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Sample records for paediatric practice impact

  1. Azithromycin use in paediatrics: A practical overview

    PubMed Central

    Ovetchkine, Philippe; Rieder, Michael J

    2013-01-01

    Azithromycin is an antibiotic that is commonly prescribed for upper and lower respiratory tract infections in children. While it has proven benefits, some concerns regarding azithromycin use have arisen in recent years. This practice point considers azithromycin therapy for acute respiratory infections in otherwise healthy children. Pharmacokinetics, spectrum of activity, the problem of resistant bacteria and clinical aspects are considered, along with recommendations for use and contraindications. Azithromycin should be avoided in patients with a significant risk of bacteremia. It is associated with pneumococcal resistance and, with stated exceptions, is generally not recommended for the treatment of acute pharyngitis, acute otitis media or pneumococcal community-acquired pneumonia in the paediatric population. PMID:24421702

  2. Impact of the European paediatric legislation in paediatric rheumatology: past, present and future.

    PubMed

    Ruperto, Nicolino; Vesely, Richard; Saint-Raymond, Agnes; Martini, Alberto

    2013-12-01

    Conducting clinical trials in paediatric rheumatology has been difficult mainly because of the lack of funding for academic studies and the lack of interest by pharmaceutical companies in the small and non-rewarding paediatric market. The situation changed dramatically a few years ago with the introduction of the Best Pharmaceuticals for Children Act in the USA and of specific legislation for the development of paediatric medicines (Paediatric Regulation) in the European Union (EU). The EU Paediatric Regulation had a positive impact in paediatric rheumatology-in particular, on the development of new treatments for children with juvenile idiopathic arthritis (JIA). Some problems remain, however, such as greater harmonisation of the regulatory aspects of medicines, how to handle me-too agents, how to conduct adequate pharmacokinetic studies and develop age-appropriate formulations, ethical problems in study review and implementation, and a change in the current JIA classification. The introduction of specific legislation, coupled with the existence of large international networks such as the Pediatric Rheumatology Collaborative Study Group (PRCSG at http://www.prcsg.org), covering North America, and the Paediatric Rheumatology International Trials Organisation (PRINTO at http://www.printo.it), covering more than 50 countries, has led to great advances in paediatric rheumatology. Future changes might increase the possibility of conducting trials with similar approaches in other paediatric rheumatological conditions and provide evidence-based treatments for children affected by rheumatic diseases. PMID:23962457

  3. Medicolegal issues in paediatric practice: proceedings of the 4th Northern Regional Paediatric Colloquium.

    PubMed

    Cousins, D A; Barrett, I; Kaplan, C A

    2004-01-01

    Ethical dilemmas frequently arise in paediatric practice. Given the nature of the speciality, these issues are pertinent to both the medical and legal professions. It is of potential benefit for the professions to meet and discuss such cases outwith the immediate clinical setting. A series of such meetings have been held in the Northern region. We report the proceedings of the fourth meeting. Four cases were presented and the issues arising were debated. The key points from each discussion are described. PMID:14984219

  4. Clinical practice: immune thrombocytopenia in paediatrics.

    PubMed

    Labarque, Veerle; Van Geet, Chris

    2014-02-01

    Immune thrombocytopenia (ITP) is a disease affecting both children and adults. It is defined as acquired isolated thrombocytopenia caused by the autoimmune production of anti-platelet antibodies. Childhood ITP most frequently occurs in young children who have been previously well, although a viral respiratory tract infection often precedes thrombocytopenia. A benign and self-limiting course is common, but major bleeding complications such as intracranial haemorrhage may occur. Yet one cannot predict which child will have a prolonged course of thrombocytopenia and who will develop an intracranial haemorrhage. In children without atypical characteristics, only minimal diagnostic investigations are needed, and most paediatric ITP patients do not need platelet-enhancing therapy even though various treatment options are available. A "watch and wait" strategy should be considered in paediatric patients with mild disease. Steroids, intravenous immunoglobulin G or anti-D immunoglobulin are the current first-line therapeutic measures for children at risk for severe bleeding. When life-threatening bleeding occurs, a combination of therapies is needed. In this review, we summarise the current knowledge on primary ITP in children and adolescents. PMID:24390128

  5. Thomas Willis's practice of paediatric neurology and neurodisability.

    PubMed

    Williams, A N

    2003-12-01

    Thomas Willis (1621-1675) is regarded as a founder of modern clinical neuroscience. He conceived the word "neurology" and left a body of work that defined mid-seventeenth-century medicine. Recent interpretations of Willis's work have led to a growing appreciation of his significant contributions to paediatric neurology, a speciality founded properly some three centuries after his death. This paper presents abstracts and plates taken from Willis's major published works, together with student notes by John Locke (1632-1704) and Robert Boyle (1627-1691) taken from lectures delivered by Willis in Oxford in the 1660s. The material embraces a wide variety of conditions now managed within modern paediatric neurology and neurodisability. In several cases, these are the first descriptions recorded in the medical literature. Willis fused astute history taking and clinical observation (sometimes supported by subsequent post-mortem studies) into a structured medical intervention. Willis's practice was state of the art, being based on acceptance of Harvey, a traditional Galenic infrastructure, iatrochemistry and Gassendi's "psychology". Although Willis's discoveries became a cornerstone of modern medical science, his medical practice did not lead to any therapeutic advances. However, up to the mid-eighteenth century his works were internationally accepted for their practical usefulness. The corpus of material left by Willis affords a fascinating insight into the clinical rationale of a seventeenth century physician in his management of paediatric cases. PMID:15069866

  6. The impact of paediatric early warning systems.

    PubMed

    Naddy, Catherine

    2012-10-01

    The child who is ill enough to be admitted to a children's ward has the potential to deteriorate rapidly. If this deterioration is not recognised and acted on in a timely manner, such children may require cardiopulmonary resuscitation, high dependency or intensive care. A paediatric early warning tool used with routine nursing observations will alert staff to the need for increased monitoring, the support of an associated outreach team or emergency medical attention. If the tool is used, a nurse can provide objective, transparent evidence of the child's condition to experienced clinicians. Appropriate education and supervision of staff should be ensured through the use of an outreach team. PMID:23167014

  7. Paediatric nursing in Europe: influencing policy and practice.

    PubMed

    Smith, Fiona

    2007-12-01

    The WHO European Health Report 2005 called for significant efforts from all countries to protect and promote children's health. Nurses across Europe have a major role to play in this effort but in many countries they lack the appropriate education and organisational support to make a meaningful contribution. A network of paediatric nursing associations in Europe was formed in 2003 to strengthen nurses' voices in child health policy and improve the potential of nurses to contribute to protecting and promoting the health of children and young people. Based on a consensus definition of the European paediatric nurse, the Paediatric Nursing Associations of Europe has developed consensus position statements on issues such as regulation and educational preparation. These have been used to lobby at national levels with positive results such as new mechanisms for identifying paediatric nurses on some national nursing registers, legislation to protect the use of the title 'paediatric nurse' and consideration of the reintroduction of specific programmes at both pre and post registration level for preparation of paediatric nurses. PMID:18196854

  8. Paediatric drug development: the impact of evolving regulations.

    PubMed

    Turner, M A; Catapano, M; Hirschfeld, S; Giaquinto, C

    2014-06-01

    Children deserve medicines that are adapted to their needs. The need to include children in drug development has been recognised increasingly over the past few decades. Legal and regulatory frameworks are well established in the EU and US. The amount of work done to study medicines for children is significantly greater than it was 10 years go. Proof-of-concept has been demonstrated for all segments of the paediatric drug development pipeline. It is now time to examine how the practice of developing medicines for children has evolved within those frameworks and to determine how that work should be generalised. This review describes the development of medicines for children and critically appraises the work that has been done within those frameworks. Significant effort is needed to realize the potential provided by the current regulatory framework. Using the work programme of the Global Research in Paediatrics (GRiP) Network of Excellence as a template we outline current work and future growing points. PMID:24556465

  9. Maintenance Intravenous Fluid Prescribing Practices Among Paediatric Residents

    PubMed Central

    Freeman, Michael A; Ayus, Juan C; Moritz, Michael L

    2014-01-01

    Aim To investigate the sodium composition of maintenance intravenous fluids used by paediatric residents throughout the United States in common clinical scenarios of arginine vasopressin excess. Methods We distributed an online survey to paediatric residency programs asking what type of maintenance intravenous fluids (0.2%, 0.45%, 0.9% NaCl or Lactated Ringers) they would administer in four common clinical scenarios of arginine vasopressin excess (gastroenteritis, pneumonia, meningitis and post-operative) in both a 6-month-old (mo) and a 13-year-old (yo) child. Results We had 472 responses, representing 5% of the total paediatric residency population in the US. Hypotonic maintenance intravenous fluids were selected in 78% of children (88.2% of 6 mo and 68.5% of 13 yo). Isotonic maintenance intravenous fluids were selected approximately twice as often for patients with meningitis as for those without (21.4% vs 8.7% 6 mo and 42.8% vs 27.7% 13 yo; p <.0.001). Conclusions The majority of US paediatric residents would prescribe hypotonic maintenance intravenous fluids in disease states associated with arginine vasopressin excess. However, a significant number of residents are using isotonic maintenance intravenous fluids. Isotonic fluids are more likely to be prescribed in older children and children with meningitis. PMID:22765308

  10. Paediatric Interventional Uroradiology

    SciTech Connect

    Barnacle, Alex M.; Wilkinson, A. Graham; Roebuck, Derek J.

    2011-04-15

    Paediatric interventional uroradiology lies at the intersection of the disciplines of paediatric interventional radiology and paediatric endourology. Interdisciplinary collaboration has led to the development of new techniques and refinement of procedures adopted from adult practice. This article reviews the major procedures used in paediatric interventional uroradiology, with emphasis on nephrostomy, percutaneous nephrolithotomy, balloon-burst pyeloplasty, and antegrade ureteric stenting.

  11. The impact of electronic cigarettes on the paediatric population

    PubMed Central

    Durmowicz, Elizabeth L

    2014-01-01

    Objective To review the impact of electronic cigarettes (e-cigarettes) on children. Methods Five electronic databases were searched through 31 December 2013. Studies in English that included data for children younger than 18 years of age were included. In addition, relevant data from articles identified during searches of the e-cigarette literature, relevant state survey data and paediatric voluntary adverse event reports submitted to the US Food and Drug Administration (FDA) were reviewed and included. Results Use of e-cigarettes by youth is increasing and is not limited to traditional cigarette smokers. Data regarding the reasons for youth e-cigarette initiation and ongoing use are limited. The effects of e-cigarette marketing and the availability of flavoured e-liquids on youth use are unknown. The abuse liability of e-cigarettes in youth is also not known. Unintentional exposures to e-cigarettes and e-liquids have been reported in children. The number of e-cigarette-related reports received by poison centres is increasing. No data are available on secondhand and thirdhand e-cigarette aerosol exposures in children. Conclusions Data on the impact of e-cigarettes on children are extremely limited. The available data indicate that youth awareness is high and use is increasing rapidly. The extent to which e-cigarette use in youth will result in nicotine dependence and subsequent use of other tobacco products is unknown. e-cigarettes present risks of unintentional nicotine exposure and are potential choking hazards. A greater understanding of the impact of e-cigarettes on children is needed and will be important in the evaluation of the effects of these products on the public health. PMID:24732163

  12. Professional and organizational commitment in paediatric occupational therapists: the influence of practice setting.

    PubMed

    Seruya, Francine M; Hinojosa, Jim

    2010-09-01

    The professional and organizational commitment of paediatric occupational therapists working in two distinct practice settings, schools and medically based settings, was investigated. A web-based survey program was used to administer a questionnaire to occupational therapists employed in New York, New Jersey and Connecticut. The study employed social identity theory as a guiding perspective in understanding therapists' professional and organizational commitment. One hundred and fifty-seven paediatric therapists responded to the Professional Commitment Questionnaire and the Organizational Commitment Questionnaire to gauge their commitment to both the profession and their employing organizations. Results indicated that paediatric therapists, regardless of employment setting, have high professional commitment. Paediatric occupational therapists employed in medically based settings indicated statistically significant higher organizational commitment than their school-based counterparts. For therapists that work in school settings, the presence of a professional cohort did not influence professional commitment scores. As the study employed a web-based survey methodology, only individuals who were members of associations and had access to a computer and the Internet were able to participate. Further study might include widening the participant pool as well as adding additional instruments to explore both professional and organizational commitment on a more national scale. PMID:20806287

  13. Survey of Oxygen Delivery Practices in UK Paediatric Intensive Care Units

    PubMed Central

    Peters, Mark J.

    2016-01-01

    Purpose. Administration of supplemental oxygen is common in paediatric intensive care. We explored the current practice of oxygen administration using a case vignette in paediatric intensive care units (PICU) in the united kingdom. Methods. We conducted an online survey of Paediatric Intensive Care Society members in the UK. The survey outlined a clinical scenario followed by questions on oxygenation targets for 5 common diagnoses seen in critically ill children. Results. Fifty-three paediatric intensive care unit members from 10 institutions completed the survey. In a child with moderate ventilatory requirements, 21 respondents (42%) did not follow arterial partial pressure of oxygen (PaO2) targets. In acute respiratory distress syndrome, cardiac arrest, and sepsis, there was a trend to aim for lower PaO2 as the fraction of inspired oxygen (FiO2) increased. Conversely, in traumatic brain injury and pulmonary hypertension, respondents aimed for normal PaO2 even as the FiO2 increased. Conclusions. In this sample of clinicians PaO2 targets were not commonly used. Clinicians target lower PaO2 as FiO2 increases in acute respiratory distress syndrome, cardiac arrest, and sepsis whilst targeting normal range irrespective of FiO2 in traumatic brain injury and pulmonary hypertension. PMID:27516901

  14. Discussing patient management online: the impact of roles on knowledge construction for students interning at the paediatric ward.

    PubMed

    De Wever, Bram; Van Winckel, Myriam; Valcke, Martin

    2008-03-01

    The objectives of this study are to explore the use of asynchronous discussion groups during medical students' clinical rotation in paediatrics. In particular, the impact of role assignment on the level of knowledge construction through social negotiation is studied. Case-based asynchronous discussion groups were introduced to enhance reflection and critical thinking on patient management and treatment, and to offer an exercise in evidence-based medical practice. Groups of approximately 4-5 students were asked to discuss 4 authentic cases during clinical rotation in paediatrics. 49 students interning at the paediatric ward participated in this study. With respect to role assignment, differences between groups (1) with a student or an instructor as moderator and (2) with or without a developer of alternatives for patient management were explored. A content analysis was performed to explore the different levels of social construction of knowledge. The results of multilevel logit analyses show a significant difference in knowledge construction through social negotiation between conditions with a student moderator and conditions where the instructor is moderating, but only when a developer of alternatives is involved. No significant difference was revealed between student-moderated and instructor-moderator groups without a developer of alternatives. It can be concluded that when both the moderator and developer role are assigned to students, their contributions are more likely to reflect a high level of knowledge construction. PMID:16841238

  15. Auditing paediatric diabetes care and the impact of a specialist nurse trained in paediatric diabetes

    PubMed Central

    Cowan, F; Warner, J; Lowes, L; Riberio, J; Gregory, J

    1997-01-01

    Accepted 13 May 1997
 AIMS—To define outcome measures for auditing the clinical care of children and adolescents with insulin dependent diabetes mellitus (IDDM) and to assess the benefit of appointing a dedicated paediatric trained diabetes specialist nurse (PDSN).
METHODS—Retrospective analysis of medical notes and hospital records. Glycaemic control, growth, weight gain, microvascular complications, school absence, and the proportion of children undergoing an annual clinical review and diabetes education session were assessed. The effect of the appointment of a PDSN on the frequency of hospital admission, length of inpatient stay, and outpatient attendance was evaluated.
RESULTS—Children with IDDM were of normal height and grew well for three years after diagnosis, but grew suboptimally thereafter. Weight gain was above average every year after diagnosis. Glycaemic control was poor at all ages with only 16% of children having an acceptable glycated haemoglobin. Eighty five per cent of patients underwent a formal annual clinical review, of whom 16% had background retinopathy and 20% microalbuminuria in one or more samples. After appointing the PDSN the median length of hospital stay for newly diagnosed patients decreased from five days to one day, with 10of 24 children not admitted. None of the latter was admitted during the next year. There was no evidence of the PDSN affecting the frequency of readmission or length of stay of children with established IDDM. Non-attendance at the outpatient clinic was reduced from a median of 19 to 10%.
CONCLUSIONS—Outcome measures for evaluating the care of children with IDDM can be defined and evaluated. Specialist nursing support markedly reduces the length of hospital stay of newly diagnosed patients without sacrificing the quality of care.

 PMID:9301347

  16. Beyond counting cases: public health impacts of national Paediatric Surveillance Units

    PubMed Central

    Grenier, D; Elliott, E J; Zurynski, Y; Pereira, R Rodrigues; Preece, M; Lynn, R; von Kries, R; Zimmermann, H; Dickson, N P; Virella, D

    2007-01-01

    Paediatric Surveillance Units (PSUs) have been established in 14 countries and facilitate national, prospective, active surveillance for a range of conditions, with monthly reporting by child health specialists. The International Network of Paediatric Surveillance Units (INoPSU) was established in 1998 and facilitates international collaboration among member PSUs and allows for sharing of resources, simultaneous data collection and hence comparison of data from different geographical regions. The impact of data collected by PSUs, both individually and collectively as members of INoPSU, on public health outcomes, clinical care and research is described. PMID:17158859

  17. Developing a culture to facilitate research capacity building for clinical nurse consultants in generalist paediatric practice.

    PubMed

    Wilkes, Lesley; Cummings, Joanne; McKay, Nicola

    2013-01-01

    This paper reports a research capacity building exercise with a group of CNCs practicing in the speciality of paediatrics in New South Wales (NSW), Australia. It explores the first step in building a research culture, through identifying the research priorities of members of the NSW Child Health Networks Paediatric Clinical Nurse Consultant group, and this forms the major focus of this paper. A nominal group technique (NGT) was utilised with sixteen members to identify research topics for investigation which were considered a priority for improving children's health care. The group reviewed and prioritised 43 research topics in children's health which were identified in the literature. As a result of conducting this research prioritisation exercise, the group chose two research topics to investigate: reasons for children representing to the Emergency Department and a comparison of the use of high-flow and low-flow nasal prongs in children with bronchiolitis. The research team will continue to mentor the nurses throughout their research projects which resulted from the NGT. One bridge to leadership development in enhancing patient care is translating knowledge to practice and policy development. This study leads the way for a group of CNCs in paediatric nursing to combine their research capacity and influence clinical knowledge. PMID:23956854

  18. Practising what we preach: A look at healthy active living policy and practice in Canadian paediatric hospitals

    PubMed Central

    Solh, Ziad; Adamo, Kristi B; Platt, Jennica L; Ambler, Kathryn; Boyd, Erin; Orrbine, Elaine; Cummings, Elizabeth; LeBlanc, Claire MA

    2010-01-01

    BACKGROUND: In the past 30 years, the rate of obesity has risen considerably among Canadian children. Paediatric hospitals are in a unique position to model healthy environments to Canadian children. OBJECTIVE: To obtain an overview of healthy active living (HAL) policy and practice in Canadian paediatric hospitals. METHODS: Working in partnership with the local Canadian Paediatric Society HAL champions and the Canadian Association of Paediatric Health Centres liaisons, a nationwide survey was conducted in 2006/2007 to identify healthy eating, physical activity and smoking cessation practices in all 16 Canadian paediatric academic hospitals. RESULTS: Policies addressing healthy eating and/or physical activity promotion were present in 50% of hospitals with a greater focus on nutrition. Wellness committees were created in 50% of the hospitals, most of which were recently established. Healthy food options were available in cafeterias, although they were often more expensive. Fast food outlets were present in 75% of hospitals. Although inpatient meals were designed by dietitians, 50% offered less nutritious replacement kids meals (ie, meal substitutions) on request. Options for play available to inpatients and outpatients were primarily sedentary, with screen-based activities and crafts predominating over active play. Physical activity promotion for staff focused on reduced membership fees to fitness centres and classes. CONCLUSION: Canadian paediatric hospitals do not adequately promote HAL for patients and staff. The present study findings suggest further effort is required to create necessary healthy lifestyle modifications in these institutions through Canadian Paediatric Society/Canadian Association of Paediatric Health Centres-led policy development and implementation initiatives. A national-level policy framework is required to regulate interhospital variability in policies and practices. PMID:22131867

  19. Paediatric day-case neurosurgery in a resource challenged setting: Pattern and practice

    PubMed Central

    Owojuyigbe, Afolabi Muyiwa; Komolafe, Edward O.; Adenekan, Anthony T.; Dada, Muyiwa A.; Onyia, Chiazor U.; Ogunbameru, Ibironke O.; Owagbemi, Oluwafemi F.; Talabi, Ademola O.; Faponle, Fola A.

    2016-01-01

    Background: It has been generally observed that children achieve better convalescence in the home environment especially if discharged same day after surgery. This is probably due to the fact that children generally tend to feel more at ease in the home environment than in the hospital setting. Only few tertiary health institutions provide routine day-case surgery for paediatric neurosurgical patients in our sub-region. Objective: To review the pattern and practice of paediatric neurosurgical day-cases at our hospital. Patients and Methods: A prospective study of all paediatric day-case neurosurgeries carried out between June 2011 and June 2014. Results: A total of 53 patients (34 males and 19 females) with age ranging from 2 days to 14 years were seen. Majority of the patients (77.4%) presented with congenital lesions, and the most common procedure carried out was spina bifida repair (32%) followed by ventriculoperitoneal shunt insertion (26.4%) for hydrocephalus. Sixty-eight percentage belonged to the American Society of Anesthesiologists physical status class 2, whereas the rest (32%) belonged to class 1. General anaesthesia was employed in 83% of cases. Parenteral paracetamol was used for intra-operative analgesia for most of the patients. Two patients had post-operative nausea and vomiting and were successfully managed. There was no case of emergency re-operation, unplanned admission, cancellation or mortality. Conclusion: Paediatric day-case neurosurgery is feasible in our environment. With careful patient selection and adequate pre-operative preparation, good outcome can be achieved. PMID:27251657

  20. The Clinical Impact of Chromosomal Microarray on Paediatric Care in Hong Kong

    PubMed Central

    Tao, Victoria Q.; Chan, Kelvin Y. K.; Chu, Yoyo W. Y.; Mok, Gary T. K.; Tan, Tiong Y.; Yang, Wanling; Lee, So Lun; Tang, Wing Fai; Tso, Winnie W. Y.; Lau, Elizabeth T.; Kan, Anita S. Y.; Tang, Mary H.; Lau, Yu-lung; Chung, Brian H. Y.

    2014-01-01

    Objective To evaluate the clinical impact of chromosomal microarray (CMA) on the management of paediatric patients in Hong Kong. Methods We performed NimbleGen 135k oligonucleotide array on 327 children with intellectual disability (ID)/developmental delay (DD), autism spectrum disorders (ASD), and/or multiple congenital anomalies (MCAs) in a university-affiliated paediatric unit from January 2011 to May 2013. The medical records of patients were reviewed in September 2013, focusing on the pathogenic/likely pathogenic CMA findings and their “clinical actionability” based on established criteria. Results Thirty-seven patients were reported to have pathogenic/likely pathogenic results, while 40 had findings of unknown significance. This gives a detection rate of 11% for clinically significant (pathogenic/likely pathogenic) findings. The significant findings have prompted clinical actions in 28 out of 37 patients (75.7%), while the findings with unknown significance have led to further management recommendation in only 1 patient (p<0.001). Nineteen out of the 28 management recommendations are “evidence-based” on either practice guidelines endorsed by a professional society (n = 9, Level 1) or peer-reviewed publications making medical management recommendation (n = 10, Level 2). CMA results impact medical management by precipitating referral to a specialist (n = 24); diagnostic testing (n = 25), surveillance of complications (n = 19), interventional procedure (n = 7), medication (n = 15) or lifestyle modification (n = 12). Conclusion The application of CMA in children with ID/DD, ASD, and/or MCAs in Hong Kong results in a diagnostic yield of ∼11% for pathogenic/likely pathogenic results. Importantly the yield for clinically actionable results is 8.6%. We advocate using diagnostic yield of clinically actionable results to evaluate CMA as it provides information of both clinical validity and clinical utility. Furthermore, it

  1. Manipulation of drugs to achieve the required dose is intrinsic to paediatric practice but is not supported by guidelines or evidence

    PubMed Central

    2013-01-01

    Background A lack of age-appropriate formulations can make it difficult to administer medicines to children. A manipulation of the dosage form may be required to achieve the required dose. This study aimed to describe medicines that are manipulated to achieve the required dose in paediatric practice. Method A structured, undisguised observational study and postal survey. The observational study investigated drug manipulations occurring in clinical practice across three sites. The questionnaire, administered to a sample of paediatric nurses throughout the UK, surveyed manipulations conducted and nurses’ experiences and views. Results The observational study identified 310 manipulations, of which 62% involved tablets, 21% were intravenous drugs and 10% were sachets. Of the 54 observed manipulations 40 involved tablets with 65% of the tablets being cut and 30% dispersed to obtain a smaller dose. 188 manipulations were reported by questionnaire respondents, of these 46% involved tablets, 12% were intravenous drugs, and 12% were nebuliser solutions. Manipulations were predominantly, but not exclusively, identified in specialist clinical areas with more highly dependent patients. Questionnaire respondents were concerned about the accuracy of the dose achieved following manipulations and the lack of practice guidance. Conclusion Manipulations to achieve the required dose occur throughout paediatric in-patient settings. The impact of manipulations on the efficacy of the drugs, the accuracy of the dose and any adverse effects on patients is not known. There is a need to develop evidence-based guidance for manipulations of medicines in children. PMID:23688279

  2. Handwashing practice and policy variability when caring for central venous catheters in paediatric intensive care.

    PubMed

    Morritt, Mary Lou; Harrod, Mary Ellen; Crisp, Jackie; Senner, Anne; Galway, Robyn; Petty, Sheila; Maurice, Lucy; Harvey, Alice; Hardy, Jan; Donnellan, Robyn

    2006-02-01

    It has been estimated that there may be as many as 150,000 healthcare associated infections (HCAI) in Australia each year, contributing to 7,000 deaths, many of which could be prevented through the implementation of appropriate infection control practices. Contact with contaminated hands is a primary source of HCAI. Intensive care staff have been identified as one of the least adherent groups of health care professionals with handwashing; they are less likely to practise hand antisepsis before invasive procedures than staff working in other patient care specialties. The study examined the self-reported clean and aseptic handwashing practices of nurses working in paediatric intensive care units (PICUs) across Australia and New Zealand, the patterns in variation between nurses' reported handwashing practices and the local policies, and patterns in the duration of procedural handwashing for specific procedures. A survey was undertaken in 2001 in which participating tertiary paediatric hospitals provided copies of their infection control policies pertaining to central venous catheter (CVC) management; five nurses on each unit were asked to provide information in relation to their handwashing practices. Seven hospitals agreed to participate and 30 nurses completed the survey. The study found an enormous level of variation among and between nurses' reported practices and local policies. This variation extended across all aspects of handwashing practices - duration and extent of handwash, type of solution and drying method used. The rigour of handwashing varied according to the procedure undertaken, with some evidence that nurses made their own risk assessments based on the proximity of the procedure to the patient. In conclusion, this study's findings substantiate the need for standardisation of practice in line with the current Centers for Disease Control and Prevention Guidelines, including the introduction of alcohol handrub. PMID:16544674

  3. The future potential of eicosanoids and their inhibitors in paediatric practice.

    PubMed

    Shimizu, T

    1998-08-01

    Eicosanoids may have many potential uses in paediatric practice. Since E-type prostaglandins were first applied to treat ductus-dependent congenital heart diseases in paediatric practice, many eicosanoid-related drugs have been examined for the treatment of pathophysiological conditions in children. Prostaglandins (PG), thromboxane (TX) and leukotrienes (LT), produced from arachidonic acid in the phospholipids of cell membranes, are considered to be biologically active eicosanoids. Corticosteroids reduce eicosanoid production by impairing phospholipase A2 activation, while cyclo-oxygenase inhibiting drugs such as the nonsteroidal anti-inflammatory drugs (NSAID) suppress PG and TX production. PGE1 (alprostadil) and PGE2 (dinoprostone) therapy has been shown to improve oxygenation in neonates whose pulmonary and systemic blood flow are dependent on a patent ductus arteriosus, while epoprostenol (prostacyclin, PGI2) and beraprost (beraprost sodium), another PGI2 analogue, are often effective as acute vasodilators in paediatric pulmonary hypertension. Synthetic PGE analogues such as misoprostol have gastric antisecretory and cytoprotective effects, and are effective in both prophylaxis and treatment of NSAID-induced gastroduodenal mucosal lesions. Both alprostadil and epoprostenol have been shown to be effective in treating peripheral vascular and skin diseases. Since TX, a platelet aggregator and vasoconstrictor, has been implicated as a potential mediator of asthma, its inhibition by agents such as seratrodast (AA-2414) and ozagrel (OKY-046) has proven effective in the treatment of adult patients with asthma; studies of these agents in paediatric patients is awaited with interest. Developing the clinical use of eicosanoid-related drugs and assessing the potential use of these drugs requires a 3-phase approach: reducing the complications in the treatment of neonates with ductus-dependent congenital heart diseases and primary pulmonary hypertension requiring PGE1, PGE2

  4. Paediatric manpower.

    PubMed Central

    Liberman, M M; Bellman, M H

    1982-01-01

    Two investigations of paediatric manpower in England, Wales, and Northern Ireland were carried out, each using a different method. The first survey located registrars and senior registrars and checked on their occupational status 3 years later in order to see which ones had been promoted. Loss factors--such as emigration, retirement for personal reasons, part-time training, or transfer to general practice, community paediatrics, or other medical specialties--were examined closely. The second survey was a cross-sectional analysis of the entire paediatric establishment. It examined in particular the distribution of consultants and registrars. Using figures from survey 2 and loss factors from survey 1, a model of the paediatric career structure could be constructed. This showed that the present career pyramid would be unable to absorb the current number of registrars in training. There is an urgent need for a comprehensive registration scheme for registrars, especially those with honorary contracts, who are not currently included in official records. Paediatrics is unique in having a high proportion of women for whom there is little opportunity of reconciling career aspirations with family commitments. PMID:7125690

  5. The evolution of paediatrics from archaeological times to the mid-nineteenth century and the historical influence on present day practice.

    PubMed

    Rangroo, Vinita

    2008-05-01

    The history of childcare dates back to the beginning of time. This article critically analyses the history of paediatrics from its roots to mid-nineteenth century with the view to examine its evolution and influence on today's practice. Paediatrics as a sub-speciality of medicine only began in the fifteenth century when the Four Incunabula were published in the West. This was the first attempt at producing a comprehensive and accessible reference paediatric text. However, long before the Incunabula, early traces of childcare are found in different cultures like Egyptian, Indian and Chinese. Modern paediatrics is a highly advanced field of medicine that relies on many recent technological innovations. In spite of these, this paper concludes that paediatrics today is very much based on concepts, such as observation and clinical skills, introduced many centuries ago. The basic approach used in everyday clinical practice owes more to century-old ideas of scientists. PMID:18394119

  6. The world's longest surviving paediatric practices: some themes of Aboriginal medical ethnobotany in Australia.

    PubMed

    Pearn, John

    2005-01-01

    Contemporary paediatric practices of Australian Aboriginal men and women, in more than 100 Aboriginal Language Groups, comprise a living discipline whose origins predate Western medicine by tens of millennia. The history of paediatrics acknowledges this surviving continuum of the world's oldest child-care practices. Because of the inextricable nexus between Aboriginal men and women and the land in which they live, medical ethnobotany forms a major part of the medical aspects of Aboriginal child care. Traditional tribal healers, called 'Nungungi' in some language groups of Central Australia, are identified as such whilst still young children and are given special education in the healing arts, especially that of medical ethnobotany, by older healers. Distinct from this specialized role, all Aboriginal men and women (and in particular grandmothers) in traditional communities use a sophisticated botanical materia medica in the treatment of sick and injured children. In cultures in transition, medical ethnobotanical practices may persist long after the local use of flora as sources of traditional food, weaponry, totemic identity and religious rites have disappeared. Some selected botanical 'cures' were adopted by early European settlers and a number of such relict uses have become part of mainstream Western life today, particularly as this applies to self-medication. Drugs and medicaments used in the treatment of children are obtained from leaves, bark, roots and flowers, usually as fresh preparations. They are prepared as infusions, decoctions and macerations and may be enjoined with emollients such as emu or kangaroo fat for topical application. Botanical drugs and medicaments are usually prepared fresh for each administration and are rarely stored. Contemporary Australian ethnobotany exploits the medicinal properties of more than 100 genera - using such extracts as antiseptics, analgesics, astringents, antipyretics, sedatives, hypnotics, expectorants and

  7. Neurodevelopmental and behavioural paediatrics.

    PubMed

    McDowell, Michael

    2015-01-01

    One of the notable shifts in Paediatrics across the last 50 years has been towards disorders that are chronic and qualitative in nature. In addition to physical health, these impact on childhood development, behaviour and wellbeing. Understanding and management of these problems extends the traditional biological toolkit of paediatrics into the complexities of uncertainties of psychological and social context. In Australasia, the profession has responded with the development of Community Paediatrics as a recognised sub-specialty, of which Neurodevelopmental and Behavioural Paediatrics is an important component. These developments are reviewed along with consideration of future challenges for this field of health care. PMID:25586854

  8. The Impact and Successes of a Paediatric Endocrinology Fellowship Program in Africa.

    PubMed

    Odundo, Gordon Otieno; Ngwiri, Thomas; Otuoma, Olivia; Laigong, Paul; Mukhwana, Renson; Limbe, Mary Slessor; Chanzu, Nadia Musimbi

    2016-01-01

    Background. The prevalence and distribution of endocrine disorders in children in Africa are not well known because most cases are often undiagnosed or diagnosed too late. The awareness of this led to the launch of the Paediatric Endocrinology Training Center for Africa (PETCA) designed to improve quality and access to health care by training paediatricians from Africa in paediatric endocrinology. Methods. The fellowship is undertaken over an 18-month period: six months of clinical and theoretical training in Kenya, nine months of project research at the fellow's home country, and three months of consolidation in Kenya. Upon completion, certified paediatricians are expected to set up centers of excellence. Results. There have been two phases, phase I from January 2008 to October 2012 and phase II from January 2012 to April 2015. Fifty-four fellows from 12 African countries have been certified, 34 (phase I) and 20 (phase II). Over 1,000 patients with wide ranging diabetes and endocrine disorders have been diagnosed and treated and are being followed up at the centers of excellence. Conclusion. The successes of the PETCA initiative demonstrate the impact a capacity building and knowledge transfer model can have on people in resource-poor settings using limited resources. PMID:26904118

  9. The Impact and Successes of a Paediatric Endocrinology Fellowship Program in Africa

    PubMed Central

    Odundo, Gordon Otieno; Ngwiri, Thomas; Otuoma, Olivia; Laigong, Paul; Mukhwana, Renson; Limbe, Mary Slessor; Chanzu, Nadia Musimbi

    2016-01-01

    Background. The prevalence and distribution of endocrine disorders in children in Africa are not well known because most cases are often undiagnosed or diagnosed too late. The awareness of this led to the launch of the Paediatric Endocrinology Training Center for Africa (PETCA) designed to improve quality and access to health care by training paediatricians from Africa in paediatric endocrinology. Methods. The fellowship is undertaken over an 18-month period: six months of clinical and theoretical training in Kenya, nine months of project research at the fellow's home country, and three months of consolidation in Kenya. Upon completion, certified paediatricians are expected to set up centers of excellence. Results. There have been two phases, phase I from January 2008 to October 2012 and phase II from January 2012 to April 2015. Fifty-four fellows from 12 African countries have been certified, 34 (phase I) and 20 (phase II). Over 1,000 patients with wide ranging diabetes and endocrine disorders have been diagnosed and treated and are being followed up at the centers of excellence. Conclusion. The successes of the PETCA initiative demonstrate the impact a capacity building and knowledge transfer model can have on people in resource-poor settings using limited resources. PMID:26904118

  10. The Working Practices and Clinical Experiences of Paediatric Speech and Language Therapists: A National UK Survey

    ERIC Educational Resources Information Center

    Pring, Tim; Flood, Emma; Dodd, Barbara; Joffe, Victoria

    2012-01-01

    Background: The majority of speech and language therapists (SLTs) work with children who have speech, language and communication needs. There is limited information about their working practices and clinical experience and their views of how changes to healthcare may impact upon their practice. Aims: To investigate the working practices and…

  11. Discussing Patient Management Online: The Impact of Roles on Knowledge Construction for Students Interning at the Paediatric Ward

    ERIC Educational Resources Information Center

    De Wever, Bram; Van Winckel, Myriam; Valcke, Martin

    2008-01-01

    The objectives of this study are to explore the use of asynchronous discussion groups during medical students' clinical rotation in paediatrics. In particular, the impact of role assignment on the level of knowledge construction through social negotiation is studied. Case-based asynchronous discussion groups were introduced to enhance reflection…

  12. Organisation of workplace learning: a case study of paediatric residents' and consultants' beliefs and practices.

    PubMed

    Skipper, Mads; Nøhr, Susanne Backman; Jacobsen, Tine Klitgaard; Musaeus, Peter

    2016-08-01

    Several studies have examined how doctors learn in the workplace, but research is needed linking workplace learning with the organisation of doctors' daily work. This study examined residents' and consultants' attitudes and beliefs regarding workplace learning and contextual and organisational factors influencing the organisation and planning of medical specialist training. An explorative case study in three paediatric departments in Denmark including 9 days of field observations and focus group interviews with 9 consultants responsible for medical education and 16 residents. The study aimed to identify factors in work organisation facilitating and hindering residents' learning. Data were coded through an iterative process guided by thematic analysis. Findings illustrate three main themes: (1) Learning beliefs about patient care and apprenticeship learning as inseparable in medical practice. Beliefs about training and patient care expressed in terms of training versus production caused a potential conflict. (2) Learning context. Continuity over time in tasks and care for patients is important, but continuity is challenged by the organisation of daily work routines. (3) Organisational culture and regulations were found to be encouraging as well inhibiting to a successful organisation of the work in regards to learning. Our findings stress the importance of consultants' and residents' beliefs about workplace learning as these agents handle the potential conflict between patient care and training of health professionals. The structuring of daily work tasks is a key factor in workplace learning as is an understanding of underlying relations and organisational culture in the clinical departments. PMID:26696031

  13. How have the past 5 years of research changed clinical practice in paediatric nephrology?

    PubMed Central

    Marks, Stephen D

    2007-01-01

    Clinical practice in paediatric nephrology is continuously evolving to mirror the research output of the 21st century. The management of antenatally diagnosed renal anomalies, urinary tract infections, nephrotic syndrome and hypertension is becoming more evidence based. Obesity and related hypertension is being targeted at primary and secondary care. The evolving field of molecular and cytogenetics is discovering genes that are facilitating clinicians and families with prenatal diagnoses and understanding of disease processes. The progression of chronic kidney disease in childhood to end‐stage renal failure (ESRF) can be delayed using medical treatment to reduce proteinuria and treat hypertension. Pre‐emptive living‐related renal transplantation has become the treatment of choice for children with ESRF, thereby reducing the morbidity and mortality associated with peritoneal and haemodialysis. Although peritoneal dialysis, which is performed in the patient's home, is the preferred modality for children for whom there is no living or deceased donor for transplantation, home nocturnal haemodialysis is becoming a feasible option. Imaging modalities with the use of magnetic resonance and computerised tomography are continuously improving. As mortality for renal and vasculitic diseases improves, the gauntlet is now thrown down to reduce morbidity with secondary prevention of longer‐term complications such as atherosclerosis and hyperlipidaemia. Clinical and drug trials in the fields of hypertension, nephrotic syndrome, systemic lupus erythematosus, vasculitis and transplantation are producing more effective treatments, thereby reducing the morbidity resulting from the disease processes and the side effects of drugs. PMID:17376945

  14. What Evidence Underlies Clinical Practice in Paediatric Surgery? A Systematic Review Assessing Choice of Study Design

    PubMed Central

    Allin, Benjamin; Knight, Marian

    2016-01-01

    Objective Identify every paediatric surgical article published in 1998 and every paediatric surgical article published in 2013, and determine which study designs were used and whether they were appropriate for robustly assessing interventions in surgical conditions. Methods A systematic review was conducted according to a pre-specified protocol (CRD42014007629), using EMBASE and Medline. Non-English language studies were excluded. Studies were included if meeting population criteria and either condition or intervention criteria. Population: Children under the age of 18, or adults who underwent intervention for a condition managed by paediatric surgeons when they were under 18 years of age. Condition: One managed by general paediatric surgeons. Intervention: Used for treatment of a condition managed by general paediatric surgeons. Main Outcome Measure Studies were classified according to whether the IDEAL collaboration recommended their design for assessing surgical interventions or not. Change in proportions between 1998 and 2013 was calculated. Results 1581 paediatric surgical articles were published in 1998, and 3453 in 2013. The most commonly used design, accounting for 45% of studies in 1998 and 46.8% in 2013, was the retrospective case series. Only 1.8% of studies were RCTs in 1998, and 1.9% in 2013. Overall, in 1998, 9.8% of studies used a recommended design. In 2013, 11.9% used a recommended design (proportion increase 2.3%, 95% confidence interval 0.5% increase to 4% increase, p = 0.017). Conclusions and Relevance A low proportion of published paediatric surgical manuscripts utilise a design that is recommended for assessing surgical interventions. RCTs represent fewer than 1 in 50 studies. In 2013, 88.1% of studies used a less robust design, suggesting the need for a new way of approaching paediatric surgical research. PMID:26959824

  15. Early impact of rotavirus vaccination in a large paediatric hospital in the UK.

    PubMed

    Hungerford, D; Read, J M; Cooke, R P D; Vivancos, R; Iturriza-Gómara, M; Allen, D J; French, N; Cunliffe, N

    2016-06-01

    The impact of routine rotavirus vaccination on community-acquired (CA) and healthcare-associated (HA) rotavirus gastroenteritis (RVGE) at a large paediatric hospital, UK, was investigated over a 13-year period. A total of 1644 hospitalized children aged 0-15 years tested positive for rotavirus between July 2002 and June 2015. Interrupted time-series analysis demonstrated that, post vaccine introduction (July 2013 to June 2015), CA- and HA-RVGE hospitalizations were 83% [95% confidence interval (CI): 72-90%) and 83% (95% CI: 66-92%] lower than expected, respectively. Rotavirus vaccination has rapidly reduced the hospital rotavirus disease burden among both CA- and HA-RVGE cases. PMID:26876744

  16. Off-label use of maraviroc in HIV-1-infected paediatric patients in clinical practice.

    PubMed

    Palladino, Claudia; Gómez, María Luisa Navarro; Soler-Palacín, Pere; González-Tomé, María Isabel; De Ory, Santiago J; Espiau, María; Hoyos, Santiago Pérez; León-Leal, Juan Antonio; Méndez, María; Moreno-Pérez, David; Guasch, Claudia Fortuny; Sierra, Antoni Mur; Guruceta, Itziar Pocheville; Guillén, Santiago Moreno; Briz, Verónica

    2015-10-23

    Maraviroc (MVC) is not approved for HIV-1-infected paediatric patients. This is the first assessment of the use of MVC-based salvage therapy in vertically HIV-1-infected paediatric patients in clinical settings. The results suggest that MVC-based salvage therapy is useful in children and adolescents with extensive resistance profile leading to maintained virological suppression in up to 88% of the patients with CCR5-tropic virus. The likelihood of treatment success might increase when MVC is combined with other active drugs. PMID:26544580

  17. Good practice recommendations for paediatric outpatient parenteral antibiotic therapy (p-OPAT) in the UK: a consensus statement.

    PubMed

    Patel, Sanjay; Abrahamson, Ed; Goldring, Stephen; Green, Helen; Wickens, Hayley; Laundy, Matt

    2015-02-01

    There is compelling evidence to support the rationale for managing children on intravenous antimicrobial therapy at home whenever possible, including parent and patient satisfaction, psychological well-being, return to school/employment, reductions in healthcare-associated infection and cost savings. As a joint collaboration between the BSAC and the British Paediatric Allergy, Immunity and Infection Group, we have developed good practice recommendations to highlight good clinical practice and governance within paediatric outpatient parenteral antibiotic therapy (p-OPAT) services across the UK. These guidelines provide a practical approach for safely delivering a p-OPAT service in both secondary care and tertiary care settings, in terms of the roles and responsibilities of members of the p-OPAT team, the structure required to deliver the service, identifying patients and pathologies that are suitable for p-OPAT, ensuring appropriate vascular access, antimicrobial choice and delivery and the clinical governance aspects of delivering a p-OPAT service. The process of writing a business case to support the introduction of a p-OPAT service is also addressed. PMID:25331058

  18. The impact of parental accompaniment in paediatric trauma: a helicopter emergency medical service (HEMS) perspective

    PubMed Central

    2014-01-01

    Major trauma remains a significant cause of mortality and morbidity in young people and adolescents throughout the western world. Both the physical and psychological consequences of trauma are well documented and it is shown that peri-traumatic factors play a large part in the emotional recovery of children involved in trauma. Indeed, parental anxiety levels may play one of the biggest roles. There are no publically available guidelines on pre-hospital accompaniment, and where research has been done on parental presence it often focuses primarily on the parents or staff, rather than the child themselves. Whilst acknowledging the impact on parents and staff, the importance of the emotional wellbeing of the child should be reinforced, to reduce the likelihood of developing symptoms in keeping with post-traumatic stress disorder. This non-systematic literature review, aims to examine the impact of parental accompaniment to hospital, following paediatric trauma, and to help pre-hospital clinicians decide whether accompaniment would be of benefit to their patient population. The lack of published data does not enable a formal recommendation of parental accompaniment in the helicopter to be mandated, though it should be the preference in land based conveyance. Future research is needed into the emotional recovery of children after trauma, as well as the experiences of patient, parent and staff during conveyance. PMID:24887082

  19. Impact of complex NOTCH1 mutations on survival in paediatric T-cell leukaemia

    PubMed Central

    2012-01-01

    Background Molecular alterations occur frequently in T-ALL and the potential impact of those abnormalities on outcome is still controversial. The current study aimed to test whether NOTCH1 mutations and additional molecular abnormalities would impact T-ALL outcome in a series of 138 T-ALL paediatric cases. Methods T-ALL subtypes, status of SIL-TAL1 fusion, ectopic expression of TLX3, and mutations in FBXW7, KRAS, PTEN and NOTCH1 were assessed as overall survival (OS) and event-free survival (EFS) prognostic factors. OS and EFS were determined using the Kaplan-Meier method and compared using the log-rank test. Results The frequencies of mutations were 43.5% for NOTCH1, while FBXW7, KRAS and PTEN exhibited frequencies of 19.1%, 9.5% and 9.4%, respectively. In 78.3% of cases, the coexistence of NOTCH1 mutations and other molecular alterations was observed. In multivariate analysis no statistical association was revealed between NOTCH1 mutations and any other variable analyzed. The mean length of the follow-up was 68.4 months and the OS was 50.7%. SIL-TAL1 was identified as an adverse prognostic factor. NOTCH1 mutation status was not associated with outcome, while the presence of NOTCH1 complex mutations (indels) were associated with a longer overall survival (p = 0.031) than point mutations. Conclusion NOTCH1 mutations alone or in combination with FBXW7 did not impact T-ALL prognosis. Nevertheless, complex NOTCH1 mutations appear to have a positive impact on OS and the SIL-TAL1 fusion was validated as a negative prognostic marker in our series of T-ALL. PMID:22225590

  20. Impact of a Virtual Clinic in a Paediatric Cardiology Network on Northeast Brazil.

    PubMed

    de Araújo, Juliana Sousa Soares; Dias Filho, Adalberto Vieira; Silva Gomes, Renata Grigório; Regis, Cláudio Teixeira; Rodrigues, Klecida Nunes; Siqueira, Nicoly Negreiros; Albuquerque, Fernanda Cruz de Lira; Mourato, Felipe Alves; Mattos, Sandra da Silva

    2015-01-01

    Introduction. Congenital heart diseases (CHD) affect approximately 1% of live births and is an important cause of neonatal morbidity and mortality. Despite that, there is a shortage of paediatric cardiologists in Brazil, mainly in the northern and northeastern regions. In this context, the implementation of virtual outpatient clinics with the aid of different telemedicine resources may help in the care of children with heart defects. Methods. Patients under 18 years of age treated in virtual outpatient clinics between January 2013 and May 2014 were selected. They were divided into 2 groups: those who had and those who had not undergone a screening process for CHD in the neonatal period. Clinical and demographic characteristics were collected for further statistical analysis. Results. A total of 653 children and teenagers were treated in the virtual outpatient clinics. From these, 229 had undergone a neonatal screening process. Fewer abnormalities were observed on the physical examination of the screened patients. Conclusion. The implementation of pediatric cardiology virtual outpatient clinics can have a positive impact in the care provided to people in areas with lack of skilled professionals. PMID:26265913

  1. Impact of a Virtual Clinic in a Paediatric Cardiology Network on Northeast Brazil

    PubMed Central

    de Araújo, Juliana Sousa Soares; Dias Filho, Adalberto Vieira; Silva Gomes, Renata Grigório; Regis, Cláudio Teixeira; Rodrigues, Klecida Nunes; Siqueira, Nicoly Negreiros; Albuquerque, Fernanda Cruz de Lira; Mourato, Felipe Alves; Mattos, Sandra da Silva

    2015-01-01

    Introduction. Congenital heart diseases (CHD) affect approximately 1% of live births and is an important cause of neonatal morbidity and mortality. Despite that, there is a shortage of paediatric cardiologists in Brazil, mainly in the northern and northeastern regions. In this context, the implementation of virtual outpatient clinics with the aid of different telemedicine resources may help in the care of children with heart defects. Methods. Patients under 18 years of age treated in virtual outpatient clinics between January 2013 and May 2014 were selected. They were divided into 2 groups: those who had and those who had not undergone a screening process for CHD in the neonatal period. Clinical and demographic characteristics were collected for further statistical analysis. Results. A total of 653 children and teenagers were treated in the virtual outpatient clinics. From these, 229 had undergone a neonatal screening process. Fewer abnormalities were observed on the physical examination of the screened patients. Conclusion. The implementation of pediatric cardiology virtual outpatient clinics can have a positive impact in the care provided to people in areas with lack of skilled professionals. PMID:26265913

  2. The impact of early viral infections and graft-versus-host disease on immune reconstitution following paediatric stem cell transplantation.

    PubMed

    Olkinuora, H; von Willebrand, E; Kantele, J M; Vainio, O; Talvensaari, K; Saarinen-Pihkala, U; Siitonen, S; Vettenranta, K

    2011-06-01

    Viral infections and graft-versus-host disease (GVHD) render an impact on both the clinical and immunological recovery following allogeneic hematopoietic stem cell transplantation (HSCT). We studied the recuperation of the immune defence after transplant in the paediatric setting and assessed the impact of early (<100 days post-HSCT) viral [cytomegalovirus (CMV), Ebstein-Barr virus (EBV) and adenovirus] reactivations/infections and GVHD. Fifty-one paediatric recipients of HSCT were enrolled. T cell recovery was evaluated on lymphocyte subpopulations using flow cytometry and functionally by measuring T cell excision circles (TRECs) and through the analysis of T lymphocyte responses to mitogens. B cell recovery was studied by flow cytometry and functionally by ELISPOT. Acute and mild chronic GVHD allowed for a brisk recovery of both cellular and humoral immunity while moderate to severe chronic graft-versus-host disease (cGVHD) associated with a significant, tampering effect on the immunological recovery after transplant. In the former group, the early viral reactivations/infections seemingly linked with a delayed recovery of T lymphocytes and low TRECs values. Moderate to severe cGVHD appears to associate with an impaired immunological recovery after HSCT. Early viral infections linked with prolonged T cell immunodeficiency and thymic dysfunction may be indicative of the presence of subclinical GVHD. PMID:21323694

  3. Media Coverage of Youth Suicides and Its Impact on Paediatric Mental Health Emergency Department Presentations

    PubMed Central

    Leon, Stephanie L.; Cloutier, Paula; BéLair, Marc-André; Cappelli, Mario

    2014-01-01

    Background: To examine mental health (MH) presentations to the emergency department (ED) of a paediatric hospital following two highly publicized local teen suicides. Methods: Youths aged 12–18 years with a MH chief complaint and/or diagnosis were included. Differences in frequencies were analyzed using chi-square tests, and relative risks were evaluated using generalized linear modelling. Results: Significant increases in the number of ED presentations were found within the months of the publicized suicides compared to the same months of previous years. No differences were found in symptom acuity, suicidal status and psychiatric hospitalization rates. Significant increases were found in relative risk of presenting to the ED 28 and 90 days post both publicized suicides. Conclusions: Results suggest there was an association between highly publicized suicides and an increase in the number of MH presentations to the local paediatric ED. Considerations of media's potentially positive role in MH awareness are needed. PMID:25410699

  4. Impacted Sharp Oesophageal Foreign Bodies--A Novel Technique of Removal with the Paediatric Bronchoscope.

    PubMed

    Mitra, Aparajita; Bajpai, Minu

    2016-04-01

    Sharp foreign bodies in the oesophagus may present as an entirely asymptomatic child with only radiological evidence but require emergent surgical management. Safety pins, razor blades and needles are a few of the commonly ingested sharp objects in developing countries. The open safety pin is a particularly interesting clinical problem, as the management depends on its location and orientation. Many methods and instruments have been used over the years to remove them from the upper digestive tract. We present a novel method using the rigid paediatric bronchoscope and alligator forceps for the extraction of this unusual foreign body from the oesophagus of a 6 year old girl. PMID:26851436

  5. The impact of injury severity on long-term social outcome following paediatric traumatic brain injury.

    PubMed

    Muscara, Frank; Catroppa, Cathy; Eren, Senem; Anderson, Vicki

    2009-08-01

    Despite suggestions that paediatric traumatic brain injury (TBI) disrupts social skill development, few studies have investigated long-term social outcome following the transition into adulthood. The current study aimed to investigate long-term social outcome, in a sample of 36 survivors who suffered a mild, moderate or severe TBI between 8 and 12 years of age. At 7-10 years post-injury, the age of participants ranged between 16 and 22 years. Social outcome was assessed using a number of self-rated and parent-rated questionnaires, in order to obtain self- and other-rated accounts of the groups' current social functioning. Predictors of long-term social outcome were also explored, with findings suggesting that young people who suffered mild TBI during childhood tended to be functioning at a higher level on some measures of social functioning, compared to those that suffered a moderate and severe injury. Further, results suggested that pre-injury adaptive functioning and socio-economic status predicted long-term functioning for some measures of social outcome. Finally, social problem-solving skills predicted the success of social reintegration post-TBI. These preliminary findings indicate that there is a risk of social difficulties following paediatric TBI continuing into adulthood, and that a number of demographic, social, and neuropsychological variables continue to predict social outcome even at this late stage post-injury. PMID:18839384

  6. Paediatric diabetes.

    PubMed

    Kalra, Sanjay

    2013-09-01

    Diabetes does not spare any section of society, and its prevalence in the paediatric and adolescent age group is rising. This review highlights the etiological and clinical features of childhood diabetes, including secular changes in epidemiology. It discusses the aspects of non pharmacological and pharmacological therapy which are unique to the paediatric age group, and explores current use of novel therapeutic modalities. The article calls for modulation of the psychological environment of the child with diabetes, to help improve his or her quality of life, and sensitizes physicians to take proactive, affirmative action to address the special needs of children with type1 diabetes. PMID:24601207

  7. Emergency readmissions to paediatric surgery and urology: The impact of inappropriate coding.

    PubMed

    Peeraully, R; Henderson, K; Davies, B

    2016-04-01

    Introduction In England, emergency readmissions within 30 days of hospital discharge after an elective admission are not reimbursed if they do not meet Payment by Results (PbR) exclusion criteria. However, coding errors could inappropriately penalise hospitals. We aimed to assess the accuracy of coding for emergency readmissions. Methods Emergency readmissions attributed to paediatric surgery and urology between September 2012 and August 2014 to our tertiary referral centre were retrospectively reviewed. Payment by Results (PbR) coding data were obtained from the hospital's Family Health Directorate. Clinical details were obtained from contemporaneous records. All readmissions were categorised as appropriately coded (postoperative or nonoperative) or inappropriately coded (planned surgical readmission, unrelated surgical admission, unrelated medical admission or coding error). Results Over the 24-month period, 241 patients were coded as 30-day readmissions, with 143 (59%) meeting the PbR exclusion criteria. Of the remaining 98 (41%) patients, 24 (25%) were inappropriately coded as emergency readmissions. These readmissions resulted in 352 extra bed days, of which 117 (33%) were attributable to inappropriately coded cases. Conclusions One-quarter of non-excluded emergency readmissions were inappropriately coded, accounting for one-third of additional bed days. As a stay on a paediatric ward costs up to £500 a day, the potential cost to our institution due to inappropriate readmission coding was over £50,000. Diagnoses and the reason for admission for each care episode should be accurately documented and coded, and readmission data should be reviewed at a senior clinician level. PMID:26924486

  8. The reduction of dose in paediatric panoramic radiography: the impact of collimator height and programme selection

    PubMed Central

    Safi, H; Maddison, S M

    2015-01-01

    Objectives: The aim of this work was to estimate the doses to radiosensitive organs in the head of a young child undergoing panoramic radiography and to establish the effectiveness of a short collimator in reducing dose. Methods: Thermoluminescent dosemeters were used in a paediatric head phantom to simulate an examination on a 5-year-old child. The panoramic system used was an Instrumentarium OP200 D (Instrumentarium Dental, Tuusula, Finland). The collimator height options were 110 and 140 mm. Organ doses were measured using exposure programmes intended for use with adult and child size heads. The performance of the automatic exposure control (AEC) system was also assessed. Results: The short collimator reduced the dose to the brain and the eyes by 57% and 41%, respectively. The dose to the submandibular and sublingual glands increased by 32% and 20%, respectively, when using a programme with a narrower focal trough intended for a small jaw. The effective dose measured with the short collimator and paediatric programme was 7.7 μSv. The dose to the lens of the eye was 17 μGy. When used, the AEC system produced some asymmetry in the dose distribution across the head. Conclusions: Panoramic systems when used to frequently image children should have programmes specifically designed for imaging small heads. There should be a shorter collimator available and programmes that deliver a reduced exposure time and allow reduction of tube current. Programme selection should also provide flexibility for focal trough size, shape and position to match the smaller head size. PMID:25352427

  9. "Age-Appropriate Development" as Measure and Norm: An Ethnographic Study of the Practical Anthropology of Routine Paediatric Checkups

    ERIC Educational Resources Information Center

    Kelle, Helga

    2010-01-01

    The article provides an ethnographic study of the logic of conducting routine paediatric checkups in children from birth to the age of 5 in Germany (U1 to U9). These checkups are meant as a continual evaluation of a child's developmental process and progress, and their outcomes inform decisions on children's careers in educational institutions.…

  10. [The Appointment of Paediatric Professorships in the Soviet Occupation Zone and the early GDR. The Impact of the Political System Change after 1945].

    PubMed

    Hinz-Wessels, Annette

    2016-01-01

    This paper examines the impact of the political system change after 1945 on the appointment of paediatric professorships in the Soviet Occupation Zone and the GDR up until the time the Wall was built in 1961. It can be demonstrated that the political purge in the post-war period had only minor impact on the appointment of professorships and the National Socialist past no longer mattered after the conclusion of denazification. In 1957, the proportion of former NSDAP members among East German university professors of paediatrics was 100 per cent. When it came to new appointments, both members of the "bourgeois" academic non-professorial teaching staff from the GDR as well as paediatricians from West Germany, who had largely gained their scientifically qualifications under National Socialism, were in the running. A politically-controlled elite exchange did not take place until the construction of the Wall. State and party organs generally followed the personnel proposals of the universities since an insufficient number of qualified candidates was available for the systematic appointment of ,,progressive" paediatricians. Given the lack of staff, the SED personnel policy was aimed at the integration of previous elites, as long as they behaved loyally towards the new state. Since the East German faculties continued to make the questioning of the professionally competent professors in West Germany and East Germany the basis for their appointment lists, West German university paediatricians were able to exert considerable influence on the appointment of East German paediatric professorship until 1960s. PMID:27476257

  11. Paediatric blood pressure and anaesthesia.

    PubMed

    Mather, C M

    1991-05-01

    One percent of children have appreciably and consistently raised arterial blood pressure. A 7-year-old girl admitted for routine tonsillectomy, had unrecognised hypertension which put her at increased risk. Should anaesthetic practice take more note of paediatric blood pressures? PMID:2035786

  12. Whole-genome sequencing as standard practice for the analysis of clonality in outbreaks of meticillin-resistant Staphylococcus aureus in a paediatric setting.

    PubMed

    Ugolotti, E; Larghero, P; Vanni, I; Bandettini, R; Tripodi, G; Melioli, G; Di Marco, E; Raso, A; Biassoni, R

    2016-08-01

    Meticillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of hospital-associated infections. This study investigated the potential use of whole-genome sequencing (WGS) for surveillance purposes by re-examining MRSA strains related to past outbreaks among hospitalized paediatric patients. WGS data ameliorated the genotypic profile previously obtained with Sanger sequencing and pulsed-field gel electrophoresis typing, and discriminated between strains that were related and unrelated to the outbreaks. This allowed strain clonality to be defined with a higher level of resolution than achieved previously. This study demonstrates the potential of WGS to trace hospital outbreaks, which may lead to WGS becoming standard practice in outbreak investigations. PMID:27184087

  13. Surgical strategies in paediatric inflammatory bowel disease

    PubMed Central

    Baillie, Colin T; Smith, Jennifer A

    2015-01-01

    Inflammatory bowel disease (IBD) comprises two distinct but related chronic relapsing inflammatory conditions affecting different parts of the gastrointestinal tract. Crohn’s disease is characterised by a patchy transmural inflammation affecting both small and large bowel segments with several distinct phenotypic presentations. Ulcerative colitis classically presents as mucosal inflammation of the rectosigmoid (distal colitis), variably extending in a contiguous manner more proximally through the colon but not beyond the caecum (pancolitis). This article highlights aspects of the presentation, diagnosis, and management of IBD that have relevance for paediatric practice with particular emphasis on surgical considerations. Since 25% of IBD cases present in childhood or teenage years, the unique considerations and challenges of paediatric management should be widely appreciated. Conversely, we argue that the organizational separation of the paediatric and adult healthcare worlds has often resulted in late adoption of new approaches particularly in paediatric surgical practice. PMID:26034347

  14. JACIE accreditation in paediatric haemopoietic SCT.

    PubMed

    Cornish, J M

    2008-10-01

    The Joint Accreditation Committee of the International Society for Cellular Therapy (ISCT) and European Group for Blood and Marrow Transplantation (EBMT), known as JACIE, is a nonprofit body established for the purposes of assessment and accreditation in the field of haemopoietic SCT (HSCT). The committee was established in 1999 with the aim of creating a standardized system of accreditation officially recognized across Europe and based on the accreditation standards established by the US-based Foundation for the Accreditation of Cellular Therapy (FACT). The major objectives of JACIE are to improve the quality of HSCT in Europe by providing a means whereby transplant centres, cell collection facilities and processing facilities can demonstrate high-quality practice. JACIE launched its official inspection programme in January 2004, and since then more than 35 centres in Europe have been inspected. The history of paediatric-specific accreditation guidelines has lagged behind the overall development but is now incorporated within the standards. There is now acknowledgement that a paediatric transplant team will be headed by a paediatric programme director, that an independent paediatric unit will perform no less than 10 allogeneic transplants in children under the age of 18 per year, be looked after by nurses and junior doctors specifically trained in paediatric practice and have access to paediatric subspecialties with an intensive care unit on site. Paediatric units will be examined by a paediatric-trained inspector. Remaining issues of difference with the guidelines relate to the numbers required for accreditation in combined units. Overall, the paediatric community in Europe has embraced the JACIE guidelines. JACIE is working more closely with other international organizations in cellular therapy to develop international standards for all aspects of SCT. The recent implementation of Directive 2004/23/EC has provided an impetus for the implementation of JACIE in

  15. Impact of 24 hour critical care physician staffing on case-mix adjusted mortality in paediatric intensive care.

    PubMed

    Goh, A Y; Lum, L C; Abdel-Latif, M E

    2001-02-10

    The 24 h availability of intensive care consultants (intensivists) has been shown to improve outcomes in adult intensive care units (ICU) in the UK. We tested whether such availability would improve standardised mortality ratios when compared to out-of-hours cover by general paediatricians in the paediatric ICU setting of a medium-income developing country. The standardised mortality ratio (SMR) improved significantly from 1.57 (95%CI 1.25-1.95) with non-specialist care to 0.88 (95%CI 0.63-1.19) with intensivist care (rate ratio 0.56, 95% CI 0.47-0.67). Mortality odds ratio decreased by 0.234, 0.246 and 0.266 in the low, moderate and high-risk patients. 24 h availability of intensivists was associated with improved outcomes and use of resources in paediatric intensive care in a developing country. PMID:11273070

  16. Practical Collaborations for Positive Impact

    ERIC Educational Resources Information Center

    Newton, Andrew R.; Maher, Michelle A.; Smith, Douglas A.

    2015-01-01

    Assessment has assumed an increasingly prominent place in academic and student affairs practice. Yet, in smaller student affairs departments with limited staffing and resources, how might a department identify the resources or time to thoroughly assess student learning outcomes? This Notes in Brief details the partnership between the University of…

  17. Understanding and evaluating the effects of implementing an electronic paediatric prescribing system on care provision and hospital work in paediatric hospital ward settings: a qualitatively driven mixed-method study protocol

    PubMed Central

    Farre, Albert; Cummins, Carole

    2016-01-01

    Introduction Electronic prescribing systems can improve the quality and safety of healthcare services, but their implementation is not straightforward and may create unexpected change. However, the added complexity of paediatric prescribing (eg, dose calculations, dilutions, manipulations) may pose additional challenges. This study will aim to (1) understand the complex organisational reality of a paediatric hospital in which a new electronic paediatric prescribing (ePP) system will be introduced; (2) describe ePP-related change, over time, in paediatric hospital ward settings; (3) explore staff perspectives in relation to currently established practices and processes; and (4) assess the impact of ePP on care provision and hospital work from the perspective of paediatricians, paediatric nurses and managers. Methods and analysis A qualitatively driven mixed-method approach will be adopted, including 3 inter-related substudies. The core component of the study will be qualitative (substudy 1): we will use ethnographic research methods, including non-participant observation in wards and informal conversational interviews with members of staff. In addition, the design will include 2 embedded supplementary components: a qualitative 1 (substudy 2) based on in-depth interviews and/or focus groups with paediatricians, paediatric nurses, paediatric pharmacists/pharmacy technicians and managers; and a quantitative 1 (substudy 3) in which a staff survey will be developed and administered before and after the ePP implementation. Analytic themes will be identified from ethnographic field notes and interview data. Survey data will be analysed using descriptive statistics and baseline and follow-up data compared to establish impact evaluation measures. Ethics and dissemination A favourable ethical opinion has been obtained from a National Health Service (NHS) Research Ethics Committee (15/SS/0157). NHS research governance approval has been obtained at the relevant hospital site

  18. Paediatric cardiac nursing education: a national collaboration.

    PubMed

    Cook, Kerry; Daniels, Amanda; Sheehan, Karen; Langton, Helen

    2006-02-01

    Educational courses for staff working in paediatric specialties may not be financially viable because of the small numbers involved and the difficulties that potential students have in getting released from their units. The UK Paediatric Cardiac Nurses Association worked with other groups to explore the feasibility of a national multi-professional paediatric cardiac education pathway. Three options were identified, including the continuation of local in-house provision with its associated variation in standards. The relative benefits and resource implications of each option were explored and approaches made to educational institutions for support in developing the pathway. A university with an established reputation for e-learning undertook this development and a post graduate certificate in Paediatric Cardiothoracic Practice will soon be available. PMID:16518954

  19. Diagnostic paediatric imaging

    SciTech Connect

    Hall, C.M.; Lingam, S.

    1986-01-01

    This book is a case study teaching manual presenting radiographs and examples of other imaging modalities from 100 paediatric patients. The material comes from the radiological teaching collection at the Hospital for Sick Children at Great Ormond Street in London and was compiled over a ten year period. With each case a short clinical history is given and a series of questions posed, similar to those encountered in postgraduate medical examinations. Sample answers with comments and more illustrations are presented on the following page. The last decade has seen a rapid expansion in the range and sophistication of diagnostic imaging modalities which are available to clinicians. Since it is impossible to achieve comprehensive coverage in a book of this size, the authors have selected examples of cases which illustrate the range of imaging modalities currently available and which may be encountered in both clinical practice and in examinations.

  20. Paediatric anaesthesia: an overview.

    PubMed

    Langton, Helen Elizabeth

    2015-10-28

    This article provides an overview of the nursing considerations for paediatric anaesthesia. It is aimed at newly qualified operating department practitioners and anaesthetic nurses, and those with limited experience in the care of paediatric patients. It explores the ways in which paediatric anatomy and physiology differ from those of adults and looks at the implications for treatment in the anaesthetic environment. It also discusses the equipment required and the rationale for its use. PMID:26508256

  1. What's new in paediatric dentistry?

    NASA Astrophysics Data System (ADS)

    Vitale, M. C.

    2016-03-01

    Since the early 80's, the use of laser has been introduced in the daily dental practice and the technological development has also provided over time to optimize its use. Various types of lasers with different wavelengths have been developed for use in a handy, easy and ergonomic manner. In daily paediatric dentistry, laser could be a very useful medical device which can completely replace the traditional high hand-piece and bur to realize a "micro-invasive" dentistry and a "clean" surgery, without bleeding and sutures. According to the international literature and in the light of recent researches, this work could give an overview on assisted laser therapy in paediatric dentistry, highlighting advantages and disadvantages of this new technology and pointing out the high compliance of the young patient.

  2. Where should paediatric surgery be performed?

    PubMed

    Arul, G S; Spicer, R D

    1998-07-01

    evidence that all neonatal surgery and anaesthesia should be conducted only by specialists. The debate now centres around the number of complex surgical cases a unit should treat to maintain its specialist status. The NHS executive, in its guidelines on contracting for specialist services, emphasises that "Sensible contracting needs to take into account the optimum population size not only for the stability of contracted referrals but also to give sufficient 'critical mass' for clinical effectiveness." Achieving this balance has consequences, not just for the maintenance of surgical expertise, but for the essential ancilliary services. There is clear evidence in anaesthesia that anaesthetists doing small numbers of neonatal procedures had significantly worse results. The same seems to be true in the fields of oncology, radiology, pathology, and intensive care. The reasons why the results of management of certain paediatric conditions are better at specialist centres are open to speculation. Presumably greater exposure to rare complex cases, concentration of expertise, more peer review, and a trickle down effect of the multidisciplinary approach all help to keep health care workers up to date with current world practice. In addition, it allows for appropriate specialist on call rotas and dedicated junior staff. If insufficient numbers of specialist surgical cases are being treated at a centre then the whole multidisciplinary team suffers. The 1989 NCEPOD report states "that paediatricians and general surgeons must recognise that small babies differ from other patients not only in size, and that they pose quite separate problems of pathology and management." The need for large centres of paediatric surgical expertise is now accepted by the Royal College of Surgeons of England, the British Association of Paediatric Surgeons, the Senate of Surgery of Great Britain and Ireland, the Royal College of Paediatrics and Child Health, the Royal College of Anaesthetists, the Audit PMID

  3. Measuring the Expertise of Paediatric Rehabilitation Therapists

    ERIC Educational Resources Information Center

    King, Gillian; Bartlett, Doreen J.; Currie, Melissa; Gilpin, Michelle; Baxter, Donna; Willoughby, Colleen; Tucker, Mary Ann; Strachan, Deborah

    2008-01-01

    This article describes the development of a classification system to measure the expertise levels of practicing paediatric rehabilitation therapists. Seventy-five therapists from five disciplines (physical, occupational, speech-language, behaviour, and recreational therapy) were involved, along with 170 peers, and 188 parents of children with…

  4. Use of smartphone apps by paediatric trainees.

    PubMed

    Jyothi, Srinivas; Halton, Fiona; Goodyear, Helen

    2015-08-01

    Over 70% of the population owns a smartphone and there are now millions of apps available. This study looks at smartphone and app use among paediatric trainees, in particular whether they are accessing medical apps to help with clinical practice. PMID:26255919

  5. Gene therapy for paediatric leukaemia.

    PubMed

    Rousseau, R F; Bollard, C M; Heslop, H E

    2001-07-01

    Improvements in the chemotherapeutic and transplant regimens have had a significant impact in improving survival rates for paediatric leukaemia. However, there are still important problems to address including what options are available for patients with chemoresistant disease and what strategies are available to avoid the concerns regarding the toxicity associated with highly cytotoxic treatment regimens. Gene therapy and immunotherapy protocols hold great promise. Using gene transfer of a marker gene, a number of biological issues in the therapy of leukaemia have been addressed. For example, by gene marking autologous bone marrow grafts it has been possible to demonstrate that infused marrow contributes to relapse in acute and chronic myeloid leukaemias. In the allogeneic transplant setting, genetically modified T-cells have proven valuable for the prophylaxis and treatment of viral diseases and may have an important role in preventing or treating disease relapse. Gene transfer is also being used to modify tumour function, enhance immunogenicity, and confer drug-resistance to normal haematopoietic stem cells. With the continued scientific advancements in this field, gene therapy will almost certainly have a major impact on the treatment of paediatric leukaemia in the future. PMID:11727502

  6. Paediatric asthma and obesity.

    PubMed

    Lucas, Sean R; Platts-Mills, Thomas A E

    2006-12-01

    None of the explanations proposed for the increase in paediatric asthma have been adequate. It is becoming apparent that the cause of the increase in asthma must be multi-factorial. Increasing attention has been focused on the role of lifestyle in the development of asthma. Lifestyle changes that have occurred in children are those in diet and decreased physical activity, with obesity being the product of these changes. The increase in asthma, obesity and a sedentary lifestyle have occurred together. However, a temporal relationship between asthma, obesity and decreased physical activity has not been determined in the paediatric literature. Limited data suggest that decreased physical activity could be playing a role in the aetiology of asthma independent of obesity. Furthermore, there has been substantial research on the benefits of exercise programmes for paediatric patients with asthma. Longitudinal trials monitoring physical activity, obesity and the development of asthma are needed. PMID:17098637

  7. Generalisability and Cost-Impact of Antibiotic-Impregnated Central Venous Catheters for Reducing Risk of Bloodstream Infection in Paediatric Intensive Care Units in England

    PubMed Central

    Harron, Katie; Mok, Quen; Hughes, Dyfrig; Muller-Pebody, Berit; Parslow, Roger; Ramnarayan, Padmanabhan; Gilbert, Ruth

    2016-01-01

    Background We determined the generalisability and cost-impact of adopting antibiotic-impregnated CVCs in all paediatric intensive care units (PICUs) in England, based on results from a large randomised controlled trial (the CATCH trial; ISRCTN34884569). Methods BSI rates using standard CVCs were estimated through linkage of national PICU audit data (PICANet) with laboratory surveillance data. We estimated the number of BSI averted if PICUs switched from standard to antibiotic-impregnated CVCs by applying the CATCH trial rate-ratio (0.40; 95% CI 0.17,0.97) to the BSI rate using standard CVCs. The value of healthcare resources made available by averting one BSI as estimated from the trial economic analysis was £10,975; 95% CI -£2,801,£24,751. Results The BSI rate using standard CVCs was 4.58 (95% CI 4.42,4.74) per 1000 CVC-days in 2012. Applying the rate-ratio gave 232 BSI averted using antibiotic CVCs. The additional cost of purchasing antibiotic-impregnated compared with standard CVCs was £36 for each child, corresponding to additional costs of £317,916 for an estimated 8831 CVCs required in PICUs in 2012. Based on 2012 BSI rates, management of BSI in PICUs cost £2.5 million annually (95% uncertainty interval: -£160,986, £5,603,005). The additional cost of antibiotic CVCs would be less than the value of resources associated with managing BSI in PICUs with standard BSI rates >1.2 per 1000 CVC-days. Conclusions The cost of introducing antibiotic-impregnated CVCs is less than the cost associated with managing BSIs occurring with standard CVCs. The long-term benefits of preventing BSI could mean that antibiotic CVCs are cost-effective even in PICUs with extremely low BSI rates. PMID:26999045

  8. Impact of paediatric human immunodeficiency virus infection on children's and caregivers' daily functioning and well-being: a qualitative study

    PubMed Central

    Punpanich, W.; Gorbach, P. M.; Detels, R.

    2012-01-01

    Background Human immunodeficiency virus (HIV) infection impacts not only upon the physical health of affected children, but also their psychosocial functions, family relationships and economical status. Caregivers are confronted with complex challenges related to the physical, emotional and financial demands of raising these children.The purpose of this study was to enhance our understanding of the impact of HIV disease on both children's and caregivers' well-being, using a qualitative inquiry approach. Methods A total of 35 primary caregivers of HIV-infected children participated in in-depth interviews. The issues discussed included the major negative impacts on children's daily functioning and well-being, and the perceived caregiver/parental burden. Participants included parents (40%), grandparents (22.8%), other relatives (e.g. uncles, aunts) (34.3%) and one foster parent (2.8%). Results Qualitative analysis revealed that the major negative impacts of HIV/AIDS included physical symptoms, school performance and relationship changes. The major negative impacts on caregivers' well-being included acceptance of the diagnosis, dealing with the financial burden and keeping the diagnosis private. Conclusions Approaches are needed to address these challenges by enhancing families' coping skills and building supportive networks. PMID:21851376

  9. Paediatric obesity and renal transplantation: current challenges and solutions.

    PubMed

    Terrace, John D; Oniscu, Gabriel C

    2016-04-01

    The increased incidence of obesity in the paediatric population poses significant challenges to renal transplantation. Whilst the body mass index appears to be widely used as a measure of obesity in adults, there are no standardised definitions in the paediatric population, making comparative analyses difficult. In the paediatric transplant population, obesity is associated with an increased incidence of surgical complications, diabetes, hyperlipidaemia and cardiovascular morbidity, leading to diminished graft function and impacting patient and graft survival. Management of obesity in renal transplantation requires multiple interventions starting with life-style and behavioural modification combined with medical and possibly surgical therapies, representing a unique challenge in the childhood setting. In this review we discuss the current challenges of obesity and potential solutions in the setting of paediatric transplantation. PMID:26018121

  10. Effects of anaesthesia on paediatric lung function.

    PubMed

    Trachsel, D; Svendsen, J; Erb, T O; von Ungern-Sternberg, B S

    2016-08-01

    Respiratory adverse events are one of the major causes of morbidity and mortality in paediatric anaesthesia. Aside from predisposing conditions associated with an increased risk of respiratory incidents in children such as concurrent infections and chronic airway irritation, there are adverse respiratory events directly attributable to the impact of anaesthesia on the respiratory system. Anaesthesia can negatively affect respiratory drive, ventilation/perfusion (V/Q) matching and tidal breathing, all resulting in potentially devastating hypoxaemia. Understanding paediatric respiratory physiology and its changes during anaesthesia will enable anaesthetists to anticipate, recognize and prevent deterioration that can lead to respiratory failure. This review aims to give a comprehensive overview of the effects of anaesthesia on respiration in children. It focuses on the impact of the different components of anaesthesia, patient positioning and procedure-related changes on respiratory physiology. PMID:27440626

  11. How small is small enough? Role of robotics in paediatric urology.

    PubMed

    Ganpule, Arvind P; Sripathi, Venkat

    2015-01-01

    The well-known advantages of robotic surgery include improved dexterity, three-dimensional operating view and an improved degree of freedom. Robotic surgery is performed for a wide range of surgeries in urology, which include radical prostatectomy, radical cystectomy, and ureteric reimplantation. Robotic paediatric urology is evolving. The major hindrance in the development of paediatric robotics is, first, the differences in practice patterns in paediatric urology compared with adult urology thereby making development of expertise difficult and secondly it is challenging to conduct proper studies in the paediatric population because of the paucity of cases. The difficulties in conducting these studies include difficulty in designing a proper randomised study, difficulties with blinding, and finally, the ethical issues involved, finally the instruments although in the phase of evolution require a lot of improvement. In this article, we review the relevant articles for paediatric robotic surgery. We emphasise on the technical aspects and results in contemporary paediatric robotic case series. PMID:25598599

  12. How small is small enough? Role of robotics in paediatric urology

    PubMed Central

    Ganpule, Arvind P.; Sripathi, Venkat

    2015-01-01

    The well-known advantages of robotic surgery include improved dexterity, three-dimensional operating view and an improved degree of freedom. Robotic surgery is performed for a wide range of surgeries in urology, which include radical prostatectomy, radical cystectomy, and ureteric reimplantation. Robotic paediatric urology is evolving. The major hindrance in the development of paediatric robotics is, first, the differences in practice patterns in paediatric urology compared with adult urology thereby making development of expertise difficult and secondly it is challenging to conduct proper studies in the paediatric population because of the paucity of cases. The difficulties in conducting these studies include difficulty in designing a proper randomised study, difficulties with blinding, and finally, the ethical issues involved, finally the instruments although in the phase of evolution require a lot of improvement. In this article, we review the relevant articles for paediatric robotic surgery. We emphasise on the technical aspects and results in contemporary paediatric robotic case series. PMID:25598599

  13. Salbutamol in paediatrics: pharmacology, prescribing and controversies.

    PubMed

    Andrzejowski, Paul; Carroll, Will

    2016-08-01

    Salbutamol has become a key drug in respiratory medicine since it was first developed by Sir David Jack et al in 1968, 5000 years after the β agonist ephedrine was first used in its raw form, as the Ma Huang herb in Chinese medicine to treat asthma. It is one of the most commonly encountered medicines in paediatric practice and the authors have found that an understanding of its pharmacology in clinical practice is incredibly helpful. In this article, we discuss its pharmacology and pharmacodynamics, practical prescribing points and some unresolved issues surrounding its use, which should serve to provide an essential working knowledge for the busy paediatrician. PMID:27059284

  14. [New analgesics in paediatrics].

    PubMed

    Avez-Couturier, Justine; Wood, Chantal

    2016-01-01

    There are a number of different types of analgesics in paediatrics. They must be used in accordance with the situation, the type of pain and the characteristics of the child. In all cases, strict compliance with the posology and the instructions for use is essential to avoid any risk of error. Finally, pharmacological, physical and psychological treatments are employed in a complementary manner, for the biopsychosocial management of the child's care. PMID:27177483

  15. Swearing: its prevalence in healthcare settings and impact on nursing practice.

    PubMed

    Stone, T E; McMillan, M; Hazelton, M

    2010-08-01

    Despite its prevalence there has been little academic research into swearing, and certainly none on its impact on nurses and nursing practice. Nurses are, of all health workers, most likely to be targets of verbal aggression, and up to 100% of nurses in mental health settings report verbal abuse. The literature contains no reference to the effects on nurses of exposure to swearing. This paper reports the findings of a questionnaire study of 107 nurses working in three clinical settings, which used a mixed methods approach. Participants reported high levels of swearing by patients, 32% citing its occurrence from one to five times per week and 7% 'continuously'; a similar incidence arose across the nursing teams at all sites, but being sworn at in anger by another staff member happened rarely. The study failed to show significant differences in the frequency of swearing between mental health and paediatric settings, but did find gender-based differences in both frequency of use and offendedness. High degrees of distress among nurses subjected to swearing were evident; moreover, respondents appeared to have only a limited range of interventions to draw upon in dealing with exposure to such treatment. PMID:20633080

  16. High magnitude head impacts experienced during youth football practices.

    PubMed

    Young, Tyler; Rowson, Steven; Duma, Stefan M

    2014-01-01

    To reduce the risk of concussion in the 3.5 million youth athletes who participate in organized football leagues in the United States each year, practice structure can be modified to decrease impact frequency and magnitude. The objective of this study is to identify activities that result in high magnitude head impacts in youth football players during practice. The HIT System was used to record the head acceleration magnitude, impact location on the helmet, and time of each impact for each game and practice players participated in. These data were used to quantify the head impact exposure associated with players between the ages of 9 and 11 years. Video footage recorded during each practice and game session was used to identify the activity associated with any impact above 45 g. The incidence rate of high magnitude impacts in various activities were compared by normalizing by the amount of time associated with each activity. It was determined that scrimmages accounted for 0.094 impacts greater than 45 g per minute in practices while contact drills contributed to 0.102 impacts greater than 45 g per minute during practices. The results of this study indicate future youth football practice modifications should focus on both scrimmages and contact drills. PMID:25405410

  17. Theory and Practice of Environmental Impact Analysis

    ERIC Educational Resources Information Center

    Mason, Peter F.

    1974-01-01

    Preliminary assessment of Environmental Impact Statements in California indicate that their effectiveness is directly related to the local political structure. Environmental planning is expected to improve as environmental impact reports gain more credence as an information base for city planners. The need for uniform impact guidelines are…

  18. Training Research: Practical Recommendations for Maximum Impact

    PubMed Central

    Beidas, Rinad S.; Koerner, Kelly; Weingardt, Kenneth R.; Kendall, Philip C.

    2011-01-01

    This review offers practical recommendations regarding research on training in evidence-based practices for mental health and substance abuse treatment. When designing training research, we recommend: (a) aligning with the larger dissemination and implementation literature to consider contextual variables and clearly defining terminology, (b) critically examining the implicit assumptions underlying the stage model of psychotherapy development, (c) incorporating research methods from other disciplines that embrace the principles of formative evaluation and iterative review, and (d) thinking about how technology can be used to take training to scale throughout all stages of a training research project. An example demonstrates the implementation of these recommendations. PMID:21380792

  19. Paediatric radiation oncology in the care of childhood cancer: A position paper by the International Paediatric Radiation Oncology Society (PROS).

    PubMed

    Kortmann, Rolf-Dieter; Freeman, Carolyn; Marcus, Karen; Claude, Line; Dieckmann, Karin; Halperin, Edward; Esiashvili, Natia; Paulino, Arnold; Mahajan, Anita; Seiersen, Klaus; Ahern, Verity; Ricardi, Umberto; Carrie, Christian

    2016-05-01

    Paediatric malignancies are a challenge for the radiation oncologist due to their rarity, the great variety of histological types, and the complexity of treatment concepts that evolve over time. The Paediatric Radiation Oncology Society (PROS) is the only internationally operating society for paediatric radiation oncology. The objectives of PROS are to set a world-wide standard of excellence with respect to radiation oncology aspects in curing children and adolescents with cancer, to provide a forum for communication between radiation oncologists, and to exchange information with all professionals involved in the management of paediatric and adolescent cancer. Challenges include the need to promote education and support practice in low and middle income countries (LMIC) as well as the cost and availability of modern treatment technologies for all but most especially these countries. Collaborations with other societies that include for example the education programmes provided jointly with ESTRO, and the upgraded technical platform of the PROS web site offer new possibilities to enhance the efficacy of PROS in education and support of paediatric radiation oncology practice world-wide. PROS has made an important contribution to the management of childhood malignancies over the past decade and new and developing collaborations between PROS and other societies or organizations will ultimately lead to a reduction in world-wide health care inequalities. PMID:27106553

  20. Theatre of paediatric surgery.

    PubMed

    McBride, Craig A; Holland, Andrew J A

    2015-01-01

    In the 50 years since the first edition of this journal, operative paediatric surgery has undergone radical change. Many of the most common instruments are unchanged, both as a testament to their utility and in recognition of past surgeons remembered eponymously. Surrounding that basic core of instruments, theatre has changed radically as new tools and techniques have arisen. Surgeons have come down from their pedestals, recognising surgery as a team sport rather than a solo performance. More than half of the current paediatric surgical trainees are women, a higher proportion than in any other craft group of the Royal Australasian College of Surgeons. The appearance, and rapid development, of laparoscopy is to many observers the most notable change in surgery over the last 50 years. Placed in its context though, it is simply the most prominent example of a frameshift in surgical thinking. The patient as a whole is now the focus, rather than just the disease. Recent developments are as much about minimising harm to normal tissues as they are about extirpating pathology. As a surgical maxim, 'Primum non nocere' is even more in evidence in 2015 than it was in 1965. PMID:25586851

  1. Impact of Biotechnology on Pharmacy Practice.

    ERIC Educational Resources Information Center

    Black, Curtis D.; And Others

    1990-01-01

    Discussed is the role of schools of pharmacy in (1) preparing future practitioners to assimilate and shape the impact of biotechnology; (2) establish graduate and research programs to enhance and apply products of biotechnology; and (3) identify manpower needs to fully realize potential advances caused by biotechnology. (DB)

  2. Examining Internships as a High-Impact Educational Practice

    ERIC Educational Resources Information Center

    Keller, Kerri Day

    2012-01-01

    Colleges and universities across the United States seek new, creative, and impactful ways to enhance student engagement. The study of student engagement has led to the identification of several "high-impact" educational practices that appear to generate higher levels of student performance, learning, and development than the traditional…

  3. Hospital Based Prospective Observational Study to Audit the Prescription Practices and Outcomes of Paediatric Patients (6 months to 5 years age group) Presenting with Acute Diarrhea

    PubMed Central

    Kondekar, Santosh; Rathi, Surbhi

    2016-01-01

    Introduction Diarrhea is a leading killer of children, accounting for 9% of all deaths among under-five children worldwide. WHO protocol deviation in management of diarrheas in children is likely due to various reasons. Aim To study the prescription practices, regarding adherence to WHO protocol and deviations, in the management of acute diarrhea in children presenting at a tertiary care hospital and its impact on the outcome. Materials and Methods This was a prospective observational hospital based study at a tertiary care carried out over a 12-month period including all cases of acute diarrhea (defined as 3 or more loose stools in last 24 hours) in children belonging to the age group of 6 months to 5 years. Patients were followed up on day 3,7,14 and 28 from the day of presentation. Software SPSS Version 17.0 was used for analysis. Correlation regression analysis was used to study predictiveness of different variables affecting outcome. Results In this study, 447 children aged between 6 months and 5 years were enrolled, of which 45 cases were lost in follow-up and excluded. The median age was 14 months. Some deviation from WHO protocol was noted in 78.4% of the cases. Most common deviations from WHO protocol were addition of probiotics (78.1% of cases) and addition of race cadotril (15.9% of cases). Inadvertent use of antibiotics in diarrhea was noted in 12.2% of cases. Presence of fever was strong predictor for use of antibiotics. Cases of early recovery within 3 days of presentation were higher in WHO protocol deviation group. Use of probiotics had statistically significant association with early recovery. Conclusion In diarrhea management, WHO protocol deviation is common. Probiotics are likely to help in early recovery. PMID:27437317

  4. [Paediatric simulation today and tomorrow. Perspectives and concepts].

    PubMed

    Jordi Ritz, E-M; Eich, C; Gisin, S; Heinzel, O; Hüpfl, M; Erb, T O

    2009-12-01

    The confrontation with critically ill newborns, infants and small children is rare and poses a particular challenge for the medical team. Confident technical and non-technical skills are essential for successful emergency treatment. Paediatric simulators facilitate a didactic infrastructure, linking textbook theory with experience-based practice. To summarize the current status of paediatric simulation in Germany, Austria and Switzerland an online survey of all associated centres was conducted. Paediatric simulation is currently available at 24 centres, which have 39 paediatric simulators available, including 8 for newborns, 26 for infants and 5 for children. A certain congruence of standards is detectable among these centres and most instructors have completed a specialized instructor training. Of the instructors 26% are specialized nursing personnel and 67% are physicians of which most are paediatricians and anaesthesiologists. Many centres (38%) operate solely by means of the enthusiastic dedication of the employees who organize various activities during their free time. Nearly all centres (92%) place particular emphasis on non-technical skills which include the interpersonal aspects of crisis resource management. Video-supported debriefing is considered to be the basis for effective training. Within the scope of the recently established PaedSim project the curricula of paediatric simulation courses should be more structured and internationally standardized, thereby increasing both efficacy and sustainability of these training programs. PMID:20012246

  5. Infection control in paediatric office settings

    PubMed Central

    2008-01-01

    Transmission of infection in the paediatric office is of increasing concern. The present document discusses routes of transmission of infection and the principles of current infection control measures. Prevention includes appropriate office design and administrative policies, triage, routine practices for the care of all patients (eg, hand hygiene; use of gloves, masks, eye protection and gowns for specific procedures; adequate cleaning, disinfection and sterilization of surfaces and equipment including toys, and aseptic technique for invasive procedures), and additional precautions for specific infections. Personnel should be adequately immunized, and those infected should follow work-restriction policies. PMID:19412374

  6. Paediatric procedural sedation within the emergency department.

    PubMed

    Krieser, David; Kochar, Amit

    2016-02-01

    Procedural sedation and analgesia in children requires the use of non-pharmacological and pharmacological approaches to facilitate the management of painful procedures. The development of skills in such techniques has mirrored the development of paediatric emergency medicine as a subspecialty. Governance, education and credentialing must facilitate safe sedation practice, using a structured approach, as sedating children in the busy environment of an emergency department is not without risk. Emergency clinicians, patients and caregivers all have a role to play in developing a safe, effective sedation plan. PMID:27062624

  7. Drug discovery in paediatric oncology: roadblocks to progress

    PubMed Central

    Adamson, Peter C.; Houghton, Peter J.; Perilongo, Giorgio; Pritchard-Jones, Kathy

    2015-01-01

    Approval of new cancer drugs for paediatric patients generally occurs after their development and approval for treating adult cancers. As most drug development occurs in the industry setting, the relatively small market of paediatric oncology does not provide the financial incentives for companies to actively pursue paediatric oncology solutions. Indeed, between 1948 and January 2003 the FDA approved 120 new cancer drugs, of which only 30 have been used in children. This slow rate of development must be addressed in a meaningful way if we are to make progress in the most pressing settings in childhood cancer. In this Viewpoint article, the key opinion leaders in the field weigh in and offer practical advice on how to address this issue. PMID:25223555

  8. Potential for optimisation of paediatric chest X-ray examination.

    PubMed

    Kostova-Lefterova, D; Taseva, D; Ingilizova, K; Hristova-Popova, J; Vassileva, J

    2011-09-01

    The purpose of this study was to compare the important aspects of paediatric radiological practice and the patient doses from chest X-ray examinations performed in three hospitals in Bulgaria. Data from 163 paediatric patients were recorded using a standardised form. Entrance surface air kerma (ESAK) to patient was calculated from the air-kerma air product (KAP) and field size measurements. Large variations were found for KAP and ESAK. Inappropriate film size and insufficient collimation were often used. Inappropriate use of automatic exposure control and antiscatter grid was found. In most cases, no attention was paid to reduce dose to sensitive organs by means of shielding or proper collimation. Recommendations were given to the hospitals on how to reduce patient doses in paediatric chest radiography. PMID:21824872

  9. [Toxicology screening in paediatrics].

    PubMed

    Garcia-Algar, Óscar; Cuadrado González, Ainoha; Falcon, María

    2016-09-01

    The prevalence of acute or chronic exposure to substances of abuse in paediatric patients, from the neonatal period to adolescence, is not well established as most cases go unnoticed. Regardless of clinical cases of acute poisoning leading to visits to emergency room, the exposure is usually detected by a questionnaire to the parents or children. In the last few years, new validated analytical methodologies have been developed in order to detect parent drugs and their metabolites in different biological matrices. These biological matrices have different time windows for detection of the exposure: acute (i.e., urine, blood, oral fluid), and chronic (i.e., hair, meconium or teeth). The aim of this paper was to review the scenarios where the use of biological matrices is indicated for the detection of acute or chronic exposure to substances of abuse. PMID:26458521

  10. Paediatric Blunt Torso Trauma

    PubMed Central

    Bhatti, Khalid M.; Taqi, Kadhim M.; Al-Harthy, Ahmed Z. S.; Hamid, Rana S.; Al-Balushi, Zainab N.; Sankhla, Dilip K.; Al-Qadhi, Hani A.

    2016-01-01

    Objectives: Trauma is the greatest cause of morbidity and mortality in paediatric/adolescent populations worldwide. This study aimed to describe trauma mechanisms, patterns and outcomes among children with blunt torso trauma admitted to the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. Methods: This retrospective single-centre study involved all children ≤12 years old with blunt torso trauma admitted for paediatric surgical care at SQUH between January 2009 and December 2013. Medical records were analysed to collect demographic and clinical data. Results: A total of 70 children were admitted with blunt torso trauma during the study period, including 39 (55.7%) male patients. The mean age was 5.19 ± 2.66 years. Of the cohort, 35 children (50.0%) received their injuries after having been hit by cars as pedestrians, while 19 (27.1%) were injured by falls, 12 (17.1%) during car accidents as passengers and four (5.7%) by falling heavy objects. According to computed tomography scans, thoracic injuries were most common (65.7%), followed by abdominal injuries (42.9%). The most commonly involved solid organs were the liver (15.7%) and spleen (11.4%). The majority of the patients were managed conservatively (92.9%) with a good outcome (74.3%). The mortality rate was 7.1%. Most deaths were due to multisystem involvement. Conclusion: Among children with blunt torso trauma admitted to SQUH, the main mechanism of injury was motor vehicle accidents. As a result, parental education and enforcement of infant car seat/child seat belt laws are recommended. Conservative management was the most successful approach. PMID:27226913

  11. The practical impact of elastohydrodynamic lubrication

    NASA Technical Reports Server (NTRS)

    Anderson, W. J.

    1978-01-01

    Elastohydrodynamic lubrication has had its most significant impact on, among all the types of concentrated contact mechanisms, rolling element bearings. EHL technology, through its inclusion in computer codes, now provides us with more effective methods for optimizing bearing design and for predicting bearing life, power loss, temperature and dynamic behavior. Bearing life prediction has advanced to a much more sophisticated level as compared to the calculation of fatigue life based on Lundberg-Palmgren theory. Application of elastohydrodynamics to gearing has, more or less, been limited to the calculation of pitch point film thicknesses. Techniques for calculating film thicknesses over the entire range of tooth meshes for arbitrarily shaped gear teeth (noninvolute, spur, helical, etc.) need to be developed. Elastomer seals with both unidirectional and reciprocating motion offer a fruitful application for the elastohydrodynamics of low modulus materials.

  12. The impact of globalisation on teleradiology practice.

    PubMed

    Shieh, Yao Y; Tsai, Fong Y; Shieh, Mengkai

    2008-01-01

    Some advocates of globalisation argue that a free market with little regulation is the best approach for achieving cost-effective healthcare. Healthcare, however, is different from other business activities in that it is typically less profit-driven; instead, it often involves the goal of providing equitable care to the underprivileged. Traditionally, the government has subsidised the expenses of delivering affordable healthcare to underserved communities. Because of the many recent advances in telecommunications technology, telemedicine has gained increasing attention. Teleradiology, in particular, is by far the maturest of all telemedicine disciplines and, thus, it may serve as a pivotal indicator of whether telemedicine on a global scale is feasible or not. In this paper, a prediction of the future landscape of globalised teleradiology operations is attempted based on the extrapolation of the historical trends in teleradiology practice as well as the growing pressure on federal and local governments to reduce their regulatory power under the General Agreement on Trade in Services (GATS). PMID:19174364

  13. Possible global environmental impacts of solid waste practices

    SciTech Connect

    Davis, M.M.; Holter, G.M.; DeForest, T.J.; Stapp, D.C.; Dibari, J.C.

    1994-09-01

    Pollutants resulting from the management of solid waste have been shown to affect the air, land, oceans, and waterways. In addition, solid wastes have other, more indirect impacts such as reduction in feedstocks of natural resources, because useful materials are disposed of rather than recycled. The objective of this study is to evaluate solid waste management practices that have negative implications on the global environment and develop recommendations for reducing such impacts. Recommendations identifying needed changes are identified that will reduce global impacts of solid waste practices in the future. The scope of this study includes the range of non-hazardous solid wastes produced within our society, including municipal solid waste (MSW) and industrial solid waste (ISW), as well as industry-specific wastes from activities such as construction, demolition, and landclearing. Most solid waste management decisions continue to be made and implemented at very local levels, predominantly with a short-term focus to respond to relatively immediate pressures of landfill shortages, funding problems, political considerations, and the like. In this rush to address immediate local problems, little consideration is being given to potential impacts, either short- or long-term, at the national or global level resulting from solid waste management practices. More and more, the cumulative impacts from local decisions concerning solid waste management are beginning to manifest themselves in broader, longer-term impacts than are being addressed by the decision-makers or, at the very least, are presenting a greater and greater potential for such impacts.

  14. PGD training and its impact on general dentist practice patterns.

    PubMed

    Atchison, Kathryn A; Mito, Ronald S; Rosenberg, Dara Jean; Lefever, Karen H; Lin, Sylvia; Engelhardt, Rita

    2002-12-01

    This study compares the practice patterns of general dentists with and without formal advanced training in AGED or GPR programs. The UCLA School of Dentistry surveyed a random selection of dentists from graduating years 1989, 1993, and 1997 as part of a Health Resources Services Administration (HRSA)-supported evaluation of the impact of federal funding on postgraduate general dentistry (PGD) programs. Using a sample drawn by the American Dental Association (ADA), 6,725 dentists were surveyed about their practice, advanced training, patients served, and services provided. Of the 2,029 dentists (30 percent) who responded, 49 percent were practicing dentists with no formal advanced training in general dentistry or one of the eight ADA specialties; 7 percent had Advanced Education in General Dentistry (AEGD) experience; 20 percent trained in a General Practice Residency (GPR); and 24 percent were specialists. Additionally, 7 percent of respondents had PGD training and a clinical specialty. GPR-trained dentists were significantly more likely to be on a hospital staff and to treat medically compromised patients even after ten years of practice. PGD dentists were less likely to seek specialty training. Major reasons for seeking PGD training were increasing treatment speed, learning to treat medically compromised patients, and wanting hospital experience. Primary reasons for not selecting training were starting a practice and having a great practice opportunity. Our conclusion is that PGD training has an enduring impact on practice patterns and improves access to dental care for underserved populations. PMID:12521061

  15. Paediatric personnel extremity dose study.

    PubMed

    Gallet, J M C; Reed, M H

    2002-03-01

    Concern has been expressed in paediatric radiology regarding the magnitude of the extremity dose received by attending personnel during routine fluoroscopic procedures and CT. Common procedures that may be of short duration in adults can be quite the opposite in paediatric patients. The extremities of attending personnel are more likely to be exposed to the primary beam and for a longer period of time owing to a variety of reasons such as assisting in the procedure or physically restraining the patient during the examination. During the period mid 1998 to mid 2000, two paediatric radiologists, four senior radiographers and two paediatric nurses were monitored using ring thermoluminescent dosemeters (TLDs). Each participant wore the ring TLD on either the left or right ring finger, depending on which hand the individual favoured. Left/right asymmetrical studies were not conducted, nor were records kept of whether an examination used a grid or gridless technique. Initial apprehension about higher paediatric fluoroscopic and CT extremity doses was dispelled as a result of this quantitative dosimetric study. PMID:11932219

  16. Management of paediatric GERD.

    PubMed

    Vandenplas, Yvan

    2014-03-01

    Paediatric GERD is complicated to manage, as symptoms are diverse and often difficult to interpret. In infants, regurgitation is a common physiological condition. Nevertheless, when it occurs frequently (>4 times per day) and causes the infant distress, parents often seek medical help. In children 2-10 years of age, GERD is often considered to cause extra-oesophageal symptoms, despite the absence of hard evidence. Diagnostic investigations often lack solid validation and the signs and symptoms of GERD overlap with those of cow's milk protein allergy and eosinophillic oesophagitis. Reassurance, dietary treatment and positional adaptations are recommended for troublesome infant reflux. Anti-acid medication, mainly PPIs, is over-used in infants even though, in many children, reflux is not an acid-related condition. Moreover, evidence is increasing that PPIs cause adverse events such as gastroenteritis and respiratory tract infections. Management in children older than 10 years is similar to that in adults. Using prokinetics to treat nonerosive reflux disease remains only a promising theoretical concept, as no such molecule is currently available. Today, the adverse effects of each prokinetic molecule largely outweigh its potential benefit. Laparoscopic surgery is indicated in children who have life-threatening symptoms or in cases of drug dependence. PMID:24126561

  17. High-Impact Practices and the First-Year Student

    ERIC Educational Resources Information Center

    Tukibayeva, Malika; Gonyea, Robert M.

    2014-01-01

    High-impact practices, programs, and activities where students commit considerable time and effort in different settings can help to define the first-year college experience and are likely to increase success in areas like persistence, deep learning, and self-reported gains.

  18. The Impact of Action Learning Experience on Reflective Practice

    ERIC Educational Resources Information Center

    Harris, Nicole S.

    2012-01-01

    This case study examines the changes that occur with respect to reflective practices as a result of participating in an action learning group through the identification of aspects/activities of action learning that contribute to such changes and the impact these aspects/activities had on the program participants at a department of the federal…

  19. Study motives, career choices and interest in paediatric dentistry among final year dental students in Nigeria

    PubMed Central

    2014-01-01

    Background Students’ motives for studying Dentistry have been a subject of interest for years because of the potential for understanding the psychological makeup and subsequent job satisfaction for the dentist. It is also useful in identifying expectations of the profession. This study therefore tried to identify study motives and career preferences of dental students especially with respect to the practice of paediatric dentistry. Methods This was a cross-sectional study using a self-administered questionnaire. The final year students in six dental schools in Nigeria were required to fill the questionnaire. Students were asked to rank their motives and career preferences on a Likert like scale with points ranging from 0–5 where 0 represented a factor that had no influence on their decision and 5 represented a very influential factor. The underlying dimensions for study motives, career preference, impression about and motive for interest in the practice of paediatric dentistry were identified using factor analysis. Results One hundred and seventy nine of 223 students (80.3%) participated in this study. Motives for the practice of dentistry included characteristics of the profession, altruism and intellectual challenges, existence of artistic theme in dentistry and parent’s recommendation. Overall, 67.1% of respondents indicated interest in postgraduate studies and 50.8% were interested in paediatric dentistry practice. The main motives for showing interest in the practice of paediatric dentistry were ‘personal interest, professional interest and interest of significant others in children’, and ‘family influence’. Significantly more males than females were interested in the practice of paediatric dentistry though the motives for interest in the practice of paediatric dentistry did not differ significantly by sex or age. Conclusion The non-significant sex difference in the motives for interest in the practice of paediatric dentistry is a possible

  20. Electronic nursing documentation in a paediatrics hospital: impact on quality of care by using OpenEHR, IHE and HL7.

    PubMed

    Oštir, Majda; Purkart, Marinka; Stih, Anita; Prinčič, Biljana; Orel, Andrej

    2012-01-01

    The acuity of illness of sick children requiring care in hospital is increasing. There are many more children now with disabilities and complicated long term illnesses. Respiratory illness is the commonest cause of morbidity in young children. Nurses have a pivotal role in the anticipation of and/or early identification of the sick child with potential or actual respiratory failure through the assessment and measurement of the child's pattern of breathing, including rate, rhythm and effort. It should also be conducted and interpreted in association with other clinical assessments, for example cardiovascular. Record keeping is an essential part of nursing care because it details the patient journey through the healthcare process. Good quality record keeping can improve the quality of patient care and for this reason nurses must seek to ensure that their documentation practices meet high standards. Poor standards of documentation were a contributory factor in the failure to detect patients who were clinically deteriorating. In this article we searched for evidence whether electronic health records has positive impact on quality of nursing care and present our experiences with electronic nursing documentation in the field of respiratory assessment of the children and young people. PMID:22874358

  1. A paediatric X-ray exposure chart

    PubMed Central

    Knight, Stephen P

    2014-01-01

    The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes. PMID:26229655

  2. A paediatric X-ray exposure chart.

    PubMed

    Knight, Stephen P

    2014-09-01

    The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies - body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior-posterior (AP)/posterior-anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes. PMID:26229655

  3. Recent advances in paediatric cardiac anaesthesia.

    PubMed

    Vakamudi, Mahesh; Ravulapalli, Harish; Karthikeyan, Ranjith

    2012-09-01

    Paediatric cardiac anaesthesia involves anaesthetizing very small children with complex congenital heart disease for major surgical procedures. The unique nature of this patient population requires considerable expertise and in-depth knowledge of the altered physiology. There have been several developments in the last decade in this subspecialty that has contributed to better care and improved outcome in this vulnerable group of patients. The purpose of this review is to present some of the recent advances in the anesthetic management of these children from preoperative evaluation to postoperative care. This article reviews the role of magnetic resonance imaging and contrast-enhanced magnetic resonance angiography in preoperative evaluation, the use of ultrasound to secure vascular access, the use of cuffed endotracheal tubes, the optimal haematocrit and the role of blood products, including the use of recombinant factor VIIa. It also deals with the advances in technology that have led to improved monitoring, the newer developments in cardiopulmonary bypass, the use of centrifugal pumps and extracorporeal membrane oxygenation and the role of DHCA. The role of new drugs, especially the α-2 agonists in paediatric cardiac anesthetic practice, fast tracking and effective postoperative pain management have also been reviewed. PMID:23293388

  4. A paediatric X-ray exposure chart

    SciTech Connect

    Knight, Stephen P

    2014-09-15

    The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes.

  5. Pediatric & Congenital Electrophysiology Society: building an international paediatric electrophysiology organisation.

    PubMed

    Cohen, Mitchell; Sanatani, Shubhayan; Stephenson, Elizabeth; Skinner, Jon; Drago, Fabrizio; Davis, Andrew; Janousek, Jan; Rosenthal, Eric; Collins, Kathryn K; Triedman, John

    2016-05-01

    The Pediatric and Congenital Electrophysiology Society (PACES) is a non-profit organisation comprised of individuals dedicated to improving the care of children and young adults with cardiac rhythm disturbances. Although PACES is a predominantly North American-centric organisation, international members have been a part of PACES for the last two decades. This year, PACES expanded its North American framework into a broadly expansive international role. On May 12, 2015, paediatric electrophysiology leaders from within the United States of America and Canada met with over 30 international paediatric electrophysiologists from 17 countries and five continents discussing measures to (1) expand PACES' global vision, (2) address ongoing challenges such as limited resource allocation that may be present in developing countries, (3) expand PACES' governance to include international representation, (4) promote joint international sessions at future paediatric EP meetings, and (5) facilitate a global multi-centre research consortium. This meeting marked the inception of a formal international collaborative spirit in PACES. This editorial addresses some solutions to breakdown the continental silos paediatric electrophysiologists have practiced within; however, there remain ongoing limitations, and future discussions will be needed to continue to move the PACES global international vision forward. PMID:27090729

  6. Pediatric & Congenital Electrophysiology Society: building an international paediatric electrophysiology organisation.

    PubMed

    Cohen, Mitchell; Sanatani, Shubhayan; Stephenson, Elizabeth; Skinner, Jon; Drago, Fabrizio; Davis, Andrew; Janousek, Jan; Rosenthal, Eric; Collins, Kathryn K; Triedman, John

    2016-08-01

    The Pediatric and Congenital Electrophysiology Society (PACES) is a non-profit organisation comprised of individuals dedicated to improving the care of children and young adults with cardiac rhythm disturbances. Although PACES is a predominantly North American-centric organisation, international members have been a part of PACES for the last two decades. This year, PACES expanded its North American framework into a broadly expansive international role. On 12 May, 2015, paediatric electrophysiology leaders from within the United States of America and Canada met with over 30 international paediatric electrophysiologists from 17 countries and five continents discussing measures to (1) expand PACES' global vision, (2) address ongoing challenges such as limited resource allocation that may be present in developing countries, (3) expand PACES' governance to include international representation, (4) promote joint international sessions at future paediatric EP meetings, and (5) facilitate a global multi-centre research consortium. This meeting marked the inception of a formal international collaborative spirit in PACES. This editorial addresses some solutions to breakdown the continental silos paediatric electrophysiologists have practiced within; however, there remain ongoing limitations, and future discussions will be needed to continue to move the PACES global international vision forward. PMID:27075202

  7. Usage of unpublished paediatric data.

    PubMed

    Saint-Raymond, Agnès; Pelle, Benjamin; Zaccaria, Cosimo; Sennwitz, Matthias; Branch, Sarah

    2016-01-01

    The European Paediatric Regulation (EC No 1901/2006) has three main objectives: increasing the number of appropriate medicines for children, increasing information on these medicines and stimulating high-quality ethical research with children. To contribute to the information, pharmaceutical companies were required under article 45 of the Regulation to submit existing paediatric studies to regulatory authorities for review and update of the product information. Nearly, 19 000 study reports have been identified for a thousand active substances. The data are being assessed by member states' competent authorities in collaboration with European Medicines Agency (EMA). After 7 years, 262 active substances have been assessed, all of the 62 centrally approved and nearly 200 nationally approved medicines. The review so far has led to 16 new paediatric indications, of importance in addressing previously unmet needs, in particular, in younger age groups. The information is being made publicly available in an EMA database accessible directly or through the public face of the European Clinical Trials Register. This will increase awareness of existing data that are useful to researchers and other healthcare professionals, and contribute to avoiding unnecessary duplication of paediatric trials. PMID:26543071

  8. Essentials of paediatric infection control

    PubMed Central

    Moore, Dorothy L

    2001-01-01

    Young children readily transmit and acquire nosocomial infections. Children are also vulnerable to endogenous infections as a result of the breakdown of their normal defences by disease, invasive procedures or therapy. The increasing acuity of illness in hospitalized children and therapeutic advances have resulted in a patient population that is increasingly at higher risk for nosocomial infections. Antibiotic resistance has emerged as a problem in some paediatric hospitals, usually in intensive care and oncology units. Infection rates are the highest in neonatal and paediatric intensive care units (where bloodstream infections are the most frequent), and are usually associated with intravascular devices. On general paediatric wards, respiratory and gastrointestinal infections predominate, reflecting the occurrence in the community. The surveillance of nosocomial infections identifies priorities for infection control activities and permits evaluation of interventions. The prevention of transmission between patients and to personnel requires that certain measures be taken with all patients, and that additional precautions be taken with some infections, based on the route of transmission. The prevention of transmission from personnel involves ensuring that personnel are appropriately immunized and counselled about working with infections. The prevention of nosocomial infection also involves control of visitors, appropriate management of invasive procedures and devices, sterilization and disinfection of equipment, provision of a clean environment and adequate staffing. Severely immunocompromised children require extra protection, including ventilation systems that reduce the risk of exposure to filamentous fungi. Infection control in paediatrics is an evolving field that must adapt to changes in the paediatric patient population and in health care technology. PMID:20084127

  9. Impact of human resource management practices on nursing home performance.

    PubMed

    Rondeau, K V; Wagar, T H

    2001-08-01

    Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain

  10. Targeted detection of genetic alterations reveal the prognostic impact of H3K27M and MAPK pathway aberrations in paediatric thalamic glioma.

    PubMed

    Ryall, Scott; Krishnatry, Rahul; Arnoldo, Anthony; Buczkowicz, Pawel; Mistry, Matthew; Siddaway, Robert; Ling, Cino; Pajovic, Sanja; Yu, Man; Rubin, Joshua B; Hukin, Juliette; Steinbok, Paul; Bartels, Ute; Bouffet, Eric; Tabori, Uri; Hawkins, Cynthia

    2016-01-01

    Paediatric brain tumours arising in the thalamus present significant diagnostic and therapeutic challenges to physicians due to their sensitive midline location. As such, genetic analysis for biomarkers to aid in the diagnosis, prognosis and treatment of these tumours is needed. Here, we identified 64 thalamic gliomas with clinical follow-up and characterized targeted genomic alterations using newly optimized droplet digital and NanoString-based assays. The median age at diagnosis was 9.25 years (range, 0.63-17.55) and median survival was 6.43 (range, 0.01-27.63) years. Our cohort contained 42 and 22 tumours reviewed as low and high grade gliomas, respectively. Five (12 %) low grade and 11 (50 %) high grade gliomas were positive for the H3F3A/HIST1H3B K27M (H3K27M) mutation. Kaplan-Meier survival analysis revealed significantly worse overall survival for patients harbouring the H3K27M mutation versus H3F3A/HIST1H3B wild type (H3WT) samples (log-rank p < 0.0001) with a median survival of 1.02 vs. 9.12 years. Mitogen-activated protein kinase (MAPK) pathway activation via BRAF or FGFR1 hotspot mutations or fusion events were detected in 44 % of patients, and was associated with long-term survival in the absence of H3K27M (log-rank p < 0.0001). Multivariate analysis demonstrated H3K27M status and high grade histology to be the most significant independent predictors of poor overall survival with hazard ratios of 6.945 and 7.721 (p < 0.0001), respectively. In contrast, MAPK pathway activation is a predictor of favourable patient outcome, although not independent of other clinical factors. Importantly, we show that low grade malignancies may harbour H3K27M mutations and that these tumours show a dismal survival compared to low grade H3WT cases. Our data strongly supports the inclusion of targeted genetic testing in childhood thalamic tumours to most accurately stratify patients into appropriate risk groups. PMID:27577993

  11. Medical thermography (digital infrared thermal imaging - DITI) in paediatric forearm fractures - A pilot study.

    PubMed

    Ćurković, S; Antabak, A; Halužan, D; Luetić, T; Prlić, I; Šiško, J

    2015-11-01

    Trauma is the most common cause of hospitalisation in children, and forearm fractures comprise 35% of all paediatric fractures. One-third of forearm fractures are distal forearm fractures, which are the most common fractures in the paediatric population. This type of fracture represents an everyday problem for the paediatric surgeon. The three phases of fracture healing in paediatric trauma are associated with skin temperature changes that can be measured and then compared with standard plain radiographs of visible callus formation, and eventually these methods can be used in everyday practice. Thermographic assessment of temperature distribution within the examined tissues enables a quick, non-contact, non-invasive measurement of their temperature. Medical thermography is used as a screening method in other parts of medicine, but the use of this method in traumatology has still not been researched. PMID:26603613

  12. Proceedings of the seventh Northern region paediatric colloquium.

    PubMed

    Barkla, Xanthe; Kaplan, Carole

    2014-01-01

    Ethical and legal dilemmas frequently arise in paediatric practice. Given the nature of the speciality, these issues are relevant to both the medical and legal professions. To this end, senior figures from the medical and legal professions in the Northern region have met on a regular basis in order to discuss anonymised case material. We report on the proceedings of the seventh such meeting. Six cases are described and key points arising from the subsequent discussion are presented. PMID:23864488

  13. Therapeutic upper gastrointestinal tract endoscopy in Paediatric Gastroenterology

    PubMed Central

    Rahman, Imdadur; Patel, Praful; Boger, Philip; Rasheed, Shahnawaz; Thomson, Mike; Afzal, Nadeem Ahmad

    2015-01-01

    Since the first report of use of endoscopy in children in the 1970s, there has seen an exponential growth in published experience and innovation in the field. In this review article we focus on modern age therapeutic endoscopy practice, explaining use of traditional as well as new and innovative techniques, for diagnosis and treatment of diseases in the paediatric upper gastrointestinal tract. PMID:25789087

  14. Paediatric entrance doses from exposure index in computed radiography

    NASA Astrophysics Data System (ADS)

    Vano, E.; Martinez, D.; Fernandez, J. M.; Ordiales, J. M.; Prieto, C.; Floriano, A.; Ten, J. I.

    2008-06-01

    Over the last two years we have evaluated paediatric patient doses in projection radiography derived from exposure level (EL) in computed radiography (CR) in a large university hospital. Entrance surface air kerma (ESAK) for 3501 paediatric examinations was calculated from the EL, which is a dose index parameter related to the light emitted by the phosphor-stimulable plate, archived in the Digital Imaging and Communications in Medicine (DICOM) header of the images and automatically transferred to a database using custom-built dedicated software. Typical mean thicknesses for several age bands of paediatric patients was estimated to calculate ESAK from the EL values, using results of experimental measurements with phantoms for the typical x-ray beam qualities used in paediatric examinations. Mean/median ESAK values (in µGy) for the age bands of <1 year, 1-5 years, 6-10 years and 11-15 years have been obtained for chest without a bucky: 51/41, 57/34, 91/54 and 122/109; chest with a bucky (for only the last three age bands): 114/87, 129/105 and 219/170; abdomen: 119/91, 291/225, 756/600 and 1960/1508 and pelvis: 65/48, 455/314, 943/707 and 2261/1595. Sample sizes of clinical images used for the (indirect) measurements were 1724 for chest without a bucky, 799 for chest with a bucky, 337 for abdomen and 641 for pelvis. The methodology we describe could be applicable to other centres using CR as an imaging modality for paediatrics. Presently, this method is the only practical approach to automatically extract parameters contained in the DICOM header, for the calculation of patient dose values for the CR modality.

  15. Paediatric non-Hodgkin lymphoma in low and middle income countries.

    PubMed

    Gross, Thomas G; Biondi, Andrea

    2016-05-01

    Great advances have been made in the treatment of paediatric non-Hodgkin lymphoma (NHL). In high-income countries (HIC), cure rates now exceed 85%. However, in low- and middle-income countries (LMIC), cure rates remain less than 50%. It is estimated that over 90% of paediatric NHL worldwide occur in LMIC; therefore, even modest improvements in outcome would have significant impact in reducing the burden of paediatric NHL globally. This article will discuss some of the issues required to improve the outcome of paediatric NHL in LMIC using data presented at the Fifth International Symposium on Childhood, Adolescent and Young Adult Non-Hodgkin Lymphoma held in Varese, Italy, 2015 to illustrate these issues. Additionally, potential bi-directional benefits for patients in both LMIC and HIC from future collaborations will be discussed. PMID:27098084

  16. Evidence-based paediatric nursing: paediatric early warning systems.

    PubMed

    Gawronski, Orsola

    2016-05-01

    In hospital cardiac arrest are rare events in paediatrics. Most children receive appropriate care without experiencing undetected severe clinical deterioration during hospital admission. Outcomes of paediatric cardiac arrests are however generally poor, with high mortality rates and neurological damage at survival. A review of child mortality in the UK showed that a high proportion of unexpected deaths were preventable ( Pearsons 2008 ). Several studies of patient records of children who suffered cardiac arrests showed the presence of clear signs of clinical deterioration up to 24 hours before (Tume 2006). Appropriate recognition of clinical deterioration could have led to timely intervention to stabilise the patient. Missed deterioration may be due to lack of staff situational awareness, communication failure among professionals or between staff and families and other human factors ( Brady 2014 ). PMID:27214413

  17. A review of epidemiology of paediatric elbow injuries in sports.

    PubMed

    Magra, Merzesh; Caine, Dennis; Maffulli, Nicola

    2007-01-01

    The elbow is a common site of orthopaedic injury in the paediatric population. The number of these injuries continues to rise following increased levels of participation in paediatric recreational and competitive sport. Injuries to the paediatric elbow can be classified as either overuse or acute. Delineating injury patterns to the elbow in children can be challenging, given the cartilaginous composition of the distal humerus and the multiple secondary ossification centres that appear and unite with the epiphysis at defined ages. Pitching in baseball, serving in tennis, spiking in volleyball, passing in American football and launching in javelin-throwing can all produce elbow pathology by forceful valgus stress, with medial stretching, lateral compression and posterior impingement. In children and adolescents, the epiphyseal plate is weaker than the surrounding ligaments, predisposing them to epiphyseal plate injuries. On the other hand, post-pubescent or skeletally mature athletes are more prone to tendinous or ligamentous injury. Injuries may cause significant impact on the athlete, parents and healthcare system. With the exception of baseball, there are few prospective cohort studies on the epidemiological trends of childhood elbow injuries in other sports. This paper aims to describe the epidemiological trends in paediatric elbow injuries related to sports, suggests prevention strategies and discusses the scope for further research. A web-based search of existing articles pertaining to paediatric elbow injuries in sports was performed. The implications of acute and overuse injuries and the possibility of permanent damage should be understood by parents, coaches and the athletes. Proper understanding of the intrinsic and extrinsic risk factors that could lead to elbow injuries is thus required. Measures to prevent elbow injuries should include proper coaching, warm-up, officiation, legislation, medical expertise and protective gear. There are still many

  18. Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.

    PubMed

    Jacobi, Judith; Ray, Shaunta'; Danelich, Ilya; Dodds Ashley, Elizabeth; Eckel, Stephen; Guharoy, Roy; Militello, Michael; O'Donnell, Paul; Sam, Teena; Crist, Stephanie M; Smidt, Danielle

    2016-05-01

    This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed. PMID:27118546

  19. The impact of the `Getting Practical: Improving Practical Work in Science' continuing professional development programme on teachers' ideas and practice in science practical work

    NASA Astrophysics Data System (ADS)

    Abrahams, Ian; Reiss, Michael J.; Sharpe, Rachael

    2014-09-01

    Background:Despite the widespread use of practical work in school it has been recognised that more needs to be done to improve its effectiveness in developing conceptual understanding. The 'Getting Practical' CPD (Continuing Professional Development) programme was designed to contribute towards an improvement in the effectiveness of practical work through initiating changes in teachers' predominantly 'hands-on' approach to practical work to one which manifests a more equitable balance between 'hands-on' and 'minds-on'. Purpose:To evaluate the impact of the Getting Practical: Improving Practical Work in Science CPD programme on teachers' ideas and practice in science practical work in primary and secondary schools in England. Programme description:The CPD programme was designed to improve the effectiveness of science practical work in developing conceptual understanding in primary and secondary schools in England. Sample:Ten teachers of primary science and 20 secondary science teachers. Design and methods:The study employed a condensed fieldwork strategy with data collected using interviews, observational field notes and pre- and post-CPD training observations in practical lessons within 30 schools. Results:Whilst the CPD programme was effective in getting teachers to reflect on the ideas associated with the Getting Practical programme, it was much less effective in bringing about changes in actual teaching practice. Conclusion:The findings suggest that if change, rather than only an enhanced awareness of the issues, is to be brought about in established teaching <span class="hlt">practice</span> then there is a need for ongoing support over an extended period of time. Furthermore, the <span class="hlt">impact</span> of such CPD is more likely to be effective if it is undertaken by a senior member of a department or school with the full support of the SMT.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27420083','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27420083"><span id="translatedtitle">Inequality of <span class="hlt">Paediatric</span> Workforce Distribution in China.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Song, Peige; Ren, Zhenghong; Chang, Xinlei; Liu, Xuebei; An, Lin</p> <p>2016-01-01</p> <p>Child health has been addressed as a priority at both global and national levels for many decades. In China, difficulty of accessing paediatricians has been of debate for a long time, however, there is limited evidence to assess the population- and geography-related inequality of <span class="hlt">paediatric</span> workforce distribution. This study aimed to analyse the inequality of the distributions of the <span class="hlt">paediatric</span> workforce (including paediatricians and <span class="hlt">paediatric</span> nurses) in China by using Lorenz curve, Gini coefficient, and Theil L index, data were obtained from the national maternal and child health human resource sampling survey conducted in 2010. In this study, we found that the <span class="hlt">paediatric</span> workforce was the most inequitable regarding the distribution of children <7 years, the geographic distribution of the <span class="hlt">paediatric</span> workforce highlighted very severe inequality across the nation, except the Central region. For different professional types, we found that, except the Central region, the level of inequality of <span class="hlt">paediatric</span> nurses was higher than that of the paediatricians regarding both the demographic and geographic distributions. The inner-regional inequalities were the main sources of the <span class="hlt">paediatric</span> workforce distribution inequality. To conclude, this study revealed the inadequate distribution of the <span class="hlt">paediatric</span> workforce in China for the first time, substantial inequality of <span class="hlt">paediatric</span> workforce distribution still existed across the nation in 2010, more research is still needed to explore the in-depth sources of inequality, especially the urban-rural variance and the inner- and inter-provincial differences, and to guide national and local health policy-making and resource allocation. PMID:27420083</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_4");'>4</a></li> <li><a href="#" onclick='return showDiv("page_5");'>5</a></li> <li class="active"><span>6</span></li> <li><a href="#" onclick='return showDiv("page_7");'>7</a></li> <li><a href="#" onclick='return showDiv("page_8");'>8</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_6 --> <div id="page_7" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_5");'>5</a></li> <li><a href="#" onclick='return showDiv("page_6");'>6</a></li> <li class="active"><span>7</span></li> <li><a href="#" onclick='return showDiv("page_8");'>8</a></li> <li><a href="#" onclick='return showDiv("page_9");'>9</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="121"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4962244','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4962244"><span id="translatedtitle">Inequality of <span class="hlt">Paediatric</span> Workforce Distribution in China</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Song, Peige; Ren, Zhenghong; Chang, Xinlei; Liu, Xuebei; An, Lin</p> <p>2016-01-01</p> <p>Child health has been addressed as a priority at both global and national levels for many decades. In China, difficulty of accessing paediatricians has been of debate for a long time, however, there is limited evidence to assess the population- and geography-related inequality of <span class="hlt">paediatric</span> workforce distribution. This study aimed to analyse the inequality of the distributions of the <span class="hlt">paediatric</span> workforce (including paediatricians and <span class="hlt">paediatric</span> nurses) in China by using Lorenz curve, Gini coefficient, and Theil L index, data were obtained from the national maternal and child health human resource sampling survey conducted in 2010. In this study, we found that the <span class="hlt">paediatric</span> workforce was the most inequitable regarding the distribution of children <7 years, the geographic distribution of the <span class="hlt">paediatric</span> workforce highlighted very severe inequality across the nation, except the Central region. For different professional types, we found that, except the Central region, the level of inequality of <span class="hlt">paediatric</span> nurses was higher than that of the paediatricians regarding both the demographic and geographic distributions. The inner-regional inequalities were the main sources of the <span class="hlt">paediatric</span> workforce distribution inequality. To conclude, this study revealed the inadequate distribution of the <span class="hlt">paediatric</span> workforce in China for the first time, substantial inequality of <span class="hlt">paediatric</span> workforce distribution still existed across the nation in 2010, more research is still needed to explore the in-depth sources of inequality, especially the urban-rural variance and the inner- and inter-provincial differences, and to guide national and local health policy-making and resource allocation. PMID:27420083</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/17191101','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/17191101"><span id="translatedtitle">The <span class="hlt">impact</span> of PACS on radiologists' work <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Fridell, Kent; Edgren, Lars; Lindsköld, Lars; Aspelin, Peter; Lundberg, Nina</p> <p>2007-12-01</p> <p>This paper identifies and analyzes how the implementation and use of picture archiving and communication system <span class="hlt">impacts</span> radiologists' work <span class="hlt">practice</span>. The study is longitudinal from 1999 to 2005 and have a qualitative perspective were data were collected by structured interviews in a total of 46. The interviews were transcribed, analyzed, and coded using grounded theory as an organizing principle. In radiologists' work <span class="hlt">practice</span>, three main categories were defined: professional role, diagnostic <span class="hlt">practice</span>, and technology in use. The changing trends within the professional role indicated that radiologists moved from a more individual professional expertise to become more of an actor in a network. The diagnostic <span class="hlt">practice</span> changed, as reading x-ray films was seen as an art form in 1999, requiring years of training. Once everyone could view digital images, including 3-dimensional technology, it was easier for other clinicians to see and interpret the images and the skills become accessible to everyone. The change in technology in use as a result of the shift to digital images led to an increased specialization of the radiologist. PMID:17191101</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3938221','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3938221"><span id="translatedtitle">Clostridium difficile in <span class="hlt">paediatric</span> populations</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Allen, Upton D</p> <p>2014-01-01</p> <p>An increase in Clostridium difficile infection incidence has been observed among hospitalized children in the United States. The present statement, targeted at clinicians caring for infants and children in community and institutional settings, summarizes the relevant information relating to the role of C difficile in childhood diarrhea and provides recommendations for diagnosis, prevention and treatment. Significant differences between adult and <span class="hlt">paediatric</span> risk factors and disease are discussed, along with emerging therapies. The relationship between age and disease severity in children with a newly emergent and more fluoroqinolone-resistant strain of C difficile (North American Pulse-field type-1 [NAP1]) remains unknown. The importance of antimicrobial stewardship as a preventive strategy is highlighted. This statement replaces a previous Canadian <span class="hlt">Paediatric</span> Society position statement on C difficile published in 2000. PMID:24627655</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/23758424','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/23758424"><span id="translatedtitle">Simulation in nursing <span class="hlt">practice</span>: the <span class="hlt">impact</span> on patient care.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Aebersold, Michelle; Tschannen, Dana</p> <p>2013-01-01</p> <p>Simulation has a well-known history in the military, nuclear power, and aviation. It is also a recommended teaching and learning strategy supported by several landmark studies. Although in the past 20 years simulation has become more integrated into the education of nurses and physicians, it has not been as well integrated into the development of skills for <span class="hlt">practicing</span> nurses. This article will provide an overview of simulation techniques and uses and review of selected simulation research. Despite recommendations for using simulation and growing integration of simulation into education, we still lack empirical evidence of its <span class="hlt">impact</span> on patient outcomes. Our discussion provides a review of the current uses of simulation in the nursing <span class="hlt">practice</span> environment with several exemplars and offers recommendations to develop a simulation program. PMID:23758424</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4237943','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4237943"><span id="translatedtitle">The influence of the European <span class="hlt">paediatric</span> regulation on marketing authorisation of orphan drugs for children</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2014-01-01</p> <p>Background Drug development for rare diseases is challenging, especially when these orphan drugs (OD) are intended for children. In 2007 the EU <span class="hlt">Paediatric</span> Drug Regulation was enacted to improve the development of high quality and ethically researched medicines for children through the establishment of <span class="hlt">Paediatric</span> Investigation Plans (PIPs). The effect of the EU <span class="hlt">Paediatric</span> Drug Regulation on the marketing authorisation (MA) of drugs for children with rare diseases was studied. Methods Data on all designated orphan drugs, their indication, MA, PIPs and indication group (adult or child) were obtained from the European Medicines Agency (EMA). The outcome and duration of the process from orphan drug designation (ODD) to MA, was compared, per indication, by age group. The effect of the <span class="hlt">Paediatric</span> Drug Regulation, implemented in 2007, on the application process was assessed with survival analysis. Results Eighty-one orphan drugs obtained MA since 2000 and half are authorised for (a subgroup of) children; another 34 are currently undergoing further investigations in children through agreed PIPs. The <span class="hlt">Paediatric</span> Drug Regulation did not significantly increase the number of ODDs with potential <span class="hlt">paediatric</span> indications (58% before vs 64% after 2007 of ODDs, p = 0.1) and did not lead to more MAs for ODs with <span class="hlt">paediatric</span> indications (60% vs 43%, p = 0.22). ODs authorised after 2007 had a longer time to MA than those authorised before 2007 (Hazard ratio (95% CI) 2.80 (1.84-4.28), p < 0.001); potential <span class="hlt">paediatric</span> use did not influence the time to MA (Hazard ratio (95% CI) 1.14 (0.77-1.70), p = 0.52). Conclusions The EU <span class="hlt">Paediatric</span> Drug Regulation had a minor <span class="hlt">impact</span> on development and availability of ODs for children, was associated with a longer time to MA, but ensured the further <span class="hlt">paediatric</span> development of drugs still off-label to children. The <span class="hlt">impact</span> of the <span class="hlt">Paediatric</span> Drug Regulation on research quantity and quality in children through PIPs is not yet clear. PMID</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/6161337','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/6161337"><span id="translatedtitle"><span class="hlt">Impact</span> of an education program on perinatal care <span class="hlt">practices</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Harlan, W R; Hess, G E; Borer, R C; Hiss, R G</p> <p>1980-12-01</p> <p>Education of health professionals has an important role in improving health care. A media-based, self-instructional, perinatal education program was developed and field tested in rural and urban regions of Michigan. Cognitive tests, chart audits, and consultation/referral times were used to measure the <span class="hlt">impact</span> on education and patient care. The program effectively increased knowledge and improved patient care <span class="hlt">practices</span> by physicians and nurses. This study presents evidence that a targeted educational program in a media-based format can significantly improve perinatal care. PMID:6161337</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/8461171','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/8461171"><span id="translatedtitle">Priorities and <span class="hlt">practice</span> in tropical <span class="hlt">paediatrics</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Biddulph, J</p> <p>1993-02-01</p> <p>More than 14 million children under 5 years of age die annually in the Third World, mainly due to diarrhoea, pneumonia, malaria and immunizable diseases. The problems of poverty, malnutrition, poor sanitation, illiteracy and high fertility that traditionally are associated with underdevelopment are now being compounded by social disruption due to rapid changes in lifestyle, new diseases such as AIDS and Third World debt. A vital part of the solution is provision of basic medical and education services to all, with emphasis on female literacy and improving the status of women. Key elements in providing basic medical services are delegation and empowerment. Doctors must delegate the delivery of essential child health services to appropriately trained and adequately supported auxiliaries. Parents, especially mothers, need to be empowered with the knowledge and resources to recognize and manage, or assist in the management of, their children's health problems. PMID:8461171</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/15051247','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/15051247"><span id="translatedtitle">Life cycle assessment part 2: current <span class="hlt">impact</span> assessment <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Pennington, D W; Potting, J; Finnveden, G; Lindeijer, E; Jolliet, O; Rydberg, T; Rebitzer, G</p> <p>2004-07-01</p> <p>Providing our society with goods and services contributes to a wide range of environmental <span class="hlt">impacts</span>. Waste generation, emissions and the consumption of resources occur at many stages in a product's life cycle-from raw material extraction, energy acquisition, production and manufacturing, use, reuse, recycling, through to ultimate disposal. These all contribute to <span class="hlt">impacts</span> such as climate change, stratospheric ozone depletion, photooxidant formation (smog), eutrophication, acidification, toxicological stress on human health and ecosystems, the depletion of resources and noise-among others. The need exists to address these product-related contributions more holistically and in an integrated manner, providing complimentary insights to those of regulatory/process-oriented methodologies. A previous article (Part 1, Rebitzer et al., 2004) outlined how to define and model a product's life cycle in current <span class="hlt">practice</span>, as well as the methods and tools that are available for compiling the associated waste, emissions and resource consumption data into a life cycle inventory. This article highlights how practitioners and researchers from many domains have come together to provide indicators for the different <span class="hlt">impacts</span> attributable to products in the life cycle <span class="hlt">impact</span> assessment (LCIA) phase of life cycle assessment (LCA). PMID:15051247</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2014PMB....59.1165X&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2014PMB....59.1165X&link_type=ABSTRACT"><span id="translatedtitle">Evaluation of radiation dose to anthropomorphic <span class="hlt">paediatric</span> models from positron-emitting labelled tracers</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Xie, Tianwu; Zaidi, Habib</p> <p>2014-03-01</p> <p>PET uses specific molecules labelled with positron-emitting radionuclides to provide valuable biochemical and physiological information. However, the administration of radiotracers to patients exposes them to low-dose ionizing radiation, which is a concern in the <span class="hlt">paediatric</span> population since children are at a higher cancer risk from radiation exposure than adults. Therefore, radiation dosimety calculations for commonly used positron-emitting radiotracers in the <span class="hlt">paediatric</span> population are highly desired. We evaluate the absorbed dose and effective dose for 19 positron-emitting labelled radiotracers in anthropomorphic <span class="hlt">paediatric</span> models including the newborn, 1-, 5-, 10- and 15-year-old male and female. This is achieved using pre-calculated S-values of positron-emitting radionuclides of UF-NCI <span class="hlt">paediatric</span> phantoms and published biokinetic data for various radiotracers. The influence of the type of anthropomorphic model, tissue weight factors and direct human- versus mouse-derived biokinetic data on the effective dose for <span class="hlt">paediatric</span> phantoms was also evaluated. In the case of 18F-FDG, dosimetry calculations of reference <span class="hlt">paediatric</span> patients from various dose regimens were also calculated. Among the considered radiotracers, 18F-FBPA and 15O-water resulted in the highest and lowest effective dose in the <span class="hlt">paediatric</span> phantoms, respectively. The ICRP 103 updated tissue-weighting factors decrease the effective dose in most cases. Substantial differences of radiation dose were observed between direct human- versus mouse-derived biokinetic data. Moreover, the effect of using voxel- versus MIRD-type models on the calculation of the effective dose was also studied. The generated database of absorbed organ dose and effective dose for various positron-emitting labelled radiotracers using new generation computational models and the new ICRP tissue-weighting factors can be used for the assessment of radiation risks to <span class="hlt">paediatric</span> patients in clinical <span class="hlt">practice</span>. This work also contributes</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/2703266','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/2703266"><span id="translatedtitle">Forty years of research--its <span class="hlt">impact</span> on dental <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Mandel, I D</p> <p>1989-03-01</p> <p>With the multiple use of fluorides the philosophical basis of dental <span class="hlt">practice</span> shifted from the restoration of the dentition to the prevention of the initiation of dental disease. In the United States, the profound <span class="hlt">impact</span> on caries in children, with 50 per cent of the 5-17 year olds caries-free, has changed the relative distribution of the various dental services and the pattern of dental care. The child orientation has been superceded by greater attention to the restorative and other needs of the middle-aged and geriatric population. The research-generated insights into the role of plaque in the periodontal diseases and the wide-scale efforts to improve oral hygiene via plaque control have resulted in a marked reduction in gingivitis and manageable levels of periodontis in the employed population below the age of 65. More advanced disease can be treated more effectively because of new diagnostic procedures and new technologies as well as the use of anti-bacterial and anti-inflammatory agents. Major research advances in oral biology, oral medicine and oral diagnosis have extended both the depth and breadth of preventive dental <span class="hlt">practice</span>. The scope of preventive dentistry now goes well beyond caries and periodontal disease to include: (1) injury, oro-facial defects, malocclusion and temporomandibular joint dysfunction; (2) oral mucosal lesions; (3) systemic diseases with oral manifestations and (4) hazards associated with dental <span class="hlt">practice</span>. Dentistry is now being practised with an ordered set of priorities. PMID:2703266</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22935113','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22935113"><span id="translatedtitle">Incorporating educative environments into the holistic care of <span class="hlt">paediatric</span> patients.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Wilks, Susan E; Green, Julie B; Zazryn, Tsharni R</p> <p>2012-08-01</p> <p>Hospital settings can, and should, create educative spaces and learning opportunities as part of their holistic care for young patients. The purpose of this paper is to examine the evidence for creating high quality, child-centred learning environments within <span class="hlt">paediatric</span> settings. We explore the <span class="hlt">impact</span> of physical spaces on learning; the literature on developmental stages of learning for children and young people as it relates to learning environments; and the literature on learning in out-of-school settings, particularly as this applies to children who are separated from their daily communities. As all <span class="hlt">paediatric</span> settings can create opportunities for the ongoing educational development of their patients, this paper presents a way forward for this approach to holistic care. PMID:22935113</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3500799','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3500799"><span id="translatedtitle">Sedation/anaesthesia in <span class="hlt">paediatric</span> radiology</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Arlachov, Y; Ganatra, R H</p> <p>2012-01-01</p> <p>Objectives In this article we will give a comprehensive literature review on sedation/general anaesthesia (S/GA) and discuss the international variations in <span class="hlt">practice</span> and options available for S/GA for imaging children. Methods The key articles were obtained primarily from PubMed, MEDLINE, ERIC, NHS Evidence and The Cochrane Library. Results Recently, <span class="hlt">paediatric</span> radiology has seen a surge of diagnostic and therapeutic procedures, some of which require children to be still and compliant for up to 1 h. It is difficult and sometimes even impossible to obtain quick and high-quality images without employing sedating techniques in certain children. As with any medical procedure, S/GA in radiological <span class="hlt">practice</span> is not without risks and can have potentially disastrous consequences if mismanaged. In order to reduce any complications and <span class="hlt">practice</span> safety in radiological units, it is imperative to carry out pre-sedation assessments of children, obtain parental/guardian consent, monitor them closely before, during and after the procedure and have adequate equipment, a safe environment and a well-trained personnel. Conclusion Although the S/GA techniques, sedative drugs and personnel involved vary from country to country, the ultimate goal of S/GA in radiology remains the same; namely, to provide safety and comfort for the patients. Advances in knowledge Imaging children under general anaesthesia is becoming routine and preferred by operators because it ensures patient conformity and provides a more controlled environment. PMID:22898157</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27214414','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27214414"><span id="translatedtitle">Design of <span class="hlt">paediatric</span> hospitals.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Lambert, Veronica</p> <p>2016-05-01</p> <p>The <span class="hlt">impact</span> of healthcare environments on children and young people's (CYP) health and psychosocial wellbeing has attracted much attention in recent years. This sits within the realm of the political drive for enhanced awareness of the need to take account of the rights and voice of the child. Perhaps as a direct result of the United Nations Convention on the Rights of the Child, and recognition from evidence in adult population studies of the <span class="hlt">impact</span> of healthcare environments on psychosocial healing, contemporary times have witnessed a discernible movement towards enhancing quality care by promoting child and adolescent-friendly hospital environments. The Council of Europe guidelines on child-friendly health care moved to place the rights and needs of children at the heart of health care. The Council acknowledges that the delivery of child-oriented services, which includes the notion of family-centred care, should be delivered in child and family friendly environments. However, knowledge about what constitutes a child-friendly healthcare environment from CYP's perspective is often lacking with hospital architectural blueprints predominantly designed around adult proxy-reported assumptions about the needs and desires of children. PMID:27214414</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26946709','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26946709"><span id="translatedtitle">[News in <span class="hlt">paediatrics</span>].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Depallens, Sarah; Lutz, Nicolas; Carlomagno, Raffaella; Meyrat, Blaise; Barazzoni, Mirjam Schuler; Tchameni, Yves Yamgoue; Pascual, Andres; Scerba, François; Superti-Furga, Andrea</p> <p>2016-01-13</p> <p>Every pediatrician will be confronted with newborns oryoung infants with skin lesions in proximity of the vertebral column. It is important not to miss a spinal dysraphism because of the risk of meningeal infection or of the possible presence of a tethered cord. A <span class="hlt">practical</span> algorithm is presented. Non-accidental injury in young infants and toddlers is not rare but difficult to detect. Bruises and fractures are highly suspicious for non-accidental injury and should trigger specific investigations. Emergency departments and hospitals are switching from hypotonic to isotonic solutions as maintenance infusions of children. They reduce the risk of hyponatremia without increasing that of hypernatremia, and they should be used preferentially in the majority of pediatric clinical settings. PMID:26946709</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/servlets/purl/1166033','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/servlets/purl/1166033"><span id="translatedtitle">Resilient Control Systems <span class="hlt">Practical</span> Metrics Basis for Defining Mission <span class="hlt">Impact</span></span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Craig G. Rieger</p> <p>2014-08-01</p> <p>"Resilience” describes how systems operate at an acceptable level of normalcy despite disturbances or threats. In this paper we first consider the cognitive, cyber-physical interdependencies inherent in critical infrastructure systems and how resilience differs from reliability to mitigate these risks. Terminology and metrics basis are provided to integrate the cognitive, cyber-physical aspects that should be considered when defining solutions for resilience. A <span class="hlt">practical</span> approach is taken to roll this metrics basis up to system integrity and business case metrics that establish “proper operation” and “<span class="hlt">impact</span>.” A notional chemical processing plant is the use case for demonstrating how the system integrity metrics can be applied to establish performance, and</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/16443953','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/16443953"><span id="translatedtitle">The <span class="hlt">impact</span> of genetic information on policy and clinical <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Abel, Elizabeth; Horner, Sharon D; Tyler, Diane; Innerarity, Sheryl A</p> <p>2005-02-01</p> <p>This article discusses genetics-related policy issues that have an <span class="hlt">impact</span> on health care systems, health care providers, and their patients: privacy, mass screening, family screening, and knowledge dissemination. Access, cost, and ethical implications are important discussant points for each of these genetic-related policy issues. Embedded in the issue of privacy are concerns of insurability, confidentiality, and discrimination. The public health policy implications related to mass screening programs include efficacy of the screening tests, availability of primary and secondary interventions, access, costs, and program evaluation. Policy issues for family screening are similar to mass screening, with added concerns about privacy and availability of adequate resources, including health care providers and counselors trained in genetics. Knowledge dissemination is critical to maintaining currency of clinical information and applications of genetic technologies and treatments. As genetic information expands, the need for knowledge dissemination will increase. The importance of advanced <span class="hlt">practice</span> nurses' involvement in these policy issues is discussed. PMID:16443953</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2008AIPC.1064...46S','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2008AIPC.1064...46S"><span id="translatedtitle"><span class="hlt">Impact</span> of Chemistry Teachers' Knowledge and <span class="hlt">Practices</span> on Student Achievement</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Scantlebury, Kathryn</p> <p>2008-10-01</p> <p>Professional development programs promoting inquiry-based teaching are challenged with providing teachers content knowledge and using pedagogical approaches that model standards based instruction. Inquiry <span class="hlt">practices</span> are also important for undergraduate students. This paper focuses on the evaluation of an extensive professional development program for chemistry teachers that included chemistry content tests for students and the teachers and the <span class="hlt">impact</span> of undergraduate research experiences on college students' attitudes towards chemistry. Baseline results for the students showed that there were no gender differences on the achievement test but white students scored significantly higher than non-white students. However, parent/adult involvement with chemistry homework and projects, was a significant negative predictor of 11th grade students' test chemistry achievement score. This paper will focus on students' achievement and attitude results for teachers who are mid-way through the program providing evidence that on-going, sustained professional development in content and pedagogy is critical for improving students' science achievement.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4518764','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4518764"><span id="translatedtitle">Conflict escalation in <span class="hlt">paediatric</span> services: findings from a qualitative study</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Forbat, Liz; Teuten, Bea; Barclay, Sarah</p> <p>2015-01-01</p> <p>Objective To explore clinician and family experiences of conflict in <span class="hlt">paediatric</span> services, in order to map the trajectory of conflict escalation. Design Qualitative interview study, employing extreme-case sampling. Interviews were analysed using an iterative thematic approach to identify common themes regarding the experience and escalation of conflict. Participants Thirty-eight health professionals and eight parents. All participants had direct experience of conflict, including physical assault and court proceedings, at the interface of acute and palliative care. Setting Two teaching hospitals, one district general hospital and two <span class="hlt">paediatric</span> hospices in England, in 2011. Results Conflicts escalate in a predictable manner. Clearly identifiable behaviours by both clinicians and parents are defined as mild, moderate and severe. Mild describes features like the insensitive use of language and a history of unresolved conflict. Moderate involves a deterioration of trust, and a breakdown of communication and relationships. Severe marks disintegration of working relationships, characterised by behavioural changes including aggression, and a shift in focus from the child's best interests to the conflict itself. Though conflicts may remain at one level, those which escalated tended to move sequentially from one level to the next. Conclusions Understanding how conflicts escalate provides clinicians with a <span class="hlt">practical</span>, evidence-based framework to identify the warning signs of conflict in <span class="hlt">paediatrics</span>. PMID:25940425</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4717424','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4717424"><span id="translatedtitle">Varicella <span class="hlt">paediatric</span> hospitalisations in Belgium: a 1-year national survey</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Blumental, Sophie; Sabbe, Martine; Lepage, Philippe</p> <p>2016-01-01</p> <p>Background Varicella universal vaccination (UV) has been implemented in many countries for several years. Nevertheless, varicella UV remains debated in Europe and few data are available on the real burden of infection. We assessed the burden of varicella in Belgium through analysis of hospitalised cases during a 1-year period. Methods Data on children admitted to hospital with varicella were collected through a national network from November 2011 to October 2012. Inclusion criteria were either acute varicella or related complications up to 3 weeks after the rash. Results Participation of 101 hospitals was obtained, covering 97.7% of the total <span class="hlt">paediatric</span> beds in Belgium. 552 children were included with a median age of 2.1 years. Incidence of <span class="hlt">paediatric</span> varicella hospitalisations reached 29.5/105 person-years, with the highest <span class="hlt">impact</span> among those 0–4 years old (global incidence and odds of hospitalisation: 79/105 person-years and 1.6/100 varicella cases, respectively). Only 14% (79/552) of the cohort had an underlying chronic condition. 65% (357/552) of children had ≥1 complication justifying their admission, 49% were bacterial superinfections and 10% neurological disorders. Only a quarter of children (141/552) received acyclovir. Incidence of complicated hospitalised cases was 19/105 person-years. <span class="hlt">Paediatric</span> intensive care unit admission and surgery were required in 4% and 3% of hospitalised cases, respectively. Mortality among Belgian <span class="hlt">paediatric</span> population was 0.5/106 and fatality ratio 0.2% among our cohort. Conclusions Varicella demonstrated a substantial burden of disease in Belgian children, especially among the youngest. Our thorough nationwide study, run in a country without varicella UV, offers data to support varicella UV in Belgium. PMID:26130380</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/16854558','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/16854558"><span id="translatedtitle">Recent pharmacological advances in <span class="hlt">paediatric</span> analgesics.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Anderson, B J; Palmer, G M</p> <p>2006-08-01</p> <p>Growth and development are two linked processes that distinguish children from adults. The use of size as the primary covariate during pharmacokinetic (PK) analyses allows exploration of the effects of age. Allometric scaling models have assisted understanding of the developmental clearance changes in common analgesic drugs such as paracetamol, morphine, tramadol and local anaesthetics agents. Single nucleotide polymorphisms (pharmacogenomics [PG]) and their <span class="hlt">impact</span> on hepatic drug metabolism for opioids, tramadol, non-steroidal anti-inflammatory drugs (NSAIDs) and drug receptor responses are increasingly reported. Altered chemical structure or formulations of common analgesics alter pharmacodynamic (PD) effects enhancing safety and efficacy for NSAIDs by stereoselectivity and the addition of nitric oxide, for intravenous paracetamol by formulation and structural difference from propacetamol and for local anaesthetics through stereoselectivity. This article focuses upon recent data for analgesics used in <span class="hlt">paediatric</span> pain management including paracetamol, NSAIDs, morphine, tramadol, amide local anaesthetics and ketamine. It centres on PK and clinical studies in neonates, infants and children. PG studies are acknowledged as potentially allowing individual drug therapy tailoring through a decrease in between-patient population variability, although the <span class="hlt">impact</span> of PG in the very young is less certain. There are few data describing age-related PD changes in children despite recognition that the number, affinity and type of receptors or the availability of natural ligands changes with age. PMID:16854558</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_5");'>5</a></li> <li><a href="#" onclick='return showDiv("page_6");'>6</a></li> <li class="active"><span>7</span></li> <li><a href="#" onclick='return showDiv("page_8");'>8</a></li> <li><a href="#" onclick='return showDiv("page_9");'>9</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_7 --> <div id="page_8" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_6");'>6</a></li> <li><a href="#" onclick='return showDiv("page_7");'>7</a></li> <li class="active"><span>8</span></li> <li><a href="#" onclick='return showDiv("page_9");'>9</a></li> <li><a href="#" onclick='return showDiv("page_10");'>10</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="141"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24907888','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24907888"><span id="translatedtitle">[The electrocardiogram in the <span class="hlt">paediatric</span> age group].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Sanches, M; Coelho, A; Oliveira, E; Lopes, A</p> <p>2014-09-01</p> <p>A properly interpreted electrocardiogram (ECG) provides important information and is an inexpensive and easy test to perform. It continues to be the method of choice for the diagnosis of arrhythmias. Although the principles of cardiac electrophysiology are the same, there are anatomical and physiological age-dependent changes which produce specific alterations in the <span class="hlt">paediatric</span> ECG, and which may be misinterpreted as pathological. The intention of this article is to address in a systematic way the most relevant aspects of the <span class="hlt">paediatric</span> ECG, to propose a possible reading scheme of the ECG and to review the electrocardiograph tracings most frequently found in the <span class="hlt">paediatric</span> age group. PMID:24907888</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24351606','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24351606"><span id="translatedtitle"><span class="hlt">Paediatric</span> exercise training in prevention and treatment.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Pieles, Guido E; Horn, Richard; Williams, Craig A; Stuart, A Graham</p> <p>2014-04-01</p> <p>Exercise training is an underused intervention in <span class="hlt">paediatric</span> healthcare. This is surprising, since initial evidence demonstrates its effectiveness and safety; furthermore it confers socioeconomic benefits for healthcare systems. Pilot studies have assessed and confirmed the feasibility of exercise training in many <span class="hlt">paediatric</span> disease settings. However, more research is needed to understand the pathophysiology, quantify treatment effects and monitor outcomes. A concerted effort from researchers, health professionals and police makers will be necessary to make exercise training an evidence-based and cost-effective intervention in <span class="hlt">paediatric</span> care. PMID:24351606</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=211787','TEKTRAN'); return false;" href="http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=211787"><span id="translatedtitle">Designing <span class="hlt">impact</span> assessments for evaluating ecological effects of agricultural conservation <span class="hlt">practices</span> on streams</span></a></p> <p><a target="_blank" href="http://www.ars.usda.gov/services/TekTran.htm">Technology Transfer Automated Retrieval System (TEKTRAN)</a></p> <p></p> <p></p> <p>Conservation <span class="hlt">practices</span> are regularly implemented within agricultural watersheds throughout the United States without evaluating their ecological <span class="hlt">impacts</span>. Scientific evaluations documenting how habitat and aquatic biota within streams respond to these <span class="hlt">practices</span> are needed for evaluating the effects o...</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2011epsc.conf.1775H','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2011epsc.conf.1775H"><span id="translatedtitle">Teacher Workshops in the US: Goals, Best <span class="hlt">Practices</span> and <span class="hlt">Impact</span></span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Hörst, S. M.</p> <p>2011-10-01</p> <p>The goal of the workshop is to educate the teachers on a few focused topics so that they can transfer the knowledge they gain to their students. We will recruit scientists who are attending the meeting to participate in the workshops and will also pair the teachers with scientists in the field who can serve as a resource for the teacher and their class throughout the school year. The scientists can answer questions the teachers may have, be available to do video lectures or interactive question and answer sessions over skype, and work with the teachers to develop hands-on classroom activities. We will partner closely with EPO professionals in NASA's Science Mission Directorate to ensure that best <span class="hlt">practices</span> for the workshops are employed, including ensuring that the workshop and workshop materials are designed within the framework of the state standards, surveying participating teachers before the workshops about their needs and goals, assessing the participants pre-workshop knowledge, and engaging participants as learners during the workshop [1]. The <span class="hlt">impact</span> of the workshop will be increased by providing the teachers and students with a scientist who will serve as a long-term resource. We will maintain contact with the teachers after the workshop to ensure that the scientists are still actively engaged in their classroom and to collect feedback. References [1] Shupla C, et al. (2011) Lessons Learned: Best <span class="hlt">Practices</span> in Educator Workshops. 42nd Lunar and Planetary Science Conference, no. 2828. EPSC Abstracts Vol. 6, EPSC-DPS2011-1775, 2011 EPSC-DPS Joint Meeting 2011 c Author(s) 2011</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22776610','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22776610"><span id="translatedtitle">Popliteal vasculature injuries in <span class="hlt">paediatric</span> trauma patients.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Jones, S A; Roberts, D C; Clarke, N M P</p> <p>2012-10-01</p> <p>Popliteal-artery injuries in the <span class="hlt">paediatric</span>-trauma patient are uncommon, difficult to diagnose and with prolonged ischaemia lead to substantial complications. We report three cases of popliteal-vasculature injury in <span class="hlt">paediatric</span>-trauma patients with diverse mechanisms of injury: blunt trauma, penetrating injury and a Salter-Harris I fracture. We present a range of the significant sequelae that can result from <span class="hlt">paediatric</span> popliteal-artery injury, both physically and psychologically. It is imperative that clinicians have a high index of suspicion when confronted with <span class="hlt">paediatric</span> patients with trauma around the knee and that popliteal-vasculature injuries are diagnosed early. If insufficiencies are detected, further imaging should be considered, but surgical exploration should not be delayed in the presence of ischaemia. PMID:22776610</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25836694','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25836694"><span id="translatedtitle">Establishment of diagnostic reference levels in computed tomography for <span class="hlt">paediatric</span> patients in Sudan: a pilot study.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Sulieman, A</p> <p>2015-07-01</p> <p><span class="hlt">Paediatric</span> patients are recognised to be at higher risk of developing radiation-induced cancer than adults. The purpose of this pilot study was to evaluate the radiation doses to <span class="hlt">paediatric</span> patients during computed tomography (CT) procedures in order to propose local diagnostic reference levels (DRLs). A total of 296 patients (aged 6-10 y) were investigated in 8 hospitals equipped with 64-, 16- and dual-slice CT machines. The mean dose length product values were 772, 446 and 178 mGy cm for head, abdomen and chest, respectively. Imaging protocols were not adapted to the patient's weight in certain CT machines. The results confirmed that <span class="hlt">paediatric</span> patients are exposed to an unnecessary radiation dose. The established DRLs were higher than those available in other countries. This study showed the need for harmonisation of the <span class="hlt">practice</span> in CT departments and radiation dose optimisation. PMID:25836694</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3005666','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3005666"><span id="translatedtitle">Steroid Assays in <span class="hlt">Paediatric</span> Endocrinology</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2010-01-01</p> <p>Most steroid disorders of the adrenal cortex come to clinical attention in childhood and in order to investigate these problems, there are many challenges to the laboratory which need to be appreciated to a certain extent by clinicians. The analysis of sex steroids in biological fluids from neonates, over adrenarche and puberty present challenges of specificities and concentrations often in small sample sizes. Different reference ranges are also needed for interpretations. For around 40 years, quantitative assays for the steroids and their regulatory peptide hormones have been possible using immunoassay techniques. Problems are recognised and this review aims to summarise the benefits and failings of immunoassays and introduce where tandem mass spectrometry is anticipated to meet the clinical needs for steroid analysis in <span class="hlt">paediatric</span> endocrine investigations. It is important to keep a dialogue between clinicians and the laboratory, especially when any laboratory result does not make sense in the clinical investigation. Conflict of interest:None declared. PMID:21274330</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/21646328','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/21646328"><span id="translatedtitle"><span class="hlt">Paediatrics</span>: the etymology of a name.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Pearn, John</p> <p>2011-08-01</p> <p>Within the history of <span class="hlt">paediatrics</span> is the history of the name used to describe it. The etymology of the word '<span class="hlt">paediatrics</span>' dates from its first written use, recorded as 'pädiatrik' in the German literature and as '<span class="hlt">paediatric</span>', later 'pediatric' in the USA, both first in 1850. Professor Robley Dunglison (1788-1869), the British and American medical lexicographer, first defined 'paediatria' as 'the treatment of the diseases of children' in 1855. 'Pediatric medicine' was promoted as a specialty in the USA in 1880. The oldest monumental inscription defining the specialty of '<span class="hlt">paediatrics</span>' in the UK is to be found on a plaque added (in 1950) to the memorial to Dr George Armstrong (1719-1789), a founder of the specialty of <span class="hlt">paediatrics</span>, in Castleton Cemetery, Scottish Borders, Roxburghshire. '<span class="hlt">Paediatrics</span>' and 'child health', with subtle semantic distinctions, had become well established in the English-speaking world by the middle of the 20th century. This paper presents an interpretative chronology of the etymology of the descriptors of the specialty that enjoins all who care for children. PMID:21646328</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4349440','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4349440"><span id="translatedtitle"><span class="hlt">Paediatrics</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Shumer, Daniel E.</p> <p>2015-01-01</p> <p>Medical intervention for transgender adolescents is a controversial issue but a recently published article describing long-term psychological outcomes using ‘the Dutch model’ of care should help to silence critics and reassure the growing number of clinicians treating this patient population. PMID:25403246</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/10168441','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/10168441"><span id="translatedtitle"><span class="hlt">Impact</span> of tax sanctions on physician <span class="hlt">practice</span> acquisitions and employment.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Hardy, C T; Lyden, S M; Kasmarcak, S J</p> <p>1997-07-01</p> <p>The intermediate tax sanctions create significant concerns for tax-exempt healthcare organizations that seek to integrate <span class="hlt">practicing</span> physicians through <span class="hlt">practice</span> acquisition or employment. The sanctions will force not-for-profit healthcare organizations to examine both the strategic and business implications of the dollars they have committed to <span class="hlt">practice</span> acquisition and physician employment. The sanctions also should motivate organizations to reexamine their existing physician compensation arrangements, which may be creating negative incentives for <span class="hlt">practice</span> productivity. PMID:10168441</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25458138','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25458138"><span id="translatedtitle"><span class="hlt">Impact</span> of evidence and health policy on nursing <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Geurden, Bart; Adriaenssens, Jef; Franck, Erik</p> <p>2014-12-01</p> <p>The story of evidence-based <span class="hlt">practice</span> in nursing is long, with many successes, contributors, leaders, scientists, and enthusiasts. Nurse educators have great advantages offered from a wide variety of educational resources for evidence-based <span class="hlt">practice</span>. These resources offer students the opportunity to connect their emerging competencies with clinical needs for best <span class="hlt">practices</span> in clinical and microsystem changes. PMID:25458138</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3178788','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3178788"><span id="translatedtitle">Parental involvement in <span class="hlt">paediatric</span> cancer treatment decisions</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>McKenna, K; Collier, J; Hewitt, M; Blake, H</p> <p>2010-01-01</p> <p>This study investigated parents' information needs and involvement in decision-making processes affecting the care of children diagnosed with cancer. Interviews and questionnaires were used to assess parental satisfaction in 50 mothers and 16 fathers responsible for 58 children in an English <span class="hlt">Paediatric</span> Oncology Unit. Parents reported that doctors contributed almost twice as much to the decision-making process as they did, but parental satisfaction was positively correlated with the amount of information provided when giving informed consent. Satisfaction about their involvement in this process relied heavily upon the level of support received from others. Parents consenting to their child's involvement in non-randomised trials perceived themselves to be under greater pressure from others during the decision-making process while those whose children were further along the treatment trajectory were more uncertain about decisions previously made. Findings indicate that the accessibility, support, information and degree of control afforded to parents by healthcare professionals <span class="hlt">impacts</span> upon their satisfaction with both the decision-making process and their confidence in the decisions thus made. Information and support tailored to parents' specific needs may therefore enhance satisfaction with clinical decision making and reassure parents about decisions made in the long-term interest of their child's health. PMID:19807776</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=stroke&id=EJ1032116','ERIC'); return false;" href="http://eric.ed.gov/?q=stroke&id=EJ1032116"><span id="translatedtitle">The Self-Directed Learning Experience of Mothers Whose Child Has Had a <span class="hlt">Paediatric</span> Stroke</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Grover, Kenda S.</p> <p>2014-01-01</p> <p>This study employed qualitative research methodology to explore the experiences of mothers who self-directed their learning following their child's stroke diagnosis. <span class="hlt">Paediatric</span> stroke, although rare, is among the top 10 causes of death in children in the USA, but information about the cause, treatment and long-term <span class="hlt">impact</span> are difficult to…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=evaluation+AND+institutional&pg=4&id=EJ1033982','ERIC'); return false;" href="http://eric.ed.gov/?q=evaluation+AND+institutional&pg=4&id=EJ1033982"><span id="translatedtitle">The Conditional Nature of High <span class="hlt">Impact</span>/Good <span class="hlt">Practices</span> on Student Learning Outcomes</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Seifert, Tricia A.; Gillig, Benjamin; Hanson, Jana M.; Pascarella, Ernest T.; Blaich, Charles F.</p> <p>2014-01-01</p> <p>Using a multi-institutional sample of undergraduate students, this study found that the relationships between engaging in high <span class="hlt">impact</span>/good <span class="hlt">practices</span> and liberal arts outcomes differ based on students' precollege and background characteristics. Findings suggest that high <span class="hlt">impact</span>/good <span class="hlt">practices</span> are not a panacea and require a greater degree of…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25579287','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25579287"><span id="translatedtitle"><span class="hlt">Impact</span> of conversion from an open ward design <span class="hlt">paediatric</span> intensive care unit environment to all isolated rooms environment on incidence of bloodstream infections and antibiotic resistance in Southern Israel (2000 to 2008).</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Lazar, I; Abukaf, H; Sofer, S; Peled, N; Leibovitz, E</p> <p>2015-01-01</p> <p>We studied the epidemiology, microbiology, clinical aspects and outcome of bloodstream infections (BSI) in a tertiary <span class="hlt">paediatric</span> intensive care unit. All BSI episodes were prospectively identified and analysed. The <span class="hlt">paediatric</span> intensive care unit moved in 2006 from an open-plan unit to a new (all single room) unit. Three hundred and fifty-three BSI episodes occurred in 299 of 4162 patients. Overall, BSI incidence was 85 per 1000 hospitalised children. Fewer BSI episodes occurred during the last two years of the study (2007 to 2008), compared with 2000 to 2006 (70 of 1061 admissions, 6.5% versus 283 of 3101 admissions, 9.1%, respectively, P=0.01). There were 127 of 340 (37.4%) community-acquired and 213 of 340 (62.6%) nosocomial BSI episodes (31 of 1000 and 51 of 1000, respectively). Nosocomial BSI episodes decreased during 2007 to 2008 versus 2000 to 2006 (37.7% versus 55.8%, P=0.03). In 448 instances, pathogens were isolated, 231 (52%) Gram-positive and 188 (42%) Gram-negative. Coagulase-negative Staphylococci, S. pneumoniae and S. aureus (41.1%, 19.9% and 11.7%, respectively) were the most common Gram-positive and Enterobacteriaceae spp. the most frequent Gram-negative organisms (45.2%, of them Klebsiella spp. and E. coli 40% and 29.4%, respectively). A significant decrease was recorded during 2007 to 2008 in Enterobacteriaceae resistance to piperacillin, gentamicin and ciprofloxacin. Thirty of 299 (10%, 9 with S. pneumoniae-BSI) patients died. A significant decrease in BSI and nosocomial incidence and Enterobacteriaceae spp. antibiotic resistance was recorded following the conversion of the <span class="hlt">paediatric</span> intensive care unit from an open ward to an all isolated rooms environment. PMID:25579287</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25486164','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25486164"><span id="translatedtitle">Community psychology <span class="hlt">practice</span>: expanding the <span class="hlt">impact</span> of psychology's work.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Wolff, Tom</p> <p>2014-11-01</p> <p>This article introduces the reader to community psychology <span class="hlt">practice</span> by defining the field and its key principles and then illustrating through brief case stories what community psychology <span class="hlt">practice</span> looks like in various employment settings. An exploration of the development of the field includes a review of the competencies of community psychology <span class="hlt">practice</span>. Finally, the emerging opportunities for community psychology <span class="hlt">practice</span> for psychologists are outlined. Well-publicized issues such as health disparities give psychologists an opportunity to bring social problems such as racism, sexism, homophobia, and income inequality to the forefront and to create community-wide efforts to improve the ways in which people live. Community psychology <span class="hlt">practice</span> offers psychologists a format and a set of competencies for moving forward on this work by focusing on approaches that are ecological, community centered, population based, preventive, focused on systems change and empowerment, and multidisciplinary and that bring those most affected by the issues to the heart of the decision making. PMID:25486164</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26377723','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26377723"><span id="translatedtitle">Can linking databases answer questions about <span class="hlt">paediatric</span> heart failure?</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Pasquali, Sara K; Schumacher, Kurt R; Davies, Ryan R</p> <p>2015-08-01</p> <p>Numerous data sets collect information on patients with <span class="hlt">paediatric</span> cardiovascular disease, including <span class="hlt">paediatric</span> heart failure and transplant patients. This review discusses methodologies available for linking and integrating information across data sets, which may help facilitate answering important questions in the field of <span class="hlt">paediatric</span> heart failure and transplant that cannot be answered with individual data sets or single-centre data alone. PMID:26377723</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/19614789','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/19614789"><span id="translatedtitle">V.A.C. Therapy in the management of <span class="hlt">paediatric</span> wounds: clinical review and experience.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Baharestani, Mona; Amjad, Ibrahim; Bookout, Kim; Fleck, Tatjana; Gabriel, Allen; Kaufman, David; McCord, Shannon Stone; Moores, Donald C; Olutoye, Oluyinka O; Salazar, Jorge D; Song, David H; Teich, Steven; Gupta, Subhas</p> <p>2009-08-01</p> <p>Usage of negative pressure wound therapy (NPWT) in the management of acute and chronic wounds has grown exponentially in the past decade. Hundreds of studies have been published regarding outcomes and methods of therapy used for adult wounds. This treatment is increasingly being used to manage difficult-to-treat <span class="hlt">paediatric</span> wounds arising from congenital defects, trauma, infection, tumour, burns, pressure ulceration and postsurgical complications in children, although relatively few studies have been aimed at this population. Given the anatomical and physiological differences between adults and children, a multidisciplinary expert advisory panel was convened to determine appropriate use of NPWT with reticulated open cell foam (NPWT/ROCF) as delivered by Vacuum Assisted Closure (V.A.C. Therapy, KCI Licensing, Inc., San Antonio, TX) for the treatment of <span class="hlt">paediatric</span> wounds. The primary objectives of the expert advisory panel were to exchange state-of-<span class="hlt">practice</span> information on <span class="hlt">paediatric</span> wound care, review the published data regarding the use of NPWT/ROCF in <span class="hlt">paediatric</span> wounds, evaluate the strength of the existing data and establish guidelines on best <span class="hlt">practices</span> with NPWT/ROCF for the <span class="hlt">paediatric</span> population. The proposed <span class="hlt">paediatrics</span>-specific clinical <span class="hlt">practice</span> guidelines are meant to provide practitioners an evidence base from which decisions could be made regarding the safe and efficacious selection of pressure settings, foam type, dressing change frequency and use of interposing contact layer selections. The guidelines reflect the state of knowledge on effective and appropriate wound care at the time of publication. They are the result of consensus reached by expert advisory panel members based on their individual clinical and published experiences related to the use of NPWT/ROCF in treating <span class="hlt">paediatric</span> wounds. Best <span class="hlt">practices</span> are described herein for novice and advanced users of NPWT/ROCF. Recommendations by the expert panel may not be appropriate for use in all</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4351256','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4351256"><span id="translatedtitle">Estimation of head <span class="hlt">impact</span> exposure in high school football: Implications for regulating contact <span class="hlt">practices</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Broglio, Steven P.; Martini, Douglas; Kasper, Luke; Eckner, James T.; Kutcher, Jeffrey S.</p> <p>2015-01-01</p> <p>Background Increased attention is being placed on the role of subconcussive <span class="hlt">impacts</span> to the head during football participation and long-term cognitive health. Some have suggested that mitigating <span class="hlt">impacts</span> to the head can be achieved by reducing or eliminating contact football <span class="hlt">practices</span>. The effect that this might have on the number and magnitude of <span class="hlt">impacts</span> is unknown. Purpose To estimate the effect of limiting contact <span class="hlt">practices</span> on the frequency and magnitude of head <span class="hlt">impacts</span> through the retrospective assessment of in vivo head <span class="hlt">impact</span> data. Study Design Cross-sectional study; Level of evidence, 3. Methods Data on <span class="hlt">impact</span> magnitude and frequency were collected with the Head <span class="hlt">Impact</span> Telemetry System during the 2009 football season among 42 varsity high school football athletes (mean age, 16.2 ± 0.6 years; mean height, 180.9 ± 7.2 cm; mean weight, 89.8 ± 20.1 kg). Head <span class="hlt">impacts</span> were compared between player positions and session types (noncontact <span class="hlt">practice</span>, contact <span class="hlt">practice</span>, and game). These results were used to estimate the frequency and magnitude of head <span class="hlt">impacts</span> when contact sessions were restricted. Results The participants collectively sustained 32,510 <span class="hlt">impacts</span> over the 15-week season. The typical athlete sustained a mean of 774 ± 502 <span class="hlt">impacts</span> during the season with linemen (center, guard, and offensive or defensive tackle positions) sustaining the highest number of <span class="hlt">impacts</span> per athlete (1076 ± 541), followed by the tight ends, running backs, and linebackers (779 ± 286);wide receivers, cornerbacks, and safeties (417 ± 266); and quarterbacks (356 ± 433). When viewed by session type, noncontact <span class="hlt">practices</span> (n = 21) accounted for 1998 total <span class="hlt">impacts</span> (2.4 ± 1.4 per athlete per session), contact <span class="hlt">practices</span> (n = 36) accounted for 16,346 <span class="hlt">impacts</span> (10.5 ± 7.7 per athlete per session), and games (n = 14) accounted for 14,166 <span class="hlt">impacts</span> (24.1 ± 19.1 per athlete per session). Significantly more <span class="hlt">impacts</span> occurred during games when compared with contact (P = .02) and noncontact <span class="hlt">practices</span></p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3555046','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3555046"><span id="translatedtitle"><span class="hlt">Paediatric</span> use of mycophenolate mofetil</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Downing, Heather J; Pirmohamed, Munir; Beresford, Michael W; Smyth, Rosalind L</p> <p>2013-01-01</p> <p>A number of medications do not have a licence, or label, for use in the <span class="hlt">paediatric</span> age group nor for the specific indication for which they are being used in children. Over recent years, mycophenolate mofetil has increasingly been used off-label (i.e. off-licence) in adults for a number of indications, including autoimmune conditions; progressively, this wider use has been extended to children. This review summarizes current use of mycophenolate mofetil (MMF) in children, looking at how MMF works, the pharmacokinetics, the clinical conditions for which it is used, the advantages it has when compared with other immunosuppressants and the unresolved issues remaining with use in children. The review aims to focus on off-label use in children so as to identify areas that require further research and investigation. The overall commercial value of MMF is limited because it has now come off patent in adults. Given the increasing knowledge of the pharmacodynamics, pharmacokinetics and pharmacogenomics demonstrating the clinical benefits of MMF, new, formal, investigator-led studies, including trials focusing on the use of MMF in children, would be of immense value. PMID:22519685</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_6");'>6</a></li> <li><a href="#" onclick='return showDiv("page_7");'>7</a></li> <li class="active"><span>8</span></li> <li><a href="#" onclick='return showDiv("page_9");'>9</a></li> <li><a href="#" onclick='return showDiv("page_10");'>10</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_8 --> <div id="page_9" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_7");'>7</a></li> <li><a href="#" onclick='return showDiv("page_8");'>8</a></li> <li class="active"><span>9</span></li> <li><a href="#" onclick='return showDiv("page_10");'>10</a></li> <li><a href="#" onclick='return showDiv("page_11");'>11</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="161"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/EJ1083261.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/EJ1083261.pdf"><span id="translatedtitle">The <span class="hlt">Impact</span> of OER on Teaching and Learning <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Weller, Martin; de los Arcos, Bea; Farrow, Rob; Pitt, Beck; McAndrew, Patrick</p> <p>2015-01-01</p> <p>The OER Research Hub has been investigating the <span class="hlt">impact</span> of OER, using eleven hypotheses, and a mixed methods approach to establish an evidence base. This paper explores the findings relating to teaching and learning. The findings reveal a set of direct <span class="hlt">impacts</span>, including an increase in factors relating to student performance, increased reflection…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/ED372106.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/ED372106.pdf"><span id="translatedtitle">Evaluation for Training <span class="hlt">Impact</span>: Insights from Advanced <span class="hlt">Practices</span>.</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Voerman, Irene; And Others</p> <p></p> <p>A literature review examined major trends in organizations and training and the ways in which evaluation may help drive training <span class="hlt">impact</span>. In addition, 3 case studies and 18 interviews were conducted in the United States to study evaluation methods. Recommendations about the use of evaluation for training <span class="hlt">impact</span> were then formulated, and four Dutch…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/19436534','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/19436534"><span id="translatedtitle">Social <span class="hlt">paediatrics</span> and early child development: Part 1.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Ford-Jones, Elizabeth Lee; Williams, Robin; Bertrand, Jane</p> <p>2008-11-01</p> <p>Diseases of modernism, rather than infectious diseases and chronic medical conditions, increasingly cause childhood morbidity and mortality. Thus, the goal of enhancing life outcomes for all children has become imperative. Paediatricans may begin with a renewed interest in social <span class="hlt">paediatrics</span> - the care of the disadvantaged child in Canada, requiring a focus on all the complex factors that <span class="hlt">impact</span> families and the community. New paediatricians need the tools to <span class="hlt">impact</span> both social determinants of health and political policies to support health for all. Such interest is as old as the field of <span class="hlt">paediatrics</span> (social medicine began with the great pathologist, Virchow, in the 1800s). The new neuroscience of experience-based brain and biological development has caught up with the social epidemiology literature. It is now known from both domains that a child's poor developmental and health outcomes are a product of early and ongoing socioeconomic and psychological experiences. In the era of epigenetics, it is now understood that both nature and nurture control the genome. Future paediatricians need to understand the science of experience-based brain development, and the interventions demonstrated to improve life trajectories. A challenge is to connect the traditional population health approach with traditional primary care responsibilities. New and enhanced collaborative interdisciplinary networks with, for example, public health, primary care, community resources, education and justice systems are required. PMID:19436534</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4451793','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4451793"><span id="translatedtitle">Bounded rationality alters the dynamics of <span class="hlt">paediatric</span> immunization acceptance</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Oraby, Tamer; Bauch, Chris T.</p> <p>2015-01-01</p> <p>Interactions between disease dynamics and vaccinating behavior have been explored in many coupled behavior-disease models. Cognitive effects such as risk perception, framing, and subjective probabilities of adverse events can be important determinants of the vaccinating behaviour, and represent departures from the pure “rational” decision model that are often described as “bounded rationality”. However, the <span class="hlt">impact</span> of such cognitive effects in the context of <span class="hlt">paediatric</span> infectious disease vaccines has received relatively little attention. Here, we develop a disease-behavior model that accounts for bounded rationality through prospect theory. We analyze the model and compare its predictions to a reduced model that lacks bounded rationality. We find that, in general, introducing bounded rationality increases the dynamical richness of the model and makes it harder to eliminate a <span class="hlt">paediatric</span> infectious disease. In contrast, in other cases, a low cost, highly efficacious vaccine can be refused, even when the rational decision model predicts acceptance. Injunctive social norms can prevent vaccine refusal, if vaccine acceptance is sufficiently high in the beginning of the vaccination campaign. Cognitive processes can have major <span class="hlt">impacts</span> on the predictions of behaviour-disease models, and further study of such processes in the context of vaccination is thus warranted. PMID:26035413</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26036205','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26036205"><span id="translatedtitle">Evaluating an outreach service for <span class="hlt">paediatric</span> burns follow up.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Cubitt, Jonathan J; Chesney, Amy; Brown, Liz; Nguyen, Dai Q</p> <p>2015-09-01</p> <p>Complications following <span class="hlt">paediatric</span> burns are well documented and care needs to be taken to ensure the appropriate follow up of these patients. Historically this has meant follow up into adulthood however this is often not necessary. The centralisation of burns services in the UK means that patients and their parents may have to travel significant distances to receive this follow up care. To optimise our burns service we have introduced a burns outreach service to enable the patients to be treated closer to home. The aim of this study is to investigate the <span class="hlt">impact</span> of the introduction of the burns outreach service and within this environment define the optimum length of time needed to follow up these patients. A retrospective analysis was carried out of 100 consecutive <span class="hlt">paediatric</span> burns patients who underwent surgical management of their burn. During the follow up period there were 43 complications in 32 patients (32%). These included adverse scarring (either hypertrophic or keloid), delayed healing (taking >1 month to heal) and contractures (utilising either splinting or surgical correction). Fifty-nine percent of these complications occurred within 6 months of injury and all occurred within 18 months. Size of burn was directly correlated to the risk of developing a complication. The outreach service reduced the distance the patient needs to travel for follow up by more than 50%. There was also a significant financial benefit for the service as the follow up clinics were on average 50% cheaper with burns outreach than burns physician. Burns outreach is a feasible service that not only benefits the patients but also is cheaper for the burns service. The optimum length of follow up for <span class="hlt">paediatric</span> burns in 18 months, after which if there have not been any complications they can be discharged. PMID:26036205</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2540224','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2540224"><span id="translatedtitle">Guidelines for <span class="hlt">paediatric</span> life support. <span class="hlt">Paediatric</span> Life Support Working Party of the European Resuscitation Council.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>1994-01-01</p> <p>The <span class="hlt">paediatric</span> life support working party of the European Resuscitation Council was set up in 1992 with the aim of producing guidelines for basic and advanced <span class="hlt">paediatric</span> resuscitation that would be acceptable throughout Europe. The commonest cause of cardiac arrest in children is problems with the airway. The resulting difficulties in breathing and the associated hypoxia rapidly cause a severe bradycardia or asystole. In contrast, adults have primary cardiac events resulting in ventricular fibrillation. This important difference in the pathogenesis of <span class="hlt">paediatric</span> and adult cardiac arrest is reflected in these European Resuscitation Council guidelines, which complement those already published for adults. PMID:8019227</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=review&pg=2&id=EJ1098870','ERIC'); return false;" href="http://eric.ed.gov/?q=review&pg=2&id=EJ1098870"><span id="translatedtitle">Beyond Synthesis: Augmenting Systematic Review Procedures with <span class="hlt">Practical</span> Principles to Optimise <span class="hlt">Impact</span> and Uptake in Educational Policy and <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Green, Chris; Taylor, Celia; Buckley, Sharon; Hean, Sarah</p> <p>2016-01-01</p> <p>Whilst systematic reviews, meta-analyses and other forms of synthesis are considered amongst the most valuable forms of research evidence, their limited <span class="hlt">impact</span> on educational policy and <span class="hlt">practice</span> has been criticised. In this article, we analyse why systematic reviews do not benefit users of evidence more consistently and suggest how review teams…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4054483','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4054483"><span id="translatedtitle">Hot tonsillectomy for <span class="hlt">paediatric</span> obstructive sleep apnoea</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Coyle, Paula; Marzouk, Sherief Deya; Gerolympou, Margarita; Marais, Joe</p> <p>2014-01-01</p> <p>Obstructive sleep apnoea is a common presentation in <span class="hlt">paediatric</span> ear, nose and tongue (ENT) outpatients. The use of sleep studies is controversial however once a diagnosis has been made, frequently treatment is surgery. Should these patients be operated on as urgent cases? A 5-year-old boy was admitted under the <span class="hlt">paediatric</span> team with difficultly breathing and desaturations to 77%. The patient had previously been seen by ENT as an outpatient with an 8-month history of obstructive sleep apnoea and was listed for an adenotonsillectomy with the standard waiting time. During this admission he had an emergency adenotonsillectomy. The patient improved immediately with no large desaturations in recovery and normal observations throughout his stay. It is never ideal to do a <span class="hlt">paediatric</span> emergency operation and we have reviewed the evidence base to answer the question: Should these patients be treated urgently when seen in outpatients? PMID:24907212</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3781994','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3781994"><span id="translatedtitle">Disease Activity Measures in <span class="hlt">Paediatric</span> Rheumatic Diseases</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Luca, Nadia J.; Feldman, Brian M.</p> <p>2013-01-01</p> <p>Disease activity refers to potentially reversible aspects of a disease. Measurement of disease activity in <span class="hlt">paediatric</span> rheumatic diseases is a critical component of patient care and clinical research. Disease activity measures are developed systematically, often involving consensus methods. To be useful, a disease activity measure must be feasible, valid, and interpretable. There are several challenges in quantifying disease activity in <span class="hlt">paediatric</span> rheumatology; namely, the conditions are multidimensional, the level of activity must be valuated in the context of treatment being received, there is no gold standard for disease activity, and it is often difficult to incorporate the patient's perspective of their disease activity. To date, core sets of response variables are defined for juvenile idiopathic arthritis, juvenile systemic lupus erythematosus, and juvenile dermatomyositis, as well as definitions for improvement in response to therapy. Several specific absolute disease activity measures also exist for each condition. Further work is required to determine the optimal disease activity measures in <span class="hlt">paediatric</span> rheumatology. PMID:24089617</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4081767','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4081767"><span id="translatedtitle">The HOPE (Helping to Outline <span class="hlt">Paediatric</span> Eating Disorders) Project: development and debut of a <span class="hlt">paediatric</span> clinical eating disorder registry</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2013-01-01</p> <p>Background The HOPE (Helping to Outline <span class="hlt">Paediatric</span> Eating Disorders) Project is an ongoing registry study made up of a sequential cross-sectional sample prospectively recruited over 17 years, and is designed to answer empirical questions about <span class="hlt">paediatric</span> eating disorders. This paper introduces the HOPE Project, describes the registry sample to-date, and discusses future directions and challenges and accomplishments. The project and clinical service were established in a tertiary academic hospital in Western Australia in 1996 with a service development grant. Research processes were inbuilt into the initial protocols and data collection was maintained in the following years. Recognisable progress with the research agenda accelerated only when dedicated research resources were obtained. The registry sample consists of consecutive children and adolescents assessed at the eating disorder program from 1996 onward. Standardised multidisciplinary data collected from family intake interview, parent and child clinical interviews, medical review, parent, child and teacher psychometric assessments, and inpatient admission records populate the HOPE Project database. Results The registry database to-date contains 941 assessments, of whom 685 met DSM-IV diagnostic criteria for an eating disorder at admission. The majority of the sample were females (91%) from metropolitan Perth (83%). The cases with eating disorders consist of eating disorders not otherwise specified (68%), anorexia nervosa (25%) and bulimia nervosa (7%). Among those with eating disorders, a history of weight loss since illness onset was almost universal (96%) with fear of weight gain (71%) common, and the median duration of illness was 8 months. Conclusions Over the next five years and more, we expect that the HOPE Project will make a strong scientific contribution to <span class="hlt">paediatric</span> eating disorders research and will have important real-world applications to clinical <span class="hlt">practice</span> and policy as the research unfolds</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24567497','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24567497"><span id="translatedtitle"><span class="hlt">Paediatric</span> CT optimisation utilising Catphan® 600 and age-specific anthropomorphic phantoms.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Santos, Joana; Batista, Maria do Carmo; Foley, Shane; Paulo, Graciano; McEntee, Mark F; Rainford, Louise</p> <p>2014-12-01</p> <p>The purpose of the study is to perform phantom-based optimisation of <span class="hlt">paediatric</span> computed tomography (CT) protocols and quantify the <span class="hlt">impact</span> upon radiation dose and image noise levels. The study involved three Portuguese <span class="hlt">paediatric</span> centres. Currently employed scanning protocols for head and chest examinations and combinations of exposure parameters were applied to a Catphan(®)600 phantom to review the CT dose <span class="hlt">impact</span>. Contrast-noise ratio (CNR) was quantified using Radia Diagnostic(®) tool. Imaging parameters, returning similar CNRs (<1) and dose savings were applied to three <span class="hlt">paediatric</span> anthropomorphic phantoms. OsiriX software based on standard deviation pixel values facilitated image noise analysis. Currently employed protocols and age categorisation varied between centres. Manipulation of exposure parameters facilitated mean dose reductions of 33 and 28 % for <span class="hlt">paediatric</span> head and chest CT examinations, respectively. The majority of the optimised CT examinations resulted in image noise similar to currently employed protocols. Dose reductions of up to 33 % were achieved with image quality maintained. PMID:24567497</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/23263630','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/23263630"><span id="translatedtitle">Promoting <span class="hlt">practice</span> in public health academia: assessing <span class="hlt">impact</span> on student education.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Beck, Angela J; Sarigiannis, Amy N; Thomas, Dana; Montgomery, JoLynn P; Boulton, Matthew L</p> <p>2013-01-01</p> <p>This article reviews the activities of an office of public health <span class="hlt">practice</span> in a school of public health (SPH) and assesses their <span class="hlt">impact</span> on master's of public health student training and education. The University of Michigan SPH established a <span class="hlt">Practice</span> Office in 2005 to develop programs in community-based public health, workforce development, student training, and <span class="hlt">practice</span>-based research. Student training objectives included increasing <span class="hlt">practice</span> activity offerings and participation rates, ensuring participant satisfaction with activities, and raising the number of students seeking public health <span class="hlt">practice</span> employment. According to student survey results from the 2007-2008 and 2008-2009 academic years, the <span class="hlt">Practice</span> Office achieved mixed success in meeting objectives. Approximately 50% of students participated in at least 1 activity, nearly 50% of students reported that the activities <span class="hlt">impacted</span> their decision to pursue a <span class="hlt">practice</span> career, and approximately 75% of students reported moderate to extensive public health <span class="hlt">practice</span> experience on graduation, compared with 30% at the beginning of their degree program, although this change was not significantly different for those who had participated in <span class="hlt">Practice</span> Office activities. Initiation of a systematic process to evaluate the <span class="hlt">impact</span> of <span class="hlt">practice</span>-based activities early in program development is recommended for all <span class="hlt">Practice</span> Offices. PMID:23263630</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27117211','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27117211"><span id="translatedtitle">[<span class="hlt">Impact</span> of digital technology on clinical <span class="hlt">practices</span>: perspectives from surgery].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Zhang, Y; Liu, X J</p> <p>2016-04-01</p> <p>Digital medical technologies or computer aided medical procedures, refer to imaging, 3D reconstruction, virtual design, 3D printing, navigation guided surgery and robotic assisted surgery techniques. These techniques are integrated into conventional surgical procedures to create new clinical protocols that are known as "digital surgical techniques". Conventional health care is characterized by subjective experiences, while digital medical technologies bring quantifiable information, transferable data, repeatable methods and predictable outcomes into clinical <span class="hlt">practices</span>. Being integrated into clinical <span class="hlt">practice</span>, digital techniques facilitate surgical care by improving outcomes and reducing risks. Digital techniques are becoming increasingly popular in trauma surgery, orthopedics, neurosurgery, plastic and reconstructive surgery, imaging and anatomic sciences. Robotic assisted surgery is also evolving and being applied in general surgery, cardiovascular surgery and orthopedic surgery. Rapid development of digital medical technologies is changing healthcare and clinical <span class="hlt">practices</span>. It is therefore important for all clinicians to purposefully adapt to these technologies and improve their clinical outcomes. PMID:27117211</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/8466242','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/8466242"><span id="translatedtitle">Evaluation and audit in a <span class="hlt">paediatric</span> disability service.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Cass, H D; Kugler, B T</p> <p>1993-03-01</p> <p>Parental and professional responses to questionnaires evaluating a <span class="hlt">paediatric</span> disability service are reported and the viability of auditing structural, process, and outcome aspects of clinical <span class="hlt">practice</span> are discussed. Expectations of waiting time to first appointment (met for only 52% of consumers) illustrate structural issues. Process issues are reflected in consumer reactions to outreach work (for example, 94% of parents and 84% of professionals found this supportive). Outcome measures such as consumer satisfaction with the service (76% of consumers reported being 'very satisfied' and 20% 'fairly satisfied') suggest that service aims are being met. Good concurrence of service aims with consumer needs is indicated by parental reasons for referral (for example, 75% for diagnostic help, 73% for a better understanding of the disorder, 88% for <span class="hlt">practical</span> help), referrers' reasons (for example, 55% for a second diagnostic opinion, 45% due to lack of local expertise), and reports from most other professionals involved with the case that a similar service was not provided locally. PMID:8466242</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/17119078','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/17119078"><span id="translatedtitle">Resuscitation of general <span class="hlt">paediatrics</span> in the UK.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Wacogne, I; Scott-Jupp, R; Chambers, T</p> <p>2006-12-01</p> <p>"The report of my death was an exaggeration", said Mark Twain. For a dying specialty, general <span class="hlt">paediatrics</span> has certainly been looking very healthy recently. It is timely to examine why our specialty was thought to be at such risk, and to explore why, although in many cases shocked and confused, it is well on the way to recovery. This article explores what is needed to keep it healthy to ensure that the general paediatrician is at the centre of the delivery of <span class="hlt">paediatrics</span> in the UK. PMID:17119078</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25439093','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25439093"><span id="translatedtitle"><span class="hlt">Practical</span> management of cumulative anthropogenic <span class="hlt">impacts</span> with working marine examples.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Wright, Andrew J; Kyhn, Line A</p> <p>2015-04-01</p> <p>Human pressure on the environment is expanding and intensifying, especially in coastal and offshore areas. Major contributors to this are the current push for offshore renewable energy sources, which are thought of as environmentally friendly sources of power, as well as the continued demand for petroleum. Human disturbances, including the noise almost ubiquitously associated with human activity, are likely to increase the incidence, magnitude, and duration of adverse effects on marine life, including stress responses. Stress responses have the potential to induce fitness consequences for individuals, which add to more obvious directed takes (e.g., hunting or fishing) to increase the overall population-level <span class="hlt">impact</span>. To meet the requirements of marine spatial planning and ecosystem-based management, many efforts are ongoing to quantify the cumulative <span class="hlt">impacts</span> of all human actions on marine species or populations. Meanwhile, regulators face the challenge of managing these accumulating and interacting <span class="hlt">impacts</span> with limited scientific guidance. We believe there is scientific support for capping the level of <span class="hlt">impact</span> for (at a minimum) populations in decline or with unknown statuses. This cap on <span class="hlt">impact</span> can be facilitated through implementation of regular application cycles for project authorization or improved programmatic and aggregated <span class="hlt">impact</span> assessments that simultaneously consider multiple projects. Cross-company collaborations and a better incorporation of uncertainty into decision making could also help limit, if not reduce, cumulative <span class="hlt">impacts</span> of multiple human activities. These simple management steps may also form the basis of a rudimentary form of marine spatial planning and could be used in support of future ecosystem-based management efforts. PMID:25439093</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/12373007','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/12373007"><span id="translatedtitle">Growth in <span class="hlt">paediatric</span> Crohn's disease.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Cezard, J P; Touati, G; Alberti, C; Hugot, J P; Brinon, C; Czernichow, P</p> <p>2002-01-01</p> <p>Growth failure (GF) is one of the major complications affecting children with inflammatory bowel disease. The faltering is temporary in 40-50% of cases and prolonged in 10-20% in Crohn's disease (CD). Such failure is rare in children with ulcerative colitis (5%). This complication is often associated with retarded bone development and delayed onset of sexual maturation. The delayed linear growth has a variety of causes including insufficient intake due to anorexia and the inflammatory process with increased energy and protein expenditure. Other factors are increased intestinal loss, secondary hypopituitarism and treatment with steroids. Therapeutic strategies of CD in children have changed this last decade by introducing new therapeutic agents such as topic steroids, immunosuppressors, anti-TNF (antibody and notably in children enteral nutrition which has shown its efficacy in inducing remissions of active CD, restoring nutritional status and stimulation of linear growth. The results of a recent prospective multicentric study over 2 years in 82 CD show that severe GF (-2 SD) is initially present in 15% (n = 12), among them 11 remain < -2SD after 2 years of follow-up. Six patients who were on the normal range initially increased their GF during the follow-up (< -2SD) (total 21% < -2SD (n = 17) at 2 years). At inclusion in this group there was no difference in growth velocity, used of steroids, enteral nutrition or severity of CD as compared to the group with no GF. It suggests that new treatment strategy should be developed in the future for this specific complication of <span class="hlt">paediatric</span> CD. PMID:12373007</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=226386&keyword=irrigation&actType=&TIMSType=+&TIMSSubTypeID=&DEID=&epaNumber=&ntisID=&archiveStatus=Both&ombCat=Any&dateBeginCreated=&dateEndCreated=&dateBeginPublishedPresented=&dateEndPublishedPresented=&dateBeginUpdated=&dateEndUpdated=&dateBeginCompleted=&dateEndCompleted=&personID=&role=Any&journalID=&publisherID=&sortBy=revisionDate&count=50&CFID=68566309&CFTOKEN=44092942','EPA-EIMS'); return false;" href="http://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=226386&keyword=irrigation&actType=&TIMSType=+&TIMSSubTypeID=&DEID=&epaNumber=&ntisID=&archiveStatus=Both&ombCat=Any&dateBeginCreated=&dateEndCreated=&dateBeginPublishedPresented=&dateEndPublishedPresented=&dateBeginUpdated=&dateEndUpdated=&dateBeginCompleted=&dateEndCompleted=&personID=&role=Any&journalID=&publisherID=&sortBy=revisionDate&count=50&CFID=68566309&CFTOKEN=44092942"><span id="translatedtitle">Novel Use of Time Domain Reflectometry in Infiltration-based Low <span class="hlt">Impact</span> Development <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://oaspub.epa.gov/eims/query.page">EPA Science Inventory</a></p> <p></p> <p></p> <p>Low <span class="hlt">impact</span> development (LID) <span class="hlt">practices</span> are structures that intercept stormwater runoff and infiltrate it through a range of media types, including aggregate, rain garden media, and underlying soils. Hydrologic performance is typically evaluated by comparing inlet and underdrain o...</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/23513431','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/23513431"><span id="translatedtitle"><span class="hlt">Impact</span> of unit <span class="hlt">practice</span> councils on culture and outcomes.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Wessel, Susan</p> <p>2012-01-01</p> <p>This article describes positive outcomes in culture, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, employee engagement, and clinical quality as a result of using shared governance, specifically unit <span class="hlt">practice</span> councils (UPC) or staff councils, to implement Relationship-Based Care (RBC). PMID:23513431</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=heart+AND+failure&pg=3&id=EJ926393','ERIC'); return false;" href="http://eric.ed.gov/?q=heart+AND+failure&pg=3&id=EJ926393"><span id="translatedtitle">Evidence and <span class="hlt">Impact</span>: How Scholarship Can Improve Policy and <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Lingenfelter, Paul E.</p> <p>2011-01-01</p> <p>Researchers, policy makers, and practitioners share a sincere interest in improving the human condition. Academics may be tempted to fault irrationality, ideology, or ignorance for the failure of research to inform policy and <span class="hlt">practice</span> more powerfully, but policy makers and practitioners want academics to tell them "what works" in order to find a…</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_7");'>7</a></li> <li><a href="#" onclick='return showDiv("page_8");'>8</a></li> <li class="active"><span>9</span></li> <li><a href="#" onclick='return showDiv("page_10");'>10</a></li> <li><a href="#" onclick='return showDiv("page_11");'>11</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_9 --> <div id="page_10" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_8");'>8</a></li> <li><a href="#" onclick='return showDiv("page_9");'>9</a></li> <li class="active"><span>10</span></li> <li><a href="#" onclick='return showDiv("page_11");'>11</a></li> <li><a href="#" onclick='return showDiv("page_12");'>12</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="181"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://pubs.er.usgs.gov/publication/70157273','USGSPUBS'); return false;" href="http://pubs.er.usgs.gov/publication/70157273"><span id="translatedtitle"><span class="hlt">Impact</span> of fishing and stocking <span class="hlt">practices</span> on Coregonid diversity</span></a></p> <p><a target="_blank" href="http://pubs.er.usgs.gov/pubs/index.jsp?view=adv">USGS Publications Warehouse</a></p> <p>Anneville, Orlane; Lasne, Emilien; Guillard, Jean; Eckmann, Reiner; Stockwell, Jason D.; Gillet, Christian; Yule, Daniel</p> <p>2015-01-01</p> <p>Fish species diversity can be lost through interacting stressors including habitat loss, stocking and overfishing. Although a multitude of stressors have played a role in the global decline of coregonid (Coregonus spp.) diversity, a number of contemporary studies have identified habitat loss stemming from eutrophication as the primary cause. Unfortunately, reconstructing the role of fishing and stocking <span class="hlt">practices</span> can be difficult, because these records are incomplete or appear only in hard-to-access historic grey literature. Based on an illustrative set of historic and contemporary studies, we describe how fisheries management <span class="hlt">practices</span> may have contributed to coregonid diversity loss in European and North American lakes. We provide case studies examining how fishing and stocking may reduce coregonid diversity through demographic decline and introgressive hybridization. In some lakes, fisheries management <span class="hlt">practices</span> may have led to a loss of coregonid diversity well before issues with habitat degradation manifested. Our review suggests that fish conservation policies could beneficially consider the relative importance of all stressors, including management <span class="hlt">practices</span>, as potential drivers of diversity loss.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=277969','TEKTRAN'); return false;" href="http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=277969"><span id="translatedtitle">Nutritional <span class="hlt">practices</span> to reduce environmental <span class="hlt">impact</span> of grazing beef cattle.</span></a></p> <p><a target="_blank" href="http://www.ars.usda.gov/services/TekTran.htm">Technology Transfer Automated Retrieval System (TEKTRAN)</a></p> <p></p> <p></p> <p>The effects of beef cattle operations on water quality, climate change, wildlife, and the general environment is a growing concern. With increased concern about the environment, many "common" <span class="hlt">practices</span> might need to be revised in order to balance production efficiency and income with real and percei...</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=Workflow+AND+Design&pg=7&id=ED255988','ERIC'); return false;" href="http://eric.ed.gov/?q=Workflow+AND+Design&pg=7&id=ED255988"><span id="translatedtitle">Research <span class="hlt">Impact</span> on Educational Policy and <span class="hlt">Practice</span> in the USA.</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Mitchell, Douglas E.</p> <p></p> <p>This chapter examines, from four perspectives, the ways in which educational research, development, and evaluation activities in the United States are organized, controlled, and supported, and considers whether research can be properly used to shape educational policy and <span class="hlt">practice</span>. First, the size and historical development of the research and…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=information+AND+confidence&pg=7&id=EJ1021207','ERIC'); return false;" href="http://eric.ed.gov/?q=information+AND+confidence&pg=7&id=EJ1021207"><span id="translatedtitle">Considering the <span class="hlt">Impact</span> of Preservice Teacher Beliefs on Future <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Thomas, Cathy Newman</p> <p>2014-01-01</p> <p>Preservice teacher beliefs merit additional attention from special education teacher-educators. Given current policy and reforms aimed at improving outcomes for students with disabilities and increasing the adoption of evidence-based <span class="hlt">practices</span>, teacher-educators should recognize the barrier that preservice teacher beliefs can pose and consider…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/15279861','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/15279861"><span id="translatedtitle"><span class="hlt">Paediatric</span> nurses' attitudes to massage and aromatherapy massage.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Hunt, V; Randle, J; Freshwater, D</p> <p>2004-08-01</p> <p>Complementary therapies have continued to increase in popularity in healthcare and it is widely accepted that they can be incorporated into the nursing role. However, this acceptance does not necessarily mean that the introduction of therapies into the nursing arena has been without confusion and without professional and legal implications. Consequently, this small-scale, qualitative study aimed to explore the perceptions and lived experiences of <span class="hlt">paediatric</span> nurses of two therapies, namely massage and aromatherapy massage. There is a dearth of literature exploring nurses' perceptions to the incorporation of these therapies, especially in the arena of <span class="hlt">paediatric</span> nursing where massage and aromatherapy massage are common <span class="hlt">practice</span>. Semi-structured interviews were undertaken with qualified nurses and revealed the themes of 'benefit', 'family centred care', 'nursing care' and 'being held back'. It was found that at some stage during their professional career each nurse had performed massage and/or aromatherapy massage. All nurses were able to recall certain benefits of the therapies for the children that they had observed and many discussed the importance of involving the family as a way of including them in to the care of their child. However, for the nurses in this study, it was evident that the incorporation of complementary therapies into the nursing role was determined by the context in which they practised. Due to the dominance of the medical model, nurses faced pressures and conflicts in the realities of their nursing work, which meant they were often unable to carry out these therapies. PMID:15279861</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=safety&pg=5&id=EJ950091','ERIC'); return false;" href="http://eric.ed.gov/?q=safety&pg=5&id=EJ950091"><span id="translatedtitle">Safety Education <span class="hlt">Impact</span> and Good <span class="hlt">Practice</span>: A Review</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Mulvaney, Caroline A.; Watson, Michael C.; Errington, Gail</p> <p>2012-01-01</p> <p>Purpose: The aim of this literature review was to examine recent evidence of the <span class="hlt">impact</span> of safety education for children and young people on unintentional injury rates and to update an earlier review. Evidence was sought that linked safety education for children and young people in schools, centres and other settings with changes in knowledge,…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=ERI&pg=2&id=ED508108','ERIC'); return false;" href="http://eric.ed.gov/?q=ERI&pg=2&id=ED508108"><span id="translatedtitle">Capturing Research <span class="hlt">Impacts</span>: A Review of International <span class="hlt">Practice</span>. Documented Briefing</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Grant, Jonathan; Brutscher, Philipp-Bastian; Kirk, Susan Ella; Butler, Linda; Wooding, Steven</p> <p>2010-01-01</p> <p>In February 2009, the Higher Education Funding Council for England (HEFCE) commissioned RAND Europe to review approaches to evaluating the <span class="hlt">impact</span> of research as part of their wider work programme to develop new arrangements for the assessment and funding of research--referred to as the Research Excellence Framework (REF). The objectives were 1) to…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=scientific+AND+revolution&pg=6&id=EJ214976','ERIC'); return false;" href="http://eric.ed.gov/?q=scientific+AND+revolution&pg=6&id=EJ214976"><span id="translatedtitle">The <span class="hlt">Impact</span> of Paradigm-Based Research on Classroom <span class="hlt">Practice</span>.</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Peterson, Rita W.</p> <p>1979-01-01</p> <p>The first part of the paper describes the nature of scientific revolutions and how paradigms of scientists drive these revolutions. Against their background, the second part describes studies of the <span class="hlt">impact</span> of paradigm-based research on the classroom. The third part speculates on the likelihood of a science teaching revolution. (Author/RE)</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=instructional+AND+practices+AND+student+AND+achievement+AND+science&pg=6&id=EJ1034755','ERIC'); return false;" href="http://eric.ed.gov/?q=instructional+AND+practices+AND+student+AND+achievement+AND+science&pg=6&id=EJ1034755"><span id="translatedtitle">Modeling Instruction: The <span class="hlt">Impact</span> of Professional Development on Instructional <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Barlow, Angela T.; Frick, Tasha M.; Barker, Heather L.; Phelps, Amy J.</p> <p>2014-01-01</p> <p>Modeling Instruction holds the potential for transforming science instruction and improving student achievement. Key to the success of Modeling Instruction, however, is the fidelity of implementation of its curriculum. This qualitative study examined the <span class="hlt">impact</span> of Modeling Instruction professional development on participating teachers'…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/18799306','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/18799306"><span id="translatedtitle">Global child health priorities: what role for <span class="hlt">paediatric</span> oncologists?</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Kellie, Stewart J; Howard, Scott C</p> <p>2008-11-01</p> <p>Despite increasing globalisation, international mobility and economic interdependence, 9.7 million children aged less than 5 years in low income countries will die this year, almost all from preventable or treatable diseases. Diarrhoea, pneumonia and malaria account for 5 million of these deaths each year, compared to about 150,000 deaths from childhood cancer in low- and middle-income countries. In high-income countries, 80% of the 50,000 children diagnosed with cancer each year survive, yet cancer remains the leading disease-related cause of childhood death. In low- and middle-income countries, where 80% of children live, the 200,000 children diagnosed with cancer each year have limited access to curative treatment, and only about 25% survive. Some might argue that death from <span class="hlt">paediatric</span> cancer in poor countries is insignificant compared to death from other causes, and that scarce health resources may be better used in other areas of public health. Is there a role for the treatment of children with cancer in these regions? Do international partnerships or 'twinning' programmes enhance local health care or detract from other public health priorities? What is ethical and what is possible? This review examines the health challenges faced by infants and children in low-income countries, and assesses the role and <span class="hlt">impact</span> of international <span class="hlt">paediatric</span> oncology collaboration to improve childhood cancer care worldwide. PMID:18799306</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/ED472070.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/ED472070.pdf"><span id="translatedtitle">Form or Flesh: Social Factors That <span class="hlt">Impact</span> Women's <span class="hlt">Practice</span> of Breast Self-Examination.</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>London, Patricia A.</p> <p></p> <p>The social factors that <span class="hlt">impact</span> Caucasian middle-class women's <span class="hlt">practice</span> of breast self-examination (BSE) were examined through in-depth interviews with 15 women who were selected to represent a mix of women who <span class="hlt">practiced</span> BSE monthly, occasionally, or never. The meaning of BSE was analyzed in relation to body image and the social definition of being…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3627201','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3627201"><span id="translatedtitle">National Board Certification and Developmentally Appropriate <span class="hlt">Practices</span>: Perceptions of <span class="hlt">Impact</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>McKenzie, Ellen Nancy</p> <p>2013-01-01</p> <p>The study investigated a relationship between National Board certification and perceived use of developmentally appropriate <span class="hlt">practices</span> (DAP). A self-developed survey, the Early-childhood Teacher Inventory of <span class="hlt">Practices</span>, was e-mailed to participants. Participants included 246 non-National Board-certified (non-NBCT) and 135 National Board-certified (NBCT) early childhood teachers. Descriptives were reported for age, years of teaching experience, grade level currently teaching, ethnicity, degree type, certification type, and degree level. Inferential statistics were used to understand the differences between perceived use of DAP. NBCTs scored significantly higher than non-NBCTs in three of the four target areas and on the total of the scale. Pearson product-moment corelations were used to determine a relationship between years of experience or level of education and NBCTs’ perceived use of DAP. Years of experience were significantly related, but level of education was not. The findings indicate that NBCT teachers perceive they incorporate more developmentally appropriate <span class="hlt">practices</span> into their teaching than do non-NBCT teachers. PMID:23626399</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27177481','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27177481"><span id="translatedtitle">[The medicine use pathway in <span class="hlt">paediatrics</span>].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Didelot, Nicolas</p> <p>2016-01-01</p> <p>The medicine use pathway is a process which is constantly evolving in order to comply with intangible rules. As in other therapeutic fields, the drug regimen in <span class="hlt">paediatrics</span> must tolerate no error and must be able to detect all warning signs, however minor, in order to optimise this approach. PMID:27177481</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24525527','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24525527"><span id="translatedtitle"><span class="hlt">Paediatric</span> pituitary adenomas: a decade of change.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Guaraldi, Federica; Storr, Helen L; Ghizzoni, Lucia; Ghigo, Ezio; Savage, Martin O</p> <p>2014-01-01</p> <p>Pituitary adenomas, although rare in the <span class="hlt">paediatric</span> age range and mostly benign, represent very challenging disorders for diagnosis and management. The recent identification of genetic alterations in young individuals with pituitary adenomas has broadened the scope of molecular investigations and contributed to the understanding of mechanisms of tumorigenesis. Recent identification of causative mutations of genes such as GNAS, PRKAR1A, MEN1 and AIP has introduced the concept of molecular screening of young apparently healthy family members. Population-based studies have reported a significantly higher number of affected subjects and genetic variations than expected. Radiological techniques have advanced, yet many microadenomas remain undetectable on scanning. However, experience with transsphenoidal and endoscopic pituitary surgery has led to higher rates of cure. Prolactinomas, corticotroph and somatotroph adenomas remain the most prevalent, with each diagnosis presenting its own challenges. As <span class="hlt">paediatric</span> pituitary adenomas occur very infrequently within the <span class="hlt">paediatric</span> age range, <span class="hlt">paediatric</span> endocrine units cannot provide expert management in isolation. Consequently, close co-operation with adult endocrinology colleagues with experience of pituitary disease is strongly recommended. PMID:24525527</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26289061','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26289061"><span id="translatedtitle">Recent advances in <span class="hlt">paediatric</span> respiratory medicine.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Turnbull, Andrew; Balfour-Lynn, Ian M</p> <p>2016-02-01</p> <p>This review highlights important advances in <span class="hlt">paediatric</span> respiratory medicine since 2014, excluding cystic fibrosis. It focuses mainly on the more common conditions, bronchopulmonary dysplasia, bronchiolitis and preschool wheezing, asthma, pneumonia and sleep, and highlights some of the rarer conditions such as primary ciliary dyskinesia and interstitial lung disease (ILD). PMID:26289061</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3531002','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3531002"><span id="translatedtitle">Recent developments in <span class="hlt">paediatric</span> neuraxial blocks</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Ponde, Vrushali Chandrashekhar</p> <p>2012-01-01</p> <p><span class="hlt">Paediatric</span> anaesthesia and <span class="hlt">paediatric</span> regional anaesthesia are intertwined. Almost all surgeries unless contradicted could be and should be supplemented with a regional block. The main objective of this review is to elaborate on the recent advances of the central neuraxial blocks, such as application of ultrasound guidance and electrical stimulation in the pursuit of safety and an objective end point. This review also takes account of the traditional technique and understand the benefits as well the risk of each as compared with the recent technique. The recent trends in choosing the most appropriate peripheral block for a given surgery thereby sparing the central neuroaxis is considered. A penile block for circumcision or a sciatic block for unilateral foot surgery, rather than caudal epidural would have a better risk benefit equation. Readers will find a special mention on the recent thoughts on continuous epidural analgesia in <span class="hlt">paediatrics</span>, especially its rise and fall, yet its unique importance. Lastly, the issue of block placements under sedation or general anaesthesia with its implication in this special population is dealt with. We conducted searches in MEDLINE (PubMed) and assessed the relevance of the abstracts of citations identified from literature searches. The search was carried out in English, for last 10 years, with the following key words: Recent advances in <span class="hlt">paediatric</span> regional anaesthesia; ultrasound guidance for central neuraxial blocks in children; role of electrical stimulation in neuraxial blocks in children; complications in neuraxial block. Full-text articles of potentially relevant abstracts were retrieved for further review. PMID:23293386</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=EFFICIENT+AND+ICT&pg=3&id=EJ731454','ERIC'); return false;" href="http://eric.ed.gov/?q=EFFICIENT+AND+ICT&pg=3&id=EJ731454"><span id="translatedtitle">The <span class="hlt">Impact</span> of Information and Communication Technology (ICT) on the Management <span class="hlt">Practices</span> of Malaysian Smart Schools</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Zain, Muhammad Z. M.; Atan, Hanafi; Idrus, Rozhan M.</p> <p>2004-01-01</p> <p>The <span class="hlt">impact</span> of Information and Communication Technology (ICT) on the management <span class="hlt">practices</span> in the Malaysian Smart Schools was investigated. The analysis revealed that the <span class="hlt">impact</span> has resulted in changes that include the enrichment of the ICT culture among students and teachers, more efficient student and teacher administration, better accessibility…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=instructional+AND+practices+AND+student+AND+achievement+AND+science&pg=3&id=EJ975185','ERIC'); return false;" href="http://eric.ed.gov/?q=instructional+AND+practices+AND+student+AND+achievement+AND+science&pg=3&id=EJ975185"><span id="translatedtitle">Faculty Development Programs: Assessing the <span class="hlt">Impact</span> on Instructional <span class="hlt">Practices</span>, and Student Learning and Motivation</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Ambrosino, Roberta; Peel, Jennifer</p> <p>2011-01-01</p> <p>Demonstrating the <span class="hlt">impact</span> of faculty development activities is difficult and infrequently attempted beyond assessing participant satisfaction. This study examines how faculty development activities affect instructional <span class="hlt">practices</span> and the <span class="hlt">impact</span> on student learning and motivation in accordance with Kirkpatrick's levels of evaluation. Ten instructors…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=pharmaceutical+AND+industry&pg=3&id=EJ941445','ERIC'); return false;" href="http://eric.ed.gov/?q=pharmaceutical+AND+industry&pg=3&id=EJ941445"><span id="translatedtitle"><span class="hlt">Impact</span> of Knowledge Management on Learning Organization <span class="hlt">Practices</span> in India: An Exploratory Analysis</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Chawla, Deepak; Joshi, Himanshu</p> <p>2011-01-01</p> <p>Purpose: This paper aims to report the preliminary findings of the difference in learning organization (LO) <span class="hlt">practices</span> across industries. It also reports the <span class="hlt">impact</span> of knowledge management (KM) dimensions on LO and whether this <span class="hlt">impact</span> is different across manufacturing, IT and IT-enabled services (ITES) and power generation and distribution in…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27298135','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27298135"><span id="translatedtitle">Translating Knowledge Into <span class="hlt">Practice</span> Through an Academic-<span class="hlt">Practice</span> Partnership for Exploring Barriers That <span class="hlt">Impact</span> Management of Homebound Patients With Heart Failure.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Echevarria, Mercedes</p> <p>2016-01-01</p> <p>A knowledge translation project involving an academic-<span class="hlt">practice</span> partnership and guided by action-oriented research was used for exploring barriers that <span class="hlt">impact</span> management of homebound heart failure patients. The intervention process followed an action research model of interaction, self-reflection, response, and change in direction. External facilitators (academia) and internal facilitators (<span class="hlt">practice</span>) worked with clinicians to identify a topic for improvement, explore barriers, locate the evidence compare current <span class="hlt">practice</span> against evidence-based <span class="hlt">practice</span> recommendations, introduce strategies to "close the gap" between actual <span class="hlt">practice</span> and the desired <span class="hlt">practice</span>, develop audit criteria, and reevaluate the <span class="hlt">impact</span>. PMID:27298135</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_8");'>8</a></li> <li><a href="#" onclick='return showDiv("page_9");'>9</a></li> <li class="active"><span>10</span></li> <li><a href="#" onclick='return showDiv("page_11");'>11</a></li> <li><a href="#" onclick='return showDiv("page_12");'>12</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_10 --> <div id="page_11" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_9");'>9</a></li> <li><a href="#" onclick='return showDiv("page_10");'>10</a></li> <li class="active"><span>11</span></li> <li><a href="#" onclick='return showDiv("page_12");'>12</a></li> <li><a href="#" onclick='return showDiv("page_13");'>13</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="201"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2975087','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2975087"><span id="translatedtitle"><span class="hlt">Paediatric</span> and adult colonic manometry: A tool to help unravel the pathophysiology of constipation</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Dinning, Philip G; Benninga, Marc A; Southwell, Bridget R; Scott, S Mark</p> <p>2010-01-01</p> <p>Colonic motility subserves large bowel functions, including absorption, storage, propulsion and defaecation. Colonic motor dysfunction remains the leading hypothesis to explain symptom generation in chronic constipation, a heterogeneous condition which is extremely prevalent in the general population, and has huge socioeconomic <span class="hlt">impact</span> and individual suffering. Physiological testing plays a crucial role in patient management, as it is now accepted that symptom-based assessment, although important, is unsatisfactory as the sole means of directing therapy. Colonic manometry provides a direct method for studying motor activities of the large bowel, and this review provides a contemporary understanding of how this technique has enhanced our knowledge of normal colonic motor physiology, as well as helping to elucidate pathophysiological mechanisms underlying constipation. Methodological approaches, including available catheter types, placement technique and recording protocols, are covered, along with a detailed description of recorded colonic motor activities. This review also critically examines the role of colonic manometry in current clinical <span class="hlt">practice</span>, and how manometric assessment may aid diagnosis, classification and guide therapeutic intervention in the constipated individual. Most importantly, this review considers both adult and <span class="hlt">paediatric</span> patients. Limitations of the procedure and a look to the future are also addressed. PMID:21049550</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25993151','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25993151"><span id="translatedtitle">The <span class="hlt">impact</span> of industry on oncology research and <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Moy, Beverly; Jagsi, Reshma; Gaynor, Richard B; Ratain, Mark J</p> <p>2015-01-01</p> <p>Public scrutiny has increased over potential conflicts of interest among oncology researchers and providers. Given the increased prevalence and complexity of industry relationships, oncologists are increasingly faced with ethical challenges when navigating their financial relationships with industry. Oncologists are continually dealing with changing conflict of interest policies within academic centers and professional societies. With the recent passage of The Sunshine Act, oncologists are beginning to understand the repercussions of this new law. The consequences of the increasing use of direct-to-consumer advertising on patients with cancer are also unclear. Finally, industry's perspective on the evolution of these relationships is not clearly understood. This manuscript discusses issues related to industry's influence on oncology <span class="hlt">practice</span> and research. PMID:25993151</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3954187','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3954187"><span id="translatedtitle"><span class="hlt">Paediatric</span> admissions to the British military hospital at Camp Bastion, Afghanistan</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Arul, GS; Reynolds, J; DiRusso, S; Scott, A; Bree, S; Templeton, P; Midwinter, MJ</p> <p>2012-01-01</p> <p>INTRODUCTION International humanitarian law requires emergency medical support for both military personnel and civilians, including children. Here we present a detailed review of <span class="hlt">paediatric</span> admissions with the pattern of injury and the resources they consume. METHODS All <span class="hlt">paediatric</span> admissions to the hospital at Camp Bastion between 1 January and 29 April 2011 were analysed prospectively. Data collected included time and date of admission, patient age and weight, mechanism of injury, extent of wounding, treatment, length of hospital stay and discharge destination. RESULTS Eighty-five children (65 boys and 17 girls, median age: 8 years, median weight: 20kg) were admitted. In 63% of cases the indication for admission was battle related trauma and in 31% non-battle trauma. Of the blast injuries, 51% were due to improvised explosive devices. Non-battle emergencies were mainly due to domestic burns (46%) and road traffic accidents (29%). The most affected anatomical area was the extremities (44% of injuries). Over 30% of patients had critical injuries. Operative intervention was required in 74% of cases. The median time to theatre for all patients was 52 minutes; 3 patients with critical injuries went straight to theatre in a median of 7 minutes. A blood transfusion was required in 27 patients; 6 patients needed a massive transfusion. Computed tomography was performed on 62% of all trauma admissions and 40% of patients went to the intensive care unit. The mean length of stay was 2 days (range: 1–26 days) and there were 7 deaths. CONCLUSIONS <span class="hlt">Paediatric</span> admissions make up a small but significant part of admissions to the hospital at Camp Bastion. The proportion of serious injuries is very high in comparison with admissions to a UK <span class="hlt">paediatric</span> emergency department. The concentration of major injuries means that lessons learnt in terms of teamwork, the speed of transfer to theatre and massive transfusion protocols could be applied to UK <span class="hlt">paediatric</span> <span class="hlt">practice</span>. PMID:22524930</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4958657','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4958657"><span id="translatedtitle">Beyond the guidelines of <span class="hlt">paediatric</span> septic shock: A focused review</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Temsah, Mohamad-Hani</p> <p>2015-01-01</p> <p>Severe sepsis and septic shock continue to cause major morbidity and mortality among children, especially in the resource-limited areas. Guidelines that focus on these entities, such as “Surviving Sepsis” and “<span class="hlt">Paediatric</span> Advanced Life Support” guidelines, are revised and updated on regular basis to incorporate new evidence based medicine. There is ongoing need to review these updated guidelines, and address potentially best available solutions for adapting them into suitable <span class="hlt">practical</span> steps for paediatricians worldwide, especially those working in resource-limited areas. The available recommendations may help to improve sepsis management in middle- and low-income countries; however, guidelines must be wisely implemented according to the available resources, with follow up auditing to ensure appropriate implementation.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4955460','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4955460"><span id="translatedtitle">Endoscopic removal of <span class="hlt">impacted</span> oesophageal foreign body: A case report and a review of literature</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Obateru, Olusegun A.; Durowaye, Matthew O.; Olokoba, Abdulfatai B.; Olaniyi, Olufemi K.</p> <p>2016-01-01</p> <p>Foreign body (FB) <span class="hlt">impaction</span> in the oesophagus is fairly common in <span class="hlt">paediatric</span> Gastroenterology <span class="hlt">practice</span>. This study aims to describe a case of an unusually <span class="hlt">impacted</span> button lithium battery, in the mid-oesophagus of a 7-year-old child that was confirmed, and removed during oesophagogastroduodenoscopy. A 7-year-old male child, presented at the Emergency <span class="hlt">Paediatric</span> Unit of our hospital with a history of ingestion of a button-like metallic object. A plain soft tissue X-ray of the neck and chest, however, revealed a dense round object located at the sternal angle of Louis. The object was dislodged and identified as a flat lithium battery after an oesophagogastroduodenoscopy, carried out under general anaesthesia using a flexible forward-viewing video gastroscope. The button battery was subsequently passed in faeces. Endoscopic removal of <span class="hlt">impacted</span> oesophageal FBs under general anaesthesia is an effective and safe procedure in children in experienced hands. PMID:27251523</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27251523','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27251523"><span id="translatedtitle">Endoscopic removal of <span class="hlt">impacted</span> oesophageal foreign body: A case report and a review of literature.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Obateru, Olusegun A; Durowaye, Matthew O; Olokoba, Abdulfatai B; Olaniyi, Olufemi K</p> <p>2016-01-01</p> <p>Foreign body (FB) <span class="hlt">impaction</span> in the oesophagus is fairly common in <span class="hlt">paediatric</span> Gastroenterology <span class="hlt">practice</span>. This study aims to describe a case of an unusually <span class="hlt">impacted</span> button lithium battery, in the mid-oesophagus of a 7-year-old child that was confirmed, and removed during oesophagogastroduodenoscopy. A 7-year-old male child, presented at the Emergency <span class="hlt">Paediatric</span> Unit of our hospital with a history of ingestion of a button-like metallic object. A plain soft tissue X-ray of the neck and chest, however, revealed a dense round object located at the sternal angle of Louis. The object was dislodged and identified as a flat lithium battery after an oesophagogastroduodenoscopy, carried out under general anaesthesia using a flexible forward-viewing video gastroscope. The button battery was subsequently passed in faeces. Endoscopic removal of <span class="hlt">impacted</span> oesophageal FBs under general anaesthesia is an effective and safe procedure in children in experienced hands. PMID:27251523</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/18051997','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/18051997"><span id="translatedtitle">[Consensus on <span class="hlt">paediatric</span> parenteral nutrition: a document approved by SENPE/SEGHNP/SEFH].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Muñoz, P Gomis; López, L Gómez; Costa, C Martínez; Villares, J M Moreno; Giner, C Pedrón; Maristany, C Pérez-Portabella; del Río, M T Pozas</p> <p>2007-01-01</p> <p>In current medical <span class="hlt">practice</span>, standardization of procedures has become a desirable objective. The Spanish Society of Parenteral and Enteral Nutrition (SENPE) has undertaken a considerable effort to create clinical <span class="hlt">practice</span> guidelines or documents of consensus and quality gold standards in artificial nutrition. As a result the SENPE group of standardization has put together a document called "Consensus of <span class="hlt">Paediatric</span> Parenteral Nutrition" supported by the Spanish Society of Gastroenterology, Hepatology and Nutrition (SEGHNP) and by the Spanish Society of Hospital Pharmacies (SEFH). This is a reduced version of our work. The complete version is available at www.nutricionhospitalaria.com and www.senpe.com. This document covers many aspects such as <span class="hlt">paediatric</span> patient indications, vascular access, macro and micro nutrients needs; also preparation in special situations, components, forms of prescription, possibilities for standardization of the elaboration and prescription, elaboration, administration, monitoring, complications and side effects. Much research has been done, incorporating current publications, books and clinical <span class="hlt">practice</span> guidelines such as those published by the American Society for Parenteral and Enteral Nutrition (ASPEN) and by the European Society of <span class="hlt">Paediatric</span> Gastroenterology, Hepatology and Nutrition (ESPGHAN) in collaboration with the European Society for Clinical Nutrition and Metabolism (ESPEN). PMID:18051997</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2010EGUGA..1214168G','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2010EGUGA..1214168G"><span id="translatedtitle">Serbian Torrent Flood Defense <span class="hlt">Practice</span> - Modeling, observation, forecasting and <span class="hlt">impact</span></span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Gavrilovic, Zoran; Stefnovic, Milutin</p> <p>2010-05-01</p> <p>Many areas in Europe have been affected by an increasing number of severe flood events in the past few years. Because of these floods numerous measures to improve the organization of disaster management have been taken. This includes the preparation of specific alarm plans for flood disaster events. Serbian Torrent Flood Defense methodology, combines observation by radar meteorology, torrential hydrology and new GIS techniques to enable quick determination and assessment of the detected situation in order to provide a sufficient time for the flood defense system to be put in operation. Alarm plans can be seen as one corner stone of disaster management but their <span class="hlt">practical</span> use can still be optimized. For this end aims to support the risk analysis and risk communication process by improving the availability, reliability and communicability of hazard maps and alarm plans. The main focus will be on levels of population protection and critical infrastructure protection in respect to natural hazards. Paper presents Obtained results in the field of torrent defense in Serbia. Key words: Hydrology, Torrent Flood Analysis, Meteorology, Flood Defense</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27062615','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27062615"><span id="translatedtitle">Quality in <span class="hlt">paediatric</span> emergency medicine: Measurement and reporting.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Borland, Meredith L; Shepherd, Mike</p> <p>2016-02-01</p> <p>There is a clear demand for quality in the delivery of health care around the world; <span class="hlt">paediatric</span> emergency medicine is no exception to this movement. It has been identified that gaps exist in the quality of acute care provided to children. Regulatory bodies in Australia and New Zealand are moving to mandate the implementation of quality targets and measures. Within the <span class="hlt">paediatric</span> emergency department (ED), there is a lack of research into <span class="hlt">paediatric</span> specific indicators. The existing literature regarding <span class="hlt">paediatric</span> acute care quality measures has been recently summarised, and expert consensus has now been reported. It is clear that there is much work to be performed to generalise this work to ED. We review suggestions from the current literature relating to feasible indicators within the <span class="hlt">paediatric</span> acute care setting. We propose options to develop a quality 'scorecard' that could be used to assist Australian and New Zealand EDs with quality measurement and benchmarking for their <span class="hlt">paediatric</span> patients. PMID:27062615</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3163536','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3163536"><span id="translatedtitle"><span class="hlt">Paediatric</span> UK demyelinating disease longitudinal study (PUDDLS)</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2011-01-01</p> <p>Background There is evidence that at least 5% of Multiple sclerosis (MS) cases manifest in childhood. Children with MS present with a demyelinating episode involving single or multiple symptoms prior to developing a second event (usually within two years) to then meet criteria for diagnosis. There is evidence from adult cohorts that the incidence and sex ratios of MS are changing and that children of immigrants have a higher risk for developing MS. A <span class="hlt">paediatric</span> population should reflect the vanguard of such changes and may reflect trends yet to be observed in adult cohorts. Studying a <span class="hlt">paediatric</span> population from the first demyelinating event will allow us to test these hypotheses, and may offer further valuable insights into the genetic and environmental interactions in the pathogenesis of MS. Methods/Design The <span class="hlt">Paediatric</span> UK Demyelinating Disease Longitudinal Study (PUDDLS) is a prospective longitudinal observational study which aims to determine the natural history, predictors and outcomes of childhood CNS inflammatory demyelinating diseases. PUDDLS will involve centres in the UK, and will establish a cohort of children affected with a first CNS inflammatory demyelinating event for long-term follow up by recruiting for approximately 5 years. PUDDLS will also establish a biological sample archive (CSF, serum, and DNA), allowing future hypothesis driven research. For example, the future discovery of a biomarker will allow validation within this dataset for the evaluation of novel biomarkers. Patients will also be requested to consent to be contacted in the future. A secondary aim is to collaborate internationally with the International <span class="hlt">Paediatric</span> Multiple Sclerosis Study Group when future collaborative studies are proposed, whilst sharing a minimal anonymised dataset. PUDDLS is the second of two jointly funded studies. The first (UCID-SS) is an epidemiological surveillance study that already received ethical approvals, and started on the 1st September 2009. There is</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/22479770','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/22479770"><span id="translatedtitle">Putting social <span class="hlt">impact</span> assessment to the test as a method for implementing responsible tourism <span class="hlt">practice</span></span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>McCombes, Lucy; Vanclay, Frank; Evers, Yvette</p> <p>2015-11-15</p> <p>The discourse on the social <span class="hlt">impacts</span> of tourism needs to shift from the current descriptive critique of tourism to considering what can be done in actual <span class="hlt">practice</span> to embed the management of tourism's social <span class="hlt">impacts</span> into the existing planning, product development and operational processes of tourism businesses. A pragmatic approach for designing research methodologies, social management systems and initial actions, which is shaped by the real world operational constraints and existing systems used in the tourism industry, is needed. Our pilot study with a small Bulgarian travel company put social <span class="hlt">impact</span> assessment (SIA) to the test to see if it could provide this desired approach and assist in implementing responsible tourism development <span class="hlt">practice</span>, especially in small tourism businesses. Our findings showed that our adapted SIA method has value as a <span class="hlt">practical</span> method for embedding a responsible tourism approach. While there were some challenges, SIA proved to be effective in assisting the staff of our test case tourism business to better understand their social <span class="hlt">impacts</span> on their local communities and to identify actions to take. - Highlights: • Pragmatic approach is needed for the responsible management of social <span class="hlt">impacts</span> of tourism. • Our adapted Social <span class="hlt">impact</span> Assessment (SIA) method has value as a <span class="hlt">practical</span> method. • SIA can be embedded into tourism businesses existing ‘ways of doing things’. • We identified challenges and ways to improve our method to better suit small tourism business context.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3425877','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3425877"><span id="translatedtitle"><span class="hlt">Impact</span> of spinal cord injury on sexuality: Broad-based clinical <span class="hlt">practice</span> intervention and <span class="hlt">practical</span> application</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Hess, Marika J.; Hough, Sigmund</p> <p>2012-01-01</p> <p>This study focuses on the <span class="hlt">impact</span> a spinal cord injury may have on achieving physical and emotional intimacy, and potential to maximize sexual ability and quality of life. Spinal cord injury is a traumatic, life-altering event that is usually associated with loss of motor and sensory function, as well as sexual impairment. At the time of injury, the individual is faced with devastating loss and an abundance of new information in a setting of extreme stress and challenge. In the acute rehabilitation setting, there is often a considerable void in providing education and resources regarding sexual concerns and needs. There is a positive relationship between sexual education and sexual activity. The <span class="hlt">impact</span> of inadequate sexual counseling and education as a part of rehabilitation can be deleterious. PMID:22925747</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=1996SPIE.2711..168D&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=1996SPIE.2711..168D&link_type=ABSTRACT"><span id="translatedtitle"><span class="hlt">Impact</span> of ultrasound video transfer on the <span class="hlt">practice</span> of ultrasound</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Duerinckx, Andre J.; Hayrapetian, Alek S.; Grant, Edward G.; Valentino, Daniel J.; Rahbar, Darius; Kiszonas, Mike; Franco, Ricky; Melany, Michelle; Narin, Sherelle L.; Ragavendra, Nagesh</p> <p>1996-05-01</p> <p>Sonography can be highly dependent on real-time imaging and as such is highly physician intensive. Such situations arise mostly during complicated ultrasound radiology studies or echocardiology examinations. Under those circumstances it would be of benefit to transmit real-time images beyond the immediate area of the ultrasound laboratory when a physician is not on location. We undertook this study to determine if both static and dynamic image transfer to remote locations might be accomplished using an ultrafast ATM network and PACS. Image management of the local image files was performed by a commercial PACS from AGFA corporation. The local network was Ethernet based, and the global network was based on Asynchronous Transfer Mode (ATM, rates up to 100 Mbits/sec). Real-time image transfer involved two teaching hospitals, one of which had 2 separate ultrasound facilities. Radiologists consulted with technologists via telephone while the examinations were being performed. The applications of ATM network providing real time video for ultrasound imaging in a clinical environment and its potential <span class="hlt">impact</span> on health delivery and clinical teaching. This technology increased technologist and physician productivity due to the elimination of commute time for physicians and waiting time for technologists and patients. Physician confidence in diagnosis increased compared to reviewing static images alone. This system provided instant access for radiologists to real-time scans from remote sites. Image quality and frame rate were equivalent to the original. The system increased productivity by allowing physicians to monitor studies at multiple sites simultaneously.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4726865','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4726865"><span id="translatedtitle">Current views and advances on <span class="hlt">Paediatric</span> Virology: An update for <span class="hlt">paediatric</span> trainees</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>MAMMAS, IOANNIS N.; GREENOUGH, ANNE; THEODORIDOU, MARIA; KRAMVIS, ANNA; CHRISTAKI, ILIANA; KOUTSAFTIKI, CHRYSSIE; KOUTSAKI, MARIA; PORTALIOU, DIMITRA M.; KOSTAGIANNI, GEORGIA; PANAGOPOULOU, PARASKEVI; SOURVINOS, GEORGE; SPANDIDOS, DEMETRIOS A.</p> <p>2016-01-01</p> <p><span class="hlt">Paediatric</span> Virology is a bold new scientific field, which combines <span class="hlt">Paediatrics</span> with Virology, Epidemiology, Molecular Medicine, Evidence-based Medicine, Clinical Governance, Quality Improvement, Pharmacology and Immunology. The Workshop on <span class="hlt">Paediatric</span> Virology, which took place on Saturday October 10, 2015 in Athens, Greece, provided an overview of recent views and advances on viral infections occurring in neonates and children. It was included in the official programme of the 20th World Congress on Advances in Oncology and the 18th International Symposium on Molecular Medicine, which attracted over 500 delegates from the five continents. During the Workshop, the topics covered included the challenges of vaccine implementation against human papillomaviruses in countries under financial crisis, strategies for eradicating poliomyelitis and its 60th vaccine anniversary, as well as the debate on the association between autism and vaccination against measles, mumps and rubella. Among the non-vaccine related topics, emphasis was given to viral infections in prematurely born infants and their long-term outcomes, new <span class="hlt">paediatric</span> intensive care management options for bronchiolitis related to respiratory syncytial virus, the clinical implications of hepatitis B virus and cytomegalovirus genotyping, the Ebola virus threat and preparedness in <span class="hlt">Paediatric</span> Emergency Departments, oral, oropharynx, laryngeal, nasal and ocular viral infections and Merkel cell polyomavirus as a novel emerging virus of infancy and childhood. In this review, we provide selected presentations and reports discussed at the Workshop. PMID:26889211</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/8721907','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/8721907"><span id="translatedtitle">Advances in computer technology: <span class="hlt">impact</span> on the <span class="hlt">practice</span> of medicine.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Groth-Vasselli, B; Singh, K; Farnsworth, P N</p> <p>1995-01-01</p> <p>Advances in computer technology provide a wide range of applications which are revolutionizing the <span class="hlt">practice</span> of medicine. The development of new software for the office creates a web of communication among physicians, staff members, health care facilities and associated agencies. This provides the physician with the prospect of a paperless office. At the other end of the spectrum, the development of 3D work stations and software based on computational chemistry permits visualization of protein molecules involved in disease. Computer assisted molecular modeling has been used to construct working 3D models of lens alpha-crystallin. The 3D structure of alpha-crystallin is basic to our understanding of the molecular mechanisms involved in lens fiber cell maturation, stabilization of the inner nuclear region, the maintenance of lens transparency and cataractogenesis. The major component of the high molecular weight aggregates that occur during cataractogenesis is alpha-crystallin subunits. Subunits of alpha-crystallin occur in other tissues of the body. In the central nervous system accumulation of these subunits in the form of dense inclusion bodies occurs in pathological conditions such as Alzheimer's disease, Huntington's disease, multiple sclerosis and toxoplasmosis (Iwaki, Wisniewski et al., 1992), as well as neoplasms of astrocyte origin (Iwaki, Iwaki, et al., 1991). Also cardiac ischemia is associated with an increased alpha B synthesis (Chiesi, Longoni et al., 1990). On a more global level, the molecular structure of alpha-crystallin may provide information pertaining to the function of small heat shock proteins, hsp, in maintaining cell stability under the stress of disease. PMID:8721907</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25529375','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25529375"><span id="translatedtitle">[Child health and international cooperation: A <span class="hlt">paediatric</span> approach].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Sobrino Toro, M; Riaño Galan, I; Bassat, Q; Perez-Lescure Picarzo, J; de Aranzabal Agudo, M; Krauel Vidal, X; Rivera Cuello, M</p> <p>2015-05-01</p> <p>The international development cooperation in child health arouses special interest in <span class="hlt">paediatric</span> settings. In the last 10 10 years or so, new evidence has been presented on factors associated with morbidity and mortality in the first years of life in the least developed countries. This greater knowledge on the causes of health problems and possible responses in the form of interventions with <span class="hlt">impact</span>, leads to the need to disseminate this information among concerned professional pediatricians. Serious efforts are needed to get a deeper insight into matters related to global child health and encourage pediatricians to be aware and participate in these processes. This article aims to provide a social pediatric approach towards international cooperation and child health-related matters. PMID:25529375</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4664207','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4664207"><span id="translatedtitle"><span class="hlt">Impact</span> of Advertising on Tampon Wear-time <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Woeller, Kara E.; Miller, Kenneth W.; Robertson-Smith, Amy L.; Bohman, Lisa C.</p> <p>2015-01-01</p> <p>OBJECTIVES (1) To determine whether advertising nighttime tampon use for up to eight hours was understood to be consistent with label recommendations and (2) to determine whether television and print advertising with this message affected tampon wear times in adults and teens. METHODS (1) A comprehension study (online advertising and follow-up questionnaire) among women aged 14–49 years (300 per group) who viewed either the test or a control advertising message; (2) Diary-based surveys of tampon wear times performed prior to (n = 292 adults, 18–49 years, 74 teens, 12–17 years) and after (n = 287 adults, 104 teens) the launch of national advertising. RESULTS Significantly more test message viewers than controls stated tampons should be worn less than or equal to eight hours (93.6% vs. 88.6%, respectively, P = 0.049). A directionally higher percentage of test message viewers said they would use a pad if sleeping longer than eight hours (52% vs. 42% of controls). Among the women who used tampons longer than eight hours when sleeping, 52% reported they would wake up and change compared with 45% of controls. No significant difference between baseline and follow-up diary surveys was found among teens or adults in various measures of tampon wear time (mean wear times; usage intervals from less than two hours to more than 10 hours; percentage of tampons used for more than or equal to eight hours; frequency of wearing at least one tampon more than eight hours). CONCLUSIONS Advertising nighttime tampon wear for up to eight hours effectively communicated label recommendations but did not alter tampon wear times. The informational intervention had limited <span class="hlt">impact</span> on established habits. PMID:26688668</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26152791','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26152791"><span id="translatedtitle">Economic <span class="hlt">impact</span> of homeopathic <span class="hlt">practice</span> in general medicine in France.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Colas, Aurélie; Danno, Karine; Tabar, Cynthia; Ehreth, Jenifer; Duru, Gérard</p> <p>2015-12-01</p> <p>Health authorities are constantly searching for new ways to stabilise health expenditures. To explore this issue, we compared the costs generated by different types of medical <span class="hlt">practice</span> in French general medicine: i.e. conventional (CM-GP), homeopathic (Ho-GP), or mixed (Mx-GP).Data from a previous cross-sectional study, EPI3 La-Ser, were used. Three types of cost were analysed: (i) consultation cost (ii) prescription cost and (iii) total cost (consultation + prescription). Each was evaluated as: (i) the cost to Social Security (ii) the remaining cost (to the patient and/or supplementary health insurance); and (iii) health expenditure (combination of the two costs).With regard to Social Security, treatment by Ho-GPs was less costly (42.00 <euro> vs 65.25 <euro> for CM-GPs, 35 % less). Medical prescriptions were two-times more expensive for CM-GPs patients (48.68 <euro> vs 25.62 <euro>). For the supplementary health insurance and/or patient out-of-pocket costs, treatment by CM-GPs was less expensive due to the lower consultation costs (6.19 <euro> vs 11.20 <euro> for Ho-GPs) whereas the prescription cost was comparable between the Ho-GPs and the CM-GPs patients (15.87 <euro> vs 15.24 <euro> respectively) . The health expenditure cost was 20 % less for patients consulting Ho-GPs compared to CM-GPs (68.93 <euro> vs 86.63 <euro>, respectively). The lower cost of medical prescriptions for Ho-GPs patients compared to CM-GPs patients (41.67 <euro> vs 63.72 <euro>) was offset by the higher consultation costs (27.08 <euro> vs 22.68 <euro> respectively). Ho-GPs prescribed fewer psychotropic drugs, antibiotics and non-steroidal anti-inflammatory drugs.In conclusions management of patients by homeopathic GPs may be less expensive from a global perspective and may represent an important interest to public health. PMID:26152791</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26856027','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26856027"><span id="translatedtitle">Focus On <span class="hlt">Impact</span> for a Profit-Driven Medical <span class="hlt">Practice</span>. Part II: Six Processes You Can Use to Maximize and Capitalize on the Uniqueness of Your <span class="hlt">Practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Lipton-Dibner, Wendy</p> <p>2015-01-01</p> <p>This article presents the second part of the proven Focus on <span class="hlt">Impact</span> strategic model for <span class="hlt">practice</span> growth. It spotlights six specific processes you can use to maximize and capitalize on the uniqueness of your <span class="hlt">practice</span> to increase revenues, enhance patient care and service, improve executive team alignment and intra- and interdepartmental teamwork, and dramatically reduce conflict and stress among <span class="hlt">practice</span> personnel. PMID:26856027</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26165241','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26165241"><span id="translatedtitle">The use of nalbuphine in <span class="hlt">paediatric</span> anaesthesia.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Kubica-Cielińska, Anna; Zielińska, Marzena</p> <p>2015-01-01</p> <p>Nalbuphine is an agonist-antagonist opioid. It causes analgesic and sedative effect and because of ceiling effect it does not cause a respiratory depression. In a perioperative therapy of <span class="hlt">paediatric</span> patients it may be used for premedication, sedation during diagnostic procedures as well as for postoperative pain treatment. It reverses adverse reactions of other opioids such as itch or urinary retention, not significantly influencing its analgetic properties. After sevoflurane anaesthesia of small children, it reduces the incidences of emergence agitation. Nalbuphine is considered a safe drug, which causes nausea and vomiting less frequently than other opioids. Analgesic effect, the ability to provide moderate sedation and a large margin of safety make that analgesic often used for <span class="hlt">paediatric</span> patients. PMID:26165241</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_9");'>9</a></li> <li><a href="#" onclick='return showDiv("page_10");'>10</a></li> <li class="active"><span>11</span></li> <li><a href="#" onclick='return showDiv("page_12");'>12</a></li> <li><a href="#" onclick='return showDiv("page_13");'>13</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_11 --> <div id="page_12" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_10");'>10</a></li> <li><a href="#" onclick='return showDiv("page_11");'>11</a></li> <li class="active"><span>12</span></li> <li><a href="#" onclick='return showDiv("page_13");'>13</a></li> <li><a href="#" onclick='return showDiv("page_14");'>14</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="221"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3155117','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3155117"><span id="translatedtitle">Ciprofloxacin safety in <span class="hlt">paediatrics</span>: a systematic review</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Adefurin, Abiodun; Sammons, Helen; Jacqz-Aigrain, Evelyne; Choonara, Imti</p> <p>2011-01-01</p> <p>Objective To determine the safety of ciprofloxacin in <span class="hlt">paediatric</span> patients in relation to arthropathy, any other adverse events (AEs) and drug interactions. Methods A systematic search of MEDLINE, EMBASE, CINAHL, CENTRAL and bibliographies of relevant articles was carried out for all published articles, regardless of design, that involved the use of ciprofloxacin in any <span class="hlt">paediatric</span> age group ≤17 years. Only articles that reported on safety were included. Results 105 articles met the inclusion criteria and involved 16 184 <span class="hlt">paediatric</span> patients. There were 1065 reported AEs (risk 7%, 95% CI 3.2% to 14.0%). The most frequent AEs were musculoskeletal AEs, abnormal liver function tests, nausea, changes in white blood cell counts and vomiting. There were six drug interactions (with aminophylline (4) and methotrexate (2)). The only drug related death occurred in a neonate who had an anaphylactic reaction. 258 musculoskeletal events occurred in 232 <span class="hlt">paediatric</span> patients (risk 1.6%, 95% CI 0.9% to 2.6%). Arthralgia accounted for 50% of these. The age of occurrence of arthropathy ranged from 7 months to 17 years (median 10 years). All cases of arthropathy resolved or improved with management. One prospective controlled study estimated the risk of arthropathy as 9.3 (OR 95% CI 1.2 to 195). Pooled safety data of controlled trials in this review estimated the risk of arthropathy as 1.57 (OR 95% CI 1.26 to 1.97). Conclusion Musculoskeletal AEs occur due to ciprofloxacin use. However, these musculoskeletal events are reversible with management. It is recommended that further prospective controlled studies should be carried out to evaluate the safety of ciprofloxacin, with particular focus on the risk of arthropathy. PMID:21785119</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1747440','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1747440"><span id="translatedtitle">Sleep · 8: <span class="hlt">Paediatric</span> obstructive sleep apnoea</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Nixon, G; Brouillette, R</p> <p>2005-01-01</p> <p>In the past 25 years there has been increasing recognition of obstructive sleep apnoea (OSA) as a common condition of childhood. Morbidity includes impairment of growth, cardiovascular complications, learning impairment, and behavioural problems. Diagnosis and treatment of this condition in children differs in many respects from that in adults. We review here the key features of <span class="hlt">paediatric</span> OSA, highlighting differences from adult OSA, and suggest future directions for research. PMID:15923253</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25557805','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25557805"><span id="translatedtitle"><span class="hlt">Paediatric</span> infectious diseases: the last 50 years.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Starr, Mike</p> <p>2015-01-01</p> <p>Many advances and challenges have occurred in the field of <span class="hlt">paediatric</span> infectious diseases during the past 50 years. It is impossible to cover all of these in a short review, but a few highlights and lowlights will be covered. These include virtual disappearance of some infectious diseases, emergence of new ones, infections in the immunocompromised, antimicrobial resistance, development of new and improved antimicrobials, improved diagnostic tests and the Human Microbiome Project. PMID:25557805</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2015PhDT........11Y','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2015PhDT........11Y"><span id="translatedtitle">The <span class="hlt">impact</span> of a professional development program on teachers' <span class="hlt">practice</span> and how context variables influenced such <span class="hlt">practice</span>: a case study</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Yarema, Sandra Lynn</p> <p></p> <p>This case study investigated how context variables influenced the <span class="hlt">impact</span> of a state-funded longitudinal professional development (PD) program on the participant teachers' <span class="hlt">practice</span>. Data was collected to compare differences in Science Content Knowledge, Science Pedagogical Content Knowledge, and the teachers' <span class="hlt">practice</span> over the course of the PD program. Contextual variables related to district restructuring and school implementation of district policy evidence a direct effect on time spent on science instruction, specific instructional strategies used, and on the development of a professional community among the participants. This case study substantiates the implication that districts and school policies must provide adequate support for teachers to implement what is learned in professional development to enact any effective science education reform at the elementary school level.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26803366','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26803366"><span id="translatedtitle"><span class="hlt">Paediatric</span> suicidal burns: A growing concern.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Segu, Smitha; Tataria, Rachana</p> <p>2016-06-01</p> <p>An alarming rise in rates of <span class="hlt">paediatric</span> population committing self-immolation acts is a growing social and medical problem. In recent times there seems to be a rising concern in <span class="hlt">paediatric</span> population. A study was conducted at a government tertiary care burn centre over 5 years in <span class="hlt">paediatric</span> age group of <18 years who had committed self-immolation. Demographic data, aetiology, burn severity, associated illnesses, treatment and outcomes of the patients were collected with preventive strategies. Of total 89 patients, 12 patients were below 12 years (children) and 77 between 12-18 years (adolescent) with female preponderance. Majority belonged to lower middle and upper lower class families. Most had deep partial thickness burns. Psychiatric and personality disorder were found in 24.03% and 31.46% patients respectively. Kerosene was the main agent chosen to inflict injury. The average length of hospital stay was 19.8 days. The crude mortality rate observed was 38.2%. With cultural and socio-economic changes children and adolescents are exposed to increased levels of stress and peer pressure leaving them vulnerable. A multidisciplinary care involving medical, psychological and social support is required. Identifying children at risk and proper counselling and support can form an important strategy at prevention rather than cure. PMID:26803366</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26686529','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26686529"><span id="translatedtitle">Voluntary Informed Consent in <span class="hlt">Paediatric</span> Oncology Research.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Dekking, Sara A S; Van Der Graaf, Rieke; Van Delden, Johannes J M</p> <p>2016-07-01</p> <p>In <span class="hlt">paediatric</span> oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for <span class="hlt">paediatric</span> oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating <span class="hlt">paediatric</span> oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. PMID:26686529</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3530999','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3530999"><span id="translatedtitle"><span class="hlt">Paediatric</span> airway management: What is new?</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Ramesh, S; Jayanthi, R; Archana, SR</p> <p>2012-01-01</p> <p>Airway management plays a pivotal role in <span class="hlt">Paediatric</span> Anaesthesia. Over the last two decades many improvements in this area have helped us to overcome this final frontier. From an era where intubation with a conventional laryngoscope or blind nasal intubation was the only tool for airway management, we have come a long way. Today supraglottic airway devices have pride of place in the Operating Room and are becoming important airway devices used in routine procedures. Direct and indirect fibreoptic laryngoscopes and transtracheal devices help us overcome difficult and previously impossible airway situations. These developments mean that we need to update our knowledge on these devices. Also much of our basic understanding of the physiology and anatomy of the <span class="hlt">paediatric</span> airway has changed. This article attempts to shed light on some of the most important advances/opinions in <span class="hlt">paediatric</span> airway management like, cuffed endotracheal tubes, supraglottic airway devices, video laryngoscopes, rapid sequence intubation, the newly proposed algorithm for difficult airway management and the role of Ex Utero Intrapartum Treatment (EXIT) procedure in the management of the neonatal airway. PMID:23293383</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4950906','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4950906"><span id="translatedtitle"><span class="hlt">Paediatric</span> Virology in the Hippocratic Corpus</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Mammas, Ioannis N.; Spandidos, Demetrios A.</p> <p>2016-01-01</p> <p>Hippocrates (Island of Kos, 460 B.C.-Larissa, 370 B.C.) is the founder of the most famous Medical School of the classical antiquity. In acknowledgement of his pioneering contribution to the new scientific field of <span class="hlt">Paediatric</span> Virology, this article provides a systematic analysis of the Hippocratic Corpus, with particular focus on viral infections predominating in neonates and children. A mumps epidemic, affecting the island of Thasos in the 5th century B.C., is described in detail. ‘Herpes’, a medical term derived from the ancient Greek word ‘ἕρπειν’, meaning ‘to creep’ or ‘crawl’, is used to describe the spreading of cutaneous lesions in both childhood and adulthood. Cases of children with exanthema ‘resembling mosquito bites’ are presented in reference to varicella or smallpox infection. A variety of upper and lower respiratory tract viral infections are described with impressive accuracy, including rhinitis, pharyngitis, tonsillitis, laryngitis, bronchiolitis and bronchitis. The ‘cough of Perinthos’ epidemic, an influenza-like outbreak in the 5th century B.C., is also recorded and several cases complicated with pneumonia or fatal outcomes are discussed. Hippocrates, moreover, describes conjunctivitis, otitis, lymphadenitis, meningoencephalitis, febrile convulsions, gastroenteritis, hepatitis, poliomyelitis and skin warts, along with proposed treatment directions. Almost 2,400 years later, Hippocrates' systematic approach and methodical innovations can inspire <span class="hlt">paediatric</span> trainees and future <span class="hlt">Paediatric</span> Virology subspecialists. PMID:27446241</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/12035326','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/12035326"><span id="translatedtitle">The establishment of a nurse consultant role in <span class="hlt">paediatric</span> intensive care: a reflective analysis.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Haines, Caroline</p> <p>2002-01-01</p> <p>Through a review of literature and research, together with reflection on clinical <span class="hlt">practice</span>, this article reflectively analyses and evaluates the concept of the establishment and development of a nurse consultant post in <span class="hlt">paediatric</span> intensive care. Manley's (1997) conceptual framework is used as a structure for the reflection, which has enabled a detailed and logical approach and allowed both reflection and analysis of the role in relation to the speciality. It is evident that nurse consultant posts have been developed in a variety of clinical specialities and are providing a real opportunity to improve patient care, progress nursing as a profession and provide a clinical career framework for nurses. The concept of the nurse consultant in <span class="hlt">paediatric</span> intensive care is both innovative and strategic: Manley has identified many sub-roles, skills and processes necessary to influence and develop the role. The elements of 'transformational leadership', 'change agent' and 'collaborator' identified by Manley appear to hold the key to the ability to influence and develop <span class="hlt">paediatric</span> intensive care nursing from a <span class="hlt">practice</span> perspective. PMID:12035326</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=231482&keyword=delivery+AND+service&actType=&TIMSType=+&TIMSSubTypeID=&DEID=&epaNumber=&ntisID=&archiveStatus=Both&ombCat=Any&dateBeginCreated=&dateEndCreated=&dateBeginPublishedPresented=&dateEndPublishedPresented=&dateBeginUpdated=&dateEndUpdated=&dateBeginCompleted=&dateEndCompleted=&personID=&role=Any&journalID=&publisherID=&sortBy=revisionDate&count=50&CFID=68603602&CFTOKEN=74704475','EPA-EIMS'); return false;" href="http://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=231482&keyword=delivery+AND+service&actType=&TIMSType=+&TIMSSubTypeID=&DEID=&epaNumber=&ntisID=&archiveStatus=Both&ombCat=Any&dateBeginCreated=&dateEndCreated=&dateBeginPublishedPresented=&dateEndPublishedPresented=&dateBeginUpdated=&dateEndUpdated=&dateBeginCompleted=&dateEndCompleted=&personID=&role=Any&journalID=&publisherID=&sortBy=revisionDate&count=50&CFID=68603602&CFTOKEN=74704475"><span id="translatedtitle">Of birds, carbon and water: integrating multiple ecosystem service <span class="hlt">impacts</span> to identify locations for agricultural conservation <span class="hlt">practice</span> adoption</span></a></p> <p><a target="_blank" href="http://oaspub.epa.gov/eims/query.page">EPA Science Inventory</a></p> <p></p> <p></p> <p>Human use of the landscape for crop production can degrade ecosystem services. A number of agricultural conservation <span class="hlt">practices</span> are touted as mitigating these <span class="hlt">impacts</span>. Many of these <span class="hlt">practices</span> are encouraged by incentive programs such as the Conservation Reserve Program administere...</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=post+AND+notes&pg=5&id=EJ1041694','ERIC'); return false;" href="http://eric.ed.gov/?q=post+AND+notes&pg=5&id=EJ1041694"><span id="translatedtitle">The <span class="hlt">Impact</span> of the "Getting <span class="hlt">Practical</span>: Improving <span class="hlt">Practical</span> Work in Science" Continuing Professional Development Programme on Teachers' Ideas and <span class="hlt">Practice</span> in Science <span class="hlt">Practical</span> Work</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Abrahams, Ian; Reiss, Michael J.; Sharpe, Rachael</p> <p>2014-01-01</p> <p>Background: Despite the widespread use of <span class="hlt">practical</span> work in school it has been recognised that more needs to be done to improve its effectiveness in developing conceptual understanding. The "Getting <span class="hlt">Practical</span>" CPD (Continuing Professional Development) programme was designed to contribute towards an improvement in the effectiveness of…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3641117','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3641117"><span id="translatedtitle">Potential of Best <span class="hlt">Practice</span> to Reduce <span class="hlt">Impacts</span> from Oil and Gas Projects in the Amazon</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Finer, Matt; Jenkins, Clinton N.; Powers, Bill</p> <p>2013-01-01</p> <p>The western Amazon continues to be an active and controversial zone of hydrocarbon exploration and production. We argue for the urgent need to implement best <span class="hlt">practices</span> to reduce the negative environmental and social <span class="hlt">impacts</span> associated with the sector. Here, we present a three-part study aimed at resolving the major obstacles impeding the advancement of best <span class="hlt">practice</span> in the region. Our focus is on Loreto, Peru, one of the largest and most dynamic hydrocarbon zones in the Amazon. First, we develop a set of specific best <span class="hlt">practice</span> guidelines to address the lack of clarity surrounding the issue. These guidelines incorporate both engineering-based criteria and key ecological and social factors. Second, we provide a detailed analysis of existing and planned hydrocarbon activities and infrastructure, overcoming the lack of information that typically hampers large-scale <span class="hlt">impact</span> analysis. Third, we evaluate the planned activities and infrastructure with respect to the best <span class="hlt">practice</span> guidelines. We show that Loreto is an extremely active hydrocarbon front, highlighted by a number of recent oil and gas discoveries and a sustained government push for increased exploration. Our analyses reveal that the use of technical best <span class="hlt">practice</span> could minimize future <span class="hlt">impacts</span> by greatly reducing the amount of required infrastructure such as drilling platforms and access roads. We also document a critical need to consider more fully the ecological and social factors, as the vast majority of planned infrastructure overlaps sensitive areas such as protected areas, indigenous territories, and key ecosystems and watersheds. Lastly, our cost analysis indicates that following best <span class="hlt">practice</span> does not impose substantially greater costs than conventional <span class="hlt">practice</span>, and may in fact reduce overall costs. Barriers to the widespread implementation of best <span class="hlt">practice</span> in the Amazon clearly exist, but our findings show that there can be great benefits to its implementation. PMID:23650541</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/23650541','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/23650541"><span id="translatedtitle">Potential of best <span class="hlt">practice</span> to reduce <span class="hlt">impacts</span> from oil and gas projects in the Amazon.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Finer, Matt; Jenkins, Clinton N; Powers, Bill</p> <p>2013-01-01</p> <p>The western Amazon continues to be an active and controversial zone of hydrocarbon exploration and production. We argue for the urgent need to implement best <span class="hlt">practices</span> to reduce the negative environmental and social <span class="hlt">impacts</span> associated with the sector. Here, we present a three-part study aimed at resolving the major obstacles impeding the advancement of best <span class="hlt">practice</span> in the region. Our focus is on Loreto, Peru, one of the largest and most dynamic hydrocarbon zones in the Amazon. First, we develop a set of specific best <span class="hlt">practice</span> guidelines to address the lack of clarity surrounding the issue. These guidelines incorporate both engineering-based criteria and key ecological and social factors. Second, we provide a detailed analysis of existing and planned hydrocarbon activities and infrastructure, overcoming the lack of information that typically hampers large-scale <span class="hlt">impact</span> analysis. Third, we evaluate the planned activities and infrastructure with respect to the best <span class="hlt">practice</span> guidelines. We show that Loreto is an extremely active hydrocarbon front, highlighted by a number of recent oil and gas discoveries and a sustained government push for increased exploration. Our analyses reveal that the use of technical best <span class="hlt">practice</span> could minimize future <span class="hlt">impacts</span> by greatly reducing the amount of required infrastructure such as drilling platforms and access roads. We also document a critical need to consider more fully the ecological and social factors, as the vast majority of planned infrastructure overlaps sensitive areas such as protected areas, indigenous territories, and key ecosystems and watersheds. Lastly, our cost analysis indicates that following best <span class="hlt">practice</span> does not impose substantially greater costs than conventional <span class="hlt">practice</span>, and may in fact reduce overall costs. Barriers to the widespread implementation of best <span class="hlt">practice</span> in the Amazon clearly exist, but our findings show that there can be great benefits to its implementation. PMID:23650541</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=surveys+AND+applied+AND+mathematics&pg=6&id=ED549895','ERIC'); return false;" href="http://eric.ed.gov/?q=surveys+AND+applied+AND+mathematics&pg=6&id=ED549895"><span id="translatedtitle"><span class="hlt">Impact</span> of a Professional Learning Community on Teacher Collaboration, Teaching <span class="hlt">Practice</span>, and Student Achievement</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Morris, Iris J.</p> <p>2011-01-01</p> <p>Best instructional <span class="hlt">practice</span> occurs when teachers work collaboratively. Many teachers in the target elementary school appeared to work in isolation, struggling to respond to the needs of low-performing students without the benefit of collaboration with colleagues. The purpose of this applied dissertation was to investigate the <span class="hlt">impact</span> of a…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/EJ939937.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/EJ939937.pdf"><span id="translatedtitle">The <span class="hlt">Impact</span> of <span class="hlt">Practicing</span> Autonomy on the Writing Proficiency of Iranian Intermediate EFL Learners</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Bagheri, Mohammad Sadegh; Aeen, Laleh</p> <p>2011-01-01</p> <p>The present study examined the <span class="hlt">impact</span> of <span class="hlt">practicing</span> autonomy on the writing proficiency of Iranian intermediate EFL learners. To this end, Preliminary English Test (PET) by Thomas and Sharon (2006) was administered to 92 intermediate language learners as a pre-test. Accordingly, 60 homogeneous learners comprised the research sample. The…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=Ma&pg=2&id=EJ932627','ERIC'); return false;" href="http://eric.ed.gov/?q=Ma&pg=2&id=EJ932627"><span id="translatedtitle">Emerging: The <span class="hlt">Impact</span> of the Artist Teacher Scheme MA on Students' Pedagogical and Artistic <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Page, Tara; Adams, Jeff; Hyde, Wendy</p> <p>2011-01-01</p> <p>The United Kingdom Artist Teacher Scheme (ATS) commissioned a study of the artistic and pedagogical <span class="hlt">practices</span> of students on a recently established Artist Teacher Scheme MA (ATS MA). The aims of this study were to: investigate the motives and objectives teachers/educators have for undertaking this ATS MA programme, the <span class="hlt">impact</span> the programme had on…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/ED545597.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/ED545597.pdf"><span id="translatedtitle"><span class="hlt">Impact</span> of Professional Learning Community <span class="hlt">Practices</span> on Morale of Urban High School Teachers</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Almanzar, Angel</p> <p>2014-01-01</p> <p>This applied dissertation was designed to determine the <span class="hlt">impact</span> a planned intervention, or participants' engagement in lesson study <span class="hlt">practices</span>, had on teacher morale and professional learning communities within a public high school located in the Southeastern part of the United States. A review of a yearly teacher survey conducted by the…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ars.usda.gov/research/publications/publication/?seqNo115=315219','TEKTRAN'); return false;" href="http://www.ars.usda.gov/research/publications/publication/?seqNo115=315219"><span id="translatedtitle">Kitchen <span class="hlt">practices</span> <span class="hlt">impact</span> on volatile flavors in ripe tomatoes: effects of refrigeration and blanching</span></a></p> <p><a target="_blank" href="http://www.ars.usda.gov/services/TekTran.htm">Technology Transfer Automated Retrieval System (TEKTRAN)</a></p> <p></p> <p></p> <p>Both blanching and refrigeration of ripe tomatoes are common <span class="hlt">practices</span> in kitchen and food service prior to being sliced. However, little is reported on the <span class="hlt">impact</span> of such treatments on volatile profiles in tomato fruit. In this study, ‘FL 47’ tomatoes at full red stage were dipped in 52 °C hot wate...</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=high+AND+impact+AND+test&pg=6&id=EJ726953','ERIC'); return false;" href="http://eric.ed.gov/?q=high+AND+impact+AND+test&pg=6&id=EJ726953"><span id="translatedtitle"><span class="hlt">Impact</span> of a High School Graduation Examination on Social Studies Teachers' Instructional <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Vogler, Kenneth E.</p> <p>2005-01-01</p> <p>The purpose of this study was to explore the <span class="hlt">impact</span> of high-stakes tests on teachers' instructional <span class="hlt">practices</span>. Data were obtained from a survey instrument given to a stratified random sample of Mississippi social studies teachers who teach the same content that is tested on their state's high school graduation examination. An analysis found…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/EJ1058165.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/EJ1058165.pdf"><span id="translatedtitle">Creating a Model for High <span class="hlt">Impact</span> <span class="hlt">Practices</span> at a Large, Regional, Comprehensive University: A Case Study</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>McMahan, Shari</p> <p>2008-01-01</p> <p>Student engagement in High <span class="hlt">Impact</span> <span class="hlt">Practices</span> (HIPs) has been gaining the attention of higher education leaders and researchers. When students are actively engaged in the learning process they report greater gains in learning and personal development. Students involved in HIPs show better retention, higher GPA and succeed in graduating college in a…</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_10");'>10</a></li> <li><a href="#" onclick='return showDiv("page_11");'>11</a></li> <li class="active"><span>12</span></li> <li><a href="#" onclick='return showDiv("page_13");'>13</a></li> <li><a href="#" onclick='return showDiv("page_14");'>14</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_12 --> <div id="page_13" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_11");'>11</a></li> <li><a href="#" onclick='return showDiv("page_12");'>12</a></li> <li class="active"><span>13</span></li> <li><a href="#" onclick='return showDiv("page_14");'>14</a></li> <li><a href="#" onclick='return showDiv("page_15");'>15</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="241"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4177634','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4177634"><span id="translatedtitle">“Budget <span class="hlt">Impact</span> Analyses”: A <span class="hlt">Practical</span> Policy Making Tool for Drug Reimbursement Decisions</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Jamshidi, Hamid Reza; Foroutan, Naghmeh; Salamzadeh, Jamshid</p> <p>2014-01-01</p> <p>In the present article, Budget <span class="hlt">Impact</span> Analysis as an effective, <span class="hlt">practical</span> financial tool has been introduced to the policy makers for improving drug formulary and reimbursement decision making. In Iran, Ministry of Health (MOH), health insurance organizations, and health care providers such as hospitals could take the most advantage of the BIAs reports. PMID:25276214</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25276214','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25276214"><span id="translatedtitle">"Budget <span class="hlt">impact</span> analyses": a <span class="hlt">practical</span> policy making tool for drug reimbursement decisions.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Jamshidi, Hamid Reza; Foroutan, Naghmeh; Salamzadeh, Jamshid</p> <p>2014-01-01</p> <p>In the present article, Budget <span class="hlt">Impact</span> Analysis as an effective, <span class="hlt">practical</span> financial tool has been introduced to the policy makers for improving drug formulary and reimbursement decision making. In Iran, Ministry of Health (MOH), health insurance organizations, and health care providers such as hospitals could take the most advantage of the BIAs reports. PMID:25276214</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/EJ1053724.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/EJ1053724.pdf"><span id="translatedtitle">Accounting Practitioners Reflect on Faculty <span class="hlt">Impact</span>: Bridging the Gap between Theory and <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Johnson, Ryan</p> <p>2014-01-01</p> <p>A gap exists between the perception of accounting education in the classroom and accounting as it is <span class="hlt">practiced</span>. This study explores qualitatively the perceptions and experiences of mid-career accounting professionals with respect to the <span class="hlt">impact</span> of academic faculty on their careers in accounting. The study identifies a perception gap in the…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=Michael+AND+Brown&pg=3&id=EJ695646','ERIC'); return false;" href="http://eric.ed.gov/?q=Michael+AND+Brown&pg=3&id=EJ695646"><span id="translatedtitle">Examining the Legacy of "Brown": The <span class="hlt">Impact</span> on Special Education and Teacher <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Shealey, Monikawilliams; Lue, Marthascott; Brooks, Michael; McCray, Erica</p> <p>2005-01-01</p> <p>The "Brown v. Board of Education" (1954) case has left a lasting <span class="hlt">impact</span> on the way children are educated in this country. Much has been written about the legacy of "Brown" as it relates to current desegregation <span class="hlt">practices</span>, academic achievement for students of color, and school reform. This paper will examine the implications of the "Brown" decision…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=Dentistry&pg=2&id=EJ879861','ERIC'); return false;" href="http://eric.ed.gov/?q=Dentistry&pg=2&id=EJ879861"><span id="translatedtitle">Using Dentistry as a Case Study to Examine Continuing Education and Its <span class="hlt">Impact</span> on <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Bullock, Alison; Firmstone, Vickie; Frame, John; Thomas, Hywel</p> <p>2010-01-01</p> <p>Continuing education is a defining characteristic of work in the professions. Yet the approach various professional groups take to continuing professional development (CPD) differs widely in terms of regulatory frameworks and requirements, modes of delivery and funding. Importantly, little is understood about how CPD <span class="hlt">impacts</span> on <span class="hlt">practice</span>. This…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/ED431041.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/ED431041.pdf"><span id="translatedtitle">The <span class="hlt">Impact</span> of Mandated Statewide Testing on Teachers' Classroom Assessment and Instructional <span class="hlt">Practices</span>.</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>McMillan, James H.; Myran, Steve; Workman, Daryl</p> <p></p> <p>The <span class="hlt">impact</span> of the new Virginia statewide Standards of Learning (SOL) testing program on classroom instructional and assessment <span class="hlt">practices</span> was studied through surveys before and after implementation of the testing program. The sample represented responses from 570 secondary school teachers (of mathematics, social studies, English, and science) and…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=discourse+AND+manipulation&pg=3&id=EJ938484','ERIC'); return false;" href="http://eric.ed.gov/?q=discourse+AND+manipulation&pg=3&id=EJ938484"><span id="translatedtitle"><span class="hlt">Impact</span> of Curriculum Reform: Evidence of Change in Classroom <span class="hlt">Practice</span> in Mainland China</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Li, Qiong; Ni, Yujing</p> <p>2011-01-01</p> <p>The study examined the <span class="hlt">impact</span> of curriculum reform on teaching <span class="hlt">practice</span> in primary mathematics in mainland China. The participants included 58 fifth grade mathematics teachers from 20 schools. Thirty-two of the classrooms had utilized a reform curriculum for 5 years prior to conducting the study, and the remaining 26 had been using the…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=liberal+AND+conservative&pg=3&id=EJ943856','ERIC'); return false;" href="http://eric.ed.gov/?q=liberal+AND+conservative&pg=3&id=EJ943856"><span id="translatedtitle"><span class="hlt">Impact</span> of Occupational Socialization on the Perspectives and <span class="hlt">Practices</span> of Sport Pedagogy Doctoral Students</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Lee, Hong-Min; Curtner-Smith, Matthew D.</p> <p>2011-01-01</p> <p>The purpose of this study was to examine the <span class="hlt">impact</span> of occupational socialization on the perspectives and <span class="hlt">practices</span> of sport pedagogy doctoral students in terms of physical education (PE) teaching and physical education teacher education (PETE). Participants were 12 students. Data were collected through formal and informal interviews,…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=211408','TEKTRAN'); return false;" href="http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=211408"><span id="translatedtitle">Modeling Biochemical <span class="hlt">Impacts</span> of Alternative Management <span class="hlt">Practices</span> for a Row-Crop Field in Iowa</span></a></p> <p><a target="_blank" href="http://www.ars.usda.gov/services/TekTran.htm">Technology Transfer Automated Retrieval System (TEKTRAN)</a></p> <p></p> <p></p> <p>The management of contemporary agriculture is rapidly shifting from single-goal to multi-goal strategies. The bottleneck of implementing the strategies is the capacity of predicting the simultaneous <span class="hlt">impacts</span> of change in management <span class="hlt">practices</span> on agricultural production, soil, and water resources and e...</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=cameroon&pg=6&id=EJ638416','ERIC'); return false;" href="http://eric.ed.gov/?q=cameroon&pg=6&id=EJ638416"><span id="translatedtitle">The <span class="hlt">Impact</span> of a Community Mobilization Project on Health-Related Knowledge and <span class="hlt">Practices</span> in Cameroon.</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Babalola, Stella; Sakolsky, Natasha; Vondrasek, Claudia; Mounlom, Damaris; Brown, Jane; Tchupo, Jean-Paul</p> <p>2001-01-01</p> <p>Evaluated the <span class="hlt">impact</span> of a reproductive health community mobilization initiative in Cameroon. Baseline and followup survey data indicated that at a rural site, the intervention positively influenced family planning knowledge and <span class="hlt">practices</span>, HIV/AIDS and sexually transmitted disease knowledge and attitudes, and use of health services. At an urban…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24573884','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24573884"><span id="translatedtitle">Lost among the trees? The autonomic nervous system and <span class="hlt">paediatrics</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Rees, Corinne A</p> <p>2014-06-01</p> <p>The autonomic nervous system (ANS) has been strikingly neglected in Western medicine. Despite its profound importance for regulation, adjustment and coordination of body systems, it lacks priority in training and <span class="hlt">practice</span> and receives scant attention in numerous major textbooks. The ANS is integral to manifestations of illness, underlying familiar physical and psychological symptoms. When ANS activity is itself dysfunctional, usual indicators of acute illness may prove deceptive. Recognising the relevance of the ANS can involve seeing the familiar through fresh eyes, challenging assumptions in clinical assessment and in approaches to <span class="hlt">practice</span>. Its importance extends from physical and psychological well-being to parenting and safeguarding, public services and the functioning of society. Exploration of its role in conditions ranging from neurological, gastrointestinal and connective tissue disorders, diabetes and chronic fatigue syndrome, to autism, behavioural and mental health difficulties may open therapeutic avenues. The ANS offers a mechanism for so-called functional illnesses and illustrates the importance of recognising that 'stress' takes many forms, physical, psychological and environmental, desirable and otherwise. Evidence of intrauterine and post-natal programming of ANS reactivity suggests that neonatal care and safeguarding <span class="hlt">practice</span> may offer preventive opportunity, as may greater understanding of epigenetic change of ANS activity through, for example, accidental or psychological trauma or infection. The aim of this article is to accelerate recognition of the importance of the ANS throughout <span class="hlt">paediatrics</span>, and of the potential physical and psychological cost of neglecting it. PMID:24573884</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/21933475','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/21933475"><span id="translatedtitle">Exciting times: towards a totally minimally invasive <span class="hlt">paediatric</span> urology service.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Lazarus, John</p> <p>2011-02-01</p> <p>Following on from the first <span class="hlt">paediatric</span> laparoscopic nephrectomy in 1992, the growth of minimally invasive ablative and reconstructive procedures in <span class="hlt">paediatric</span> urology has been dramatic. This article reviews the literature related to laparoscopic dismembered pyeloplasty, optimising posterior urethral valve ablation and intravesical laparoscopic ureteric reimplantation. PMID:21933475</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26062057','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26062057"><span id="translatedtitle">XI. Management of <span class="hlt">paediatric</span> and adult non-Hodgkin lymphoma: what lessons can each teach the other?</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Burkhardt, Birgit; Lenz, Georg</p> <p>2015-06-01</p> <p>Is there anything that we can learn from each other regarding <span class="hlt">paediatric</span> and adult non-Hodgkin Lymphoma (NHL) management? Do we treat the same patients? Are there differences in lymphoma biology in the different age groups? Are the procedures of decision making and the infrastructure comparable? Is the weighing of toxicity and outcome aspects in the benefit and risk assessments prior to treatment decisions comparable? Interestingly, the proportional distribution of the NHL subtypes and the spectrum of NHL occurring in children and adolescents differs significantly from that in adults. This observation might motivate biological studies aiming to elucidate the pathomechanisms of lymphomagenesis. Concerning NHL diagnosis and staging, the comparison of outcome data reported for <span class="hlt">paediatric</span> and adult patient series is often impaired by the use of different staging systems. However, the <span class="hlt">impact</span> of reference laboratories supporting correct subtyping and the advantages of population-based patient recruitment are experiences that might be transferable between <span class="hlt">paediatric</span> and adult oncologists. Interestingly, the process of implementing new drugs into current treatment strategies and making these drugs available to patients varies substantially across patient's age groups. The far lower absolute number of patients, especially of relapsed patients, and the favorable outcome with current standard treatment may contribute to the marked differences in the kinetic of implementing new compounds comparing adult with <span class="hlt">paediatric</span> NHL patients. Also, the basis for the conduction of cooperative clinical trials with pharmaceutical companies needs to be strengthened in <span class="hlt">paediatric</span> clinical trial groups. In conclusion, both <span class="hlt">paediatric</span> and adult oncologists benefit from the interdisciplinary discussion with each other, not only concerning results and experiences in clinical trials but also with respect to critical aspects of infrastructure. PMID:26062057</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4770863','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4770863"><span id="translatedtitle">The path to <span class="hlt">impact</span> of operational research on tuberculosis control policies and <span class="hlt">practices</span> in Indonesia</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Probandari, Ari; Widjanarko, Bagoes; Mahendradhata, Yodi; Sanjoto, Hary; Cerisha, Ancila; Nungky, Saverina; Riono, Pandu; Simon, Sumanto; Farid, Muhammad Noor; Giriputra, Sardikin; Putra, Artawan Eka; Burhan, Erlina; Wahyuni, Chatarina U.; Mustikawati, Dyah; Widianingrum, Christina; Tiemersma, Edine W.; Alisjahbana, Bachti</p> <p>2016-01-01</p> <p>Background Operational research is currently one of the pillars of the global strategy to control tuberculosis. Indonesia initiated capacity building for operational research on tuberculosis over the last decade. Although publication of the research in peer-reviewed journals is an important indicator for measuring the success of this endeavor, the influence of operational research on policy and <span class="hlt">practices</span> is considered even more important. However, little is known about the process by which operational research influences tuberculosis control policy and <span class="hlt">practices</span>. Objective We aimed to investigate the influence of operational research on tuberculosis control policy and <span class="hlt">practice</span> in Indonesia between 2004 and 2014. Design Using a qualitative study design, we conducted in-depth interviews of 50 researchers and 30 policy makers/program managers and performed document reviews. Transcripts of these interviews were evaluated while applying content analysis. Results Operational research contributed to tuberculosis control policy and <span class="hlt">practice</span> improvements, including development of new policies, introduction of new <span class="hlt">practices</span>, and reinforcement of current program policies and <span class="hlt">practices</span>. However, most of these developments had limited sustainability. The path from the dissemination of research results and recommendations to policy and <span class="hlt">practice</span> changes was long and complex. The skills, interests, and political power of researchers and policy makers, as well as health system response, could influence the process. Conclusions Operational research contributed to improving tuberculosis control policy and <span class="hlt">practices</span>. A systematic approach to improve the sustainability of the <span class="hlt">impact</span> of operational research should be explored. PMID:26928217</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/22334155','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/22334155"><span id="translatedtitle">Health <span class="hlt">impact</span> assessment in the United States: Has <span class="hlt">practice</span> followed standards?</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Schuchter, Joseph; Bhatia, Rajiv; Corburn, Jason; Seto, Edmund</p> <p>2014-07-01</p> <p>As an emerging <span class="hlt">practice</span>, Health <span class="hlt">Impact</span> Assessment is heterogeneous in purpose, form, and scope and applied in a wide range of decision contexts. This heterogeneity challenges efforts to evaluate the quality and <span class="hlt">impact</span> of <span class="hlt">practice</span>. We examined whether information in completed HIA reports reflected objectively-evaluable criteria proposed by the North American HIA <span class="hlt">Practice</span> Standards Working Group in 2009. From publically-available reports of HIAs conducted in the U.S. and published from 2009 to 2011, we excluded those that were components of, or comment letters on, Environmental <span class="hlt">Impact</span> Assessments (5) or were demonstration projects or student exercises (8). For the remaining 23 reports, we used <span class="hlt">practice</span> standards as a template to abstract data on the steps of HIA, including details on the rationale, authorship, funding, decision and decision-makers, participation, pathways and methods, quality of evidence, and recommendations. Most reports described screening, scoping, and assessment processes, but there was substantial variation in the extent of these processes and the degree of stakeholder participation. Community stakeholders participated in screening or scoping in just two-thirds of the HIAs (16). On average, these HIAs analyzed 5.5 determinants related to 10.6 health <span class="hlt">impacts</span>. Most HIA reports did not include evaluation or monitoring plans. This study identifies issues for field development and improvement. The standards might be adapted to better account for variability in resources, produce fit-for-purpose HIAs, and facilitate innovation guided by the principles. - Highlights: • Our study examined reported HIAs in the U.S. against published <span class="hlt">practice</span> standards. • Most HIAs used some screening, scoping and assessment elements from the standards. • The extent of these processes and stakeholder participation varied widely. • The average HIA considered multiple health determinants and <span class="hlt">impacts</span>. • Evaluation or monitoring plans were generally not included in</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/21790830','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/21790830"><span id="translatedtitle">Diagnosis in developmental-behavioural <span class="hlt">paediatrics</span>: the art of diagnostic formulation.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>O'Keeffe, Mick; Macaulay, Caroline</p> <p>2012-02-01</p> <p>This paper considers diagnostic frameworks in developmental-behavioural <span class="hlt">paediatrics</span>. The purpose of a diagnostic assessment is reviewed, and the use of categorical diagnoses is explored. A multi-level process of diagnostic formulation is outlined, highlighting the importance of a comprehensive focus on presenting symptoms, neuropsychological constructs, biological factors and environmental influences. The axis of time, developmental benchmarks and the enhancement of resilience are discussed as part of the diagnostic formulation framework. Limitations imposed on diagnostic <span class="hlt">practice</span> by systemic and personal factors are reviewed. Implications for training and <span class="hlt">practice</span> are discussed. PMID:21790830</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/18251444','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/18251444"><span id="translatedtitle">Sustainable <span class="hlt">practice</span> improvements: <span class="hlt">impact</span> of the Comprehensive Advanced Palliative Care Education (CAPCE) program.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Harris, Diane; Hillier, Loretta M; Keat, Nancy</p> <p>2007-01-01</p> <p>This paper describes an education program designed to improve palliative care <span class="hlt">practice</span> through the development of workplace hospice palliative care resources (PCRs), and its <span class="hlt">impact</span> on knowledge transfer and longer-term changes to clinical <span class="hlt">practice</span>. Evaluation methods included pre- and post-program questionnaires, and a survey of learners' (n=301) perceptions of program learning strategies. Interviews (n=21) were conducted with a purposeful sample of PCRs and representatives from their work sites. Ratings of the sessions indicated that they were relevant to learners' clinical <span class="hlt">practice</span>. At follow up, the majority of learners (83%) continued to serve as PCRs. Many positive effects were identified, including enhanced pain and symptom management, staff education, and development of care policies and guidelines. Management support, particularly the prioritization of palliative care and staff development, were factors facilitating sustained implementation. These findings highlight the importance of multimodal learning strategies and supportive work environments in the development of PCRs to enhance palliative care <span class="hlt">practice</span>. PMID:18251444</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/17002771','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/17002771"><span id="translatedtitle"><span class="hlt">Impact</span> of criticism of null-hypothesis significance testing on statistical reporting <span class="hlt">practices</span> in conservation biology.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Fidler, Fiona; Burgman, Mark A; Cumming, Geoff; Buttrose, Robert; Thomason, Neil</p> <p>2006-10-01</p> <p>Over the last decade, criticisms of null-hypothesis significance testing have grown dramatically, and several alternative <span class="hlt">practices</span>, such as confidence intervals, information theoretic, and Bayesian methods, have been advocated. Have these calls for change had an <span class="hlt">impact</span> on the statistical reporting <span class="hlt">practices</span> in conservation biology? In 2000 and 2001, 92% of sampled articles in Conservation Biology and Biological Conservation reported results of null-hypothesis tests. In 2005 this figure dropped to 78%. There were corresponding increases in the use of confidence intervals, information theoretic, and Bayesian techniques. Of those articles reporting null-hypothesis testing--which still easily constitute the majority--very few report statistical power (8%) and many misinterpret statistical nonsignificance as evidence for no effect (63%). Overall, results of our survey show some improvements in statistical <span class="hlt">practice</span>, but further efforts are clearly required to move the discipline toward improved <span class="hlt">practices</span>. PMID:17002771</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/22479750','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/22479750"><span id="translatedtitle">Life cycle thinking in <span class="hlt">impact</span> assessment—Current <span class="hlt">practice</span> and LCA gains</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Bidstrup, Morten</p> <p>2015-09-15</p> <p>It has been advocated that life cycle thinking (LCT) should be applied in <span class="hlt">impact</span> assessment (IA) to a greater extent, since some development proposals pose a risk of significant <span class="hlt">impacts</span> throughout the interconnected activities of product systems. Multiple authors have proposed the usage of life cycle assessment (LCA) for such analytical advancement, but little to no research on this tool application has been founded in IA <span class="hlt">practice</span> so far. The aim of this article is to elaborate further on the gains assigned to application of LCA. The research builds on a review of 85 Danish IA reports, which were analysed for analytical appropriateness and application of LCT. Through a focus on the non-technical summary, the conclusion and the use of specific search words, passages containing LCT were searched for in each IA report. These passages were then analysed with a generic framework. The results reveal that LCT is appropriate for most of the IAs, but that LCA is rarely applied to provide such a perspective. Without LCA, the IAs show mixed performance in regard to LCT. Most IAs do consider the product provision of development proposals, but they rarely relate <span class="hlt">impacts</span> to this function explicitly. Many IAs do consider downstream <span class="hlt">impacts</span>, but assessments of upstream, distant <span class="hlt">impacts</span> are generally absent. It is concluded that multiple analytical gains can be attributed to greater application of LCA in IA <span class="hlt">practice</span>, though some level of LCT already exists. - Highlights: • Life cycle thinking is appropriate across the types and topics of <span class="hlt">impact</span> assessment. • Yet, life cycle assessment is rarely used for adding such perspective. • <span class="hlt">Impact</span> assessment <span class="hlt">practice</span> does apply some degree of life cycle thinking. • However, application of life cycle assessment could bring analytical gains.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/12596745','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/12596745"><span id="translatedtitle">Knowledge and <span class="hlt">practices</span> of a control authority: <span class="hlt">impact</span> on the environment and food safety.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Toh, Poh See</p> <p>2002-12-01</p> <p>This study investigates the <span class="hlt">practices</span> and knowledge of a Control Authority dealing with the environment and the safety and control of hawker foods. Experience and background education are used as likely determinants of food safety <span class="hlt">practices</span> and knowledge of the control authority. A total of 60 questionnaires were distributed to the Health Inspectors (HIs) in the Hawkers' and Health Departments, City Hall, Kuala Lumpur. The return rate was 93%. The structured questionnaire contained 14 main food safety <span class="hlt">practices</span> and knowledge constructs. Significance was found pertaining to knowledge of HIs with different experience backgrounds but experience was not demonstrated to <span class="hlt">impact</span> on <span class="hlt">practices</span> of HIs. However, education was noted to have significantly but inconsistently influenced certain <span class="hlt">Practices</span> and Knowledge scores of HIs. A Pearson bivariate coefficient characterised an association between food safety <span class="hlt">practices</span> and knowledge of the control authority. The findings: (1) highlight the actual shortcomings in the staff resources relating to environmental health, food safety, foodborne illnesses and their control, and (2) provide information on the control aspect within the hawker micro-industry with the view of protecting the public from health hazards arising from the hawkers' <span class="hlt">practices</span> and consumption of hawker foods. PMID:12596745</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_11");'>11</a></li> <li><a href="#" onclick='return showDiv("page_12");'>12</a></li> <li class="active"><span>13</span></li> <li><a href="#" onclick='return showDiv("page_14");'>14</a></li> <li><a href="#" onclick='return showDiv("page_15");'>15</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_13 --> <div id="page_14" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_12");'>12</a></li> <li><a href="#" onclick='return showDiv("page_13");'>13</a></li> <li class="active"><span>14</span></li> <li><a href="#" onclick='return showDiv("page_15");'>15</a></li> <li><a href="#" onclick='return showDiv("page_16");'>16</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="261"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22277221','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22277221"><span id="translatedtitle"><span class="hlt">Impact</span> of water source management <span class="hlt">practices</span> in residential areas on sewer networks - a review.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Marleni, N; Gray, S; Sharma, A; Burn, S; Muttil, N</p> <p>2012-01-01</p> <p>Prolonged drought which has occurred everywhere around the world has caused water shortages, leading many countries to consider more sustainable <span class="hlt">practices</span>, which are called source management <span class="hlt">practices</span> (SMPs) to ensure water availability for the future. SMPs include the <span class="hlt">practices</span> of water use reduction, potable water substitution and wastewater volume reduction such as water demand management, rainwater harvesting, greywater recycling and sewer mining. Besides the well known advantages from SMPs, they also contribute to the alteration of wastewater characteristics which finally affect the process in downstream infrastructure such as sewerage networks. Several studies have shown that the implementation of SMPs decreases the wastewater flow, whilst increasing its strength. High-strength wastewater can cause sewer problems such as sewer blockage, odour and corrosion. Yet, not all SMPs and their <span class="hlt">impact</span> on existing sewer networks have been investigated. Therefore, this study reviews some examples of four common SMPs, the wastewater characteristics and the physical and biochemical transformation processes in sewers and the problems that might caused by them, and finally the potential <span class="hlt">impacts</span> of those SMPs on wastewater characteristics and sewer networks are discussed. This paper provides sewer system managers with an overview of potential <span class="hlt">impacts</span> on the sewer network due to the implementation of some SMPs. Potential research opportunities for the <span class="hlt">impact</span> of SMPs on existing sewers are also identified. PMID:22277221</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/servlets/purl/249771','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/servlets/purl/249771"><span id="translatedtitle">An assessment of alternative agricultural management <span class="hlt">practice</span> <span class="hlt">impacts</span> on soil carbon in the corn belt</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Barnwell, T.O. Jr.; Jackson, R.B.; Mulkey, L.A.</p> <p>1993-12-31</p> <p>This <span class="hlt">impact</span> of alternative management <span class="hlt">practices</span> on agricultural soil C is estimated by a soil C mass balance modeling study that incorporates policy considerations in the analysis. A literature review of soil C modeling and <span class="hlt">impacts</span> of management <span class="hlt">practices</span> has been completed. The models selected for use and/or modification to meet the needs of representing soil C cycles in agroecosystems and <span class="hlt">impacts</span> of management <span class="hlt">practices</span> are CENTURY and DNDC. These models share a common ability to examine the <span class="hlt">impacts</span> of alternative management <span class="hlt">practices</span> on soil organic C, and are readily accessible. An important aspect of this effort is the development of the modeling framework and methodology that define the agricultural production systems and scenarios (i.e., crop-soil-climate combinations) to be assessed in terms of national policy, the integration of the model needs with available databases, and the operational mechanics of evaluating C sequestration potential with the integrated model/database system. We are working closely with EPA`s Office of Policy and Program Evaluation to define a reasonable set of policy alternatives for this assessment focusing on policy that might be affected through a revised Farm Bill, such as incentives to selectively promote conservation tillage, crop rotations, and/or good stewardship of the conservation reserve. Policy alternatives are translated into basic data for use in soil C models through economic models. These data, including such elements as agricultural <span class="hlt">practices</span>, fertilization rates, and production levels are used in the soil C models to produce net carbon changes on a per unit area basis. The unit-area emissions are combined with areal-extent data in a GIS to produce an estimate of total carbon and nitrogen changes and thus estimate greenhouse benefits.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4963728','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4963728"><span id="translatedtitle">Predictors of Mortality in <span class="hlt">Paediatric</span> Myocarditis</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Ansari, Mohammed Junaid; Mittal, Mahima; Kushwaha, K.P.</p> <p>2016-01-01</p> <p>Introduction <span class="hlt">Paediatric</span> myocarditis can present as mild flu like symptoms to fulminent form. Early identification of the severity of illness and prioritization of intensive care is helpful especially in developing countries with limited resources. Aim To know the factors at admission that can predict mortality in <span class="hlt">paediatric</span> myocarditis. Materials and Methods This was an observational study which enrolled children who presented with fever of acute onset (less than 15 days in duration), and were diagnosed as suspected myocarditis on the basis of clinical features, Troponin I and echocardiography, according to Expanded criteria for myocarditis in <span class="hlt">Paediatric</span> ward at our institute over a period from August 2014 to December 2015. Their clinical features, cardiac biomarkers and echocardiography findings were compared between survivors and non-survivors. Statistical Analysis All statistical analysis was done using graphpad Prism 5 and SPSS statistical software. A Fisher exact p-value <0.05 was regarded as significant. Multivariate Logistic Regression was carried out to quantify the relationship between cardiac death and other predictor variables. The logistic coefficients for the predictor variables and their exponents, that is, log odds were calculated. Statistical significance of these predictor variables was interpreted by p-values. Results A 17.7% (n=11/62) patients of <span class="hlt">paediatric</span> myocarditis died in this study. New York Heart Association (NYHA) class IV dyspnea (p=0.0115) and hypotension (p=0.0174) were more in patients who did not survive. The mean value of Troponin I was more in the non-survivor group (0.958 ± 1.13ng/ml); (p=0.0074). More number of patients who died had Brain Natriuretic Peptide (BNP) levels increased in their plasma (p=0.0087) with higher mean value (p=0.0175). LV ejection fraction was decreased markedly in non survivor group with mean value of 37±8.09 % as compared to survivor group with mean value of 46.6±10.5%, (p=0.0115). On multivariate</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3690101','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3690101"><span id="translatedtitle"><span class="hlt">Paediatric</span> travel medicine: vaccines and medications</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Starr, Mike</p> <p>2013-01-01</p> <p>The <span class="hlt">paediatric</span> aspects of travel medicine can be complex, and individual advice is often required. Nonetheless, children are much more likely to acquire common infections than exotic tropical diseases whilst travelling. Important exceptions are malaria and tuberculosis, which are more frequent and severe in children. Overall, travellers' diarrhoea is the most common illness affecting travellers. This review discusses vaccines and medications that may be indicated for children who are travelling overseas. It focuses on immunizations that are given as part of the routine schedule, as well as those that are more specific to travel. Malaria and travellers' diarrhoea are also discussed. PMID:23163285</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/22479765','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/22479765"><span id="translatedtitle">Advancing the <span class="hlt">practice</span> of health <span class="hlt">impact</span> assessment in Canada: Obstacles and opportunities</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>McCallum, Lindsay C.; Ollson, Christopher A.; Stefanovic, Ingrid L.</p> <p>2015-11-15</p> <p>Health <span class="hlt">Impact</span> Assessment (HIA) is recognized as a useful tool that can identify potential health <span class="hlt">impacts</span> resulting from projects or policy initiatives. Although HIA has become an established <span class="hlt">practice</span> in some countries, it is not yet an established <span class="hlt">practice</span> in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA <span class="hlt">practice</span>. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout the process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of <span class="hlt">practice</span> in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA <span class="hlt">practice</span> in Canada.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4670843','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4670843"><span id="translatedtitle">Achieving 90–90–90 in <span class="hlt">paediatric</span> HIV: adolescence as the touchstone for transition success</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Lee, Sonia; Hazra, Rohan</p> <p>2015-01-01</p> <p>Introduction The number of children less than 15 years estimated to be living with HIV globally approximated 3.2 million in 2013. Young people aged 15 to 24 years living with HIV approximated 4 million. The survival of these children and adolescents into adulthood poses new and urgent challenges of transition from the <span class="hlt">paediatric</span> to adolescent to adult healthcare settings due to emerging developmental, psychosocial and comorbid issues. In order to achieve treatment targets of 90–90–90 across the continuum of care for <span class="hlt">paediatric</span> HIV by 2020, focused efforts on the implementation of appropriate healthcare transition plans across the lifespan, with a focus on adolescence, should be prioritized. Discussion Published data or empirical evidence examining implementation of transition models and association with clinical outcomes are limited. While some guidelines do exist that offer recommendations about how to promote seamless transitions, very few data are available to assess the adequacy of these guidelines and whether they are effectively adhered to in clinical care settings globally. Furthermore, <span class="hlt">paediatric</span> and adolescent HIV infection, either acquired perinatally or behaviourally, is set apart from other chronic illnesses as a highly stigmatizing disease that disproportionately affects poor, minority and often marginalized populations. Focused efforts on adolescence as the touchstone for transition <span class="hlt">practices</span> and policies need to be implemented. Conclusions Optimal healthcare for these vulnerable populations, particularly in resource-limited settings, will require HIV-specific transitional care services and programmes that are coordinated, collaborative, integrated and, importantly, evidence-based. PMID:26639113</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24070789','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24070789"><span id="translatedtitle">The STEP (Safety and Toxicity of Excipients for <span class="hlt">Paediatrics</span>) database: part 2 - the pilot version.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Salunke, Smita; Brandys, Barbara; Giacoia, George; Tuleu, Catherine</p> <p>2013-11-30</p> <p>The screening and careful selection of excipients is a critical step in <span class="hlt">paediatric</span> formulation development as certain excipients acceptable in adult formulations, may not be appropriate for <span class="hlt">paediatric</span> use. While there is extensive toxicity data that could help in better understanding and highlighting the gaps in toxicity studies, the data are often scattered around the information sources and saddled with incompatible data types and formats. This paper is the second in a series that presents the update on the Safety and Toxicity of Excipients for <span class="hlt">Paediatrics</span> ("STEP") database being developed by Eu-US PFIs, and describes the architecture data fields and functions of the database. The STEP database is a user designed resource that compiles the safety and toxicity data of excipients that is scattered over various sources and presents it in one freely accessible source. Currently, in the pilot database data from over 2000 references/10 excipients presenting preclinical, clinical, regulatory information and toxicological reviews, with references and source links. The STEP database allows searching "FOR" excipients and "BY" excipients. This dual nature of the STEP database, in which toxicity and safety information can be searched in both directions, makes it unique from existing sources. If the pilot is successful, the aim is to increase the number of excipients in the existing database so that a database large enough to be of <span class="hlt">practical</span> research use will be available. It is anticipated that this source will prove to be a useful platform for data management and data exchange of excipient safety information. PMID:24070789</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4928186','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4928186"><span id="translatedtitle">Cost-effectiveness analysis of the direct and indirect <span class="hlt">impact</span> of intranasal live attenuated influenza vaccination strategies in children: alternative country profiles</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Gibson, Edward; Begum, Najida; Martinón-Torres, Federico; Safadi, Marco Aurélio; Sackeyfio, Alfred; Hackett, Judith; Rajaram, Sankarasubramanian</p> <p>2016-01-01</p> <p>Background Influenza poses a significant burden on healthcare systems and society, with under-recognition in the <span class="hlt">paediatric</span> population. Existing vaccination policies (largely) target the elderly and other risk groups where complications may arise. Objective The goal of this study was to evaluate the cost-effectiveness of annual <span class="hlt">paediatric</span> vaccination (in 2–17-year-olds) with live attenuated influenza vaccination (LAIV), as well as the protective effect on the wider population in England and Wales (base). The study aimed to demonstrate broad applications of the model in countries where epidemiological and transmission data is limited and that have sophisticated vaccination policies (Brazil, Spain, and Taiwan). Methods The direct and indirect <span class="hlt">impact</span> of LAIV in the <span class="hlt">paediatric</span> cohort was simulated using an age-stratified dynamic transmission model over a 5-year time horizon of daily cycles and applying discounting of 3.5% in the base case. Pre-existing immunity structure was based on a 1-year model run. Sensitivity analyses were conducted. Results In the base case for England and Wales, the annual <span class="hlt">paediatric</span> strategy with LAIV was associated with improvements in influenza-related events and quality-adjusted life years (QALYs) lost, yielding an incremental cost per QALY of £6,208. The model was robust to change in the key input parameters. The probabilistic analysis demonstrated LAIV to be cost effective in more than 99% of iterations, assuming a willingness-to-pay threshold of £30,000. Incremental costs per QALY for Brazil were £2,817, and for the cases of Spain and Taiwan the proposed strategy was dominant over the current <span class="hlt">practice</span>. Conclusion In addition to existing policies, annual <span class="hlt">paediatric</span> vaccination using LAIV provides a cost-effective strategy that offers direct and indirect protection in the wider community. <span class="hlt">Paediatric</span> vaccination strategies using LAIV demonstrated clinical and economic benefits over alternative (current vaccination) strategies in</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/23875726','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/23875726"><span id="translatedtitle"><span class="hlt">Impact</span> of Doctor of Nursing <span class="hlt">Practice</span> education in shaping health care systems for the future.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Dunbar-Jacob, Jacqueline; Nativio, Donna G; Khalil, Heba</p> <p>2013-08-01</p> <p>The approval of the Doctor of Nursing <span class="hlt">Practice</span> (DNP) by the American Association of Colleges of Nursing in 2004 and publication of The Essentials of Doctoral Education for Advanced Nursing <span class="hlt">Practice</span> in 2006 promised significant benefit to nursing and to shaping health care systems. Currently, 229 DNP programs exist and more are planned. This article provides an overview of program types, graduates, and postgraduation placement, using Pennsylvania as an exemplar, to describe the potential <span class="hlt">impact</span> of DNP education in health care systems. Nurse educators need to consider whether our current directions enable us to realize opportunities for shaping health care systems or whether we need to make course corrections. [ PMID:23875726</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=191282&keyword=UNITED+AND+NATIONS&actType=&TIMSType=+&TIMSSubTypeID=&DEID=&epaNumber=&ntisID=&archiveStatus=Both&ombCat=Any&dateBeginCreated=&dateEndCreated=&dateBeginPublishedPresented=&dateEndPublishedPresented=&dateBeginUpdated=&dateEndUpdated=&dateBeginCompleted=&dateEndCompleted=&personID=&role=Any&journalID=&publisherID=&sortBy=revisionDate&count=50&CFID=76641408&CFTOKEN=98263497','EPA-EIMS'); return false;" href="http://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=191282&keyword=UNITED+AND+NATIONS&actType=&TIMSType=+&TIMSSubTypeID=&DEID=&epaNumber=&ntisID=&archiveStatus=Both&ombCat=Any&dateBeginCreated=&dateEndCreated=&dateBeginPublishedPresented=&dateEndPublishedPresented=&dateBeginUpdated=&dateEndUpdated=&dateBeginCompleted=&dateEndCompleted=&personID=&role=Any&journalID=&publisherID=&sortBy=revisionDate&count=50&CFID=76641408&CFTOKEN=98263497"><span id="translatedtitle">Guidance on How to Move from Current <span class="hlt">Practice</span> to Recommended <span class="hlt">Practice</span> in Life Cycle <span class="hlt">Impact</span> Assessment (UNEP/SETAC Life Cycle Initiative Publication)</span></a></p> <p><a target="_blank" href="http://oaspub.epa.gov/eims/query.page">EPA Science Inventory</a></p> <p></p> <p></p> <p>The report provides guidance on how to move from current <span class="hlt">practice</span> to recommended <span class="hlt">practice</span> in Life Cycle <span class="hlt">Impact</span> Assessment. It is composed of three complementary parts elaborated in the first task force (TFI) of the LCIA programme, with contribution of the other three task forces:</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/22246880','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/22246880"><span id="translatedtitle">Advancing the theory and <span class="hlt">practice</span> of <span class="hlt">impact</span> assessment: Setting the research agenda</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Pope, Jenny; Bond, Alan; Morrison-Saunders, Angus; Retief, Francois</p> <p>2013-07-15</p> <p><span class="hlt">Impact</span> assessment has been in place for over 40 years and is now practised in some form in all but two of the world's nations. In this paper we reflect on the state of the art of <span class="hlt">impact</span> assessment theory and <span class="hlt">practice</span>, focusing on six well-established forms: EIA, SEA, policy assessment, SIA, HIA and sustainability assessment. We note that although the fundamentals of <span class="hlt">impact</span> assessment have their roots in the US National Environmental Policy Act 1969 (NEPA) each branch of the field is distinct in also drawing on other theoretical and conceptual bases that in turn shape the prevailing discourse in each case, generating increasing degrees of specialisation within each sub-field. Against this backdrop, we consider the strengths and weaknesses of collective <span class="hlt">impact</span> assessment <span class="hlt">practice</span>, concluding that although there are substantial strengths, the plethora of specialist branches is generating a somewhat confusing picture and lack of clarity regarding how the pieces of the <span class="hlt">impact</span> assessment jigsaw puzzle fit together. We use this review to suggest an overarching research agenda that will enable <span class="hlt">impact</span> assessment to evolve in line with changing expectations for what it should deliver. -- Highlights: ► Strengths, weakness, opportunities and threats for IA are explored in this paper ► EIA, SEA, policy assessment, SIA, HIA and sustainability assessment are reviewed ► Diversity of <span class="hlt">practice</span> is both a strength and weakness in the current economic climate ► There are opportunities to simplify IA by focusing on common and fundamental elements ► Continued research into theory related to IA effectiveness is also essential.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/22447510','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/22447510"><span id="translatedtitle">Is the ecosystem service concept improving <span class="hlt">impact</span> assessment? Evidence from recent international <span class="hlt">practice</span></span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Rosa, Josianne Claudia Sales Sánchez, Luis E.</p> <p>2015-01-15</p> <p>Considering ecosystem services (ES) could foster innovation and improve environmental and social <span class="hlt">impact</span> assessment (ESIA) <span class="hlt">practice</span>, but is the potential being fulfilled? In order to investigate how ES have been treated in recent international <span class="hlt">practice</span>, three questions are asked: (i) were the tasks of an ES analysis carried out? (ii) how is such analysis integrated with other analysis presented in the ESIA? (iii) does ES analysis result in additional or improved mitigation or enhancement measures? These research questions were unfolded into 15 auxiliary questions for reviewing five ESIA reports prepared for mining, hydroelectric and transportation infrastructure projects in Africa, Asia and South America. All cases incorporated ES into ESIA to meet a requirement of the International Finance Corporation's Performance Standards on Environmental and Social Sustainability. It was found that: (i) in only three cases most tasks recommended by current guidance were adopted (ii) all reports feature a dedicated ES chapter or section, but in three of them no evidence was found that the ES analysis was integrated within <span class="hlt">impact</span> assessment (iii) in the two ESIAs that followed guidance, ES analysis resulted in specific mitigation measures. Few evidence was found that the ES concept is improving current ESIA <span class="hlt">practice</span>. Key challenges are: (i) integrating ES analysis in such a way that it does not duplicate other analysis; (ii) adequately characterizing the beneficiaries of ES; and (iii) quantifying ES supply for <span class="hlt">impact</span> prediction. - Highlights: • Incorporating ecosystem services analysis in <span class="hlt">impact</span> assessment can improve results. • Additional <span class="hlt">impacts</span> and mitigation were identified. • Challenges include developing appropriate indicators for <span class="hlt">impact</span> prediction. • A key challenge is integrating the concept in such a way that it does not duplicate other analysis.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24711586','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24711586"><span id="translatedtitle">Psychological consultation in a <span class="hlt">paediatric</span> setting: A qualitative analysis of staff experiences of a psychosocial forum.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Douglas, Jessica L; Benson, Sally</p> <p>2015-07-01</p> <p>The use of psychosocial forums in <span class="hlt">paediatric</span> settings has been recommended as a means of providing psychological consultancy. However, no research has explored staff perceptions of these meetings or whether they have a positive <span class="hlt">impact</span> on patient care. In this study, six members of a <span class="hlt">paediatric</span> gastroenterology multidisciplinary team were interviewed about their experience of a weekly psychosocial forum using a qualitative approach. The data revealed that staff regarded the forum as an essential and useful part of the service. Staff reported a number of benefits to their clinical work as a result of attending the forum, in addition to the general benefits of having a clinical psychologist available to see patients. However, staff also made recommendations for improving the forum. The results suggest that psychosocial forums may provide an efficient means of delivering specialist psychological consultation for patients with psychological difficulties, in line with Department of Health recommendations for <span class="hlt">paediatric</span> services. Future research should aim to investigate the effectiveness of psychosocial forums in different settings and to establish the cost-effectiveness of these meetings. PMID:24711586</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2560634','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2560634"><span id="translatedtitle">Epidemiology of <span class="hlt">paediatric</span> surgical admissions to a government referral hospital in the Gambia.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Bickler, S. W.; Sanno-Duanda, B.</p> <p>2000-01-01</p> <p>INTRODUCTION: There is a paucity of published data on the type of conditions that require surgery among children in sub-Saharan Africa. Such information is necessary for assessing the <span class="hlt">impact</span> of such conditions on child health and for setting priorities to improve <span class="hlt">paediatric</span> surgical care. METHODS: Described in the article is a 29-month prospective study of all children aged < 15 years who were admitted to a government referral hospital in the Gambia from January 1996 to May 1998. RESULTS: A total of 1726 children were admitted with surgical problems. Surgical patients accounted for 11.3% of <span class="hlt">paediatric</span> admissions and 34,625 total inpatient days. The most common admission diagnoses were injuries (46.9%), congenital anomalies (24.3%), and infections requiring surgery (14.5%). The diagnoses that accounted for the greatest number of inpatient days were burns (18.8%), osteomyelitis (15.4%), fractures (12.7%), soft tissue injuries (3.9%), and head injuries (3.4%). Gambian children were rarely admitted for appendicitis and never admitted for hypertrophic pyloric stenosis. The leading causes of surgical deaths were burns, congenital anomalies, and injuries other than burns. DISCUSSION: Prevention of childhood injuries and better trauma management, especially at the primary and secondary health care levels, should be the priorities for improving <span class="hlt">paediatric</span> surgical care in sub-Saharan Africa. Surgical care of children should be considered an essential component of child health programmes in developing countries. PMID:11143193</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25008221','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25008221"><span id="translatedtitle"><span class="hlt">Paediatric</span> emergency department utilisation: is it necessary an educational intervention?</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>De Tina, Annalisa; Quattrin, Rosanna; Montina, Laura; Brusaferro, Silvio</p> <p>2014-01-01</p> <p>Over the past ten years there has been a progressive increase in accesses to services for <span class="hlt">paediatric</span> emergency room, documented in Italy and abroad. The aim of the study is describe the sociodemographic, cultural, subjective and objective factors for non-urgent access to <span class="hlt">paediatric</span> emergency service in an Italian region. It was adopted a descriptive survey of a sample of non-urgent accesses to two <span class="hlt">paediatric</span> emergency room services in an Italian region during the period from February-March 2009, through the administration of questionnaires and the consultation of facilities databases. Half of the accesses to the <span class="hlt">paediatric</span> emergency room are not urgent and are to be referred to the <span class="hlt">paediatric</span> primary care. 80% of the users do not call for advice before coming to the emergency room. The convenience of the service, which accounts for more than 50% of the case, and the proximity from home are reasons to go to the emergency room. Approximately half of the accesses to the <span class="hlt">paediatric</span> emergency department could be managed by primary care services. The convenience of the service, the self-referred and the proximity to home are emerging as the only influential factors reported by literature. In the future it should become crucial providing strategies for education/health information focused on non-urgent <span class="hlt">paediatric</span> problems and offering people a call center phone service in order to filter and prevent the inappropriate accesses. PMID:25008221</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/17725846','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/17725846"><span id="translatedtitle">Developing <span class="hlt">paediatric</span> medicines: identifying the needs and recognizing the challenges.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Ernest, Terry B; Elder, David P; Martini, Luigi G; Roberts, Matthew; Ford, James L</p> <p>2007-08-01</p> <p>There is a significant need for research and development into <span class="hlt">paediatric</span> medicines. Only a small fraction of the drugs marketed and utilized as therapeutic agents in children have been clinically evaluated. The majority of marketed drugs are either not labelled, or inadequately labelled, for use in <span class="hlt">paediatric</span> patients. The absence of suitable medicines or critical safety and efficacy information poses significant risks to a particularly vulnerable patient population. However, there are many challenges associated with developing medicines for the <span class="hlt">paediatric</span> population and this review paper is intended to highlight these. The <span class="hlt">paediatric</span> population is made up of a wide range of individuals of substantially varied physical size, weight and stage of physiological development. Experimentation on children is considered by many to be unethical, resulting in difficulties in obtaining critical safety data. Clinical trials are subject to detailed scrutiny by the various regulatory bodies who have recently recognized the need for pharmaceutical companies to invest in <span class="hlt">paediatric</span> medicines. The costs associated with <span class="hlt">paediatric</span> product development could result in poor or negative return on investment and so incentives have been proposed by the EU and US regulatory bodies. Additionally, some commonly used excipients may be unsuitable for use in children; and some dosage forms may be undesirable to the <span class="hlt">paediatric</span> population. PMID:17725846</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3925410','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3925410"><span id="translatedtitle">The <span class="hlt">Impact</span> of Electronic Health Records on Workflow and Financial Measures in Primary Care <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Fleming, Neil S; Becker, Edmund R; Culler, Steven D; Cheng, Dunlei; McCorkle, Russell; da Graca, Briget; Ballard, David J</p> <p>2014-01-01</p> <p>Objective To estimate a commercially available ambulatory electronic health record’s (EHR’s) <span class="hlt">impact</span> on workflow and financial measures. Data Sources/Study Setting Administrative, payroll, and billing data were collected for 26 primary care <span class="hlt">practices</span> in a fee-for-service network that rolled out an EHR on a staggered schedule from June 2006 through December 2008. Study Design An interrupted time series design was used. Staffing, visit intensity, productivity, volume, <span class="hlt">practice</span> expense, payments received, and net income data were collected monthly for 2004–2009. Changes were evaluated 1–6, 7–12, and >12 months postimplementation. Data Collection/Extraction Methods Data were accessed through a SQLserver database, transformed into SAS®, and aggregated by <span class="hlt">practice</span>. <span class="hlt">Practice</span>-level data were divided by full-time physician equivalents for comparisons across <span class="hlt">practices</span> by month. Principal Findings Staffing and <span class="hlt">practice</span> expenses increased following EHR implementation (3 and 6 percent after 12 months). Productivity, volume, and net income decreased initially but recovered to/close to preimplementation levels after 12 months. Visit intensity did not change significantly, and a secular trend offset the decrease in payments received. Conclusions Expenses increased and productivity decreased following EHR implementation, but not as much or as persistently as might be expected. Longer term effects still need to be examined. PMID:24359533</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3240921','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3240921"><span id="translatedtitle">Osteoporosis in <span class="hlt">paediatric</span> patients with spina bifida</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Marreiros, Humberto Filipe; Loff, Clara; Calado, Eulalia</p> <p>2012-01-01</p> <p>The prevalence and morbidity associated with osteoporosis and fractures in patients with spina bifida (SB) highlight the importance of osteoporosis prevention and treatment in early childhood; however, the issue has received little attention. The method for the selection of appropriate patients for drug treatment has not been clarified. Objective To review the literature concerning fracture risks and low bone density in <span class="hlt">paediatric</span> patients with SB. We looked for studies describing state-of-the-art treatments and for prevention of secondary osteoporosis. Methods Articles were identified through a search in the electronic database (PUBMED) supplemented with reviews of the reference lists of selected papers. The main outcome measures were incidence of fractures and risk factors for fracture, an association between bone mineral density (BMD) and occurrence of fracture, risk factors of low BMD, and effects of pharmacological and non-pharmacological treatments on BMD and on the incidence of fractures. We considered as a secondary outcome the occurrence of fractures in relation to the mechanism of injury. Results Results indicated that patients with SB are at increased risk for fractures and low BMD. Risk factors that may predispose patients to fractures include higher levels of neurological involvement, non-ambulatory status, physical inactivity, hypercalciuria, higher body fat levels, contractures, and a previous spontaneous fracture. Limitations were observed in the number and quality of studies concerning osteoporosis prevention and treatment in <span class="hlt">paediatric</span> patients with SB. The safety and efficiency of drugs to treat osteoporosis in adults have not been evaluated satisfactorily in children with SB. PMID:22330186</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/20180866','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/20180866"><span id="translatedtitle"><span class="hlt">Paediatric</span> pandemic planning: children's perspectives and recommendations.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Koller, Donna; Nicholas, David; Gearing, Robin; Kalfa, Ora</p> <p>2010-07-01</p> <p>Children, as major stakeholders in <span class="hlt">paediatric</span> hospitals, have remained absent from discussions on important healthcare issues. One critical area where children's voices have been minimised is in the planning for future pandemics. This paper presents a subset of data from a programme of research which examined various stakeholder experiences of the severe acute respiratory syndrome (SARS) outbreaks of 2003. These data also generated recommendations for future pandemic planning. Specifically, this paper will examine the perspectives and recommendations of children hospitalised during SARS in a large <span class="hlt">paediatric</span> hospital in Canada. Twenty-one (n = 21) child and adolescent participants were interviewed from a variety of medical areas including cardiac (n = 2), critical care (n = 2), organ transplant (n = 4), respiratory medicine (n = 8) and infectious diseases (patients diagnosed with suspected or probable SARS; n = 5). Data analyses exposed a range of children's experiences associated with the outbreaks as well as recommendations for future pandemic planning. Key recommendations included specific policies and guidelines concerning psychosocial care, infection control, communication strategies and the management of various resources. This paper is guided by a conceptual framework comprised of theories from child development and literature on children's rights. The authors call for greater youth participation in healthcare decision-making and pandemic planning. PMID:20180866</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27546541','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27546541"><span id="translatedtitle">Selective lung intubation during <span class="hlt">paediatric</span> thoracic surgeries.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Mixa, V; Nedomova, B; Rygl, M</p> <p>2016-01-01</p> <p>Selective lung intubation is a necessary prerequisite for the completion of most interventions comprising thoracotomy and thoracoscopy. In <span class="hlt">paediatric</span> care, our site uses Univent tubes for children up to the age of three years and double-lumen tubes (DLT) for children from 6-8 years of age. In younger children, we usually use regular endotracheal intubation, with the lung being held in the hemithorax position being operated on using a surgical retractor. The article presents the analysis of 860 thoracic surgeries, of which 491 comprised selective intubation (Univent 57 cases, DLT 434 cases). The use of the aforementioned devices is connected with certain complications. Univent tube can be connected with intraoperative dislocation of the obturating balloon (29.8%) and balloon perforation (5.2%). DLT insertion may be connected with failure of tube fitting. In 84 cases we had to repeat DLT insertion (20.6%). In 8 cases we were not able to insert DLT at all (1.8%). Standard use of selective intubation methods in <span class="hlt">paediatric</span> patients from two years of age improved the conditions for surgical interventions (Tab. 2, Fig. 2, Ref. 19). PMID:27546541</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_12");'>12</a></li> <li><a href="#" onclick='return showDiv("page_13");'>13</a></li> <li class="active"><span>14</span></li> <li><a href="#" onclick='return showDiv("page_15");'>15</a></li> <li><a href="#" onclick='return showDiv("page_16");'>16</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_14 --> <div id="page_15" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_13");'>13</a></li> <li><a href="#" onclick='return showDiv("page_14");'>14</a></li> <li class="active"><span>15</span></li> <li><a href="#" onclick='return showDiv("page_16");'>16</a></li> <li><a href="#" onclick='return showDiv("page_17");'>17</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="281"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1963523','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1963523"><span id="translatedtitle"><span class="hlt">Paediatric</span> Preputial Pathology: Are we Circumcising Enough?</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Yardley, IE; Cosgrove, C; Lambert, AW</p> <p>2007-01-01</p> <p>INTRODUCTION Preputial problems are a common reason for referral to the <span class="hlt">paediatric</span> surgical out-patient department. Many boys referred do not need surgical intervention. One indication for intervention is balanitis xerotica obliterans (BXO), a potentially serious condition previously considered rare in childhood. PATIENTS AND METHODS Consecutive boys referred to a <span class="hlt">paediatric</span> general surgical out-patient department with problems relating to their prepuce during a period of 4 years were included. The out-patient diagnosis and management was recorded. All foreskins excised were sent for histological analysis. RESULTS A total of 422 boys were referred, median age 6 years 2 months (range, 3 months to 16 years). Over half the boys referred simply required re-assurance that all was normal with their penis. However, 186 boys (44.1%) were listed for surgical procedures – 148 circumcision, 33 preputial adhesiolysis, and 5 frenuloplasty. There were histological abnormalities in 110 specimens (84.8%); chronic inflammation (n = 69; 46.6%), BXO (n = 51; 34.5%), and fibrosis(n = 4; 2.7%). Nineteen (12.8%) specimens were reported as histologically normal. The overall prevalence of BXO in the boys referred was 12.1%. CONCLUSIONS In this series, the percentage of boys circumcised and the prevalence of BXO were both higher than in other published series. BXO may be more common and present at a younger age than previously thought. PMID:17316525</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4668961','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4668961"><span id="translatedtitle">Systems for <span class="hlt">Paediatric</span> Sepsis: A Global Survey</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Kang, KT; Chandler, HK; Espinosa, V; Kissoon, N</p> <p>2014-01-01</p> <p>ABSTRACT Objectives: To evaluate the resources available for early diagnosis and treatment of <span class="hlt">paediatric</span> sepsis at hospitals in developing and developed countries. Methods: This was a voluntary online survey involving 101 hospitals from 41 countries solicited through the World Federation of Pediatric Intensive and Critical Care Societies contact list and website. The survey was designed to assess the spectrum of sepsis epidemiology, patterns of applied therapies, availability of resources and barriers to optimal sepsis treatment. Results: Ninety per cent of respondents represented a tertiary or general hospital with <span class="hlt">paediatric</span> intensive care facilities, including 63% from developed countries. Adequate triage services were absent in more than 20% of centres. Insufficiently trained personnel and lack of a sepsis protocol was reported in 40% of all sites. While there were specific guidelines for sepsis management in 78% of centres (n = 100), protocols for assessing sepsis patients were not applied in nearly 70% of centres. Lack of parental recognition of sepsis and failure of referring centres to diagnose sepsis were identified as major barriers by more than 50% of respondents. Conclusions: Even among centres with no significant resource constraints and advanced medical systems, significant deficits in sepsis care exist. Early recognition and management remains a key issue and may be addressed through improved triage, augmented support for referring centres and public awareness. Focussed research is necessary at the institutional level to identify and address specific barriers. PMID:25867557</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/18589025','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/18589025"><span id="translatedtitle">Trends <span class="hlt">impacting</span> food safety in retail foodservice: implications for dietetics <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Sneed, Jeannie; Strohbehn, Catherine H</p> <p>2008-07-01</p> <p>Food safety in retail foodservice is increasingly important to consumers. Trends that <span class="hlt">impact</span> food safety concerns include the increasing number of meals eaten away from home, increasing consumer awareness about food safety, an aging population, changes in the foodservice workforce, changing technology in work environments, changes in food procurement, foodservice risk factors, and food defense concerns. Each of these trends has implications for dietetics <span class="hlt">practice</span>, both in working with consumers and managing foodservice operations. PMID:18589025</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/22131071','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/22131071"><span id="translatedtitle">Determination of significance in Ecological <span class="hlt">Impact</span> Assessment: Past change, current <span class="hlt">practice</span> and future improvements</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Briggs, Sam; Hudson, Malcolm D.</p> <p>2013-01-15</p> <p>Ecological <span class="hlt">Impact</span> Assessment (EcIA) is an important tool for conservation and achieving sustainable development. 'Significant' <span class="hlt">impacts</span> are those which disturb or alter the environment to a measurable degree. Significance is a crucial part of EcIA, our understanding of the concept in <span class="hlt">practice</span> is vital if it is to be effective as a tool. This study employed three methods to assess how the determination of significance has changed through time, what current <span class="hlt">practice</span> is, and what would lead to future improvements. Three data streams were collected: interviews with expert stakeholders, a review of 30 Environmental Statements and a broad-scale survey of the United Kingdom Institute of Ecology and Environmental Management (IEEM) members. The approach taken in the determination of significance has become more standardised and subjectivity has become constrained through a transparent framework. This has largely been driven by a set of guidelines produced by IEEM in 2006. The significance of <span class="hlt">impacts</span> is now more clearly justified and the accuracy with which it is determined has improved. However, there are limitations to accuracy and effectiveness of the determination of significance. These are the quality of baseline survey data, our scientific understanding of ecological processes and the lack of monitoring and feedback of results. These in turn are restricted by the limited resources available in consultancies. The most notable recommendations for future <span class="hlt">practice</span> are the implementation of monitoring and the publication of feedback, the creation of a central database for baseline survey data and the streamlining of guidance. - Highlights: Black-Right-Pointing-Pointer The assessment of significance has changed markedly through time. Black-Right-Pointing-Pointer The IEEM guidelines have driven a standardisation of <span class="hlt">practice</span>. Black-Right-Pointing-Pointer Currently limited by quality of baseline data and scientific understanding. Black-Right-Pointing-Pointer Monitoring and</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22271406','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22271406"><span id="translatedtitle">Adolescent online gambling: the <span class="hlt">impact</span> of parental <span class="hlt">practices</span> and correlates with online activities.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Floros, Georgios D; Siomos, Konstantinos; Fisoun, Virginia; Geroukalis, Dimitrios</p> <p>2013-03-01</p> <p>We present results from a cross-sectional study of the entire adolescent student population aged 12-19 of the island of Kos and their parents, on the relationship between their Internet gambling and respective parental <span class="hlt">practices</span>, including aspects of psychological bonding and online security measures. The sample consisted of 2,017 students (51.8% boys, 48.2% girls). Our results indicate that gender, parenting <span class="hlt">practices</span> as perceived by the adolescents and distinct patterns of adolescent Internet activities are among the best predictor variables for Internet gambling. Security <span class="hlt">practices</span> exercised by the parents failed to make an <span class="hlt">impact</span> on the extent of Internet gambling, demonstrating the need for specific measures to tackle this phenomenon since the provision of simple education on the dangers of the Internet is not sufficient to this regard. PMID:22271406</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/22058872','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/22058872"><span id="translatedtitle">Walking the sustainability assessment talk - Progressing the <span class="hlt">practice</span> of environmental <span class="hlt">impact</span> assessment (EIA)</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Morrison-Saunders, Angus; Retief, Francois</p> <p>2012-09-15</p> <p>Internationally there is a growing demand for environmental <span class="hlt">impact</span> assessment (EIA) to move away from its traditional focus towards delivering more sustainable outcomes. South Africa is an example of a country where the EIA system seems to have embraced the concept of sustainability. In this paper we test the existing objectives for EIA in South Africa against sustainability principles and then critique the effectiveness of EIA <span class="hlt">practice</span> in delivering these objectives. The outcome of the research suggests that notwithstanding a strong and explicit sustainability mandate through policy and legislation, the effectiveness of EIA <span class="hlt">practice</span> falls far short of what is mandated. This shows that further legislative reform is not required to improve effectiveness but rather a focus on changing the behaviour of individual professionals. We conclude by inviting further debate on what exactly practitioners can do to give effect to sustainability in EIA <span class="hlt">practice</span>.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24228374','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24228374"><span id="translatedtitle">Is your glass half full or half empty? Your decision may <span class="hlt">impact</span> your <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Baum, Neil; Homisakt, Lynn</p> <p>2013-01-01</p> <p>The attitude of the doctor and the medical staff can have a profound <span class="hlt">impact</span> on the success of a <span class="hlt">practice</span>. You can be sure that if everyone has a positive attitude toward patients, your patients will have a positive experience and will tell others about that positive experience. On the other hand, if a doctor is sullen, unhappy, and uninterested in his or her work, you can be sure that this negativity will be transferred to the staff and subsequently to the patients. As a result, there will be unhappy patients, unhappy staff, increased staff turnover, and a doctor who continues to be unhappy and dissatisfied with the <span class="hlt">practice</span> of medicine. This article will describe both types of attitudes, and what can be done to improve the attitude of the <span class="hlt">practice</span> and have a glass that is half full and not half empty. PMID:24228374</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1314236','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1314236"><span id="translatedtitle">The <span class="hlt">impact</span> of a general <span class="hlt">practice</span> group intervention on prescribing costs and patterns.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Walker, Jane; Mathers, Nigel</p> <p>2002-01-01</p> <p>BACKGROUND: The formation of primary care groups (PCGs) and trusts (PCTs) has shifted the emphasis from individual <span class="hlt">practice</span> initiatives to group-based efforts to control rising prescribing costs. However, there is a paucity of literature describing such group initiatives. We report the results of a multilevel group initiative, involving input from a pharmaceutical adviser, <span class="hlt">practice</span> comparison feedback, and peer review meetings. AIM: To determine the <span class="hlt">impact</span> of a prescribing initiative on the prescribing patterns of a group of general <span class="hlt">practices</span>. DESIGN OF STUDY: A comparative study with non-matched controls. SETTING: Nine semi-rural/rural <span class="hlt">practices</span> forming a commissioning group pilot, later a PCG, in Southern Derbyshire with nine <span class="hlt">practices</span> as controls. METHOD: <span class="hlt">Practice</span> data were collated for overall prescribing and for therapeutic categories, between the years 1997/1998 and 1998/1999 and analysed statistically. Prescribing expenditure trends were also collated. RESULTS: Although both groups came well within their prescribing budgets, in the study group this was for the first time in five years. Their rate of increase in expenditure slowed significantly following the initiative compared with that of the comparison group, which continued to rise (median <span class="hlt">practice</span> net ingredient cost/patient unit (nic/PU) increase: Pound Sterling0.69 and Pound Sterling3.80 respectively; P = 0.03). The study group's nic/PU dropped below, and stayed below, that of the comparison group one month after the start of the initiative. For most therapeutic categories the study group had lower increases in costs and higher increases in percentage of generic items than the comparison group. Quality markers were unaffected. CONCLUSION: We suggest that <span class="hlt">practices</span> with diverse prescribing patterns can work together effectively within a PCT locality to control prescribing costs. PMID:12030659</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/servlets/purl/554756','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/servlets/purl/554756"><span id="translatedtitle">Development of a <span class="hlt">practical</span> modeling framework for estimating the <span class="hlt">impact</span> of wind technology on bird populations</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Morrison, M.L.; Pollock, K.H.</p> <p>1997-11-01</p> <p>One of the most pressing environmental concerns related to wind project development is the potential for avian fatalities caused by the turbines. The goal of this project is to develop a useful, <span class="hlt">practical</span> modeling framework for evaluating potential wind power plant <span class="hlt">impacts</span> that can be generalized to most bird species. This modeling framework could be used to get a preliminary understanding of the likelihood of significant <span class="hlt">impacts</span> to birds, in a cost-effective way. The authors accomplish this by (1) reviewing the major factors that can influence the persistence of a wild population; (2) briefly reviewing various models that can aid in estimating population status and trend, including methods of evaluating model structure and performance; (3) reviewing survivorship and population projections; and (4) developing a framework for using models to evaluate the potential <span class="hlt">impacts</span> of wind development on birds.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/21499659','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/21499659"><span id="translatedtitle">Environmental <span class="hlt">impact</span> assessment by means of a procedure based on fuzzy logic: A <span class="hlt">practical</span> application</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Peche, Roberto Rodriguez, Esther</p> <p>2011-03-15</p> <p>This study shows the <span class="hlt">practical</span> application of the EIA method based on fuzzy logic proposed by the authors (Peche and Rodriguez, 2009) to a simplified case of study-the activity of a petrol station throughout its exploitation. The intensity (p{sub 1}), the extent (p{sub 2}) and the persistence (p{sub 3}) were the properties selected to describe the <span class="hlt">impacts</span> and their respective assessment functions v-bar{sub i}=f(p-bar{sub i}) were determined. The main actions (A) and potentially affected environmental factors (F) were selected. Every <span class="hlt">impact</span> was identified by a pair A-F and the values of the three <span class="hlt">impact</span> properties were estimated for each of them by means of triangular fuzzy numbers. Subsequently, the fuzzy estimation of every <span class="hlt">impact</span> was carried out, the estimation of the <span class="hlt">impact</span> A{sub 1}-F{sub 2} (V-bar{sub 1}) being explained in detail. Every <span class="hlt">impact</span> was simultaneously represented by its corresponding generalised confidence interval and membership function. Since the membership functions of all <span class="hlt">impacts</span> were similar to triangular fuzzy numbers, a triangular approach (TA) was used to describe every <span class="hlt">impact</span>. A triangular approach coefficient (TAC) was introduced to quantify the similarity of each fuzzy number and its corresponding triangular approach, where TAC (V-bar) element of (0, 1] and TAC being 1 when the fuzzy number is triangular. The TACs-ranging from 0.96 to 0.99-proved that TAs were valid in all cases. Next, the total positive and negative <span class="hlt">impacts</span>-TV-bar{sup +} and TV-bar{sup -} were calculated and later, the fuzzy value of the total environmental <span class="hlt">impact</span> TV-bar was determined from them. Finally, the defuzzification of TV-bar led to the punctual <span class="hlt">impact</span> estimator TV{sup (1)} = -88.50 and its corresponding uncertainty interval [{delta}{sub l}(TV-bar),{delta}{sub r}(TV-bar)]=[6.52,6.96], which represent the total value of the EI. In conclusion, the EIA method enabled the integration of heterogeneous <span class="hlt">impacts</span>, which exerted influence on environmental factors of a</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2002PhDT........82P','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2002PhDT........82P"><span id="translatedtitle">Communities of <span class="hlt">practice</span>: Participation patterns and professional <span class="hlt">impact</span> for high school mathematics and science teachers</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Printy, Susan M.</p> <p></p> <p>Improving the quality of teachers in schools is a keystone to educational improvement. New and veteran teachers alike need to enhance their content knowledge and pedagogical skills, but they must also examine, and often change, their underlying attitudes, beliefs, and values about the nature of knowledge and the abilities of students. Best accomplished collectively rather than individually, the interactions between teachers as they undertake the process of collaborative inquiry create "communities of <span class="hlt">practice</span>." This dissertation investigates the importance of science and mathematics teachers' participation in communities of <span class="hlt">practice</span> to their professional capabilities. The study tests the hypothesis that the social learning inherent in community of <span class="hlt">practice</span> participation encourages teachers to learn from others with expertise, enhances teachers' sense of competence, and increases the likelihood that teachers' will use student-centered, problem-based instructional techniques aligned with national disciplinary standards. The researcher conceptualizes communities of <span class="hlt">practice</span> along two dimensions that affect social learning: legitimate participation in activities and span of engagement with school members. Differences in teachers' subject area and the curricular track of their teaching assignment contribute to variation in teachers' participation in communities of <span class="hlt">practice</span> along those dimensions. Using data from the National Educational Longitudinal Study, first and second follow-up, the study has two stages of multi-level analysis. The first stage examines factors that contribute to teachers' participation in communities of <span class="hlt">practice</span>, including teachers' social and professional characteristics and school demographic and organizational characteristics. The second stage investigates the professional <span class="hlt">impact</span> of such participation on the three outcome variables: teacher learning, teacher competence, and use of standards-based pedagogy. Hierarchical linear models provide</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4276388','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4276388"><span id="translatedtitle"><span class="hlt">Paediatric</span> patient family engagement with clinical research at a tertiary care <span class="hlt">paediatric</span> hospital</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Gill, Carson; Ansermino, Mark J; Sanatani, Shubhayan; Mulpuri, Kishore; Doan, Quynh</p> <p>2014-01-01</p> <p>BACKGROUND: Subject recruitment is essential for conducting clinical research; however, there are very few studies evaluating research uptake by families in a <span class="hlt">paediatric</span> setting. OBJECTIVES: To determine how frequently <span class="hlt">paediatric</span> patients and their families receiving care at a tertiary <span class="hlt">paediatric</span> hospital participated in research. The secondary objectives were to explore factors that influence patient families’ decisions to participate in research and how they perceived their experiences. METHODS: A cross-sectional study surveying families of children receiving care in a sample of clinical areas at a tertiary care <span class="hlt">paediatric</span> hospital in British Columbia was conducted. A self-administered questionnaire was used, and was facilitated by trained interviewers. Descriptive statistics were used to report the proportion of patient families that have previously been invited to participate in research and, among these, the proportion who had agreed to participate. Patient families’ perceptions of research and their past experiences therein were also reported. RESULTS: A total of 657 families were approached, of which 543 were enrolled (82.6% response rate). Among the 439 families that had visited the hospital previously, 114 (26.0%) had been invited to participate in research and 99 (87%) had consented to participate. Of these 99 families, only one had a negative experience, and 84 (85%) of these participant families were at least somewhat likely to participate in research again in the future. CONCLUSIONS: Only one-quarter of families that had previously visited the hospital had been invited to participate in a research project. Of the families approached previously, there was a high rate of participation and willingness to participate in future research. PMID:25587233</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25261748','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25261748"><span id="translatedtitle">Enhancing a rainfall-runoff model to assess the <span class="hlt">impacts</span> of BMPs and LID <span class="hlt">practices</span> on storm runoff.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Liu, Yaoze; Ahiablame, Laurent M; Bralts, Vincent F; Engel, Bernard A</p> <p>2015-01-01</p> <p>Best management <span class="hlt">practices</span> (BMPs) and low <span class="hlt">impact</span> development (LID) <span class="hlt">practices</span> are increasingly being used as stormwater management techniques to reduce the <span class="hlt">impacts</span> of urban development on hydrology and water quality. To assist planners and decision-makers at various stages of development projects (planning, implementation, and evaluation), user-friendly tools are needed to assess the effectiveness of BMPs and LID <span class="hlt">practices</span>. This study describes a simple tool, the Long-Term Hydrologic <span class="hlt">Impact</span> Assessment-LID (L-THIA-LID), which is enhanced with additional BMPs and LID <span class="hlt">practices</span>, improved approaches to estimate hydrology and water quality, and representation of <span class="hlt">practices</span> in series (meaning combined implementation). The tool was used to evaluate the performance of BMPs and LID <span class="hlt">practices</span> individually and in series with 30 years of daily rainfall data in four types of idealized land use units and watersheds (low density residential, high density residential, industrial, and commercial). Simulation results were compared with the results of other published studies. The simulated results showed that reductions in runoff volume and pollutant loads after implementing BMPs and LID <span class="hlt">practices</span>, both individually and in series, were comparable with the observed <span class="hlt">impacts</span> of these <span class="hlt">practices</span>. The L-THIA-LID 2.0 model is capable of assisting decision makers in evaluating environmental <span class="hlt">impacts</span> of BMPs and LID <span class="hlt">practices</span>, thereby improving the effectiveness of stormwater management decisions. PMID:25261748</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=Obsessive+AND+compulsive+AND+disorder&pg=5&id=EJ945092','ERIC'); return false;" href="http://eric.ed.gov/?q=Obsessive+AND+compulsive+AND+disorder&pg=5&id=EJ945092"><span id="translatedtitle">Randomized Controlled Trial of Full and Brief Cognitive-Behaviour Therapy and Wait-List for <span class="hlt">Paediatric</span> Obsessive-Compulsive Disorder</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Bolton, Derek; Williams, Tim; Perrin, Sean; Atkinson, Linda; Gallop, Catherine; Waite, Polly; Salkovskis, Paul</p> <p>2011-01-01</p> <p>Background: Reviews and <span class="hlt">practice</span> guidelines for <span class="hlt">paediatric</span> obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/15851434','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/15851434"><span id="translatedtitle">Tracing Sydenham's chorea: historical documents from a British <span class="hlt">paediatric</span> hospital.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Martino, D; Tanner, A; Defazio, G; Church, A J; Bhatia, K P; Giovannoni, G; Dale, R C</p> <p>2005-05-01</p> <p>Sydenham's chorea (SC) became a well defined nosological entity only during the second half of the nineteenth century. Such progress was promoted by the availability of large clinical series provided by newly founded <span class="hlt">paediatric</span> hospitals. This paper analyses the demographic and clinical features of patients with chorea admitted to the first British <span class="hlt">paediatric</span> hospital (the Hospital for Sick Children, Great Ormond Street, London) between 1852 and 1936. The seasonal and demographic characteristics of SC during this time appear strikingly similar to those observed today, and witness the introduction of modern "statistically averaging" techniques in the approach to complex <span class="hlt">paediatric</span> syndromes. Great Ormond Street (GOS) hospital case notes provide detailed descriptions of the "typical cases" of SC, and show that British physicians working in the early age of <span class="hlt">paediatric</span> hospitals succeeded in recognising the most distinctive clinical features of this fascinating condition. PMID:15851434</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3198656','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3198656"><span id="translatedtitle">Management of Ventriculo-Peritoneal Shunts in the <span class="hlt">Paediatric</span> Population</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Low, David; Drake, James M; Seow, Wan Tew; Ng, Wai Hoe</p> <p>2010-01-01</p> <p>The treatment of hydrocephalus is a challenging one. The development of shunt devices have greatly improved the survival and quality of life of <span class="hlt">paediatric</span> patients with hydrocephalus; however, shunt dysfunction is a common problem which represents a significant scope of work for <span class="hlt">paediatric</span> neurosurgeons with shunt failures occuring in up to 40 to 50% of patients during the first two years after shunt surgery. Numerous pathologies ranging from congenital to acquired conditions can result in the development of hydrocephalus in the <span class="hlt">paediatric</span> population. Obstruction of proximal or distal catheter ends, misplacement, infections and over drainage are some of the common problems accounting for shunt failures. We discussed some of the pertinent problems and nuances involved in treatment of <span class="hlt">paediatric</span> hydrocephalus with VPS as well as to review the role of endoscopic procedures as an alternative to VPS. PMID:22028738</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25417228','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25417228"><span id="translatedtitle">How are arrhythmias managed in the <span class="hlt">paediatric</span> population in Europe? Results of the European Heart Rhythm survey.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Hernández-Madrid, Antonio; Hocini, Mélèze; Chen, Jian; Potpara, Tatjana; Pison, Laurent; Blomström-Lundqvist, Carina</p> <p>2014-12-01</p> <p>The aim of this survey was to provide insight into current <span class="hlt">practice</span> regarding the management of <span class="hlt">paediatric</span> arrhythmias in Europe. The survey was based on a questionnaire sent via the Internet to the European Heart Rhythm Association (EHRA) electrophysiology research network centres. The following topics were explored: patient and treatment selection, techniques and equipment, treatment outcomes and complications. The vast majority of <span class="hlt">paediatric</span> arrhythmias concerns children older than 1 year and patients with grown-up congenital heart disease. In 65% of the hospitals there is a specialized <span class="hlt">paediatric</span> centre, and the most commonly observed arrhythmias include Wolff-Parkinson-White syndrome and atrioventricular nodal re-entry tachycardias (90.24%). The medical staff performing <span class="hlt">paediatric</span> catheter ablations in Europe are mainly adult electrophysiology teams (82.05% of the centres). Radiofrequency is the preferred energy source used for <span class="hlt">paediatric</span> arrhythmia ablation. Catheter ablation is only chosen if two or more antiarrhythmic drugs have failed (94.59% of the centres). The majority of the centres use flecainide (37.8%) or atenolol (32.4%) as their first choice drug for prevention of recurrent supraventricular arrhythmias. While none of the centres performed catheter ablation in asymptomatic infants with pre-excitation, 29.7% recommend ablation in asymptomatic children and adolescents. The preferred choice for pacemaker leads in infants less than 1 year old is implantation of epicardial leads in 97.3% of the centres, which continues to be the routine even in patients between 1 and 5 years of age as reported by 75.68% of the hospitals. Almost all centres (94.59%) report equally small number of complications of catheter ablation in children (aged 1-14 years) as observed in adults. PMID:25417228</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3366615','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3366615"><span id="translatedtitle"><span class="hlt">Paediatric</span> Obesity Research in Early Childhood and the Primary Care Setting: The TARGet Kids! Research Network</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Morinis, Julia; Maguire, Jonathon; Khovratovich, Marina; McCrindle, Brian W.; Parkin, Patricia C.; Birken, Catherine S.</p> <p>2012-01-01</p> <p>Primary <span class="hlt">paediatric</span> health care is the foundation for preventative child health. In light of the recent obesity epidemic, paediatricians find themselves at the frontline of identification and management of childhood obesity. However, it is well recognized that evidence based approaches to obesity prevention and subsequent translation of this evidence into <span class="hlt">practice</span> are critically needed. This paper explores the role of primary care in obesity prevention and introduces a novel application and development of a primary care research network in Canada—TARGet Kids!—to develop and translate an evidence-base on effective screening and prevention of childhood obesity. PMID:22690197</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27110286','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27110286"><span id="translatedtitle">Highlights of Children with Cancer UK's Workshop on Drug Delivery in <span class="hlt">Paediatric</span> Brain Tumours.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Nailor, Audrey; Walker, David A; Jacques, Thomas S; Warren, Kathy E; Brem, Henry; Kearns, Pamela R; Greenwood, John; Penny, Jeffrey I; Pilkington, Geoffrey J; Carcaboso, Angel M; Fleischhack, Gudrun; Macarthur, Donald; Slavc, Irene; Meijer, Lisethe; Gill, Steven; Lowis, Stephen; van Vuurden, Dannis G; Pearl, Monica S; Clifford, Steven C; Morrissy, Sorana; Ivanov, Delyan P; Beccaria, Kévin; Gilbertson, Richard J; Straathof, Karin; Green, Jordan J; Smith, Stuart; Rahman, Ruman; Kilday, John-Paul</p> <p>2016-01-01</p> <p>The first Workshop on Drug Delivery in <span class="hlt">Paediatric</span> Brain Tumours was hosted in London by the charity Children with Cancer UK. The goals of the workshop were to break down the barriers to treating central nervous system (CNS) tumours in children, leading to new collaborations and further innovations in this under-represented and emotive field. These barriers include the physical delivery challenges presented by the blood-brain barrier, the underpinning reasons for the intractability of CNS cancers, and the <span class="hlt">practical</span> difficulties of delivering cancer treatment to the brains of children. Novel techniques for overcoming these problems were discussed, new models brought forth, and experiences compared. PMID:27110286</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4817522','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4817522"><span id="translatedtitle">Highlights of Children with Cancer UK’s Workshop on Drug Delivery in <span class="hlt">Paediatric</span> Brain Tumours</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Nailor, Audrey; Walker, David A; Jacques, Thomas S; Warren, Kathy E; Brem, Henry; Kearns, Pamela R; Greenwood, John; Penny, Jeffrey I; Pilkington, Geoffrey J; Carcaboso, Angel M; Fleischhack, Gudrun; Macarthur, Donald; Slavc, Irene; Meijer, Lisethe; Gill, Steven; Lowis, Stephen; van Vuurden, Dannis G; Pearl, Monica S; Clifford, Steven C; Morrissy, Sorana; Ivanov, Delyan P; Beccaria, Kévin; Gilbertson, Richard J; Straathof, Karin; Green, Jordan J; Smith, Stuart; Rahman, Ruman; Kilday, John-Paul</p> <p>2016-01-01</p> <p>The first Workshop on Drug Delivery in <span class="hlt">Paediatric</span> Brain Tumours was hosted in London by the charity Children with Cancer UK. The goals of the workshop were to break down the barriers to treating central nervous system (CNS) tumours in children, leading to new collaborations and further innovations in this under-represented and emotive field. These barriers include the physical delivery challenges presented by the blood–brain barrier, the underpinning reasons for the intractability of CNS cancers, and the <span class="hlt">practical</span> difficulties of delivering cancer treatment to the brains of children. Novel techniques for overcoming these problems were discussed, new models brought forth, and experiences compared. PMID:27110286</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_13");'>13</a></li> <li><a href="#" onclick='return showDiv("page_14");'>14</a></li> <li class="active"><span>15</span></li> <li><a href="#" onclick='return showDiv("page_16");'>16</a></li> <li><a href="#" onclick='return showDiv("page_17");'>17</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_15 --> <div id="page_16" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_14");'>14</a></li> <li><a href="#" onclick='return showDiv("page_15");'>15</a></li> <li class="active"><span>16</span></li> <li><a href="#" onclick='return showDiv("page_17");'>17</a></li> <li><a href="#" onclick='return showDiv("page_18");'>18</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="301"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27569017','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27569017"><span id="translatedtitle">[The Moral Deliberation: The Clinical Ethics Method. Presentation of a <span class="hlt">Paediatric</span> Case].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Atuesta, Juana; Vásquez, Pablo; Roa, Juan David; Acuña, Hilda</p> <p>2016-01-01</p> <p>Decision-making is one of the most difficult tasks of medical judgment, especially when cases involve <span class="hlt">paediatric</span> patients with different cultural characteristics. It is the obligation of clinical ethics, taking the interdisciplinary approach as a tool to comprehensively analyse the clinical, social, cultural and legal aspects, among other topics, when choosing the treatment options that will be more beneficial for the patient. A clinical case, should enable this process of analysis and teamwork to be understood in <span class="hlt">practical</span> way in order to address difficult medical problems. PMID:27569017</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27053692','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27053692"><span id="translatedtitle">Diagnostics, monitoring and outpatient care in children with suspected pulmonary hypertension/<span class="hlt">paediatric</span> pulmonary hypertensive vascular disease. Expert consensus statement on the diagnosis and treatment of <span class="hlt">paediatric</span> pulmonary hypertension. The European <span class="hlt">Paediatric</span> Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Lammers, Astrid E; Apitz, Christian; Zartner, Peter; Hager, Alfred; Dubowy, Karl-Otto; Hansmann, Georg</p> <p>2016-05-01</p> <p>Pulmonary hypertension (PH) is a condition of multiple aetiologies with underestimated prevalence and incidence. Indeed, despite access to modern therapies, pulmonary hypertensive vascular disease (PHVD) remains a progressive, usually life-limiting condition, severely <span class="hlt">impacting</span> on the patients' well-being. We herein provide <span class="hlt">practical</span>, expert consensus recommendations on the initial diagnostic work-up, clinical management and follow-up of children and adolescents with PH/PHVD, including a diagnostic algorithm. The major topics and methods that need to be tailored and put into context of the individual patient include PH classification, clinical signs and symptoms, basic diagnostic and advanced imaging measures (ECG, chest X-ray, transthoracic echocardiography, cardiac magnetic resonance, chest CT angiography, cardiac catheterisation, ventilation-perfusion lung scan, abdominal ultrasound), lung function tests, 6 min walk and cardiopulmonary exercise testing, sleep study (polysomnography), laboratory/immunological tests, considerations for elective surgery/ general anaesthesia, physical education and exercise, flying on commercial airplanes, vaccinations, care of central intravenous lines and palliative care. Due to the complexity of PH/PHVD, the clinical care has to be multidisciplinary and coordinated by a dedicated specialist <span class="hlt">paediatric</span> PH centre, not only to decrease mortality but to allow children with PH/PHVD to reach a reasonable quality of life. PMID:27053692</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22525415','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22525415"><span id="translatedtitle">An inconvenient truth: treatment of displaced <span class="hlt">paediatric</span> supracondylar humeral fractures.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Donnelly, M; Green, C; Kelly, I P</p> <p>2012-06-01</p> <p>The need for emergent management of displaced <span class="hlt">paediatric</span> supracondylar humeral fractures is being questioned in the literature. Open reduction rates of up to 46% have been reported in the non-emergent management of these injuries. At our institution these fractures are managed as operative emergencies by senior personnel. To examine the ongoing need for this policy we reviewed our results. All patients managed over a five year period with Gartland type IIB or III paeditric supracondylar humeral fractures were identified and a comprehensive chart and radiographic review undertaken. The mean time from injury to fracture reduction and stabilization was 6.6 h. Consultants performed or supervised 90% of cases. Open reduction was necessary in 5% of cases. Complications included a perioperative nerve injury rate of 6% and a superficial pin site infection rate of 3%. This study suggests that, despite the challenge to trauma on-call rostering, the emergency management of these injuries is advantageous to patients in units of our size. Based on the data presented here we continue our <span class="hlt">practice</span> of emergent management. We suggest that units of a similar size to our own would show a benefit from an analogous policy albeit an inconvenient truth. PMID:22525415</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4460874','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4460874"><span id="translatedtitle">The Detrimental <span class="hlt">Impact</span> of Maladaptive Personality on Public Mental Health: A Challenge for Psychiatric <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Hengartner, Michael Pascal</p> <p>2015-01-01</p> <p>Experts in personality psychology and personality disorders have long emphasized the pervasive and persistent detrimental <span class="hlt">impact</span> of maladaptive personality traits on mental health and functioning. However, in routine psychiatric <span class="hlt">practice</span>, maladaptive personality is readily ignored and personality traits are seldom incorporated into clinical guidelines. The aim of this narrative review is to outline how pervasively personality influences public mental health and how personality thereby challenges common psychiatric <span class="hlt">practice</span>. A comprehensive search and synthesis of the scientific literature demonstrates that maladaptive personality traits and personality disorders, in particular high neuroticism and negative affectivity, first, are risk factors for divorce, unemployment, and disability pensioning; second, relate to the prevalence, incidence, and co-occurrence of common mental disorders; third, impair functioning, symptom remission, and recovery in co-occurring common mental disorders; and fourth, predispose to treatment resistance, non-response and poor treatment outcome. In conclusion, maladaptive personality is not only involved in the development and course of mental disorders but also predisposes to chronicity and re-occurrence of psychopathology and reduces the efficacy of psychiatric treatments. The pernicious <span class="hlt">impact</span> of maladaptive personality on mental health and functioning demands that careful assessment and thorough consideration of personality should be compulsory in psychiatric <span class="hlt">practice</span>. PMID:26106335</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2014MS%26E...65a2028S&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2014MS%26E...65a2028S&link_type=ABSTRACT"><span id="translatedtitle"><span class="hlt">Impact</span> of Company Size on Manufacturing Improvement <span class="hlt">Practices</span>: An empirical study</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Syan, C. S.; Ramoutar, K.</p> <p>2014-07-01</p> <p>There is a constant search for ways to achieve a competitive advantage through new manufacturing techniques. Best performing manufacturing companies tend to use world-class manufacturing (WCM) <span class="hlt">practices</span>. Although the last few years have witnessed phenomenal growth in the use of WCM techniques, their effectiveness is not well understood specifically in the context of less developed countries. This paper presents an empirical study to investigate the <span class="hlt">impact</span> of company size on improving manufacturing performance in manufacturing organizations based in Trinidad and Tobago (T&T). Empirical data were collected via a questionnaire survey which was send to 218 manufacturing firms in T&T. Five different company sizes and seven different industry sectors were studied. The analysis of survey data was performed with the aid of Statistical Package for Social Sciences (SPSS) software. The study signified facilitating and impeding factors towards improving manufacturing performance. Their relative <span class="hlt">impact</span>/importance is dependent on varying company size and industry sectors. Findings indicate that T&T manufacturers are still <span class="hlt">practicing</span> traditional approaches, when compared with world class manufacturers. In the majority of organizations, these <span class="hlt">practices</span> were not 100% implemented even though they started the implementation process more than 5 years ago. The findings provided some insights in formulating more optimal operational strategies, and later develop action plans towards more effective implementation of WCM in T&T manufacturers.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3495402','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3495402"><span id="translatedtitle">The <span class="hlt">impact</span> of childhood acute rotavirus gastroenteritis on the parents’ quality of life: prospective observational study in European primary care medical <span class="hlt">practices</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2012-01-01</p> <p>Background Rotavirus (RV) is the commonest cause of acute gastroenteritis in infants and young children worldwide. A Quality of Life study was conducted in primary care in three European countries as part of a larger epidemiological study (SPRIK) to investigate the <span class="hlt">impact</span> of <span class="hlt">paediatric</span> rotavirus gastroenteritis (RVGE) on affected children and their parents. Methods A self-administered questionnaire was linguistically validated in Spanish, Italian and Polish. The questionnaire was included in an observational multicentre prospective study of 302 children aged <5 years presenting to a general practitioner or paediatrician for RVGE at centres in Spain, Italy or Poland. RV infection was confirmed by polymerase chain reaction (PCR) testing (n = 264). The questionnaire was validated and used to assess the emotional <span class="hlt">impact</span> of <span class="hlt">paediatric</span> RVGE on the parents. Results Questionnaire responses showed that acute RVGE in a child adversely affects the parents’ daily life as well as the child. Parents of children with RVGE experience worry, distress and <span class="hlt">impact</span> on their daily activities. RVGE of greater clinical severity (assessed by the Vesikari scale) was associated with higher parental worries due to symptoms and greater changes in the child’s behaviour, and a trend to higher <span class="hlt">impact</span> on parents’ daily activities and higher parental distress, together with a higher score on the symptom severity scale of the questionnaire. Conclusions Parents of a child with acute RVGE presenting to primary care experience worry, distress and disruptions to daily life as a result of the child’s illness. Prevention of this disease through prophylactic vaccination will improve the daily lives of parents and children. PMID:22650611</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22194438','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22194438"><span id="translatedtitle">Aspects of deceased organ donation in <span class="hlt">paediatrics</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Brierley, J; Hasan, A</p> <p>2012-01-01</p> <p>Organ transplantation offers children in acute or chronic severe organ failure similar opportunities to adults. However, while the number who might benefit is relatively low, significantly fewer cadaveric donors exist for any given child compared with an adult. Incompatible organ size and relatively low donation rates mean that despite living parental donation and innovations to reduce donated organ size, children die before organs become available. The severity of the UK situation is compounded by restrictions on <span class="hlt">paediatric</span> living donation, uncertainties over the application of brain death criteria, and ethical concerns about the use of donation after circulatory death. The UK Department of Health's Organ Donation Task Force suggested the means by which the adult donor pool might be increased, recommending that outstanding ethical and legal issues be resolved, but made no specific recommendations about children. PMID:22194438</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24644226','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24644226"><span id="translatedtitle">Retinal haemorrhages associated with fatal <span class="hlt">paediatric</span> infections.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Salvatori, Marcus C; Lantz, Patrick E</p> <p>2015-04-01</p> <p>For many physicians, retinal haemorrhages (RHs) in infants and young children remain highly diagnostic of non-accidental (abusive) head trauma. Because clinicians have applied indirect ophthalmoscopy selectively to cases of suspected child abuse, the association between RH and other conditions such as infection, coagulopathy and accidental trauma has encountered habitual bias, creating the potential for iatrogenic misdiagnosis of child abuse. We present an autopsy case series of four children, aged three years old or younger, in whom RHs were detected by post-mortem monocular indirect ophthalmoscopy after the patients had died from infections. We discuss the laterality, number, type and location of RHs in these cases, and summarize proposed mechanisms of RH formation in fatalities from <span class="hlt">paediatric</span> infection. We demonstrate that many of the ophthalmological findings that have been considered diagnostic of abusive head trauma can also occur in association with infective processes. PMID:24644226</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2013IJEEP..14..245L','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2013IJEEP..14..245L"><span id="translatedtitle">Commercial <span class="hlt">Impact</span> and Optimum Capacity Determination of Pumped Storage Hydro Plant for a <span class="hlt">Practical</span> Power System</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Latha, P. G.; Anand, S. R.; Imthias, Ahamed T. P.; Sreejith, P. S., Dr.</p> <p>2013-06-01</p> <p>This paper attempts to study the commercial <span class="hlt">impact</span> of pumped storage hydro plant on the operation of a stressed power system. The paper further attempts to compute the optimum capacity of the pumped storage scheme that can be provided on commercial basis for a <span class="hlt">practical</span> power system. Unlike the analysis of commercial aspects of pumped storage scheme attempted in several papers, this paper is presented from the point of view of power system management of a <span class="hlt">practical</span> system considering the <span class="hlt">impact</span> of the scheme on the economic operation of the system. A realistic case study is presented as the many factors that influence the pumped storage operation vary widely from one system to another. The suitability of pumped storage for the particular generation mix of a system is well explored in the paper. To substantiate the economic <span class="hlt">impact</span> of pumped storage on the system, the problem is formulated as a short-term hydrothermal scheduling problem involving power purchase which optimizes the quantum of power to be scheduled and the duration of operation. The optimization model is formulated using an algebraic modeling language, AMPL, which is then solved using the advanced MILP solver CPLEX.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4259013','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4259013"><span id="translatedtitle">Arts <span class="hlt">practice</span> and disconnected youth in Australia: <span class="hlt">Impact</span> and domains of change</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Wright, Peter; Davies, Christina; Haseman, Brad; Down, Barry; White, Mike; Rankin, Scott</p> <p>2013-01-01</p> <p>Background: This paper describes research conducted with Big hART, Australia's most awarded participatory arts company. It considers three projects, LUCKY, GOLD and NGAPARTJI NGAPARTJI across separate sites in Tasmania, Western NSW and Northern Territory, respectively, in order to understand project <span class="hlt">impact</span> from the perspective of project participants, Arts workers, community members and funders. Methods: Semi-structured interviews were conducted with 29 respondents. The data were coded thematically and analysed using the constant comparative method of qualitative data analysis. Results: Seven broad domains of change were identified: psychosocial health; community; agency and behavioural change; the Art; economic effect; learning and identity. Conclusions: Experiences of participatory arts are interrelated in an ecology of <span class="hlt">practice</span> that is iterative, relational, developmental, temporal and contextually bound. This means that questions of <span class="hlt">impact</span> are contingent, and there is no one path that participants travel or single measure that can adequately capture the richness and diversity of experience. Consequently, it is the productive tensions between the domains of change that are important and the way they are animated through Arts <span class="hlt">practice</span> that provides sign posts towards the <span class="hlt">impact</span> of Big hART projects. PMID:25530802</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4371534','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4371534"><span id="translatedtitle">Adverse drug reactions and off-label and unlicensed medicines in children: a prospective cohort study of unplanned admissions to a <span class="hlt">paediatric</span> hospital</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Bellis, Jennifer R; Kirkham, Jamie J; Nunn, Anthony J; Pirmohamed, Munir</p> <p>2014-01-01</p> <p>Aims To examine the <span class="hlt">impact</span> of off-label and unlicensed (OLUL) prescribing on adverse drug reactions (ADRs) causing unplanned admissions to a <span class="hlt">paediatric</span> hospital. Methods Prescription data from a 12 month prospective cohort study of ADRs detected in children admitted to a <span class="hlt">paediatric</span> hospital were scrutinized. The relative risk for off-label and unlicensed medicines being implicated in an ADR was calculated. Logistic regression analyses were carried out with exposure to off-label and unlicensed medicines and number of off-label and unlicensed medicines administered as predictor variables. Results Off-label and unlicensed medicines were more likely to be implicated in an ADR than authorized medicines (relative risk 1.67, 95% CI 1.38, 2.02, P < 0.001). There was a 25% increase in ADR risk (95% CI 1.16, 1.35, P < 0.001) with each additional authorized medicine and 23% (95% CI 1.10, 1.36, P < 0.001) with each additional off-label or unlicensed medicine. Logistic regression analysis focusing on non-oncology patients demonstrated that the number of authorized medicines (odds ratio 1.33, 95% CI 1.23, 1.44, P < 0.001), but not the number of off-label and unlicensed medicine courses, was a predictor of ADR risk. Conclusions In a heterogeneous population of children admitted to a secondary/tertiary hospital, off-label and unlicensed medicines are more likely to be implicated in an ADR than authorized medicines. This was largely driven by ADRs related to drugs used in oncological <span class="hlt">practice</span>, where the usage of off-label or unlicensed medicines was associated with a higher ADR risk than in non-oncological areas. PMID:23919928</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25239008','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25239008"><span id="translatedtitle">What can volunteer co-providers contribute to health systems? The role of people living with HIV in the Thai <span class="hlt">paediatric</span> HIV programme.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Tulloch, Olivia; Taegtmeyer, Miriam; Ananworanich, Jintanat; Chasombat, Sanchai; Kosalaraksa, Pope; Theobald, Sally</p> <p>2015-11-01</p> <p>In Thailand people living with HIV (PLHIV) have played a major role in shaping policy and <span class="hlt">practice</span>. They have acted as volunteer co-providers, although their potential in terms of <span class="hlt">paediatric</span> service provision has seldom been explored from a health systems perspective. We describe the Thai <span class="hlt">paediatric</span> HIV care system and use both demand- and supply-side perspectives to explore the <span class="hlt">impact</span>, opportunities and challenges of PLHIV acting as volunteer co-providers. We employed qualitative methods to assess experiences and perceptions and triangulate stakeholder perspectives. Data were collected in Khon Kaen province, in the poorest Northeastern region of Thailand: three focus group discussions and two workshops (total participants n = 31) with co-providers and hospital staff; interviews with ART service-users (n = 35). Nationally, key informant interviews were conducted with policy actors (n = 20). Volunteer co-providers were found to be ideally placed to broker the link between clinic and communities for HIV infected children and played an important part in the vital psychosocial support component of HIV care. As co-providers they were recognized as having multiple roles linking and delivering services in clinics and communities. Clear emerging needs include strengthened coordination and training as well as strategies to support funding. Using motivated volunteers with a shared HIV status as co-providers for specific clinical services can contribute to strengthening health systems in Asia; they are critical players in delivering care (supply side) and being responsive to service-users needs (demand side). Co-providers blur the boundaries between these two spheres. Sustaining and optimising co-providers' contribution to health systems strengthening requires a health systems approach. Our findings help to guide policy makers and service providers on how to balance clinical priorities with psycho-social responsiveness and on how best to integrate the views and</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26249644','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26249644"><span id="translatedtitle">Standard instruction versus simulation: Educating registered nurses in the early recognition of patient deterioration in <span class="hlt">paediatric</span> critical care.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>O'Leary, Jessica; Nash, Robyn; Lewis, Peter</p> <p>2016-01-01</p> <p>Identifying and stabilising deterioration in a child with significant clinical compromise is both a challenging and necessary role of the <span class="hlt">paediatric</span> critical care nurse. Within adult critical care research, high fidelity patient simulation (HFPS) has been shown to positively <span class="hlt">impact</span> learner outcomes regarding identification and management of a deteriorating patient; however, there is a paucity of evidence examining the use of HFPS in <span class="hlt">paediatric</span> nursing education. The aim of this study was to investigate the effect of HFPS on nurses' self-efficacy and knowledge for recognising and managing <span class="hlt">paediatric</span> deterioration. Further, participants' perceptions of the learning experiences specific to the identification and management of a deteriorating child were also explored. Registered nurses working in a tertiary-referral <span class="hlt">paediatric</span> critical care unit were recruited for this quasi-experimental study. Using a pre-test/post-test control-group design, participants were assigned to one of two learning experiences: HFPS or standard instruction. Following the learning experience, nurses were also invited to participate in semi-structured interviews. 30 nurses participated in the study (control n=15, experiment n=15). Participants in the HFPS intervention were most likely to demonstrate an increase in both perceived self-efficacy (p=<0.01) and knowledge (p=<0.01). No statistically significant change was observed in control group scores. The mean difference in self-efficacy gain score between the two groups was 5.67 score units higher for the experiment group compared to the control. HFPS also yielded higher follow-up knowledge scores (p=0.01) compared to standard instruction. Ten nurses participated in semi-structured interviews. Thematic analysis of the interview data identified four themes: self-awareness, hands-on learning, teamwork, and maximising learning. The results of this study suggest that HFPS can positively influence nurses' self-efficacy and knowledge test scores</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/8918151','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/8918151"><span id="translatedtitle">Immunity to hepatitis A in <span class="hlt">paediatric</span> and nursery nurses.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Poole, C J; Shakespeare, A T</p> <p>1996-10-01</p> <p>A cross-sectional epidemiological survey of immunity to the hepatitis A virus (HAV) was undertaken in <span class="hlt">paediatric</span> and nursery nurses to ascertain whether these occupational groups were at an increased risk of infection with the virus. Seropositivity to HAV was measured in 33 surgical (control), 36 <span class="hlt">paediatric</span>, 55 nursery and 29 specialist <span class="hlt">paediatric</span> nurses in a district general hospital, community clinics and a children's hospital in the West Midlands. IgG antibodies to HAV were found in 27% of surgical (control), 31% of <span class="hlt">paediatric</span> (relative risk [RR] = 1.19, 95% confidence interval [Cl] = 0.56-2.51), 26% of nursery nurses (RR = 0.99, Cl = 0.48-2.04) and 10% of specialist <span class="hlt">paediatric</span> nurses (RR = 0.40, Cl = 0.12-1.35). These data are comparable to immunity to HAV for this age group in the general population of this country and do not support routine immunization of <span class="hlt">paediatric</span> or nursery nurses against HAV. PMID:8918151</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/23076360','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/23076360"><span id="translatedtitle">The <span class="hlt">impact</span> of case mix on timely access to appointments in a primary care group <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Ozen, Asli; Balasubramanian, Hari</p> <p>2013-06-01</p> <p>At the heart of the <span class="hlt">practice</span> of primary care is the concept of a physician panel. A panel refers to the set of patients for whose long term, holistic care the physician is responsible. A physician's appointment burden is determined by the size and composition of the panel. Size refers to the number of patients in the panel while composition refers to the case-mix, or the type of patients (older versus younger, healthy versus chronic patients), in the panel. In this paper, we quantify the <span class="hlt">impact</span> of the size and case-mix on the ability of a multi-provider <span class="hlt">practice</span> to provide adequate access to its empanelled patients. We use overflow frequency, or the probability that the demand exceeds the capacity, as a measure of access. We formulate problem of minimizing the maximum overflow for a multi-physician <span class="hlt">practice</span> as a non-linear integer programming problem and establish structural insights that enable us to create simple yet near optimal heuristic strategies to change panels. This optimization framework helps a <span class="hlt">practice</span>: (1) quantify the imbalances across physicians due to the variation in case mix and panel size, and the resulting effect on access; and (2) determine how panels can be altered in the least disruptive way to improve access. We illustrate our methodology using four test <span class="hlt">practices</span> created using patient level data from the primary care <span class="hlt">practice</span> at Mayo Clinic, Rochester, Minnesota. An important advantage of our approach is that it can be implemented in an Excel Spreadsheet and used for aggregate level planning and panel management decisions. PMID:23076360</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4809729','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4809729"><span id="translatedtitle">Does research through Structured Operational Research and Training (SORT IT) courses <span class="hlt">impact</span> policy and <span class="hlt">practice</span>?</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Shewade, H. D.; Tripathy, J. P.; Guillerm, N.; Tayler-Smith, K.; Berger, S. Dar; Bissell, K.; Reid, A. J.; Zachariah, R.; Harries, A. D.</p> <p>2016-01-01</p> <p>Setting: Structured Operational Research and Training Initiative (SORT IT) courses are well known for their output, with nearly 90% of participants completing the course and publishing in scientific journals. Objective: We assessed the <span class="hlt">impact</span> of research papers on policy and <span class="hlt">practice</span> that resulted from six SORT IT courses initiated between July 2012 and March 2013. Design: This was a cross-sectional study involving e-mail-based, self-administered questionnaires and telephone/skype/in-person responses from first and/or senior co-authors of course papers. A descriptive content analysis of the responses was performed and categorised into themes. Results: Of 72 participants, 63 (88%) completed the course. Course output included 81 submitted papers, of which 76 (94%) were published. Of the 81 papers assessed, 45 (55%) contributed to a change in policy and/or <span class="hlt">practice</span>: 29 contributed to government policy/<span class="hlt">practice</span> change (20 at national, 4 at subnational and 5 at hospital level), 11 to non-government organisational policy change and 5 to reinforcing existing policy. The changes ranged from modifications of monitoring and evaluation tools, to redrafting of national guidelines, to scaling up existing policies. Conclusion: More than half of the SORT IT course papers contributed to a change in policy and/or <span class="hlt">practice</span>. Future assessments should include more robust and independent verification of the reported change(s) with all stakeholders. PMID:27051612</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25658974','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25658974"><span id="translatedtitle">Mindfulness and False-Memories: The <span class="hlt">Impact</span> of Mindfulness <span class="hlt">Practice</span> on the DRM Paradigm.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Rosenstreich, Eyal</p> <p>2016-01-01</p> <p>Mindfulness <span class="hlt">practice</span> is the cultivation of awareness to the present moment and has been shown in recent years to have beneficial effects on cognition. However, to date, the data regarding the <span class="hlt">impact</span> of mindfulness on memory--and specifically on memory distortions--is scarce and incomplete. The present study was aimed to examine whether mindfulness <span class="hlt">practice</span> would have an effect on true and false memories. To this end, the effect of mindfulness meditation <span class="hlt">practice</span> on memory performance was examined in two experiments in which false memories were provoked using the Deese-Roediger-McDermott (DRM) paradigm (Roediger & McDermott, 1995). In Experiment 1, college students were randomly divided into either a 5-week mindfulness-<span class="hlt">practice</span> group (n = 29) or a waitlist control group (n = 22). In Experiment 2, college students were randomly divided into either a brief mindfulness session (n = 21) or a mind-wandering control group (n = 19). The results indicated that mindfulness increased the recognition of true memories with no effect on spontaneous false-memories, yet increased the rate of provoked false-memories. These findings are discussed in terms of memory sensitivity and response bias, and it is argued that mindfulness may have a lesser effect on encoding processes than previously suggested. PMID:25658974</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22668921','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22668921"><span id="translatedtitle">Our surgical heritage: the role of the Department of <span class="hlt">Paediatric</span> Surgery in the development of <span class="hlt">paediatric</span> surgery in Cape Town, in Africa, and around the world.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Rode, Heinz; Millar, Alastair J W</p> <p>2012-06-01</p> <p>The Department of <span class="hlt">Paediatric</span> Surgery at the University of Cape Town has made a remarkable contribution to the academic body of knowledge of <span class="hlt">Paediatric</span> Surgery both in South Africa and around the world. It has played a key role in the development of the specialty in South Africa and through the South African diaspora has trained many <span class="hlt">paediatric</span> surgeons who have made their mark internationally. More recently it has become a major focus of teaching and training for African <span class="hlt">paediatric</span> surgeons. This article traces this legacy through its origins in the early 1920s to its current prominent position in the world <span class="hlt">paediatric</span> surgical community. PMID:22668921</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=308412&keyword=flooding&actType=&TIMSType=+&TIMSSubTypeID=&DEID=&epaNumber=&ntisID=&archiveStatus=Both&ombCat=Any&dateBeginCreated=&dateEndCreated=&dateBeginPublishedPresented=&dateEndPublishedPresented=&dateBeginUpdated=&dateEndUpdated=&dateBeginCompleted=&dateEndCompleted=&personID=&role=Any&journalID=&publisherID=&sortBy=revisionDate&count=50&CFID=65344628&CFTOKEN=77286153','EPA-EIMS'); return false;" href="http://cfpub.epa.gov/si/si_public_record_report.cfm?dirEntryId=308412&keyword=flooding&actType=&TIMSType=+&TIMSSubTypeID=&DEID=&epaNumber=&ntisID=&archiveStatus=Both&ombCat=Any&dateBeginCreated=&dateEndCreated=&dateBeginPublishedPresented=&dateEndPublishedPresented=&dateBeginUpdated=&dateEndUpdated=&dateBeginCompleted=&dateEndCompleted=&personID=&role=Any&journalID=&publisherID=&sortBy=revisionDate&count=50&CFID=65344628&CFTOKEN=77286153"><span id="translatedtitle">Automated Geospatial Watershed Assessment Tool (AGWA): Applications for Assessing the <span class="hlt">Impact</span> of Urban Growth and the use of Low <span class="hlt">Impact</span> Development <span class="hlt">Practices</span>.</span></a></p> <p><a target="_blank" href="http://oaspub.epa.gov/eims/query.page">EPA Science Inventory</a></p> <p></p> <p></p> <p>New tools and functionality have been incorporated into the Automated Geospatial Watershed Assessment Tool (AGWA) to assess the <span class="hlt">impact</span> of urban growth and evaluate the effects of low <span class="hlt">impact</span> development (LID) <span class="hlt">practices</span>. AGWA (see: www.tucson.ars.ag.gov/agwa or http://www.epa.gov...</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25647440','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25647440"><span id="translatedtitle">The <span class="hlt">impact</span> of non-economic damages caps on obstetrics: incentives versus <span class="hlt">practice</span> style.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Cotet-Grecu, Anca</p> <p>2015-04-01</p> <p>This paper uses 1989-2010 county-level data to reexamine the effect of non-economic damages caps on the field of obstetrics. Previous literature found that caps on damages lead to both changes in the number of physicians and changes in treatment patterns. This paper investigates whether the changes in procedures are attributable to changes in incentives or to selection when new entrants could have a different <span class="hlt">practice</span> style than incumbents. First, I find that the relationship between non-economic damages caps and the number of physicians and procedures identified in previous literature is not robust to the inclusion of the newer policy changes. Second, over the period when such changes were observed, the <span class="hlt">impact</span> on procedures is concentrated in areas with the greatest changes in the number of obstetricians/gynecologists per capita, suggesting that most of the effect on procedures is driven by differences in <span class="hlt">practice</span> style between entrants and incumbents. PMID:25647440</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_14");'>14</a></li> <li><a href="#" onclick='return showDiv("page_15");'>15</a></li> <li class="active"><span>16</span></li> <li><a href="#" onclick='return showDiv("page_17");'>17</a></li> <li><a href="#" onclick='return showDiv("page_18");'>18</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_16 --> <div id="page_17" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_15");'>15</a></li> <li><a href="#" onclick='return showDiv("page_16");'>16</a></li> <li class="active"><span>17</span></li> <li><a href="#" onclick='return showDiv("page_18");'>18</a></li> <li><a href="#" onclick='return showDiv("page_19");'>19</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="321"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27152544','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27152544"><span id="translatedtitle">Evaluating the perceived <span class="hlt">impact</span> of an interprofessional childhood obesity course on competencies for collaborative <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Iachini, Aidyn L; Dunn, Brianne L; Blake, Christine; Blake, Elizabeth W</p> <p>2016-05-01</p> <p>Interprofessional education (IPE) is needed to prepare health professional students to address the complexities of childhood obesity in <span class="hlt">practice</span>. This mixed-method study sought to evaluate the perceived <span class="hlt">impact</span> of a childhood obesity IPE intervention on health professional students' collaborative competency development within two domains: roles/responsibilities and teams/teamwork. Fourteen health professional students participated in this mixed-methods study. Quantitative data were collected through pre/post surveys, while qualitative data were collected through reflection assignments. Survey findings indicated that students reported significant increases in growth within both interprofessional competency domains. Qualitative data elaborated on the types of learning students experienced relative to each domain. Implications of this study for research and <span class="hlt">practice</span> related to IPE to address complex health issues, such as childhood obesity, are shared. PMID:27152544</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2443242','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2443242"><span id="translatedtitle">Cities of Consumption: The <span class="hlt">Impact</span> of Corporate <span class="hlt">Practices</span> on the Health of Urban Populations</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Galea, Sandro</p> <p>2008-01-01</p> <p>The increasing concentration of the world’s population in cities and the growing accumulation of political and economic power by corporations create new threats to health and opportunities for improving global health. By considering the intersection of these two fundamental social determinants of well-being, we elucidate some of the mechanisms by which they influence the health of urban populations. After reviewing the changing historical <span class="hlt">impact</span> of corporations on cities, we focus on the growth of consumption as a leading cause of mortality and morbidity and describe how the food, tobacco, automobile, and other industries promote unhealthy behaviors and lifestyles in urban settings. Cities are also sites for developing alternatives to unhealthy corporate <span class="hlt">practices</span>, and we assess strategies used to modify <span class="hlt">practices</span> that harm health. PMID:18437582</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4245599','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4245599"><span id="translatedtitle">Advancing Efforts to Achieve Health Equity: Equity Metrics for Health <span class="hlt">Impact</span> Assessment <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Heller, Jonathan; Givens, Marjory L.; Yuen, Tina K.; Gould, Solange; Benkhalti Jandu, Maria; Bourcier, Emily; Choi, Tim</p> <p>2014-01-01</p> <p>Equity is a core value of Health <span class="hlt">Impact</span> Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA <span class="hlt">practice</span>. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the <span class="hlt">impacts</span> of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA <span class="hlt">practice</span>. These metrics also intend to further push the field to deepen its <span class="hlt">practice</span> and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health <span class="hlt">Impact</span> Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric. PMID:25347193</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26215296','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26215296"><span id="translatedtitle">Spirituality and Aging in Place: The <span class="hlt">Impact</span> of Extreme Climatic Conditions on Domestic Gardening <span class="hlt">Practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Adams, Joanne; Pascal, Jan; Dickson-Swift, Virginia</p> <p>2014-12-01</p> <p>There is limited research exploring how domestic water restrictions imposed as a result of drought conditions <span class="hlt">impact</span> upon the lives of independently living older people. Within this age group (60 years plus), the domestic garden frequently forms an intrinsic component of ongoing health and well-being. Gardening <span class="hlt">practice</span> offers components of both mental and physical activity and, for many older people, leads to emotional and spiritual connection on a number of levels. The capacity of older people to maintain a garden during a period of water restrictions is greatly reduced, and the resulting <span class="hlt">impact</span> on health and well-being is considerable. A recent study, conducted in south-eastern Australia, aimed to determine the benefits to health and well-being of maintaining a domestic garden for older people and the <span class="hlt">impact</span> of water restrictions on garden <span class="hlt">practice</span>. This occurred at a time following a prolonged period of drought and, in central Victoria, a complete ban on outside watering. In-depth qualitative interviews were conducted with 10 gardeners aged between 60 and 83 who had tended their garden over an extended period. The lived experience of gardening was explored through hermeneutic phenomenological analysis. Clear benefits to health and well-being were established, and yet, the essence of this experience lay in the capacity of gardeners to remain connected to their garden despite change. The crisis imposed by ongoing drought and restricted use of water generated a strong impetus for adaptation, resilience and acceptance of change. The spiritual nature of gardening <span class="hlt">practice</span> clearly emerged and appeared to intensify the experience of gardening and consolidate adaption to change on a number of levels. PMID:26215296</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3774008','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3774008"><span id="translatedtitle">The Family Medicine Residency Training Initiative in Miscarriage Management: <span class="hlt">Impact</span> on <span class="hlt">Practice</span> in Washington State</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Darney, Blair G.; Weaver, Marcia R.; Stevens, Nancy; Kimball, Jeana; Prager, Sarah W.</p> <p>2013-01-01</p> <p>BACKGROUND AND OBJECTIVES Non-complicated spontaneous abortion cases should be counseled about the full range of management approaches, including uterine evacuation using manual vacuum aspiration (MVA). The Residency Training Initiative in Miscarriage Management (RTI-MM) is an intensive, multidimensional intervention designed to facilitate implementation of office-based management of spontaneous abortion using MVA in family medicine residency settings. The purpose of this study was to test the <span class="hlt">impact</span> of the RTI-MM on self-reported use of MVA for management of spontaneous abortion. METHODS We used a pretest/posttest one group study design and a web-based, anonymous survey to collect data on knowledge, attitudes, perceived barriers, and <span class="hlt">practice</span> of office-based management of spontaneous abortion. We used multivariable models to estimate incident relative risks and accounted for data clustering at the residency site level. RESULTS Our sample included 441 residents and faculty from 10 family medicine residency sites. Our findings show a positive association between the RTI-MM and self-reported use of MVA for management of spontaneous abortion (adjusted RR=9.11 [CI=4.20-19.78]) and were robust to model specification. Male gender, doing any type of management of spontaneous abortion (eg, expectant, medication), other on-site reproductive health training interventions, and support staff knowledge scores were also significant correlates of physician <span class="hlt">practice</span> of MVA. CONCLUSIONS Our findings suggest that the RTI-MM was successful in influencing the <span class="hlt">practice</span> of management of spontaneous abortion using MVA in this population and that support staff knowledge may <span class="hlt">impact</span> physician <span class="hlt">practice</span>. Integrating MVA into family medicine settings would potentially improve access to evidence-based, comprehensive care for women. PMID:23378077</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24251868','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24251868"><span id="translatedtitle"><span class="hlt">Paediatric</span> models in motion: requirements for model-based decision support at the bedside.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Barrett, Jeffrey S</p> <p>2015-01-01</p> <p>Optimal <span class="hlt">paediatric</span> pharmacotherapy is reliant on a detailed understanding of the individual patient including their developmental status and disease state as well as the pharmaceutical agents he/she is receiving for treatment or management of side effects. Our appreciation for size and maturation effects on the pharmacokinetic/pharmacodynamic (PK/PD) phenomenon has improved to the point that we can develop predictive models that permit us to individualize therapy, especially in the situation where we are monitoring drug effects or therapeutic concentrations. The growth of efforts to guide <span class="hlt">paediatric</span> pharmacotherapy via model-based decision support necessitates a coordinated and systematic approach to ensuring reliable and robust output to caregivers that represents the current standard of care and adheres to governance imposed by the host institution or coalition responsible. Model-based systems which guide caregivers on dosing <span class="hlt">paediatric</span> patients in a more comprehensive manner are in development at several institutions. Care must be taken that these systems provide robust guidance with the current best <span class="hlt">practice</span>. These systems must evolve as new information becomes available and ultimately are best constructed from diverse data representing global input on demographics, ethnic / racial diversity, diet and other lifestyle factors. Multidisciplinary involvement at the project team level is key to the ultimate clinical valuation. Likewise, early engagement of clinical champions is also critical for the success of model-based tools. Adherence to regulatory requirements as well as best <span class="hlt">practices</span> with respect to software development and testing are essential if these tools are to be used as part of the routine standard of care. PMID:24251868</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4294079','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4294079"><span id="translatedtitle"><span class="hlt">Paediatric</span> models in motion: requirements for model-based decision support at the bedside</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Barrett, Jeffrey S</p> <p>2015-01-01</p> <p>Optimal <span class="hlt">paediatric</span> pharmacotherapy is reliant on a detailed understanding of the individual patient including their developmental status and disease state as well as the pharmaceutical agents he/she is receiving for treatment or management of side effects. Our appreciation for size and maturation effects on the pharmacokinetic/pharmacodynamic (PK/PD) phenomenon has improved to the point that we can develop predictive models that permit us to individualize therapy, especially in the situation where we are monitoring drug effects or therapeutic concentrations. The growth of efforts to guide <span class="hlt">paediatric</span> pharmacotherapy via model-based decision support necessitates a coordinated and systematic approach to ensuring reliable and robust output to caregivers that represents the current standard of care and adheres to governance imposed by the host institution or coalition responsible. Model-based systems which guide caregivers on dosing <span class="hlt">paediatric</span> patients in a more comprehensive manner are in development at several institutions. Care must be taken that these systems provide robust guidance with the current best <span class="hlt">practice</span>. These systems must evolve as new information becomes available and ultimately are best constructed from diverse data representing global input on demographics, ethnic / racial diversity, diet and other lifestyle factors. Multidisciplinary involvement at the project team level is key to the ultimate clinical valuation. Likewise, early engagement of clinical champions is also critical for the success of model-based tools. Adherence to regulatory requirements as well as best <span class="hlt">practices</span> with respect to software development and testing are essential if these tools are to be used as part of the routine standard of care. PMID:24251868</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/377203','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/377203"><span id="translatedtitle">The <span class="hlt">practical</span> application of remediating soil <span class="hlt">impacted</span> by salt from produced water</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Cresswell, G.A.; Williams, O.W.</p> <p>1995-12-31</p> <p>In many geographical areas where crude oil is produced, saltwater is a natural by-product of the oil production stream. The dissolved solids of this produced saltwater varies significantly with geography. Often the higher salinity values are associated with produced water at secondary crude oil recovery waterfloods and on occasion with depletion-drive and water drive primary crude oil recovery. Secondary recovery methods, waterfloods, typically follow many years of primary crude oil production thereby extending the producing life another 20 to 40 years. Many of the major fields producing today have been on stream for more than 50 years. The historical actions associated with these operations, high salt concentrations of the water and the cumulative volumes of saltwater handled all combine to increase the environmental risk of adversely <span class="hlt">impacting</span> surface. This paper shares some of the experiences one company has encountered in an effort to assess and reduce the economic and environmental risks associated with salt <span class="hlt">impacted</span> soils at waterfloods. The focus of this paper is on the <span class="hlt">practical</span> aspects of identifying soil areas <span class="hlt">impacted</span> before the nationwide improvements in environmental requirements in the mid 1970s and improving the productivity of surface soils. It summarizes how successful remediation approaches have been aligned with soil characteristics and intended surface uses. Remediation approaches have included calcium/sodium exchange, fresh water flushing, and organic additives. Also presented are the precautions used to make sure potential adverse <span class="hlt">impacts</span> from the salt are not passed from the soil to other media.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2011PhDT........98G&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2011PhDT........98G&link_type=ABSTRACT"><span id="translatedtitle">Assessing the <span class="hlt">Impact</span> of Lesson Study on the Teaching <span class="hlt">Practice</span> of Middle School Science Teachers</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Grove, Michael C.</p> <p></p> <p>Despite wave after wave of educational reform in the United States our students continue to lag behind their peers in other industrialized countries on virtually all measures of academic achievement. Effective professional development (PD) is seen as a key to improving instructional <span class="hlt">practice</span> and therefore student learning, but traditional forms of PD have been wholly unsuccessful in changing teaching <span class="hlt">practice</span>. Over the last two decades an emerging body of research has identified some key features of effective PD that seem to create meaningful change and improvement in instructional <span class="hlt">practice</span>. Some of this research highlights the promise of adapting Japanese lesson study (LS) to the American context as a means of incrementally improving instruction. Much of the existing research around LS is descriptive in nature and offers little insight into if and how participation in LS <span class="hlt">impacts</span> subsequent instructional <span class="hlt">practice</span>. This study utilized case study methodology to examine the instructional <span class="hlt">practice</span> of one group of four middle school science teachers before, during, and after participation in LS. The study attempted to identify specific learning outcomes of a LS process, to identify influences on teacher learning during LS, and to identify subsequent changes in the instructional <span class="hlt">practice</span> of participants resulting from participation in LS. Key findings from the study include significant teacher learning derived from the LS process, the identification of influences that enhanced or inhibited teacher learning, and clear evidence that participants successfully integrated learning from the LS into subsequent instructional <span class="hlt">practice</span>. Learning outcomes included deepening of subject matter knowledge, increased understanding of student thinking and abilities, clarity of expectations for student performance, recognition of the ineffectiveness of past instructional <span class="hlt">practice</span>, specific instructional strategies, shared student learning goals, and an increased commitment to future</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/19413050','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/19413050"><span id="translatedtitle"><span class="hlt">Practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Chambers, David W</p> <p>2008-01-01</p> <p><span class="hlt">Practice</span> refers to a characteristic way professionals use common standards to customize solutions to a range of problems. <span class="hlt">Practice</span> includes (a) standards for outcomes and processes that are shared with one's colleagues, (b) a rich repertoire of skills grounded in diagnostic acumen, (c) an ability to see the actual and the ideal and work back and forth between them, (d) functional artistry, and (e) learning by doing that transcends scientific rationality. Communities of <span class="hlt">practice</span>, such as dental offices, are small groups that work together in interlocking roles to achieve these ends. PMID:19413050</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2015AGUFM.H51O1615K','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2015AGUFM.H51O1615K"><span id="translatedtitle"><span class="hlt">Impact</span> of Uncertainty in SWAT Model Simulations on Consequent Decisions on Optimal Crop Management <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Krishnan, N.; Sudheer, K. P.; Raj, C.; Chaubey, I.</p> <p>2015-12-01</p> <p>The diminishing quantities of non-renewable forms of energy have caused an increasing interest in the renewable sources of energy, such as biofuel, in the recent years. However, the demand for biofuel has created a concern for allocating grain between the fuel and food industry. Consequently, appropriate regulations that limit grain based ethanol production have been developed and are put to <span class="hlt">practice</span>, which resulted in cultivating perennial grasses like Switch grass and Miscanthus to meet the additional cellulose demand. A change in cropping and management <span class="hlt">practice</span>, therefore, is essential to cater the conflicting requirement for food and biofuel, which has a long-term <span class="hlt">impact</span> on the downstream water quality. Therefore it is essential to implement optimal cropping <span class="hlt">practices</span> to reduce the pollutant loadings. Simulation models in conjunction with optimization procedures are useful in developing efficient cropping <span class="hlt">practices</span> in such situations. One such model is the Soil and Water Assessment Tool (SWAT), which can simulate both the water and the nutrient cycle, as well as quantify long-term <span class="hlt">impacts</span> of changes in management <span class="hlt">practice</span> in the watershed. It is envisaged that the SWAT model, along with an optimization algorithm, can be used to identify the optimal cropping pattern that achieves the minimum guaranteed grain production with less downstream pollution, while maximizing the biomass production for biofuel generation. However, the SWAT simulations do have a certain level of uncertainty that needs to be accounted for before making decisions. Therefore, the objectives of this study are twofold: (i) to understand how model uncertainties influence decision-making, and (ii) to develop appropriate management scenarios that account the uncertainty. The simulation uncertainty of the SWAT model is assessed using Shuffled Complex Evolutionary Metropolis Algorithm (SCEM). With the data collected from St. Joseph basin, IN, USA, the preliminary results indicate that model</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4604087','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4604087"><span id="translatedtitle">Understanding Market Size and Reporting Gaps for <span class="hlt">Paediatric</span> TB in Indonesia, Nigeria and Pakistan: Supporting Improved Treatment of Childhood TB in the Advent of New Medicines</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2015-01-01</p> <p>Objective of the Study We sought to understand gaps in reporting childhood TB cases among public and private sector health facilities (dubbed “non-NTP” facilities) outside the network of national TB control programmes, and the resulting <span class="hlt">impact</span> of under-reporting on estimates of <span class="hlt">paediatric</span> disease burden and market demand for new medicines. Methodology Exploratory assessments were carried out in Indonesia, Nigeria and Pakistan, reaching a range of facility types in two selected areas of each country. Record reviews and interviews of healthcare providers were carried out to assess numbers of unreported <span class="hlt">paediatric</span> TB cases, diagnostic pathways followed and treatment regimens prescribed. Main Findings A total of 985 unreported diagnosed <span class="hlt">paediatric</span> TB cases were identified over a three month period in 2013 in Indonesia from 64 facilities, 463 in Pakistan from 35 facilities and 24 in Nigeria from 20 facilities. These represent an absolute additional annualised yield to 2013 notifications reported to WHO of 15% for Indonesia, 2% for Nigeria and 7% for Pakistan. Only 12% of all facilities provided age and sex-disaggregated data. Findings highlight the challenges of confirming childhood TB. Diagnosis patterns in Nigeria highlight a very low suspicion for childhood TB. Providers note the need for <span class="hlt">paediatric</span> medicines aligned to WHO recommendations. Conclusion: How Market Data Can Support Better Public Health Interventions This study emphasises the <span class="hlt">impact</span> of incomplete reporting on the estimation of disease burden and potential market size of <span class="hlt">paediatric</span> TB medicines. Further studies on “hubs” (facilities treating large numbers of childhood TB cases) will improve our understanding of the epidemic, support introduction efforts for new treatments and better measure markets for new <span class="hlt">paediatric</span> medicines. PMID:26460607</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=climate+AND+area&pg=2&id=ED520555','ERIC'); return false;" href="http://eric.ed.gov/?q=climate+AND+area&pg=2&id=ED520555"><span id="translatedtitle">Principals' Perceptions of Superintendents' Leadership <span class="hlt">Practices</span> and Its <span class="hlt">Impact</span> on School Climate in Selected South Florida Public School District Areas</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>McFarlane, Donovan A.</p> <p>2010-01-01</p> <p>Purpose: This research study sought to determine the leadership <span class="hlt">practices</span> of area superintendents in selected South Florida public school district areas based on principals' perceptions and assess school climate <span class="hlt">impact</span> using descriptive and inferential approaches. Methodology: The "Leadership <span class="hlt">Practices</span> Inventory" ("LPI") 360 Online was used…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=boy&pg=7&id=EJ1016884','ERIC'); return false;" href="http://eric.ed.gov/?q=boy&pg=7&id=EJ1016884"><span id="translatedtitle">Broken Voices or a Broken Curriculum? The <span class="hlt">Impact</span> of Research on UK School Choral <span class="hlt">Practice</span> with Boys</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Ashley, Martin R.</p> <p>2013-01-01</p> <p>Work such as that of John Cooksey on boys' changing voices has influenced choral <span class="hlt">practice</span> in the USA and in certain UK youth choirs, but has hitherto had little <span class="hlt">impact</span> in UK schools where many teachers continue to believe that boys' voices "break". Different <span class="hlt">practices</span> are found across the independent and maintained sectors of…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=literacy+AND+review&pg=5&id=ED524458','ERIC'); return false;" href="http://eric.ed.gov/?q=literacy+AND+review&pg=5&id=ED524458"><span id="translatedtitle">The <span class="hlt">Impact</span> of <span class="hlt">Practice</span> Test-Taking on NJ ASK 3, 4, and 5 Language Arts Scores</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Rohrman, Susan T.</p> <p>2011-01-01</p> <p>This study examined the effectiveness of a pilot program utilizing <span class="hlt">practice</span> standardized test questions for 3rd, 4th, and 5th graders in an economically disadvantaged school and evaluated the <span class="hlt">impact</span> of the pilot program on pre- and post-test <span class="hlt">practice</span> tests in language arts literacy and on the 2009 New Jersey Assessment of Skills and Knowledge…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=223974','TEKTRAN'); return false;" href="http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=223974"><span id="translatedtitle">Evalution of Long-Term <span class="hlt">Impacts</span> of Conservation <span class="hlt">Practice</span> Within the Little River Watershed Using the SWAT Model</span></a></p> <p><a target="_blank" href="http://www.ars.usda.gov/services/TekTran.htm">Technology Transfer Automated Retrieval System (TEKTRAN)</a></p> <p></p> <p></p> <p>The SWAT model was used to simulate the long-term <span class="hlt">impacts</span> of conservation <span class="hlt">practices</span> implemented within the South Georgia Little River Watershed on streamflow hydrology and water quality. Typical <span class="hlt">practices</span> which have been implemented within the watershed include nutrient management, residue manageme...</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=understanding+AND+space&pg=2&id=EJ995982','ERIC'); return false;" href="http://eric.ed.gov/?q=understanding+AND+space&pg=2&id=EJ995982"><span id="translatedtitle">Spaces in between Us: A Qualitative Study into the <span class="hlt">Impact</span> of Spatial <span class="hlt">Practice</span> when Learning in "Second Life"</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Savin-Baden, Maggi</p> <p>2013-01-01</p> <p>This paper will present a study that explored the perceived <span class="hlt">impact</span> of spatial <span class="hlt">practice</span> in "Second Life" (SL) on teaching and learning from the point of view of participants in higher education (lecturers, developers and researchers). Narrative inquiry was used to access stories and experiences of space and spatial <span class="hlt">practice</span> from staff perspectives.…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2636760','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2636760"><span id="translatedtitle">Inhaled corticosteroids for asthma: <span class="hlt">impact</span> of <span class="hlt">practice</span> level device switching on asthma control</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Thomas, Mike; Price, David; Chrystyn, Henry; Lloyd, Andrew; Williams, Angela E; von Ziegenweidt, Julie</p> <p>2009-01-01</p> <p>Background As more inhaled corticosteroid (ICS) devices become available, there may be pressure for health-care providers to switch patients with asthma to cheaper inhaler devices. Our objective was to evaluate <span class="hlt">impact</span> on asthma control of inhaler device switching without an accompanying consultation in general <span class="hlt">practice</span>. Methods This 2-year retrospective matched cohort study used the UK General <span class="hlt">Practice</span> Research Database to identify <span class="hlt">practices</span> where ICS devices were changed without a consultation for ≥5 patients within 3 months. Patients 6–65 years of age from these <span class="hlt">practices</span> whose ICS device was switched were individually matched with patients using the same ICS device who were not switched. Asthma control over 12 months after the switch was assessed using a composite measure including short-acting β-agonist and oral corticosteroid use, hospitalizations, and subsequent changes to therapy. Results A total of 824 patients from 55 <span class="hlt">practices</span> had a device switch and could be matched. Over half (53%) of device switches were from dry powder to metered-dose inhalers. Fewer patients in switched than matched cohort experienced successful treatment based on the composite measure (20% vs. 34%) and more experienced unsuccessful treatment (51% vs. 38%). After adjusting for possible baseline confounding factors, the odds ratio for treatment success in the switched cohort compared with controls was 0.29 (95% confidence interval [CI], 0.19 to 0.44; p < 0.001) and for unsuccessful treatment was 1.92 (95% CI, 1.47 to 2.56; p < 0.001). Conclusion Switching ICS devices without a consultation was associated with worsened asthma control and is therefore inadvisable. PMID:19121204</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24798609','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24798609"><span id="translatedtitle">Observational gait assessment tools in <span class="hlt">paediatrics</span>--a systematic review.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Rathinam, Chandrasekar; Bateman, Andrew; Peirson, Janet; Skinner, Jane</p> <p>2014-06-01</p> <p>Instrumented gait analysis (IGA) is an expensive technique used to objectively detect gait abnormalities in children. Observational gait assessment is considered as a cost effective alternate for IGA in regular clinical <span class="hlt">practice</span>. This article is aimed at systematically reviewing the available <span class="hlt">paediatric</span> gait analysis tools and examines their reliability and validity compared to IGA. This review also examines the structure of these tools, their clinical use and limitations. Articles were searched from PubMed, CINHL, AMED, BNI, EMBASE, PEDro and Cochrane library from the earliest record on the database to December 2012. Hand searches were carried out in a few journals. Studies that examined children's gait using a structured assessment tool were included and analysed for their quality, reliability and validity. Pre-established criteria were used to judge the quality of methodology and reliability and validity. Five observational gait tools for children with Cerebral Palsy (CP) and one for children with Downs Syndrome were identified. Nine studies related to children with CP were enrolled for this review. None of the tools have accomplished the level of IGA's consistency. Edinburgh Visual Gait Score (EVGS) was found to have better reliability and validity than the other tools. Very limited studies were available for most of the gait assessment tools therefore their clinical use cannot be judged based on the existing evidence. EVGS was found to have better concurrent validity and reliability and it should be considered to assess CP gait in regular <span class="hlt">practice</span>. Future work to investigate the use of low cost technology to improve observers' accuracy of EVGS is suggested. PMID:24798609</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2016PhDT........23A&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2016PhDT........23A&link_type=ABSTRACT"><span id="translatedtitle">Energy Market Transparency: Analyzing the <span class="hlt">Impacts</span> of Constraint Relaxation and Out-of-Market Correction <span class="hlt">Practices</span> in Electric Energy Markets</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Al-Abdullah, Yousef Mohammad</p> <p></p> <p>This work presents research on <span class="hlt">practices</span> in the day-ahead electric energy market, including replication <span class="hlt">practices</span> and reliability coordinators used by some market operators to demonstrate the <span class="hlt">impact</span> these <span class="hlt">practices</span> have on market outcomes. The <span class="hlt">practice</span> of constraint relaxations similar to those an Independent System Operator (ISO) might perform in day-ahead market models is implemented. The benefits of these <span class="hlt">practices</span> are well understood by the industry; however, the implications these <span class="hlt">practices</span> have on market outcomes and system security have not been thoroughly investigated. By solving a day-ahead market model with and without select constraint relaxations and comparing the resulting market outcomes and possible effects on system security, the effect of these constraint relaxation <span class="hlt">practices</span> is demonstrated. Proposed market solutions are often infeasible because constraint relaxation <span class="hlt">practices</span> and approximations that are incorporated into market models. Therefore, the dispatch solution must be corrected to ensure its feasibility. The <span class="hlt">practice</span> of correcting the proposed dispatch solution after the market is solved is known as out-of-market corrections (OMCs), defined as any action an operator takes that modifies a proposed day-ahead dispatch solution to ensure operating and reliability requirements. The way in which OMCs affect market outcomes is illustrated through the use of different corrective procedures. The objective of the work presented is to demonstrate the implications of these industry <span class="hlt">practices</span> and assess the <span class="hlt">impact</span> these <span class="hlt">practices</span> have on market outcomes.</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_15");'>15</a></li> <li><a href="#" onclick='return showDiv("page_16");'>16</a></li> <li class="active"><span>17</span></li> <li><a href="#" onclick='return showDiv("page_18");'>18</a></li> <li><a href="#" onclick='return showDiv("page_19");'>19</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_17 --> <div id="page_18" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_16");'>16</a></li> <li><a href="#" onclick='return showDiv("page_17");'>17</a></li> <li class="active"><span>18</span></li> <li><a href="#" onclick='return showDiv("page_19");'>19</a></li> <li><a href="#" onclick='return showDiv("page_20");'>20</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="341"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4743702','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4743702"><span id="translatedtitle">Clinical implications of reduced susceptibility to fluoroquinolones in <span class="hlt">paediatric</span> Shigella sonnei and Shigella flexneri infections</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Thompson, Corinne N.; Thieu, Nga Tran Vu; Vinh, Phat Voong; Duc, Anh Nguyen; Wolbers, Marcel; Vinh, Ha; Campbell, James I.; Ngoc, Dung Tran Thi; Hoang, Nguyen Van Minh; Thanh, Tuyen Ha; The, Hao Chung; Nguyen, To Nguyen Thi; Lan, Nguyen Phu Huong; Parry, Christopher M.; Chau, Nguyen Van Vinh; Thwaites, Guy; Thanh, Duy Pham; Baker, Stephen</p> <p>2016-01-01</p> <p>Objectives We aimed to quantify the <span class="hlt">impact</span> of fluoroquinolone resistance on the clinical outcome of <span class="hlt">paediatric</span> shigellosis patients treated with fluoroquinolones in southern Vietnam. Such information is important to inform therapeutic management for infections caused by this increasingly drug-resistant pathogen, responsible for high morbidity and mortality in young children globally. Methods Clinical information and bacterial isolates were derived from a randomized controlled trial comparing gatifloxacin with ciprofloxacin for the treatment of <span class="hlt">paediatric</span> shigellosis. Time–kill experiments were performed to evaluate the <span class="hlt">impact</span> of MIC on the in vitro growth of Shigella and Cox regression modelling was used to compare clinical outcome between treatments and Shigella species. Results Shigella flexneri patients treated with gatifloxacin had significantly worse outcomes than those treated with ciprofloxacin. However, the MICs of fluoroquinolones were not significantly associated with poorer outcome. The presence of S83L and A87T mutations in the gyrA gene significantly increased MICs of fluoroquinolones. Finally, elevated MICs and the presence of the qnrS gene allowed Shigella to replicate efficiently in vitro in high concentrations of ciprofloxacin. Conclusions We found that below the CLSI breakpoint, there was no association between MIC and clinical outcome in <span class="hlt">paediatric</span> shigellosis infections. However, S. flexneri patients had worse clinical outcomes when treated with gatifloxacin in this study regardless of MIC. Additionally, Shigella harbouring the qnrS gene are able to replicate efficiently in high concentrations of ciprofloxacin and we hypothesize that such strains possess a competitive advantage against fluoroquinolone-susceptible strains due to enhanced shedding and transmission. PMID:26679253</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/9927954','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/9927954"><span id="translatedtitle"><span class="hlt">Impact</span> of HIV on the <span class="hlt">practice</span> of dentistry in Houston, Texas.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Quartey, J B</p> <p>1998-11-01</p> <p>Texas ranks fourth in the nation in the number of documented HIV-infected and AIDS cases. The city of Houston has the highest prevalence of HIV-infected and AIDS cases in Texas. Dental health personnel have an ethical and legal obligation to provide dental services for HIV-infected persons. The purpose of this study was to assess the <span class="hlt">impact</span> of HIV on the <span class="hlt">practice</span> of dentistry in Houston. The study population was all dentists with a current Houston <span class="hlt">practice</span> address registered with the Texas State Dental Board. A 41-item questionnaire was mailed to a stratified random sample of 500 dentists in Houston. The questionnaire covered four main areas: demographics, knowledge, attitudes, and behavior. About three-quarters of the dentists said they had treated an AIDS or HIV+ patient. Sixty percent of the dentists were not aware that breastmilk is a mode of transmission of HIV. There was a significant correlation between "ever treated" an HIV+ patients and "willingness to treat" an AIDS or HIV+ patient (p < 0.01). The experience of treating HIV-infected patients has a greater <span class="hlt">impact</span> than knowledge alone in influencing dentists' behavior towards AIDS/HIV+ patients. PMID:9927954</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2013HESSD..1010313W','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2013HESSD..1010313W"><span id="translatedtitle">Indigenous vegetation burning <span class="hlt">practices</span> and their <span class="hlt">impact</span> on the climate of the northern Australian monsoon region</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Wyrwoll, K.-H.; McRobie, F. H.; Notaro, M.; Chen, G.</p> <p>2013-08-01</p> <p>Here we pose the question: was there a downturn in summer monsoon precipitation over northern Australia due to Aboriginal vegetation <span class="hlt">practices</span> over prehistoric time scales? In answering this question we consider the results from a global climate model incorporating ocean, land, ice, atmosphere and vegetation interactions, reducing the total vegetation cover over northern Australia by 20% to simulate the effects of burning. The results suggest that burning forests and woodlands in the monsoon region of Australia led to a shift in the regional climate, with a delayed monsoon onset and reduced precipitation in the months preceding the "full" monsoon. We place these results in a global context, drawing on model results from five other monsoon regions, and note that although the precipitation response is highly varied, there is a general but region specific climate response to reduced vegetation cover in all cases. Our findings lead us to conclude that large-scale vegetation modification over millennial time-scales due to indigenous burning <span class="hlt">practices</span>, would have had significant <span class="hlt">impacts</span> on regional climates. With this conclusion comes the need to recognise that the Anthropocene saw the <span class="hlt">impact</span> of humans on regional-scale climates and hydrologies at much earlier times than generally recognized.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=THESIS+AND+DOCTORAL&pg=5&id=EJ953720','ERIC'); return false;" href="http://eric.ed.gov/?q=THESIS+AND+DOCTORAL&pg=5&id=EJ953720"><span id="translatedtitle">The <span class="hlt">Impact</span> of Research Training and Research Codes of <span class="hlt">Practice</span> on Submission of Doctoral Degrees: An Exploratory Cohort Study</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Humphrey, Robin; Marshall, Neill; Leonardo, Laura</p> <p>2012-01-01</p> <p>The paper examines the <span class="hlt">impact</span> of the transformations in doctoral education in the arts, humanities and social sciences in the United Kingdom over the past decade. It focuses on the introduction of formal research training and codes of research <span class="hlt">practice</span> and in the first longitudinal candidate cohort study examines their <span class="hlt">impact</span> on doctoral outcomes,…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1312867','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1312867"><span id="translatedtitle">Prescribing behaviour in general <span class="hlt">practice</span>: the <span class="hlt">impact</span> of promoting therapeutically equivalent cheaper medicines.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Roberts, S J; Bateman, D N; Smith, J M</p> <p>1997-01-01</p> <p>BACKGROUND: The volume and cost of prescribing varies considerably between <span class="hlt">practices</span>. This variation is at least in part due to the prescribing behaviour of individual doctors, who are often faced with a range of therapeutically equivalent generic and brand-name drugs. AIM: To assess the <span class="hlt">impact</span> on general practitioners' prescribing behaviour of promoting therapeutically equivalent lower cost prescribing in conjunction with an incentive scheme. METHOD: Annual prescribing data from before (1992-93) and after (1993-94) implementation of the incentive scheme were compared retrospectively for general <span class="hlt">practices</span> in the former Northern Regional Health Authority. Main outcome measures were the <span class="hlt">practices</span>' 1993-94 rates of prescribing relative to those in 1992-93 for 18 drugs prescribed by brand name, of which 10 were targeted in the promotion, and for 14 drugs or classes of drugs either with equivalent cheaper alternatives or of limited clinical value (10 targeted and four not). RESULTS: For 17 of the 18 drugs, brand name prescribing rates were significantly lower in 1993-94. Reductions in rates were greater for the 10 drugs appearing in the scheme's promotional literature. For other cost-saving measures, total prescribing rates were lower for seven classes of drugs, unchanged for one, but higher for the other six, all of which had been targeted. According to the growth in their overall per capita prescribing costs between the two study years, the 499 <span class="hlt">practices</span> were categorized as low, average or high. Overall costs and individual prescribing rates for the majority of drugs studied were similar for these three <span class="hlt">practice</span> groups in 1992-93. In 1993-94, <span class="hlt">practices</span>' changes in prescribing volume differed between the groups, with the lowest increases in the low cost-growth group for all but one of the 32 classes of drugs. CONCLUSION: Generic substitution was more easily implemented than more complex hints regarding cost-saving substitutions. <span class="hlt">Practices</span> with smaller overall cost</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2890072','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2890072"><span id="translatedtitle">Assessing the burden of <span class="hlt">paediatric</span> influenza in Europe: the European <span class="hlt">Paediatric</span> Influenza Analysis (EPIA) project</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Paget, W. John; Casas, Inmaculada; Donker, Gé; Edelman, Laurel; Fleming, Douglas; Larrauri, Amparo; Meijer, Adam; Puzelli, Simona; Rizzo, Caterina; Simonsen, Lone</p> <p>2010-01-01</p> <p>The European <span class="hlt">Paediatric</span> Influenza Analysis (EPIA) project is a multi-country project that was created to collect, analyse and present data regarding the <span class="hlt">paediatric</span> influenza burden in European countries, with the purpose of providing the necessary information to make evidence-based decisions regarding influenza immunisation recommendations for children. The initial approach taken is based on existing weekly virological and age-specific influenza-like illness (ILI) data from surveillance networks across Europe. We use a multiple regression model guided by longitudinal weekly patterns of influenza virus to attribute the weekly ILI consultation incidence pattern to each influenza (sub)type, while controlling for the effect of respiratory syncytial virus (RSV) epidemics. Modelling the ILI consultation incidence during 2002/2003–2008 revealed that influenza infections that presented for medical attention as ILI affected between 0.3% and 9.8% of children aged 0–4 and 5–14 years in England, Italy, The Netherlands and Spain in an average season. With the exception of Spain, these rates were always higher in children aged 0–4 years. Across the six seasons analysed (five seasons were analysed from the Italian data), the model attributed 47–83% of the ILI burden in primary care to influenza virus infection in the various countries, with the A(H3N2) virus playing the most important role, followed by influenza viruses B and A(H1N1). National season averages from the four countries studied indicated that between 0.4% and 18% of children consulted a physician for ILI, with the percentage depending on the country and health care system. Influenza virus infections explained the majority of <span class="hlt">paediatric</span> ILI consultations in all countries. The next step will be to apply the EPIA modelling approach to severe outcomes indicators (i.e. hospitalisations and mortality data) to generate a complete range of mild and severe influenza burden estimates needed for decision making</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26207673','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26207673"><span id="translatedtitle">The <span class="hlt">impact</span> of <span class="hlt">practical</span> support on parental bereavement: Reflections from a study involving parents bereaved through military death.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Rolls, Liz; Harper, Mairi</p> <p>2016-01-01</p> <p>This article, drawing on data from a wider study, describes the <span class="hlt">impact</span> that U.K. bereaved military parents ascribe to the <span class="hlt">practical</span> support (help with home and garden maintenance) that they received following the death of their son. The type of <span class="hlt">practical</span> support offered to parents has had a wide-ranging and significant <span class="hlt">impact</span> on them. In addition to helping them find meaning and maintain continuing bonds, this form of support contributed to their capacity to engage in restoration-focused coping. As a symbolic resource, this type of <span class="hlt">practical</span> support may be a significant moderator of distress in the psychosocial transition of bereavement. PMID:26207673</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4988676','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4988676"><span id="translatedtitle">The <span class="hlt">Impact</span> of the Nursing <span class="hlt">Practice</span> Environment on Missed Nursing Care</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Hessels, Amanda J.; Flynn, Linda; Cimiotti, Jeannie P.; Cadmus, Edna; Gershon, Robyn R.M.</p> <p>2016-01-01</p> <p>Objectives Missed nursing care is an emerging problem negatively <span class="hlt">impacting</span> patient outcomes. There are gaps in our knowledge of factors associated with missed nursing care. The aim of this study was to determine the relationship between the nursing <span class="hlt">practice</span> environment and missed nursing care in acute care hospitals. Methods This is a secondary analysis of cross sectional data from a survey of over 7.000 nurses from 70 hospitals on workplace and process of care. Ordinary least squares and multiple regression models were constructed to examine the relationship between the nursing <span class="hlt">practice</span> environment and missed nursing care while controlling for characteristics of nurses and hospitals. Results Nurses missed delivering a significant amount of necessary patient care (10–27%). Inadequate staffing and inadequate resources were the <span class="hlt">practice</span> environment factors most strongly associated with missed nursing care events. Conclusions This multi-site study examined the risk and risk factors associated with missed nursing care. Improvements targeting modifiable risk factors may reduce the risk of missed nursing care.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27120179','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27120179"><span id="translatedtitle">Novelty, Challenge, and <span class="hlt">Practice</span>: The <span class="hlt">Impact</span> of Intensive Language Learning on Attentional Functions.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Bak, Thomas H; Long, Madeleine R; Vega-Mendoza, Mariana; Sorace, Antonella</p> <p>2016-01-01</p> <p>We investigated the <span class="hlt">impact</span> of a short intensive language course on attentional functions. We examined 33 participants of a one-week Scottish Gaelic course and compared them to 34 controls: 16 active controls who participated in courses of comparable duration and intensity but not involving foreign language learning and 18 passive controls who followed their usual routines. Participants completed auditory tests of attentional inhibition and switching. There was no difference between the groups in any measures at the beginning of the course. At the end of the course, a significant improvement in attention switching was observed in the language group (p < .001) but not the control group (p = .127), independent of the age of participants (18-78 years). Half of the language participants (n = 17) were retested nine months after their course. All those who <span class="hlt">practiced</span> Gaelic 5 hours or more per week improved from their baseline performance. In contrast, those who <span class="hlt">practiced</span> 4 hours or fewer showed an inconsistent pattern: some improved while others stayed the same or deteriorated. Our results suggest that even a short period of intensive language learning can modulate attentional functions and that all age groups can benefit from this effect. Moreover, these short-term effects can be maintained through continuous <span class="hlt">practice</span>. PMID:27120179</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4847793','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4847793"><span id="translatedtitle">Novelty, Challenge, and <span class="hlt">Practice</span>: The <span class="hlt">Impact</span> of Intensive Language Learning on Attentional Functions</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Bak, Thomas H.; Long, Madeleine R.; Vega-Mendoza, Mariana; Sorace, Antonella</p> <p>2016-01-01</p> <p>We investigated the <span class="hlt">impact</span> of a short intensive language course on attentional functions. We examined 33 participants of a one-week Scottish Gaelic course and compared them to 34 controls: 16 active controls who participated in courses of comparable duration and intensity but not involving foreign language learning and 18 passive controls who followed their usual routines. Participants completed auditory tests of attentional inhibition and switching. There was no difference between the groups in any measures at the beginning of the course. At the end of the course, a significant improvement in attention switching was observed in the language group (p < .001) but not the control group (p = .127), independent of the age of participants (18–78 years). Half of the language participants (n = 17) were retested nine months after their course. All those who <span class="hlt">practiced</span> Gaelic 5 hours or more per week improved from their baseline performance. In contrast, those who <span class="hlt">practiced</span> 4 hours or fewer showed an inconsistent pattern: some improved while others stayed the same or deteriorated. Our results suggest that even a short period of intensive language learning can modulate attentional functions and that all age groups can benefit from this effect. Moreover, these short-term effects can be maintained through continuous <span class="hlt">practice</span>. PMID:27120179</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4759988','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4759988"><span id="translatedtitle"><span class="hlt">Impact</span> of dialysis <span class="hlt">practice</span> patterns on outcomes in acute kidney injury in Intensive Care Unit</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Annigeri, Rajeev A.; Nandeesh, Venkatappa; Karuniya, Ramanathan; Rajalakshmi, Sasikumar; Venkataraman, Ramesh; Ramakrishnan, Nagarajan</p> <p>2016-01-01</p> <p>Aim: Recent advances in dialysis therapy have made an <span class="hlt">impact</span> on the clinical <span class="hlt">practice</span> of renal replacement therapy (RRT) in acute kidney injury (AKI) in Intensive Care Unit (ICU). We studied the <span class="hlt">impact</span> of RRT <span class="hlt">practice</span> changes on outcomes in AKI in ICU over a period of 8 years. Subjects and Methods: AKI patients requiring RRT in ICU referred to a nephrologist during two different periods (period-1: Between May 2004 and May 2007, n = 69; period-2: Between August 2008 and May 2011, n = 93) were studied. The major changes in the dialysis <span class="hlt">practice</span> during the period-2, compared to period-1 were introduction of prolonged intermittent RRT (PIRRT), early dialysis for metabolic acidosis, early initiation of RRT for anuria and positive fluid balance and use of bicarbonate-based fluids for continuous RRT (CRRT) instead of lactate buffer. The primary study outcome was 28-day hospital mortality. Results: The mean age was 53.8 ± 16.1 years and 72.6% were male. Introduction of PIRRT resulted in 37% reduction in utilization of CRRT during period-2 (from 85.5% to 53.7%). The overall mortality was high (68%) but was significantly reduced during period-2 compared to period-1 (59% vs. 79.7%, P = 0.006). Metabolic acidosis but not the mode of RRT, was the significant factor which influenced mortality. Conclusions: Adaption of PIRRT resulted in 37% reduction of utilization of CRRT. The mortality rate was significantly reduced during the period of adaption of PIRRT, possibly due to early initiation of RRT in the latter period for indications such as anuria and metabolic acidosis. PMID:26955212</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4073542','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4073542"><span id="translatedtitle">Management <span class="hlt">practices</span> <span class="hlt">impact</span> vine carbohydrate status to a greater extent than vine productivity</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Pellegrino, Anne; Clingeleffer, Peter; Cooley, Nicola; Walker, Rob</p> <p>2014-01-01</p> <p>Light pruning and deficit irrigation regimes are <span class="hlt">practices</span> which are widely used in high yielding commercial vineyards in the warm climate regions of Australia. Little information is available on their <span class="hlt">impacts</span> on carbohydrate dynamics in vegetative organs within and between seasons, and on the resulting plant capacity to maintain productivity and ripen fruits. This study was conducted to address this gap in knowledge over five vintages on Vitis vinifera L. cv. Cabernet Franc, Shiraz, and Cabernet Sauvignon in the Sunraysia region of Victoria, Australia. Lighter pruning did not change the total carbohydrates concentration and composition in wood and roots within seasons in Cabernet Franc and Shiraz. However, the total carbohydrate pool (starch and soluble sugars) at the end of dormancy increased under lighter pruning, due to higher vine size, associated with retention and growth of old-wood (trunk and cordons). Water deficit negatively <span class="hlt">impacted</span> trunk and leaf starch concentrations, over the day and within seasons in Cabernet Sauvignon. Soluble sugars concentrations in these tissues tended to be higher under limited water supply, possibly due to higher sugar mobilization as photosynthesis decreased. Trunk carbohydrate concentrations markedly varied within and between seasons, highlighting the importance of interactive factors such as crop load and climate on carbon status. The period between fruit-set and véraison was shown to be critical for its <span class="hlt">impact</span> on the balance between carbon accretion and depletion, especially under water deficit. The lower leaf and trunk starch concentration under water deficit resulted in a decrease of yield components at harvest, while similar yields were reached for all pruning systems. The sugar allocated to berries at harvest remained remarkably stable for all <span class="hlt">practices</span> and seasons, irrespective of vine yield and carbohydrate status in vegetative organs in Shiraz and Cabernet Sauvignon. PMID:25018758</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25018758','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25018758"><span id="translatedtitle">Management <span class="hlt">practices</span> <span class="hlt">impact</span> vine carbohydrate status to a greater extent than vine productivity.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Pellegrino, Anne; Clingeleffer, Peter; Cooley, Nicola; Walker, Rob</p> <p>2014-01-01</p> <p>Light pruning and deficit irrigation regimes are <span class="hlt">practices</span> which are widely used in high yielding commercial vineyards in the warm climate regions of Australia. Little information is available on their <span class="hlt">impacts</span> on carbohydrate dynamics in vegetative organs within and between seasons, and on the resulting plant capacity to maintain productivity and ripen fruits. This study was conducted to address this gap in knowledge over five vintages on Vitis vinifera L. cv. Cabernet Franc, Shiraz, and Cabernet Sauvignon in the Sunraysia region of Victoria, Australia. Lighter pruning did not change the total carbohydrates concentration and composition in wood and roots within seasons in Cabernet Franc and Shiraz. However, the total carbohydrate pool (starch and soluble sugars) at the end of dormancy increased under lighter pruning, due to higher vine size, associated with retention and growth of old-wood (trunk and cordons). Water deficit negatively <span class="hlt">impacted</span> trunk and leaf starch concentrations, over the day and within seasons in Cabernet Sauvignon. Soluble sugars concentrations in these tissues tended to be higher under limited water supply, possibly due to higher sugar mobilization as photosynthesis decreased. Trunk carbohydrate concentrations markedly varied within and between seasons, highlighting the importance of interactive factors such as crop load and climate on carbon status. The period between fruit-set and véraison was shown to be critical for its <span class="hlt">impact</span> on the balance between carbon accretion and depletion, especially under water deficit. The lower leaf and trunk starch concentration under water deficit resulted in a decrease of yield components at harvest, while similar yields were reached for all pruning systems. The sugar allocated to berries at harvest remained remarkably stable for all <span class="hlt">practices</span> and seasons, irrespective of vine yield and carbohydrate status in vegetative organs in Shiraz and Cabernet Sauvignon. PMID:25018758</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25813630','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25813630"><span id="translatedtitle">Bioenergy Development Policy and <span class="hlt">Practice</span> Must Recognize Potential Hydrologic <span class="hlt">Impacts</span>: Lessons from the Americas.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Watkins, David W; de Moraes, Márcia M G Alcoforado; Asbjornsen, Heidi; Mayer, Alex S; Licata, Julian; Lopez, Jose Gutierrez; Pypker, Thomas G; Molina, Vivianna Gamez; Marques, Guilherme Fernandes; Carneiro, Ana Cristina Guimaraes; Nuñez, Hector M; Önal, Hayri; da Nobrega Germano, Bruna</p> <p>2015-12-01</p> <p>Large-scale bioenergy production will affect the hydrologic cycle in multiple ways, including changes in canopy interception, evapotranspiration, infiltration, and the quantity and quality of surface runoff and groundwater recharge. As such, the water footprints of bioenergy sources vary significantly by type of feedstock, soil characteristics, cultivation <span class="hlt">practices</span>, and hydro-climatic regime. Furthermore, water management implications of bioenergy production depend on existing land use, relative water availability, and competing water uses at a watershed scale. This paper reviews previous research on the water resource <span class="hlt">impacts</span> of bioenergy production-from plot-scale hydrologic and nutrient cycling <span class="hlt">impacts</span> to watershed and regional scale hydro-economic systems relationships. Primary gaps in knowledge that hinder policy development for integrated management of water-bioenergy systems are highlighted. Four case studies in the Americas are analyzed to illustrate relevant spatial and temporal scales for <span class="hlt">impact</span> assessment, along with unique aspects of biofuel production compared to other agroforestry systems, such as energy-related conflicts and tradeoffs. Based on the case studies, the potential benefits of integrated resource management are assessed, as is the need for further case-specific research. PMID:25813630</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/16706089','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/16706089"><span id="translatedtitle">Perceived <span class="hlt">impact</span> of TennCare reform on patients' health in a medical teaching <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Connelly, Stephanie A; Sprabery, Laura R; Bailey, James E</p> <p>2006-03-01</p> <p>From 1994-2005, TennCare, Tennessee's innovative Medicaid managed care program, dramatically expanded coverage to around 1.3 million Tennesseans (roughly 23 percent of the state population) by employing cost savings achieved through capitation and managed care. Rising healthcare costs and a static state budget resulted in program downsizing that started in mid-2005. This cross-sectional survey sought to document the perspectives of TennCare enrollees before disenrollment about the likely <span class="hlt">impacts</span> of changes in TennCare coverage and benefits. In February 2005, a convenience sample of 89 patients served by an internal medicine resident staffed teaching <span class="hlt">practice</span> in Memphis, TN, participated in a survey to assess their perspectives about the potential <span class="hlt">impact</span> of the upcoming disenrollment and benefits limitations. Ninety percent or more expressed concerns that loss of TennCare would lead to health problems, difficulty with paying for prescriptions and difficulty finding alternative health insurance. This survey suggests that before disenrollment, most people served by TennCare believed that loss of TennCare would have serious negative consequences on their health. Further studies are needed to assess the true <span class="hlt">impact</span> of the disenrollment and benefit cuts and the effectiveness of alternative safety net services for vulnerable Tennessee citizens. PMID:16706089</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2015EnMan..56.1295W&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2015EnMan..56.1295W&link_type=ABSTRACT"><span id="translatedtitle">Bioenergy Development Policy and <span class="hlt">Practice</span> Must Recognize Potential Hydrologic <span class="hlt">Impacts</span>: Lessons from the Americas</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Watkins, David W.; de Moraes, Márcia M. G. Alcoforado; Asbjornsen, Heidi; Mayer, Alex S.; Licata, Julian; Lopez, Jose Gutierrez; Pypker, Thomas G.; Molina, Vivianna Gamez; Marques, Guilherme Fernandes; Carneiro, Ana Cristina Guimaraes; Nuñez, Hector M.; Önal, Hayri; da Nobrega Germano, Bruna</p> <p>2015-12-01</p> <p>Large-scale bioenergy production will affect the hydrologic cycle in multiple ways, including changes in canopy interception, evapotranspiration, infiltration, and the quantity and quality of surface runoff and groundwater recharge. As such, the water footprints of bioenergy sources vary significantly by type of feedstock, soil characteristics, cultivation <span class="hlt">practices</span>, and hydro-climatic regime. Furthermore, water management implications of bioenergy production depend on existing land use, relative water availability, and competing water uses at a watershed scale. This paper reviews previous research on the water resource <span class="hlt">impacts</span> of bioenergy production—from plot-scale hydrologic and nutrient cycling <span class="hlt">impacts</span> to watershed and regional scale hydro-economic systems relationships. Primary gaps in knowledge that hinder policy development for integrated management of water-bioenergy systems are highlighted. Four case studies in the Americas are analyzed to illustrate relevant spatial and temporal scales for <span class="hlt">impact</span> assessment, along with unique aspects of biofuel production compared to other agroforestry systems, such as energy-related conflicts and tradeoffs. Based on the case studies, the potential benefits of integrated resource management are assessed, as is the need for further case-specific research.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25251703','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25251703"><span id="translatedtitle">Development and implementation of a <span class="hlt">paediatric</span> rehabilitation care path for hard-to-reach families: a case report.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Phoenix, M; Rosenbaum, P</p> <p>2015-05-01</p> <p>Service providers, policy makers and researchers are increasingly concerned with service provisions for hard-to-reach families. These are defined as families who are eligible for a service, but are difficult for service providers to identify or engage. In our setting, hard-to-reach families were those who missed appointments without prior notice, a problem that was inefficient for the organization, frustrating for clinicians and did not meet child or family needs. This case report describes the development of a care path to promote engagement with hard-to-reach families (MATCH: Making Alternative Therapy Choices Happen) and its adoption among clinicians within a community-based <span class="hlt">paediatric</span> rehabilitation centre in Ontario, Canada. The care path was developed and implemented at a pilot site at KidsAbility Centre for Child Development (KidsAbility), which allowed us to tailor the care path using clinician input via questionnaires, and to monitor use of the care path. Following pilot implementation clinicians reported being satisfied with the approach and perceived improved child and family outcomes. The care path was expanded to four service sites using a Knowledge Brokering model. After training, clinicians reported a good understanding of the care path: 87% felt that they would have an opportunity to use it within six months, however only 68% felt ready to use it. Challenges to offering MATCH and continuing training preferences were investigated. The MATCH care path illustrates a <span class="hlt">practical</span> application of the principles of best-<span class="hlt">practice</span> for engaging hard-to-reach families, tailored for a specific <span class="hlt">paediatric</span> rehabilitation setting. Continued research is planned to further define the hard-to-reach families within <span class="hlt">paediatric</span> rehabilitation, determine how hard-to-reach families view engagement in services, and evaluate the effectiveness of MATCH implementation in reducing missed appointments and promoting family engagement in <span class="hlt">paediatric</span> rehabilitation services. PMID</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/17453272','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/17453272"><span id="translatedtitle">Modeling the <span class="hlt">impacts</span> of farming <span class="hlt">practices</span> on water quality in the Little Miami River Basin.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Tong, Susanna T Y; Naramngam, Sarawuth</p> <p>2007-06-01</p> <p>Since intensive farming <span class="hlt">practices</span> are essential to produce enough food for the increasing population, farmers have been using more inorganic fertilizers, pesticides, and herbicides. Agricultural lands are currently one of the major sources of non-point source pollution. However, by changing farming <span class="hlt">practices</span> in terms of tillage and crop rotation, the levels of contamination can be reduced and the quality of soil and water resources can be improved. Thus, there is a need to investigate the amalgamated hydrologic effects when various tillage and crop rotation <span class="hlt">practices</span> are operated in tandem. In this study, the Soil Water Assessment Tool (SWAT) was utilized to evaluate the individual and combined <span class="hlt">impacts</span> of various farming <span class="hlt">practices</span> on flow, sediment, ammonia, and total phosphorus loads in the Little Miami River basin. The model was calibrated and validated using the 1990-1994 and 1980-1984 data sets, respectively. The simulated results revealed that the SWAT model provided a good simulation performance. For those tested farming scenarios, no-tillage (NT) offered more environmental benefits than moldboard plowing (MP). Flow, sediment, ammonia, and total phosphorus under NT were lower than those under MP. In terms of crop rotation, continuous soybean and corn-soybean rotation were able to reduce sediment, ammonia, and total phosphorus loads. When the combined effects of tillage and crop rotation were examined, it was found that NT with continuous soybean or corn-soybean rotation could greatly restrain the loss of sediments and nutrients to receiving waters. Since corn-soybean rotation provides higher economic revenue, a combination of NT and corn-soybean rotation can be a viable system for successful farming. PMID:17453272</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2007EnMan..39..853T&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2007EnMan..39..853T&link_type=ABSTRACT"><span id="translatedtitle">Modeling the <span class="hlt">Impacts</span> of Farming <span class="hlt">Practices</span> on Water Quality in the Little Miami River Basin</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Tong, Susanna T. Y.; Naramngam, Sarawuth</p> <p>2007-06-01</p> <p>Since intensive farming <span class="hlt">practices</span> are essential to produce enough food for the increasing population, farmers have been using more inorganic fertilizers, pesticides, and herbicides. Agricultural lands are currently one of the major sources of non-point source pollution. However, by changing farming <span class="hlt">practices</span> in terms of tillage and crop rotation, the levels of contamination can be reduced and the quality of soil and water resources can be improved. Thus, there is a need to investigate the amalgamated hydrologic effects when various tillage and crop rotation <span class="hlt">practices</span> are operated in tandem. In this study, the Soil Water Assessment Tool (SWAT) was utilized to evaluate the individual and combined <span class="hlt">impacts</span> of various farming <span class="hlt">practices</span> on flow, sediment, ammonia, and total phosphorus loads in the Little Miami River basin. The model was calibrated and validated using the 1990-1994 and 1980-1984 data sets, respectively. The simulated results revealed that the SWAT model provided a good simulation performance. For those tested farming scenarios, no-tillage (NT) offered more environmental benefits than moldboard plowing (MP). Flow, sediment, ammonia, and total phosphorus under NT were lower than those under MP. In terms of crop rotation, continuous soybean and corn-soybean rotation were able to reduce sediment, ammonia, and total phosphorus loads. When the combined effects of tillage and crop rotation were examined, it was found that NT with continuous soybean or corn-soybean rotation could greatly restrain the loss of sediments and nutrients to receiving waters. Since corn-soybean rotation provides higher economic revenue, a combination of NT and corn-soybean rotation can be a viable system for successful farming.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22352308','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22352308"><span id="translatedtitle">Biological <span class="hlt">impact</span> of divergent land management <span class="hlt">practices</span> on tomato crop health.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Chellemi, Dan O; Wu, Tiehang; Graham, Jim H; Church, Greg</p> <p>2012-06-01</p> <p>Development of sustainable food systems is contingent upon the adoption of land management <span class="hlt">practices</span> that can mitigate damage from soilborne pests. Five diverse land management <span class="hlt">practices</span> were studied for their <span class="hlt">impacts</span> on Fusarium wilt (Fusarium oxysporum f. sp. lycopersici), galling of roots by Meloidogyne spp. and marketable yield of tomato (Solanum lycopersicum) and to identify associations between the severity of pest damage and the corresponding soil microbial community structure. The incidence of Fusarium wilt was >14% when tomato was cultivated following 3 to 4 years of an undisturbed weed fallow or continuous tillage disk fallow rotation and was >4% after 3 to 4 years of bahiagrass (Paspalum notatum) rotation or organic production <span class="hlt">practices</span> that included soil amendments and cover crops. The incidence of Fusarium wilt under conventional tomato production with soil fumigation varied from 2% in 2003 to 15% in 2004. Repeated tomato cultivation increased Fusarium wilt by 20% or more except when tomato was grown using organic <span class="hlt">practices</span>, where disease remained less than 3%. The percent of tomato roots with galls from Meloidogyne spp. ranged from 18 to 82% in soil previously subjected to a weed fallow rotation and 7 to 15% in soil managed previously as a bahiagrass pasture. Repeated tomato cultivation increased the severity of root galling in plots previously subjected to a conventional or disk fallow rotation but not in plots managed using organic <span class="hlt">practices</span>, where the percentage of tomato roots with galls remained below 1%. Marketable yield of tomato exceeded 35 Mg ha(-1) following all land management strategies except the strip-tillage/bahiagrass program. Marketable yield declined by 11, 14, and 19% when tomato was grown in consecutive years following a bahiagrass, weed fallow, and disk rotation. The composition of fungal internal transcribed spacer 1 (ITS1) and bacterial 16S rDNA amplicons isolated from soil fungal and bacterial communities corresponded with</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_16");'>16</a></li> <li><a href="#" onclick='return showDiv("page_17");'>17</a></li> <li class="active"><span>18</span></li> <li><a href="#" onclick='return showDiv("page_19");'>19</a></li> <li><a href="#" onclick='return showDiv("page_20");'>20</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_18 --> <div id="page_19" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_17");'>17</a></li> <li><a href="#" onclick='return showDiv("page_18");'>18</a></li> <li class="active"><span>19</span></li> <li><a href="#" onclick='return showDiv("page_20");'>20</a></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="361"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25638607','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25638607"><span id="translatedtitle">Understanding the responsibilities and obligations of the modern <span class="hlt">paediatric</span> surgeon.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Beasley, Spencer W</p> <p>2015-02-01</p> <p>The modern <span class="hlt">paediatric</span> surgeon needs to be competent in multiple domains that extend well beyond their clinical and technical expertise. This article, based on the Journal of Pediatric Surgery Lecture at the BAPS Congress (2014), explores some of these less well understood responsibilities and obligations, including professionalism, leadership, effective clinical teaching, and research. The consequence of falling short in these areas includes risks to our profession as a whole as well as compromising our ability to provide our patients with the best clinical care. <span class="hlt">Paediatric</span> surgeons have a responsibility to influence the configuration of services to improve the quality of care and equity of access to specialist services for all children in their region. Evidence presented shows how a well-organised and funded regional <span class="hlt">paediatric</span> surgical service allows children to receive quality treatment closer to home and is reflected in better clinical outcomes, less unnecessary surgery, and fewer complications. A paradigm for support to emerging countries as they increase the capacity and infrastructure of their <span class="hlt">paediatric</span> surgical services is proposed. The way we judge ourselves and others should relate to our performance across the full scope of roles that a responsible and committed <span class="hlt">paediatric</span> surgeon is expected to display. PMID:25638607</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4452752','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4452752"><span id="translatedtitle">The design of a multicentre Canadian surveillance study of sedation safety in the <span class="hlt">paediatric</span> emergency department</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Bhatt, Maala; Roback, Mark G; Joubert, Gary; Farion, Ken J; Ali, Samina; Beno, Suzanne; McTimoney, C Michelle; Dixon, Andrew; Dubrovsky, Alexander Sasha; Barrowman, Nick; Johnson, David W</p> <p>2015-01-01</p> <p>Introduction Procedural sedation and analgesia have become standard <span class="hlt">practice</span> in <span class="hlt">paediatric</span> emergency departments worldwide. Although generally regarded as safe, serious adverse events such as bradycardia, asystole, pulmonary aspiration, permanent neurological injury and death have been reported, but their incidence is unknown due to the infrequency of their occurrence and lack of surveillance of sedation safety. To improve our understanding of the safety, comparative effectiveness and variation in care in <span class="hlt">paediatric</span> procedural sedation, we are establishing a multicentre patient registry with the goal of conducting regular and ongoing surveillance for adverse events in procedural sedation. Methods This multicentre, prospective cohort study is enrolling patients under 18 years of age from six <span class="hlt">paediatric</span> emergency departments across Canada. Data collection is fully integrated into clinical care and is performed electronically in real time by the healthcare professionals caring for the patient. The primary outcome is the proportion of patients who experience a serious adverse event as a result of their sedation. Secondary outcomes include the proportion of patients who experience an adverse event that could lead to a serious adverse event, proportion of patients who receive a significant intervention in response to an adverse event, proportion of patients who experience a successful sedation, and proportion of patients who experience a paradoxical reaction to sedation. There is no predetermined end date for data collection. Ethics and dissemination Ethics approval has been obtained from participating sites. Results will be disseminated using a multifaceted knowledge translation strategy by presenting at international conferences, publication in peer-reviewed journals, and through established networks. PMID:26024999</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4768207','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4768207"><span id="translatedtitle">Outcomes and patients’ perspectives of transition from <span class="hlt">paediatric</span> to adult care in inflammatory bowel disease</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Bennett, Alice L; Moore, David; Bampton, Peter A; Bryant, Robert V; Andrews, Jane M</p> <p>2016-01-01</p> <p>AIM: To describe the disease and psychosocial outcomes of an inflammatory bowel disease (IBD) transition cohort and their perspectives. METHODS: Patients with IBD, aged > 18 years, who had moved from <span class="hlt">paediatric</span> to adult care within 10 years were identified through IBD databases at three tertiary hospitals. Participants were surveyed regarding demographic and disease specific data and their perspectives on the transition process. Survey response data were compared to contemporaneously recorded information in <span class="hlt">paediatric</span> service case notes. Data were compared to a similar age cohort who had never received <span class="hlt">paediatric</span> IBD care and therefore who had not undergone a transition process. RESULTS: There were 81 returned surveys from 46 transition and 35 non-transition patients. No statistically significant differences were found in disease burden, disease outcomes or adult roles and responsibilities between cohorts. Despite a high prevalence of mood disturbance (35%), there was a very low usage (5%) of psychological services in both cohorts. In the transition cohort, knowledge of their transition plan was reported by only 25/46 patients and the majority (54%) felt they were not strongly prepared. A high rate (78%) of discussion about work/study plans was recorded prior to transition, but a near complete absence of discussion regarding sex (8%), and other adult issues was recorded. Both cohorts agreed that their preferred method of future transition <span class="hlt">practices</span> (of the options offered) was a shared clinic appointment with all key stakeholders. CONCLUSION: Transition did not appear to adversely affect disease or psychosocial outcomes. Current transition care processes could be optimised, with better psychosocial preparation and agreed transition plans. PMID:26937149</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3851858','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3851858"><span id="translatedtitle">Clowning as a supportive measure in <span class="hlt">paediatrics</span> - a survey of clowns, parents and nursing staff</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2013-01-01</p> <p>Background Hospital clowns, also known as clown doctors, can help <span class="hlt">paediatric</span> patients with the stress of a hospitalization and to circumvent the accompanying feelings of fear, helplessness and sadness, thus supporting the healing process. The objectives of the present study were to clarify the structural and procedural conditions of <span class="hlt">paediatric</span> clowning in Germany and to document the evaluations of hospital clowns, parents and hospital staff. Methods A nationwide online survey of hospital clowns currently active in <span class="hlt">paediatric</span> departments and an accompanying field evaluation in Hamburg hospitals with surveys of parents and hospital staff were conducted. In addition to items developed specifically for the study regarding general conditions, procedures, assessments of effects and attitudes, the Work Satisfaction Scale was used. The sample included n = 87 hospital clowns, 37 parents and 43 hospital staff members. Results The online survey showed that the hospital clowns are well-trained, motivated and generally satisfied with their work. By their own estimate, they primarily boost morale and promote imagination in the patients. However, hospital clowns also desire better interdisciplinary collaboration and financial security as well as more recognition of their work. The Hamburg field study confirmed the positive results of the clown survey. According to the data, a clown intervention boosts morale and reduces stress in the patients. Moreover, there are <span class="hlt">practically</span> no side effects. Both parents and hospital staff stated that the patients as well as they themselves benefited from the intervention. Conclusions The results match those of previous studies and give a very positive picture of hospital clowning, so that its routine use and expansion thereof can be recommended. Furthermore, the intervention should be subject to the rules of evidence-based medicine like other medical treatments. PMID:24112744</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/19878352','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/19878352"><span id="translatedtitle">PENTA 2009 guidelines for the use of antiretroviral therapy in <span class="hlt">paediatric</span> HIV-1 infection.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Welch, Steve; Sharland, Mike; Lyall, E G Hermione; Tudor-Williams, Gareth; Niehues, Tim; Wintergerst, Uwe; Bunupuradah, Torsak; Hainaut, Marc; Della Negra, Marinella; Pena, Maria José Mellado; Amador, José Tomas Ramos; Gattinara, Guido Castelli; Compagnucci, Alexandra; Faye, Albert; Giaquinto, Carlo; Gibb, Diana M; Gandhi, Kate; Forcat, Silvia; Buckberry, Karen; Harper, Lynda; Königs, Christoph; Patel, Deepak; Bastiaans, Diane</p> <p>2009-11-01</p> <p>PENTA Guidelines aim to provide <span class="hlt">practical</span> recommendations for treating children with HIV infection in Europe. Changes to guidance since 2004 have been informed by new evidence and by expectations of better outcomes following the ongoing success of antiretroviral therapy (ART). Participation in PENTA trials of simplifying treatment is encouraged. The main changes are in the following sections: 'When to start ART': Treatment is recommended for all infants, and at higher CD4 cell counts and percentages in older children, in line with changes to adult guidelines. The number of age bands has been reduced to simplify and harmonize with other <span class="hlt">paediatric</span> guidelines. Greater emphasis is placed on CD4 cell count in children over 5 years, and guidance is provided where CD4% and CD4 criteria differ. 'What to start with': A three-drug regimen of two nucleoside reverse transcriptase inhibitors (NRTIs) with either a nonnucleoside reverse transcriptase inhibitor (NNRTI) or a boosted protease inhibitor (PI) remains the first choice combination. Lamivudine and abacavir are the NRTI backbone of choice for most children, based on long-term follow-up in the PENTA 5 trial. Stavudine is no longer recommended. Whether to start with an NNRTI or PI remains unclear, but PENPACT 1 trial results in 2009 may help to inform this. All PIs should be ritonavir boosted. Recommendations on use of resistance testing, therapeutic drug monitoring and HLA testing draw from data in adults and from European <span class="hlt">paediatric</span> cohort studies. Recently updated US and WHO <span class="hlt">paediatric</span> guidelines provide more detailed review of the evidence base. Differences between guidelines are highlighted and explained. PMID:19878352</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25531632','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25531632"><span id="translatedtitle">[Strategies for <span class="hlt">paediatric</span> spleen and liver injuries].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Zundel, S; Lieber, J; Tsiflikas, I; Henk, A-K; Schmittenbecher, P</p> <p>2014-12-01</p> <p>Traumatic injuries of the spleen and liver are typically caused by age-related falls or sports and traffic accidents. Today, the non-operative management for isolated injuries is established and evidence-based guidelines are available. The intact abdominal wall and the limited space within the peritoneum produce a compression which is the pathophysiological explanation for the limitation of the haemorrhage. Precondition for the non-operative therapy is the radiology-based classification of the injury (organ injury scale) and a haemodynamically stable patient. Haemodynamic stability is, if necessary maintained with blood transfusion, volume substitutes and the administration of catecholamines. In cases of hilar vascular injury and devascularisation or haemodynamic instability of the patient, despite utilisation of the measures mentioned above, urgent operative therapy needs to be performed. Organ sparing surgery is the therapy of choice for both liver and spleen. The spleen is required for the development of a competent immune system in the growing organism. Liver injuries can be further complicated by injury to the bile system, which might require operative reconstruction. If a patient suffers from multiple injuries and spleen or liver are involved, the decision on the management needs to be taken individually, no guidelines exist but the rate for operative therapy increases. Independent of the dimensions of injury, an experienced <span class="hlt">paediatric</span> surgeon with his multidisciplinary team, considering the anatomic and age specific characteristics of a child, achieves the best therapeutic results. PMID:25531632</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27008068','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27008068"><span id="translatedtitle">Satisfaction and attrition in <span class="hlt">paediatric</span> weight management.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Skelton, J A; Martin, S; Irby, M B</p> <p>2016-04-01</p> <p><span class="hlt">Paediatric</span> obesity treatment experiences unacceptably high rates of attrition. Few studies have explored parent and child perspectives on dropout. This study sought to capture child and parent experience in treatment and expressed contributors to attrition. Children and parents enrolled in a single family-based weight management programme participated in semi-structured interviews, conducted either upon completion of the first intensive phase of treatment or program dropout. Interviews were recorded, transcribed and coded using a multistage inductive approach. Interviews were obtained from 57 parents and 30 children, nearly equal between 'completers' or 'dropouts'. Five themes emerged: overall positive experience with programme; logistical challenges of participation; improved health; discrepancies between child and parent experience and perception, and importance of structure and expectations of weight loss. Primary reasons given for dropout were time commitment; distance from clinic; missed school and work; lack of dedicated adolescent programme; clinic hours; and stress. Few parents or children expressed dissatisfaction. Children reportedly enjoyed 'having someone to talk to' about weight, and spending increased time with family. Children and parents overall reported positive experiences in this weight management programme. Attrition appears more related to logistical issues than low satisfaction. Innovative approaches to help overcome logistical challenges and preserve positive aspects may help in decreasing programme attrition. PMID:27008068</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22471873','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22471873"><span id="translatedtitle"><span class="hlt">Paediatrics</span> and the doctor-soldier.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Pearn, John H</p> <p>2012-08-01</p> <p>Sick and injured children, like combatants wounded by shot and shell in war, are disproportionately represented in the tallies of both man-made and national disasters. Paediatricians have a particularly proud heritage of military service, a nexus dating in Australia from the early 19th century. This paper traces this link between service to children in peacetime and the care of servicemen, women and children in times of war and disaster. The extraordinary record of Australian '<span class="hlt">paediatric</span>' doctors who also served in the Gallipoli Campaign (1915) is documented as an illustration of this duality. Paediatricians who serve in the Defence Reserves and in civilian non-government organisations which respond to disasters and civil wars have special credentials in their advocacy for the protection of children enmeshed in conflict or disaster. Such applies particularly to the banning of the recruitment and use of child soldiers; support for children caught up in refugee and illegal immigrant confrontations; and continued advocacy for greater international compliance with the Ottawa Convention to ban the use of anti-personnel landmines. Volunteering for such service must occur in cold 'down time', ensuring that paediatricians are trained in disaster and conflict response, when such challenges inevitably confront the paediatricians of the future. PMID:22471873</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26631075','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26631075"><span id="translatedtitle">Whole-body MRI in <span class="hlt">paediatric</span> oncology.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Nievelstein, Rutger A J; Littooij, Annemieke S</p> <p>2016-05-01</p> <p>Imaging plays a crucial role in the diagnosis and follow-up of <span class="hlt">paediatric</span> malignancies. Until recently, computed tomography (CT) has been the imaging technique of choice in children with cancer, but nowadays there is an increasing interest in the use of functional imaging techniques like positron emission tomography and single-photon emission tomography. These later techniques are often combined with CT allowing for simultaneous acquisition of image data on the biological behaviour of tumour, as well as the anatomical localisation and extent of tumour spread. Because of the small but not negligible risk of radiation induced secondary cancers and the significantly improved overall survival rates of children with cancer, there is an increasing interest in the use of alternative imaging techniques that do not use ionising radiation. Magnetic resonance imaging (MRI) is a radiation-free imaging tool that allows for acquiring images with a high spatial resolution and excellent soft tissue contrast throughout the body. Moreover, recent technological advances have resulted in fast diagnostic sequences for whole-body MR imaging (WB-MRI), including functional techniques such as diffusion weighted imaging. In this review, the current status of the technique and major clinical applications of WB-MRI in children with cancer will be discussed. PMID:26631075</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2013EGUGA..15.9860V','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2013EGUGA..15.9860V"><span id="translatedtitle">Long term <span class="hlt">impact</span> of different tillage <span class="hlt">practices</span> on soil C sequestration potential</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Valboa, Giuseppe; Lagomarsino, Alessandra; Papini, Rossella; Brandi, Giorgio; Elio Agnelli, Alessandro; Simoncini, Stefania; Vignozzi, Nadia; Pellegrini, Sergio</p> <p>2013-04-01</p> <p>Long-term experiments provide important information on the <span class="hlt">impact</span> of agricultural management <span class="hlt">practices</span> on soil quality. In 1994, a trial was started to investigate the effects of four different tillage systems on organic carbon and physical properties of a Calcari Fluvic Cambisol loam soil under continuous maize. The tillage <span class="hlt">practices</span> compared were: conventional tillage by mould-board ploughing to 40 cm depth (DP); ripper sub-soiling to 40-45 cm (RS); shallow tillage by mould-board ploughing to 20 cm depth (SP); minimum tillage by disk harrowing to 10-15 cm (DH). Soil carbon pool, bulk density, macroporosity and aggregate stability were studied at different depth increments (0-10, 10-20, 20-30 and 30-40 cm) and by two repeated samplings (in 1999 and 2011), in order to evaluate their temporal evolution under the different tillage systems. For a better understanding of mechanisms leading to C sequestration, a qualitative characterization of soil organic matter (OM) was performed by acid hydrolysis (HCl 6N), in order to separate the labile and the recalcitrant fractions. After 18 years of treatments we hypothesized changes in OM content and quality, as well as in its vertical distribution, due to tillage <span class="hlt">practices</span>. At the end of the trial, soil total organic carbon (TOC) stock increased in the surface layers under DH (to 10 cm depth), RS (to 20 cm depth) and SP (to 10 cm depth), while it was unchanged under DP. When considering the whole 0-40 cm layer, all tillage treatments resulted in no significant variation in TOC stock. OM quality and its evolution over time showed well defined differences among treatments: the OM recalcitrant fraction increased under RS (up to 30 cm depth), decreased under DP (up to 40 cm depth) and showed no significant changes under DH and SP. The negative <span class="hlt">impact</span> of DP on C stabilization was confirmed by a significant decrease of the recalcitrant to TOC ratio in the whole sampled layer. In conclusion, DP showed the worst <span class="hlt">impact</span> on C storage</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2902453','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2902453"><span id="translatedtitle"><span class="hlt">Paediatric</span> palliative home care by general paediatricians: a multimethod study on perceived barriers and incentives</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2010-01-01</p> <p>Background Non-specialist palliative care, as it is delivered by general practitioners, is a basic component of a comprehensive palliative care infrastructure for adult patients with progressive and far advanced disease. Currently palliative care for children and adolescents is recognized as a distinct entity of care, requiring networks of service providers across different settings, including paediatricians working in general <span class="hlt">practice</span>. In Germany, the medical home care for children and adolescents is to a large extent delivered by general paediatricians working in their own <span class="hlt">practice</span>. However, these are rarely confronted with children suffering from life-limiting diseases. The aim of this study was therefore to examine potential barriers, incentives, and the professional self-image of general paediatricians with regard to <span class="hlt">paediatric</span> palliative care. Methods Based on qualitative expert interviews, a questionnaire was designed and a survey among general paediatricians in their own <span class="hlt">practice</span> (n = 293) was undertaken. The survey has been developed and performed in close cooperation with the regional professional association of paediatricians. Results The results showed a high disposition on part of the paediatricians to engage in palliative care, and the majority of respondents regarded palliative care as part of their profile. Main barriers for the implementation were time restrictions (40.7%) and financial burden (31.6%), sole responsibility without team support (31.1%), as well as formal requirements such as forms and prescriptions (26.6%). Major facilitations were support by local specialist services such as home care nursing service (83.0%), access to a specialist <span class="hlt">paediatric</span> palliative care consultation team (82.4%), as well as an option of exchange with colleagues (60.1%). Conclusions Altogether, the high commitment to this survey reflects the relevance of the issue for paediatricians working in general <span class="hlt">practice</span>. Education in basic palliative care competence and</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22227301','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22227301"><span id="translatedtitle">An <span class="hlt">impact</span> assessment methodology for urban surface runoff quality following best <span class="hlt">practice</span> treatment.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Ellis, J Bryan; Revitt, D Michael; Lundy, Lian</p> <p>2012-02-01</p> <p>The paper develops an easy to apply desk-based semi-quantitative approach for the assessment of residual receiving water quality risks associated with urban surface runoff following its conveyance through best <span class="hlt">practice</span> sustainable drainage systems (SUDS). The innovative procedure utilises an integrated geographical information system (GIS)-based pollution index approach based on surface area impermeability, runoff concentrations/loadings and individual SUDS treatment performance potential to evaluate the level of risk mitigation achievable by SUDS drainage infrastructure. The residual <span class="hlt">impact</span> is assessed through comparison of the determined pollution index with regulatory receiving water quality standards and objectives. The methodology provides an original theoretically based procedure which complements the current acute risk assessment approaches being widely applied within pluvial flood risk management. PMID:22227301</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/21364707','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/21364707"><span id="translatedtitle">Vital statistics relating to the <span class="hlt">practice</span> of Health <span class="hlt">Impact</span> Assessment (HIA) in the United Kingdom</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Chilaka, M.A.</p> <p>2010-02-15</p> <p>Purpose of research: To examine the <span class="hlt">practice</span> of Health <span class="hlt">Impact</span> Assessment (HIA) in the UK and provide information which can serve as baseline data for monitoring changes and future developments in HIA. A survey of HIA practitioners was conducted using semi-structured questionnaires. Results: - 42% of the 103 HIAs were rapid assessments, 33% were intermediate, and 25% were comprehensive appraisals. - While 70% of the HIAs were conducted prospectively, 23% were concurrent, and 7% were retrospective assessments. - 64% of the 52 practitioners were employed in the public sector, 13% in the academia and research sector, 10% were employed in the private sector, 6% were self employed and the remaining 7% were working in other sectors of the British economy. Conclusions: The majority of the HIAs investigated in this study were rapid and prospective assessments, which were mostly commissioned by government agencies. Additionally, the majority of the HIA practitioners were employed in the public sector of the UK economy.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2012ChJOL..30..388Z&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2012ChJOL..30..388Z&link_type=ABSTRACT"><span id="translatedtitle"><span class="hlt">Impacts</span> of mariculture <span class="hlt">practices</span> on the temporal distribution of macrobenthos in Sandu Bay, South China</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Zhou, Jin</p> <p>2012-05-01</p> <p>Sandu Bay is located in the East China Sea and is characterized by high-density fish farming and kelp culture. Despite this, little is known about the <span class="hlt">impacts</span> of these different mariculture <span class="hlt">practices</span> on the local environment. We investigated the temporal variation in macrobenthos and environmental conditions at three sites in the bay (fish farming site, kelp culture site, and a control site). We collected water and sediment samples during nine cruises between May 2009 and February 2010. The density of macrobenthos peaked at the fish farming site in July (655 ind./m2) whereas density did not fluctuate as widely at the other two sites. Biomass varied significantly at both the control and kelp culture sites, but had only a single peak at the fish farming site in June (21.90 g/m2). The dominant species varied throughout the study period at the control and kelp culture sites, whereas a single terebellid species ( Lysilla pacifica) dominated the macrobenthos at the fish farming site. The diversity index H' increased at the control site beginning in February then decreased after May, whereas H' was low at the other sites in December. The mean dissolved oxygen level was highest at the control site (6.59 mg/L) and lowest at the fish farming site (5.54 mg/L). DO levels were lowest at all sites in summer (July and August). The sediment acid volatile sulfide content was higher at the fish farming site (1.46 mg/g dry weight) than those at the kelp culture and control sites (1.22 and 0.14 mg/g, respectively). Our results suggest that mariculture <span class="hlt">practices</span> have a clear <span class="hlt">impact</span> on the benthic environment/community in Sandu Bay.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25617786','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25617786"><span id="translatedtitle"><span class="hlt">Impact</span> of water management <span class="hlt">practice</span> scenarios on wastewater flow and contaminant concentration.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Marleni, N; Gray, S; Sharma, A; Burn, S; Muttil, N</p> <p>2015-03-15</p> <p>Due to frequent droughts and rapid population growth in urban areas, the adoption of <span class="hlt">practices</span> to reduce the usage of fresh water is on the rise. Reduction in usage of fresh water can be achieved through various local water management <span class="hlt">practices</span> (WMP) such as Water Demand Management (WDM) and use of alternative water sources such as Greywater Recycling (GR) and Rainwater Harvesting (RH). While the positive effects of WMPs have been widely acknowledged, the implementation of WMPs is also likely to lower the wastewater flow and increase the concentration of contaminants in sewage. These in turn can lead to increases in sewer problems such as odour and corrosion. This paper analyses <span class="hlt">impacts</span> of various WMP scenarios on wastewater flow and contaminant load. The Urban Volume and Quality (UVQ) model was used to simulate wastewater flow and the associated wastewater contaminants from different WMP scenarios. The wastewater parameters investigated were those which influence odour and corrosion problems in sewerage networks due to the formation of hydrogen sulphide. These parameters are: chemical oxygen demand (COD), nitrate (NO3(-)), sulphate (SO4(2-)), sulphide (S(2-)) and iron (Fe) that were contributed by the households (not including the biochemical process in sewer pipe). The results will help to quantify the <span class="hlt">impact</span> of WMP scenarios on odour and corrosion in sewerage pipe networks. Results show that the implementation of a combination of WDM and GR had highly increased the concentration of all selected contaminant that triggered the formation of hydrogen sulphide, namely COD, sulphate and sulphide. On the other hand, the RH scenario had the least increase in the concentration of the contaminants, except iron concentrations. The increase in iron concentrations is actually beneficial because it inhibits the formation of hydrogen sulphide. PMID:25617786</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24932845','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24932845"><span id="translatedtitle">Basics, principles, techniques and modern methods in <span class="hlt">paediatric</span> ultrasonography.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Riccabona, Michael</p> <p>2014-09-01</p> <p>Ultrasonography (US) is the mainstay of <span class="hlt">paediatric</span> Radiology. This review aims at revisiting basic US principles, to list specific needs throughout childhood, and to discuss the application of new and modern US methods. The various sections elude to basic US physics, technical requisites and tips for handling, diagnostically valuable applications of modern techniques, and how to properly address hazards, risks and limitations. In conclusion, US holds vast potential throughout childhood in almost all body regions and many childhood specific queries - helping to reduce the need for or to optimize more invasive or irradiating imaging. Make the most of US and offerings a dedicated <span class="hlt">paediatric</span> US service throughout the day, the week and the year thus is and will stay a major task of <span class="hlt">Paediatric</span> Radiology. PMID:24932845</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/19655302','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/19655302"><span id="translatedtitle">Estimation of risks associated with <span class="hlt">paediatric</span> cochlear implantation.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Johnston, J Cyne; Smith, Andrée Durieux; Fitzpatrick, Elizabeth; O'Connor, Annette; Angus, Douglas; Benzies, Karen; Schramm, David</p> <p>2010-09-01</p> <p>The objectives of this study were to estimate the rates of complications associated with <span class="hlt">paediatric</span> cochlear implantation use: a) at one Canadian cochlear implant (CI) centre, and b) in the published literature. It comprised a retrospective hospital-based chart review and a concurrent review of complications in the published literature. There were 224 children who had undergone surgery from 1994 to June 2007. Results indicate that the rates of complications at the local Canadian <span class="hlt">paediatric</span> CI centre are not significantly different from the literature rates for all examined complication types. This hospital-based retrospective chart review and review of the literature provide readers with an estimation of the risks to aid in evidence-based decision-making surrounding <span class="hlt">paediatric</span> cochlear implantation. PMID:19655302</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4589933','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4589933"><span id="translatedtitle"><span class="hlt">Paediatric</span> Pain Management: Using Complementary and Alternative Medicine</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Tsao, Jennie C.I; Zeltzer, Lonnie K.</p> <p>2008-01-01</p> <p>Children undergo acute painful procedures and many also experience chronic pain. Due to their developing systems, infants and children may be at greater risk than adults for protracted pain sensitivity. There is a need to manage acute and chronic <span class="hlt">paediatric</span> pain to reduce children's suffering and to prevent future pain problems. Consistent with a biopsychosocial perspective, complementary and alternative medicine (CAM) should be considered in management of acute and chronic <span class="hlt">paediatric</span> pain. Although research is limited for <span class="hlt">paediatric</span> pain, CAM interventions receiving the most empirical attention include hypnotherapy, acupuncture and music therapy. Evidence also exists for the therapeutic benefits of yoga, massage, humor therapy and the use of certain biological based therapies. PMID:26525515</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26525515','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26525515"><span id="translatedtitle"><span class="hlt">Paediatric</span> Pain Management: Using Complementary and Alternative Medicine.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Evans, Subhadra; Tsao, Jennie C I; Zeltzer, Lonnie K</p> <p>2008-09-01</p> <p>Children undergo acute painful procedures and many also experience chronic pain.Due to their developing systems, infants and children may be at greater risk than adults for protracted pain sensitivity.There is a need to manage acute and chronic <span class="hlt">paediatric</span> pain to reduce children's suffering and to prevent future pain problems.Consistent with a biopsychosocial perspective, complementary and alternative medicine (CAM) should be considered in management of acute and chronic <span class="hlt">paediatric</span> pain.Although research is limited for <span class="hlt">paediatric</span> pain, CAM interventions receiving the most empirical attention include hypnotherapy, acupuncture and music therapy. Evidence also exists for the therapeutic benefits of yoga, massage, humor therapy and the use of certain biological based therapies. PMID:26525515</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22826516','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22826516"><span id="translatedtitle">Informing policy and programme decisions for scaling up the PMTCT and <span class="hlt">paediatric</span> HIV response through joint technical missions.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Jashi, Mariam; Viswanathan, Rekha; Ekpini, Rene; Chandan, Upjeet; Idele, Priscilla; Luo, Chewe; Legins, Ken; Chatterjee, Anirban</p> <p>2013-07-01</p> <p>In 2005, due to slow global progress in the scale-up of prevention of mother-to-child transmission (PMTCT) and <span class="hlt">paediatric</span> HIV programmes, the Inter-agency Task Team (IATT) on the Prevention of HIV infection among Pregnant Women, Mothers, and their Children initiated joint technical missions (JTMs) to countries of high HIV disease burden. The JTMs were intended to galvanize country actions for a more comprehensive response to PMTCT and <span class="hlt">paediatric</span> HIV by bringing national and global stakeholders together to review national policies and programmes and develop country-specific recommendations for accelerating scale-up. Between 2005 and 2010, the IATT conducted JTMs in 18 low- and middle-income countries. In 2007, to assess the role played by the missions, a review in the first eight countries (Burkina Faso, Cameroon, Côte d'Ivoire, India, Malawi, Rwanda, Tanzania and Zambia) that hosted JTMs was undertaken. Country progress was assessed through desk review and key informant interviews. For each country, documents reviewed included JTM reports, baseline data for PMTCT and <span class="hlt">paediatric</span> HIV care and treatment, and 2004 to 2007 trend data on key PMTCT and <span class="hlt">paediatric</span> HIV indicators. Drawing upon the findings, this paper posits that JTMs contributed to national scale-up of PMTCT and <span class="hlt">paediatric</span> HIV programmes through strengthening governance and co-ordination mechanisms for the programmes, promoting enabling policy environments, and supporting the development of national scale-up plans, which have been critical for leveraging additional financial resources for scale-up. Although the <span class="hlt">impact</span> of the JTMs could be enhanced through greater follow-up and continued targeted assistance in technical areas such as infant and young child feeding, community-based programming and supply chain management, findings indicate that the JTMs are a useful mechanism for informing policy and programme decisions necessary for scaling up PMTCT and <span class="hlt">paediatric</span> HIV responses. Moreover, by bringing</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_17");'>17</a></li> <li><a href="#" onclick='return showDiv("page_18");'>18</a></li> <li class="active"><span>19</span></li> <li><a href="#" onclick='return showDiv("page_20");'>20</a></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_19 --> <div id="page_20" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_18");'>18</a></li> <li><a href="#" onclick='return showDiv("page_19");'>19</a></li> <li class="active"><span>20</span></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li><a href="#" onclick='return showDiv("page_22");'>22</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="381"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/22058851','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/22058851"><span id="translatedtitle">Health <span class="hlt">impact</span> assessment research and <span class="hlt">practice</span>: A place for paradigm positioning?</span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Haigh, Fiona; Harris, Patrick; Haigh, Neil</p> <p>2012-02-15</p> <p>In this article, we provide a critical review of the place of paradigm in health <span class="hlt">impact</span> assessment (HIA) research and <span class="hlt">practice</span>. We contend that most HIA practitioners have given insufficient attention to paradigm positioning when developing and applying HIA methodologies and that some concerns about current HIA <span class="hlt">practice</span> can be attributed to this. We review HIA literature to assess the extent and nature of attention given to paradigm positioning and these related concerns. We then respond to our critique by exploring the implications, opportunities and challenges of adopting a critical realist paradigm, which we believe has the potential to help HIA practitioners to develop HIA methodology in a way that addresses these issues. - Highlights: Black-Right-Pointing-Pointer We provide a critical review of the place of paradigm in HIA. Black-Right-Pointing-Pointer We demonstrate that HIA practitioners give insufficient attention to paradigm. Black-Right-Pointing-Pointer The implications, opportunities and challenges of adopting a critical realist paradigm are explored. Black-Right-Pointing-Pointer This is the first paper, to our knowledge, that discusses a critical realist approach to HIA.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2016AIPC.1761b0059L&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2016AIPC.1761b0059L&link_type=ABSTRACT"><span id="translatedtitle">The <span class="hlt">impact</span> of preventive maintenance <span class="hlt">practices</span> on manufacturing performance: A proposed model for SMEs in Malaysia</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Lazim, Halim Mad; Taib, Che Azlan; Lamsali, Hendrik; Saleh, Mohamed Najib; Subramaniam, Chandrakantan</p> <p>2016-08-01</p> <p>Preventive maintenance (PM) plays important role to avoid or mitigate potential stoppages and disruptions of equipment or machinery from occurring in daily operations. PM emphasized total employee involvement and it is important for companies as well as Small and Medium Sized Enterprises (SMEs). SME sectors contribution to the Malaysian economy makes up 95% of the total manufacturers, however PM remain relatively lacking. The ability, reliability and effective maintenance management is highly important in order to achieve desired manufacturing performance. Therefore, organizational capability in planning, controlling, implementing and monitoring PM activities is important. Furthermore, empirical evidence on the potential <span class="hlt">impact</span> of PM <span class="hlt">practices</span> towards manufacturing performance with organizational capability as a moderating effect is still limited and indecisive. Henceforth, this paper aims to explore and investigate potential relationships between PM <span class="hlt">practices</span> and manufacturing performance moderated by organizational capability in the contact of Malaysian SMEs in the manufacturing sector. Correspondently, the study intends to propose a new research framework and hypotheses to examine the abovementioned relationships. The proposed framework includes PM team, PM strategy and planned maintenance as the determinants, while organizational capability serves as the moderating variable. Manufacturing performance will be viewed in terms of innovation and financial factors. Proposed research direction and conclusion are discussed at the end of the study.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3069694','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3069694"><span id="translatedtitle"><span class="hlt">Impact</span> of Chlamydia trachomatis in the reproductive setting: British Fertility Society Guidelines for <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Akande, Valentine; Turner, Cathy; Horner, Paddy; Horne, Andrew; Pacey, Allan</p> <p>2010-01-01</p> <p>C. trachomatis infection of the genital tract is the most common sexually transmitted infection and has a worldwide distribution. The consequences of infection have an adverse effect on the reproductive health of women and are a common cause of infertility. Recent evidence also suggests an adverse effect on male reproduction. There is a need to standardise the approach to managing the <span class="hlt">impact</span> of C. trachomatis infection on reproductive health. We have surveyed current UK <span class="hlt">practice</span> towards screening and management of Chlamydia infections in the fertility setting. We found that at least 90% of clinicians surveyed offered screening. The literature on this topic was examined and revealed a paucity of solid evidence for estimating the risks of long-term reproductive sequelae following lower genital tract infection with C. trachomatis. The mechanism for the damage that occurs following Chlamydial infections is uncertain. However, instrumentation of the uterus in women with C. trachomatis infection is associated with a high risk of pelvic inflammatory disease, which can be prevented by appropriate antibiotic treatment andmay prevent infected women from being at increased risk of the adverse sequelae such as ectopic pregnancy and tubal factor infertility. Recommendations for <span class="hlt">practice</span> have been proposed and the need for further studies identified. PMID:20849196</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25836697','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25836697"><span id="translatedtitle">Eight years of quality control in Bulgaria: <span class="hlt">impact</span> on mammography <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Avramova-Cholakova, S; Lilkov, G; Kaneva, M; Terziev, K; Nakov, I; Mutkurov, N; Kovacheva, D; Ivanova, M; Vasilev, D</p> <p>2015-07-01</p> <p>The requirements for quality control (QC) in diagnostic radiology were introduced in Bulgarian legislation in 2005. Hospital medical physicists and several private medical physics groups provide QC services to radiology departments. The aim of this study was to analyse data from QC tests in mammography and to investigate the <span class="hlt">impact</span> of QC introduction on mammography <span class="hlt">practice</span> in the country. The study was coordinated by the National Centre of Radiobiology and Radiation Protection. All medical physics services were requested to fill in standardised forms with information about most important parameters routinely measured during QC. All QC service providers responded. Results demonstrated significant improvement of <span class="hlt">practice</span> since the introduction of QC, with reduction of established deviations from 65 % during the first year to 7 % in the last year. The systems that do not meet the acceptability criteria were suspended from use. Performance of automatic exposure control and digital detectors are not regularly tested because of the absence of requirements in the legislation. The need of updated guidance and training of medical physicists to reflect the change in technology was demonstrated. PMID:25836697</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1487803','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1487803"><span id="translatedtitle">Neonatal circumcision revisited. Fetus and Newborn Committee, Canadian <span class="hlt">Paediatric</span> Society.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>1996-01-01</p> <p>OBJECTIVE: To assist physicians in providing guidance to parents regarding neonatal circumcision. OPTIONS: Whether to recommend the routine circumcision of newborn male infants. OUTCOMES: Costs and complications of neonatal circumcision, the incidence of urinary tract infections, sexually transmitted diseases and cancer of the penis in circumcised and uncircumcised males, and of cervical cancer in their partners, and the costs of treating these diseases. EVIDENCE: The literature on circumcision was reviewed by the Fetus and Newborn Committee of the Canadian <span class="hlt">Paediatric</span> Society. During extensive discussion at meetings of the committee over a 24-month period, the strength of the evidence was carefully weighed and the perspective of the committee developed. VALUES: The literature was assessed to determine whether neonatal circumcision improves the health of boys and men and is a cost-effective approach to preventing penile problems and associated urinary tract conditions. Religious and personal values were not included in the assessment. BENEFITS, HARMS AND COSTS: The effect of neonatal circumcision on the incidence of urinary tract infection, sexually transmitted diseases, cancer of the penis, cervical cancer and penile problems; the complications of circumcision; and estimates of the costs of neonatal circumcision and of the treatment of later penile conditions, urinary tract infections and complications of circumcision. RECOMMENDATION: Circumcision of newborns should not be routinely performed. VALIDATION: This recommendation is in keeping with previous statements on neonatal circumcision by the Canadian <span class="hlt">Paediatric</span> Society and the American Academy of Pediatrics. The statement was reviewed by the Infectious Disease Committee of the Canadian <span class="hlt">Paediatric</span> Society. The Board of Directors of the Canadian <span class="hlt">Paediatric</span> Society has reviewed its content and approved it for publication. SPONSOR: This is an official statement of the Canadian <span class="hlt">Paediatric</span> Society. No external</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4045729','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4045729"><span id="translatedtitle">Oral Medicines for Children in the European <span class="hlt">Paediatric</span> Investigation Plans</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>van Riet – Nales, Diana A.; Römkens, Erwin G. A. W.; Saint-Raymond, Agnes; Kozarewicz, Piotr; Schobben, Alfred F. A. M.; Egberts, Toine C. G.; Rademaker, Carin M. A.</p> <p>2014-01-01</p> <p>Introduction Pharmaceutical industry is no longer allowed to develop new medicines for use in adults only, as the 2007 <span class="hlt">Paediatric</span> Regulation requires children to be considered also. The plans for such <span class="hlt">paediatric</span> development called <span class="hlt">Paediatric</span> Investigation Plans (PIPs) are subject to agreement by the European Medicines Agency (EMA) and its <span class="hlt">Paediatric</span> Committee (PDCO). The aim of this study was to evaluate the key characteristics of oral <span class="hlt">paediatric</span> medicines in the PIPs and the changes implemented as a result of the EMA/PDCO review. Methods All PIPs agreed by 31 December 2011 were identified through a proprietary EMA-database. PIPs were included if they contained an agreed proposal to develop an oral medicine for children 0 to 11 years. Information on the therapeutic area (EMA classification system); target age range (as defined by industry) and pharmaceutical characteristics (active substance, dosage form(s) as listed in the PIP, strength of each dosage form, excipients in each strength of each dosage form) was extracted from the EMA website or the EMA/PDCO assessment reports. Results A hundred and fifty PIPs were included corresponding to 16 therapeutic areas and 220 oral dosage forms in 431 strengths/compositions. Eighty-two PIPs (37%) included tablets, 44 (20%) liquids and 35 (16%) dosage forms with a specific composition/strength that were stored as a solid but swallowed as a liquid e.g. dispersible tablets. The EMA/PDCO review resulted in an increase of 13 (207 to 220) oral <span class="hlt">paediatric</span> dosage forms and 44 (387 to 431) dosage forms with a specific composition/strength. For many PIPs, the target age range was widened and the excipient composition and usability aspects modified. Conclusion The EMA/PDCO review realized an increase in the number of requirements for the development of oral dosage forms and a larger increase in the number of dosage forms with a specific composition/strength, both targeting younger children. Changes to their pharmaceutical design were</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/16335596','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/16335596"><span id="translatedtitle"><span class="hlt">Impact</span> of land use <span class="hlt">practices</span> on faunal abundance, nutrient dynamics and biochemical properties of desert pedoecosystem.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Tripathi, G; Sharma, B M</p> <p>2005-11-01</p> <p>Increased dependence of resource-poor rural communities on soils of low inherent fertility are the major problem of desert agroecosystem. Agrisilviculture <span class="hlt">practices</span> may help to conserve the soil biota for maintaining essential soil properties and processes in harsh climate. Therefore, the <span class="hlt">impacts</span> of different land use systems on faunal density, nutrient dynamics and biochemical properties of soil were studied in agrisilviculture system of Indian desert. The selected fields had trees (Zizyphus mauritiana, Prosopis cineraria, Acacia nilotica) and crops (Cuminum cyminum, Brassica nigra, Triticum aestivum) in different combinations. Populations of Acari, Myriapoda, Coleoptera, Collembola, other soil arthropods and total soil fauna showed significant changes with respect to different land use <span class="hlt">practices</span> and tree species, indicating a strong relation between above and below ground biodiversity. The Coleoptera exhibited greatest association with all agrisilviculture fields. The Z. mauritiana system indicated highest facilitative effects (RTE value) on all groups of soil fauna. Soil temperature, moisture, organic carbon, nitrate- and ammonical-nitrogen, available phosphorus, soil respiration and dehydrogenase activity were greater under tree than that of tree plus cropping system. It showed accumulation of nitrate-nitrogen in tree field and more utilization by crops in cultivated lands. Positive and significant correlation among organic carbon, nitrate- and ammonical-nitrogen, phosphorus, soil respiration and dehydrogenase activity clearly reflects increase in soil nutrients with the increase in microbial and other biotic activity. P. cineraria field was the best pedoecosystem, while C. cyminum was the best winter crop for cultivation in desert agroforestry system for soil biological health and soil sustainability. The increase in organic carbon, soil nutrients and microbial activity is associated with the increase in soil faunal population which reflect role of soil fauna</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.osti.gov/scitech/biblio/21499664','SCIGOV-STC'); return false;" href="http://www.osti.gov/scitech/biblio/21499664"><span id="translatedtitle">An evaluation of the environmental <span class="hlt">impact</span> assessment system in Vietnam: The gap between theory and <span class="hlt">practice</span></span></a></p> <p><a target="_blank" href="http://www.osti.gov/scitech">SciTech Connect</a></p> <p>Clausen, Alison; Vu, Hoang Hoa; Pedrono, Miguel</p> <p>2011-03-15</p> <p>Vietnam has one of the fastest growing economies in the world and has achieved significant socio-economic development in recent years. However this growth is placing increased pressure on an already depleted natural environment. Environmental <span class="hlt">impact</span> assessment (EIA) is recognised by the Government and international organizations as an important tool in the management of the <span class="hlt">impacts</span> of future development on the country's natural resource base. The Government's commitment to EIA has been demonstrated through the development and adoption of the Law on Environment Protection (Revised) in 2005 which sets out the requirements for EIA and which represents a major step in the development of a robust legislative framework for EIA in Vietnam. The Law on Environment Protection (Revised) 2005 has now been operational for several years and we have undertaken an evaluation of the resulting EIA system in Vietnam. We argue that while significant improvements have been achieved in the EIA policy framework, an important gap remains between EIA theory and <span class="hlt">practice</span>. We contend that the basis of the current EIA legislation is strong and that future developments of the EIA system in Vietnam should focus on improving capacity of EIA practitioners rather than further substantial legislative change. Such improvements would allow the Vietnamese EIA system to emerge as an effective and efficient tool for environmental management in Vietnam and as a model EIA framework for other developing countries.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/19276317','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/19276317"><span id="translatedtitle">Managed care regulation in the States: the <span class="hlt">impact</span> on physicians' <span class="hlt">practices</span> and clinical autonomy.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Kronebusch, Karl; Schlesinger, Mark; Thomas, Tracey</p> <p>2009-04-01</p> <p>While the states engaged in an extended period of adopting and revising laws regulating managed care during the 1990s, there has been to date only limited empirical assessment of the <span class="hlt">impacts</span> of these laws. For this analysis, we constructed a data set using information on state laws combined with survey responses of physicians. We distinguish regulations with a typology based on whether they affect the context or content of care and the target group of the regulation (consumer or provider). Our findings indicate that the context of care appears to be more efficaciously regulated than the content of care. Provisions concerning consumer access and contractual relationships lead to greater reported physician ability to obtain referrals and services, improved quality of clinical interactions, and greater perceived clinical autonomy. Regulations intended to enhance professional autonomy are associated with lower reported levels of utilization constraints and higher reported quality of clinical interactions. In contrast, consumer protection provisions, including procedures for appeals from plan decisions, appear to have had little <span class="hlt">impact</span> on most physicians' <span class="hlt">practices</span>. Despite structural and legal constraints on the potential effectiveness of these regulations, state managed care legislation appears to have provided some protections against managed care restrictions on physicians' clinical autonomy. PMID:19276317</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2014E%26ES...18a2092H','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2014E%26ES...18a2092H"><span id="translatedtitle">Road-networks, a <span class="hlt">practical</span> indicator of human <span class="hlt">impacts</span> on biodiversity in Tropical forests</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Hosaka, T.; Yamada, T.; Okuda, T.</p> <p>2014-02-01</p> <p>Tropical forests sustain the most diverse plants and animals in the world, but are also being lost most rapidly. Rapid assessment and monitoring using remote sensing on biodiversity of tropical forests is needed to predict and evaluate biodiversity loss by human activities. Identification of reliable indicators of forest biodiversity and/or its loss is an urgent issue. In the present paper, we propose the density of road networks in tropical forests can be a good and <span class="hlt">practical</span> indicator of human <span class="hlt">impacts</span> on biodiversity in tropical forests through reviewing papers and introducing our preliminary survey in peninsular Malaysia. Many previous studies suggest a strong negative <span class="hlt">impact</span> of forest roads on biodiversity in tropical rainforests since they changes microclimate, soil properties, drainage patterns, canopy openness and forest accessibility. Moreover, our preliminary survey also showed that even a narrow logging road (6 m wide) significantly lowered abundance of dung beetles (well-known bio-indicator in biodiversity survey in tropical forests) near the road. Since these road networks are readily to be detected with remote sensing approach such as aerial photographs and Lider, regulation and monitoring of the road networks using remote sensing techniques is a key to slow down the rate of biodiversity loss due to forest degradation in tropical forests.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/20618385','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/20618385"><span id="translatedtitle">Health and social <span class="hlt">impacts</span> of a flood disaster: responding to needs and implications for <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Carroll, Bob; Balogh, Ruth; Morbey, Hazel; Araoz, Gonzalo</p> <p>2010-10-01</p> <p>Carlisle in northwest England suffered its worse floods for more than 180 years in 2005. A study, reported here, was undertaken to assess the health and social <span class="hlt">impacts</span> of these floods via in-depth, taped individual and focus-group interviews with people whose homes had been flooded and with agency workers who helped them. Respondents spoke of physical health ailments, psychological stress, water health-and-safety issues related to the floods, and disputes with insurance and construction companies, which they felt had caused and exacerbated psychological health problems. Support workers also suffered from psychological stress. Furthermore, it was found that people had low expectations of a flood and were not prepared. The findings are presented in five sections covering flood risk awareness, water contamination issues, physical health, mental health, and <span class="hlt">impact</span> on frontline support workers. The discussion focuses on the implications of the findings for policy and <span class="hlt">practice</span> vis-à-vis psychological health provision, contamination issues, training and support for frontline support workers, matters relating to restoration, and preparation for flooding. PMID:20618385</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2016EGUGA..18.2964C','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2016EGUGA..18.2964C"><span id="translatedtitle">The <span class="hlt">impact</span> of disturbance and ensuing forestry <span class="hlt">practices</span> on Collembola in spruce forest stands</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Čuchta, Peter</p> <p>2016-04-01</p> <p>Soil Collembola communities were investigated in spruce forest stands of the High Tatra Mts that had been heavily damaged by a windstorm in November 2004 and subsequently by a wildfire in July 2005. The study focused on the <span class="hlt">impact</span> of these disturbances and forestry <span class="hlt">practices</span> on collembolan community distribution and structure four years after the disturbance. Four different treatments were selected for this study: intact forest stands (REF), non-extracted windthrown stands (NEX), clear-cut windthrown stands (EXT) and burnt windthrown stands (FIR). From a total of 7,820 individuals, 72 species were identified. The highest total abundance mean was recorded in FIR stands followed by NEX and EXT stands and, surprisingly, the lowest in REF stands. The highest total species richness was observed in REF stands, followed by NEX stands and FIR stands and the lowest in EXT stands. In REF and NEX stands the most abundant species were Folsomia penicula and Tetracanthella fjellbergi, while in heavily damaged stands the most abundant was Anurophorus laricis. The present study shows the negative <span class="hlt">impact</span> of windthrow on Collembola communities as reflected in decreased species richness and abundance. However, disturbance by fire caused a considerable increase in collembolan abundance three years after the event. Moreover, we found out that clearing of windthrown spruce forests after a windstorm is less favourable for communities of soil collembolans and slows down the recovery process.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2720361','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2720361"><span id="translatedtitle">The <span class="hlt">Impact</span> of Advanced Pharmacy <span class="hlt">Practice</span> Experiences on Students' Readiness for Self-directed Learning</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Haines, Stuart T.; Plaza, Cecilia M.; Sturpe, Deborah A.; Williams, Greg; Rodriguez de Bittner, Magaly A.; Roffman, David S.</p> <p>2009-01-01</p> <p>Objective To evaluate the <span class="hlt">impact</span> of advanced pharmacy <span class="hlt">practice</span> experiences (APPEs) on doctor of pharmacy (PharmD) students' readiness for self-directed learning. Methods The Self-Directed Learning Readiness Scale (SDLRS) was administered to students prior to and after completing their APPEs. SDLRS is a validated instrument that determines the relative degree to which students have the attitudes and motivation to engage in self-directed learning. Results Seventy-seven (64%) students completed the SDLRS prior to starting their APPEs and 80 (67%) students completed the instrument after completing their APPEs. Forty-six (38%) students completed both. Prior to starting their APPEs, 74% of students scored greater than 150 on the SDLRS, indicating a high level of readiness for self-directed learning. No significant difference was found between the mean scores of students who took the SDLRS both prior to (159 ± 20) and after completing their APPEs (159 ± 24; p > 0.05). Conclusion Students at our institution appear to be ready for self-directed learning but APPEs had a minimal <span class="hlt">impact</span> on their readiness for self-directed learning. PMID:19657498</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2491451','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2491451"><span id="translatedtitle">Global Challenges in the Development and Delivery of <span class="hlt">Paediatric</span> Antiretrovirals</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Bowen, Asha; Palasanthiran, Pamela; Sohn, Annette H.</p> <p>2008-01-01</p> <p>By the end of 2006, compared with 28% coverage for adults, only 15% of children with HIV who needed antiretroviral treatment were receiving it. Major challenges in delivering treatment include the lack of <span class="hlt">paediatric</span> antiretrovirals that can be dosed in small children and limited studies examining safety and efficacy for existing antiretroviral formulations. The high costs of treatment have been reduced through the use of generic, fixed-dose combination drugs. Evidence-based strategies for managing resistance and the scale-up of pharmacological trials for children in low- and middle-income countries are critical to the success and future development of <span class="hlt">paediatric</span> antiretrovirals. PMID:18549980</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25498582','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25498582"><span id="translatedtitle">Challenges in <span class="hlt">paediatric</span> procedural sedation: political, economic, and clinical aspects.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Mason, K P</p> <p>2014-12-01</p> <p><span class="hlt">Paediatric</span> sedation has expanded in volume and demand over the past decade. In parallel with the increasing demand for and delivery of sedation by multi-specialty providers, conflicting political agendas have surfaced. With a limited selection of sedatives and few new sedatives to market over the past decade, some providers utilize agents that formerly were considered exclusive for administration by anaesthesiologists. This review highlights the important contributions to <span class="hlt">paediatric</span> sedation over the past century. Considerations include the barriers and politics that impede progress and also future advances and contributions that may lie ahead. PMID:25498582</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/23714394','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/23714394"><span id="translatedtitle">Clinical competence in developmental-behavioural <span class="hlt">paediatrics</span>: raising the bar.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>O'Keeffe, Mick</p> <p>2014-01-01</p> <p>For our specialist <span class="hlt">paediatric</span> workforce to be suitably equipped to deal with current childhood morbidity, a high level of competence in developmental-behavioural <span class="hlt">paediatrics</span> (DBP) is necessary. New models of training and assessment are required to meet this challenge. An evolution of training in DBP, built around the centrepiece of competency-based medical education, is proposed. Summative assessment based upon entrustable professional activities, and a menu of formative workplace-based assessments specific to the DBP context are key components. A pilot project to develop and implement these changes is recommended. PMID:23714394</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27350522','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27350522"><span id="translatedtitle">The <span class="hlt">Impact</span> of Twitter and Facebook on Nursing <span class="hlt">Practice</span> and Education: A Systematic Review of the Literature.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Asiri, Hanan; Househ, Mowafa</p> <p>2016-01-01</p> <p>This systematic review aims to answer the following question: What is the <span class="hlt">impact</span> of Twitter and Facebook on nursing <span class="hlt">practice</span> and education? Any article that was written in English and was published in PubMed and Computers Informatics Nursing (CIN) journal from 2011 up to 2016 and discussed the <span class="hlt">impact</span> of Twitter and Facebook on nursing <span class="hlt">practice</span> and education was included, while any opinion and review articles were excluded. The results show three themes that are covered by the literature: (1) using social media to enhance students' confidence and /or self-efficacy, (2) characteristics of nurses who use social media, and (3) preferred modes of communication. Further research is still needed to reveal the <span class="hlt">impact</span> of Twitter and Facebook on nursing education as well as other specialties of nursing <span class="hlt">practice</span>. PMID:27350522</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26227314','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26227314"><span id="translatedtitle">[Blood cultures in the <span class="hlt">paediatric</span> emergency department. Guidelines and recommendations on their indications, collection, processing and interpretation].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Hernández-Bou, S; Álvarez Álvarez, C; Campo Fernández, M N; García Herrero, M A; Gené Giralt, A; Giménez Pérez, M; Piñeiro Pérez, R; Gómez Cortés, B; Velasco, R; Menasalvas Ruiz, A I; García García, J J; Rodrigo Gonzalo de Liria, C</p> <p>2016-05-01</p> <p>Blood culture (BC) is the gold standard when a bacteraemia is suspected, and is one of the most requested microbiological tests in <span class="hlt">paediatrics</span>. Some changes have occurred in recent years: the introduction of new vaccines, the increasing number of patients with central vascular catheters, as well as the introduction of continuous monitoring BC systems. These changes have led to the review and update of different factors related to this technique in order to optimise its use. A <span class="hlt">practice</span> guideline is presented with recommendations on BC, established by the Spanish Society of <span class="hlt">Paediatric</span> Emergency Care and the Spanish Society for <span class="hlt">Paediatric</span> Infectious Diseases. After reviewing the available scientific evidence, several recommendations for each of the following aspects are presented: BC indications in the Emergency Department, how to obtain, transport and process cultures, special situations (indications and interpretation of results in immunosuppressed patients and/or central vascular catheter carriers, indications for anaerobic BC), differentiation between bacteraemia and contamination when a BC shows bacterial growth and actions to take with a positive BC in patients with fever of unknown origin. PMID:26227314</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27179812','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27179812"><span id="translatedtitle">Cosmet'eau-Changes in the personal care product consumption <span class="hlt">practices</span>: from whistle-blowers to <span class="hlt">impacts</span> on aquatic environments.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Bressy, Adèle; Carré, Catherine; Caupos, Émilie; de Gouvello, Bernard; Deroubaix, José-Frédéric; Deutsch, Jean-Claude; Mailler, Romain; Marconi, Anthony; Neveu, Pascale; Paulic, Laurent; Pichon, Sébastien; Rocher, Vincent; Severin, Irina; Soyer, Mathilde; Moilleron, Régis</p> <p>2016-07-01</p> <p>The Cosmet'eau project (2015-2018) investigates the "changes in the personal care product (PCP) consumption <span class="hlt">practices</span>: from whistle-blowers to <span class="hlt">impacts</span> on aquatic environments." In this project, the example of PCPs will be used to understand how public health concerns related to micropollutants can be addressed by public authorities-including local authorities, industries, and consumers. The project aims to characterize the possible changes in PCP consumption <span class="hlt">practices</span> and to evaluate the <span class="hlt">impact</span> of their implementation on aquatic contamination. Our goals are to study the whistle-blowers, the risk perception of consumers linked with their <span class="hlt">practices</span>, and the contamination in parabens and their substitutes, triclosan, and triclocarban from wastewater to surface water. The project investigates the following potential solutions: modifications of industrial formulation or changes in consumption <span class="hlt">practices</span>. The final purpose is to provide policy instruments for local authorities aiming at building effective strategies to fight against micropollutants in receiving waters. PMID:27179812</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24231050','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24231050"><span id="translatedtitle">Design and physicochemical stability studies of <span class="hlt">paediatric</span> oral formulations of sildenafil.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Provenza, N; Calpena, A C; Mallandrich, M; Halbaut, L; Clares, B</p> <p>2014-01-01</p> <p>Personalized medicine is a challenging research area in <span class="hlt">paediatric</span> treatments. Elaborating new <span class="hlt">paediatric</span> formulations when no commercial forms are available is a common <span class="hlt">practice</span> in pharmacy laboratories; among these, oral liquid formulations are the most common. But due to the lack of specialized equipment, frequently studies to assure the efficiency and safety of the final medicine cannot be carried out. Thus the purpose of this work was the development, characterization and stability evaluation of two oral formulations of sildenafil for the treatment of neonatal persistent pulmonary hypertension. After the establishment of a standard operating procedure (SOP) and elaboration, the physicochemical stability parameters appearance, pH, particle size, rheological behaviour and drug content of formulations were evaluated at three different temperatures for 90 days. Equally, prediction of long term stability, as well as, microbiological stability was performed. Formulations resulted in a suspension and a solution slightly coloured exhibiting fruity odour. Formulation I (suspension) exhibited the best physicochemical properties including Newtonian behaviour and uniformity of API content above 90% to assure an exact dosification process. PMID:24231050</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_18");'>18</a></li> <li><a href="#" onclick='return showDiv("page_19");'>19</a></li> <li class="active"><span>20</span></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li><a href="#" onclick='return showDiv("page_22");'>22</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_20 --> <div id="page_21" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_19");'>19</a></li> <li><a href="#" onclick='return showDiv("page_20");'>20</a></li> <li class="active"><span>21</span></li> <li><a href="#" onclick='return showDiv("page_22");'>22</a></li> <li><a href="#" onclick='return showDiv("page_23");'>23</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="401"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26909217','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26909217"><span id="translatedtitle">Prevalence of and Reasons for Patients Leaving Against Medical Advice from <span class="hlt">Paediatric</span> Wards in Oman.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Al-Ghafri, Mohamed; Al-Bulushi, Abdullah; Al-Qasmi, Ahmed</p> <p>2016-02-01</p> <p>The objective of this study was to determine the prevalence of and reasons for patients leaving against medical advice (LAMA) in a <span class="hlt">paediatric</span> setting in Oman. This retrospective study was carried out between January 2007 and December 2009 and assessed patients who left the <span class="hlt">paediatric</span> wards at the Royal Hospital, Muscat, Oman, against medical advice. Of 11,482 regular discharges, there were 183 cases of LAMA (prevalence: 1.6%). Dissatisfaction with treatment and a desire to seek a second opinion were collectively the most cited reasons for LAMA according to data from the hospital's electronic system (27.9%) and telephone conversations with patients' parents (55.0%). No reasons for LAMA were documented in the hospital's electronic system for 109 patients (59.6%). The low observed prevalence of LAMA suggests good medical <span class="hlt">practice</span> at the Royal Hospital. This study indicates the need for thorough documentation of all LAMA cases to ensure the availability of high-quality data for healthcare workers involved in preventing LAMA. PMID:26909217</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26679269','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26679269"><span id="translatedtitle">The church and <span class="hlt">paediatric</span> HIV care in rural South Africa: a qualitative study.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Norder, Wilma A J; Peters, Remco P H; Kok, Maarten O; van Elsland, Sabine L; Struthers, Helen E; Tutu, Mpho A; van Furth, A Marceline</p> <p>2015-01-01</p> <p>Religion has substantial - positive and negative - influence on South Africa's HIV context. This qualitative study explored possibilities for positive church engagement in <span class="hlt">paediatric</span> HIV care in a rural district in Limpopo Province, South Africa. Opinions, attitudes and experiences of various stakeholders including religious leaders, healthcare workers and people infected/affected with/by HIV were investigated through participant observation, semi-structured interviews and focus group discussions. During the research the original focus on <span class="hlt">paediatric</span> HIV care shifted to HIV care in general in reaction to participant responses. Participants identified three main barriers to positive church engagement in HIV care: (a) stigma and disclosure; (b) sexual associations with HIV and (c) religious beliefs and <span class="hlt">practices</span>. All participant groups appreciated the opportunity and relevance of strengthening church involvement in HIV care. Opportunities for positive church engagement in HIV care that participants identified included: (a) comprehensive and holistic HIV care when churches and clinics collaborate; (b) the wide social reach of churches and (c) the safety and acceptance in churches. Findings indicate that despite barriers great potential exists for increased positive church engagement in HIV care in rural South Africa. Recommendations include increased medical knowledge and dialogue on HIV/AIDS within church settings, and increased collaboration between churches and the medical sector. PMID:26679269</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4443823','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4443823"><span id="translatedtitle">Use of growth charts in Canada: A National Canadian <span class="hlt">Paediatric</span> Surveillance Program survey</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Lawrence, Sarah; Cummings, Elizabeth; Chanoine, Jean-Pierre; Metzger, Daniel; Palmert, Mark; Sharma, Aul; Rodd, Celia</p> <p>2015-01-01</p> <p>BACKGROUND: In 2010, the WHO Growth Charts for Canada were recommended for use in Canada, while the US Centers for Disease Control and Prevention (Georgia, USA) charts remained in active use. OBJECTIVE: To assess the availability, utilization of and satisfaction with growth charts in clinical <span class="hlt">practice</span> in Canada. METHODS: In October 2012, a one-time survey was sent through the Canadian <span class="hlt">Paediatric</span> Surveillance Program (CPSP) to 2544 paediatricians and 280 family physicians with a stated interest in <span class="hlt">paediatrics</span>. RESULTS: The response rate was 24% (63% general paediatricians, 36% subspecialists, 1% family physicians). Of these respondents, 68% preferred the WHO charts for infants and 49% for children and youth. Regarding the WHO charts, 49.7% of respondents reported concerns with their inability to assess weight for children >10 years of age, and many believed that there were too few percentile lines between the third and 97th percentiles for infant (24%) and for child and youth measures (19%). The addition of extreme percentiles (0.1 and 99.9), shading on charts and lack of availability with electronic medical record providers were other concerns mentioned by 10% to 13% of respondents. CONCLUSION: There is support for the use of the WHO data for monitoring the growth of Canadian children. Concerns regarding the design of the charts were raised. These survey results lend support to the redesign of the WHO Growth Charts for Canada, as was recently completed in 2014. PMID:26038634</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2015PhDT........33E&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2015PhDT........33E&link_type=ABSTRACT"><span id="translatedtitle">Mathematics education <span class="hlt">practice</span> in Nigeria: Its <span class="hlt">impact</span> in a post-colonial era</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Enime, Noble O. J.</p> <p></p> <p>This qualitative research method of study examined the <span class="hlt">impacts</span> of the Nigerian pre-independence era Mathematics Education <span class="hlt">Practice</span> on the Post-Colonial era Mathematics Education <span class="hlt">Practice</span>. The study was designed to gather qualitative information related to Pre-independence and Postcolonial era data related to Mathematics Education <span class="hlt">Practice</span> in Nigeria (Western, Eastern and the Middle Belt) using interview questions. Data was collected through face to face interviews. Over ten themes emerged from these qualitative interview questions when data was analyzed. Some of the themes emerging from the sub questions were as follows. "Mentally mature to understand the mathematics" and "Not mentally mature to understand the mathematics", "mentally mature to understand the mathematics, with the help of others" and "Not Sure". Others were "Contented with Age of Enrollment" and "Not contented with Age of Enrollment". From the questions of type of school attended and liking of mathematics the following themes emerged: "Attended UPE (Universal Primary Education) and understood Mathematics", and "Attended Standard Education System and did not like Mathematics". Connections between the liking of mathematics and the respondents' eventual careers were seen through the following themes that emerged. "Biological Sciences based career and enjoyed High School Mathematics Experience", "Economics and Business Education based career and enjoyed High School Mathematics Experience" and five more themes. The themes, "Very helpful" and "Unhelpful" emerged from the question concerning parents and students' homework. Some of the themes emerging from the interviews were as follows: "Awesome because of method of Instruction of Mathematics", "Awesome because Mathematics was easy", "Awesome because I had a Good Teacher or Teachers" and four other themes, "Like and dislike of Mathematics", "Heavy work load", "Subject matter content" and "Rigor of instruction". More emerging themes are presented in this</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3040127','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3040127"><span id="translatedtitle">Supporting work <span class="hlt">practices</span> through telehealth: <span class="hlt">impact</span> on nurses in peripheral regions</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2011-01-01</p> <p>Background In Canada, workforce shortages in the health care sector constrain the ability of the health care system to meet the needs of its population and of its health care professionals. This issue is of particular importance in peripheral regions of Quebec, where significant inequalities in workforce distribution between regions has lead to acute nursing shortages and increased workloads. Information and communication technologies (ICTs) are innovative solutions that can be used to develop strategies to optimise the use of available resources and to design new nursing work <span class="hlt">practices</span>. However, current knowledge is still limited about the real <span class="hlt">impact</span> of ICTs on nursing recruitment and retention. Our aim is to better understand how work <span class="hlt">practice</span> reorganization, supported by ICTs, and particularly by telehealth, may influence professional, educational, and organizational factors relating to Quebec nurses, notably those working in peripheral regions. Methods/Design First, we will conduct a descriptive study on the issue of nursing recruitment. Stratified sampling will be used to select approximately twenty innovative projects relating to the reorganization of work <span class="hlt">practices</span> based upon ICTs. Semi-structured interviews with key informants will determine professional, educational, and organizational recruitment factors. The results will be used to create a questionnaire which, using a convenience sampling method, will be mailed to 600 third year students and recent graduates of two Quebec university nursing faculties. Descriptive, correlation, and hierarchical regression analyses will be performed to identify factors influencing nursing graduates' intentions to <span class="hlt">practice</span> in peripheral regions. Secondly, we will conduct five case studies pertaining to the issue of nursing retention. Five ICT projects in semi-urban, rural, and isolated regions have been identified. Qualitative data will be collected through field observation and approximately fifty semi</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4228245','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4228245"><span id="translatedtitle"><span class="hlt">Impact</span> of a large-scale educational intervention program on venous blood specimen collection <span class="hlt">practices</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2013-01-01</p> <p>Background Phlebotomy performed with poor adherence to venous blood specimen collection (VBSC) guidelines jeopardizes patient safety and may lead to patient suffering and adverse events. A first questionnaire study demonstrated low compliance to VBSC guidelines, motivating an educational intervention of all phlebotomists within a county council. The aim was to evaluate the <span class="hlt">impact</span> of a large-scale educational intervention program (EIP) on primary health care phlebotomists’ adherence to VBSC guidelines. We hypothesised that the EIP would improve phlebotomists’ VBSC <span class="hlt">practical</span> performance. Methods The present study comprise primary health care centres (n = 61) from two county councils in northern Sweden. The final selected study group consisted of phlebotomists divided into an intervention group (n = 84) and a corresponding control group (n = 79). Both groups responded to a validated self-reported VBSC questionnaire twice. The EIP included three parts: guideline studies, an oral presentation, and an examination. Non-parametric statistics were used for comparison within and between the groups. Results Evaluating the EIP, we found significant improvements in the intervention group compared to the control group on self-reported questionnaire responses regarding information search (ES = 0.23-0.33, p < 0.001-0.003), and patient rest prior to phlebotomy (ES = 0.27, p = 0.004). Test request management, patient identity control, release of venous stasis, and test tube labelling had significantly improved in the intervention group but did not significantly differ from the control group (ES = 0.22- 0.49, p = < 0.001- 0.006). The control group showed no significant improvements at all (ES = 0–0.39, p = 0.016-0.961). Conclusions The present study demonstrated several significant improvements on phlebotomists’ adherence to VBSC <span class="hlt">practices</span>. Still, guideline adherence improvement to several crucial phlebotomy <span class="hlt">practices</span> is needed. We</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2008AGUFM.H33F1090I&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2008AGUFM.H33F1090I&link_type=ABSTRACT"><span id="translatedtitle">Environmental <span class="hlt">Impact</span> Assessment of Shrimp Culture <span class="hlt">Practice</span> in Southwest Coastal Region of Bangladesh</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Islam, M. M.; Rouf, M. A.; Hambrey, J.</p> <p>2008-12-01</p> <p> nutrients through supply water was slightly higher than nutrient discharged through water outlet, which indicates a net retention of nutrients in the pond ecosystems. A large portion of this sediment nutrient eventually finds its routes into the wider aquatic system every year during pond preparation. Though the aquatic environment is able to accommodate the load from the present level of aquaculture <span class="hlt">practice</span>, the assimilative power of aquatic environment is in danger of being degraded with the unplanned intensification of shrimp culture areas. In planning aquaculture and future development all the issues and <span class="hlt">impacts</span> must be considered.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=vision&pg=3&id=EJ972718','ERIC'); return false;" href="http://eric.ed.gov/?q=vision&pg=3&id=EJ972718"><span id="translatedtitle">From Philosophy to <span class="hlt">Practice</span>: An Investigation of the <span class="hlt">Impact</span> of a School's Philosophy on Policy and Classroom <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Scouller, Dianne L.</p> <p>2012-01-01</p> <p>Recent research in two New Zealand Christian schools found that despite biblical vision and mission statements and declarations of pedagogy built on biblical foundations, actual classroom <span class="hlt">practice</span> frequently differed little from that in secular schools. Teachers could clearly articulate their respective school's vision and goals but all except one…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27213867','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27213867"><span id="translatedtitle">Modelling the <span class="hlt">impacts</span> of agricultural management <span class="hlt">practices</span> on river water quality in Eastern England.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Taylor, Sam D; He, Yi; Hiscock, Kevin M</p> <p>2016-09-15</p> <p>Agricultural diffuse water pollution remains a notable global pressure on water quality, posing risks to aquatic ecosystems, human health and water resources and as a result legislation has been introduced in many parts of the world to protect water bodies. Due to their efficiency and cost-effectiveness, water quality models have been increasingly applied to catchments as Decision Support Tools (DSTs) to identify mitigation options that can be introduced to reduce agricultural diffuse water pollution and improve water quality. In this study, the Soil and Water Assessment Tool (SWAT) was applied to the River Wensum catchment in eastern England with the aim of quantifying the long-term <span class="hlt">impacts</span> of potential changes to agricultural management <span class="hlt">practices</span> on river water quality. Calibration and validation were successfully performed at a daily time-step against observations of discharge, nitrate and total phosphorus obtained from high-frequency water quality monitoring within the Blackwater sub-catchment, covering an area of 19.6 km(2). A variety of mitigation options were identified and modelled, both singly and in combination, and their long-term effects on nitrate and total phosphorus losses were quantified together with the 95% uncertainty range of model predictions. Results showed that introducing a red clover cover crop to the crop rotation scheme applied within the catchment reduced nitrate losses by 19.6%. Buffer strips of 2 m and 6 m width represented the most effective options to reduce total phosphorus losses, achieving reductions of 12.2% and 16.9%, respectively. This is one of the first studies to quantify the <span class="hlt">impacts</span> of agricultural mitigation options on long-term water quality for nitrate and total phosphorus at a daily resolution, in addition to providing an estimate of the uncertainties of those <span class="hlt">impacts</span>. The results highlighted the need to consider multiple pollutants, the degree of uncertainty associated with model predictions and the risk of</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/16448770','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/16448770"><span id="translatedtitle">Are <span class="hlt">paediatric</span> burns more common in asylum seekers? An analysis of <span class="hlt">paediatric</span> burn admissions.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Dempsey, M P; Orr, D J A</p> <p>2006-03-01</p> <p>The number of asylum seekers in Ireland has increased dramatically over the last 10 years. Based on our impression that the number of children admitted to our burn unit was disproportionately represented by children of asylum seekers we performed an audit to establish (1) what proportion of admissions are from this subgroup and (2) the characteristics of their burns. All <span class="hlt">paediatric</span> burn admissions from May 2003 to April 2004 were reviewed. Data collected from a retrospective chart review included patient demographics and details of the burn injuries. The National Census of 2002 and the Office of the Refugee Applications Commissioner were consulted for population statistics. Total burn admissions for the period were 126: Irish nationals (n=107), non-national residents (n=2), asylum seekers (n=14) and patients of unknown asylum status (n=3, excluded from study). In the asylum seeker group, the median age was 18.6 months (range 10 months-5.3 years) with the majority less than 2 years (n=11). All burns occurred in the domestic setting. Scalds accounted for 13 cases, one contact burn occurred from a hot grill. The median total body surface area burned was 5.7% (range 1.5-26%). The National Census of 2002 recorded a population of 3,917,203. With less than 12,000 asylum seekers in the country, they comprise only approximately 0.3% of the population yet they account for 11.4% of the burn patients admitted to our unit, p<0.0001. Children of asylum seekers are over-represented in our series of <span class="hlt">paediatric</span> admissions for burns and are more likely than Irish children to sustain a burn at a younger age and in the domestic setting. This may indicate an increased risk of injury and warrants further investigation. PMID:16448770</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26970680','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26970680"><span id="translatedtitle">Sex bias in <span class="hlt">paediatric</span> autoimmune disease - Not just about sex hormones?</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Chiaroni-Clarke, Rachel C; Munro, Jane E; Ellis, Justine A</p> <p>2016-05-01</p> <p>Autoimmune diseases affect up to 10% of the world's population, and approximately 80% of those affected are female. The majority of autoimmune diseases occur more commonly in females, although some are more frequent in males, while others show no bias by sex. The mechanisms leading to sex biased disease prevalence are not well understood. However, for adult-onset autoimmune disease, at least some of the cause is usually ascribed to sex hormones. This is because levels of sex hormones are one of the most obvious physiological differences between adult males and females, and their <span class="hlt">impact</span> on immune system function is well recognised. While for <span class="hlt">paediatric</span>-onset autoimmune diseases a sex bias is not as common, there are several such diseases for which one sex predominates. For example, the oligoarticular subtype of juvenile idiopathic arthritis (JIA) occurs in approximately three times more girls than boys, with a peak age of onset well before the onset of puberty, and at a time when levels of androgen and oestrogen are low and not strikingly different between the sexes. Here, we review potential explanations for autoimmune disease sex bias with a particular focus on <span class="hlt">paediatric</span> autoimmune disease, and biological mechanisms outside of sex hormone differences. PMID:26970680</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26848103','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26848103"><span id="translatedtitle">How to use faecal calprotectin in management of <span class="hlt">paediatric</span> inflammatory bowel disease.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Saha, Amit; Tighe, Mark P; Batra, Akshay</p> <p>2016-06-01</p> <p>Faecal calprotectin (FC) is a neutrophil-derived protein released in stool in response to mucosal inflammation. It is a simple, cheap and non-invasive test with high sensitivity and moderate specificity, which can be useful in the diagnosis and monitoring of inflammatory bowel disease (IBD). FC levels correlate well with bowel inflammation (both macroscopic and histological activity) and are not influenced by disease location or type of IBD. Despite the shortcoming with regards to specificity, it is the high sensitivity of FC that makes it a valuable screening tool in the diagnosis of IBD. It is especially effective in identifying children with low probability of IBD who would not benefit from further investigations. The cut-off value selected has a significant <span class="hlt">impact</span> on the diagnostic accuracy of the test, influencing its sensitivity and specificity, and must be interpreted judiciously. Its role in disease monitoring is as an add-on test to <span class="hlt">Paediatric</span> Ulcerative Colitis Activity Index and <span class="hlt">Paediatric</span> Crohn's Disease Activity Index scores and can be used to differentiate disease relapse from functional symptoms. High levels of FC are also seen in a number of other conditions, such as gastrointestinal infections and coeliac disease. It is recommended that infective causes affecting the gut must be excluded first, before FC is measured. PMID:26848103</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/23943468','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/23943468"><span id="translatedtitle">Improved neurocognitive test performance in both arms of the SMART study: <span class="hlt">impact</span> of <span class="hlt">practice</span> effect.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Grund, Birgit; Wright, Edwina J; Brew, Bruce J; Price, Richard W; Roediger, Mollie P; Bain, Margaret P; Hoy, Jennifer F; Shlay, Judith C; Vjecha, Michael J; Robertson, Kevin R</p> <p>2013-08-01</p> <p>We evaluated factors associated with improvement in neurocognitive performance in 258 HIV-infected adults with baseline CD4 lymphocyte counts above 350 cells/mm³ randomized to intermittent, CD4-guided antiretroviral therapy (ART) (128 participants) versus continuous therapy (130) in the Neurology substudy of the Strategies for Management of Antiretroviral Therapy trial. Participants were enrolled in Australia, North America, Brazil, and Thailand, and neurocognitive performance was assessed by a five-test battery at baseline and month 6. The primary outcome was change in the quantitative neurocognitive performance z score (QNPZ-5), the average of the z scores of the five tests. Associations of the 6-month change in test scores with ART use, CD4 cell counts, HIV RNA levels, and other factors were determined using multiple regression models. At baseline, median age was 40 years, median CD4 cell count was 513 cells/mm³, 88 % had plasma HIV RNA ≤ 400 copies/mL, and mean QNPZ-5 was -0.68. Neurocognitive performance improved in both treatment groups by 6 months; QNPZ-5 scores increased by 0.20 and 0.13 in the intermittent and continuous ART groups, respectively (both P < 0.001 for increase and P = 0.26 for difference). ART was used on average for 3.6 and 5.9 out of the 6 months in the intermittent and continuous ART groups, respectively, but the increase in neurocognitive test scores could not be explained by ART use, changes in CD4, or plasma HIV RNA, which suggests a <span class="hlt">practice</span> effect. The <span class="hlt">impact</span> of a <span class="hlt">practice</span> effect after 6 months emphasizes the need for a control group in HIV studies that measure intervention effects using neurocognitive tests similar to ours. PMID:23943468</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3963803','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3963803"><span id="translatedtitle">Improved neurocognitive test performance in both arms of the SMART study: <span class="hlt">impact</span> of <span class="hlt">practice</span> effect</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Grund, Birgit; Wright, Edwina J.; Brew, Bruce J.; Price, Richard W.; Roediger, Mollie P.; Bain, Margaret P.; Hoy, Jennifer F.; Shlay, Judith C.; Vjecha, Michael J.; Robertson, Kevin R.</p> <p>2013-01-01</p> <p>We evaluated factors associated with improvement in neurocognitive performance in 258 HIV-infected adults with baseline CD4 lymphocyte counts above 350 cells/mm3 randomized to intermittent, CD4-guided antiretroviral therapy (ART) (128 participants) versus continuous therapy (130) in the Neurology substudy of the Strategies for Management of Antiretroviral Therapy trial. Participants were enrolled in Australia, North America, Brazil, and Thailand, and neurocognitive performance was assessed by a five-test battery at baseline and month 6. The primary outcome was change in the quantitative neurocognitive performance z score (QNPZ-5), the average of the z scores of the five tests. Associations of the 6-month change in test scores with ART use, CD4 cell counts, HIV RNA levels, and other factors were determined using multiple regression models. At baseline, median age was 40 years, median CD4 cell count was 513 cells/mm3, 88 % had plasma HIV RNA ≤400 copies/mL, and mean QNPZ-5 was −0.68. Neurocognitive performance improved in both treatment groups by 6 months; QNPZ-5 scores increased by 0.20 and 0.13 in the intermittent and continuous ART groups, respectively (both P<0.001 for increase and P=0.26 for difference). ART was used on average for 3.6 and 5.9 out of the 6 months in the intermittent and continuous ART groups, respectively, but the increase in neurocognitive test scores could not be explained by ART use, changes in CD4, or plasma HIV RNA, which suggests a <span class="hlt">practice</span> effect. The <span class="hlt">impact</span> of a <span class="hlt">practice</span> effect after 6 months emphasizes the need for a control group in HIV studies that measure intervention effects using neurocognitive tests similar to ours. PMID:23943468</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4644023','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4644023"><span id="translatedtitle">Scribe <span class="hlt">Impacts</span> on Provider Experience, Operations, and Teaching in an Academic Emergency Medicine <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Hess, Jeremy J.; Wallenstein, Joshua; Ackerman, Jeremy D.; Akhter, Murtaza; Ander, Douglas; Keadey, Matthew T.; Capes, James P.</p> <p>2015-01-01</p> <p>Introduction Physicians dedicate substantial time to documentation. Scribes are sometimes used to improve efficiency by performing documentation tasks, although their <span class="hlt">impacts</span> have not been prospectively evaluated. Our objective was to assess a scribe program’s <span class="hlt">impact</span> on emergency department (ED) throughput, physician time utilization, and job satisfaction in a large academic emergency medicine <span class="hlt">practice</span>. Methods We evaluated the intervention using pre- and post-intervention surveys and administrative data. All site physicians were included. Pre- and post-intervention data were collected in four-month periods one year apart. Primary outcomes included changes in monthly average ED length of stay (LOS), provider-specific average relative value units (RVUs) per hour (raw and normalized to volume), self-reported estimates of time spent teaching, self-reported estimates of time spent documenting, and job satisfaction. We analyzed data using descriptive statistics and appropriate tests for paired pre-post differences in continuous, categorical, and ranked variables. Results Pre- and post-survey response rates were 76.1% and 69.0%, respectively. Most responded positively to the intervention, although 9.5% reported negative impressions. There was a 36% reduction (25%–50%; p<0.01) in time spent documenting and a 30% increase (11%–46%, p<0.01) in time spent in direct patient contact. No statistically significant changes were seen in job satisfaction or perception of time spent teaching. ED volume increased by 88 patients per day (32–146, p=0.04) pre- to post- and LOS was unchanged; rates of patients leaving against medical advice dropped, and rates of patients leaving without being seen increased. RVUs per hour increased 5.5% and per patient 5.3%; both were statistically significant. No statistically significant changes were seen in patients seen per hour. There was moderate correlation between changes in ED volume and changes in productivity metrics. Conclusion</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=203397','TEKTRAN'); return false;" href="http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=203397"><span id="translatedtitle">The <span class="hlt">Impact</span> of Business <span class="hlt">Practices</span> on the Environment: Best <span class="hlt">Practices</span> for Communicating Remediation Efforts to Non-Scientists</span></a></p> <p><a target="_blank" href="http://www.ars.usda.gov/services/TekTran.htm">Technology Transfer Automated Retrieval System (TEKTRAN)</a></p> <p></p> <p></p> <p>This research focuses on how a specialty chemical manufacturing company managed the aftermath of a competitive marketplace and the <span class="hlt">impact</span> of offshore chemical production, which forced the facility to cease manufacturing operations in 2003. The facility operated in central Pennsylvania and had earned...</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=needs+AND+educational+AND+Special&pg=5&id=EJ1035704','ERIC'); return false;" href="http://eric.ed.gov/?q=needs+AND+educational+AND+Special&pg=5&id=EJ1035704"><span id="translatedtitle">2014 Code of <span class="hlt">Practice</span>: How Research Evidence on the Role and <span class="hlt">Impact</span> of Teaching Assistants Can Inform Professional <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Webster, Rob</p> <p>2014-01-01</p> <p>In this article, the author reflects on findings from research on the role and <span class="hlt">impact</span> of teaching assistants and experience of working as a special educational needs (SEN) officer. Research evidence suggests the reliance on teaching assistants to include pupils with Statements of SEN in mainstream settings masks a collective, though unintentional,…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=microcephaly&id=EJ928486','ERIC'); return false;" href="http://eric.ed.gov/?q=microcephaly&id=EJ928486"><span id="translatedtitle">Aetiology of Intellectual Disability in <span class="hlt">Paediatric</span> Outpatients in Northern India</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Jauhari, Prashant; Boggula, Raju; Bhave, Anupama; Bhargava, Roli; Singh, Chandrakanta; Kohli, Neera; Yadav, Rajesh; Kumar, Rashmi</p> <p>2011-01-01</p> <p>Aim: To study the aetiology of intellectual disability in patients presenting to hospital and the diagnostic yield of a standardized examination. Method: Over a 1-year period, the first three children presenting to the <span class="hlt">paediatric</span> outpatients department (OPD) on 2 selected weekdays with developmental delay, suspected intellectual disability, or…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25913919','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25913919"><span id="translatedtitle">A review of nutrient treatments for <span class="hlt">paediatric</span> depression.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Lopresti, Adrian L</p> <p>2015-08-01</p> <p><span class="hlt">Paediatric</span> depression is estimated to affect 15-20% of youths prior to adulthood and is associated with significant social, educational and physical impairment. Current treatments comprise moderately efficacious psychological therapies and pharmaceutical antidepressants. However, nutritional therapies are also available and are regularly sought by people with depressive illnesses and parents of depressed youths. In this narrative review, studies examining the antidepressant effects of individual nutritional supplements in child and adolescent populations are appraised. Epidemiological studies examining the relationship between nutritional status and <span class="hlt">paediatric</span> depression, or depressive symptoms are also reviewed. Nutrients covered in this article include: omega-3 polyunsaturated fatty acids, s-adenosylmethionine, vitamin C, vitamin D, zinc, iron and B-vitamins. Although several of these nutrients present as promising treatments for <span class="hlt">paediatric</span> depression, there is a lack of high-quality studies examining the antidepressant effects of all the aforementioned ingredients. Before nutritional treatments are accepted as validated treatments for <span class="hlt">paediatric</span> depression, further high-quality studies are required. PMID:25913919</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27177486','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27177486"><span id="translatedtitle">[Assessing and making safe the medicine use pathway in <span class="hlt">paediatrics</span>].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Didelot, Nicolas; Guerrier, Catherine; Didelot, Anne; Fritsch, Sandrine; Pelte, Jean-Pierre; Socha, Marie; Javelot, Hervé</p> <p>2016-01-01</p> <p>Based on an assessment of adverse events in a follow-up care and rehabilitation unit in <span class="hlt">paediatrics</span>, audits were carried out of the medicine use pathway. The evaluation grid taken from this study today serves as a basis for the audits carried out on the medicine use pathway on a national level. PMID:27177486</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_19");'>19</a></li> <li><a href="#" onclick='return showDiv("page_20");'>20</a></li> <li class="active"><span>21</span></li> <li><a href="#" onclick='return showDiv("page_22");'>22</a></li> <li><a href="#" onclick='return showDiv("page_23");'>23</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_21 --> <div id="page_22" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_20");'>20</a></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li class="active"><span>22</span></li> <li><a href="#" onclick='return showDiv("page_23");'>23</a></li> <li><a href="#" onclick='return showDiv("page_24");'>24</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="421"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26573404','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26573404"><span id="translatedtitle">[The nurse consultation in a Swiss university <span class="hlt">paediatric</span> emergency department].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Yersin, Corinne; Hemme, Denis; Gehri, Mario; Pittet, Anne; Rey-Bellet Gasser, Céline</p> <p>2015-01-01</p> <p>In Switzerland, overcrowding in tertiary emergency departments is a frequent problem, resulting in lengthy waiting times, lower satisfaction on the part of families and a risk for patient's safety. The setting up of a nurse consultation in a university <span class="hlt">paediatric</span> emergency centre has helped to improve the quality of care in this context. PMID:26573404</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3462058','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3462058"><span id="translatedtitle">The Infancy of an International <span class="hlt">Paediatric</span> Pharmacy Network</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Knoppert, David; Arenas-Lopez, Sara; McArtney, Rowena</p> <p>2008-01-01</p> <p>There are several pharmacy and clinical pharmacology organizations in which pediatrics is one of many special interest groups and a few whose focus is entirely pediatric drug therapy. Recently the foundation for the establishment of an International Network of <span class="hlt">Paediatric</span> Pharmacists has been laid. This paper describes that network. PMID:23055865</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27306873','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27306873"><span id="translatedtitle">Surveillance biopsies after <span class="hlt">paediatric</span> kidney transplantation: A review.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Rose, Edward M; Kennedy, Sean E; Mackie, Fiona E</p> <p>2016-09-01</p> <p>Kidney transplantation is the most effective means of treating children with end-stage kidney disease, and yet, there continues to be a limited "life span" of transplanted kidneys in <span class="hlt">paediatric</span> recipients. Early graft monitoring, using the surveillance biopsy, has the potential to extend renal allograft survival in <span class="hlt">paediatric</span> recipients. The surveillance biopsy provides important and timely information about acute and chronic graft pathology, particularly SCR and calcineurin inhibitor-induced nephrotoxicity, which can subsequently guide management decisions and improve long-term graft survival. The ostensible value of the surveillance biopsy is furthered by the limitations of conventional renal functional studies. However, there is still much debate surrounding the surveillance biopsy in <span class="hlt">paediatric</span> recipients, particularly in regard to its overall utility, safety and timing. This review discusses the current literature regarding the utility, safety, and potential predictive value of surveillance biopsies for guiding post-transplant management in <span class="hlt">paediatric</span> renal allograft recipients, as well as the viability of other potentially newer non-invasive strategies for renal allograft monitoring. PMID:27306873</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27085928','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27085928"><span id="translatedtitle">[The management of an adverse event in a <span class="hlt">paediatric</span> unit].</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Cruz, Emmanuelle; Dubrulle, Aurélie</p> <p>2016-04-01</p> <p>Adverse events remain a major issue in care services. The mission of hospital authorities is to analyse them in order to put in place corrective and preventive measures. The objective is to prevent them reoccurring and to ensure the sustainable improvement of the quality and safety of care. This article presents an example in <span class="hlt">paediatrics</span> with parenteral nutrition. PMID:27085928</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2015PhDT.......248C','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2015PhDT.......248C"><span id="translatedtitle">The <span class="hlt">impacts</span> and "best <span class="hlt">practices</span>" of undergraduate - graduate student mentoring relationships in undergraduate research experiences</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Campanile, Megan Faurot</p> <p></p> <p>With the growth of undergraduate research in the U.S., over the past two decades, faculty are more often assigning graduate students to mentor undergraduate students than providing the one-on-one mentoring themselves. A critical gap that exists in the literature is how undergraduate -- graduate student mentoring relationships in undergraduate research influences both students' academic and career paths. The research questions that framed this study were: (1) What, if any, changes occur in the academic and career paths of undergraduate and graduate students who participate in undergraduate research experiences? and (2) Are there variables that constitute "best <span class="hlt">practices</span>" in the mentoring relationships in undergraduate research experiences and, if so, what are they? The study context was the National Science Foundation Research Experiences for Undergraduates program at Illinois Institute of Technology and the 113 undergraduate researchers and 31 graduate student mentors who participated from 2006 -- 2014. Surveys and interviews were administered to collect pre- and post-program data and follow-up data during the 2014 -- 2015 academic year. Descriptive statistics, content analysis method, and constant comparative method were used to analyze the data. Key findings on the undergraduate researchers were their actual earned graduate degree types (Ph.D. 20%, M.D. 20%, M.S. 48%, other 12%) and fields (STEM 57%, medical 35%, other 8%) and the careers they were pursuing or working in. All the graduate student mentors were pursuing or working in the STEM fields (academia 50%, industry 40%, government 10%). More than 75% of both the undergraduate and graduate students reported that their mentoring relationships had a somewhat to extremely influential <span class="hlt">impact</span> on their academic and career paths. A set of "best <span class="hlt">practices</span>" of mentoring were developed for both the undergraduate and graduate students and focused on the mentoring experiences related to learning and teaching about</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2007PhDT.......110B','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2007PhDT.......110B"><span id="translatedtitle"><span class="hlt">Practicing</span> biology: Undergraduate laboratory research, persistence in science, and the <span class="hlt">impact</span> of self-efficacy beliefs</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Berkes, Elizabeth</p> <p></p> <p>As undergraduate laboratory research internships become more popular and universities devote considerable resources towards promoting them, it is important to clarify what students specifically gain through involvement in these experiences and it is important to understand their <span class="hlt">impact</span> on the science pipeline. By examining recent findings describing the primary benefits of undergraduate research participation, along with self-efficacy theory, this study aims to provide more explanatory power to the anecdotal and descriptive accounts regarding the relationship between undergraduate research experiences and interest in continuing in science. Furthermore, this study characterizes <span class="hlt">practices</span> that foster students' confidence in doing scientific work with detailed description and analysis of the interactions of researchers in a laboratory. Phase 1 of the study, a survey of undergraduate biology majors (n=71) at a major research university, investigates the relationships among participation in biology laboratory research internships, biology laboratory self-efficacy strength, and interest in persisting in science. Phase 2 of the study, a two-year investigation of a university biology research laboratory, investigates how scientific communities of <span class="hlt">practice</span> develop self-efficacy beliefs. The findings suggest that participation in lab internships results in increased interest in continuing in life science/biology graduate school and careers. They also suggest that a significant proportion of that interest is related to the students' biology laboratory self-efficacy. The findings of this study point to two primary ways that undergraduate research participation might work to raise self-efficacy strength. First, university research laboratory communities can provide students with a variety of resources that scaffold them into biology laboratory mastery experiences. Second, university research laboratory communities can provide students with coping and mastery Discourse models</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4958759','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4958759"><span id="translatedtitle">AB018. Improving the management of patients’ assigned COPD treatment (<span class="hlt">IMPACT</span>): turning risk assessment into <span class="hlt">practice</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Freeman, Daryl; Gerrard, Val; Turton, Janet</p> <p>2016-01-01</p> <p> standardised documents namely self-management plans, step down guidance & high risk patient management. All <span class="hlt">practices</span> have access to good quality pulmonary rehabilitation and prompt radiology, smoking cessation services. Results Q2–3 2016 further data extraction will take place to evaluate <span class="hlt">impact</span> on exacerbations and prescribing. Patient feedback was used to influence future services, and following on from this work a respiratory network and more focus on high risk patients are planned. This will include standardised respiratory management templates for GP clinical systems, drug formularies, management guidelines and a separate service for high risk patients. Conclusions Considerable variation in nurse standards was seen across the CCG during delivery of the mentored clinics with some excellent care & some training needs identified. A unified approach is required and should be part of the restructuring of health care in the CCG in line with the 5-year forward plan set out by NHS England.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=mechanical+AND+design&pg=6&id=EJ920310','ERIC'); return false;" href="http://eric.ed.gov/?q=mechanical+AND+design&pg=6&id=EJ920310"><span id="translatedtitle"><span class="hlt">Impact</span> of the Script in a Supplemental Reading Program on Instructional Opportunities for Student <span class="hlt">Practice</span> of Specified Skills</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Cooke, Nancy L.; Galloway, Tara W.; Kretlow, Allison G.; Helf, Shawnna</p> <p>2011-01-01</p> <p>Many educators are reluctant to use scripted instruction, reporting that scripts are mechanical in nature and only appropriate for low-level skills. This study sought to investigate the <span class="hlt">impact</span> of a supplemental program's script on the rate of on-task and off-task instructional opportunities offered by the instructor for students to <span class="hlt">practice</span> the…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=pesticides&pg=5&id=EJ1085739','ERIC'); return false;" href="http://eric.ed.gov/?q=pesticides&pg=5&id=EJ1085739"><span id="translatedtitle">Environmental <span class="hlt">Impact</span> Assessment: Teaching the Principles and <span class="hlt">Practices</span> by Means of a Role-Playing Case Study</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Crittenden, Barry D.; England, Richard</p> <p>2005-01-01</p> <p>The principles and <span class="hlt">practices</span> of environmental <span class="hlt">impact</span> assessment are best taught to chemical engineering undergraduate students by means of a role­-playing case study. Many suitable examples are available from public sources. The planning appeal process has been selected so as to introduce an adversarial style involving cross-­examination on…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=sequence+AND+analysis+AND+history&pg=4&id=ED553251','ERIC'); return false;" href="http://eric.ed.gov/?q=sequence+AND+analysis+AND+history&pg=4&id=ED553251"><span id="translatedtitle">The <span class="hlt">Impact</span> of Teachers' Characteristics and Self-Reported <span class="hlt">Practices</span> on Students' Algebra Achievement</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Cope, Liza M.</p> <p>2013-01-01</p> <p>This study examined the <span class="hlt">impact</span> of teachers' characteristics and self-reported <span class="hlt">practices</span> on students' Algebra achievement while controlling for students' characteristics. This study is based on the secondary analysis of data collected from a nationally representative sample of 9 th grade students and their mathematics teachers during…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=southwest+AND+iowa&id=ED524973','ERIC'); return false;" href="http://eric.ed.gov/?q=southwest+AND+iowa&id=ED524973"><span id="translatedtitle">The <span class="hlt">Impact</span> of Mathematics Professional Development on Elementary Teachers' Mathematics Content Knowledge for Teaching and Implementation of Innovative Pedagogical <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Oleson, Vicki</p> <p>2010-01-01</p> <p>This study sought to understand the process of change elementary teachers experienced as they participated in mathematics professional development. This investigation explored the <span class="hlt">impact</span> of mathematics professional development on teachers' content knowledge for teaching, their ability to implement innovative pedagogical <span class="hlt">practices</span>, and the…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/ED069924.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/ED069924.pdf"><span id="translatedtitle">An Assessment of the <span class="hlt">Impact</span> of Vocational Education Research and Related Projects on Educational <span class="hlt">Practice</span> in Pennsylvania Since 1966.</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>American Management Center, Inc., Philadelphia, PA.</p> <p></p> <p>To determine the <span class="hlt">impact</span> of vocational education research and related projects on educational <span class="hlt">practice</span> in Pennsylvania since 1966, descriptive data were gathered on 115 Research Coordinating Unit (RCU) projects funded from 1966 through March 1972. Some general findings were: (1) Most projects were housed in public schools (Grades 9-12) serving…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=Watershed&pg=7&id=EJ767734','ERIC'); return false;" href="http://eric.ed.gov/?q=Watershed&pg=7&id=EJ767734"><span id="translatedtitle">The <span class="hlt">Impact</span> of a Place-Based Professional Development Program on Teachers' Confidence, Attitudes, and Classroom <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Meichtry, Yvonne; Smith, Jeffrey</p> <p>2007-01-01</p> <p>The purposes of this study were to determine the <span class="hlt">impact</span> of a professional development program on the confidence levels and classroom <span class="hlt">practices</span> of the participants and their attitudes toward the environment. The program had immersed teachers in a watershed study that took them from the headwaters of a 310-mile river to its confluence with the Ohio…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/ED518171.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/ED518171.pdf"><span id="translatedtitle">The <span class="hlt">Impact</span> of Extended Professional Development and a Comprehensive Approach to Assessment on Teacher Use of Assessment for Learning <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Robinson, Jack; Reed, William; Strauss, Richard</p> <p>2011-01-01</p> <p>This study sought to examine the <span class="hlt">impact</span> of teachers' participation in an extended period of embedded professional development (PD) emphasizing teachers' use of assessment for learning <span class="hlt">practices</span> (AFL) in extended problem based units of instruction within a comprehensive AFL framework. The extended and comprehensive approach of using both course…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=mindfulness&pg=6&id=ED561855','ERIC'); return false;" href="http://eric.ed.gov/?q=mindfulness&pg=6&id=ED561855"><span id="translatedtitle">The <span class="hlt">Impact</span> of Classroom-Based Meditation <span class="hlt">Practice</span> on Cognitive Engagement, Mindfulness and Academic Performance of Undergraduate College Students</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Napora, Lisa</p> <p>2013-01-01</p> <p>This study explored the potential of classroom-based meditation <span class="hlt">practice</span> as a tool to facilitate learning. Moreover, the <span class="hlt">impact</span> of meditation on cognitive engagement, mindfulness and academic performance of undergraduate college students was investigated. Additionally, the relationships between mindfulness and cognitive engagement, and between…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=roswell&pg=2&id=EJ613991','ERIC'); return false;" href="http://eric.ed.gov/?q=roswell&pg=2&id=EJ613991"><span id="translatedtitle">From Perception to <span class="hlt">Practice</span>: The <span class="hlt">Impact</span> of Teachers' Scoring Experience on Performance-based Instruction and Classroom Assessment.</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Goldberg, Gail Lynn; Roswell, Barbara Sherr</p> <p>2000-01-01</p> <p>Studied the <span class="hlt">impact</span> of experience scoring the Maryland School Performance Assessment tasks on teachers' instructional and classroom assessment <span class="hlt">practice</span>. Interview data, questionnaires, classroom observation, and classroom artifacts from approximately 5 teacher-scorers demonstrated that teachers' appropriation of performance-based instruction may be…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=GPS&pg=2&id=EJ827148','ERIC'); return false;" href="http://eric.ed.gov/?q=GPS&pg=2&id=EJ827148"><span id="translatedtitle">An Exploratory Study of GP Perceptions of the <span class="hlt">Impact</span> of a Primary Care Counselling Service on Their <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Schafer, Tim; Amoateng, Geoffrey; Wrycraft, Nick</p> <p>2009-01-01</p> <p>This paper presents the results of research into GP perceptions of the <span class="hlt">impact</span> of on-site counselling on general <span class="hlt">practice</span>. The research is part of a larger evaluation of a local enhanced primary care mental service. The initial survey and in-depth interviews with GPs reported here focused on the pre-existing counselling service. The results suggest…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=Decision+AND+Analysis&pg=4&id=EJ908089','ERIC'); return false;" href="http://eric.ed.gov/?q=Decision+AND+Analysis&pg=4&id=EJ908089"><span id="translatedtitle">Developing Indicators of Classroom <span class="hlt">Practice</span> to Evaluate the <span class="hlt">Impact</span> of District Mathematics Reform Initiative: A Generalizability Analysis</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Newton, Xiaoxia A.</p> <p>2010-01-01</p> <p>This paper reported results from a generalizability study that examined the process of developing classroom <span class="hlt">practice</span> indicators used to evaluate the <span class="hlt">impact</span> of a school district's mathematics reform initiative. The study utilized classroom observational data from 32 second, fourth, eighth, and tenth grade teachers. The study addresses important…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/ED502232.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/ED502232.pdf"><span id="translatedtitle">The Ripple Effect of Virginia Tech: Assessing the Nationwide <span class="hlt">Impact</span> on Campus Safety and Security Policy and <span class="hlt">Practice</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Rasmussen, Chris; Johnson, Gina</p> <p>2008-01-01</p> <p>This report is the result of a nationwide survey conducted in March 2008 of student life officers and campus safety directors to assess the <span class="hlt">impact</span> of the April 2007 shootings at Virginia Tech on campus safety and security policy and <span class="hlt">practice</span>. Discussion areas include: (1) Student Privacy vs. Need-to-Know; (2) Prevention, Mitigation and Recovery;…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=grammar&pg=2&id=EJ1032480','ERIC'); return false;" href="http://eric.ed.gov/?q=grammar&pg=2&id=EJ1032480"><span id="translatedtitle">The <span class="hlt">Impact</span> of Self-Perceived Subject Matter Knowledge on Pedagogical Decisions in EFL Grammar Teaching <span class="hlt">Practices</span></span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Sanchez, Hugo Santiago</p> <p>2014-01-01</p> <p>Recent developments in language teacher cognition research highlight the need to explore subject matter knowledge in relation to classroom <span class="hlt">practice</span>. This study examines the <span class="hlt">impact</span> of two foreign language teachers' knowledge about grammar upon their pedagogical decisions. The primary database consisted of classroom observations and post-lesson…</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_20");'>20</a></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li class="active"><span>22</span></li> <li><a href="#" onclick='return showDiv("page_23");'>23</a></li> <li><a href="#" onclick='return showDiv("page_24");'>24</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_22 --> <div id="page_23" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li><a href="#" onclick='return showDiv("page_22");'>22</a></li> <li class="active"><span>23</span></li> <li><a href="#" onclick='return showDiv("page_24");'>24</a></li> <li><a href="#" onclick='return showDiv("page_25");'>25</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="441"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://files.eric.ed.gov/fulltext/ED520872.pdf','ERIC'); return false;" href="http://files.eric.ed.gov/fulltext/ED520872.pdf"><span id="translatedtitle">The <span class="hlt">Impact</span> of Two Teachers' Use of Specific Scaffolding <span class="hlt">Practices</span> on Low-Attaining Upper Primary Students</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Ferguson, Sarah; McDonough, Andrea</p> <p>2010-01-01</p> <p>This paper reports on two upper primary teachers' use of particular scaffolding <span class="hlt">practices</span>, individual discussion and the use of manipulatives. The cognitive and affective <span class="hlt">impact</span> on four low-attaining students in these classes is described. The teachers and students were observed during eight to ten sequential tasks. "Scaffolding conversations"…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4928427','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4928427"><span id="translatedtitle"><span class="hlt">Impact</span> of waste management training intervention on knowledge, attitude and <span class="hlt">practices</span> of teaching hospital workers in Pakistan</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Kumar, Ramesh; Somrongthong, Ratana; Ahmed, Jamil</p> <p>2016-01-01</p> <p>Objective: To evaluate the sustainability and effectiveness of training as an intervention to improve the knowledge, attitude and <span class="hlt">practices</span> of hospital workers on health care waste management. Method: We conducted this quasi-experimental study in two tertiary care teaching hospitals in Rawalpindi in October 2013. Training, <span class="hlt">practical</span> demonstrations and reminders on standard waste management were given to 138 hospital workers in one hospital and compared with 137 workers from the control hospital. We collected data 18 months after intervention through a structured questionnaire to assess the <span class="hlt">impact</span> of the intervention. We used paired t-test to compare the scores on knowledge, attitude and <span class="hlt">practices</span> at baseline and first follow up and final <span class="hlt">impact</span> assessment. Chi square test was used to compare group variables between intervention and control groups. Results: After 18 months since intervention the mean scores on knowledge attitude and <span class="hlt">practices</span> differed statistically significantly since baseline and intervention group had statistically significantly better knowledge positive attitudes and good health care waste management <span class="hlt">practices</span> (p < 0.001). Health care and sanitary workers in intervention group scored statistically significantly higher (p < 0.001). Conclusion: Trainings of health and sanitary workers on health care waste management guidelines were sustainable among the intervention group after 18 months which shows the positive <span class="hlt">impact</span> of our intervention. It is recommended that the trainings as intervention be included in the overall policies of the public and private sector hospitals in Pakistan and other similar settings. PMID:27375718</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4453589','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4453589"><span id="translatedtitle">Virtual support for <span class="hlt">paediatric</span> HIV treatment decision making</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Le Doare, Kirsty; Mackie, N E; Kaye, S; Bamford, A; Walters, S; Foster, C</p> <p>2015-01-01</p> <p>Objective The objective of this study is to review clinical outcomes of recommendations made by a multidisciplinary <span class="hlt">paediatric</span> virtual clinic (PVC) for complex case management of <span class="hlt">paediatric</span> HIV as a model of care within a tertiary network. Design A retrospective review of the clinical outcomes of <span class="hlt">paediatric</span> and adolescent (0–21 years) referrals to the PVC at St. Mary's Hospital, Imperial College Healthcare NHS Trust, London was performed between October 2009 and November 2013. Results 234 referrals were made for 182 children from 37 centres, discussed in 42 meetings (median age 13 years, IQR 10–15 years). Reasons for referral included virological failure (44%), simplification of the current regimen (24%) and antiretroviral drug complications (24%). At latest follow-up, PVC advice had been instituted in 80% of referrals. Suppression following virological failure was achieved in 48% following first referral and 57% following subsequent discussions and was maintained in 95% of children referred for regimen simplification. Following advice, dyslipidaemia resolved in 42% and liver function normalised in 73% with biochemical hepatitis. Adherence support aided resolution of viraemia in nine children and 12% of referrals resulted in additional support, including psychology, social services and mental health input. Conclusions Combined multidisciplinary virtual input with adult expertise in resistance and newer agents, <span class="hlt">paediatric</span> knowledge of pill swallowing, childhood formulations/weight banding and parental support, assists complex treatment decision making in <span class="hlt">paediatric</span> HIV infection. The Virtual Clinic model could be applied to the management of other rare complex diseases of childhood within a clinical network. PMID:25549664</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3175517','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3175517"><span id="translatedtitle">Licensing and labelling of drugs in a <span class="hlt">paediatric</span> oncology ward</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>van den Berg, Henk; Tak, Nanda</p> <p>2011-01-01</p> <p>AIM <span class="hlt">Paediatric</span> drug prescriptions are known for their high percentages of off-label and unlicensed use. In <span class="hlt">paediatric</span> oncology data available are scarce. The aim of this paper is an analysis of the licensing and labelling status of all prescribed medication over a 2 week period in a Dutch <span class="hlt">paediatric</span> oncology centre. METHODS An analysis of the delivery of medication by the hospital pharmacy to patients admitted to the <span class="hlt">paediatric</span> oncology centre was carried out. RESULTS In total 268 precriptions were filed for 39 patients. In 87% of children unlicensed medication was used. Fifty-nine per cent of the children received at least two unlicensed drugs. In total 72% of the drugs were used licensed and on-label was found in 57% of the prescriptions. There was a trend that in younger children percentages were lower. International and local guidelines necessitated in many cases unlicensed use, e.g. intrathecal prednisolone, low dose medication such as heparin, ethanol and vancomycin for locking intravenous devices and higher intravenous vancomycin dosages. There were no major differences with respect to type of malignancy. CONCLUSION Our figures are substantially higher than the figures reported from adult oncology. Comparison with other <span class="hlt">paediatric</span> reports are cumbersome, due to different percentages of diseases in the reports and other rules to dispense medication in the outpatient setting. Our data are in line with reports mentioning the higher percentages of unlicensed and off-label use. Our data further underpin the need for more research on suitable formulations, dosages, safety and efficacy in these children. PMID:21453298</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2008PhDT........49H','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2008PhDT........49H"><span id="translatedtitle">The <span class="hlt">impact</span> of federal policy on teachers' use of science manipulatives: A survey of teacher philosophy and <span class="hlt">practices</span></span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Helgoe, Catherine A.</p> <p></p> <p>Recently, educators in public K-12 schools have added testing of science knowledge to the measures of Adequate Yearly Progress required by the federal No Child Left Behind (NCLB) legislation. Research of the <span class="hlt">impact</span> of NCLB policy on general teaching <span class="hlt">practices</span> had credited the policy with improving instruction; however, negative <span class="hlt">impacts</span> noted included the concern that teachers "teach to the test," narrowing the curriculum. Testing as an assessment strategy was not advocated by the professional educators and scientists responsible for the National Science Education Standards (NSES). Results from previous studies pointed to a potential conflict between the NCLB reforms and the National Science Education Standards science standards, in which teachers might reduce or eliminate hands-on activities and other constructivist <span class="hlt">practices</span> in order to focus class time on other topics and tasks. Most research on NCLB policy, however, had not evaluated instructional <span class="hlt">practices</span> regarding science education. This study examined the relationship among teacher beliefs, specifically the strength of their constructivist versus traditional beliefs, teachers' responses to NCLB policy, and teachers' use of constructivist <span class="hlt">practices</span> in the form of manipulatives. This study showed that national policy did have an <span class="hlt">impact</span> on teachers; however, that <span class="hlt">impact</span> was not specific to the hands-on <span class="hlt">practices</span> in science education. Teachers who responded to this survey had found many benefits in student learning using manipulatives and those positive <span class="hlt">impacts</span> on their students justified the increased use of manipulatives in the classroom. The strength of teachers' constructivist beliefs showed a weak positive correlation to choices related to curriculum priorities, learning goals and advantages in using manipulatives. However, a relationship to beliefs was not found in the changes teachers made to various instructional <span class="hlt">practices</span>, or in how they viewed certain manipulative materials, or in how they viewed</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27281525','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27281525"><span id="translatedtitle">Retail food environments in Canada: Maximizing the <span class="hlt">impact</span> of research, policy and <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Minaker, Leia M</p> <p>2016-01-01</p> <p>Retail food environments are gaining national and international attention as important determinants of population dietary intake. Communities across Canada are beginning to discuss and implement programs and policies to create supportive retail food environments. Three considerations should drive the selection of food environment assessment methods: relevance (What is the problem, and how is it related to dietary outcomes?); resources (What human, time and financial resources are required to undertake an assessment?); and response (How will policy-makers find meaning out of and act on the information gained through the food environment assessment?). Ultimately, food environment assessments should be conducted in the context of stakeholder buy-in and multi-sectoral partnerships, since food environment solutions require multi-sectoral action. Partnerships between public health actors and the food and beverage industry can be challenging, especially when mandates are not aligned. Clarifying the motivations, expectations and roles of all stakeholders takes time but is important if the <span class="hlt">impact</span> of food environment research, policy and <span class="hlt">practice</span> is to be maximized. The articles contained in this special supplementary issue describe ongoing food environments research across Canada and fill some of the important gaps in the current body of Canadian food environments literature. PMID:27281525</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://pubs.usgs.gov/sir/2011/5165/','USGSPUBS'); return false;" href="http://pubs.usgs.gov/sir/2011/5165/"><span id="translatedtitle">Hydraulic characteristics of low-<span class="hlt">impact</span> development <span class="hlt">practices</span> in northeastern Ohio, 2008–2010</span></a></p> <p><a target="_blank" href="http://pubs.er.usgs.gov/pubs/index.jsp?view=adv">USGS Publications Warehouse</a></p> <p>Darner, Robert A.; Dumouchelle, Denise H.</p> <p>2011-01-01</p> <p>Low-<span class="hlt">impact</span> development (LID) is an approach to managing stormwater as near to its source as possible; this is accomplished by minimizing impervious surfaces and promoting more natural infiltration and evapotranspiration than is typically associated with developed areas. Two newly constructed LID sites in northeastern Ohio were studied to document their hydraulic characteristics. A roadside best-management <span class="hlt">practice</span> (BMP) was constructed by replacing about 1,400 linear feet of existing ditches with a bioswale/rain garden BMP consisting of a grassed swale interspersed with rain-garden/overflow structures. The site was monitored in 2008, 2009, and 2010. Although some overflows occurred, numerous precipitation events exceeding the 0.75-inch design storm did not result in overflows. A second study site consists of an 8,200-square-foot parking lot made of a pervious pavers and a rain garden that receives runoff from the roof of a nearby commercial building. A comparison of data from 2009 and 2010 indicates that the median runoff volume in 2010 decreased relative to 2009. The centroid lag times (time difference between centroid of precipitation and centroid of flow) decreased in 2010, most likely due to more intense, shorter duration precipitation events and maturation of the rain garden. Additional data could help quantify the relation between meteorological variables and BMP efficiency.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25362694','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25362694"><span id="translatedtitle"><span class="hlt">Impact</span> of pedagogical method on Brazilian dental students' waste management <span class="hlt">practice</span>.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Victorelli, Gabriela; Flório, Flávia Martão; Ramacciato, Juliana Cama; Motta, Rogério Heládio Lopes; de Souza Fonseca Silva, Almenara</p> <p>2014-11-01</p> <p>The purpose of this study was to conduct a qualitative analysis of waste management <span class="hlt">practices</span> among a group of Brazilian dental students (n=64) before and after implementing two different pedagogical methods: 1) the students attended a two-hour lecture based on World Health Organization standards; and 2) the students applied the lessons learned in an organized group setting aimed toward raising their awareness about socioenvironmental issues related to waste. All eligible students participated, and the students' learning was evaluated through their answers to a series of essay questions, which were quantitatively measured. Afterwards, the <span class="hlt">impact</span> of the pedagogical approaches was compared by means of qualitative categorization of wastes generated in clinical activities. Waste categorization was performed for a period of eight consecutive days, both before and thirty days after the pedagogical strategies. In the written evaluation, 80 to 90 percent of the students' answers were correct. The qualitative assessment revealed a high frequency of incorrect waste disposal with a significant increase of incorrect disposal inside general and infectious waste containers (p<0.05). Although the students' theoretical learning improved, it was not enough to change behaviors established by cultural values or to encourage the students to adequately segregate and package waste material. PMID:25362694</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26506293','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26506293"><span id="translatedtitle">Patient and <span class="hlt">Practice</span> Characteristics: <span class="hlt">Impact</span> on Career Satisfaction of Obstetrician-Gynecologists.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Schmidt, Alex M</p> <p>2015-01-01</p> <p>This study examined demographic and <span class="hlt">practice</span> characteristics that affect the career satisfaction of obstetrician-gynecologists. Data were retrieved from the 2008 Health Tracking Physician Survey, conducted by the Center for Studying Health System Change. The survey consisted of a nationally representative sample of physicians belonging to the American Medical Association. A final sample of 290 obstetrician-gynecologists was obtained from the study. Results indicated more than 80% of obstetrician-gynecologists were either "somewhat satisfied" or "very satisfied" with their careers in medicine. Nearly 56% were older than 48 years; 59% of respondents were men and 77% were of white race. The average obstetrician-gynecologist worked 54 hours per week in medically related activities. Regression analysis showed a significant relationship between obstetrician-gynecologist career satisfaction and the following: adequate time with patients, perceived quality of care, income, work hours, and revenue from Medicaid. In addition, Hispanic patients and the presence of formal written guidelines had a positive <span class="hlt">impact</span> on career satisfaction. It was concluded that quality care, time with patients, work hours, and income are the major predictors of obstetrician-gynecologist career satisfaction. Further research is needed to understand the relationship between patient demographics and career satisfaction. PMID:26506293</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24400803','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24400803"><span id="translatedtitle">Catheter-related infection and septicemia: <span class="hlt">impact</span> of seasonality and modifiable <span class="hlt">practices</span> from the DOPPS.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Lok, Charmaine E; Thumma, Jyothi R; McCullough, Keith P; Gillespie, Brenda W; Fluck, Richard J; Marshall, Mark R; Kawanishi, Hideki; Robinson, Bruce M; Pisoni, Ronald L</p> <p>2014-01-01</p> <p>Hemodialysis (HD) catheter-related infection (CRI) and septicemia contribute to adverse outcomes. The <span class="hlt">impact</span> of seasonality and prophylactic dialysis <span class="hlt">practices</span> during high-risk periods remain unexplored. This multicenter study analyzed DOPPS data from 12,122 HD patients (from 442 facilities) to determine the association between seasonally related climatic variables and CRI and septicemia. Climatic variables were determined by linkage to National Climatic Data Center of National Oceanic and Atmospheric Administration data. Catheter care protocols were examined to determine if they could mitigate infection risk during high-risk seasons. Survival models were used to estimate the adjusted hazard ratio (AHR) of septicemia by season and by facility catheter dressing protocol. The overall catheter-related septicemia rate was 0.47 per 1000 catheter days. It varied by season, with an AHR for summer of 1.46 (95% CI: 1.19-1.80) compared with winter. Septicemia was associated with temperature (AHR = 1.07; 95% CI: 1.02-1.13; p < 0.001). Dressing protocols using chlorhexidine (AHR of septicemia = 0.55; 95% CI: 0.39-0.78) were associated with fewest episodes of CRI or septicemia. Higher catheter-related septicemia in summer may be due to seasonal conditions (e.g., heat, perspiration) that facilitate bacterial growth and compromise protective measures. Extra vigilance and use of chlorhexidine-based dressing protocols may provide prophylaxis against CRI and septicemia. PMID:24400803</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/1573597','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/1573597"><span id="translatedtitle">The <span class="hlt">Paediatric</span> Board of the Royal College of Physicians of London: its role in the college.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Chambers, T</p> <p>1992-01-01</p> <p>Conscious of its responsibilities to its Fellows and Members who are paediatricians, the Royal College of Physicians (RCP) is anxious to play its part, along with others, in maintaining and improving standards in <span class="hlt">paediatrics</span>. Recognising the importance and prominence of the specialty within the generality of specialist medicine, and alongside general internal medicine, it has established a <span class="hlt">Paediatric</span> Board, reporting directly to Council, which will deal with and advise on all matters concerning <span class="hlt">paediatrics</span> and child health, and thus enhance the autonomy and influence of the specialty both within the College and on medical affairs in general. It will do this in close association with the British <span class="hlt">Paediatric</span> Association (BPA) which will nominate members of the Board. In particular the RCP will continue to set standards in <span class="hlt">paediatrics</span> through examinations, accreditation, representatives on consultant advisory appointment committees, and its membership of the GMC and the Conference of Medical Royal Colleges and their Faculties, to which the <span class="hlt">Paediatric</span> Board will make a substantial contribution. The network of regional <span class="hlt">paediatric</span> advisers to the RCP will ensure that the Board is kept in touch with <span class="hlt">paediatric</span> opinion throughout England, Wales and Northern Ireland. Relationships with Scottish <span class="hlt">paediatrics</span> and paediatricians will be important, for example, in the organisation and development of the MRCP(UK) examination and its <span class="hlt">paediatric</span> Part II. Links with paediatricians in the Irish Republic exist through the Joint Committee on Higher Medical Training. PMID:1573597</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3637183','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3637183"><span id="translatedtitle">Quality of life assessment in preterm children: physicians’ knowledge, attitude, belief, <span class="hlt">practice</span> - a KABP study</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2013-01-01</p> <p>Background The sequelae of extremely preterm birth have an <span class="hlt">impact</span> on the quality of life (QoL) of these children. Standardized assessment of their QoL is rarely done in France. The aim of this study is to examine among all the types of physicians involved in the management of children born extremely preterm, their knowledge, use in routine <span class="hlt">practice</span> and expectations concerning QoL assessment of these children using standardized questionnaires. Methods Prospective survey among heads of obstetric, neonatal medicine and <span class="hlt">paediatric</span> neurology departments, by means of questionnaires. Two qualitative methods were used: focus groups and Delphi method. Results Seventy-eight physicians participated (obstetricians 24%, neonatologists 58%, <span class="hlt">paediatric</span> neurologists 18%). The physicians considered QoL a relevant concept which they assessed subjectively. They expressed a need for information on methods of assessment. An ideal QoL questionnaire was described. Expectations regarding availability of QoL data were expressed from a medical, family and societal perspective. The <span class="hlt">impact</span> of QoL measurement on the ethical aspect of decision-making was approached, in particular the potential <span class="hlt">impact</span> of this tool on the decision made. Expectations were found to differ between specialties. Conclusion This original study reports the perspective of experts on taking into consideration the QoL of children born extremely preterm. This is a subjective notion that is difficult to implement and which may influence therapeutic choices. PMID:23601174</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27242862','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27242862"><span id="translatedtitle">Understanding the <span class="hlt">Impacts</span> of Soil, Climate, and Farming <span class="hlt">Practices</span> on Soil Organic Carbon Sequestration: A Simulation Study in Australia.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Godde, Cécile M; Thorburn, Peter J; Biggs, Jody S; Meier, Elizabeth A</p> <p>2016-01-01</p> <p>Carbon sequestration in agricultural soils has the capacity to mitigate greenhouse gas emissions, as well as to improve soil biological, physical, and chemical properties. The review of literature pertaining to soil organic carbon (SOC) dynamics within Australian grain farming systems does not enable us to conclude on the best farming <span class="hlt">practices</span> to increase or maintain SOC for a specific combination of soil and climate. This study aimed to further explore the complex interactions of soil, climate, and farming <span class="hlt">practices</span> on SOC. We undertook a modeling study with the Agricultural Production Systems sIMulator modeling framework, by combining contrasting Australian soils, climates, and farming <span class="hlt">practices</span> (crop rotations, and management within rotations, such as fertilization, tillage, and residue management) in a factorial design. This design resulted in the transposition of contrasting soils and climates in our simulations, giving soil-climate combinations that do not occur in the study area to help provide insights into the importance of the climate constraints on SOC. We statistically analyzed the model's outputs to determinate the relative contributions of soil parameters, climate, and farming <span class="hlt">practices</span> on SOC. The initial SOC content had the largest <span class="hlt">impact</span> on the value of SOC, followed by the climate and the fertilization <span class="hlt">practices</span>. These factors explained 66, 18, and 15% of SOC variations, respectively, after 80 years of constant farming <span class="hlt">practices</span> in the simulation. Tillage and stubble management had the lowest <span class="hlt">impacts</span> on SOC. This study highlighted the possible negative <span class="hlt">impact</span> on SOC of a chickpea phase in a wheat-chickpea rotation and the potential positive <span class="hlt">impact</span> of a cover crop in a sub-tropical climate (QLD, Australia) on SOC. It also showed the complexities in managing to achieve increased SOC, while simultaneously aiming to minimize nitrous oxide (N2O) emissions and nitrate leaching in farming systems. The transposition of contrasting soils and climates in</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4870243','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4870243"><span id="translatedtitle">Understanding the <span class="hlt">Impacts</span> of Soil, Climate, and Farming <span class="hlt">Practices</span> on Soil Organic Carbon Sequestration: A Simulation Study in Australia</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Godde, Cécile M.; Thorburn, Peter J.; Biggs, Jody S.; Meier, Elizabeth A.</p> <p>2016-01-01</p> <p>Carbon sequestration in agricultural soils has the capacity to mitigate greenhouse gas emissions, as well as to improve soil biological, physical, and chemical properties. The review of literature pertaining to soil organic carbon (SOC) dynamics within Australian grain farming systems does not enable us to conclude on the best farming <span class="hlt">practices</span> to increase or maintain SOC for a specific combination of soil and climate. This study aimed to further explore the complex interactions of soil, climate, and farming <span class="hlt">practices</span> on SOC. We undertook a modeling study with the Agricultural Production Systems sIMulator modeling framework, by combining contrasting Australian soils, climates, and farming <span class="hlt">practices</span> (crop rotations, and management within rotations, such as fertilization, tillage, and residue management) in a factorial design. This design resulted in the transposition of contrasting soils and climates in our simulations, giving soil–climate combinations that do not occur in the study area to help provide insights into the importance of the climate constraints on SOC. We statistically analyzed the model’s outputs to determinate the relative contributions of soil parameters, climate, and farming <span class="hlt">practices</span> on SOC. The initial SOC content had the largest <span class="hlt">impact</span> on the value of SOC, followed by the climate and the fertilization <span class="hlt">practices</span>. These factors explained 66, 18, and 15% of SOC variations, respectively, after 80 years of constant farming <span class="hlt">practices</span> in the simulation. Tillage and stubble management had the lowest <span class="hlt">impacts</span> on SOC. This study highlighted the possible negative <span class="hlt">impact</span> on SOC of a chickpea phase in a wheat–chickpea rotation and the potential positive <span class="hlt">impact</span> of a cover crop in a sub-tropical climate (QLD, Australia) on SOC. It also showed the complexities in managing to achieve increased SOC, while simultaneously aiming to minimize nitrous oxide (N2O) emissions and nitrate leaching in farming systems. The transposition of contrasting soils and</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2015IJSEd..37..529Z&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2015IJSEd..37..529Z&link_type=ABSTRACT"><span id="translatedtitle">Exploring the <span class="hlt">Impacts</span> of Cognitive and Metacognitive Prompting on Students' Scientific Inquiry <span class="hlt">Practices</span> Within an E-Learning Environment</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Zhang, Wen-Xin; Hsu, Ying-Shao; Wang, Chia-Yu; Ho, Yu-Ting</p> <p>2015-02-01</p> <p>This study explores the effects of metacognitive and cognitive prompting on the scientific inquiry <span class="hlt">practices</span> of students with various levels of initial metacognition. Two junior high school classes participated in this study. One class, the experimental group (n = 26), which received an inquiry-based curriculum with a combination of cognitive and metacognitive prompts, was compared to the other class, the comparison group (n = 25), which received only cognitive prompts in the same curriculum. Data sources included a test of inquiry <span class="hlt">practices</span>, a questionnaire of metacognition, and worksheets. The results showed that the mixed cognitive and metacognitive prompts had significant <span class="hlt">impacts</span> on the students' inquiry <span class="hlt">practices</span>, especially their planning and analyzing abilities. Furthermore, the mixed prompts appeared to have a differential effect on those students with lower level metacognition, who showed significant improvement in their inquiry abilities. A combination of cognitive and metacognitive prompts during an inquiry cycle was found to promote students' inquiry <span class="hlt">practices</span>.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/abs/2009EGUGA..11.5056C','NASAADS'); return false;" href="http://adsabs.harvard.edu/abs/2009EGUGA..11.5056C"><span id="translatedtitle">Vineyard weeds control <span class="hlt">practices</span> <span class="hlt">impact</span> on surface water transfers: using numerical tracer experiment coupled to a distributed hydrological model to manage agricultural <span class="hlt">practices</span> spatial arrangements.</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Colin, F.; Moussa, R.</p> <p>2009-04-01</p> <p>In rural basins, agricultural landscape management highly influences water and pollutants transfers. Landuse, agricultural <span class="hlt">practices</span> and their spatial arrangements are at issue. Hydrological model are widely used to explore <span class="hlt">impacts</span> of anthropogenic influences on experimental catchments. But planning all spatial arrangements leads to a possible cases count which cannot be considered. On the basis of the recent « numerical experiment » approach, we propose a « numerical tracer function » which had to be coupled to a distributed rainfall-runoff model. This function simulate the transfer of a virtual tracer successively spread on each distributed unit inside the catchment. It allows to rank hydrological spatial units according to their hydrological contribution to the surface flows, particularly at the catchment outlet. It was used with the distributed model MHYDAS in an agricultural context. The case study concerns the experimental Roujan vine-growing catchment (1km², south of France) studied since 1992. In this Mediterranean context, we focus on the soil hydraulic conductivity distributed parameter because it highly depends on weed control <span class="hlt">practices</span> (chemical weeding induces a lot more runoff than mechanical weeding). We checked model sensitivity analysis to soil hydraulic conductivity spatial arrangement on runoff coefficient, peak discharge and catchment lag-time. Results show (i) the use of the tracer function is more efficient than a random approach to improve sensitivity to spatial arrangements from point of view of simulated discharge range, (ii) the first factor explaining hydrological simulations variability was <span class="hlt">practices</span> area ratio, (iii) variability induced by <span class="hlt">practices</span> spatial arrangements was significant on runoff coefficient and peak discharge for balanced <span class="hlt">practices</span> area ratio and on lag-time for low area ratio of chemical weeding <span class="hlt">practices</span>. From the actual situation on the experimental Roujan catchment (40% of tilled and 60% of non tilled vineyard</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://ntrs.nasa.gov/search.jsp?R=EC84-31672-12&hterms=Drones+aircraft+impact&qs=N%3D0%26Ntk%3DAll%26Ntx%3Dmode%2Bmatchall%26Ntt%3DDrones%2Baircraft%2Bimpact','NASA-TRS'); return false;" href="http://ntrs.nasa.gov/search.jsp?R=EC84-31672-12&hterms=Drones+aircraft+impact&qs=N%3D0%26Ntk%3DAll%26Ntx%3Dmode%2Bmatchall%26Ntt%3DDrones%2Baircraft%2Bimpact"><span id="translatedtitle">CID Aircraft in <span class="hlt">practice</span> flight above target <span class="hlt">impact</span> site with wing cutters</span></a></p> <p><a target="_blank" href="http://ntrs.nasa.gov/search.jsp">NASA Technical Reports Server (NTRS)</a></p> <p></p> <p>1984-01-01</p> <p>In this photograph the B-720 is seen making a <span class="hlt">practice</span> close approach over the prepared <span class="hlt">impact</span> site. The wing openers, designed to tear open the wings and spill the fuel, are clearly seen on the ground just at the start of the bed of rocks. In a typical aircraft crash, fuel spilled from ruptured fuel tanks forms a fine mist that can be ignited by a number of sources at the crash site. In 1984 the NASA Dryden Flight Research Facility (after 1994 a full-fledged Center again) and the Federal Aviation Administration (FAA) teamed-up in a unique flight experiment called the Controlled <span class="hlt">Impact</span> Demonstration (CID), to test crash a Boeing 720 aircraft using standard fuel with an additive designed to supress fire. The additive, FM-9, a high-molecular-weight long-chain polymer, when blended with Jet-A fuel had demonstrated the capability to inhibit ignition and flame propagation of the released fuel in simulated crash tests. This anti-misting kerosene (AMK) cannot be introduced directly into a gas turbine engine due to several possible problems such as clogging of filters. The AMK must be restored to almost Jet-A before being introduced into the engine for burning. This restoration is called 'degradation' and was accomplished on the B-720 using a device called a 'degrader.' Each of the four Pratt & Whitney JT3C-7 engines had a 'degrader' built and installed by General Electric (GE) to break down and return the AMK to near Jet-A quality. In addition to the AMK research the NASA Langley Research Center was involved in a structural loads measurement experiment, which included having instrumented dummies filling the seats in the passenger compartment. Before the final flight on December 1, 1984, more than four years of effort passed trying to set-up final <span class="hlt">impact</span> conditions considered survivable by the FAA. During those years while 14 flights with crews were flown the following major efforts were underway: NASA Dryden developed the remote piloting techniques necessary for the B-720</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27504025','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27504025"><span id="translatedtitle">The <span class="hlt">paediatric</span> rheumatologist and orphan disease - a story without happy ending.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Roszkiewicz, Justyna; Biernacka-Zielińska, Małgorzata; Smolewska, Elżbieta</p> <p>2016-01-01</p> <p>Orphan diseases are not a common challenge in the everyday <span class="hlt">practice</span> of the rheumatologist. Despite their extremely rare occurrence one of the patients under our care developed one of them - neuronal ceroid lipofuscinosis, the most frequent neurodegenerative disease observed in the <span class="hlt">paediatric</span> population. We report a case of 2-year-old girl diagnosed with oligoarticular form of juvenile idiopathic arthritis treated in our Department with steroids and methotrexate and staying in the stage of disease remission. During routine checkups at Outpatient Clinic we observed progressive deterioration of girls neurological condition resulting in ataxia, gait disturbances with no rheumatological cause behind and speech impairment. The appearance of the symptoms was accompanied by frequent episodes of epileptic seizures, with little clinical improvement on combined antiepileptic treatment. Magnetic resonance imaging that we performed showed a picture highly suggestive of neuronal ceroid lipofuscinosis - atrophy of the patients cerebrum and cerebellum. Genetic testing conducted resulted in the diagnosis of late infantile neuronal ceroid lipofuscinosis (LINCL). PMID:27504025</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/19103691','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/19103691"><span id="translatedtitle">An overview of moral distress and the <span class="hlt">paediatric</span> intensive care team.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Austin, Wendy; Kelecevic, Julija; Goble, Erika; Mekechuk, Joy</p> <p>2009-01-01</p> <p>A summary of the existing literature related to moral distress (MD) and the <span class="hlt">paediatric</span> intensive care unit (PICU) reveals a high-tech, high-pressure environment in which effective teamwork can be compromised by MD arising from different situations related to: consent for treatment, futile care, end-of-life decision making, formal decision-making structures, training and experience by discipline, individual values and attitudes, and power and authority issues. Attempts to resolve MD in PICUs have included the use of administrative tools such as shift worksheets, the implementation of continuing education, and encouragement to report. The literature does not yet show these approaches to be effective in the resolution of MD. The need to acknowledge MD among PICU teams is discussed and an argument made that, to facilitate understanding among team members, <span class="hlt">practice</span> stories need to be shared. PMID:19103691</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24589964','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24589964"><span id="translatedtitle">Regulatory policies in <span class="hlt">paediatric</span> research: how harmonised are the ethical principles?</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Petrini, C</p> <p>2014-01-01</p> <p>Trials involving children generate considerable <span class="hlt">practical</span> problems of a mainly ethical nature. While there is wide-ranging agreement on the basic ethical requisites for these trials, substantial--and even profound--differences remain between national and international regulatory policies. For the European Union Directive 2001/20/EC is the basic reference for national regulations regarding clinical trials. Article 4 of this Directive deals with trials on minors. The present article compares the regulations of this Article with four other documents regulating <span class="hlt">paediatric</span> trials in Europe, the US and Japan. This comparison points to different approaches relating particularly to: risk acceptability, risk/benefit assessments, informed consent, assent of minors. PMID:24589964</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li><a href="#" onclick='return showDiv("page_22");'>22</a></li> <li class="active"><span>23</span></li> <li><a href="#" onclick='return showDiv("page_24");'>24</a></li> <li><a href="#" onclick='return showDiv("page_25");'>25</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_23 --> <div id="page_24" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li><a href="#" onclick='return showDiv("page_22");'>22</a></li> <li><a href="#" onclick='return showDiv("page_23");'>23</a></li> <li class="active"><span>24</span></li> <li><a href="#" onclick='return showDiv("page_25");'>25</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="461"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2004AGUFMED33C..02K&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2004AGUFMED33C..02K&link_type=ABSTRACT"><span id="translatedtitle">PUMAS (<span class="hlt">Practical</span> Uses of Math And Science) - Low Cost, High <span class="hlt">Impact</span></span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Kahn, R. A.</p> <p>2004-12-01</p> <p>PUMAS is an on-line journal, aimed at giving pre-college teachers brief examples showing how math and science topics taught in K-12 classes can be used in interesting settings, including everyday life. The concept is a simple one - (1) ask scientists, engineers, and other content experts to write up their favorite examples of <span class="hlt">practical</span> uses, (2) ask the authors to key their examples to the National Standards and Benchmarks, so the material is grade-appropriate and useful in the classroom, (3) have each example peer-reviewed by at least one scientist with a relevant background, and at least one teacher at an appropriate grade level, helping keep an emphasis on quality, and (4) disseminate the examples widely and inexpensively through the PUMAS Web Site (http://pumas.jpl.nasa.gov). PUMAS examples may be activities, anecdotes, descriptions of "neat ideas," formal exercises, puzzles, or demonstrations; each one is a gem, written in the voice of its author. The PUMAS site also provides opportunities for feedback on individual examples and on the journal as a whole. As with most scientific journals, the writing, reviewing, and editing efforts are volunteered; they leverage the "community service" offered by so many teachers and scientists. We have streamlined all aspects of the example submission, review, and search processes so participants can contribute at a high level, with a minimum of extraneous effort. The primary PUMAS operating expenses cover Web Site technical maintenance and computer security. The PUMAS site receives several thousand unique queries per week, and publishes an average of about one new example per month. Maintaining a strong user base has been helped by endorsements from such organizations as the NSTA and NCTM. To contributors we offer an avenue for making a real <span class="hlt">impact</span> on pre-college education with a relatively small time commitment, and the opportunity for peer-reviewed publication. We are always looking for good examples of the <span class="hlt">Practical</span> Uses</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=243074','TEKTRAN'); return false;" href="http://www.ars.usda.gov/research/publications/Publications.htm?seq_no_115=243074"><span id="translatedtitle"><span class="hlt">Impacts</span> of management <span class="hlt">practices</span> on microbial dynamics in a semi-arid agroecosystem</span></a></p> <p><a target="_blank" href="http://www.ars.usda.gov/services/TekTran.htm">Technology Transfer Automated Retrieval System (TEKTRAN)</a></p> <p></p> <p></p> <p>Understanding how interactions between management <span class="hlt">practices</span> and soil biota within agroecosytems can help to develop <span class="hlt">practices</span> that will maximize crop productivity while helping to reduce human input. A key indicator to how agricultural management <span class="hlt">practices</span> are affecting soil microbial dynamics of th...</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/27301046','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/27301046"><span id="translatedtitle">Ethical issues of clinical trials in <span class="hlt">paediatric</span> oncology from 2003 to 2013: a systematic review.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Dupont, Jean-Claude K; Pritchard-Jones, Kathy; Doz, François</p> <p>2016-05-01</p> <p>A state-of-the art approach to the debates on ethical issues is key in order to gain guidance on research <span class="hlt">practices</span> involving sick children and adolescents, as well as to identify research avenues in which it might be worth cooperating, to generate better or supplementary evidence. Based on a systematic literature search using MEDLINE, we report the main ethical developments in <span class="hlt">paediatric</span> oncology clinical trials from 2003-13. The present knowledge about normative and empirical ethical demands in this setting is quantified and summarised in a list of 46 issues. This list primarily aims to provide readers with a comprehensive account of the main decision nodes and professional attitudes that enable families to make a safe, competent, and satisfactory decision about their child's enrolment, or non-participation, in cancer clinical trials. Our systematic Review shows how important it is for professionals to engage in a constant reflection on optimum trial designs, on the effect of offering trial participation on key family dynamics, and on the ways to understand families' needs and values accurately. In view of present scientific developments, we further emphasise the need to enhance societal awareness about research in children and adolescents, to prevent so-called research fatigue in small populations due to multiple solicitations or inadequate legal demands, and to reassess longstanding ethical certainties in the strictest view of promoting sick children's interests. This systematic Review allows a series of questions to be drawn to guide and encourage collective and individual endeavours that should lead to constant improvements in our research <span class="hlt">practices</span> in <span class="hlt">paediatric</span> clinical oncology research. PMID:27301046</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4144360','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4144360"><span id="translatedtitle">Financial and Quality <span class="hlt">Impacts</span> of the Medicare Physician Group <span class="hlt">Practice</span> Demonstration</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Pope, Gregory; Kautter, John; Leung, Musetta; Trisolini, Michael; Adamache, Walter; Smith, Kevin</p> <p>2014-01-01</p> <p>Objective To examine the <span class="hlt">impact</span> of the Medicare Physician Group <span class="hlt">Practice</span> (PGP) demonstration on expenditure, utilization, and quality outcomes. Data Source Secondary data analysis of 2001–2010 Medicare claims for 1,776,387 person years assigned to the ten participating provider organizations and 1,579,080 person years in the corresponding local comparison groups. Study Design We used a pre-post comparison group observational design consisting of four pre-demonstration years (1/01–12/04) and five demonstration years (4/05–3/10). We employed a propensity-weighted difference-in-differences regression model to estimate demonstration effects, adjusting for demographics, health status, geographic area, and secular trends. Principal Findings The ten demonstration sites combined saved $171 (2.0%) per assigned beneficiary person year (p<0.001) during the five-year demonstration period. Medicare paid performance bonuses to the participating PGPs that averaged $102 per person year. The net savings to the Medicare program were $69 (0.8%) per person year. Demonstration savings were achieved primarily from the inpatient setting. The demonstration improved quality of care as measured by six of seven claims-based process quality indicators. Conclusions The PGP demonstration, which used a payment model similar to the Medicare Accountable Care Organization (ACO) program, resulted in small reductions in Medicare expenditures and inpatient utilization, and improvements in process quality indicators. Judging from this demonstration experience, it is unlikely that Medicare ACOs will initially achieve large savings. Nevertheless, ACOs paid through shared savings may be an important first step toward greater efficiency and quality in the Medicare fee-for-service program. PMID:25161812</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2013AGUFMED14B..01M&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2013AGUFMED14B..01M&link_type=ABSTRACT"><span id="translatedtitle">Teacher Research Experiences: <span class="hlt">Impacting</span> and Benefiting Teacher Professional Development and School-wide <span class="hlt">Practices</span> (Invited)</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Manning, C. B.</p> <p>2013-12-01</p> <p>Providing authentic research opportunities is a potent form of professional development that significantly <span class="hlt">impacts</span> teaching <span class="hlt">practices</span>. The University of Rhode Island's ARMADA Project (2003-2010) was funded by the National Science Foundation to create opportunities for teachers to work with marine science researchers and implement best-<span class="hlt">practices</span> in their classrooms. In early 2009, I participated in a 6-week research experience that has changed how I teach and how I learn. On board the R/V Knorr, I worked as a sedimentologist with an international crew who used geophysics, geochemistry, microbiology and geology to understand the controls on and distribution of subseafloor microbial life in the equatorial Pacific. This experience has affected my educational <span class="hlt">practices</span> in two ways: (1) motivating me to fill gaps in my own understanding of natural chemical processes, and (2) prioritizing authentic research opportunities for all students at my school. My participation in the ARMADA project underscored the importance of an interdisciplinary approach to research. The team of scientists exposed me to a variety of topics. Biochemistry and the role of redox reactions in biological systems were relatively new to me. Scientists encouraged me to dig deeper into the chemical systems that we were researching. Through self-study and coursework focusing on biogeochemical cycles, deriving energy through chemical processes, and atmospheric chemistry, I have learned much of the chemistry that I am now expected to teach in my courses. I continue to seek out opportunities to learn more and am currently volunteering at geochemistry laboratories at the USGS. My ARMADA research experience depended on teamwork. I learned that while the dynamics of research teams can be simplified if the teams are carefully designed, it is important that students need to learn to work with a variety of people in different situations. Therefore, in my courses, students work in different teams to design and</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4672375','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4672375"><span id="translatedtitle">Promoting a Combination Approach to <span class="hlt">Paediatric</span> HIV Psychosocial Support</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Amzel, Anouk; Toska, Elona; Lovich, Ronnie; Widyono, Monique; Patel, Tejal; Foti, Carrie; Dziuban, Eric J.; Phelps, B. Ryan; Sugandhi, Nandita; Mark, Daniella; Altschuler, Jenny</p> <p>2015-01-01</p> <p>Ninety percent of the 3.4 million HIV-infected children live in sub-Saharan Africa. Their psychosocial well being is fundamental to establishing and maintaining successful treatment outcomes and overall quality of life. With the increased roll-out of antiretroviral treatment, HIV infection is shifting from a life-threatening to a chronic disease. However, even for <span class="hlt">paediatric</span> patients enrolled in care and treatment, HIV can still be devastating due to the interaction of complex factors, particularly in the context of other household illness and overextended healthcare systems in sub-Saharan Africa. This article explores the negative effect of several interrelated HIV-specific factors on the psychosocial well being of HIV-infected children: disclosure, stigma and discrimination, and bereavement. However, drawing on clinical studies of resilience, it stresses the need to move beyond a focus on the individual as a full response to the needs of a sick child requires support for the individual child, caregiver-child dyads, extended families, communities, and institutions. This means providing early and progressive age appropriate interventions aimed at increasing the self-reliance and self-acceptance in children and their caregivers and promoting timely health-seeking behaviours. Critical barriers that cause poorer biomedical and psychosocial outcomes among children and caregiver must also be addressed as should the causes and consequences of stigma and associated gender and social norms. This article reviews interventions at different levels of the ecological model: individual-centred programs, family-centred interventions, programs that support or train healthcare providers, community interventions for HIV-infected children, and initiatives that improve the capacity of schools to provide more supportive environments for HIV-infected children. Although experience is increasing in approaches that address the psychosocial needs of vulnerable and HIV-infected children</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/24361624','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/24361624"><span id="translatedtitle">Promoting a combination approach to <span class="hlt">paediatric</span> HIV psychosocial support.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Amzel, Anouk; Toska, Elona; Lovich, Ronnie; Widyono, Monique; Patel, Tejal; Foti, Carrie; Dziuban, Eric J; Phelps, B Ryan; Sugandhi, Nandita; Mark, Daniella; Altschuler, Jenny</p> <p>2013-11-01</p> <p>Ninety percent of the 3.4 million HIV-infected children live in sub-Saharan Africa. Their psychosocial well being is fundamental to establishing and maintaining successful treatment outcomes and overall quality of life. With the increased roll-out of antiretroviral treatment, HIV infection is shifting from a life-threatening to a chronic disease. However, even for <span class="hlt">paediatric</span> patients enrolled in care and treatment, HIV can still be devastating due to the interaction of complex factors, particularly in the context of other household illness and overextended healthcare systems in sub-Saharan Africa.This article explores the negative effect of several interrelated HIV-specific factors on the psychosocial well being of HIV-infected children: disclosure, stigma and discrimination, and bereavement. However, drawing on clinical studies of resilience, it stresses the need to move beyond a focus on the individual as a full response to the needs of a sick child requires support for the individual child, caregiver-child dyads, extended families, communities, and institutions. This means providing early and progressive age appropriate interventions aimed at increasing the self-reliance and self-acceptance in children and their caregivers and promoting timely health-seeking behaviours. Critical barriers that cause poorer biomedical and psychosocial outcomes among children and caregiver must also be addressed as should the causes and consequences of stigma and associated gender and social norms.This article reviews interventions at different levels of the ecological model: individual-centred programs, family-centred interventions, programs that support or train healthcare providers, community interventions for HIV-infected children, and initiatives that improve the capacity of schools to provide more supportive environments for HIV-infected children. Although experience is increasing in approaches that address the psychosocial needs of vulnerable and HIV-infected children, there</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3701006','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3701006"><span id="translatedtitle">Parents’ Agendas in <span class="hlt">Paediatric</span> Clinical Trial Recruitment Are Different from Researchers’ and Often Remain Unvoiced: A Qualitative Study</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Woolfall, Kerry; Shilling, Valerie; Hickey, Helen; Smyth, Rosalind L.; Sowden, Emma; Williamson, Paula R.; Young, Bridget</p> <p>2013-01-01</p> <p>Ensuring parents make an informed decision about their child’s participation in a clinical trial is a challenge for practitioners as a parent’s comprehension of a trial may differ from that intended by the practitioners responsible for recruitment. We explored what issues parents consider important when making a decision about participation in a <span class="hlt">paediatric</span> clinical trial and their comprehension of these issues to inform future recruitment <span class="hlt">practice</span>. This qualitative interview and observational study examined recruitment in four placebo-controlled, double-blind randomised clinical trials of medicines for children. Audio-recorded trial recruitment discussions between practitioners and parents (N = 41) were matched with semi-structured interviews with parents (N = 41). When making a decision about trial entry parents considered clinical benefit, child safety, <span class="hlt">practicalities</span> of participation, research for the common good, access to medication and randomisation. Within these prioritised issues parents had specific misunderstandings, which had the potential to influence their decisions. While parents had many questions and concerns about trial participation which influenced their decision-making, they rarely voiced these during discussions about the trials with practitioners. Those involved in the recruitment of children to clinical trials need to be aware of parents’ priorities and the sorts of misunderstandings that can arise with parents. Providing trial information that is tailored to what parents consider important in making a decision about a clinical trial may improve recruitment <span class="hlt">practice</span> and ultimately benefit evidence-based <span class="hlt">paediatric</span> medicine. PMID:23844006</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=PHYSIOTHERAPIST&pg=2&id=EJ1105966','ERIC'); return false;" href="http://eric.ed.gov/?q=PHYSIOTHERAPIST&pg=2&id=EJ1105966"><span id="translatedtitle">Use of Outcome Measurement by <span class="hlt">Paediatric</span> AHPs in Northern Ireland</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Harron, Anita; Titterington, Jill</p> <p>2016-01-01</p> <p>Background: Professional standards advocate routine use of outcome measurement (OM) in the <span class="hlt">practice</span> of allied health professionals (AHPs). Historically, OM has focused on impairment and its immediate constraints on activity, while current policy encourages the development and addition of <span class="hlt">impact</span>-based OM. There appears to be an assumption at this…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2014AGUFMGC21B0528L&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2014AGUFMGC21B0528L&link_type=ABSTRACT"><span id="translatedtitle">Land Transformation and Occupation <span class="hlt">Impacts</span> of Farming <span class="hlt">Practices</span> for the Production of Soybean in Mato Grosso, Brazil, Using Life Cycle <span class="hlt">Impact</span> Assessment</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Lathuilliere, M. J.; Miranda, E. J.; Couto, E. G.; Johnson, M. S.</p> <p>2014-12-01</p> <p>The state of Mato Grosso is the largest producer of soybean in Brazil with production continuously increasing since 2000 through a near tripling of cropland area under soybean cultivation. This increase in production has occurred by land cover transformation (extensification into natural ecosystems, e.g. forest to crop) and land use intensification (increase in area by conversion of already cleared land, e.g. pasture to crop), largely to satisfy international demand. In this study, we assess cradle-to-farm gate <span class="hlt">impacts</span> of soybean production in Mato Grosso using life cycle <span class="hlt">impact</span> assessment applied to data collected from 110 farms. We combine 21 <span class="hlt">impact</span> indicators of land transformation and occupation (i.e. land use and land cover change) to show <span class="hlt">impacts</span> of life cycle stages of production to land, air, water, resource use, biodiversity and ecosystem services. The greatest damage to human health and ecosystem quality came from land transformation which primarily takes place in the tropical forest (Amazon) and savanna (Cerrado/Cerradão) biomes. Soybean production in tropical forest landscapes has greater <span class="hlt">impacts</span> on climate regulation, biotic production and groundwater recharge compared to production in native savanna areas, while <span class="hlt">impacts</span> on biodiversity, erosion and soil water purification are roughly equivalent for tropical forest vs. savanna transformation and occupation. Soybean production <span class="hlt">practices</span> showed hot spots of damage to environmental quality and resources from phosphorous fertilizer application and diesel consumption in machinery through <span class="hlt">impact</span> pathways such as terrestrial and aquatic acidification and the use of non-renewable energy. Life cycle <span class="hlt">impact</span> assessment modeling can provide further information into the production process to enlighten decision making with respect to <span class="hlt">impacts</span> occurring along the soybean product supply chain.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://pubs.er.usgs.gov/publication/5224932','USGSPUBS'); return false;" href="http://pubs.er.usgs.gov/publication/5224932"><span id="translatedtitle">Managing visitor <span class="hlt">impacts</span> in parks: A multi-method study of the effectiveness of alternative management <span class="hlt">practices</span></span></a></p> <p><a target="_blank" href="http://pubs.er.usgs.gov/pubs/index.jsp?view=adv">USGS Publications Warehouse</a></p> <p>Park, L.O.; Marion, J.L.; Manning, R.E.; Lawson, S.R.; Jacobi, C.</p> <p>2008-01-01</p> <p>How can recreation use be managed to control associated environmental <span class="hlt">impacts</span>? What management <span class="hlt">practices</span> are most effective and why? This study explored these and related questions through a series of experimental ?treatments? and associated ?controls? at the summit of Cadillac Mountain in Acadia National Park, a heavily used and environmentally fragile area. The treatments included five management <span class="hlt">practices</span> designed to keep visitors on maintained trails, and these <span class="hlt">practices</span> ranged from ?indirect? (information/education) to ?direct? (a fence bordering the trail). Research methods included unobtrusive observation of visitors to determine the percentage of visitors who walked off-trail and a follow-up visitor survey to explore why management <span class="hlt">practices</span> did or didn?t work. All of the management <span class="hlt">practices</span> reduced the percentage of visitors who walked off-trail. More aggressive applications of indirect <span class="hlt">practices</span> were more effective than less aggressive applications, and the direct management <span class="hlt">practice</span> of fencing was the most effective of all. None of the indirect management <span class="hlt">practices</span> reduced walking off-trail to a degree that is likely to control damage to soil and vegetation at the study site. Study findings suggest that an integrated suite of direct and indirect management <span class="hlt">practices</span> be implemented on Cadillac Mountain (and other, similar sites) that includes a) a regulation requiring visitors to stay on the maintained trail, b) enforcement of this regulation as needed, c) unobtrusive fencing along the margins of the trail, d) redesign of the trail to extend it, widen it in key places, and provide short spur trails to key ?photo points?, and e) an aggressive information/education program to inform visitors of the regulation to stay on the trail and the reasons for it. These recommendations are a manifestation of what may be an emerging principle of park and outdoor recreation management: intensive use requires intensive management.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/22184466','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/22184466"><span id="translatedtitle"><span class="hlt">Paediatric</span> cardiac surgery in a patient with cold agglutinins.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Hasegawa, Tomomi; Oshima, Yoshihiro; Maruo, Ayako; Matsuhisa, Hironori</p> <p>2012-03-01</p> <p>Cold agglutinins (CAs) lead to organ thrombosis or haemolysis due to increased blood viscosity and red blood cell clumping when blood temperature drops below the thermal amplitude for haemagglutination. Although it is well known that CAs are particularly relevant to adult cardiac surgery with hypothermic cardiopulmonary bypass (CPB), <span class="hlt">paediatric</span> cardiac surgery with congenital heart disease and with CAs has been reported very rarely. We present here a case of <span class="hlt">paediatric</span> cardiac surgery to repair atrial septal defect with pulmonary stenosis in an 11-month old infant with a family history of CAs. She was detected to have a high titre of CAs preoperatively, and underwent an intracardiac repair with normothermic CPB using temporary electrical fibrillation for added safety. Her post-operative course was uneventful without any complications. PMID:22184466</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4442882','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4442882"><span id="translatedtitle">The evolving role of laparoscopic surgery in <span class="hlt">paediatric</span> urology</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Hidas, Guy; Watts, Blake; Khoury, Antoine E.</p> <p>2012-01-01</p> <p>Objectives We review the various applications of laparoscopic and robotic-assisted laparoscopy in <span class="hlt">paediatric</span> urology, as the laparoscopic and robotic approach in this population is gradually being recognised. Methods We searched PubMed for human studies in English that were published between 1990 and the present, focusing on laparoscopic nephrectomies and partial nephrectomies, laparoscopic and robotic pyeloplasties and ureteric reimplantation, laparoscopic orchidopexy and varicocelectomy. We also reviewed robotic-assisted laparoscopic urological major reconstructions. Key articles were reviewed, extracting the indications, techniques, and the advantages and disadvantages. Results and conclusions Laparoscopy has a defined place in modern <span class="hlt">paediatric</span> urological surgery. Laparoscopic nephrectomies, pyeloplasties and abdominal exploration for the evaluation and management of impalpable undescended testicles have become the standard of care. Robotic-assisted laparoscopic surgery is developing as a safe and effective option even for infant patients. PMID:26558007</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/18158698','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/18158698"><span id="translatedtitle">Epidemiology of <span class="hlt">paediatric</span> metabolic syndrome and type 2 diabetes mellitus.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>De Ferranti, Sarah D; Osganian, Stavroula K</p> <p>2007-12-01</p> <p>The epidemic in childhood obesity is a driving force behind the increase in <span class="hlt">paediatric</span> metabolic syndrome, a collection of abnormalities that is associated in adults with increased risk for cardiovascular disease and type 2 diabetes mellitus. Although there is no clear consensus about the <span class="hlt">paediatric</span> definition for metabolic syndrome, the prevalence of this syndrome is clearly rising. Children with metabolic syndrome are at increased risk for metabolic syndrome in adulthood. A late consequence of metabolic syndrome is type 2 diabetes, which increasingly affects adolescents. The rise in metabolic syndrome and type 2 diabetes in children is almost sure to lead to an increase in associated complications in young adulthood, including early cardiovascular disease. This epidemic will bear fruit in forthcoming decades, putting further stress on the healthcare system and probably leading to increased morbidity and a shorter lifespan for future generations. PMID:18158698</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26940318','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26940318"><span id="translatedtitle">Concepts from <span class="hlt">paediatric</span> extracorporeal membrane oxygenation for adult intensivists.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Butt, Warwick; MacLaren, Graeme</p> <p>2016-12-01</p> <p>Over the last 5 years, there has been a dramatic increase in the use of extracorporeal membrane oxygenation (ECMO) in adult patients with severe respiratory or cardiac failure. This contrasts to the use of the technology in neonatal and <span class="hlt">paediatric</span> intensive care units, where it has been regarded as a standard of care for a number of conditions for over 25 years. Many innovations in ECMO circuitry or clinical management evolve first in one particular discipline and it may be helpful for individual clinicians to keep abreast of developments in ECMO across the entire age range, from neonatology to older adults. This review addresses nine concepts in ECMO that are better studied or established in <span class="hlt">paediatric</span> medicine and considers their application in adult patients. PMID:26940318</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25595513','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25595513"><span id="translatedtitle">Sentinel lymph node biopsy in <span class="hlt">paediatric</span> melanoma. A case series.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Sánchez Aguilar, M; Álvarez Pérez, R M; García Gómez, F J; Fernández Ortega, P; Borrego Dorado, I</p> <p>2015-01-01</p> <p>The incidence of melanoma in children is uncommon, being particularly rare in children under 10 years-old. However, this disease is increasing by a mean of 2% per year. As in adults, the lymph node status is the most important prognostic factor, crucial to performing the selective sentinel lymph node biopsy (SLNB). We report 3 cases of <span class="hlt">paediatric</span> patients of 3, 4 and 8 years-old, in which SLNB was performed for malignant melanoma. <span class="hlt">Paediatric</span> age implies greater technical difficulty to the scintigraphy scan due to poor patient cooperation, with mild sedation required in some cases, and only being able to acquire planar images in other cases. SPECT/CT was only performed in the oldest patient. In our cases, SLNB was useful for selecting the least invasive surgery in order to reduce morbidity. PMID:25595513</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/26529229','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/26529229"><span id="translatedtitle">Utility of double inversion recovery MRI in <span class="hlt">paediatric</span> epilepsy.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Soares, Bruno P; Porter, Samuel G; Saindane, Amit M; Dehkharghani, Seena; Desai, Nilesh K</p> <p>2016-01-01</p> <p>Detecting focal abnormalities in MRI examinations of children with epilepsy can be a challenging task given the frequently subtle appearance of cortical dysplasia, mesial temporal sclerosis and similar lesions. In this report, we demonstrate the utility of double inversion recovery MRI in the detection of <span class="hlt">paediatric</span> epileptogenic abnormalities, promoted primarily by increased lesion conspicuity due to complementary suppression of both cerebrospinal fluid and normal white matter signal. PMID:26529229</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4039982','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4039982"><span id="translatedtitle"><span class="hlt">Paediatric</span> ventriculoperitoneal shunt infection caused by Actinomyces neuii</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Anderson, Ian A; Jarral, Fazain; Sethi, Kavita; Chumas, Paul D</p> <p>2014-01-01</p> <p>We present the first reported case of ventriculoperitoneal shunt infection secondary to Actinomyces neuii in a <span class="hlt">paediatric</span> patient. Our patient was managed with temporary shunt removal, intrathecal antibiotics and a prolonged course of intravenous and then oral antibiotics. She went on to make a complete recovery. Subsequent cerebrospinal fluid analysis at 5 months post-treatment demonstrated no evidence of residual infection. PMID:24859562</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4415099','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4415099"><span id="translatedtitle">Distribution of branchial anomalies in a <span class="hlt">paediatric</span> Asian population</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Teo, Neville Wei Yang; Ibrahim, Shahrul Izham; Tan, Kun Kiaang Henry</p> <p>2015-01-01</p> <p>INTRODUCTION The objective of the present study was to review the distribution and incidence of branchial anomalies in an Asian <span class="hlt">paediatric</span> population and highlight the challenges involved in the diagnosis of branchial anomalies. METHODS This was a retrospective chart review of all <span class="hlt">paediatric</span> patients who underwent surgery for branchial anomalies in a tertiary <span class="hlt">paediatric</span> hospital from August 2007 to November 2012. The clinical notes were correlated with preoperative radiological investigations, intraoperative findings and histology results. Branchial anomalies were classified based on the results of the review. RESULTS A total of 28 children underwent surgery for 30 branchial anomalies during the review period. Two children had bilateral branchial anomalies requiring excision. Of the 30 branchial anomalies, 7 (23.3%) were first branchial anomalies, 5 (16.7%) were second branchial anomalies, 3 (10.0%) were third branchial anomalies, and 4 (13.3%) were fourth branchial anomalies (one of the four patients with fourth branchial anomalies had bilateral branchial anomalies). In addition, seven children had 8 (26.7%) branchial anomalies that were thought to originate from the pyriform sinus; however, we were unable to determine if these anomalies were from the third or fourth branchial arches. There was inadequate information on the remaining 3 (10.0%) branchial anomalies for classification. CONCLUSION The incidence of second branchial anomalies appears to be lower in our Asian <span class="hlt">paediatric</span> population, while that of third and fourth branchial anomalies was higher. Knowledge of embryology and the related anatomy of the branchial apparatus is crucial in the identification of the type of branchial anomaly. PMID:25917471</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3149840','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3149840"><span id="translatedtitle"><span class="hlt">IMPACTING</span> POPULATION CARDIOVASCULAR HEALTH THROUGH A COMMUNITY-BASED <span class="hlt">PRACTICE</span> NETWORK: UPDATE ON AN ASH-SUPPORTED COLLABORATIVE</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Egan, Brent M.; Laken, Marilyn A.; Wagner, C. Shaun; Mack, Sheryl S.; Seymour-Edwards, Kim; Dodson, John; Zhao, Yumin; Lackland, Daniel T.</p> <p>2011-01-01</p> <p>The Hypertension Initiative began in 1999 to help transition South Carolina from a leader in cardiovascular disease (CVD) to a model of heart and vascular health. Goals were to reduce heart disease and stroke 50% by promoting healthy lifestyles and access to effective care and medications. Continuing medical education was used to train providers, encourage physicians to become American Society of Hypertension (ASH) certified Hypertension Specialists and recruit <span class="hlt">practices</span> into the community-based <span class="hlt">practice</span> network (CBPN). <span class="hlt">Practice</span> data audit with provider specific feedback is a key quality improvement tool. With ASH support, the CBPN has grown to 197 <span class="hlt">practices</span> with ~1.6 million patients (~700,000 hypertensives). Clinical data are obtained from electronic health records and quarterly provider feedback reports generated. Hypertension, hypercholesterolemia and diabetes control rose and South Carolina improved from 51st to 35th in CVD mortality from 1995 to 2006. The Hypertension Initiative expanded to the Outpatient Quality Improvement Network to encompass comparative effectiveness research and other chronic diseases. Lessons learned include: trust enables success, addressing <span class="hlt">practice</span> priorities powers participation, infrastructure support must be multilateral, strategic planning identifies opportunities and pitfalls. A collaborative <span class="hlt">practice</span> network is attainable that produces positive, sustainable, and growing <span class="hlt">impacts</span> on cardiovascular and other chronic diseases. PMID:21806763</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li><a href="#" onclick='return showDiv("page_22");'>22</a></li> <li><a href="#" onclick='return showDiv("page_23");'>23</a></li> <li class="active"><span>24</span></li> <li><a href="#" onclick='return showDiv("page_25");'>25</a></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_24 --> <div id="page_25" class="hiddenDiv"> <div class="row"> <div class="col-sm-12"> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li><a href="#" onclick='return showDiv("page_22");'>22</a></li> <li><a href="#" onclick='return showDiv("page_23");'>23</a></li> <li><a href="#" onclick='return showDiv("page_24");'>24</a></li> <li class="active"><span>25</span></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div> </div> <div class="row"> <div class="col-sm-12"> <ol class="result-class" start="481"> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3130659','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3130659"><span id="translatedtitle">Unlimited access to health care - <span class="hlt">impact</span> of psychosomatic co-morbidity on utilisation in German general <span class="hlt">practices</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2011-01-01</p> <p>Background The effect of psychosomatic co-morbidity on resource use for systems with unlimited access remains unclear. The aim of this study was to evaluate the <span class="hlt">impact</span> on <span class="hlt">practice</span> visits, referrals and periods of disability in German general <span class="hlt">practices</span> and to identify predictors of health care utilisation. Methods Cross sectional observational study in 13 <span class="hlt">practices</span> in Upper Bavaria. Patients were included consecutively and filled in the Patients Health Questionnaire (PHQ). Numbers of <span class="hlt">practice</span> visits, referrals and periods of disability within the last twelve months and permanent mental and somatic diagnoses were extracted manually by review of the computerised charts. Physicians in Germany are obliged to document repetitive reasons of encounter as permanent diagnoses in terms of ICD-10-codes. These ICD-10-codes are used for legitimisation of reimbursement in German general <span class="hlt">practices</span>. Results 1005 patients were included (58.6% female). On average, patients had 15.3 (sd 16.3) <span class="hlt">practice</span> contacts, 3.8 (sd 4.2) referrals and 7.5 (sd 23.1) days of disability per year. The mean number of coded permanent diagnoses was 0.4 (sd 0.7) for mental and 4.0 (sd 4.0) for somatic diagnoses. Patients with mental diagnoses scored higher in depression, anxiety, panic and somatoform disorder scales of PHQ. Frequent <span class="hlt">practice</span> visits were associated stronger with coded permanent mental diagnoses (OR 20.0; 95%CI 7.5-53.9) than with coded permanent somatic diagnoses (OR 14.4; 95%CI 5.9-35.4). Frequent referrals were associated stronger with somatic diagnoses (OR 4.9; 95%CI 2.0-11.9) than with mental diagnoses (OR 3.6; 95%CI 1.4-9.8). Periods of disability were predicted by mental diagnoses (OR 5.0; 95%CI 1.6-15.8) but not by somatic diagnoses (OR 2.5; 95%CI 0.7-8.1). Conclusions Psychosomatic co-morbidity has a stronger <span class="hlt">impact</span> on health care utilisation in German general <span class="hlt">practices</span> with respect to <span class="hlt">practice</span> visits and periods of disability whereas somatic disorders play a stronger role for</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4111023','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4111023"><span id="translatedtitle">RADIATION DOSE IN <span class="hlt">PAEDIATRIC</span> COMPUTED TOMOGRAPHY: RISKS AND BENEFITS</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Ogbole, G.I.</p> <p>2010-01-01</p> <p>Computed tomography (CT) is a powerful tool for the accurate and effective diagnosis and treatment of a variety of conditions because it allows high-resolution three-dimensional images to be acquired very quickly. However as the number of CT procedures performed globally have continued to increase; with growing concerns about patient protection. Currently, no system is in place to track patient doses and the lifetime cumulative dose from medical sources. The widespread use of CT even in developing countries has raised questions regarding the possible threat to public health especially in children. The best available risk estimates suggest that <span class="hlt">paediatric</span> CT will result in significantly increased lifetime radiation risk over adult CT. Studies have shown that lower milliampere-second (mAs) settings can be used for children without significant loss of information. Although the risk–benefit balance is still strongly tilted toward benefit, there is still need for caution. Furthermore since the frequency of <span class="hlt">paediatric</span> CT examinations is rapidly increasing, and estimates suggest that quantitative lifetime radiation risks for children are not negligible, efforts should be made toward more active reduction of CT exposure settings in <span class="hlt">paediatric</span> patients. This article hopes to address this concerns and draw attention to the fact that children are not ‘small adults ’ and should therefore be treated differently. PMID:25161479</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4773020','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4773020"><span id="translatedtitle">Safety of Levetiracetam in <span class="hlt">Paediatrics</span>: A Systematic Review</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Egunsola, Oluwaseun; Choonara, Imti; Sammons, Helen Mary</p> <p>2016-01-01</p> <p>Objective To identify adverse events (AEs) associated with Levetiracetam (LEV) in children. Methods Databases EMBASE (1974-February 2015) and Medline (1946-February 2015) were searched for articles in which <span class="hlt">paediatric</span> patients (≤18 years) received LEV treatment for epilepsy. All studies with reports on safety were included. Studies involving adults, mixed age population (i.e. children and adults) in which the <span class="hlt">paediatric</span> subpopulation was not sufficiently described, were excluded. A meta-analysis of the RCTs was carried out and association between the commonly reported AEs or treatment discontinuation and the type of regimen (polytherapy or monotherapy) was determined using Chi2 analysis. Results Sixty seven articles involving 3,174 <span class="hlt">paediatric</span> patients were identified. A total of 1,913 AEs were reported across studies. The most common AEs were behavioural problems and somnolence, which accounted for 10.9% and 8.4% of all AEs in prospective studies. 21 prospective studies involving 1120 children stated the number of children experiencing AEs. 47% of these children experienced AEs. Significantly more children experienced AEs with polytherapy (64%) than monotherapy (22%) (p<0.001). Levetiracetam was discontinued in 4.5% of all children on polytherapy and 0.9% on monotherapy (p<0.001), the majority were due to behavioural problems. Conclusion Behavioural problems and somnolence were the most prevalent adverse events to LEV and the most common causes of treatment discontinuation. Children on polytherapy have a greater risk of adverse events than those receiving monotherapy. PMID:26930201</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/25615996','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/25615996"><span id="translatedtitle"><span class="hlt">Paediatric</span> nurses' attitudes towards the promotion of healthy eating.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Blake, Holly; Patterson, Joanna</p> <p></p> <p>This study assessed <span class="hlt">paediatric</span> nurses' attitudes towards promoting healthy eating and their opinions regarding nurses as role models for health. In all, 67 nurses from 14 wards at an acute hospital trust completed questionnaires on weight, diet, physical activity, self-efficacy and attitudes towards nurses as role models for health. Forty-eight percent felt that they could incorporate health promotion into their patient care better, and 84% believed that nurses should present themselves as role models for health. Nurses felt that their own health behaviours influenced the quality of their care: 77% reported that patients and families would heed advice better from those who appeared to follow it themselves, and 48% reported difficulties in promoting health behaviours they did not adhere to themselves. These views were inconsistent with their own lifestyle choices, since one third of respondents did not meet physical-activity guidelines, almost half were an unhealthy weight, and the majority did not consume five portions of fruits/vegetables per day. <span class="hlt">Paediatric</span> nurses identified barriers and facilitators to promoting healthy eating. Education, training and access to evidence-based resources may help to increase <span class="hlt">paediatric</span> nurses' confidence to promote healthy eating to children and their families. Hospital workplaces should make provision to support nurses who seek to improve their own health. PMID:25615996</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4941652','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4941652"><span id="translatedtitle">Marketing <span class="hlt">paediatric</span> influenza vaccination: results of a major metropolitan trial</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Van Buynder, Paul G.; Carcione, Dale; Rettura, Vince; Daly, Alison; Woods, Emily</p> <p>2010-01-01</p> <p>Please cite this paper as: Van Buynder et al. (2010) Marketing <span class="hlt">paediatric</span> influenza vaccination: results of a major metropolitan trial. Influenza and Other Respiratory Viruses 5(1), 33–38. Objectives  After a cluster of rapidly fulminant influenza related toddler deaths in a Western Australian metropolis, children aged six to 59 months were offered influenza vaccination in subsequent winters. Some parental resistance was expected and previous poor uptake of <span class="hlt">paediatric</span> influenza vaccination overseas was noted. A marketing campaign addressing barriers to immunization was developed to maximise uptake. Design  Advertising occurred in major statewide newspapers, via public poster displays and static ‘eye‐lite’ displays, via press releases, via a series of rolling radio advertisements, via direct marketing to child care centres, and via a linked series of web‐sites. Parents were subsequently surveyed to assess reasons for vaccination. Main Outcome Results  The campaign produced influenza vaccination coverage above that previously described elsewhere and led to a proportionate reduction in influenza notifications in this age group compared to previous seasons. Conclusions  Influenza in children comes with significant morbidity and some mortality. <span class="hlt">Paediatric</span> influenza vaccination is safe, well tolerated and effective if two doses are given. A targeted media campaign can increase vaccine uptake if it reinforces the seriousness of influenza and addresses community ‘myths’ about influenza and influenza vaccine. The lessons learned enabling enhancements of similar programs elsewhere. PMID:21138538</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4969420','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4969420"><span id="translatedtitle">Thyroid abnormalities in <span class="hlt">paediatric</span> patients with vitiligo: retrospective study</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Borlu, Murat; Çınar, Salih Levent; Kesikoğlu, Ayten; Utaş, Serap</p> <p>2016-01-01</p> <p>Introduction The association between vitiligo and thyroid disease is not fully investigated especially in <span class="hlt">paediatric</span> patients. Aim To determine the incidence of vitiligo and thyroid disorders in children. This is the first report from middle Anatolia and the second report from Turkey. Material and methods A retrospective chart review was performed to examine the presence of thyroid abnormalities in <span class="hlt">paediatric</span> patients who had been admitted to the dermatology department with vitiligo. Results A total of 155 <span class="hlt">paediatric</span> patients, including 80 (52%) male and 75 (48%) female patients were included. The mean age was 8.6 years. Non segmental vitiligo was the most common type of the disease in 140 (90%) reviewed patients, while segmental vitiligo appeared only in 15 (10%) patients. The mean onset of vitiligo was 5.6 ±0.9 years. A family history of vitiligo was found in 14 (9%) children. Thirty-four (22%) patients had thyroid function tests and/or thyroid autoantibody abnormality. All of these patients had non segmental vitiligo. It was statistically significant (p < 0.05) in types of vitiligo and thyroid disease parameters. Conclusions Our results show that it may be useful to screen thyroid in children with non segmental vitiligo. PMID:27512360</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2006PMB....51.3723A&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2006PMB....51.3723A&link_type=ABSTRACT"><span id="translatedtitle"><span class="hlt">Paediatric</span> x-ray examinations in Rio de Janeiro</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Azevedo, A. C. P.; Osibote, O. A.; Boechat, M. C. B.</p> <p>2006-08-01</p> <p>This work presents the results of a dose survey performed for <span class="hlt">paediatric</span> patients and carried out in two large <span class="hlt">paediatric</span> public hospitals in Rio de Janeiro city. The entrance surface dose (ESD) and the effective dose (ED) were evaluated for chest, skull, abdomen, lumbar spine, cervical spine and pelvis in antero-posterior (AP), postero-anterior (PA) and lateral (LAT) projections. For each examination, four age groups 0-1, 1-5, 5-10 and 10-15 years were studied. The DoseCal software was used to calculate these doses. Wide variations for the same type of examination and projection have been detected. These variations were evident, in Brazil, from previous work. In spite of the present results being still preliminary, they can give an idea of what <span class="hlt">paediatric</span> ESDs are like in Brazil. Also, with respect to the entrance surface dose, some of the results are above the reference levels, which cause high ED, as well. On the other hand, the wide range of ESD reflects the disparity of radiographic techniques and demonstrates that the ALARA principle is not being applied in Brazilian hospitals and becomes a concern in terms of public health.</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.ncbi.nlm.nih.gov/pubmed/19291199','PUBMED'); return false;" href="http://www.ncbi.nlm.nih.gov/pubmed/19291199"><span id="translatedtitle">Noddings's caring ethics theory applied in a <span class="hlt">paediatric</span> setting.</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed">PubMed</a></p> <p>Lundqvist, Anita; Nilstun, Tore</p> <p>2009-04-01</p> <p>Since the 1990s, numerous studies on the relationship between parents and their children have been reported on in the literature and implemented as a philosophy of care in most <span class="hlt">paediatric</span> units. The purpose of this article is to understand the process of nurses' care for children in a <span class="hlt">paediatric</span> setting by using Noddings's caring ethics theory. Noddings's theory is in part described from a theoretical perspective outlining the basic idea of the theory followed by a critique of her work. Important conceptions in her theory are natural caring (reception, relation, engrossment, motivational displacement, reciprocity) and ethical caring (physical self, ethical self, and ethical ideal). As a nurse one holds a duty of care to patients and, in exercising this duty, the nurse must be able to develop a relationship with the patient including giving the patient total authenticity in a 'feeling with' the patient. Noddings's theory is analysed and described in three examples from the <span class="hlt">paediatrics</span>. In the first example, the nurse cared for the patient in natural caring while in the second situation, the nurse strived for the ethical caring of the patient. In the third example, the nurse rejected the impulse to care and deliberately turned her back to ethics and abandoned her ethical caring. According to the Noddings's theory, caring for the patient enables the nurse to obtain ethical insights from the specific type of nursing care which forms an important contribution to an overall increase of an ethical consciousness in the nurse. PMID:19291199</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2813227','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2813227"><span id="translatedtitle">Evidence-based <span class="hlt">practice</span> implementation: The <span class="hlt">impact</span> of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based <span class="hlt">practice</span></span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p></p> <p>2009-01-01</p> <p>Background The goal of this study is to extend research on evidence-based <span class="hlt">practice</span> (EBP) implementation by examining the <span class="hlt">impact</span> of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Methods Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the <span class="hlt">impact</span> of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Results Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in <span class="hlt">practice</span>. Conclusion This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in <span class="hlt">practice</span>. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings. PMID</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2014AGUFM.H53F0913S&link_type=ABSTRACT','NASAADS'); return false;" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=2014AGUFM.H53F0913S&link_type=ABSTRACT"><span id="translatedtitle">Evaluation of the Effectiveness of Low <span class="hlt">Impact</span> Development <span class="hlt">Practices</span> (LIDs) under Various Conditions</span></a></p> <p><a target="_blank" href="http://adsabs.harvard.edu/abstract_service.html">NASA Astrophysics Data System (ADS)</a></p> <p>Seo, M.; Jaber, F. H.</p> <p>2014-12-01</p> <p>Stormwater problems from urban development have been occurring in recent years in the United States. Low <span class="hlt">Impact</span> Development <span class="hlt">practices</span> (LIDs) have been used as an alternative stormwater management approach in urban areas. The effects of LIDs on hydrology and water quality have been indicated to be positive through much of research, showing the decrease of surface runoff volumes and pollutant loadings. However, LIDs can cause different effectiveness under a variety of conditions. In this study, the effectiveness of LIDs was assessed under various urban planning (a compact high-density urban type (UHD), a conventional medium-density urban type (UMD), and a conservational medium-density urban type (UMC)) and under various LIDs conditions (types, locations, and percent allocations of LIDs) for surface runoff, nitrate, and total phosphorus to evaluate the effectiveness of LIDs for these conditions at a development scale. Rain gardens, rainwater harvesting systems, and permeable pavements were considered for simulations. The Soil and Water Assessment Tool (SWAT) was used and model development was performed to simulate the LIDs considered. A manual optimization was used to identify the LIDs conditions that meet both targeted reduction amounts and minimal cost. The effectiveness of LIDs was evaluated for the three urban land uses and for the optimized LIDs conditions. The study demonstrated different effectiveness of LIDs under various conditions considered. Under the condition of the urban land uses, the largest reduction by LIDs occurred in the order of following land uses for all variables: in UMD land use > in UMC land use > in UHD land use. Among post-LIDs scenarios, the UHD land use represented low values for surface runoff and nitrate and the UMD land use for TP. For the LIDs optimization, the various combinations of type, location, and percent allocation for each variable changed the effectiveness of LIDs and/or caused the same effectiveness of LIDs. This study can</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4728955','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4728955"><span id="translatedtitle"><span class="hlt">Impact</span> of 10-weeks of yoga <span class="hlt">practice</span> on flexibility and balance of college athletes</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Polsgrove, M Jay; Eggleston, Brandon M; Lockyer, Roch J</p> <p>2016-01-01</p> <p>Background: With clearer evidence of its benefits, coaches, and athletes may better see that yoga has a role in optimizing performance. Aims: To determine the <span class="hlt">impact</span> of yoga on male college athletes (N = 26). Methods: Over a 10-week period, a yoga group (YG) of athletes (n = 14) took part in biweekly yoga sessions; while a nonyoga group (NYG) of athletes (n = 12) took part in no additional yoga activity. Performance measures were obtained immediately before and after this period. Measurements of flexibility and balance, included: Sit-reach (SR), shoulder flexibility (SF), and stork stand (SS); dynamic measurements consisted of joint angles (JA) measured during the performance of three distinct yoga positions (downward dog [DD]; right foot lunge [RFL]; chair [C]). Results: Significant gains were observed in the YG for flexibility (SR, P = 0.01; SF, P = 0.03), and balance (SS, P = 0.05). No significant differences were observed in the NYG for flexibility and balance. Significantly, greater JA were observed in the YG for: RFL (dorsiflexion, l-ankle; P = 0.04), DD (extension, r-knee, P = 0.04; r-hip; P = 0.01; flexion, r-shoulder; P = 0.01) and C (flexion, r-knee; P = 0.01). Significant JA differences were observed in the NYG for: DD (flexion, r-knee, P = 0.01: r-hip, P = 0.05; r-shoulder, P = 0.03) and C (flexion r-knee, P = 0.01; extension, r-shoulder; P = 0.05). A between group comparison revealed the significant differences for: RFL (l-ankle; P = 0.01), DD (r-knee, P = 0.01; r-hip; P = 0.01), and C (r-shoulder, P = 0.02). Conclusions: Results suggest that a regular yoga <span class="hlt">practice</span> may increase the flexibility and balance as well as whole body measures of male college athletes and therefore, may enhance athletic performances that require these characteristics. PMID:26865768</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3613075','PMC'); return false;" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3613075"><span id="translatedtitle">Adopting Best <span class="hlt">Practices</span> from Team Science in a Healthcare Improvement Research Network: The <span class="hlt">Impact</span> on Dissemination and Implementation</span></a></p> <p><a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pmc">PubMed Central</a></p> <p>Stevens, Kathleen R.; Patel, Darpan I.</p> <p>2013-01-01</p> <p>Healthcare is a complex adaptive system, and efforts to improve through the implementation of best <span class="hlt">practice</span> are well served by various interacting disciplines within the system. As a transdisciplinary model is new to clinicians, an infrastructure that creates academic-<span class="hlt">practice</span> partnerships and builds capacity for scientific collaboration is necessary to test, spread, and implement improvement strategies. This paper describes the adoption of best <span class="hlt">practices</span> from the science of team science in a healthcare improvement research network and the <span class="hlt">impact</span> on conducting a large-scale network study. Key components of the research network infrastructure were mapped to a team science framework and evaluated in terms of their effectiveness and <span class="hlt">impact</span> on a national study of nursing operations. Results from this study revealed an effective integration of the team science principles which facilitated the rapid collection of a large dataset. Implications of this study support a collaborative model for improvement research and stress a need for future research and funding to further evaluate the <span class="hlt">impact</span> on dissemination and implementation. PMID:23577246</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=procedure+AND+administrative&pg=7&id=ED548635','ERIC'); return false;" href="http://eric.ed.gov/?q=procedure+AND+administrative&pg=7&id=ED548635"><span id="translatedtitle"><span class="hlt">Impact</span> of Selection <span class="hlt">Practices</span> on Career Advancement of African American Women in Community College Administration</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Yancy-Tooks, Barbara J.</p> <p>2012-01-01</p> <p>The purpose of this qualitative ethnographic study was to explore the experiences of African American women about their perceptions of factors (i.e. senior administrator selection <span class="hlt">practices</span>, institutional <span class="hlt">practices</span>, barriers, and coping strategies) that hinder or facilitate advancement in community college administration. The following questions…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=Middle+AND+English&pg=3&id=EJ1092893','ERIC'); return false;" href="http://eric.ed.gov/?q=Middle+AND+English&pg=3&id=EJ1092893"><span id="translatedtitle">Learning in a Community of <span class="hlt">Practice</span>: Factors <span class="hlt">Impacting</span> English-Learning Students' Engagement in Scientific Argumentation</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>González-Howard, María; McNeill, Katherine L.</p> <p>2016-01-01</p> <p>Recent education reform efforts have included an increasing push for school science to better mirror authentic scientific endeavor, including a focus on science <span class="hlt">practices</span>. However, despite expectations that all students engage in these language-rich <span class="hlt">practices</span>, little prior research has focused on how such opportunities will be created for…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=Veal&id=EJ939566','ERIC'); return false;" href="http://eric.ed.gov/?q=Veal&id=EJ939566"><span id="translatedtitle">The <span class="hlt">Impact</span> of the COPET Programme on Student PE Teachers' Teaching <span class="hlt">Practice</span> Experiences</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Dunning, Carol; Meegan, Sarah; Woods, Catherine; Belton, Sarah Jane</p> <p>2011-01-01</p> <p>Teaching <span class="hlt">practice</span> is a decisive event in a student teacher's training and shapes the beginnings of their life in the teaching profession. It is widely recognized that student teachers' learning opportunities can be maximized during teaching <span class="hlt">practice</span> by cooperating teacher contribution (Hardy, 1999; O'Sullivan, 2003; Rikard and Veal, 1996;…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=Journal+AND+medical+AND+dental+AND+research&pg=4&id=EJ252475','ERIC'); return false;" href="http://eric.ed.gov/?q=Journal+AND+medical+AND+dental+AND+research&pg=4&id=EJ252475"><span id="translatedtitle">The Changing Character of Dental <span class="hlt">Practice</span> and Its <span class="hlt">Impact</span> on Dental Education.</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Kerr, I. Lawrence</p> <p>1981-01-01</p> <p>The "<span class="hlt">practice</span>" aspect of the dental profession is reviewed. It is suggested that there is no way to separate education, <span class="hlt">practice</span>, research, financing, government, science, business, management, motivation, and the public from one another. Retail dentistry, health maintenance organizations, franchising, advertising, and denturism are discussed.…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=dental+AND+pain&id=EJ844838','ERIC'); return false;" href="http://eric.ed.gov/?q=dental+AND+pain&id=EJ844838"><span id="translatedtitle"><span class="hlt">Impact</span> of Curriculum on Understanding of Professional <span class="hlt">Practice</span>: A Longitudinal Study of Students Commencing Dental Education</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Kieser, Jules A.; Dall'Alba, Gloria; Livingstone, Vicki</p> <p>2009-01-01</p> <p>This longitudinal study examines changes in understanding of dental <span class="hlt">practice</span> among a cohort of students in the early years of a dentistry programme. In their first two professional years, we identified five distinct understandings of dental <span class="hlt">practice</span> that we have ordered from least to most comprehensive: "relieving pain or generally caring for…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=effect+AND+light&pg=5&id=EJ1100437','ERIC'); return false;" href="http://eric.ed.gov/?q=effect+AND+light&pg=5&id=EJ1100437"><span id="translatedtitle">Changes in Coaching Study Design Shed Light on How Features <span class="hlt">Impact</span> Teacher <span class="hlt">Practice</span>. Lessons from Research</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Killion, Joellen</p> <p>2016-01-01</p> <p>Teacher coaching is a powerful form of professional learning that improves teaching <span class="hlt">practices</span> and student achievement, yet little is known about the specific aspects of coaching programs that are more effective. Researchers used a blocked randomized experiment to study the effects of one-to-one coaching on teacher <span class="hlt">practice</span>. When pooled across all…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=markova&pg=2&id=EJ226119','ERIC'); return false;" href="http://eric.ed.gov/?q=markova&pg=2&id=EJ226119"><span id="translatedtitle"><span class="hlt">Impact</span> of Haemophilia on Child-rearing <span class="hlt">Practices</span> and Parental Co-operation.</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Markova, Ivana; And Others</p> <p>1980-01-01</p> <p>The parents of eight 3-5-year-old hemophilic boys and 3-5-year-old nonhemophilic boys were interviewed to explore (a) extent to which the rearing <span class="hlt">practices</span> and cooperation between the parents of a hemophilic child differ from the parents of a nonhemophilic child and (b) differences between rearing <span class="hlt">practices</span> and parental cooperation in families…</p> </li> <li> <p><a target="_blank" onclick="trackOutboundLink('http://eric.ed.gov/?q=reflective+AND+practice&pg=3&id=ED550382','ERIC'); return false;" href="http://eric.ed.gov/?q=reflective+AND+practice&pg=3&id=ED550382"><span id="translatedtitle">Becoming Critical Thinkers: The <span class="hlt">Impact</span> of Treatments on Student Reflective <span class="hlt">Practice</span> in the College Classroom</span></a></p> <p><a target="_blank" href="http://www.eric.ed.gov/ERICWebPortal/search/extended.jsp?_pageLabel=advanced">ERIC Educational Resources Information Center</a></p> <p>Depinet, Andrea</p> <p>2012-01-01</p> <p>The purpose of the study was to determine the effect of instructional treatments on reflective <span class="hlt">practice</span> and critical thinking in the college classroom at Bowling Green State University in the College of Business. The study employed a quasi-experimental pretest posttest control group design to examine student reflective <span class="hlt">practice</span> among three…</p> </li> </ol> <div class="pull-right"> <ul class="pagination"> <li><a href="#" onclick='return showDiv("page_1");'>«</a></li> <li><a href="#" onclick='return showDiv("page_21");'>21</a></li> <li><a href="#" onclick='return showDiv("page_22");'>22</a></li> <li><a href="#" onclick='return showDiv("page_23");'>23</a></li> <li><a href="#" onclick='return showDiv("page_24");'>24</a></li> <li class="active"><span>25</span></li> <li><a href="#" onclick='return showDiv("page_25");'>»</a></li> </ul> </div> </div><!-- col-sm-12 --> </div><!-- row --> </div><!-- page_25 --> <center> <div class="footer-extlink text-muted"><small>Some links on this page may take you to non-federal websites. 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