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There is no consensus on who might be qualified to conduct ethical analysis in the field of health technology assessment (HTA). Is there a specific expertise or skill set for doing this work? The aim of this article is to (i) clarify the concept of ethics expertise and, based on this, (ii) describe and specify the characteristics of ethics expertise in HTA.
Based on the current literature and experiences in conducting ethical analysis in HTA, a group of members of the Health Technology Assessment International (HTAi) Interest Group on Ethical Issues in HTA critically analyzed the collected information during two face-to-face workshops. On the basis of the analysis, working definitions of “ethics expertise” and “core competencies” of ethics experts in HTA were developed. This paper reports the output of the workshop and subsequent revisions and discussions online among the authors.
Expertise in a domain consists of both explicit and tacit knowledge and is acquired by formal training and social learning. There is a ubiquitous ethical expertise shared by most people in society; nevertheless, some people acquire specialist ethical expertise. To become an ethics expert in the field of HTA, one needs to acquire general knowledge about ethical issues as well as specific knowledge of the ethical domain in HTA. The core competencies of ethics experts in HTA consist of three fundamental elements: knowledge, skills, and attitudes.
The competencies described here can be used by HTA agencies and others involved in HTA to call attention to and strengthen ethical analysis in HTA.
Potential effectiveness of harvest weed seed control (HWSC) systems depends upon seed shatter of the target weed species at crop maturity, enabling its collection and processing at crop harvest. However, seed retention likely is influenced by agroecological and environmental factors. In 2016 and 2017, we assessed seed shatter phenology in thirteen economically important broadleaf weed species in soybean [Glycine max (L.) Merr.] from crop physiological maturity to four weeks after physiological maturity at multiple sites spread across fourteen states in the southern, northern, and mid-Atlantic U.S. Greater proportions of seeds were retained by weeds in southern latitudes and shatter rate increased at northern latitudes. Amaranthus species seed shatter was low (0 to 2%), whereas shatter varied widely in common ragweed (Ambrosia artemisiifolia L.) (2 to 90%) over the weeks following soybean physiological maturity. Overall, the broadleaf species studied shattered less than ten percent of their seeds by soybean harvest. Our results suggest that some of the broadleaf species with greater seed retention rates in the weeks following soybean physiological maturity may be good candidates for HWSC.
In the era of Indigenising the academy, health disciplines like nursing are required to teach Indigenous peoples' health, history and culture in their undergraduate programmes in order to meet national accreditation standards. This inclusion of Indigenous peoples' perspectives within nursing education towards registration thus qualifies respective Indigenous perspectives as legitimate parts of the Australian nursing profession's scope of practice, which may sound like a reason to celebrate. However, caution should be exercised. Indigenous and Western knowledge systems are incommensurable. The practice of defining Indigenous perspectives for placements within curricula could be likened to extractive colonialism. Thus, the commodifying of Indigenous perspectives in creating competitive education products is problematic. As a Meriam and Wuthathi man who grew up in the Zenadth Kes (Torres Straits) now living and working on Turrbul and Yuggera country, and as a nurse academic, being immersed in this space of contentions is my reality. In order to enhance the education preparation of nursing students I teach, while simultaneously protect my embodied Indigenous knowledges and the Indigenous perspectives included in the curricula I teach, I privilege Indigenous ways of knowing, being and doing in my teaching practice. This yarn is about my experience in this cultural interface.
Seed shatter is an important weediness trait on which the efficacy of harvest weed seed control (HWSC) depends. The level of seed shatter in a species is likely influenced by agroecological and environmental factors. In 2016 and 2017, we assessed seed shatter of eight economically important grass weed species in soybean [Glycine max (L.) Merr.] from crop physiological maturity to four weeks after maturity at multiple sites spread across eleven states in the southern, northern, and mid-Atlantic U.S. From soybean maturity to four weeks after maturity, cumulative percent seed shatter was lowest in the southern U.S. regions and increased as the states moved further north. At soybean maturity, the percent of seed shatter ranged from 1 to 70%. That range had shifted to 5 to 100% (mean: 42%) by 25 days after soybean maturity. There were considerable differences in seed shatter onset and rate of progression between sites and years in some species that could impact their susceptibility to HWSC. Our results suggest that many summer annual grass species are likely not ideal candidates for HWSC, although HWSC could substantially reduce their seed output at during certain years.
Information on performance of sequential treatments of quizalofop-P-ethyl with florpyrauxifen-benzyl on rice is lacking. Field studies were conducted in 2017 and 2018 in Stoneville, MS, to evaluate sequential timings of quizalofop-P-ethyl with florpyrauxifen-benzyl included in preflood treatments of rice. Quizalofop-P-ethyl treatments were no quizalofop-P-ethyl; sequential applications of quizalofop-P-ethyl at 120 g ha−1 followed by (fb) 120 g ai ha−1 applied to rice in the 2- to 3-leaf (EPOST) fb the 4-leaf to 1-tiller (LPOST) growth stages or LPOST fb 10 d after flooding (PTFLD); quizalofop-P-ethyl at 100 g ha−1 fb 139 g ha−1 EPOST fb LPOST or LPOST fb PTFLD; quizalofop-P-ethyl at 139 g ha−1 fb 100 g ha−1 EPOST fb LPOST and LPOST fb PTFLD; and quizalofop-P-ethyl at 85 g ha−1 fb 77 g ha−1 fb 77 g ha−1 EPOST fb LPOST fb PTFLD. Quizalofop-P-ethyl was applied alone and in mixture with florpyrauxifen-benzyl at 29 g ai ha−1 LPOST. Visible rice injury 14 d after PTFLD (DA-PTFLD) was no more than 3%. Visible control of volunteer rice (‘CL151’ and ‘Rex’) 7 DA-PTFLD was similar and at least 95% for each quizalofop-P-ethyl treatment. Barnyardgrass control with quizalofop-P-ethyl at 120 fb 120 g ha−1 LPOST fb PTFLD was greater (88%) in mixture with florpyrauxifen-benzyl. The addition of florpyrauxifen-benzyl to quizalofop-P-ethyl increased rough rice yield when quizalofop-P-ethyl was applied at 100 g ha−1 fb 139 g ha−1 EPOST fb LPOST. Sequential applications of quizalofop-P-ethyl at 120 g ha−1 fb 120 g ha−1 EPOST fb LPOST, 100 g ha−1 fb 139 g ha−1 EPOST fb LPOST, or 139 g ha−1 fb 100 g ha−1 EPOST fb LPOST controlled grass weed species. The addition of florpyrauxifen-benzyl was not beneficial for grass weed control. However, because quizalofop-P-ethyl does not control broadleaf weeds, florpyrauxifen-benzyl could provide broad-spectrum weed control in acetyl coenzyme A carboxylase–resistant rice.
Differential tolerance may be observed among rice cultivars with desiccant exposure events during rice reproduction and ripening. Five field studies were established at the Mississippi State University Delta Research and Extension Center in Stoneville, MS, to determine the effects of exposure to sublethal concentrations of common desiccants across multiple rice cultivars. Rice cultivars in the study were ‘CLXL745’, ‘XL753’, ‘CL163’, ‘Rex’, and ‘Jupiter’. Desiccant treatments included no desiccant, paraquat, or glyphosate and were applied at the 50% heading growth stage respective to cultivar. Differential injury estimates among cultivars and desiccant treatments was observed when glyphosate or paraquat was applied at 50% heading. Injury from glyphosate at 50% heading was nondetectable across all cultivars. However, injury following paraquat applications was >7% across all rating intervals and cultivars. Hybrid cultivars exhibited less injury with paraquat applications than the inbred cultivars in the study. Rice following exposure to glyphosate or paraquat at 50% heading growth stage produced rough rice grain yield decreases ranging from 0% to 20% and 9% to 21%, respectively. Rough rice grain yield decreases were observed across all cultivars following paraquat exposure, and all inbred cultivars following glyphosate exposure. Across desiccant treatment, head rice yield was reduced in three of five cultivars in the study. When pooled across cultivar, paraquat applications cause a head rice yield reduction of 10%, whereas rice yield following glyphosate application remained >95%. Although differential tolerance among cultivars to paraquat or glyphosate exposure was observed, impacts on grain quality coupled with yield reductions suggests extreme rice sensitivity to exposure to sublethal concentrations of these desiccants at the 50% heading growth stage.
We investigate the effects of magnetisation on the two-fluid plasma Richtmyer–Meshkov instability of a single-mode thermal interface using a computational approach. The initial magnetic field is normal to the mean interface location. Results are presented for a magnetic interaction parameter of 0.1 and plasma skin depths ranging from 0.1 to 10 perturbation wavelengths. These are compared to initially unmagnetised and neutral fluid cases. The electron flow is found to be constrained to lie along the magnetic field lines resulting in significant longitudinal flow features that interact strongly with the ion fluid. The presence of an initial magnetic field is shown to suppress the growth of the initial interface perturbation with effectiveness determined by plasma length scale. Suppression of the instability is attributed to the magnetic field's contribution to the Lorentz force. This acts to rotate the vorticity vector in each fluid about the local magnetic-field vector leading to cyclic inversion and transport of the out-of-plane vorticity that drives perturbation growth. The transport of vorticity along field lines increases with decreasing plasma length scales and the wave packets responsible for vorticity transport begin to coalesce. In general, the two-fluid plasma Richtmyer–Meshkov instability is found to be suppressed through the action of the imposed magnetic field with increasing effectiveness as plasma length scale is decreased. For the conditions investigated, a critical skin depth for instability suppression is estimated.
The final 10 Myr of the Paleozoic saw two of the biggest biological crises in Earth history: the middlePermian extinction (often termed the Guadalupian–Lopingian extinction [GLE]) that was followed 7–8 Myr later by Earth's most catastrophic loss of diversity, the Permian–Triassic mass extinction (PTME). These crises are not only manifest as sharp decreases in biodiversity and—particularly for the PTME—total ecosystem collapse, but they also drove major changes in biological morphological characteristics such as the Lilliput effect. The evolution of test size among different clades of foraminifera during these two extinction events has been less studied. We analyzed a global database of foraminiferal test size (volume) including 20,226 specimens in 464 genera, 98 families, and 9 suborders from 632 publications. Our analyses reveal significant reductions in foraminiferal mean test size across the Guadalupian/Lopingian boundary (GLB) and the Permian/Triassic boundary (PTB), from 8.89 to 7.60 log10 μm3 (lg μm3) and from 7.25 to 5.82 lg μm3, respectively. The decline in test size across the GLB is a function of preferential extinction of genera exhibiting gigantism such as fusulinoidean fusulinids. Other clades show little change in size across the GLB. In contrast, all Lopingian suborders in our analysis (Fusulinina, Lagenina, Miliolina, and Textulariina) experienced a significant decrease in test size across the PTB, mainly due to size-biased extinction and within-lineage change. The PTME was clearly a major catastrophe that affected many groups simultaneously, and the GLE was more selective, perhaps hinting at a subtler, less extreme driver than the later PTME.
Health research remains a vital activity of Indigenous health workforces. This paper reports on the main findings of yarning interviews with 14 Indigenous researchers, that was central to a project analysing the role of research training infrastructures in strengthening the Indigenous health research workforce in Australia. The findings highlighted Indigenous researcher peers as core sources of inspiration, moral support and sustenance in academia and in life. Peer generative power arising from peer groups provide a unique enriching to the educational and research experience. Indigenous researcher peers have a strong shared aspiration to champion change to health research and higher education as a key pathway to widespread positive impacting on health and well-being. We suggest the (revived) development at a collective level of a strategic and planned approach to capitalising on the positive outcomes of peer generated leadership and support.
Guenther and Osborne's (2020) article ‘Did DI do it?’ raises concerns about the outcomes of a programme designed to improve literacy for First Nations students in remote schools. A critique of the article challenges the methods and findings. In this response, the authors respond to the criticism.
The Aboriginal and Torres Strait Islander Health Worker/Practitioner (A&TSIHW) workforce provides not only clinical skills but also responds to specific social and cultural needs of the communities they serve bringing knowledge derived from lived and embodied knowledges. The A&TSIHW is a recognised health professional within the Australian health system; however, this workforce continues to be under-supported, under-recognised and under-utilised. A common discourse in literature written about A&TSIHWs focused on the need to empower and enhance the A&TSIHW capabilities, or rendered the A&TSIHW as part of the problem in improving the health of Indigenous peoples. In contrast, articles written by A&TSIHWs, published in the Aboriginal and Islander Health Worker Journal, tell a different story, one about the limitations of the health system in its ability to care for Indigenous peoples, recognising A&TSIHW leadership. This paper deals with two interrelated tensions—the undervaluing of the A&TSIHW as a clinician and the undervaluing of the A&TSIHW as an academic—both of which the author has had to navigate. It explores the specific challenges of the A&TSIHW academic who too seeks recognition beyond that of ‘assistant’ within the research enterprise, drawing upon personal experiences and engagement with educational institutions, including higher education.
In an article published in this journal, Guenther and Osborne (2020) use data from the reading test of the National Assessment Program for Literacy and Numeracy (NAPLAN) to evaluate the effectiveness of the Flexible Literacy for Remote Primary Schools program in its first 3 years of implementation. However, their analysis has some serious flaws, including that the ‘post-intervention’ data were actually collected from the start of the implementation period. This calls their conclusions that the program was ineffective into question.
The current agenda in public health training in higher education works to produce well-trained public health professionals. Operating within a western pedagogical framework it aims to build a cohort of critical and analytical thinkers, skilful problem solvers and extraordinary communicators across key disciplines in health. Many graduates possess interdisciplinary specialities, skills and knowledge transferable within health and other sectors. Core competencies in the curricula, which notably does not currently include Indigenous health, are considered the foundational platform of theory and practical understandings of public health and the health system. Despite a framework that aims to produce health professionals capable of improving the health of the population as a whole; the lack of engagement with an Indigenous health criticality maintains a longstanding Australian public health tradition of failure when it comes to addressing the health disparities experienced by Indigenous people. As a recent Indigenous public health graduate with practical training and experience working in the public health system, I consider possibilities for decolonising the curricula through an Indigenist approach to health, including theories of transformative learning which could strengthen public health practice and in turn facilitate the changes necessary to improving Indigenous health outcomes.
This is a reflective piece that examines the nature of racial complaint with reference to Dr Kris Rallah-Baker's concerns about the racism that characterised his medical education. It will further examine the anti-racist campaign that sprung up in support of Rallah-Baker with a view to illustrating the limits of conventional critical race theory in understanding the course of events. Using the work of Aileen Moreton-Robinson, Gramsci and Stuart Hall, it will be argued that the Rallah-Baker case illustrates that Australian hegemonic formations can never quite command total legitimacy because sovereign formations, anti-racist in outlook, erupt with a frequency and facticity that lay bare the conceit of settler-colonialism. In so doing the paper will work towards an understanding of the critical Indigenous/race paradigm that goes beyond critical race insights borne of other places and experiences. As will be seen, what followed Rallah-Baker's complaint, the campaign that supported him and the concessions finally won was not, as critical race theory is wont to claim, a case simply of ‘interest convergence’; rather it was, I propose, an example of ‘sovereign divergence’.
This study takes a retrospective look at the educational experiences of Indigenous health professionals who graduated from The University of Queensland's Indigenous Health Program between 1994 and 2005, to understand the enablers for growing an Indigenous health workforce capable of advancing the health of Indigenous peoples. Drawing on the qualitative accounts of 31 students and 9 staff members, this paper examines the enablers to educational success at this time, juxtaposed against current Indigenising agendas in higher education, of aspiration and capacity building alongside the task of embedding Indigenous knowledges within curricula. We look back not as a call to return to Indigenous-specific cohort courses but rather reconsider both the measures of and strategies for success in Indigenous higher education, within health and beyond, interrogating the ideological assumptions that inform them.