Group membership: Who gets to decide?

In this commentary, I focus on several problems that the authors' understanding of group identity raises: the legality of avoiding background diversity, the problem of effectively unshareable knowledge, the practical quality of some outcomes arrived at by groups with homogeneous backgrounds, and moral issues about fairness. I note also that much recent research challenges the view that background diversity is more likely to be a detriment than a benefit.

Modified Berg Balance Scale: making assessment appropriate for people with aphasia.

OBJECTIVE: Modifying assessments for people with aphasia has the potential to increase the validity of healthcare assessments across professional domains. This pilot study addressed the challenges of giving people with aphasia the power to fully participate in the assessment process. The study aimed to investigate the feasibility of using an aphasia-modified version of the Berg Balance Scale (BBS), a physical therapy assessment tool to quantify dynamic sitting and standing balance. METHOD: The study compared how people with aphasia performed on the original BBS to an aphasia-modified version (MBBS), created for this study. We examined the relationship between auditory comprehension scores and balance performance of 15 participants with chronic aphasia and three control participants. We tested the hypothesis that individuals with aphasia would perform higher on the MBBS rather than the BBS, thus more closely approaching a score reflective of their true physical abilities. RESULTS: Overall people with aphasia performed significantly better on the MBBS than the BBS, indicating that at least some portion of their performance difficulty was likely due to poor auditory comprehension of test instructions rather than true balance difficulty. CONCLUSION: Implications of this study suggest that modifying assessments, such as the BBS, by reducing linguistic complexity and adding visual and written cues along with modeling and repetition has the potential to increase the validity of healthcare assessments for individuals with aphasia.

The FAS gene, brain volume, and disease progression in Alzheimer's disease.

OBJECTIVE: We sought to identify single-nucleotide polymorphisms (SNPs) associated with Alzheimer's disease (AD) progression and brain volume. METHODS: Ninety-seven SNPs were genotyped in 243 subjects from a longitudinal study of healthy aging. Subjects who received a diagnosis of cognitive impairment (CI) at any study visit (before their most recent visit) and had DNA in the study's DNA bank were included. Progression of AD was defined as the duration from onset of CI to diagnosis of AD. Association of each of the 97 SNPs with AD progression was tested via Cox model. Those SNPs meeting a criterion of nominal significance (P < 0.05) for association with AD progression were reassessed to account for multiple testing by repeating the marker selection process in 10,000 random permutations. Next, the association between the one SNP that survived the multiple-testing adjustment and brain volume was determined by multiple regression analysis in a subgroup of subjects for whom magnetic-resonance imaging (MRI)-derived brain-volume data were available. Brain volumes were adjusted for age at MRI, gender, and time from MRI to onset of CI. RESULTS: The minor allele of rs1468063 in the FAS gene, which is member 6 of the tumor necrosis factor receptor superfamily, was significantly associated with faster AD progression after adjustment for multiple testing (P(permutation) = 0.049). The same allele in rs1468063 was associated with smaller brain volumes and larger ventricular volumes (P = 0.02 and 0.04, respectively). CONCLUSIONS: The FAS gene, which plays a role in apoptosis, may be associated with AD by modulating the apoptosis and neuronal loss secondary to AD neuropathology.

The faux, fake, forged, false, fabricated, and phony: problems for the independence of similarity-based theories of concepts.

Some things in our environment are not what they seem, and they provide a challenge to theories of concepts that emphasize similarity. Section 1 of my commentary explores a dilemma this situation creates for Machery. Section 2 describes a more general problem for prototype and exemplar theories. Section 3 locates a place for similarity-based concepts, and indicates an alternative to Machery's thesis.

Feasibility of Integrating a Mobile Decision-Support App into a Multicomponent CME Initiative: Developing Clinician Competence at the Point of Care.

Mobile health (mHealth) technologies such as smartphone applications are increasingly being adopted in the healthcare setting to support the delivery of evidence-based care. Given the approaching ubiquity of mHealth tools in medical practice, it is incumbent on the continuing medical education (CME) community to understand how these tools can be leveraged to develop clinician knowledge and competence, and how we can assess these educational outcomes. In this report, we describe our experience developing and incorporating a mobile decision-support tool into multiple activity formats within the European Immuno-Oncology Clinic Companion CME initiative.

State of play of CME in Europe in 2015: Proceedings from the Eighth Annual European CME Forum.

European CME Forum is a not-for-profit organisation that brings together all stakeholder groups with an interest in European continuing medical education (CME) and promote multichannel discussion in an independent and neutral environment. This report summarises the discussions that took place at the 8th Annual European CME Forum in Manchester on 11-12 November 2015. Held at a time of increased scrutiny on the quality and value of the CME, the forum provided a space for attendees to share perspectives on trends, challenges, and opportunities related to European CME accreditation, funding, and regulation. Discussions focused on specific "hot topics" identified through a pre-meeting survey and needs assessment conducted among CME stakeholders in Europe and beyond. Chief among these were issues related to managing the transparency of relationships between industry and healthcare professionals, evolving systems of European CME accreditation, and the future of CME funding. The programme structure included multiple workshops conducted by leaders in the CME field, and plenary sessions that facilitated multidisciplinary interactions with invited guests, including the very learners the CME field is designed to serve. Attendee feedback was gathered to begin shaping the programme for the 9th Annual European CME Forum (#9ECF), which will take place in Amsterdam, The Netherlands, on 9-11 November 2016.