A new engineering course at a large land-grant university seeks to introduce non-engineers to the profession via a combination of artistic endeavors, social science analyses, engineering design thinking, and community practice. The course introduces a new concept, "citizen engineering," borrowed from a tradition of citizen science in which community members ("non-experts") identify scientific questions and proceed through a formal process, such as participatory action research, to seek answers to their questions by defining and driving their own processes of inquiry and analysis, sometimes but not always with the cooperation of trained scientists.The course first introduces multiple definitions of engineering and citizenship for critical discussion, develops the idea of citizen engineering from citizen science, and then proceeds to a unit on Making where students ponder through examination of examples from art exhibits and popular media what kinds of activities might constitute Making, and which might constitute citizen engineering, and why. The students engage in various Making activities including a short project in which they design and build prototypes of an artifact to improve dorm life. After this, students gain an introduction to engineering studies through analysis of the co-construction of technology and society, and through examining the roles of citizens in large engineering projects such as nuclear power or gas pipelines. Throughout the course there is an underlying argument that non-engineers can and should engage engineering, problematizing the notion of engineering expertise as unique. A series of short essays encourage students to analyze engineering as a profession and consider their own roles as citizen engineers with the power to intervene as nonexperts in engineering activities that impact society.In this first iteration of the course, one of the authors served as a participant-observer and ethnographer focused on student learning. The observer witnessed student engagement with course topics and with one another, and interviewed all the students in the class (n=5) individually. Using the observer's analysis of his observation notes and interview responses, and using the instructors' analysis of student work and course feedback, we reflect on the outcomes of this first iteration of the course and consider avenues for improvement.Although the course was designed for non-engineers and particularly students outside of STEM fields, those who enrolled for this iteration were three seniors majoring in the sciences, and three first year students who intend to major in engineering but are not yet admitted to the engineering college. This population of students struggled with critical analysis and in particular with the central argument of the course that engineering ought to be democratized, that non-engineers can make crucial contributions that improve engineering practice and hold engineering accountable for its roles in society. Improved reading selection, better scaffolding for more challe...
Definitions of engineering literacy, as a concept, revolve around abilities and awarenesses those who are engineering literate have. From the National Assessment Governing Board (NAGB), engineering literacy is "the ability to solve problems and accomplish goals by applying the engineering design process."1 Or, from John Heywood, it "requires that we understand how individual's [sic], organizations and society interact with technology, and this requires an appreciation of the values we bring to that understanding." 2 These definitions work together to provide a fuller notion of engineering literacy, as recognizing the fact of it as well as why it is necessary give us reason and means to becoming engineering literate.Adapting from definitions of technological literacy, from Gramire and Pearson, engineering literacy is, at its core, a broad appreciation of what engineering is.3 Though not an exhaustive comprehension, engineering literacy develops citizens through their participation in a culture and society that depends on engineering projects. Engineering literate persons function fully within such a society, participating in engineering projects not only insofar as engineering training is required, but also in recognition of the broader social impact of those projects.In previous work in engineering literacy, we identified four major factors as significant in self-assessments of engineering literacy: Basic knowledge of engineers and engineering, Impacts of engineering on human life, Thinking and acting like an engineer, and Basic skills in the use of technology. 4 We used these factors to develop a survey that has measured students' perceptions of their own engineering literacy.Our 2015 study in engineering literacy revealed that student perceptions of their own knowledge, skills, and perceptions of the impact of engineers and ways of thinking and acting, were relatively stable across dimensions of gender, ethnicity, degree progress, and curricular focus. 4 The survey used for the study resulted in several conclusions, which acknowledged little to no meaningful differences across these dimensions. The most significant conclusion drawn, though, was this absence of meaningful difference between students in engineering courses of study and students in non-engineering programs.Despite these small differences, we believed that conversations with individual students could yield deeper insights into how students perceive their engineering literacy. We expanded our research through observing a course aimed, in part, at introducing and increasing students' information literacy, as well as interviewing the students in that course.The rationale for engaging in a qualitative study was simple: though surveys reveal general trends and paint broad pictures with regards to a particular set of questions, interviews could provide more detail as to experiences and thought processes of individuals. Aim of StudyThe aim of this study, then, was to clarify how undergraduate students' engineering literacy developed over the course of a ...
Body dysmorphic disorder (BDD) is a rare disease. Although described in the last century it was only recently classified in the DSM-IV. BDD is characterized by an excessive concern about an imagined deformity of the body. Establishing the diagnosis of BDD remains to be demanding, yet of utmost importance for the surgeon. Only a timely diagnosis will prevent dissatisfaction of both the patient and the surgeon. In this article, strategies to cope with such patients after diagnosis are described.
Objectives: Complications in instrumental spinal surgeries (ISS) pose a considerable burden on patients. Necessary reoperations are associated with significant resource utilization and cost and from the perspective of the German Statutory Health Insurance (SHI). Dependable data on the frequency of reoperations and associated costs are lacking for Germany. The aim of this study was to estimate the incidence of ISS and consecutive reoperations, and to calculate the related costs. MethOds: We conducted a retrospective claims data analysis using the Health Risk Institute research database, which contains anonymized claims data and covers approximately 5.42% of the German population. The study period comprised 01 January 2009 to 31 December 2011. An algorithm of operation and procedure codes (OPS) identified primary ISS and following reoperations. Reoperation rates were calculated for an individual period of 12 months after the primary ISS in 2010. Annual costs for reoperations were calculated based on group comparison of patients with reoperation and those without reoperation (control group). Existing differences in cost levels in the year before the primary ISS were adjusted by the difference in differences approach. Results: A total of 3,316 individuals had a primary ISS in 2010. The reoperation rate was 9.98% (95% CI = 8.98% to 11.02%). Mean cost per ISS was € 11,331 for all patients (€ 13,358 reoperation group, € 11,106 control group). The mean adjusted annual cost for a reoperation was € 11,370, with € 8,432 directly attributed to the reoperation procedure and € 2,938 to excess costs in the first year after the primary ISS. cOnclusiOns: The direct cost of ISS has a significant impact on health insurance budgets. With 10% of primary ISS patients requiring a reoperation in Germany, their associated annual costs are relevant from the SHI perspective. As demonstrated elsewhere, these cost might be partly avoidable by using intra-operative 3-D imaging with navigation.Objectives: This study aims to estimate the incidence and costs of osteoporotic fractures in The Netherlands in 2010 and project them to 2030. MethOds: The incidence and health care costs of fractures were derived from claims data of all health care insurers in The Netherlands. We obtained 5-year age-and gender-specific costs of patients with and without fractures. Cost included hospital admission, physical therapy, occupational therapy, general practitioner and medication. In order to attribute fractures to osteoporosis we used a large dataset from a general hospital that included patients with a fracture screened with Dexa scan. Future projections were based on four different scenarios: 1. demographic scenario, 2. demographic+trend in incidence scenario, 3. demographic+trend in incidence+trend in cost scenario, and 4. increased treatment scenario. Results: Of all registered fractures 32% could be attributed to osteoporosis. In women this percentage was larger than in men (36 versus 21 %). This resulted in an incidence for all osteoporotic fractures of ...
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