigraphy uses a radiolabelled tracer (e.g., 99mTc-rhenium sulfate) that is injected into the skin (intradermal or subdermal) between the digits (fingers or toes). A gamma camera helps to visualize the route of the tracer and the radiation can be quantified. Stress tests are suggested to obtain reliable results. This technique is used to detect primary lymphedema while it is not needed for secondary lymphedema when there is a clear diagnosis. Contrast lymphography – This technique is being slowly replaced by lymphoscintigraphy. Contrast lymphography, as the name suggests, makes use of an iodine-based contrast dye that is oil-based. The technique is used to visualize the structure of the lymphatic system before an individual goes in for reconstructive lymphatic surgery. Other Tests – There are additional tests that are in use although they are not confirmed diagnostic techniques. For example: Near Infra-Red Fluorescence Imaging (NIR) – Indocyanine green is introduced into the skin and the green dye is detected with an infrared fluorescence camera. It gives a real-time assessment of the lymphatic system including the small lymph vessels. Any potential swelling can also be detected, and hence, the condition can be identified at an extremely early stage. Imaging of the Soft Tissues Magnetic Resonance Imaging (MRI) – Limb edema can be diagnosed using MRI. Identification of the different types of lymphatic system obstruction in secondary lymphedema is made easier with MRI. Similarly, affected lymphatic trunks and lymph nodes can also be identified. Computed tomography – This is another technique that is used to visualize the structure of the lymphatic system and to identify the location of the edema along with the typical thickening of the skin and a honeycomb pattern of the tissue. One of the uses of computed tomography (CT) is to monitor the effect of therapy on an area affected by lymphedema. Ultrasound – In order to avoid an invasive assessment of the lymphatic system, ultrasound can be used to detect any thickening of the lymphatic tissue. The frequency used for detection is 20 MHz. Ultrasound can be used to assess the condition of the lymphatic system before treatment and it can also be used to monitor the benefits of therapy on the lymphatic system. Test Electrical Conductance: Electrical conductance is used to measure the water content in the body. However, it cannot distinguish other edemas from lymphedema. Measurement of Volume: This technique has been in use for many years where the volume within a swollen arm or leg is measured. This technique can confirm the presence of lymphedema. Genetic Tests: These tests are useful for patients who have primary lymphedema. The tests can reveal the type of chromosome affected. For example, the FLT4 gene in Milroy’s disease. Treatment and Medications Lymphedema is incurable. However, treatment can help reduce swelling and pain. Complex decongestive therapy (CDT): This starts with an intensive therapy phase, during which the patient receives daily treatment and training. This is followed by the maintenance phase when the patient is encouraged to take over their own care using techniques that they have been taught. The four components of CDT are: - Remedial exercises: These are light exercises aimed at encouraging the movement of the lymph fluid out of the limb. - Skincare: Good skin care reduces the risks of skin infections, such as cellulitis. - Manual lymphatic drainage (MLD): The lymphedema therapist uses special massage techniques to move fluid into working lymph nodes, where they are drained. The lymphedema therapist also teaches several massage techniques that can be used during the maintenance phase. - Multilayer lymphedema bandaging (MLLB): Muscles surrounding lymph vessels and nodes move the fluid through the lymphatic system. Unlike the circulation of blood, there is no central pump (heart). The aim is to use bandages and compression garments to support the muscles and encourage them to move fluid out of the affected body part. Patients will also be taught how to apply their own bandages and compression garments correctly so that MLLB can continue during the maintenance period. A range of compression stockings is available for purchase online. Surgery has historically had disappointing results compared with non-surgical therapies for lymphedema. However, a new surgical technique using liposuction has proved more successful. It removes fat from the affected limb, resulting in less swelling. How to Prevent Lymphedema? If you have had or you are going to have cancer surgery, ask your doctor whether your procedure will involve your lymph nodes or lymph vessels. Ask if your radiation treatment will be aimed at lymph nodes, so you’ll be aware of the possible risks. To reduce your risk of lymphedema, try to: - Protect your arm or leg. Avoid injury to your affected limb. Cuts, scrapes, and burns can invite infection. Protect yourself from sharp objects. For example, shave with an electric razor, wear gloves when you garden or cook, and use a thimble when you sew. If possible, avoid medical procedures, such as blood draws and vaccinations, in your affected limb. - Rest your arm or leg while recovering. After cancer treatment, exercise and stretching are encouraged. But avoid strenuous activity until you’ve recovered from surgery or radiation. - Avoid heat on your arm or leg. Don’t apply ice or heat, such as with a heating pad, to your affected limb. Also, protect your affected limb from extreme cold. - Elevate your arm or leg. Whenever possible, elevate your affected limb above the level of your heart. - Avoid tight clothing. Avoid anything that could constrict your arm or leg, such as tightfitting clothing and, in the case of your arm, blood pressure cuffs. Ask that your blood pressure is taken in your other arm. - Keep your arm or leg clean. Make skin and nail care high priorities. Inspect the skin on your arm or leg daily, watching for changes or breaks in your skin that could lead to infection. Don’t go barefoot.

http://diseasesdic.com/lymphedema/

OregonASK is a collaboration of public and private organizations and community members which seek to address common-issues and concerns across all expanded learning areas- child care, content specialists, recreation, education, and youth development. OUR MISSION: To support, expand, and educate on quality expanded learning opportunities for children, youth, and families throughout Oregon. OUR VISION: All Oregon children, youth and families will have access to quality expanded learning opportunities within their communities. All services will enhance children’s positive development, and future opportunities while keeping them safe from harm. All programs, services and activities will be of high quality and contribute to strong communities and schools. OregonASK is part of the 50 State Afterschool Network, supporting efforts in every state committed to building the systems development and sustainability of quality afterschool programs and the growth of statewide policies to secure the resources needed to sustain programs. This work has been funded by the CS Mott Foundation since 2001. OregonASK is also the state affiliate to the National AfterSchool Association (NAA), the voice of the out-of-school time profession for those who work with and on behalf of children and youth during out-of-school time. In coordination with NAA, we are building the capacity, knowledge, and competency of the out-of-school time community. OregonASK also serves as the convenor for the Oregon Girls Collaborative Project to support girl-serving STEM organizations by working to strengthen capacity, increase continuation of girl-serving STEM programs, and create more champions for gender equity in STEM education and careers. As part of the National Girls Collaborative Project, we have access to thousands of programs and resources focused on providing high quality STEM experiences for girls and underserved youth. OregonASK supports creating more high-quality expanded learning opportunities through connecting partners, supporting policy change, and providing professional development. We provide training and resources to education and community organizations to equip them with structured, educational, and enrichment opportunities for students. These organizations provide services to students before school, after school, on weekends, during school breaks, and during summer vacation – any time the students are out of the regular school day. Professional Development: To assist in improving the overall quality of afterschool and summer programs in Oregon, we provide direct training opportunities to hundreds of people annually, as well as advancing the professional development infrastructure for all out-of-school time providers throughout the state. Our largest professional development event of the year is the Oregon Afterschool Conference or you can find out more about specific training opportunities on our website or training brochure. Partnership: In addition to providing direct training opportunities, OregonASK connects partners with other professionals from around the state. We help programs find new local, state, or national partners, aligning our work to all those who have overlapping goals; this creates an efficient and impactful environment. Such partners include government agencies, businesses, and other nonprofit organizations. Policy: Providers, organizations, and agencies interested in the field of afterschool look to OregonASK to answer questions and keep informed about local, state, and national issues and legislation that could have an impact on afterschool, children and youth, and families in our communities. Our work is centered on educating policy makers and organizations through research, tools, strategies, and partnerships with many organizations throughout the state. We educate the community about the importance of afterschool and summer programs by working directly with providers, public administrators, and elected officials to create policies supporting the work of afterschool programs, professionals, and youth in Oregon. HOW WE DO IT OregonASK believes quality afterschool & summer programs are a critical component in providing every youth with equitable, enriching experiences. As the statewide afterschool network, OregonASK is working with partners & stakeholders throughout the state to design and implement our Quest for Quality in Expanded Learning. This quality work is centered around five components we feel encompass quality expanded learning, regardless of your role in the out-of-school world. Our five components are: - Inspiring Student Dreams - Building Systems and Structures - Supporting Professional Development - Engaging Parents and Families - Increasing School and Community Partnerships Using Oregon Quality Standards for Afterschool & Summer Programs at our core, OregonASK provides support both directly to programs & through systems level partners. We work directly with programs, partners and stakeholders using Coaching & Consultation, Connection, Evaluation, Resources, and Training to equip programs to reach their Commitment to Quality. Consultation & Coaching – OregonASK brings expertise to programs and individuals who want to focus on organizational and programmatic issues, as well as individual skills or needs. Connection – We use our knowledge of afterschool programs and partners across the state to connect people who can learn from one another and build sustainable relationships with partner organizations. Evaluation – The data and evaluation team uses a variety of tools to measure program quality and staff competency. Conclusions are used to encourage self- reflection, inform training plans, and support continuous quality improvement. Resources & Curriculum – As an active member in the afterschool field nationally, OregonASK is the state affiliate of the National Afterschool Association and the Mott Foundation’s 50 State Afterschool Network, allowing us to bring the best resources back to Oregon. Our curriculum development specialists collaborate with programs to create custom, inquiry-based learning content perfect for local communities. Training – OregonASK’s two certified Master Trainers share expertise in afterschool curriculum implementation, behavior management, youth development, program management, and family engagement. All trainings are approved for credit by the Oregon Center for Career Development’s Registry system. WHY WE DO IT OregonASK works to support & increase quality expanded learning opportunities that inspire learning, keep kids safe, help working families, and support whole-child development and wellness. We know that: - 45% of Oregon’s children live in low-income families, as defined by household income at or below 200% of poverty level. - 15% (or 229,050 families) of Oregon’s families are considered food insecure. - Underrepresented students have disproportionate representation among Oregon’s high school dropout rate. HOW WE DO IT As the statewide afterschool network, OregonASK provides support through Coaching & Consultation, Training, Evaluation, Resources, and Connection. We partner directly with over 60 organizations and engages hundreds of members across the state, from five primary sectors of afterschool & summer providers: - YOUTH DEVELOPMENT | 4-H, Boys & Girls Clubs, Scouts, Camp Fire and other youth leadership programs - RECREATION | Park & Recreation, Community Groups, and other non-profit organizations. - EDUCATION | Educational Organizations, Afterschool Programs, Schools, and School Districts. - CONTENT SPECIALISTS | Programs/Individuals specializing in specific fields of study (eg. art, science, math, technology) - CHILD CARE | Licensed programs throughout the state providing learning opportunities to their children up to age 13. OUR OPPORTUNITY: OregonASK recognizes that… - Over 91,000 children participate in afterschool programs in Oregon. However, 221,708 more children (44% of Oregon’s school-age children) would participate if an afterschool program were available in their community. - Students who participate in afterschool programs attend school more regularly, engage in fewer high-risk behaviors, and perform better academically. - 83% of Oregon parents support public funding for afterschool programs, while just 37% report receiving government assistance with the cost of afterschool. - More than half of the achievement gap between lower- and higher-income youth can be explained by unequal access to summer learning opportunities. As a result, low-income youth are less likely to graduate from high school or enter college. IMPACT: OregonASK is delighted that… - 93% of parents in Oregon with children attending afterschool are satisfied with their child’s afterschool program. - Hundreds of afterschool and summer staff from dozens of programs have received professional development training on high-quality, evidence-based curriculums from OregonASK. - Oregon has risen to be a Top Ten State in Afterschool, as determined by the Afterschool Alliance. - More than half of Oregon parents agree that afterschool programs excite children about learning. JOIN US Join us in supporting afterschool and summer programs in Oregon to provide equitable access to children and provide them a safe environment to expand their learning opportunities and achieve at a higher level. OUR HISTORY Founded in 2005, with a grant from the C.S. Mott Foundation and match contributions from Oregon Employment Division – Child Care Division, OregonASK was created as a collaboration of public and private organizations and community members which sought to address common issues and concerns across all out-of-school time services – child care, recreation, education and youth development and content delivery programs. In the ten years since, OregonASK has grown to over 35 organizations, and has developed partnerships across the state; created the first database of afterschool programs in Oregon; developed Quality Standards, Competencies and Outcomes; provided support to Oregon’s 21st CCLC programs; compiled reports to gain a better understanding of the issues surrounding afterschool in Oregon; plus a myriad of other projects and initiatives to advance the quality, accessibility and sustainability of afterschool and summer programs in the state. As the statewide network, OregonASK works to coordinate and lead efforts throughout the state, including: - Promotion of quality out-of-school time activities - Education of legislators regarding affordability, accessibility, safety, and quality - Advocacy for resources - Outreach to the private sector - Encouragement of true collaborative partnerships To find out more about the work OregonASK is doing and our national affiliations, click here.

https://oregonask.org/oregon-statewide-network/

Give an Hour has become a recognized expert in developing and implementing community based efforts to address the needs of our service members, veterans, and their families. Give an Hour’s Community Collaborative approach is focused on bringing together individuals, agencies, and organizations committed to providing assistance and opportunities to service members, veterans, and their families at the community level. We invite nonprofits, government agencies, corporations, faith based efforts, and the military and veteran communities — to work together toward the common goal of engaging and supporting those who serve. D.C. Community Collaborative The DC Community Collaborative strives to better the lives of service members, veterans, and their families in the District of Columbia through an exchange of ideas and information with a focus on identifying and working to fill gaps in service availability and provision. - Housing and financial services - Identifying availability of dental insurance coverage and services - Raising awareness of mental health (and other available) services to veterans - Educating health professionals and family caregivers working with this community D.C. Partners Universal public support for veterans, service members, and their families exists. Nonprofit and private resources as well as federal, state, and local government services have increased in communities across the nation over the last decade to meet the needs of those who serve. Supporting and assisting veterans, service members (including active duty, Reservists, and National Guard), and their families is about ensuring that communities are prepared to organize services, resources, and provide assistance. Hopefully, this will provide opportunities to help our service members and veterans lead healthy and successful lives. However, significant gaps in service remain and there is a great deal of untapped potential that could be harnessed. It would provide more effective and sustainable care through focused planning and coordination, capacity-building, identifying gaps, and linking those in need with resources and services available. In speaking with community leaders, the D.C. Community Collaborative team has already identified key thought leaders and critical stakeholders and is looking to expand and invite additional leaders and community members to join this effort. Give an Hour takes a “big tent” approach that allows all who share this mission to join as we facilitate collaboration and improve services. Veterans Integrative Arts and Healing Alliance Houston and Tacoma Community Collaboratives Give an Hour has launched a community collaborative initiative in the Tacoma and Houston Metro Areas in recognition of the challenge that all communities experience in their effort to support local veterans and active duty forces. The goal for this project is to create a comprehensive and integrated system of care for service members, veterans, and their families in these communities so that they have the knowledge of and access to the resources and services they need to lead the productive lives they deserve. Objectives in Houston and Tacoma Give an Hour is actively working in the South Sound area and Houston Metro area to accomplish the following objectives: Within the community: - Greater knowledge about available community resources and services among local agencies and organizations serving veterans - Increased collaboration and coordination among local agencies and providers serving the military community - Increased knowledge among healthcare professionals within each community regarding the behavioral health issues that affect this population - Establishing a shared system for tracking efforts and measure progress - Establishing a sustainable coalition within each community to facilitate and support ongoing collaboration Among veterans, service members, and military families:

https://giveanhour.org/initiatives-and-programs/community-collaboratives/

A stakeholder is anyone who is involved in the welfare and success of a school and its students, including administrators, teachers, staff, students, parents, community members, school board members, city councilors and state representatives. Stakeholders may also be collective entities, such as organizations, initiatives, committees, media outlets, and cultural institutions. They have a stake in the school and its students, which means they have personal, professional, civic, financial interest or concern in the school. Stakeholder engagement is considered vital to the success and improvement of a school. The involvement of the broader community of the school with it can improve communication and public understanding and allows for the incorporation of the perspectives, experiences and expertise of participating community members to improve reform proposals, strategies, or processes. Parenting: Help families by providing them with parenting skills and family support, make them understand the phases of child development, its complexities and ways to cope with it. Help schools understand backgrounds and cultures of families and their goals for children. Communicating: Create reliable communication channels between school and home to communicate with families about school programs and student progress. Volunteering: Enable educators to work with volunteers who support students and the school. Involve families as volunteers and as audiences at the school. Learning at Home: Encourage the involvement of families in their children’s academic learning at home through curriculum-related activities such as including homework and goal setting. Decision Making: Make families participants in school decisions, governance and advocacy activities. Collaborating with the Community: Co-ordinate resources and services for families, students and the school with community groups such as businesses, cultural and civic organizations, colleges or universities. Determine the needs, interests and ideas of parents and educators about involvement and partnering through surveys or polls. Develop family-friendly policies and laws to encourage participation by diverse families. Provide professional development for school teachers on family and community engagement for school. Provide training to community stakeholders and parents to help them develop effective communications and partnering skills. Provide better information on school and school district policies and procedures. Use effective communications tools to ensure timely access to information which is in a format that can be easily comprehended. Hire and train school-community intermediaries who are aware of the history, language, and cultural background of communities to contact parents and coordinate activities. Collaborate with higher education institutions for teacher and administrator preparation programs to bring out the parent, family, and community involvement in education. Develop an outreach strategy to inform families, businesses and community about the school involvement opportunities, policies and programs. Regularly evaluate the effectiveness of family involvement programs and activities. The involvement of the broader community of a school with it leads to higher academic performance and school improvement. When schools, parents, families and communities work together to support learning, students feel more encouraged, attend school more regularly and take part in higher-level programs. This involvement is a key to addressing school drop-out crisis and strong partnerships foster higher educational aspirations and more motivated students. Share your views and knowledge on the context. The Comment Box is waiting.

http://edtechreview.in/trends-insights/insights/894-how-to-involve-various-educational-stakeholders-in-education-improvement

Summary of Southeast Philadelphia Collaborative (SEPC): The Southeast Philadelphia Collaborative informs, educates and organizes a broad, diverse network of community partners, policymakers and stakeholders to leverage greater access to resources and opportunities that address the needs of youth in Southeast Philadelphia. As an initiative of United Communities, the collaborative encompasses the majority of the agency’s community outreach efforts. SEPC staff work to build partnerships and collaboration among agencies in the neighborhood through a combination of school-based coordination and neighborhood-based substance abuse prevention, the South Philadelphia Prevention Coalition. The School Partnerships Coordinator will be responsible for coordination work at two local high schools. Duties: • Increase the capacity of schools to meet the social and emotional needs of students by filling gaps with existing partners or recruiting new partners • Identify teachers and share school day needs and resources with partner organizations • Increase parent and family engagement at schools • Ensure partnerships are supporting teachers during and after the school day • Support the maintenance of SEPC’s social media presence, including Facebook and monthly email blasts Qualifications – Essential: • Four (4) year college degree in education, social work, or social services • Ability to network and build relationships with diverse groups of people • Current PA State Criminal Clearance, DPW Child Abuse History Clearance, FBI Fingerprint, Health Appraisal w/ Mantoux TB Test Knowledge, Skills & Experience – Essential: • Experience leading or facilitating meetings, discussions, and/or collaborative projects • Experience using Microsoft Office (Word, Excel, Access, Outlook), particularly using Excel to collate data sets and create user-friendly graphs • Excellent oral and written communication skills Knowledge, Skills & Experience – Desirable: • Experience with collaboration and relationship-building • Basic understanding of data use and statistics • Experience working with Philadelphia public schools and non-profit organizations Interested applicants should send cover letter and resume: jobs@ucsep.org United Communities is an Equal Opportunity Employer. United Communities, in its name and its mission statement, affirms its celebration of diversity. It welcomes the employment of a diverse staff and provides equal employment opportunities to all persons qualified by reason of education, training, experience and/or personal character, regardless of age, race, religion, gender, sexual orientation, non-job related disability or military/veteran status. All employees or applicants are treated equitably with regard to hiring, promoting, demoting, transfers, layoffs, terminations, recommendations, benefits, rates of pay or other forms of compensation. More in "Job Opportunities/AmeriCorps Opportunities" - Senior Project Manager (One Year Contract), Phila. Youth Network - Associate, Communications and Outreach, Phila. Youth Network - Program Associate, Phila. Youth Network Stay Current in Philly's Higher Education and Nonprofit Sector We compile a weekly email with local events, resources, national conferences, calls for proposals, grant, volunteer and job opportunities in the higher education and nonprofit sectors.

https://phennd.org/update/school-partnerships-coordinator-southeast-philadelphia-collaborative-2/

School psychologists are uniquely trained to provide a comprehensive range of services to help students overcome barriers to learning. The Every Student Succeeds Act (ESSA) presents significant opportunities to expand access to comprehensive school psychological services within multitiered systems of support (MTSS). MTSS is a foundational, evidence-based framework for effectively integrating multiple systems and services to simultaneously address students’ academic achievement, behavior, and social–emotional well-being. Exactly how states and local districts choose to structure MTSS under the provisions in ESSA will greatly impact the effectiveness of service delivery. It is imperative that school psychologists actively advocate for and participate in the implementation of MTSS in their schools to facilitate the selection of evidence-based curriculum and interventions, administer psychometrically sound universal screening and progress monitoring tools, support fidelity of intervention implementation, and facilitate appropriate data analysis and interpretation. Multitiered Systems of Support ESSA provides states and districts with great flexibility to blend various funding streams (e.g., Title I, Title II, and Title IV) to provide high-quality instruction, professional development, and comprehensive learning supports based on the unique needs of the school community. States and districts could also use these funds to implement multitiered systems of support (MTSS). MTSS describes a framework for providing comprehensive systems of differentiated supports. Data-driven decisions regarding instruction and intervention are provided in increasing intensity (i.e., tiers) based on student need. Tier 1, or universal supports, typically refers to services available to all students (e.g., wellness/skills promotion and school-wide programs). Tier 2 services (targeted) are available to some students identified as needing some additional services or supports (e.g., small group counseling, tutoring, targeted behavioral skills training). Tier 3 refers to more intensive services for individuals or small groups and is usually limited to only 5–10% of students (e.g., individualized instruction, intensive therapy, wraparound services). MTSS facilitates the integration of multiple school improvement efforts and represents an effective strategy to: - Improve outcomes for all students, including high-performing students, English language learners, students receiving special education services, and those struggling with barriers to learning. - Improve instruction and alignment of curricula across general and special education. - Improve school climate and safety. - Create safe and supportive learning environments free from bullying and harassment. - Support students’ mental and behavioral health. - Implement effective discipline policy and practice. Key Messages School psychologists are often an untapped resource. When utilized appropriately, we can help schools and districts use limited dollars more effectively while simultaneously improving school and student outcomes. As states, districts, and schools begin to consider various strategies to meet student needs, school psychologists can support the effective development, implementation, and evaluation of multitiered systems of support. - School psychologists are trained to design, implement, and evaluate a comprehensive range of interventions for students at risk for academic, social–emotional, or mental and behavioral health concerns. - School psychologists are uniquely trained to provide a comprehensive range of services that enable schools to implement comprehensive systems of student supports, improve school and district effectiveness, and support improved outcomes for all students. - School psychologists help children and youth succeed academically, socially, behaviorally, and emotionally. They collaborate with educators, parents, and other professionals to create safe, healthy, and supportive learning environments that strengthen connections between home, school, and the community for all students. - School psychologists have expertise in collecting and analyzing data that can be utilized in progress monitoring; helping to develop indicators of academic, social, emotional, and behavioral health of students; and utilizing data to assist administrators in developing school improvement plans. - School improvement efforts are most effective when parents, families, and the school work together. School psychologists collaborate with parents and families to promote treatment integrity and improve intervention success at home and school. - Students with the most significant needs may require wraparound supports available in the community. School psychologists facilitate collaboration and coordination between the home, school, and community providers to promote student success. Key Stakeholders Engaging as early as possible with the key stakeholders most relevant to designing accountability is critical. Although specifics in each school district and state will vary, these stakeholders are likely to include: - State chief school officers - State/local school boards - State governors and legislators - District superintendents Additional details and contact information for various stakeholder groups can be found at www.nasponline.org/essa/key-contacts.pdf Companion Versions This handout provides an overview of MTSS in ESSA's provisions relevant to school psychologists. Download a PDF version of this handout to share with your colleagues. View a companion handout for decision-makers. Related Resources ESSA/MTSS/NASP Practice Model Crosswalk Resources and Guidance From the U.S. Department of Education NASP Practice Model Implementation Guide School Psychologists: A More Valuable Resource Ready to Learn, Empowered to Teach Topic Specific Resources:

https://www.nasponline.org/research-and-policy/policy-priorities/relevant-law/the-every-student-succeeds-act/essa-implementation-resources/essa-and-mtss-for-school-psychologists

Curtin University – Addressing Higher Education Access Disadvantage (AHEAD) The Curtin Addressing Higher Education Access Disadvantage (AHEAD) program aims to provide pre-tertiary learning experiences and resources, in collaboration with school and community partners, that facilitate student learning in low socioeconomic status (SES) school and community groups to overcome the challenges to participation in higher education. AHEAD works with low SES K–12 schools and community groups in three distinct clusters: metro; regional; and remote. AHEAD also partners with organisations that share similar mandates to provide exemplary aspiration-focused learning experiences for people from low SES backgrounds, and to contribute to the development of best practice widening participation initiatives. AHEAD collaborates with over 80 external school and community groups, as well as local governments, including: Role Models and Leaders Australia; Follow the Dream (the Graham Farmer Foundation); the Department of Corrective Services; Boronia Pre-Release Centre for Women; Women in Leadership Driving Change (WILD’C); Ruah Community Services; The Smith Family; YourTutor; Acacia Prison; and Future Footprints. Objectives AHEAD focuses on creating and facilitating career development and university readiness learning experiences, designed to raise aspirations and strengthen capability for higher education. With the aim of increasing participation of underrepresented individuals and groups, AHEAD experiences are designed to increase confidence and capacity to make informed choices; expose people to new and enhanced opportunities; and change perceptions and attitudes about higher education. AHEAD is a collaborative and innovative outreach hub that develops the potential of promising underrepresented higher education students. The program harnesses university services and facilities to create unique learning experiences that foster tertiary interest. Activities and Progress AHEAD was formed in 2014 by bringing together the platforms and early lessons from several outreach initiatives that focused on secondary school tutoring and tertiary awareness workshops funded through the HEPPP. Originally a school-focused program, the suite of AHEAD learning opportunities has expanded to include design solutions to educational challenges impacting young people in their communities, those from culturally and linguistically diverse backgrounds, and people seeking education while incarcerated. AHEAD activities include: in-school, in-community and in-prison workshops; on-campus learning experiences; mentoring; support groups; participation at community events; aspiration through sport; Row AHEAD — introduction to university rowing with current university student mentors (Clontarf Aboriginal College); university aspiration camps; and AHEAD with Confidence (regional Year 12 one-week camps). AHEAD has achieved significant growth in demand for its services, which has enabled collaboration with more than 60 schools, increased from 11 in 2010. AHEAD participants have grown from 1,000 in 2010 to over 4,000 in 2016. Over the years, AHEAD has developed engagement strategies to foster progressive learning experiences that build the knowledge and confidence that empowers students and community participants to enter higher education. Outcomes AHEAD’s successful outcomes are represented by strong partnerships, which enable it to engage with and support over 4,000 low SES school and community members a year. Since 2014, AHEAD has supported 1,041 students into university, and 41 prison residents through the Curtin UniReady program, of which 10 have transitioned into university. As AHEAD develops, it is able to work closely with many different areas of the university to create comprehensive and innovative support mechanisms for potential higher education students from low SES backgrounds. Since 2012, 1,678 AHEAD students have applied for university. Sustainable Impacts AHEAD, funded primarily through the HEPPP, is strongly supported by Curtin University. Its achievements have been recognised and celebrated, having recently won the Vice-Chancellor’s Excellence Award for Professional Staff in 2016 for Engagement and Collaboration. AHEAD is situated within the Learning Futures directorate, as part of Curtin Learning and Teaching. Learning Futures develops innovative learning strategies, promotes talent development for high potential students and builds strategic partnerships. The inclusion of AHEAD within Learning Futures is fostering the development of new opportunities for AHEAD participants, including blended learning opportunities, processes for validating and rewarding AHEAD student achievement, and documenting evidence of learning through innovation, creativity and entrepreneurship activities. This case study was one of 35 featured in the NCSEHE’s 2017 publication Higher Education Participation and Partnerships Program: Seven Years On.

https://www.ncsehe.edu.au/curtin-university-addressing-higher-education-access-disadvantage-ahead/

Similar presentations: The Connect Effect: Working across Groups in a Community of Practice 1. The Connect Effect: Working across Groups in a Community of PracticeNancy Reder, Deputy Director, National Association of State Directors of Special Education (NASDSE) www.ideapartnership.org www.sharedwork.org 1-877-IDEA INFo Joanne Cashman, Director The IDEA Partnership at NASDSE www.nasdse.org IDEA [email protected] NASDSE 2010 1 2. A Little About NASDSE• We’ve been around since 1938 • We represent the state directors of special education • “Committed to a performance-based educational system responsive to the needs of all children and youth, including those with disabilities.” IDEA [email protected] NASDSE 2010 2 3. Thinking Like a Partner• Everyone has something to share and everyone has something to learn about our most challenging community issues. • States and stakeholders are turning varied perspectives into strategies to change the way we approach complex problems together IDEA [email protected] NASDSE 2009 3 4. Our Time Together Today• Ask o Can we learn to work across boundaries of roles, agencies and levels to solve critical problems? o Can we afford not to? o To what extent are Communities of Practice and Community Schools approaches aligned? • Describe o The strategic advantage of partnerships with stakeholders o Kinds of partnerships o Communities of Practice (CoP) o Examples of CoP for strategic advantage IDEA [email protected] NASDSE 2010 4 5. Our Time Together Today• Apply o IDEA Partnership Framework to current issues • Examine o Some examples Communities of Practice o Some scenarios that might be addressed through a CoP IDEA [email protected] NASDSE 2010 5 6.“ In theory there is no difference between theory and practice; in practice there is.” Yogi Berra IDEA [email protected] NASDSE 2010 6 7. The IDEA Partnership• The U.S. Department of Education’s investment in stakeholder expertise • An affiliation of 55 national organizations • Collaborating across roles and settings • Translating research and policy to practice • Solving persistent and complex problems IDEA [email protected] 2010 7 8. 9. The Vocabulary of Collaboration: What Elements Matter?Common Terms Critical Elements • Partnership • Coalition • Community of Practice Duration Role Depth Strategic Value ‘Push’ or ‘Pull ‘ IDEA [email protected] NASDSE 2010 9 10. Knowledge Management (KM): The New Focus on Information and Experience“Knowledge is an asset to be managed like other assets” Etienne Wenger IDEA [email protected] NASDSE 2010 10 11.Illusory constraints Substantial constraints Flexible constraints Absolute and rigid constraints Source: CA Dept of ED IDEA [email protected] NASDSE 2010 11 12. Where Is the Value Added in Engaging the Stakeholders?Emerging First Thoughts • Build relationships that undergird real change • Develop connections to extensive and deep networks • Create customized messages • Share aligned messages • Sense issues before critical points • Specify the dimensions of an issue with those impacted • Identify shared interests • Move beyond organizational positions to shared interests • Unite the state and the stakeholders around common goals • Introduce two–way learning • Extend the capacity to the state staff efforts by drawing on the reach of existing networks IDEA [email protected] NASDSE 2010 12 13.Two-Way Learning: Partnering to Learn What Works Decisionmakers Implementers and Consumers IDEA [email protected] NASDSE 2010 13 14. Communities of Practice: The Evolution of Knowledge Management• Untapped knowledge resides with those who are closest to the work • To reveal opportunities and gaps, leaders need to engage those who have a role in resolving persistent problems • Real change requires that leaders, implementers and consumers build a shared sense of purpose around the change IDEA [email protected] NASDSE 2010 14 15. What Do You Think?Can this style of leadership be learned? Can authority learn to share leadership? 16. Can This Leadership Style Be Learned? Belief (in ‘Smart Power’) Leading by convening Using ‘authority position’ to legitimize and propel Convey that decisionmakers cannot abdicate responsibility and oversight while demonstrating a willing to use other, more collaborative, strategies • Intentionality • Practice, practice, practice! • Communicate, communicate, communicate! IDEA [email protected] NASDSE 2010 16 17. What are Communities of Practice?A way of working • Involving those who do shared work • Involving those that share issues • Always asking “who isn’t here?” A way of learning • To create new knowledge grounded in ‘doing the work’ • With those who can advocate for and make change IDEA [email protected] NASDSE 2010 17 18. What Do Communities Do?• Seek and invite others doing shared work • Share learnings within organizations, agencies and roles • Share learnings across organizations, agencies and roles • Decide to go things together that will address a shared concern • Create new knowledge grounded in ‘doing’ the work IDEA [email protected] NASDSE 2010 18 19. Why Are Communities of Value?• Provide the support that individuals need • Respect the ‘expertise’ that individuals bring • Recognize the differences in the settings where people do their work • Seek commonality within differing viewpoints • Unite individuals in action • Focus on ‘learning’ • Use ‘learning’ to transform practice IDEA [email protected] NASDSE 2010 19 20. How Do Communities Make a Difference?• Use the natural bonds between people that do common work • Maintain communication that strengthen natural bonds • Keep community members focused on outcomes • Use the ‘community status’ to bring attention to issues • Use the ‘community status’ to engage the people that can help move the issues • Move change to the ‘Tipping Point’ IDEA [email protected] NASDSE 2009 20 21. We Need to be Able to Operate at the Intersection of Research, Policy and Practice States as leverage points Stakeholders as partners Federal agencies as collaborators Federal investments as resources Learning within states with the stakeholders Learning across states with peers Bringing it down to the local level NASDSE, 2002 IDEA [email protected] NASDSE 2010 21 22. Communities as a State TA Strategy: The SEA Role in Supporting Practice ChangeShaping and spreading effective practice • Sharing promising strategies • Learning how and why they work • Helping locals learn from each other • Creating new knowledge across organizational boundaries • Using durable networks to support and spread practice change Reframing policy, research and practice • Learning how to move from ‘knowing’ to ‘doing’ • Translating learning to policy • Encouraging investments that will move the work • Recognizing the value of all contributions to a more complete & effective approach • Creating new relationships among policymakers, researchers & implementers NASDSE, 2002 IDEA [email protected] NASDSE 2010 22 23. Understanding Shared Work• Who is interested in this issue and why? • What efforts are underway separately to address the work? • What will make the shared work need fulfilling for others? • How can we build new connections? What venues and communication vehicles will deepen connections? • What goals can unite us? • Reach out and invite! IDEA [email protected] NASDSE 2010 23 24. How Can Separate Work Become Shared Work? Cross-walk initiatives Map current efforts Examine your networks Commit to building a ‘Community’ Demonstrate the strategic advantage to the community to maintain their engagement • Demonstrate the strategic advantage of the community to help build the culture for collaboration in the SEA IDEA [email protected] NASDSE 2009 24 25. How Can We Build the Connections That Create Community ? Be intentional about collaboration Invest in collaborative strategies Plan together Create levels of community that reach the multiple levels Share training Do your ‘real work’ through the community. The community is not an ‘add on’ • Invent new ways to connect • List serves • Forums • Routine Learning Calls • Create issue focused Practice Groups • Involve Practice Groups in advising and decision making • Undertake shared work IDEA [email protected] NASDSE 2009 25 26. What Does a CoP Look Like…• In states/at the local level/in schools? • Around issues • www.sharedwork.org 27. New Eyes on Challenges Through Communities of PracticeFor you, is there value in building a community for strategic advantage? IDEA [email protected] NASDSE 2009 27 28. Common Scenarios that ‘Beg’ for Community Approaches:What Would You Do? 29. Scenario 1• The SEA has invested in a large scale behavioral support program that is very effective for most students. Increasingly, more students are requiring interventions that are beyond the current scope of school resources. The SEA wants to refine current relationships and build new strategies with human service agencies. 30. Scenario 2• The school district has invested heavily in programs and consultants to increase the quality of its core academic program and the professional development of its teachers. The results have been disappointing. An analysis shows that academic achievement is not improving. Teacher satisfaction is low. In a related finding, the district identifies high student absentee rates, high numbers of out-of-school suspensions and a moderately high rate of transience.

https://en.ppt-online.org/427873

The University was the first authorizer in the state and the first university authorizer in the nation. The CMU Board of Trustees voluntarily issues charter contracts to establish charter schools. The Governor John Engler Center for Charter Schools works closely with CMU‐authorized schools across the state to fulfill the ambitious goal of preparing students academically for success in college, work and life. The CMU Board of Trustees established chartering policies and developed the following questions that guide the work of the Center: - Is the Academy’s academic program successful? - Is the Academy organizationally and financially viable? - Is there a demonstration of good faith in following the terms of the charter contract and applicable law? These questions are the foundation for CMU’s authorizing model. The Center takes pride in building partnerships with schools that drive innovative educational programs, while connecting schools to leading-edge resources such as computer adaptive testing, the Performance Suite of Reports and automated compliance and accountability systems. Coupled together, these tools help target student needs, reduce unnecessary bureaucracy and influence future decisions. The Center works to ensure that the operational schools are serving the best interests of students and providing access to the quality education they deserve. CMU has dedicated its resources to providing expertise in all essential areas including: academic, finance, state and federal accountability, facility regulations and requirements, staff certification, special education, board governance, educational program and curriculum development, public policy, data analysis, compliance requirements and state regulations. Providing Resources and Sharing Expertise The Center understands that schools are successful when they can focus on what is most important, the education of students. The Center has the experience, knowledge and expertise to assist schools from day one. Beyond the application process, content area experts provide assistance in navigating through the Michigan school landscape. The Center’s content area experts are respected and called upon throughout the state by departments, agencies and other authorizers. In addition to content area experts, the Center has built relationships with the Michigan Department of Education, various state agencies, state and national charter school advocacy organizations, and community and philanthropic organizations. These relationships and partnerships provide additional resources, assist schools to resolve issues and open the doors to opportunities. With a commitment to impacting all education, the Center works to help inform legislators, the Governor’s office, community organizations and stakeholders to ensure that the educational landscape in Michigan continues to develop and support school choice and charter school success. The Center has the experience, knowledge and expertise to assist schools from day one. CMU’s commitment to the charter school movement and CMU‐authorized schools is also demonstrated through initiatives and programs developed to increase access to opportunities and continued learning experiences for both students and educators. The Center has worked with the University to create opportunities for students, teachers and administrators. The Center continues to share best practices and has been relied upon by organizations and authorizers across the nation. With a focus on driving innovation, supporting choice and demonstrating excellence, the Center lives its mission of transforming public education.

http://www.thecenterforcharters.org/about/center-for-charter-schools/our-impact-approach/

To work in collaboration with all staff to: • promote the general progress and well-being of individual students through ensuring the maintenance of good order and discipline among all students and safeguard their Health and Safety, both on school premises and when they are engaged in authorised activities elsewhere; • plan engaging lessons and home learning according to the educational needs, abilities and achievement of individual students which develop a culture of enquiry and dialogue within a knowledge based curriculum; • assess, record and report on the progress, attainment, attendance and behaviour of students; • ensure teaching builds on the success of the primary phase, working with primary teachers both inside and outside the classroom; • promote high standards of learning, teaching and student achievement and progression through active engagement in and contribution to the schools’ CPD program; • work with the Senior Leadership Team and SENDCo, ensuring that the needs of all children are met; • fully engage with the school’s pastoral system within lessons and as a form tutor; • ensure regular and effective communication with parents, governors and other key stakeholders in supporting and improving students’ achievement and personal development; • create and promote positive strategies for challenging all forms of prejudice and harassment and promoting British values. Assist in; • delivering an exciting, cohesive and integrated curriculum that bridges the gap between KS2 and KS3, eliminates transition regression and ensures continued relevance to the needs of the students and the school’s values; • developing the KS4/5 curriculum, instilling a love of Science and ensuring sustained and accelerated progress in order to best prepare students for the demands of the examining and awarding bodies; • developing the school’s partnerships with parents, the local community, businesses, other organisations and schools, to enhance and enrich the school and its values to the wider community; • building a school culture and curriculum that takes account of the richness and diversity of the school’s communities; • promoting the concept of lifelong learning and family engagement with learning through partnership. We are looking to appoint an outstanding teacher and creative leader to join our evolving team and be fundamental in shaping our all-through school. You will lead the strategic direction and development of an inspiring, cohesive, curriculum which will excite and prepare pupils for the next phase in their learning journey. - School visits for prospective applicants are warmly welcomed and encouraged - please contact Androulla Oritis, HR Manager on 0208 764 1825 or email recruitment@woodmansterne.london Essential educational requirements Educated to degree level, QTS Essential qualifications Qualified Teacher Status Essential skills and experience • Proven successful teaching and achievement of outstanding student progress. • Ability to teach across all key stages, building on the success of the primary phase by working with primary teachers both inside and outside the classroom. • Ability and flexibility to teach and support in other areas of the curriculum. • Ability to contribute to professional leadership and management of a staff team to secure high quality teaching, effective use of resources and improved standards of learning and achievement for all students across the school. • Ability to analyse data to monitor progress towards challenging targets. • Knowledge of current educational issues beyond current school. - a creative and innovative approach to school improvement; - the ability lead on the educational progress, achievement and enrichment experience (including trips, rewards and clubs) of all pupils across the school. Employee benefits As a Woodmansterne staff member, you can expect regular and relevant professional development, opportunities to work across phases, be creative and risk taking in your teaching, work closely with colleagues in planning and training. You will be an integral part of this wonderful school and supported by an experienced and supportive leadership team. Why should you come and work with us? - we have fantastic children and families (many schools say that, but we really do); - we have amazing new buildings with two fantastic libraries, dedicated ICT suites, specialist food rooms, science labs, music provision and well-resourced, ICT rich learning spaces and a huge playing field; - our exciting, enriched, curriculum is pupil-centred aimed at capturing every child’s full learning potential; - we are committed to staff well-being alongside professional and career development; - we are a cohesive, friendly, highly skilled and passionate staff body, committed to Woodmansterne’s values and ethos; - the uniqueness of our all-though provision means exciting opportunities for cross-phase collaboration, leadership and management; - our strong partnerships with families, the local community, other Lambeth schools and Teaching Alliances. - you will be joining our team at an exciting stage of our journey as an all-through school; TLR available for the right candidate.

https://teaching-vacancies.service.gov.uk/jobs/teacher-of-physics-secondary

NEA and its leaders and members in public schools across the country, have joined with families, communities, school districts, and other key partners, to implement a powerful tool to achieve “the promise of public education to prepare every student to succeed in a diverse and interdependent world.” Community schools provide not only tremendous opportunities for learning and success for students, but also offer hope, opportunity, and transformation to entire communities. History The Community Schools Model is based on the work in Chicago immigrant communities in the late 1800s. In a picture reminiscent of the current reality—there was a lack of resources to support recent immigrant families, and many of their children were living in poverty. Jane Addams, known as the “mother of social work” and the first American woman to receive the Nobel Peace Prize, cofounded a settlement house that provided support for families that was based on her theory that social ills are interconnected and must be approached holistically. John Dewey adapted Addams’ ideas and placed them within the school structure. In his 1902 article titled, “The School as Social Center,” Dewey argued that “ . . .it was the community’s role to organize to attain the services they needed.” Throughout the Depression and through World War II, communities started supporting wraparound services in schools, and in many places the community began to see the school as a place to interact with art and music. Often the impetus for these programs was poverty. Policymakers (President Johnson’s Great Society initiative—Elementary and Secondary Education Act) began to realize that students who came to school without their basic needs met might not be as successful as their peers who were healthy and fed. The Six Pillars of Community Schools The Community Schools Model advanced by NEA includes six pillars of practice. Unlike most public education models, these pillars are adaptable to the needs of an individual school’s students, staff, families, and community and pay particular attention to creating, supporting, and sustaining a culturally relevant and responsive climate. NEA was instrumental in ensuring the inclusion of two pillars—high-quality teaching and learning and inclusive leadership. Strong and proven culturally relevant curriculum Educators provide a rich and varied academic program allowing students to acquire both foundational and advanced knowledge and skills in many content areas. Students learn with challenging, culturally relevant materials that address their learning needs and expand their experience. They also learn how to analyze and understand the unique experiences and perspectives of others. The curriculum embraces all content areas including the arts, second languages, and physical education. Teachers and education support professionals (ESP) are engaged in developing effective programs for language instruction for English learners and immigrant students. These schools offer rigorous courses such as Advanced Placement or International Baccalaureate. They provide learning and enrichment activities before and after the regular school day, including sports, the arts, and homework assistance. Schools address the needs of parents and families through programs such as English-as-a-Second-Language classes, GED preparation, and job training programs. High-quality Teaching and Learning Teachers are fully licensed, knowledgeable about their content, and skillful in their practice. Instructional time focuses on learning rather than testing. Individual student needs are identified and learning opportunities are designed to address them. Higher-order thinking skills are at the core of instruction so that all students acquire problem solving, critical thinking, and reasoning skills. Educators work collaboratively to plan lessons, analyze student work, and adjust curriculum as required. Experienced educators work closely with novices as mentors, coaches, and “guides on the side,” sharing their knowledge and expertise. ESP members take part in professional learning experiences and are consulted and collaborate when developing plans to improve instruction. Together, educators identify the methods and approaches that work and change those that do not meet student needs. Inclusive Leadership Leadership teams with educators, the community school coordinator, and other school staff share the responsibility of school operations with the principal. This leadership team ensures that the community school strategy remains central in the decision-making process. Positive Behavior Practices (including restorative justice) Community school educators emphasize positive relationships and interactions and model these through their own behavior. Negative behaviors and truancy are acknowledged and addressed in ways that hold students accountable while showing them they are still valued members of the school community. All members of the faculty and staff are responsible for ensuring a climate where all students can learn. Restorative behavior practices such as peer mediation, community service, and post-conflict resolution help students learn from their mistakes and foster positive, healthy school climates where respect and compassion are core principles. Zero-tolerance practices leading to suspension and expulsion are avoided. Family and Community Partnerships Families, parents, caregivers, and community members are partners in creating dynamic, flexible community schools. Their engagement is not related to a specific project or program, but is on-going and extends beyond volunteerism to roles in decision making, governance, and advocacy. Both ESP and teachers are part of developing family engagement strategies, and they are supported through professional learning opportunities. Their voices are critical to articulating and achieving the school’s overall mission and goals. When families and educators work together, students are more engaged learners who earn higher grades and enroll in more challenging classes; student attendance and grade and school completion rates improve. Coordinated and Integrated Wraparound Supports (community support services) Community school educators recognize that students often come to school with challenges that impact their ability to learn, explore, and develop in the classroom. Because learning does not happen in isolation, community schools provide meals, health care, mental health counseling, and other services before, during, and after school. Staff members support the identification of services that children need. These wraparound services are integrated into the fabric of the school that follows the Whole Child tenets. Connections to the community are critically important, so support services and referrals are available for families and other community members. Beyond a definition of community schools and the six pillar model, there are four mechanisms that are important to the implementation of the model. - Community School Coordinator: Every community school should have a community school coordinator (CSC) that plays a leadership role at the school, is a member of the school leadership team, and is a full-time staff member. The CSC has training and specialized skills that support building and managing partnerships in diverse communities, creating and coordinating an integrated network of services for students and their families, and optimizing both internal and external resources. The leadership team should consist of administrators, ESP, teachers, and other school staff, along with the CSC. All share the responsibility of school operations with the principal. This leadership team ensures that the community school strategy remains central in the decision-making process. The CSC’s primary role is to facilitate a deep needs and asset assessment in collaboration with students, teachers, ESP, families, and community stakeholders to determine the root causes of problems and to determine school and community assets that can fill needs. The CSC also facilitates teams of stakeholders dedicated to solving root cause problems. - Needs and Assets Assessment: The foundation for the community school model is a school-based needs and asset assessment that assesses needed academic, social, and emotional supports (including staff expertise and community supports of the school and surrounding community). The needs and asset assessment, facilitated by the CSC, is an inclusive process in which families, students, community members, partners, teachers, ESP, administrators, and other school staff define their needs and assets. Problem solving teams are established based on the needs determined in the needs and asset assessment. - School Stakeholder Problem Solving Teams: Every community school should have teams of school and community stakeholders dedicated to solving problems that are identified in the needs and asset assessment, as well as problems identified by stakeholders subsequent to the assessment. The solutions identified by the stakeholder problem-solving teams change the way things are done in and outside of school hours and, at times, involve partnerships with outside organizations and individuals. - Community School Stakeholder/Partner Committee: The community school stakeholder committee (CSSC) coordinates between school staff, partners (organizations, businesses, town and city service providers), and stakeholders to ensure goals are achieved and obstacles are surmounted . The CSSC, which is inclusive of families, community partners, school staff, students, the Association, and other stakeholders from the school’s various constituencies, works in collaboration with the school leadership team and supports coordination across and among community schools within a school district.

https://www.nea.org/student-success/smart-just-policies/community-schools

The mission of the School and Community Partnerships Department (SCP) is to build collaborative, cross-sector partnership systems that facilitate a consistent and student-centered ecosystem of supports and experiences for students. SCP’s vision is that Seattle Public Schools and Community Partners build transformational, equity-driven, anti-racist partnerships that spark students’ curiosity, affirm their identities, and support them to thrive in school and in life. Areas of Focus Our department collaborates with partners representing our district, community-based organizations (CBOs) and public agencies. We seek to build new and improved ways of collaborating with partners across sectors so that we can find alignment in our shared work of serving our youth and work together to provide the right supports for partnerships to thrive. Our department is committed to creating and offering supports that build the capacity of schools and community based organizations to effectively and authentically partner. We also work to create connections between Seattle Public Schools (SPSSeattle Public Schools) departments and partners, especially to promote alignment with district priorities and key initiatives. To see the rich calendar of professional learning opportunities our department and partners have jointly organized for community-based organizations, visit our Professional Development page. In order to support consistent, high-quality partnerships, our office is engaged in building and improving partnership onboarding processes, establishing key partnership tools and processes, and providing technical assistance. In addition, we will build systems to better match schools and partners, to support principals to effectively select partners that will meet their students’ needs, and to support both schools and community-based organizations to align services and work through challenges. Our department seeks to create consistent and accessible systems for collecting feedback from CBOs that center students of color furthest from educational justice, as well as centering Black-led and culturally-responsive CBOs to inform partnership models, approaches and supports for schools and partnering organizations. Strategic Initiatives The SCP Department has a number of strategic initiatives. These initiatives are borne from strong, intentional partnerships with major strategic partners that are supporting Seattle Public Schools to improve outcomes for children. This initiative aims to address and end the pervasive cycle of multi-generational poverty in our community in an innovative way. Together, we focus on improving the educational outcomes of low-income children and youth as a strategy to support families and strengthen our broader community. Read more about the district housing partnerships. The Community Alignment Initiative is a framework that guides how schools and school-based before and after school licensed child care programs, community learning centers, and school-based health centers work collectively to support the academic pursuits, social and emotional development, and overall well-being of students. Visit our Aligned Partners page to learn more Creative Advantage is a public-private partnership between the City of Seattle, Seattle Public Schools, the Seattle Foundation and community-based organizations. Through this partnership, we work to ensure equitable implementation of the arts for all students in the District. Visit the Creative Advantage website to learn more. The City’s Department of Education and Early Learning and Seattle Public Schools are working in partnership to implement strategic investments in select elementary, middle and high schools during the school year, summer learning programs, physical and mental health supports, and community-based family support organizations. In 2011 Seattle University launched the Seattle University Youth Initiative, a long-term commitment which unites campus and the wider community to improve the academic achievement of low-income youth living in the greater Yesler Terrace/Bailey Gatzert neighborhood. For more information on how the partnership functions and lesson learned thus far, check out this report from Cohen Research and Evaluation. Partnership Recognition Our community is enriched by the hundreds of community partnerships that celebrate, engage, and support the students and families of Seattle Public Schools. Strong partnerships between schools, our central office, and community-based organizations are key to ensuring that every student has the supports they need to thrive. Below is a selection of just a few of the amazing partnerships that positively impacted Seattle Public Schools students over the last year, nominated by members of our community. Have a celebration to share? We want to hear about it! Use this form to tell us more. The Chinese Information Service Center (CISC) has been partnering closely with Seattle Public Schools for over 15 years. The focus of their partnership is to provide youth development, academic support, family engagement and advocacy, as well as family workshops to SPSSeattle Public Schools students and families. Throughout their partnership, Chinese Information Service Center (CISC) has helped create bridgesA Seattle Public Schools post-secondary program that supports students with disabilities between school communities, district departments, and our Chinese community. CISC is truly an advocate for the students and families they serve, building trusting relationships with many SPSSeattle Public Schools schools and departments as well as families to improve the flow of communication between them. With the support of CISC workshops, families learned how to communicate with their student’s school and advocate for their student’s educational rights. Throughout the COVID-19 pandemic, the Chinese Information Service Center has helped families get access to resources, academic support, social emotional supports, and help navigating technology. Particularly for students who newly immigrated during the pandemic, CISC was a critical advocate to make sure that schools and teachers knew how to best support students navigating virtual learning while also learning a new language and a new culture. Their partnership continuously reflects their commitment to advocacy and authentic family engagement. Visit the CISC website to learn more about their programs City Year Seattle is a non-profit that partners with multiple schools in Seattle Public Schools. During the 2020-21 school year, City Year partnered with Rising Star to provide small groups for students in math and literacy, social emotional learning activities, and enrichment activities before, during, and after school. To maximize the impact of their partnership, City Year worked with Rising Star interventionists and teachers to align small group supports with classroom instruction, then participated in professional learning throughout the year alongside school staff to increase collaboration and Corps Member skill. Clear progress monitoring and highly trained Corps Members made this support invaluable to students. City Year Corps Members also led after school programming virtually to support students with homework help and enrichment activities such as art, cooking, and technology. This partnership worked closely with the Rising Star PBIS Team to identify additional positive behavior recognition for students, and support with virtual assemblies for students and families. This partnership thrived during the 2020-21 school year because City Year was flexible and willing to adapt, focused on building strong relationships with students and teachers alike, were responsive to feedback and willing to adapt programming to match the needs of Rising Star’s School community. Visit City Year Seattle’s website to learn more about their partnerships Communities In Schools of Seattle (CISS) is a non-profit that serves multiple schools within Seattle Public Schools and has been partnering with Aki Kurose Middle School since 2010. The partnership has played an essential role in supporting students and families during the 2020-21 school year. The CISS Site Coordinator has worked to fill these needs, connecting students and families to resources that could remove barriers to school participation. This included connecting 143 families to the Right Now Needs Fund, as well as housing and utilities assistance, food and clothing resources, and much more. As the CISS Site Coordinator works closely with the school administration, to implement an annual school support plan, to ensure they are providing the right supports that meet community needs. By integrating themselves into the school building and attending regular staff team meetings, CISS stays connected to school wide needs and builds strong relationships throughout the building. By building trusting relationships, CISS has been a key connection between students and families and Aki Kurose Middle School, making this partnership truly impactful. Visit CISS’ website to learn more about how they support Seattle students The Madrona Family Resource Center is a partnership between Madrona Elementary PTSA and Madrona Elementary that was started to support families with a variety of resources. When schools closed in March 2020, Madrona staff and PTSA immediately began providing weekly groceries to families through both home deliveries and a Grab & Go Pantry. This was a collective effort of the entire Madrona community working together to support one another. The Madrona Family Resource Center reached out to partner with local food banks, organizations, and local businesses, and began a fundraising campaign called the Madrona Family Support Fund. During the past 16 months, this fund has raised more than $60,000 and served more than 120 families. Averaging 35 families per week, the Madrona Family Resource Center has given out 4,500 bags of groceries, $50,000 in grocery gift cards, and thousands of face masks, hand sanitizer, and other household items. Currently the Family Resource team is preparing for the future of this program to continue working together as a community to support each other in service of students. Visit their website to learn more! Operation School Bell is a program of the Assistance League of Seattle that has been supporting students in Seattle Public Schools since 1990. The all-volunteer organization has historically focused on helping students and families who are most in need. Through their Operation School Bell program, the Assistance League of Seattle has partnered with the SPSSeattle Public Schools Family Support Worker Program to provide thousands of elementary children new coats, school clothes, shoes, school supplies and gift cards for basic needs. In the fall of 2019, they served approximately 2,400 students. Operation Schools Bell’s support has not wavered during the pandemic. Families can work directly with the Family Support Worker or Counselor in their school to get connected. What has sustained this partnership over time is a commitment to supporting students and families in our district, strong relationships, and a deep connection to the community. Operation School Bell and the Assistance League of Seattle demonstrate the power of coming together to do make sure every student has what they need to succeed. Visit their website to learn more Throughout the 2020-21 school year, Middle College High School partnered with Totem Star Records to take a new approach to teaching and learning about U.S. History. Working alongside Social Studies teachers Shmuel Rubinstein and Soladoye Oyelowo, Totem Star used music as the medium to facilitate a discussion on how people have responded to and shaped historical events in the United States. Students had the opportunity to learn directly from Seattle music legends, including: Lady A, Clinton Fearon, and Steve Fisk. Mr. Rubinstein wrote that these type of engaging learning experiences increased student participation and motivated several students to explore their own personal journey through the world of music. One student wrote that “Learning history through the lens of music has helped me see connections that I would never have noticed. It gave new meaning to some of the events that shaped our country by understanding the role that music played. Learning about the people who played that music showed me a whole new side to the history, one that was vibrant and full of life, one in which we can still relate to.” This partnership thrived because of a joint commitment to prioritizing students and elevating their voices. Totem Star supported students in creating their own music and offered students the opportunity to receive musical mentors to help them advance in their understanding of music. Visit Totem Star’s website to learn more! WestSide Baby is committed to working with Seattle Public Schools (SPSSeattle Public Schools) to help support families who are experiencing barriers to basic needs for babies and children. WestSide Baby believes that the health of the entire family is strengthened when parents have access to the resources that help keep their children warm, dry, safe, and healthy. WestSide Baby and SPSSeattle Public Schools Family Support Services worked closely throughout the school year to provide baby essentials such as diapers, baby wipes, safety equipment, and other items that were delivered to four SPSSeattle Public Schools school locations. including over 300,000 diapers! The SPSSeattle Public Schools meal sites served as a low-barrier, community access point for families throughout the district to access diapers and WestSide Baby’s partnership was elemental in getting these resources to families. Visit their website to learn more! To get an idea of the many programs and services available in Seattle and King County, visit our SPS Community Partner Platform and the Elevate Washington program directory.

https://www.seattleschools.org/departments/community-partnerships/

Sheena Manuel is an outreach specialist at the Professional Development and Research Institute on Blindness at Louisiana Tech University. Abstract Collaboration is one of the many factors that contributes to the education and success of children, specifically children with disabilities. Collaboration among teachers, parents, and community members is an essential factor. However, the Individualized Education Program (IEP) team, which includes teachers, parents, related service providers, and community members, is responsible for the education of blind students. To ensure that blind students succeed in life, educators have a duty to build their blindness knowledge and share that knowledge with other key stakeholders, collaborate with experts in the field of blindness and in other fields relating to the education of students with additional needs, share standards and develop methods and strategies to promote success in the regular education classroom, foster community relationships to ensure adequate access, and develop professional growth plans for continual professional development opportunities. This manuscript presents guiding information for stakeholders in building blindness knowledge, being an effective team, and aiding student success in the regular-education classroom. The implications aid stakeholders in facilitating professional growth and knowledge about blindness as it relates to school-aged students. Keywords Public education, individualized education program, blind students Collaboration: Free and Appropriate Education for Blind Students Many factors contribute to the education and success of children, specifically children with disabilities (Vaz et al., 2015; Willis et al., 2016). Collaboration among teachers, parents, and community members is an essential factor for students to receive appropriate instruction (Goddard, Goddard, Kim, & Miller, 2015; Ronfeldt, Farmer, McQueen, & Grissom, 2015). When stakeholders collaborate to meet the needs of blind students, they can present innovative ideas, new skills, and address or adjust their misconceptions about blindness. Educational leaders and educators must create safe spaces for peers, parents, and students to question and understand their respective philosophies on blindness. These leaders and educators must also evaluate their philosophies and strategies or methods used when working with blind students and their families. Effective and efficient collaboration efforts among stakeholders may foster an increase in knowledge about blindness and the development of an effective team, which may lead to student success in the regular-education setting (Goddard et al., 2015; Ronfeldt et al., 2015). Without collaboration efforts, some students and families may experience the following scenario: Scenario A blind student lives in a small town where he is the only blind person. The student has repeated a grade, reads below grade level, and has some functional vision. The presence of functional vision makes it seem as if he can complete all assignments using large print. Despite his disability, visual impairment, his IEP does not include authentic assessments, the appropriate reading medium, or list a qualified expert in the field of blindness; however, the regular educator understands that the student works better with large-print materials. The parents are uneducated about blindness and know only one blind person: their child. Consequently, they are unaware of his right, which is stated in the IDEA, to receive braille instruction unless evaluation results determine otherwise (Individuals with Disabilities Education Act, 2004). After conducting an evaluation, the school district learns that the student needs braille instruction as braille is the most appropriate reading medium. However, the school district does not have a qualified staff member to provide these services and is unaware of institutions or organizations that can offer instructional assistance. Therefore, the student will continue to read large print for the remainder of the school year with his nose to the desk, bent over, or head tilted, thus affecting his posture and potentially his attitude about academics and life as an adult. Finding qualified staff members and educating parents on their child’s rights can enrich the lives of blind students. When providing a free and appropriate public education, administrators, educators, parents, and all involved will collaborate with each other and work toward providing accessible materials to students. Stakeholders in the field of education like teacher preparation programs will increase their efforts to multiplying the number of experts in the field of blindness and elementary and secondary public education. Along with these efforts, stakeholders need to collaborate to develop clear definitions and interpretations of “appropriate education,” as well as IEP plans that lead to success in the workforce or higher educational system. Building Blindness Knowledge Some parents, schools, and community members may lack knowledge about blindness due to its low incidence and the limited availability of blindness information (Holbrook, 2015). What does the word blind mean when discussing students who have some functioning vision? How do blind people live and work? What are the skills needed to succeed after school? Where does training occur?These questions are often thought of by educators and the public when discussions arise in the educational setting; however, some blindness educators have limited experiences and resources to answer these questions thoroughly. In an online nationwide poll, respondents across all ethnic and racial groups described loss of eyesight as the worst ailment that could happen to them relative to losing memory, speech, hearing, or a limb (Scott, Bressler, Ffolkes, Wittenborn, & Jorkasky, 2016). The process of overcoming the fear of the unknown starts with having faith that better circumstances are in the future. Blind individuals who view blindness as a burden may need experiences, opportunities, and proper training that promote a positive outlook on life. In collaborating with experts, parents, and students, educators can devise an appealing plan of action to ensure that blindness becomes a characteristic as opposed to a burden. Accepting blindness as a non-defining characteristic requires people to change their thinking. All educators in the field of blindness do not share the same philosophy about blindness. Some experts believe that blind students can live an independent life, but these expectations often mean non-challenging activities or limited exposure to situations; other experts believe that blind students can live an independent life with expectations commensurate to all peers and have a wide range of exposure to different situations. The philosophy that drives this manuscript extends the word blind to encompass all individuals whose vision adversely affects their education and daily living skills. Blind individuals may have functional vision, light perception, or be totally blind. The word blind is not demeaning or a characteristic that is perceived negatively but embraced as a physical feature that requires stakeholders in education to reconsider the means of educating students in the P-12 setting. This paradigm shift reveals the lack of early interventions regarding braille and orientation and mobility instruction for students who have visual impairments or low vision. Blind is just another word when stakeholders are knowledgeable, receptive, and have personal experiences with blind individuals. Building blindness knowledge can assist educators in developing a common philosophy that blind students can achieve anything with the help of collaborating teachers, appropriate instruction/tools, and a wider variety of learning opportunities. When building blindness knowledge, all stakeholders have a responsibility to search for resources on the local, state, and national levels. Educators can build their knowledge through professional development opportunities and online publications. Parents can build their knowledge through IEP meetings and online resources such as state websites, publications, and support groups. Members of the community can build their knowledge through visiting local organizations and/or businesses that cater to this population. When collaborative efforts are presented, every stakeholder can provide their interpretation of information about blindness that they have gathered or offer their perspective from personal experience. An Effective Team Tannock (2009) stated, “collaboration requires a unique set of individual skills to develop a successful foundation for a working relationship” (p. 174). In the educational setting, an effective team will possess the set of skills required to ensure success in all areas of blind students’ lives. The team also needs unique skills to develop working relationships with other teachers, advocates, and local businesses to expand the opportunities of blind students. Each party plays a role and can share the common goal of providing rigorous educational experience for any student. When discussing blind students, the collaboration must be voluntary between the service providers on the educational team. In the field of blindness, an effective team understands significant legislation such as the Individuals with Disabilities Education Act (2004), which states: …in the case of a child who is blind or visually impaired, provide for instruction in Braille and the use of Braille unless the IEP team determines, after an evaluation of the child’s reading and writing skills, needs, and appropriate reading and writing media (including an evaluation of the child’s future needs for instruction in Braille or the use of Braille), that instruction in Braille or the use of Braille is not appropriate for the child. An effective team must also be aware of significant research related to early braille instruction, braille reading as it relates to well-being, and quality literacy instruction (Koenig & Holbrook, 2000; Ryles, 1996; Silverman & Bell, 2018). Appropriate instruction can promote independence and motivation among blind students. If educators create appropriate braille instruction, blind children are more likely to be employed and self-sufficient than those who do not (Ryles, 1996). Therefore, authentic assessments should drive the instruction provided by all service providers on the educational team. In developing an educational plan that matches a learning environment, service providers will conduct and explain the results of the assessments administered. Teachers of blind students will provide information about accessing the general education and expanded core curriculum. Orientation and mobility instructors will provide information about traveling at home, school, and in the community independently. Regular education teachers will provide information about core content knowledge, typical performance rates, and classroom routines. Parents will provide information regarding the behaviors and skills students display when in familiar and natural environments. Collaboration among these team members aids blind students in reaching the goal of literacy and independence. Success in the Regular Education Classroom Teachers must think creatively to appropriately teach blind/visually impaired students through multiple engaging experiences. Success begins at the foundational level if teachers understand how to get visual concepts across to blind students (Castellano, 2005). Furthermore, blind students need opportunities to experience common age/stage-appropriate activities within the regular classroom setting. Regular educators can develop ways to include blind students when they collaborate with teachers of blind students, orientation and mobility instructors, and service providers such as occupational/physical therapists. The team must gather ideas and respect each other’s knowledge base to develop creative ways to teach blind students. Setting ambitious standards for student success is a model goal; if genuine collaboration is required among school leaders, teachers, and communities, then that serves the mutually beneficial goals of schools and communities (Harmon & Schafft, 2009). With creative ideas and multisensory methods, educators can develop an action plan that facilitates success in academic, social, and living skills. Moreover, educators can measure the success of blind students using the same standards as the students’ sighted peers. If a child is encouraged and expected to make progress, that child will have academic success (Castellano, 2005). Accessible Materials Success for blind students in the classroom starts with accessible materials. All materials, including worksheets, maps, pictures, and textbooks, must be provided in a timely manner and in an accessible format to foster learning in the classroom setting for blind students. Collaboration among team members can provide experiences and create an engaging environment; however, the student needs immersion in the appropriate reading medium just as their sighted peers experience immersion in print. Preparing accessible materials may require collaboration from a qualified transcriptionist, regular educator, teacher of blind students, materials center at the local or state level, and textbook publishing companies. However, the teacher of blind students is the primary person with the training on how to introduce and maintain the use of non-visual skills, manipulatives, and assistive technology; confirm appropriate formatting of educational materials per age/stage; and emphasize the importance of having materials in front of the blind students at the same time, if not before their sighted peers. Everyone involved must become aware of the print provided to those who have sight and consider what blind students need in relation to accessing the curriculum. If braille is the learning medium, braille is placed around the classroom and any other place blind students will visit. Establishing braille as the primary medium may encourage children to develop a positive lifelong habit of reading as adults, enhance their later employment opportunities, and thereby increase the possibility of financial independence (Ryles, 1996). Community Access Once the effective team has increased their blindness knowledge, redesigned the classroom environment for success, and provided the appropriate reading medium, they must collaborate with the community (blind and sighted) to enhance the experiences of blind students. The community, once aware of the needs, can come together and provide resources (monetary, service-related, internet access, networking events, etc.) to enhance the educational setting. The community, from the mayor to the small business owner to local educational institutions and organizations, must actively search for ways to become engaged with the local school district. Volunteering time, fundraising, and fostering student success through mentoring allows all involved to tear down barriers to promote improvement in student achievement and the quality of life. Blind students need exposure to positive blind role models who are parenting children, participating in the workforce, or attending college. Surrounded by blind mentors, students learn how to live confidently, address common issues, and build a support group. Blind mentors can aid students to grow personally and professionally. With the collaboration of the community (blind and sighted) and school, blind students not only learn about the opportunities that exist beyond the 12th grade but can have a physical representation of life after school. Professional Development Tannock (2009) noted that educators can expand their knowledge by incorporating the ideas of others (general and special educators, supporting staff) to enhance students’ experiences. However, the effective team must regularly reflect and stay true to their philosophy and the end goal. When working together as a team in a school setting, experiences of resistance from others outside of the team occur often. People’s practices are often in conflict, and the reason for that conflict is that we make sense of our social world in diverse ways, which generates contradictions between our understandings (Riveros, 2012). Consequently, faculty and staff at the school and within the district need opportunities to talk about blindness and to reflect on theirown beliefs and common misconceptions. These opportunities range from faculty and staff meetings, seminars, conferences, and conventions on the district, state, and national level. School district leaders should encourage team members to attend these opportunities on a biannual/annual basis. Educators’ self-evaluation practices, professional growth plans, and flexibility should evolve to meet the needs of blind students in the 21st century. Conclusion In the field of education, IEP team members often lack information about the standards, methods, rights, and expectations of blind students. Blind students lack access to appropriate expectations, accessible educational materials, and qualified experts. An effective team’s plan to meet the needs of blind students will include creative thinking in the regular education classroom; access to the curriculum using the appropriate reading medium and learning tools; interactions with the community (blind and sighted) to build endless experiences; elevated expectations (comparing a student’s ability to all peers, sighted and blind); and professional development opportunities that enhance collaboration skills and introduce new skills, methods, and tools in the field of blindness. In providing a free and appropriate education to blind students, the key stakeholders must collaborate effectively and efficiently to ensure that students become independent contributors to our society, whether in the workforce or higher educational system. Implications for Practitioners - Participate in team-building activities or regular professional development at the district level to help build relationships with team members - Hold regular team conferences aside from the annual IEP meeting to help the team maintain focus and adjust strategies as needed - Attend state and national conferences annually to stay abreast of current trends, strategies, and products in the blindness field - Join local organizations that focus on blindness/visual impairments to learn of current or future opportunities to interact with the community - Subscribe to journals, magazines, and other publications that discuss blindness/visual impairments to build content knowledge Implications for Educational Leaders - Promote and attend annually state and national conferences related to blindness - Attend local consumer groups and professional organizations meetings to learn of current trends, legislation, and issues regarding the blindness community - Subscribe to journals, magazines, and other publications that discuss blindness to build personal blindness knowledge - Facilitate the growth and maintenance of a learning community among faculty and staff within their institution/organization References Castellano, C. (2005). Making it work: Educating the blind student in the regular school. Greenwich, CT: IAP - Information Age Pub. Goddard, R., Goddard, Y., Kim, E. S., & Miller, R. (2015). A theoretical and empirical analysis of the roles of instructional leadership, teacher collaboration, and collective efficacy beliefs in support of student learning. American Journal of Education 121(4), 501-530. https://doi.org/10.1086/681925 Harmon, H. L., & Schafft, K. (2009). Rural school leadership for collaborative community development. The Rural Educator, 30(3), 4-9. https://doi.org/10.35608/ruraled.v30i3.443 Holbrook, C. M. (2015) Renewing and refreshing knowledge base of the field of visual impairment: A call to action. Journal of Visual Impairment & Blindness, 109(2), 159-162. Individuals with Disabilities Education Act (IDEA), 20 U.S.C. § 1400 (2004). Retrieved June 24, 2019, from https://sites.ed.gov/idea/statuteregulations/ Koenig, A. J. & Holbrook, M. C. (2000). Ensuring high-quality instruction for students in braille literacy programs. Journal of Visual Impairment & Blindness, 94(11), 677-694. https://doi.org/10.1177/0145482X0009401102 Riveros, A. (2012). Beyond collaboration: Embodied teacher learning and the discourse of collaboration in education reform. Studies in Philosophy and Education, 31(6), 603-612. doi: 10.1007/s11217-012-9323-6 Ronfeldt, M., Farmer, S. O., McQueen, K. & Grissom, J. A. (2015). Teacher collaboration in instructional teams and student achievement. American Education Research Journal, 52(3), 475-514. doi: 10.3102/0002831215585562 Ryles, R. (1996). The impact of braille reading skills on employment, income, education, and reading habits. Journal of Visual Impairment & Blindness, 90, 219-226. Scott, A.W., Bressler, N.M., Ffolkes, S., Wittenborn, J.S., & Jorkasky, J. (2016). Public attitudes about eye and vision health. JAMA Ophthalmology, 134(10), 1111–1118. doi: https://doi.org/10.1001/jamaophthalmol.2016.2627 Silverman, A. M., & Bell, E. C. (2018). The association between braille reading history and well-being for blind adults. Journal of Blindness Innovation and Research, 8(1). Tannock, M. T. (2009). Tangible and intangible elements of collaborative teaching. Intervention in School and Clinic, 44(3), 173-178. doi: 10.1177/1053451208318682 Vaz, S., Wilson, N., Falkmer, M., Sim, A., Scott, M., Cordier, R., & Falkmer, T. (2015). Factors associated with primary school teachers’ attitudes towards the inclusion of students with disabilities. PLOS ONE, 10(8), 1-12. https://doi.org/10.1371/journal.pone.0137002Willis, C., Girdler, S., Thompson, M., Rosenberg, M., Reid, S., & Elliott, C. (2016). Elements contributing to meaningful participation for children and youth with disabilities: A scoping review. Disability and Rehabilitation, 39(17), 1771-1784. doi: 10.1080/09638288.2016.1207716 The Journal of Blindness Innovation and Research is copyright (c) 2020 to the National Federation of the Blind.

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A key strategy is to bring together the resources of a school - or a cluster of primary and secondary schools or a larger network of schools - with local family, community and business resources. While it is relatively easy to make informal links, building strong, formal links is obviously more difficult. What are the practical steps schools and organisations such as local government use to to bring this about? A small group (e.g., a school council team such as a school-family-community partnerships team or a team representing several schools or a local government education committee) is formed to begin to explore what may be done. The team involves, ideally, school leaders, parents, teachers, and students, and plans for, and improves, partnerships over time. The team identifies other stakeholders. The list that follows can help identify your school's or organisation's current and potential partners: With other partners invited to take part, the larger group meets and sets ground rules for working together. The partners share information about each other and the needs of students and families in the community. They build a culture of respect and acceptance for the contributions of each person and group in the evolving partnership. Essential in this regard is a good chairperson (or, better, co-chairs) who understand partnerships and communicate well. During meetings, the chair/co-chairs will: These meetings also provide an opportunity to share information about what is already happening and what needs to improve or change in relation to broader school-family-community partnerships. Using the shared information, the partners begin to create a shared vision and to develop some shared goals. They explore further what they want to focus on. Someone may write a brief paper that begins to work out what will be worked on together. It may be a set of ‘talking points’ or a draft action plan. To further identify the issues and options for action as well as other partners to become involved, they may propose a forum or roundtable discussion that draws participants from as many parts of the community as possible. Following this, the action plan may be finalised and may obviously include: Talk & Action is a useful online conversations resource for helping to develop such plans. In our school council training program, see the section entitled 'Your Community' that outlines many issues relating to building school-family-community community partnerships and participation. Schools Connect Australia (formerly known as Business Working with Education Foundation) is an independent organisation focused on facilitating partnerships between education, business and philanthropy to enhance the learning of students in government schools. See the It Takes a Village to Raise a Child report. Published in 2003 by the Victorian Local Governance Association, it remains a very useful discussion of the roles that local governments play in relation to education and schooling and learning communities and partnerships. The VLGA report identified five distinct roles including the work of local governments as community capacity builders. As well, see the Creating synergies: Local government facilitating learning and development through partnerships report. Published in 2006, this report documents the evolution and development of four ‘learning communities’ in Victoria where local government has been involved. It investigates the challenges and complexities faced in getting these communities off the ground and the role that the vocational education and training (VET) sector has played. Introduction This checklist can be used by local government personnel in meetings with school principals and other school community members. The questions are prompts to facilitate discussion and explore practical possibilities for collaboration. Depending on the time available during meetings, obviously not all of these questions may be used. Responses to these questions can also help identity the key issues around which a local council may want to focus on in working with schools and related stakeholders. 1. Key educational challenges What are the most important developments at your school in the past few years? Where would you like to see your school in five years from now? What needs to be developed to achieve your school's vision? What are the key educational issues and challenges facing your school, and how is your school addressing these issues? In developing 21st century teaching and learning, how is your school: What may be the broader community role of local council in supporting and promoting some of these initiatives? Are you aware of council's current work that may be relevant to the above? 2. Engaging parents and families How does your school engage parents and families of socially, culturally and linguistically diverse backgrounds? What types of parent participation and partnerships exist within your school? What would you like to see develop? Does your school have a parent club? Is there good communication between families and school? How often do teachers and parents (and students) talk together about how improvements in learning can be made? Are families engaged in conversations to set future directions for the school? Are they able to participate in various forms of planning? How can local government assist broadly with work around parents, families and schools as partners? 3. School community partnerships What broader links and partnerships are important for your school, and how are they being developed and by whom? What are the specific challenges with building and sustaining these partnerships? What are your school’s current and potential links and partnerships with: How can local government help support partnerships? What improved services and opportunities for students could be explored in partnership with community stakeholders including your local council? 4. School governance Given the emphasis on school autonomy, in what ways is your school council/board likely to evolve? What do you see as the key areas for improvement in the work of your school council/board? Is the school's strategic plan owned by the school community? Are there shared school-family-community goals? How does the the school council add value? What existing networks enable school council members to share good ideas and good practices? Would it be useful for local government to be involved in networking around governance in education? 5. Student participation and well-being To what extent are students at your school involved in: What are the examples? Are only some or are all or most students involved in local leadership initiatives? In what ways can local government assist broadly with further developing this work? What strategies ensure that student participation is more than tokenistic (young people’s views do not have any impact on major decisions) and elitist (a select few students represent all students)? Local governments in partnership with schools have also been involved in programs that build and enable students' school leadership capacity. To what extent is there on-going student input into: What strategies and programs are in place to promote student well-being? How are student mental health issues addressed? Is there a preventative, whole school approach to student welfare? Can local government broadly assist? 6. Professional networking Have staff at your school been involved in local community professional learning and broader networking such as with LLENs, local government, health agencies, cultural groups, and local businesses and industry? Would your school be interested in local professional networking among, for example, women who are school principals, teachers, parents, and members of local community organisations? 7. Resources and facilities What specific resources, support and facilities does your school require? What facilities are shared with other schools and community organisations such as sporting clubs? Can local government help with this? How could local government assist in supporting shared community resources? Community Manifesto: Valuing Australia's Community Groups, Our Community For further discussion and reading, see the school-family-community partnerships section.

http://www.viccso.org.au/community/information

Regional Partnerships Provide Leadership Yvonne Hunter is program director of the Climate Change Program for the Institute for Local Government (ILG) and can be reached at yhunter@ca-ilg.org. Steve Sanders is program director of the Land Use and Healthy Neighborhoods programs for ILG and can be reached at ssanders@ca-ilg.org. Jessica Aviña, Lindsay Buckley and Robin Evans, program coordinators for ILG, also contributed to this article. The whole is more than the sum of its parts. – Aristotle, Metaphysica The current efforts of cities and counties to partner with others as they adopt sustainability policies and programs aptly epitomize this famous quotation. Such partnerships help cities and counties expand their information base and benefit from the expertise of collaborating partners, including other local and regional agencies, nonprofit organizations, universities, the private sector and philanthropic foundations. In today’s adverse budgetary and economic climate, collaboration takes on more importance and contributes to local efforts to avoid duplicative activities and leverage outside resources and expertise. Partnerships among public, private and nonprofit groups are nothing new, and examples abound. However, innovative partnerships that build capacity to address sustainability, energy efficiency, climate change and reductions in greenhouse gas (GHG) emissions are relatively new. Two examples illustrate the creativity and vibrancy of these efforts. Philanthropic and Public Sector Leadership In the San Diego Region The San Diego Climate Protection Network was launched in 2009 and provides a forum for regional stakeholders to address common issues related to sustainability and climate change. Participants include San Diego County and the 18 cities located there, San Diego County Water Authority, Port of San Diego, San Diego County Regional Airport Authority, CleanTECH San Diego (a private nonprofit membership organization) and San Diego Gas & Electric Company. The San Diego Foundation provides financial support for the network. Examples of collaborative projects funded through the foundation include: - Preparation of GHG inventories for 17 local agencies; - Support for the Port of San Diego and its member cities to prepare for and manage the risks from sea-level rise; and - Research by local scientists to identify the potential local impacts of global climate change and ways to reduce local GHG emissions and minimize climate change impacts. The foundation convenes quarterly meetings of the network for agency staff, the University of San Diego’s Energy Policy Initiatives Center, San Diego Gas & Electric and others to learn about resources and funding opportunities, share best practices and discuss topics of common interest. The San Diego County Water Authority and local universities, with support from the foundation, are also working together to integrate climate change projections into planning for the region’s future water supply and demand. “This represents an unprecedented collaboration of philanthropy, business, local governments and public agencies,” says Emily Young, senior director of the Environment Program for the San Diego Foundation. “We believe that the region’s leadership can serve as a national model for dealing with climate change.” Stanislaus County Region Creates a Sustainability Toolbox Like many Central Valley cities, the communities of Stanislaus County have experienced both the benefits and disadvantages associated with rapid growth. Recently the region has faced high unemployment and foreclosure rates, a loss of farmland, insufficient infrastructure, increased traffic, heavy dependence on automobiles, and public health challenges including high rates of asthma, diabetes and heart disease. Recognizing that they share complex challenges, the communities of Stanislaus County decided to leverage their local resources by developing shared planning principles that could be incorporated into their respective local plans, policies and ordinances. The communities successfully applied for a Sustainable Communities Planning Grant from the Strategic Growth Council to develop a Regional Sustainable Toolbox. The toolbox will include 11 planning components that can be used to develop local projects that meet community needs while helping the region achieve greenhouse gas emission reductions. Working together, the partner jurisdictions are creating a local planning framework to achieve: - Appropriate urban development; - Increased conservation of their rich agricultural land base and water resources; - Improved public health; and - Broader prosperity for the region. In keeping with the project’s collaborative nature, each city is leading the development of one toolkit component and will provide training for the other partner jurisdictions on how to implement the new tools. The 11 components of the Regional Sustainable Toolbox and the local leader for each are: - Water-Efficient Landscape Guidelines and Standards — City of Ceres; - Model Climate-Action Plan — City of Hughson; - Downtown Form-Based Code — City of Modesto; - Non-Motorized Transportation Plan and Policies — City of Newman; - Model Housing-Element Policies and Implementation Measures — City of Oakdale; - Sustainable Development Ordinance — City of Patterson; - Low-Impact Developments Standards and Specifications — City of Riverbank; - Fiscal Assessment of Greenfield Versus Infill Development — City of Turlock; - Urban Forest Plan, Valley Blueprint Compliance Matrix and California Environmental Quality Act Policies and Procedures — City of Waterford; - Countywide GHG Emissions Inventory — Stanislaus County; and - Coordinated Geographic Information System Central Database and GHG Tracking System — Stanislaus County. Stretching Limited Resources Local agencies can achieve goals that they might not otherwise be able to attain and stretch limited resources by partnering with other public agencies, nonprofits, foundations, colleges, universities and the private sector. In these difficult economic times, collaborating with others to leverage resources is a smart way to demonstrate leadership in promoting sustainability and enhancing economic development to benefit local residents. Resources for Leaders Collaboration provides opportunities to demonstrate leadership in reaching mutual policy goals and providing services to community residents. The Institute for Local Government offers resources on a variety of issues where collaboration can be beneficial. These issues include public engagement, intergovernmental collaboration and joint use of facilities as well as more focused collaborative activities surrounding sustainability and reducing greenhouse gas emissions. San Diego Regional Collaboration San Diego Foundation Climate change program activities Research commissioned by the Foundation University of San Diego School of Law Energy Policy Initiatives Center San Diego Regional Greenhouse Gas Mitigation Model: A Dynamic Decision Making Tool to Estimate the Impact of Policy Options CleanTECH San Diego Stanislaus County Regional Sustainable Toolbox Stanislaus County Strategic Growth Council Planning Grant Application for the Regional Sustainable Toolbox Stanislaus Council of Governments Strategic Growth Council Planning Grant Information Institute for Local Government Resources on Collaboration Intergovernmental Collaboration Public Engagement How to Harness the Power of Your Community to Address Climate Change Climate Leadership Stories on Civic Engagement Tell Us About Your Efforts Does your agency collaborate with others to promote or undertake sustainability activities? Do you have a story to tell? Share your story with the Institute for Local Government by e-mailing sustainability@ca-ilg.org.

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Supporting the needs of teachers and students in the Georgia public school system. | | | | Title I Programs Title I, Part A is a part of the No Child Left Behind Act of 2001 (NCLB). This act provides federal funds through the Georgia Department of Education to local educational agencies (LEAs) and public schools with high percentages of poor children to help ensure that all children meet challenging State academic content and student academic achievement standards. The Title I, Part A Program Unit is a division of the Education Support and Improvement. The Unit provides technical assistance, resources, and program monitoring of LEAs to ensure that all children have an opportunity to obtain a high quality education and to achieve proficiency on high academic standards. Parent Involment The purpose of parental involvement under Title I is to promote active engagement among local school officials and staff, education leaders, parents, parent advocacy organizations, parental involvement coordinators/liaisons, and others working to improve student achievement and learning. The program will promote engagement through communications, collaboration, and coordination strategies. The program intends to increase parents/legal guardians’ knowledge of academic information and resources. Public School Choice The No Child Left Behind Act of 2001 (NCLB) mandates that children enrolled in a Title I school that is identified for (1) school improvement, (2) corrective action, or (3) restructuring is offered the opportunity to transfer to a school that has not been so identified. Your school district will notify you if your child is eligible. Supplemental Educational Services Supplemental Educational Services (SES) are free tutoring and academic enrichment services mandated by the No Child Left Behind Act of 2001. SES are high quality, research-based educational programs. These services provide additional academic instruction, which are offered outside of the regular school day. The service is designed to increase the academic achievement of low-income students who attend qualifying schools. Students who are eligible for free or reduced price meals and who are enrolled in Title I schools that have been placed on the state’s “Needs Improvement” list for two or more years qualify for SES. Your school district will notify you if your child is eligible. 21st Century, CLC This program supports the creation of community learning centers that provide academic enrichment opportunities during nonschool hours for children, particularly students who attend high-poverty and low-performing schools. The program intends to help students meet state and local student standards in core academic subjects, such as reading and math; offers students a broad array of enrichment activities that can complement their regular academic programs; and offers literacy and other educational services to the families of participating children.

http://archives.gadoe.org/title_complaint.aspx

3 edition of Strengthening families to build strong communities ... working together found in the catalog. Strengthening families to build strong communities ... working together Sheila M. Shinman Published 1999 by Home-Start in Leicester . Written in English Edition Notes Cover title. |Statement||Sheila M.Shinman.| |Contributions||Home-Start UK.| |The Physical Object| |Pagination||22p.| |Number of Pages||22| |ID Numbers| |Open Library||OL18448648M| |ISBN 10||0950834939| |OCLC/WorldCa||278222673| Many states like Massachusetts, who are implementing the Strengthening Families framework, use Parent Cafés to engage parents and families in discussions on how to support the development of the five strengthening families protective factors that make their families strong. Parent Cafés are fun, engaging, inclusive and culturally inclusive. Additionally, here is what CSSP’s Strengthening Families mentioned about making the link to FAST in its e-newsletter: In many communities, both Strengthening Families and Families and Schools Together (FAST) are being implemented – often by community organizations and schools that serve the same families. Strengthening Families Washington is a program within the Department of Children, Youth & Families whose main focus is helping families become stronger together through a variety of tactics, including: Home visiting; Community outreach and partnerships; Funding opportunities with local organizations. examine and discuss what teachers do to build strong positive relationships with other teachers, children, families, whānau, and the wider community. Teaching practices identified are findings from a collaborative research project with kindergarten teachers and early childhood stakeholders. Supporting Families Together Association is a Wisconsin-based association of regional and local organizations that work on behalf of children and families. It is essential for adults to build bridges in order to work together so children are healthy and safe. It is important to provide children with a rich and supportive learning environment. Schools, families, and community members must recognize these common goals and work together for the sake of children. The dialectical dancer empirical-simulation approach to competition Field studies in teaching economics Abstracts of works published by the staff of Jagellonian University in the years 1966-1968 Engine Lubrication. Hearings on H.R. 3980 ... H.R. 3544 ... H.R. 626 ... before the Seapower and Strategic and Critical Materials Subcommittee of the Committee on Armed Services, House of Representatives, Ninety-eighth Congress, first session, October 19 and 20, 1983. The portable Emerson Encouragement for seamen & mariners Godliness and good learning Contemporary adult fiction, 1945-1965 for school and college libraries Winnie-the-Pooh A funeral elegy, by way of dialogue; between Death, Soul, Body, World, and Jesus Christ. Education and Health of the Partially Seeing Child The management of dental practice Handwriting Workbook The Shadow of Longing This item: Heroes Among Us: Social Enrtepreneurs Strengthening Families and Building Communities by Peter Heegaard Paperback $ Ships from and sold by FREE Shipping on orders over $/5(1). Strengthening Families is a research-informed approach to increase family strengths, enhance child development, and reduce the likelihood of child abuse and neglect. It is based on engaging families, programs, and communities in building five key protective factors. Strengthening Families Together is a free session group for families and friends, which provides information, skill-building, and support. (For more information on the Strengthening Families Together-First Nations program, the same course offered through a cultural indigenous lens. The work of Strengthening Families won’t be done until all children grow up in families that are strong in these key protective factors, and in communities that support families to build those protective factors. We’re not there yet, but Strengthening Families has helped us move in that direction. Strengthening Families and Communities: Resource Guide. The resources in this book were developed with input from numerous national organizations, Federal partners, and parents committed to strengthening families and communities. Its goal is to support service providers in their work with parents, caregivers, and their children toFile Size: 1MB. Vulnerable children and families need a strong social support net-work that acts as a safety net to effectively and sustainably respond to the situation of children and families at risk. In order to find out more about how SOS Children’s Villages works with different stakeholders to strengthen social safety nets in communities, 58 interviews were. within families and communities, we can support all families in providing a safe, loving environment for their children. This work is the theme of the Children’s Bureau’s 17th National Conference on Child Abuse and Neglect, Focusing on the Future: Strengthening Families and Communities. Strengthening Families is a research-based, cost-effective framework developed by the Center for the Study of Social Policy (CSSP) over the last decade to increase family strengths, enhance child development and reduce child abuse and neglect. This approach helps child welfare systems, early education, prevention organizations and other programs work with parents to build five protective. But what does it take to create a strong community. Below we will discuss five key points for creating a strong community. Related: Short Term Rentals in Your HOA Community. Trustworthy Leadership. Leadership is key in setting a collaborative tone to build trust between board members and community. Edifying our family will build and strengthen it. When studying for this talk I came upon a talk by Robert D. Hales of the Quorum of the Twelve, which he gave in the April Conference called “Strengthening Families: Our Sacred Duty“. “The key to strengthening our families is having the Spirit of the Lord come into our homes. professionals working with children to build strong partnerships with families to achieve the best long term outcomes for children. “Partnerships are based on the foundations of understanding each other’s expectations and attitudes, and building on the strength of each other’s knowledge”. (The Educator’s Guide to the EYLF, p). The guide includes information about protective factors that help reduce the risk of child maltreatment, strategies for changing how communities support families, and evidence-informed practices. This Resource Guide was written to support service providers in their work with parents, caregivers, and their children to strengthen families and Reviews: 1. The Strengthening Families Program (SFP) is an evidence-based family skills training program for high-risk and general population families that is recognized both nationally and internationally. Parents and youth attend weekly SFP skills classes together, learning parenting skills and youth life and refusal skills. Building Strong Families: Strengthening Unmarried Parents' Relationships Mathematica’s Response to COVID Mathematica is continuously monitoring this fluid situation, and we are proactively working to minimize any potential impacts on our clients, partners, staff, and the important work that we do together. Helping Communities Build Strong Families 7 Triple P (Positive Parenting Program) Building a system of support to meet the needs of South Carolina families Children’s Trust and Triple P both have a focus of community transformation and the well-being of children. So with those aligned visions, we then work together to make those things a reality. Strong Families-Strong Communities. We need to unite together to strengthen our families and communities. My dream is to start a non-profit organization that will build family centers all across the world to strengthen families in all aspects. Along with working together to maintain our home or complete a project, we should make time. Building Community, Building Hope i DEPARTMENT OF HEALTH & HUMAN SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES Administration on Children, Youth and Families C Street, S.W. Washington, D.C. Dear Colleagues: We are pleased to introduce the. Strong Families-Strong Communities. We need to unite together to strengthen our families and communities. Home About Contact Blog The Family Center Orphanages Homeless Shelter Building Homes When I was 4 or 5 I used to day dream of organizing businesses to donate materials and volunteers to come with me in a big truck to Mexico and build homes. Be Strong Families specializes in promoting better relationships between child welfare systems and the families and communities they serve. We assist child welfare agencies with achieving their goals, including: preventing child abuse and neglect, reuniting families more quickly, making foster care work better for kids, and soliciting and. Option 2: Qualities of a Strong Family Have students make a list of qualities of a strong family on the board or in small groups. Have students answer the questionnaire How Strong is your Family (pdf). Make a list of areas where your family may need help. Show slides 4, 5, and 6 of the power point presentation on strong families. Option 3. Strengthening Families As a Platform for Collaboration Collaboration across multiple service systems is central to the Strengthening Families approach. State and local leadership teams for Strengthening Families are made up of multiple agencies and partners, including community and parent leaders. Each represent a unique part of the systems of.This is an important book for teachers, coaches, program leaders, family educators, and anyone who wants to build culturally responsive relationships with families. The strategies, resources, and examples of effective family engagement in this book are based on current research and theories on how to build mutual, respectful family partnerships.The Cafés promote holistic well-being by building Be Strong Families’ domains of Vitality: physical, mental/emotional, spiritual, financial, environmental, and social. We offer them as a valuable contribution to the recovery process, catalyzing peer support to sustain motivation.

https://carodarocyp.maybom247.com/strengthening-families-to-build-strong-communities-working-together-book-5348yw.php

Partnerships with Schools & Communities Positively impacting the lives of children and families through education involves multiple levels of support. It requires teachers and educational leaders who have exceptional preparation to work with students of diverse backgrounds. It requires the development and implementation of improved approaches for teaching and learning. It requires new ways of providing community-based services promoting socio-emotional well-being of individuals and families. These support systems can only thrive if universities have strong partnerships with schools and community organizations to allow our students to develop their clinical skills through extensive field experiences. We are dedicated to the ongoing cultivation of partnerships with schools and community organizations, and many of those efforts are housed right in the School of Education (SOE) building. The Piedmont Triad Education Consortium (PTEC) — the primary provider of educator professional development in the region — is located on the first floor. Our SELF Design Studio, a state of the art makerspace on the third floor, helps prepare teachers from across the region to integrate technology into their teaching and learning. Our building is also home to the New Teacher Support Program, which provides coaching services to new teachers across the region. While our physical building and aforementioned resources reside on the campus of UNCG, our partnerships extend to hundreds of schools, public libraries, and community organizations across North Carolina. Working in continuous collaboration with the Reidsville community and surrounding school district, we have launched a new elementary school, the Moss Street Partnership School. SOE faculty lead a broad network of research-practice partnerships, including the STEM-Teacher Leader Collaborative (TLC), the Healthy Relationships Initiative, and the Gate City Writes professional development program to enhance the teaching of writing and the associated Young Writer’s Camp. Just as these partnerships serve as extensions of our campus, they also provide substantial extended capacity for schools and community organizations. Each year, the faculty and students of the SOE provide more than 250,000 hours of service to these organizations and allocate capacity and support to the community valued at more than $11 million. The training we provide our students is connected to every point of these partnerships. Through a wide range of experiential learning opportunities through practicums, internships, field placements, student teaching, and service learning, our students gain real-world experience in the very same professional settings where they will begin their careers after graduation.

https://soe.uncg.edu/partners/

What just happened? Last week the Royal Swedish Academy of Sciences awarded the Nobel Prize in Chemistry 2020 to Emmanuelle Charpentier of the Max Planck Unit for the Science of Pathogens, Berlin, Germany and Jennifer A. Doudna of the University of California, Berkeley, for the development of a method for genome editing. According to the Nobel committee: Emmanuelle Charpentier and Jennifer A. Doudna have discovered one of gene technology’s sharpest tools: the CRISPR/Cas9 genetic scissors. Using these, researchers can change the DNA of animals, plants and microorganisms with extremely high precision. This technology has had a revolutionary impact on the life sciences, is contributing to new cancer therapies and may make the dream of curing inherited diseases come true. Although still largely unknown by the general public, CRISPR/Cas9 has the potential to be one of the most influential technologies developed in the 21st century. What is CRISPR/Cas9 genetic scissors? CRISPR/Cas9 genetic scissors (hereafter, CRISPR) is a technology that enables geneticists and medical researchers to edit the genome of plants, animals, and humans. Genome editing (or gene editing) is a form of genome engineering in which DNA is inserted, replaced, or removed from the genetic material of a cell using artificially engineered enzymes, or “molecular scissors.” Germline editing is when this procedure is used on the genome of germline cells. (See below for explanations of these terms.) The simplistic explanation is that the molecular scissors”—Cas9, an RNA-guided DNA enzyme—cuts an enzyme on a specific spot of DNA in the nucleus of a cell. The cell then repairs the break using a piece of single-stranded DNA that has been injected into the cell by scientists. The following video provides a more in-depth, technical explanation of how CRISPR and Cas9 edit genes. What is a genome? A genome is an organism’s complete set of DNA, including all of its genes. Each genome contains all of the information needed to build and maintain that organism. In humans, a copy of the entire genome—more than 3 billion DNA base pairs—is contained in all cells that have a nucleus. What is a human germline? Our genes, the basic physical and functional unit of heredity, are passed on from generation to generation through our sex cells (i.e., ovum [egg] and sperm). These sex cells are part of the germline. The term germline can refer to these cells in an individual or to the lineage of cells spanning generations of individuals. The other cells in the body that are not part of the germ line (and hence do not pass on traits to other generations of people) are called somatic cells. What is genome editing used for? According to the National Human Genome Research Institute (NHGRI), genome editing is currently being applied to research on cancer, mental health, rare diseases, and many other disease areas. The CRISPR/Cas9 method has also been used for such purposes as editing genes in crop plants to improve and increase food production, and on laboratory animals to mimic human diseases so they can be studied to test new therapies. CRISPR may also be used to treat diseases that have genetic bases, ranging from asthma to cancer. Through the application of genome editing technologies, the NHGRI says, physicians might eventually be able to prescribe targeted gene therapy to make corrections to patient genomes and prevent, stop, or reverse disease. However, such germline therapies raise ethical concerns because changes made on the genome affect future generations. There is also the possibility that germline therapies would pave the way for genetic enhancement, the use of genome editing to change non-medically relevant characteristics, such as athletic ability or height, or to create “designer babies.” Is genome editing ethical? The main ethical consideration for genome editing is the purpose, whether for therapy or enhancement, and the long-term effect on future generations of humanity. This is why the ethical issues differ for genome editing on somatic cells, which are non-reproductive cells and would affect only the individual being treated, and on germline cells, which are reproductive cells that could potentially affect not only the individual but also their offspring and future generations of their descendants. The concern for germline editing is that therapeutic treatments passed along to future generations may have unexpected and unintended consequences. In essence, we would be experimenting on future generations without their consent. The other worry is that the procedure could eventually be adopted for non-therapeutic genetic enhancement, a form of eugenics. The process could be used by wealthy people to create “designer babies” whose genetic “improvements” (e.g., height, intelligence, longevity) would be passed along to future generations. From a Christian perspective, therapy implies fixing a malady that results from sin entering the world, such as curing diseases or restoring broken physical systems. Enhancement, in contrast, is attempting to make improvements of the body that are either not the result of sin or not necessarily caused by human brokenness. Distinguishing between therapy and enhancement is a perennially tricky issue for Christian ethicists. Additionally, not all therapy is beneficial, and not all enhancements are sinful. Using genome editing for enhancement, though, is troubling for several reasons. For example, using the process on ourselves implies that humans know how to “improve” on God’s general design for the human body. It also can imply that certain traits (such as height or a particular IQ) are so preferable that they should be purposefully engineered so that they can be distributed in a way that is outside the normal distribution range for the human species. Other concerns include questions about the cultural and social effects of having certain humans be engineered to have the “right” traits. Will the changes lead to unjust forms of inequality? Will those who do not possess the preferred traits be treated as inferior or sub-human? Will discrimination increase for those who are unable or unwilling to modify their children? Ultimately, we should oppose non-therapeutic germline editing because children (and future generations of children) are to be considered as gift from God (Ps. 127:3) and not as products that we can tinker with and modify to our preferences.

https://www.thegospelcoalition.org/article/the-faqs-what-christians-should-know-about-crispr-genetic-scissors/

The insertion of robotic and artificial intelligent (AI) systems in therapeutic settings is accelerating. In this paper, we investigate the legal and ethical challenges of the growing inclusion of social robots in therapy. Typical examples of such systems are Kaspar, Hookie, Pleo, Tito, Robota,Nao, Leka or Keepon. Although recent studies support the adoption of robotic technologies for therapy and education, these technological developments interact socially with children, elderly or disabled, and may raise concerns that range from physical to cognitive safety, including data protection. Research in other fields also suggests that technology has a profound and alerting impact on us and our human nature. This article brings all these findings into the debate on whether the adoption of therapeutic AI and robot technologies are adequate, not only to raise awareness of the possible impacts of this technology but also to help steer the development and use of AI and robot technologies in therapeutic settings in the appropriate direction. Our contribution seeks to provide a thoughtful analysis of some issues concerning the use and development of social robots in therapy, in the hope that this can inform the policy debate and set the scene for further research.

https://comdig.unam.mx/2019/03/21/ill-take-care-of-you-said-the-robot-reflecting-upon-the-legal-and-ethical-aspects-of-the-use-and-development-of-social-robots-for-therapy/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+comdig+%28Complexity+Digest%29

The insertion of robotic and artificial intelligent (AI) systems in therapeutic settings is accelerating. In this paper, we investigate the legal and ethical challenges of the growing inclusion of social robots in therapy. Typical examples of such systems are Kaspar, Hookie, Pleo, Tito, Robota,Nao, Leka or Keepon. Although recent studies support the adoption of robotic technologies for therapy and education, these technological developments interact socially with children, elderly or disabled, and may raise concerns that range from physical to cognitive safety, including data protection. Research in other fields also suggests that technology has a profound and alerting impact on us and our human nature. This article brings all these findings into the debate on whether the adoption of therapeutic AI and robot technologies are adequate, not only to raise awareness of the possible impacts of this technology but also to help steer the development and use of AI and robot technologies in therapeutic settings in the appropriate direction. Our contribution seeks to provide a thoughtful analysis of some issues concerning the use and development of social robots in therapy, in the hope that this can inform the policy debate and set the scene for further research.

https://comdig.unam.mx/2019/03/21/ill-take-care-of-you-said-the-robot-reflecting-upon-the-legal-and-ethical-aspects-of-the-use-and-development-of-social-robots-for-therapy/

By Mark W. Foreman In the 1997 film, Gattaca, we are introduced to a brave new world where genetic screening of newborns is routine and embryonic genetic manipulation is preferred over traditional conception. We are told the story of two boys in the Freeman family. The elder son, Vincent, is conceived naturally while his younger brother, Anton, is conceived in vitro and is genetically manipulated to remove any prejudicial genetic defects. At birth, Vincent is genetically screened and it is determined that there is a 99% probability that he will develop a heart disorder. He is given a life expectancy of only 30 years. From the moment of his birth the manner and time of his death are already known. As they grow, Anton excels in every area and becomes the favorite son. Unfortunately, Vincent’s DNA follows him throughout his life. We observe how, as a child, he is denied admission to school because of his “chronic illness” and how the school’s insurance won’t cover him. As a teenager, he dreams of joining the astronaut program. His mother discourages him, telling him to be realistic. His chances are one in a hundred of being accepted into the program with his “heart condition.” As an adult, we see how, at each job interview, a routine “drug screen” is performed. Everyone knows that they are really checking DNA. There is a law against such discrimination, called Genoism, but no one takes it seriously. If you refuse to disclose, they can take a sample from secretions left by your hand off a door handle, or a handshake, or even the sweat left on the application you turn in. It is a world where they have discrimination down to a science. There is now a new underclass, “In-valids.” These are people discriminated against not because of race or religion, but because of “inferior” DNA. To the in-valids are left the menial and unimportant tasks in society while the “valids,” the genetically engineered elite, are given the better jobs and the better lives. Is a world like that presented in Gattaca possible? While we do not have the technology to be there yet, many fear that the progress we have made in genetic research in the past few decades indicates that we are not far from a society much like the one Vincent Freeman lives in. While the advances in genetic screening, therapy and engineering promise great benefits in solving genetic disorders and diseases, they also raise very disturbing questions: Will we be forced to undergo genetic screening? Who will be able to obtain our genetic information? What about genetic discrimination? How easy will it be to shift from treatment for the human race to enhancement of the human race? In manipulating genes, have we stepped into a role reserved only for the Creator? Certainly one of the most important discoveries of the past century was the 1953 discovery of the basic structure of the DNA (deoxyribonucleic acid) molecule. This is the famous “double-helix” model that looks like a spiraling staircase. DNA is responsible for transmitting hereditary characteristics from parent to child. This discovery laid the groundwork for understanding the basic mechanism for copying genetic material from one cell to another and from one human generation to another. This would eventually lead to recombinant DNA research, screening of genetic diseases, gene therapy and mapping the entire human genome. The last of these was accomplished by the Human Genome Project. Inaugurated in January of 1990 as a joint project of the National Institute of Health and the Department of Energy, the HGP was estimated at the time to cost about 15 billion dollars and take about 15 years to complete. It finished ahead of schedule and in June 2000 the NIH announced that the entire human genome had been sequenced. According to one source, in the latest catalog of genetic disorders there are described 5,710 distinguishable genetic or chromosomal conditions.1 Statistically, genetic disorders are the second leading cause of death among children 1-4 in the United States and the third leading cause of death among teenagers 15-17. 25-30% of admissions to hospitals in the United States for children under 18 and 13% of adults are estimated to be due to genetic disorders. Also, 20-25% of institutionalized mentally retarded persons have genetic disorders.2 There are a number of different aspects in genetic technology to help solve the problems of genetic disorders. However, we will explore just two: genetic screening and genetic intervention. Genetic Screening The major advance in genetic technology has primarily been in the areas of diagnosis and prediction of genetic disorders. We can presently diagnose far more than we can treat. These activities involve genetic screening in which a geneticist attempts to discover the presence or absence of one or more genetic traits or conditions in an individual. There are predominantly four kinds of screening. Neonatal screening is genetically testing newborns for certain disorders and was the first form of genetic screening to be developed. The PKU screen was developed in the 1960’s and is now a standard screen for newborns. Prenatal Diagnosis is the genetic screening of a fetus. It was historically the second type of genetic testing to develop. In 1966 the first amniocentesis was performed. As a result, physicians could successfully diagnose chromosomal abnormalities and inborn errors of the fetal metabolism. Today, prenatal testing can diagnose over one hundred genetic disorders including Tay-Sachs Disease, Down’s Syndrome, Cystic Fibrosis, Spina Bifida, Trisomy 13, Trisomy 18, Sickle Cell Anemia, Muscular Dystrophy, and Hemophilia. Carrier Screening is usually done when one desires to know if he or she will pass on a genetic disorder to his or her children. It is possible not to have a genetic disorder, but to be a carrier of one if it is on a recessive gene. Most often, couples will consider such a screening if they are contemplating marriage. Carrier screening almost always is performed only on those who have a suspicion that they might be carriers of genetic disorders. Finally, Predictive or Pre-symptomatic Screening is the most recent form of genetic screening and will probably expand in usage over the next decade. It allows individuals with family histories of certain genetic disorders to be tested to see if they are at risk of developing the disorder. It is called “pre-symptomatic” because the test is taken long before any symptoms of the genetic disorder might develop. A common genetic disorder that falls under this test is Huntington disease which strikes a person later in life, usually between 35 to 45 years of age. In 1993, the actual HD gene was finally discovered and now persons from families with a history of HD can be tested early in life to see if they will contract Huntington’s disease much later. Other genes responsible for genetic disorders have been discovered, all of which can be tested for pre-symptomatically. While there is nothing inherently wrong with genetic screening in and of itself, it does raise a number of ethical concerns. The first concern has to do with the use of the knowledge arrived at through the screening. Once we have this knowledge, what can we do about it? Most proponents of genetic screening propose that such knowledge gives persons the freedom to make choices based on such information. However, at present, only a handful of genetic diseases are treatable and therefore advance knowledge can do nothing to prevent the onset of the disease nor treat it once it begins. Therefore, one is not sure what “choices” one can make. Having knowledge of most genetic diseases just doesn’t seem to help very much and, in fact, it may be harmful. For example, take prenatal screening. Such screening is done to determine if a fetus has a specific genetic disorder and has become almost routine in pregnancy. If the test comes back positive, what is the parent supposed to do? The assumption among most of the medical community is to abort the fetus, for that is the only way to “treat” the disease. In fact, for many, this assumption underlies the whole purpose of prenatal screening. However, abortion is not an option. The fetus, by nature of the kind of being it is, is a human person from the moment of conception. The presence of a genetic disorder does not in any way diminish its personhood. As a human person, it is an “image-of-God bearer” and therefore to take its life is an affront to God Himself. Also, it would be unwise to make a decision to take the life of a child based upon such tests because genetic tests are not completely accurate. Many of them have substantial margins of error for false positives and false negatives. Even if such tests were to become more accurate, they cannot inform one of the magnitudes of deformity. Several genetic disorders have differing degrees of abnormality from mild forms to severe. Prenatal screening is not the only area where the question of what to with the knowledge of a genetic disorder arises. It is also problematic for other types of screening. If an infant undergoes a neonatal screen that determines that he will develop Tay Sachs disease or muscular dystrophy, that could possibly lead parents to treat him differently, like Vincent was treated in the story of Gattaca. Leon Kass, the chairman of President Bush’s Council on Bioethics, relates the story of the father of a 10 year old girl who, upon learning that his daughter was a carrier of the BRCA-1 gene, an indicator of the possibility of breast cancer, insisted that she have a radical ovariectomy and mastectomy.3 There are also problems with the knowledge gained from Carrier screening. If a person has knowledge that he may pass on a genetic disorder, does he have a moral obligation not to get married or, if he does marry, not to have children? Should he seek sterilization even though screening might not be accurate or the chances are only one in four? There are also concerns about the knowledge gained with presymptomatic screening. Is it better to know for sure if you do or do not have a genetic disorder, or is it better not to know? Suppose a person is suspicious that she might have HD and so she is tested for it and finds out that she will develop the disease. How might that affect her life? Some argue that gaining such knowledge actually deprives a person of one of the most basic aspects of human life, the right to be ignorant concerning one’s future. Such ignorance is necessary for authentic free choices and actions. We often decry that too little knowledge can be dangerous without realizing that the same can be said of too much. A second concern about genetic screening is the question of who else will be able to access the knowledge of a genetic disorder. Normally, health information is kept confidential between physician and patient. However, others may believe they have a right to your genetic information. For example, insurance companies argue that they have a right to this information. After all, they have a legitimate interest in controlling costs and therefore want to insure persons who are at low risk of disease or debilitation. If they get your genetic information and find there is a 60% chance of your developing a genetic heart disorder, they might charge a higher premium or even refuse to insure you, even though you might be perfectly healthy and never actually develop the disease. While the government attempted to prohibit such discrimination with the passage of the Health Insurance Portability and Accountability Act of 1996, which prohibits insurance discrimination on the basis of genetics, insurance companies can find ways of getting around such legislation. Businesses may also feel they have a right to your genetic screen. Like insurance companies, businesses have a legitimate interest to control costs and they may not want to invest in hiring and training an employee if they know he might become ill early in life. However, this constitutes discrimination. It’s not even discrimination on the basis of handicap, but on a possible future handicap. While the Equal Employment Opportunities Commission has ruled that the denial of jobs on the basis of genetic information is illegal, many argue that there are still too many loopholes and exceptions. Finally, the government might feel it has the right to know. If a person has a genetic disorder, there is a good possibility that he or she will eventually need state or federal resources to help defray medical costs. Therefore, the government might want to know a person’s genetic screen. In 1970, a relatively inexpensive test was developed for sickle cell anemia making it possible to identify carriers of the disease. During 1971 and 1972, twelve states passed mandatory laws for testing African-Americans to determine if they were sickle cell carriers as a condition to getting married. The idea was that by knowing their status in relation to sickle cell, married couples could think through their options and plans for children. However, as a result of the laws, many African-Americans lost their jobs, health insurance, and were even discharged from the military, even though they were perfectly healthy and had no risk of developing the disease.4 While the federal government rescinded all such laws in 1972, the idea of government mandatory genetic testing is still a very real possibility. None of this is to say that genetic screening is unethical. Nor am I arguing that we should just remain ignorant. However, we need to realize that with such God-like knowledge comes a heavy burden and responsibility. The main question is, “What will you do with this knowledge?” One needs to seriously reflect on one’s motives and desires before taking such a significant step. Genetic Intervention Genetic Intervention involves actually manipulating genes in order to improve them. This is sometimes called genetic engineering or, more commonly, gene therapy. We stated earlier that genetic screening is the main activity taking place in genetics today. This is primarily due to the fact that our technology is still in its infancy when it comes to actually being able to intervene in a person’s genetic make-up and make changes. However, it is the goal of almost all geneticists to be able to perform genetic therapy on human beings. What kind of intervention can or may be done someday? Genetic Therapy There are two types of genetic therapy currently in research. Somatic cell therapy is intervention which aims to cure a genetic disorder by modifying the non-reproductive cells in a person. If successful, this would cure the person, but he would not pass that cure on to other generations. Germ line therapy is an intervention in the reproductive cells to attempt to modify them so that a particular genetic disorder would not be passed on to future generations. In this type of intervention both somatic cells and germ line cells are treated to affect both the present person and his or her future offspring. While there has been some success with somatic cell therapy, as far as is known germ line therapy has not been performed on human beings. There are many benefits to genetic intervention. The possibility of curing, possibly forever, a number of genetic disorders is certainly an admirable and important goal in medical science. However, there are some very real concerns and moral problems with intervening in creation that should urge us to proceed with caution. One of these is the danger of commercialization. Many medical laboratories are run by large corporations. It would be naive to deny that one of the primary motivations behind genetic research is the possibility for enormous profits that a genetic cure would bring. Imagine the corporation that discovers and patents a cure for genetic heart disease or cystic fibrosis. The corporation would have complete control over the patent and could charge almost anything for it. Corporations can justify high prices by appealing to the expense of genetic research. Anticipation for profits might also cause companies to cut corners, place undue pressures on researchers, and slant studies in favor of the company. While there is some government regulation of genetic research itself, in a free market society such as ours, it is difficult to see how government could regulate the distribution of genetic cures. For many, a more serious problem is the over all attitude found among many in the genetic research community which is often referred to as the “presumption of knowledge.” The idea is that if something can be known, then it should be known. This attitude often results in running full speed ahead into scientific experimentation and research, without taking the time to think through the ethical and social issues that such knowledge and experimentation might affect. My point here is not to impugn science in general, nor any specific scientist. Those in medical science are often motivated by a desire to do good, to cure disease and make the world a better place for people to live. However, even pure motives can blind one to the social and ethical implications of scientific work. The recent claims by many to have either cloned or be attempting to clone a human being are an excellent example of this attitude. Almost all experts in bioethics agree that human cloning should not even be considered until the religious, ethical and social implications of such actions be considered and discussed by the research community. Yet there are those who have decided to proceed into this very controversial procedure without allowing any time for serious reflection of the possible ethical and social repercussions involved. Charles Colson states it well: “So while genetic research may lead to important medical advances, we must probe the deeper question: What are the restraints? Technological advance may make it possible to do something, but ought we to do it?”5 The restraints need to come from outside of science itself—these are not scientific issues. They are philosophical, ethical, societal and religious issues. As far as specific types of interventions go, currently somatic cell therapy is the only type that has been performed on human persons. Since this is therapeutic, few have been morally critical of it beyond the points made above. Germ line therapy is a bit more controversial. More than just the present patient will be affected by such therapy and more needs to be considered. One may not know for a number of generations if a particular germ line treatment has been effective, or worse, if it is causing other unforeseen damage. Therefore it is difficult to form an adequate research design plan and to balance harms and benefits. The issue of informed consent is also raised by some, for we are now discussing performing experimental treatment on future generations who do not have any say in such experimentation. Another problem with germ line therapy is that it must be performed on embryos in order for the intervention to spread to all cells including reproductive cells. This causes two problems: first, much of the early work in laboratory animals has been unsuccessful, resulting in defective embryos and embryos that did not survive the procedure. It is highly probable that such therapy, when used on humans, will have a similar effect, at least in the beginning. Given the personhood of the fetus from conception, this means we would be creating defective children who would most likely be aborted, or simply killing the unborn. While I would not completely rule out the possibility of germ line therapy, the present problems raise extreme difficulties that make such therapy on human persons unjustifiable for the present. Genetic Enhancement However, the area of most concern in germ line therapy is the temptation of crossing the line from therapy to enhancement. Therapy has to do with the curing or preventing of a genetic disorder. Enhancement has to do with improving traits and abilities that are not diseases. Here is where genetic technology differs drastically from other forms of treatment. While some argue that genetic technology is just another form of medical intervention, it differs substantially in the ways that it can literally change our understanding on what it means to be human. Some argue that this really is playing God. While this charge is often legitimately dismissed, as any life or death medical intervention can be seen from the perspective of playing God, in the case of genetic technology it is a very real analogy in two senses. First, God created man with certain abilities and limitations and to attempt to expand them is to step into a role that is reserved only for Him. Secondly, those researchers who develop the procedures for genetic enhancement have a God-like control over the destiny of future generations. What will be the standard of what it means to be a healthy, functioning human being? The standard will be the values and concerns of a handful of genetic scientists—a community that is predominantly naturalistic in its thinking and outlook. What we are really talking about here is eugenics, though few will use that term. In the early part of the last century, there was strong negative eugenics movement that dominated the medical community. Negative eugenics is the attempt to improve the race by eliminating undesirable traits. Forced sterilization of the mentally handicapped, regularly practiced in the first half of the 20th century, is an example of negative eugenics. It only died out after it became associated with the Nazi atrocities of WW II. However, today many researchers are advocating positive eugenics—improving the race by enhancing desirable traits such as intelligence, memory, and physical abilities, including an extended lifespan. With its promises to end suffering and many social burdens, the public will have a hard time saying no to the persuasiveness of the research community. Conclusion Genetic technology offers some very real benefits to mankind that cannot be ignored. The opportunity to cure or prevent such genetic diseases as Down’s syndrome, Cystic Fibrosis, or Spina Bifida is one that should be explored to its fullest extent. It would be just as foolhardy to abandon genetic research altogether as it would be to run full steam into it without pausing to consider some of the very real dangers such research poses. My argument presented here is not to advocate a halt on either screening or intervention. My purpose is to call for serious reflection on the ethical implications of genetic technology. We need to define the parameters of such technology and to seek out its limitations, for it certainly has some. We need to be ever careful of the temptation so prevalent in modern society to justify almost any action in the name of happiness or the relief of suffering. We have made a god of good health and often give the impression that the only truly good human life is one that is devoid of any suffering. Such a view of life is not only inaccurate, but is outside the design that God has imposed on us. Suffering, illness, and death are signs of our frailty and dependence on the Divine healer. Certainly this does not mean that we should pursue suffering nor that we should not attempt to relieve what suffering we can. But it does mean a recognition on our part that there are limits to what we can do. Trust in God means that we should not move beyond those limits. For ultimately all things belong to Him. Soli Deo Gloria.AJ Mark W. Foreman is Assistant Professor of Philosophy and Religion at Liberty University in Lynchburg, VA. He is the author of Christianity and Bioethics (College Press, 1999). NOTES 1 Leroy Walters, “Reproductive Technologies and Genetics”, in Medical Ethics, 2nd. ed. Ed. Robert M. Veatch (Boston, MA: Jones and Bartlett, 1998), 220. 2 Ibid. 3 Kass, MD, Leon R., Life, Liberty, and the Defense of Dignity (San Fransisco: Encounter Books, 2002), 125. 4 C. Christopher Hook, MD, “Genetic Testing and Confidentiality” in Genetic Ethics: Do the Ends Justify the Genes?, eds. John F. Kilner, Rebecca D. Pentz, and Frank E. Young (Grand Rapids, MI: Eerdmans, 1997), 127. 5 Charles W. Colson, “Contemporary Christian Responsibility,” in Genetic Ethics: Do the Ends Justify the Genes?, 220. GLOSSARY OF TERMS Bioethics. A branch of the discipline of ethics which analyses and studies ethical issues that arise within the medical and biological sciences Cloning. The popular name for what is technically known as somatic cell nuclear transfer. It is producing a genetically identical copy of a living organism by replacing the nucleus of an egg cell with the nucleus of a somatic (body) cell. Reproductive Cloning involves the implanting of a cloned embryo in a female organism’s womb in order to produce a live birth. Therapeutic cloning involves producing cloned embryos whose cells will be harvested for research in treating diseases. DNA. Deoxyribonucleic acid. The famous “double-helix” molecule contained within each living cell which transmits hereditary characteristics from parent to child. Eugenics. The idea of improving the human race through genetic engineering. Genetic engineering. Also called genetic intervention. The modification, manipulation, or replacement of genetic material for therapeutic or enhancement purposes. Genetic enhancement. A kind of genetic engineering which modifies a person’s genes in order to enhance or improve individual traits such as height, eye color, or intelligence. Genetic screening. Also called genetic testing. The use of diagnostic procedures to determine whether or not an individual has a particular genetic trait. Genetic therapy. A kind of genetic engineering which modifies a person’s genes in order to cure a genetic defect or disease. Stem cell research. Scientific research that utilizes or is conducted on stem cells, usually for the purpose of treating certain diseases. Stem cells are unspecialized cells which can develop into cells found in other types of tissues. Stem cells are prevalent in human embryos.

https://arcapologetics.org/genetic-engineering-benefits-and-dangers/

Younggren has provided important ethical and legal information that should dispel some of the misunderstandings about termination. It is not clear how such misunderstandings arose in the first place. If their origins lie in psychotherapists’ clinical training and early supervision experiences, then ultimately the solutions may lie there (Murdock, Edwards, & Murdock, 2010). But regardless of their origins, it is hard to understand why the misunderstandings have persisted. Practicing psychologists have long had access to detailed advice about managing difficult terminations and about differentiating between psychotherapist-initiated termination and abandonment. (For recent examples see Davis & Younggren, 2009; Shefet & Curtis, 2005; Vasquez, Bingham & Barnett, 2008; Younggren & Gottlieb, 2008). This commentary will focus on possible reasons why such resources have not ended the confusion. Psychotherapist Variables Termination is a complex process that is affected by both patient and psychotherapist variables. Psychotherapists tend to blame problematic or premature terminations on the patient rather than on themselves (Murdock et al., 2010). Undoubtedly, certain categories of patients may complicate the termination process. But perhaps, in focusing on patient variables, we have paid too little attention to psychotherapist variables (Behnke, 2009; Boyer & Hoffman, 1993). It is recommended that psychologists initiate a discussion of termination at three different stages of psychotherapy: (1) at intake; (2) during treatment, in anticipation of termination; and (3) when the ending actually occurs (Vasquez et al., 2008). The quality of such discussions might depend to some degree on the patient, and on the nature of the patient-psychotherapist relationship. But whether such discussions are actually initiated at each of these stages, and whether they are introduced in a manner conducive to effective interactions, would depend on psychotherapist variables, not patient variables. Intake is the appropriate time for a psychotherapist to introduce discussion of the patient duties that Younggren describes. In fact, talking about termination during the initial informed consent conversation may be the most important thing one can do to reduce the likelihood of later difficulties with closure (Younggren & Gottlieb, 2008). Written intake materials can provide information about when the psychotherapist might initiate termination, such as “when feasibility or quality of service is compromised; services are not benefitting or harming the client; or when client conduct is inconsistent with the safety or integrity of the work” (Davis & Younggren, 2009, p. 576). Davis (2008) even provides sample paragraphs that psychotherapists can use to describe both their termination policy and patient responsibilities. Yet, reportedly, few psychotherapists include the topic of termination in their informed consent documents or discuss it at intake (Davis & Younggren, 2009). Failure to initiate that discussion may result as much from a general tendency to shortcut the informed consent conversation as from avoidance of the topic of termination in particular. Obtaining the patient’s informed consent includes (1) providing clear information about what the rules will be and (2) obtaining the informed patient’s consent to accept the conditions described. Many psychotherapists are either reluctant to begin a therapy relationship that way, or are confused about the specifics of the process (Barnett, Wise, Johnson-Greene & Bucky, 2007; Somberg, Stone, & Claiborn, 1993). The APA Ethics Code (Standard 10.01, Informed Consent to Therapy) lists numerous things that psychotherapists are required to inform prospective patients about; and HIPAA has expanded the list. If the item of “termination” is simply added to these ethically- and legally-required intake topics, it is likely to go unnoticed on a crowded handout. Yet, Younggren suggests that patient duties about termination should be emphasized, not ignored. Once therapy begins, numerous psychotherapist factors might affect whether termination is discussed. Martin & Schurtman (1985) suggested that psychotherapists might experience anxiety about termination because of such things as overconcern about whether it will be a “successful” termination; response to the patient’s termination anxiety; or personal loss at the ending of what has been a meaningful therapy relationship. Others found that dissatisfaction with the results of treatment may be the most frequent psychotherapist hindrance to successful terminations, perhaps because the pending termination brings to the surface feelings of defeat and incompetency about the case (Brady, Guy, Poelstra & Brown, 1996). Conscious or not, such emotions might make it less likely that a psychotherapist would follow the advice to make reference to termination during the therapy or to raise issues of non-payment or non-compliance that might lead to the need to end the relationship. Finally, reluctance to terminate can arise from practical concerns (e.g., financial worries; dwindling caseload) or from psychotherapist fears that the patient will be angry, retaliate, or file a complaint. Regardless of the underlying reasons, among the most visible signs of psychotherapist discomfort with termination may be the tendency to prolong the therapy relationship inappropriately. Lambert (2000) suggested that clinicians tend to defend against the awareness that a patient is failing to progress. According to Stewart and Chambless (2008), 36 percent of psychotherapists in private practice continue to treat patients who are not improving. Earlier research suggested that, even when the patient showed little or no progress, more than half of psychotherapists tended to continue doing “more of the same” rather than revising the treatment plan or raising the possibility of referring the patient to another provider (Kendall, Kipnis & Otto-Salaj, 1992). Yet, as Younggren notes, this is in direct contradiction to APA Ethical Standards. Although therapy is a bilateral relationship in which patients share responsibility about the termination process, psychotherapists must nevertheless take responsibility for unilaterally ending the relationship in certain circumstances. The fact that it is sometimes unethical for a psychologist not to end a therapy relationship makes it logically impossible to equate every psychotherapist-initiated termination with an unethical “abandonment” of the patient. Yet psychotherapists who are dealing with unresolved issues of loss or abandonment might so experience it. Boyer & Hoffman (1993) found a correlation between the psychotherapist’s loss history and feelings of anxiety and depression during termination. A psychotherapist with unresolved feelings around loss may fail to be aware when termination is appropriate, or “may respond to the termination phase in a manner that is detrimental not only to ending the therapy but also to progress made up to that point” (p. 276). This suggests that a belated or inept ending can have an “undoing” effect on the progress that was accomplished during the therapy. Self-Reflection and Consultation Psychotherapists who are uncomfortable with termination for any reason are less likely to initiate sufficient conversation about it at any stage of the relationship. Davis and Younggren (2009) suggest that a psychotherapist’s competence in conducting a well-executed termination not only requires a strong ethical foundation and good clinical skills, but also taps such things as self-reflection and relationship capabilities. Questions such as the following might help psychotherapists recognize when they are doing things that unnecessarily complicate or hinder the termination process: 1. At intake, do I discuss patient duties such as responsibility for participating in mutual goal-setting, monitoring progress, or planning for termination? If not, why not? 2. Do my written informed consent documents and patient contracts mention patient responsibilities, including those related to termination? If not, why not? 3. Do I re-open the conversation about termination if the contract needs to change (e.g., patient is making no progress; third party reimbursement is ending)? If not, why not? 4. Do I raise issues of nonpayment or noncompliance when they first arise, and consider the possible need for termination? If not, why not? 5. Do I dread ending particular therapy relationships? If so, which ones, and why? 6. As therapy relationships end, do I spend sufficient time exploring patients’ issues related to the ending, including negative as well as positive feelings about the therapy? If not, why not? 7. Do I remain aware of my possible role in complicating a termination, instead of just blaming the problems on patient variables? If not, why not? 8. Do I obtain consultation in cases involving difficult terminations? If not, why not? Psychotherapists can use such self-reflection to remain aware of their possible need for ongoing consultation when facing difficult terminations. Psychotherapists who are unwilling to engage in self-examination will not likely benefit from the available resources, even when they come in the form of helpful ethical and legal recommendations such as those provided by Younggren. Finally, we must count on clinical training programs to be alert to issues related to both informed consent and termination, and to use classroom and supervision experiences to monitor trainees’ competence with both beginnings and endings. REFERENCES Barnett, J.E., Wise, E.H., Johnson-Greene, D., & Bucky, S.F. (2007). Informed consent: Too much of a good thing or not enough? Professional Psychology: Research and Practice, 38, 179-186. Behnke, S. (2009). Termination and abandonment: A key ethical distinction. Monitor on Psychology 40 (8), 70. Boyer, S.P. & Hoffman, M.A. (1993) Counselor affective reactions to termination: Impact of counselor loss history and perceived client sensitivity to loss. Journal of Counseling Psychology, 40, 271-277. Brady, J.L., Guy, J.D., Poelstra, P.L. & Brown, C.K. (1996). Difficult good-byes: A national survey of therapists’ hindrances to successful terminations. Psychotherapy in Private Practice, 14, 65-76. Davis, D.D. (2008). Terminating therapy: A professional guide to ending on a positive note. Hoboken, N.J., John Wiley & Sons. Davis, D.D. & Younggren, J.N. (2009). Ethical competence in psychotherapy termination. Professional Psychology: Research and Practice, 40, 572-578. DOI: 10.1037/a0017699 Lambert, M. J. (2000, August). Promise and problems of evaluating clinical practice in everyday clinical settings. In J. A. Carter & G. K. Lampropoulos (Chairs), Reprioritizing the role of science in the scientist-practitioner model in psychotherapy. Symposium conducted at the 108th Annual Convention of the American Psychological Association,Washington, DC. Martin, E.S. & Schurtman, R. (1985). Termination anxiety as it affects the therapist. Psychotherapy, 22, 92-96. Murdock, N.L., Edwards, C. & Murdock, T.B. (2010). Therapists’ attributions for client premature termination: Are they self-serving? Psychotherapy: Theory, Research, Practice, Training, 47, 221-234. DOI: 10.1037/a0019786 Shefet, O.M. & Curtis, R.C. (2005). Guidelines for terminating psychotherapy. In: G.P. Koocher, J.C. Norcross & S. S. Hill III (Eds). Psychologists’ Desk Reference, 2nd Edition, pp. 354-359. New York, Oxford University Press. Somberg, D.R., Stone, G.L., & Claiborn, C.D. (1993). Informed consent: Therapists’ beliefs and practices. Professional Psychology: Research and Practice, 24, 153-159.

https://centerforethicalpractice.org/articles/articles-mary-alice-fisher/psychotherapist-variables-affecting-termination/

OFFICE POLICY AND INFORMED CONSENT Confidentiality: The laws of the State of Illinois require that most issues discussed during the course of therapy with a psychotherapist are confidential. These laws permit you to waive the privilege of confidentiality by signing a “Release of Information Form”. However, the release of confidential materials is required in situations of suspected child abuse, of potential harm to oneself or others, and in instances where the court may subpoena records. During the course of your therapy, you may request that some information be discussed with another person (ie. your physician, spouse/partner, children, parents, etc.) If you desire that information be communicated about you to someone else, please ask for a “Release of Information Form”. If we feel that it will be useful to you during the course of your therapy, to discuss your progress or situation with another person (i.e. your physician), your therapist will request your written permission to do so and would not release that information without such written permission. Appointments: Therapy sessions will typically be on a weekly or bi-weekly basis. Additional appointment times can be arranged with your therapist. A therapy “hour” is 45 minutes in duration and is referred to a “clinical hour”. Cancellations and Missed Appointments: It is requested that you provide advance notice of cancellation at least 24 hours before a scheduled appointment. If a cancellation has not been made prior to this time, the session is a loss for someone else wishing to use that therapy time. A scheduled appointment means that it will be held only for you and, therefore, cannot be used by another person. Late cancellations, or appointments not canceled, will be billed as a “failed appointment”. Failed appointments will be billed at your regular session feel. Most insurance companies do not cover failed appointments, resulting in the client themselves being solely responsible for any such charges. If you are late, the session will still end at the scheduled end time. Children in the Waiting Room: We are unable to provide supervision for children in the waiting room and cannot accept responsibility for their safety if left unattended. For the safety and welfare of the children, as well as consideration for other clients and staff, please make other arrangements for childcare during therapy sessions. Parents who do not comply will risk the cancellation of their designated appointment. Parents will be held responsible for any property damage caused by their child. Telephone Calls: Fees are not charged for phone calls to therapists regarding appointments and similar matters. As well, fees are not charged for phone calls requiring just a few minutes. However, a pro-rated charge will be made for psychotherapy or psychotherapeutic consultations conducted over the phone that require more than 5 minutes. This would be billed at the same rate as face-to-face sessions. Phone calls may be made from our offices for emergencies. Fees: You will be billed for all time spent with you or on your behalf, including the therapist’s time spent preparing reports, reading letters or other documents, consultations, travel time for “out of office” services, and telephone calls. A list of all clinical fees is available by request. Payment is requested at the time of each session either by cash, check or charge card. Each client remains responsible for any fees not covered by insurance carriers. Insurance Coverage: If you maintain health insurance, part of your therapy expenses may be covered through that insurance. In the case of Blue Cross/Blue Shield of Illinois, PPO, or other insurance companies with whom we have a contractual agreement, however, we will honor the amount BCBSIL writes-off, and will only charge the responsible party the co-pay and deductible amount. Returned Checks: In the event that a check given for payment of your account is returned by your bank, a charge of $50.00 will be added to your account. Delinquent Accounts: Payments not made within one (1) month of the billing date will be considered late and the account charged a fee of 12% the outstanding balance. Further delinquent accounts may be sent to collections. This is typically not done unless the account is seriously overdue by 90 days. Be aware that the adult who contracts the counseling services by signing this policy and informed consent, is solely responsible for all incurred fees. A third party may be billed with their consent. If the third party does not cover the expense as outlined above, then the responsibility for payment defaults to the contracting adult. Ethical and Professional Standards: As professional and licensed therapists, we work diligently to uphold the most responsible, ethical and professional standards possible, and we are accountable to you. If you have any questions or concerns about your course of contact with us, please feel free to discuss these issues with us. In signing this contract you are agreeing that should you have any dissatisfaction or concern about your treatment, you will do your best to indicate your concerns to us so we can attempt to address them to your satisfaction. If you are unhappy with your services here and need help finding additional or alternative resources, we will assist you in locating a more suitable referral source. Illinois Law for Mandated Reporting: If information is revealed in your treatment regarding potential harm to minors or serious threat of harm to yourself or others, your therapist is required by law to report this information to the proper authorities. Therapy May be Upsetting: You need to be aware that engaging in psychotherapy may involve experiencing uncomfortable past traumatic events, difficult intense emotions such as depression, anger, grief, confusion or anxiety. It may also result in changes in your life that could be difficult to face. Your therapist will discuss these situations with you if they come up in the course of therapy. Ending Therapy: You can end therapy at any point you wish. Ending therapy is an important aspect to a successful therapeutic experience. Usually therapy pursues specific goals that you and your therapist will discuss together, including an appropriate termination process. If you decide you need to terminate your treatment prematurely, please discuss this with your therapist. Your therapist will also discuss with you if they conclude that the therapeutic process is not benefiting you. In the case where you do not discuss the termination with your therapist and have outstanding appointments scheduled, please be aware that you will be charged the set fee for the un-canceled appointment(s).

https://thomasgillandassociates.com/office-policy-informed-consent.html

applies to psychology, as it does in any other medical practice. When seeking psychological treatment or therapy, only the client/s and therapist know exactly what happens in each session. Clients have the absolute right to confidentially and to be treated with the utmost respect by their therapist, ensuring trust and dependency. Client interaction: the therapy process should attempt to be as interactive as possible. Clients should feel free to ask their therapist questions, request further information, as well as discuss treatment methods and overall approach to therapy. Their participation is most often the key to proper progress. Ethics & code of conduct. As a member of the Cyprus Psychologists' Association, Cyprus-Therapy and Zoe Anthouli conduct all therapy sessions as per the association's Ethical Principles and Codes of Conduct as well as following the Ethical Guidelines set out by the European Federation of Psychologists' Association . Cyprus-Therapy's Exceptions to confidentiality in therapy Understanding professional limitations and the greater good. As per industry practice, therapy with a psychologist (psychotherapy) is a personal and confidential process. Despite adhering to this ethic and professional code-of-conduct, there are certain exceptions that may apply, either as required by law or for the purpose of protection, security and safety, including: Suspicion of harm caused to client unless protective measures taken Reasonable suspicion of danger of violence to others Suspicion of abuse to others, i.e. child or elder adult abuse Suspicion of a possible crime; committed or intention Legal requirements by court-of-law – testifying in court * Some of therapist's records are part of larger medical study * Health insurance may request more information on therapy In all of the above cases, the therapists is either permitted or indeed required by law to break confidentiality ethics and code-of-conduct in order to protect the client, or someone else that might be endangered from harm. * The client will be properly informed ahead of time (i.e. before therapy begins) if and where records will be utilised, whilst also providing informed consent. Special notice on therapy confidentiality Distinguishing who the client is and their ability to comprehend during therapy. There are a number of other special cases regarding client confidentiality privileges in therapy, namely with regards to who is deemed to be the client and what rights should they have. This is most common when children or those with mental disabilities are concerned. Therapy with couples, families, and psychotherapy groups may also sometimes raise confidentiality issues. read more The most obvious example is with children. When a child is a minor without legal rights, then the child's parents or guardians are often considered to be the legal client and must be incorporated into the practice – the same holds true for those with mental disabilities (i.e. Alzheimer's disease) that are not in a position to legally make decisions on their own accord. Thus, the therapists must distinguish a child from an adult during psychotherapy; or the client's ability to make decisions. However, when a child is in psychotherapy, sometimes the success of the treatment depends on providing privacy to the child and not telling the parents everything that happens. Other times, it might be necessary to only keep them informed of the child's progress and of any serious issues, such as substance abuse or criminal activity. Such client confidentiality matters should always be discussed and negotiated with the therapist prior to the beginning of treatment. With couples, families, and groups, confidentiality issues usually arise regarding how each person interacts and shares information with the therapists, or when some one requests information on the other. Again, level of confidentiality should always be clarified in advance prior to treatment sessions. Remember, each situation is unique, with its own special circumstances, issues and possible treatments. As such, it is up to the therapists to distinguish the environment and the path to treatment, together with the client. Hence, initial assessment is vital to successful therapy and treatment. Main Menu: Home Page | Credentials | Therapy | Confidentiality | FAQs | Journal | Location Psych Info:

http://www.cyprus-therapy.com/confidentiality.asp

38.1 Individuals engage in sporting activities for a range of reasons: as a form of social interaction, for fun, to keep fit, for the thrill of competition and, in some cases, to earn a living. At the elite or professional level, sport can involve exploring the limits of what is humanly possible in terms of speed, strength and skill. At this end of the sporting spectrum there are powerful incentives, including financial incentives, to use new technologies such as gene therapy and genetic testing to maximise potential and provide a competitive edge. The use of genetic information in elite sports is the focus of this chapter. 38.2 While there is potential for the use of gene therapy to treat sport injuries and to enhance performance, these applications are experimental and the subject of continuing research. Part D of this Report addresses the regulatory framework for the ethical conduct of human genetic research in Australia. That framework, and the recommendations made in Part D, extends to genetic research in the field of sports medicine. The issues raised by the potential application of this research, although of great significance for sport’s governing bodies and sport’s drug agencies, largely fall outside the terms of reference of this Inquiry. It is of interest to note, however, that the World Anti-Doping Agency and the International Olympic Committee have recently included the non-therapeutic use of genes, genetic elements and/or cells that have the capacity to enhance athletic performance in their list of proscribed substances and methods. 38.3 The use of genetic information in sport does, however, fall within the Inquiry’s Terms of Reference. The Inquiry received few submissions on the use of genetic information in sport, but this application clearly has the potential to raise ethical, discrimination and privacy issues. Two uses, in particular, are considered in this chapter. These are the use of genetic testing to identify: potential elite athletes carrying particular ‘performance’ genes; and individuals with a genetic predisposition to sports-related injury. G Breivik, Limits to Growth in Elite Sport – Some Ethical Considerations, 16 September 2002. International Olympic Committee, Press Release: IOC Gene Therapy Working Group — Conclusions, International Olympic Committee, <www.olympic.org/uk/news/publications/press_uk.asp?release=179>, 20 February 2003.

https://www.alrc.gov.au/publication/essentially-yours-the-protection-of-human-genetic-information-in-australia-alrc-report-96/38-sport/introduction-58/

This paper will study through some of the diverse ethical issues that can arise within group therapy sessions, such as conflict and confidentiality. While discussing the ethical issues within group counseling we will take note of how these ethical issues may differ and compare to the ethical issues of those within individual counseling sessions. This paper will also discuss reasons why a therapist might choose to lead a group therapy session over individual counseling and vice versa. Throughout this paper you will be accurately informed of the ethical issues surrounding group therapy and individual counseling. As someone just starting out in the counseling field this paper may help to address any questions you had in deciding if leading group therapy is right for you or if you would be better suited for individual counseling. Ethics in group counseling 3 Ethics in groups Group counseling includes psychiatric treatment where more than one patient meets together with a therapist at the same time. Some groups are specific to a certain topic or issues that all members with the group are interested in or a problem that they are dealing with such as substance abuse, others may be involved in a group that is more for support such as a support group for parents struggling with children with autism. Groups have different topics but those attending a particular group are all attending for the same reason, they want personal growth. (Jacobs, 2012) Jacobs (2012, p.3) says “Although there is still a place in a community agency for individual counseling, limiting the delivery of services to this model is no longer practical, especially in these tight financial times. Not only do groups let practitioners work with more clients, but the group process is a unique learning advantages.” Amato (2000) warns therapists to be aware that records may be disclosed directly to patients and that boundary violations may occur as a result of any secondary relationships that alters the therapeutic relationship with the client. Therapists must also be aware that members of the group may abuse other members in the group; avoidance of this behavior may be avoided with proper guidelines in place and disclosure at the start of the group process for each Ethics in group counseling 4 member. A close relationship can be built between all group members as well as the therapist, Forsyth (2011) refers to this relationship as group cohesion. Tenbrunsel (2006) mentions social cohesion, as enabling unethical and selfish actions, instead of a positive feature of group life. Certain modalities of therapeutic treatments are linked to ethical dilemmas as well; these modalities affect treatment outcomes as well. Dyadic therapists may misuse the intimate nature of the sessions by pushing their values on the client or clients, or by allowing therapy to extend beyond its efficiency. Confidentiality can be broken much easier with the group setting; therapists need to be highly guarded on this topic. (Amato, 2000) “In group psychotherapies, the therapist may fail to obtain fully informed consent, or may inadequately explain that confidentiality cannot be guaranteed in a group setting. The group therapist may not have the skills to differentiate between helpful and harmful feedback from the group, may lack the knowledge to understand when premature disclosures can be harmful to a group member, or might misunderstand how groups form norms that can be either healthy or unhealthy. Family therapists are faced with problems of agency, forthrightness to the family, working with members who do not want to participate in therapy, and issues of informed consent. Family therapists must be able to distinguish between their own values and those of the family, and refrain from promoting their own Ethics in group counseling 5 value systems.” (Amato, 2000) Corey (2014) described some ethical issues within the group setting as making sure the group leader has quality training. As many references stated Corey (2014) also noted that confidentiality is an important issue within the group. Continuing with the values that each group should uphold, utilization of what techniques to use in the sessions, and ethical issues in-group membership. Ethics in individual counseling Dufrene (2011) conducted a study on current and emerging ethical issues in individual counseling situations. Their study was based off of three research questions: What di experts believe are the most important ethical issues currently facing the counseling profession, what do experts believe are the most important emerging ethical issues that the counseling profession will need to address during the next five years, and do experts identify social justice concerns as important current and emerging ethical issues. Dufrene (2011) used the Delphi technique that uses written responses rather than bringing all the experts together for a discussion. This technique reduces potential bias because the participants and separate and unknown to each other. The twenty-two participants believed that the top four current ethical issues were ensuring that counselors practice ethically/abide by the code of ethics, strengthening the professional identity of counselors, determining boundaries of Ethics in group counseling 6 competence, and practicing with multicultural competence. These same twenty-two participants noted that the top four rising future issues were: dealing with social justice and diversity issues, being accountable for measuring effectiveness of counseling, serving emerging populations and dealing with issues created by medical advances, and managing diagnosis and changing concepts of mental health. Compare/contrast group and individual counseling What is the difference between group and individual counseling? We know that individual counseling is one on one counseling between the client and the therapist. Group counseling includes psychiatric treatment where more than one patient meets together with a therapist at the same time. We also know that there are ethical issues within both types of counseling relationships. How do they compare? How are they different? From the research done so far regarding ethics in both groups and individually we can see that the standards for counseling and ethics do not change. The same codes apply to the counselor counseling the individual or the counselor facilitating a therapeutic group. The major difference is that within a group setting it becomes more difficult to manage ethical principles and that therapist must be highly trained to manage such groups to avoid falling into ethical dilemmas. The group counselor must be guarded for confidentiality and cautious of dual relationships. Full disclosure and guidelines is important in the Ethics in group counseling 7 first group session to set the right pace of the group sessions. The same should be done for the individual counseling session. The one on one therapist will still face ethical issues but they may be must easier to be cautious of in this type of setting. “Counselors should take clients’ words as significant communications about what they need or what is troubling them.” (Jungers, 2012) This needs to be applied to all settings, especially the group setting, the counselor must be highly aware of all discussions within the group. Amato (2000) examined ethical differences within group and individual counseling. In doing so she noted that group therapists have less control over what occurs during their sessions. Because group interactions are encouraged, it is important for the therapist to closely monitor these interactions to insure what is being said is appropriate for the therapeutic process and helps to move the process along and does not promote negativity throughout. Sensitivity to cultural issues must be promoted within the group setting. It must be advised to those attending group sessions that confidentiality cannot be guaranteed within the group setting. While it may be hard to avoid the pairing of group members it is important to stress that dual relationships are discouraged. Choosing a preference When choosing group therapy the therapist must be aware that the American Counseling Association (ACA) and the Association for Specialist in Group Work Ethics in group counseling 8 (ASGW) Code of Ethics both require a formal assessment of the group prior to the actual start of the therapy sessions. I feel the most challenging type of group to lead would be a therapy group. I feel like the group setting, with many different individuals, each with their own needs could be overwhelming for the counselor when trying to help each person in the group. While I also believe that group counseling could be extremely helpful for many individuals over individual therapy, from the counselors perspective I could see myself favoring one on one counseling with the client as opposed to counseling and therapy groups. Jacobs (2012) mentioned “Because members of these groups vary in their degree of mental health, the chances for complex dynamics are much higher than in any other group discussed”. Only certain individuals under certain circumstances will benefit the most from group therapy. The leadership style that would be best for this type of counseling would be a leader directed leadership style. This puts the leader in control as opposed to the group. This approach ensures that there is structure and the needs of the group and individuals are being met through the group. Jacobs et al. (2012) also mentioned that an intrapersonal approach would best suit a counseling and therapy group. When using the intrapersonal approach the focus it put on the specific needs of each individual member as opposed to an interpersonal approach, that focuses on the group as a whole (Jacobs et al, 2012). The counselor is to make sure there are Ethics in group counseling 9 no dominating factors that could hinder the work of the counselor and the goals of the group.

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Four years ago, the US Food and Drug Administration (FDA) ceased compliance with the Declaration of Helsinki (DoH) (2000 revision and all subsequent revisions) for conduct of clinical trials outside its borders. It instead ruled that compliance with the Good Clinical Practices (GCP) of the International Conference of Harmonization (ICH) is sufficient. However, the ICH-GCP guidelines do not address certain ethical requirements stipulated in the DoH, such as the use of placebos v. standard therapy, post-trial access to treatment and other benefits for participants; public disclosure of trial design; publication of trial results; and disclosure of conflicts of interest. The FDA’s adoption of less morally stringent guidelines could encourage pharmaceutical companies to take ethical short cuts. It could also have practical consequences for trial ethics in developing countries, especially where research ethics committees may not be promoting high standards of protection for participants in clinical trials, due to lack of financial and human resources. Pharmaceutical companies may also pressurise research ethics committees to relax guidelines and legislation, in order to facilitate future clinical trials in developing and emerging countries that lack the resources to conduct their own clinical research on epidemics such as HIV/AIDS, which have devastating effects on their populations. S Afr J BL 2012;5(2):87-90. DOI:10.7196/SAJBL.222 In April 2008, the US Food and Drug Administration (FDA) published its controversial decision to abandon the Declaration of Helsinki (DoH) as an ethical guideline when conducting, and reviewing data from, clinical trials performed outside the USA. As early as 2006, the FDA declared it would eliminate all reference to the 2000 and subsequent revisions of the DoH. While it stipulated that it would continue to recognise the 1989 revision, this revision is considered invalid by the World Medical Association (WMA), the authors of the DoH.1 Accordingly, the FDA now considers it sufficient that a trial performed outside USA soil adhere to the Good Clinical Practices of the International Conference of Harmonization (ICH-GCP). The reasons for this decision include the need to protect human subjects and to assure the quality and integrity of foreign data obtained from studies performed outside the USA.2 Discussion The DoH has been considered the benchmark of ethical and medical standards in clinical trials worldwide, even though it is not a legally binding document in international law. It has its origins in the Nuremberg Code (1947), and was developed in 1964. Its author, the WMA, includes 85 national medical societies from around the world, compared with the ICH which consists only of voting members from the USA, the European Union, and Japan.3 In October 2008, the WMA General Assembly, meeting in Seoul, South Korea, voted to adopt the latest revision of the DoH after an 18-month revision process.4 The WMA considers the 2008 DoH the only official revision, and regards it not just as an internal policy but as a universal statement of medical research ethics.4 The 2008 revision of the DoH5 is more ethically demanding than the ICH-GCP, and addresses moral issues that the ICH-GCP guidelines do not.6 These include the restriction of placebo controls in clinical trials in developing countries; the disclosure of the trial design to the public; a requirement that the population in which the research is conducted should benefit from it, particularly in developing countries, and that participants should have post-trial access to treatment; the need to publish results; and the disclosure of conflicts of interest.3 There are concerns that the FDA’s abandonment of the DoH may cause other regulators to follow suit, with serious implications for ethical standards and participant safety in Third-world countries. Research ethics in South Africa In 2001, the World Health Organization Regional Committee for Africa expressed its concern that some health-related trials undertaken in developing African countries were not subjected to any form of ethics review.7 Some of the reasons quoted for conducting research in Africa, rather than in developed countries such as the USA or Europe, include lower costs, lower risk of litigation and less stringent ethical review.7 Concerns have also been raised that research ethics committees (RECs) in developing countries may not promote high standards of protection for research participants, due to a lack of financial and adequately trained human resources.7 However, a 2010 comparison between the US Common Rule and South African research ethics requirements by Cleaton-Jones and Wassenaar8 revealed that, at a structural level, the research ethics review process in South Africa is in many cases equivalent to the US institutional review board (IRB) and Office of Human Research Protections (OHRP) oversight system. In fact, it would appear to be stricter as it makes no exclusions, compared with the many exemptions allowed in ethics review and waivers of participant-informed consent in the USA system.8 Although strict guidelines and regulations per se will not prevent sub-standard ethical review, the FDA’s renouncement of the DoH may have long-term practical implications, and could encourage pharmaceutical companies to take ethical short cuts in developing and emerging countries. The use of placebos versus standard therapy The clinical research testing of new strategies for the prevention and treatment of epidemics, such as HIV/AIDS, has become a critical necessity.9 However, developing countries, which stand to benefit the most from such research, lack the resources to conduct their own clinical trials.9 Many have a limited healthcare infrastructure and citizens may not have access to basic medical services. Article 32 of the DoH provides for the limited use of placebo arms in clinical trials. While a new test drug should be compared with the available golden standard of treatment or therapy instead of a placebo, placebo-controlled trials are allowed where no standard therapy exists, or ‘where for compelling and scientifically sound methodological reasons the use of placebo is necessary to determine the efficacy or safety of an intervention and the patients who receive placebo or no treatment will not be subject to any risk of serious or irreversible harm’.5 The debate over the application of research ethics and the use of placebo-controlled trials in developing countries surfaced in the early 1990s, in trials concerning the early prevention of mother-to-child-transmission (MTCT) of HIV.10 In 1994, while there was an existing protocol from the AIDS Clinical Trial Group 076 (ACTG 076) for preventing MTCT, high antiretroviral (ARV) costs and insufficient infrastructure placed it out of reach of most of the HIV-infected population in the developing world.10 Due to an almost 70% reduction in the risk of HIV transmission in the ACTG 076 trial, zidovudine became the de facto standard of care.11 To find a more cost-effective and applicable treatment for resource-poor settings, randomised placebo-controlled trials were initiated to investigate a short-course ARV regimen.10 However, these trials sparked intense debate. On the one hand, they were viewed as exploitative as they violated the condition of equipoise, namely that placebo groups are only deemed ethical if the merit of the intervention is sufficiently uncertain. On the other hand, the responsiveness of the research was stressed. In fact, without these short placebo-based trials, countries such as South Africa would not have developed a low-cost intervention to prevent MTCT. The subsequent initiation of these trials in developing countries, funded by the US Center for Disease Control (CDC) and National Institutes of Health (NIH), raised further concern when it was learned that patients in trials in the USA had unrestricted access to the drug.11 The arguments for not providing the ‘gold standard’ treatment available in developed countries were founded on the low standard of care in developing countries,10 and the fact that pregnant women in these countries did not access care early enough and were unlikely to cease breastfeeding. The NIH and CDC defended the trials’ design and, despite early opposition, the trials began in 16 countries and included over 12 000 HIV-infected women.10 These trials also appeared to be in direct conflict with guidelines for international research published by the Council for International Organizations of Medical Sciences (1993, Guideline 11), which stated that the ethical standards should be applied no less exactingly than they would be in the sponsoring or initiating country.11 , 12 In addition to various international regulatory requirements, clinical trial investigators and pharmaceutical companies in South Africa need to adhere to the South African Good Clinical Practice (SAGCP) guideline, published by the Department of Health in 2000 and revised in 2006.13 Section 1.4 states that ‘Regulations established in terms of section 90(s) [health research] of the National Health Act (Act No. 61 of 2003)14 enforces these guidelines. Compliance with these guidelines is compulsory under the direction of the Director-General of Health’.13 Alongside other international guidelines, the SAGCP is based on the ICH-GCP as well as DoH (2004) (Section 1.3 of the SAGCP).13 Thus, the National Health Act indirectly enforces compliance with the ICH-GCP as well as the DoH for clinical trials conducted in SA.13 The SAGCP states that the use of placebos should be justified, and only when there is no known effective treatment should it be considered ethical to compare a potential new treatment with a placebo.13 However, taking into account the 2004 DoH’s statements on the use of placebo-controlled trials, it seems that placebo control is more flexible. Given the already flexible grounds for placebo-controlled trials based on scientific justification and compelling methodology, it would seem unlikely that the FDA’s decision would significantly affect South Africa. However, other developing countries could risk having their guidelines relaxed to allow these trials. This particularly affects emerging countries which lack standard therapies and the resources to conduct their own clinical trials. Given that pharmaceutical companies can already argue that emerging countries usually lack their own standard treatments, this could put an even greater burden on the future ethical rights and safety of trial participants. Post-trial access to treatment and other trial benefits Articles 14 and 33 of the DoH state that the clinical trial protocol should contain a statement of the ethical considerations involved, and should indicate how the DoH’s principles have been addressed.5 It should also describe arrangement for participants’ post-trial access to appropriate care or benefits resulting from the trial.5 However, this requirement is absent from the ICH-GCP. SAGCP stipulates that specific recommendations should be made for the continuation of treatments beyond after the trial, especially in research requiring additional attention, such as HIV research involving vulnerable communities.13 In developing countries without such an additional guarantee, this issue could become problematic. Since the FDA renounced the DoH, some pharmaceutical companies are choosing to omit any reference to the DoH when drafting protocols for trial conduct in South Africa or any other developing country. These companies can also test their new drugs in developing or emerging countries without planning to register them there, and with no obligation to provide participants with post-trial access to any treatment or other benefits. Trial registration and publication of results Article 19 of the DoH requires that all clinical trials be registered in a publicly accessible database before the first participant is recruited.5 Likewise, the WHO considers trial registration a scientific, ethical and moral responsibility.9 In early 2009, the HIV/AIDS, Tuberculosis and Malaria (ATM) Clinical Trials Registry became the principal registry for all clinical trials conducted in Africa.9 Recently renamed the Pan African Clinical Trials Registry (PACTR), it is part of a growing trend of compliance with the DoH and increasing local oversight of international medical research.9 In the past several years some countries, including the USA, have established mandatory clinical trial registries.9 As well as revealing the trial design, Article 30 of the 2008 DoH states that authors and sponsors have an ethical obligation to the public to publish research conducted on human participants,5 including negative, inconclusive and positive outcomes. A significant proportion of medical research remains unpublished, or may be published with some results omitted.9 Selective reporting leads to an incomplete and potentially biased view of a trial and its results.9 A lot of money, time and resources have been spent on compliance with the DoH. For countries such as SA, which already have guidelines for trial registration and results publication, the FDA’s decision might not be as significant. Yet for developing countries without these guidelines, this could hamper the current and future efforts of trial registries, and have financial implications for efforts already invested. Conflicts of interest Article 14 of the 2008 DoH states that the clinical trial protocol should contain a statement of the ethical considerations involved and indicate how the DoH’s principles have been addressed. It should also provide information on funding, sponsors, institutional affiliations, and other potential conflicts of interest to both RECs and trial participants. 5 However, this principle is not specified in ICH-GCP. This raises another ongoing ethical issue, since in 2012 the FDA announced that it might relax certain conflict-of-interest restrictions that prevent scientists with financial ties to the drug industry from becoming members of its advisory panels15 (the FDA appears to be holding back on its decision for the time being).16 In January 2012, a conflict-of-interest scandal rocked the FDA when a pharmaceutical giant was allowed to keep its oral birth-control product on the US market, despite the FDA’s own reports of dozens of deaths caused by blood clots in women using the product.17 The FDA had appointed at least three scientists with financial ties to the pharmaceutical company to the product’s advisory committee, who voted in favour of the product. The FDA neglected to disclose their connections with the pharmaceutical company.17 Once again, the inclusion of a conflict-of-interest clause in the SAGCP is instrumental in dealing with this issue in South Africa. Conclusion The FDA’s reliance on the ethically less stringent ICH-GCP rather than the DoH may weaken the protection of research participants in many developing countries. This will depend on how well drug developers and clinical trial investigators will be able to abide by moral ethics, and how well they regulate themselves in terms of ethical conduct when conducting research in Third-world countries, especially where RECs are unable to uphold participant protection. In South Africa, research participants should be informed about these areas of concern in order to maintain awareness and emphasise the importance of a strong bio-ethical system. This could be done through public conferences, published articles, training methodologies for investigators and other research personnel, and discussion forums with leading and representative organisations and committees in the industry. Fortunately, in South Africa, the SAGCP goes a long way towards protecting research participants. It is imperative, however, that researchers in other developing countries are also made aware of these issues and advocate for stronger national ethico-guidelines. References 1. Wolinsky H. The battle of Helsinki: Two troublesome paragraphs in the Declaration of Helsinki are causing a furore over medical research ethics. EMBO Rep 2006;7:670-672. [http//dx.doi.org/10.1038/sj.embor.7400743] 2. Food and Drug Administration, HHS. Human subject protection; foreign clinical studies not conducted under an investigational new drug application. Final rule. Fed Registr 2008;73(82):22800-22816. 3. Kimmelman J, Weijer C, Meslin EM. Helsinki discords: FDA, ethics and international drug trials. Lancet 2009;373(9657):13-14. [http://dx.doi.org/10.1016/S0140-6736(08)61936-4] 4. Williams J. Revising the Declaration of Helsinki. World Medical Journal 2008;54(4):120-124. http://www.wma.net/en/30publications/20journal/pdf/wmj20.pdf (accessed 20 September 2012). 5. World Medical Association. Declaration of Helsinki. Ferney-Voltaire: World Medical Association, 1964. 6. International Conference on Harmonization. International Conference on Harmonization Guideline for Good Clinical Practice (E6). Geneva: ICH, 1996. 7. Moodley K, Myer L. Health research ethics committees in South Africa 12 years into democracy. BMC Med Ethics 2007;8:1. [http//dx.doi.org/10.1186/1472-6939-8-1] 8. Cleaton-Jones P, Wassenaar D. Issues in Research. Protection of human participants in health research – a comparison of some US federal regulations and South African research ethics guidelines. S Afr Med J 2010;100(11):712-716. 9. Moffett J. New Strategies in research ethics: Guidance for a global approach. Fam Health Int July 2009. http://www.fhi360.org/NR/rdonlyres/efma2ljokjf57ewgcpmwy73cdl4vk35bmrrnlw4hj7qpai3dlj2m7cm4mboco cu6kasrakrdgnjxtd/Mera0907.pdf (accessed 8 May 2012). 10. Landes M. Can context justify an ethical double standard for clinical research in developing countries? Global Health 2005;1(1):11. [http://dx.doi.org/10.1186/1744-8603-1-11] 11. Wikimedia Foundation, Inc. Declarationn of Helsinki. http://en.wikipedia.org/wiki/Declaration_of_Helsinki (accessed 8 May 2012). 12. Levine RJ. New international ethical guidelines for research involving human subjects. Ann Int Med 1993;119(4):339-341. [http//dx.doi.org/10.2307/3528269]. 13. SA Department of Health. Guidelines for Good Practice in the Conduct of Clinical Trials with Human Participants in South Africa. Pretoria: Government Printer, 2006. 14. National Health Act (Act No 61 of 2003). Government Gazette, RSA; Vol 469, No 26595; 23 July 2004. http://www.info.gov.za/view/DownloadFileAction?id=68039 (accessed 31 July 2012). 15. Huff EA. FDA Commissioner Margaret Hamburg pushing to eliminate conflict of interest laws, allow paid drug company shills to fill advisory positions. Naturalnews. com 18 August 2011. http://www.naturalnews.com/033361_FDA_conflicts_of_interest.html (accessed 8 May 2012). 16. Philippidis A. FDA backtracks on conflict-of-interest rule changes for advisory panel members. Genetic Engineering and Biotechnology News 5 March 2012. http://www.genengnews.com/insight-and-intelligenceand153/fda-backtracks-on-conflict-of-interest-rule-changes-for-advisory-panel-members/77899566/ (accessed 11 May 2012). 17. Malone P. Conflict of interest strikes again at the FDA. Jdsupra.com, 24 January 2012. http://www.jdsupra.com/post/documentViewer.aspx?fid=7918d12d-8afa-4617-a264-f8bc6c8781d0 (accessed 9 May 2012). Accepted 2 November 2012.

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What Is Therapy? What do I need? Therapy, also called psychotherapy or counseling, is the process of meeting with a therapist to resolve problematic behaviors, beliefs, feelings, relationship issues, and/or somatic responses (sensations in the body). Beginning therapy can be a big step toward being the healthiest version of yourself and living the best life possible—no matter what challenges you may be facing. Through therapy, you can change self-destructive behaviors and habits, resolve painful feelings, improve your relationships, and more. Through the process of therapy with your therapist, you will establish goals for your therapy and determine the steps you will take to get there. Whether in individual, group, or family therapy, your relationship with your therapist is a confidential one and focuses not only on the content of what you talk about, but also the process. The therapeutic process--how you share your feelings and experiences--is considered to be just as important as the specific issues or concerns you share in therapy. Your therapist should be someone who supports you, listens to you non-judgmentally, role models a positive and healthy relationship. Your therapist will give you feedback and help you make decisions about things but should never tell you what to do. Your therapist should also follow ethical guidelines to have a good therapeutic relationship with you. We Would Love to Have You Visit Soon!

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By Reas Kondraschow Gene therapy was discovered in the 1980's a few years after researchers were already able to isolate specific genes from DNA. These techniques matured from the massive surge of ideas generated during the Recombinant DNA (rDNA) era. Over 40 years ago, James Watson and Francis Crick discovered the structure of deoxyribonucleic acid (DNA). Gene therapy is basically the repairing of genes to correct for diseases that result from a loss or change in our genetic material. It is a process that results in the correction of a genetic disorder by the addition of a piece or fragment of DNA into the genetic material of a living, functioning cell. It is hard to comprehend the total effects of gene therapy, because we do not know if it should really be used? It's hard to try to comprehend the extent of gene therapy. Should research continue? Who will benefit from its use? Should it be used at all? How is it affecting society? How do we answer all of these questions? Can we answer all these questions? There are answers to these questions but which is the best? Is it even ethical to answer these questions? To even begin answering the ethics behind gene therapy we need to know what it is. The goal of gene therapy is to correct mistakes that have occurred within the genetic material, or DNA, of the living cell. In very simple terms, DNA is often thought of as the "language" of the biological functioning of organisms. This language is organized by letters (nucleotide pairs), words (codons), sentences (genes), and books (genomes). Before being able to repair the damaged or defective genetic material, the location of the gene or genes causing the dysfunction in the individual must be determined. DNA is present in the nucleus of cells and is the genetic information of all organisms. The information of a human genome could be thought of in terms as an "encyclopedia", the 23 chromosome pairs would be "chapters", each gene a "sentence", three letter words "codons", which are spelled by each letter a "molecular nucleotide"--adenine (A), cytosine (C), guanine (G), and thymine (T) (Elmer-Dewitt, 1994). A gene acts as a blueprint and if these were blueprints for a house and the measurements were off by a foot, it has a huge influence on its total structure. This is the same for our bodies; if a slight alteration in our genetic information occurs like a mutation this could lead to a disease. Over the last forty years or so, scientists have made a great amount of progress in this area, including the development of techniques that allow for the controlled manipulation and replication of specific segments of the human genome. These types of techniques have come to be known as recombinant DNA (rDNA) technology and have allowed scientists to analyze functions of genes that are not necessarily directly expressed at the phenotypic level. This is done by excising a particular segment of DNA of interest from the genetic material of an individual and inserting it into a bacterial plasmid (a tiny ring of DNA in addition to the normal chromosomal material found within the cells of bacteria). The excising is done with the use of restriction enzymes, which are a group of molecules capable of "cutting" the DNA at specific points along its sequence of nucleotide pairs. By observing the end products of these gene inserts, scientists are able to determine the functions of the genes themselves and are therefore better able to analyze and understand the dysfunction of certain genes at the molecular level. Detecting whether an individual has the capacity to develop a specific disease during their life and being able to link the disease to a specific chromosome and ultimately the gene responsible is done by genetic testing. Genetic testing is basically done by cutting a piece of DNA with restriction enzymes and inserting them into a plasmid and finally analyzing the gene. Once a gene is located and defined as the cause of the disease, scientists can then start to develop a plan of action for gene therapy. They now begin to read our blue prints and fix the areas that are wrong. There are three sequential steps to gene therapy: first, the partial removal of a patient's cells, second, the introduction of normal, functional copies of the gene via vectors to replace defective cells in the patient, and finally, the reintroduction of the modified cells into the patient once the genes have been fixed in their vectors (Gardner et al. 1991). The blue print has been read and the design fixed. According to Mulligan (1993), transfer of appropriate target cells is the first critical step in gene therapy. There are many different methods of accomplishing gene delivery and these viral methods are retrovirus, adenovirus, adeno-associated virus, herpes virus, vaccinia virus, polio virus, sindbis and other RNA viruses. Nonviral methods like ligand-DNA conjugates, lipofection, direct injection of DNA, or CaOP4 precipitation are also used. So far retroviral vectors seem to work the best because they do not transfer their own genetic material into their host only the new genetic material is passed. One of gene therapy's most evasive goals has been the development of safe and effective methods of implanting normal genes into the human cell. One of the biggest problems in gene therapy is the reoccurring plague of inconsistent results. An example is two children with an ADA deficiency receiving periodic infusions of T cells modified ex vivo with the normal ADA gene have shown a resulting proportion of normal ADA cells varying from 0.1 to 60%. There have been problems with development of gene transfer in animals and once experimented on humans the outcomes varied. There have also been significant problems with the production of vectors. The ability to generate replicates and be able to keep them uncontaminated has posed a problem. The ideal gene delivery vector should be capable of efficiently delivering one or more genes of the size needed for clinical application. The vector should be very specific, unrecognized by the immune system, stable, highly reproducible, and be purified in large quantities at high concentrations. Then once the vector is inserted into the patient it should not create an allergic reaction like vomiting or nausea. This is a huge hurdle for vectors because generally the most effective vectors are the most toxic. They have the ability to get the DNA into the cells, but are very costly to the patient. To execute the repairing of our blue prints there are two techniques used to deliver these vectors and they are the ex-vivo and the in-vivo. The most common technique of delivery has been the ex-vivo method (outside the living body), which uses extracted cells from the patient. First, the normal genes are inserted into vectors like viruses whose disease-causing genes have been removed. Next, the blood cells with defective genes are removed from the patient, the patient's blood is then mixed with the engineered viruses, and the genetically engineered blood cells are reinfused in the patient to produce the protein needed to fight the disease. The in-vivo method (in the living body) does not use cells from the patient's body. Vectors, like viruses are again cut of their disease-causing genes and given the normal genes. The vectors are then injected into the patient's bloodstream to seek out and bind with the targeted cells like ADA diseased cells. The normal gene in the virus is incorporated into the chromosome of the target cell and forces a reaction with the protein needed to reverse the effects of the disease. Since the cells are not taken from the patients own cells the time and money spent on the procedure are much less. Inserting the gene into specific cells of the body where the defect is causing the disease is called somatic cell gene therapy. Each cell in the body has the exact same DNA as the original fertilized egg. All cells use different parts of their total genotype to develop different tissues that perform different functions. As a result, the genetic defect is often only distinguished in a specific area like tissues. The goal of somatic cell gene therapy is to insert the normal or transformed cell into the specific affected tissue. Not all tissues need to be treated, only enough cells need to be treated to provide the correct amount of enzymes to allow for the protein to develop and reach the site of action in a particular tissue. The first use of somatic cell gene therapy was for the treatment of adenosine deaminase deficiency (ADA) in children commonly known as "bubble babies." This is a rare immune system disorder that ultimately prohibits the body from defending against invaders like the common cold. Because doctors were able to successful insert healthy, normal cells into the child with the blood from its umbilical cord, their immune defenses were able to fully form. The child did not reject the healthy genes and doctors claim the genes are "expressing" (Gorman 1995). The second type of gene therapy is germinal gene therapy. Germinal gene therapy consists of introducing new genetic material into the germ line cells (those cells from which the gametes are derived). The altered gene is inserted into the sperm or egg cells (germ cells), and this ultimately leads to a change in not only the individual receiving the treatment, but also future offspring. Germinal gene therapy has yet to be tried on humans. It is also possible to insert the altered cells into an early stage embryo that would affect both the germ line and somatic cells. Yet, most governments have limited all gene therapy experiments to somatic gene therapy because the alteration performed in germ gene therapy would change future generations. Until the development of this technology, people have had to deal with genetic inequality as a fact of life. With the advent of gene therapy, this may no longer be the case for some people. Most people feel that it is okay to use gene therapy to treat human genetic diseases. Surprisingly, even the Catholic Church has taken a stand for the use of gene therapy. Reverend Russell E. Smith, president of the Pope John XXIII Medical-Moral Research and Education Center, stated that gene therapy is "a very noble enterprise, because it is aimed at the actual cure of actual diseases." Some individuals, however, are concerned that the technique may be used for "treatment" of genetic "disorders" other than diseases. For example, in January of 1993, it was reported in USA Today that an 11-year-old boy was receiving gene therapy treatments at a cost of $150,000 per year to increase his height. At 4' 11", four inches below average height, he was tired of being picked on at school for being short. His father was quoted in the article as saying, "You want to give your child that edge no matter what. I think you'd do just about anything." Is this ethical? What makes this child a good candidate for gene therapy? Should we be able to give ourselves gene therapy to change who or what we are? Isn't it vital to our development that we learn through socialization? Won't we be changing the way we were meant to be and if so won't this have repercussions later in life? A study showed that approximately a 50/50 split for and against gene therapy. Dr. Maurice Super, a consultant clinical geneticist at the Royal Manchester Children's Hospital in Manchester, England and supporter of genetic engineering capabilities, opened a pavilion type Gene Shop (a motto: "What keeps body and soul together? Your genes") in an airport that aims at educating people about the benefits of new technologies. He has said, "The aim is to decrease the fear of a brave new world and encourage people to be more proactive about their health." Most of the general public remains fearful of the consequences of gene testing, yet more than 7,000 people have visited the Gene Shop Because many people are concerned about the safety of gene therapy a special committee called the National Academy of Science was created to look into the consequences of releasing rDNA engineered organisms into the environment. The committee concluded that "there is no evidence that unique hazards exist either in the use of rDNA technique or in the transfer of genes between unrelated organisms," and that, "the risks associated with the introduction of rDNA engineered organisms are the same kind as those associated with the introduction of unmodified organisms." However, John Fagan, a professor of molecular biology at Maharishi International University in Fairfield, Iowa, is highly concerned about the fact that very little is known about the long-term effects of the existence of genetically engineered organisms in the environment. To make known his concern, he returned about $614,000 in grant money to the National Institutes of Health. His underlying concern is that an engineering mishap with devastating effects does not occur as a result of carelessness and or lack of precaution. No one denies that gene therapy will yield results that will in some people's eyes be a miracle. Yet, even citizens for the advancements of gene therapy are growing increasingly concerned that the initial studies and excitement led to a premature rush of approved gene therapy experiments (Gorman 1995). Researchers are not certain what is the best method of gene transportation. As stated earlier, there are several different types of transport systems such as: viral; retroviral or adenoviral, or non viral; ligand-DNA conjugates or lipofection and deciding the best vector takes time. Important issues concerning decision-making and regulation of research were addressed at the now famous Asilomar Conference held in 1975. This conference, which involved mostly molecular biologists, the press, and some government officials, set the tone for dealing with rDNA public policy issues. The major concern at the time was the possible health risks to researchers and the public at large. Many people were also concerned about the possible environmental affects. These concerns are normal and even expected with the advent of new technology; however, there existed then and to a certain extent still exists today a concern unique to the study of rDNA and its related fields. The concern is for the possible development, by some engineering mistake, of a kind of Frankenstein running rampant throughout the environment. This concern has been considered very carefully and has had a large impact on the development of public policy concerning rDNA technology. More so than gene therapy to grow taller and change your hair color patenting rights to human clones is even more unethical in the eyes of many. The Supreme Court's 5-4 decision in Diamond v. Chakrabarty in 1980 permitted the right to patent life forms. Many opponents said the court's decision permits ownership of things that cannot, morally or ethically, be owned. Other objectors also say, "it debases life itself" by commercializing human and animal life forms, and again fuel supporters of eugenics. Jeremy Rifkin, president of the Foundation on Economic Trends, said, "It took Congress 30 years of debate before allowing patents for some varieties of plants. The Supreme Court's decision was a construction created out of sand that has no foundation." Chief Justice Warren E. Burger, writer for the majority of the Supreme Court's decision, argued that the decision for patents was justified. Their example was the case of genetically engineered bacteria that was designed to degrade petroleum and help clean up oil spills. He said the bacteria were different than any found in nature and could not be considered God's handiwork, but the result of human ingenuity. Patent supporters do not confer ownership or try to make gods of human beings, but enable researchers to raise money. Investors could not support expensive and uncertain biotechnological endeavors without the guarantee of a patent (Donegan 1995). Some arguments against gene therapy stem from World War II. At that time Hitler was experimenting with eugenics and creating his own master race. This is a reality and a fear to many people. They often feel that "the advances being made by scientists are running ahead of our ability to deal with the ethical consequences," stated David King, editor of Genethics News. He also went on to say there is nothing holy about a fragment of DNA. Which is contrary to what 58% of the people polled by Time/CNN think, that altering human genes is against the will of God. And that is holy in many people's eyes. Of those same people polled, 90% said they thought it should be against the law for insurance companies to use genetic tests to decide who is insured (Elmer-Dewitt 1994). Did God intend for us to change ourselves as we saw fit? Are these changes not to occur naturally? What will happen to the evolution of our species? So how should the development and use of gene therapy be regulated, and who should be doing the regulating? I would imagine that there are as many answers to these questions as there are people on the planet. So how do we come to any decisions about anything, how do changes come about, and how do we incorporate these changes into our individual lives? I believe these things come about as a result of natural processes. For example, it is very natural for people to be interested in what controls our physical, mental, emotional and social development. It is as equally natural for people to be interested in finding cures for diseases and ailments that afflict humankind. Once these interests are carried over into research, and answers to some of these questions about our development are found, it is quite natural for people to want to regulate how these findings should be used. What makes a disease suitable for gene therapy? Darryl Macer, Ph.D. (1990) stated that gene therapy is generally considered for single gene disorders until researchers understand more. I think diseases that are easily understood medically and genetically and have no other recourse for treatment (a last resort) are suitable diseases. This can cover a broad base of diseases from enzyme deficiencies to AIDS or cancer. I believe in continued careful and regulated research of gene therapy techniques for the benefit of individuals suffering from genetic diseases. I, like most people, do not like to see human suffering, most especially that of individuals close to me. If the technology is available to provide relief, I most definitely believe that it should be used. However, this seemingly black and white issue becomes very gray when one tries to define human pain and suffering. It is obvious to most that Parkinson's disease fit this definition, but what about the eleven year old boy who is tired of being picked on at school for being short? Should being below average height be considered a source of pain and suffering? A point must be made that practically everyone gets 'picked on' at some point in his or her life because of a particular physical trait. Perspective is needed here. Having to deal with being below average height simply cannot be compared to having to deal with Parkinson's disease. I do believe that it will be necessary to develop new laws and regulations to prevent industries and individuals from taking advantage of human gene therapy techniques. I understand that forming such regulations would be a very difficult and complex task, but I personally believe it to be very necessary. . Recombinant DNA techniques need to be regulated and I believe our government has done the right thing ever since the Asilomar conference by forming the Recombinant DNA Advisory Committee (R.A.C.) of the National Institute of Health (N.I.H.). Sources Cited: 999 American Society of Gene Therapy Presidential Address www.med.upenn.edu. "Ethical Issues in Genetics in the Next 100 Years www.upen.edu "How Far Should We Go, Time Magazine, www.time.com "The Limits Which Society May Place On Genetic Technology www.srtp.org 1 WCED Report. Our Common Future. 43. 2 UN Agenda 21. Preamble. Chapter 1.1. 3 UN Sustainable Development and CSD webpage: www.un.org/esa/sustdev/csd.htm 4 ibid. 5 NCSD homepage, Frequently Asked Questions: www.ncsdnetwork.org 6 ibid. 7 NCSD Sustainable Development Report: www.ncsdnetwork.org/global/reports/ncsd1999.htm 8 Citizens Network for Sustainable Development homepage: www.citnet.org The Earth Council homepage: www.ecouncil.ac.cr/ 9 UN Agenda 21. Introduction. Chapter 2.3. 10 UN Agenda 21. Integrating Environment and Development in Decision-Making. Chapter 8.3 11 Andre de Moor. Perverse Incentives: Subsidies and Sustainable Development.??? ?? www.ecouncil.ac.cr/rio/focus/report/english/subsidies.htm 12 ibid. Summary, p.2. 13 ibid. Chapter 7.4 14 John T. Preston. Technological Innovation and Environmental Progress. In Chertow M.R. 1997. p.136. 15 ibid. p. 140-145.

http://www.theunedited.com/econauts/art11.html

Companies continue to grapple with how to use artificial intelligence (AI) technology in a way that doesn’t compromise privacy and that takes into account other key ethical considerations. It is undeniable that AI is one of the fastest-growing categories today. But if we are unable to build tools that live up to high ethical standards, not only are we doing end users a disservice, but we are failing to deliver on the promise of this technology as a force for good. AI and ethics has been one of the hottest topics within the technology community for decades. However, as an industry, we are still finding it hard to put our best foot forward in terms of ensuring ethical use—let alone solving the problems these systems were meant to address. Fortunately, there is one group that could be the guiding force we need: Developers. From the ideation process to implementation, the developer community is by far the group with the most intimate knowledge of how AI products actually work; therefore, they can have a tremendous influence on what these tools actually do and how ethical they are—and they need to be empowered to make these calls. With that in mind, here are four key questions that companies and their developer teams should ask as they work to build the ethical AI solutions of the future. Is This Transparent in Every Way? If a developer ever finds themselves saying, “I don’t know,” when asked about how a product works or how the product is ultimately going to be used, production should stop immediately. The power of automation is tremendous. But given how quickly it can morph and learn, making sure that oversight and explainability are ingrained in its functionality is imperative to ensure ethical use. If this can’t be guaranteed, developers should be empowered to flag their concerns and look for ways to remedy them before continuing production. As AI continues to evolve, designing and developing AI systems will likely continue to lead us into areas where no clear legal, social or policy guidelines address many of the potential uses—and misuses. So, now is the time for developers to establish a transparent and clear channel of communication where they can actively raise concerns, discuss and deliberate on ethical dilemmas with diverse stakeholders. This is crucial in reducing or eliminating any negative effects of AI. Otherwise, we will continue to see the current faux pas around AI ethics continue. Have we Accounted for Risk or Exceeded Regulatory Boundaries? Virtually any big idea has its risks. Unfortunately, when it comes to AI, these risks generally involve unethical use or unintended consequences. The ongoing debate around facial recognition and AI is a perfect example of this. While this use case is intended to improve security and may have other benefits, facial recognition software comes with significant privacy risks and fears over misuse and misapplication. Moreover, because the regulatory landscape around AI is still taking shape, companies can fall into a trap of looking to exploit these gray areas in exchange for being the first to market or gaining a competitive edge. This is why companies that are not using ethical privacy-preserving AI in facial recognition implementations, for example, are having to walk back their products. Simply put, acting in this manner can have terrible consequences for the ethics around an AI product. But there is good news; the fix for this mistake is relatively straightforward: Instead of just making sure that products barely comply with regulatory gray areas, make sure they exceed them. Granted, this can lead to increased go-to-market time and significant leg work. However, this is the only way to realistically “future-proof” products against potential unethical use cases. Is This System Adaptable? Even the best preparation and forethought does not guarantee that a tool will operate exactly as it was intended. This is why it is so important for developers to have the ability to plan for contingencies and build adaptability into their tools so that adjustments can be made periodically if any ethical questions arise. This can be particularly helpful when it comes to addressing bias concerns that may occur as AI products learn and expand. Technology is a dynamic and rapidly evolving category. And as such, developers are often working on very compressed timelines. But to get AI right, developers need time to suss out the bigger picture around their products and bake in everything possible to make sure products are set up for ethical use in the short, medium and long term. If they don’t, not only will reputational damage be done to a company, but a company’s entire product pipeline could be stunted indefinitely as products need to be pulled offline entirely. Are Developer Teams Actually Prepared to Build Ethically? Setting a concrete mission statement that is centered around ethics is a great start for any technology company. But without a more systematic approach to instilling principled behavior in developer teams, companies will struggle to drive tangible results in their pursuit of building ethical products. Additionally, given how complex ethical AI development has become—thanks to innovations in quantum computing, among other things—even the most seasoned developers will have trouble keeping up with the developments and desired standards relating to a company’s ethical AI goals. Therefore, beyond just laying out overarching messaging, companies need to codify their ethical intentions by building an entire infrastructure that equips developers with the ongoing training and resources they need to constantly keep ethical standards in mind. If not, confusion will almost certainly ensue, missteps will occur and ethical standards will slip as a result. Unfortunately, despite the promise, the AI world has fallen short of meeting the ethical frameworks we need to have in place to both solve the problems of tomorrow while also serving the public good. But this doesn’t have to be the case. By asking these few simple questions, companies can empower developers and build the ethical development infrastructure that is needed for AI to achieve its full potential.

https://devops.com/4-keys-to-developing-ethical-ai/

Emergency medical services are a source of hope and restoration, which makes them the most valuable and respected among all other medical services. Ethical standards and codes of conduct are the fundamental factors, which govern delivery of emergency services. However, due to their high demand for prompt actions, there are numerous chances of ethical concerns and moral questions. The ethical concerns are based moral foundations and implications of society. This is the reason why there is a need to create a standardized way, offering guidance and defining things for the sake of professionalism. Emergency services, being a crucial part of the healthcare industry, do not offer much time for discussions and consultations. Every step should always be linear; it should be taken with absolute respect to the ethical foundations of this practice, such as confidentiality, justice, fairness, informed consent as well as moral obligations. Due to numerous fundamental challenges caused by moral pluralism, there is a need for an initiation of a central referencing platform that defines all aspects of medical emergency service delivery. Protection of patients’ privacy is a responsibility entrusted to the emergency services personnel by the ethical standards guiding the profession, as well as the medical codes of conduct. There have always been questions about ethical responsibilities of many professions. However, of late, there has been a growing concern regarding the manner in which emergency medical services are rendered to members of the public. Hastily offered emergency medical services and their subsequent requirements call for the necessity to make several ethical decisions within a short period of time and with or without consultations (Friend, 2012). The fact is that physicians are allowed to make decisions without prior knowledge of the medical history of patients. Therefore, they create a room for mistakes and judgmental actions, raising ethical concerns. As a result, negligence and discrimination coupled with greed for money have been at the top of the list of complaints. The objectives of this paper explore the ethical foundation of the emergency services, the definition of unique responsibilities where ethics is critically necessary, as well as emergency physician-patient relationship. Finally, the paper will offer an alternative solution to some of the challenges in the patient-physician relationships. The underlying themes in the analysis are ethical foundations of emergency services, the uniqueness in responsibilities of EMS personnel, the relationship between patients and physicians, virtues in emergency medicine, as well as the alternative solution recommendation to moral pluralism. Ethical standards and codes of conduct are the fundamental factors driving delivery of emergency services, without compromising the dignity of the profession and its stakeholders. As the world becomes more and more technologically advanced, ethical issues continue arising whereby people use technology and other advancements to erode social and professional responsibilities. The issue becomes even more crucial when it relates to the field of medicine where absolute care and confidentiality are demanded. The increase in technology and upgrade of the contemporary medicine, sophistications of patients, societal clustering on the basis of social status, growing interest in human and civil rights, as well as rising cost of health care services are some of the primary factors (Friend, 2012). The medical field where emergency services are offered is a sector in the economy that demands absolute responsibility and professionalism in every step taken by all stakeholders. Emergency medicine is any activity that is carried out before the patient can check into a health facility. This immediate medical care, geared towards saving a person’s life or reducing suffering, can be performed either at home or on their way to the hospital. In this situation, reasoning and decision making are the most essential aspects since every involved party has to work out their best strategy without consultations or with disregard for any pre-existing conditions. According to the medical code of conduct, no patient is supposed to be stripped of their dignity even during their point of death (Jecker, 2010). It means that every action should ensure that nothing personal is revealed to non-parties when a person is receiving emergency treatment, especially outside a health facility. However, most of the time, actions taken to save a life partly fail to meet ethical requirements since not all physicians and their assistants follow ethical foundations of the profession. Moral pluralism is an idea that presupposes existence of several channels of consultancy within the medical industry (Jecker, 2010). Due to the diversity of the rendered services, there are things that require guidance from different platforms. For instance, there are medical ethics that apply to all levels, and there are those which only apply to specific disciplines within the industry. There are codes of conduct that are taught in professional schools during the training of medical personnel, while those who specialize in emergency services have to undergo different sets of training (Friend, 2012). All these aspects are connected with a body of knowledge that governs the medical industry with pluralism effects on specific aspects. Social norms are primary determinants in the medical services, especially in the emergency medicine, where society takes great responisbility. For example, society teaches children certain virtues; some of those values are also learned in schools while others can only be taught through religion. Moral pluralism compromises ethical standards in instances where individuals define actions in different terms, but expect the same outcome. There have been different unsuccessful attempts to create a standard source of guidance and consultation platform for related medical services in order to eliminate the adverse effects of moral pluralism. However, nature has its way of holding things back, since everything has its advantages and disadvantages. Emergency personnel have their specified duties that are only available within the scope of emergency situations and not in any other level of medical procedures. It makes these people some of the most dependable professionals since their services are not meant for improvement, but for the stability of life conditions. The unique setting of these services may bring up different ethical concerns. Considering the fact that this is a department that deals with acute medical conditions and life-threatening injuries, physicians have to make quick decisions based on their experience and the existent situation (Friend, 2012). However, not every aspect of help is morally acceptable, not to mention a socially upright one. Patients requiring emergency treatment are often unable to participate actively in making decisions since some of them are torn between pain and death, making the physician the only sober and dependable party. Due to this basic misfortune, it is not ethically possible to satisfy social and moral needs of the person, and in most cases, it may result in misunderstanding between a doctor and a patient. One fundamental aspect in the medical field that emergency services lack is the availability of the existing information regarding the medical conditions of patients during the first few hours of the response (Jecker, 2010). It makes it difficult for the medical personnel offering pre-hospital services to identify the possible causes of sudden illness or to know for sure what should not be done to a particular patient, among other things. For instance, there are people who suffer from acute allergies that should not be compromised by treatment of other diseases. This is vital information that is required by the medical personnel offering emergency services, but, unfortunately, it is not always available. Due to such information deficiency, physicians are forced to conduct confidential tests on patients without seeking consent, and might discover issues that are not meant to be discussed in such instances (Nelson, Venkat, & Davenport, 2014). It is unethical to carry out a secret medical test on a patient in spite of a probable benefit of its outcome. This is prohibited by medical ethics and codes of conduct. As it has been mentioned above, the emergency services sector involves a unique practice within the medical environment with its distinctive and intact moral challenges. To respond precisely and appropriately to some of these moral and ethical challenges, emergency physicians need to have adequate knowledge of their moral concepts and principles governing moral reasoning. Character traits, morally ethical attitudes, and ethical dispositions, defined in ethical theories as virtues, are as paramount for moral actions as skills and knowledge for individuals (Nelson, Venkat, & Davenport, 2014). Anyone who works according to virtues is motivated to act in a manner that supports their moral beliefs and ideals. Hence, such a person turns into a significant role model for society. Therefore, it is imperative to positively identify, nurture and promote those moral virtues required by the emergency physicians. Every profession is guided by a certain form of fundamental practices that dictate the course of action, and the EMS department is not an exception. Fostering these virtues would be taken as a kind of moral vaccination to the profession against pitfalls that are inherent in the emergency medical practice. Two most fundamental virtues in the practice of emergency medical responses are justice and courage. Courage is the ability and strength to carry out an obligation, regardless of the perceived risks. The duty of an emergency respondent is to take the risk and assure patients of their safety and recovery without compromising the system (Jecker, 2010). The work of emergency medical respondents involves assuming personal responsibility in matters of health and doing everything humanly possible to comprehend and control the situation. It is courage that makes an emergency physician venture into a war zone armed with a first aid box instead of a rifle in order to take care of the wounded. Due to this virtue, professional bodies managing the EMS practice have established an understanding with security forces; thus, anyone offering services should be protected and assured of their safety as they struggle to help those in desperate need of health attention. Thus, EMS providers must act with responsibility and impartiality when delivering their services in order to be regarded as neutral parties as well as to be protected (Friend, 2012). Justice or fairness is the other virtue critical for provision of medical services. Its aim is to offer such patients the necessary health care. Justice involves offering services without referring to the social status of the person, as well as acting with equality among all the available cases. Emergency services involve saving lives. According to the code of ethics, no one possesses a more expensive or valuable life than the others, neither is there someone who is not worth living (Nelson, Venkat, & Davenport, 2014). In emergency medical services, both culprits and their victims have an equal right to medical attention; thus, justice and fairness drive actions within the practice. EMS does not involve passing judgments on those who are supposed to be assisted, and involves even those who attempt to commit suicide. Every medical condition demands equal attention, and no one should be denied their right to healthcare. Emergency medical services require impartiality, where the personnel has to equally serve people, without gauging situations based on their favoritism. In case there is an accident that involves many casualties, the EMS team is expected to use professionalism in giving priority to those who are more critically injured, and not to those who, in their opinion, should be attended first. Favoritism is the genesis of unfair treatment and unethical practice within the medical field. Other virtues required in the EMS profession include resilience, vigilance, and honesty. One has to be honest when offering emergency services, since the recipient of such services trusts and believes in every step undertaken in their favor. There are small chances of consultation within the first few steps when the situation is critical. Hence, it depends on any decision or advice issued by the professional in charge. Resilience is required to make the EMS professionals composed and competent in their actions regardless of the possible clinical chaos (Nelson, Venkat, & Davenport, 2014). These people are required to be flexible and attentive all the time, as well as aware of their personal health status, so that individual issues may not impede service delivery. Resilience assists them in recovering from shocks brought by diverse severe medical conditions and outcomes of previous emergencies. This relationship is supposed to be the driver of the events that take place during the delivery of emergency services. There must be cooperation between the parties, which have to show mutual confidence. This relationship acts in the center of all moral obligations and responsibilities within medical service delivery. During the provision of emergency services, patients are considered to be the key stakeholders; thus, all the attention should be directed to their complaints and sentiments, since every activity is aimed to help them. There is also a challenge of inconsistency in EM services since different situations call for different measures. It means that consistent consultation is required before major decisions are adopted (Jecker, 2010). Emergency teams act and behave in a manner that yields positivity for the sake of their victims and not for business or personal interest. Beneficence encourages personnel to offer an emergency response to make sure that all efforts are aimed at helping the patient before anything else can be discussed or adopted. Thus, it is the duty of the person in charge of emergency service delivery to make sure that nothing is done against the will or the best interest of the patient. Otherwise, it will be against the principle of beneficence. Confidentiality and respect are the fundamental drivers in the principle of beneficence since the best interest of the patient can only be achieved by making sure their personality and privacy are not compromised (Friend, 2012). Nonmaleficence is the principle, which demands that no harm ought to be done to the victim or anyone else in need of emergency services. Moreover, it predetermines that a minimal or no pain should be caused by the actions aimed to help the patient. It means that the condition of the person by the time the emergency response is offered should only improve and not become more painful than it was initially. All the activities should adopt a well-considered step with no subsequent pain or harm(Nelson, Venkat, & Davenport, 2014). Emergency physicians are trained on how to handle issues without inflicting pain on the victims. Therefore, any person who is not trained should not represent themselves in such activities as professionals. Any insignificant pain can be a major determinant of the situation outcome, which means that every emergency service personnel should always adhere to the principle of nonmaleficence. According to the code of conduct guiding the emergency and medical services delivery, every adult patient has a right to accept, propose or reject an offered health care. This is called patient autonomy, and must be respected at all cost by those in charge of offering such services. This principle is guided by the doctrine of informed consent, where every decision must be communicated to the patient before it can be executed, no matter the benefit it is expected to yield. Since every move is meant to helpful to the patient, according to the principle of beneficence, informed consent must be exercised at all stages of treatment (Nelson, Venkat, & Davenport, 2014). It gives the patient an opportunity to offer suggestions and also raise crucial details that could determine the next course of actions. However, there are instances where informed consent is overruled and actions are taken without seeking permission from the patient. Such instances include a medical condition that is considered a risk to the public health. For example, a patient diagnosed with a contagious disease, such as Ebola or Hepatitis B, may not have many chances of giving consent to the medical practitioners, since their delay in consultation might create a risk to other people around them. Other than such particular circumstances, informed consent and patient autonomy should be respected and adhered. In emergency medicine practice, many details revealed throughout the process should be kept between the giver and the receiver, not involving unnecessary third parties. This is the ethical principle of confidentiality and privacy. There are those patients who would prefer to maintain their issues as personal as possible, without making friends or family members aware, just because of their own reasons (Jecker, 2010). Such requests are supposed to be respected by the physicians attending to such people. Thus, health care professionals should not negotiate with patients about their medical issues. In such case, personal medical issues should be ethically treated with much confidentiality. Some aspects are supposed to be known only by one physician in a team, who should not discuss it with his colleagues, while others have to be revealed only to the family of the patient and not to the patient. Considering the above-explained concepts within the emergency medical services, some issues need to be implemented in order to make the practice more ethical and socially acceptable. It is believed that most ethical questions are raised in instances when medical practitioners lack adequate knowledge about handling assorted incidents. Thus, there should be a universal training for all the people dealing with emergencies. A person trained to handle injuries should be adequately trained to handle disease outbreaks as well. These health care workers should be also trained on how to handle fire incidents as well as drowning situations. It helps to ensure that such a person can help people who are in need despite complication of their situations. Negligence is one of the issues that raise ethical questions within emergency services. However, at times, it occurs not because of unwillingness, but because of the lack of facilities and training to handle situations. To eliminate a possibility of negligence, there is a need to ensure that the emergency department is fully prepared, having trained personnel and the equipment to handle every possible situation where people are in need of urgent medical attention. For example, an emergency department should have the equipment to help in fighting the fire while taking care of the affected. Nevertheless, due to the challenge of moral pluralism, many issues hinder the delivery of service, raising ethical concerns regarding the emergency services. There should be a standardized central training that serves as the point of reference for all health care professionals, even if there will be other ethical codes of conduct that govern different services. It is needed to ensure that everybody involved in an emergency situation understands a common way of coping with difficult issues. Hence, it will reduce chances of conflicts. There are many diverse ethical concerns within the practice of emergency medicine services based on their moral foundations and social implications. That is why there is a desperate need to develop a standardized way of defining things for the sake of professionalism and patient satisfaction, without compromising morality. Emergency services are known to be the most crucial part of medical care. They do not give much time for discussions between parties. Every move engaged should always be linear, adhering to the ethical foundations of the practice. Health care professionals are obliged to maintain confidentiality, informed consent, and moral obligations. Due to the challenges posed by moral pluralism in the medical industry, there is a need for a standard referencing point aimed to define every aspect of service delivery in an attempt to eliminate social and ethical conflicts. Ethical standards and codes of conduct are the fundamental factors, driving the delivery of emergency services. Protection of patients’ dignity, clearly stipulated in the medical codes of conduct and the ethical standards guiding the profession, is a key responsibility of the emergency services personnel. However, different situations cause different concerns, based on the immediate decisions made by the respondents. Hence, there is a vital need for the creation of a standardized reference system.

https://primedissertations.com/essays/medicine/emergency-services-ethics-essay/

This is the published version of a paper presented at Future Active Safety Technology - Towards zero traffic accidents, FastZero2017, September 18-22, 2017, Nara, Japan. Citation for the original published paper: Durán, B., Englund, C., Habobovic, A., Andersson, J. (2017) Modeling vehicle behavior with neural dynamics. In: Future Active Safety Technology - Towards zero traffic accidents Nara, Japan N.B. When citing this work, cite the original published paper. Permanent link to this version: http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-35480 Copyright 2017 Society of Automotive Engineers of Japan, Inc. All rights reserved MODELING VEHICLE BEHAVIOR WITH NEURAL DYNAMICS Boris Durán1) Cristofer Englund1) 2) Azra Habibovic1) Jonas Andersson1) 1) RISE – Viktoria, Lindholmenspiren 3A SE-417 56 Gothenburg, Sweden 2) School of Information Technology, Halmstad University, SE-301 18 Halmstad, Sweden (E-mail: boris.duran@ri.se, cristofer.englund@ri.se, azra.habibovic@ri.se, jonas.andersson@ri.se ) ABSTRACT: Modeling the interaction of vehicles during certain traffic situations is the starting point for creating autonomous driving. Data collected from field trials where test subjects drive through a single-vehicle intersection was used to create behavioral models. The present work describes two implementations of models based on the dynamical systems approach and compares similarities and differences between them. The proposed models are designed to closely replicate the behavior selection in the intersection crossing experiment. KEYWORDS: vehicle behavior, modeling, behavioral dynamics, neural dynamics, dynamic field theory 1. Introduction The interaction of vehicles in roads can be studied independently from their drivers. The behavior of a vehicle will, of course, be no more than a simplified reflection of the driver’s behavior. However, this simplification allows us to focus on fewer variables for modeling and ultimately controlling a vehicle interaction with the environment in specific scenarios. Dynamic Field Theory (DFT) is the mathematical framework used in this project as the core for this type of modeling due to its elegant description of cognitive processes. DFT is based on the concepts of dynamical systems and inspired by findings in neurophysiology(1) . The result of activating this type of network is a continuously adaptive system that responds dynamically to any change from external stimulus. This implicit combination of nonlinear dynamical systems and neuroscience provides a solid tool for modeling behavioral paradigms and a flexible approach for considering a vehicle as an autonomous agent. Active safety functions such as adaptive cruise control and collision avoidance are typically enabled by fused proximity sensor signals creating situation awareness that allows safe maneuvering. In a future scenario with automated driving where vehicles completely handle all traffic situations on their own we foresee significant increase in intelligence within the situation awareness. From currently only being able to react on the current situation, to also be able to make interpretations of the current behavior and predictions about the future behavior of the road users in the surrounding traffic. In this work we make an attempt to model vehicle behavior with neural dynamics using data captured from vehicles driving in a common traffic scenario. This study is divided in two main categories that originate from a single scenario, i.e. two vehicles meet at an intersection with space for only one of them to cross it, Fig. 1. Each of these agents must take the decision about which one drives first through the intersection and which one waits for its turn. A first model assumes that vehicles cannot communicate to each other and their behavior is solely dependent on sensors providing information about their relative position to each other and to the center of the crossing. A second model is created assuming vehicle communication and both agents working as a single coupled dynamic system. At the same time, this work will be described in terms of the ritualized social rules observed when participants meet at a crossroad or intersection: continuity, competition and positioning(2) . Fig. 1 A picture of our study scenario, two vehicles meet at an intersection where one must wait for the other to cross. Data from GPS sensors mounted on two different vehicles was collected throughout several trials to study their average behavior for this scenario. Once the data is post-processed and synchronized it is possible to design a dynamic neural model of behavior activation with time as the main design variable. The goal is to create an autonomous behavior as similar as possible in time as to the behavior of a vehicle controlled by a human user and observed from the GPS data. Noise was also introduced in the system with a dual purpose. On the one hand, noise accounts for the nature of sensors and readings from a real environment. On the other hand, noise is a desired component in neural dynamics since it helps the decision-making process when competition is close. The article is divided in three main sections: first, section 2 describes the origin of the data where our models are compared to and a brief explanation of the mathematical framework used for creating our models of vehicle interaction; section 3 shows the results obtained from the design and implementation of our two models; and finally section 4 discusses the results of this project and describe future work. 20174675 Copyright 2017 Society of Automotive Engineers of Japan, Inc. All rights reserved Fig. 2 Left, plotting the gps data of all vehicles. Right, a simulation of the behavior activation. 2. Modeling 2.1. Data description The data was collected during a controlled field trial in the city environment at test track Astazero in Sweden. The purpose of the test was to study how an external interface [REF AVIP?] could make it easier for road users to interpret the intent of an autonomous vehicle in a meeting on a narrow road where only one vehicle could pass. 30 drivers were invited to experience narrow road encounters. The vehicles they met were a car and a truck. Vehicle #2 (car) shifted between three conditions: manual, AD: automated without intent communication interface, and AVIP: automated with intent communication interface. Vehicle #3 (truck) shifted between two conditions: manual and AVIP (AD was omitted due to no difference could be noticed between manual and AD since the truck driver could not be seen from the position of the test pin Vehicle #1). Each test participant experienced the conditions in a randomized order when approaching the narrow road (Fig 1.). The other test vehicle mirrored the test participants behavior to create a negotiation situation, but always gave the test participant the possibility to pass first. If the test participant waited, the other test vehicles (car or truck) passed first. To emulate autonomous driving, a Wizard of Oz (WOZ) technique was applied. WOZ is a well-established approach for evaluating user interfaces in various domains, from robotics(3) to mobile applications (Carter, Mankoff, 2005) and automotive industry(4) . It is based on the idea of simulating a fully working technical system by a human operator – a wizard(5) . To create the WOZ setup for our study, a dummy steering wheel was installed in a right-hand steered vehicle (a Volvo V40) and the real steering wheel was hidden from pedestrians’ sight. This way, it appeared to be a standard left-hand steered vehicle seen from the pedestrian’s perspective. When the vehicle was operating in the manual mode, the fake driver on the left-hand side interacted with the pedestrians and seemingly drove the vehicle. When the vehicle was driven in the automated mode corresponding to SAE’s automation level 4(6) , the fake driver on the left-hand side was reading a newspaper. The test participants were accompanied by a test leader who evaluated their situation understanding by asking the participants to rate how clear it was who would drive first, on a seven grade rating scale. They were also asked questions about their general experience of encountering an automated vehicle. 2.2. Neural Dynamics The interaction of an agent with a structured environment over time generates patterns of behavior. The study of the temporal evolution of behavior is called behavioral dynamics. There are two main behaviors that are of interest for us in this project: stop and go. The activity of each node in the following models will be used to take a decision whether a vehicle is allowed to continue through the intersection or if it should stop and wait. This system can be seen as a competition between two agents where the winner is allowed to go and the loser has to stop. In behavioral dynamics, actions based on sensory information create a continuous link between sensing and acting. In an application like the one studied in this project, it is very important to have this continuous flow of information from the environment in order to generate the correct and immediate action or actions. Any agent, or in our case any vehicle, controlled by a rule-based system suffers from what we can call blind spots in time where actions need to be kept on hold until the rule has been evaluated. This “pauses” in decision making could lead to wrong and even dangerous situations if an autonomous vehicle is not allowed to modify its behavior in continuous time. A continuous evaluation of sensory information producing a dynamic process in action selection starts with the right definition of variables on continuous dimensions. Once those variables have been defined it could be possible to find the solutions for that dynamical system which in turn generate behavior over time. A behavior is represented as a region in state space toward which trajectories converge, an attractor. In the same way, those behaviors to be avoided are represented from regions in state space from which trajectories diverge, repellers. 2.2.1. Model I The first model was designed to represent the same elements that existed in the original setup when the data was collected. The input into each node is given by the speed of each of the vehicles arriving the intersection, Fig. (3). Input Ii is set to zero when the output of the competing node becomes active, i.e. the output of the sigmoidal function is greater than zero. This inhibitory mechanism represents the visual cue given by observing the other vehicle move first towards the intersection. The strength of the self-excitatory contribution is given by constant c+ and controls how stable the “go” behavior is for each vehicle. The dynamics of this system is given by Eq (1). Fig. 3 Diagram of the neural dynamics used for model I.

https://5dok.org/document/yd7e55ve-modeling-vehicle-behavior-with-neural-dynamics.html

Zip Plus 4 94 recent viewsThis dataset contains points which represent the location for each ZIP+4® range in Arkansas. This base data serves a variety of public functions that include index layer for... - Autonomous Vehicle Survey of Bicyclists and Pedestrians in Pittsburgh, 2017 93 recent viewsIn Pittsburgh, Autonomous Vehicle (AV) companies have been testing autonomous vehicles since September 2016. However, the tech is new, and there have been some high-profile... - Traffic Flow Counts 72 recent viewsVehicle traffic volumes for arterial streets in Seattle based on spot studies that have been adjusted for seasonal variation. To provide a high level view of traffic volumes on... - Airport Runways 54 recent viewsDownloaded 10/22/07 from http://www.bts.gov/publications/national_transportation atlasdatabase/2007/. Queryed out ND via attributes and reprojected in ArcMap. Brian Bieber -... - Traffic Flow Map Volumes 43 recent viewsAverage annual weekday traffic volumes used to produce the SDOT Traffic Flow Map - - Mile Marker Post 41 recent viewsThe State Highway LRS system consists of the Interstate, U.S. and State Highways of Arkansas. Each point represents a Mile Marker reading on stated routes.. - Allegheny County Crash Data 41 recent viewsContains locations and information about every crash incident reported to the police in Allegheny County from 2004 to 2016. Fields include injury severity, fatalities,... - Traffic Cameras 34 recent viewsThis dataset contains information about traffic cameras in Austin, TX. Traffic cameras are owned and operated by the City of Austin Transportation Department and are used to... - - Allegheny County Traffic Counts 31 recent viewsTraffic sensors at over 1,200 locations in Allegheny County collect vehicle counts for the Pennsylvania Department of Transportation. Data included in the Health Department's... - - - LADOT Traffic Counts Summary 20 recent viewsLADOT automated and manual traffic count summary data for intersections throughout Los Angeles. Manual counts ("MAN" under the "Type" column) are generally 6-hr counts which... - Hartford GIS Data 20 recent viewsThis data set will give the user access to our enterprise GIS Data layers through our ArcGIS Online Open Data website. Data is always current to our GIS data. - Used Motor Vehicle and Parts Commission Dealer License Search 19 recent viewsA list of licensed Used Motor Vehicle Dealers (UD), Wholesale Dealers (WD), Automotive Dismantler (AD), Manufactured Home Dealers (MH), Manufactured Home Installers (I) and... - Road Centerline GIS Data 19 recent viewsRoad Centerline GIS Data exported from the CIty's GIS. See summary description (txt) file for information about intended use, projection, currency, attributes, etc. This map... - - Red Light Camera Locations 16 recent viewsThis dataset shows the location, first operational date, and approaches of the red light cameras in the City of Chicago. The approach describes the originating direction of...

https://catalog.data.gov/group/ccc6c266-eee8-44bd-89aa-7cd8c4c6bf46?tags=transportation

Jordan Rakei’s take on the Selected series brings together five of London’s finest current jazz and alternative soul acts to the Pizza Express Holborn live venue. Artists personally chosen by Jordan will perform across three nights, with a special intimate show by Jordan himself. Tonight's show will feature Waaju and Sarah Meth. Waaju believe in highlighting the world's connection through less familiar creative collaboration. Encapsulating influence from a number of cultures across Africa, South America & beyond, the band delves deeper to leave behind preconception & promote forces largely unexplored in a Western context. Citing the rich history of Malian music as centrepiece, Waaju presents the vision of drummer & percussionist Ben Brown which draws from the exceptional spirit of the likes of Ali Farka Toure, Oumou Sangare, Tinariwen & Baba Sissoko. Drawing inspiration from Jazz & Blues, 18-year-old Sarah Meth has been quietly crafting classic sounds delivered alongside her unique vocal essence.

https://www.pizzaexpresslive.com/whats-on/waaju-sarah-meth/234007350207

Klimt was born in 1862 near Vienna in Austria-Hungary. He was trained at the Vienna School of Arts and Crafts and later worked on a private commission for portraits for much of his career. He did also paint murals and interior ceilings in large public buildings as well while working alongside his brother Ernst. Klimt’s work was created during the Belle Epoque which was a period of high art in the city of Vienna. Gustav was also one of the founding members of the Vienna Secession which was a group of artists who wanted to break from conservatism and create new and exciting art. The Portrait of Adele Bloch-Bauer I was one such work that challenged the boundaries of accepted art styles at the time. This portrait was commissioned in 1903 by Ferdinand Bloch-Bauer for Adele’s parents. Klimt drew more than 100 preliminary sketches for the piece before starting on the actual work of painting it. He was heavily influenced in the painting style by pieces of art in the Basilica of San Vitale from the period of Justinian I. The style of the painting mimics the mosaics that were the inspiration for the design and offers a unique blend of realistic detail and mosaic-inspired segments. The viewer is not sure whether they are looking at a mosaic or at a painting and this revolutionary combination of styles within the same painting was commented upon then and is still famous today. With colors carefully imprinted in the same shades and degree as the original, it is a replica of his masterpiece. On the reverse, the painting is delivered as is with a highly textured relief, especially mirroring the texture of the actual artwork. There are few pieces of art on the market in any form that look like this one. The combination of classical painting and mosaic-style details is totally unique to this piece and is very memorable. This is a wonderful piece to add to any collection of art and there is no better rendering process to give collectors the right blend of texture and design. This is a really unique piece of art that corresponds well with being rendered in this way with ease. The obverse presents an original design depicting a portrait of the artist himself and the theme of this collectible, Portrait of Adele Bloch-Bauer I, in a currency note style as the design of the legal tender, featuring the Coat of Arms du Tchad. On a canvas of 12 x 12cm, a new minting technique called “Bi-Metal Max” was applied to give this piece its remarkable weight while keeping its proportions true to the actual painting. This is made possible by combining 33.5 oz of copper as a base with a top layer of 2 oz of 999 pure Silver. This is a limited edition of 500 pieces only. Each piece is packaged and delivered with a Certificate verifying its edition number and authenticity.

https://pmcollectors.com/product/portrait-of-adele-bloch-bauer-i-by-gustav-klimt-2-oz-silver-coin/

Art is an expression of that creativity which transcends the material realm. The birth of art requires boundless imagination which elevates the artist to a state of complete focus and through that single-pointed equanimity, the artist may experience unity with the art being created, i.e. a state of oneness which is otherwise termed as Yoga in its truest form. “The true essence of spirituality is what I feel when I am painting, and to me it is meditation”, says Anita Merchant, the born artist who has been channeling creativity onto layers of canvas displayed in her surreal home in Kuwait. Anita Merchant is a born artist with a passion for painting since the early age of five. Anita expresses herself through her paintings, with a focus on the aspects of divinity as well as womanpower. With a natural inclination to the colour blue which depicts calmness and serenity, her paintings are often seen as a sign of harmony and humanity. "My passion for painting started when I was five years old. During my childhood days, I started doing drawings, embroideries etc., and my father always encouraged me," says the artist. Being the daughter of a diplomat, Anita had a diverse upbringing and spent her childhood in many foreign countries. Anita's father, the Late Mr. O. P. Khanna was in the Indian Foreign Services. She was born in Stockholm and completed her schooling in Germany in German medium, and has a fluent grasp of the language till date. Anita later pursued her Masters in Zoology at Khartoum University, Sudan and further completed a second Masters in Social Work from Delhi University, Miranda House. While doing her masters in Social Work she was actively involved in doing community service in rural villages near Delhi. Later in 1975 her father was posted as the Charge De Affairs at the Indian Embassy in Kuwait, where Anita also moved. Kuwait was a turning point in her artistic career, as she completed around 75 paintings within a period of four months. "Basically, unlike other countries where I stayed, I got a lot of free time in Kuwait as outdoor activities were limited here. So I could dedicate a lot of time painting," says Anita. Her first solo painting exhibition was held at the National Art Gallery of Kuwait at the Daiya Abdulla Al Salam area in the year 1975. The exhibition was inaugurated by then Advisor to the Amir of the State of Kuwait H.E. Sheikh Abdullah Al Jaber. Then Indian Ambassador to Kuwait, Shri Axel Khan, and several other dignitaries attended the exhibition, which was impressed by a large number of art enthusiasts. Anita was the very first Indian national to conduct an art exhibition at the Kuwait National Art Gallery. Previous Next Post her father's tenure in Kuwait, Anita stayed back and pursued a job opportunity with the Air India office in Kuwait. Mr. Mahmoud Alghanim, who was the GSA of Air India at that time, commissioned her to do up the entire office in Kuwait City with her paintings, the theme of which depicts ‘unity in diversity of secular India’, and these beautiful art works adorned the office of Air India for several years. "During those days, it was not easy to get large canvases. I had to travel to Switzerland just to get high quality canvases for my paintings," Anita said. She is proud that her artwork is now a part of Air India’s collections in Mumbai. During that phase in Kuwait, Anita married Mr. Mohammed Merchant, who is a famous Indian businessman and currently the tycoon of the steel business in Kuwait, where they have lived since. With the constant support of her husband, Anita continued her passion for painting and did many other exhibitions. When her father was subsequently posted to Islamabad after Kuwait, Anita got an opportunity to conduct her painting exhibitions there. Her dream came true when she then did an exhibition in Sweden, the country she kept close to her heart given that she was born there. Later on she continued exhibiting her paintings in many exhibitions held here in Kuwait. Anita’s paintings use calm and soothing colours, and they express spirituality, many of which are adorned by Radha and Krishna depicting transcendental love and unity. Being an animal and nature-lover, animals also find a significant place in her paintings. Being a big admirer of Buddha, we always find the 'Moksha' feelings in her paintings. One of her unique series of painting was a depiction of the works of the famous Persian poet, Omar Khayam, which adorn the beautiful walls of a famous Diwaniya in Kuwait. Her paintings are also exhibited in several dignitaries' houses in Kuwait, including that of the Late Sheikh Abdullah Al Jaber, which she gifted to him. "If I don't paint for a while, I feel something is missing in my life," says Anita, who spends hours every day on her canvas. "I feel I have truly done something worthwhile after spending a few hours every day with my brush," she added. Anita’s life experiences and her subconscious are what are the inspirations for her work. During the 1980s she created the famous paintings ‘Cosmic Creation’ and ‘Cosmic Birth’ which were then followed by the birth of her two daughters, Maeesha and Anushka. Anita’s life, experiences, soul, creativity and expressions all come together in the form of her signature Art, which is a depiction of who she is. An artist always loves to experiment with colors, creativity and her brush. Several of Anita's paintings are marvelous in the true sense of the word, many of which are made with sterling silver as well as 24-karat gold leaf. She learned the technique of painting with gold leaf, and the results are amazing. Ink painting on silk is another wonder in her gallery. As silk is highly soft and delicate, one has to choose the brush and the density of the ink very specifically, otherwise the ink spreads throughout the silk cloth. Anita had done wonders on silk cloths with her extremely careful brush. Anita Merchant also has a passion for designing silver. It has been over two decades since she started creating silver designs in the form of ornaments, cutlery, crockery or jewelry. Anita would make the designs on paper and gets them crafted by artisans in India. She has done several private exhibitions of her silver designs in Kuwait which were attended by the elite of Kuwait. As the famous saying of Thomas Edison goes “Genius is 1 percent inspiration and 99 percent perspiration.” The inspiration behind her works it truly a gift, but undoubtably the dedication to perfection and patience to see it through is what sets Anita apart. She often spends up to 10 hours a day painting and her intricate work often means that a single painting may take several months to complete. “I believe in giving my 100% to whatever it is that I do, especially painting”, says Anita. Her steadfast efforts and sincere dedication to whatever it is that she chooses to pursue is the secret to her success, and an inspiration to all!

https://www.indiansinkuwait.com/news/print/63852

ÏTTAG first collection takes its inspiration from the neons signs of the hotels and casinos of the 1950s Las Vegas Strip. The signs have been stored over the years in a ground called the “Bone Yard” creating a fascinating collection. The strong colours, the enormous sizes and the unique designs of every sign were of great inspiration as much as the history behind each one of them.

https://ittag.uk/pages/neon-signs-collection

Liberty of London is the first painting in the 'London Landmarks series. An iconic building in London built in the Tudor Revival style and turned into a visionary store which became a mecca for designers and artists including famous pre-Raphaelite artists. Arthur Lasenby Liberty the founder of Liberty had the vision to bring in the best artifacts and design from the Far East and the Orient and also support and nurture homegrown talent such as William Morris and The Arts and Crafts movement. Clare's painting depicts the store as it is today with the colourful flower shop at the Great Marlborough Street entrance. Using her trademark mixed media technique Clare combines detailed monoprint line drawn figures outside the front of the building which Oscar Wilde once referred to as 'The home of the artistic shopper', "I feel a real connection with the Liberty store, I used to go there as an art student and drool over the textiles, Later I found out a textile agent I had been working with had sold one of my Dragonfly designs to Liberty Store for a range of stationery. Today its connection to the Far East as part of its history made me choose this striking building as the first in my collection of London Landmarks.

https://clarehaxby.com/collections/fine-art-paintings/products/liberty-of-london-original-painting

Laura H Elliott is a contemporary, multi-media artist who is passionate about mixed-media painting and creating sculptural metal clay designs with genuine gemstones. Laura is the same in the arts as she is with life and learning, inquisitive and driven. Her work is a dichotomy of mediums, creating paintings side by side with metal clay work. The exploration of ideas over the years has led to an abstraction in her work, with one medium directly inspiring the other. It was a slow progression towards this change, but it has ignited such a new energy into Laura’s work. She adores both mediums, with each having its own process and challenges. Laura finds painting an unfocussed, instinctual process, with a simple colour palette choice being the only planning she needs to do. Art and the execution of her designs is an instinctive process which allows her to express her feelings and representations of life and draws out of her the essence of who she really is as a person. Laura’s collection featured on Flying Ducks Art Gallery website ‘The Landscape Moods Collection’ focuses on landscapes creating a dialogue unique to this collection with a combination of mediums. Exploring Laura’s fire, passion for life and the challenging her creativity just as life does. Art is a deep love for Laura and is a reflection of who Laura is, part of her identity. “The ‘Landscape Moods Collection’ of paintings have progressively exploring abstraction, colour and texture. These artworks reflect Laura’s desire to be constantly evolving, in order to progress her work. These collections draw inspiration from a number of sources, including patterns, shapes and colours found within the four different elements: earth, water, wind and fire. Bright colours and fluorescent neon paints will express energy and vibrance. As with all Laura’s work, the key components are emotions and mood at the time of creation, maintaining a fluidity of ideas and a freedom of exploration.” It was in 2002 that Laura began studying for an Art and Design Access Diploma, taking a step towards becoming a professional artist, further developing her knowledge of the arts. The final piece of her professional puzzle was achieved when she gained her Art and Media Bachelor with Honors in 2008 at The University of the Creative Arts Farnham, specialising in Fine Art and Photography. Laura’s paintings and metal clay designs are displayed in private collections worldwide and have been exhibited within exciting group and solo exhibitions, memberships and galleries.

https://www.flyingducksartgallery.com/featured-artist-laura-h-elliott/

Leslie Mark believes one of the greatest gifts of her life is rooted in being born in the Cranberry Island. Her mother and her sisters were raised on the same Island. Her grandfather was a boat builder there, and her grandmother made some of the best homemade donuts around. Leslie’s father is still a lobsterman more than 50 years after pulling his first traps from the waters. Living on the Island inspired her and her art because it was a unique way of life that left an indelible mark on her soul. The elements and the challenge of isolation give way to the gifts of creative inspiration, resourceful spirit and hearty resilience. She saw the ladies of the island sharing the tradition of handwork, sewing and knitting at the annual Ladies Aid fair and the Whales Rib gift shop. Her passion for being a designer is so much related to being an Island girl. She’s involved in a lifelong passion with that tradition of hard work and handwork, sewing and fabric combined with a permanent desire to, create paint and draw. As a designer, her goal is to collaborate with people from other industries including manufacturers to provide adaptable designs which can be modified in color and scale to suit specific market trends, product designs, and ultimately be profitable in the marketplace. She’s fortunate to be energetic, happy, healthy, and to live in an area providing constant inspiration for her primarily designs that are nature-themed. Her personal Interests include painting, drawing, biking, doodling, hiking, walking, challenging her fears, and figuring stuff out.

http://www.georgiaokeeffegallery.com/showartist.aspx?id=118787

Search Upcoming Events Our searchable event list includes only events with fixed start and end dates. For a list of destinations and events that are open year-round, or that repeat regularly throughout the year, check out our Ongoing Events. - This event has passed. Experience the Wonder of Indian Folk Art with Gond Painting April 7, 2018 - April 14, 2018 With a history that’s rich in culture and heritage, India is a treasure trove of art forms. One such art form is “Gond,” developed by one of India’s largest tribes. The Gond believe that everything in nature is sacred and inhabited by a spirit. Their paintings reflect reverence for nature and an appreciation of the connection between humans and the natural world. Painters get their inspiration from nature, from the myths and legends of India, or just from their imaginations. Learn about the tradition of Gond and experiment with the designs, patterns and vivid colors used. Leave the second week with your own unique painting and ideas about how you will be able to continue to play with this delightful art form. Mitra Verma has recently emigrated from India. For ten years she held workshops in painting, puppet-making, basket weaving, and more. She is eager to share her love of art with students here who want venture into new areas.

https://frontporchne.com/event/experience-the-wonder-of-indian-folk-art-with-gond-painting/

MisuraEmme was established in 1939 and has made an infallible contribution to the ‘Made in Italy’ values. All their designs represent an attentive monitoring of market trends along with meticulously designed products and high quality materials that form part of their philosophy. Ferrucio Laviani is an Italian born designer who has collaborated with the likes of Kartell, Molteni & C, Moroso and Dolce & Gabbana to name a few. He gathers inspiration from Scandinavian design, almost obsessive in material processing and his sensitivity to wood is palpable in the Gaudi collection for MisuraEmme. The Gaudi Table has a semi-oval shaped top and forms part of the ‘Gaudi’ collection designed by Ferrucio Laviani. The collection’s slightly organic forms are inspired by Antoni Gaudi’s famous Sagrada Familia cathedral in Spain. The base and top are both stained black and made from solid ash wood.

https://www.thelongeststay.com/gaudi-dining-table

Instantly recognizable as one of the most iconic images of modern culture, Vincent van Gogh''s "Starry Night" draws thousands of visitors every day at The Museum of Modern Art. Yet few are familiar with the story behind this unlikely masterpiece, envisioned and executed by Van Gogh during his stay at a mental hospital in Saint-Rémy. "The Starry Night" is no ordinary landscape painting, with its surging forces, resonant chromatics and mysterious shapes that reflect Van Gogh''s unique state of mind at the time. In this informative volume--the latest in a series on favorite artists and important works in MoMA''s collection--distinguished art historian Richard Thomson provides an overview of the painting within the context of its creation, bringing together Van Gogh''s correspondence regarding the painting and the Parisian art scene of his time with an in-depth exploration of his technique and style. Highlighting significant details not easily visible at first glance, and illustrated with dozens of comparable works, Vincent van Gogh: The Starry Night is an indispensable guide to one of the most famous paintings of the nineteenth century.

https://www.chapters.indigo.ca/en-ca/books/vincent-van-gogh-the-starry/9780870707483-item.html?ikwsec=Books&ikwidx=0

Today we’re looking to the futuristic work of architect and designer Neri Oxman for inspiration! Oxman’s designs are particularly striking, incorporating digital and computational design with materials science and synthetic biology to explore the relationship between the natural world and the artificial components that we build into it. We find the ‘Wanderers’ collection particularly compelling, not least for Oxman’s stunning use of colour, materials, and surface textures. This project is a collaboration with Stratasys, a 3D printing company, and ties in with their collection ‘The Sixth Element: Exploring the Natural Beauty of 3D Printing’. The designs are tailored to the various environments of the planets within our solar system, and the concept behind each design is to aid humanity’s survival within that landscape through absorption and production of biomatter. What we find so inspiring about Oxman’s designs is their tactile quality; you can’t help but be drawn in by the diverse textures and materials. Though beautiful, the designs are also subversive and surreal – a unique blend of science, technology, and design innovation that we can’t resist.

https://www.moodymonday.co.uk/tag/inspire/page/4/

Designer Kobi Halperin conveys nature motifs as the main pillar for his fall lineup. The collection was inspired by James Abbott McNeill Whistler’s painting The Peacock Room and larger “cult of beauty” aesthetic. The designer turned to the pages of books that have helped him understand different cultures in his American journey as an immigrant. A bamboo motif served as a symbol of strength, elegance and flexibility. Halperin seamlessly blended his European sensibility with Moroccan influence to elevate daytime separates. The inspiration behind pre-fall started at the Met and ended in Capri, resulting in playful prints and intricate embroidery adorning summery styles. Halperin built his spring collection on three major tenets: historical textiles, color and emotion. Halperin’s resort collection was a contemporary interpretation of the artwork of Hilma af Klint — a blend of poppy colors, abstract designs and pioneering spirit. Halperin offered a breadth of warm, inviting patterns culled from carpet textiles in his homeland of Israel. Canadian designers featured on digital wholesale platform Showroom Canada discuss emerging fall fashion trends.

https://wwd.com/fashion-shows-reviews/fashion-designer/kobi-halperin/

A new exhibition, Imperial Threads: Motifs and Artisans from Turkey, Iran and India opened at the Museum of Islamic Art (MIA) today, under the patronage of Qatar Museums’ (QM) Chairperson, Her Excellency Sheikha Al Mayassa bint Hamad bin Khalifa Al Thani. The exhibition, which will run from 15th March until 4th November 2017, brings a new perspective to MIA’s remarkable permanent collection by showcasing the connection between three major dynasties that marked the start of the early modern period in Islamic art - the Ottoman, Safavid, and Mughal empires. Imperial Threads: Motifs and Artisans from Turkey, Iran and India highlights the exchange of artistic and material cultures between the empires, primarily from the 15th to the 19th centuries. The exhibition illustrates the cultural and artistic background of this time by featuring artefacts including carpets, manuscripts, metalwork and ceramics. Dr. Mounia Chekhab Abudaya, Curator of the show at the Museum of Islamic Art said: “MIA houses one of the greatest collections of Islamic art spanning over 1,400 years, and we are extremely excited to showcase some of our most exquisite objects from the Ottoman, Safavid, and Mughal empires in this exhibition. Through this exhibition, we hope to take art and history lovers on a unique journey to truly understand the connection behind these major dynasties. The exhibition is broken down into three sections, each one focusing on a specific empire. The Safavid Empire section (1501-1736) showcases works from the Safavid royal Kitabkhanah, or manuscripts workshop, as well as artistic motifs developed under patrons such as Shah Tahmasp. The Safavids played a major role in the transfer of artistic practices by means of travelling artists to the neighbouring Ottoman and Mughal courts. The second section introduces visitors to the Ottoman artistic production with works ranging from the 16th to 18th centuries. It showcases examples of carpets in addition to other mediums characteristic of local tribal designs, merged with outside influences coming from Iranian ateliers. The last section highlighting the Mughal Empire (1526-1858), offers a look into the culmination of artistic styles integrating Safavid, Ottoman and local traditions. Of note are the detailed floral designs that represent a major part of the decorative repertoire, found particularly in carpets and jewellery. A range of educational programmes, workshops, activities and events will be organised alongside the exhibition, which will inspire engagement and enrich young peoples’ lives. Workshops and activities being organised include a talk by Artist Faig Ahmed who is inspired by designs from Islamic Art in his contemporary work. There will also be an introduction to Carpet Weaving workshop taking place from 19 – 23 March, 2017. For more information on upcoming educational programmes and to register, visit: http://www.mia.org.qa/en/whats-on or www.qm.org.qa/education Categories:

https://www.qatarisbooming.com/article/qatar-museums-reveals-artistic-connections-between-three-major-dynasties

Hi, I’m Kath and I am a self taught textile artist based in Wainsgate Chapel, a beautiful, deconsecrated baptist chapel, in Old Town above Hebden Bridge. All of my designs are inspired by my love of nature, stirred with a good dollop of childlike imagination. I make a wide range of brooches, accessories, homewares and original artwork featuring our native birds and creatures. Each one is lovingly hand cut, needle felted and free motion embroidered, to have its own unique character. The majority of my fabrics are carefully sourced S... My willow work is influenced by the natural environment all around me. Using much of my own grown willow I create work that is often functional and connected to the land. I love being able to create something from just a bunch of sticks. Willow is so flexible and strong it can be woven into almost anything only limited by my skill and imagination. I enjoy the physical nature of what I do, that along with the repetitiveness of weaving keeps me completely absorbed while I work and I am always reminded of the people and cult... I enjoy painting landscapes and seascapes that play with form and formlessness. I aim to create scenes that feel half-remembered, at once familiar but also dream-like. In my art I experiment with the boundaries between the real and the imagined, creating scenes that seem both familiar and yet distant. While many of my paintings are inspired by real places I rarely paint specific locations, instead preferring intuitive and meditative painting methods to paint through pure, direct creative expression. Some of the most rewarding and exciting feedback I’ve... Inspiration for my fibre artwork comes from my wanderings of the land and wild seascapes, my love of vibrant colour, abstract expressionism, free flowing forms and textural surfaces. I’ve always been a wanderer, exploring the moorlands, flora and fauna. I lived on a small farm in my childhood, drawing, creating, making imaginary worlds with whatever I could find both in and outdoors. After my art degree, I worked as a designer, participatory artist and lecturer. I now love to create my fibre felted paintings, sculptural pieces... I was initially inspired by reflections in a department store shop window in Peckham High Street when I was student at Camberwell School of Art. Peering at my own reflection a woman in a fur coat rushed by reflecting in the glass and captured my imagination. The reflections theme has kept me painting in various guises for over 40 years. Over this time the paintings have changed in form, size and medium. They question and consolidate a momentary experience, recording a pinch of life at a particular time – a historical document. Shops and displays modif... My work draws on architecture, machines, and natural forms to produce unique lamps and clocks that combine a strong mechanical or structural aesthetic and a playful character. All my work is designed to encourage interaction and introduce a sense of play into everyday activities; for example a kinetic element or simple mechanism to adjust the piece or to set it in motion. The overall aesthetic draws on the beauty of industrial materials and the charm of simple machine assemblies, made using materials with a strong practical and decorative heritag... In my paintings I celebrate our connection with treasured books and the way our bookshelves reflect the stories of our lives. My work brings together my love of oil painting, books and typography and a fascination with how our bookshelves can hold on to our stories and reflect our lives. I specialise in carefully rendered, reverential Shelf Portrait oil paintings: collections of treasured books gathered together, resonating with the relationships they hold. Local inspiration has come from Shibden Hall in my ‘Gentleman Jack’ Shelf Portrait, commissioned... From my sunny studio I make glowing paper-cut lighting, wallpaper, window film and a large collection of tiny laser cut treasures, all inspired by the exquisite details found in nature. I’m always inspired and enthralled by the tiny details found in nature and I love living in this valley with its many woodlands paths, moorland and meadows. I walk often with my camera taking it all in and trying to figure out how to express what I see in my work. My studio is home to my incredible laser-cutting machine, which I use to cut all the motifs for my la... I create unique, articulated jewellery inspired by the natural world and the process of making. Growing up on a farm near the coast in West Wales I spent my childhood playing outside with my brothers, exploring rock pools, and making things. Most of my ideas stem from this early immersion in nature. I completed an Arts Foundation course at Carmarthen College of Art, I studied Design Crafts at Staffordshire University, where I specialised in fine metal, growing to love the scale and personal connection of jewellery making. After graduation I continued ... This month our tour of Calder Valley creativity continues with stops along the way to see some extraordinary articulated jewellery, exquisite nature inspired designs for the home, and ends up exploring a unique fusion of oil painting, books and typography. Follow #hbosFridayFeature on social media or check out our blog on the following Fridays for the full length features: All aboard! Tickets and pas... Always a fan of a good story I studied illustration at Edinburgh College of Art, my passion for screen printing followed and I brought to life literary characters I loved in little hand printed books. A move to Brighton gave me the opportunity to study a Masters in Sequential Illustration and to continue with making and printing. A painting career then developed from showing a few tentative paintings in a pop up shop. I painted florals and landscapes and have been published nationally and internationally. My love of the outdoors and surrounding nature ... I am a small batch potter working from my home studio in Hebden Bridge. I hand craft functional earthenware ceramics such as vases, mugs, jugs, plates and candleholders. I use white earthenware clay to create my pieces and slab-building or hand-made moulds to create the shapes. I decorate my pieces with vintage lace, or simple bird, leaf or flower shaped paper templates. Using quick, vibrant brush strokes I apply coloured slips to my ceramics and after they have been bisque fired I add more details with brush-on underglaze and pencil. I then apply a lu...

https://hebdenbridgeopenstudios.org/blog/

Verner Panton is considered one of Denmark's most influential 20th-century furniture and interior designers. During his career, he created innovative and futuristic designs in a variety of materials, especially plastics, and in vibrant colors. His style was very "1960s" but regained popularity at the end of the 20th century; as of 2004, Panton's most well-known furniture models are still in production (at Vitra, among others). Panton was trained as an architectural engineer in Odense; next, he studied architecture at the Royal Danish Academy of Art (Det Kongelige Danske Kunstakademi) in Copenhagen, graduating in 1951. During the first two years of his career, 1950-1952, he worked at the architectural practice of Arne Jacobsen, another Danish architect and furniture designer. Panton turned out to be an "enfant terrible" and he started his own design and architectural office. He became well known for his innovative architectural proposals, including a collapsible house (1955), the Cardboard House and the Plastic House (1960). Near the end of the 1950s, his chair designs became more and more unconventional, with no legs or discernible back. In 1960 Panton was the designer of the very first single-form injection-moulded plastic chair. The Stacking chair or S chair, which would become his most famous and mass-produced design. In the late 1960s and early 1970s, Verner Panton experimented with designing entire environments: radical and psychedelic interiors that were an ensemble of his curved furniture, wall upholstering, textiles and lighting. He is best known for the design of a German boats interior, now a famous museum. He is also known for a hotel in Europe that utilized circular patterns and cylindrical furniture. Additionally, Panton is well-known for his innovative design work for "Der Spiegel," a well-known German publication in Hamburg. Exhibition Stand: Gebrüder Thonet AG, 1968 The fair stand designed by Panton for the firm of Gebr. Thonet was not just a presentation platform for the products which Panton designed for the company (see the section on furniture). In addition numerous bentwood classics from the Thonet collection were shown here in unusual colour variations initiated by Panton. Further integral parts of the fair were the Flower Pot lamps and the Marguerite and Roulette carpets. Spiegel publishing house in Hamburg, 1969 The furnishing of the Spiegel Publishing house buildings in Hamburg count among the most outstanding examples of Panton’s interior designs and are some of the few that still exist, at least in part. For the famous news magazine which moved into the modernized premises in 1969 in Hamburg’s Ost-West Street, Panton designed the entrance area with courtyard and lobby, the canteen and the bar areas, the swimming pool for the employees in the basement of the building, the rooms for the editorial conferences and the lounges, as well as the colour schemes for the hallways of the administration or editorial highrise buildings. Here again the colour schemes became a major design element, providing Panton’s typical fusion of room design. All designs were his own – lamps, textiles and wall claddings, only the furniture had to be ordered from Knoll International according to his contracts. The specially designed mirror lighting used on walls and ceilings was of major importance. While the swimming pool area was destroyed soon afterwards by a fire and the entry and lobby saw major redesign in the 90s, the canteen has so far remained in the original version and today represents a unique and valuable historic document. Visiona 2, 1970 From the end of the Sixties to the mid-Seventies the chemical company Bayer rented a pleasure boat during every Cologne furniture fair and had it transformed into a temporary showroom by a well-known contemporary designer. The main aim was to promote various synthetics products in connection with home furnishings. Verner Panton was commissioned no less than twice to design this exhibition, entitled 'Visiona'. The 1970 'Visona 2' exhibition showed the Fantasy Landscape which was created in this environment. The resulting room installation consisting of vibrant colours and organic forms is one of the principal highlights of Panton's work. In terms of design history this installation is regarded as one of the major spatial designs of the second half of the twentieth century. The creative fireworks which Panton lit with his studio within a preparation time of only a few months for 'Visiona 2' is expressed not only in the highly diversified room designs in the exhibition ship, but also in the wide range of furniture, lighting, wall coverings and textiles developed specially for this presentation. Some of these were adapted and went into series production later. Varna restaurant, Arhus DK, 1971 The architectural commission at the Varna restaurant in Arhus was for the interior design. Verner Panton took his inspiration here from the outside design of the building which shows in particular in the round corner columns of the building. Fabrics from Mira-X were used by Panton to focus on proportions and connections, and using colour and shapes gave each room its unique dynamics. Mira-X exhibition of home furnishing textiles Frankfurt, 1971. At the 'Heimtextil' home furnishing fabrics exhibition in Frankfurt am Main, the firm of Mira-X first presented the Mira-X set developed by Verner Panton in its entirety. In the atmospherically dense design of the stand, which attracted attention in particular by its vibrant colours, Panton also integrated his own furniture and lighting designs. Private appartment in Kopenhagen, 1994-1999 Living Sculpture, 1972 Text and images from verner-panton.com & Wikipedia. Previous to this. Everyone marched in step, wore their hair exactly the same, dressed exactly the same, believed and behaved exactly the same. This was the first of making unorthodox choices, going into new, never before explored ideas, concepts, questioning basic long held believes of color, function, forms and shapes. This platform was acquired by a joint venture in Israel. changes have been made to the relevant jurisdiction for disputes which may arise out of your use of the platform. Changes made to the monetization of users’ creations and the ability to opt out from your account settings. Please view the revised Terms here. If you don’t mind anything there, then you don’t need to do anything. Your continued use of the platform will constitute your acceptance of the latest version of the Terms. If you disagree with anything there, you can terminate your account within seven days from today.

https://www.colourlovers.com/blog/2009/05/18/the-colors-of-verner-panton

The year 2020 will be an exciting year for Bloorcourt! For the past couple of years, we have been planning for the installation for three parkettes in the neighbourhood. Locations include: Inspiration for the elements of the parkette designs draws on the imagery of a local fruit market and the recent Rosina Shopkeeper research project with Heritage Toronto. Construction for the parkettes is slated to begin in spring 2020. We look forward to seeing people enjoying the parkettes once they are complete. These are made possible with a partnership with the City of Toronto BIA Office. Leave a Reply. | | Bloorcourt BIA Highlighting unique stories, events or neat stuff about the community here. Archives September 2021 Categories | | Copyright 2021 | | Land Acknowledgement The City of Toronto acknowledges that what we now call Toronto is on the traditional territory of many nations including the Mississaugas of the Credit, the Anishnabeg, the Chippewa, the Haudenosaunee and the Wendat peoples and is now home to many diverse First Nations, Inuit and Métis peoples. The City also acknowledges that Toronto is covered by Treaty 13 signed with the Mississaugas of the Credit, and the Williams Treaties signed with multiple Mississaugas and Chippewa bands.

http://www.bloorcourttoronto.com/bloorcourtblog/bloorcourt-parkettes-in-2020

Like most designers, Rei Kawakubo doesn't confine herself to a set of rules and guidelines when it comes to inspiration or aesthetic vision. But the way she stands out from the rest in the industry is through the extent of her reach in terms of creativity and originality—from her radical, boundary-breaking designs at her label Comme des Garçons, founded in 1969; to Six, her biannual photo-ladden magazine and Dover Street Market, her multilevel fashion retail and concept store that goes through a "tachiagari" whereby the interior concept is renewed twice a year. Kawakubo's most famous for her groundbreaking, distinctive concepts spotted on runways of Paris—her first collection in 1981 was mostly sombre black, shapeless and shredded, essentially the antithesis of the ostentatious designs from the rest of the high fashion pundits. Her 2D collection during A/W 2012 featured bright oversized and flat-fronted proportions, as a personal take on the current state of fashion at that time—lacking in depth and void of meaning. When Kawakubo saw potential in her protégés Junya Watanabe and Kei Ninomiya, she encouraged them to open their own line of apparel under the Comme des Garçons umbrella, with designs that are always conceptual, at times deconstructed, but with poignancy like hers—there's always something that goes beneath the surface. As Kawakubo turns 73, here's a look back at her 7 best moments as a master tailor, creative artist, entrepreneur and more:

https://www.buro247.my/fashion/buro-loves/rei-kawakubo-s-7-best-moments.html

“Dito” means “finger” in Italian. And Dito von Tease (nice nickname, right?) is the pseudonym of an Italian artist who authored a very peculiar body of work: a collection of portraits of famous characters from history, literature, art, pop-culture and more painted on fingertips (we’ve all tried this once, but probably with less striking results!). He looks great, doesn’t he? Ditology, the collection of Dito’s images, came about unexpectedly. The first portrait was created to be used as a Facebook profile picture: the author literally wanted to himself behind a finger to protect his privacy! The rest is history. Check out the gallery to see some of the best of Dito, and visit his website: you can keep this as an inspiration for next time you decide to entertain your kids by painting faces on your fingertips and using them as characters!

http://timbuktu.me/blog/celebrities-fingers/

Fife based designer and embroidery artist Rebecca Sarah Black, also known as Blackbird & Bloom, creates modern embroidery designs, craft kits and bespoke artworks. A former DJCAD Jewellery graduate, Rebecca took a break from her jewellery practice in 2019 and has since become immersed in the world of embroidery. Much of Rebecca's inspiration and motivation behind her work is mindfulness. After struggling with her own anxiety during the first 2020 lockdown, Rebecca took to embroidery to support her journey to improve her mental health. The craft of embroidery is hugely therapeutic, and therefore, Rebecca wanted to share this craft and it's benefits through embroidery craft kits everyone could learn from and enjoy. As well as embroidery craft kits, Rebecca specialises in bespoke Pet Portraits – using the technique of thread painting – and custom name artworks, each unique and created by hand.

https://www.teagreen.co.uk/tgmd2/blackbird-and-bloom

I am a proud Yorta Yorta women with a love for drawing a talent I have had from a very young age. My family have a strong connection to Cummeragunja mission and the Murray. I have been painting and illustrating for many years as a self-taught artist. My work has been described as unique and I have sold paintings all over Australia and overseas. Most of my work combines wildlife and country and is distinguished by its clean lines and distinct sense of structure. I layer my dots with paint to add texture to make them appear 3D in different lighting tones throughout the day. The medium I use is acrylic paint on canvas and when I can go back on to country I combine traditional ochre in my painting with symbols that have meaning. I like my art to appeal to our younger generation in a fun way but also to tell a story of our wonderful culture and our land as we have for many years through dream time stories, painting's and dance. Working with children with disabilities and mentoring our youth about our culture through my art has made me a better artist. My designs have also been printed on to fabric for M&S Textiles Australia a company whom were established to promote Authentic Aboriginal design fabric to the quilting community in Australia and overseas. Samantha is unable to be at the exhibition in person as she is battling serious health problems. We are proud to be able to display her work on her behalf.

https://naradreaming.com.au/main/page_artists_samantha_james.html

A technical writer is a competent communicator of information whose job is to transmit information between two or more parties through some means that promotes information transfer and understanding in the best way possible. Via a variety of distribution channels (electronic, printed, audio-visual and even touch), Technical Writers study and build information. Online support, manuals, white papers, concept requirements, project plans and program test plans are examples of information categories. Technical writers are rapidly engaging in the development of educational training materials with the emergence of e-learning. Similar Job Titles: Tech Writer, Technical Author What Does a Technical Writer Usually Do? In order to share detailed and specialized knowledge more effectively, technical writers prepare instruction manuals, how-to guides, journal articles, and other supporting materials. Via the contact networks of an entity, they also create, collect, and disseminate technological knowledge. Below is a rundown of a Technical Writer’s monthly tasks: - Ascertain the most applicable medium of documentation for the assignment - Assemble project brief by analyizing client information - Collaborate internally with the technical department to understand company products and strategy - Review / rework internal content Ascertain the Most Applicable Medium of Documentation Technical writing is used if it is necessary to express technical details through simplified text. Scientific or technical knowledge will be broken down and explained in the text and the reader will be able to use the information in an easier manner. Technical writing is particularly popular thanks to the technological shifts seen in the workplace and day-to-day life. While text may still be the most popular form of relaying information, as a Technical Writer, you will need to decide what format will be best suited for the users’ needs, i.e. graphic, audio or illustrated. Text may be best for scientific papers, and basic instruction manuals. Technical Writers may need to collaborate with internal graphic designers to shift the medium to a visual aid, or even work with the sound department to produce an audio guide. This versatility is key to becoming a successful Technical Writer. Assemble Project Brief by Analyzing Client Information Depending on the company industry, different clients will require different content. If you’re working in the science industry, client briefs may require you to simplify scientific papers for the general public to access, or schools to use in their textbooks. You could also be working on instructional pamphlets for Lego blocks. This is why it’s important as a Technical Writer to gather resources and information on the customers’ requirements, and then take this info through to the internal team to collaborate on. Collaborate Internally with The Technical Department Technical Writers often collaborate with multiple internal departments. In order to monitor the way knowledge circulates across the organization and to clients, Technical Writers consult with the technical department, as well as marketing, management, and other technical personnel. This also allows consistency to remain at maximum, thanks to multiple experts providing feedback on tone and ease of use. While Technical Writers don’t always need to be in the office in the modern work environment, this specific function will require regular conference calls and group meetings in order to stay within the same company “voice”. Review / Rework Internal Content In the same way that Technical Writers create content based on information they’ve received, the team you’ll be working with also creates content. Just as a Technical Writer submits their work to be reviewed, you’ll also be required to analyze, edit, and submit suggestions for the work your peers submit. This process helps keep the content consistent, simple, and ultimately suitable for the targeted audience. Roles a Technical Writer Typically Collaborates With Depending on the corporation’s structures, Technical Writers often collaborate with varies aspects of the business. The most common are: |Roles Technical Writers Collaborate With| |Marketing Director||Advertising Director||Customer Experience| |Creative Director||Public Relations||Social Media Manager| Technical Writer Salary A Technical Writer’s median salary in the United States is around $60,500. A Technical Writer’s annual salary ranges between $42,000 and $87,000, depending on skill level, industry experience, and the company. What is the Technical Writer Pay Difference by Location? Annual salaries for a Technical Writer vary across the major U.S. cities: |City||Average Annual Salary| |San Francisco, CA||$83,456| |Seattle, WA||$76,624| |Denver, CO||$61,558| |Austin, TX||$63,290| |Washington, DC||$66,807| |Milwaukee, WI||$49,343| |Boston, MA||$67,934| |New York, NY||$72,092| What is the Technical Writer Pay Difference by Experience? Experience levels also determine a Technical Writer’s salary. Below is a table of the average wages for Technical Writers based on years of experience: |Years of Experience||Average Annual Salary| |< 1||$49,000| |1–4||$55,000| |5–9||$65,000| |10–19||$71,000| |20+||$73,000| Technical Writer Job Description Template [Company Name] is actively seeking a motivated, accurate and detailed technical writer to assist with creating user-friendly content from complex resources. To improve product transparency, engagement, and accessibility, your role will require you to develop user-friendly content and supplement documentation for products. A solid knowledge base and the willingness to collaborate with other departments cooperatively are a must. Technical Writer Responsibilities: - Ascertain the requirements of technical documentation consumers - Research trial outcomes and collaborate with designers and product designers where needed - Collaborate internally with the technical department to make it easier to understand instructions and products - Create or rework supportive product material where needed - Rework content from internal team where needed - Ensure the content contains the appropriate visual stimulus in order to make understanding the concept easier - Decide on the best means of communication (video, text, audio etc.) for the message - Ensure content is uniform across all content channels - Gather and analyze feedback from users in order to enhance or rewrite content Technical Writer Requirements:

https://monsterworking.com/job-descriptions/page/3/

We have an exciting opportunity for a Technical Writer Summer Intern in the IBM Watson Health unit, responsible for defining the user experience of a large and complex product user experience. Our environment is ever changing and requires a candidate who is flexible, thrives in ambiguity, and can effectively collaborate across cross-functional groups and locations. Technical content plays a critical role in ensuring that our clients know how to use and manage our products. The digital experience provides rich opportunities to optimize touch points by delivering the right content at every stage of their journey. This is why our teams need people with a passion for technology and communication. Technical Writers across IBM employ design thinking principles to identify and present the information that clients need to succeed with our products. In this position, you will create valuable technical content that enables and inspires our clients. Our technical content encompasses content embedded in the UI, messages, product documentation, API documentation, support content, chatbots, and much more. We’re looking for a summer intern who knows how to organize information into clear and compelling communications, and deliver it in a format that best suits our clients’ needs. You’ll work alongside subject matter experts to scope and define objectives, then create and deliver the content. You will collaborate with a wide range of project stakeholders to make sure the materials are well-aligned with other product and content deliverables. You’ll respect our history and stay on the Watson Health brand, but you’ll have the creativity and expertise to enable client success with the technical content we provide at scale. We are looking for a motivated, self-directed, innovative team member who will incubate new ideas as part of a collaborative team. Bring us your enthusiasm for improving the world through better content and we will help you enrich your career. What You’ll Do: critical skills and responsibilities · Create clear, concise, and relevant technical content that helps our clients achieve their goals. · Apply appropriate technical writing, editing, multimedia, visual design and tools skills. · Participate in a collaborative model, where teams such as Technical Publications, Offering Management, Development, Design, and Implementation work together to ensure content is designed as part of the user experience from the beginning, not as an afterthought. · Collaborate with other IBM stakeholder teams, such as Offering Management, Development, Training, Implementation, to ensure content is cohesive, accurate, and streamlined to enable client success across their journey. · Gather information from a broad range of resources and synthesize into comprehensive deliverables. · Prepare documentation plans, define audience and purpose, and establish project schedules while balancing competing priorities. · Create, edit, and revise content to continuously improve accuracy, usability, and engagement. · Collaborate with worldwide teams, meet deadlines on multiple projects, often with competing priorities. Who You Are: · You are focused on client success and advocate for their need to quickly find, use, and act on the content we provide. · Your curiosity and critical thinking lead to innovative ways of working. · You can easily adapt to fast-paced environments that change frequently. · You are a solid communicator (and sometimes negotiator) when emphasizing the value of content to the client experience. · You thrive on teamwork and have excellent verbal and written communication and collaboration skills. · You work independently, while maintaining an extremely strong sense of responsibility and commitment to teamwork. · You have the talent to turn your understanding of our products into content that’s easy to read and drives outcomes. This is an office-based position in an IBM location in either Cambridge, MA or Raleigh, NC, ONLY! Introduction At IBM, work is more than a job – it’s a calling: To build. To design. To code. To consult. To think along with clients and sell. To make markets. To invent. To collaborate. Not just to do something better, but to attempt things you’ve never thought possible. Are you ready to lead in this new era of technology and solve some of the world’s most challenging problems? If so, lets talk. Required Technical and Professional Expertise - Demonstrated writing skills in English with a deliberate focus on tone and voice - Analyzing and deriving insights from quantitative and qualitative user feedback - Writing, editing, building, and publishing content for different types of users - Creating topic-based information that meets audience requirements - Ability to produce grammatically and typographically correct documentation that complies with IBM and Watson Health written usage and design standards - Basic knowledge of graphics tools, screen capture, and manipulation of graphics - Familiarity with structural and markup languages (HTML, DITA XML, Markdown) - Familiarity with industry-standard authoring tools (MadCap Flare, Adobe FrameMaker) - Familiarity with development tools (GitHub, Visual Studio Code, Atom) - Basic knowledge of Microsoft Office tools, especially Word and Excel - Working in an agile, squad-based, continuous delivery development model - Proven project management skills Preferred Technical and Professional Experience - Documenting APIs & SDKs - Act on results of customer feedback & formal or informal usability tests - Index or apply keywords to complex documentation sets - Effective visual design skills (use of white space, illustrations & graphics) - Experience with personas & user stories, used by product teams to help identify target audiences - Consistently apply company branding, including standard fonts, logos, & service marks - Understanding of accepted technical writing concepts, editorial standards & methods - Produce work consistent with corporate or professional style guides such as IBM Style or Microsoft Manual of Style - Knowledge of information architecture to help system concepts – workflow, context-sensitive help, minimalism & usability - Aptitude to prepare content for new or emerging products & technologies, (eg. chatbot conversations) Required Education High School Diploma/GED Preferred Education Bachelor’s Degree About Business Unit IBM’s Cloud and Cognitive software business is committed to bringing the power of IBM’s Cloud and Watson/AI technologies to life for our clients and ecosystem partners around the world. IBM provides you with the most comprehensive and consistent approach to development, security and operations across hybrid environments—with complete software solutions for business and IT operations, development, data science, security, and management. Our experts and software capabilities help organizations develop applications once and deploy them anywhere, integrate security across the breadth of their IT estate, and automate operations with management visibility. With IBM, you also have access to new skills and methods, governance and management approaches, and a deep ecosystem of industry experts and partners. Your Life @ IBM What matters to you when you’re looking for your next career challenge? Maybe you want to get involved in work that really changes the world? What about somewhere with incredible and diverse career and development opportunities – where you can truly discover your passion? Are you looking for a culture of openness, collaboration and trust – where everyone has a voice? What about all of these? If so, then IBM could be your next career challenge. Join us, not to do something better, but to attempt things you never thought possible. Impact. Inclusion. Infinite Experiences. Do your best work ever. About IBM IBM’s greatest invention is the IBMer. We believe that progress is made through progressive thinking, progressive leadership, progressive policy and progressive action. IBMers believe that the application of intelligence, reason and science can improve business, society and the human condition. Restlessly reinventing since 1911, we are the largest technology and consulting employer in the world, with more than 380,000 IBMers serving clients in 170 countries. Location Statement IBM will not be providing visa sponsorship for this position now or in the future. Therefore, in order to be considered for this position, you must have the ability to work without a need for current or future visa sponsorship. Being You @ IBM IBM is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics. IBM is also committed to compliance with all fair employment practices regarding citizenship and immigration status.

https://careerconnections.twu.edu/jobs/ibm-technical-writer-summer-intern-2021/

Copyright © Cezarotto, M., Stearns, S., Cushman, J., Connolly, C., Ricard, R., and Chamberlin, B. 2021, Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). Published by Extension Foundation. e-pub: 978-1-955687-08-9 Publish Date: November 15 th , 2021 Citations for this publication may be made using the following: Cezarotto, M., Stearns, S., Cushman, J., Connolly, C., Ricard, R., and Chamberlin, B (2021). Collaborative Design in Extension: Using a Modified Game Jam to Explore Game-Based Learning (1 st ed). Kansas City: Extension Foundation. ISBN: 978-1- 955687-08-9 Producer: Ashley S. Griffin Peer Review Coordinator: Rose Hayden-Smith Editorial Assistant: Heather Martin Technical Implementer: Rose Hayden-Smith Welcome to the Collaborative Design in Extension: Using a Modified Game Jam to Explore Game-Based Learning, a resource created for the Cooperative Extension Service and published by the Extension Foundation. We welcome feedback and suggested resources for this publication, which could be included in any subsequent versions. This work is supported by New Technologies for Agriculture Extension grant no. 2020-41595-30123 from the USDA National Institute of Food and Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture. For more information please contact: Extension Foundation c/o Bryan Cave LLP One Kansas City Place 1200 Main Street, Suite 3800 Kansas City, MO 64105-2122 https://impact.extension.org/ 2 T A B L E O F CON T E N T S Attribution ............................................................................................................................................. 2 Meet the Authors ................................................................................................................................... 4 Acknowledgments .................................................................................................................................. 7 Executive Summary ................................................................................................................................ 7 Purpose of the Guide........................................................................................................................................................ 7 Context .................................................................................................................................................. 7 Introduction ........................................................................................................................................... 8 Part 1: Game Design for Extension Audiences ............................................................................... 10 Challenges for Extension in Game Design...................................................................................................................... 10 NMSU’s Learning Games Lab ......................................................................................................................................... 11 University of Connecticut (UConn) and Extension Foundation ..................................................................................... 11 The Team........................................................................................................................................................................ 12 Part 2: Game Jam......................................................................................................................... 13 Traditional Game Jams ................................................................................................................................................... 13 Part 3: This Modified Game Jam ................................................................................................... 14 Needs for the Process .................................................................................................................................................... 14 Process Overview ........................................................................................................................................................... 14 Differences from Traditional Game Jam Formats .......................................................................................................... 15 Part 4: Case Study of Unpeeled..................................................................................................... 17 Schedule ......................................................................................................................................................................... 17 Prototype of Game ......................................................................................................................................................... 22 Final Result ..................................................................................................................................................................... 24 Part 5: Recommendations ............................................................................................................ 25 Best Practices ................................................................................................................................................................. 25 Part 6: Conclusions ....................................................................................................................... 28 References ................................................................................................................................... 29 3 M E E T TH E AU THO R S Matheus Cezarotto, PhD Stacey Stearns Stacey Stearns is a Program Specialist focused on communications for Extension, and formal and informal reporting. She works with Extension teams on farm to community, Bug Week, GMOs, and trails. Stacey earned a bachelor of science in Animal Science from the University of Connecticut and a master of science in Agricultural Education and Communication from the University of Florida. Matheus Cezarotto is a postdoctoral researcher in the New Mexico State University (NMSU) Innovative Media Research and Extension department and its Learning Games Lab. He researches the Learning Games Lab's products, working through grant development and providing instructional design expertise. His published work focuses on building a research-based understanding of instructional and information design, specifically to design meaningful educational media supporting learners’ variability. Matheus Cezarotto, PhD Postdoctoral Researcher Department of Innovative Media, Research and Extension New Mexico State University matheus@nmsu.edu • innovativemedia.nmsu.edu • @macezarotto Stacey Stearns Educational Program Administrator College of Agriculture, Health and Natural Resources, University of Connecticut stacey.stearns@uconn.edu 4 Jennifer Cushman Cristina Connolly, PhD Cristina Connolly is an assistant professor at the College of Agriculture, Health and Natural Resources at the University of Connecticut. She has a Ph.D. in Agricultural, Environmental and Development Economics. Her research areas are local and regional food systems and consumer preferences, and she also holds a partial appointment in the department of Extension. Jennifer Cushman is Co-Center Coordinator and a 4-H Youth Development Associate Extension Educator at the College of Agriculture, Health and Natural Resources at the University of Connecticut. She oversees the Hartford County 4-H programs and provides leadership to the UConn 4-H program in the role of State 4-H Program Leader. She also coordinates the statewide 4-H dairy goat program. Jennifer holds a Sixth Year in Educational Leadership and M.A. in Curriculum and Instruction as well as a B.S. in Animal Science and Agriculture and Natural Resources, from UConn. Jennifer Cushman Co-Center Coordinator & 4-H Youth Cristina Connolly Assistant Professor College of Agriculture, Health and Natural Resources, University of Connecticut cristina.connolly@uconn.edu Development Associate Extension Educator College of Agriculture, Health and Natural Resources, University of Connecticut jennifer.cushman@uconn.edu 5 Robert Ricard, PhD Barbara Chamberlin, PhD Barbara Chamberlin has been developing educational games, media, and interactive programs with Extension for almost 30 years. She leads instructional design of digital tools in the department, working with the amazing programmers, artists and designers on the team and collaborating with content experts at universities throughout the United States. Her areas of research include user testing, and the processes behind developing educational media. She oversees research and development in the Learning Games Lab, and developed the game models used in design at the Lab. Robert Ricard is a senior Extension educator at the College of Agriculture, Health and Natural Resources at the University of Connecticut. He is responsible for helping Connecticut cities and towns better manage public trees and forests, focusing mostly on municipal tree wardens and community forestry volunteers. He also helps educators and researchers conduct social science research design and methods. He conducts the Tree Warden School and assists the Tree Wardens Association of Connecticut, Inc., which he formed in 1992. He is co-author, with Glenn Dreyer, of Greening Connecticut Cities and Towns: Managing Public Trees and Community Forests. Robert has a Ph.D. in public policy with other degrees in forest resources. He is a Fellow of the Society of American Foresters. Barbara Chamberlin, PhD Professor, Extension Specialist Department of Innovative Media, Research and Extension New Mexico State University bchamber@nmsu.edu • innovativemedia.nmsu.edu @bchamber Robert Ricard, Ph.D. Senior Extension Educator College of Agriculture, Health and Natural Resources, University of Connecticut robert.ricard@uconn.edu 6 A C K NOWL E D GM E N T S In this publication, we document a project and the process used to design that project. This effort included a larger team of game designers and content experts. We gratefully acknowledge their significant roles in creating both the game prototype, and going through the design process articulated here: University of Connecticut Joseph Bonelli, Sharon Gray, Michael Puglisi, PhD, Cindy Tian, PhD New Mexico State University Pamela N. Martinez, EdD, Adrián Aguirre, David Abraham, Anastasia Hames, John “CC” Chamberlin, Philip McVann, Amy Smith Muise Funding Statement Funding for this project was made possible by the New Technologies for Agricultural Extension Program, the Extension Foundation, Northeast Ag Enhancement, and UConn Extension. E X E CU T I V E S UMMA R Y Purpose of the Guide. Educational games can be an innovative way for Extension educators to teach content to any given audience. While many in Extension have an interest and passion for using and designing games, the process may seem intimidating to Extension professionals, especially those without experience in game design. This publication offers an alternative to full game design, in which game developers, content experts, and Extension educators collaborate to design a game prototype. This modified game jam process is budget-friendly and can be completed in a few weeks. CON T E X T Educational games can be an innovative way for Extension educators to teach content to any given audience. Educational games have the potential to transform learners of different ages through unique experiences with interactive media. Unfortunately, game development can be costly in terms of time and budget. The process to design and develop an educational game requires an interdisciplinary and collaborative team, and can take from several months to a couple of years, depending on the game’s complexity. While many in Extension have an interest and passion for using and designing games, the process may seem intimidating to Extension professionals, especially those without experience in game design. This publication offers an alternative to full game design, in which game developers, content experts, and Extension educators collaborate to design a game prototype. This modified game jam process is budget- friendly and can be completed in a few weeks. Through this process, teams can move through the design process to articulate transformational outcomes, refine their desired content, and create a framework for a larger-scale game; produce a working prototype to enable testing with the intended audience and further refine design goals; and establish working relationships for future partnerships in development. Using this approach, the authors created a game prototype, “Unpeeled: The Case Files of Maya McCluen,” which was used in a pilot study with focus groups, allowing the team to refine their recommendations for future research and development towards a full game. This publication shares the process the team used and offers recommendations for other Extension educators who want to explore game development as part of their outreach. 7 I N T RO D U C T I ON Extension educators looking for innovative ways to teach content to diverse audiences may consider using educational games. This interactive media has the potential to create meaningful learning experiences for a wide range of subjects and ages (Hsiao, Tsai, and Hsu, 2020; Trujillo et al., 2016; Ulery et al., 2020). Research overwhelmingly indicates that interactive multimedia learning tools can help audiences understand concepts better than traditional education practices can, and they are powerful mechanisms to create behavioral change (Dede, 2009; Gee, 2003). Empirical research also shows the effectiveness of multimedia game-based learning (Plass, Mayer, and Homer, 2019). Multimedia helps to visualize and engage users with specific content that is hard to convey with photos or video. These interfaces offer users multiple learning paths and conceptual reinforcement, providing opportunities for cognitive enhancement. The multimedia learning theory suggests that people learn better when words and images are used together (multimodal) (Mayer, 2009; Clark and Lyons, 2011). New Mexico State University (NMSU)’s team has been refining their educational media development process for over 30 years to meet the specialized needs of education and research projects. Their approach has similarities to the backward design approach outlined in Understanding by Design (UbD), including a focus on what intended groups need to know and an emphasis on practice that encourages adoption of new ideas, using key design questions to define the expected outcomes (Wiggins & McTighe, 2005). Game design can be a lengthy process. Extension educators may have tremendous interest in using games for their educational outreach, but may find the cost or time commitments prohibitive. This publication provides ways educators can engage in game design, without the barriers of a full-length project. It describes game prototyping where developers, content experts, and researchers from the Learning Games Lab at NMSU and the University of Connecticut (UConn) Extension collaborated to teach consumers about non-GMO (Genetically Modified Organism) foods and labels. A content publication from this project on food marketing labels is available online (Stearns et al., 2021). Traditionally, a game jam is a two- or three-day rapid prototyping challenge used by teams of students or game developers to develop skills, explore several aspects of development at a cursory level, and create a working game. This team modified the traditional game jam model to include the instructional design of the content for the game, to expand the activity to a week, and to then include two weeks of follow-up development to polish the prototype and respond to feedback. The experience was a budget-friendly approach for designing a preliminary structure for the game, assessing needs and related issues, to then be able to propose a full game on the content and seek funding for development. This publication’s primary purpose is to share this modified gam jam process with content experts and other Extension educators who are interested in designing and researching educational games. It includes specifics on how the team used the model — including process, time, and budget — and provides recommendations on how the game jam structure can be used by others who want to explore game design without the full commitment of a complete game build. The team created a simple prototype of the game “Unpeeled: The Case Files of Maya McCluen,” and then used it in a pilot study with focus groups. The team is using feedback from that testing to refine their recommendations for future research and development of a full game. In addition, the project resulted in a process for the rapid prototyping of future games through the collaboration between developers and content experts. Extension educators can use the same process as a way to explore the outcomes they want for a potential game and brainstorm activities prompted by the game prototype. They can work through a game design, particularly if they have a small budget, as a way to understand what they want a game to accomplish and gather input from stakeholders. They will then have a clearer idea of what the finished game needs to be , be able to pitch their idea to funders, and be able to work with a professional development team to produce it. Game jams are a project accelerator that allows Extension educators to rapidly address audience needs Who can benefit from this study? The primary audience for this publication is content experts in Extension, those who are looking for new approaches to bring content to their clientele. This publication will allow Extension educators to 8 understand how collaboration between game developers and content experts leads to the design of educational games and media; become aware of one instructional design process for refining educational goals for game design; reflect on ways that game prototypes can be used to inform future game development ; and receive recommendations on how to use the modified game jam model in their own work. 9 Part 1: Game Design for Extension Audiences Chal lenges for Extension in Game Design Beginning with radio, then video, interactive media, and web delivery, Extension educators have embraced digital media to reach their clientele with research-based information. They have several options for development: Many land-grant institutions have professional-quality communications units that have the capacity to create most digital media. Though game development isn’t as common as video and digital publications, communications units are gradually increasing their capacity for games and app development. The Learning Games Lab at NMSU is one such professional games design studio within Extension, and collaborates with extension educators and faculty at other universities on almost all of their projects. The Learning Games Lab functions as a non-profit design and production studio for educational projects. As game development evolves as a career field, many design or computer science departments at universities include game design or programming as majors, and often engage in student-developed projects. These labs can provide an opportunity for Extension educators to collaborate on educational or transformational games . Consider that work in these types of environments is often completed by students — thus the work may have varying levels of quality, may not always be sustainable (as students graduate or move through finals). Talk with faculty in these labs to make sure your expectations meet the levels of quality student work can produce. Extension can also collaborate with game design companies , many of which are now engaged in developing games that are designed to change their users in meaningful ways: often called educational, learning, serious, or transformational games. Game development can be time-consuming and costly —it isn’t uncommon f or it to start at $80,000, and the cost can easily extend to hundreds of thousands of dollars, depending on the extent of the game, distribution and marketing needs, and research or evaluation demands of the funders. Games have tremendous advantages over other types of media: They can customize learning for each user, provide meaningful feedback, offer safe failure and engaging play, and help players apply what they understand in a meaningful context. However, the cost of game development suggests that games should be used for content that cannot be taught as effectively any other way. An intentional, research-based effort can ensure that the money and time invested in game development are used effectively. One challenge for Extension educators can be taking their first steps as game developers or co-designers when they don’t have experience designing for this unique medium. Development of a complete game requires more than a good idea; it should include five key processes: a solid preparation process through which developers secure funding, assemble the team, and conduct initial research on the content and need (Schell, Chamberlin 2022); a design process to articulate and refine learning goals and activities; a development process in which the game is programmed, art assets are finalized, and extensive testing informs playability, interface, and engagement; a marketing and distribution process to deliver the game to users and support its implementation for years after development; and research processes throughout the entire cycle to inform development, test the product, and evaluate the game as an intervention. Extension educators bring significant resources to the game design table: their research-based orientation serves them well in identifying the needs of their audience, refining content, and designing evaluation 10 measures. This type of research is often done in the preparatory phases of game design: where they identify the need, propose educational intervention, and refine what needs to happen to create the change. As informal educators, Extension specialists and agents often have unique and valuable expertise in their clientele’s experiences and can articulate what has worked with content, and what hasn’t worked when it comes to changing behavior. Finally, at their core, Extension professionals are designers of educational experiences — from creating workshops to designing publications or writing scripts for media, Extension specialists and agents are centered in creating interventions that work. NMSU’s Learning Games Lab In the Innovative Media Research and Extension department, Extension educational technology experts and professional developers in the Learning Games Lab develop a wide range of digital media tools: video, animation, websites, virtual labs, apps, and games. Because of the unique nature of their work, they frequently partner with content experts at other universities and in the Extension network to create educational media in various disciplines, often funded by grants. They function like a non-profit, digital media studio. All of their work is research-based: from formative research to inform the interventions and test products throughout development, to summative research to measure the impact or document processes used. Because all products developed in the Learning Games Lab are designed to create some kind of a change in the user, the team traditionally uses a design summit to move through the educational design process. Developers, researchers, and content experts work together by immersing themselves in the content area and the tools used to address that content. Using the “Transformational Design Process” (Chamberlin & Schell, 2018), they refine the objectives to define the change needed in the user, identify what learners have to do to create that change, and discuss ways in which a game or other type of media can engage the user in the necessary actions. The design summit ends with documentation for all partners to review and a process for moving forward in production. The proposed work is often driven by specific parameters, such as the final budget or timeline. The team builds around who the audience is, the ways in which the product is used, and the scope of the work. The content experts or external clients have usually defined their initial goals, budget, and audience for the team, and they share that at the start of the design summit. Often, this design summit takes two or three days, but it can be done over the course of a few meetings. Once the design process is complete, the team usually moves into a production process, which can take several months, and then begins work on distribution, support, and marketing or placement of developed games. University of Connecticut (UConn) and Extension Foundation UConn received funding through the Extension Foundation’s New Technologies in Agricultural Extension (NTAE) program to create a game that educates consumers about food marketing labels. Expertise on the UConn team includes nutrition, biotechnology, agricultural production, youth development, and communications. The team focused on the non-GMO food marketing label and an intended audience of mothers and primary grocery shoppers who may be overspending on food with non-GMO marketing labels. The UConn team wanted to explore game-based learning as an educational outreach tool for the intended audience. Content experts from UConn Extension approached Extension developers from the NMSU Learning Games Lab with a request for a game. They had already established broad goals for what they wanted their game to accomplish. They wanted to do some initial design work with startup funding to better understand what kinds of outcomes their game could lead to and to define the scope (and ultimately the budget and timeline) of a larger effort. They also wanted to review initial ideas for games with potential learners and refine who their audience should be. Given their budget of less than $12,000 and a timeline of only a few months, the combined team agreed to engage in a design prototyping project, rather than a full development project. 11 The Team NMSU and UConn researchers began to talk about the best process for meeting their goals. One of the contributing factors to the success of the project was the collaboration across two universities, several disciplines, and different areas of contribution. Often, we use the term design to refer to several aspects: instructional design, graphic design, project design. The term content can also refer to multiple aspects: content can be the educational information conveyed in interventions, as well as the collections of assets in a project (such as the sound files, graphic files). While the team sees all participants on this project as having expertise in some area of content, and in some aspect of design, we know it is helpful to understand the different groups involved, and the roles they played. In this publication, we use these terms to differentiate the different groups who collaborated. The team : The combined team from NMSU and UConn who collaborated on designing the process, creating the overall game, finalizing decisions, and documenting results. The content experts: The UConn Extension researchers who investigated the need, proposed a game as the intervention, and provided research-based guidance on which audience to target and what kind of behavioral and other changes they wanted to see in that audience. The team included a variety of content expertise: nutrition, biotechnology, agricultural production, youth development, and communications. They also did user testing and researching with the game prototype. The designers : The NMSU developers who designed the game and produced assets, which included two programmers, three artists and animators, and three instructional designers. The design team translated content guidance and initial discussions into the design of a game and developed assets. The designers produced the prototype. 12 Part 2: Game Jam Traditional Game Jams Game jams are events where students and professionals from game-related fields get together as a team to rapidly prototype and develop a game in a short time. Usually taking place in a 48-hour competition format and with a specific problem or theme to be addressed, a game jam provides participants an open, entertaining, and creative space to foster innovative ideas (Guevara-Villalobos, 2011, Preston et al., 2012). The biggest and most well-known jam is the Global Game Jam. This jam happens every year, engaging simultaneous participants from six continents and more than 100 countries. In the Global Game Jam, all participants receive a theme and then create a game around that theme. Jam events give participants an immediate and collaborative environment and a safe space for risk-taking and failure. These features provide participants experiences such as professional development and network building, learning new tools, and opportunities to experience new approaches, techniques, or roles. The immersive approach of a jam can inform research, bringing developers and content experts in Extension together to work on developing educational media in a short time. Rapid prototyping in a game jam can help teams advance quickly through a design process, moving them into consensus about desired outcomes and implementation. In a game jam with a short time frame, the game design and production process are expedited with the entire team, and the playable prototype represents the final product for the event. This version of the game is still not the final design, but it is closer to a “beta” version of the game, a fully functional game that may still need improvements in art, mechanics, sound, etc. Game jams are not unique in rapid prototyping approaches: immediate prototype jams have been successfully used in other design methodologies, such as Agile (McGuire, 2006). Using Agile as a management structure for game design, teams work towards a larger game by working on smaller sprints, which may include rapid development cycles and development of quick prototypes. These methodologies focus on a more adaptive and people-centric process (avoiding too much top-down management), allowing smaller teams to solve game design problems in a more frequent iteration process (Chamberlin, Trespalacios, Gallagher, 2014; Fullerton, 2008). Often, game jams are viewed as a singular event, rather than a small part of a larger process. Much of the challenge of a game jam is in completing all of the processes from ideation through brainstorming and on to prototyping into a short period of time, which should always yield a playable game, rather than one part of a larger game. 13 Part 3: This Modified Game Jam Needs for the Process The general approach of a game jam seemed to fit the non-GMO project, but it missed some key aspects of the development of an educational game, and had to do additional development after the initial jam. This team modified the game jam format to meet their specific goals: to move a combined team of content experts and game developers quickly through a design process, allowing them to do the following: Refine the problem and audience: Based on previous research, the team wanted to articulate the intended audience for the game and what problem this audience faces when learning the content. Specify transformational outcomes: The team needed to define how the intended audience would be different after using the game, including the kind of behavioral and other changes the team wanted to see the users make. Refine content: The team needed to decide which content could be included in a game and the scope of the information that the audience could process and that would fit within the constraints of a game. Produce a playable prototype: To inform future work and secure funding, the team wanted a working version of the game, which could then be tested with the intended audience and could be a model to help funders understand what a full version would look like. Establish a framework for the development of a full game: The team wanted to complete the game jam with a picture of the team’s next steps, such as a budget and timeline for the full game, and research needs before moving forward. They also wanted to establish working relationships among developers and content experts to contribute to future partnerships and co-development. This team collaboration was entirely online because of their size and the fact that team members lived in three states — COVID-19 regulations also had limited travel options. Prior to the pandemic, the team would likely have requested that this collaborative week happen in person. However, based on the success of this project it is clear that the necessarily collaboration is possible with remote teams working online. Process Overview The team identified the key activities that would help them meet their goals. They started with a week-long game jam, and determined what follow-up work and meetings would need to happen after that jam. Going into the experience, the content experts had broad goals regarding what content would be addressed, but they knew this needed to be flexible to meet what was doable in a prototype. They also knew they wanted to leave with some version of a game for their stakeholders to see, but they weren’t sure if it would be a fully playable prototype or just a description of the game. Finally, they expected that some amount of work would need to be done as a result of stakeholder feedback. They collaborated with the designers to propose these activities for the modified game jam process: Activity 1: Engage in an Educational Design Process The team would use transformational design as a framework to guide the instructional design process. The content experts would begin by giving a content overview to the game developers, reviewing what was known about the content, what learners didn’t understand about it and related products used to teach the content, and why they felt an educational initiative was needed. The content experts and designers would then collaborate to articulate the following: the desired changes for the audience (such as changes in physiology, emotion, behavior, skill, and/or knowledge) activities that create the desired changes 14 the types of engagement a game could use to engage the player in the defined activities (Chamberlin & Schell, 2018) In full game development projects, the team starts with a multi-day summit. The team anticipated starting the jam with this process and having flexibility to see when they would be able to move to the next step. During this process, the team designed and discussed a full version of the game, envisioning what the game could look like if lim ited funding and time weren’t barriers . Activity 2: Decide on Final Deliverables from Jam It is difficult to predict what the outcome of a game jam could be until some amount of design is complete. For example, if the team reviews content needs and decides on a modular game, a prototype could show one of the paths of the larger project. If the game is more complex and difficult to show a single path, it might be better for the team to create concept art and a trailer that demonstrates how the game could work rather than a playable prototype. The team agreed to discuss their prototype after talking about what a larger game could look like. It can be difficult for the team to brainstorm what the full game would be if they feel pressured to create a prototype first. By deciding to commit to the deliverables after the design process, the team was freed to brainstorm the best version of a full game and then decide what the output of the shorter jam would be. Activity 3: Produce Deliverables Once the team agreed on what the full game would be and what kind of prototype they could create in one week, the designers started producing the prototype. The designers were comfortable creating different types of products: such as a written design document, a slide deck that is used as a pitch, sample artwork, a trailer showing possible gameplay, a paper prototype, and digital prototypes. The content team agreed that once the designers knew what their deliverable would be, they would commit the remainder of the week to producing that deliverable. This should be done as a large group, as the designers can predict what is doable with the time left in the jam, and the content experts know what they need to do to meet the goals of their funded project and pitch completion of the full project. Activity 4: Gather Feedback Throughout early planning, both groups knew there were outstanding questions about who would play and give feedback on the prototype: What is the ideal length of time for play in the environment they had proposed? How open would players be to the messages about the content? Should content offer in-depth studies of one or two products or give a broader review of concepts? The content experts knew they wanted an opportunity to get feedback on the product from their colleagues and from other stakeholders. The decision to include an opportunity to gather feedback through an online survey and user testing was important for the process, so that designers had a clear understanding of the audience for their prototype, the delivery medium, and the level of compilation required to make it viable. Activity 5: Polish and Refine Finally, the team knew that the last step would be to make changes to the prototype before the content experts were able to use the prototype for future funding. In advance, the team agreed that some work would have to be done after the game jam to polish and refine it before sending it for feedback and to make small changes to the product to reflect the feedback. The team agreed on how long they would spend after the game jam prioritizing and supporting post-game jam changes. Differences from Traditional Game Jam Formats With the necessary steps defined, the team also knew that the proposed game jam would differ from traditional game jams in a number of ways: 15 A combined team of developers and Extension educators: Where other game jams often have multiple teams working towards a theme, this jam had only one team, which included developers from the Learning Games Lab (NMSU); and researchers from UConn Extension as content experts. No competition: Unlike other Game Jams, this jam was not a contest. The team worked collaboratively on the same project, delivering a single prototype at the end. Online format: The entire jam event occurred online, with larger meetings (with developers and content experts) and small group meetings (developers only) collaborating via Zoom. During the game jam week, the combined team met daily for 1-3 hours either to establish initial goals, or review discussion. The smaller design team would then meet and collaborate the remainder of the work day (and near the end of the week, chose to spend 10-14 hours to finish a working prototype by the end of the week). Week-long process: Instead of happening in two or three days, this project took place primarily during one week; developers and content experts met daily to work towards goals and then continued to work collaboratively offline. Transformational content: Some game jams may include serious or educational games. As with other Extension educational initiatives, this team researched what kind of content would lead to the behavioral and other changes they wanted to see in their audience. Interdisciplinary collaboration: This jam format gave the combined and interdisciplinary team ways to test ideas, shape future research, understand the game development process, and build partnerships. With key goals refined and activities identified for the modified game jam, the combined development team set a time for their game jam and began the process. 16 Part 4: Case Study of Unpeeled In a week-long game jam and a few hours of follow- up work, the team designed “Unpeeled: The Case Files of Maya McCluen.” This game prototype teaches consumers about food marketing labels, mainly non -GMO labels. The intended game audiences are mothers and primary grocery shoppers who may be overspending money on food with non-GMO and other food marketing labels. Schedule The modified game jam occurred during a week-long, online format over Zoom. To avoid day-long Zoom fatigue, the team agreed that they would devote most of the days of the full week to activities for development on the project and meet one or two times as a large group each day. There were two kinds of meetings: large meetings with the entire team of designers and content experts and small meetings solely with designers. While the main meetings were held over Zoom, participants also interacted through chat software (e.g. Basecamp) and collaborated online in documents (e.g. Google Drive, Google Docs) to refine ideas during the week. This format could be replicated for in-person projects, depending on team preferences and needs. The larger team participated in all five proposed activities throughout the week: engaging in the design process, deciding what the final deliverables would be, producing the prototype, gathering feedback, and polishing and refining the prototype. They were spread throughout the initial week and post-jam activities. Table 1. Game Jam Schedule Monday Tuesday Wednesday Thursday Friday Post Jam Activity 1 Engage in design process Activity 2 Decide on final deliverables from Jam Activity 3 Produce deliverables Activity 4 Gather feedback Activity 5 Polish and refine Content Immersion Idea • Game Production • Script Production • Script Playable prototype • Discussion • Feedback • List of changes Post Jam • List of changes • User testing findings • Future steps • Problem • Audience • Objectives Transforma- tional Design Model • Changes • Activities • Game ideas premise • Expected outcomes • Script • Sketches • Mood board Pitch • Presentation • Feedback improvement • Art assets • Programming improvement • Art assets • Programming Follow-up plans • User testing plan • Future steps 17 Monday | Activity 1: Engage in Design Process & Activity 2: Decide on Final Deliverables from Jam Designers and content experts joined the first Zoom meeting of the jam. Participants introduced themselves and shared their interests and expectations for the project. To start the project and establish project definitions, the team worked on “Activity 1: Engage in Design Process.” This activity began with content experts giving a short presentation reviewing their outcomes and desires based on their research, immersing designers in the content. This presentation fostered discussions and allowed the group to outline the problem, audience, and objective (Table 1). Table 2. Project Definitions and Deliverables Project Definitions “Unpeeled” Game Problem: The problem represents the main issue that the team is trying to address with the project. In other words, what problem does the intended audience face when learning the content? Audience: The intended audience for the project includes the people who will use the game and in what kind of environment or setting. Consumers have trouble understanding food labels and are perhaps overspending because of misinformation about “natural,” “organic,” and non-GMO food labels. • Moms ages 25 -40 with kids at home (do grocery shopping for the family), particular focus on lower-income shoppers • To be used possibly in large group workshops and training settings at existing Extension programs • Short (15 minutes) and replayable rather than a one-time, longer experience. Objectives: Objectives are the measurable change in the players of the game. • Clarify consumers’ common misconceptions of food labels (“non - GMO,” “natural,” “organic”) • Empower consumers to make confident grocery shopping decisions based on their needs. With the problem, intended audience, and project objectives loosely defined, the team moved into the design process. One of the designers shared the transformational design process and led the group in a discussion about the first of three steps in the transformational game design model “Describe the Change” (Table 3). The team reviewed the five key kinds of changes in people (changes in physiology, emotion, behavior, skill, and knowledge) and which were most relevant to the needs of this game. In small groups (Zoom breakout rooms), participants discussed possible changes and defined specific types of changes desired (Figure 1) . They returned to the large group and discussed the second step in design: “Define the doing.” In this step, they talked through the kinds of activities indivi duals need to do to be able to experience change, such as reading labels and comparing that information with what they already know about what can and can’t be a GMO crop. In small groups, the teams talked about the desired change, and 18 Figure 1: Google Document with notes on intended changes for the audience, built collaboratively by the team. had more discussion about what a learner needs to do to be able to change. In the large group, the teams shared what they had discussed, and then they prioritized the desired changes and activities. It’s important to note that often in the design step, it’s useful to identify what the game will not try to do . For example, in this jam, the team felt strongly that all shoppers execute some level of judgment in prioritizing their shopping behavior, and the game shouldn’t try to establish what those priorities are; rather, they wanted to make sure that the shopper had information to make the decisions that aligned with their values. This helped the team limit the scope of the game, ultimately deciding to focus on just a couple of GMO crops. Throughout the first Monday meeting, the team collaborated on a group design document, noting decisions and discussions. Before adjourning the large group, the team began “Activity 2: Decide on Final Deliverables from Jam.” In this discussion, the larger team balanced the expectations and needs from the content experts with what was doable for the designers to produce in a week of work. The team articulated how they could expand the prototype in future projects and the need for the prototype to be playable (at least a portion of it) to allow user testing with the intended audience, to inform research. The larger team would not be happy with paper documents: they really wanted a playable experience for consumers. The larger team adjourned, and a smaller designers’ group continued to meet so that they could move into the third design step: “Design the engagement” (Table 2). Using the decisions documented during the larger meeting, the smaller team of designers worked towards a proposal idea to pitch to the large group on Tuesday, the second day of the game jam. Designers brainstormed several ideas, culminating in a game around a fact-finding mission during which the player would shop in stores, get help reading labels, experience surprise about what content was and wasn’t on the label, and could make decisions that aligned with their own values. Designers decided to use a film noir approach for the game idea, creating a script/proposal and producing initial sketches to illustrate the idea: a detective helping puzzled consumers investigate food labels. This idea was good because it met the defined change goals and activities that the larger group had articulated; it also lent itself to an easy prototype — just one example of an episode that could be expanded into a larger game in the full version. 19 Table 3. Transformational Game Design Model Steps Decisions 1. Describe the Change: Identify a desired change for the audience, such as in physiology, emotion, behavior, skill, and or knowledge. • Clarify common misconceptions, such as those about GMO products. • Understand that labels are valuable, but marketing may cause misconceptions. • People have different opinions, needs, and priorities: labels try to help all of them. It is up to me to determine what I need and where I want to spend money. 2. Define the Doing: Think of likely activities to create that change in the audience. • Allow game users to prioritize their own shopping goals: for example, saving money, buying organic, or aligning shopping practices to “what I care about.” • Clarify what makes a product GMO or what can’t be GMO, and connect that with the user’s shopping practices. • Allow users to practice reading labels and applying what they learn about GMO crops and what can’t be a GMO crop. • Give users opportunity to experience surprise at misleading labels. 3. Design the Engagement: Work through ideas for creating the game, articulating the changes and the activities into an experience. A sleuth-themed shopping game in which a player solves mysteries about labels by getting source information from growers, nutritionists, and other science-based sources. On the first day, the combined team met for three hours to go through the design process. The smaller team of developers met for the remainder of the day. The subsequent schedule followed a similar pattern: Each day, the combined, larger team of developers and content experts would meet for a couple of hours, and then the smaller team of developers would work eight to 14 hours to discuss and develop.

https://online.flippingbook.com/view/687221337/?fbclid=IwAR08pfYLT7qiWlipuTTRfvh8iaJePzVdZnX1GUL5AnzamZEUbTuyk_Noxio

Location: Field Based, U.S. space space If you are interested in the below position, please send your resume to [email protected] and reference the position title within the subject line. Role The RML National Lead (NL) will be responsible for strategically building and leading a high performing field medical organization to successfully support the launch of the first two commercialized products (umbralisib and ublituximab) in Follicular and Marginal Zone Lymphoma (FL and MZL) as well as Chronic Lymphocytic Leukemia (CLL). Furthermore, the NL will also lead the RML team to provide field medical support for subsequent hematology/oncology indications and pipeline assets. She/he will be externally focused and represent the “voice of the customer” to the home office. The goals/objectives of the RML team will be to execute the field medical plan and quarterly priorities/initiatives with key community medical customers, including providing on-label peer-to-peer product education as a company speaker, 1:1 on-label medical education interactions with community oncologists and nurses, and accurate and complete responses to unsolicited medical information requests. The NL will also collaborate appropriately with other TGTX field team leaders (sales, account executives, etc.) to support on-label product educational needs of customers in the community oncology setting and will collaborate with others within the Medical Affairs and Clinical teams to gather experts’ opinion and feedback on developments in patient care. Reporting directly to the VP, Head of Medical Affairs, this is a critical leadership position for the company and will be a key member of the senior medical affairs leadership team. The role provides the unique career opportunity to set the direction, shape the culture and build a new team from the ground up.

https://www.tgtherapeutics.com/careers-7-national-lead-regional-medical-liaisons-rml/

In translation and localization, a term base, also known as translation glossary, is a list of established terms, usually organized in alphabetical order, that clarifies the use of terms related to a specific subject area. Along with translation memory (TM), term bases play a key role in keeping translation quality and consistency at an unparalleled height when adapting products for global markets. Why should you use a term base? A term base clarifies terms that are otherwise hard to translate. It is basically a list of terminologies with fixed meaning and translation. Your translators may not always have access to the context information that your content is based on. They might end up spending hours trying to find a proper translation for a single technical term. A term base helps them skip this tiresome step, suggesting an accurate and well-accepted translation. How does a term base work? A term base works when a translator starts translating a segment in a tool such as a translation management system. If the segment contains a term or a phrase that matches an entry in the term base, the translator will receive a suggestion about how certain /terms should be translated. Sometimes, there may be confusion over how a term base differs from translation memory. In fact, translation memory is used to pre-translate a document. It is only after this process that a term base starts to join the game. In this sense, a term base has a more “live” taste compared with translation memory. It’s also worth noting that neither TM nor term base has a formally defined character limitation on the length of each translation unit. In other words, it is possible that you have a terminology-like sentence in a TM file while also having a term base file that contains sentence-long terminologies. Best practices for using a term base for translation Now that you have a better understanding of what a term base is and how it works, you may start wondering how you could make use of it. Explore our ultimate list of proven practices to make sure you make the best of using a term base. Put “non-translatables” in your term base Do you have any portions of content that you would rather have in their original language, such as the company founder’s name, product name, acronyms, or something your translator thinks should better remain untranslated? A good practice here is to include all these terms in your term base, especially when you plan to outsource the translation to a third party that may not be familiar with your company preferences. Keep your term base up to date As the volume of translation expands, so do your TM and term base. It’s only a matter of time before you realize that your TMs and term base start to overlap or run counter to one another. You may have 3 or 4 translation versions for the same string that uses different vocabularies. Make sure to have your translator update the term base—and even translation memory—every time new content has been introduced. Use term bases for quality (QA) checks A term base is important not only because it holds the most accurate, “official” translation, but also because it’s a good way to ensure your translation is consistent, especially if the content you seek to translate is technology-focused. Therefore, it’s recommendable to use a term base as a QA check tool to ensure certain terms have an accurate and consistent translation. Documentation Before you put your term base to use, you may want to include some descriptions for each of the terms involved. Specifying what each term represents provides important context information for your translators, helping them to understand the source content and improving their work efficiency. Categorize your term base when necessary Context matters. A “tier” can mean one thing in construction but something completely different in political science. If you need to translate documents in different business fields, you should catalog your term base based on topics. Phrase TMS, for example, allows you to create multiple term based and associate them with different project types. Beware of locales A language can have different locales. Spanish is spoken in not only Spain but also Latin America as well as a number of areas of North America as well. Therefore, the translation of a term may differ across these locales. Phrase TMS offers an effective and flexible way to associate your term base with certain locales. Communicate with your translators There is no “perfect” translation. Even if you believe the terms you have included in your term base are the most official or accurate ones, there might be cases where you need a workaround (especially when you are translating marketing-related materials). Make sure you always keep good communication with your translator resource team for their opinions. Phrase TMS The enterprise-ready translation management system Work with the leading TMS to automate translation workflows with cost control and quality checks. Last updated on March 23, 2023.

https://phrase.com/blog/posts/term-base/

Exploros is an open-educational resource (OER) that provides comprehensive products that support instruction in the social studies and English language arts/reading (ELAR) core content areas. Exploros is available at no cost. Content is available online and facilitates instruction in teacher-led, technology-based learning environments, such as 1:1 programs and flipped classrooms. This review is of ELAR resources for grades 4-8. At each grade level, Exploros organizes content in seven units that address: (1) foundational skills, (2) literary genres, (3) non-fiction texts, (4) author’s craft, (5) personal narrative, (6) the writing process, and (7) inquiry and research. Each unit is made up of a set of “experiences” or lessons that are organized using the 5E model (i.e., engage, explore, explain, elaborate, and evaluate). A “scene” or a set of online page(s) is provided for each “E” in the model. Scenes are activities related to the E of the 5E model. For example, the first scene in each lesson/experience is an engagement activity that clarifies the lesson’s learning objectives. [Read more…] At each grade level, Exploros includes a unit titled “The Writing Process” that provides explicit instruction in the writing process, including punctuation, drafting, editing, and revising. Students evaluate their writing using a rubric. The final lesson in the unit is titled “Writing for Assessments.” Students learn to write in response to assessment prompts using the “PAST” strategy (i.e., Purpose, Audience, Subject, Type of Writing) and related graphic organizers. About Exploros* Exploros drives student engagement and transitions classrooms to student-centered learning. Teachers can focus on guiding instruction, and personalizing the classroom learning experience. Students collaborate as a class, work in small groups, and individually, developing graphic organizers, writing essays, investigating primary sources, creating drawings, tables, word clouds, and much more. *Information in this section is provided by or adapted from Exploros.

https://blog.learninglist.com/new-product-review-exploros-english-language-arts-reading/

EaglePicher is searching for a Technical Writer to join our team at our C Street Facility in Joplin, MO! The Technical Writer will be responsible for working directly with Engineers, Quality, Production, Document Control, Subject Matter Experts (SME), and other team members for creating, writing, editing, and maintaining various technical documentation. The ideal candidate will be able to work efficiently and effectively across multiple battery chemistries to create high quality technical procedures and specifications. The Technical Writer will support EaglePicher by serving as the primary resource for technical documentation expertise. Responsibilities Your core responsibilities will be to: - Create, write, edit, and maintain key technical documents including: - Processing Engineering Change Requests - Interviewing Subject Matter Experts (SME) and working with Manufacturing to create Work Instructions - Creating graphs and other visual aids for inclusion in technical documents - Working with Engineering and Quality to develop manufacturing and inspection procedures, build documentation, test plans, etc. - Documenting team policies and procedures, while conforming to appropriate styles, policies, and procedures - Work with various teams to create accurate, clear documentation and assess document functionality - Collaborate with various functional groups to gain an understanding of the product and/or process for documentation - Ensure accuracy and completeness of all technical documentation prior to release to customers which includes resolving content issues or gaps - Research, interpret, and chart technical data for incorporation into procedures - Assist with customer presentations and support customer onsite visits - Support Design Reviews, Contract Reviews, Corrective Action Boards (CAB), and Destructive Physical Analysis (DPA) - Facilitate and attend meetings and/or activities to create, edit and/or improve materials/process documents - Use photography to capture and archive pictures for incorporation into procedures. - Understanding of battery manufacturing a plus Qualifications To succeed in this position, you must: - Bachelor Degree in Engineering, English, Communications, or related field preferred - 2-5 years’ experience as technical writer for complex electromechanical or similar system based products, or equivalent combination of education and experience - Excellent verbal and written communication skills. Ability to communicate, interview, and work quickly and effectively in a diverse team environment - Self-motivated and high energy; ability to work under demanding deadlines; excellent priority/judgment skills; ability to support multiple projects - Outstanding attention to detail, especially regarding formatting, grammar, and excellent organizational skills - Proficient with Microsoft Office application, with emphasis on MS Word - Experience with Adobe Acrobat and Visio highly recommended - Proficiency with desktop publishing highly recommended - Excellent record of attendance and reliability Preferences: In addition to meeting the basic requirements, the most successful candidate will also have: - Experience within a manufacturing environment and/or battery industry experience - Good working knowledge of PLEXUS or similar ERP system - A quality and continuous improvement mindset - Strong technical and/or mechanical aptitude ABOUT EAGLEPICHER EaglePicher Technologies, LLC is a leading producer of batteries and energetic devices for the defense, aerospace, medical, commercial, oil, and gas industries. The company provides the most experience and broadest capability in battery electrochemistry of any battery supplier in the United States. Battery technologies include lithium ion, thermal, silver zinc, lithium carbon monofluoride, lithium thionyl chloride, lithium manganese dioxide, lithium sulfur dioxide, and reserve lithium oxyhalide. EaglePicher also provides custom battery assemblies, battery management systems, pyrotechnic devices, and other power solutions. EaglePicher Technologies is headquartered in Joplin, MO. and is ISO9001:2008, ISO 13485, and AS9100C certified. For more information, visit www.eaglepicher.com. PERKS OF BEING AN EAGLEPICHER EMPLOYEE Some of the great things about being an EaglePicher employee include: - Medical, dental, vision, life, and disability insurance; - 10 paid holidays and PTO; - Matching 401K; - Tuition reimbursement; - Dependent scholarship programs. EaglePicher Technologies LLC is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

https://jobs.eaglepicher.com/technical-writer/job/19538095

Combining the strengths of the American Institute of CPAs and the Chartered Institute of Management Accountants, we empower the worlds most highly-skilled accountants CPAs and CGMA designation holders with the knowledge, insight and foresight to meet todays demands and tomorrows challenges. We drive a dynamic accounting profession that works every day to build trust, create opportunity and grow prosperity worldwide. Summary of Role Develop technical content and manage content developers to serve public accountants/management accountants working in or with accounting, financial reporting, and audit and non-audit competency development needs. Understand member needs and propose new products and product enhancements to maximize revenue and margin and enhance member value. This role serves as a lead contributor as well as a collaborative leader to manage internal and external content developers to develop high quality and technically accurate content. Accountabilities & Responsibilities Develop content in an individual contributor role, demonstrating by example the application of best practices and adherence to team guidelines/policies to develop high quality content that address competency needs of the accounting profession. Manage internal and external content developers to deliver products that address competency needs of the profession. Serve role as product manager/owner including develop and manage content development schedules for timely release maintain product management database to inform 18 month calendar and product setup participate in revenue and cost of goods sold (COGS) budgeting collaborate in format delivery and development decisions serve as product champions with marketing, communications, and channel and business development to ensure market awareness understand and propose rationales for product financial performance and propose recommendations for improvement. Monitor and research the activities of standard setting, regulatory, and governing bodies as well as market and environmental developments to understand the needs of the profession. Develop and review technical guidance, of notable complexity, to ensure it is conveyed in an easily understood way to serve competency needs of management and public accountants. Collaborate in ideation and concept development of new products. Ensure content and products are developed in accordance with scope, quality guidelines, COGS budget, and product schedules. Identify and secure contractors for product development and adhere to contracting policies and procedures to ensure contracts and agreements are executed according to the Associations contract policy and accounted for appropriately. Manage and strengthen relationships with, as applicable, internal technical subject matter experts, expert reviewers, technical committees, and regulators to ensure proper development of technical content. Ensure content is aligned with competency frameworks and if applicable, CPE courses are developed in accordance with internal and external CPE/CPD standards (i.e. NASBA). Actively maintain internal tools for resource allocation and product tracking. Champion agile principles in product development to drive innovation, efficiency and increased ROI. Perform other duties and special projects as assigned. Supervisory Responsibilities None Knowledge, Skills & Abilities Required Strong technical knowledge within the profession (assigned subject matter varies) Ability to develop high quality and timely products under tight deadlines and with resource constraints Ability to develop and leverage a network of prominent professionals for use in product development Knowledge of intellectual property law, copyright and best practices in author contracts and agreements Ability to work collaboratively with regulatory stakeholders, standard setters, internal and external subject matter experts and influence decision-making where appropriate. Skilled in managing people and cross-functional groups, including promotion of collaboration, innovation, excellence, and entrepreneurial spirit. Strong, articulate oral and written communication skills including presentation skills Availability for travel on as-needed basis. Required Experience, Qualifications & Education Minimum of 5-7 years combined experience in public accounting/management accounting and learning product development Demonstrated experience in scoping and developing products in a successful manner (e.g. timely, on budget, high quality) Demonstrated ability in meeting budgets and deadlines, and growing revenue Bachelors degree CPA license, CGMA credential, or equivalent Preferred Experience, Qualifications & Education Masters in Accounting or equivalent degree Expertise in developing content and multi-format products for learning and competency development of the profession Knowledge of IFRS and other international/globally applicable standards Why us? At the Association, you are part of a global, diverse and talented group of colleagues. You have opportunities to innovate and collaborate in a leading organization that impacts individuals, businesses, the public interest and even national economies. Youll have opportunities to progress while enjoying an exciting work environment that supports and celebrates individual achievement, development and professional satisfaction. Together, we will lead the most influential body of professional accountants and create the future of the global accounting profession. Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

http://hireahero.org/jobs/technical-accounting-manager-product-development-durham-nc-27701-115661222-d

Renal WeekEnds (RWE) 2010 provides a comprehensive overview of Renal Week 2009. The fundamental aspects of the basic sciences that have potential for future integration into clinical medicine are presented alongside translational research and novel clinical breakthroughs in renal medicine. Six disciplines of nephrology are presented by respected experts in this format: acute kidney injury, kidney transplantation, hypertension, end-stage renal disease, glomerular disorders, and clinical nephrology. State-of-the-art information is cogently gauged against the prevailing body of knowledge, in evidence-based fashion, and summarized succinctly. A personalized Q & A session with the faculty melds these intellectual discussions with the practicing nephrologist. ASN designates this educational activity for a maximum of 9.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. At the end of the session, the participant will be able to be able to: 1) identify new discoveries and forefronts in basic science that have potential importance in nephrology; 2) comprehend those novel translational medical therapies that will apply to future practice; 3) construct novel clinical research questions based upon the materials presented; 4) delineate best practices, based on quality of evidence that should be used in the learner’s practice; and 5) determine those clinical advances in hypertension, glomerular disorders, acute kidney injury, chronic kidney disease, kidney transplantation, and end-stage renal disease that are transferable to daily practice. Faculty at ASN Renal WeekEnds dissects and clarifies key presentations from ASN Renal Week 2009 in San Diego. Disclosure: Consultant: GSK, Roche, Merck, Daiichi-Sankyo; Research Funding: Novartis, NiCox; Honoraria: Merck, Bristol Myers-Squibb, Novartis. It is the policy of ASN that all individuals in a position to control the content of ASN’s sponsored CME activities are expected to provide full disclosure for both themselves and their spouse/partner, and indicate to the activity audience any financial or other relationships held by themselves or their spouse/partner 1) with the manufacture(s) of any commercial product(s) and/or provider(s) of commercial service(s) discussed in an educational presentation; and 2) with any commercial supporter(s) of the activity. All responses should reflect activities within the last 12 months. The intent of this disclosure information prior to participation in the educational activity, in accordance with Accreditation Council for Continuing Medical Education (ACCME) guidelines. Further, ASN requires all faculty to disclose any planned discussion of investigational and/or off-label use of pharmaceutical products or devices within their presentation. Participants should note that the use of pharmaceutical products or devices within their presentation. Participants should note that the use of products outside Federal Drug Administration-approved labeling should be considered experimental and are advised to consult current prescribing information for approval indications. There may be discussion of unapproved of off-label use of product(s) during the presentation. The intent of this policy is not to prevent expert faculty with relevant relationship(s) with commercial interest(s) from involvement in Continuing Medical Education (CME), but rather to ensure that ASN CME activities promote quality and safety, are effective in improving medical practice, are based on valid content, and are independent of control from commercial interests and free of commercial interests and free of commercial bias. In addition, all faculty members were instructed to provide balanced, scientifically rigorous, and evidence-based presentations. If you previously completed and received credit for the live CME activity, Renal WeekEnds 2010, please note that you will not receive credit for completing this activity.

https://www.asn-online.org/education/distancelearning/courses/rwe2010.aspx

Purpose: The purpose of this paper is to provide historical and legal definitions for categories of immigrants while helping educators use facts to address their students’ misperceptions about the terms “migrants,” “undocumented immigrants,” “refugees,” “asylum seekers,” and “internally displaced persons.” The 1951 Convention related to the status of Refugees and its 1967 Protocol provided a clear definition for refugees, also used to create the 1980 Refugee Act. However, recent political and media rhetoric have increased public misunderstanding of immigration terms. Design/methodology/approach: The paper uses over 30 news reports to demonstrate recent perceptions of refugees and other migrants. Other citations provide historical accounts, international documents, and legislation to explain ways in which the USA and other countries have defined refugees. Findings: Findings suggest ways in which leadership have ignored research by denouncing resettlement in spite of statistics indicating that refugees are not a threat to the American people. Research limitations/implications: The author’s perspective is as a researcher who has conducted research with resettled refugees for over 15 years. The author’s findings have created a pro-refugee stance. Practical implications: This paper suggests the importance of exploring multiple perspectives and not settling for the claims of popular media. It also provides information for teachers to provide educational materials about refugees and other immigrants. Social implications: Readers are called to look beyond popular opinion to consider accurate information about refugees and immigrants. Refugees and asylum seekers flee from terrorism; they are not terrorists. Originality/value: This paper confronts contentious popular media reporting on refugees and migration. This is especially valuable in the current time, as negative misconceptions about such people abound. Digital Object Identifier (DOI) https://doi.org/10.1108/SSRP-03-2017-0001 Citation / Publisher Attribution Social Studies Research and Practice, v. 12, issue 2, p. 113-124 Scholar Commons Citation McBrien, Jody Lynn, "Refugees, Asylum Seekers, and other Immigrants: Help for Teachers with Problematic Definitions" (2017). School of Interdisciplinary Global Studies Sarasota Manatee Campus Faculty Publications. 37. https://digitalcommons.usf.edu/sigs_facpub_sm/37 Was this content written or created while at USF?

https://digitalcommons.usf.edu/sigs_facpub_sm/37/

Podcasts are experiencing a renaissance today. More high-quality programming is available for more diverse audiences than ever before. And in this report, Nicole Hennig will provide you with a guide that includes some of the best educational, accessible, and diverse podcasts available for your library users. Hennig provides suggestions for how you can find the best podcasts, discusses the purposes and benefits of podcasts, and share tips on how we can use this knowledge to point our users to the most relevant content and help increase digital literacy in our communities. In this issue of Library Technology Reports (vol. 53, no. 2), Hennig will cover About the Author Nicole Hennig is an independent user experience professional, helping librarians and educators effectively use mobile technologies. She is the author of several books, including Apps for Librarians: Using the Best Mobile Technology to Educate, Create, and Engage. Her online courses, such as Apps for Librarians & Educators, have enabled librarians from all types of institutions to effectively implement mobile technologies in their programs and services. Her newsletter, Mobile Apps News, helps librarians stay current with mobile technologies. Hennig worked for the MIT Libraries for fourteen years as head of user experience and web manager. She is the winner of several awards, including the MIT Excellence Award for Innovative Solutions. About Library Technology Reports Published by ALA TechSource, Library Technology Reports helps librarians make informed decisions about technology products and projects. Library Technology Reports publishes eight issues annually and provides thorough overviews of current technology. Reports are authored by experts in the field and may address the application of technology to library services, offer evaluative descriptions of specific products or product classes, or cover emerging technology. Find out more information on this publication and how you can subscribe here.

http://alastore.ala.org/detail.aspx?ID=11977

Straive's staff of education experts have decades of experience creating education products for all age levels and across all education disciplines. Straive’s curriculum-specialist teams create a quality framework for every project and deliver each project on time, within scope, and at top quality. Leveraging our extensive network of subject-matter-expert writers and editors, Straive produces engaging and accurate content in ELA, Social Studies, Science, Mathematics, and many other disciplines in the K-16 education space. Our areas of support comprise Straive's Learning Design team of SME authors and editors creates content based on our client's program prototypes and guidelines. Our agile team of curriculum experts also creates prototype materials to help our clients achi...Read More Straive has a network of 400+ writers, all of whom are subject-matter experts who specialize in academic disciplines and learning levels. We assemble a content-authoring team with both classroom teaching experience and top-le...Read More All content written by our SME writers is reviewed by editors with deep experience in education best practices and in publishing protocols. Our content editors ensure that all text is appropriate for the intended age level, m...Read More In addition to creating student- and teacher-facing content, our team provides additional essential services for curriculum products. Straive's Editorial Services teams provide various quality-control services to meet our client's needs and follow their documented requirements. Our solutioning team is eager to know about your challenge and how we can help.

https://www.straive.com/solutions/content-design-and-development

The Manager of Education Development for the Winter Institute of Simulation, Education and Research (WISER) directs the planning, organization, and coordination of all educational programming for the department. Partners with clinical care providers and professors to help create both simulation-based and online-based educational programs. Utilizes clinical knowledge to ensure established standards of quality and performance are upheld throughout the overall goals and activities of UPMC, the University of Pittsburgh, and WISER, ultimately supporting quality patient outcomes. Responsibilities Curriculum Development - Provide strategic and tactical leadership for educational programming at WISER, UPMC and the University of Pittsburgh Schools of Health Sciences considering both the internal and external environments. - Supervise the development, editing, and instructional design of WISER courses by working with subject matter experts; and manage, revise, and update the existing course library as needed. - Create faculty development programs focused on the best practices of simulation educational methods of teaching, debriefing, and assessment. - Manage multiple subject matter experts simultaneously during content development and course revisions. - Supervise curriculum developer(s) to finalize courses for publication by providing feedback on content, structure, format, and execution. - Maintain and expand current and develop new educational collaborators including, but not limited to: academic centers, national and regional professional societies /associations, hospitals, and medical groups. - Ensure the overall educational program conforms with standards set forth by appropriate accrediting bodies. - Oversee the procurement of copyright clearances of materials used within educational programs when appropriate. Evaluation & Data Analysis - Establish and manage effective and efficient processes for developing, delivering, and evaluating educational programs to determine their impact. - Provide performance management feedback to all members of the curriculum development team - Facilitate and participate in live and/or written updates and outcomes reports to course directors and other stakeholders. - Use data and analyze industry trends to make recommendations to the Director for new curriculum development and enhancements to the existing curriculum. - Actively participate in department or practice-specific quality improvement efforts. Assess the need for an implement an evidence-based system or process improvement to meet care delivery protocol outcomes. - Identify opportunities for quality improvement to colleagues and management. Utilizes research and evidence-based practice to support improvement in clinical care, identifies research issues or articles related to clinical specialty or areas of interest. - Partake in research activities, submit abstracts for presentation at local, regional and national professional meetings, and submit articles for publication. - Apply creative and innovative strategies in problem solving to achieve the goals of WISER. Teaching - Teach a variety of healthcare and non-healthcare related simulation courses for both internal and external users. - Remains current and seeks opportunities to participate within and among the CME/CE community at large. Leadership & Professionalism - Manage the human, financial, and operational resources for the development of educational programs including but not limited to the use of WISER Information Technology resources, videographers, photographers, contract artists, and administrative personnel. - With the WISER Director, serve as liaison to other hospital departments, affiliating agencies, and accrediting bodies. - Communicate and collaborate with health system and university personnel, administrators, community, and professional leaders to plan, promote, and evaluate their collaborative work at WISER. - Takes a leading role in major hospital-wide projects. Assume responsibility for complex assignments and view problems as challenges. Develops relationships with service/specialty physicians and other disciplines to promote and proactively instruct nursing personnel on newer therapies and procedures to enhance nursing care delivery. Leads healthcare team conferences - Develops and maintains productive working relationships internally and externally by building teams and relationships through mentoring and modeling uplifting and positive communication Extends trust by acknowledging the contributions of others; listens first, creates transparency in communications, confronts reality, and clarifies expectations. - Conveys information and ideas clearly through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the message. Role models professional communication and encourages free exchange of ideas that serves as a catalyst for transformation. Perform related duties as required - Assume responsibility for self-direction in professional activities in order to promote professional and personal growth. - Utilize independent decision-making at the appropriate level as an everyday leadership practice in order to achieve delivery of quality educational services and high faculty satisfaction. - Participates in professional organizations. - Represent WISER in a professional manner to facilitate customer relations and to maintain a reputation of excellence. Performs other duties as assigned Qualifications - Advanced degree in Behavioral Health, Social Work, Education, or a related field preferred. - Eight years of progressively responsible experience in behavioral health or related human services field in developing, implementing, and providing staff development and/or community training. - Excellent project management, organizational, editing, writing, and communication skills. - Demonstrated success working with subject matter experts in an area other than that of his/her own training. - Knowledge of educational evaluation methods and data management is essential Preferred Experience - MSN, MSEd-Nursing, or Master’s degree in related field (or comparable advanced healthcare education) - Minimum 3 years clinical experience - Minimum 2 years clinical specialty project management, teaching or curriculum development, and/or leadership preferred Licensure, Certifications, and Clearances: - Act 34 - Current Pennsylvania licensure as a Registered Professional Nurse license preferred, or comparable clinical/healthcare licensure or certification - Basic Life Support (BLS) or CPR certification preferred - UPMC is an Equal Opportunity Employer/Disability/Veteran Total Rewards More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more. Our Values At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

https://careers.upmc.com/jobs/10351478-manager-education-and-consultative-services

Gary Staunch, Director of Education for North America at Compaq Computer Corporation, is responsible for marketing Compaq products and services to public and private educational institutions throughout the United States. Staunch leads the strategic planning, marketing and communication efforts to identify and promote the products, solutions and services that best meet the needs of K-12 and higher education customers. Staunch was named to his current position in June 1998. James L. Morrison (JLM): Gary, as a senior manager for one of the worlds leading producers of information technology, what do you see on the horizon regarding how these tools will affect the way we conduct teaching in educational organizations? Gary Staunch (GS): From the teaching perspective, the most dramatic change that I see coming is the portability issue and how to extend learning outside the classroom. We need to design devices that are portable, durable, functional, and capable enough to extend the learning experience outside of the traditional school environmentand to change the dynamics of student-teacher interaction so that the classroom is not necessarily the only location where learning takes place. I believe that portability expands the learning process by allowing students to access current information from anywhere, at anytimewhether that information resides with an instructor, with someone whom you want to collaborate as a peer, or on the Internet. JLM: What about the management of educational organizations? GS: Lets look at the K-12 environment. Today, many districts don't have access to the on-demand data they need to make intelligent, on-the-spot decisions or to react to current trends. That data usually resides in an Information Technology-directed environment. Data-driven technology tools currently in development will provide K-12 administrators with access to important information on a real-time basis to make informed, strategic decisions. These tools allow decision-makers to react immediately, make changes mid-course and apply whatever information or resources are needed in given situations. For example, how do superintendents get information about attendance trends at specific schools in their districts? Traditionally, they get a report from somebody, but that report does not provide real-time access to attendance information. Real-time, data-driven technology tools respond to an administrators need for a steady flow of new information that is continually updated. What I see are systems that will be able to give school leaders information so that they will be able to make need-driven decisions. JLM: Virtual universities and virtual classrooms are recent developments. How do you see these entities affecting public schools, colleges and universities in the future? GS: Distance learning, also known as virtual learning, is a key issue involving several teaching and learning activities. We view distance learning as Web-enabled learning, where technology and the Internet enhance the curriculum for both students on campus and across the country. Many people interpret "Web-enabled learning" as a teaching format in which information is broadcast to students around the world through the Internet. We define Web-enabled learning as a curriculum delivery vehicle, not a teaching format. Web-enabled learning provides anytime, anywhere access to best-of-breed curriculum. Web-enabled learning will be widespread in the future. To that end, Compaq will announce this year solutions to support Web-enabled learning through content developmentthe ability to import content for curriculum, and the ability to deliver that content across a Web-based environment. If academic institutions want to bring a curriculum to either higher education or K-12 campuses that do not have that resource within their academic structure, then Web-enabled learning provides the solution to meet that need. Web-enabled learning provides enormous flexibility in the learning process for students. With the import of real-time content, the information accessed is always refreshed and up-to-date, which is important. The virtual university revolution is making traditional colleges examine the way content is delivered. In order for traditional institutions to remain competitive in the future, they must offer Web-enabled learning as an option for their students. JLM: Several weeks ago, I went to a conference where the focus was on Web-enabling textbooksputting them in Web-syllabi, where students could use hypertext for the explanation of complex words, or go to simulations and exercises, or even to click on a button and hear a professor's audio comments on a particular section of text. Are computer companies and textbook publishers starting to collaborate? Do you foresee a merger or partnership of computer companies and textbook publishers? GS: Absolutely. Part of the publishers' challenge is that they have gone from producing hard-copy textbooks to CD-ROMs, but they are unsure what the next interaction, relative to content delivery, will be in a Web-based environment. We are working closely with leading publishers in order to determine how content can best be delivered. In addition, publishers are addressing the many intellectual property issues associated with Web-enabled textbooks. JLM: Relatively few faculty members are using Web-enabled delivery systems. What are the implications of that sparse usage? How can educational leaders address these implications? GS: You are right; there are very few teachers that develop or deliver their curricula in a Web-based environment. Educators need to seriously investigate Web-enabled learning and ask themselves: How do I deliver Web-enabled learning to my students? How do I incorporate content? How do I take the content that I have, as a subject matter expert, and put that into an engaging format for my students? These are the questions facing all schools, including traditional colleges and universities. Compaq is currently working to develop a program in higher education that will deliver the technology, tools, training and information that will enable professors to: (1) take the content that they have historically delivered to students via lectures and put it into a Web-enabled format, and (2) access content imported from other content providers. Is the infrastructure in place to support such technology on campuses today? Probably not. JLM: Will Compaq assist educational leaders and faculty members who want to participate in the Web-enabled course business? GS: Yes, absolutely. By the end of this quarter, we will have a Web site up and running called "CoursePaq" that educators can access as a resource for Web-enabled learning. Anything that educators want to know about developing, implementing or supporting Web-based education resides on this site. It will be a key resource for potential providers of Web-based curricula. JLM: A major challenge is to get faculty members interested in being Web-based learning providers. What hints or tips can you give educational leaders about how they can convince faculty to essentially get involved with a steep learning curve when they are already busy people? GS: I understand the reluctance of faculty: this is why we are trying to make the implementation of information and technology tools as easy as possible. As students graduate from schools in which technology is more and more prevalent and move into the workforcewhether it is into the academic community or into the commercial business environmentthe interest by faculty in Web-enabled learning will naturally increase. JLM: How can information technology tools be used to stimulate and enhance learning? GS: When students have access to up-to-the-minute, current information, and when that information is shared with their peers and faculty, the learning experience changes dramatically. Teachers, who used to be the subject matter experts and the deliverers of all content, will transfer more of the learning process and responsibility to students. Students then become responsible for understanding where to access information and how to collaborate in a Web-based environment. Students must ask themselves: How do I learn? How can I use information and technology to gain information? Such an experience prepares an individual to be a life-long learner, which is critical for success in the workforce of tomorrow. So the whole learning paradigm changes. On top of that, technology enables students to express themselves differently than they ever have before. Students are no longer limited to using a piece of paper and a pencil or pen, but instead have a unique online environment in which they can express what information they have been able to gather, internalize that data, and then integrate it into their assignments. JLM: My experience is that students are uncomfortable when the focus shifts to their competency in accessing, analyzing and communicating information. This shift is also uncomfortable for professors because it is a whole different way of looking at teaching behavior. We have put so much stock in teachers being the purveyors of content. Do you have any tips on how to ease this transition in which both students and teachers adopt new roles? GS: It is difficult, especially for a teacher who transitions from being the subject expert to being the facilitator. But just as business management has changed, so too must education management change. Business managers used to simply state, "I want you to do this task," and now they empower employees to be responsible for an area of the business. Instructors still need to direct student learning activities, but they must also put responsibility for learning on the students. It is going to be an uncomfortable, but worthwhile transition. The measure of success should not simply be test scores, but instead, increased attendance and graduation rates and the visible engagement of the student in the learning process. Once teachers see their students engaged and excited about learning and producing thoughtful work, they will find it easier to make the transition from actor to director.

http://www.technologysource.org/article/information_technology_tools_and_the_future_of_teaching_and_learning/

Bring your demonstrated expertise in information management, content development and content deployment frameworks to work with the American Alliance of Museums in an exciting new position. The Alliance’s new strategic plan calls for a comprehensive program of rich professional resources which will comprise the core of AAM’s individual and museum membership offerings. To that end, AAM seeks a Senior Director of Integrated Content to lead the vision and implementation of this program. The successful candidate will have knowledge of emerging trends in digital humanities and other content-rich environments and keen entrepreneurial instincts. S/he will work with Alliance leadership and subject matter experts to develop and implement a holistic, enterprise-wide approach to the creation, management and distribution of educational content across channels (website, webcasts, print, face-to-face meetings and social media) in support of the AAM’s mission and strategic goals. Leading a staff of four, the Senior Director will work closely with the Director of Communications to distribute timely and relevant content that resonates with target audiences. S/he will collaborate with the Development Office in preparing grant and sponsorship proposals and reports, and will serve as the primary liaison to the Alliance’s 22 Professional Networks to leverage their expertise. The Senior Director will also collaborate externally with national, regional and state museum associations and others to aggregate and curate relevant digital content. Requires 7+ years’ experience in project/information management, and multi-channel content development and deployment; demonstrated expertise in technology infrastructures that support content development and delivery; digital asset management; fluency in web analytics and program evaluation tools. Must be able to think at a high strategic level while also managing details and taking a hands-on approach when needed. B.A., in information technology, library & information science, English, communications or related field required; graduate degree preferred. The American Alliance of Museums, a 501(c)3 non-profit organization, is a trusted leader, partner, and advocate for museums and works to build a field that includes dynamic individuals, institutions and communities. With a budget of $10M, the Alliance provides leadership, advocacy and service to its membership and the field at large. For more information, please visit www.aam-us.org. Interested applicants should submit cover letter, resume and salary requirements to: hr@aam-us.org, citing “Content Director” in the subject line. The Alliance is an equal opportunity employer and values a diverse workplace.

https://www.museweb.net/job/senior-director-of-integrated-content-aam/

Program coordinators: Kelly Gentille (kmg120@pitt.edu) and Nicole Stenger (nstenger@cs.cmu.edu). Biomolecular systems dynamics, multiscale modeling and simulations, computer-aided drug design, molecular and systems pharmacology, bridging sequence evolution, structure and function. Our group develops computational methods for understanding the interactions, dynamics and conservation of complex biological systems. We develop new computational methods to model biological processes and mine high-dimensional, multi-modal biomedical data. Dr. Berg’s research focuses the relationships between the structures and functions of biological molecules. We develop new technologies to predict and model protein structures, their physical interactions, and substrates. Machine Learning in Computational Proteomics; Active and Proactive Machine Learning; Transfer and Multitask Learning; Low-Resource Language Analysis; ML & LT for On-Line Education. I work to quantitatively understand the evolutionary architecture of intelligent, collective systems, using the tools of dynamical systems, network theory, population genetics, machine learning and statistical inference, and widely available, yet underused, datasets. Our research aims at understanding the molecular mechanisms of evolutionary change and innovation by examining systems biology in the light of evolution and evolution in the light of systems biology. Statistical and computational methods for high-throughput genetic/genomic and the genetic study of complex diseases, including age-related macular degeneration (AMD), childhood asthma, and chronic obstructive pulmonary disease (COPD). We investigate the molecular and cellular origins of human epithelial malignancies through computational approaches. The goal of Dr. Chikina’s research is to use genome scale data to advance our understanding of how genes contribute to the function of a complex organism, in health and disease. Research in the Chong lab involves the development and application of molecular simulation approaches to model a variety of biophysical processes. Database Systems, Mobile and Pervasive Data Management, Distributed Computing, Operating Systems, Real-Time Systems. Our research focuses on the process of adaptive evolution in response to natural and sexual selection, and on co-evolutionary patterns within gene networks. Quantum Dynamics Theory, with Application to Condensed Phase Systems; Colloid Science: Structural and Dynamics of Charged Polystyrene Sphere Suspensions; Design of Dielectric Waveguides. Application of decision theory, probability theory, Bayesian statistics, and artificial intelligence to biomedical informatics research problems. We study evolution-in-action in the laboratory, in infections, and in cancers using genomics to identify and ultimately predict adaptations. Using rheological, biophysical and optical techniques to understand the structure and organization of the cell nucleus. Reverse Engineering Morphogenesis – From Cell Motility & ECM to Tissue Mechanics. Computational molecular biology and computational genomics; especially, the evolution of genomic organization and function. Develop broadly applicable, innovative computer-aided drug design (CADD) techniques and apply those techniques to further infectious-disease, neurological, and cancer drug discovery. Dr. Ermentrout’s main focus is in the area of mathematical neuroscience where he tries to understand the patterns of activity in networks of neurons. Developing mathematical models of biological regulatory processes that integrate specific knowledge about protein-protein interactions. Data Mining for graphs and streams. Fractals, self-similarity and power laws. Indexing and data mining for video, biological and medical databases. Statistical methods for complex family-based datasets. Detecting identity-by-descent and testing relationships using dense (sequence or chip) data. Pattern mining whole-genome and whole-proteome sequences, with application of suffix array data structures for preprocessing genome sequences. The design and development of computational methods for solving clinically relevant biological problems. Our lab uses quantitative approaches to understand how cells process stimuli to determine the appropriate functional response. Identifying the activating receptors, kinases and transcription factors that make up signaling pathways is necessary but not sufficient to predict how a cell will respond. The molecular and atomic details that govern specificity in a variety of cellular interactions and that result in the amazing functional diversity observed in living organisms. We study eye development and disease. We’re particularly interested in the genomic and epigenomic regulation of retinal development and regeneration. The molecular genetics of the mycobacteria and their mycobacteriophages. The development of modern machine learning technologies for analysis of high dimensional time-series data in electronic health record (EHR) data and their application in clinical decision support and clinical alerting. Understanding the role of bacteria in both health and disease. How genomes control cell fate decisions during embryonic development and also later regeneration. We apply artificial intelligence, machine learning, Bayesian, and other computational methods to problems in biology, medicine, and translational research. Theory and experimental studies of molecules and clusters, reaction at surfaces, electron and proton localization transfer in polyatomic molecules and waterclusters. Developing statistical machine learning techniques to address significant methodological problems in computational genomics. Designing graph and optimization algorithms to extract insight from biological data. We develop computational algorithms and full-scale systems to support rapid and inexpensive drug discovery and apply these methods to develop novel therapeutics. We model epigenomic marks during differentiation and development, and build methods to elucidate the role of transcriptional enhancer sequences in vertebrate left-right patterning. Understanding the work of membrane proteins, such as receptors, signal transduction proteins, toxins and ion channels. Personalized Medicine and Computational Structural Biology using Machine Learning and Mechanistic Modeling. Modeling the evolution of drug resistance. Elucidating the evolution of bacterial genomes, including their size, composition, variability and organization. To investigate biological systems with mechanical engineering approaches, which we enable by synthesizing novel technologies. My research addresses how gene expression programs change, leading to changes to cellular identity. We use single cell experiments and mathematical models to understand how cells process information to make cell fate decisions. Using coarse-grained models and statistical physics techniques to elucidate the underlying physical rules that are applied to the elements of living systems. Big data, user-centric data management, scientific data management, data stream management systems and data-intensive computing. Computational methods to identify signaling pathways underlying biological processes and diseases as well as statistical methods for acquiring knowledge from biomedical literature. Developing novel algorithms to study genome structure and function, chromatin and nuclear genome organization, and gene regulation in mammalian genomes as well as in cancer. Understanding the genetic causes of variation in gene expression. Biological design automation and systems and synthetic biology. Machine learning to understand how the human brain uses neural activity to represent information, and statistical learning algorithms for natural language processing. Dr. Mohimani’s research focuses on the development of computational metabolomics and metagenomics methods for antibiotic discovery and microbiome analysis. Cell and computational biology. Experimental and computational methods to learn and represent how proteins are organized within eukaryotic cells. My research uses system biology approaches to understand disease pathologies, and develop improved diagnostic and therapeutic approaches. The neurogenomics laboratory studies how genome sequence differences influence behavior and neurological disorder predisposition. Models, methods and applications of discrete optimization. We study the evolution of gene regulatory networks that control differences in morphology. The use of statistical tools to understand the workings of the human genome and the nature of inherited diseases. My research philosophy is to bring a physical, problem-ori­ented ap­proach to the acquisition and interpretation of biomolecular structural information. The long term vision of our DELPHI research group is to make epidemiological forecasting as universally accepted and useful as weather forecasting is today. Modeling and analysis of neuronal network dynamics, especially respiratory, locomotor and pathological rhythms; modeling acute inflammation, including in traumatic brain injury; multiple time scale dynamics and parameter estimation for biological models. My research is directed at understanding inter-molecular interactions in biological systems. For the last 20 years, the Russell laboratory has been discovering what can be achieved by exploiting the rich interface of chemistry, biology and materials. We advance areas of optimization theory, algorithms, and software, and develop comprehensive solutions to problems involving biological, chemical, and engineering systems. Our research aims to understand mechanisms of collective behavior and variability in bacterial cultures and their effect on responses to changing environments. Steering evolution and biological adaptation using computational game theory and opponent exploitation techniques; generating multi-step treatment plans; optimization, game theory, artificial intelligence, and market design. Computational genomics, population genetics and phylogenetics, cancer heterogeneity and progression, computational biophysics, simulation and model inference of complex reaction networks. COMPUTATIONALLY DRIVEN DISCOVERY IN HEALTH Biological information – from molecular events to personal genomics – has exploded. Our group aims to develop computational approaches to exploit large-scale data to promote disease treatment discovery and optimization. My research is in the area of mathematical biology. We construct mathematical models of biological systems within the framework of continuum mechanics and stochastic dynamic systems. We are interested in the action of low-affinity drugs, such as general anesthetics and alcohols, on the neurotransmitter-gated receptor channels. I am focusing my efforts in Quantitative Systems Pharmacology in order to change the paradigm in drug discovery and development. We develop rigorous, timely and useful statistical and computational methodologies to understand disease mechanisms and improve disease diagnosis and treatment. Dr. Urban’s research interests seek to understand the physiological mechanisms underlying functional and computational properties of brain neuronal networks. Application of AI, machine learning, data mining of biomedical data, and Bayesian methods to problems in clinical medicine and bioinformatics with focus on patient-specific predictive modeling. Our group’s research focuses on studying mechanisms of inflammation and gaining a systems-level perspective into this central physiological and pathological process. Apply integrative bioinformatics, cancer genetics, molecular cancer biology, and translational studies to identify driving genetic aberrations and appropriate cancer targets on the basis of deep sequencing and genomic profiling datasets. Mechanics represent a key aspect of live cells. Our lab seeks a cellular-level understanding of the mechanisms of actuating and sensing mechanical events. We are group of faculty and students in Statistics and Machine Learning broadly interested in theoretical work at the intersection of these two disciplines. Her research is focused on computational modeling of the brain representation of language and other high-level tasks. She uses machine learning and neuroimaging -- fMRI and MEG -- to study how the brain represents information during complex naturalistic tasks. Her research is at the interface between natural language processing, machine learning and cognitive neuroscience. Developing new strategies for treating pathogens in the clinic, ultimately turning the tide against increasing antibiotic resistance. My research uses integrative approaches to study complex human diseases by combining biology, computational and statistical learning, bioinformatics, and genomics. Dr. Xie’s research group designs and discovers GPCRs chemical genomics-based drugs for osteoporosis, multiple myeloma and breast cancer research. We develop machine learning, statistical methodology, and computational systems for solving problems of learning, reasoning, and decision-making in artificial, biological, and social systems. The lab currently focuses on Epithelial-to-Mesenchymal Transition (EMT), characterized by loss of cell-cell adhesion and increased cell motility. We develop computational methods for modelling cell organization derived from electron cryotomography 3D images. High-Resolution Channel Protein Structure and Function; Molecular Mechanisms of General Anesthesia; MRI of Brain Protection after Cardiac Arrest and Resuscitation. The Yang lab focuses on computational and functional studies to identify mechanisms of cancer drug resistance, and to develop approaches/markers for personalized cancer medicine. Designing programming models, language implementation strategies, and tools to make it easier to create software. Security and privacy of medical data and modeling protein interactions.

http://www.compbio.cmu.edu/faculty-list/

According to the tripartite synapse model, astrocytes have a modulatory effect on neuronal signal transmission. More recently, astrocyte malfunction has been associated with psychiatric diseases such as schizophrenia. Several hypotheses have been proposed on the pathological mechanisms of astrocytes in schizophrenia. For example, post-mortem examinations have revealed a reduced astrocytic density in patients with schizophrenia. Another hypothesis suggests that disease symptoms are linked to an abnormality of glutamate transmission, which is also regulated by astrocytes (glutamate hypothesis of schizophrenia). Electrophysiological findings indicate a dispute over whether the disorder causes an increase or a decrease in neuronal and astrocytic activity. Moreover, there is no consensus as to which molecular pathways and network mechanisms are altered in schizophrenia. Computational models can aid the process in finding the underlying pathological malfunctions. The effect of astrocytes on the activity of neuron-astrocyte networks has been analysed with computational models. These can reproduce experimentally observed phenomena, such as astrocytic modulation of spike and burst signalling in neuron-astrocyte networks. Using an established computational neuron-astrocyte network model, we simulate experimental data of healthy and pathological networks by using different neuronal and astrocytic parameter configurations. In our simulations, the reduction of neuronal or astrocytic cell densities yields decreased glutamate levels and a statistically significant reduction in the network activity. Amplifications of the astrocytic ATP release toward postsynaptic terminals also reduced the network activity and resulted in temporarily increased glutamate levels. In contrast, reducing either the glutamate release or re-uptake in astrocytes resulted in higher network activities. Similarly, an increase in synaptic weights of excitatory or inhibitory neurons raises the excitability of individual cells and elevates the activation level of the network. To conclude, our simulations suggest that the impairment of both neurons and astrocytes disturbs the neuronal network activity in schizophrenia.

https://graz.pure.elsevier.com/en/publications/neuronal-and-astrocytic-regulations-in-schizophrenia-a-computatio

Citizens Financial Group, Inc. (CFG) seeks a Senior Data Scientist for its Boston, MA location. Duties: Analyze credit risk valuation models, correlations, concentrations, rating migrations, and risk contributions to support the development of industry risk assessment methodologies and quantitative techniques for credit risk exposures and structured products. Develop econometric models built on solid conceptual foundation that supports all business needs and intuition. Work with business line partners in embedding and socializing econometric models and support them with on-going requests for economic model enhancements. Work with the independent model validation team to facilitate the approval of models following development. Analyze portfolios on commercial lending side to identify data trends to support reserve, regulatory capital, loss forecasts under benign and stressed economic scenarios. Maintain large data sets using advanced statistical/modeling tools and by pulling datasets directly from source systems. Identify data quality issues and work with appropriate parties to resolve or remediate. Maintain, review, and adhere to organizations credit policy; verifying the integrityof the underlying data; constant monitoring andvalidation of the underlying theories and methodologies. Implement in-house developed models, and support implementation of third party vendor solutions for credit risk and other applications. Participate in peer review sessions and maintain awareness of new advances in credit risk modeling techniques to ensure the application of best practices to CFG credit risk models. Assure quality and leading-edge nature of work by helping to solve problems faced by others. Explain to all stakeholders including model users and model validation all the rules and regulations related to ALLL and CCAR/ DFAST. Utilize national and regional macroeconomic variables for model building with strong understanding of how these variables influence the credit events. Direct applicants only. Qualifications Requirements: Must have a Masters degree in Mathematics, Mathematical Finance or related field. Must possess the following experience gained either through industry experience or graduate level academic studies: Utilizing relational database and statistical analysis programming language and software including STATA, SAS Enterprise Guide, SQL, R and Python to extract high volume and complex data from financial/banking Data Marts and perform related analysis; Developing predictive models by implementing advanced data analysis and research: time series analysis, regression analysis, categorical analysis, advanced econometric techniques related to panel data analysis, data imputation while demonstrating an understanding of the underlying mathematical principles behind these statistical methods and the ability to evaluate and interpret the results in a reasonable manner; Utilizing advanced statistical programming and visualization software, including STATA, R and Python to create complex reports/graphs for illustration of the analysis performed; Coding in unix environment, including automation of tasks using unix shell scripts; Utilizing Git version control system, including but not limited to branching and working with remote repositories; Utilization of Latex toprepare manuscripts and presentations; Knowledge of corporate finance, ability to read financial reports and understand the implication of financial ratios on credit risk of a company; Implementing complex computational methods and models using R; and Knowledge of tools such as debugging, unit testing to efficiently build and implement models. Must have CFA Level I. Why Work for Us At Citizens, you”ll find a customer-centric culture built around helping our customers and giving back to our local communities. When you join our team, you are part of a supportive and collaborative workforce, with access to training and tools to accelerate your potential and maximize your career growth. Equal Employment Opportunity It is the policy of Citizens to provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to race, color, ethnicity, religion, gender, pregnancy/childbirth, colleague or a dependents reproductive health decision making, age, national origin, sexual orientation, gender identity or expression, disability or perceived disability, genetic information, genetic characteristic, citizenship, veteran or military status, marital or domestic partner status, family status/parenthood, victim of domestic violence, or any other category protected by federal, state and/or local laws. Equal Employment and Opportunity Employer/Disabled/Veteran Citizens is a brand name of Citizens Bank, N.A.

https://www.massachusettshiring.com/it-tech-support/citizens-sr-data-scientist-44620f/

Abstract: Precise spike coordination between the spiking activities of multiple neurons is suggested as an indication of coordinated network activity in active cell assemblies. Spike correlation analysis aims to identify such cooperative network activity by detecting excess spike synchrony in simultaneously recorded multiple neural spike sequences. Cooperative activity is expected to organize dynamically during behavior and cognition; therefore currently available analysis techniques must be extended to enable the estimation of multiple time-varying spike interactions between neurons simultaneously. In particular, new methods must take advantage of the simultaneous observations of multiple neurons by addressing their higher-order dependencies, which cannot be revealed by pairwise analyses alone. In this paper, we develop a method for estimating time-varying spike interactions by means of a state-space analysis. Discretized parallel spike sequences are modeled as multi-variate binary processes using a log-linear model that provides a well-defined measure of higher-order spike correlation in an information geometry framework. We construct a recursive Bayesian filter/smoother for the extraction of spike interaction parameters. This method can simultaneously estimate the dynamic pairwise spike interactions of multiple single neurons, thereby extending the Ising/spin-glass model analysis of multiple neural spike train data to a nonstationary analysis. Furthermore, the method can estimate dynamic higher-order spike interactions. To validate the inclusion of the higher-order terms in the model, we construct an approximation method to assess the goodness-of-fit to spike data. In addition, we formulate a test method for the presence of higher-order spike correlation even in nonstationary spike data, e.g., data from awake behaving animals. The utility of the proposed methods is tested using simulated spike data with known underlying correlation dynamics. Finally, we apply the methods to neural spike data simultaneously recorded from the motor cortex of an awake monkey and demonstrate that the higher-order spike correlation organizes dynamically in relation to a behavioral demand. Partial Text: Precise spike coordination within the spiking activities of multiple single neurons is discussed as an indication of coordinated network activity in the form of cell assemblies comprising neuronal information processing. Possible theoretical mechanisms and conditions for generating and maintaining such precise spike coordination have been proposed on the basis of neuronal network models –. The effect of synchronous spiking activities on downstream neurons has been theoretically investigated and it was demonstrated that these are more effective in generating output spikes . Assembly activity was hypothesized to organize dynamically as a result of sensory input and/or in relation to behavioral context –. Supportive experimental evidence was provided by findings of the presence of excess spike synchrony occurring dynamically in relation to stimuli –, behavior –, or internal states such as memory retention, expectation, and attention , –. In this study, we introduced a novel method for estimating dynamic spike interactions in multiple parallel spike sequences by means of a state-space analysis (see Methods for details). By applying this method to nonstationary spike train data using the pairwise log-linear model, we can extend the stationary analysis of the spike train data by the Ising/spin-glass model to within-trial nonstationary analysis (Figure 3). In addition, our approach is not limited to a pairwise analysis, but can perform analyses of time-varying higher-order spike interactions (Figure 4). It has been discussed whether higher-order spike correlations are important to characterize neuronal population spiking activities, assuming stationarity in the spike data –. Based on the state-space model optimized by our algorithm, we developed two methods to validate and test its latent spike interaction parameters, in particular the higher-order interaction parameters, which may dynamically change within an experimental trial. In the first method, we selected the proper order for the spike interactions incorporated in the model under the model selection framework using the approximate formula of the AIC for this state-space model (In Methods, ‘Selection of state-space model by information criteria’). This method selects the model that best fits the data overall across the entire observation period. The selected model can then be used to visualize the dynamic spike interactions or for a performance comparison with other statistical models of neuronal spike data. However, more importantly, the detailed structure of the transient higher-order spike interactions needs to be tested locally in time, particularly in conjunction with the behavioral paradigm. To meet this goal, we combined the Bayesian model comparison method (the Bayes factor) with a surrogate method (In Methods, ‘Bayesian model comparison method for detecting spike correlation’). The method allows us to test for the presence of higher-order spike correlations and examine its relations to experimentally relevant events. We demonstrated the utility of the method using neural spike train data simultaneously recorded from primary motor cortex of an awake monkey. The result is consistent with, and further extended the findings in the previous report : We detected an increase in triple-wise spike interaction among three neurons in the motor cortex during the preparatory period in a delayed motor task, which was also tightly locked to the expected signals. Although the analysis was done for a limited number of neurons, smaller than the expected size of an assembly, it demonstrates that the nonstationary analysis of the higher-order activities is useful to reveal cooperative activities of the neurons that are organized in relation to behavioral demand. Of course, further analysis is required to strengthen the findings made above including a meta-analysis of many different sets of multiple neurons recorded under the same conditions. Source:

https://chromoscience.com/research-article-state-space-analysis-of-time-varying-higher-order-spike-correlation-for-multiple-neural-spike-train-data/

Project description: The World Health Organization (WHO) estimates that about one billion people around the world are affected by neurological disorders, including 60 million who have epilepsy and 24 million with Alzheimer disease and other dementias. Neurological disorders are an important cause of mortality and constitute 12% of total deaths globally [1,2,3]. Epilepsy is a neurological disorder manifested by episodic disruption of brain electrical activity associated with abnormal body movement, loss of consciousness, and sensory disturbances. Neurological disorders such as epilepsy affect the mental health of individual with significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorder is commonly associated with substantial distress or impairment in social, occupational, or other essential activities . Psychiatric and neurological comorbidities are relatively common and often co-exist in people with epilepsy. For example, depression and anxiety disorders are the most common psychiatric comorbidities, and they are particularly common in these patients who also have a neurological comorbidity, such as stroke, traumatic brain injury or dementia. A considerable number of epileptic patients are pharmaco-resistant and require surgical intervention specifically aimed to identify the location of the epileptic zone and evaluate the dynamics of the epileptic network. To prepare the patients for the surgical intervention, a complex procedure and several diagnostic tests are performed on the patient, with long hospitalization and high costs. Thus, we identify a need to analyze and improve the current assessment tools and intervention methods taking into account the interrelated nature of neurological symptomatology. Identifying the network of neurological derived symptoms may help to understanding its dynamics and provide better prognosis and intervention after epilepsy and brain damage in general. New technologies are needed to enhance the capacity of the clinicians to plan the surgical intervention, monitoring and identification of the epileptic zones for the upcoming therapeutic outcome. In this project we want to build a simulation of a damaged brain based on structural and functional connectivity networks using BrainX3, a computational tool for multi-level integrative in-silico modeling of brain networks. Using BrainX3, this project will target the localization and dynamics of brain lesions and the analyses of their impact on brain functionality. The BrainX3 platform is specifically designed for integrating multiple types of data and simulating network dynamics at multiple scales. This is particularly important for simulating detailed disease models and assessing the effects of various interventions. In a large-scale simulation study with BrainX3 we have recently demonstrated the dynamics of the healthy resting-state attractor and compared that to the neural dynamics of brain networks with cortical lesions . We have found that the convergence between the data centric and model-based approach will define the confidence the system has on its prognostics. This project aims at providing in-silico dynamics of neural activity after brain damage and make longitudinal predictions about plasticity changes, neurodynamic reorganization and changing symptomatology. These model predictions about the prognosis after brain damage will be validated on epileptic patients using behavioral data/symptomatology as well as longitudinal EEG/fMRI data. For individual patients this will mean building a simulation of a brain using structural and functional data obtained at the onset of an epileptic crisis for that patient and comparing model predictions about changes in plasticity and brain activity over time with new longitudinal functional data for the same patient. At the population level, we will validate our computational models by analyzing the statistics of model-predicted changes in symptomatology and comparing those to large cohorts of longitudinal behavioral data. In relation to other brain pathologies such as Stroke and Alzheimer disease, the patient diagnostics and prognostics will be defined by running BrainX3 simulations. The project will be developed in collaboration with: · Prof. Paul Verschure at IBEC, ICREA, Barcelona. paul.verschure@ibecbarcelona.eu · Prof. Rodrigo Alberto Rocamora at the Epilepsy Unit, UMIM, Barcelona 99267@parcdesalutmar.cat The proposed research activity is aligned with the Advanced Societal Health Challenges SHC2 and SHC3, and the Advanced Technological Platform ATP5 of the Severo Ochoa program. Job position description PhD position: The group is offering a PhD position for a research study that contributes to uncovering neural and behavioral mechanisms underlying brain changes taking place in health and disease as well as in artificial behaving systems. The research will be within the framework of the Eu project: Virtual Brain Cloud. The main tasks and responsibilities for the PhD candidate will be - Behavioral testing of epileptic patients with electrode implants (learning, memory, cognition) - Data analysis and brain modeling with BrainX3 using brain data recorded from intracranially planted electrodes in epileptic patients - Translation of the epileptic BrainX3 model to simulate other brain diseases such as Stroke and Alzheimer disease. The requirement for the candidate are: Degree and Master on any field of Neuroscience, Computational Neuroscience, Neurorehabilitation. Multidisciplinary qualifications Neuroscience, Psychology, Imaging, Modeling, Statistics etc. Knowledge on EEG analysis and machines learning will be a plus. Competencies and skills: Programming, Data analysis, Modeling, Communication, Teamwork, Commitment, Critical and Analytical thinking. High level of English.

https://ibecbarcelona.eu/analysis-modeling-and-visualization-of-brain-physiological-data