Morrongiello, Barbara A; Pickett, William; Berg, Richard L; Linneman, James G; Brison, Robert J; Marlenga, Barbara
Appropriate supervision is recommended as a strategy to prevent pediatric farm injuries, yet virtually nothing is known about the quality of adult supervision on farms. We therefore explored the nature of adult supervision among pediatric farm injury cases using three theoretically relevant dimensions of supervision: (1) attention, (2) proximity, and (3) continuity. We examined a retrospective case series of 334 pediatric farm injury cases from Canada and the United States that resulted in death or required hospitalization. Patterns of supervision were coded according to the three dimensions. Approximately two-thirds of the injured children (231/334; 69%) had an adult supervisor available (attention). The supervisor was in close proximity of the child in only about half the cases (169/334; 51%) and it was even less common for the supervision to be continuous (37%). Thus, many injuries occurred when children were inadequately supervised. However, approximately one-third of the injured children (112/334; 34%) had what in other circumstances would be considered adequate adult supervision at the time of their injury event, defined theoretically as having supervision available, proximal, and continuous. Yet, children on farms were injured even in the presence of adequate adult supervision. These findings, along with a growing body of literature examining pediatric farm injuries, suggest a need to develop a new definition of adequate adult supervision within the context of the agricultural work environment, or to consider restricting the access of children, especially the very young, to this hazardous worksite. PMID:18460383
Westefeld, John S.
Current models and issues related to psychotherapy supervision are examined. These include ethical and legal issues, problems of interpersonal competence, and multicultural issues. As a part of this analysis, interviews about supervision with five prominent counseling psychologists are included to provide their perspectives. Implications for the…
Objective/Background: For decades, across almost every training site, clinical supervision has been considered "central to the development of skills" in psychiatry. The crucial supervisor/supervisee relationship has been described extensively in the literature, most often framed as a clinical apprenticeship of the novice to the master craftsman.…
Oldfield, Benjamin J; Stewart, Rosalyn W
Although the provision of immunoprophylaxis to children has become routine in the practice of pediatric preventive care, the same is not true in adult primary care. Contributing to this problem is a lack of knowledge among providers of adult preventive care. This review aimed to bolster providers' understanding of adult vaccinations by highlighting changes in vaccination recommendations and addressing common knowledge gaps. This is not a comprehensive list of vaccination recommendations, but rather the "top 10" common misconceptions, advancements, and updates we have found in our reading of the vaccination literature and in our own experience in a training institution. PMID:26840962
Verma, Ramesh; Khanna, Pardeep; Chawla, Suraj
Vaccination is recommended throughout life to prevent infectious diseases and their sequelae. Vaccines are crucial to prevent mortality in that >25% of deaths are due to infections. Vaccines are recommended for adults on the basis of a range of factors. Substantial improvement and increases in adult vaccination are needed to reduce the health consequences of vaccine-preventable diseases among adults. Incomplete and inadequate immunization in India against these communicable diseases results in substantial and unnecessary costs both in terms of hospitalization and treatment. The government of India as well as the World Health Organization (WHO) consider childhood vaccination as the first priority, but there is not yet focus on adult immunization. Adult immunization in India is the most ignored part of heath care services. The Expert Group recommended that data on infectious diseases in India should be updated, refined, and reviewed periodically and published regularly. This group suggested that the consensus guidelines about adult immunization should be reviewed every 3 years to incorporate new strategies from any emerging research from India. There is an immediate need to address the problem of adult immunization in India. Although many issues revolving around efficacy, safety, and cost of introducing vaccines for adults at the national level are yet to be resolved, there is an urgent need to sensitize the health planners as well as health care providers regarding this pertinent issue. PMID:25483654
Planton, Jonathan; Meyer, Jennifer O; Edlund, Barbara J
A goal of primary prevention is to avoid the development of disease. Immunizations are one of several strategies used by clinicians in primary prevention. Influenza and pneumococcal disease--both preventable--cause significant morbidity and mortality in older adults who have an altered immune system, often have several chronic health problems, and are at higher risk for complications. Tetanus, while not as common in older adults, carries a high mortality rate in those 65 and older. These infections are associated with significant disability that results from hospitalizations for congestive heart failure, hip fracture, stroke, and pneumonia. The goal of immunizing older adults is to decrease functional decline and disability, as well as potential hospital admissions linked to these preventable diseases, which often exacerbate underlying health problems. Age-defined recommendations are available to guide clinicians on the appropriate vaccinations and schedules for administration to older adults. PMID:22715960
This brief provides an overview of the knowledge and skills that administrators need in order to support and supervise teachers of adult English language learners. It begins with a review of resources and literature related to teacher supervision in general and to adult ESL education. It continues with information on the background and…
Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian
Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine's report, entitled "Resident duty hours: Enhancing sleep, supervision and safety", published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation's teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release, discussion of the
Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian
Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine’s report, entitled “Resident duty hours: Enhancing sleep, supervision and safety”, published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation’s teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release
Ethridge, Philip A; White, Thomas G
For more than 20 years, lawmakers in Texas acknowledged that offenders with special needs such as the elderly, physically handicapped, and mentally impaired who are housed in the Texas Department of Criminal Justice presented challenges in health care and cost. In response to these perceived needs, the Texas legislature created "medically recommended intensive supervision" (MRIS) to permit the early release of eligible offenders. This article examines how and why the MRIS law was implemented. It also discusses how MRIS is being utilized in Texas. Next, it delineates the MRIS process an offender must endure. The article elaborates on recent legislative attempts to amend the MRIS law. Finally, several conclusions about the use of MRIS in Texas are discussed. PMID:26377383
Preventive Care Recommendations THE BASIC FACTS MULTIPLE SCLEROSIS The Three Most Common Eye Disorders Carlos Healey, diagnosed in 2001 in Multiple Sclerosis Medical checklist: Recommendations: Dates of last & next test ...
This position paper of the International Osteoporosis Foundation makes recommendations for vitamin D nutrition in elderly men and women from an evidence-based perspective. The key recommendations are that the optimal level of 25-hydroxyvitamin D for musculoskeletal health is 75 nmol/L. An intake of ...
Morrow, James R., Jr.; Krzewinski-Malone, Jeanette A.; Jackson, Allen W.; Bungum, Timothy J.; FitzGerald, Shannon J.
Physical inactivity is a major risk factor for cardiovascular disease, stroke, hypertension, diabetes, obesity, osteoporosis, and some cancers. Approximately 950,000 Americans die annually from cardiovascular diseases. The purpose of this study was to determine whether American adults know which traditional and lifestyle physical activities affect…
Even, Mary Jane
Results of a study of supervisory practices among administrators of adult basic education (ABE) programs in Nebraska are reported. Highly significant associations were found between supervisory practices and employee attitudes toward their work, longevity, interest in promotion, productivity, and salary, among others. (TA)
van Rijn, Rogier M; van Os, Anton G; Kleinrensink, Gert-Jan; Bernsen, Roos MD; Verhaar, Jan AN; Koes, Bart W; Bierma-Zeinstra, Sita MA
Background During the recovery period after acute ankle sprain, it is unclear whether conventional treatment should be supported by supervised exercise. Aim To evaluate the short- and long-term effectiveness of conventional treatment combined with supervised exercises compared with conventional treatment alone in patients with an acute ankle sprain. Design Randomised controlled clinical trial. Setting A total of 32 Dutch general practices and the hospital emergency department. Method Adults with an acute lateral ankle sprain consulting general practices or the hospital emergency department were allocated to either conventional treatment combined with supervised exercises or conventional treatment alone. Primary outcomes were subjective recovery (0–10 point scale) and the occurrence of a re-sprain. Measurements were carried out at intake, 4 weeks, 8 weeks, 3 months, and 1 year after injury. Data were analysed using intention-to-treat analyses. Results A total of 102 patients were enrolled and randomised to either conventional treatment alone or conventional treatment combined with supervised exercise. There was no significant difference between treatment groups concerning subjective recovery or occurrence of re-sprains after 3 months and 1-year of follow-up. Conclusion Conventional treatment combined with supervised exercises compared to conventional treatment alone during the first year after an acute lateral ankle sprain does not lead to differences in the occurrence of re-sprains or in subjective recovery. PMID:17925136
Chaudrey, Khadija; Salvaggio, Michelle; Ahmed, Aftab; Mahmood, Sultan; Ali, Tauseef
Treatment regimens for inflammatory bowel disease (IBD) incorporate the use of a variety of immunosuppressive agents that increase the risk of infections. Prevention of many of these infections can be achieved by the timely and judicious use of vaccinations. IBD patients tend to be under-immunized. Some of the contributing factors are lack of awareness regarding the significance of vaccinating IBD patients, misperception about safety of vaccinations in immunocompromised patients, ambiguity about the perceived role of the gastroenterologist in contrast to the primary care physician and unavailability of vaccination guidelines focused on IBD population. In general, immunocompetent IBD patients can be vaccinated using standard vaccination recommendations. However there are special considerations for IBD patients receiving immunosuppressive therapy, IBD travelers and pregnant women with IBD. This review discusses current vaccination recommendations with updates for adult IBD patients. Centers for Disease Control and Prevention 2013 vaccination guidelines with 2014 updates and the Advisory Committee on Immunization Practices recommendations have been highlighted as a primary source of recommendations. PMID:25805924
Rufo, Paul A.; Denson, Lee A.; Sylvester, Francisco A.; Szigethy, Eva; Sathya, Pushpa; Lu, Ying; Wahbeh, Ghassan T.; Sena, Laureen M.; Faubion, William A.
Ulcerative colitis (UC) and Crohn disease (CD), collectively referred to as inflammatory bowel disease (IBD), are chronic inflammatory disorders that can affect the gastrointestinal tract of children and adults. Like other autoimmune processes, the cause(s) of these disorders remain unknown but likely involves some interplay between genetic vulnerability and environmental factors. Children, in particular with UC or CD, can present to their primary care providers with similar symptoms, including abdominal pain, diarrhea, weight loss, and bloody stool. Although UC and CD are more predominant in adults, epidemiologic studies have demonstrated that a significant percentage of these patients were diagnosed during childhood. The chronic nature of the inflammatory process observed in these children and the waxing and waning nature of their clinical symptoms can be especially disruptive to their physical, social, and academic development. As such, physicians caring for children must consider these diseases when evaluating patients with compatible symptoms. Recent research efforts have made available a variety of more specific and effective pharmacologic agents and improved endoscopic and radiologic assessment tools to assist clinicians in the diagnosis and interval assessment of their patients with IBD; however, as the level of complexity of these interventions has increased, so too has the need for practitioners to become familiar with a wider array of treatments and the risks and benefits of particular diagnostic testing. Nonetheless, in most cases, and especially when frequent visits to subspecialty referral centers are not geographically feasible, primary care providers can be active participants in the management of their pediatric patients with IBD. The goal of this article is to educate and assist pediatricians and adult gastroenterology physicians caring for children with IBD, and in doing so, help to develop more collaborative care plans between primary care and
Miller, Wayne C.; Hering, Michelle; Cothran, Carrie; Croteau, Kim; Dunlap, Rebecca
Objective: Examine after-school activity patterns, eating behaviors, and social environment of overweight and normal weight middle school students. Design: Eating and physical activity behaviors of 141 students, ages 10-14, were monitored. Students completed a diary documenting type of activity, location, adult supervision, accompanying…
Laforest, Sophie; Goldin, Benita; Nour, Kareen; Roy, Marie-Andree; Payette, Helene
Nutrition screening and early intervention in home-bound older adults are key to preventing unfavourable health outcomes and functional decline. This pilot study's objectives were (a) to test the reliability of the Elderly Nutrition Screening Tool (ENS [C]) when administered by dietician-trained and supervised nutrition volunteers, and (b) to…
This document addresses the recommendation contained in the 1989 California Strategic Plan for Adult Education for an integrated adult education data system. The recommendation proposes collecting and organizing community adult education information into groups of data on: program services, program delivery, learner characteristics, and learning…
Liacouras, Chris A; Furuta, Glenn T; Hirano, Ikuo; Atkins, Dan; Attwood, Stephen E; Bonis, Peter A; Burks, A Wesley; Chehade, Mirna; Collins, Margaret H; Dellon, Evan S; Dohil, Ranjan; Falk, Gary W; Gonsalves, Nirmala; Gupta, Sandeep K; Katzka, David A; Lucendo, Alfredo J; Markowitz, Jonathan E; Noel, Richard J; Odze, Robert D; Putnam, Philip E; Richter, Joel E; Romero, Yvonne; Ruchelli, Eduardo; Sampson, Hugh A; Schoepfer, Alain; Shaheen, Nicholas J; Sicherer, Scott H; Spechler, Stuart; Spergel, Jonathan M; Straumann, Alex; Wershil, Barry K; Rothenberg, Marc E; Aceves, Seema S
Eosinophilic esophagitis (EoE) is a clinicopathologic condition of increasing recognition and prevalence. In 2007, a consensus recommendation provided clinical and histopathologic guidance for the diagnosis and treatment of EoE; however, only a minority of physicians use the 2007 guidelines, which require fulfillment of both histologic and clinical features. Since 2007, the number of EoE publications has doubled, providing new disease insight. Accordingly, a panel of 33 physicians with expertise in pediatric and adult allergy/immunology, gastroenterology, and pathology conducted a systematic review of the EoE literature (since September 2006) using electronic databases. Based on the literature review and expertise of the panel, information and recommendations were provided in each of the following areas of EoE: diagnostics, genetics, allergy testing, therapeutics, and disease complications. Because accumulating animal and human data have provided evidence that EoE appears to be an antigen-driven immunologic process that involves multiple pathogenic pathways, a new conceptual definition is proposed highlighting that EoE represents a chronic, immune/antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. The diagnostic guidelines continue to define EoE as an isolated chronic disorder of the esophagus diagnosed by the need of both clinical and pathologic features. Patients commonly have high rates of concurrent allergic diatheses, especially food sensitization, compared with the general population. Proved therapeutic options include chronic dietary elimination, topical corticosteroids, and esophageal dilation. Important additions since 2007 include genetic underpinnings that implicate EoE susceptibility caused by polymorphisms in the thymic stromal lymphopoietin protein gene and the description of a new potential disease phenotype, proton pump inhibitor
Pneumococcal Vaccination Recommendations for Children 1 and Adults by Age and/or Risk Factor Routine Recommendations for Pneumococcal Conjugate ... X X X X X 1 For PCV13 vaccination of healthy children, see “Recommen- dations for Pneumococcal ...
Trotman, Adria J.; Taxman, Faye S.
A cognitive-behaviorally based substance abuse treatment program was implemented within a community supervision setting. This program included a goals group that used a contingency management component and included the probation agent as a part of the treatment. In this article, the authors describe the contingency management component of the…
TROTMAN, ADRIA J.; TAXMAN, FAYE S.
A cognitive-behaviorally based substance abuse treatment program was implemented within a Community Supervision setting. This program included a goals group that included a contingency management component and included the probation agent as a part of treatment. This paper describes the contingency management component of the treatment and discusses, in detail, issues that arose throughout the course of the study. Possible causes and solutions to the issues are discussed from a contingency management perspective that can result in improved reinforcements to achieve better probationer outcomes. PMID:22235164
One recommendation of the 1989 California Strategic Plan for Adult Education is the use of EduCard. EduCard, the Adult Education Access Card, is a means of giving learners access to information about educational opportunities and providing administrators with machine-readable information on learners' prior education and traiing. Three models are:…
The issues facing the following areas of adult education in Ireland in the era of lifelong learning were examined in a white paper: (1) second chance and further education; (2) community education; (3) workplace education; and (4) higher education. The Irish National Association of Adult Education (AONTAS) analyzed the recommendations presented in…
Brazelton, G. Blue; Renn, Kristen A.; Stewart, Dafina-Lazarus
In this chapter, the editors provide a summary of the information shared in this sourcebook about the success of students who have minoritized identities of sexuality or gender and offer recommendations for policy, practice, and further research.
National Center for Higher Education Management Systems (NJ1), 2009
With generous support from the Lilly Endowment, the Indiana Chamber has contracted with National Center for Higher Education Management Systems (NCHEMS) to provide a policy framework and specific recommendations for improving the system of adult education and workforce training in Indiana--building on the important initiatives that have already…
Incidence of pediatric inflammatory bowel disease (IBD) is rising. Adult gastroenterologists are seeing increasing numbers of young adults with IBD, a subpopulation with unique needs and challenges that can impair their readiness to thrive in an adult healthcare system. Most adult gastroenterologists might not have the training or resources to address these needs. “Emerging adulthood” is a useful developmental lens through which this group can be studied. With complex disease phenotype and specific concerns of medication side effects and reproductive health, compounded by challenges of geographical and social flux and lack of adequate health insurance, emerging adults with IBD (EAI) are at risk of disrupted care with lack of continuity. Lessons learned from structured healthcare transition process from pediatric to adult services can be applied towards challenges in ongoing care of this population in the adult healthcare system. This paper provides an overview of the challenges in caring for the post transition EAI from the perspective of adult gastroenterologists and offers a checklist of provider and patient skills that enable effective care. This paper discusses the system-based challenges in care provision and search for meaningful patient-oriented outcomes and presents a conceptual model of determinants of continuity of care in this unique population. PMID:26064089
Kimmons, Joel; Gillespie, Cathleen; Seymour, Jennifer; Serdula, Mary; Blanck, Heidi Michels
Context Fruit and vegetable intake is an important part of a healthy diet and is associated with numerous positive health outcomes. MyPyramid provides recommendations for fruit and vegetable consumption based on individual calorie requirements as determined by an individual's age, sex, and physical activity level. Objectives To determine (1) median fruit and vegetable consumption from all dietary sources among adolescent and adult consumers and the percentage of adolescents and adults meeting individual recommended intake levels based on caloric requirements and (2) consumption levels among various demographic groups, intake levels from subtypes of fruits and vegetables, and primary contributors to fruit and vegetable intake. Design Analysis of 2-day, 24-hour recall data from the 2003–2004 National Health and Nutrition Examination Survey (NHANES), a continuous, nationally representative, cross-sectional survey. Results This study included dietary contributions of fruits and vegetables from all dietary sources. Fewer than 1 in 10 Americans meet their calorie-specific MyPyramid fruit or vegetable recommendations. Higher intake was not observed in subgroups with higher recommendations for fruit and vegetable consumption based on caloric requirements. The primary contributors to total fruit intake were whole fruits among adults and fruit juices among adolescents. The largest single contributor to overall fruit intake was orange juice. Potatoes dominated vegetable consumption, particularly among adolescents, in whom fried potatoes increased the median vegetable intake from 0.72 cup to 1.21 cups per day. Dark green and orange vegetables and legumes accounted for a small portion of vegetable intake, and few people met the recommendations. Conclusions Few American adolescents or adults reported consuming the recommended amounts of fruits or vegetables. Increasing consumption will probably require multifaceted approaches that augment educational campaigns with policy and
Marsh, Stephanie R.
Adult development theory can assist supervisors in understanding the needs of staff member sin various stages on their psychosocial and career development. A chart was created that identifies developmental tasks or challenges many student affairs professionals face during their working lives, and approaches supervisors may use to assist staff in…
Verver, Didi; Merten, Hanneke; Robben, Paul; Wagner, Cordula
Introduction The Dutch healthcare inspectorate (IGZ) supervises the quality and safety of healthcare in the Netherlands. Owing to the growing population of (community dwelling) older adults and changes in the Dutch healthcare system, the IGZ is exploring new methods to effectively supervise care networks that exist around frail older adults. The composition of these networks, where formal and informal care takes place, and the lack of guidelines and quality and risk indicators make supervision complicated in the current situation. Methods and analysis This study consists of four phases. The first phase identifies risks for community dwelling frail older adults in the existing literature. In the second phase, a qualitative pilot study will be conducted to assess the needs and wishes of the frail older adults concerning care and well-being, perception of risks, and the composition of their networks, collaboration and coordination between care providers involved in the network. In the third phase, questionnaires based on the results of phase II will be sent to a larger group of frail older adults (n=200) and their care providers. The results will describe the composition of their care networks and prioritise risks concerning community dwelling older adults. Also, it will provide input for the development of a new supervision framework by the IGZ. During phase IV, a second questionnaire will be sent to the participants of phase III to establish changes of perception in risks and possible changes in the care networks. The framework will be tested by the IGZ in pilots, and the researchers will evaluate these pilots and provide feedback to the IGZ. Ethics and dissemination The study protocol was approved by the Scientific Committee of the EMGO+institute and the Medical Ethical review committee of the VU University Medical Centre. Results will be presented in scientific articles and reports and at meetings. PMID:26307619
Vatanparast, Hassanali; Dolega-Cieszkowski, Jadwiga H; Whiting, Susan J
The objective of this study was to determine trends in calcium intake from foods of Canadian adults from 1970-1972 to 2004. We compiled the calcium intake of adults (aged >or=19 years) from foods from Nutrition Canada (1970-1972; n = 7036); 9 provincial nutrition surveys (1990-1999; n = 16 915); and the 2004 Canadian Community Health Survey 2.2 (n = 20 197). Where possible, we used published confidence intervals to test for significant differences in calcium intake. In 2004, the mean calcium intake of Canadians was below Dietary Reference Intake recommendations for most adults, with the greatest difference in older adults (>or=51 years), in part because the recommended calcium intake for this group is higher (1200 mg) than that for younger adults (1,000 mg). The calcium intake of males in every age category was greater than that of females. Calcium intake increased from 1970 to 2004, yet, despite the introduction of calcium-fortified beverages to the market in the late 1990s, increases in calcium intake between 1970 and 2004 were modest. Calcium intakes in provinces were mostly similar in the 1990s and in 2004, except for women in Newfoundland and Labrador, who consumed less, especially in the 1990s, and for young men in 2004 in Prince Edward Island, who consumed more. When supplemental calcium intake was added, mean intakes remained below recommended levels, except for males 19-30 years, but the prevalence of adequacy increased in all age groups, notably for women over 50 years. The calcium intake of Canadian adults remains in need of improvement, despite fortification and supplement use. PMID:19370049
Kim, David K; Bridges, Carolyn B; Harriman, Kathleen H
In October 2015, the Advisory Committee on Immunization Practices (ACIP)* approved the Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2016. This schedule provides a summary of ACIP recommendations for the use of vaccines routinely recommended for adults aged 19 years or older in two figures, footnotes for each vaccine, and a table that describes primary contraindications and precautions for commonly used vaccines for adults. Although the figures in the adult immunization schedule illustrate recommended vaccinations that begin at age 19 years, the footnotes contain information on vaccines that are recommended for adults that may begin at age younger than age 19 years. The footnotes also contain vaccine dosing, intervals between doses, and other important information and should be read with the figures. PMID:26845417
Rostain, Anthony L
Attention-deficit/hyperactivity disorder (ADHD) is associated with impairments in educational, occupational, neuropsychological, and social functioning in adults. Successful diagnosis and treatment of the disorder in adults can be a challenge because recent and integrative clinical guidelines are lacking and diagnostic criteria are based on making a retrospective diagnosis of childhood-onset ADHD. To develop evidence-based recommendations for the treatment of ADHD in adults, the scientific literature was reviewed, including primary clinical studies, meta-analyses, and available clinical guidelines. Studies show that stimulant therapy is highly effective and safe in the management of ADHD in adults, with similar response rates to those reported in children at doses that are equivalent on a mg/kg basis. Long-acting stimulants, such as OROS methylphenidate (OROS MPH, Concerta), dexmethylphenidate (d-MPH, Focalin), and mixed amphetamine salts extended release (MAS XR, Adderall XR), have durations of action of up to 10 to 12 hours, which permit once-daily dosing. For adults with ADHD who do not respond to stimulant therapy or who have a comorbid condition in which a stimulant is contraindicated, the nonstimulant atomoxetine (Strattera) may be an appropriate alternative. For many adults, cognitive-behavioral therapy in addition to pharmacotherapy may improve treatment response. Attention-deficit/hyperactivity disorder medications may increase blood pressure and heart rate in adults, so patients should be monitored. PMID:18824823
Al Khaja, Khalid A J; Sequeira, Reginald P; Alkhaja, Alwaleed K; Damanhori, Awatif H H
This review evaluates the guideline recommendations for the management of hypertension in pregnancy as presented by 25 national/international guidelines developed for the management of arterial hypertension in adults. There is a general consensus that oral α-methyldopa and parenteral labetalol are the drugs of choice for nonsevere and severe hypertension in pregnancy, respectively. Long-acting nifedipine is recommended by various guidelines as an alternative for first-line and second-line therapy in nonsevere and severe hypertension. The safety of β-blockers, atenolol in particular, in early and late stages of pregnancy is unresolved; their use is contraindicated according to several guidelines. Diuretic-associated harmful effects on maternal and fetal outcomes are controversial: their use is discouraged in pregnancy. It is important to develop specific guidelines for treating hypertension in special groups such as adult females of childbearing age and sexually active female adolescents to minimize the risk of adverse effects of drugs on the fetus. In several guidelines, the antihypertensive classes, recommended drug(s), intended drug formulation, and route of administration are not explicit. These omissions should be addressed in future guideline revisions in order to enhance the guidelines' utility and credibility in clinical practice. PMID:24384846
Musher, Daniel M; Rodriguez-Barradas, Maria B
The Advisory Committee on Immunization Practices of the US Centers for Disease Control (ACIP) has recently recommended the 13-valent protein-conjugate pneumococcal vaccine (PCV13) for routine use in adults age 18-65 who have immunocompromising conditions as well as in all adults over the age of 65. By comparison to 23-valent pneumococcal polysaccharide vaccine (PPSV23), antibody responses to PCV13 are similar or modestly better one month after vaccination. The implication that PCV13 will provide more persistent immunity has been disproven; 12 months later, recipients of PPSV23 or PCV13 have identical anti-pneumococcal activity. The theoretical concept that a protein-based vaccine will be followed by a booster effect when pure polysaccharide antigens are administered is based on remarkably little evidence. The strongest objection to the current recommendations is that, since PCVs stimulate mucosal antibodies, the widespread use of these PCVs has led to a near-disappearance of vaccine serotypes from the population. This phenomenon has been amply documented for PCV7, and PCV13 is well on its way to doing the same. Thus, as US physicians are convincing their adult patients to receive 2 "pneumonia shots" instead of one, the use of PCV13 in the USA is rapidly becoming irrelevant. PMID:26606172
Levy, Bruno; Bastien, Olivier; Karim, Bendjelid; Benjelid, Karim; Cariou, Alain; Chouihed, Tahar; Combes, Alain; Mebazaa, Alexandre; Megarbane, Bruno; Plaisance, Patrick; Ouattara, Alexandre; Spaulding, Christian; Splaulding, Christian; Teboul, Jean-Louis; Vanhuyse, Fabrice; Boulain, Thierry; Kuteifan, Kaldoun
Unlike for septic shock, there are no specific international recommendations regarding the management of cardiogenic shock (CS) in critically ill patients. We present herein recommendations for the management of cardiogenic shock in adults, developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of the French-Language Society of Intensive Care (Société de Réanimation de Langue Française (SRLF)), with the participation the French Society of Anesthesia and Intensive Care (SFAR), the French Cardiology Society (SFC), the French Emergency Medicine Society (SFMU), and the French Society of Thoracic and Cardiovascular Surgery (SFCTCV). The recommendations cover 15 fields of application such as: epidemiology, myocardial infarction, monitoring, vasoactive drugs, prehospital care, cardiac arrest, mechanical assistance, general treatments, cardiac surgery, poisoning, cardiogenic shock complicating end-stage cardiac failure, post-shock treatment, various etiologies, and medical care pathway. The experts highlight the fact that CS is a rare disease, the management of which requires a multidisciplinary technical platform as well as specialized and experienced medical teams. In particular, each expert center must be able to provide, at the same site, skills in a variety of disciplines, including medical and interventional cardiology, anesthesia, thoracic and vascular surgery, intensive care, cardiac assistance, radiology including for interventional vascular procedures, and a circulatory support mobile unit. PMID:26152849
Kim, Dae Hyun; Schneeweiss, Sebastian
Purpose Geriatric frailty is a common syndrome of older adults that is characterized by increased vulnerability to adverse health outcomes and influences treatment choice. Pharmacoepidemiologic studies in older adults that rely on administrative claims data are limited by confounding due to unmeasured frailty. A claim-based frailty score may be useful to minimize confounding by frailty in such databases. We provide an overview of definitions and measurement of frailty, evaluated the claim-based models of frailty in literature, and recommend ways to improve frailty adjustment in claims analysis. Methods We searched MEDLINE and EMBASE from inception to April 2014, without language restriction, to identify claim-based multivariable models that predicted frailty or its related outcome, disability. We critically appraised their approach, including population, predictor selection, outcome definition, and model performance. Results Of 152 reports, three models were identified. One model that predicted poor functional status using health care service claims in a representative sample of community-dwelling and institutionalized older adults showed an excellent discrimination (C statistic, 0.92). The other two models that predicted disability using either diagnosis codes or prescription claims alone in institutionalized or frail adults had limited generalizability and modest model performance. None of the models have been applied to reduce confounding bias in pharmacoepidemiologic studies of drug therapy. Conclusions We found little research conducted on development and application of a claim-based frailty index for confounding adjustment in pharmacoepidemiologic studies in older adults. More research is needed to advance this innovative, potentially useful approach by incorporating the expertise from aging research. PMID:24962929
Rokach, Lior; Maimon, Oded
This chapter summarizes the fundamental aspects of supervised methods. The chapter provides an overview of concepts from various interrelated fields used in subsequent chapters. It presents basic definitions and arguments from the supervised machine learning literature and considers various issues, such as performance evaluation techniques and challenges for data mining tasks.
Kiddle, Henry; Schem, Alexander
Proper supervision has been a concern of those responsible for education for many years. The 100-year-old definition used here may help us gain some insights regarding our sophistication and/or needs in the important area of supervision. (Editor/RK)
Sexton, Patrick; Levy, Linda S.; Willeford, K. Sean; Barnum, Mary G.; Gardner, Greg; Guyer, M. Susan; Fincher, A. Louise
Objective: The primary objective of this paper is to present the evolution, purpose, and definition of direct supervision in the athletic training clinical education. The secondary objective is to briefly present the factors that may negatively affect the quality of direct supervision to allow remediation and provide higher quality clinical…
Jimenez-Trujillo, Isabel; Jiménez-García, Rodrigo; Esteban-Hernández, Jesus; Hernández-Barrera, Valentin; Carrasco Garrido, Pilar; Salinero-Fort, Miguel A.; Cardenas-Valladolid, Juan; López-de-Andrés, Ana
Objective This study aims to describe adherence to seven clinical preventive services among Spanish adults with diabetes, to compare adherence with people without diabetes and to identify predictor of adherence to multiple practices among adults with diabetes. Design Cross-sectional study based on data obtained from the European Health Survey for Spain 2009 and the Spanish National Health Survey 2011. We analyzed those aged 40-69 years (n= 20,948). Diabetes status was self-reported. The study variables included adherence to blood pressure (BP) checkup, cholesterol measurement, influenza vaccination, dental examination, fecal occult blood test (FOBT), mammography and cytology. Independent variables included socio-demographic characteristics, variables related to health status and lifestyle factors. Results The study sample included 1,647 subjects with diabetes and 19,301 without. Over 90% had measured their BP and cholesterol in the last year, 44.4% received influenza immunization, 36.4% had a dental checkup within the year and only 8.1% underwent a FOBT. Among diabetic women 75.4% had received a mammography and 52.4% a cytology in the recommended periods. The adherence to BP and cholesterol measurements and influenza vaccination was significantly higher among those suffering diabetes and cytology and dental checkup were lower. Only 63.4% of people with diabetes had fulfilled half or more of the recommended practices. Female sex, higher educational level, being married or cohabiting, higher number of chronic conditions and number of physician visits increased the adherence to multiple preventive practices. For each unhealthy lifestyle reported the probability of having a higher adherence level decreased. Conclusions Acceptable adherence is found for BP and cholesterol checkups and mammography. Unacceptably low rates were found for influenza vaccine, dental care, cytology and FOBT. Moreover, preventive services are provided neither equitably nor efficiently so future
Hulya, Tuna Donat; Sevi, Yeşilyaprak Subasi Sevgi; Serap, Acar; Ayse, Ozcan Edeer
[Purpose] This study determined the effects of age, gender, and participation on the benefits of a 6-month supervised exercise program on older adults. [Subjects and Methods] Eighty-five (37 women, 48 men) community-dwelling older adults participated. The chair sit-and-reach test, the 8-foot up-and-go test, the 6-minute walk test, the Berg Balance Scale, lower-body flexibility, dynamic balance, aerobic endurance, balance, metabolic rate, muscle strength, and position sense were evaluated. Repeated-measures of analysis of variance was performed including dependent variables of age, gender, and participation in the exercise program as dependent inter-subject factors and time of assessment as an intra-subject factor. [Results] Mean exercise participation was 29.88 ± 1.29 sessions. Flexibility, balance, position sense, and strength showed a significant main effect of time. There was a significant gender interaction for right shoulder flexion strength and knee extension strength, a significant gender-participation interaction for pre-/post-intervention measures of functional mobility, and a significant age-participation interaction for flexibility. [Conclusion] Exercise training improved outcomes after 6 months of supervised exercise, but the changes were similar regardless of participation level. Changes in strength were more pronounced in men than women. PMID:26157233
Langerhans Cell Histiocytosis (LCH) is an orphan disease of clonal dendritic cells which may affect any organ of the body. Most of the knowledge about the diagnosis and therapy is based on pedriatic studies. Adult LCH patients are often evaluated by physicians who focus on only the most obviously affected organ without sufficient evaluation of other systems, resulting in patients being underdiagnosed and/or incompletely staged. Furthermore they may be treated with pediatric-based therapies which are less effective and sometimes more toxic for adults. The published literature on adult LCH cases lacks a comprehensive discussion on the differences between pediatric and adult patients and there are no recommendations for evaluation and comparative therapies. In order to fill this void, a number of experts in this field cooperated to develop the first recommendations for management of adult patients with LCH. Key questions were selected according to the clinical relevance focusing on diagnostic work up, therapy, and follow up. Based on the available literature up to December 2012, recommendations were established, drafts were commented by the entire group, and redrafted by the executive editor. The quality of evidence of the recommendations is predominantly attributed to the level of expert opinion. Final agreement was by consensus. PMID:23672541
Karimi, Roxanne; Silbernagel, Susan; Fisher, Nicholas S; Meliker, Jaymie R
Mercury (Hg) exposure from seafood continues to be a public health concern due to health effects from elevated exposure, increasing worldwide seafood consumption, and continued Hg inputs into the environment. Elevated Hg exposure can occur in populations with specialized diets of sport-caught freshwater fish. However, we need a better understanding of Hg exposure from seafood, the most common exposure source, and from specific seafood types. We examined Hg exposure in avid seafood consumers, and the seafood items and consumption frequency that confer the largest Hg exposure. Adult, avid seafood consumers, in Long Island, NY, USA, with blood total Hg concentrations predicted to exceed the USEPA reference concentration that is considered safe (5.8 μg L(-1)), were eligible for the study; 75% of self-reported avid seafood consumers were eligible to participate. We measured blood total Hg concentrations and seafood consumption in 285 participants. We examined relationships between Hg and seafood consumption using multiple linear regression. Seafood consumption rate for our population (14.4 kg yr(-1)) was >2 times that estimated for the U.S. (6.8 kg yr(-1)), and lower than the worldwide estimate (18.4 kg yr(-1)). Mean blood Hg concentration was 4.4 times the national average, and 42% of participants had Hg concentrations exceeding 5.8 μg L(-1). Elevated Hg exposures occurred at all seafood consumption frequencies, including the recommended frequency of 2 meals per week. Blood Hg concentrations were positively associated with weekly tuna steak or sushi intake (β=6.30 change in blood Hg, μg L(-1)) and monthly (β=2.54) or weekly (β=9.47) swordfish, shark or marlin intake. Our findings show that seafood consumers in this population have elevated Hg exposures even at relatively low seafood consumption rates that are at or below current dietary recommendations. Further study should examine health risks and benefits of avid seafood consumption, and consider modifying
System Development Corp., Falls Church, VA.
The aims of this project have been to collect and analyze information on existing Adult Basic Education (ABE) programs, to identify types of programs which are successful in job-related settings, and to recommend promising new models for job-related ABE. Eighty programs were selected as possible for the study. When it was found impossible to…
de Souto Barreto, Philipe; Morley, John E; Chodzko-Zajko, Wojtek; H Pitkala, Kaisu; Weening-Djiksterhuis, Elizabeth; Rodriguez-Mañas, Leocadio; Barbagallo, Mario; Rosendahl, Erik; Sinclair, Alan; Landi, Francesco; Izquierdo, Mikel; Vellas, Bruno; Rolland, Yves
A taskforce, under the auspices of The International Association of Gerontology and Geriatrics-Global Aging Research Network (IAGG-GARN) and the IAGG European Region Clinical Section, composed of experts from the fields of exercise science and geriatrics, met in Toulouse, in December 2015, with the aim of establishing recommendations of physical activity and exercise for older adults living in long-term care facilities (LTCFs). Due to the high heterogeneity in terms of functional ability and cognitive function that characterizes older adults living in LTCFs, taskforce members established 2 sets of recommendations: recommendations for reducing sedentary behaviors for all LTCF residents and recommendations for defining specific, evidence-based guidelines for exercise training for subgroups of LTCF residents. To promote a successful implementation of recommendations, taskforce experts highlighted the importance of promoting residents' motivation and pleasure, the key factors that can be increased when taking into account residents' desires, preferences, beliefs, and attitudes toward physical activity and exercise. The importance of organizational factors related to LTCFs and health care systems were recognized by the experts. In conclusion, this taskforce report proposes standards for the elaboration of strategies to increase physical activity as well as to prescribe exercise programs for older adults living in LTCFs. This report should be used as a guide for professionals working in LTCF settings. PMID:27012368
Diet quality and physical activity outcome improvements resulting from a church-based diet and supervised physical activity intervention for rural, southern, Africian American adults: Delta Body and Soul III
We assessed the effects of a 6-month, church¬-based, diet and supervised physical activity intervention, conducted between 2011 and ¬2012, on improving diet quality and increasing physical activity of southern, African American adults. Using a quasi¬-experimental design, 8 self-selected, eligible c...
Vinetti, Giovanni; Mozzini, Chiara; Desenzani, Paolo; Boni, Enrico; Bulla, Laura; Lorenzetti, Isabella; Romano, Claudia; Pasini, Andrea; Cominacini, Luciano; Assanelli, Deodato
To evaluate the effects of supervised exercise training (SET) on cardiometabolic risk, cardiorespiratory fitness and oxidative stress status in 2 diabetes mellitus (T2DM), twenty male subjects with T2DM were randomly assigned to an intervention group, which performed SET in a hospital-based setting, and to a control group. SET consisted of a 12-month supervised aerobic, resistance and flexibility training. A reference group of ten healthy male subjects was also recruited for baseline evaluation only. Participants underwent medical examination, biochemical analyses and cardiopulmonary exercise testing. Oxidative stress markers (1-palmitoyl-2-[5-oxovaleroyl]-sn-glycero-3-phosphorylcholine [POVPC]; 1-palmitoyl-2-glutaroyl-sn-glycero-3-phosphorylcholine [PGPC]) were measured in plasma and in peripheral blood mononuclear cells. All investigations were carried out at baseline and after 12 months. SET yielded a significant modification (p < 0.05) in the following parameters: V'O2max (+14.4%), gas exchange threshold (+23.4%), waist circumference (−1.4%), total cholesterol (−14.6%), LDL cholesterol (−20.2%), fasting insulinemia (−48.5%), HOMA-IR (−52.5%), plasma POVPC (−27.9%) and PGPC (−31.6%). After 12 months, the control group presented a V'O2max and a gas exchange threshold significantly lower than the intervention group. Plasma POVC and PGPC were significantly different from healthy subjects before the intervention, but not after. In conclusion, SET was effective in improving cardiorespiratory fitness, cardiometabolic risk and oxidative stress status in T2DM. PMID:25783765
Kaywell, Joan F.
Describes a seven-step process that uses young adult literature to help teenagers understand and deal with their troubles. Offers brief annotations of five young adult titles in each of nine areas: alienation and identity; divorce; dropouts, delinquency, and gangs; poverty; teenage pregnancy; abused children; alcohol and drugs; homosexuality; and…
Ministry of Education and Culture, Jerusalem (Israel).
ADULT EDUCATION IN ISRAEL IS UNDER THE SUPERVISION OF THE CULTURAL DEPARTMENT, WHICH RECOMMENDS TEACHERS AND LECTURERS AND IS RESPONSIBLE FOR INSPECTION AND FINANCIAL SUPPORT. STUDENT FEES ARE COLLECTED LOCALLY. PREVIOUSLY DEVOTED TO JEWISH TOPICS AND HEBREW LANGUAGE, THE PROGRAM HAS BEEN EXPANDED TO INCLUDE FORMAL SECONDARY EDUCATION, HUMANITIES,…
Barret, Robert L.; Schmidt, John J.
Explores issues related to school counselor certification and supervision. Recommends actions to clarify the professional identity of school counselors and contribute to appropriate definitions and descriptions of counselor supervision. (Author)
Collins, Vickie L.
This edition is an annotated list of 390 literacy materials for adult new readers. All the materials are written on an eighth-grade level or below. These paperback instructional titles, many in workbook format, are for use with adult basic education (ABE) and English-as-a-Second-Language (ESL) students. The introduction includes guidelines for…
Gibbins, Christopher; Weiss, Margaret
Attention-deficit/hyperactivity disorder (ADHD) is a lifelong neurodevelopmental disorder in which approximately two thirds of patients experience impairment in adulthood. Although some adults with ADHD were diagnosed as children, many are first diagnosed as adults. This poses particular challenges given the limited familiarity with ADHD of many adult mental health services. As a result, several organizations, including the Canadian ADHD Resource Alliance, the American Academy of Child and Adolescent Psychiatry, the National Institutes of Health, and the British Association for Psychopharmacology, have developed practice guidelines for the assessment and treatment of adults with ADHD. This article reviews those guidelines in order to examine current best practices in adult ADHD. There is considerable agreement among these guidelines, which should be a critical part of moving from emerging knowledge to patient care, although both empirical evaluation and ongoing updates as new knowledge emerges will be important for their future development. PMID:17915083
Introduction The purpose of this research is to provide recommendations for the management of glycemic control in critically ill patients. Methods Twenty-one experts issued recommendations related to one of the five pre-defined categories (glucose target, hypoglycemia, carbohydrate intake, monitoring of glycemia, algorithms and protocols), that were scored on a scale to obtain a strong or weak agreement. The GRADE (Grade of Recommendation, Assessment, Development and Evaluation) system was used, with a strong recommendation indicating a clear advantage for an intervention and a weak recommendation indicating that the balance between desirable and undesirable effects of an intervention is not clearly defined. Results A glucose target of less than 10 mmol/L is strongly suggested, using intravenous insulin following a standard protocol, when spontaneous food intake is not possible. Definition of the severe hypoglycemia threshold of 2.2 mmol/L is recommended, regardless of the clinical signs. A general, unique amount of glucose (enteral/parenteral) to administer for any patient cannot be suggested. Glucose measurements should be performed on arterial rather than venous or capillary samples, using central lab or blood gas analysers rather than point-of-care glucose readers. Conclusions Thirty recommendations were obtained with a strong (21) and a weak (9) agreement. Among them, only 15 were graded with a high level of quality of evidence, underlying the necessity to continue clinical studies in order to improve the risk-to-benefit ratio of glucose control. PMID:20840773
Stepping Up to the Future: Adult Literacy Challenges at Work, at Home, and in the Maryland Community. Findings and Recommendations from the 2005 Superintendent's Panel on Excellence in Adult Education
Maryland State Department of Education, 2005
This report outlines a series of findings and recommendations that illustrate both educational and economic implications for the state and its local communities. The Superintendent's Panel on Excellence in Adult Education recommends a 95% increase in the state's support of adult education and a 70% increase in local support. There are significant…
The Literacy Connection: Improving Adult Literacy in New Jersey. Report and Recommendations from the Commission on Higher Education and the State Employment and Training Commission's Task Force on Adult Literacy.
New Jersey State Employment and Training Commission, Trenton.
A New Jersey Task Force on Adult Literacy recommended ways to improve the literacy delivery system for adults. This report and its recommendations focus on improving coordinated interagency planning and accountability to increase governmental efficiency, and on advancing the employability and self-sufficiency of the three million low-literate…
Sibley, Kathryn M.; Howe, Tracey; Lamb, Sarah E.; Lord, Stephen R.; Maki, Brian E.; Rose, Debra J.; Scott, Vicky; Stathokostas, Liza; Straus, Sharon E.; Jaglal, Susan B.
Background Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice. Objective To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults. Methodology A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria. Data sources The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS. Results Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations. Limitations Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate. Conclusions The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally. PMID:25768435
Miller, Susanne; Isaac, Megan; Watts, Linda S.; Barnhouse, Rebecca
Includes four teachers' recommendations of summer reading for other teachers. Details Anita Shreve's "The Last Time They Met"; Barbara Kingsolver's "Small Wonder"; Lynda Barry's "Cruddy"; and Ina Rilke's "Balzac and the Little Chinese Seamstress." (PM)
Alghadir, Ahmad H; Gabr, Sami A; Al-Eisa, Einas S; Alghadir, Muaz H
Background Life style and physical activity play a pivotal role in prevention and treatment of osteoporosis. The mechanism for better bone metabolism and improvement of physical disorders is not clear yet. Trace minerals such as Ca, Mn, Cu, and Zn are essential precursors for most vital biological process, especially those of bone health. Objective The main target of this study was evaluating the effective role of supervised aerobic exercise for 1 hour/day, 3 days/week for 12 weeks in the functions of trace elements in bone health through measuring bone mineral density (BMD), osteoporosis (T-score), bone markers, and trace element concentrations in healthy subjects aged 30–60 years with age average of 41.2±4.9. Methods A total of 100 healthy subjects (47 males, 53 females; age range 30–60 years) were recruited for this study. Based on dual-energy x-ray absorptiometry (DEXA) scan analysis, the participants were classified into three groups: normal (n=30), osteopenic (n=40), and osteoporotic (n=30). Following, 12 weeks of moderate aerobic exercise, bone-specific alkaline phosphatase (BAP), BMD, T-score, and trace elements such as Ca, Mn, Cu, and Zn were assessed at baseline and post-intervention. Results Significant improvement in serum BAP level, T-score, and BMD were observed in all participants following 12 weeks of moderate exercise. Participants with osteopenia and osteoporosis showed significant increase in serum Ca and Mn, along with decrease in serum Cu and Zn levels following 12 weeks of aerobic training. In control group, the improvements in serum trace elements and body mass index were significantly linked with the enhancement in the levels of BAP, BMD hip, and BMD spine. These results supported the preventive effects of moderate exercise in healthy subjects against osteoporosis. In both sexes, the changes in serum trace elements significantly correlated (P<0.05) with the improvement in BAP, BMD hip, BMD spine, and body mass index in all groups
Battaglia, Agatino; Filippi, Tiziana; Carey, John C
Wolf-Hirschhorn syndrome (WHS) is a well-known multiple congenital anomalies/mental retardation syndrome, firstly described in 1961 by Cooper and Hirschhorn. Its frequency is estimated as 1/50,000-1/20,000 births, with a female predilection of 2:1. The disorder is caused by partial loss of material from the distal portion of the short arm of chromosome 4 (4p16.3), and is considered a contiguous gene syndrome. No single gene deletions or intragenic mutations have been shown to confer the full WHS phenotype. Since the disorder was brought to the attention of geneticists, many additional cases have been published. Only in 1999, however, were the first data on the natural history brought to the attention of the medical community. The purpose of the present study is to help delineate in more detail and over a longer period of time, the natural history of WHS, in order to establish appropriate health supervision and anticipatory guidance for individuals with this disorder. We have collected information on 87 patients diagnosed with WHS (54 females and 33 males) both in USA and Italy. Age at first observation ranged between newborn and 17 years. Twenty patients have been followed from 4 months to 23 years. The deletion proximal breakpoint varied from 4p15.32 to 4p16.3, and, by FISH, was terminal and included both WHSCR. Deletion was detected by standard cytogenetics in 44/87 (50.5%) patients, whereas FISH was necessary in the other 43 (49.5%). Array-CGH analysis at 1 Mb resolution was performed in 34/87 patients, and, in 15/34 (44%), showed an unbalanced translocation leading to both a 4p monosomy and a partial trisomy for another chromosome arm. Six more patients had been previously shown to have an unbalanced translocation by karyotype analysis or FISH with a WHS-specific probe. Sixty-five of 87 patients had an apparent pure, de novo, terminal deletion; and 1/87 a tandem duplication of 4p16.1p16.3 associated with 4p16.3pter deletion. Age at diagnosis varied between 7
Stein, Pamela; Aalboe, Joanna
Frail older adults disproportionately suffer from untreated dental problems. Age-related biological changes to hard and soft dental tissues, existing medical conditions, polypharmacy, diet and uncontrolled plaque exacerbate the problem. All of these factors increase the complexity of treatment and will differ greatly from standard treatment of younger adults. This article discusses the key considerations and suggestions for risk assessment, disease management, treatment planning and palliative care to maintain the patient's comfort and quality of life. PMID:26819997
Pastore, Robert L; Brooks, Judith T; Carbone, John W
Recent research suggests that traditional grain-based heart-healthy diet recommendations, which replace dietary saturated fat with carbohydrate and reduce total fat intake, may result in unfavorable plasma lipid ratios, with reduced high-density lipoprotein (HDL) and an elevation of low-density lipoprotein (LDL) and triacylglycerols (TG). The current study tested the hypothesis that a grain-free Paleolithic diet would induce weight loss and improve plasma total cholesterol, HDL, LDL, and TG concentrations in nondiabetic adults with hyperlipidemia to a greater extent than a grain-based heart-healthy diet, based on the recommendations of the American Heart Association. Twenty volunteers (10 male and 10 female) aged 40 to 62 years were selected based on diagnosis of hypercholesterolemia. Volunteers were not taking any cholesterol-lowering medications and adhered to a traditional heart-healthy diet for 4 months, followed by a Paleolithic diet for 4 months. Regression analysis was used to determine whether change in body weight contributed to observed changes in plasma lipid concentrations. Differences in dietary intakes and plasma lipid measures were assessed using repeated-measures analysis of variance. Four months of Paleolithic nutrition significantly lowered (P < .001) mean total cholesterol, LDL, and TG and increased (P < .001) HDL, independent of changes in body weight, relative to both baseline and the traditional heart-healthy diet. Paleolithic nutrition offers promising potential for nutritional management of hyperlipidemia in adults whose lipid profiles have not improved after following more traditional heart-healthy dietary recommendations. PMID:26003334
Collins, Clare E.; Burrows, Tracy L.; Rollo, Megan E.; Boggess, May M.; Watson, Jane F.; Guest, Maya; Duncanson, Kerith; Pezdirc, Kristine; Hutchesson, Melinda J.
Adult diet quality indices are shown to predict nutritional adequacy of dietary intake as well as all-cause morbidity and mortality. This study describes the reproducibility and validity of a food-based diet quality index, the Australian Recommended Food Score (ARFS). ARFS was developed to reflect alignment with the Australian Dietary Guidelines and is modelled on the US Recommended Food Score. Dietary intakes of 96 adult participants (31 male, 65 female) age 30 to 75 years were assessed in two rounds, five months apart. Diet was assessed using a 120-question semi-quantitative food frequency questionnaire (FFQ). The ARFS diet quality index was derived using a subset of 70 items from the full FFQ. Reproducibility of the ARFS between round one and round two was confirmed by the overall intraclass correlation coefficient of 0.87 (95% CI 0.83, 0.90), which compared favourably to that for the FFQ at 0.85 (95% CI 0.80, 0.89). ARFS was correlated with FFQ nutrient intakes, particularly fiber, vitamin A, beta-carotene and vitamin C (0.53, 95% CI 0.37–0.67), and with mineral intakes, particularly calcium, magnesium and potassium (0.32, 95% CI 0.23–0.40). ARFS is a suitable brief tool to evaluate diet quality in adults and reliably estimates a range of nutrient intakes. PMID:25625814
Lagging, Martin; Wejstål, Rune; Norkrans, Gunnar; Karlström, Olle; Aleman, Soo; Weiland, Ola; Castedal, Maria; Josephson, Filip
Abstract In a recent expert meeting, Swedish recommendations for the treatment of HCV infection were updated. An interferon-free combination of direct-acting antiviral agents was recommended as the first line standard-of-care treatment for chronic HCV infection. Interferon-based therapy should be considered as a second line option after an individual benefit-risk assessment. Treatment is strongly recommended for HCV infected patients with bridging fibrosis or cirrhosis (Metavir stages F3–4), before and after liver transplantation, and in the presence of extra-hepatic manifestations. Additionally, patients with moderate liver fibrosis (stage F2) as well as women in need of in vitro fertilisation should be prioritised for therapeutic intervention. Treatment indications for people who inject drugs, children, chronic kidney disease and HIV co-infection are also discussed. PMID:26624849
This book examines how popular science information resources contribute to the improvement of science literacy in the United States. Nearly 2,500 titles are recommended--70% published since 1990--representing all fields of modern science. This guide provides librarians, educators, and other information specialists with an understanding of science…
Jensen, K. M.; Taylor, L. C.; Davis, M. M.
Background: Due to significant medical improvements, persons with Down syndrome now live well into adulthood. Consequently, primary care for adults with Down syndrome needs to incorporate routine care with screening for condition-specific comorbidities. This study seeks to evaluate the adherence of primary care physicians to age- and…
Cogan, Morris L.
The author, one of the originators and developers of the clinical supervision process, offered a cogent rationale for clinical supervision. He defined clinical supervision and discussed the psychological-sociological basis for its practice. (Editor)
Malcovati, Luca; Hellström-Lindberg, Eva; Bowen, David; Adès, Lionel; Cermak, Jaroslav; del Cañizo, Consuelo; Della Porta, Matteo G.; Fenaux, Pierre; Gattermann, Norbert; Germing, Ulrich; Jansen, Joop H.; Mittelman, Moshe; Mufti, Ghulam; Platzbecker, Uwe; Sanz, Guillermo F.; Selleslag, Dominik; Skov-Holm, Mette; Stauder, Reinhard; Symeonidis, Argiris; van de Loosdrecht, Arjan A.
Within the myelodysplastic syndrome (MDS) work package of the European LeukemiaNet, an Expert Panel was selected according to the framework elements of the National Institutes of Health Consensus Development Program. A systematic review of the literature was performed that included indexed original papers, indexed reviews and educational papers, and abstracts of conference proceedings. Guidelines were developed on the basis of a list of patient- and therapy-oriented questions, and recommendations were formulated and ranked according to the supporting level of evidence. MDSs should be classified according to the 2008 World Health Organization criteria. An accurate risk assessment requires the evaluation of not only disease-related factors but also of those related to extrahematologic comorbidity. The assessment of individual risk enables the identification of fit patients with a poor prognosis who are candidates for up-front intensive treatments, primarily allogeneic stem cell transplantation. A high proportion of MDS patients are not eligible for potentially curative treatment because of advanced age and/or clinically relevant comorbidities and poor performance status. In these patients, the therapeutic intervention is aimed at preventing cytopenia-related morbidity and preserving quality of life. A number of new agents are being developed for which the available evidence is not sufficient to recommend routine use. The inclusion of patients into prospective clinical trials is strongly recommended. PMID:23980065
Barsevick, Andrea M; Irwin, Michael R; Hinds, Pamela; Miller, Andrew; Berger, Ann; Jacobsen, Paul; Ancoli-Israel, Sonia; Reeve, Bryce B; Mustian, Karen; O'Mara, Ann; Lai, Jin-Shei; Fisch, Michael; Cella, David
Over the past decades, some scientific progress has been made in understanding and treating cancer-related fatigue (CRF). However, three major problems have limited further progress: lack of agreement about measurement, inadequate understanding of the underlying biology, and problems in the conduct of clinical trials for CRF. This commentary reports the recommendations of a National Cancer Institute Clinical Trials Planning Meeting and an ongoing National Cancer Institute working group to address these problems so that high-priority research and clinical trials can be conducted to advance the science of CRF and its treatment. Recommendations to address measurement issues included revising the current case definition to reflect more rigorous criteria, adopting the Patient Reported Outcomes Measurement Information System fatigue scales as standard measures of CRF, and linking legacy measures to the scales. With regard to the biology of CRF, the group identified the need for longitudinal research to examine biobehavioral mechanisms underlying CRF and testing mechanistic hypotheses within the context of intervention research. To address clinical trial issues, recommendations included using only placebo-controlled trial designs. setting eligibility to minimize sample heterogeneity or enable subgroup analysis, establishing a CRF severity threshold for participation in clinical trials, conducting dissemination trials of efficacious interventions (such as exercise), and combining nonpharmacologic and pharmacologic interventions to exploit the potential synergy between these approaches. Accomplishing these goals has the potential to advance the science of CRF and improve the clinical management of this troubling symptom. PMID:24047960
Toporek, Rebecca L.; Ortega-Villalobos, Lideth; Pope-Davis, Donald B.
Reports of supervisors' and supervisees' critical incidents in multicultural supervision were used to (a) explore events in supervision that influenced supervisees' multicultural competence, (b) explore how supervision was experienced differently by supervisors and supervisees, and (c) identify recommendations for improving multicultural…
Young, Susan; Adamou, Marios; Asherson, Philip; Coghill, David; Colley, Bill; Gudjonsson, Gisli; Hollis, Chris; McCarthy, Jane; Müller, Ulrich; Paul, Moli; Pitts, Mark; Arif, Muhammad
The aim of this consensus statement was to discuss transition of patients with ADHD from child to adult healthcare services, and formulate recommendations to facilitate successful transition. An expert workshop was convened in June 2012 by the UK Adult ADHD Network (UKAAN), attended by a multidisciplinary team of mental health professionals, allied professionals and patients. It was concluded that transitions must be planned through joint meetings involving referring/receiving services, patients and their families. Negotiation may be required to balance parental desire for continued involvement in their child's care, and the child's growing autonomy. Clear transition protocols can maintain standards of care, detailing relevant timeframes, responsibilities of agencies and preparing contingencies. Transition should be viewed as a process not an event, and should normally occur by the age of 18, however flexibility is required to accommodate individual needs. Transition is often poorly experienced, and adherence to clear recommendations is necessary to ensure effective transition and prevent drop-out from services. PMID:27561259
Steingart, Richard M; Yadav, Nandini; Manrique, Carlos; Carver, Joseph R; Liu, Jennifer
Many types of cancer are now curable or, if not cured, becoming a chronic illness. In 2012, it was estimated that there were more than 13,500,000 cancer survivors in the United States. Late outcomes of these survivors are increasingly related to cardiovascular disease, either as a consequence of the direct effects of cancer therapy or its adverse effects on traditional cardiac risk factors (eg, obesity, hypertension, dyslipidemia, and diabetes mellitus). This article describes the therapies that have led to advances in cancer survival and the acute and chronic cardiovascular toxicities associated with these therapies. Recommendations are made for the surveillance and management of cancer survivors. Published guidelines on the subject of cardio-oncology are reviewed in light of clinical experience caring for these patients. To supplement this cancer-related knowledge base, appropriateness criteria and guidelines for cardiac care in the general population were extrapolated to cancer survivors. The result is a series of recommendations for surveillance and management of cardiovascular disease in cancer survivors. PMID:24331191
Stanmore, Emma K
Rheumatoid arthritis (RA) is a debilitating disease that affects younger as well as older adults. It is associated with a high risk of injurious falls due to problems such as lower-limb muscle weakness, balance impairment, swollen and tender joints, pain, and fatigue. Falls are typically associated with older people; hence, many professionals do not recognise the risks for younger persons with diseases such as RA. Falls can lead to devastating consequences, such as fatalities, hip fractures (with 50% of those affected never regaining their previous level of mobility and 30% dying within 1 year), or loss of independence and confidence. Research has shown that many people are either unaware or deny their risk of falling. Therefore, it is important that health professionals, such as community nurses, are aware of the risk factors, methods of assessment, and evidence-based preventative measures, so that falls can be avoided in this population. This article presents research and practice implications for community nurses to enable them to assess, treat, and appropriately refer adults with RA who are also at risk of falls. PMID:26551381
Buhr, Gwendolen; Bales, Connie W
The use of nutritional supplements (NS) with the intention of improving health and delaying age-related chronic disease is a common practice among older adults; however, randomized controlled trials have yielded mixed results regarding the likelihood that these NS provide true health benefits. We reviewed the findings of these studies regarding the effects of NS of folic acid, vitamin B(12), vitamin B(6), and omega-3 fatty acids on health outcomes in older adults. Our conclusions include the following: Supplements of the B vitamins folate, B(12) and B(6) have been studied with regards to primary and secondary prevention of a number of major age-related chronic diseases, including cardiovascular disease (CVD), stroke, cognitive decline, and cancer. While there are some encouraging findings with regards to stroke, depression, and macular degeneration (although in only one study in the latter case), there is little evidence of benefit of B vitamin NS for delaying CVD or age-related cognitive changes. In the few cancer-related studies, the evidence of benefit is coupled with concerns about enhancing the growth of existing undiagnosed cancers. In contrast, clear health benefits have been shown with modest increases in consumption of fatty fish or fish oil supplements, including a reduction in the risk of sudden cardiac death. In addition, there is evidence that high dose fish oil supplements may lower serum triglyceride levels. PMID:20391042
Thompson, David R; Kirkman, Sandy; Watson, Roger; Stewart, Simon
In this paper, four experienced researchers from the UK, China and Australia offer guidance in research supervision based on their experiences and the recent document, Improving standards in postgraduate research degree programmes [Higher Education Funding Council for England, 2003. Improving standards in postgraduate research degree programmes. Formal consultation. Department for Employment and Learning, Northern Ireland, Higher Education Funding Council for England, Higher Education Funding Council for Wales, Scottish Higher Education Funding Council, HEFCE, London]. Supervision is an important aspect of not only the development of the neophyte researcher, but of academic staff and research activity in general. With increased academic accountability, good supervision should be an integral component of a quality research governance framework and resourced as such. Recommendations include: adoption of these standards; rigorous selection of research students and supervisors and development of projects; development of departmental procedures for monitoring, feedback and intellectual property; and transparency, rigour and fairness in examination procedures. PMID:15896413
Levrini, Luca; Sacchi, Franco; Milano, Francesca; Polimeni, Antonella; Cozza, Paolo; Bernkopf, Edoardo; Segù, Marzia; Zucconi, Marco; Vicini, Claudio; Brunello, Enrico
Summary Background The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. Methods With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring. Results Oral appliances can be used to treat: - simple snoring, in patients who do not respond to, or do not appear to be suitable candidates for behavioral measures such as weight loss or positional therapy; - mild or moderate OSAS, in patients who prefer OAs to continuous positive airway pressure (CPAP) or who are not suitable candidates for CPAP, because of its failure or failure of behavioral approaches like weight loss or positional therapy; - severe OSAS, in patients who do not respond to or do not tolerate CPAP and in whom no indication for either maxillofacial or ENT surgery appears applicable. Conclusions The application of oral appliances is highly desirable in cases of simple snoring or mild to moderate OSAS, whereas considerable caution is warranted when treating severe OSAS. It is fundamental to ensure that the patient understands his problem and, at the same time, to present all the various treatment options. PMID:26941893
Dodson, Robin E; Van den Eede, Nele; Covaci, Adrian; Perovich, Laura J; Brody, Julia Green; Rudel, Ruthann A
Phosphate flame retardants (PFRs) are abundant and found at the highest concentrations relative to other flame retardant chemicals in house dust; however, little is known about the biological levels of PFRs and their relationship with house dust concentrations. These relationships provide insight into major exposure pathways and potential health risks. We analyzed urine samples from 16 California residents in 2011 for 6 chlorinated and nonchlorinated dialkyl or diaryl phosphates (DAPs), the expected major metabolites of the most prominent PFRs, and qualitatively screened for 18 other metabolites predicted from in vitro studies. We detected all 6 DAPs within the range of previously reported levels, although very few comparisons are available. We found weakly positive nonsignificant correlations between urine and dust concentrations and maxima urine corresponding to maxima dust for the pairs bis(1,3-dichloro-2-propyl) phosphate (BDCIPP)-tris(1,3-dichloro-isopropyl) phosphate (TDCIPP) and bis(2-chloroethyl) phosphate (BCEP)-tris(2-chloroethyl) phosphate (TCEP). Metabolite levels of PFRs were correlated for many PFR combinations, suggesting they commonly co-occur. As far as we know, this is the first study to measure these 6 DAP metabolites simultaneously and to detect other PFR metabolites in US urine samples. We recommend biomonitoring studies include these 6 DAPs as well as several additional compounds detected through qualitative screening and previous ADME studies. PFRs represent a class of poorly studied commercial chemicals with widespread exposure and raise concerns for health effects including carcinogenicity and neurotoxicity. PMID:25388620
Phosphate flame retardants (PFRs) are abundant and found at the highest concentrations relative to other flame retardant chemicals in house dust; however, little is known about the biological levels of PFRs and their relationship with house dust concentrations. These relationships provide insight into major exposure pathways and potential health risks. We analyzed urine samples from 16 California residents in 2011 for 6 chlorinated and nonchlorinated dialkyl or diaryl phosphates (DAPs), the expected major metabolites of the most prominent PFRs, and qualitatively screened for 18 other metabolites predicted from in vitro studies. We detected all 6 DAPs within the range of previously reported levels, although very few comparisons are available. We found weakly positive nonsignificant correlations between urine and dust concentrations and maxima urine corresponding to maxima dust for the pairs bis(1,3-dichloro-2-propyl) phosphate (BDCIPP)-tris(1,3-dichloro-isopropyl) phosphate (TDCIPP) and bis(2-chloroethyl) phosphate (BCEP)-tris(2-chloroethyl) phosphate (TCEP). Metabolite levels of PFRs were correlated for many PFR combinations, suggesting they commonly co-occur. As far as we know, this is the first study to measure these 6 DAP metabolites simultaneously and to detect other PFR metabolites in US urine samples. We recommend biomonitoring studies include these 6 DAPs as well as several additional compounds detected through qualitative screening and previous ADME studies. PFRs represent a class of poorly studied commercial chemicals with widespread exposure and raise concerns for health effects including carcinogenicity and neurotoxicity. PMID:25388620
MacNeil, Jessica R; Rubin, Lorry; Folaranmi, Temitope; Ortega-Sanchez, Ismael R; Patel, Manisha; Martin, Stacey W
At its June 2015 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended that adolescents and young adults aged 16–23 years may be vaccinated with a serogroup B meningococcal (MenB) vaccine to provide short-term protection against most strains of serogroup B meningococcal disease. This report summarizes the deliberations of ACIP, the rationale for its decision, and recommendations for use of MenB vaccines in adolescents and young adults. Two MenB vaccines have recently been licensed by the Food and Drug Administration (FDA) for use in the United States and approved for use in persons aged 10–25 years: MenB-FHbp (Trumenba, Wyeth Pharmaceuticals, Inc.) and MenB-4C (Bexsero, Novartis Vaccines). Both MenB vaccines were licensed based on statutory regulations for accelerated approval, which enabled FDA to approve the MenB vaccines for serious or life-threatening diseases based on safety and demonstration that vaccine effectiveness, as measured by bactericidal antibody responses with assays using several MenB test strains that were representative of prevalent strains in the United States, is reasonably likely to predict clinical benefit. As a requirement for accelerated approval, confirmatory studies in the postmarketing period will be conducted to verify and further describe the effectiveness of the vaccines against an extended number of MenB strains that represent a broader diversity of endemic disease. Additional postlicensure safety data are also needed and will be reviewed by ACIP as they become available. PMID:26492381
Eilat-Adar, Sigal; Xu, Jiaqiong; Zephier, Ellie; O’Leary, Veronica; Howard, Barbara V.; Resnick, Helaine E.
The objective of this article was to evaluate how well American Indians with diabetes met dietary recommendations and to compare adherence to dietary recommendations with those of U.S. adults with diabetes in the National Health and Nutrition Examination Survey (NHANES). Dietary intake in both studies was assessed using a 24-h recall questionnaire. Dietary intakes were evaluated against American Diabetes Association (ADA) dietary recommendations. The analysis sample consisted of 1,008 participants from SHS examined from 1997–1999 and 373 participants from NHANES examined from 1999–2000, all with diabetes. In both samples, intake of protein, polyunsaturated fatty acids (PUFA), monounsaturated fatty acids (MUFA), and carbohydrates met the 1997 ADA dietary recommendations. However, intakes of saturated fatty acid (SFA) as well as sodium were higher and dietary fiber intake was lower than recommended. In the SHS and NHANES, only 4.6% and 8.5% of persons with diabetes met recommendations for both SFA and fiber (p = 0.02), respectively. However, only 8.3% of the NHANES sample met the 2006 recommendations for SFA and fiber, and none of the SHS sample met those recommendations. This cross-sectional study shows low adherence to ADA dietary recommendations for saturated fat, fiber, and sodium by American Indians with diabetes and by the broader U.S. population of adults with diabetes, and shows that in American Indians with diabetes programs to decrease SFA and increase fiber intakes are warranted. PMID:18716172
Chritton, M.R. ); Matter, J.C. )
This purpose of this NUREG is to present technical information that should be useful to NRC licensees for understanding and applying line supervision techniques to security communication links. A review of security communication links is followed by detailed discussions of link physical protection and DC/AC static supervision and dynamic supervision techniques. Material is also presented on security for atmospheric transmission and video line supervision. A glossary of security communication line supervision terms is appended. 16 figs.
Li, Li; Somerset, Shawn
An increased prevalence of cystic fibrosis (CF) related complications such as impaired bone health and diabetes has accompanied increased survival of patients with CF. This review was conducted to determine the extent to which adults with CF are meeting current nutrition recommendations for micronutrients in association with CF-related complications management. Although dietary intake and nutritional status in CF has improved significantly in recent decades, micronutrient status seems to have diverged. While vitamin A and E intakes appear adequate, frequent vitamin D and K deficiency/insufficiency and compromised bone health in CF, occurs despite supplementation. Although deficiency of water-soluble vitamins and minerals is uncommon, ongoing surveillance will enhance overall health outcomes, particularly in cases of CF-related liver disease and deteriorated lung function and bone health. Salt and fluid status in CF may also need attention due to diminished thirst sensation and voluntary rehydration. Further investigation in micronutrient status optimisation in CF will inform the development of more effective and targeted nutrition therapies to enable integration of more refined recommendations for micronutrient intakes in CF based on individual needs and disease progression. PMID:26159903
McAvay, Gail; Trentalange, Mark; Cohen, Andrew B; Allore, Heather G
Objective To estimate the association between guideline recommended drugs and death in older adults with multiple chronic conditions. Design Population based cohort study. Setting Medicare Current Beneficiary Survey cohort, a nationally representative sample of Americans aged 65 years or more. Participants 8578 older adults with two or more study chronic conditions (atrial fibrillation, coronary artery disease, chronic kidney disease, depression, diabetes, heart failure, hyperlipidemia, hypertension, and thromboembolic disease), followed through 2011. Exposures Drugs included β blockers, calcium channel blockers, clopidogrel, metformin, renin-angiotensin system (RAS) blockers; selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs); statins; thiazides; and warfarin. Main outcome measure Adjusted hazard ratios for death among participants with a condition and taking a guideline recommended drug relative to participants with the condition not taking the drug and among participants with the most common combinations of four conditions. Results Over 50% of participants with each condition received the recommended drugs regardless of coexisting conditions; 1287/8578 (15%) participants died during the three years of follow-up. Among cardiovascular drugs, β blockers, calcium channel blockers, RAS blockers, and statins were associated with reduced mortality for indicated conditions. For example, the adjusted hazard ratio for β blockers was 0.59 (95% confidence interval 0.48 to 0.72) for people with atrial fibrillation and 0.68 (0.57 to 0.81) for those with heart failure. The adjusted hazard ratios for cardiovascular drugs were similar to those with common combinations of four coexisting conditions, with trends toward variable effects for β blockers. None of clopidogrel, metformin, or SSRIs/SNRIs was associated with reduced mortality. Warfarin was associated with a reduced risk of death among those with atrial fibrillation
McGill, Carla R.; Birkett, Anne; Fulgonii III, Victor L.
Background The proportion of the US adult population who meet fiber intake recommendations is very low. Information about food groups consumed and diet quality for the adults who consume recommended amounts of fiber are scarce. Objective To examine food groups consumed and Healthy Eating Index (HEI-2010) scores for US adults meeting the fiber adequate intake (AI) based on National Health and Nutrition Examination Survey (NHANES) data 2001–2010. Design A secondary analysis of NHANES data from 2001 to 2010. Participants included adults aged 19 and older (n=24,807) with complete day 1 dietary records. Variables measured were food group sources of fiber and HEI-2010 scores. Sample-weighted data were used to calculate least square means (LSM)±standard error of the mean (SEM) by fiber intake quartile along with HEI-2010 scores. Significance was set at P<0.05. Results Major fiber food sources for US adults meeting the AI were grain products, vegetables, legumes, and fruits. The top grain products consumed were grain mixtures, ready-to-eat (RTE) cereals, and breads/rolls. The mean HEI-2010 score for adults meeting the AI for fiber was significantly (P<0.001) higher compared with all adult participants. The mean HEI-2010 score increased with increasing fiber intake in both groups. Conclusions Adults who meet the AI for fiber have a higher quality diet. Fiber may be an important dietary component that predicts diet quality. PMID:27098562
Vidal, Sarah; Skeem, Jennifer L
Probation officers exercise substantial discretion in their daily work with troubled and troubling juvenile offenders. In this experiment, we examine the effect of psychopathic features, child abuse, and ethnicity on 204 officers' expectancies of, recommendations for, and approach to supervising, juvenile offenders. The results indicate that officers (a) have decision-making and supervision approaches that are affected by a youth's psychopathic traits and history of child abuse-but not ethnicity; (b) view both abused youth and psychopathic youth as highly challenging cases on a path toward adult criminality; and (c) have greater hope and sympathy for abused youth than psychopathic youth. For abused youth, officers are likely to recommend psychological services and "go the extra mile" by providing greater support, referrals, and networking than is typical for their caseload. For psychopathic youth, officers expect poor treatment outcomes and are" extra strict," enforcing rules that typically are not enforced for others on their caseload. PMID:17294135
Diet Quality and Physical Activity Outcome Improvements Resulting From a Church-Based Diet and Supervised Physical Activity Intervention for Rural, Southern, African American Adults: Delta Body and Soul III.
Thomson, Jessica L; Goodman, Melissa H; Tussing-Humphreys, Lisa
We assessed the effects of a 6-month, church-based, diet and supervised physical activity intervention, conducted between 2011 and 2012, on improving diet quality and increasing physical activity of Southern, African American adults. Using a quasi-experimental design, eight self-selected, eligible churches were assigned to intervention or control. Assessments included dietary, physical activity, anthropometric, and clinical measures. Mixed model regression analysis and McNemar's test were used to determine if within and between group differences were significant. Cohen's d effect sizes for selected outcomes also were computed and compared with an earlier, lower dose intervention. Retention rates were 84% (102/122) for control and 76% (219/287) for intervention participants. Diet quality components, including fruits, vegetables, discretionary calories, and total quality, improved significantly in the intervention group. Strength/flexibility physical activity also increased in the intervention group, while both aerobic and strength/flexibility physical activity significantly decreased in the control group. Effect sizes for selected health outcomes were larger in the current intervention as compared to an earlier, less intense iteration of the study. Results suggest that more frequent education sessions as well as supervised group physical activity may be key components to increasing the efficacy of behavioral lifestyle interventions in rural, Southern, African American adults. PMID:25603798
Consensus statement of the academy of nutrition and dietetics/american society for parenteral and enteral nutrition: Characteristics recommended for the identification and documentation of adult malnutrition (undernutrition)
The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recommend that a standardized set of diagnostic characteristics be used to identify and document adult malnutrition in routine clinical practice. An etiologically based diagno...
Objective: To issue a recommendation on the types and amounts of physical activity needed to improve and maintain health in older adults. Participants: A panel of scientists with expertise in public health, behavioral science, epidemiology, exercise science, medicine, and gerontology. Evidence: The ...
This article illustrates an approach to therapeutic supervision informed by a philosophy of solidarity and social justice activism. Called a "Supervision of Solidarity", this approach addresses the particular challenges in the supervision of therapists who work alongside clients who are subjected to social injustice and extreme marginalization. It…
Krajewski, Robert J.
Various views of clinical supervision are analyzed and examined. The "process" definition of clinical supervision emphasizes an eight-step cycle of supervision. Clinical supervision as "concept" is also considered and seven conceptual elements are examined. (JN)
Mulatu, Mesfin S.; Godette, Dionne C.; Gaines, Tommi L.
Objective This study examined temporal trends in HIV testing among U.S. older adults (50–64 years of age) before and after the release of CDC's routine HIV testing recommendations in 2006. Methods The sample (n=872,797; 51.4% female) comprised 2003–2010 Behavioral Risk Factor Surveillance System respondents in the oldest categories to which the recommendations apply: 50–54 years (34.5%, n=301,519), 55–59 years (34.1%, n=297,865), and 60–64 years (31.3%, n=273,413). We calculated (1) four-year pooled prevalences of past-year HIV testing before and after 2006, when the recommendations were released; and (2) annual prevalences of HIV testing overall and by age category from 2003–2010. Using weighted, multivariable logistic regression analyses, we examined binary (pre- vs. post-recommendations) and annual changes in testing, controlling for covariates. We stratified the data by recent doctor visits, examined racial/ethnic differences, and tested for linear and quadratic temporal trends. Results Overall and within age categories, the pooled prevalence of past-year HIV testing decreased following release of the recommendations (p<0.001). The annual prevalence decreased monotonically from 2003 (5.5%) to 2006 (3.6%) (b=–0.16, p<0.001) and then increased immediately after release of the recommendations, but decreased to 3.7% after 2009 (b=0.01, p<0.001). By race/ethnicity, testing increased over time among non-Hispanic black people only. Annual prevalence also increased among respondents with recent doctor visits. Conclusion CDC's HIV testing recommendations were associated with a reversal in the downward trend in past-year HIV testing among older adults; however, the gains were neither universal nor sustained over time. PMID:26327729
Draves, David D.
The secondary student teaching program at the University of New Hampshire incorporates resident supervisors'', teachers who supervise student teachers responsible for four of the supervisor's classes. (SP)
Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra
The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. SLEEP 2015;38(8):1161–1183. PMID:26194576
Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra
The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. J Clin Sleep Med 2015;11(8):931–952. PMID:26235159
Gaumnitz, W. H.
This study attempts to show the parts played by the State departments of education relative to general comprehensive programs of adult education, illiteracy eradication, and Americanization; adult-education programs of the Works Progress Administration and the National Youth Administration; educational programs of the Civilian Conservation Corps…
... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Supervision and monitoring. 115.13 Section 115.13 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Prevention Planning § 115.13 Supervision...
... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Supervision and monitoring. 115.13 Section 115.13 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Prevention Planning § 115.13 Supervision...
... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Supervision and monitoring. 115.13 Section 115.13 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Prevention Planning § 115.13 Supervision...
Scanlan, Aaron T; Arkinstall, Hayley; Dalbo, Vincent J; Humphries, Brendan J; Jennings, Cameron T; Kingsley, Michael I C
Although active gaming is popular and can increase energy expenditure in young adults, its efficacy as a prescriptive exercise tool is not well understood. This study aimed to: (a) compare the activity intensities experienced by young adults while playing active tennis gaming with conventional sedentary gaming, tennis game-play, and current activity recommendations for health; and (b) identify changes in activity intensities across playing time. After habitualization, 10 active young adults (age: 20.2 ± 0.4 years; stature: 1.74 ± 0.03 m; body mass: 67.7 ± 3.3 kg) completed 3 experimental trials (sedentary gaming, active tennis gaming, and tennis game-play) on separate days in a randomized order. Heart rate (HR) and metabolic equivalents (METs) were averaged across 5 minutes and 10 minutes intervals, and the entire 20 minutes bout within each condition. Active gaming produced greater intensities across 5-10, 10-15, and 15-20 minutes time intervals compared with sedentary gaming (p < 0.01). Tennis game-play elicited greater HR (67 ± 5% HR(max)) and METs (5.0 ± 0.2) responses than both sedentary (40 ± 2% HR(max), 1.1 ± 0.1 METs) and active gaming (45 ± 2% HR(max), 1.4 ± 0.1 METs) (p < 0.001). Only tennis game-play produced activity intensities meeting current recommendations for health benefit. Lower HR intensities were reached across 0-5 minutes than during later time intervals during active gaming (6%) and tennis game-play (9%) (p < 0.01). Activity intensities elicited by active gaming were greater than sedentary gaming but less than tennis game-play and insufficient to contribute toward promoting and maintaining good health in young adults. These data suggest that active tennis gaming should not be recommended by exercise professionals as a substitute for actual sports participation in young adults. PMID:23238089
Legislative Side-By-side for The AEEG Act of Congressmen Kennedy and Hinojosa. WIA I and II & Related. To Advance the Recommendations of the National Commission On Adult Literacy and "Reach Higher, America"
Council for Advancement of Adult Literacy (NJ1), 2009
The purpose of this report is to help advance the recommendations of the National Commission on Adult Literacy, for the Adult Education and Economic Growth Act under development by Congressmen Patrick Kennedy and Reuben Hinojosa. Current law is compared to National Commission amendments in such areas as: Adult and Dislocated Worker Employment and…
Gargallo Fernández, Manuel; Marset, Julio Basulto; Lesmes, Irene Breton; Izquierdo, Joan Quiles; Sala, Xavier Formiguera; Salas-Salvadó, Jordi
This paper is a summary of the Spanish Federation of Nutrition, Food and Dietetics Associations (FESNAD) and the Spanish Association for the Study of Obesity (SEEDO) consensus document on the role of diet in prevention and treatment of overweight and obesity. To prepare this document, and in order to achieve the maximum evidence level possible, a systematic review was made of all medical literature published between January 1, 1996 and January 31, 2011 (15 years). The obtained findings were catalogued by evidence level following the Scottish Intercollegiate Guidelines Network system, and recommendations were produced based on data collected. As a result, 65 evidences and 31 recommendations applicable to obese adults without any other pathological process were produced. Evidences and resulting recommendations are provided, and the most significant findings are discussed. This consensus document is intended to provide healthcare professionals with a reference tool that may help them design dietary strategies for prevention and treatment of overweight and obesity. PMID:22795577
Nanney, Marilyn S; Glatt, Carissa
Objective The aim of the present study was to explore the implementation of nutrition recommendations made in the 2010 Institute of Medicine (IOM) report, Child and Adult Care Food Program: Aligning Dietary Guidance for All, in school-based after-school snack programmes. Design A descriptive study. Setting One large suburban school district in Minneapolis, Minnesota, USA. Subjects None. Results Major challenges to implementation included limited access to product labelling and specifications inconsistent with the IOM’s Child and Adult Care Food Program (CACFP) recommendations, limited access to healthier foods due to current school district buying consortium agreement, and increased costs of wholegrain and lower-sodium foods and pre-packaged fruits and vegetables. Conclusions Opportunities for government and industry policy development and partnerships to support schools in their efforts to promote healthy after-school food environments remain. Several federal, state and industry leadership opportunities are proposed: provide product labelling that makes identifying snacks which comply with the 2010 IOM CACFP recommended standards easy; encourage compliance with recommendations by providing incentives to programmes; prioritize the implementation of paperwork and technology that simplifies enrolment and accountability systems; and provide support for food safety training and/or certification for non-food service personnel. PMID:22050891
Reiman, Alan J.; Thies-Sprinthall, Lois
The fields of instructional supervision, adult development, teacher education and mentoring, and ongoing professional development are synthesized in this text. Examples and case studies are drawn from local systems in North Carolina as well as state, national, and international public school/university consortia to identify emerging trends in…
Annan, Jean; Ryba, Ken
An ecological analysis of the supervisory activity of 31 New Zealand school psychologists examined simultaneously the theories of school psychology, supervision practices, and the contextual qualities that mediated participants' supervisory actions. The findings indicated that the school psychologists worked to achieve the supervision goals of…
Bolin, Frances S.
The shift of focus from teachers to curriculum has left supervision as a field struggling to find its place within its own professional organization. This article searches for a proper definition of supervision, highlighting scientific, developmental, and democratic approaches and exploring problems of perspective and common ground. Includes 48…
This paper examines the use of First Class conferencing software to create a virtual culture among research students and as a vehicle for supervision and advising. Topics discussed include: computer-mediated communication and research; entry to cyberculture, i.e., research students' induction into the research community; supervision and the…
Worthen, Vaughn E.; Dougher, M. Kirk
This paper outlines the purposes, professional obligations, and key components to consider when providing effective evaluation in psychotherapy supervision. An overview of various methods for gathering supervision data for evaluation purposes is provided including self-reporting; process notes; video and audiotaping; live observation; co-therapy;…
Bailey, Martha J.
Although the literature of library administration draws extensively on that of business management, it is difficult to compare library supervision to business or industrial supervision. Library supervisors often do not have managerial training and may consider their management role as secondary. The educational level of the staff they supervise…
Reinhartz, Judy; Beach, Don M.
Describes the salient attributes of adult cognitive functioning and supervisory styles and integrates them within the systems of developmental and clinical supervision to create an individualized professional development plan. (FL)
Harvey, Virginia Smith; Amador, Andria; Finer, Diana; Gotthelf, David; Hintze, John; Kruger, Lou; Li, Chieh; Lichtenstein, Bob; Rogers, Laura; Struzziero, Joan; Wandle, Caroline
Adequate and appropriate supervision of interns is frequently identified as a significant problem by training programs while, on their part, field placement sites often indicate that training programs generate expectations for interns that are not always "in synch" with district expectations of school psychologists. As a result of an increasing…
Iliodromiti, Stamatina; Ghouri, Nazim; Celis-Morales, Carlos A.; Sattar, Naveed; Lumsden, Mary Ann; Gill, Jason M. R.
International public health guidelines recommend that adults undertake at least 150 min.week−1 of moderate-intensity physical activity. However, the underpinning evidence has largely been obtained from studies of populations of white European descent. It is unclear whether these recommendations are appropriate for other ethnic groups, particularly South Asians, who have greater cardio-metabolic risk than white Europeans. The objective of our study was to determine the level of moderate-intensity physical activity required in South Asians adults to confer a similar cardio-metabolic risk profile to that observed in Europeans of similar age and body mass index (BMI) undertaking the currently recommended levels of 150 min.week−1. 148 South Asians and 163 white Europeans aged 18 to 70 years were recruited. Physical activity was measured objectively via vertical axis accelerations from hip-worn accelerometers. Factor analysis was used to summarize the measured risk biomarkers into a single underlying latent “factor” describing overall cardio-metabolic risk. Sex did not modify the association between physical activity and the cardio-metabolic risk factor, so data for both sexes were combined and models adjusted for age, sex, BMI and accelerometer wear time. We estimated that South Asian adults needed to undertake 232 (95% Confidence interval: 200 to 268) min.week−1 in order to obtain the same cardio-metabolic risk factor score as a white European undertaking 150 minutes of moderate-equivalent physical activity per week. The present findings suggest that South Asian men and women need to undertake ~230 minutes of moderate intensity physical activity per week. This equates to South Asians undertaking an extra 10–15 minutes of moderate intensity physical activity per day on top of existing recommendations. PMID:27529339
Bramoweth, Adam D; Renqvist, Jenna G; Germain, Anne; Buysse, Daniel J; Gentili, Angela; Kochersberger, Gary; Rodriguez, Eric; Rossi, Michelle I; Weiner, Debra K
OBJECTIVE : To present the seventh in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. This article focuses on insomnia and presents a treatment algorithm for managing insomnia in older adults, along with a representative clinical case. METHODS : A modified Delphi process was used to develop the algorithm and supportive materials. A multidisciplinary expert panel representing expertise in health psychology and sleep medicine developed the algorithm and supporting documents that were subsequently refined through an iterative process of input from a primary care provider panel. RESULTS : We present an illustrative clinical case and an algorithm to help guide the care of older adults with insomnia, an important contributor to CLBP and disability. Multicomponent cognitive behavioral therapy for insomnia (CBTI) and similar treatments (e.g., brief behavioral treatment for insomnia [BBTI]) are the recommended first-line treatment. Medications should be considered only if BBTI/CBTI is suboptimal or not effective and should be prescribed at the lowest effective dose for short periods of time (< 90 days). CONCLUSIONS : Insomnia is commonly comorbid with CLBP in older adults and should be routinely evaluated and treated because it is an important contributor to pain and disability. The algorithm presented was structured to assist primary care providers in planning treatment for older adults with CLBP and insomnia. PMID:27173512
... a physician's advice to exercise vary by body mass index (BMI)? Adults who were obese were about ... and varies substantially across population subgroups. Definitions Body mass index : Based on respondent-reported height and weight ...
PEERSON, NELL; AND OTHERS
THE APPLICATION OF THE LAUBACH METHOD TO TEACH ILLITERATE ADULTS BY TELEVISION WAS REPORTED. THE PROGRAM INVOLVED 600 STUDENTS OF WHOM 250 COMPLETED THE COURSE OF STUDY. THE STUDENTS WERE ILLITERATES ABOUT 40 YEARS OF AGE WITH 2 TO 3 YEARS OF FORMAL SCHOOLING. LESSONS WERE PREPARED AND TELECAST USING MATERIAL DEVELOPED BY F.C. LAUBACH. CLASSES…
Shultz, Laura A Schwent; Pedersen, Heather A; Roper, Brad L; Rey-Casserly, Celiane
Within the psychology supervision literature, most theoretical models and practices pertain to general clinical or counseling psychology. Supervision specific to clinical neuropsychology has garnered little attention. This survey study explores supervision training, practices, and perspectives of neuropsychology supervisors. Practicing neuropsychologists were invited to participate in an online survey via listservs and email lists. Of 451 respondents, 382 provided supervision to students, interns, and/or fellows in settings such as VA medical centers (37%), university medical centers (35%), and private practice (15%). Most supervisors (84%) reported supervision was discussed in graduate school "minimally" or "not at all." Although 67% completed informal didactics or received continuing education in supervision, only 27% reported receiving training specific to neuropsychology supervision. Notably, only 39% were satisfied with their training in providing supervision and 77% indicated they would likely participate in training in providing supervision, if available at professional conferences. Results indicate that clinical neuropsychology as a specialty has paid scant attention to developing supervision models and explicit training in supervision skills. We recommend that the specialty develop models of supervision for neuropsychological practice, supervision standards and competencies, training methods in provision of supervision, and benchmark measures for supervision competencies. PMID:25116655
Alothman, Adel F; Al-Musawi, Tariq; Al-Abdely, Hail M; Salman, Jameela Al; Almaslamani, Muna; Yared, Nadine; Butt, Adeel A; Raghubir, Nirvana; Morsi, Waleed El; Al Thaqafi, Abdulhakeem O
Invasive Candida infections contribute to significant morbidity and mortality in patients with healthcare-associated infections. They represent a major burden on the public health system, and are challenging to diagnose and treat. A multidisciplinary expert panel critically reviewed available evidence to provide consensus recommendations for the management of invasive Candida infections in the Middle East. Based on diagnosis, recommendations were provided for the management of Candida infections in non-neutropenic and neutropenic patients. Polyenes (amphotericin B-deoxycholate [AmB-d] and lipid formulations amphotericin B [LFAmB]), triazoles (fluconazole, itraconazole and voriconazole), echinocandins (caspofungin, anidulafungin, and micafungin) and flucytosine are the recommended categories of antifungal agents for treatment of Candida infections. Echinocandins are preferred for treatment of proven and suspected Candida infections, especially in critically ill patients or those with previous exposure to azoles. Recommendations were also provided for infections caused by specific Candida species as well as management of different disease conditions. The experts highlighted that the guidelines should be used along with clinical judgment. Given the paucity of published data from the region, research in the form of randomized clinical trials should be given priority. PMID:24035607
Marchini, J S; Rodrigues, M M; Cunha, S F; Fausto, M A; Vannucchi, H; de Oliveira, J E
The recommendations for protein consumption depend on the essential amino acid and total nitrogen content of a diet, and food digestibility. International recommendations are based on egg or milk proteins. However, populations eat different food mixtures. Brazilians use rice and beans as their main protein food source. This study presents different Brazilian diets, with variable amount of rice and beans. The results show that for each diet there is a different amount of protein recommended. Pre-school children, for example, must receive from 1.15 to 1.77 g/protein/day, depending on the mixture of their dietary protein intake. Besides the diet protein's quality and quantity, the total food intake and presence of other essential nutrients, such as iron, calcium and vitamin C has also to be considered. The correct protein recommendation with respect to a diet or a mixture of food, should take into consideration: digestibility, total nitrogen, essential amino acids, presence of others nutrients and weight of food consumed. PMID:7824848
Yager, Geoffrey G.; Littrell, John M.
This guide attempts to solve problems caused when a certain designated "brand" of supervision is forced on the counselor trainee with neither choice nor checklist of important criteria. As a tentative start on a guide to supervision the paper offers the following: a definition of supervision; a summary of the various types of supervision; a…
Anderson, Eugene M.
Criteria are established for a definition of "clinical supervision" and the effectiveness of such supervisory programs in a student teaching context are considered. Two differing genres of clinical supervision are constructed: "supervision by pattern analysis" is contrasted with "supervision by performance objectives." An outline of procedural…
Johnson, Alice H.
This report summarizes issues facing New Zealand's modern adult literacy movement and places it in the context of the rapidly changing skill demands of the 21st century. Part I introduces political, economic, and social issues facing New Zealand. Chapter 1 provides an overview of the issues and structures that create the current climate. Part II…
Finnerup, Nanna B; Attal, Nadine; Haroutounian, Simon; McNicol, Ewan; Baron, Ralf; Dworkin, Robert H; Gilron, Ian; Haanpaa, Maija; Hansson, Per; Jensen, Troels S; Kamerman, Peter R; Lund, Karen; Moore, Andrew; Raja, Srinivasa N; Rice, Andrew SC; Rowbotham, Michael; Sena, Emily; Siddall, Philip; Smith, Blair H; Wallace, Mark
Summary Background Neuropathic pain is difficult to treat. New treatments, clinical trials and standards of quality for assessing evidence justify an update of evidence-based recommendations for its pharmacological treatment. Methods The Neuropathic Pain Special Interest Group (NeuPSIG) of the International Association for the Study of Pain conducted a systematic review of randomised double-blind studies of oral and topical pharmacotherapy for neuropathic pain, including unpublished trials (retrieved from clinicaltrials.gov and pharmaceutical websites). Meta-analysis used Numbers Needed to Treat (NNT) for 50 % pain relief as primary measure and assessed publication bias. Recommendations used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Findings In total 229 studies were included. Analysis of publication bias suggested a 10% overstatement of treatment effects. Studies published in peer-review journals reported greater effects than online studies (R2=9·3%, p<0·01). Trial outcomes were generally modest even for effective drugs : in particular NNTs were 3·6 (95 % CI 3·0–4·4) for tricyclic antidepressants (TCAs), 6·4 (95 % CI 5·2–8·4) for serotonin- noradrenaline reuptake inbibitor (SNRI) antidepressants duloxetine and venlafaxine, 7·7 (95 % CI 6·5–9·4) for pregabalin and 6·3 (95 % CI 5·0–8·3) for gabapentin. NNTs were higher for gabapentin ER/enacarbil and capsaicin high concentration patches, lower for opioids and botulinum toxin A (BTX-A) and undetermined for lidocaine patches. Final quality of evidence was lower for lidocaine patches and BTX-A. Tolerability/safety and values/preferences were high for lidocaine patches and lower for opioids and TCAs. This permitted a strong GRADE recommendation for use and proposal as first line for TCAs, SNRIs, pregabalin, gabapentin and gabapentin ER/enacarbil in neuropathic pain, a weak recommendation for use and proposal as second line for lidocaine patches, capsaicin
Smith, Ashley Wilder; Seibel, Nita L; Lewis, Denise R; Albritton, Karen H; Blair, Donald F; Blanke, Charles D; Bleyer, W Archie; Freyer, David R; Geiger, Ann M; Hayes-Lattin, Brandon; Tricoli, James V; Wagner, Lynne I; Zebrack, Bradley J
Each year, 70,000 adolescents and young adults (AYAs) between ages 15 and 39 years in the United States are diagnosed with cancer. In 2006, a National Cancer Institute (NCI) Progress Review Group (PRG) examined the state of science associated with cancer among AYAs. To assess the impact of the PRG and examine the current state of AYA oncology research, the NCI, with support from the LIVESTRONG Foundation, sponsored a workshop entitled "Next Steps in Adolescent and Young Adult Oncology" on September 16 and 17, 2013, in Bethesda, Maryland. This report summarizes the findings from the workshop, opportunities to leverage existing data, and suggestions for future research priorities. Multidisciplinary teams that include basic scientists, epidemiologists, trialists, biostatisticians, clinicians, behavioral scientists, and health services researchers will be essential for future advances for AYAs with cancer. Cancer 2016;122:988-999. © 2016 American Cancer Society. PMID:26849003
Noel, Melanie; Taddio, Anna; McMurtry, C Meghan; Chambers, Christine T; Pillai Riddell, Rebecca; Shah, Vibhuti
The HELPinKids&Adults knowledge synthesis for the management of vaccination-related pain and high levels of needle fear updated and expanded upon the 2010 HELPinKIDS knowledge synthesis and clinical practice guideline for pain mitigation during vaccine injections in childhood. Interventions for vaccine pain management in adults and treatment of individuals with high levels of needle fear, phobias, or both were included, thereby broadening the reach of this work. The present paper outlines the overarching limitations of this diverse evidence base and provides recommendations for future research. Consistent with the framing of clinical questions in the systematic reviews, the Participants, Intervention, Comparison, Outcome, Study design (PICOAS) framework was used to organize these predominant issues and research directions. The major limitations we identified across systematic reviews were an overall dearth of trials on vaccination, lack of methodological rigor, failure to incorporate important outcomes, poor study reporting, and various sources of heterogeneity. Future research directions in terms of conducting additional trials in the vaccination context, improving methodological quality and rigor, assessment of global acceptability and feasibility of interventions, and inclusion of outcomes that stakeholders consider to be important (eg, compliance) are recommended. Given concerns about pain and fear are known contributors to vaccine hesitancy, improving and expanding this evidence base will be integral to broader efforts to improve vaccine compliance and public health worldwide. PMID:26352918
Short term treatment versus long term management of neck and back disability in older adults utilizing spinal manipulative therapy and supervised exercise: a parallel-group randomized clinical trial evaluating relative effectiveness and harms
Background Back and neck disability are frequent in older adults resulting in loss of function and independence. Exercise therapy and manual therapy, like spinal manipulative therapy (SMT), have evidence of short and intermediate term effectiveness for spinal disability in the general population and growing evidence in older adults. For older populations experiencing chronic spinal conditions, long term management may be more appropriate to maintain improvement and minimize the impact of future exacerbations. Research is limited comparing short courses of treatment to long term management of spinal disability. The primary aim is to compare the relative effectiveness of 12 weeks versus 36 weeks of SMT and supervised rehabilitative exercise (SRE) in older adults with back and neck disability. Methods/Design Randomized, mixed-methods, comparative effectiveness trial conducted at a university-affiliated research clinic in the Minneapolis/St. Paul, Minnesota metropolitan area. Participants Independently ambulatory community dwelling adults ≥ 65 years of age with back and neck disability of minimum 12 weeks duration (n = 200). Interventions 12 weeks SMT + SRE or 36 weeks SMT + SRE. Randomization Blocked 1:1 allocation; computer generated scheme, concealed in sequentially numbered, opaque, sealed envelopes. Blinding Functional outcome examiners are blinded to treatment allocation; physical nature of the treatments prevents blinding of participants and providers to treatment assignment. Primary endpoint 36 weeks post-randomization. Data collection Self-report questionnaires administered at 2 baseline visits and 4, 12, 24, 36, 52, and 78 weeks post-randomization. Primary outcomes include back and neck disability, measured by the Oswestry Disability Index and Neck Disability Index. Secondary outcomes include pain, general health status, improvement, self-efficacy, kinesiophobia, satisfaction, and medication use. Functional outcome assessment occurs
Al-Abdely, Hail M; Alothman, Adel F; Salman, Jameela Al; Al-Musawi, Tariq; Almaslamani, Muna; Butt, Adeel A; Al Thaqafi, Abdulhakeem O; Raghubir, Nirvana; Morsi, Waleed El; Yared, Nadine A
The incidence of invasive Aspergillus infections in the Middle East continues to rise with the increase in the number of immunocompromised patients, and carries significant morbidity and mortality. A panel of experts analysed the evidence from the most recent international guidelines and relevant published literature to reach consensus and develop clear clinical practice guidelines to aid diagnosis and treatment of invasive Aspergillus infections in the Middle East. Disease-specific recommendations were provided for the management of invasive aspergillosis. The expert panel acknowledged that these guidelines should be followed as closely as possible but used alongside clinical judgement. PMID:24029495
Ridout, Susan Ramp; Bailey, Kevin Sue
Designed for graduate students supervising undergraduate work in a reading clinic, this practicum manual provides guidelines and materials needed for the graduate section of the Reading Practicum (Methods of Teaching Reading II) at Indiana University Southeast. In addition to the syllabus, which includes course description and objectives, course…
Falvey, Janet Elizabeth
This handbook is one of four handbooks developed for preservice and inservice counselor preparation and professional development. It was developed as a practical guide which will provide resources for supervisors to use in the field for enhancing their own skills or for use with other counselors under their supervision. It is also appropriate for…
Flinders, David J.
Describes a framework for "culturally responsive supervision." An understanding of analogic or iconic metaphors reveals the power of language to shape what are regarded as matters of fact. Kinesics, proxemics, and prosody bring into focus channels of nonverbal communication. The concept of "framing" calls attention to the metamessages of verbal…
White, Jessica; Nonnamaker, John
Discussions of personnel management in student affairs literature and at national conferences often focus on supervising new or midlevel professionals and the myriad challenges and possibilities these relationships entail (Carpenter, 2001; Winston and Creamer, 1997). Graduate students as employees and the often-complicated and ill-structured…
Krajewski, Robert J.
Definitions of supervision and instructional supervision are provided, along with financial and educational rationale for better quality-control of public education through the development and maintenance of an effective instructional improvement program. A suggested supervisory model is described. (MJB)
Roblot, F; Robin, S; Chubilleau, C; Giraud, J; Bouffard, B; Ingrand, P
We aimed to assess vaccination coverage (VC) in 17-year-old French young adults (YAs) participating in one mandatory Day of Defence and Citizenship (DDC). Between June 2010 and May 2011, YAs participating in 43 randomly selected mandatory sessions of the DDC programme in Poitou-Charentes (France) were asked to provide their personal vaccination record. Tetanus, diphtheria, polio, hepatitis B, Haemophilus influenzae b, pertussis, measles, mumps and rubella vaccination status were assessed at ages 2, 6, 13 and 17 years. Of 2610 participants, 2111 (81%) supplied documents for evaluation. Of these, 1838 (87%, M:F sex ratio 0·96) were aged 17 years (9% of the global population of this age in the area). The assessment of the 17-year-olds demonstrated the following rates of complete vaccination: diphtheria-tetanus-polio 83%; measles, mumps and rubella 83%; pertussis 69%; H. influenzae b 61%; human papillomavirus 47%; and hepatitis B 40%. At age 6 years, only 46% had received two doses of the vaccine against measles. The YAs were not aware of their status but were in favour of vaccination. VC in YAs is insufficient, particularly for hepatitis B, pertussis and measles. Combined vaccines and the simplification of vaccination schedules should improve VC. Preventive messages should focus on YAs. PMID:26159149
Findings of a study that examined novice supervisors' understandings of supervision are presented in this paper. Data were collected from 110 graduate-level students enrolled in an introductory supervision class. Four themes emerged from students' definitions of supervision-domains, relationships, traits, and tasks. The most surprising finding was…
Holloway, Elizabeth L.
Presents a framework of different sources of outcome data in supervision, and classifies research according to this framework. Challenges assumptions of previous research in supervision. Emphasizes influences of trainee and client in supervision and counseling contexts, respectively. Supports broader definition and expanded view of outcome in…
Irvine, Freeman R., Jr.
This literature review presents a concise chronology of supervision as it evolved on the American scene. It is emphasized that supervision has a unique definition for each user. Supervision in America evolved out of a basic school pattern inherited from the European school system. The early definition and concept of this position was vague. The…
Abdullah, Mohammad M H; Cyr, Audrey; Lépine, Marie-Claude; Labonté, Marie-Ève; Couture, Patrick; Jones, Peter J H; Lamarche, Benoît
Dairy products are rich sources of an array of fatty acids (FA) that have been shown individually and in certain clusters to exert varying effects on cardiovascular health, for which the circulating lipid profile is a powerful biomarker. Whether the profile of these FA is reflected in blood upon short terms of intake, possibly contributing to the lipid-related health impacts of dairy products, remains to be fully established. The objectives of the present study were to assess a recommended dairy product consumption in relation to circulating FA and lipid profiles, and to evaluate certain FA in dairy fat as potential biomarkers of intake. In a free-living, multi-centre, cross-over design, 124 healthy individuals consumed 3 servings/d of commercial dairy (DAIRY; 1% fat milk, 1·5% fat yogurt and 34% fat cheese) or energy-equivalent control (CONTROL; fruit and vegetable juice, cashews and a cookie) products for 4 weeks each, separated by a 4-week washout period. Plasma FA and serum lipid profiles were assessed by standard methods at the end of each dietary phase. After 4 weeks of intake, plasma levels of FA pentadecanoic acid (15 : 0) and heptadecanoic acid (17 : 0) were higher (0·26 v. 0·22% and 0·42 v. 0·39% of the total identified FA, respectively) after the DAIRY phase than after the CONTROL phase (P< 0·0001). This was accompanied by a small but significant increase in serum LDL-cholesterol levels after the DAIRY phase compared with the CONTROL phase (+0·08 mmol/l; P= 0·04). In conclusion, intake of 3 servings/d of conventional dairy products may modify certain circulating FA and lipid profiles within 4 weeks, where 15 : 0 and 17 : 0 may be potential short-term biomarkers of intake. PMID:25609231
Morel, Jacques; Czitrom, Séverine Guillaume; Mallick, Auriane; Sellam, Jérémie; Sibilia, Jean
The risk of infection associated with autoimmune diseases is further increased by the use of biotherapies. Recommendations to minimize this risk include administering the full complement of vaccines on the standard immunization schedule, as well as the pneumococcal and influenza vaccines. Adults with chronic inflammatory joint disease (IJD) may receive a 13-valent pneumococcal conjugate vaccine, as well as a live attenuated vaccine against recurrent herpes zoster, recently licensed by European regulatory authorities. Live attenuated vaccines can be given only after an interval without immunosuppressant and/or glucocorticoid therapy. The effectiveness of vaccines, as assessed based on titers of protective antibodies, varies across vaccine types and disease-modifying antirheumatic drugs (DMARDs). Thus, methotrexate and rituximab are usually associated with decreased vaccine responses. The risks associated with vaccines are often considerably exaggerated by the media, which serve lobbies opposed to immunizations and make some patients reluctant to accept immunizations. Increasing immunization coverage may diminish the risk of treatment-related infections. A physician visit dedicated specifically to detecting comorbidities in patients with chronic IJD may result in improved immunization coverage. In this review, we discuss immunizations for adults with chronic IJD based on the treatments used, as well as immunization coverage. Many questions remain unanswered and warrant investigation by studies coordinated by the French networks IREIVAC (Innovative clinical research network in vaccinology) and IMIDIATE (Immune-Mediated Inflammatory Disease Alliance for Translational and Clinical Research). PMID:26453106
Wang, Zhicheng; Zhou, Yisu; Wen, Lijie
Glasses removal is an important task on face recognition, in this paper, we provide a weakly supervised method to remove eyeglasses from an input face image automatically. We choose sparse coding as face reconstruction method, and optical flow to find exact shape of glasses. We combine the two processes iteratively to remove glasses more accurately. The experimental results reveal that our method works much better than these algorithms alone, and it can remove various glasses to obtain natural looking glassless facial images.
Barnett, Jeffrey E; Molzon, Corey H
Clinical supervision is an essential aspect of every mental health professional's training. The importance of ensuring that supervision is provided competently, ethically, and legally is explained. The elements of the ethical practice of supervision are described and explained. Specific issues addressed include informed consent and the supervision contract, supervisor and supervisee competence, attention to issues of diversity and multicultural competence, boundaries and multiple relationships in the supervision relationship, documentation and record keeping by both supervisor and supervisee, evaluation and feedback, self-care and the ongoing promotion of wellness, emergency coverage, and the ending of the supervision relationship. Additionally, the role of clinical supervisor as mentor, professional role model, and gatekeeper for the profession are discussed. Specific recommendations are provided for ethically and effectively conducting the supervision relationship and for addressing commonly arising dilemmas that supervisors and supervisees may confront. PMID:25220636
Glaes, Janet M.
The American School Counseling Association's (ASCA) National Model has been recognized in the field of professional school counseling as an effective framework for the training and supervision of school counselor interns. Despite this recommendation, school counselor supervision models which incorporate the ASCA model have until recently been rare…
The purpose of this study was to determine the effect of fast food (FF) consumption on food and nutrient intakes and likelihood of meeting recommendations outlined in USDA’s MyPyramid Food Guidance System. Adults 19-50 years of age (n=2,160) who completed two 24-hour dietary recalls in the What We ...
"Breakthrough" 1981 Eight Months Later. A Summary of the Presentations, Recommendations, and Outcomes of the 1981 Breakthrough Conference, to Assist Minority Women and Men and Nonminority Women Achieve Leadership Positions in Wisconsin's Vocational, Technical, and Adult Education System.
Grengg, Dolores A., Ed.; Thompson, Mary B., Ed.
These proceedings consist of a summary of the presentations, recommendations, and outcomes of a conference held to assist minority women and men and nonminority women achieve leadership positions in Wisconsin's vocational, technical, and adult education (VTAE) system. Following a brief introduction and copy of the conference agenda, summaries are…
Cairo, Mitchell S; Coiffier, Bertrand; Reiter, Alfred; Younes, Anas
Tumour lysis syndrome (TLS) is a life-threatening oncological emergency characterized by metabolic abnormalities including hyperuricaemia, hyperphosphataemia, hyperkalaemia and hypocalcaemia. These metabolic complications predispose the cancer patient to clinical toxicities including renal insufficiency, cardiac arrhythmias, seizures, neurological complications and potentially sudden death. With the increased availability of newer therapeutic targeted agents, such as rasburicase (recombinant urate oxidase), there are no published guidelines on the risk classification of TLS for individual patients at risk of developing this syndrome. We convened an international TLS expert consensus panel to develop guidelines for a medical decision tree to assign low, intermediate and high risk to patients with cancer at risk for TLS. Risk factors included biological evidence of laboratory TLS (LTLS), proliferation, bulk and stage of malignant tumour and renal impairment and/or involvement at the time of TLS diagnosis. An international TLS consensus expert panel of paediatric and adult oncologists, experts in TLS pathophysiology and experts in TLS prophylaxis and management, developed a final model of low, intermediate and high risk TLS classification and associated TLS prophylaxis recommendations. PMID:20331465
Ibara, E. C.
This paper examines clinical supervision approaches that have the potential to promote and implement effective teacher supervision in Nigeria. The various approaches have been analysed based on the conceptual framework of instructional supervisory behavior. The findings suggest that a clear distinction can be made between the prescriptive and…
Levy, Linda S.; Johnson, Lynn V.
Physical education teacher candidates (PETCs) often, as part of their curricular requirements, engage in early field experiences that prepare them for student teaching. Matching the PETC's developmental level with the mentor's supervision style enhances this experience. The situational supervision model, based on the situational leadership model,…
Blair, Billie Goode
Discusses how administrators can help teachers and administrators become role effective. After considering what teachers need to function as professionals, the article examines the leadership function and its relationship to supervision, clarifying the use of supervision as a process, describing major supervisory functions, and noting the…
Dyer, James E.; Williams, David L.
A review of literature from 1964 to 1993 found that supervised agricultural experience (SAE) teachers, students, parents, and employers value the teachers' supervisory role. Implementation practices vary widely and there are no cumulative data to guide policies and standards for SAE supervision. (SK)
Baker, Thomas E.
This paper describes the 5-year Austin Teacher Program (ATP) at Austin College with emphasis on the collaboratively supervised internship in the graduate year. Some results of a comprehensive survey of over 400 ATP graduates are discussed, as well as issues and needs in the supervision of interns, and implications for the future in the supervision…
DiMino, John L.; Risler, Robin
The issue of training psychologists to become competent supervisors has only been clearly articulated in the past two decades. In this article a rationale for training supervisors in a group format is given. Then, a supervision of supervision group is presented that the authors co-led with two successive cohorts of four predoctoral interns in a…
Lee, Howard D.
This document contains an outline of a workshop on instructional supervision for vocational, technical, and adult education supervisors in Wisconsin. Materials used in the workshop, along with preparation materials, are included. Extensive appendixes include a list of workshop participants, the agenda, handouts on instructional supervision, and…
Bernard, Janine M.
This special issue about clinical supervision offers an array of contributions with disparate insights into the supervision process. Using a synergy of supervision model, the articles are categorized as addressing the infrastructure required for adequate supervision, the relationship dynamics endemic to supervision, or the process of delivering…
Ünal, Ali; Sürücü, Abdullah; Yavuz, Mustafa
The aim of this study is to investigate elementary and high school counselors' supervision processes and efficiency of their supervision. The interview method was used as it was thought to be better for realizing the aim of the study. The study group was composed of ten counselors who were chosen through purposeful sampling method. Data were…
Supervisors must become aware of the possible conflicts that could arise during clinical supervision. It is important that supervisors communicate their roles and expectations effectively with their supervisees. This paper supports the notion that supervision is a mutual agreement between the supervisee and the supervisor and the roles of…
Within the now burgeoning literature on doctoral research education, postgraduate research supervision continues to be a problematical issue, practically and theoretically. This paper seeks to explore and understand supervision as a distinctive kind of pedagogic practice. Informed by a larger research project, it draws on poststructuralism,…
Pawl, Jeree, Ed.
This newsletter theme issue focuses on the value of supervision in developing personnel in programs for infants with disabilities and their families. The first article, titled "Learning through Supervision and Mentorship To Support the Development of Infants, Toddlers and Their Families" (Emily Fenichel), is an essay explaining the thinking of the…
Miller, Robert; Miller, Kathleen
There is a natural link between clinical supervision and its current interest in effective teaching. Describes how the process affects practice in schools today. Lists Morris Cogan's eight phases of supervision and Madeline Hunter's seven steps in the development of an effective teaching lesson. Includes five references. (Author/MD)
Callaghan, Glenn M.
The interpersonal behavior therapy, Functional Analytic Psychotherapy (FAP) has been empirically investigated and described in the literature for a little over a decade. Still, little has been written about the process of supervision in FAP. While there are many aspects of FAP supervision shared by other contemporary behavior therapies and…
Sociodemographic and Geographic Correlates of Meeting Current Recommendations for Physical Activity in Middle-Aged French Adults: the Supplémentation en Vitamines et Minéraux Antioxydants (SUVIMAX) Study
Bertrais, Sandrine; Preziosi, Paul; Mennen, Louise; Galan, Pilar; Hercberg, Serge; Oppert, Jean-Michel
Objective. We evaluated the characteristics of French subjects meeting current public health recommendations for physical activity. Methods. We assessed leisure-time physical activity cross-sectionally in 7404 adults aged 45 to 68 years with applied logistic regression models. Results. Meeting the recommended physical activity levels was more likely in subjects aged 60 years and older and in women with higher education levels or living in rural areas and was less likely in smokers. No association was found with time spent watching television. The contribution of vigorous activity to total time spent being active was approximately 2 times higher in subjects meeting recommendations. Conclusions. Participation in some vigorous activity may be viewed as a “facilitator” to attain physical activity recommendations. Relationships with physical environment variables in Europe need further investigation. PMID:15333315
Tang, Hao; Chu, Stephen Mingyu; Hasegawa-Johnson, Mark; Huang, Thomas S
Content-based multimedia indexing, retrieval, and processing as well as multimedia databases demand the structuring of the media content (image, audio, video, text, etc.), one significant goal being to associate the identity of the content to the individual segments of the signals. In this paper, we specifically address the problem of speaker clustering, the task of assigning every speech utterance in an audio stream to its speaker. We offer a complete treatment to the idea of partially supervised speaker clustering, which refers to the use of our prior knowledge of speakers in general to assist the unsupervised speaker clustering process. By means of an independent training data set, we encode the prior knowledge at the various stages of the speaker clustering pipeline via 1) learning a speaker-discriminative acoustic feature transformation, 2) learning a universal speaker prior model, and 3) learning a discriminative speaker subspace, or equivalently, a speaker-discriminative distance metric. We study the directional scattering property of the Gaussian mixture model (GMM) mean supervector representation of utterances in the high-dimensional space, and advocate exploiting this property by using the cosine distance metric instead of the euclidean distance metric for speaker clustering in the GMM mean supervector space. We propose to perform discriminant analysis based on the cosine distance metric, which leads to a novel distance metric learning algorithm—linear spherical discriminant analysis (LSDA). We show that the proposed LSDA formulation can be systematically solved within the elegant graph embedding general dimensionality reduction framework. Our speaker clustering experiments on the GALE database clearly indicate that 1) our speaker clustering methods based on the GMM mean supervector representation and vector-based distance metrics outperform traditional speaker clustering methods based on the “bag of acoustic features” representation and statistical
Discusses recommendation, or preference ordering, in document retrieval systems that ranks documents in order of the likelihood with which they match the preferences of any person searching the system. Describes the ERIn (Evaluation-Recommendation-Information) model, a decision-theoretic framework for understanding information-related activity…
Lü, Linyuan; Medo, Matúš; Yeung, Chi Ho; Zhang, Yi-Cheng; Zhang, Zi-Ke; Zhou, Tao
The ongoing rapid expansion of the Internet greatly increases the necessity of effective recommender systems for filtering the abundant information. Extensive research for recommender systems is conducted by a broad range of communities including social and computer scientists, physicists, and interdisciplinary researchers. Despite substantial theoretical and practical achievements, unification and comparison of different approaches are lacking, which impedes further advances. In this article, we review recent developments in recommender systems and discuss the major challenges. We compare and evaluate available algorithms and examine their roles in the future developments. In addition to algorithms, physical aspects are described to illustrate macroscopic behavior of recommender systems. Potential impacts and future directions are discussed. We emphasize that recommendation has great scientific depth and combines diverse research fields which makes it interesting for physicists as well as interdisciplinary researchers.
... ACIP Vaccination Recommendations Why Immunize? Vaccines: The Basics Immunization Schedules for Adults in Easy-to-read Formats ... previous immunizations. View or Print a Schedule Recommended Immunizations for Adults (19 Years and Older) by Age ...
Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid).
Esposito, Susanna; Bonanni, Paolo; Maggi, Stefania; Tan, Litjan; Ansaldi, Filippo; Lopalco, Pier Luigi; Dagan, Ron; Michel, Jean-Pierre; van Damme, Pierre; Gaillat, Jacques; Prymula, Roman; Vesikari, Timo; Mussini, Cristina; Frank, Uwe; Osterhaus, Albert; Celentano, Lucia Pastore; Rossi, Marta; Guercio, Valentina; Gavazzi, Gaetan
Rapid population aging has become a major challenge in the industrialized world and progressive aging is a key reason for making improvement in vaccination a cornerstone of public health strategy. An increase in age-related disorders and conditions is likely to be seen in the near future, and these are risk factors for the occurrence of a number of vaccine-preventable diseases. An improvement in infectious diseases prevention specifically aimed at adults and the elderly can therefore also decrease the burden of these chronic conditions by reducing morbidity, disability, hospital admissions, health costs, mortality rates and, perhaps most importantly, by improving the quality of life. Among adults, it is necessary to identify groups at increased risk of vaccine-preventable diseases and highlight the epidemiological impact and benefits of vaccinations using an evidence-based approach. This document provides clinical practice guidance on immunization for adults in order to provide recommendations for decision makers and healthcare workers in Europe. Although immunization is considered one of the most impactful and cost-effective public health measures that can be undertaken, vaccination coverage rates among adults are largely lower than the stated goal of ≥ 95% among adults, and stronger efforts are needed to increase coverage in this population. Active surveillance of adult vaccine-preventable diseases, determining the effectiveness of the vaccines approved for marketing in the last 5 y, the efficacy and safety of vaccines in immunocompromised patients, as well as in pregnant women, represent the priorities for future research. PMID:27135390
... 32 National Defense 5 2010-07-01 2010-07-01 false Supervision. 727.11 Section 727.11 National... Supervision. The Judge Advocate General will exercise supervision over all legal assistance activities in the Department of the Navy. Subject to the supervision of the Judge Advocate General, officers in charge of...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Supervised recruitment. 656.21 Section 656.21... Supervised recruitment. (a) Supervised recruitment. Where the Certifying Officer determines it appropriate, post-filing supervised recruitment may be required of the employer for the pending application...
Engels, Dennis W., Ed.; Dameron, Joseph D., Ed.
Numerous researchers have recognized that supervision is critical in the preparation of counselors and psychotherapists. This supervision manual, which is organized around a coherent theory of training, is intended to help practitioners as they learn to supervise counselors and therapists. The manual is designed primarily for supervision of…
Rele, Kiran; Tarrant, C. Jane
Objective: The authors studied the regularity and content of supervision sessions in one of the U.K. postgraduate psychiatric training schemes (Mid-Trent). Methods: A questionnaire sent to psychiatry trainees assessed the timing and duration of supervision, content and protection of supervision time, and overall quality of supervision. The authors…
Joint European League Against Rheumatism and European Renal Association–European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis
Bertsias, George K; Tektonidou, Maria; Amoura, Zahir; Aringer, Martin; Bajema, Ingeborg; Berden, Jo H M; Boletis, John; Cervera, Ricard; Dörner, Thomas; Doria, Andrea; Ferrario, Franco; Floege, Jürgen; Houssiau, Frederic A; Ioannidis, John P A; Isenberg, David A; Kallenberg, Cees G M; Lightstone, Liz; Marks, Stephen D; Martini, Alberto; Moroni, Gabriela; Neumann, Irmgard; Praga, Manuel; Schneider, Matthias; Starra, Argyre; Tesar, Vladimir; Vasconcelos, Carlos; van Vollenhoven, Ronald F; Zakharova, Helena; Haubitz, Marion; Gordon, Caroline; Jayne, David; Boumpas, Dimitrios T
Objectives To develop recommendations for the management of adult and paediatric lupus nephritis (LN). Methods The available evidence was systematically reviewed using the PubMed database. A modified Delphi method was used to compile questions, elicit expert opinions and reach consensus. Results Immunosuppressive treatment should be guided by renal biopsy, and aiming for complete renal response (proteinuria <0.5 g/24 h with normal or near-normal renal function). Hydroxychloroquine is recommended for all patients with LN. Because of a more favourable efficacy/toxicity ratio, as initial treatment for patients with class III–IVA or A/C (±V) LN according to the International Society of Nephrology/Renal Pathology Society 2003 classification, mycophenolic acid (MPA) or low-dose intravenous cyclophosphamide (CY) in combination with glucocorticoids is recommended. In patients with adverse clinical or histological features, CY can be prescribed at higher doses, while azathioprine is an alternative for milder cases. For pure class V LN with nephrotic-range proteinuria, MPA in combination with oral glucocorticoids is recommended as initial treatment. In patients improving after initial treatment, subsequent immunosuppression with MPA or azathioprine is recommended for at least 3 years; in such cases, initial treatment with MPA should be followed by MPA. For MPA or CY failures, switching to the other agent, or to rituximab, is the suggested course of action. In anticipation of pregnancy, patients should be switched to appropriate medications without reducing the intensity of treatment. There is no evidence to suggest that management of LN should differ in children versus adults. Conclusions Recommendations for the management of LN were developed using an evidence-based approach followed by expert consensus. PMID:22851469
Fischer, Leonard S.; Becker, Andrew; Paraguya, Maria; Chukwu, Cecilia
Adults with intellectual and developmental disabilities (IDD) frequently have comorbidities that might interfere with colonoscopy preparation and examination. In this article, the authors review their experience with colonoscopies performed from 2002 through 2010 on adults with IDD at a state institution to evaluate quality and safety of…
Horn Book Magazine, 1980
Lists recommended paperback books for children in the following categories: picture books; stories for younger, for intermediate, and for older readers; folklore, legend, and mythology; and nonfiction. Tells if and when the original editions were reviewed in this journal. (GT)
The author argues that an intersubjective perspective on the analytic process makes the notion of purely didactic supervision, avoiding countertransference issues, untenable and that countertransference is both a clue to the analysand's psychic reality and a factor in its evolution. Supervision is seen as a highly personal learning process for both supervisor and supervisee and its emotional climate as a crucial factor in its evolution into a transitional space, generating new meanings. Supervision is portrayed as the crossroads of a matrix of object relations of three persons, of a complex network of transference/countertransference patterns. The avoidance or denial of the supervisor's subjective role in it, maintaining 'a myth of the supervisory situation', may make supervision stilted or even oppressive and stand in the way of resolving supervisory crises and stalemates. It is argued that several factors contribute to the conflictuality of supervision for all partners (often including the analysand): the continuous process of mutual evaluation, the reciprocal fears of exposing one's weaknesses, the impact of the institute as a setting and the transferences it arouses and the inherent conflicts of loyalty for each participant in the analytic/supervisory triad. The resulting dynamics and relational patterns could become a legitimate and freeing topic in supervisory discourse. PMID:10889961
Anderson, Dylan Zachary
This thesis develops the supervised gamma process Poisson factorization (S- GPPF) framework, a novel supervised topic model for joint modeling of count matrices and document labels. S-GPPF is fully generative and nonparametric: document labels and count matrices are modeled under a uni ed probabilistic framework and the number of latent topics is controlled automatically via a gamma process prior. The framework provides for multi-class classification of documents using a generative max-margin classifier. Several recent data augmentation techniques are leveraged to provide for exact inference using a Gibbs sampling scheme. The first portion of this thesis reviews supervised topic modeling and several key mathematical devices used in the formulation of S-GPPF. The thesis then introduces the S-GPPF generative model and derives the conditional posterior distributions of the latent variables for posterior inference via Gibbs sampling. The S-GPPF is shown to exhibit state-of-the-art performance for joint topic modeling and document classification on a dataset of conference abstracts, beating out competing supervised topic models. The unique properties of S-GPPF along with its competitive performance make it a novel contribution to supervised topic modeling.
Lindquist, Ingegerd; Johansson, Ingrid; Severinsson, Elisabeth
The value of supervision that is provided to student nurses during their education is high. The aim of this study was to evaluate the organizational changes in an educational program for Swedish student nurses, focusing on the content and quality of process-oriented supervision. The research question was: Do the organizational changes pertaining to the student nurses' supervision (its reduced frequency and mandatory nature) influence its content and quality and, if so, in which ways? The data were collected by focus group discussions and were analyzed by a qualitative content analysis. Three themes emerged: difficulties with the new organization, the content and learning outcomes of supervision, and the nurse supervisors' intentions. Supervision is recommended in order to achieve the goal of nursing education and to ensure that student nurses gain an understanding of their experiences, thus equipping them with the professional skills and competence that are required to meet patients' needs. PMID:21827585
A Smart Choice Adult Day Services Comparison At-a-Glance 1 Adult Day Services Assisted Living Home Care Nursing Homes Live at home with family ... supervision Nursing care available as needed during the day Flexibility to receive care only on days when ...
Ghadirian, Laleh; Sayarifard, Azadeh; Majdzadeh, Reza; Rajabi, Fatemeh; Yunesian, Masoud
Background: Conduction of thesis by the students is one of their major academic activities. Thesis quality and acquired experiences are highly dependent on the supervision. Our study is aimed at identifing the challenges in thesis supervision from both students and faculty members point of view. Methods: This study was conducted using individual in-depth interviews and Focus Group Discussions (FGD). The participants were 43 students and faculty members selected by purposive sampling. It was carried out in Tehran University of Medical Sciences in 2012. Data analysis was done concurrently with data gathering using content analysis method. Results: Our data analysis resulted in 162 codes, 17 subcategories and 4 major categories, "supervisory knowledge and skills", "atmosphere", "bylaws and regulations relating to supervision" and "monitoring and evaluation". Conclusion: This study showed that more attention and planning in needed for modifying related rules and regulations, qualitative and quantitative improvement in mentorship training, research atmosphere improvement and effective monitoring and evaluation in supervisory area. PMID:25250273
Hook, Joshua N; Watkins, C Edward; Davis, Don E; Owen, Jesse; Van Tongeren, Daryl R; Ramos, Marciana J
As a core component of multicultural orientation, cultural humility can be considered an important attitude for clinical supervisees to adopt and practically implement. How can cultural humility be most meaningfully incorporated in supervision? In what ways can supervisors stimulate the development of a culturally humble attitude in our supervisees? We consider those questions in this paper and present a model for addressing cultural humility in clinical supervision. The primary focus is given to two areas: (a) modeling and teaching of cultural humility through interpersonal interactions in supervision, and (b) teaching cultural humility through outside activities and experiences. Two case studies illustrating the model are presented, and a research agenda for work in this area is outlined. PMID:27329404
Hess, Shirley A; Knox, Sarah; Schultz, Jill M; Hill, Clara E; Sloan, Lea; Brandt, Susan; Kelley, Frances; Hoffman, Mary Ann
In interviews with 14 counseling center predoctoral interns regarding a significant nondisclosure in supervision, eight interns reported good supervisory relationships and six indicated that they experienced problematic supervisory relationships. Nondisclosures for the interns in good supervisory relationships related to personal reactions to clients, whereas nondisclosures for interns in problematic supervisory relationships related to global dissatisfaction with the supervisory relationship. In both groups, interns mentioned concerns about evaluation and negative feelings as typical reasons for nondisclosure. Additional reasons for nondisclosure for interns in problematic supervision were power dynamics, inhibiting demographic or cultural variables, and the supervisor's theoretical orientation. Both groups described negative effects of nondisclosure on themselves and their relationships with clients. Interns in problematic supervision also reported that nondisclosures had negative effects on the supervisory relationship. PMID:18815992
Maas, Meridean L; Specht, Janet P; Buckwalter, Kathleen C; Gittler, Josephine; Bechen, Kate
Caught between the inability or unwillingness of nursing home corporations and owners to redistribute revenue and the reluctance of federal and state agencies to increase payments to nursing homes, the nation's most vulnerable older adults are not receiving the care they deserve. Widespread recognition of substandard care and quality of life of older adults in nursing homes has existed for decades. In addition, there is substantial evidence that poor quality of care is related to inadequate numbers and training of nursing staff. Still, policy makers and nursing home owners have failed to take needed action. In the first article of this two-part series, major deficits in the care of older adult nursing home residents are reviewed, and research documenting the relationship between nursing home staffing and the quality of care and life of residents is summarized. PMID:20078025
Anderst, James; Moffatt, Mary
Primary care providers (PCPs) have the opportunity to improve child health and well-being by addressing supervision issues before an injury or exposure has occurred and/or after an injury or exposure has occurred. Appropriate anticipatory guidance on supervision at well-child visits can improve supervision of children, and may prevent future harm. Adequate supervision varies based on the child's development and maturity, and the risks in the child's environment. Consideration should be given to issues as wide ranging as swimming pools, falls, dating violence, and social media. By considering the likelihood of harm and the severity of the potential harm, caregivers may provide adequate supervision by minimizing risks to the child while still allowing the child to take "small" risks as needed for healthy development. Caregivers should initially focus on direct (visual, auditory, and proximity) supervision of the young child. Gradually, supervision needs to be adjusted as the child develops, emphasizing a safe environment and safe social interactions, with graduated independence. PCPs may foster adequate supervision by providing concrete guidance to caregivers. In addition to preventing injury, supervision includes fostering a safe, stable, and nurturing relationship with every child. PCPs should be familiar with age/developmentally based supervision risks, adequate supervision based on those risks, characteristics of neglectful supervision based on age/development, and ways to encourage appropriate supervision throughout childhood. PMID:25369578
Ashmore, Russell; Carver, Neil; Clibbens, Nicola; Sheldon, Julie
In 1994 the Department of Health recommended that nurses be introduced to the process of clinical supervision during pre-registration training. Since then a body of literature has emerged, largely focusing on students' experiences of a variety of training initiatives in supervision. There is however a paucity of literature exploring the experiences of nursing lecturers engaged in such initiatives. This paper reports the findings from one part of a three-year prospective longitudinal study examining mental health students' and lecturers' experiences of group clinical supervision undertaken as part of a pre-registration course. In this part of the study eight mental health nursing lecturers participated in semi-structured individual interviews in which they discussed their experiences of facilitating student supervision groups. Content analysis of the interview data produced eight major categories: 'attitudes to supervision'; 'perceptions of the student experience'; 'preparation and support'; 'approaches to supervision'; 'the "good" supervisor'; 'the lecturer as supervisor'; 'the structure and process of sessions; and 'the content of supervision'. The findings suggest that the idea of undertaking supervision for students is attractive to lecturers. However, several issues need to be addressed if this type of initiative is to be successful in preparing students for their future role as supervisee. PMID:21640446
Myers, Peter G; Bibbs, Tonya; Orozco, Candy
Residential care workers must be offered opportunities for formalized and systematic supervision in individual and group formats to provide the highest possible level of care to children and adolescents whom they serve. Effective supervision with residential care staff should be open to exploring issues at all levels of their experience and in relation to each component of the broader organizational structure within which they work. Systems theory offers a useful lens through which to view supervising staff in residential treatment. Systems theory proposes that human behavior is shaped by interactional processes and internal factors. Although the development of the individual occurs within intrinsic cognitive and emotional spheres, it also is believed to be related to several other elements. These additional variables include the point at which the family and system function in their own life cycle, the historical and current emotional context, the current and changing structure of the system, narratives, and the cultural context. This article discussed how methods of training and supervision would be most effective if they were designed specifically for the developmental level of the participants. Some literature reviews have concluded that youth care workers, like all professionals, pass through developmental stages and progress through them in their work. To assist youth care workers in their jobs, supervisors must understand these stages and the ways in which they may be enacted in the workplace. PMID:15062348
Bercik, Janet T.; Blair-Larsen, Susan M.
Notes that few college faculty use technology in their teaching despite rapid growth in technology-based instruction in K-12 education. Describes two projects using AT&T's PersonaLink Service and Sony's Magic Link PIC 1000 in field experience supervision. (SG)
Graham, Mary Amanda; Pehrsson, Dale-Elizabeth
This article offers a guide for bibliosupervision, a creative intervention that can be used when supervising counseling students. Bibliosupervision assists students in developing trust with the supervisor, as well as trust in their own abilities as emerging counselors. This supervisory process promotes the exploration of themes that might…
Huber, Charles H.
Reviews the section on supervision in the "Ethical Code for the International Association of Marriage and Family Counselors" and a recent article from the family counseling literature that provides a schema for more specific direction, thus enhancing the ethical code. (JBJ)
In order to continue to do great work with challenging youth, teachers should know that learning helps them be better professionals. Clinical supervision is one of the vehicles used. In a Re-ED program, those who work directly with youth (called teacher-counselors) are the primary agents of change. This makes it necessary to equip them with the…
West, John; Sonstegard, Manford
This paper contains a model for practicum supervision developed by Dr. Manford Sonstegard. The procedure allows the supervisor, student-counselor, client, and practicum class to participate in the session. Whereas one-way mirrors, audio tapes and audio-visual tapes allow for only delayed feedback from the supervisor, Dr. Sonstegard's approach…
This article explores the experiences of four early career academics as they begin to undertake doctoral supervision. Each supervisor focused on one of their supervisees and drew and described a Journey Plot depicting the high and low points of their supervisory experience with their student. Two questions were addressed by the research: (1) How…
Duarte, Rui; Raphael, Jon; Eldabe, Sam
This article provides a summary of the updated British Pain Society Guidance on Intrathecal Drug Delivery for the management of pain and spasticity in adults. We aim to highlight the areas of the guidance that have been updated and to provide a concise summary. PMID:27551415
Moore, Kristina M., Ed.; And Others
This document contains 27 essays and 5 policy statements regarding creation of a comprehensive and unified federal employment and training policy for youth and adults. The following essays are included: "In Search of the American Way" (Wills); "Rethink the Demand Side" (Smith); "The Federal Government as a Change Agent" (Nathan); "Making Sense of…
Bindels-de Heus, Karen G. C. B.; van Staa, AnneLoes; van Vliet, Ingeborg; Ewals, Frans V. P. M.; Hilberink, Sander R.
Many children with profound intellectual and multiple disabilities (PIMD) now reach adulthood. The aim of this study was to elicit parents' experiences with the transfer from pediatric to adult medical care. A convenience sample of 131 Dutch parents of young people with PIMD (16--26 years) completed a web-based questionnaire. Twenty-two…
El Maestro, Mexico, 1970
This document is an English-language abstract (approximately 1,500 words) of the Mexican Education Minister's remarks at a conference for adult education. He stated that educational reform was part of a far reaching plan for social reform; he characterized civic training as an all-sector task, transcending confinement to the classroom and…
DuVall, Charles R.; Pck, John E.
A project assessed educational effectiveness of the Adult Proficiency Level (APL) Pilot Project in Area B of the Indiana Office of Occupational Development. Activities involved design of data collection instrument, sampling and data collection at all six educational classroom sites in Area B, and data analysis. Program strengths identified were…
The supervision process represents one of the possible processes of life-long learning and development of an adult. This paper presents a developmental-educational model of supervision. It is a specific learning developmental and supportive method of professional reflection and counselling used in social and educational settings in Slovenia. Different concepts that explain learning and acquiring competence in the process of supervision are discussed. Special emphasis is given to the process of experiential learning (Kolb), learning within the zone of proximal development (Vygotsky) and the process of mental adaptation leading to new cognition (Piaget). PMID:12201990
Perera-Diltz, Dilani M.; Mason, Kimberly L.
Supervision is vital for personal and professional development of counselors. Practicing school counselors (n = 1557) across the nation were surveyed to explore current supervision practices. Results indicated that 41.1% of school counselors provide supervision. Although 89% receive some type of supervision, only 10.3% of school counselors receive…
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Government supervision. 836.572 Section 836.572 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SPECIAL... supervision. The contracting officer shall insert the clause at 852.236-78, Government supervision,...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgagor supervision. 200.105... supervision. (a) As long as the Commissioner is the insurer or holder of the mortgage, the Commissioner shall... Regulatory Agreement or other instrument granting the Commissioner supervision of the mortgagor....
Eklund, Katie; Aros-O'Malley, Megan; Murrieta, Imelda
Multicultural sensitivity and competency represent critical components to contemporary practice and supervision in school psychology. Internship and supervision experiences are a capstone experience for many new school psychologists; however, few receive formal training and supervision in multicultural competencies. As an increased number of…
Halse, Christine; Bansel, Peter
This paper is concerned with the ethics of relationships in doctoral supervision. We give an overview of four paradigms of doctoral supervision that have endured over the past 25 years and elucidate some of their strengths and limitations, contextualise them historically and consider their implications for doctoral supervision in the contemporary…
... 19 Customs Duties 1 2010-04-01 2010-04-01 false Responsible supervision. 111.28 Section 111.28... TREASURY CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.28 Responsible supervision... exercise responsible supervision and control (see § 111.1) over the transaction of the customs business...
... Office of Thrift Supervision Purchase of Branch Office(s) and/or Transfer of Assets/Liabilities AGENCY: Office of Thrift Supervision (OTS), Treasury. ACTION: Notice and request for comment. SUMMARY: The... Supervision within the Department of the Treasury will submit the proposed information collection...
Bultsma, Shawn A.
This qualitative study examined the supervision experiences of 11 new professional school counselors. They reported that their supervision experiences were most often administrative in nature; reports of clinical and developmental supervision were limited to participants whose supervisors were licensed as professional counselors. In addition,…
... 32 National Defense 4 2010-07-01 2010-07-01 true Supervision. 631.3 Section 631.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL....3 Supervision. The following will develop and have staff supervision over AFDCB and...
This research was conducted with the purpose of describing the general effectiveness of the academic supervision for teachers with three main focus, which is to analyze the competence of supervisors; academic supervision program implementation and the results and impact of academic supervision. The research location is SMU Maria Mediatrix Ambon,…
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Supervision. 46.79 Section... § 46.79 Supervision. Before payment is made under this subpart in respect of the tax, or tax and duty... under the supervision of an appropriate TTB officer who will be assigned for that purpose by...
... Office of Thrift Supervision Identity Theft Red Flags and Address Discrepancies Under the Fair and Accurate Credit Transactions Act of 2003 AGENCY: Office of Thrift Supervision (OTS), Treasury. ACTION... Office, Office of Thrift Supervision, 1700 G Street, NW., Washington, DC 20552, by fax to (202)...
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Supervision. 354.13 Section 354.13... CERTIFICATION VOLUNTARY INSPECTION OF RABBITS AND EDIBLE PRODUCTS THEREOF Basis of Service § 354.13 Supervision. All inspection service shall be subject to supervision at all times by the station supervisor,...
... 7 Agriculture 3 2010-01-01 2010-01-01 false Supervision. 56.6 Section 56.6 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections... Grading of Shell Eggs General § 56.6 Supervision. All grading service shall be subject to supervision...
... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Supervision responsibility. 2.91 Section 2.91 Judicial Administration DEPARTMENT OF JUSTICE PAROLE, RELEASE, SUPERVISION AND RECOMMITMENT OF....91 Supervision responsibility. (a) Pursuant to D.C. Code 24-133(c), the District of Columbia...
... 7 Agriculture 3 2010-01-01 2010-01-01 false Supervision. 70.12 Section 70.12 Agriculture... PRODUCTS AND RABBIT PRODUCTS Grading of Poultry Products and Rabbit Products General § 70.12 Supervision. All grading service shall be subject to supervision at all times by the responsible State...
Smyth, W. John
The etymology of the term "clinical supervision" is discussed. How clinical supervision can be used with teachers as an active force toward reform and change is then examined. Through clinical supervision teachers can assist each other to gain control over their own professional lives and destinies. (RM)
Clothier, Grant; Kingsley, Elizabeth
This training series was developed to improve the working relationships between supervising teachers and their student teachers. This supervising teacher's edition contains suggestions for such teachers as regards various activities dealing with the supervising/teaching situation, behavior problems, change, conference sessions, communication,…
Bonta, James; Rugge, Tanya; Scott, Terri-Lynne; Bourgon, Guy; Yessine, Annie K.
Community supervision has been an integral part of corrections since the establishment of probation more than 100 years ago. It has commonly been assumed that offenders benefit from community supervision much more than if they were incarcerated. However, empirical evidence in support of the effectiveness of community supervision in reducing…
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Supervised recruitment. 655.30 Section 655.30... Workers) § 655.30 Supervised recruitment. (a) Supervised recruitment. Where an employer is found to have... failed to adequately conduct recruitment activities or failed in any obligation of this part, the CO...
Harvey, Virginia Smith; Pearrow, Melissa
Previous studies suggest that the majority of school psychologists do not believe they receive sufficient supervision, despite a growing body of research providing empirical support for supervision to maintain and improve skills. This study explores the dynamics underlying the challenges of providing adequate supervision to school psychologists.…
... 19 Customs Duties 1 2013-04-01 2013-04-01 false Responsible supervision. 111.28 Section 111.28... TREASURY CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.28 Responsible supervision... exercise responsible supervision and control (see § 111.1) over the transaction of the customs business...
... 19 Customs Duties 1 2014-04-01 2014-04-01 false Responsible supervision. 111.28 Section 111.28... TREASURY CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.28 Responsible supervision... exercise responsible supervision and control (see § 111.1) over the transaction of the customs business...
... 19 Customs Duties 1 2011-04-01 2011-04-01 false Responsible supervision. 111.28 Section 111.28... TREASURY CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.28 Responsible supervision... exercise responsible supervision and control (see § 111.1) over the transaction of the customs business...
Spanjer, R. Allan
This author contends that student-teacher supervision cannot be done effectively in traditional ways. He discusses five myths of supervision and explains a program developed at Portland (Ore.) State University that puts the emphasis where it should be--on the supervising teacher. (Editor)
... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Government supervision... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 836.572 Government supervision. The contracting officer shall insert the clause at 852.236-78, Government supervision,...
... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Government supervision... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 836.572 Government supervision. The contracting officer shall insert the clause at 852.236-78, Government supervision,...
... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Government supervision... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 836.572 Government supervision. The contracting officer shall insert the clause at 852.236-78, Government supervision,...
... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Government supervision... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 836.572 Government supervision. The contracting officer shall insert the clause at 852.236-78, Government supervision,...
Colón-Ramos, Uriyoán; Finney Rutten, Lila J; Moser, Richard P; Colón-Lopez, Vivian; Ortiz, Ana P; Yaroch, Amy Lazarus
Health information correlates of fruit and vegetable intake and of knowledge of the fruit and vegetable recommendations were examined using bivariate and multivariate regressions with data from the 2007-2008 U.S. National Cancer Institute's Health Information National Trends Survey in the United States and in Puerto Rico. Residents from Puerto Rico had the lowest reported fruit and vegetable intake and the lowest knowledge of the recommended servings of fruits and vegetables to maintain good health, compared with U.S. Hispanics, non-Hispanic Whites, and Blacks. Sixty-seven percent of Puerto Rican residents and 62% of U.S. Hispanics reported never seeking information on health or medical topics. In multivariate analysis, those who never sought information on health or medical topics reported significantly lower fruit and vegetable intake (coefficient = -0.24; 95% CI [-0.38, -0.09]), and were less likely to know the fruit and vegetable recommendations (OR = 0.32; 95% CI [0.20, 0.52]), compared with those who obtained information from their health care providers. Health promotion initiatives in the United States and Puerto Rico have invested in mass media campaigns to increase consumption of and knowledge about fruit and vegetables, but populations with the lowest intake are less likely to seek information. Strategies must be multipronged to address institutional, economic, and behavioral constraints of populations who do not seek out health information from any sources. PMID:25204843
ESMAEILI, Naseh; ALIZADEH, Mohammad; TARIGHAT ESFANJANI, Ali; KHEIROURI, Sorayya
Background: Metabolic syndrome (MS) is defined as a pattern of metabolic disorders including central obesity, insulin resistance or hyperglycemia, high blood pressure, and dyslipidemia. Many studies show a clear relationship between diet and components of MS. The aim of the current study was to identify barriers to adherence to dietary recommendations among Iranian MS patients. Methods: The theory of reasoned action (TRA) served as the framework for this qualitative study. Data collection was conducted through six semi-structured focus group discussions, from Apr to Jun 2013. Subjects included 36 married men and women with different levels of education between the ages of 20–50 with MS diagnosed based on IDF’s (International Diabetes federation) criteria. All focus group discussions were audio recorded and transcribed. The thematic content analysis method was used to analyze the study data. Results: This study identified the most important barriers to adherence to dietary recommendations. MS patients have problems in their attitude toward MS components and their relationship to nutrition. They also had wrong attitudes toward fats and oils, salt, dairy products, cereals, and sugary drinks and sweets. Subjective norms that affects patient eating identifies too. Conclusion: We identified barriers to adherence to dietary recommendations in MS patients that could be used to prevent MS consequences and provide patients with nutrition education. PMID:27517000
Dupre, Madeleine; Echterling, Lennis G.; Meixner, Cara; Anderson, Robin; Kielty, Michele
In this phenomenological study, the authors explored supervision experiences of 13 licensed professional counselors in situations requiring crisis counseling. Five themes concerning crisis and supervision were identified from individual interviews. Findings support intensive, immediate crisis supervision and postlicensure clinical supervision.
Berg, Carla J; Stratton, Erin; Esiashvili, Natia; Mertens, Ann
We examined correlates of low engagement in the healthcare system, experiences with survivorship care, barriers to follow-up care, and potential resources for promoting follow-up care among young adult survivors of childhood cancers. We conducted a mixed-method study involving surveys of 106 survivors of childhood cancer aged 18-34 recruited from a university-affiliated children's hospital and an NCI-designated cancer center in the Southeastern USA. Phone-based semistructured interviews were then conducted in a subset of 26. Assessments included health factors, psychosocial factors, healthcare system interaction, and interest in resources to promote engagement in healthcare. Survey participants were on average 22.14 (SD = 3.16) years old, 50.0 % female, and 77.4 % White. Overall, 46.0 % had attended survivorship clinic, 47.2 % reported receiving a treatment summary, 68.9 % had a primary care provider, and 17.0 % reported no interaction with healthcare in the past 2 years. Correlates of less than annual healthcare provider visits included being older (p = 0.003), being male (p < 0.001), lack of insurance (p = 0.002), and having had chemotherapy (p = 0.05). Participants reported varied experiences in terms of how health and treatment information was presented, from none or too little to overwhelming or anxiety-provoking amounts. Barriers to engaging in survivorship care included no/limited insurance, time, or transportation; major life changes; anxiety; and difficulty transitioning from pediatrics to adult care. Participants highlighted the need for educational and psychosocial resources, particularly technology-based resources. Multilevel interventions are needed to increase engagement in survivorship care among young adult cancer survivors. Technology-based resources addressing social support and mental well-being are intervention possibilities. PMID:25948413
Stratton, Erin; Esiashvili, Natia; Mertens, Ann
We examined correlates of low engagement in the healthcare system, experiences with survivorship care, barriers to follow-up care, and potential resources for promoting follow-up care among young adult survivors of childhood cancers. We conducted a mixed-method study involving surveys of 106 survivors of childhood cancer aged 18–34 recruited from a university-affiliated children’s hospital and an NCI-designated cancer center in the Southeastern USA. Phone-based semistructured interviews were then conducted in a subset of 26. Assessments included health factors, psychosocial factors, healthcare system interaction, and interest in resources to promote engagement in healthcare. Survey participants were on average 22.14(SD=3.16) years old, 50.0 % female, and 77.4 % White. Overall, 46.0 % had attended survivorship clinic, 47.2 % reported receiving a treatment summary, 68.9 % had a primary care provider, and 17.0 % reported no interaction with healthcare in the past 2 years. Correlates of less than annual healthcare provider visits included being older (p=0.003), being male (p<0.001), lack of insurance (p=0.002), and having had chemotherapy (p=0.05). Participants reported varied experiences in terms of how health and treatment information was presented, from none or too little to overwhelming or anxiety-provoking amounts. Barriers to engaging in survivorship care included no/limited insurance, time, or transportation; major life changes; anxiety; and difficulty transitioning from pediatrics to adult care. Participants highlighted the need for educational and psychosocial resources, particularly technology-based resources. Multilevel interventions are needed to increase engagement in survivor-ship care among young adult cancer survivors. Technology-based resources addressing social support and mental well-being are intervention possibilities. PMID:25948413
Dai, Andrew M; Storkey, Amos J
We propose the supervised hierarchical Dirichlet process (sHDP), a nonparametric generative model for the joint distribution of a group of observations and a response variable directly associated with that whole group. We compare the sHDP with another leading method for regression on grouped data, the supervised latent Dirichlet allocation (sLDA) model. We evaluate our method on two real-world classification problems and two real-world regression problems. Bayesian nonparametric regression models based on the Dirichlet process, such as the Dirichlet process-generalised linear models (DP-GLM) have previously been explored; these models allow flexibility in modelling nonlinear relationships. However, until now, hierarchical Dirichlet process (HDP) mixtures have not seen significant use in supervised problems with grouped data since a straightforward application of the HDP on the grouped data results in learnt clusters that are not predictive of the responses. The sHDP solves this problem by allowing for clusters to be learnt jointly from the group structure and from the label assigned to each group. PMID:26353239
Snowball, J; Ross, K; Murphy, K
This paper describes a small research study designed to explore the role of the dissertation supervisor and to examine the potential of using reflection as a tool for learning and for enhancing professional educational practice. The authors met to discuss and reflect upon the processes of supervision and the role of the supervisor throughout the period of supervising three dissertation students. Each author maintained individual reflective written accounts of supervisory meetings with students. These accounts and the transcribed tape-recordings of the group meetings provided two sets of data which were analysed using qualitative techniques. From the data analysis the authors were able to identify various phases in dissertation supervision--partnership; setting the learning contract; signposting; ownership of the dissertation; letting go; the rush at the end; maintaining the balance--and also contextual issues of humanness; time; and energy, which were needed to sustain the supervisory processes. The role of the dissertation supervisor was illuminated and the potential of using reflection as a tool for developing professional educational practice was realized. The importance of constructive support while engaged in processes of reflection cannot be underestimated. PMID:7930105
Wang, Yunyun; Chen, Songcan
Though semi-supervised classification learning has attracted great attention over past decades, semi-supervised classification methods may show worse performance than their supervised counterparts in some cases, consequently reducing their confidence in real applications. Naturally, it is desired to develop a safe semi-supervised classification method that never performs worse than the supervised counterparts. However, to the best of our knowledge, few researches have been devoted to safe semi-supervised classification. To address this problem, in this paper, we invent a safety-control mechanism for safe semi-supervised classification by adaptive tradeoff between semi-supervised and supervised classification in terms of unlabeled data. In implementation, based on our recent semi-supervised classification method based on class memberships (SSCCM), we develop a safety-aware SSCCM (SA-SSCCM). SA-SSCCM, on the one hand, exploits the unlabeled data to help learning (as SSCCM does) under the assumption that unlabeled data can help learning, and on the other hand, restricts its prediction to approach that of its supervised counterpart least-square support vector machine (LS-SVM) under the assumption that unlabeled data can hurt learning. Therefore, prediction by SA-SSCCM becomes a tradeoff between those by semi-supervised SSCCM and supervised LS-SVM, respectively, in terms of the unlabeled data. As in SSCCM, the optimization problem in SA-SSCCM can be efficiently solved by the alternating iterative strategy, and the iteration convergence can theoretically be guaranteed. Experiments over several real datasets show the promising performance of SA-SSCCM compared with LS-SVM, SSCCM, and off-the-shelf safe semi-supervised classification methods. PMID:24808610
Evidence-based guidelines for management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults: recommendations from the British Association for Psychopharmacology.
Nutt, D J; Fone, K; Asherson, P; Bramble, D; Hill, P; Matthews, K; Morris, K A; Santosh, P; Sonuga-Barke, E; Taylor, E; Weiss, M; Young, S
Attention-deficit/hyperactivity disorder (ADHD) is an established diagnosis in children, associated with a large body of evidence on the benefits of treatment. Adolescents with ADHD are now leaving children's services often with no readily identifiable adult service to support them, which presents problems as local pharmacy regulations often preclude the prescription of stimulant drugs by general practitioners (GPs). In addition, adults with ADHD symptoms are now starting to present to primary care and psychiatry services requesting assessment and treatment. For these reasons, the British Association for Psychopharmacology (BAP) thought it timely to hold a consensus conference to review the body of evidence on childhood ADHD and the growing literature on ADHD in older age groups. Much of this initial guidance on managing ADHD in adolescents in transition and in adults is based on expert opinion derived from childhood evidence. We hope that, by the time these guidelines are updated, much evidence will be available to address the many directions for future research that are detailed here. PMID:17092962
Stone, Elizabeth; Fletcher, Keron
To assess the views of opiate-dependent individuals about supervised methadone consumption. Three groups of opinions were sought: (i). new patients referred for assessment and treatment, using rating scales; (ii). the consensus view of the Methadone Alliance (a national users' forum); and (iii). the consensus view of a local service users' forum. All three groups expressed the view that supervised consumption has an important place in methadone treatments. Users understand the need for daily supervision of methadone and are generally willing to accept it. Users' views provide support for the introduction of flexible methadone prescribing regimes incorporating supervised consumption. Privacy in pharmacies and the possibility of moving away from supervision are important elements in an acceptable programme. Supervised consumption is an important component of safe, effective and responsible methadone prescribing. PMID:12745415
Some progress has been made in a continuing effort to develop mathematical models of the behaviors of multi-agent systems known in biology, economics, and sociology (e.g., systems ranging from single or a few biomolecules to many interacting higher organisms). Living systems can be characterized by nonlinear evolution of probability distributions over different possible choices of the next steps in their motions. One of the main challenges in mathematical modeling of living systems is to distinguish between random walks of purely physical origin (for instance, Brownian motions) and those of biological origin. Following a line of reasoning from prior research, it has been assumed, in the present development, that a biological random walk can be represented by a nonlinear mathematical model that represents coupled mental and motor dynamics incorporating the psychological concept of reflection or self-image. The nonlinear dynamics impart the lifelike ability to behave in ways and to exhibit patterns that depart from thermodynamic equilibrium. Reflection or self-image has traditionally been recognized as a basic element of intelligence. The nonlinear mathematical models of the present development are denoted self-supervised dynamical systems. They include (1) equations of classical dynamics, including random components caused by uncertainties in initial conditions and by Langevin forces, coupled with (2) the corresponding Liouville or Fokker-Planck equations that describe the evolutions of probability densities that represent the uncertainties. The coupling is effected by fictitious information-based forces, denoted supervising forces, composed of probability densities and functionals thereof. The equations of classical mechanics represent motor dynamics that is, dynamics in the traditional sense, signifying Newton s equations of motion. The evolution of the probability densities represents mental dynamics or self-image. Then the interaction between the physical and
Lythgoe, Jeanne; Bacon, Lisa
Making it Better' (MiB) is a programme of reorganisation of future women and children's services in Greater Manchester (Children and Young People's Network (CYPN) 2011). The challenge for midwifery supervision is to maintain the safety and quality of services whilst managing the emotional needs of those involved. A consultation with midwives revealed they wanted an opportunity away from the clinical area to create a positive way forward. A study day was developed entitled 'Midwives building a future within reconfiguration'. Midwives shared their experiences and plans for the future, strengthening their resolve to continue being the advocates for women and the profession. PMID:22720443
Giese, Coralie; Mereckiene, Jolita; Danis, Kostas; O'Donnell, Joan; O'Flanagan, Darina; Cotter, Suzanne
The World Health Organization (WHO), and European Agencies recommend influenza vaccination for individuals at-risk due to age (≥65 years), underlying diseases, pregnancy and for health care workers (HCWs) in Europe. Pneumococcal vaccine is recommended for those at-risk of pneumococcal disease. In Ireland, vaccination uptake among at-risk adults is not routinely available. In 2013, we conducted a national survey among Irish residents ≥18 years of age, to estimate size and vaccination coverage of at-risk groups, and identify predictive factors for influenza vaccination. We used computer assisted telephone interviews to collect self-reported information on health, vaccination status, attitudes towards vaccination. We calculated prevalence and prevalence ratios (PR) using binomial regression. Overall, 1770 individuals participated. For influenza, among those aged 18-64 years, 22% (325/1485) [95%CI: 17%-20%] were at-risk; 28% [95%CI: 23%-33%] were vaccinated. Among those aged ≥65 years, 60% [95%CI: 54%-66%] were vaccinated. Influenza vaccine uptake among HCWs was 28% [95%CI: 21%-35%]. For pneumococcal disease, among those aged 18-64 years, 18% [95%CI: 16%-20%] were at-risk; 16% [95%CI: 12%-21%] reported ever-vaccination; among those aged ≥65 years, 36% [95%CI: 30%-42%] reported ever-vaccination. Main reasons for not receiving influenza vaccine were perceptions of not being at-risk, or not thinking of it; and among HCWs thinking that vaccination was not necessary or they were not at-risk. At-risk individuals were more likely to be vaccinated if their doctor had recommended it (PR 3.2; [95%CI: 2.4%-4.4%]) or they had access to free medical care or free vaccination services (PR 2.0; [95%CI: 1.5%-2.8%]). Vaccination coverage for both influenza and pneumococcal vaccines in at-risk individuals aged 18-64 years was very low. Influenza vaccination coverage among individuals ≥65 years was moderate. Influenza vaccination status was associated with GP vaccination
Part 3: Adult Basic Life Support and Automated External Defibrillation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.
Travers, Andrew H; Perkins, Gavin D; Berg, Robert A; Castren, Maaret; Considine, Julie; Escalante, Raffo; Gazmuri, Raul J; Koster, Rudolph W; Lim, Swee Han; Nation, Kevin J; Olasveengen, Theresa M; Sakamoto, Tetsuya; Sayre, Michael R; Sierra, Alfredo; Smyth, Michael A; Stanton, David; Vaillancourt, Christian
This review comprises the most extensive literature search and evidence evaluation to date on the most important international BLS interventions, diagnostics, and prognostic factors for cardiac arrest victims. It reemphasizes that the critical lifesaving steps of BLS are (1) prevention, (2) immediate recognition and activation of the emergency response system, (3) early high-quality CPR, and (4) rapid defibrillation for shockable rhythms. Highlights in prevention indicate the rational and judicious deployment of search-and-rescue operations in drowning victims and the importance of education on opioid-associated emergencies. Other 2015 highlights in recognition and activation include the critical role of dispatcher recognition and dispatch-assisted chest compressions, which has been demonstrated in multiple international jurisdictions with consistent improvements in cardiac arrest survival. Similar to the 2010 ILCOR BLS treatment recommendations, the importance of high quality was reemphasized across all measures of CPR quality: rate, depth, recoil, and minimal chest compression pauses, with a universal understanding that we all should be providing chest compressions to all victims of cardiac arrest. This review continued to focus on the interface of BLS sequencing and ensuring high-quality CPR with other important BLS interventions, such as ventilation and defibrillation. In addition, this consensus statement highlights the importance of EMS systems, which employ bundles of care focusing on providing high-quality chest compressions while extricating the patient from the scene to the next level of care. Highlights in defibrillation indicate the global importance of increasing the number of sites with public-access defibrillation programs. Whereas the 2010 ILCOR Consensus on Science provided important direction for the “what” in resuscitation (ie, what to do), the 2015 consensus has begun with the GRADE methodology to provide direction for the quality of
Summary Background Antiretroviral therapy (ART) is crucial for controlling HIV-1 infection through wide-scale treatment as prevention and pre-exposure prophylaxis (PrEP). Potent tenofovir disoproxil fumarate-containing regimens are increasingly used to treat and prevent HIV, although few data exist for frequency and risk factors of acquired drug resistance in regions hardest hit by the HIV pandemic. We aimed to do a global assessment of drug resistance after virological failure with first-line tenofovir-containing ART. Methods The TenoRes collaboration comprises adult HIV treatment cohorts and clinical trials of HIV drug resistance testing in Europe, Latin and North America, sub-Saharan Africa, and Asia. We extracted and harmonised data for patients undergoing genotypic resistance testing after virological failure with a first-line regimen containing tenofovir plus a cytosine analogue (lamivudine or emtricitabine) plus a non-nucleotide reverse-transcriptase inhibitor (NNRTI; efavirenz or nevirapine). We used an individual participant-level meta-analysis and multiple logistic regression to identify covariates associated with drug resistance. Our primary outcome was tenofovir resistance, defined as presence of K65R/N or K70E/G/Q mutations in the reverse transcriptase (RT) gene. Findings We included 1926 patients from 36 countries with treatment failure between 1998 and 2015. Prevalence of tenofovir resistance was highest in sub-Saharan Africa (370/654 [57%]). Pre-ART CD4 cell count was the covariate most strongly associated with the development of tenofovir resistance (odds ratio [OR] 1·50, 95% CI 1·27–1·77 for CD4 cell count <100 cells per μL). Use of lamivudine versus emtricitabine increased the risk of tenofovir resistance across regions (OR 1·48, 95% CI 1·20–1·82). Of 700 individuals with tenofovir resistance, 578 (83%) had cytosine analogue resistance (M184V/I mutation), 543 (78%) had major NNRTI resistance, and 457 (65%) had both. The mean plasma
The paper focuses on a routine activity of academic supervision: Giving and receiving feedback based on the student's master's thesis manuscript. Two case analyses are presented on fundamentally critical feedback. Such feedback constitutes a recommendation to the student to seriously rethink the thesis, but there are various interactional…
Walters, Scott T.; Vader, Amanda M.; Nguyen, Norma; Harris, T. Robert; Eells, Jennifer
Motivational interviewing (MI) has been recommended as a supervision style in probation. This project examined the effectiveness of an MI training curriculum on probation officer MI skill and subsequent probationer outcome. Twenty probation officers were randomized to receive MI training, or to a waiting list control, while an additional group of…
Cano, Esteban Vazquez; Garcia, Ma. Luisa Sevillano
This study aims to evaluate and analyze strategies, proposals, and ICT tools to promote a paradigm shift in educational supervision that enhances the schools of this century involved not only in teaching-face learning, but e-learning and blended learning. Traditional models of educational supervision do not guarantee adequate supervision of the…
Harvey, David R.; Schramski, Thomas G.
Proposes the Effective Supervision and Consultation (ESC) model as a guide for counselor educators who are helping agencies build effective supervision programs. The ESC model is presented with an emphasis on the assessment, training, and evaluation components of consultation services in counselor supervision. (JAC)
Bullough, Robert V., Jr.
Presents the case study of Heidi, a beginning Spanish teacher struggling with self-definition while shifting from content-area expert to friend to caring adult. The technical approach to supervision failed Heidi. To discover Heidi's actual experiences would have required relating to her in ways not encouraged by the existing evaluation system.…
Steeves, Valerie; Webster, Cheryl
Batten, Susan; Koenig, Stephanie L.
Under the 1996 federal welfare law, Temporary Assistance for Needy Families (TANF), an unmarried minor parent with a child generally cannot receive federal welfare assistance unless she is living with her family or in some type of adult-supervised arrangement. Exemptions are available and states have flexibility in designing their policies and…
... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Medical supervision. 640.62 Section 640.62 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.62 Medical supervision....
... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Medical supervision. 640.62 Section 640.62 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.62 Medical supervision....
... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Medical supervision. 640.62 Section 640.62 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.62 Medical supervision....
... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Medical supervision. 640.62 Section 640.62 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.62 Medical supervision....