How this guideline was created: An international guideline development panel including patients, clinicians with content expertise, and methodologists produced this recommendation in adherence with standards for trustworthy guidelines using the GRADE approach. The MAGIC Evidence Ecosystem Foundation (MAGIC) provided methodological support. The panel applied an individual patient perspective.
Johnson NR; Pelletier A; Berkowitz LR. Mini-clinical evaluation exercise in the era of milestones and entrustable professional activities in obstetrics and gynaecology: resume or reform J Obstet Gynaecology Can. Epub 2019 Dec 24.
Misinformation and disinformationFootnote 2 come in endless guises and spread via different mechanisms, including campaigns of persistent inaccurate beliefs and falsehoods, deceptive messages, and engagement echo chambersFootnote 3 [13, 14]. The pandemic has brought a paper tsunami with widespread misinterpretation of both peer-reviewed research and preprints, press releases without scrutinizable data, sensationalized media reporting, and endless conspiracy theories [5, 11, 15, 16]. As a result, finding trustworthy sources of information and guidance on COVID-19 has been difficult for the public. Over the past months, logical fallacies and cognitive biases have relentlessly distracted from critical appraisal and transparent communication of the scientific evidence related to COVID-19 . Confirmation bias, availability bias, motivated reasoning, the Dunning-Kruger effect, black-or-white fallacy (also known as false dilemma, false dichotomy, either/or fallacy, or false choice), straw man fallacy, ad hominem fallacy, appeal to emotion, appeal to ignorance, and appeal to authority fallacies have all run rampant across social media.
Since long-term restrictive measures come with enormous collateral damage and real-world conditions lead individuals to take some risks, the way forward is to advocate a harm reduction approach instead of social abstinence-only policy [29, 38, 77]. Applied to COVID-19, harm reduction entails enhancing awareness about SARS-CoV-2 transmission and infection risk mitigation, self-assessment of risk related to personal activities, and engagement through alternatives of safer socializing. Although finding balance in the response plans is not an easy task, harm reduction is a sustainable and realistic strategy and a way of negotiating a middle ground. Allowing people to make their own compromises and informed judgments make harm reduction an ethically correct approach that enhances community engagement and trust [30, 77]. In contrast, COVID-19 absolutismFootnote 10 is not a viable or reasonable strategy .
Bridging the interdisciplinary communication barriers and disagreements between the medical and engineering fields has proven complicated. Although academic disagreements may be valid and should not be met with hostility, narratives of misinformation and false dichotomies cause harm or do little to address the global needs for COVID-19 mitigation. There have been large-scale, continued attacks on those working in public health, which undermines public trust and is counterproductive to the pandemic response. Different disciplines should work together , instead of taking an adversarial position against public health agencies like the WHO and the CDC [426, 427], which is decidedly not constructive.
At any rate within a year or so the trustees of J. B.'s estate wanted to liquidate their holdings in the Herreshoff Manufacturing Company. By this time the war had been going on in Europe two or so years, and it looked as if this country would become involved. This made some of the yachtsmen who had had Herreshoff yachts willing to buy into the company as they anticipated profits from war work in a company already tooled up to build torpedo boats, etc. Thus the stock in the company sold like hot cakes, and Captain Nat, seeing this, very wisely sold most of his stock also. The company was now owned by several wealthy yachtsmen of Boston and New York, and had a board of directors who unfortunately knew little about running a yacht yard, although their names were among the first in the social register of these two cities. They acquired a highly paid general superintendent and a sales executive and were all set to do big business, but for some reason or other failed to get paying work during World War I, although they did do much troublesome work for the government which included repair work, building the hulls for seaplanes, building steel pontoons or floats that were planned to carry seaplanes about as they were towed behind destroyers at high speed (in those days the flying radius of the seaplanes was small). Although they built three or four steamers for the government they failed to get the order for some of the two hundred foot Eagle boats so that at the close of the war the stockholders were quite disappointed. Then directly after the war followed a few years with little yachting activity when for some reason or other some of the directors seemed to think the trouble was that the men in the company were not working well, while the real trouble was that the executives had not secured work for them to do. So one of the directors got up at a board meeting and said, I know how to make the men work; we will reduce the salary of the superintendents. Perhaps this man did not know what their salaries were, but if I remember right it was only about twenty-five dollars a week so that when notified of this cut some of the best superintendents resigned, and this included Mr. Murray who was soon to build up the Nevins Company at City Island.
At any rate soon after Lipton's challenge was accepted in 1913 the New York Yacht Club formed a syndicate to build a yacht for the defense of the cup, and although Captain Nat was getting along in years, being then sixty-five and at the time far from well, the syndicate entrusted him with the order for the yacht that was later named Resolute. At the time Mr. Alexander Smith Cochran, who had owned Westward, was having the large three-masted schooner Sea Call built, designed by William Gardner and built at the George Lawley & Son Corporation. He decided to build also a cup candidate designed and built by the same firms, which made one of the greatest outlays that an individual has made for sailboats in one year. While I do not know the combined cost of these two yachts I do suppose it was over half a million, and I doubt if they could be duplicated today for one and a half million. This new cup candidate was a very handsome vessel and, when new and throughout her first year, was polished bronze from keel to rail cap; she was most appropriately named Vanitie in remembrance of the poem of the Golden Vanitie, for her polished bronze plating glistened like gold.
Real name: Gil Moss. A former camper at Camp Wannaweep. When Ron attended Camp Wannaweep, he swapped Gill his afternoon swim, for arts and crafts. In the episode \"Sink or Swim\" Gill relates how the polluted lake where he swam in so often caused him to mutate into a fish-man mutant. At the end of \"Sink or Swim\" Gill is taken away in a fish tank to be cured. The scene where he is pulled along the lake is featured in the Kim Possible title sequence. Later in \"Return to Camp Wannaweep\", Gil shows up at Kim's cheerleading camp, cured of his mutation, posing as a mascot for another cheerleading team. Gil appears to want to befriend Ron, who does not trust that he has changed his ways. This turns out to be wise as Gil is actually seeking a source of mutagenic water to return to being \"2-L\" Gill again. It turns out as much as he hated being a fish-man monster, he hates being returned to normal even more. There is a slight difference in Gill's second form as he is bulkier than in his first. After a brief rampage terrorizing all the cheerleaders, he is again defeated by Ron with the help of Kim, Bonnie, and Mr. Barkin, and taken away in a giant fishbowl. He tells Ron at the end of the episode of \"Return to Camp Wanna Weep\" that what happened at Camp Wannaweep is \"far from over\" but he is never seen again in any episode.
Democratic representatives heard testimony concerning how Republican proposed Medicare and Medicaid changes would affect health care services for the poor and elderly which utilized these programs. They focused on aspects of the plan including managed care options and price caps for services and how these changes would affect the entire health care system, not just beneficiaries. close
Functional facial deformities are usually described as those that impair respiration, eating, hearing, or speech. Yet facial scars and cutaneous deformities have a significant negative effect on social functionality that has been poorly documented in the scientific literature. Insurance companies are declining payments for reconstructive surgical procedures for facial deformities caused by congenital disabilities and after cancer or trauma operations that do not affect mechanical facial activity. The purpose of this study was to establish a large, sample-based evaluation of the perceived social functioning, interpersonal characteristics, and employability indices for a range of facial appearances (normal and abnormal). Adult volunteer evaluators (n = 210) provided their subjective perceptions based on facial physical appearance, and an analysis of the consequences of facial deformity on parameters of preferential treatment was performed. A two-group comparative research design rated the differences among 10 examples of digitally altered facial photographs of actual patients among various age and ethnic groups with \"normal\" and \"abnormal\" congenital deformities or posttrauma scars. Photographs of adult patients with observable congenital and posttraumatic deformities (abnormal) were digitally retouched to eliminate the stigmatic defects (normal). The normal and abnormal photographs of identical patients were evaluated by the large sample study group on nine parameters of social functioning, such as honesty, employability, attractiveness, and effectiveness, using a visual analogue rating scale. Patients with abnormal facial characteristics were rated as significantly less honest (p = 0.007), less employable (p = 0.001), less trustworthy (p = 0.01), less optimistic (p = 0.001), less effective (p = 0.02), less capable (p = 0.002), less intelligent (p = 0.03), less popular (p = 0.001), and less attractive (p = 0.001) than were the same patients with normal facial 153554b96e