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Sample records for achieve good clinical

  1. Good clinical sense in diabetology.

    PubMed

    Kalra, Sanjay; Gupta, Yashdeep

    2015-08-01

    This article defines and explains the concept of good clinical sense. It defines good clinical sense as "the presence of sensory faculties, their usage and interpretation, by which one is able to practice good clinical medicine". Good clinical sense differs from good clinical practice (GCP) and good clinical acumen. It encompasses all steps of the clinical, diagnostic and therapeutic process, and encourages diligent practice of clinical medicine. Good clinical sense is integral to the practice of diabetology.

  2. Good Clinical Practice Training

    PubMed Central

    Arango, Jaime; Chuck, Tina; Ellenberg, Susan S.; Foltz, Bridget; Gorman, Colleen; Hinrichs, Heidi; McHale, Susan; Merchant, Kunal; Shapley, Stephanie; Wild, Gretchen

    2016-01-01

    Good Clinical Practice (GCP) is an international standard for the design, conduct, performance, monitoring, auditing, recording, analyses, and reporting of clinical trials. The goal of GCP is to ensure the protection of the rights, integrity, and confidentiality of clinical trial participants and to ensure the credibility and accuracy of data and reported results. In the United States, trial sponsors generally require investigators to complete GCP training prior to participating in each clinical trial to foster GCP and as a method to meet regulatory expectations (ie, sponsor’s responsibility to select qualified investigators per 21 CFR 312.50 and 312.53(a) for drugs and biologics and 21 CFR 812.40 and 812.43(a) for medical devices). This training requirement is often extended to investigative site staff, as deemed relevant by the sponsor, institution, or investigator. Those who participate in multiple clinical trials are often required by sponsors to complete repeated GCP training, which is unnecessarily burdensome. The Clinical Trials Transformation Initiative convened a multidisciplinary project team involving partners from academia, industry, other researchers and research staff, and government to develop recommendations for streamlining current GCP training practices. Recommendations drafted by the project team, including the minimum key training elements, frequency, format, and evidence of training completion, were presented to a broad group of experts to foster discussion of the current issues and to seek consensus on proposed solutions. PMID:27390628

  3. How To Achieve Good Library Acoustics.

    ERIC Educational Resources Information Center

    Wiens, Janet

    2003-01-01

    Discusses how to create a good acoustical environment for college libraries, focusing on requirements related to the HVAC system and lighting, and noting the importance of good maintenance. A sidebar looks at how to design and achieve the most appropriate HVAC and lighting systems for optimum library acoustics. (SM)

  4. Decreased Sperm Motility Retarded ICSI Fertilization Rate in Severe Oligozoospermia but Good-Quality Embryo Transfer Had Achieved the Prospective Clinical Outcomes

    PubMed Central

    Zheng, Jufeng; Lu, Yongning; Qu, Xianqin; Wang, Peng; Zhao, Luiwen; Gao, Minzhi; Shi, Huijuan; Jin, Xingliang

    2016-01-01

    . Overall rates in all groups were 41.26% clinical pregnancy, 25.74% implantation and 36.32% live birth, which gave live birth to 252 girls and 252 boys. Conclusions The reduction of motile spermatozoa in severe oligozoospermia decreased the rates of fertilization and good-quality embryo. Obtaining and transfer of good-quality embryos was the good prognostic to achieve prospective clinical outcomes regardless of the severity of oligozoospermia. PMID:27661081

  5. The Impossibility of Achieving Consistently Good Mental Health.

    ERIC Educational Resources Information Center

    Ellis, Albert

    1987-01-01

    People disturb themselves with irrational beliefs, some of which are obvious and blatant while others are subtle and tricky. The latter type make people more disturbed than do the former kind. Even when helped by the most efficient forms of psychotherapy, humans have difficulty achieving and maintaining good mental health. (Author/VM)

  6. The clinic as a good corporate neighbor.

    PubMed

    Sass, Hans-Martin

    2013-02-01

    Clinics today specialize in health repair services similar to car repair shops; procedures and prices are standardized, regulated, and inflexibly uniform. Clinics of the future have to become Health Care Centers in order to be more respected and more effective corporate neighbors in offering outreach services in health education and preventive health care. The traditional concept of care for health is much broader than repair management and includes the promotion of lay health competence and responsibility in healthy social and natural environments. The corporate profile and ethics of the clinic as a good and competitive local neighbor will have to focus on [a] better personalized care, [b] education and services in preventive care, [c] direct or web-based information and advice for general, seasonal, or age related health risks, and on developing and improving trustworthy character traits of the clinic as a corporate person and a good neighbor.

  7. The clinic as a good corporate neighbor

    PubMed Central

    Sass, Hans-Martin

    2013-01-01

    Clinics today specialize in health repair services similar to car repair shops; procedures and prices are standardized, regulated, and inflexibly uniform. Clinics of the future have to become Health Care Centers in order to be more respected and more effective corporate neighbors in offering outreach services in health education and preventive health care. The traditional concept of care for health is much broader than repair management and includes the promotion of lay health competence and responsibility in healthy social and natural environments. The corporate profile and ethics of the clinic as a good and competitive local neighbor will have to focus on [a] better personalized care, [b] education and services in preventive care, [c] direct or web-based information and advice for general, seasonal, or age related health risks, and on developing and improving trustworthy character traits of the clinic as a corporate person and a good neighbor. PMID:23444251

  8. Guidelines on Good Clinical Laboratory Practice

    PubMed Central

    Ezzelle, J.; Rodriguez-Chavez, I. R.; Darden, J. M.; Stirewalt, M.; Kunwar, N.; Hitchcock, R.; Walter, T.; D’Souza, M. P.

    2008-01-01

    A set of Good Clinical Laboratory Practice (GCLP) standards that embraces both the research and clinical aspects of GLP were developed utilizing a variety of collected regulatory and guidance material. We describe eleven core elements that constitute the GCLP standards with the objective of filling a gap for laboratory guidance, based on IND sponsor requirements, for conducting laboratory testing using specimens from human clinical trials. These GCLP standards provide guidance on implementing GLP requirements that are critical for laboratory operations, such as performance of protocol-mandated safety assays, peripheral blood mononuclear cell processing and immunological or endpoint assays from biological interventions on IND-registered clinical trials. The expectation is that compliance with the GCLP standards, monitored annually by external audits, will allow research and development laboratories to maintain data integrity and to provide immunogenicity, safety, and product efficacy data that is repeatable, reliable, auditable and that can be easily reconstructed in a research setting. PMID:18037599

  9. Achieving quality assurance through clinical audit.

    PubMed

    Patel, Seraphim

    2010-06-01

    Audit is a crucial component of improvements to the quality of patient care. Clinical audits are undertaken to help ensure that patients can be given safe, reliable and dignified care, and to encourage them to self-direct their recovery. Such audits are undertaken also to help reduce lengths of patient stay in hospital, readmission rates and delays in discharge. This article describes the stages of clinical audit and the support required to achieve organisational core values.

  10. How good are clinical laboratories? An assessment of current performance.

    PubMed

    Rej, R; Jenny, R W

    1992-07-01

    The Clinical Laboratory Improvement Act of 1967 and Amendments of 1988 (CLIA '67 and CLIA '88) were enacted to ensure that clinical laboratories within the U.S. provide a quality of service that meets clinical needs for good patient care. Approved proficiency-testing programs are to judge the quality of laboratory testing by promulgated performance criteria. We examine the quality of analytical results reported in 1991 to the New York State Department of Health Proficiency Testing program in light of these criteria and analytical goals, based on medical usefulness. Analytical performance is examined for cholesterol, potassium, sodium, calcium, glucose, aspartate aminotransferase, digoxin, and theophylline. In general, proposed CLIA '88 performance standards are compatible with the current state of practice for the population of laboratories examined. Exceptions appear to be digoxin and sodium (failure rate exceeding average) and most therapeutic substances (low failure rate). Sources of analytical bias relative to an accuracy-based target value must be characterized as method-, laboratory-, or matrix-dependent if regulatory programs are to achieve the objective of improving analytical accuracy across all testing sites.

  11. 77 FR 49449 - Food and Drug Administration Clinical Trial Requirements, Compliance, and Good Clinical Practice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-16

    ... drugs, devices, and biologics; as well as inspections of clinical investigators, IRBs, and research... HUMAN SERVICES Food and Drug Administration Food and Drug Administration Clinical Trial Requirements, Compliance, and Good Clinical Practice; Public Workshop AGENCY: Food and Drug Administration, HHS....

  12. Clinical wisdom: the essential foundation of "good" nursing care.

    PubMed

    Haggerty, Lois A; Grace, Pamela

    2008-01-01

    Clinical wisdom, an essential foundation of nursing care that provides for the "good" of individual patients while taking into account the common good, is a concept that is difficult to define and comprehend. However, understanding what constitutes clinical wisdom is essential for the education of the types of nurses who are most likely to provide leadership that is consistent with the goals of nursing as outlined in the 2005 Code of Ethics for Nurses of the International Council of Nurses and the 2001 Code of Ethics for Nurses With Interpretive Statements of the American Nurses Association. The three key elements of wisdom, derived from the psychology and philosophy literature, are (1) balancing and providing for the good of another and the common good, (2) the use of intellect and affect in problem solving, and (3) the demonstration of experience-based tacit knowing in problematic situations. We conceptualized clinical wisdom as a more specific variant of general wisdom by examining how the core elements described can be linked to wisdom for nursing practice. In doing so, the nature of clinical wisdom is clarified and strategies are suggested to assist nurse educators in developing wise nurses.

  13. Clinical trials in Russia: achieving excellence

    NASA Astrophysics Data System (ADS)

    Reznik, Robert S.; Ichim, Thomas E.; Petrov, Vladimir; Reznik, Boris N.

    2005-06-01

    The Russian population offers a unique opportunity for conducting clinical trials in general, and specifically in the area of Medical Devices. Although the regulatory framework for approval of clinical trials and eventual marketing registration is based on an American-style format, details of operating in the Russian framework are very different. Understanding and leveraging the unique characteristics of the Russian system on the patient side, the investigator side, and the regulatory side is important in extracting optimum value out of clinical trials in Russia. Having performed Medical Device research and clinical trials in Russia, the authors overview the present system and describe various strategies for working in this growing but still under-utilized clinical trials arena.

  14. A model for reflection for good clinical practice.

    PubMed

    Balla, John I; Heneghan, Carl; Glasziou, Paul; Thompson, Matthew; Balla, Margaret E

    2009-12-01

    Rationale and aim The rapidly changing knowledge base of clinical practice highlights the need to keep abreast of knowledge changes that are most relevant for the practitioner. We aimed to develop a model for reflection on clinical practice that identified the key elements of medical knowledge needed for good medical practice. Method The dual theory of cognition, an integration of intuitive and analytic processes, provided the framework for the study. The design looked at the congruence between the clinical thinking process and the dual theory. A one-year study was conducted in general practice clinics in Oxfordshire, UK. Thirty-five general practitioners participated in 20-minute interviews to discuss how they worked through recently seen clinical cases. Over a one-year period 72 cases were recorded from 35 interviews. These were categorized according to emerging themes, which were manually coded and substantiated with verbatim quotations. Results There was a close fit between the dual theory and participants' clinical thinking processes. This included instant problem framing, consistent with automatic intuitive thinking, focusing on the risk and urgency of the case. Salient features accounting for these choices were recognizable. There was a second reflective phase, leading to the review of initial judgements. Conclusions The proposed model highlights the critical steps in decision making. This allows regular recalibration of knowledge that is most critical at each of these steps. In line with good practice, the model also links the crucial knowledge used in decision making, to value judgments made in relation to the patient.

  15. 77 FR 49448 - Food and Drug Administration Clinical Trial Requirements, Compliance, and Good Clinical Practice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-16

    ... HUMAN SERVICES Food and Drug Administration Food and Drug Administration Clinical Trial Requirements, Compliance, and Good Clinical Practice; Public Workshop AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public workshop. The Food and Drug Administration (FDA), Baltimore District Office,...

  16. Good clinical practice: historical background and key aspects.

    PubMed

    Otte, Andreas; Maier-Lenz, Herbert; Dierckx, Rudi A

    2005-07-01

    Clinical research trials (both academic and industry sponsored) are increasingly playing a role in various medical disciplines, including younger fields of clinical trial interest, such as nuclear medicine research. Knowledge for and compliance with good clinical practice (GCP) is essential for anyone involved. In this review article, key aspects of GCP and the responsibilities of investigators, monitors and sponsors are described. In addition, a comprehensive overview of the historical background on the development of GCP from the US Pure Food and Drugs Act of 1906 over the Nuremberg Code, the Kefauver-Harris Amendments and the Declaration of Helsinki until now is given. Knowledge of the historical background may help understand the developments in GCP.

  17. Assessing disproportionate costs to achieve good ecological status of water bodies in a Mediterranean river basin.

    PubMed

    Molinos-Senante, María; Hernández-Sancho, Francesc; Sala-Garrido, Ramón

    2011-08-01

    Water management is becoming increasingly important as the demand for water grows, diversifies, and includes more complex environmental concerns. The Water Framework Directive (WFD) seeks to achieve a good ecological status for all European Community water bodies by 2015. To achieve this objective, economic consideration of water management must be given to all decision-making processes. Exemption (time or level of stringency) from the objectives of the EU Directive can be justified by proving that the cost of implementing measures is disproportionate to the benefits. This paper addresses the issue of disproportionate costs through a cost-benefit analysis (CBA). To predict the costs, the function costs method is used. The quantification of environmental benefits is more complex, because they are not determined by the market. As an alternative to stated preference methods, we use the distance function approach to estimate the environmental benefits of improving water quality. We then apply this methodological approach to a Mediterranean River Basin in Spain. The results show that the achievement of good status could not be rejected based on the criterion of disproportionate costs in this river basin. This paper illustrates that CBA is a useful tool to inform policy and decision making. Furthermore, it is shown that economics, particularly the valuation of environmental benefits, plays a crucial role in fulfilling the environmental objectives of the WFD.

  18. Self-esteem memories: feeling good about achievement success, feeling bad about relationship distress.

    PubMed

    Pillemer, David B; Ivcevic, Zorana; Gooze, Rachel A; Collins, Katherine A

    2007-09-01

    College students and middle-aged adults provided memories of occasions when they felt especially good or especially bad about themselves. Probes directed the memory search to several age intervals during childhood, adolescence, and adulthood. Predominant themes represented in self-esteem memories differed consistently as a function of emotional valence. Memories of positive self-worth frequently focused on achievement/mastery themes, whereas memories of negative self-worth frequently focused on interpersonal/affiliation themes. When people evaluate the self through the lens of autobiographical memory, interpersonal distress is portrayed as especially damaging and achievement success is portrayed as especially enhancing. The asymmetry between positive and negative self-esteem memories is explained using multiple theoretical perspectives within social and personality psychology.

  19. What Makes Good Teachers Good?: A Cross-Case Analysis of the Connection between Teacher Effectiveness and Student Achievement

    ERIC Educational Resources Information Center

    Stronge, James H.; Ward, Thomas J.; Grant, Leslie W.

    2011-01-01

    This study examined classroom practices of effective versus less effective teachers (based on student achievement gain scores in reading and mathematics). In Phase I of the study, hierarchical linear modeling was used to assess the teacher effectiveness of 307 fifth-grade teachers in terms of student learning gains. In Phase II, 32 teachers (17…

  20. Good Clinical Practice Guidance and Pragmatic Clinical Trials: Balancing the Best of Both Worlds.

    PubMed

    Mentz, Robert J; Hernandez, Adrian F; Berdan, Lisa G; Rorick, Tyrus; O'Brien, Emily C; Ibarra, Jenny C; Curtis, Lesley H; Peterson, Eric D

    2016-03-01

    Randomized, clinical trials are commonly regarded as the highest level of evidence to support clinical decisions. Good Clinical Practice guidelines have been constructed to provide an ethical and scientific quality standard for trials that involve human subjects in a manner aligned with the Declaration of Helsinki. Originally designed to provide a unified standard of trial data to support submission to regulatory authorities, the principles may also be applied to other studies of human subjects. Although the application of Good Clinical Practice principles generally led to improvements in the quality and consistency of trial operations, these principles have also contributed to increasing trial complexity and costs. Alternatively, the growing availability of electronic health record data has facilitated the possibility for streamlined pragmatic clinical trials. The central tenets of Good Clinical Practice and pragmatic clinical trials represent potential tensions in trial design (stringent quality and highly efficient operations). In the present article, we highlight potential areas of discordance between Good Clinical Practice guidelines and the principles of pragmatic clinical trials and suggest strategies to streamline study conduct in an ethical manner to optimally perform clinical trials in the electronic age.

  1. Who is good at this game? Linking an activity to a social category undermines children's achievement.

    PubMed

    Cimpian, Andrei; Mu, Yan; Erickson, Lucy C

    2012-05-01

    Children's achievement-related theories have a profound impact on their academic success. Children who adopt entity theories believe that their ability to perform a task is dictated by the amount of natural talent they possess for that task--a belief that has well-documented adverse consequences for their achievement (e.g., lowered persistence, impaired performance). It is thus important to understand what leads children to adopt entity theories. In the experiments reported here, we hypothesized that the mere act of linking success at an unfamiliar, challenging activity to a social group gives rise to entity beliefs that are so powerful as to interfere with children's ability to perform the activity. Two experiments showed that, as predicted, the performance of 4- to 7-year-olds (N = 192) was impaired by exposure to information that associated success in the task at hand with membership in a certain social group (e.g., "boys are good at this game"), regardless of whether the children themselves belonged to that group.

  2. [Good agricultural practice (GAP) of Chinese materia medica (CMM) for ten years: achievements, problems and proposals].

    PubMed

    Guo, Lan-Ping; Zhang, Yan; Zhu, Shou-Dong; Wang, Gui-Hua; Wang, Xiu; Zhang, Xiao-Bo; Chen, Mei-Lan; He, Ya-Li; Han, Bang-Xing; Chen, Nai-Fu; Huang, Lu-Qi

    2014-04-01

    This paper aims to summarize the achievements during the implementation process of good agricultural practice (GAP) in Chinese Materia Medica (CMM), and on basis of analyzing the existing problems of GAP, to propose further implementation of GAP in TCM growing. Since the launch of GAP in CMM growing ten years ago, it has acquired great achievements, including: (1) The promulgation of a series of measures for the administration of the GAP approval in the CMM growing; (2) The expanded planting area of CMM; (3) The increased awareness of standardized CMM growing among farmers and enterprises; (4) The establishment of GAP implementation bases for CMM growing; (5) The improvement of theory and methodology for CMM growing; (6) The development of a large group of experts and scholars in GAP approval for CMM production. The problems existing in the production include: (1) A deep understanding of GAP and its certification is still needed; (2) The distribution of the certification base is not reasonable; (3) The geo-economics effect and the backward farming practices are thought to be the bottlenecks in the standardization of CMM growing and the scale production of CMM; (4) Low comparative effectiveness limits the development of the GAP; (5) The base of breeding improved variety is blank; (6) The immature of the cultivation technique lead to the risk of production process; (7) The degradation of soil microbial and the continuous cropping obstacle restrict the sustainable development of the GAP base. To further promote the health and orderly GAP in the CMM growing, the authors propose: (1) To change the mode of production; (2) To establish a sound standard system so as to ensure quality products for fair prices; (3) To fully consider the geo-economic culture and vigorously promote the definite cultivating of traditional Chinese medicinal materials; (4) To strengthen the transformation and generalization of basic researches and achievements, in order to provide technical

  3. The good clinical nursing educator and the baccalaureate nursing clinical experience: attributes and praxis.

    PubMed

    Hanson, Karla J; Stenvig, Thomas E

    2008-01-01

    Clinical education accounts for a significant portion of baccalaureate nursing (BSN) education. This study examined recent BSN program graduates' views about clinical nursing educator attributes that enhance the ability of the graduates to provide safe, effective patient care. In this descriptive study, 6 participants were interviewed using grounded theory techniques. The study framework blended the elements of cognitive field theory, the humanistic philosophy of teaching and learning, the gestalt theory of learning, and Hergenhahn's behavioral change model. Participants identified three attributes of a good clinical nursing educator: knowledge, interpersonal presentation, and teaching strategies. Analysis revealed that educator attributes and phases of the clinical experience process together form the foundation for clinical experience praxis. Educators can improve the clinical education experience by developing teaching strategies and evaluation tools that build on the positive attributes and phases of the clinical experience identified in this study.

  4. Working and learning together: good quality care depends on it, but how can we achieve it?

    PubMed Central

    McPherson, K; Headrick, L; Moss, F

    2001-01-01

    Educating healthcare professionals is a key issue in the provision of quality healthcare services, and interprofessional education (IPE) has been proposed as a means of meeting this challenge. Evidence that collaborative working can be essential for good clinical outcomes underpins the real need to find out how best to develop a work force that can work together effectively. We identify barriers to mounting successful IPE programmes, report on recent educational initiatives that have aimed to develop collaborative working, and discuss the lessons learned. To develop education strategies that really prepare learners to collaborate we must: agree on the goals of IPE, identify effective methods of delivery, establish what should be learned when, attend to the needs of educators and clinicians regarding their own competence in interprofessional work, and advance our knowledge by robust evaluation using both qualitative and quantitative approaches. We must ensure that our education strategies allow students to recognise, value, and engage with the difference arising from the practice of a range of health professionals. This means tackling some long held assumptions about education and identifying where it fosters norms and attitudes that interfere with collaboration or fails to engender interprofessional knowledge and skill. We need to work together to establish education strategies that enhance collaborative working along with profession specific skills to produce a highly skilled, proactive, and respectful work force focused on providing safe and effective health for patients and communities. Key Words: interprofessional education; multiprofessional learning; teamwork PMID:11700379

  5. Researching "good death" in a Hong Kong palliative care program: a clinical data-mining study.

    PubMed

    Chan, Wallace C H; Epstein, I

    This study operationalizes and assesses the percentage of "good deaths" achieved among Chinese cancer patients in a palliative care program, the profile of these patients, the relationship between patients with a good death and psychosocial factors, and the differences in background factors, and physical and psychosocial conditions between patients who experienced a good death and those who did not. Clinical data mining was the research method used. Records of deceased cancer patients between 2003 and 2005 in a palliative care unit were the sole data source. Good death was operationally defined as the patient's record indicating no pain (physical) or anxiety (psychological), and having open and honest communication with family (social) in the final assessment by the Support Team Assessment Schedule (STAS) just before death. Using these criteria, about one-fifth of patients (21.5%; 137 out of 638) experienced a good death. Those with a good death were significantly older and were in palliative care longer. Their records also indicated lower levels of constipation, insomnia, oral discomfort, and family anxiety at their first and at their final STAS assessments. Good death was positively associated with recorded indicators of fullness in life, caregivers' acceptance and support, and negatively with reported feelings of upset about changes in the course of their illness. The results heighten awareness among social workers and other healthcare professionals about the value of good death in patients in palliative care. This empirically-based awareness can foster professionals' ability to set intervention objectives to help patients in palliative care achieve this universally accepted goal.

  6. Variability in Clinical Integration Achieved by Athletic Training Students across Different Clinical Sport Assignments

    ERIC Educational Resources Information Center

    Dodge, Thomas M.; Mazerolle, Stephanie M.; Bowman, Thomas G.

    2015-01-01

    Context: Clinical integration impacts athletic training students' (ATSs) motivation and persistence. Research has yet to elucidate the manner in which different clinical placements can influence clinical integration. Objective: To examine differences in the levels of clinical integration achieved by ATSs across various clinical sport assignments.…

  7. A Conceptual Framework for Achieving Good Governance at Open and Distance Learning Institutions

    ERIC Educational Resources Information Center

    Khanna, Pankaj

    2017-01-01

    This paper describes a good governance architecture framework that would bring significant improvements in the overall working of open and distance learning institutions in a well-structured and systematic way. The good governance framework is articulated with seven basic principles which are performance, transparency, accountability,…

  8. The Nation's Report Card Goes Home: Good News and Bad about Trends in Achievement.

    ERIC Educational Resources Information Center

    Linn, Robert L.; Dunbar, Stephen B.

    1990-01-01

    When test data from different sources conflict, the truth is often found somewhere in the middle. As this article shows, reports of achievement trends can be heavily influenced by the particular definition of achievement represented and by testing conditions. Recent progress in science and mathematics must be carefully nurtured in the nineties.…

  9. "Good samples make good assays" – the problem of sourcing clinical samples for a standardization project.

    PubMed

    Van Houcke, Sofie K; Thienpont, Linda M

    2013-05-01

    Clinical samples are the cornerstone in all aspects related to in vitro diagnostic testing. They are particularly valuable in the process of establishing/validating metrological traceability, because they eliminate commutability issues potentially associated with artificial calibrators. Therefore, they are essential for IFCC standardization projects. However, sourcing clinical specimens is particularly challenging. It mostly turns out that only dedicated supply sources can accommodate the varying specifications within reasonable timelines. Here we describe the torturous experience in this regard of the IFCC Working Group for Standardization of Thyroid Function tests (since transformed into a Committee). We always focused on obtaining high quality samples in sufficient volume to serve all project participants. We applied a step-up approach: in phase I, we used high volume (200 mL of plasma/serum) single donations from apparently healthy individuals, and switched in phase II and III to medium-sized volume clinical samples (15 – 30 mL) from well-defined patient categories. In the first two phases we observed for some assays a sample-related discrepant analytical performance for total/free triiodothyronine and thyroid stimulating hormone (TSH), whereas in phase III we faced a severe delay in obtaining the relevant panels for free thyroxine (FT4) and TSH (n = 90 and n = 100, respectively). Additional experiments only allowed us to exclude hypothesized causes of the observations. We believe that there would be merit in a collaborative effort by chairholders of similar projects to establish a sample procurement infrastructure based on a solid relationship with commercial supply sources with the support of a significant number of committed clinicians.

  10. Psychoticism and disruptive behavior can be also good predictors of school achievement.

    PubMed

    Flores-Mendoza, Carmen; Widaman, Keith; Mansur-Alves, Marcela; Bacelar, Tatiane Dias; Saldanha, Renata

    2013-01-01

    The relations of Gf (Standard Progressive Matrices Raven), Gc (verbal scale of Wechsler Intelligence Scale for Children-Third Version), personality dimensions (Eysenck Personality Questionnaire-Junior Version), and disruptive behavior (TDAH scale) with school achievement (measured by TDE test and PISA test) were investigated. Two samples of students (total N = 534) representing a broad range of socioeconomic status (SES) participated in this study. Path models were conducted. The results demonstrated that (1) in both samples no sex differences related to school achievement were found; (2) in the first sample, after controlling for age and SES differences, Gf and psychoticism predicted (.38 and -.13, respectively) school achievement (measured by TDE test); (3) in the second sample, after controlling for SES differences to which additional measures were administered, Gf and Gc positively predicted (.22 and .40, respectively) school achievement (measured by PISA test). In addition, psychoticism and disruptive behavior also predicted school performance (-.14 and -.28, respectively). Some theoretical and practical implications are discussed.

  11. The importance of Good Clinical Practice guidelines and its role in clinical trials

    PubMed Central

    Vijayananthan, A; Nawawi, O

    2008-01-01

    Good Clinical Practice (GCP) is an international ethical and scientific quality standard for the design, conduct, performance, monitoring, auditing, recording, analyses and reporting of clinical trials. It also serves to protect the rights, integrity and confidentiality of trial subjects. It is very important to understand the background of the formation of the ICH-GCP guidelines as this, in itself, explains the reasons and the need for doing so. In this paper, we address the historical background and the events that led up to the formation of these guidelines. Today, the ICH-GCP guidelines are used in clinical trials throughout the globe with the main aim of protecting and preserving human rights. PMID:21614316

  12. Removing the Barriers: Raising Achievement Levels for Minority Ethnic Pupils. Exploring Good Practice.

    ERIC Educational Resources Information Center

    Department for Education and Skills, London (England).

    This resource kit, which can be used with an accompanying videotape and written materials, shows how three English secondary schools have succeeded in raising the achievement of their ethnic minority students by increasing expectations of what each student is capable of, valuing diversity, working in partnership with parents, and encouraging…

  13. Alternative Methods for Estimating Achievement Trends and School Effects: When Is Simple Good Enough?

    ERIC Educational Resources Information Center

    Warkentien, Siri; Silver, David

    2016-01-01

    Public schools with impressive records of serving lower-performing students are often overlooked because their average test scores, even when students are growing quickly, are lower than scores in schools that serve higher-performing students. Schools may appear to be doing poorly either because baseline achievement is not easily accounted for or…

  14. Integrating Economic and Social Policy: Good Practices from High-Achieving Countries. Innocenti Working Papers.

    ERIC Educational Resources Information Center

    Mehrotra, Santosh

    This paper examines the successes of 10 "high achievers," countries with social indicators far higher than might be expected, given their national wealth, pulling together the lessons learned for social policy in the developing world. The 10 countries identified are Costa Rica, Cuba, Barbados, Botswana, Zimbabwe, Mauritius, Kerala, Sri…

  15. Improving International Research with Clinical Specimens: 5 Achievable Objectives

    PubMed Central

    LaBaer, Joshua

    2012-01-01

    Our increased interest in translational research has created a large demand for blood, tissue and other clinical samples, which find use in a broad variety of research including genomics, proteomics, and metabolomics. Hundreds of millions of dollars have been invested internationally on the collection, storage and distribution of samples. Nevertheless, many researchers complain in frustration about their inability to obtain relevant and/or useful samples for their research. Lack of access to samples, poor condition of samples, and unavailability of appropriate control samples have slowed our progress in the study of diseases and biomarkers. In this editorial, I focus on five major challenges that thwart clinical sample use for translational research and propose near term objectives to address them. They include: (1) defining our biobanking needs; (2) increasing the use of and access to standard operating procedures; (3) mapping inter-observer differences for use in normalizing diagnoses; (4) identifying natural internal protein controls; and (5) redefining the clinical sample paradigm by building partnerships with the public. In each case, I believe that we have the tools at hand required to achieve the objective within 5 years. Potential paths to achieve these objectives are explored. However we solve these problems, the future of proteomics depends on access to high quality clinical samples, collected under standardized conditions, accurately annotated and shared under conditions that promote the research we need to do. PMID:22998582

  16. Clinical Mass Spectrometry: Achieving Prominence in Laboratory Medicine

    SciTech Connect

    Annesley, Thomas M.; Cooks, Robert G.; Herold, David A.; Hoofnagle, Andrew N.

    2016-01-04

    Each year the journal Clinical Chemistry publishes a January special issue on a topic that is relevant to the laboratory medicine community. In January 2016 the topic is mass spectrometry, and the issue is entitled “Clinical Mass Spectrometry: Achieving Prominence in Laboratory Medicine”. One popular feature in our issues is a Q&A on a topic, clearly in this case mass spectrometry. The journal is assembling a panel of 5-6 experts from various areas of mass spectrometry ranging from instrument manufacturing to practicing clinical chemists. Dick Smith is one of the scientist requested to participate in this special issue Q&A on Mass Spectrometry. The Q&A Transcript is attached

  17. Good clinical practice in developing countries: applying recommendations.

    PubMed

    Bompart, François; Hirsch, François; Bertoye, Pierre-Henri; Vray, Muriel

    2008-01-01

    The recommendations for clinical research in developing countries were published in 2007 and the present article deals with issues which were not initially raised or discussed in depth. In particular, we discuss specific questions linked to trials conducted in developing countries with regard to informed consent, research project review by two ethics committees, standards of care, management of biological samples, study follow-up committees, notification of Serious Adverse Events, paediatric trials, and Contract Research Organizations.

  18. Good Clinical Practice Guidance and Pragmatic Clinical Trials: Balancing the Best of Both Worlds

    PubMed Central

    Mentz, Robert J.; Hernandez, Adrian F.; Berdan, Lisa G.; Rorick, Tyrus; O’Brien, Emily C.; Ibarra, Jenny C.; Curtis, Lesley H.; Peterson, Eric D.

    2016-01-01

    Randomized clinical trials are commonly regarded as the highest level of evidence to support clinical decisions. Good Clinical Practice (GCP) guidelines have been constructed to provide an ethical and scientific quality standard for trials that involve human subjects in a manner aligned with the Declaration of Helsinki. Originally designed to provide a unified standard of trial data to support submission to regulatory authorities, the principles may also be applied to other studies of human subjects. While the application of GCP principles generally led to improvements in the quality and consistency of trial operations, these principles have also contributed to increasing trial complexity and costs. Alternatively, growing availability of electronic health record data has facilitated the possibility for streamlined pragmatic clinical trials (PCTs). The central tenets of GCP and PCTs represent potential tensions in trial design (stringent quality and highly efficient operations). In the present manuscript, we highlight potential areas of discordance between GCP guidelines and the principles of PCTs and suggest strategies to streamline study conduct in an ethical manner to optimally carry out clinical trials in the electronic age. PMID:26927005

  19. Different clinical electrodes achieve similar electrical nerve conduction block

    NASA Astrophysics Data System (ADS)

    Boger, Adam; Bhadra, Narendra; Gustafson, Kenneth J.

    2013-10-01

    Objective. We aim to evaluate the suitability of four electrodes previously used in clinical experiments for peripheral nerve electrical block applications. Approach. We evaluated peripheral nerve electrical block using three such clinical nerve cuff electrodes (the Huntington helix, the Case self-sizing Spiral and the flat interface nerve electrode) and one clinical intramuscular electrode (the Memberg electrode) in five cats. Amplitude thresholds for the block using 12 or 25 kHz voltage-controlled stimulation, onset response, and stimulation thresholds before and after block testing were determined. Main results. Complete nerve block was achieved reliably and the onset response to blocking stimulation was similar for all electrodes. Amplitude thresholds for the block were lowest for the Case Spiral electrode (4 ± 1 Vpp) and lower for the nerve cuff electrodes (7 ± 3 Vpp) than for the intramuscular electrode (26 ± 10 Vpp). A minor elevation in stimulation threshold and reduction in stimulus-evoked urethral pressure was observed during testing, but the effect was temporary and did not vary between electrodes. Significance. Multiple clinical electrodes appear suitable for neuroprostheses using peripheral nerve electrical block. The freedom to choose electrodes based on secondary criteria such as ease of implantation or cost should ease translation of electrical nerve block to clinical practice.

  20. 75 FR 14448 - Food and Drug Administration Clinical Trial Requirements, Regulations, Compliance, and Good...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-25

    ... HUMAN SERVICES Food and Drug Administration Food and Drug Administration Clinical Trial Requirements, Regulations, Compliance, and Good Clinical Practices; Public Workshop AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public workshop. SUMMARY: The Food and Drug Administration (FDA) Los...

  1. Large and round tumor nuclei in osteosarcoma: good clinical outcome

    PubMed Central

    de Andrea, Carlos E; Petrilli, Antonio Sergio; Jesus-Garcia, Reynaldo; Bleggi-Torres, Luiz F; Alves, Maria Teresa S

    2011-01-01

    Osteosarcoma is the most frequent primary malignant bone tumor. Distinct histological features are distinguishable based on the morphology of the tumor. Differences in nuclei size and shape are often observed in osteosarcoma reflecting its broad histopathological heterogeneity. This study explores the relevance of two nuclear parameters in osteosarcoma: large area and round shape. Computerized nuclear morphometry was performed in 56 conventional osteosarcoma preoperative biopsies. The mean patient follow-up time was 35.1 months. Based on the nuclear area, no significant difference (P = 0.09) in overall survival between patients with large (> 42.5 μm2) and small (< 42.5 μm2) tumor nuclei was found. However, when cases with large and round nuclei were analyzed jointly (> 42.5 μm2 and coefficient of nuclear roundness > 0.7), these two parameters together were likely to be a predictive factor (P = 0.05). Osteosarcoma patients with large and round tumor nuclei had a better outcome than patients with small and polymorphic (ovoid or spindle-shaped) nuclei. In this study, nuclear morphometry proved to be a useful tool to shed light on the biology of osteosarcoma showing that some morphometric parameters can be easily applied to help identifying patients with a good prognosis. PMID:21326812

  2. Mister Sandman, bring me good marks! On the relationship between sleep quality and academic achievement.

    PubMed

    Baert, Stijn; Omey, Eddy; Verhaest, Dieter; Vermeir, Aurélie

    2015-04-01

    There is growing evidence that health factors affect tertiary education success in a causal way. This study assesses the effect of sleep quality on academic achievement at university. To this end, we surveyed 804 students about their sleep quality by means of the Pittsburgh Sleep Quality Index (PSQI) before the start of their first exam period in December 2013 at Ghent University. PSQI scores were merged with course marks in this exam period. Instrumenting PSQI scores by sleep quality during secondary education, we find that increasing total sleep quality with one standard deviation leads to 4.85 percentage point higher course marks. Based on this finding, we suggest that higher education providers might be incentivised to invest part of their resources for social facilities in professional support for students with sleep and other health problems.

  3. What makes a good program? A case study of a school admitting high academic achievers.

    PubMed

    Lam, Ching Man

    2008-10-10

    This paper reports the results of a qualitative study that explored the administration and implementation of the Tier 1 Program (Secondary 1 Curriculum) of the Project P.A.T.H.S. The case study method was used to explore perceptions of the teachers and the project coordinator of program effectiveness, and to identify various factors for program success. A school admitting high academic achievers was selected, and site visits, as well as individual and focus group interviews, were conducted with the program coordinator, social worker, and course teachers. The results suggested that clear vision and program goals, high quality of curriculum, helpful leadership, positive teacher attitude, and strong administrative support are factors for program success. Analyzing the data enables the researchers to understand the characteristics of a successful program as well as the interplay among factors for producing success.

  4. Public goods and private interests: The role of voluntary green power demand in achieving environmental improvements

    NASA Astrophysics Data System (ADS)

    Wiser, Ryan Hayes

    This dissertation explores the role of consumer purchasing behavior in providing public, environmental goods. It does so by empirically evaluating one market---voluntary demand for renewable energy. The dissertation addresses the following five research questions: (1) What does early experience with green power marketing tell us about the prospects for this market to deliver environmental benefits? (2) What product design and marketing approaches might be used to increase voluntary demand? (3) What motivates non-residential customers to voluntarily purchase green power? (4) What role might public policy play in the creation of the green power market? (5) What preferences do individuals hold on the most appropriate forms of support for renewable energy? By helping to answer these questions, this dissertation seeks to better understand the gap between widespread positive attitudes for the environment and an often-anemic response to green product offerings. It contributes to not only the public goods and environmental marketing literatures, but also to contingent valuation methodology and to an emerging literature on the motivations of firms to contribute to environmental causes. The analysis performed is diverse, and includes: a literature review, a mail survey of green power marketers, a mail survey of non-residential green power customers, and contingent valuation and opinion surveys of U.S. residents. Detailed statistical analysis is performed on the data collected from the residential and non-residential surveys. The analysis reveals that customer participation in green power programs to date has been weak. The possibility that the traditional economic concept of "free riding" may explain this low response is raised, and the dissertation identifies a number of marketing approaches that might be used to partially combat this problem. Analysis of survey data shows that non-residential green power purchases have been motivated principally by altruistic concerns

  5. Feedback and assessment for clinical placements: achieving the right balance

    PubMed Central

    Burgess, Annette; Mellis, Craig

    2015-01-01

    During clinical placements, the provision of feedback forms an integral part of the learning process and enriches students’ learning experiences. The purpose of feedback is to improve the learner’s knowledge, skills, or behavior. Receipt of accurate feedback can help to narrow the gap between actual and desired performance. Effective and regular feedback has the potential to reinforce good practice and motivate the learner toward the desired outcome. Despite the obvious role of feedback in effective teaching and learning, a common complaint from students is that they do not receive adequate feedback. Unfortunately, skills in giving and receiving feedback are rarely taught to students or clinicians. This study aims to provide an understanding of the role of feedback within the learning process, consider consequences of inadequate or poorly given feedback, consider the barriers to the feedback process, provide practical guidelines for providing feedback, and consider the need for student and faculty development in feedback skills. PMID:26056511

  6. What does it mean to be a good teacher and clinical supervisor in medical education?

    PubMed

    Stenfors-Hayes, Terese; Hult, Håkan; Dahlgren, Lars Owe

    2011-05-01

    The aim of this study was to describe the different ways medical teachers understand what constitutes a good teacher and a good clinical supervisor and what similarities and differences they report between them. Data was gathered through interviews with 39 undergraduate teachers at a medical university. The transcripts were analysed using a phenomenographic approach. Three categories regarding what it means to be a good teacher and clinical supervisor respectively were identified. Similarities between the two hierarchies were seen with the most inclusive categories of understanding what it means to be a good teacher or supervisor focuses on students' learning or growth. In the third category a good teacher and supervisor is seen as someone who conveys knowledge or shows how things are done. However, the role of being a clinical supervisor was perceived as containing a clearer focus on professional development and role modelling than the teacher role did. This is shown in the middle category where a good clinical supervisor is understood as a role model and someone who shares what it is like to be a doctor. The middle category of understanding what it means to be a good teacher instead focussing on the teacher as someone who responds to students' content requests in a partially student-centred perspective. In comparing the ways individual respondents understood the two roles, this study also implies that teachers appear to compartmentalise their roles as teachers and clinical supervisors respectively.

  7. What Does It Mean to Be a Good Teacher and Clinical Supervisor in Medical Education?

    ERIC Educational Resources Information Center

    Stenfors-Hayes, Terese; Hult, Hakan; Dahlgren, Lars Owe

    2011-01-01

    The aim of this study was to describe the different ways medical teachers understand what constitutes a good teacher and a good clinical supervisor and what similarities and differences they report between them. Data was gathered through interviews with 39 undergraduate teachers at a medical university. The transcripts were analysed using a…

  8. Goodness of fit in the home: its relationship to school behavior and achievement in children with learning disabilities.

    PubMed

    Feagans, L V; Merriwether, A M; Haldane, D

    1991-01-01

    This study examined whether a "goodness of fit" theoretical model, applied to families with and without children with learning disabilities, would be valuable in understanding the children's performance in school. A home interview was conducted with 63 families with a child with learning disabilities and 53 families with a comparable child without learning disabilities. The mothers were asked to rate how their own child fit into the family's expectations for children. It was found that, for both groups of families, children who were rated as a "poor fit" in the home demonstrated less positive behavior in the classroom and poorer achievement over the elementary school years. There was some evidence that poor fit in the home was even more negatively related to outcomes for children with learning disabilities. Discussion is centered on the importance of this theoretical model for understanding the importance of the home on successful school function.

  9. Achieving Core Indicators for HIV Clinical Care Among New Patients at an Urban HIV Clinic.

    PubMed

    Greer, Gillian A; Tamhane, Ashutosh; Malhotra, Rakhi; Burkholder, Greer A; Mugavero, Michael J; Raper, James L; Zinski, Anne

    2015-09-01

    Following the release of the 2010 National HIV/AIDS Strategy for the United States, the Institute of Medicine (IOM) issued core clinical indicators for measuring health outcomes in HIV-positive persons. As early retention in HIV primary care is associated with improved long-term health outcomes, we employed IOM indicators as a guide to examine a cohort of persons initiating HIV outpatient medical care at a university-affiliated HIV clinic in the Southern United States (January 2007-July 2012). Using indicators for visit attendance, CD4 and viral load laboratory testing frequency, and antiretroviral therapy initiation, we evaluated factors associated with achieving IOM core indicators among care- and treatment-naïve patients during the first year of HIV care. Of 448 patients (mean age = 35 years, 35.7% white, 79.0% male, 58.4% education beyond high school, 35.9% monthly income > $1,000 US, 47.3% uninsured), 84.6% achieved at least four of five IOM indicators. In multivariable analyses, persons with monthly income > $1,000 (ORadj. = 3.71; 95% CI: 1.68-8.19; p = 0.001) and depressive symptoms (ORadj. = 2.13; 95% CI: 1.02-4.45; p = 0.04) were significantly more likely to achieve at least four of the five core indicators, while patients with anxiety symptoms were significantly less likely to achieve these indicators (ORadj. = 0.50; 95% CI: 0.26-0.97; p = 0.04). Age, sex, race, education, insurance status, transportation barriers, alcohol use, and HIV status disclosure to family were not associated with achieving core indicators. Evaluating and addressing financial barriers and anxiety symptoms during the first year of HIV outpatient care may improve individual health outcomes and subsequent achievement of the National HIV/AIDS Strategy.

  10. Good practice guidelines for clinical psychologists working in paediatric cochlear implant teams.

    PubMed

    Bathgate, Fionna; Bennett, Emily; Cropper, Jenny; Edwards, Lindsey; Emond, Alice; Gamble, Caroline; Kentish, Rosie; Samuel, Victoria

    2013-11-01

    There are relatively few clinical psychologists working in paediatric cochlear implant centres in the UK and in this respect we lag behind other countries such as the USA and The Netherlands. In an effort to promote the added value our profession can offer teams, the clinical psychologists working in paediatric CI centres have put together good practice guidelines. This article outlines the rationale for putting together the guidelines, highlights the unique contribution clinical psychologists can offer, outlines the evidence base for psychological input in this clinical population, and offers a fictional case study for illustration.

  11. Achieving the World Health Organization's vision for clinical pharmacology.

    PubMed

    Martin, Jennifer H; Henry, David; Gray, Jean; Day, Richard; Bochner, Felix; Ferro, Albert; Pirmohamed, Munir; Mörike, Klaus; Schwab, Matthias

    2016-02-01

    Clinical pharmacology is a medical specialty whose practitioners teach, undertake research, frame policy, give information and advice about the actions and proper uses of medicines in humans and implement that knowledge in clinical practice. It involves a combination of several activities: drug discovery and development, training safe prescribers, providing objective and evidence-based therapeutic information to ethics, regulatory and pricing bodies, supporting patient care in an increasingly subspecialized arena where co-morbidities, polypharmacy, altered pharmacokinetics and drug interactions are common and developing and contributing to medicines policies for Governments. Clinical pharmacologists must advocate drug quality and they must also advocate for sustainability of the Discipline. However for this they need appropriate clinical service and training support. This Commentary discusses strategies to ensure the Discipline is supported by teaching, training and policy organizations, to communicate the full benefits of clinical pharmacology services, put a monetary value on clinical pharmacology services and to grow the clinical pharmacology workforce to support a growing clinical, academic and regulatory need.

  12. Achieving the World Health Organization's vision for clinical pharmacology

    PubMed Central

    Henry, David; Gray, Jean; Day, Richard; Bochner, Felix; Ferro, Albert; Pirmohamed, Munir; Mörike, Klaus; Schwab, Matthias

    2015-01-01

    Clinical pharmacology is a medical specialty whose practitioners teach, undertake research, frame policy, give information and advice about the actions and proper uses of medicines in humans and implement that knowledge in clinical practice. It involves a combination of several activities: drug discovery and development, training safe prescribers, providing objective and evidence‐based therapeutic information to ethics, regulatory and pricing bodies, supporting patient care in an increasingly subspecialized arena where co‐morbidities, polypharmacy, altered pharmacokinetics and drug interactions are common and developing and contributing to medicines policies for Governments. Clinical pharmacologists must advocate drug quality and they must also advocate for sustainability of the Discipline. However for this they need appropriate clinical service and training support. This Commentary discusses strategies to ensure the Discipline is supported by teaching, training and policy organizations, to communicate the full benefits of clinical pharmacology services, put a monetary value on clinical pharmacology services and to grow the clinical pharmacology workforce to support a growing clinical, academic and regulatory need. PMID:26466826

  13. 77 FR 13513 - Modernizing the Regulation of Clinical Trials and Approaches to Good Clinical Practice; Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Chapter I Modernizing the Regulation of Clinical... that it meets the regulatory objectives of ensuring human subject protection and the quality and... address human subject protection, data integrity, and clinical trial quality and efficiency. \\1\\ For...

  14. Establishing Good Practices for Exposure–Response Analysis of Clinical Endpoints in Drug Development

    PubMed Central

    Overgaard, RV; Ingwersen, SH; Tornøe, CW

    2015-01-01

    This tutorial aims at promoting good practices for exposure–response (E-R) analyses of clinical endpoints in drug development. The focus is on practical aspects of E-R analyses to assist modeling scientists with a process of performing such analyses in a consistent manner across individuals and projects and tailored to typical clinical drug development decisions. This includes general considerations for planning, conducting, and visualizing E-R analyses, and how these are linked to key questions. PMID:26535157

  15. Health physics manual of good practices for reducing radiation exposure to levels that are as low as reasonably achievable (ALARA)

    SciTech Connect

    Herrington, W.N.; Higby, D.P.; Kathren,., R.L.; Merwin, S.E.; Stoetzel, G.A.

    1988-06-01

    A primary objective of the US Department of Energy (DOE) health physics and radiation protection program has been to limit radiation exposures to those levels that are as low as reasonably achievable (ALARA). As a result, the ALARA concept developed into a program and a set of operational principles to ensure that the objective was consistently met. Implementation of these principles required that a guide be produced. The original ALARA guide was issued by DOE in 1980 to promote improved understanding of ALARA concepts within the DOE community and to assist those responsible for operational ALARA activities in attaining their goals. Since 1980, additional guidance has been published by national and international organizations to provide further definition and clarification to ALARA concepts. As basic ALARA experience increased, the value and role of the original guide prompted the DOE Office of Nuclear Safety (ONS) to support a current revision. The revised manual of good practices includes six sections: 1.0 Introduction, 2.0 Administration, 3.0 Optimization, 4.0 Setting and Evaluating ALARA Goals, 5.0 Radiological Design, and 6.0 Conduct of Operations. The manual is directed primarily to contractor and DOE staff who are responsible for conduct and overview of radiation protection and ALARA programs at DOE facilities. The intent is to provide sufficient guidance such that the manual, if followed, will ensure that radiation exposures are maintained as low as reasonably achievable and will establish the basis for a formally structured and auditable program. 118 refs., 16 figs., 3 tabs.

  16. Using nursing clinical decision support systems to achieve meaningful use.

    PubMed

    Harrison, Roberta L; Lyerla, Frank

    2012-07-01

    The Health Information Technology and Clinical Health Act (one component of the American Recovery and Reinvestment Act) is responsible for providing incentive payments to hospitals and eligible providers in an effort to support the adoption of electronic health records. Future penalties are planned for electronic health record noncompliance. In order to receive incentives and avoid penalties, hospitals and eligible providers must demonstrate "meaningful use" of their electronic health records. One of the meaningful-use objectives established by the Centers for Medicare & Medicaid Services involves the use of a clinical decision support rule that addresses a hospital-defined, high-priority condition. This article describes the Plan-Do-Study-Act process for creating and implementing a nursing clinical decision support system designed to improve guideline adherence for hypoglycemia management. This project identifies hypoglycemia management as the high-priority area. However, other facilities with different high-priority conditions may find the process presented in this article useful for implementing additional clinical decision support rules geared toward improving outcomes and meeting federal mandates.

  17. Expertise, Ethics Expertise, and Clinical Ethics Consultation: Achieving Terminological Clarity.

    PubMed

    Iltis, Ana S; Sheehan, Mark

    2016-08-01

    The language of ethics expertise has become particularly important in bioethics in light of efforts to establish the value of the clinical ethics consultation (CEC), to specify who is qualified to function as a clinical ethics consultant, and to characterize how one should evaluate whether or not a person is so qualified. Supporters and skeptics about the possibility of ethics expertise use the language of ethics expertise in ways that reflect competing views about what ethics expertise entails. We argue for clarity in understanding the nature of expertise and ethics expertise. To be an ethics expert, we argue, is to be an expert in knowing what ought to be done. Any attempt to articulate expertise with respect to knowing what ought to be done must include an account of ethics that specifies the nature of moral truth and the means by which we access this truth or a theoretical account of ethics such that expertise in another domain is linked to knowing or being better at judging what ought to be done and the standards by which this "knowing" or "being better at judging" is determined. We conclude with a discussion of the implications of our analysis for the literature on ethics expertise in CEC. We do think that there are clear domains in which a clinical ethics consultant might be expert but we are skeptical about the possibility that this includes ethics expertise. Clinical ethics consultants should not be referred to as ethics experts.

  18. Clinical Application of Preconditioning and Postconditioning to Achieve Neuroprotection

    PubMed Central

    Dezfulian, Cameron; Garrett, Matthew; Gonzalez, Nestor R.

    2012-01-01

    Ischemic conditioning is a form of endogenous protection induced by transient, subcritical ischemia in a tissue. Organs with high sensitivity to ischemia, such as the heart, the brain, and spinal cord represent the most critical and potentially promising targets for potential therapeutic applications of ischemic conditioning. Numerous preclinical investigations have systematically studied the molecular pathways and potential benefits of both pre- and post-conditioning with promising results. The purpose of this review is to summarize the present knowledge on cerebral pre-and post-conditioning, with an emphasis in the clinical application of these forms of neuroprotection. Methods A systematic Medline search for the terms preconditioning and postconditioning was performed. Publications related to the nervous system and to human applications were selected and analyzed. Findings Pre-and post-conditioning appear to provide similar levels of neuroprotection. The preconditioning window of benefit can be subdivided into early and late effects, depending on whether the effect appears immediately after the sublethal stress or with a delay of days. In general early effects have been associated post-translational modification of critical proteins (membrane receptors, mitochondrial respiratory chain) while late effects are the result of gene up-or down-regulation. Transient ischemic attacks appear to represent a form of clinically relevant preconditioning by inducing ischemic tolerance in the brain and reducing the severity of subsequent strokes. Remote forms of ischemic pre- and post-conditioning have been more commonly used in clinical studies, as the remote application reduces the risk of injuring the target tissue for which protection is pursued. Limb transient ischemia is the preferred method of induction of remote conditioning with evidence supporting its safety. Clinical studies in a variety of populations at risk of central nervous damage including carotid disease

  19. Is the Study Process Questionnaire (SPQ) a Good Predictor of Academic Achievement? Examining the Mediating Role of Achievement-Related Classroom Behaviours

    ERIC Educational Resources Information Center

    Choy, Jeanette Lyn Fung; O'Grady, Glen; Rotgans, Jerome I.

    2012-01-01

    Studies have shown that the Study Process Questionnaire (SPQ)--which provides a measure of student approaches to learning--is a relatively weak predictor of academic achievement. The present study sought to explore whether students' achievement-related classroom behaviours, as observed by teachers, can be used as a mediator between student…

  20. [Decree on the implementation of good clinical practice in the conduct of clinical trials on medicinal products for human use].

    PubMed

    Schwerdtfeger, W K

    2005-02-01

    In Germany, Directive 2001/20/EC is implemented by articles 40 to 42a of the Federal Drug Act and by the Decree on Good Clinical Practice. Pivotal provisions have been included into the Federal Drug Act, such as those aiming at the clinical trial subject's protection and defining responsibilities for the evaluation of applications as well as for pharmacovigilance and surveillance. The Decree comprises: relevant definitions; requirements for manufacturing, importation and labelling of investigational medicinal products; the procedures to obtain the ethics committee's opinion and the authorization from the competent authority on the trial application and on amendments thereof; documentation and information tasks of the investigator, sponsor and competent authority; rules for inspection to verify compliance with good clinical and manufacturing practice. Finally, the decree lists infringements within the meaning of article 97, paragraph 2, no. 31 of the Federal Drug Act, and lays down the necessary provisions for a transitional period and the entering into force of the new provisions.

  1. The characteristics of a good clinical teacher as perceived by resident physicians in Japan: a qualitative study

    PubMed Central

    2013-01-01

    Background It is not known whether the characteristics of a good clinical teacher as perceived by resident physicians are the same in Western countries as in non-Western countries including Japan. The objective of this study was to identify the characteristics of a good clinical teacher as perceived by resident physicians in Japan, a non-Western country, and to compare the results with those obtained in Western countries. Methods Data for this qualitative research were collected using semi-structured focus group interviews. Focus group transcripts were independently analyzed and coded by three authors. Residents were recruited by maximum variation sampling until thematic saturation was achieved. Results Twenty-three residents participated in five focus group interviews regarding the perceived characteristics of a good clinical teacher in Japan. The 197 descriptions of characteristics that were identified were grouped into 30 themes. The most commonly identified theme was “provided sufficient support”, followed by “presented residents with chances to think”, “provided feedback”, and “provided specific indications of areas needing improvement”. Using Sutkin’s main categories (teacher, physician, and human characteristics), 24 of the 30 themes were categorized as teacher characteristics, 6 as physician characteristics, and none as human characteristics. Conclusions “Medical knowledge” of teachers was not identified as a concern of residents, and “clinical competence of teachers” was not emphasized, whereas these were the two most commonly recorded themes in Sutkin’s study. Our results suggest that Japanese and Western resident physicians place emphasis on different characteristics of their teachers. We speculate that such perceptions are influenced by educational systems, educational settings, and culture. Globalization of medical education is important, but it is also important to consider differences in educational systems, local settings

  2. Good clinical practice in resource-limited settings: translating theory into practice.

    PubMed

    Tinto, Halidou; Noor, Ramadhani A; Wanga, Charles L; Valea, Innocent; Mbaye, Maimouna Ndour; D'Alessandro, Umberto; Ravinetto, Raffaella M

    2013-04-01

    A Good Clinical Practices (GCPs) course, based on the combination of theoretical modules with a practical training in real-life conditions, was held in 2010 in Burkina Faso. It was attended by 15 trainees from nine African, Asian, and Latin American countries. There were some discrepancies between the average good results at the end of the theoretical phase and the GCP application during the first days of the practical phase, underlying the difficulties of translating theoretical knowledge into good practices. Most of the findings were not unexpected and reflected the challenges commonly faced by clinical investigators in resource-poor contexts (i.e., the high workload at peripheral health facilities, the need to conciliate routine clinical activities with clinical research, and the risk of creating a double standard among patients attending the same health facility [free care for recruited patients versus user fees for non-recruited patients with the same medical condition]). Even if limited in number and time, these observations suggest that a theoretical training alone may not be sufficient to prepare trainees for the challenges of medical research in real-life settings. Conversely, when a practical phase immediately follows a theoretical one, trainees can immediately experience what the research methodology implicates in terms of work organization and relationship with recruited and non-recruited patients. This initial experience shows the complexity of translating GCP into practice and suggests the need to rethink the current conception of GCP training.

  3. Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

    PubMed Central

    2011-01-01

    The Institute of Medicine has targeted patient-centeredness as an important area of quality improvement. A major dimension of patient-centeredness is respect for patient's values, preferences, and expressed needs. Yet specific approaches to gaining this understanding and translating it to quality care in the clinical setting are lacking. From a patient perspective quality is not a simple concept but is best understood in terms of five dimensions: technical outcomes; decision-making efficiency; amenities and convenience; information and emotional support; and overall patient satisfaction. Failure to consider quality from this five-pronged perspective results in a focus on medical outcomes, without considering the processes central to quality from the patient's perspective and vital to achieving good outcomes. In this paper, we argue for applying the concept of fair process in clinical settings. Fair process involves using a collaborative approach to exploring diagnostic issues and treatments with patients, explaining the rationale for decisions, setting expectations about roles and responsibilities, and implementing a core plan and ongoing evaluation. Fair process opens the door to bringing patient expertise into the clinical setting and the work of developing health care goals and strategies. This paper provides a step by step illustration of an innovative visual approach, called photovoice or photo-elicitation, to achieve fair process in clinical work with acquired brain injury survivors and others living with chronic health conditions. Applying this visual tool and methodology in the clinical setting will enhance patient-provider communication; engage patients as partners in identifying challenges, strengths, goals, and strategies; and support evaluation of progress over time. Asking patients to bring visuals of their lives into the clinical interaction can help to illuminate gaps in clinical knowledge, forge better therapeutic relationships with patients living

  4. Using visual and narrative methods to achieve fair process in clinical care.

    PubMed

    Lorenz, Laura S; Chilingerian, Jon A

    2011-02-16

    The Institute of Medicine has targeted patient-centeredness as an important area of quality improvement. A major dimension of patient-centeredness is respect for patient's values, preferences, and expressed needs. Yet specific approaches to gaining this understanding and translating it to quality care in the clinical setting are lacking. From a patient perspective quality is not a simple concept but is best understood in terms of five dimensions: technical outcomes; decision-making efficiency; amenities and convenience; information and emotional support; and overall patient satisfaction. Failure to consider quality from this five-pronged perspective results in a focus on medical outcomes, without considering the processes central to quality from the patient's perspective and vital to achieving good outcomes. In this paper, we argue for applying the concept of fair process in clinical settings. Fair process involves using a collaborative approach to exploring diagnostic issues and treatments with patients, explaining the rationale for decisions, setting expectations about roles and responsibilities, and implementing a core plan and ongoing evaluation. Fair process opens the door to bringing patient expertise into the clinical setting and the work of developing health care goals and strategies. This paper provides a step by step illustration of an innovative visual approach, called photovoice or photo-elicitation, to achieve fair process in clinical work with acquired brain injury survivors and others living with chronic health conditions. Applying this visual tool and methodology in the clinical setting will enhance patient-provider communication; engage patients as partners in identifying challenges, strengths, goals, and strategies; and support evaluation of progress over time. Asking patients to bring visuals of their lives into the clinical interaction can help to illuminate gaps in clinical knowledge, forge better therapeutic relationships with patients living

  5. 'Good' patient/'bad' patient: clinical learning and the entrenching of inequality.

    PubMed

    Sointu, Eeva

    2017-01-01

    This article develops sociological understanding of the reproduction of inequality in medicine. The material is drawn from a longitudinal study of student experiences of clinical learning that entailed 72 qualitative in-depth interviews with 27 medical students from five medical schools in the USA. To highlight the subtle, yet powerful, ways in which inequality gets entrenched, this article analyses ideas of the 'good' and the 'bad' patient. Bad patients question not only biomedical knowledge but also medical students' commitment to helping people. Good patients engage with medical students in a manner that upholds biomedical knowledge and enables students to assume the role of the healer and the expert. At the same time, good patients possess cultural skills that align with those of medical practitioners. This alignment is, furthermore, central to definitions of the good patient. Distinctions drawn between good and bad patients thus both embody as well as enforce social inequality. The subtle reproduction of inequality is, however, difficult to discern because judgements about patients entwine with emotion.

  6. Tools to share good chairside teaching practice: a clinical scenario and appreciative questionnaire.

    PubMed

    Sweet, J; Wilson, J; Pugsley, L; Schofield, M

    2008-12-13

    This article provides a scenario for analysis of good chairside teaching practice to serve as a starting point for continued discussion in this complex field. Documented issues of good chairside teaching practice are cross-referenced to a clinical scenario with explanations in the form of a commentary. This provided the context for generating a set of questions that are provided as tools to support good chairside practice. These tools are designed to be used with 'Appreciative Inquiry', which claims that there is much to be gained by discovering where excellence is possible and elaborating upon this. Although this process can be carried out in single units or departments, it is proposed that collaboration between institutions would allow sharing of valuable innovations and greater understanding of educational training, production of good practice guidance and professional development of staff. This article is the third in a series of three and provides a scaffold for a scenario and questions to encourage collaboration in evolving and sharing good chairside teaching practice. The first article investigated the perceptions of stakeholders in chairside teaching at a single dental school and the second evaluated chairside teaching on a UK wide scale. A further accompanying article reviews some of the educational methodology and innovations in teaching and learning that may be applied to dentistry.

  7. Is Early Ability Grouping Good for High-Achieving Students' Psychosocial Development? Effects of the Transition into Academically Selective Schools

    ERIC Educational Resources Information Center

    Becker, Michael; Neumann, Marko; Tetzner, Julia; Böse, Susanne; Knoppick, Henrike; Maaz, Kai; Baumert, Jürgen; Lehmann, Rainer

    2014-01-01

    The present study investigates school context effects on psychosocial characteristics (academic self-concept, peer relations, school satisfaction, and school anxiety) of high-achieving and gifted students. Students who did or did not make an early transition from elementary to secondary schools for high-achieving and gifted students in 5th grade…

  8. Good Clinical Practice Training: Identifying Key Elements and Strategies for Increasing Training Efficiency.

    PubMed

    Arango, Jaime; Chuck, Tina; Ellenberg, Susan S; Foltz, Bridget; Gorman, Colleen; Hinrichs, Heidi; McHale, Susan; Merchant, Kunal; Seltzer, Jonathan; Shapley, Stephanie; Wild, Gretchen

    2016-07-01

    Good Clinical Practice (GCP) is an international standard for the design, conduct, performance, monitoring, auditing, recording, analyses, and reporting of clinical trials. The goal of GCP is to ensure the protection of the rights, integrity, and confidentiality of clinical trial participants and to ensure the credibility and accuracy of data and reported results. In the United States, trial sponsors generally require investigators to complete GCP training prior to participating in each clinical trial to foster GCP and as a method to meet regulatory expectations (ie, sponsor's responsibility to select qualified investigators per 21 CFR 312.50 and 312.53(a) for drugs and biologics and 21 CFR 812.40 and 812.43(a) for medical devices). This training requirement is often extended to investigative site staff, as deemed relevant by the sponsor, institution, or investigator. Those who participate in multiple clinical trials are often required by sponsors to complete repeated GCP training, which is unnecessarily burdensome. The Clinical Trials Transformation Initiative convened a multidisciplinary project team involving partners from academia, industry, other researchers and research staff, and government to develop recommendations for streamlining current GCP training practices. Recommendations drafted by the project team, including the minimum key training elements, frequency, format, and evidence of training completion, were presented to a broad group of experts to foster discussion of the current issues and to seek consensus on proposed solutions.

  9. Promoting good clinical laboratory practices and laboratory accreditation to support clinical trials in sub-Saharan Africa.

    PubMed

    Guindo, Merepen A; Shott, Joseph P; Saye, Renion; Diakité, Moussa L; Sanogo, Sintry; Dembele, Moussa B; Keita, Sekouba; Nagel, Mary C; Ellis, Ruth D; Aebig, Joan A; Diallo, Dapa A; Doumbo, Ogobara K

    2012-04-01

    Laboratory capacity in the developing world frequently lacks quality management systems (QMS) such as good clinical laboratory practices, proper safety precautions, and adequate facilities; impacting the ability to conduct biomedical research where it is needed most. As the regulatory climate changes globally, higher quality laboratory support is needed to protect study volunteers and to accurately assess biological parameters. The University of Bamako and its partners have undertaken a comprehensive QMS plan to improve quality and productivity using the Clinical and Laboratory Standards Institute standards and guidelines. The clinical laboratory passed the College of American Pathologists inspection in April 2010, and received full accreditation in June 2010. Our efforts to implement high-quality standards have been valuable for evaluating safety and immunogenicity of malaria vaccine candidates in Mali. Other disease-specific research groups in resource-limited settings may benefit by incorporating similar training initiatives, QMS methods, and continual improvement practices to ensure best practices.

  10. Electroencephalographic neurofeedback: Level of evidence in mental and brain disorders and suggestions for good clinical practice.

    PubMed

    Micoulaud-Franchi, J-A; McGonigal, A; Lopez, R; Daudet, C; Kotwas, I; Bartolomei, F

    2015-12-01

    The technique of electroencephalographic neurofeedback (EEG NF) emerged in the 1970s and is a technique that measures a subject's EEG signal, processes it in real time, extracts a parameter of interest and presents this information in visual or auditory form. The goal is to effectuate a behavioural modification by modulating brain activity. The EEG NF opens new therapeutic possibilities in the fields of psychiatry and neurology. However, the development of EEG NF in clinical practice requires (i) a good level of evidence of therapeutic efficacy of this technique, (ii) a good practice guide for this technique. Firstly, this article investigates selected trials with the following criteria: study design with controlled, randomized, and open or blind protocol, primary endpoint related to the mental and brain disorders treated and assessed with standardized measurement tools, identifiable EEG neurophysiological targets, underpinned by pathophysiological relevance. Trials were found for: epilepsies, migraine, stroke, chronic insomnia, attentional-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, major depressive disorder, anxiety disorders, addictive disorders, psychotic disorders. Secondly, this article investigates the principles of neurofeedback therapy in line with learning theory. Different underlying therapeutic models are presented didactically between two continua: a continuum between implicit and explicit learning and a continuum between the biomedical model (centred on "the disease") and integrative biopsychosocial model of health (centred on "the illness"). The main relevant learning model is to link neurofeedback therapy with the field of cognitive remediation techniques. The methodological specificity of neurofeedback is to be guided by biologically relevant neurophysiological parameters. Guidelines for good clinical practice of EEG NF concerning technical issues of electrophysiology and of learning are suggested. These require validation by

  11. Picking the Good Apples: Statistics versus Good Judgment in Choosing Stent Operators for a Multicenter Clinical Trial

    PubMed Central

    Howard, George; Voeks, Jenifer H.; Meschia, James F.; Howard, Virginia J.; Brott, Thomas G.

    2014-01-01

    Background and Purpose The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) was completed with a quite low stroke and death rate. A “lead-in” series of patients receiving carotid artery stenting (CAS) was used to select the physician-operators for the study, where performance was evaluated by complication rates and by peer review of cases. Herein, we assess the potential contribution of statistical evaluation of complication rates. Methods The ability to discriminate between stent operators who can successfully meet the published guideline of <3% combined rate of stroke and death is calculated under the binomial distribution, based upon a small consecutive case series (n = 24 patients). Results A criterion of ≤2 stroke or death events among the 24 patients (<8% event rate) was required of operators. Setting such a high criterion, however, ensures an inability to exclude operators who cannot meet the criteria. In fact, if a “good” operator is defined as having a 2% event rate, and a “poor” operator as a 6% event rate, even a series of 240 patients would (on average) still exclude 5.4% of the good operators and include 4.6% of the poor operators. Conclusions The low periprocedural event rates in the trial suggest success in separating skillful operators from less skillful. However, it seems unlikely that statistical assessment of event rates in the lead-in contributed to successful selection, but rather successful selection was more likely due to peer review of subjective and other factors including patient volume and technical approaches. PMID:25213339

  12. The clinical achievement portfolio: an outcomes-based assessment project in nursing education.

    PubMed

    Tracy, S M; Marino, G J; Richo, K M; Daly, E M

    2000-01-01

    Dynamic healthcare market forces impel educators to search for innovative methods of academic assessment to measure learning outcomes. The clinical achievement portfolio is a creative and systematic tool for documenting continuous improvement of student clinical learning. The authors describe the use of the portfolio as a pilot project aimed at introducing reflective thinking and measuring clinical learning in undergraduate nursing education. Potential benefits of the clinical portfolio and implications for future research are proposed.

  13. Promoting good clinical practices in the conduct of clinical trials: experiences in the Department of Veterans Affairs Cooperative Studies Program.

    PubMed

    Sather, Mike R; Raisch, Dennis W; Haakenson, Clair M; Buckelew, Julia M; Feussner, John R

    2003-10-01

    The ever-increasing concern for the welfare of volunteers participating in clinical trials and for the integrity of the data derived from those trials has generated the concept of Good Clinical Practice (GCP). The Veterans Affairs Cooperative Studies Program, in anticipation of the need to comply with GCP guidelines, developed a Site Monitoring and Review Team (SMART), which consists of a Good Clinical Practice Monitoring Group and a Good Clinical Practice Review Group. The review group conducted 335 site reviews from fiscal years (FY) 1999 through 2001 to assess and encourage adherence to GCP. Data from reviews were compared for two time periods, a 2-year implementation period (FYs 1999/2000, n=204) and a continuing follow-up period (FY 2001, n=131). Overall, high GCP adherence was exhibited by 11.3% (n=23) of study sites in FY 1999/2000 versus 20.6% (n=27) in FY 2001, average to good adherence was exhibited by 84.3% (n=172) in FY 1999/2000 versus 77.0% (n=101) in FY 2001, and below average adherence was exhibited by 4.4% (n=9) versus 1.5% (n=3) in these two periods. These changes were statistically significant by chi square analysis (p=0.029). Moreover, GCP adherence was assessed within eight GCP focus areas: patient informed consent, protocol adherence, safety monitoring, institutional review board interactions, regulatory document management, patient records in investigator file, drug/device accountability, and general site operations. Median assessment scores for all 62 GCP review elements improved from 0.82 to 0.89 (p<0.001). Median assessment scores for the 14 selected critical GCP items improved from 0.78 to 0.89 (p<0.001). Median scores for five of the eight GCP focus areas improved significantly (p<0.001) between the two time periods. These data suggest that the site-oriented activities of SMART combined with centralized quality assurance activities of the coordinating centers represent an integrated, versatile program to promote and assure GCP adherence

  14. What Makes a Good Student? How Emotions, Self-Regulated Learning, and Motivation Contribute to Academic Achievement

    ERIC Educational Resources Information Center

    Mega, Carolina; Ronconi, Lucia; De Beni, Rossana

    2014-01-01

    The authors propose a theoretical model linking emotions, self-regulated learning, and motivation to academic achievement. This model was tested with 5,805 undergraduate students. They completed the Self-Regulated Learning, Emotions, and Motivation Computerized Battery (LEM-B) composed of 3 self-report questionnaires: the Self-Regulated Learning…

  15. It Feels Good to Learn Where I Belong: School Belonging, Academic Emotions, and Academic Achievement in Adolescents

    ERIC Educational Resources Information Center

    Lam, Un Fong; Chen, Wei-Wen; Zhang, Jingqi; Liang, Ting

    2015-01-01

    This study examined the relationships between school belonging, academic emotions, and academic achievement in Macau adolescents. A survey of 406 junior high school students in Macau was used to collect information on the extent to which these students felt accepted and respected in their schools (school belonging), the emotions they experienced…

  16. Life Satisfaction among Highly Achieving Students in Hong Kong: Do Gratitude and the "Good-Enough Mindset" Add to the Contribution of Perfectionism in Prediction?

    ERIC Educational Resources Information Center

    Chan, David W.

    2012-01-01

    This study investigated whether gratitude and the "good-enough mindset" added to the contribution of perfectionism in predicting life satisfaction in 245 Chinese highly achieving students in Hong Kong. Participants completed self-report questionnaires that included scales on life satisfaction, positive and negative perfectionism…

  17. Person-centric clinical trials: an opportunity for the good clinical practice (GCP)-practice-based research network.

    PubMed

    Curro, Frederick A; Robbins, Dennis A; Millenson, Michael L; Fox, Chester H; Naftolin, Frederick

    2013-10-01

    Practice-based research networks (PBRNs) can function as a platform for delivery of patient-centered care consistent with the Patient Protection and Affordable Care Act. Patient-centered (centric) clinical studies encourage the patient to be an integral part of study design and outcome. The patient's electronic health record contributes to the shared national health care data set. PBRNs integrate health care data in real time at the point of care and reflect the full context of the person's health. PBRNs designed under the principles of good clinical practice (GCP) validate studies related to comparative effectiveness research and drug development. PBRNs can generate large amounts of data from known patient histories so that side effects can be assessed in their totality. The larger and more diverse number of patients recruited suggests that point-of-care-data, where both provider and patient participate in the treatment, may be more robust in that side effects, drug-drug interactions and number of concomitant medications used may be identified earlier in the development process. The GCP PBRN concept affords continuous patient information for both care and research purposes. These all contribute to an ethical approach for the pharmaceutical industry to generate clinical research data for regulatory submission and to contribute to a HIPAA-compliant national database that could contribute to improved health care delivery and pharmacovigilance.

  18. Social welfare in Mental Health Department for a Good clinical practice.

    PubMed

    Amorosi, Marilisa

    2016-09-01

    The National Plan of Action for Mental Health (PANSM), approved by the Conference of Regions has been from January 24 2013, being implemented by the Department of Mental Health Services. It requires a reorganization of the same, the functional the adoption of a methodology based on the Necessity of Working for projects which are Intervention-specific and differentiated, based on the evaluation of the need and patients and the implementation of care pathways. This implies a systemic approach by of the team, rather than a segmental working mode. Thus change is necessary in the work culture of the teams, and from the State Regions Conference November 13 2014, has emerged the need to share, among all stakeholders, good practices and the development of Clinical Management Tools so that standards of care can be defined to ensure quality, together with the measurement of Processes and Outcomes.

  19. High ear-piercing: an increasingly popular procedure with serious complications. Is good clinical practice exercised?

    PubMed

    Lyons, Marie; Stephens, Joanna; Wasson, Joseph; DeZoysa, Nilantha; Vlastarakos, Petros V

    2012-03-01

    This study aimed to explore the current practice of performing high ear-piercing regarding consent protocols, and methods of practice using questionnaire-based survey in Hertfordshire and North London. Recommendations for good clinical practice are also made. 100 establishments performing ear piercing were identified. A 16-item questionnaire on techniques used, methods of high-ear piercing, methods of sterilization, consent issues and aftercare was completed. Seventy-six establishments agreed to participate. All practitioners prepared the skin before piercing. 58 (76%) used a needle for piercing, 11 (15%) used a spring-loaded gun and seven (9%) used both. 97% of the practitioners obtained written consent before proceeding. 9 (12%) had a lower age limit of 16 years and three (4%) of 18 years. 27 piercers (36%) provided an aftercare leaflet, 41 (54%) warned the patients about risks of infection, 16 (21%) warned about cosmetic deformity and 1 (1%) specifically mentioned cauliflower ear. Results indicated that high ear piercing is an invasive procedure with a significant risk of complications leading to cosmetic deformity. Establishments should be required to counsel patients properly about the risks and potential complications of the procedure. A code of practice should be drawn up with a minimum age for piercing, requirement for proper consent, excellent hygiene and good information for postoperative care.

  20. Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management.

    PubMed

    Thoolen, Bart Johan; de Ridder, Denise; Bensing, Jozien; Gorter, Kees; Rutten, Guy

    2009-03-01

    This study examines the effectiveness of a brief self-management intervention to support patients recently diagnosed with type-2 diabetes to achieve sustained improvements in their self-care behaviours. Based on proactive coping, the intervention emphasizes the crucial role of anticipation and planning in maintaining self-care behaviours. In a randomised controlled trial among recent screen-detected patients, participants who received the intervention were compared with usual-care controls, examining changes in proximal outcomes (intentions, self-efficacy and proactive coping), self-care behaviour (diet, physical activity and medication) and weight over time (0, 3 and 12 months). Subsequently, the contribution of proactive coping in predicting maintenance of behavioural change was analysed using stepwise hierarchical regression analyses, controlling for baseline self-care behaviour, patient characteristics, and intentions and self-efficacy as measured after the course. The intervention was effective in improving proximal outcomes and behaviour with regard to diet and physical activity, resulting in significant weight loss at 12 months. Furthermore, proactive coping was a better predictor of long-term self-management than either intentions or self-efficacy. Proactive coping thus offers new insights into behavioural maintenance theory and can be used to develop effective self-management interventions.

  1. Unraveling Brazilian Indian population prostate good health: clinical, anthropometric and genetic features

    PubMed Central

    de Lima, Mario M.; Reis, Leonardo O.; Ferreira, Ubirajara; Cardoso, Ulieme Oliveira; Barbieri, Raquel Bueno; de Mendonça, Gustavo B.; Ward, Laura S.

    2015-01-01

    Purpose To compare dietary, lifestyle, clinical, anthropometric, genetic and prostatic features of Brazilian Indians and non-Indians (Amazon). Methods 315 men, 228 Indians and 89 non-Indians, ≥40 years old were submitted to digital rectal examination, serum prostate specific antigen (PSA), testosterone, TP53 and GSTP1 genotyping, anthropometric, lifestyle, dietary, personal and familial medical history. Prostatic symptoms were evaluated with the International Prostate Symptom Score (IPSS). Results Macuxis and Yanomamis represented 43.6% and 14.5% of Indians respectively who spontaneously referred no prostate symptoms. Mean IPSS was 7, range 3-19, with only 15% of moderate symptoms (score 8-19); Mean age was 54.7 years, waist circumference 86.6 cm, BMI 23.9 kg/m2. Yanomamis presented both lower BMI (21.4 versus 24.8 and 23.3, p=0,001) and prostate volume than Macuxis and “other ethnic groups” (15 versus 20, p=0.001). Testosterone (414 versus 502 and 512, p=0.207) and PSA (0.48 versus 0.6 and 0.41, p=0.349) were similar with progressive PSA increase with aging. Val/Val correlated with lower PSA (p=0.0361). Indians compared to control population presented: - TP53 super representation of Arg/Arg haplotype, 74.5% versus 42.5%, p<0.0001. -GSTP1 Ile/Ile 35.3% versus 60.9%; Ile/Val 45.9% versus 28.7%; Val/Val 18.8% versus 10.3%; p=0.0003. Conclusions Observed specific dietary, lifestyle, anthropometric and genetic profile for TP53 and GSTP1 may contribute to Brazilian Indian population prostate good health. PMID:26005978

  2. Towards a ‘Good Life’ for Farm Animals: Development of a Resource Tier Framework to Achieve Positive Welfare for Laying Hens

    PubMed Central

    Edgar, Joanne L.; Mullan, Siobhan M.; Pritchard, Joy C.; McFarlane, Una J. C.; Main, David C. J.

    2013-01-01

    Simple Summary Farm animals can be said to have a ‘good life’ if their quality of life is substantially higher than the current legal minimum and includes positive experiences such as pleasure. In commercial farms, animals can be provided with different resources such as bedding, exercise areas and enrichment objects. We used scientific evidence and expert opinion to determine which resources laying hens need to contribute to a ‘good life’. These resources were organised into three tiers, of increasing welfare, leading towards a ‘good life’. We describe how we developed the resource tiers and suggest how the overall framework might be used to promote a ‘good life’ for farm animals. Abstract The concept of a ‘good life’ recognises the distinction that an animal’s quality of life is beyond that of a ‘life worth living’, representing a standard of welfare substantially higher than the legal minimum (FAWC, 2009). We propose that the opportunities required for a ‘good life’ could be used to structure resource tiers that lead to positive welfare and are compatible with higher welfare farm assurance schemes. Published evidence and expert opinion was used to define three tiers of resource provision (Welfare +, Welfare ++ and Welfare +++) above those stipulated in UK legislation and codes of practice, which should lead to positive welfare outcomes. In this paper we describe the principles underpinning the framework and the process of developing the resource tiers for laying hens. In doing so, we summarise expert opinion on resources required to achieve a ‘good life’ in laying hens and discuss the philosophical and practical challenges of developing the framework. We present the results of a pilot study to establish the validity, reliability and feasibility of the draft laying hen tiers on laying hen production systems. Finally, we propose a generic welfare assessment framework for farm animals and suggest directions for implementation

  3. How Good Are Our Raters? Rater Errors in Clinical Skills Assessment

    ERIC Educational Resources Information Center

    Iramaneerat, Cherdsak; Yudkowsky, Rachel

    2006-01-01

    A multi-faceted Rasch measurement (MFRM) model was used to analyze a clinical skills assessment of 173 fourth-year medical students in a Midwestern medical school to investigate four types of rater errors: leniency, inconsistency, halo, and restriction of range. Each student performed six clinical tasks with six standardized patients (SPs), who…

  4. RETHINKING THE ROLE OF CLINICAL TRIAL DATA IN INTERNATIONAL INTELLECTUAL PROPERTY LAW: THE CASE FOR A PUBLIC GOODS APPROACH.

    PubMed

    Reichman, Jerome H

    2009-01-01

    This article describes the growth and consequences of new intellectual property rights given to pharmaceutical developers, and it advocates treating clinical trials as a public good. Although the soaring cost of clinical trials is well known and discussed, too little attention is given to the underlying rationale for allowing drug developers to recoup their costs through the new intellectual property rights provided in multilateral, regional, and bilateral agreements. Known in the US as "market exclusivity" and in Europe as "data exclusivity," these rights prohibit would-be generic producers from obtaining regulatory approval based on the original producers' undisclosed test data. Market and data exclusivity is codified in US and European domestic law as well as the North American Free Trade Agreement (NAFTA) and, to a lesser degree, the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). Market and data exclusivity is binding an increasing number of developing countries via Free Trade Agreements (FTAs), which hinder developing countries from manufacturing generic drugs. At a minimum, negotiators should replace the norm of exclusive control over data with a liability rule, or take and pay rule, in which generic manufacturers can use original manufacturers' clinical trial data in exchange for reasonable compensation. A more fundamental solution requires questioning the status quo of proprietary clinical trial data. The conventional wisdom is that market and data exclusivity, and drug developers' consequent ability to limit competition from generics above and beyond patent protection, are a necessary incentive for drug developers to fund ever more expensive clinical trials. Clinical trial data, however, are public goods that will be undersupplied and over protected so long as private actors provide them. Moreover, manufacturers have an incentive to present clinical trial data so that they support regulatory approval at the expense of public

  5. RETHINKING THE ROLE OF CLINICAL TRIAL DATA IN INTERNATIONAL INTELLECTUAL PROPERTY LAW: THE CASE FOR A PUBLIC GOODS APPROACH

    PubMed Central

    REICHMAN, JEROME H.

    2009-01-01

    This article describes the growth and consequences of new intellectual property rights given to pharmaceutical developers, and it advocates treating clinical trials as a public good. Although the soaring cost of clinical trials is well known and discussed, too little attention is given to the underlying rationale for allowing drug developers to recoup their costs through the new intellectual property rights provided in multilateral, regional, and bilateral agreements. Known in the US as “market exclusivity” and in Europe as “data exclusivity,” these rights prohibit would-be generic producers from obtaining regulatory approval based on the original producers’ undisclosed test data. Market and data exclusivity is codified in US and European domestic law as well as the North American Free Trade Agreement (NAFTA) and, to a lesser degree, the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). Market and data exclusivity is binding an increasing number of developing countries via Free Trade Agreements (FTAs), which hinder developing countries from manufacturing generic drugs. At a minimum, negotiators should replace the norm of exclusive control over data with a liability rule, or take and pay rule, in which generic manufacturers can use original manufacturers’ clinical trial data in exchange for reasonable compensation. A more fundamental solution requires questioning the status quo of proprietary clinical trial data. The conventional wisdom is that market and data exclusivity, and drug developers’ consequent ability to limit competition from generics above and beyond patent protection, are a necessary incentive for drug developers to fund ever more expensive clinical trials. Clinical trial data, however, are public goods that will be undersupplied and over protected so long as private actors provide them. Moreover, manufacturers have an incentive to present clinical trial data so that they support regulatory approval at the

  6. How good is the evidence base for test selection in clinical guidelines?

    PubMed

    Misra, Shivani; Barth, Julian H

    2014-05-15

    Clinical guidelines are ubiquitous, manifold and form an integral component of evidence-based clinical practice. Guidelines on test selection are often considered a useful adjunct to aid clinical decision-making, as test selection is a complex process that is influenced by many patient, clinician and laboratory factors. However, it is important to carefully evaluate several aspects of these guidelines, which include the context of the test in the guideline, the quality of the studies underpinning recommendations, the extent of the evaluation of effectiveness (or performance) of the specific test and in the clinical pathway, its applicability and ease of implementation. A robust evaluation of a diagnostic test should incorporate several stages including evaluation in healthy, symptomatic but unaffected and affected populations, and importantly a measurement of impact on patient outcomes. Few diagnostic studies meet these criteria, and therefore crucial aspects of test evaluation are overlooked prior to incorporation into clinical guidelines. Whilst efforts are made to standardise reporting of studies, strength of evidence and quality of guidelines, further work is required to improve the quality of the diagnostic studies that formulate these guidelines. It is important that clinicians using guidelines for test selection appreciate the limitations of the diagnostic test, and the guidelines themselves.

  7. "It feels good to be measured": clinical role-play, Walker Percy, and the tingles.

    PubMed

    Ahuja, Nitin K

    2013-01-01

    A large online community has recently formed around autonomous sensory meridian response (ASMR), a pleasant and poorly understood somatic reaction to specific interpersonal triggers. Its web-based manifestations include a variety of amateur videos designed to elicit the reaction, many of which feature protracted imitations of a clinician's physical exam. This analysis considers through a literary lens the proximity of this phenomenon to clinical diagnostics, focusing in particular on characterizations of spiritual isolation elaborated in Love in the Ruins (1971), the third novel by physician-writer Walker Percy (1916-1990). Within this speculative framework, the tendency to derive pleasure from clinical milieus, real or constructed, may be interpreted as a quality particular to the postmodern psyche. Viewing web-based clinical role-play in light of Percy's writing also underscores the possibility that routine diagnostic assessments may have independent therapeutic implications.

  8. 75 FR 51824 - Food and Drug Administration Clinical Trial Requirements, Regulations, Compliance, and Good...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-23

    ... District Office, in cosponsorship with the Society of Clinical Research Associates (SoCRA) is announcing a... physicians. CNE for Nurses: SoCRA is an approved provider of continuing nursing education by the Pennsylvania State Nurses Association (PSNA), an accredited approver by the American Nurses Credentialing...

  9. [Massive pulmonary artery thromboembolism after removal of sphenoid wing meningioma (clinical case with good outcome)].

    PubMed

    Lubnin, A Iu; Konovalov, A N; Markina, M S; Goriachev, A S

    2004-01-01

    The paper describes a clinical case of the severe potentially fatal postoperative complication--massive pulmonary thromboembolism--in a patient after uncomplicated removal of meningioma of the wing of os basilare. It also describes the problems in the diagnosis, treatment, prevention of perioperative deep venous thrombosis of the shin and subsequent pulmonary thromboembolism in neurosurgery patients.

  10. Good clinical outcomes from a 7-year holistic programme of fistula repair in Guinea

    PubMed Central

    Delamou, Alexandre; Diallo, Moustapha; Beavogui, Abdoul Habib; Delvaux, Thérèse; Millimono, Sita; Kourouma, Mamady; Beattie, Karen; Barone, Mark; Barry, Thierno Hamidou; Khogali, Mohamed; Edginton, Mary; Hinderaker, Sven Gudmund; Ruminjo, Joseph; Zhang, Wei-Hong; De Brouwere, Vincent

    2015-01-01

    Objectives Female genital fistula remains a public health concern in developing countries. From January 2007 to September 2013, the Fistula Care project, managed by EngenderHealth in partnership with the Ministry of Health and supported by USAID, integrated fistula repair services in the maternity wards of general hospitals in Guinea. The objective of this article was to present and discuss the clinical outcomes of 7 years of work involving 2116 women repaired in three hospitals across the country. Methods This was a retrospective cohort study using data abstracted from medical records for fistula repairs conducted from 2007 to 2013. The study data were reviewed during the period April to August 2014. Results The majority of the 2116 women who underwent surgical repair had vesicovaginal fistula (n = 2045, 97%) and 3% had rectovaginal fistula or a combination of both. Overall 1748 (83%) had a closed fistula and were continent of urine immediately after surgery. At discharge, 1795 women (85%) had a closed fistula and 1680 (79%) were dry, meaning they no longer leaked urine and/or faeces. One hundred and fifteen (5%) remained with residual incontinence despite fistula closure. Follow-up at 3 months was completed by 1663 (79%) women of whom 1405 (84.5%) had their fistula closed and 80% were continent. Twenty-one per cent were lost to follow-up. Conclusion Routine programmatic repair for obstetric fistula in low resources settings can yield good outcomes. However, more efforts are needed to address loss to follow-up, sustain the results and prevent the occurrence and/or recurrence of fistula. Objectifs La fistule génitale féminine reste un problème de santé publique dans les pays en développement. De janvier 2007 à septembre 2013, le projet Fistula Care, géré par Engender Health en partenariat avec le Ministère de la Santé et soutenu par l’USAID, a intégré les services de réparation de fistules dans les maternités des hôpitaux généraux en Guin

  11. Relevance of basic research to clinical data: good answers, wrong questions!

    PubMed

    Ben-Ari, Yehezkel; Holmes, Gregory L

    2008-01-01

    Do early seizures beget seizures later in life? Clinical data and experimental observations seem to answer that question differently, with a no and a yes, respectively, which may stem from an inadequate readout of what experimental data actually do tell us and a possible simplification of what clinical data indicate. Using specific experimental examples, it is possible to show that in the developing brain, seizures do produce long-lasting alterations of neuronal excitability, although ongoing seizures are not observed in adults. The findings suggest that the long-lasting changes in developmental programs and network activity that seizures induce do not necessarily lead to epilepsy, unless other events that remain to be identified occur.

  12. Clinical audit of leg ulceration prevalence in a community area: a case study of good practice.

    PubMed

    Hindley, Jenny

    2014-09-01

    This article presents the findings of an audit on venous leg ulceration prevalence in a community area as a framework for discussing the concept and importance of audit as a tool to inform practice and as a means to benchmark care against national or international standards. It is hoped that the discussed audit will practically demonstrate how such procedures can be implemented in practice for those who have not yet undertaken it, as well as highlighting the unexpected extra benefits of this type of qualitative data collection that can often unexpectedly inform practice and influence change. Audit can be used to measure, monitor and disseminate evidence-based practice across community localities, facilitating the identification of learning needs and the instigation of clinical change, thereby prioritising patient needs by ensuring safety through the benchmarking of clinical practice.

  13. [Value of a good example: a search for role models in practical clinical teaching].

    PubMed

    Stegeman, J H

    2001-03-03

    The importance of the role model function of the 'teacher' (m/f) was always realized to some extent in practical clinical teaching, but appears to be gaining renewed interest at present. There exists, however, a discrepancy between the importance attached by many experienced clinicians and their students to the role model on the one hand, and the amount of systematical study that has been dedicated to it on the other hand. The available date show an impressionistic image of the qualities these students and interns consider important in role models. However, the 'why' of the importance of role models is seldom considered. In an era in which it is considered important that 'learning targets', 'learning moments' and 'transfer mechanisms' are defined in detail, the function of role models in practical clinical teaching should also be given more attention. Insights from other fields of knowledge than the medical field might be of value in designing research leading to a clearer image of the function and the value of role models in practical clinical education.

  14. The good EULAR response at the first year is strongly predictive of clinical remission in rheumatoid arthritis: results from the TARAC cohort.

    PubMed

    Darawankul, Budsakorn; Chaiamnuay, Sumapa; Pakchotanon, Rattapol; Asavatanabodee, Paijit; Narongroeknawin, Pongthorn

    2015-01-01

    The purpose of this study was to identify the prevalence and prognostic factors of clinical remission in patients with rheumatoid arthritis (RA). The Thai Army Rheumatoid Arthritis Cohort (TARAC) patients were included if baseline data were available. Clinical remission was defined as 28-joint count disease activity scores (DAS28) <2.6 in the last two consecutive visits, at least 3 months apart. Three hundred and thirty-five patients were enrolled, and 89.9 % were female. Mean (SD) age was 61 years (11.4), and mean disease duration was 145.9 months (93.7). Rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) were positive in 69.9 and 67.8 %, respectively. Eighty-nine percent of patients were treated with synthetic DMARDs, of which 29 % received monotherapy. The combination of biologic and synthetic DMARDs was used in 10.4 % of the patients. Clinical remission was observed in 49 patients (14.6 %). Early diagnosis and treatment within 12 months of onset (odds ratio (OR) 1.95, 95 % confidence interval (CI) 1.02-3.74, p = 0.04), rheumatoid factor negativity (OR 2.10, 95 % CI 1.04-4.21, p = 0.04) and good EULAR response at the end of the first year of treatment (OR 2.75, 95 % CI 1.08-6.99, p = 0.03) were associated with clinical remission in univariate analysis. In multivariate regression analysis, only a good EULAR response at the first year was significantly correlated with clinical remission in this study (OR 3.1, 95 % CI 1.15-8.36, p = 0.03). Although remission is currently a treatment goal in patients with RA, only one-seventh of patients have achieved sustained clinical remission in clinical practice. The good EULAR response at the end of the first year was an independent predictive factor of clinical remission.

  15. Achieving consensus for clinical trials: the REiNS International Collaboration.

    PubMed

    Plotkin, Scott R; Blakeley, Jaishri O; Dombi, Eva; Fisher, Michael J; Hanemann, C Oliver; Walsh, Karin S; Wolters, Pamela L; Widemann, Brigitte C

    2013-11-19

    The neurofibromatoses (NF)--including neurofibromatosis 1 (NF1), neurofibromatosis 2 (NF2), and schwannomatosis--are related tumor-suppressor syndromes characterized by a predisposition to multiple tumor types and other disease manifestations, which often result in functional disability, reduced quality of life, pain, and, in some cases, malignancy. With increasing knowledge of the biology and pathogenesis of NF, clinical trials with targeted agents directed at NF tumors have become available. Most clinical trials for patients with NF have used designs and endpoints similar to oncology trials. However, differences in the disease manifestations and natural history of NF (compared to cancers) require the development of new designs and endpoints to perform meaningful NF clinical trials. The Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration was established in 2011 at the Children's Tumor Foundation meeting to achieve consensus within the NF community about the design of future clinical trials, with a specific emphasis on endpoints. The REiNS Collaboration includes 7 working groups that focus on imaging of tumor response; functional, visual, patient-reported, and neurocognitive outcomes; whole-body MRI; and disease biomarkers. This supplement includes the first series of recommendations by the REiNS Collaboration. The hope is that these recommendations will be used by members of the group and by researchers outside of the REiNS International Collaboration to standardize the measurement of outcomes and thus improve clinical trials for patients with NF. Ultimately, we plan to engage industry partners and national regulatory agencies in this process to facilitate the approval of drugs for patients with NF.

  16. What makes a good clinical app? Introducing the RCP Health Informatics Unit checklist.

    PubMed

    Wyatt, Jeremy C; Thimbleby, Harold; Rastall, Paul; Hoogewerf, Jan; Wooldridge, Darren; Williams, John

    2015-12-01

    Doctors increasingly rely on medical apps running on smart phones or tablet computers to support their work. However, these apps vary hugely in the quality of their data input screens, internal data processing, the methods used to handle sensitive patient data and how they communicate their output to the user. Inspired by Donabedian's approach to assessing quality and the principles of good user interface design, the Royal College of Physicians' Health Informatics Unit has developed and piloted an 18-item checklist to help clinicians assess the structure, functions and impact of medical apps. Use of this checklist should help clinicians to feel more confident about using medical apps themselves, about recommending them to their staff or prescribing them for patients.

  17. GOOD or BAD Responder? Behavioural and Neuroanatomical Markers of Clinical Response to Donepezil in Dementia

    PubMed Central

    Bottini, Gabriella; Berlingeri, Manuela; Basilico, Stefania; Passoni, Serena; Danelli, Laura; Colombo, Nadia; Sberna, Maurizio; Franceschi, Massimo; Sterzi, Roberto; Paulesu, Eraldo

    2012-01-01

    We explored the neuropsychological and neuromorphometrical differences between probable Alzheimer's disease patients showing a good or a bad response to nine months treatment with donepezil. Before treatment, the neuropsychological profile of the two patient groups was perfectly matched. By the ninth month after treatment, the BAD-responders showed a decline of the MMSE score together with a progressive impairment of executive functions. A voxel-based morphometry investigation (VBM), at the time of the second neuropsychological assessment, showed that the BAD-responders had larger grey and white matter atrophies involving the substantia innominata of Meynert bilaterally, the ventral part of caudate nuclei and the left uncinate fasciculus, brain areas belonging to the cholinergic pathways. A more widespread degeneration of the central cholinergic pathways may explain the lack of donepezil efficacy in those patients not responding to a treatment that operates on the grounds that some degree of endogeneous release of acetylcholine is still available. PMID:22530263

  18. A Pharmacist-Staffed, Virtual Gout Management Clinic for Achieving Target Serum Uric Acid Levels: A Randomized Clinical Trial

    PubMed Central

    Goldfien, Robert; Pressman, Alice; Jacobson, Alice; Ng, Michele; Avins, Andrew

    2016-01-01

    Context: Relatively few patients with gout receive appropriate treatment. Objective: To determine whether a pharmacist-staffed gout management program is more effective than usual care in achieving target serum uric acid (sUA) levels in gout patients. Design: A parallel-group, randomized controlled trial of a pharmacist-staffed, telephone-based program for managing hyperuricemia vs usual care. Trial duration was 26 weeks. Main Outcome Measures: Primary outcome measure was achieving sUA levels at or below 6 mg/dL at the 26-week visit. Secondary outcome was mean change in sUA levels in the control and intervention groups. Participants were adults with recurrent gout and sUA levels above 6.0 mg/dL. Participants were randomly assigned to management by a clinical pharmacist following protocol or to monitoring of sUA levels but management of their gout by their usual treating physician. Results: Of 102 patients who met eligibility criteria, 77 subjects obtained a baseline sUA measurement and were entered into the trial. Among 37 participants in the intervention group, 13 (35%) had sUA levels at or below 6.0 mg/dL at 26 weeks, compared with 5 (13%) of 40 participants in the control group (risk ratio = 2.8, 95% confidence interval [CI] = 1.1 to 7.1, p = 0.03). The mean change in sUA levels among controls was +0.1 mg/dL compared with −1.5 mg/dL in the intervention group (sUA difference = −1.6, 95% CI = −0.9 to −2.4, p < 0.001). Conclusions: A structured pharmacist-staffed program was more effective than usual care for achieving target sUA levels. These results suggest a structured program could greatly improve gout management. PMID:27352414

  19. [Relevance of basic research to clinical data: Good answers, wrong questions!].

    PubMed

    Ben-Ari, Y; Holmes, G L

    2008-05-01

    What conclusions can be derived from experimental data on human epilepsies? This review discusses these issues, notably concerning human temporal lobe epilepsies (TLEs) and infantile epilepsies, where important advances have been achieved in both theory and the comprehension of epileptogenic mechanisms. A wide spectrum of human and animal data converge to show that the naive network transforms to one that generates seizures spontaneously. Thus, in TLE, experimental and human data suggest that the inaugurating status generates a sequence of events that lead to the sprouting of fibers and the formation of novel excitatory synapses. This reactive plasticity constitutes a basis for the generation of novel seizures by the epileptic network. Similarly, in vitro studies indicate that in immature hippocampal formation, the propagation of high- but not low-frequency seizures can transform a naive network into one that generates further seizures, thereby, giving an indication as to the types of seizure that are epileptogenic. In conclusion, it is suggested that although animal data cannot mimic human seizures in all their complex and variable etiologies, it provides essential indications on the mechanisms that enable seizure generation.

  20. Clinician-Reported Outcome Assessments of Treatment Benefit: Report of the ISPOR Clinical Outcome Assessment Emerging Good Practices Task Force

    PubMed Central

    Powers, John H.; Patrick, Donald L.; Walton, Marc K.; Marquis, Patrick; Cano, Stefan; Hobart, Jeremy; Isaac, Maria; Vamvakas, Spiros; Slagle, Ashley; Molsen, Elizabeth; Burke, Laurie B.

    2017-01-01

    A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients’ health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient’s health status. This is the second of two reports by the ISPOR Clinical Outcomes Assessment—Emerging Good Practices for Outcomes Research Task Force. The first report provided an overview of COAs including definitions important for an understanding of COA measurement practices. This report focuses specifically on issues related to ClinRO assessments. In this report, we define three types of ClinRO assessments (readings, ratings, and clinician global assessments) and describe emerging good measurement practices in their development and evaluation. The good measurement practices include 1) defining the context of use; 2) identifying the concept of interest measured; 3) defining the intended treatment benefit on how patients feel, function, or survive reflected by the ClinRO assessment and evaluating the relationship between that intended treatment benefit and the concept of interest; 4) documenting content validity; 5) evaluating other measurement properties once content validity is established (including intra- and inter-rater reliability); 6) defining study objectives and end point(s) objectives, and defining study end points and placing study end points within the hierarchy of end points; 7) establishing interpretability in trial results; and 8) evaluating operational considerations for the implementation

  1. EANM Dosimetry Committee guidance document: good practice of clinical dosimetry reporting.

    PubMed

    Lassmann, M; Chiesa, C; Flux, G; Bardiès, M

    2011-01-01

    Many recent publications in nuclear medicine contain data on dosimetric findings for existing and new diagnostic and therapeutic agents. In many of these articles, however, a description of the methodology applied for dosimetry is lacking or important details are omitted. The intention of the EANM Dosimetry Committee is to guide the reader through a series of suggestions for reporting dosimetric approaches. The authors are aware of the large amount of data required to report the way a given clinical dosimetry procedure was implemented. Another aim of this guidance document is to provide comprehensive information for preparing and submitting publications and reports containing data on internal dosimetry. This guidance document also contains a checklist which could be useful for reviewers of manuscripts submitted to scientific journals or for grant applications. In addition, this document could be used to decide which data are useful for a documentation of dosimetry results in individual patient records. This may be of importance when the approval of a new radiopharmaceutical by official bodies such as EMA or FDA is envisaged.

  2. Cost-effectiveness analysis alongside clinical trials II-An ISPOR Good Research Practices Task Force report.

    PubMed

    Ramsey, Scott D; Willke, Richard J; Glick, Henry; Reed, Shelby D; Augustovski, Federico; Jonsson, Bengt; Briggs, Andrew; Sullivan, Sean D

    2015-03-01

    Clinical trials evaluating medicines, medical devices, and procedures now commonly assess the economic value of these interventions. The growing number of prospective clinical/economic trials reflects both widespread interest in economic information for new technologies and the regulatory and reimbursement requirements of many countries that now consider evidence of economic value along with clinical efficacy. As decision makers increasingly demand evidence of economic value for health care interventions, conducting high-quality economic analyses alongside clinical studies is desirable because they broaden the scope of information available on a particular intervention, and can efficiently provide timely information with high internal and, when designed and analyzed properly, reasonable external validity. In 2005, ISPOR published the Good Research Practices for Cost-Effectiveness Analysis Alongside Clinical Trials: The ISPOR RCT-CEA Task Force report. ISPOR initiated an update of the report in 2014 to include the methodological developments over the last 9 years. This report provides updated recommendations reflecting advances in several areas related to trial design, selecting data elements, database design and management, analysis, and reporting of results. Task force members note that trials should be designed to evaluate effectiveness (rather than efficacy) when possible, should include clinical outcome measures, and should obtain health resource use and health state utilities directly from study subjects. Collection of economic data should be fully integrated into the study. An incremental analysis should be conducted with an intention-to-treat approach, complemented by relevant subgroup analyses. Uncertainty should be characterized. Articles should adhere to established standards for reporting results of cost-effectiveness analyses. Economic studies alongside trials are complementary to other evaluations (e.g., modeling studies) as information for decision

  3. Non-clinical studies in the process of new drug development - Part II: Good laboratory practice, metabolism, pharmacokinetics, safety and dose translation to clinical studies.

    PubMed

    Andrade, E L; Bento, A F; Cavalli, J; Oliveira, S K; Schwanke, R C; Siqueira, J M; Freitas, C S; Marcon, R; Calixto, J B

    2016-12-12

    The process of drug development involves non-clinical and clinical studies. Non-clinical studies are conducted using different protocols including animal studies, which mostly follow the Good Laboratory Practice (GLP) regulations. During the early pre-clinical development process, also known as Go/No-Go decision, a drug candidate needs to pass through several steps, such as determination of drug availability (studies on pharmacokinetics), absorption, distribution, metabolism and elimination (ADME) and preliminary studies that aim to investigate the candidate safety including genotoxicity, mutagenicity, safety pharmacology and general toxicology. These preliminary studies generally do not need to comply with GLP regulations. These studies aim at investigating the drug safety to obtain the first information about its tolerability in different systems that are relevant for further decisions. There are, however, other studies that should be performed according to GLP standards and are mandatory for the safe exposure to humans, such as repeated dose toxicity, genotoxicity and safety pharmacology. These studies must be conducted before the Investigational New Drug (IND) application. The package of non-clinical studies should cover all information needed for the safe transposition of drugs from animals to humans, generally based on the non-observed adverse effect level (NOAEL) obtained from general toxicity studies. After IND approval, other GLP experiments for the evaluation of chronic toxicity, reproductive and developmental toxicity, carcinogenicity and genotoxicity, are carried out during the clinical phase of development. However, the necessity of performing such studies depends on the new drug clinical application purpose.

  4. Non-clinical studies in the process of new drug development - Part II: Good laboratory practice, metabolism, pharmacokinetics, safety and dose translation to clinical studies

    PubMed Central

    Andrade, E.L.; Bento, A.F.; Cavalli, J.; Oliveira, S.K.; Schwanke, R.C.; Siqueira, J.M.; Freitas, C.S.; Marcon, R.; Calixto, J.B.

    2016-01-01

    The process of drug development involves non-clinical and clinical studies. Non-clinical studies are conducted using different protocols including animal studies, which mostly follow the Good Laboratory Practice (GLP) regulations. During the early pre-clinical development process, also known as Go/No-Go decision, a drug candidate needs to pass through several steps, such as determination of drug availability (studies on pharmacokinetics), absorption, distribution, metabolism and elimination (ADME) and preliminary studies that aim to investigate the candidate safety including genotoxicity, mutagenicity, safety pharmacology and general toxicology. These preliminary studies generally do not need to comply with GLP regulations. These studies aim at investigating the drug safety to obtain the first information about its tolerability in different systems that are relevant for further decisions. There are, however, other studies that should be performed according to GLP standards and are mandatory for the safe exposure to humans, such as repeated dose toxicity, genotoxicity and safety pharmacology. These studies must be conducted before the Investigational New Drug (IND) application. The package of non-clinical studies should cover all information needed for the safe transposition of drugs from animals to humans, generally based on the non-observed adverse effect level (NOAEL) obtained from general toxicity studies. After IND approval, other GLP experiments for the evaluation of chronic toxicity, reproductive and developmental toxicity, carcinogenicity and genotoxicity, are carried out during the clinical phase of development. However, the necessity of performing such studies depends on the new drug clinical application purpose. PMID:27982281

  5. [Manual for the design of non-drug trials in primary care, taking account of Good Clinical Practice (GCP) criteria].

    PubMed

    Joos, Stefanie; Bleidorn, Jutta; Haasenritter, Jörg; Hummers-Pradier, Eva; Peters-Klimm, Frank; Gágyor, Ildikó

    2013-01-01

    In recent years studies not falling under the German Pharmaceutical Law ("non-drug trials") have also been increasingly expected to be conducted according to Good Clinical Practice (GCP) in order to ensure that uniform standards are maintained for data quality and patient safety. However, simple transfer of the GCP criteria is not always possible and often not useful. Given the fact that research questions regarding non-drug interventions are common in primary care (e.g., general practice), the "Network for Clinical Studies in General Practice" has developed a manual for planning and conducting non-drug trials. This manual is based on the GCP guideline, taking account of the conditions and circumstances in primary care settings. Both structure and relevant content of the manual are presented in the article. (As supplied by the authors).

  6. Adalimumab induction and maintenance therapy achieve clinical remission and response in Chinese patients with Crohn's disease

    PubMed Central

    Ran, Zhi Hua; Gao, Xiang; Chen, Minhu; Zhong, Jie; Sheng, Jian-Qiu; Kamm, Michael A; Travis, Simon; Wallace, Kori; Mostafa, Nael M; Shapiro, Marisa; Li, Yao; Thakkar, Roopal B; Robinson, Anne M

    2016-01-01

    Background/Aims This was a Phase 2 study (NCT02015793) to evaluate the pharmacokinetics, safety, and efficacy of adalimumab in Chinese patients with Crohn's disease (CD). Methods Thirty, adult Chinese patients with CD (CD Activity Index [CDAI] 220–450; high-sensitivity [hs]-C-reactive protein [CRP] ≥3 mg/L) received double-blind adalimumab 160/80 mg or 80/40 mg at weeks 0/2, followed by 40 mg at weeks 4 and 6. An open-label extension period occurred from weeks 8–26; patients received 40 mg adalimumab every other week. Serum adalimumab concentration and change from baseline in fecal calprotectin (FC) were measured during the double-blind period. Clinical remission (CDAI <150), response (decrease in CDAI ≥70 points from baseline), and change from baseline in hs-CRP were assessed through week 26. Nonresponder imputation was used for missing categorical data and last observation carried forward for missing hs-CRP/FC values. No formal hypothesis was tested. Adverse events were monitored. Results Mean adalimumab serum concentrations during the induction phase were 13.9–18.1 µg/mL (160/80 mg group) and 7.5−9.5 µg/mL (80/40 mg group). During the double-blind period, higher remission/response rates and greater reductions from baseline in hs-CRP and FC were observed with adalimumab 160/80 mg compared to that with 80/40 mg. Adverse event rates were similar among all treatment groups. Conclusions Adalimumab serum concentrations in Chinese patients with CD were comparable to those observed previously in Western and Japanese patients. Clinically meaningful remission rates and improvement in inflammatory markers were achieved with both dosing regimens; changes occurred rapidly with adalimumab 160/80 mg induction therapy. No new safety signals were reported. PMID:27175116

  7. Can patient decision aids help people make good decisions about participating in clinical trials? A study protocol

    PubMed Central

    Brehaut, Jamie C; Lott, Alison; Fergusson, Dean A; Shojania, Kaveh G; Kimmelman, Jonathan; Saginur, Raphael

    2008-01-01

    Background Evidence shows that the standard process for obtaining informed consent in clinical trials can be inadequate, with study participants frequently not understanding even basic information fundamental to giving informed consent. Patient decision aids are effective decision support tools originally designed to help patients make difficult treatment or screening decisions. We propose that incorporating decision aids into the informed consent process will improve the extent to which participants make decisions that are informed and consistent with their preferences. A mixed methods study will test this proposal. Methods Phase one of this project will involve assessment of a stratified random sample of 50 consent documents from recently completed investigator-initiated clinical trials, according to existing standards for supporting good decision making. Phase two will involve interviews of a purposive sample of 50 trial participants (10 participants from each of five different clinical areas) about their experience of the informed consent process, and how it could be improved. In phase three, we will convert consent forms for two completed clinical trials into decision aids and pilot test these new tools using a user-centered design approach, an iterative development process commonly employed in computer usability literature. In phase four, we will conduct a pilot observational study comparing the new tools to standard consent forms, with potential recruits to two hypothetical clinical trials. Outcomes will include knowledge of key aspects of the decision, knowledge of the probabilities of different outcomes, decisional conflict, the hypothetical participation decision, and qualitative impressions of the experience. Discussion This work will provide initial evidence about whether a patient decision aid can improve the informed consent process. The larger goal of this work is to examine whether study recruitment can be improved from (barely) informed consent

  8. Good Agreements Make Good Friends

    PubMed Central

    Han, The Anh; Pereira, Luís Moniz; Santos, Francisco C.; Lenaerts, Tom

    2013-01-01

    When starting a new collaborative endeavor, it pays to establish upfront how strongly your partner commits to the common goal and what compensation can be expected in case the collaboration is violated. Diverse examples in biological and social contexts have demonstrated the pervasiveness of making prior agreements on posterior compensations, suggesting that this behavior could have been shaped by natural selection. Here, we analyze the evolutionary relevance of such a commitment strategy and relate it to the costly punishment strategy, where no prior agreements are made. We show that when the cost of arranging a commitment deal lies within certain limits, substantial levels of cooperation can be achieved. Moreover, these levels are higher than that achieved by simple costly punishment, especially when one insists on sharing the arrangement cost. Not only do we show that good agreements make good friends, agreements based on shared costs result in even better outcomes. PMID:24045873

  9. [Good Practice of Clinical Physiology Examination for Patient Safety with a Team-Based Approach: Quality Practice in Ultrasonographic Examination].

    PubMed

    Asai, Satomi; Miyachi, Hayato

    2015-07-01

    For the safety of patient care, a team-based approach has been advocated as an effective measure. In clinical physiology examination, we have been making efforts to promote good practice for patient safety based on such an approach in Tokai University Hospital, as represented by quality practice in ultrasonographic examination. The entire process of ultrasonographic examination can be divided into three parts: pre-examination, examination, and post-examination processes. In each process of the examination, specific quality issues must be considered, eventually ensuring the quality and safety of patient care. A laboratory physician is responsible for not only quality assurance of examination, diagnosis, and reporting, but also patient safety. A laboratory physician can play a key role in all aspects of patient safety related to each process of the examination by taking a leadership role in the team-based approach.

  10. The Good-Enough Science-and-Politics of Anthropological Collaboration with Evidence-Based Clinical Research: Four Ethnographic Case Studies

    PubMed Central

    Messac, Luke; Ciccarone, Dan; Draine, Jeffrey; Bourgois, Philippe

    2013-01-01

    The apolitical legitimacy of "evidence-based medicine" offers a practical means for ethnography and critical social-science-and-humanities-of-health theory to transfer survival resources to structurally vulnerable populations and to engage policy and services audiences with urgent political problems imposed on the urban poor in the United States that harm health: most notably, homelessness, hyperincarceration, social service cut-backs and the War on Drugs. We present four examples of collaborations between ethnography and clinical research projects that demonstrate the potentials and limits of promoting institutional reform, political debate and action through distinct strategies of cross-methodological dialogue with epidemiological and clinical services research. Ethnographic methods alone, however, are simply a technocratic add-on. They must be informed by critical theory to contribute effectively and transformatively to applied health initiatives. Ironically, technocratic, neoliberal logics of cost-effectiveness can sometimes render radical service and policy reform initiatives institutionally credible, fundable and capable of generating wider political support, even though the rhetoric of economic efficacy is a double-edged sword. To extend the impact of ethnography and interdisciplinary theories of political-economic, cultural and disciplinary power relations into applied clinical and public health research, anthropologists--and their fellow travelers--have to be able to strategically, but respectfully learn to see through the positivist logics of clinical services research as well as epidemiological epistemology in order to help clinicians achieve--and extend--their applied priorities. In retrospect, these four very differently-structured collaborations suggest the potential for "good-enough” humble scientific and political strategies to work for, and with, structurally vulnerable populations in a punitive neoliberal era of rising social inequality

  11. The good-enough science-and-politics of anthropological collaboration with evidence-based clinical research: Four ethnographic case studies.

    PubMed

    Messac, Luke; Ciccarone, Dan; Draine, Jeffrey; Bourgois, Philippe

    2013-12-01

    The apolitical legitimacy of "evidence-based medicine" offers a practical means for ethnography and critical social-science-and-humanities-of-health theory to transfer survival resources to structurally vulnerable populations and to engage policy and services audiences with urgent political problems imposed on the urban poor in the United States that harm health: most notably, homelessness, hyperincarceration, social service cut-backs and the War on Drugs. We present four examples of collaborations between ethnography and clinical research projects that demonstrate the potentials and limits of promoting institutional reform, political debate and action through distinct strategies of cross-methodological dialog with epidemiological and clinical services research. Ethnographic methods alone, however, are simply a technocratic add-on. They must be informed by critical theory to contribute effectively and transformatively to applied health initiatives. Ironically, technocratic, neoliberal logics of cost-effectiveness can sometimes render radical service and policy reform initiatives institutionally credible, fundable and capable of generating wider political support, even though the rhetoric of economic efficacy is a double-edged sword. To extend the impact of ethnography and interdisciplinary theories of political-economic, cultural and disciplinary power relations into applied clinical and public health research, anthropologists - and their fellow travelers - have to be able to strategically, but respectfully learn to see through the positivist logics of clinical services research as well as epidemiological epistemology in order to help clinicians achieve - and extend - their applied priorities. In retrospect, these four very differently-structured collaborations suggest the potential for "good-enough" humble scientific and political strategies to work for, and with, structurally vulnerable populations in a punitive neoliberal era of rising social inequality

  12. Ethical principles and operational guidelines for good clinical practice in paediatric research. Recommendations of the Ethics Working Group of the Confederation of European Specialists in Paediatrics (CESP).

    PubMed

    Gill, Denis

    2004-02-01

    A child has the full right of protection of his/her life by provision of optional medical care. There is a need in paediatrics for better evidence based practice founded on quality research into efficacy and safety of children's medications. To protect the best interests of the child one must balance the ethical demand to do clinical studies with the necessity to avoid doing harm. To achieve this end good clinical practice in paediatric research demands that studies comply with the Declaration of Helsinki, ICH topic E11, EU Directives and other relevant international guidelines. Evident differences in physiology, pharmacology, pharmacokinetics and pharmacodynamics between children of differing ages and between children and adults demand properly constructed and conducted studies that respect the special somatic, emotional and mental needs of children. To justify any research project one must balance the benefit/risk ratio, provide experienced, competent personnel and infracture, obtain adequate informed consent/assent, and have the study evaluated and approved by an ethics committee containing expertise on the rights and needs of children.

  13. Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

    PubMed

    Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

    2014-07-01

    The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines.

  14. Clinical Outcomes according to the Achievement of Target Low Density Lipoprotein-Cholesterol in Patients with Acute Myocardial Infarction

    PubMed Central

    Ahn, Taehoon; Lee, Kyounghoon; Kang, Woong Chol; Han, Seung Hwan; Ahn, Youngkeun; Jeong, Myung Ho

    2017-01-01

    Background and Objectives The clinical outcome of patient with an acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI), with or without achievement of target low density lipoprotein-cholesterol (LDL-C), has little known information. This study investigated if target LDL-C level (below 70 mg/dL) achievements in patients with AMI showed better clinical outcomes or not. Subjects and Methods Between May 2008 and September 2012, this study enrolled 13473 AMI patients in a large-scale, prospective, multicenter Korean Myocardial Infarction (KorMI) registry. 12720 patients survived and 6746 patients completed a 1-year clinical follow up. Among them 3315 patients received serial lipid profile follow-ups. Propensity score matching was applied to adjust for differences in clinical baseline and angiographic characteristics, producing a total of 1292 patients (646 target LDL-C achievers vs. 646 non-achievers). The primary end point was the composite of a 1-year major adverse cardiac event (MACE) including cardiac death, recurrent myocardial infarction (MI), target lesion revascularization (TLR) and coronary artery bypass grafting. Results After propensity score matching, baseline clinical and angiographic characteristics were similar between the two groups. Clinical outcomes of the propensity score matched patients who showed no significant differences in cardiac death (0.5% vs. 0.5%, p=1.000), recurrent MI (1.1% vs. 0.8%, p=0.562), TLR (5.0% vs. 4.5%, p=0.649), MACEs (6.5% vs. 5.9%, p=0.644) and stent thrombosis (2.5% vs. 1.9%, p=0.560). Conclusion In this propensity-matched comparison, AMI patients undergoing PCI with a target LDL-C (below 70 mg/dL) achievement did not show better clinical outcomes. PMID:28154588

  15. The Return of the ’Good Neighbor’: A Policy for Achieving U.S. Objectives in Latin America through the Nineties and Beyond?

    DTIC Science & Technology

    1991-12-01

    1991 Thesis Advisor Scott D. Tollefson Approved for public release; distribution is unliiited. S9? . 92-03446 11�l111111111.l (Unclassified SECURITY...AUTHORITY 3. DISTRIBUTION/ AVAILABIIITY OF REPORT Approved for public release; distribution is unlimited. -- 2b. DCL ICATION)DOWNG NGSCHEDULE 4...Approved for public release; distribution is unlimited. The Return of the RGood Neighbor": A Policy For Achieving U.S. Objectives in Latin America

  16. A hybrid approach to achieving both marginal and conditional balances for stratification variables in sequential clinical trials.

    PubMed

    Lin, Yunzhi; Su, Zheng

    2013-01-01

    Various methods exist in the literature for achieving marginal balance for baseline stratification variables in sequential clinical trials. One major limitation with balancing on the margins of the stratification variables is that there is an efficiency loss when the primary analysis is stratified. To preserve the efficiency of a stratified analysis one recently proposed approach balances on the crossing of the stratification variables included in the analysis, which achieves conditional balance for the variables. A hybrid approach to achieving both marginal and conditional balances in sequential clinical trials is proposed, which is applicable to both continuous and categorical stratification variables. Numerical results based on extensive simulation studies and a real dataset show that the proposed approach outperforms the existing ones and is particularly useful when both additive and stratified models are planned for a trial.

  17. Achievement of recommended glucose and blood pressure targets in patients with type 2 diabetes and hypertension in clinical practice – study rationale and protocol of DIALOGUE

    PubMed Central

    2012-01-01

    Background Patients with type 2 diabetes have 2–4 times greater risk for cardiovascular morbidity and mortality than those without, and this is even further aggravated if they also suffer from hypertension. Unfortunately, less than one third of hypertensive diabetic patients meet blood pressure targets, and more than half fail to achieve target HbA1c values. Thus, appropriate blood pressure and glucose control are of utmost importance. Since treatment sometimes fails in clinical practice while clinical trials generally suggest good efficacy, data from daily clinical practice, especially with regard to the use of newly developed anti-diabetic and anti-hypertensive compounds in unselected patient populations, are essential. The DIALOGUE registry aims to close this important gap by evaluating different treatment approaches in hypertensive type 2 diabetic patients with respect to their effectiveness and tolerability and their impact on outcomes. In addition, DIALOGUE is the first registry to determine treatment success based on the new individualized treatment targets recommended by the ADA and the EASD. Methods DIALOGUE is a prospective observational German multicentre registry and will enrol 10,000 patients with both diabetes and hypertension in up to 700 sites. After a baseline visit, further documentations are scheduled at 6, 12 and 24 months. There are two co-primary objectives referring to the most recent guidelines for the treatment of diabetes and hypertension: 1) individual HbA1c goal achievement with respect to anti-diabetic pharmacotherapy and 2) individual blood pressure goal achievement with different antihypertensive treatments. Among the secondary objectives the rate of major cardio-vascular and cerebro-vascular events (MACCE) and the rate of hospitalizations are the most important. Conclusion The registry will be able to gain insights into the reasons for the obvious gap between the demonstrated efficacy and safety of anti-diabetic and anti

  18. Comparison of good clinical practice compliance and readability ease of the informed consents between observational and interventional clinical studies in the Emirates

    PubMed Central

    Nair, Satish Chandrasekhar; Ibrahim, Halah; Askar, Omar Sherif

    2016-01-01

    Background: Expansion of clinical trials activity into emerging regions has raised concerns regarding participant rights and research ethics. Increasing numbers of observational studies are now conducted in developing economies, including the United Arab Emirates. Materials and Methods: This study compares the content of information provided, Good Clinical Practice (GCP) guideline compliance, and readability of informed consent forms (ICFs) for observational compared to interventional studies. Results: GCP compliance for observational studies averaged at 79.5% + 6.8%, significantly (P < 0.001) lower than 92.2 + 5.0 percent for interventional studies. Readability ease and readability-grade level were assessed with Flesch-Kincaid scales. Results indicated higher readability grade-level 12.4 + 0.4 (P < 0.001) and lower readability Flesch-Kincaid reading ease score 35.7 + 3.6 for observational studies, as compared to 10.3 + 1.6 and 47.8 + 7.4 for interventional studies. Conclusion: Mandatory training for investigators is essential to provide readability ease and GCP compliance for the ICFs for the local population. PMID:27453828

  19. Scope-of-practice laws for nurse practitioners limit cost savings that can be achieved in retail clinics.

    PubMed

    Spetz, Joanne; Parente, Stephen T; Town, Robert J; Bazarko, Dawn

    2013-11-01

    Retail clinics have the potential to reduce health spending by offering convenient, low-cost access to basic health care services. Retail clinics are often staffed by nurse practitioners (NPs), whose services are regulated by state scope-of-practice regulations. By limiting NPs' work scope, restrictive regulations could affect possible cost savings. Using multistate insurance claims data from 2004-07, a period in which many retail clinics opened, we analyzed whether the cost per episode associated with the use of retail clinics was lower in states where NPs are allowed to practice independently and to prescribe independently. We also examined whether retail clinic use and scope of practice were associated with emergency department visits and hospitalizations. We found that visits to retail clinics were associated with lower costs per episode, compared to episodes of care that did not begin with a retail clinic visit, and the costs were even lower when NPs practiced independently. Eliminating restrictions on NPs' scope of practice could have a large impact on the cost savings that can be achieved by retail clinics.

  20. Relationships between Preferred Learning and Clinical Achievement of Baccalaureate Nursing Students.

    ERIC Educational Resources Information Center

    Wilkerson, Norma Neahr

    Paper presented at the Regional achievement in a nursing course in an integrated curriculum were studied. The theoretical framework was based on Kolb's model of experiential learning, which posited four phases: concrete experience, reflective observation, abstract conceptualization, and active experimentation. Kolb's Learning Style Inventory was…

  1. Clinical Outcome Assessments: Conceptual Foundation-Report of the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force.

    PubMed

    Walton, Marc K; Powers, John H; Hobart, Jeremy; Patrick, Donald; Marquis, Patrick; Vamvakas, Spiros; Isaac, Maria; Molsen, Elizabeth; Cano, Stefan; Burke, Laurie B

    2015-09-01

    An outcome assessment, the patient assessment used in an endpoint, is the measuring instrument that provides a rating or score (categorical or continuous) that is intended to represent some aspect of the patient's health status. Outcome assessments are used to define efficacy endpoints when developing a therapy for a disease or condition. Most efficacy endpoints are based on specified clinical assessments of patients. When clinical assessments are used as clinical trial outcomes, they are called clinical outcome assessments (COAs). COAs include any assessment that may be influenced by human choices, judgment, or motivation. COAs must be well-defined and possess adequate measurement properties to demonstrate (directly or indirectly) the benefits of a treatment. In contrast, a biomarker assessment is one that is subject to little, if any, patient motivational or rater judgmental influence. This is the first of two reports by the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force. This report provides foundational definitions important for an understanding of COA measurement principles. The foundation provided in this report includes what it means to demonstrate a beneficial effect, how assessments of patients relate to the objective of showing a treatment's benefit, and how these assessments are used in clinical trial endpoints. In addition, this report describes intrinsic attributes of patient assessments and clinical trial factors that can affect the properties of the measurements. These factors should be considered when developing or refining assessments. These considerations will aid investigators designing trials in their choice of using an existing assessment or developing a new outcome assessment. Although the focus of this report is on the development of a new COA to define endpoints in a clinical trial, these principles may be applied more generally. A critical element in appraising or developing a COA is to

  2. Randomization in clinical trials in orthodontics: its significance in research design and methods to achieve it.

    PubMed

    Pandis, Nikolaos; Polychronopoulou, Argy; Eliades, Theodore

    2011-12-01

    Randomization is a key step in reducing selection bias during the treatment allocation phase in randomized clinical trials. The process of randomization follows specific steps, which include generation of the randomization list, allocation concealment, and implementation of randomization. The phenomenon in the dental and orthodontic literature of characterizing treatment allocation as random is frequent; however, often the randomization procedures followed are not appropriate. Randomization methods assign, at random, treatment to the trial arms without foreknowledge of allocation by either the participants or the investigators thus reducing selection bias. Randomization entails generation of random allocation, allocation concealment, and the actual methodology of implementing treatment allocation randomly and unpredictably. Most popular randomization methods include some form of restricted and/or stratified randomization. This article introduces the reasons, which make randomization an integral part of solid clinical trial methodology, and presents the main randomization schemes applicable to clinical trials in orthodontics.

  3. The role of effective communication in achieving informed consent for clinical trials.

    PubMed

    Pick, Andrew; Gilbert, Kayleigh; McCaul, James

    2014-11-11

    Informed consent is fundamental to the protection of the rights, safety and wellbeing of patients in clinical research. For consent to be valid, patients must first be given all the information they need about the proposed research to be able to decide whether they would like to take part. This material should be presented in a way that is easy for them to understand. This article explores the importance of communication in clinical research, and how more effective communication with patients during the informed consent process can ensure they are fully informed.

  4. Nuclear imaging of the breast: translating achievements in instrumentation into clinical use.

    PubMed

    Hruska, Carrie B; O'Connor, Michael K

    2013-05-01

    Approaches to imaging the breast with nuclear medicine and∕or molecular imaging methods have been under investigation since the late 1980s when a technique called scintimammography was first introduced. This review charts the progress of nuclear imaging of the breast over the last 20 years, covering the development of newer techniques such as breast specific gamma imaging, molecular breast imaging, and positron emission mammography. Key issues critical to the adoption of these technologies in the clinical environment are discussed, including the current status of clinical studies, the efforts at reducing the radiation dose from procedures associated with these technologies, and the relevant radiopharmaceuticals that are available or under development. The necessary steps required to move these technologies from bench to bedside are also discussed.

  5. Nuclear imaging of the breast: Translating achievements in instrumentation into clinical use

    PubMed Central

    Hruska, Carrie B.; O'Connor, Michael K.

    2013-01-01

    Approaches to imaging the breast with nuclear medicine and/or molecular imaging methods have been under investigation since the late 1980s when a technique called scintimammography was first introduced. This review charts the progress of nuclear imaging of the breast over the last 20 years, covering the development of newer techniques such as breast specific gamma imaging, molecular breast imaging, and positron emission mammography. Key issues critical to the adoption of these technologies in the clinical environment are discussed, including the current status of clinical studies, the efforts at reducing the radiation dose from procedures associated with these technologies, and the relevant radiopharmaceuticals that are available or under development. The necessary steps required to move these technologies from bench to bedside are also discussed. PMID:23635248

  6. Achieving quality and fiscal outcomes in patient care: the clinical mentor care delivery model.

    PubMed

    Burritt, Joan E; Wallace, Patricia; Steckel, Cynthia; Hunter, Anita

    2007-12-01

    Contemporary patient care requires sophisticated clinical judgment and reasoning in all nurses. However, the level of development regarding these abilities varies within a staff. Traditional care models lack the structure and process to close the expertise gap creating potential patient safety risks. In an innovative model, senior, experienced nurses were relieved of direct patient care assignments to oversee nursing care delivery. Evaluation of the model showed significant impact on quality and fiscal outcomes.

  7. Achieving clinical statement interoperability using R-MIM and archetype-based semantic transformations.

    PubMed

    Kilic, Ozgur; Dogac, Asuman

    2009-07-01

    Effective use of electronic healthcare records (EHRs) has the potential to positively influence both the quality and the cost of health care. Consequently, sharing patient's EHRs is becoming a global priority in the healthcare information technology domain. This paper addresses the interoperability of EHR structure and content. It describes how two different EHR standards derived from the same reference information model (RIM) can be mapped to each other by using archetypes, refined message information model (R-MIM) derivations, and semantic tools. It is also demonstrated that well-defined R-MIM derivation rules help tracing the class properties back to their origins when the R-MIMs of two EHR standards are derived from the same RIM. Using well-defined rules also enable finding equivalences in the properties of the source and target EHRs. Yet an R-MIM still defines the concepts at the generic level. Archetypes (or templates), on the other hand, constrain an R-MIM to domain-specific concepts, and hence, provide finer granularity semantics. Therefore, while mapping clinical statements between EHRs, we also make use of the archetype semantics. Derivation statements are inferred from the Web Ontology Language definitions of the RIM, the R-MIMs, and the archetypes. Finally, we show how to transform Health Level Seven clinical statement instances to EHRcom clinical statement instances and vice versa by using the generated mapping definitions.

  8. Towards Achieving the Full Clinical Potential of Proton Therapy by Inclusion of LET and RBE Models

    PubMed Central

    Jones, Bleddyn

    2015-01-01

    Despite increasing use of proton therapy (PBT), several systematic literature reviews show limited gains in clinical outcomes, with publications mostly devoted to recent technical developments. The lack of randomised control studies has also hampered progress in the acceptance of PBT by many oncologists and policy makers. There remain two important uncertainties associated with PBT, namely: (1) accuracy and reproducibility of Bragg peak position (BPP); and (2) imprecise knowledge of the relative biological effect (RBE) for different tissues and tumours, and at different doses. Incorrect BPP will change dose, linear energy transfer (LET) and RBE, with risks of reduced tumour control and enhanced toxicity. These interrelationships are discussed qualitatively with respect to the ICRU target volume definitions. The internationally accepted proton RBE of 1.1 was based on assays and dose ranges unlikely to reveal the complete range of RBE in the human body. RBE values are not known for human (or animal) brain, spine, kidney, liver, intestine, etc. A simple efficiency model for estimating proton RBE values is described, based on data of Belli et al. and other authors, which allows linear increases in α and β with LET, with a gradient estimated using a saturation model from the low LET α and β radiosensitivity parameter input values, and decreasing RBE with increasing dose. To improve outcomes, 3-D dose-LET-RBE and bio-effectiveness maps are required. Validation experiments are indicated in relevant tissues. Randomised clinical studies that test the invariant 1.1 RBE allocation against higher values in late reacting tissues, and lower tumour RBE values in the case of radiosensitive tumours, are also indicated. PMID:25790470

  9. On achieving a clinically useful D-T neutron isocentric therapy system

    SciTech Connect

    Hilton, J.L.; Hendry, G.O.

    1981-04-01

    The Cyclotron Corporation's Model 4100 Neutron Cancer Therapy System with its output of 8 x 10/sup 12/ (14 MeV) neutron/sec designed for 500 hours is made up of: a factory recyclable miniature 200 kV sealed tube which radially accelerates up to 450 mA of deuterium and tritium ions from four duoplasmatron-type ion sources onto a central target; hand changeable radiation collimators; boronated hydrogenous shielding; isocentric gantry mounting; clinical diagnostics; and controls. The self-contained gas handling system which provides the needed differential gas pressure also stores, pumps, cleans, and recycles the D-T inventory. It is composed of a reversible getter high vacuum pump, a selective noble gas sputter ion pump, and a specialized uranium trap which, by controlled thermal decomposition of uranium hydride, regulates the ion source pressure. A D-T gas inventory of 3.7 k curies provides beam-on time of about three hours, while the gas recycle requires one to two hours. The four-sided target is made up from an array of heat transfer-optimized small copper tubes and their metal surface cladding which results in relatively high neutron output and long target life. The double vacuum walls, providing redundant tritium containment, are combined with other safety features.

  10. Fostering Dental Students' Academic Achievements and Reflection Skills Through Clinical Peer Assessment and Feedback.

    PubMed

    Tricio, Jorge A; Woolford, Mark J; Escudier, Michael P

    2016-08-01

    Peer assessment is increasingly being encouraged to enhance dental students' learning. The aim of this study was to evaluate the educational impact in terms of academic achievements and reflective thinking of a formative prospective peer assessment and feedback protocol. Volunteer final-year dental students at King's College London Dental Institute, UK, received training on peer assessment, peer feedback, and self-reflection. At the beginning (baseline) and end (resultant) of the 2012-13 academic year, 86 students (55% of the year group) completed a reflection questionnaire (RQ). Sixty-eight of those students used a modified Direct Observation of Procedural Skills (DOPS) as a framework for peer assessment and peer feedback during a complete academic year. End-of-year, high-stakes examination grades and RQ scores from the participants and nonparticipants were statistically compared. The participants completed 576 peer DOPS. Those 22 students who peer assessed each other ≥10 times exhibited highly statistically significant differences and powerful positive effect sizes in their high-stakes exam grades (p=0.0001, d=0.74) and critical reflection skills (p=0.005, d=1.41) when compared to those who did not assess one another. Furthermore, only the same 22 students showed a statistically significant increase and positive effect size in their critical reflection skills from baseline to resultant (p=0.003, d=1.04). The results of this study suggest that the protocol used has the potential to impact dental students' academic and reflection skills, provided it is practiced in ten or more peer encounters and ensuring peer feedback is provided followed by self-reflection.

  11. Achieving hemostasis with topical hemostats: making clinically and economically appropriate decisions in the surgical and trauma settings.

    PubMed

    Schreiber, Martin A; Neveleff, Deborah J

    2011-11-01

    Achieving hemostasis is a crucial focus of clinicians working in surgical and trauma settings. Topical hemostatic agents-including mechanical hemostats, active hemostats, flowable hemostats, and fibrin sealants-are frequently used in efforts to control bleeding, and new options such as hemostatic dressings, initially used in combat situations, are increasingly being used in civilian settings. To achieve successful hemostasis, a number of vital factors must be considered by surgeons and perioperative nurses, such as the size of the wound; bleeding severity; and the efficacy, possible adverse effects, and method of application of potential hemostatic agents. Understanding how and when to use each of the available hemostatic agents can greatly affect clinical outcomes and help to limit the overall cost of treatment.

  12. Proficiency testing linked to the national reference system for the clinical laboratory: a proposal for achieving accuracy.

    PubMed

    Lasky, F D

    1992-07-01

    I propose using proficiency testing (PT) to achieve one of the important goals of CLIA: accurate and reliable clinical testing. Routine methods for the clinical laboratory are traceable to Definitive (DM) or Reference Methods (RM) or to Methodological Principles (MP) through a modification of the National Reference System for the Clinical Laboratory. PT is the link used to monitor consistent field performance. Although PT has been effective as a relative measure of laboratory performance, the technical limitations of PT fluids and of routine methods currently in use make it unlikely that PT alone can be used as a reliable measure of laboratory accuracy. Instead, I recommend calibration of routine systems through correlation to DM, RM, or MP with use of patients' specimens. The manufacturer is in the best position to assume this responsibility because of also being responsible for consistent, reliable product. Analysis of different manufactured batches of reagent would be compared with predetermined goals for precision and accuracy, as illustrated with data from product testing of Kodak Ektachem clinical chemistry slides. Adoption of this proposal would give manufacturers of PT materials, manufacturers of analytical systems, PT providers, and government agencies time to understand and resolve sources of error that limit the utility of PT for the job required by law.

  13. How good is "evidence" from clinical studies of drug effects and why might such evidence fail in the prediction of the clinical utility of drugs?

    PubMed

    Naci, Huseyin; Ioannidis, John P A

    2015-01-01

    Promising evidence from clinical studies of drug effects does not always translate to improvements in patient outcomes. In this review, we discuss why early evidence is often ill suited to the task of predicting the clinical utility of drugs. The current gap between initially described drug effects and their subsequent clinical utility results from deficits in the design, conduct, analysis, reporting, and synthesis of clinical studies-often creating conditions that generate favorable, but ultimately incorrect, conclusions regarding drug effects. There are potential solutions that could improve the relevance of clinical evidence in predicting the real-world effectiveness of drugs. What is needed is a new emphasis on clinical utility, with nonconflicted entities playing a greater role in the generation, synthesis, and interpretation of clinical evidence. Clinical studies should adopt strong design features, reflect clinical practice, and evaluate outcomes and comparisons that are meaningful to patients. Transformative changes to the research agenda may generate more meaningful and accurate evidence on drug effects to guide clinical decision making.

  14. Exemplary Care and Learning Sites: A Model for Achieving Continual Improvement in Care and Learning in the Clinical Setting

    PubMed Central

    Ogrinc, Greg; Hoffman, Kimberly G.; Stevenson, Katherine M.; Shalaby, Marc; Beard, Albertine S.; Thörne, Karin E.; Coleman, Mary T.; Baum, Karyn D.

    2016-01-01

    Problem Current models of health care quality improvement do not explicitly describe the role of health professions education. The authors propose the Exemplary Care and Learning Site (ECLS) model as an approach to achieving continual improvement in care and learning in the clinical setting. Approach From 2008–2012, an iterative, interactive process was used to develop the ECLS model and its core elements—patients and families informing process changes; trainees engaging both in care and the improvement of care; leaders knowing, valuing, and practicing improvement; data transforming into useful information; and health professionals competently engaging both in care improvement and teaching about care improvement. In 2012–2013, a three-part feasibility test of the model, including a site self-assessment, an independent review of each site’s ratings, and implementation case stories, was conducted at six clinical teaching sites (in the United States and Sweden). Outcomes Site leaders reported the ECLS model provided a systematic approach toward improving patient (and population) outcomes, system performance, and professional development. Most sites found it challenging to incorporate the patients and families element. The trainee element was strong at four sites. The leadership and data elements were self-assessed as the most fully developed. The health professionals element exhibited the greatest variability across sites. Next Steps The next test of the model should be prospective, linked to clinical and educa tional outcomes, to evaluate whether it helps care delivery teams, educators, and patients and families take action to achieve better patient (and population) outcomes, system performance, and professional development. PMID:26760058

  15. In defense of adolescents: They really do use braces for the hours prescribed, if good help is provided. Results from a prospective everyday clinic cohort using thermobrace

    PubMed Central

    2012-01-01

    Background The effectiveness of bracing relies on the quality of the brace, compliance of the patient, and some disease factors. Patients and parents tend to overestimate adherence, so an objective assessment of compliance has been developed through the use of heat sensors. In 2010 we started the everyday clinical use of a temperature sensor, and the aim of this study is to present our initial results. Methods Population: A prospective cohort of 68 scoliosis patients that finished at least 4 months of brace treatment on March 31, 2011: 48 at their first evaluation (79% females, age 14.2±2.4) and 20 already in treatment. Treatment: Bracing (SPoRT concept); physiotherapic specific exercises (SEAS School); team approach according to the SOSORT Bracing Management Guidelines. Methods. A heat sensor, “Thermobrace” (TB), has been validated and applied to the brace. The real (measured by TB) and referred (reported by the patient) compliances were calculated. Statistics. The distribution was not normal, hence median and 95% interval confidence (IC95) and non-parametric tests had to be used. Results Average TB use: 5.5±1.5 months. Brace prescription was 23 hours/day (h/d) (IC95 18–23), with a referred compliance of 100% (IC95 70.7-100%) and a real one of 91.7% (IC95 56.6-101.7%), corresponding to 20 h/d (IC95 11–23). The more the brace was prescribed, the more compliant the patient was (94.8% in 23 h/d vs. 73.2% in 18 h/d, P < 0.05). Sixty percent of the patients had at least 90% compliance, and 45% remained within 1 hour of what had been prescribed. Non-wearing days were 0 (IC95 0–12.95), and involved 29% of patients. Conclusion This is the first study using a TB in a setting of respect for the SOSORT criteria for bracing, and it states that it is possible to achieve a very good compliance, even with a full time prescription, and better than what was previously reported (80% maximum). We hypothesize that the treating team (SOSORT criteria) plays a major role

  16. Organizational Designs for Achieving High Treatment Trial Enrollment: A Fuzzy-Set Analysis of the Community Clinical Oncology Program

    PubMed Central

    Weiner, Bryan J.; Jacobs, Sara R.; Minasian, Lori M.; Good, Marjorie J.

    2012-01-01

    Purpose: To examine the organizational design features that were consistently associated in 2010 with high levels of patient enrollment onto National Cancer Institute (NCI) cancer treatment trials among the oncology practices and hospitals participating in the NCI Community Clinical Oncology Program (CCOP). Methods: Fuzzy-set qualitative comparative analysis was used to identify the recipes (ie, combinations of organizational design features) that CCOPs used to achieve high levels of patient enrollment onto NCI treatment trials in 2010. Four organizational design features were examined: number of open treatment trials with at least one patient enrolled, number of newly diagnosed patients with cancer, number of CCOP-affiliated physicians, and number of CCOP-affiliated hospitals or practices where patient enrollment could occur. Data were obtained from NCI data systems and CCOP grant progress reports. Results: Two recipes were consistently associated with high levels of patient enrollment onto NCI treatment trials in 2010: having many open treatment trials and many new patients with cancer, and having many open treatment trials and many affiliated hospitals or practices. Together, these recipes accounted for nearly two thirds of CCOP membership in the high-performance set in 2010. Conclusion: No single organizational design feature, by itself, was consistently associated with high levels of patient enrollment onto NCI treatment trials in 2010. Having a large menu of active treatment trials may be necessary to achieve high–patient enrollment performance, but this is not sufficient unless combined with either large patient volume or many participating sites. PMID:23277765

  17. Two Flavonolignans from Milk Thistle (Silybum marianum) Inhibit CYP2C9-Mediated Warfarin Metabolism at Clinically Achievable Concentrations

    PubMed Central

    Brantley, Scott J.; Oberlies, Nicholas H.; Kroll, David J.

    2010-01-01

    Milk thistle (Silybum marianum) is a popular herbal product used for hepatoprotection and chemoprevention. Two commercially available formulations are the crude extract, silymarin, and the semipurified product, silibinin. Silymarin consists of at least seven flavonolignans, of which the most prevalent are the diastereoisomers silybin A and silybin B; silibinin consists only of silybin A and silybin B. Based on a recent clinical study showing an interaction between a silymarin product and the CYP2C9 substrate losartan, the CYP2C9 inhibition properties of silybin A and silybin B and corresponding regioisomers, isosilybin A and isosilybin B, were evaluated using human liver microsomes (HLMs), recombinant CYP2C9 (rCYP2C9) enzymes, and the clinically relevant probe, (S)-warfarin. Silybin B was the most potent inhibitor in HLMs, followed by silybin A, isosilybin B, and isosilybin A (IC50 of 8.2, 18, 74, and >100 μM, respectively). Next, silybin A and silybin B were selected for further characterization. As with HLMs, silybin B was more potent than silybin A toward rCYP2C9*1 (6.7 versus 12 μM), rCYP2C9*2 (9.3 versus 19 μM), and rCYP2C9*3 (2.4 versus 9.3 μM). Using a matrix of five substrate (1–15 μM) and six inhibitor (1–80 μM) concentrations and HLMs, both diastereoisomers inhibited (S)-warfarin 7-hydroxylation in a manner described best by a mixed-type inhibition model (Ki values of 4.8 and 10 μM for silybin B and silybin A, respectively). These observations, combined with the high systemic silibinin concentrations (>5–75 μM) achieved in a phase I study involving prostate cancer patients, prompt clinical evaluation of a potential warfarin-milk thistle interaction. PMID:19934397

  18. Making good theory practical: five lessons for an Applied Social Identity Approach to challenges of organizational, health, and clinical psychology.

    PubMed

    Haslam, S Alexander

    2014-03-01

    Social identity research was pioneered as a distinctive theoretical approach to the analysis of intergroup relations but over the last two decades it has increasingly been used to shed light on applied issues. One early application of insights from social identity and self-categorization theories was to the organizational domain (with a particular focus on leadership), but more recently there has been a surge of interest in applications to the realm of health and clinical topics. This article charts the development of this Applied Social Identity Approach, and abstracts five core lessons from the research that has taken this forward. (1) Groups and social identities matter because they have a critical role to play in organizational and health outcomes. (2) Self-categorizations matter because it is people's self-understandings in a given context that shape their psychology and behaviour. (3) The power of groups is unlocked by working with social identities not across or against them. (4) Social identities need to be made to matter in deed not just in word. (5) Psychological intervention is always political because it always involves some form of social identity management. Programmes that seek to incorporate these principles are reviewed and important challenges and opportunities for the future are identified.

  19. Subarachnoid Hemorrhage in Patients with Good Clinical Grade: Accuracy of 3.0-T MR Angiography for Detection and Characterization.

    PubMed

    Li, Minghua; Zhu, Yueqi; Song, Hongmei; Gu, Binxian; Lu, Haitao; Li, Yuehua; Tan, Huaqiao; Cheng, Yingsheng

    2017-02-23

    Purpose To evaluate the diagnostic accuracy of aneurysm detection and the fidelity of morphologic characterization of three-dimensional (3D) time-of-flight (TOF) magnetic resonance (MR) angiography at 3.0 T in patients with a Glasgow coma score of 15 and noncontrast material-enhanced computed tomography (CT) findings that showed acute nontraumatic subarachnoid hemorrhage. Materials and Methods The institutional review board approved this prospective study, and patients provided informed consent. A total of 277 patients who had not experienced trauma but in whom nonenhanced CT showed subarachnoid hemorrhage, who had a Glasgow coma score of 15, and who underwent both 3D TOF MR angiography and digital subtraction angiography (DSA) (the reference standard) were included. Three observers who were blinded to clinical and DSA results independently analyzed all 3D TOF MR angiographic data sets. The receiver operating characteristic curve was applied to analysis of the detection of aneurysms with 3D TOF MR angiography by using patient- and aneurysm-based evaluations. Multivariate logistic regression analysis was performed to identify aneurysm-specific variables, including size, shape (daughter sac/lobulation/margin), neck width (wide if > 4 mm or if fundus-to-neck ratio was < 2), and relation to adjacent artery, that significantly affected morphologic assessment with 3D TOF MR angiography. Results Aneurysms were depicted with DSA in 225 patients. In patient- and aneurysm-based evaluations, respectively, 3D TOF MR angiography yielded accuracies of 96.8% (268 of 277) and 96.6% (309 of 320), sensitivities of 98.2% (219 of 223) and 98.1% (260 of 265), specificities of 91% (49 of 54) and 89% (49 of 55), positive predictive values of 97.8% (219 of 224) and 97.7% (260 of 266), and negative predictive values of 92% (49 of 53) and 91% (49 of 54). Accuracy of display of morphologic features was 92.5% (236 of 255) for size, 86.3% (220 of 255) for neck width, 94.5% for shape (241 of

  20. Good Laboratory Practice (GLP) status of Asian countries and its implementation in non-clinical safety studies in pharmaceutical drug development.

    PubMed

    Sasaki, Madoka; Hinotsu, Shiro; Kawakami, Koji

    2009-10-01

    Non-clinical animal studies to assess the safety of compounds under development have to comply with Good Laboratory Practice (GLP). The Organization for Economic Co-operation and Development (OECD) has established the Mutual Acceptance of Data (MAD) system in OECD member countries for the mutual acceptance of non-clinical safety study data. Since 1997 non-OECD-member countries have also been able to participate in the MAD system, if the country meets the level of standardized compliance with OECD GLP. Thus, several Asian non-OECD countries are trying to develop their GLP standards in order to become official members of the MAD system. Pharmaceutical companies face significant expense in the drug-development process, including the cost of non-clinical safety studies; in response, companies in Asian countries are seeking to establish GLP facilities to provide cost-effective services for drug development. To assess the quality and cost of GLP performance in Asian countries, in this study we approached GLP facilities in a number of Asian countries to obtain price and quality information on a 'virtual compound' to be assessed in non-clinical safety studies. Also, the development status of GLP in Asian countries in terms of policy and infrastructure was analyzed. We found that, among Asian countries, India and Singapore may be candidates for participation in te MAD system in terms of their compliance with GLP, language, and costs. These findings will be beneficial to pharmaceutical companies planning GLP studies in Asian countries.

  1. Good Schools.

    ERIC Educational Resources Information Center

    Schoenheimer, Henry P.

    This book contains seventeen thumb-nail sketches of schools in Europe, the United States, Asia, Britain, and Australia, as they appeared in the eye of the author as a professional educator and a journalist while travelling around the world. The author considers the schools described to be good schools, and not necessarily the 17 best schools in…

  2. Premature Progesterone Rise Positively Correlates with Clinical Pregnancy Rate in In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI) Patients with good Ovarian Response.

    PubMed

    Cui, Na; Zhang, Jie; Xu, Yueming; Jiang, Lei; Yang, Aimin; Hao, Guimin

    2017-03-28

    Infertility affects millions of couples worldwide resulting in distress and depression. In the past several decades, in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) have been developed with high efficiency and success rate. The possible effects of gonadotropin administration on follicular metabolism have been discussed but the outcomes remain controversial. The aim of this study was to identify whether serum progesterone on the day of human chorionic gonadotropin (hCG) administration and the ratio of serum progesterone and the number of oocyte retrieved (P/O) had a predictive role for the outcomes of IVF/ICSI. Eight hundred and twenty-five patients were enrolled between January 2012 and December 2012. A positive correlation between progesterone and IVF/ICSI outcomes were found in patients with good ovarian response using receiver operating characteristic (ROC) curve. We found that when progesterone level was higher than 1.04 ng/ml in good ovarian responses, the implantation rate and clinical pregnancy rate were both reduced compared to the rates in patients exhibiting lower progesterone level (progesterone≤1.04 ng/ml). Moreover, the rise of serum progesterone on the day of hCG was negatively correlated with luteinizing hormone (LH) level. This study used 1.04 ng/ml as a definition of progesterone elevation and an adverse effect of serum progesterone rise was observed on clinical pregnancy rate.

  3. Use of focus group interviews with public health nurses to identify the efforts of and challenges faced by branches of the Japan Health Insurance Association to achieve good performance of the Specific Health Guidance initiatives.

    PubMed

    Hayashi, Fumi; Ozawa, Keiko; Kawabata, Teruko; Takemi, Yukari

    2016-01-01

    Objectives Aiming at improvement of the Japan Health Insurance Association's Specific Health Guidance initiatives and human resource development, we conducted a qualitative study to clarify the features necessary for and the challenges hindering the achievement of good performance of the initiatives.Methods From November 2014 to January 2015, we conducted 10 focus group interviews, each 90 minutes long, with 64 public health nurses from 10 Japan Health Insurance Association branches. In addition, self-administered questionnaires were administered to obtain the participants' basic characteristics. After we excluded one group for failing to meet our performance targets, we divided the remaining nine focus groups according to two patterns: Maintenance and Progress. The four focus groups fitting the Maintenance pattern had a well-established track record, and the five focus groups fitting the Progress pattern had a track record of good growth. Using open coding of the interview transcripts, we extracted efforts or needs in two domains, individual and branch, Then, we placed codes in eight main categories: [quality], [general practice], [dietary guidance practice], [success factor], [branch system], [training and skill development], [approach to the member office], and [past efforts]. We further extracted important subcategories based on their rates of appearance within branches.Results Data from 56 female public health nurses working at nine branches were included in the analysis. With respect to the individual domain, subcategories such as "building rapport," "creating the physical environment," and "taking the initiative in evaluating one's own lifestyle" in the 〈high emphasis〉 segment of the [general practice] category were common to both patterns. In addition, "increasing opportunities for training" and "enhancement of training program content" were found for both patterns in relation to the 〈demand〉 segment of the [training and skill development

  4. Good and not so good medical ethics.

    PubMed

    Rhodes, Rosamond

    2015-01-01

    In this paper, I provide a brief sketch of the purposes that medical ethics serves and what makes for good medical ethics. Medical ethics can guide clinical practice and biomedical research, contribute to the education of clinicians, advance thinking in the field, and direct healthcare policy. Although these are distinct activities, they are alike in several critical respects. Good medical ethics is coherent, illuminating, accurate, reasonable, consistent, informed, and measured. After this overview, I provide specific examples to illustrate some of the ways in which medical ethics could go wrong as a caution and a reminder that taking on the role of an ethicist involves serious responsibilities that must be exercised with care.

  5. Busulphan is active against neuroblastoma and medulloblastoma xenografts in athymic mice at clinically achievable plasma drug concentrations

    PubMed Central

    Boland, I; Vassal, G; Morizet, J; Terrier-Lacombe, M-J; Valteau-Couanet, D; Kalifa, C; Hartmann, O; Gouyette, A

    1999-01-01

    High-dose busulphan-containing chemotherapy regimens have shown high response rates in children with relapsed or refractory neuroblastoma, Ewing's sarcoma and medulloblastoma. However, the anti-tumour activity of busulfan as a single agent remains to be defined, and this was evaluated in athymic mice bearing advanced stage subcutaneous paediatric solid tumour xenografts. Because busulphan is highly insoluble in water, the use of several vehicles for enteral and parenteral administration was first investigated in terms of pharmacokinetics and toxicity. The highest bioavailability was obtained with busulphan in DMSO administered i.p. When busulphan was suspended in carboxymethylcellulose and given orally or i.p., the bioavailability was poor. Then, in the therapeutic experiments, busulphan in DMSO was administered i.p. on days 0 and 4. At the maximum tolerated total dose (50 mg kg−1), busulphan induced a significant tumour growth delay, ranging from 12 to 34 days in the three neuroblastomas evaluated and in one out of three medulloblastomas. At a dose level above the maximum tolerated dose, busulphan induced complete and partial tumour regressions. Busulphan was inactive in a peripheral primitive neuroectodermal tumour (PNET) xenograft. When busulphan pharmacokinetics in mice and humans were considered, the estimated systemic exposure at the therapeutically active dose in mice (113 μg h ml−1) was close to the mean total systemic exposure in children receiving high-dose busulphan (102.4 μg h ml−1). In conclusion, busulphan displayed a significant anti-tumour activity in neuroblastoma and medulloblastoma xenografts at plasma drug concentrations which can be achieved clinically in children receiving high-dose busulphan-containing regimens. 1999 Cancer Research Campaign PMID:10070870

  6. Perception of recovery after pediatric mild traumatic brain injury is influenced by the "good old days" bias: tangible implications for clinical practice and outcomes research.

    PubMed

    Brooks, Brian L; Kadoura, Basil; Turley, Brenda; Crawford, Susan; Mikrogianakis, Angelo; Barlow, Karen M

    2014-03-01

    Recovery from mild traumatic brain injury (mTBI) is primarily based on the resolution of post-concussive symptoms back to a premorbid level. However, the "good old days" bias means fewer premorbid symptoms are retrospectively recalled, thus skewing the determination of recovery relative to pre-injury. The objectives of this study were to investigate the "good old days" bias in pediatric mTBI and demonstrate the implications of this bias on perceived recovery. Children and adolescents 2-18 years old (mean = 10.9, SD = 4.4, N = 412) were recruited after sustaining an mTBI. Ratings of premorbid symptoms were provided: (a) in the Emergency Department (ED; by parents), (b) retrospectively at a 1-month follow-up (by parents and adolescents), and (c) retrospectively at a 3-month follow-up (by parents and adolescents). Parent ratings of premorbid symptoms decreased by 80% from the ED to 1-month post-injury (p < .001) but were stable from 1 to 3 months post-injury (p < .05). Adolescents premorbid ratings declined from 1 to 3 months post-injury. Slow recovery did not have a differential impact on premorbid reporting. Using premorbid ratings obtained in the ED, instead of retrospective symptom reporting at the time of follow-up, suggests that a significant minority of patients believed to be "not recovered" actually have the "same or lower" symptom ratings at 1 (29%) and 3 months (41%) post-injury compared with before the injury. The "good old days" bias is present in pediatric mTBI by 1-month post-injury, influences retrospective symptom reporting, and has measureable implications for determining recovery in research and clinical practice.

  7. Learners’ perspective: where and when pre-residency trainees learn more to achieve their core clinical competencies

    PubMed Central

    2016-01-01

    Purpose While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. Methods A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews. The questionnaire was based on the Accreditation Council for Graduate Medical Education core competencies. Results The majority of core clinical skills were acquired during their rotations in emergency medicine, general surgery, and cardiothoracic surgery. The semistructured interviews revealed that these departments required their trainees to be highly involved and analytical, and participate in clinical discourse. Conclusion The common factor among the three departments is an environment in which trainees are highly involved in clinical duties, and are expected to make first-contact patient encounters, participate in clinical discourse, interpret investigative results and arrive at their own conclusions. Work-based learning appear to be key to the trends observed, and further study is warranted to determine whether these findings are indicative of true acquisition of clinical competence. PMID:27907982

  8. Achieving appropriate design for developing world heath care: the case of a low-cost autoclave for primary health clinics.

    PubMed

    Cho, Hallie S; Tao, Gregory D; Winter, Amos

    2012-01-01

    In developing world health clinics, incidence of surgical site infection is 2 to 10 times higher than in developed world hospitals. This paper identifies lack of availability of appropriately designed, low-cost autoclaves in developing world health clinics as a major contributing factor to the dramatic gap in surgical site infection rates. The paper describes the process of developing a low-cost autoclave that addresses the unique challenges faced by developing world primary health clinics and discusses how appropriateness of design was determined. The resulting pressure cooker-based autoclave design was fabricated and tested against the CDC specifications. Twelve partnering clinics in Nepal trialed these autoclaves from July until December 2012.

  9. Pediatric Oncology Clinic Care Model: Achieving Better Continuity of Care for Patients in a Medium-sized Program.

    PubMed

    Johnston, Donna L; Halton, Jacqueline; Bassal, Mylène; Klaassen, Robert J; Mandel, Karen; Ramphal, Raveena; Simpson, Ewurabena; Peckan, Li

    2016-10-25

    Providing the best care in both the inpatient and outpatient settings to pediatric oncology patients is all programs goal. Using continuous improvement methodologies, we changed from a solely team-based physician care model to a hybrid model. All patients were assigned a dedicated oncologist. There would then be 2 types of weeks of outpatient clinical service. A "Doc of the Day" week where each oncologist would have a specific day in clinic when their assigned patients would be scheduled, and then a "Doc of the Week" week where one physician would cover clinic for the week. Patient satisfaction surveys done before and 14 months after changing the model of care showed that patients were very satisfied with the care they received in both models. A questionnaire to staff 14 months after changing showed that the biggest effect was increased continuity of care, followed by more efficient clinic workflow and increased consistency of care. Staff felt it provided better planning and delivery of care. A hybrid model of care with a primary physician for each patient and assigned clinic days, alternating with weeks of single physician coverage is a feasible model of care for a medium-sized pediatric oncology program.

  10. All the Vice Chancellor's Neuroscientists: Unity to Achieve Success in Solving Malaysia's Diseases via Upgrading Clinical Services and Neuroscience Research.

    PubMed

    Abdullah, Jafri Malin

    2013-05-01

    President Obama of the United States of America announced this April the Brain Research Through Advancing Innovative Neurotechnologies (BRAIN for short) investment, while Professor Henry Markram's team based in the European Union will spend over a billion euros on the Human Brain Project, breaking through the unknowns in the fifth science of the decade: Neuroscience. Malaysia's growth in the same field needs to be augmented, and thus the Universiti Sains Malaysia's vision is to excel in the field of clinical brain sciences, mind sciences and neurosciences. This will naturally bring up the level of research in the country simultaneously. Thus, a center was recently established to coordinate this venture. The four-year Integrated Neuroscience Program established recently will be a sustainable source of neuroscientists for the country. We hope to establish ourselves by 2020 as a global university with neurosciences research as an important flagship.

  11. Assessing Eating Disorder Risk: The Pivotal Role of Achievement Anxiety, Depression and Female Gender in Non-Clinical Samples

    PubMed Central

    Fragkos, Konstantinos C.; Frangos, Christos C.

    2013-01-01

    The objective of the present study was to assess factors predicting eating disorder risk in a sample of undergraduate students. A structured questionnaire was employed on a random sample (n = 1865) consisting of the following sections: demographics, SCOFF (Sick, Control, One stone, Fat, Food) questionnaire for screening eating disorders and the Achievement Anxiety Test and the Depression, Anxiety and Stress Scale. The students at risk for eating disorders (SCOFF score ≥2) were 39.7%. Eating disorder risk was more frequent in females, students with divorced parents, students who lived alone, students who were seeking a romantic relationship or were married, students who were at a post-secondary vocational institute/college (private-public) educational level and who were more likely to have marks under merit level. Also, the mean scores for the psychological factors of depression, stress and anxiety were higher in students with eating disorder risk. A logistic regression model was produced depicting that depression, stress, female gender, being married and searching for a romantic relationship were risk factors of having an eating disorder risk. The suggested psychological model examined with structural equation modelling signified the role of academic anxiety as an immediate precursor of general anxiety. Hence, college populations in Greece need organized infrastructures of nutrition health services and campaigns to assist in reducing the risk of eating disorders. PMID:23482057

  12. Clinical Outcome Assessments: Conceptual Foundation–Report of the ISPOR Clinical Outcomes Assessment – Emerging Good Practices for Outcomes Research Task Force DOES THIS HAVE TO BE LABLED AS PART 1

    PubMed Central

    Walton, Marc K; Powers, John H; Hobart, Jeremy; Patrick, Donald L; Marquis, Patrick; Vamvakas, Sprios; Isaac, Maria; Molsen, Elizabeth; Cano, Stefan J; Burke, Laurie

    2015-01-01

    An outcome assessment, the patient assessment used in an endpoint, is the measuring instrument that provides a rating or score (categorical or continuous) that is intended to represent some aspect of the patient’s health status. Outcome assessments are used to define efficacy endpoints when developing a therapy for a disease or condition. Most efficacy endpoints are based on specified clinical assessments of patients. When clinical assessments are used as clinical trial outcomes, they are called clinical outcome assessments (COAs). COAs include any assessment that may be influenced by human choices, judgment, or motivation, COAs must be well-defined and possess adequate measurement properties in order to demonstrate (directly or indirectly) the benefits of a treatment. In contrast, a biomarker assessment is one that is subject to little, if any, patient motivational or rater judgmental influence. This is the first of two reports by the ISPOR Clinical Outcomes Assessment – Emerging Good Practices for Outcomes Research Task Force. This report provides foundational definitions important for an understanding of COA measurement principles. The foundation provided in this report includes what it means to demonstrate a beneficial effect, how assessments of patients relate to the objective of showing a treatment’s benefit, and how these assessments are used in clinical trial endpoints. In addition, this report describes intrinsic attributes of patient assessments and clinical trial factors that can affect the properties of the measurements. These factors should be considered when developing or refining assessments. These considerations will aid investigators designing trials in their choice of using an existing assessment or developing a new outcome assessment. Although the focus of this report is in the development of a new COA to define endpoints in a clinical trial, these principles may be applied more generally. A critical element in appraising or developing a

  13. Effects of Achieving Target Measures in Rheumatoid Arthritis on Functional Status, Quality of Life, and Resource Utilization: Analysis of Clinical Practice Data

    PubMed Central

    Joo, Seongjung; Kawabata, Hugh; Al, Maiwenn J.; Allison, Paul D.; Rutten‐van Mölken, Maureen P. M. H.; Frits, Michelle L.; Iannaccone, Christine K.; Shadick, Nancy A.; Weinblatt, Michael E.

    2016-01-01

    Objective To evaluate associations between achieving guideline‐recommended targets of disease activity, defined by the Disease Activity Score in 28 joints using C‐reactive protein level (DAS28‐CRP) <2.6, the Simplified Disease Activity Index (SDAI) ≤3.3, or the Clinical Disease Activity Index (CDAI) ≤2.8, and other health outcomes in a longitudinal observational study. Methods Other defined thresholds included low disease activity (LDA), moderate (MDA), or severe disease activity (SDA). To control for intraclass correlation and estimate effects of independent variables on outcomes of the modified Health Assessment Questionnaire (M‐HAQ), the EuroQol 5‐domain (EQ‐5D; a quality‐of‐life measure), hospitalization, and durable medical equipment (DME) use, we employed mixed models for continuous outcomes and generalized estimating equations for binary outcomes. Results Among 1,297 subjects, achievement (versus nonachievement) of recommended disease targets was associated with enhanced physical functioning and lower health resource utilization. After controlling for baseline covariates, achievement of disease targets (versus LDA) was associated with significantly enhanced physical functioning based on SDAI ≤3.3 (ΔM‐HAQ −0.047; P = 0.0100) and CDAI ≤2.8 (−0.073; P = 0.0003) but not DAS28‐CRP <2.6 (−0.022; P = 0.1735). Target attainment was associated with significantly improved EQ‐5D (0.022–0.096; P < 0.0030 versus LDA, MDA, or SDA). Patients achieving guideline‐recommended disease targets were 36–45% less likely to be hospitalized (P < 0.0500) and 23–45% less likely to utilize DME (P < 0.0100). Conclusion Attaining recommended target disease‐activity measures was associated with enhanced physical functioning and health‐related quality of life. Some health outcomes were similar in subjects attaining guideline targets versus LDA. Achieving LDA is a worthy clinical objective in some patients. PMID:26238974

  14. Breakthrough cancer pain (BTcP): a synthesis of taxonomy, pathogenesis, therapy, and good clinical practice in adult patients in Italy.

    PubMed

    Zucco, Furio; Bonezzi, Cesare; Fornasari, Diego

    2014-07-01

    Pain presents in 80% of patients with advanced cancer, and 30% have periods of increased pain due to fluctuating intensity, known as breakthrough cancer pain (BTcP). BTcP is high-intensity, short-duration pain occurring in several episodes per day and is non-responsive to treatment. The clinical approach to BTcP is variable. A review of the literature was performed to provide clinicians and practitioners with a rational synthesis of the ongoing scientific debate on BTcP and to provide a basis for optimal clinical approach to BTcP in adult Italian patients. Data show that circadian exacerbations of pain should be carefully monitored, differentiating, if possible, between fluctuations of background pain (BP), end-of-dose effect, and BTcP. BTcP should be monitored in all care contexts in clinical practice and each care facility must have all the medications and products approved for use in BTcP at their disposal. Data show that knowledge about medications for BTcP is lacking: medications for BTcP treatment are not interchangeable, although containing the same active substance; each physician must know the specific characteristics of each medication, its pharmacological properties, limitations in clinical practice, specifics relating to titration and repeatability of administration, and technical specifics relating to the accessibility and delivery. Importantly, before choosing a rapid-onset opioid (ROO), it is essential to deeply understand the status of patient and the characteristics of their family unit/caregivers, taking into account the patient's progressive loss of autonomy and/or cognitive-relational functionality. When BTcP therapy is initiated or changed, special attention must be paid to training the patient and family members/caregivers, providing clear instructions regarding the timing of drug administration. The patient must already be treated effectively with opioids before introducing ROOs for control of BTcP.

  15. Effectiveness of Music Education for the Improvement of Reading Skills and Academic Achievement in Young Poor Readers: A Pragmatic Cluster-Randomized, Controlled Clinical Trial

    PubMed Central

    Cogo-Moreira, Hugo; de Ávila, Clara Regina Brandão; Ploubidis, George B.; Mari, Jair de Jesus

    2013-01-01

    Introduction Difficulties in word-level reading skills are prevalent in Brazilian schools and may deter children from gaining the knowledge obtained through reading and academic achievement. Music education has emerged as a potential method to improve reading skills because due to a common neurobiological substratum. Objective To evaluate the effectiveness of music education for the improvement of reading skills and academic achievement among children (eight to 10 years of age) with reading difficulties. Method 235 children with reading difficulties in 10 schools participated in a five-month, randomized clinical trial in cluster (RCT) in an impoverished zone within the city of São Paulo to test the effects of music education intervention while assessing reading skills and academic achievement during the school year. Five schools were chosen randomly to incorporate music classes (n = 114), and five served as controls (n = 121). Two different methods of analysis were used to evaluate the effectiveness of the intervention: The standard method was intention-to-treat (ITT), and the other was the Complier Average Causal Effect (CACE) estimation method, which took compliance status into account. Results The ITT analyses were not very promising; only one marginal effect existed for the rate of correct real words read per minute. Indeed, considering ITT, improvements were observed in the secondary outcomes (slope of Portuguese = 0.21 [p<0.001] and slope of math = 0.25 [p<0.001]). As for CACE estimation (i.e., complier children versus non-complier children), more promising effects were observed in terms of the rate of correct words read per minute [β = 13.98, p<0.001] and phonological awareness [β = 19.72, p<0.001] as well as secondary outcomes (academic achievement in Portuguese [β = 0.77, p<0.0001] and math [β = 0.49, p<0.001] throughout the school year). Conclusion The results may be seen as promising, but they are not, in themselves

  16. Development and characterization of a clinically compliant xeno-free culture medium in good manufacturing practice for human multipotent mesenchymal stem cells.

    PubMed

    Chase, Lucas G; Yang, Sufang; Zachar, Vladimir; Yang, Zheng; Lakshmipathy, Uma; Bradford, Jolene; Boucher, Shayne E; Vemuri, Mohan C

    2012-10-01

    Human multipotent mesenchymal stem cell (MSC) therapies are currently being tested in clinical trials for Crohn's disease, multiple sclerosis, graft-versus-host disease, type 1 diabetes, bone fractures, cartilage damage, and cardiac diseases. Despite remarkable progress in clinical trials, most applications still use traditional culture media containing fetal bovine serum or serum-free media that contain serum albumin, insulin, and transferrin. The ill-defined and variable nature of traditional culture media remains a challenge and has created a need for better defined xeno-free culture media to meet the regulatory and long-term safety requirements for cell-based therapies. We developed and tested a serum-free and xeno-free culture medium (SFM-XF) using human bone marrow- and adipose-derived MSCs by investigating primary cell isolation, multiple passage expansion, mesoderm differentiation, cellular phenotype, and gene expression analysis, which are critical for complying with translation to cell therapy. Human MSCs expanded in SFM-XF showed continual propagation, with an expected phenotype and differentiation potential to adipogenic, chondrogenic, and osteogenic lineages similar to that of MSCs expanded in traditional serum-containing culture medium (SCM). To monitor global gene expression, the transcriptomes of bone marrow-derived MSCs expanded in SFM-XF and SCM were compared, revealing relatively similar expression profiles. In addition, the SFM-XF supported the isolation and propagation of human MSCs from primary human marrow aspirates, ensuring that these methods and reagents are compatible for translation to therapy. The SFM-XF culture system allows better expansion and multipotentiality of MSCs and serves as a preferred alternative to serum-containing media for the production of large scale, functionally competent MSCs for future clinical applications.

  17. "You Need to Be a Good Listener": Recruiters' Use of Relational Communication Behaviors to Enhance Clinical Trial and Research Study Accrual.

    PubMed

    Morgan, Susan E; Occa, Aurora; Potter, JoNell; Mouton, Ashton; Peter, Megan E

    2017-02-01

    Medical and research professionals who discuss clinical trials and research studies with potential participants face an often daunting challenge, particularly when recruiting from minority and underserved populations. This study reports on findings from a focus group study of 63 research coordinators, study nurses, professional recruiters, and other professionals in Indianapolis, IN and Miami, FL who work to recruit from minority and underserved populations. These professionals discussed the importance of creating a sense of connection with potential participants as part of the recruitment and retention process. Building a relationship, however fleeting, involved a number of concrete behaviors, including listening to personal information, expressing empathy, and then providing reciprocal self-disclosures; having repeated contact, usually by working in the same environment over an extended period of time; demonstrating respect through politeness and the use of honorifics; going the extra mile for participants; offering flexibility in scheduling follow-up appointments; and creating a sense of personal and community trust by being truthful. The implications of these findings for clinical trial and research study accrual are discussed.

  18. Implant-supported overdenture manufactured using CAD/CAM techniques to achieve horizontal path insertion between the primary and secondary structure: A clinical case report

    PubMed Central

    Agustín-Panadero, Rubén; Peñarrocha-Oltra, David; Gomar-Vercher, Sonia; Ferreiroa, Alberto

    2015-01-01

    This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene. PMID:26140179

  19. The Benefits of Good Teaching Extend beyond Course Achievement

    ERIC Educational Resources Information Center

    Loes, Chad N.; Pascarella, Ernest T.

    2015-01-01

    This paper synthesizes research from the Wabash National Study on Liberal Arts Education, the National Study on Student Learning, and the Research on Iowa Student Experiences study that estimates the influence of certain effective instructional practices on a range of student outcomes. Student perceptions of two specific teacher…

  20. In patients with extensive subcutaneous emphysema, which technique achieves maximal clinical resolution: infraclavicular incisions, subcutaneous drain insertion or suction on in situ chest drain?

    PubMed

    Johnson, Charles H N; Lang, Sommer A; Bilal, Haris; Rammohan, Kandadai S

    2014-06-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: 'In patients with extensive subcutaneous emphysema, which technique achieves maximal clinical resolution: infraclavicular incisions, subcutaneous drain insertion or suction on in situ chest drain?'. Altogether more than 200 papers were found using the reported search, of which 14 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Subcutaneous emphysema is usually a benign, self-limiting condition only requiring conservative management. Interventions are useful in the context of severe patient discomfort, respiratory distress or persistent air leak. In the absence of any comparative study, it is not possible to choose definitively between infraclavicular incisions, drain insertion and increasing suction on an in situ drain as the best method for managing severe subcutaneous emphysema. All the three techniques described have been shown to provide effective relief. Increasing suction on a chest tube already in situ provided rapid relief in patients developing SE following pulmonary resection. A retrospective study showed resolution in 66%, increasing to 98% in those who underwent video-assisted thoracic surgery with identification and closure of the leak. Insertion of a drain into the subcutaneous tissue also provided rapid sustained relief. Several studies aided drainage by using regular compressive massage. Infraclavicular incisions were also shown to provide rapid relief, but were noted to be more invasive and carried the potential for cosmetic defect. No major complications were illustrated.

  1. High RAB25 expression is associated with good clinical outcome in patients with locally advanced head and neck squamous cell carcinoma

    PubMed Central

    Téllez-Gabriel, Marta; Arroyo-Solera, Irene; León, Xavier; Gallardo, Alberto; López, Montserrat; Céspedes, Maria V; Casanova, Isolda; López-Pousa, Antonio; Quer, Miquel; Mangues, Maria A; Barnadas, Agustí; Mangues, Ramón; Pavón, Miguel A

    2013-01-01

    Currently there are no molecular markers able to predict clinical outcome in locally advanced head and neck squamous cell carcinoma (HNSCC). In a previous microarray study, RAB25 was identified as a potential prognostic marker. The aim of this study was to analyze the association between RAB25 expression and clinical outcome in patients with locally advanced HNSCC treated with standard therapy. In a retrospective immunohistochemical study (n = 97), we observed that RAB25-negative tumors had lower survival (log-rank, P = 0.01) than patients bearing positive tumors. In an independent prospective mRNA study (n = 117), low RAB25 mRNA expression was associated with poor prognosis. Using classification and regression tree analysis (CART) we established two groups of patients according to their RAB25 mRNA level and their risk of death. Low mRNA level was associated with poor local recurrence-free (log-rank, P = 0.005), progression-free (log-rank, P = 0.002) and cancer-specific (log-rank, P < 0.001) survival. Multivariate Cox model analysis showed that low expression of RAB25 was an independent poor prognostic factor for survival (hazard ratio: 3.84, 95% confidence interval: 1.93–7.62, P < 0.001). Patients whose tumors showed high RAB25 expression had a low probability of death after treatment. We also found lower RAB25 expression in tumors than in normal tissue (Mann–Whitney U, P < 0.001). Moreover, overexpression of RAB25 in the UM-SCC-74B HNSCC cell line increased cisplatin sensitivity, and reduced cell migration and invasion. Our findings support a tumor suppressor role for RAB25 in HNSCC and its potential use to identify locally advanced patients with a high probability of survival after genotoxic treatment. PMID:24403269

  2. Good for the Self: Self-Compassion and Other Self-Related Constructs in Relation to Symptoms of Anxiety and Depression in Non-clinical Youths.

    PubMed

    Muris, Peter; Meesters, Cor; Pierik, Anna; de Kock, Bo

    This study examined relationships among self-compassion, self-esteem, and self-efficacy and symptoms of anxiety disorders and depression in a sample of 132 non-clinical adolescents aged 12-17 years. The results first of all indicated that the Shortened Self-Compassion Scale for Adolescents was reliable (i.e., all Cronbach's alphas were >.70) and valid in terms of both construct (as demonstrated by a principal components analysis which revealed the hypothesized three-factor structure) and concurrent validity (i.e., as shown by means of positive correlations with self-esteem and self-efficacy). Further, the expected negative correlations were found between self-compassion and anxiety and depression, indicating that higher levels of this self-related construct are associated with lower symptom levels, and vice versa. Of the three components of self-compassion, mindfulness appeared most convincingly related to symptoms of anxiety and depression. Finally, when controlling for other self-related constructs, self-compassion no longer accounted for a significant proportion in the variance of symptom levels. In contrast, self-esteem (depression) and in particular self-efficacy (anxiety and depression) did show unique explanatory power.

  3. [Creating a good relationship between hospital and clinic for the support of end-of-life home care patients-usefulness of questionnaires to indicate the capacity of home care-supporting clinics for palliative care].

    PubMed

    Takahashi, Osamu; Kato, Toshihiko; Shimizu, Kazuko; Chiba, Yasuko; Ishiguro, Motoko; Iwadare, Midori

    2012-12-01

    We have been practicing palliative care for terminal cancer patients at outpatient sections, patient wards, by home care, and by visiting nursing stations for the last 4 years. After the establishment of our palliative care unit in June 2011, it became difficult for us to provide sufficient home care support by ourselves, because of the increasing number of the patients and their widespread locations. It is therefore necessary to cooperate with regional medical clinics in order to support the patients who need home care even after their condition deteriorates. To determine the extent to which the home care-supporting clinics perform palliative care, we used an original questionnaire. Twenty-five clinics agreed to the publication of their names as our cooperating clinics. The number of patients who received palliative care at home from home care clinics after visiting our hospital increased from 8% to 14%, and the rate of patients who died at home also increased from 10% to 13%. Information about cooperating with home care clinics is very important and the improvement of palliative care skills necessary for home care doctors to continue their support for End-Of-Life cancer patients. Furthermore, the hospital should offer a strict and timely backup when the condition of patients treated at home suddenly deteriorates.

  4. Good Concrete Activity Is Good Mental Activity

    ERIC Educational Resources Information Center

    McDonough, Andrea

    2016-01-01

    Early years mathematics classrooms can be colourful, exciting, and challenging places of learning. Andrea McDonough and fellow teachers have noticed that some students make good decisions about using materials to assist their problem solving, but this is not always the case. These experiences lead her to ask the following questions: (1) Are…

  5. What Makes Teachers Good?

    ERIC Educational Resources Information Center

    Cruickshank, Donald R.

    2000-01-01

    Over time, variations in describing what constitutes good teaching have included ideal, analytic, effective, dutiful, competent, expert, reflective, satisfying, diversity-responsive, and respected. If good teaching could be observed and measured, the results would not indicate a one-size-fits-all model, but rather demonstrate that good teaching is…

  6. Depreciation of public goods in spatial public goods games

    NASA Astrophysics Data System (ADS)

    Shi, Dong-Mei; Zhuang, Yong; Li, Yu-Jian; Wang, Bing-Hong

    2011-10-01

    In real situations, the value of public goods will be reduced or even lost because of external factors or for intrinsic reasons. In this work, we investigate the evolution of cooperation by considering the effect of depreciation of public goods in spatial public goods games on a square lattice. It is assumed that each individual gains full advantage if the number of the cooperators nc within a group centered on that individual equals or exceeds the critical mass (CM). Otherwise, there is depreciation of the public goods, which is realized by rescaling the multiplication factor r to (nc/CM)r. It is shown that the emergence of cooperation is remarkably promoted for CM > 1 even at small values of r, and a global cooperative level is achieved at an intermediate value of CM = 4 at a small r. We further study the effect of depreciation of public goods on different topologies of a regular lattice, and find that the system always reaches global cooperation at a moderate value of CM = G - 1 regardless of whether or not there exist overlapping triangle structures on the regular lattice, where G is the group size of the associated regular lattice.

  7. Good Science, Good Sense and Good Sensibilities: The Three Ss of Carol Newton.

    PubMed

    Smith, Adrian J; Hawkins, Penny

    2016-11-11

    The Three Rs principle of Replacement, Reduction and Refinement developed by William M. S. Russell and Rex L. Burch in the 1950s has achieved worldwide recognition as a means of reducing the impact of science on animals and improving their welfare. However, application of the Three Rs is still far from universal, and evidence-based methods to implement the Three Rs are still lacking in many areas of laboratory animal science. The purpose of this paper is to create interest in a less well-known but equally useful principle that complements the Three Rs, which was proposed by the American biomathematician Carol M. Newton in the 1970s: the Three Ss-Good Science, Good Sense and Good Sensibilities.

  8. A Study of the Pre-Licensure Nursing Students' Perception of the Simulation Learning Environment as Helpful in Achieving Clinical Competencies and Their Perception of the Impact of the Level of Fidelity

    ERIC Educational Resources Information Center

    Crary, Wendy M.

    2012-01-01

    The research question of this study was: to what degree do nursing students perceive using the High Fidelity Simulation (HFS) learning environment to be helpful in their ability to achieve clinical competency. The research sub-questions (7) explored the students' demographics as an influence on rating of reality and helpfulness and the…

  9. Developing Good Practices

    ERIC Educational Resources Information Center

    Fox, Sharon E.

    1972-01-01

    Discusses some good oral reading concepts that teachers should consider when developing new classroom practices, including: round robin reading, silent reading before oral reading, shared reading, etc. (NL)

  10. Raising Boys' Achievement in Schools.

    ERIC Educational Resources Information Center

    Bleach, Kevan, Ed.

    This book offers insights into the range of strategies and good practice being used to raise the achievement of boys. Case studies by school-based practitioners suggest ideas and measures to address the issue of achievement by boys. The contributions are: (1) "Why the Likely Lads Lag Behind" (Kevan Bleach); (2) "Helping Boys Do…

  11. Cape of Good Hope

    Atmospheric Science Data Center

    2013-04-16

    article title:  Aerosol retrieval over Cape of Good Hope   ... Da image in the southern part of South Africa - the aerosol retrieval picks it up, and also the slightly clearer area in the middle. Also, ... MISR Science Teams Aug 23, 2000 - Aerosol retrieval over Cape of Good Hope. project:  MISR ...

  12. Cape of Good Hope

    Atmospheric Science Data Center

    2016-08-24

    article title:  Aerosol retrieval over Cape of Good Hope (Enlargement)     ... (MISR) image is an enlargement of the  aerosol retrieval over Cape of Good Hope, August 23, 2000 , showing a more detailed ... energy, so MISR's contribution is not only the aerosol retrieval necessary to do the correction, but the multi-angular integration. ...

  13. How Good Writers Punctuate.

    ERIC Educational Resources Information Center

    Dawkins, John

    The punctuation system presented in this paper has explanatory power insofar as it explains how good writers punctuate. The paper notes that good writers have learned, through reading, the differences among a hierarchy of marks and acquired a sense of independent clauses that allows them to use the hierarchy, along with a reader-sensitive notion…

  14. The Good Work.

    ERIC Educational Resources Information Center

    Csikszentmihalyi, Mihaly

    2003-01-01

    Examines the working lives of geneticists and journalists to place into perspective what lies behind personal ethics and success. Defines "good work" as productive activity that is valued socially and loved by people engaged in it. Asserts that certain cultural values, social controls, and personal standards are necessary to maintain good work and…

  15. Advice on Good Grooming.

    ERIC Educational Resources Information Center

    Tingey, Carol

    1987-01-01

    Suggestions are presented from parents on how to help children with disabilities (with particular focus on Downs Syndrome) learn good grooming habits in such areas as good health, exercise, cleanliness, teeth and hair care, skin care, glasses and other devices, and social behavior. (CB)

  16. What Are Good Universities?

    ERIC Educational Resources Information Center

    Connell, Raewyn

    2016-01-01

    This paper considers how we can arrive at a concept of the good university. It begins with ideas expressed by Australian Vice-Chancellors and in the "league tables" for universities, which essentially reproduce existing privilege. It then considers definitions of the good university via wish lists, classic texts, horror lists, structural…

  17. Productivity and Capital Goods.

    ERIC Educational Resources Information Center

    Zicht, Barbara, Ed.; And Others

    1981-01-01

    Providing teacher background on the concepts of productivity and capital goods, this document presents 3 teaching units about these ideas for different grade levels. The grade K-2 unit, "How Do They Do It?," is designed to provide students with an understanding of how physical capital goods add to productivity. Activities include a field trip to…

  18. When headaches are good.

    PubMed

    Packard, R C; Andrasik, F; Weaver, R

    1989-02-01

    Occasionally patients with headache present with the complaint of "a really good one." This paper examines three cases of patients with migraine who often referred to their headaches as "good." When the patients were asked what made the headaches good, they immediately tried to clarify their terminology as "just a figure of speech" that really meant bad. Further exploration usually revealed the headache symptoms had indeed been "good" in a relative sense, in that it had somehow served to help the patient avoid a more unpleasant emotional situation. The headache may have allowed a "time out" or a forced period of rest in a hectic schedule, resolved a conflict for the patient in an acceptable way by becoming sick, or represented a suppressed or repressed affect, usually anger. When headaches are described as good, there may very well be something in the patient's life that is worse.

  19. Reconsidering the "Good Divorce"

    PubMed

    Amato, Paul R; Kane, Jennifer B; James, Spencer

    2011-12-01

    This study attempted to assess the notion that a "good divorce" protects children from the potential negative consequences of marital dissolution. A cluster analysis of data on postdivorce parenting from 944 families resulted in three groups: cooperative coparenting, parallel parenting, and single parenting. Children in the cooperative coparenting (good divorce) cluster had the smallest number of behavior problems and the closest ties to their fathers. Nevertheless, children in this cluster did not score significantly better than other children on 10 additional outcomes. These findings provide only modest support for the good divorce hypothesis.

  20. Good vs. Bad Cholesterol

    MedlinePlus

    ... Venous Thromboembolism Aortic Aneurysm More Good vs. Bad Cholesterol Updated:Apr 3,2017 Cholesterol can't dissolve ... test . View an animation of cholesterol . LDL (Bad) Cholesterol LDL cholesterol is considered the “bad” cholesterol because ...

  1. A good death.

    PubMed

    2011-10-26

    Definitions of a good death often include being at home. Dying at home may be optimal for the patient but could place a significant burden on families and leave them with traumatic memories. Death in hospital should not mean that it is a 'bad death'. How someone dies is more important than where they die and nurses should be taught to provide good end of life care in all settings.

  2. Good Science, Good Sense and Good Sensibilities: The Three Ss of Carol Newton

    PubMed Central

    Smith, Adrian J.; Hawkins, Penny

    2016-01-01

    Simple Summary The use of animals in research is controversial and there are ongoing efforts to refine and limit their use to an absolute minimum. The Three Rs principle developed by William M. S. Russell and Rex L. Burch in the UK in the 1950s is widely used for this purpose: Replacement, Reduction and Refinement. Another useful principle which complements the Three Rs was proposed by Carol Newton in the 1970s. This principle is the Three Ss: Good Science, Good Sense and Good Sensibilities. Unlike the Three Rs, the Three Ss have not been described in detail in the literature. The purpose of this paper is to increase awareness of the Three Ss, which are a useful supplement to the Three Rs, improving animal welfare and leading to better science. Abstract The Three Rs principle of Replacement, Reduction and Refinement developed by William M. S. Russell and Rex L. Burch in the 1950s has achieved worldwide recognition as a means of reducing the impact of science on animals and improving their welfare. However, application of the Three Rs is still far from universal, and evidence-based methods to implement the Three Rs are still lacking in many areas of laboratory animal science. The purpose of this paper is to create interest in a less well-known but equally useful principle that complements the Three Rs, which was proposed by the American biomathematician Carol M. Newton in the 1970s: the Three Ss—Good Science, Good Sense and Good Sensibilities. PMID:27845707

  3. Low high-density lipoprotein cholesterol is a residual risk factor associated with long-term clinical outcomes in diabetic patients with stable coronary artery disease who achieve optimal control of low-density lipoprotein cholesterol.

    PubMed

    Ogita, Manabu; Miyauchi, Katsumi; Miyazaki, Tadashi; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Dohi, Tomotaka; Kasai, Takatoshi; Yokoyama, Takayuki; Okazaki, Shinya; Kurata, Takeshi; Daida, Hiroyuki

    2014-01-01

    Diabetes mellitus is recognized an independent risk factor for coronary artery disease (CAD) and mortality. Clinical trials have shown that statins significantly reduce cardiovascular events in diabetic patients. However, residual cardiovascular risk persists despite the achievement of target low-density lipoprotein cholesterol (LDL-C) levels with statin. High-density lipoprotein cholesterol (HDL-C) is an established coronary risk factor that is independent of LDL-C levels. We evaluated the impact of HDL-C on long-term mortality in diabetic patients with stable CAD who achieved optimal LDL-C. We enrolled 438 consecutive diabetic patients who were scheduled for percutaneous coronary intervention between 2004 and 2007 at our institution. We identified 165 patients who achieved target LDL-C <100 mg/dl. Patients were stratified into two groups according to HDL-C levels (low HDL-C group, baseline HDL-C <40 mg/dl; high HDL-C group, ≥40 mg/dl). Major adverse cardiac events (MACE) that included all-cause death, acute coronary syndrome, and target lesion revascularization were evaluated between the two groups. The median follow-up period was 946 days. The rate of MACE was significantly higher in diabetic patients with low-HDL-C who achieved optimal LDL-C (6.9 vs 17.9 %, log-rank P = 0.030). Multivariate Cox regression analysis showed that HDL-C is significantly associated with clinical outcomes (adjusted hazard ratio for MACE 1.33, 95 % confidence interval 1.01-1.75, P = 0.042). Low HDL-C is a residual risk factor that is significantly associated with long-term clinical outcomes among diabetic patients with stable CAD who achieve optimal LDL-C levels.

  4. Good clinical response to gefitinib in a non-small cell lung cancer patient harboring a rare somatic epidermal growth factor gene point mutation; codon 768 AGC > ATC in exon 20 (S768I).

    PubMed

    Masago, Katsuhiro; Fujita, Shiro; Irisa, Kaoru; Kim, Yung Hak; Ichikawa, Masataka; Mio, Tadashi; Mishima, Michiaki

    2010-11-01

    Recently, two small-molecule kinase inhibitors targeting epidermal growth factor receptor have proven effective in the treatment of non-small cell lung cancer. There are specific activating mutations within the tyrosine kinase domain of epidermal growth factor receptor related to the sensitivity of tyrosine kinase inhibitors. However, it is unknown whether rare mutations in the N-lobe (exons 18-20) and the C-lobe (exon 21) of the epidermal growth factor receptor kinase domain other than L858R in exon 21 and the in-frame deletion in exon 19 may predict the effectiveness of epidermal growth factor receptor-tyrosine kinase inhibitors. We reported a case of non-small cell lung cancer harboring a rare epidermal growth factor somatic mutation, codon 768 AGC > ATC in exon 20 (S768I), who showed a good clinical response to gefitinib. Therefore, we may suggest that this rare mutation (S768I in exon 20) may not be an insensitive epidermal growth factor receptor somatic mutation in vivo.

  5. Good Teachers: Who They Are and How We Fail Them

    ERIC Educational Resources Information Center

    Bunting, Carolyn

    2006-01-01

    In this article, the author describes what it takes to become a good teacher and what the system could do to develop good teachers. The author explains that good teachers chronicle their years by the number of flawed programs survived. The author notes that good teachers need to learn self-reliance. To achieve this, they need breathing room, and…

  6. Ecology and the Good

    ERIC Educational Resources Information Center

    Gustafson, James W.

    1971-01-01

    Our value system relating to the natural sciences is examined for its acceptability and worthiness. Scrutinized are the cognitive meanings about values, validity of values, subjective and cultural relativism, the good of objective realities, and cooperation with natural forces and God. (BL)

  7. Crafting Good Citizens

    ERIC Educational Resources Information Center

    Macedo, Stephen

    2004-01-01

    Americans are rightly concerned that schools are not providing students with the knowledge and habits necessary to be good citizens. With the notable exception of volunteer activity, every form of civic engagement among the young has declined. As a response, increasing attention is being paid to civic education in the schools. But strangely, at a…

  8. Restructuring for Good Governance

    ERIC Educational Resources Information Center

    Robert, Stephen; Carey, Russell C.

    2006-01-01

    American higher education has never been more in need of good governance than it is right now. Yet much of the structure many boards have inherited or created tends to stall or impede timely, well-informed, and broadly supported decision making. At many institutions (ours included), layers of governance have been added with each passing year,…

  9. Reconsidering the "Good Divorce"

    ERIC Educational Resources Information Center

    Amato, Paul R.; Kane, Jennifer B.; James, Spencer

    2011-01-01

    This study attempted to assess the notion that a "good divorce" protects children from the potential negative consequences of marital dissolution. A cluster analysis of data on postdivorce parenting from 944 families resulted in three groups: cooperative coparenting, parallel parenting, and single parenting. Children in the cooperative coparenting…

  10. Past and present achievements, and future direction of the Gastrointestinal Oncology Study Group (GIOSG), a Division of Japan Clinical Oncology Group (JCOG).

    PubMed

    Boku, Narikazu

    2011-12-01

    Initially, Gastrointestinal Study Group in Japan Clinical Oncology Group (GIOSG/JCOG) focused on gastric cancer. In 1980s, fluoropyrimidine, cisplatin and mitomycin C were key drugs. A randomized Phase II trial (JCOG8501) comparing futrafur plus mitomycin C and uracil plus futrafur and mitomycin C showed a higher response rate of uracil plus futrafur and mitomycin C than futrafur plus mitomycin C. From the results of two Phase II trials of etoposide, adriamycin and cisplatin, and cisplatin plus 5-fluorouracil, uracil plus futrafur and mitomycin C and cisplatin plus 5-fluorouracil were adopted for the test arms of the Phase III trial (JCOG9205) comparing with continuous infusion of 5-fluorouracil as a control arm. Neither cisplatin plus 5-fluorouracil nor uracil plus futrafur and mitomycin C showed a survival benefit over continuous infusion of 5-fluorouracil. In late 1990s, new agents, irinotecan and S-1, were developed for gastric cancer in Japan. GIOSG conducted a Phase III trial (JCOG9912) investigating superiority of irinotecan plus cisplatin and non-inferiority of monotherapy with S-1 compared with continuous infusion of 5-fluorouracil, and S-1 succeeded in showing non-inferiority. Then, SPIRITS trial showed a survival benefit of S-1 plus cisplatin over S-1, resulting in the establishment of a standard care for advanced gastric cancer in Japan. GIOSG have merged with Gastric Cancer Study Group as the Stomach Cancer Study Group (SCSG) from 2011. Recent progress in the development of new drugs has been remarkable. From the point of the roles shared with many other study groups for clinical trials, including registration trials of new drugs conducted by pharmaceutical companies, SCSG should recognize its role and conduct clinical trials with high quality for establishing new standard treatment.

  11. Ketones and lactate increase cancer cell "stemness," driving recurrence, metastasis and poor clinical outcome in breast cancer: achieving personalized medicine via Metabolo-Genomics.

    PubMed

    Martinez-Outschoorn, Ubaldo E; Prisco, Marco; Ertel, Adam; Tsirigos, Aristotelis; Lin, Zhao; Pavlides, Stephanos; Wang, Chengwang; Flomenberg, Neal; Knudsen, Erik S; Howell, Anthony; Pestell, Richard G; Sotgia, Federica; Lisanti, Michael P

    2011-04-15

    Previously, we showed that high-energy metabolites (lactate and ketones) "fuel" tumor growth and experimental metastasis in an in vivo xenograft model, most likely by driving oxidative mitochondrial metabolism in breast cancer cells. To mechanistically understand how these metabolites affect tumor cell behavior, here we used genome-wide transcriptional profiling. Briefly, human breast cancer cells (MCF7) were cultured with lactate or ketones, and then subjected to transcriptional analysis (exon-array). Interestingly, our results show that treatment with these high-energy metabolites increases the transcriptional expression of gene profiles normally associated with "stemness," including genes upregulated in embryonic stem (ES) cells. Similarly, we observe that lactate and ketones promote the growth of bonafide ES cells, providing functional validation. The lactate- and ketone-induced "gene signatures" were able to predict poor clinical outcome (including recurrence and metastasis) in a cohort of human breast cancer patients. Taken together, our results are consistent with the idea that lactate and ketone utilization in cancer cells promotes the "cancer stem cell" phenotype, resulting in significant decreases in patient survival. One possible mechanism by which these high-energy metabolites might induce stemness is by increasing the pool of Acetyl-CoA, leading to increased histone acetylation, and elevated gene expression. Thus, our results mechanistically imply that clinical outcome in breast cancer could simply be determined by epigenetics and energy metabolism, rather than by the accumulation of specific "classical" gene mutations. We also suggest that high-risk cancer patients (identified by the lactate/ketone gene signatures) could be treated with new therapeutics that target oxidative mitochondrial metabolism, such as the anti-oxidant and "mitochondrial poison" metformin. Finally, we propose that this new approach to personalized cancer medicine be termed

  12. All the Vice Chancellor’s Neuroscientists: Unity to Achieve Success in Solving Malaysia’s Diseases via Upgrading Clinical Services and Neuroscience Research

    PubMed Central

    Abdullah, Jafri Malin

    2013-01-01

    President Obama of the United States of America announced this April the Brain Research Through Advancing Innovative Neurotechnologies (BRAIN for short) investment, while Professor Henry Markram’s team based in the European Union will spend over a billion euros on the Human Brain Project, breaking through the unknowns in the fifth science of the decade: Neuroscience. Malaysia's growth in the same field needs to be augmented, and thus the Universiti Sains Malaysia’s vision is to excel in the field of clinical brain sciences, mind sciences and neurosciences. This will naturally bring up the level of research in the country simultaneously. Thus, a center was recently established to coordinate this venture. The four-year Integrated Neuroscience Program established recently will be a sustainable source of neuroscientists for the country. We hope to establish ourselves by 2020 as a global university with neurosciences research as an important flagship. PMID:23966818

  13. The Goods Upstairs Car Innovative Design

    NASA Astrophysics Data System (ADS)

    Wang, Feng-Lan; Zhang, Bo; Gao, Bo; Liu, Yan-Xin; Gao, Bo

    2016-05-01

    The design is a new kind of cars used for loading goods when you upstairs. The cars -- ones are very safe and convenient --consist of body, chassis, bottom, round, object, stage, upstairs, train wheels, handles, storage tank, security fence etc. The design, composed of combination of each structure, achieves the purpose of loading goods and even some large potted plants when you go upstairs or downstairs very flatly.

  14. Use of deception to achieve double-blinding in a clinical trial of Melaleuca alternifolia (tea tree) oil for the treatment of recurrent herpes labialis.

    PubMed

    Carson, Christine F; Smith, David W; Lampacher, Gail J; Riley, Thomas V

    2008-01-01

    Double-blinding is an important and widely implemented feature of clinical trials although its success is rarely assessed. In a randomized, placebo-controlled trial of tea tree oil, an aromatic essential oil, for the treatment of recurrent herpes labialis (RHL), or cold sores, deception was used to prevent volunteers from identifying their treatment allocation. Volunteers received placebo (n=102) or tea tree oil (n=112) ointment in preparation for their next episode of RHL and were told, falsely, that the aroma of the ointments had been changed to prevent identification of the treatment group. At the trial's end, of the volunteers who had used their ointment and presented for treatment assessment (n=100), approximately 50% correctly guessed their treatment allocation (P=0.774). Amongst volunteers that had not presented for treatment assessment (n=114), 12 volunteers did not provide blinding data and 46 did not open their tube. For the 56 volunteers who opened their tube, less than half of those receiving tea tree oil (44.4%) and only a small proportion of those on placebo (17.2%) were able to correctly identify their treatment allocation. Among the volunteers that were not treated, the P-value was 0.083. This study showed that the ethical use of deception may provide effective blinding in challenging circumstances.

  15. One of the Good Guys

    SciTech Connect

    Wiley, H. S.

    2010-10-01

    I was talking with some younger colleagues at a meeting last month when the subject of career goals came up. These colleagues were successful in that they had recently received tenure at top research universities and had some grants and good students. Thus, the early career pressure to simply survive was gone. So now what motivated them? Solving challenging and significant scientific problems was at the top of their lists. Interestingly, they were also motivated by a desire to become one of the “good guys” in science. The fact that being an important contributor to the scientific community can be fulfilling should not come as a surprise to anyone. However, what I do consider surprising is how rarely this seems to be discussed with students and postdocs. What we do discuss are either those issues that are fundamental aspects of the job (get a grant, get tenure, do research in an important field) or those that are important to our institutions. Knowing how to do our jobs well is indeed essential for any kind of professional success. However, achieving the right balance in our ambitions is also important for our happiness.

  16. A Good Death.

    PubMed

    Powell, Tia; Hulkower, Adira

    2017-01-01

    A good death is hard to find. Family members tell us that loved ones die in the wrong place-the hospital-and do not receive high-quality care at the end of life. This issue of the Hastings Center Report offers two articles from authors who strive to provide good end-of-life care and to prevent needless suffering. We agree with their goals, but we have substantial reservations about the approaches they recommend. Respect for the decisions of patients and their surrogates is a relatively new and still vulnerable aspect of medical care. For thousands of years, patients and surrogates had no say in medical decision-making. Today, standards support shared decision-making, but these articles both carve out exceptions to those standards, limiting the rights of patients and families in decisions about specific end-of-life treatments. As bioethics consultants in an acute care setting, we frequently confront conflicts similar to those described by Jeffrey Berger and by Ellen Robinson and colleagues. In such cases, our service emphasizes redoubled efforts at communication and mediation. Focusing on goals and values, rather than interventions, produces the best possible collaboration in health care decision-making. Cases in which we would overturn a surrogate's recommendations regarding palliative sedation or do-not-resuscitate orders are rare and require careful processes and clear evidence that the surrogate's choice is contrary to patient values.

  17. The Good Investment.

    PubMed

    Prescott, John E; Fresne, Julie A; Youngclaus, James A

    2017-01-24

    The authors reflect on the article in this issue entitled "Borrow or Serve? An Economic Analysis of Options for Financing a Medical School Education" by Marcu and colleagues, which makes a compelling case that a medical school education is a good investment, no matter what financing option students use, from federal service programs to federal loans. The lead author of this Commentary shares lessons learned from his own medical school education, which was funded by an Armed Forces Health Professions Scholarship, and from his current position interacting with medical students across the United States.Regardless of the financing path they choose, all students should understand basic financial concepts and the details of the various pathways that are available to pay for their medical school education, as well as how each could potentially impact their own future and that of their families. One underappreciated aspect of financing a medical school education is that federal repayment scenarios can link loan payments to income, rather than debt levels, which means that all physicians are able to afford their loan payments no matter what specialty they practice, what they are paid, or where they live.Medical education, while expensive, remains the good investment. An MD degree can lead to a lifetime of personal fulfillment and societal contributions. Everyone, with rare exceptions, accepted to a U.S. medical school will be able to finance their medical education via a path that aligns with their personal values and priorities.

  18. Patients' narratives concerning good and bad caring.

    PubMed

    Lövgren, G; Engström, B; Norberg, A

    1996-01-01

    Narratives from patients (n = 80) and patients' relatives (n = 12) were collected to illuminate experiences of good and bad caring episodes and to obtain descriptions of good caring. Narratives describing good caring included such task aspects as swift and correct assessment and access to information. Aspects less frequently mentioned were, for example, being given time, receiving pain relief and good food. Relationship aspects mentioned; having an interest shown in the care, being taken seriously and being cared about. There are parallels regarding relationship aspects between the narratives concerning good and bad caring episodes; for example what was praised in the good caring narratives was criticized in those describing bad caring. Such parallels were being/not being trusted, being/not being believed and being/not being respected. The narrations concerning bad caring were more specific and more vivid than those about good caring. The authors' interpretation was that the bad episodes were unexpected and very painful and therefore remained imprinted in the patients' memories. The descriptions of good caring included relationship aspects in only 34 cases, task aspects in only five cases and a combination of both in 50 cases. The ultimate purpose of the study was to obtain a basis for the development of a policy for good caring founded on patients' experiences. It is desirable that further studies be undertaken within various clinical specialties which would also take into consideration medical, social and cultural perspectives.

  19. Graded Achievement, Tested Achievement, and Validity

    ERIC Educational Resources Information Center

    Brookhart, Susan M.

    2015-01-01

    Twenty-eight studies of grades, over a century, were reviewed using the argument-based approach to validity suggested by Kane as a theoretical framework. The review draws conclusions about the meaning of graded achievement, its relation to tested achievement, and changes in the construct of graded achievement over time. "Graded…

  20. Sensory evaluation techniques - make "good for you" taste "good".

    PubMed

    Civille, Gail Vance; Oftedal, Katherine Nolen

    2012-11-05

    Sensory evaluation techniques are frequently used, however applied sensory is most often used within private industry. Basic sensory techniques can be an invaluable aid to research on nutritional or functional benefits of natural products such as whole fruits, nuts and vegetables (through varietal selection, breeding, etc.) in addition to clinical trials of botanicals. Products' sensory properties, including fruits and vegetables, must be tailored to ultimately appeal to the "consumer": no matter how healthy and nutritious a food is, if it does not appeal to its intended end user, it is unlikely to succeed in today's marketplace. This paper outlines the "5 S's" or basic principles of applied sensory testing; Subjects, Site, Samples, Statistics, and Sensory Methods. Two case studies are detailed where applied sensory is used to benefic academic research; one as a clinical trial of broccoli sprout extract, and the second as plant breeding research on strawberries. Finally, more in-depth techniques are discussed so that one can ensure that product sensory properties are aligned with consumer expectations, in other words, that sensory congruence is achieved.

  1. Eggs: good or bad?

    PubMed

    Griffin, Bruce A

    2016-08-01

    Eggs have one of the lowest energy to nutrient density ratios of any food, and contain a quality of protein that is superior to beef steak and similar to dairy. From a nutritional perspective, this must qualify eggs as 'good'. The greater burden of proof has been to establish that eggs are not 'bad', by increasing awareness of the difference between dietary and blood cholesterol, and accumulating sufficient evidence to exonerate eggs from their associations with CVD and diabetes. After 60 years of research, a general consensus has now been reached that dietary cholesterol, chiefly from eggs, exerts a relatively small effect on serum LDL-cholesterol and CVD risk, in comparison with other diet and lifestyle factors. While dietary guidelines have been revised worldwide to reflect this view, associations between egg intake and the incidence of diabetes, and increased CVD risk in diabetes, prevail. These associations may be explained, in part, by residual confounding produced by other dietary components. The strength of evidence that links egg intake to increased CVD risk in diabetes is also complicated by variation in the response of serum LDL-cholesterol to eggs and dietary cholesterol in types 1 and 2 diabetes. On balance, the answer to the question as to whether eggs are 'bad', is probably 'no', but we do need to gain a better understanding of the effects of dietary cholesterol and its association with CVD risk in diabetes.

  2. Suffering, compassion and 'doing good medical ethics'.

    PubMed

    de Zulueta, Paquita C

    2015-01-01

    'Doing good medical ethics' involves attending to both the biomedical and existential aspects of illness. For this, we need to bring in a phenomenological perspective to the clinical encounter, adopt a virtue-based ethic and resolve to re-evaluate the goals of medicine, in particular the alleviation of suffering and the role of compassion in everyday ethics.

  3. Competition in Healthcare: Good, Bad or Ugly?

    PubMed

    Goddard, Maria

    2015-08-01

    The role of competition in healthcare is much debated. Despite a wealth of international experience in relation to competition, evidence is mixed and contested and the debate about the potential role for competition is often polarised. This paper considers briefly some of the reasons for this, focusing on what is meant by "competition in healthcare" and why it is more valuable to think about the circumstances in which competition is more and less likely to be a good tool to achieve benefits, rather than whether or not it is "good" or "bad," per se.

  4. Defining the Good Reading Teacher.

    ERIC Educational Resources Information Center

    Kupersmith, Judy; And Others

    In the quest for a definition of the good reading teacher, a review of the literature shows that new or copious materials, one specific teaching method, and static teaching behaviors are not responsible for effective teaching. However, observations of five reading teachers, with good references and good reputations but with widely divergent…

  5. Leader as achiever.

    PubMed

    Dienemann, Jacqueline

    2002-01-01

    This article examines one outcome of leadership: productive achievement. Without achievement one is judged to not truly be a leader. Thus, the ideal leader must be a visionary, a critical thinker, an expert, a communicator, a mentor, and an achiever of organizational goals. This article explores the organizational context that supports achievement, measures of quality nursing care, fiscal accountability, leadership development, rewards and punishments, and the educational content and teaching strategies to prepare graduates to be achievers.

  6. Vertical Sextants give Good Sights

    NASA Astrophysics Data System (ADS)

    Dixon, Mark

    Many texts stress the need for marine sextants to be held precisely vertical at the instant that the altitude of a heavenly body is measured. Several authors lay particular emphasis on the technique of the instrument in a small arc about the horizontal axis to obtain a good sight. Nobody, to the author's knowledge, however, has attempted to quantify the errors involved, so as to compare them with other errors inherent in determining celestial position lines. This paper sets out to address these issues and to pose the question: what level of accuracy of vertical alignment can reasonably be expected during marine sextant work at sea ?When a heavenly body is brought to tangency with the visible horizon it is particularly important to ensure that the sextant is held in a truly vertical position. To this end the instrument is rocked gently about the horizontal so that the image of the body describes a small arc in the observer's field of vision. As Bruce Bauer points out, tangency with the horizon must be achieved during the process of rocking and not a second or so after rocking has been discontinued. The altitude is recorded for the instant that the body kisses the visible horizon at the lowest point of the rocking arc, as in Fig. 2. The only other visual clue as to whether the sextant is vertical is provided by the right angle made by the vertical edge of the horizon glass mirror with the horizon. There may also be some input from the observer's sense of balance and his hand orientation.

  7. There's No Romance without Finance: "Good Management Begins with Good People"

    ERIC Educational Resources Information Center

    Vicars, Dennis

    2008-01-01

    Centers and schools go out of business not for lack of program or good intentions. They failed because they lacked the ability to plan, budget, and utilize resources appropriately. A center or school can achieve almost any goal it desires, as long as a well-conceived plan is created and followed to the end. Yes, sometimes variables occur which…

  8. [Hashimoto's encephalopathy - rare encephalopathy with good prognosis].

    PubMed

    Kaczmarczyk, Aleksandra; Patalong-Ogiewa, M; Krzystanek, E

    2016-01-01

    Hashimoto's encephalopathy (HE) is a rare neuropsychiatric syndrome associated with increased level of antithyroid antibodies. Two types of clinical manifestation can be described: a vasculitic type with stroke like episodes and diffuse progressive type with deterioration of mental function. Neurologic symptoms are present in euthyreosis as well as in thyroid dysfunction. Because of good response to immunosuppressive therapy, the prompt diagnosis and management of HE are crucial. In this study we present the review of current literature and discuss two representative cases.

  9. Comparing Science Achievement Constructs: Targeted and Achieved

    ERIC Educational Resources Information Center

    Ferrara, Steve; Duncan, Teresa

    2011-01-01

    This article illustrates how test specifications based solely on academic content standards, without attention to other cognitive skills and item response demands, can fall short of their targeted constructs. First, the authors inductively describe the science achievement construct represented by a statewide sixth-grade science proficiency test.…

  10. Which Achievement Gap?

    ERIC Educational Resources Information Center

    Anderson, Sharon; Medrich, Elliott; Fowler, Donna

    2007-01-01

    From the halls of Congress to the local elementary school, conversations on education reform have tossed around the term "achievement gap" as though people all know precisely what that means. As it's commonly used, "achievement gap" refers to the differences in scores on state or national achievement tests between various…

  11. Pharmacodynamic Modeling of Clarithromycin against Macrolide-Resistant [PCR-Positive mef(A) or erm(B)] Streptococcus pneumoniae Simulating Clinically Achievable Serum and Epithelial Lining Fluid Free-Drug Concentrations

    PubMed Central

    Noreddin, Ayman M.; Roberts, Danielle; Nichol, Kim; Wierzbowski, Aleksandra; Hoban, Daryl J.; Zhanel, George G.

    2002-01-01

    The association between macrolide resistance mechanisms and clinical outcomes remains understudied. The present study, using an in vitro pharmacodynamic model, assessed clarithromycin (CLR) activity against mef(A)-positive and erm(B)-negative Streptococcus pneumoniae isolates by simulating free-drug concentrations in serum and both total (protein-bound and free) and free drug in epithelial lining fluid (ELF). Five mef(A)-positive and erm(B)-negative strains, one mef(A)-negative and erm(B)-positive strain, and a control [mef(A)-negative and erm(B)-negative] strain of S. pneumoniae were tested. CLR was modeled using a one-compartment model, simulating a dosage of 500 mg, per os, twice a day (in serum, free-drug Cp maximum of 2 μg/ml, t1/2 of 6 h; in ELF, CELF(total) maximum of 35μg/ml, t1/2 of 6 h; CELF(free) maximum of 14 μg/ml, t1/2 of 6 h). Starting inocula were 106 CFU/ml in Mueller-Hinton broth with 2% lysed horse blood. With sampling at 0, 4, 8, 12, 20, and 24 h, the extent of bacterial killing was assessed. Achieving CLR T/MIC values of ≥90% (AUC0-24/MIC ratio, ≥61) resulted in bacterial eradication, while T>MIC values of 40 to 56% (AUC0-24/MIC ratios of ≥30.5 to 38) resulted in a 1.2 to 2.0 log10 CFU/ml decrease at 24 h compared to that for the initial inoculum. CLR T/MIC values of ≤8% (AUC0-24/MIC ratio, ≤17.3) resulted in a static effect or bacterial regrowth. The high drug concentrations in ELF that were obtained clinically with CLR may explain the lack of clinical failures with mef(A)-producing S. pneumoniae strains, with MICs up to 8 μg/ml. However, mef(A) isolates for which MICs are ≥16 μg/ml along with erm(B) may result in bacteriological failures. PMID:12435719

  12. Pharmacodynamic modeling of clarithromycin against macrolide-resistant [PCR-positive mef(A) or erm(B)] Streptococcus pneumoniae simulating clinically achievable serum and epithelial lining fluid free-drug concentrations.

    PubMed

    Noreddin, Ayman M; Roberts, Danielle; Nichol, Kim; Wierzbowski, Aleksandra; Hoban, Daryl J; Zhanel, George G

    2002-12-01

    The association between macrolide resistance mechanisms and clinical outcomes remains understudied. The present study, using an in vitro pharmacodynamic model, assessed clarithromycin (CLR) activity against mef(A)-positive and erm(B)-negative Streptococcus pneumoniae isolates by simulating free-drug concentrations in serum and both total (protein-bound and free) and free drug in epithelial lining fluid (ELF). Five mef(A)-positive and erm(B)-negative strains, one mef(A)-negative and erm(B)-positive strain, and a control [mef(A)-negative and erm(B)-negative] strain of S. pneumoniae were tested. CLR was modeled using a one-compartment model, simulating a dosage of 500 mg, per os, twice a day (in serum, free-drug C(p) maximum of 2 micro g/ml, t(1/2) of 6 h; in ELF, C(ELF(total)) maximum of 35 micro g/ml, t(1/2) of 6 h; C(ELF(free)) maximum of 14 micro g/ml, t(1/2) of 6 h). Starting inocula were 10(6) CFU/ml in Mueller-Hinton broth with 2% lysed horse blood. With sampling at 0, 4, 8, 12, 20, and 24 h, the extent of bacterial killing was assessed. Achieving CLR T/MIC values of > or =90% (AUC(0-24)/MIC ratio, > or =61) resulted in bacterial eradication, while T>MIC values of 40 to 56% (AUC(0-24)/MIC ratios of > or =30.5 to 38) resulted in a 1.2 to 2.0 log(10) CFU/ml decrease at 24 h compared to that for the initial inoculum. CLR T/MIC values of < or =8% (AUC(0-24)/MIC ratio, < or =17.3) resulted in a static effect or bacterial regrowth. The high drug concentrations in ELF that were obtained clinically with CLR may explain the lack of clinical failures with mef(A)-producing S. pneumoniae strains, with MICs up to 8 micro g/ml. However, mef(A) isolates for which MICs are > or =16 micro g/ml along with erm(B) may result in bacteriological failures.

  13. Educating for Good Work: From Research to Practice

    ERIC Educational Resources Information Center

    Mucinskas, Daniel; Gardner, Howard

    2013-01-01

    Launched in 1995, the GoodWork Project is a long-term, multi-site effort to understand the nature of good work across the professional landscape and to promote its achievement by relevant groups of students and professionals. In this essay, the authors review the goals and methods of the initial research project and its most salient findings. They…

  14. What Are Good Child Outcomes?

    ERIC Educational Resources Information Center

    Moore, Kristin Anderson; Evans, V. Jeffery; Brooks-Gunn, Jeanne; Roth, Jodie

    This paper considers the question "What are good child outcomes?" from the perspectives of developmental psychology, economics, and sociology. Section 1 of the paper examines good child outcomes as characteristics of stage-salient tasks of development. Section 2 emphasizes the acquisition of "human capital," the development of productive traits…

  15. Enjoyment and the Good Life.

    ERIC Educational Resources Information Center

    Estes, Cheryl; Henderson, Karla

    2003-01-01

    Presents information to update parks and recreation professionals about what recent research says in regard to enjoyment and the good life, noting what applications this research has for practitioners. The article focuses on: the good life and leisure services; happiness, subjective well-being, and intrinsic motivation; leisure, happiness, and…

  16. Off to a Good Start.

    ERIC Educational Resources Information Center

    Hoffman, Carl

    1994-01-01

    Caring Start is a mobile-clinic program that provides prenatal care, well-baby clinics, childhood immunizations, counseling services, and contraceptives to rural poor families in northwest Pennsylvania. Before the mobile clinic, many rural women (mostly teenagers) went without prenatal health care due to lack of transportation. (LP)

  17. What 'makes' a good doctor?

    PubMed

    Huxham, G J; Lipton, A; Hamilton, D; Chant, D

    1989-01-01

    The relation between gender, personality, school scores, grades at medical school and eventual achievement as a medical practitioner 8 years after qualifying has been explored by path analysis in a cohort of medical students. Factor analysis of data derived from a questionnaire identified a significant factor accounting for 75% of the common variance of the professional achievement scores. Standardized path coefficients were computed to indicate the relative importance of the causal factors to postgraduate achievement. Gender played an important role at many levels. For example it was apparent that many of our women graduates were seriously disadvantaged in their professional careers. Of the school subjects, chemistry was a surprising long-term predictor of postgraduate achievement. Academic achievement during medical school training, particularly in the final year, was a significant predictor, while personality attributes made their contribution to one or other aspect of achievement at earlier stages in training but made little additional direct contribution to postgraduate performance.

  18. Good Law, Good Practice, Good Sense: Using Legal Guidelines for Drafting Educational Policies.

    ERIC Educational Resources Information Center

    Bogotch, Ira E.

    1988-01-01

    Suggests how to use legal guidelines for drafting educational policies. Analyzes the political context in which present policymaking and governance initiatives exist. Two assumptions frame this article. First, good law makes for good administrative practice. Second, administrator policymaking is more important than the content of the policy…

  19. Marge Good, RN, MPH, OCN | Division of Cancer Prevention

    Cancer.gov

    Marge Good is a nurse consultant in the Division of Cancer Prevention where she provided support to the Community Clinical Oncology Programs (CCOP) and Minority-Based CCOPs, and now provides support to the NCI Community Oncology Research Program (NCORP). |

  20. Food Science for the Public Good

    NASA Astrophysics Data System (ADS)

    Miller, Cassandra

    If you are interested in food science, looking for a meaningful career path, and are motivated by the desire to make a difference, you may find that a career working for the public good can be very rewarding. Often, such opportunities address issues of social responsibility, sustainability, public health, and/or economic development. Food scientists who choose this path typically have an interest in social and public health issues, and are usually driven by the achievement of some sort of social, health, or societal gain. As food science in itself is a very broad discipline, applying this knowledge for the public good can also take a variety of paths. Whether you're interested in manufacturing, food safety, nutrition, food policy, product development, quality control, marketing and sales, or any other discipline that makes up the diverse field of food science, various opportunities exist to make a difference to society.

  1. Good Show by Today's Students

    ERIC Educational Resources Information Center

    Lowry, W. Kenneth

    1977-01-01

    Investigates whether today's students would score as well as students of the 1930-1950 era on achievement tests. Uses the Progressive Achievement Test, a test widely used in the 1930-1950 era as a barometer of student ability. (RK)

  2. Measurement Error. For Good Measure....

    ERIC Educational Resources Information Center

    Johnson, Stephen; Dulaney, Chuck; Banks, Karen

    No test, however well designed, can measure a student's true achievement because numerous factors interfere with the ability to measure achievement. These factors are sources of measurement error, and the goal in creating tests is to have as little measurement error as possible. Error can result from the test design, factors related to individual…

  3. Good News About Childhood Cancer

    MedlinePlus

    ... Home Current Issue Past Issues Good News About Childhood Cancer Past Issues / Spring 2008 Table of Contents ... 85 percent for the most common form of childhood cancer (acute lymphoblastic leukemia or ALL). During the ...

  4. The ABCs of Good Zzzzzs

    MedlinePlus

    ... for you in a new report. The key indicators include: sleeping at least 85 percent of the ... outlined research needed to identify and describe more indicators of good sleep quality among people of all ...

  5. Diet and good health (image)

    MedlinePlus

    ... age. A healthy diet is especially important for children since a variety of food is needed for proper development. Other elements of good health include exercise, rest and avoidance of stimulants such as sugar and caffeine.

  6. Achieving Cannabis Cessation - Evaluating N-acetylcysteine Treatment (ACCENT): Design and implementation of a multi-site, randomized controlled study in the National Institute on Drug Abuse Clinical Trials Network

    PubMed Central

    McClure, Erin A.; Sonne, Susan C.; Winhusen, Theresa; Carroll, Kathleen M.; Ghitza, Udi E.; McRae-Clark, Aimee L.; Matthews, Abigail G.; Sharma, Gaurav; Van Veldhuisen, Paul; Vandrey, Ryan G.; Levin, Frances R.; Weiss, Roger D.; Lindblad, Robert; Allen, Colleen; Mooney, Larissa J.; Haynes, Louise; Brigham, Gregory S.; Sparenborg, Steve; Hasson, Albert L.; Gray, Kevin M.

    2014-01-01

    Despite recent advances in behavioral interventions for cannabis use disorders, effect sizes remain modest, and few individuals achieve long-term abstinence. One strategy to enhance outcomes is the addition of pharmacotherapy to complement behavioral treatment, but to date no efficacious medications targeting cannabis use disorders in adults through large, randomized controlled trials have been identified. The National Institute on Drug Abuse Clinical Trials Network (NIDA CTN) is currently conducting a study to test the efficacy of N-acetylcysteine (NAC) versus placebo (PBO), added to contingency management, for cannabis cessation in adults (ages 18–50). This study was designed to replicate positive findings from a study in cannabis-dependent adolescents that found greater odds of abstinence with NAC compared to PBO. This paper describes the design and implementation of an ongoing 12-week, intent-to-treat, double-blind, randomized, placebo-controlled study with one follow-up visit four weeks post-treatment. Approximately 300 treatment-seeking cannabis-dependent adults will be randomized to NAC or PBO across six study sites in the United States. The primary objective of this 12-week study is to evaluate the efficacy of twice-daily orally-administered NAC (1200 mg) versus matched PBO, added to contingency management, on cannabis abstinence. NAC is among the first medications to demonstrate increased odds of abstinence in a randomized controlled study among cannabis users in any age group. The current study will assess the cannabis cessation efficacy of NAC combined with a behavioral intervention in adults, providing a novel and timely contribution to the evidence base for the treatment of cannabis use disorders. PMID:25179587

  7. Technical Excellence: A Requirement for Good Engineering

    NASA Technical Reports Server (NTRS)

    Gill, Paul S.; Vaughan, William W.

    2008-01-01

    Technical excellence is a requirement for good engineering. Technical excellence has many different ways of expressing itself within engineering. NASA has initiatives that address the enhancement of the Agency's technical excellence and thrust to maintain the associated high level of performance by the Agency on current programs/projects and as it moves into the Constellation Program and the return to the Moon with plans to visit Mars. This paper addresses some of the key initiatives associated with NASA's technical excellence thrust. Examples are provided to illustrate some results being achieved and plans to enhance these initiatives.

  8. 'No delays achiever'.

    PubMed

    2007-05-01

    The latest version of the NHS Institute for Innovation and Improvement's 'no delays achiever', a web based tool created to help NHS organisations achieve the 18-week target for GP referrals to first treatment, is available at www.nodelaysachiever.nhs.uk.

  9. Vicarious Achievement Orientation.

    ERIC Educational Resources Information Center

    Leavitt, Harold J.; And Others

    This study tests hypotheses about achievement orientation, particularly vicarious achievement. Undergraduate students (N=437) completed multiple-choice questionnaires, indicating likely responses of one person to the success of another. The sex of succeeder and observer, closeness of relationship, and setting (medical school or graduate school of…

  10. Heritability of Creative Achievement

    ERIC Educational Resources Information Center

    Piffer, Davide; Hur, Yoon-Mi

    2014-01-01

    Although creative achievement is a subject of much attention to lay people, the origin of individual differences in creative accomplishments remain poorly understood. This study examined genetic and environmental influences on creative achievement in an adult sample of 338 twins (mean age = 26.3 years; SD = 6.6 years). Twins completed the Creative…

  11. Confronting the Achievement Gap

    ERIC Educational Resources Information Center

    Gardner, David

    2007-01-01

    This article talks about the large achievement gap between children of color and their white peers. The reasons for the achievement gap are varied. First, many urban minorities come from a background of poverty. One of the detrimental effects of growing up in poverty is receiving inadequate nourishment at a time when bodies and brains are rapidly…

  12. Achievement-Based Resourcing.

    ERIC Educational Resources Information Center

    Fletcher, Mike; And Others

    1992-01-01

    This collection of seven articles examines achievement-based resourcing (ABR), the concept that the funding of educational institutions should be linked to their success in promoting student achievement, with a focus on the application of ABR to postsecondary education in the United Kingdom. The articles include: (1) "Introduction" (Mick…

  13. States Address Achievement Gaps.

    ERIC Educational Resources Information Center

    Christie, Kathy

    2002-01-01

    Summarizes 2 state initiatives to address the achievement gap: North Carolina's report by the Advisory Commission on Raising Achievement and Closing Gaps, containing an 11-point strategy, and Kentucky's legislation putting in place 10 specific processes. The North Carolina report is available at www.dpi.state.nc.us.closingthegap; Kentucky's…

  14. Implications of Good Samaritan laws for physicians.

    PubMed

    Paterick, Timothy J; Paterick, Barbara B; Paterick, Timothy E

    2008-01-01

    Good Samaritan laws are designed to encourage individuals, including physicians, to gratuitously render medical care in emergency situations. Through these laws, immunity from civil liability is provided to physicians who act in good faith to provide emergency care gratis. Historically, emergency care involved medical assistance given to persons in motor vehicle crashes or other emergency situations in which bystanders were present. Protection of physicians from allegations of negligence was a tactic of the legislative and judicial systems to encourage active clinical participation, rather than cautious nonparticipation, in emergency care. In some states and under defined circumstances, the immunity may apply in the hospital setting, as well as in the physician's office. Legislatures have continued to amend the statutes to expand the protection provided to physicians who offer emergency care. Judicial construction of the nature and scope of physician immunity has similarly expanded.

  15. Validation of electronic systems to collect patient-reported outcome (PRO) data-recommendations for clinical trial teams: report of the ISPOR ePRO systems validation good research practices task force.

    PubMed

    Zbrozek, Arthur; Hebert, Joy; Gogates, Gregory; Thorell, Rod; Dell, Christopher; Molsen, Elizabeth; Craig, Gretchen; Grice, Kenneth; Kern, Scottie; Hines, Sheldon

    2013-06-01

    Outcomes research literature has many examples of high-quality, reliable patient-reported outcome (PRO) data entered directly by electronic means, ePRO, compared to data entered from original results on paper. Clinical trial managers are increasingly using ePRO data collection for PRO-based end points. Regulatory review dictates the rules to follow with ePRO data collection for medical label claims. A critical component for regulatory compliance is evidence of the validation of these electronic data collection systems. Validation of electronic systems is a process versus a focused activity that finishes at a single point in time. Eight steps need to be described and undertaken to qualify the validation of the data collection software in its target environment: requirements definition, design, coding, testing, tracing, user acceptance testing, installation and configuration, and decommissioning. These elements are consistent with recent regulatory guidance for systems validation. This report was written to explain how the validation process works for sponsors, trial teams, and other users of electronic data collection devices responsible for verifying the quality of the data entered into relational databases from such devices. It is a guide on the requirements and documentation needed from a data collection systems provider to demonstrate systems validation. It is a practical source of information for study teams to ensure that ePRO providers are using system validation and implementation processes that will ensure the systems and services: operate reliably when in practical use; produce accurate and complete data and data files; support management control and comply with any existing regulations. Furthermore, this short report will increase user understanding of the requirements for a technology review leading to more informed and balanced recommendations or decisions on electronic data collection methods.

  16. Knowledge for the good of the individual and society: linking philosophy, disciplinary goals, theory, and practice.

    PubMed

    McCurry, Mary K; Revell, Susan M Hunter; Roy, Sr Callista

    2010-01-01

    Nursing as a profession has a social mandate to contribute to the good of society through knowledge-based practice. Knowledge is built upon theories, and theories, together with their philosophical bases and disciplinary goals, are the guiding frameworks for practice. This article explores a philosophical perspective of nursing's social mandate, the disciplinary goals for the good of the individual and society, and one approach for translating knowledge into practice through the use of a middle-range theory. It is anticipated that the integration of the philosophical perspective and model into nursing practice will strengthen the philosophy, disciplinary goal, theory, and practice links and expand knowledge within the discipline. With the focus on humanization, we propose that nursing knowledge for social good will embrace a synthesis of the individual and the common good. This approach converges vital and agency needs described by Hamilton and the primacy of maintaining the heritage of the good within the human species as outlined by Maritain. Further, by embedding knowledge development in a changing social and health care context, nursing focuses on the goals of clinical reasoning and action. McCubbin and Patterson's Double ABCX Model of Family Adaptation was used as an example of a theory that can guide practice at the community and global level. Using the theory-practice link as a foundation, the Double ABCX model provides practising nurses with one approach to meet the needs of individuals and society. The integration of theory into nursing practice provides a guide to achieve nursing's disciplinary goals of promoting health and preventing illness across the globe. When nursing goals are directed at the synthesis of the good of the individual and society, nursing's social and moral mandate may be achieved.

  17. Independent Mobility Achieved through a Wireless Brain-Machine Interface

    PubMed Central

    Xu, Zhiming; Kyar, Toe K.; Ho, Duncun; Lim, Clement; Chan, Louiza; Chua, Yuanwei; Yao, Lei; Cheong, Jia Hao; Lee, Jung Hyup; Vishal, Kulkarni Vinayak; Guo, Yongxin; Chen, Zhi Ning; Lim, Lay K.; Li, Peng; Liu, Lei; Zou, Xiaodan; Ang, Kai K.; Gao, Yuan; Ng, Wai Hoe; Han, Boon Siew; Chng, Keefe; Guan, Cuntai; Je, Minkyu; Yen, Shih-Cheng

    2016-01-01

    Individuals with tetraplegia lack independent mobility, making them highly dependent on others to move from one place to another. Here, we describe how two macaques were able to use a wireless integrated system to control a robotic platform, over which they were sitting, to achieve independent mobility using the neuronal activity in their motor cortices. The activity of populations of single neurons was recorded using multiple electrode arrays implanted in the arm region of primary motor cortex, and decoded to achieve brain control of the platform. We found that free-running brain control of the platform (which was not equipped with any machine intelligence) was fast and accurate, resembling the performance achieved using joystick control. The decoding algorithms can be trained in the absence of joystick movements, as would be required for use by tetraplegic individuals, demonstrating that the non-human primate model is a good pre-clinical model for developing such a cortically-controlled movement prosthetic. Interestingly, we found that the response properties of some neurons differed greatly depending on the mode of control (joystick or brain control), suggesting different roles for these neurons in encoding movement intention and movement execution. These results demonstrate that independent mobility can be achieved without first training on prescribed motor movements, opening the door for the implementation of this technology in persons with tetraplegia. PMID:27802344

  18. Independent Mobility Achieved through a Wireless Brain-Machine Interface.

    PubMed

    Libedinsky, Camilo; So, Rosa; Xu, Zhiming; Kyar, Toe K; Ho, Duncun; Lim, Clement; Chan, Louiza; Chua, Yuanwei; Yao, Lei; Cheong, Jia Hao; Lee, Jung Hyup; Vishal, Kulkarni Vinayak; Guo, Yongxin; Chen, Zhi Ning; Lim, Lay K; Li, Peng; Liu, Lei; Zou, Xiaodan; Ang, Kai K; Gao, Yuan; Ng, Wai Hoe; Han, Boon Siew; Chng, Keefe; Guan, Cuntai; Je, Minkyu; Yen, Shih-Cheng

    2016-01-01

    Individuals with tetraplegia lack independent mobility, making them highly dependent on others to move from one place to another. Here, we describe how two macaques were able to use a wireless integrated system to control a robotic platform, over which they were sitting, to achieve independent mobility using the neuronal activity in their motor cortices. The activity of populations of single neurons was recorded using multiple electrode arrays implanted in the arm region of primary motor cortex, and decoded to achieve brain control of the platform. We found that free-running brain control of the platform (which was not equipped with any machine intelligence) was fast and accurate, resembling the performance achieved using joystick control. The decoding algorithms can be trained in the absence of joystick movements, as would be required for use by tetraplegic individuals, demonstrating that the non-human primate model is a good pre-clinical model for developing such a cortically-controlled movement prosthetic. Interestingly, we found that the response properties of some neurons differed greatly depending on the mode of control (joystick or brain control), suggesting different roles for these neurons in encoding movement intention and movement execution. These results demonstrate that independent mobility can be achieved without first training on prescribed motor movements, opening the door for the implementation of this technology in persons with tetraplegia.

  19. A Pretty Good Paper about Pretty Good Privacy.

    ERIC Educational Resources Information Center

    McCollum, Roy

    With today's growth in the use of electronic information systems for e-mail, data development and research, and the relative ease of access to such resources, protecting one's data and correspondence has become a great concern. "Pretty Good Privacy" (PGP), an encryption program developed by Phil Zimmermann, may be the software tool that…

  20. Answering the Complex Question of "How Good Is Good Enough?"

    ERIC Educational Resources Information Center

    Suskie, Linda

    2007-01-01

    Imagine that a student--let's call him Michael--has earned a score of 55 on an examination. How well did he do? Was his score good enough for him to pass the examination, or pass the course, or be deemed at least minimally competent in whatever the exam was assessing? Michael's score alone, in the absence of any other information, cannot answer…

  1. Achievability for telerobotic systems

    NASA Astrophysics Data System (ADS)

    Kress, Reid L.; Draper, John V.; Hamel, William R.

    2001-02-01

    Methods are needed to improve the capabilities of autonomous robots to perform tasks that are difficult for contemporary robots, and to identify those tasks that robots cannot perform. Additionally, in the realm of remote handling, methods are needed to assess which tasks and/or subtasks are candidates for automation. We are developing a new approach to understanding the capability of autonomous robotic systems. This approach uses formalized methods for determining the achievability of tasks for robots, that is, the likelihood that an autonomous robot or telerobot can successfully complete a particular task. Any autonomous system may be represented in achievability space by the volume describing that system's capabilities within the 3-axis space delineated by perception, cognition, and action. This volume may be thought of as a probability density with achievability decreasing as the distance from the centroid of the volume increases. Similarly, any task may be represented within achievability space. However, as tasks have more finite requirements for perception, cognition, and action, each may be represented as a point (or, more accurately, as a small sphere) within achievability space. Analysis of achievability can serve to identify, a priori, the survivability of robotic systems and the likelihood of mission success; it can be used to plan a mission or portions of a mission; it can be used to modify a mission plan to accommodate unpredicted occurrences; it can also serve to identify needs for modifications to robotic systems or tasks to improve achievability. .

  2. Religiosity as a public good.

    PubMed

    Sherlock, Richard

    2008-09-01

    Public Goods can be seen as one important way in which societies sustain themselves over time. These are part of the puzzle of the development of political order. Public goods like the rule of law are non-substractable and non-excludable . For economists the classic textbook examples are national defense and police protection. In this paper I argue that religiosity can function like police protection, a means of sustaining order through fear of punishment from a transcendent source. As a means of reducing defection from social norms it has a role to play as a public good. But religion cannot at the same time be seen as the source of such norms or dissention will undermine the very order that punishment seems to reinforce.

  3. Culture and Achievement Motivation

    ERIC Educational Resources Information Center

    Maehr, Martin L.

    1974-01-01

    A framework is suggested for the cross-cultural study of motivation that stresses the importance of contextual conditions in eliciting achievement motivation and emphasizes cultural relativity in the definition of the concept. (EH)

  4. Achieving Salary Equity

    ERIC Educational Resources Information Center

    Nevill, Dorothy D.

    1975-01-01

    Three techniques are outlined for use by higher education institutions to achieve salary equity: salary prediction (using various statistical procedures), counterparting (comparing salaries of persons of similar rank), and grievance procedures. (JT)

  5. What is stereoscopic vision good for?

    NASA Astrophysics Data System (ADS)

    Read, Jenny C. A.

    2015-03-01

    Stereo vision is a resource-intensive process. Nevertheless, it has evolved in many animals including mammals, birds, amphibians and insects. It must therefore convey significant fitness benefits. It is often assumed that the main benefit is improved accuracy of depth judgments, but camouflage breaking may be as important, particularly in predatory animals. In humans, for the last 150 years, stereo vision has been turned to a new use: helping us reproduce visual reality for artistic purposes. By recreating the different views of a scene seen by the two eyes, stereo achieves unprecedented levels of realism. However, it also has some unexpected effects on viewer experience. The disruption of established mechanisms for interpreting pictures may be one reason why some viewers find stereoscopic content disturbing. Stereo vision also has uses in ophthalmology. Clinical stereoacuity tests are used in the management of conditions such as strabismus and amblyopia as well as vision screening. Stereoacuity can reveal the effectiveness of therapy and even predict long-term outcomes post surgery. Yet current clinical stereo tests fall far short of the accuracy and precision achievable in the lab. At Newcastle University, we are exploiting the recent availability of autostereo 3D tablet computers to design a clinical stereotest app in the form of a game suitable for young children. Our goal is to enable quick, accurate and precise stereoacuity measures which will enable clinicians to obtain better outcomes for children with visual disorders.

  6. What Makes a Good Teacher?

    ERIC Educational Resources Information Center

    Ida, Zagyváné Szucs

    2017-01-01

    The introduction of the new Teacher Career Model, the School Inspectorate and the Complex School Assessment imply the basic question "What makes a good teacher?" The scholars have been focusing on the issue for a long period of time. The target of the recent studies is the teachers', school principals' and the teacher students' beliefs.…

  7. Measuring Goodness of Story Narratives

    ERIC Educational Resources Information Center

    Le, Karen; Coelho, Carl; Mozeiko, Jennifer; Grafman, Jordan

    2011-01-01

    Purpose: The purpose of this article was to evaluate a new measure of story narrative performance: story completeness. It was hypothesized that by combining organizational (story grammar) and completeness measures, story "goodness" could be quantified. Method: Discourse samples from 46 typically developing adults were compared with those from 24…

  8. Practicing Good Habits, Grade 2.

    ERIC Educational Resources Information Center

    Nguyen Van Quan; And Others

    This illustrated primer, designed for second grade students in Vietnam, consists of stories depicting rural family life in Vietnam. The book is divided into the following six chapters: (1) Practicing Good Habits (health, play, helpfulness); (2) Duties at Home (grandparents, father and mother, servants, the extended family; (3) Duties in School…

  9. Making the Common Good Common

    ERIC Educational Resources Information Center

    Chase, Barbara

    2011-01-01

    How are independent schools to be useful to the wider world? Beyond their common commitment to educate their students for meaningful lives in service of the greater good, can they educate a broader constituency and, thus, share their resources and skills more broadly? Their answers to this question will be shaped by their independence. Any…

  10. Metrics for Soft Goods Merchandising.

    ERIC Educational Resources Information Center

    Cooper, Gloria S., Ed.; Magisos, Joel H., Ed.

    Designed to meet the job-related metric measurement needs of students interested in soft goods merchandising, this instructional package is one of five for the marketing and distribution cluster, part of a set of 55 packages for metric instruction in different occupations. The package is intended for students who already know the occupational…

  11. Metrics for Hard Goods Merchandising.

    ERIC Educational Resources Information Center

    Cooper, Gloria S., Ed.; Magisos, Joel H., Ed.

    Designed to meet the job-related metric measurement needs of students interested in hard goods merchandising, this instructional package is one of five for the marketing and distribution cluster, part of a set of 55 packages for metric instruction in different occupations. The package is intended for students who already know the occupational…

  12. Gender Play and Good Governance

    ERIC Educational Resources Information Center

    Powell, Mark

    2008-01-01

    Like good government, thoughtful care of children requires those in power, whether teachers or parents, to recognize when it is appropriate for them to step back from day-to-day decision-making while still working behind the scenes to ensure an organizational structure that supports the independence and equitable development of those they serve.…

  13. What Good Are Conferences, Anyway?

    ERIC Educational Resources Information Center

    Pietro, David C.

    1996-01-01

    According to Frederick Herzberg's studies of employee motivation, humans are driven by motivating factors that allow them to grow psychologically and hygiene factors that help them meet physical needs. Good education conferences can enhance both factors by helping principals refocus their energies, exchange ideas with trusted colleagues, and view…

  14. Good and Bad Public Prose.

    ERIC Educational Resources Information Center

    Cockburn, Stewart

    1969-01-01

    The basic requirements of all good prose are clarity, accuracy, brevity, and simplicity. Especially in public prose--in which the meaning is the crux of the article or speech--concise, vigorous English demands a minimum of adjectives, a maximum use of the active voice, nouns carefully chosen, a logical argument with no labored or obscure points,…

  15. Are You a Good Protege?

    ERIC Educational Resources Information Center

    Perlmutter, David D.

    2008-01-01

    Perhaps getting advice seems a clearer-cut task than giving it. But at a time when budding academics seem busier and more distracted than ever, it is all the more important to understand how to learn from a mentor, and that being a good protege has its own strategies, techniques and responsibilities. The mentor relationship is alive and well in…

  16. The global public good concept: a means of promoting good veterinary governance.

    PubMed

    Eloit, M

    2012-08-01

    At the outset, the concept of a 'public good' was associated with economic policies. However, it has now evolved not only from a national to a global concept (global public good), but also from a concept applying solely to the production of goods to one encompassing societal issues (education, environment, etc.) and fundamental rights, including the right to health and food. Through their actions, Veterinary Services, as defined by the Terrestrial Animal Health Code (Terrestrial Code) of the World Organisation for Animal Health (OIE), help to improve animal health and reduce production losses. In this way they contribute directly and indirectly to food security and to safeguarding human health and economic resources. The organisation and operating procedures of Veterinary Services are therefore key to the efficient governance required to achieve these objectives. The OIE is a major player in global cooperation and governance in the fields of animal and public health through the implementation of its strategic standardisation mission and other programmes for the benefit of Veterinary Services and OIE Member Countries. Thus, the actions of Veterinary Services and the OIE deserve to be recognised as a global public good, backed by public investment to ensure that all Veterinary Services are in a position to apply the principles of good governance and to comply with the international standards for the quality of Veterinary Services set out in the OIE Terrestrial Code (Section 3 on Quality of Veterinary Services) and Aquatic Animal Health Code (Section 3 on Quality of Aquatic Animal Health Services).

  17. Cooperation and the common good

    PubMed Central

    Johnstone, Rufus A.; Rodrigues, António M. M.

    2016-01-01

    In this paper, we draw the attention of biologists to a result from the economic literature, which suggests that when individuals are engaged in a communal activity of benefit to all, selection may favour cooperative sharing of resources even among non-relatives. Provided that group members all invest some resources in the public good, they should refrain from conflict over the division of these resources. The reason is that, given diminishing returns on investment in public and private goods, claiming (or ceding) a greater share of total resources only leads to the actor (or its competitors) investing more in the public good, such that the marginal costs and benefits of investment remain in balance. This cancels out any individual benefits of resource competition. We illustrate how this idea may be applied in the context of biparental care, using a sequential game in which parents first compete with one another over resources, and then choose how to allocate the resources they each obtain to care of their joint young (public good) versus their own survival and future reproductive success (private good). We show that when the two parents both invest in care to some extent, they should refrain from any conflict over the division of resources. The same effect can also support asymmetric outcomes in which one parent competes for resources and invests in care, whereas the other does not invest but refrains from competition. The fact that the caring parent gains higher fitness pay-offs at these equilibria suggests that abandoning a partner is not always to the latter's detriment, when the potential for resource competition is taken into account, but may instead be of benefit to the ‘abandoned’ mate. PMID:26729926

  18. Association between the Achievement of Target Range CKD-MBD Markers and Mortality in Prevalent Hemodialysis Patients in Taiwan by Using the Kidney Disease: Improving Global Outcomes Clinical Guidelines

    PubMed Central

    Cheng, Ben-Chung; Lee, Chih-Hsiung; Chang, Wen-Xiu

    2016-01-01

    Background. This study evaluated the association between achieving target chronic kidney disease-mineral and bone disorder (CKD-MBD) marker levels and mortality in Taiwanese hemodialysis (HD) patients. Target levels were based on the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Methods. We performed a retrospective medical record review of 1126 HD patients between 2009 and 2013. A logistic regression model was used to evaluate the relationship between achieving target marker levels and the risk for all-cause and cardiovascular (CV) mortality. Reference target ranges were 7.9 ≤ calcium (Ca) ≤ 9.9 mg/dL, 2.4 ≤ phosphate (P) ≤ 4.7 mg/dL, and 144 ≤ intact parathyroid hormone (iPTH) ≤ 648 pg/mL. Results. Achievement of target P levels was associated with a lower risk for all-cause mortality compared to achievement of either target Ca or iPTH levels. Achieving target P + iPTH levels (OR 1.32) was associated with a lower odds ratio for all-cause mortality compared to achieving target Ca + P (OR 1.66) and Ca + iPTH (OR 1.43) levels. Similar trends were observed for CV mortality risk. Conclusions. The present study demonstrated that achieving serum P levels within the KDIGO target range is the most important factor for lowering mortality in HD patients. PMID:28003998

  19. The Parent Perspective: “Being a Good Parent” When Making Critical Decisions in the PICU

    PubMed Central

    October, Tessie W.; Fisher, Kiondra R.; Feudtner, Chris; Hinds, Pamela S.

    2015-01-01

    Objective To identify factors important to parents making decisions for their critically ill child. Design Prospective cross-sectional study. Setting Single center, tertiary care PICU. Subjects Parents making critical treatment decisions for their child. Intervention One-on-one interviews that used the Good Parent Tool-2 open-ended question that asks parents to describe factors important for parenting their ill child and how clinicians could help them achieve their definition of “being a good parent” to their child. Parent responses were analyzed thematically. Parents also ranked themes in order of importance to them using the Good Parent Ranking Exercise. Measurement and Main Results Of 53 eligible parents, 43 (81%) participated. We identified nine themes through content analysis of the parent’s narrative statements from the Good Parent Tool. Most commonly (60% of quotes) components of being a good parent described by parents included focusing on their child’s quality of life, advocating for their child with the medical team, and putting their child’s needs above their own. Themes key to parental decision making were similar regardless of parent race and socioeconomic status or child’s clinical status. We identified nine clinician strategies identified by parents as helping them fulfill their parenting role, most commonly, parents wanted to be kept informed (32% of quotes). Using the Good Parent Ranking Exercise, fathers ranked making informed medical decisions as most important, whereas mothers ranked focusing on the child’s health and putting their child’s needs above their own as most important. However, mothers who were not part of a couple ranked making informed medical decisions as most important. Conclusion These findings suggest a range of themes important for parents to “be a good parent” to their child while making critical decisions. Further studies need to explore whether clinician’s knowledge of the parent’s most valued factor

  20. Good Boys Are Problems Too!

    ERIC Educational Resources Information Center

    Warren, Simon

    2003-01-01

    The "problem" of boys' achievement in the United Kingdom has emerged as part of a policy response to a crisis in the post-war social settlement. Post-Fordism has become the dominant meta-policy of education reform in the United Kingdom, constituting both policy problems and solutions as gender-neutral. However, the economic and political…

  1. Are Standards Preventing Good Teaching?

    ERIC Educational Resources Information Center

    Berube, Clair T.

    2004-01-01

    The National Standards movement seeks to raise the quality of the American educational system. According to one of its chief architects, Diane Ravitch (2000), national standards give clear expectations for students, teachers, parents, colleges, and employers that will result in improved student achievement. Forty-nine of the fifty states (save…

  2. Switch for Good Community Program

    SciTech Connect

    Crawford, Tabitha; Amran, Martha

    2013-11-19

    Switch4Good is an energy-savings program that helps residents reduce consumption from behavior changes; it was co-developed by Balfour Beatty Military Housing Management (BB) and WattzOn in Phase I of this grant. The program was offered at 11 Navy bases. Three customer engagement strategies were evaluated, and it was found that Digital Nudges (a combination of monthly consumption statements with frequent messaging via text or email) was most cost-effective.

  3. Pure Red Cell Aplasia Associated with Good Syndrome

    PubMed Central

    Okui, Masayuki; Yamamichi, Takashi; Asakawa, Ayaka; Harada, Masahiko; Horio, Hirotoshi

    2017-01-01

    Pure red cell aplasia (PRCA) and hypogammaglobulinemia are paraneoplastic syndromes that are rarer than myasthenia gravis in patients with thymoma. Good syndrome coexisting with PRCA is an extremely rare pathology. We report the case of a 50-year-old man with thymoma and PRCA associated with Good syndrome who achieved complete PRCA remission after thymectomy and postoperative immunosuppressive therapy, and provide a review of the pertinent literature. PMID:28382272

  4. SALT and Spelling Achievement.

    ERIC Educational Resources Information Center

    Nelson, Joan

    A study investigated the effects of suggestopedic accelerative learning and teaching (SALT) on the spelling achievement, attitudes toward school, and memory skills of fourth-grade students. Subjects were 20 male and 28 female students from two self-contained classrooms at Kennedy Elementary School in Rexburg, Idaho. The control classroom and the…

  5. Iowa Women of Achievement.

    ERIC Educational Resources Information Center

    Ohrn, Deborah Gore, Ed.

    1993-01-01

    This issue of the Goldfinch highlights some of Iowa's 20th century women of achievement. These women have devoted their lives to working for human rights, education, equality, and individual rights. They come from the worlds of politics, art, music, education, sports, business, entertainment, and social work. They represent Native Americans,…

  6. Schools Achieving Gender Equity.

    ERIC Educational Resources Information Center

    Revis, Emma

    This guide is designed to assist teachers presenting the Schools Achieving Gender Equity (SAGE) curriculum for vocational education students, which was developed to align gender equity concepts with the Kentucky Education Reform Act (KERA). Included in the guide are lesson plans for classes on the following topics: legal issues of gender equity,…

  7. Achieving Peace through Education.

    ERIC Educational Resources Information Center

    Clarken, Rodney H.

    While it is generally agreed that peace is desirable, there are barriers to achieving a peaceful world. These barriers are classified into three major areas: (1) an erroneous view of human nature; (2) injustice; and (3) fear of world unity. In a discussion of these barriers, it is noted that although the consciousness and conscience of the world…

  8. Explorations in achievement motivation

    NASA Technical Reports Server (NTRS)

    Helmreich, Robert L.

    1982-01-01

    Recent research on the nature of achievement motivation is reviewed. A three-factor model of intrinsic motives is presented and related to various criteria of performance, job satisfaction and leisure activities. The relationships between intrinsic and extrinsic motives are discussed. Needed areas for future research are described.

  9. Increasing Male Academic Achievement

    ERIC Educational Resources Information Center

    Jackson, Barbara Talbert

    2008-01-01

    The No Child Left Behind legislation has brought greater attention to the academic performance of American youth. Its emphasis on student achievement requires a closer analysis of assessment data by school districts. To address the findings, educators must seek strategies to remedy failing results. In a mid-Atlantic district of the Unites States,…

  10. Appraising Reading Achievement.

    ERIC Educational Resources Information Center

    Ediger, Marlow

    To determine quality sequence in pupil progress, evaluation approaches need to be used which guide the teacher to assist learners to attain optimally. Teachers must use a variety of procedures to appraise student achievement in reading, because no one approach is adequate. Appraisal approaches might include: (1) observation and subsequent…

  11. Cognitive Processes and Achievement.

    ERIC Educational Resources Information Center

    Hunt, Dennis; Randhawa, Bikkar S.

    For a group of 165 fourth- and fifth-grade students, four achievement test scores were correlated with success on nine tests designed to measure three cognitive functions: sustained attention, successive processing, and simultaneous processing. This experiment was designed in accordance with Luria's model of the three functional units of the…

  12. Graders' Mathematics Achievement

    ERIC Educational Resources Information Center

    Bond, John B.; Ellis, Arthur K.

    2013-01-01

    The purpose of this experimental study was to investigate the effects of metacognitive reflective assessment instruction on student achievement in mathematics. The study compared the performance of 141 students who practiced reflective assessment strategies with students who did not. A posttest-only control group design was employed, and results…

  13. Achieving All Our Ambitions

    ERIC Educational Resources Information Center

    Hartley, Tricia

    2009-01-01

    National learning and skills policy aims both to build economic prosperity and to achieve social justice. Participation in higher education (HE) has the potential to contribute substantially to both aims. That is why the Campaign for Learning has supported the ambition to increase the proportion of the working-age population with a Level 4…

  14. Improving Educational Achievement.

    ERIC Educational Resources Information Center

    New York University Education Quarterly, 1979

    1979-01-01

    This is a slightly abridged version of the report of the National Academy of Education panel, convened at the request of HEW Secretary Joseph Califano and Assistant Secretary for Education Mary F. Berry, to study recent declines in student achievement and methods of educational improvement. (SJL)

  15. The Achievement Club

    ERIC Educational Resources Information Center

    Rogers, Ibram

    2009-01-01

    When Gabrielle Carpenter became a guidance counselor in Northern Virginia nine years ago, she focused on the academic achievement gap and furiously tried to close it. At first, she was compelled by tremendous professional interest. However, after seeing her son lose his zeal for school, Carpenter joined forces with other parents to form an…

  16. Achievement in Problem Solving

    ERIC Educational Resources Information Center

    Friebele, David

    2010-01-01

    This Action Research Project is meant to investigate the effects of incorporating research-based instructional strategies into instruction and their subsequent effect on student achievement in the area of problem-solving. The two specific strategies utilized are the integration of manipulatives and increased social interaction on a regular basis.…

  17. Essays on Educational Achievement

    ERIC Educational Resources Information Center

    Ampaabeng, Samuel Kofi

    2013-01-01

    This dissertation examines the determinants of student outcomes--achievement, attainment, occupational choices and earnings--in three different contexts. The first two chapters focus on Ghana while the final chapter focuses on the US state of Massachusetts. In the first chapter, I exploit the incidence of famine and malnutrition that resulted to…

  18. Advancing Student Achievement

    ERIC Educational Resources Information Center

    Walberg, Herbert J.

    2010-01-01

    For the last half century, higher spending and many modern reforms have failed to raise the achievement of students in the United States to the levels of other economically advanced countries. A possible explanation, says Herbert Walberg, is that much current education theory is ill informed about scientific psychology, often drawing on fads and…

  19. NCLB: Achievement Robin Hood?

    ERIC Educational Resources Information Center

    Bracey, Gerald W.

    2008-01-01

    In his "Wall Street Journal" op-ed on the 25th of anniversary of "A Nation At Risk", former assistant secretary of education Chester E. Finn Jr. applauded the report for turning U.S. education away from equality and toward achievement. It was not surprising, then, that in mid-2008, Finn arranged a conference to examine the…

  20. Hydroxyurea could be a good clinically relevant iron chelator.

    PubMed

    Italia, Khushnooma; Colah, Roshan; Ghosh, Kanjaksha

    2013-01-01

    Our previous study showed a reduction in serum ferritin of β-thalassemia patients on hydroxyurea therapy. Here we aimed to evaluate the efficacy of hydroxyurea alone and in combination with most widely used iron chelators like deferiprone and deferasirox for reducing iron from experimentally iron overloaded mice. 70 BALB/c mice received intraperitonial injections of iron-sucrose. The mice were then divided into 8 groups and were orally given hydroxyurea, deferiprone or deferasirox alone and their combinations for 4 months. CBC, serum-ferritin, TBARS, sTfr and hepcidin were evaluated before and after iron overload and subsequently after 4 months of drug therapy. All animals were then killed. Iron staining of the heart and liver tissue was done using Perl's Prussian Blue stain. Dry weight of iron in the heart and liver was determined by atomic absorption spectrometry. Increased serum-ferritin, TBARS, hepcidin and dry weight of iron in the liver and heart showed a significant reduction in groups treated with iron chelators with maximum reduction in the group treated with a combination of deferiprone, deferasirox and hydroxyurea. Thus hydroxyurea proves its role in reducing iron from iron overloaded mice. The iron chelating effect of these drugs can also be increased if given in combination.

  1. Adding concentrated solar power plants to wind farms to achieve a good utility electrical load match

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Texas has the greatest installed wind turbine capacity of any state in the United States, the percentage of wind capacity approaches 10% of the utilities capacity (in 2010 the total wind generated capacity in Texas was 8%). It is becomimg increasingly difficult for the utility to balance the elec...

  2. "Cheating" as Good Pedagogy: Bilingual Teachers Defying English-Only to Foster Student Achievement

    ERIC Educational Resources Information Center

    Reyes, Reynaldo, III

    2008-01-01

    "Cheating" is a form of resistance in pedagogy for bilingual educators. Bilingual educators "cheat" in classes where English as the only language of instruction is strictly imposed by school or district officials, but these teachers "cheat" by using the native language of their English language learners because they know they must. But, for many…

  3. From Good to Great: Designing a PDS Partnership that Increases Student Achievement by Preparing Better Educators

    ERIC Educational Resources Information Center

    Hill, Gloria; Lee, Valarie; Leftwich, Stacey

    2013-01-01

    The College of Education at Rowan University has held a long and continuing commitment to the tenets of the Professional Development School (PDS) movement. Two schools in the Rowan's network--Holly Glen Elementary and Edward R. Johnstone Elementary Schools--have a long history of exceptional commitment to continuous growth by all P-12 faculty and…

  4. Good News for New Orleans: Early Evidence Shows Reforms Lifting Student Achievement

    ERIC Educational Resources Information Center

    Harris, Douglas N.

    2015-01-01

    What happened to the New Orleans public schools following the tragic levee breeches after Hurricane Katrina is truly unprecedented. Within the span of one year, all public-school employees were fired, the teacher contract expired and was not replaced, and most attendance zones were eliminated. The state took control of almost all public schools…

  5. Selecting an appropriate caliper can be essential for achieving good balance with propensity score matching.

    PubMed

    Lunt, Mark

    2014-01-15

    Matching on the propensity score is widely used to estimate the effect of an exposure in observational studies. However, the quality of the matches can be affected by decisions made during the matching process, particularly the order in which subjects are selected for matching and the maximum permitted difference between matched subjects (the "caliper"). This study used simulations to explore the effects of these decisions on both the imbalance of covariates and the closeness of matching, while allowing the numbers of potential matches and strengths of association between the confounding variable and the exposure to vary. It was found that, without a caliper, substantial bias was possible, particularly with a relatively small reservoir of potential matches and strong confounder-exposure association. Use of the recommended caliper reduced the bias considerably, but bias remained if subjects were selected by increasing or decreasing propensity score. A tighter caliper led to greatly reduced bias and closer matches, although some subjects could not be matched. This study suggests that a narrow caliper can improve the performance of propensity score matching. In situations where it is impossible to find appropriate matches for all exposed subjects, it is better to select subjects in order of the best available matches, rather than increasing or decreasing the propensity score.

  6. "A Good Student, Trapped": Urban Minority Males and Constructions of Academic Achievement

    ERIC Educational Resources Information Center

    Anderson, Noel

    2004-01-01

    This article centres on the findings of an interpretive case study conducted at a college preparation program at a prestigious university in a major U.S. city that is grappling with a high attrition of poor and working class African American and Latino young men. The purpose of the study is to examine the underlying assumptions about equity and…

  7. Precepting Challenge: Helping the Student Attain the Affective Skills of a Good Midwife.

    PubMed

    Krause, Susan Agard

    2016-11-01

    Preparing students for a career in midwifery is a rewarding venture. The knowledge and techniques necessary to meet the requirements of a safe, beginning-level practitioner are familiar to experienced midwives. It is common for students to achieve learning outcomes in the classroom (actual or virtual) but struggle in the clinical setting. Other students may struggle academically but perform smoothly and comfortably when they apply knowledge and skills in the clinical setting. The cognitive and psychomotor domains of learning are represented by a student's application of knowledge and performance of skills. Affective skills of caring and professionalism are equally important. Research that describes characteristics of what is considered a good midwife identifies affective characteristics associated with effective midwifery practice. By attending equally to all domains of learning, the preceptor can more effectively support the student in attainment of the skills, values, and beliefs that make a good midwife. This article focuses on the acquisition of affective skills by students in the clinical setting. When affective skills are well developed, they require little attention, but if they are not, the recognition and remediation can be a difficult task for the preceptor. Acquisition of affective skills in the realms of caring and professionalism are necessary for midwifery practice. Effective teaching techniques and knowledge of the affective domain enhance the preceptors' ability to evaluate and remediate deficiencies.

  8. Faculty achievement tracking tool.

    PubMed

    Pettus, Sarah; Reifschneider, Ellen; Burruss, Nancy

    2009-03-01

    Faculty development and scholarship is an expectation of nurse educators. Accrediting institutions, such as the Commission on Collegiate Nursing Education, the National League for Nursing Accrediting Commission, and the Higher Learning Commission, all have criteria regarding faculty achievement. A faculty achievement tracking tool (FATT) was developed to facilitate documentation of accreditation criteria attainment. Based on criteria from accrediting organizations, the roles that are addressed include scholarship, service, and practice. Definitions and benchmarks for the faculty as an aggregate are included. Undergoing reviews from different accrediting organizations, the FATT has been used once for accreditation of the undergraduate program and once for accreditation of the graduate program. The FATT is easy to use and has become an excellent adjunct for the preparation for accreditation reports. In addition, the FATT may be used for yearly evaluations, advancement, and merit.

  9. Project ACHIEVE final report

    SciTech Connect

    1997-06-13

    Project ACHIEVE was a math/science academic enhancement program aimed at first year high school Hispanic American students. Four high schools -- two in El Paso, Texas and two in Bakersfield, California -- participated in this Department of Energy-funded program during the spring and summer of 1996. Over 50 students, many of whom felt they were facing a nightmare future, were given the opportunity to work closely with personal computers and software, sophisticated calculators, and computer-based laboratories -- an experience which their regular academic curriculum did not provide. Math and science projects, exercises, and experiments were completed that emphasized independent and creative applications of scientific and mathematical theories to real world problems. The most important outcome was the exposure Project ACHIEVE provided to students concerning the college and technical-field career possibilities available to them.

  10. Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics.

    PubMed

    Gillon, Raanan

    2015-01-01

    This paper argues that the four prima facie principles-beneficence, non-maleficence, respect for autonomy and justice-afford a good and widely acceptable basis for 'doing good medical ethics'. It confronts objections that the approach is simplistic, incompatible with a virtue-based approach to medicine, that it requires respect for autonomy always to have priority when the principles clash at the expense of clinical obligations to benefit patients and global justice. It agrees that the approach does not provide universalisable methods either for resolving such moral dilemmas arising from conflict between the principles or their derivatives, or universalisable methods for resolving disagreements about the scope of these principles-long acknowledged lacunae but arguably to be found, in practice, with all other approaches to medical ethics. The value of the approach, when properly understood, is to provide a universalisable though prima facie set of moral commitments which all doctors can accept, a basic moral language and a basic moral analytic framework. These can underpin an intercultural 'moral mission statement' for the goals and practice of medicine.

  11. Goode Gym Energy Renovation Project

    SciTech Connect

    Coleman, Andrena

    2014-12-11

    The Ida H. Goode Gymnasium was constructed in 1964 to serve as a focal point for academics, student recreation, and health and wellness activities. This 38,000 SF building contains a gymnasium with a stage, swimming pool, eight classrooms, a weight room, six offices and auxiliary spaces for the athletic programs. The gym is located on a 4-acre greenfield, which is slated for improvement and enhancement to future athletics program at Bennett College. The available funding for this project was used to weatherize the envelope of the gymnasium, installation of a new energy-efficient mechanical system, and a retrofit of the existing lighting systems in the building’s interior. The envelope weatherization was completed without disturbing the building’s historic preservation eligibility. The existing heating system was replaced with a new high efficiency condensing system. The new heating system also includes a new Building Automation System which provides additional monitoring. Proper usage of this system will provide additional energy savings. Most of the existing interior lighting fixtures and bulbs were replaced with new LED and high efficiency T-8 bulbs and fixtures. Occupancy sensors were installed in applicable areas. The Ida Goode Gymnasium should experience high electricity and natural gas savings as well as operational/maintenance efficiency increases. The aesthetics of the building was maintained and the overall safety was improved.

  12. Going public: good scientific conduct.

    PubMed

    Meyer, Gitte; Sandøe, Peter

    2012-06-01

    The paper addresses issues of scientific conduct regarding relations between science and the media, relations between scientists and journalists, and attitudes towards the public at large. In the large and increasing body of literature on scientific conduct and misconduct, these issues seem underexposed as ethical challenges. Consequently, individual scientists here tend to be left alone with problems and dilemmas, with no guidance for good conduct. Ideas are presented about how to make up for this omission. Using a practical, ethical approach, the paper attempts to identify ways scientists might deal with ethical public relations issues, guided by a norm or maxim of openness. Drawing on and rethinking the CUDOS codification of the scientific ethos, as it was worked out by Robert K. Merton in 1942, we propose that this, which is echoed in current codifications of norms for good scientific conduct, contains a tacit maxim of openness which may naturally be extended to cover the public relations of science. Discussing openness as access, accountability, transparency and receptiveness, the argumentation concentrates on the possible prevention of misconduct with respect to, on the one hand, sins of omission-withholding important information from the public-and, on the other hand, abuses of the authority of science in order to gain publicity. Statements from interviews with scientists are used to illustrate how scientists might view the relevance of the issues raised.

  13. Dose-effect relations and responsive regulation of treatment duration: the good enough level.

    PubMed

    Barkham, Michael; Connell, Janice; Stiles, William B; Miles, Jeremy N V; Margison, Frank; Evans, Chris; Mellor-Clark, John

    2006-02-01

    This study examined rates of improvement in psychotherapy as a function of the number of sessions attended. The clients (N=1,868; 73.1% female; 92.4% White; average age=40), who were seen for a variety of problems in routine primary care mental health practices, attended 1 to 12 sessions, had planned endings, and completed the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at the beginning and end of their treatment. The percentage of clients achieving reliable and clinically significant improvement (RCSI) on the CORE-OM did not increase with number of sessions attended. Among clients who began treatment above the CORE-OM clinical cutoff (n=1,472), the RCSI rate ranged from 88% for clients who attended 1 session down to 62% for clients who attended 12 sessions (r=-.91). Previously reported negatively accelerating aggregate curves may reflect progressive ending of treatment by clients who had achieved a good enough level of improvement.

  14. A posttraumatic pontomedullary rent with good outcome.

    PubMed

    De Vloo, Philippe; Declerck, Louis; Stevens, Olivier; De Vleeschouwer, Steven

    2016-03-01

    Posttraumatic pontomedullary rents have been described mainly as postmortem histopathological findings in patients who died immediately or within the first hours after trauma. To the best of our knowledge, no long-term survivors of this condition have been described, and those surviving initially were always severely impaired. We present the first patient with this condition and with corresponding lesions on imaging who survived longer than 3 months. Moreover, the patient regained almost complete independence 1 year after the trauma. We briefly discuss the proposed mechanisms of this injury. We conclude that this lesion, when incomplete, is not always lethal and can exceptionally have a good clinical outcome. Prevention of respiratory failure is of utmost importance in these patients.

  15. Many Good Years with Jila

    NASA Astrophysics Data System (ADS)

    Hall, Lindy

    It is a pleasure and privilege to add some words to this collection of writings. I think that I can claim to have known Jan longest of anyone in the world science culture, as we met in February, 1956 at Carnegie Institute of Technology in Pittsburgh, Pennsylvania. As a senior in physics, he was already taking advanced classes in that Department, so his decision that spring to transition into graduate school at CIT was an easy and natural one. The next five years were a golden time of fun and learning for us both. In our respective programs, there was a good mix of technical and humanistic specialties to study and lots of opportunities for practical application and problem solving. As we and others in our core group of students married and started families, a community of colleagues and friends developed with shared interests and interactions…

  16. What are narratives good for?

    PubMed

    Beatty, John

    2016-08-01

    Narratives may be easy to come by, but not everything is worth narrating. What merits a narrative? Here, I follow the lead of narratologists and literary theorists, and focus on one particular proposal concerning the elements of a story that make it narrative-worthy. These elements correspond to features of the natural world addressed by the historical sciences, where narratives figure so prominently. What matters is contingency. Narratives are especially good for representing contingency and accounting for contingent outcomes. This will be squared with a common view that narratives leave no room for chance. On the contrary, I will argue, tracing one path through a maze of alternative possibilities, and alluding to those possibilities along the way, is what a narrative does particularly well.

  17. 'The good of the child'

    PubMed

    Warnock, Mary

    1987-04-01

    Warnock, chair of Britain's Committee of Inquiry into Human Fertilisation and Embryology, discusses the implications of the "artificial family" for children born through the use of reproductive technologies. She considers both treatment of infertility and the possible use of assisted reproduction to enable persons other than infertile couples, such as single persons and homosexuals, to have children. Warnock has found that emphasis has been placed on the wants and well-being of the adult(s) involved, and that the "good of the child" is a "wide and vague concept, widely invoked, not always plausibly." She is particularly concerned about children born as a result of the delayed implantation of frozen embryos, AID children who are deceived about their origins, and children born of surrogate pregnancies. She recommends that a detailed study of existing "artificial family" children be conducted to aid public policy decisions on assisted reproduction.

  18. Coordinating towards a Common Good

    NASA Astrophysics Data System (ADS)

    Santos, Francisco C.; Pacheco, Jorge M.

    2010-09-01

    Throughout their life, humans often engage in collective endeavors ranging from family related issues to global warming. In all cases, the tragedy of the commons threatens the possibility of reaching the optimal solution associated with global cooperation, a scenario predicted by theory and demonstrated by many experiments. Using the toolbox of evolutionary game theory, I will address two important aspects of evolutionary dynamics that have been neglected so far in the context of public goods games and evolution of cooperation. On one hand, the fact that often there is a threshold above which a public good is reached [1, 2]. On the other hand, the fact that individuals often participate in several games, related to the their social context and pattern of social ties, defined by a social network [3, 4, 5]. In the first case, the existence of a threshold above which collective action is materialized dictates a rich pattern of evolutionary dynamics where the direction of natural selection can be inverted compared to standard expectations. Scenarios of defector dominance, pure coordination or coexistence may arise simultaneously. Both finite and infinite population models are analyzed. In networked games, cooperation blooms whenever the act of contributing is more important than the effort contributed. In particular, the heterogeneous nature of social networks naturally induces a symmetry breaking of the dilemmas of cooperation, as contributions made by cooperators may become contingent on the social context in which the individual is embedded. This diversity in context provides an advantage to cooperators, which is particularly strong when both wealth and social ties follow a power-law distribution, providing clues on the self-organization of social communities. Finally, in both situations, it can be shown that individuals no longer play a defection dominance dilemma, but effectively engage in a general N-person coordination game. Even if locally defection may seem

  19. Cultivating Hope through Learning for the Common Good

    ERIC Educational Resources Information Center

    McEwen, Rhonda M.; Herman, Wayne R.; Himes, Brant M.

    2016-01-01

    This article examines how an orientation toward "hope" can guide institutions of higher education in achieving their ultimate purpose of providing education for the common good of society. In today's cultural context, colleges and universities must navigate a multitude of challenges and competing philosophies, many of which question the…

  20. Making a Good Start As an Engineering Manager.

    ERIC Educational Resources Information Center

    Baird, Bruce F.

    1983-01-01

    Provides pointers for the new engineering manager on building self-confidence and establishing positive employer/employee relationships. Includes distinctive traits managers should have, ways to ease frustrations (such as giving a challenging first assignment and recognizing good work), a plan to achieve managerial goals, and relationships with…

  1. Updates and achievements in virology.

    PubMed

    Buonaguro, Franco M; Campadelli-Fiume, Gabriella; De Giuli Morghen, Carlo; Palù, Giorgio

    2010-07-01

    The 4th European Congress of Virology, hosted by the Italian Society for Virology, attracted approximately 1300 scientists from 46 countries worldwide. It also represented the first conference of the European Society for Virology, which was established in Campidoglio, Rome, Italy in 2009. The main goal of the meeting was to share research activities and results achieved in European virology units/institutes and to strengthen collaboration with colleagues from both western and developing countries. The worldwide representation of participants is a testament to the strength and attraction of European virology. The 5-day conference brought together the best of current virology; topics covered all three living domains (bacteria, archaea and eucarya), with special sessions on plant and veterinary virology as well as human virology, including two oral presentations on mimiviruses. The conference included five plenary sessions, 31 workshops, one hepatitis C virus roundtable, ten special workshops and three poster sessions, as well as 45 keynote lectures, 191 oral presentations and 845 abstracts. Furthermore, the Gesellschaft fur Virologie Loeffler-Frosch medal award was given to Peter Vogt for his long-standing career and achievements; the Gardner Lecture of the European Society for Clinical Virology was presented by Yoshihiro Kawaoka, and the Pioneer in Virology Lecture of the Italian Society for Virology was presented by Ulrich Koszinowski.

  2. Health physics manual of good practices for tritium facilities

    SciTech Connect

    Blauvelt, R.K.; Deaton, M.R.; Gill, J.T.

    1991-12-01

    The purpose of this document is to provide written guidance defining the generally accepted good practices in use at Department of Energy (DOE) tritium facilities. A {open_quotes}good practice{close_quotes} is an action, policy, or procedure that enhances the radiation protection program at a DOE site. The information selected for inclusion in this document should help readers achieve an understanding of the key radiation protection issues at tritium facilities and provide guidance as to what characterizes excellence from a radiation protection point of view. The ALARA (As Low as Reasonable Achievable) program at DOE sites should be based, in part, on following the good practices that apply to their operations.

  3. Are Good Intentions Good Enough?: Informed Consent Without Trained Interpreters

    PubMed Central

    de Voogd, Katherine B.

    2007-01-01

    Objective To examine the informed consent process when trained language interpreters are unavailable. Background Ensuring sufficient patient understanding for informed consent is especially challenging for patients with Limited English Proficiency (LEP). While US law requires provision of competent translation for LEP patients, such services are commonly unavailable. Design and Participants Qualitative data was collected in 8 prenatal genetics clinics in Texas, including interviews and observations with 16 clinicians, and 30 Latina patients. Using content analysis techniques, we examined whether the basic criteria for informed consent (voluntariness, discussion of alternatives, adequate information, and competence) were evident for each of these patients, contrasting LEP patients with patients not needing an interpreter. We present case examples of difficulties related to each of these criteria, and compare informed consent scores for consultations requiring interpretation and those which did not. Results We describe multiple communication problems related to the use of untrained interpreters, or reliance on clinicians’ own limited Spanish. These LEP patients appear to be consistently disadvantaged in each of the criteria we examined, and informed consent scores were notably lower for consultations which occurred across a language barrier. Conclusions In the absence of adequate Spanish interpretation, it was uncertain whether these LEP patients were provided the quality and content of information needed to assure that they are genuinely informed. We offer some low-cost practice suggestions that might mitigate these problems, and improve the quality of language interpretation, which is essential to assuring informed choice in health care for LEP patients. PMID:17443367

  4. Good news for coffee addicts.

    PubMed

    Lee, Thomas H

    2009-06-01

    Whether it's a basic Mr. Coffee or a gadget that sports a snazzy device for grinding beans on demand, the office coffee machine offers a place for serendipitous encounters that can improve the social aspect of work and generate new ideas. What's more, a steaming cup of joe may be as good for your health as it is for the bottom line, says Lee, a professor of medicine at Harvard Medical School and the CEO of Partners Community HealthCare. Fears of coffee's carcinogenic effects now appear to be unfounded, and, in fact, the brew might even protect against some types of cancer. What's more, coffee may guard against Alzheimer's disease and other forms of dementia and somehow soften the blow of a heart attack. Of course, its role as a pick-me-up is well known. So there's no need to take your coffee with a dollop of guilt, especially if you ease up on the sugar, cream, double chocolate, and whipped-cream topping.

  5. Achieving closure at Fernald

    SciTech Connect

    Bradburne, John; Patton, Tisha C.

    2001-02-25

    When Fluor Fernald took over the management of the Fernald Environmental Management Project in 1992, the estimated closure date of the site was more than 25 years into the future. Fluor Fernald, in conjunction with DOE-Fernald, introduced the Accelerated Cleanup Plan, which was designed to substantially shorten that schedule and save taxpayers more than $3 billion. The management of Fluor Fernald believes there are three fundamental concerns that must be addressed by any contractor hoping to achieve closure of a site within the DOE complex. They are relationship management, resource management and contract management. Relationship management refers to the interaction between the site and local residents, regulators, union leadership, the workforce at large, the media, and any other interested stakeholder groups. Resource management is of course related to the effective administration of the site knowledge base and the skills of the workforce, the attraction and retention of qualified a nd competent technical personnel, and the best recognition and use of appropriate new technologies. Perhaps most importantly, resource management must also include a plan for survival in a flat-funding environment. Lastly, creative and disciplined contract management will be essential to effecting the closure of any DOE site. Fluor Fernald, together with DOE-Fernald, is breaking new ground in the closure arena, and ''business as usual'' has become a thing of the past. How Fluor Fernald has managed its work at the site over the last eight years, and how it will manage the new site closure contract in the future, will be an integral part of achieving successful closure at Fernald.

  6. What is it to do good medical ethics? On the concepts of 'good' and 'goodness' in medical ethics.

    PubMed

    Solbakk, Jan Helge

    2015-01-01

    In his book The Varieties of Goodness Georg Henrik von Wright advocates that a useful preliminary to the study of the word 'good' is to compile a list of familiar uses and try to group them under some main headings. The present paper aims at exploring the question, 'What is it to do good medical ethics?', and notably from the vantage point of everyday expressions of the word 'good' and von Wright's grouping of them into six different types of goodness.

  7. MACT Partnership: A good idea

    SciTech Connect

    Bergeson, L.L.

    1995-11-01

    In light of strict deadlines imposed under the Clean Air Act (CAA) that the US Environmental Protection Agency (EPA) knows it cannot meet, the Agency is thinking of creative ways of developing maximum achievable control technology (MACT) standards. EPA`s March 1995, announcement that it is developing streamlined MACT standards, and its more recent issuance of guidance on its MACT Partnership Program, provides much needed relief for EPA and industry alike in addressing the challenges posed by CAA Section 112. Since the CAA Amendments were enacted in 1990, EPA has been under extraordinary pressure to develop MACT standards for 174 individual categories of major and selected area sources by the year 2000. On March 29, 1995, EPA rolled-out its MACT Partnership Program and requested comment. The notice announced EPA`s plan to use a streamlined approach to promulgating MACT standards. In short, the program involves two phases for each MACT standard. The first phase involves development of a presumptive MACT. The second phase is the formal standard development process which ultimately will result in the issuance of a MACT standard for a particular source category.

  8. Achievement Goals and Achievement Emotions: A Meta-Analysis

    ERIC Educational Resources Information Center

    Huang, Chiungjung

    2011-01-01

    This meta-analysis synthesized 93 independent samples (N = 30,003) in 77 studies that reported in 78 articles examining correlations between achievement goals and achievement emotions. Achievement goals were meaningfully associated with different achievement emotions. The correlations of mastery and mastery approach goals with positive achievement…

  9. 42 CFR 93.210 - Good faith.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Good faith. 93.210 Section 93.210 Public Health... MISCONDUCT Definitions § 93.210 Good faith. Good faith as applied to a complainant or witness, means having a... allegation or cooperation with a research misconduct proceeding is not in good faith if made with knowing...

  10. 42 CFR 93.210 - Good faith.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Good faith. 93.210 Section 93.210 Public Health... MISCONDUCT Definitions § 93.210 Good faith. Good faith as applied to a complainant or witness, means having a... allegation or cooperation with a research misconduct proceeding is not in good faith if made with knowing...

  11. 42 CFR 93.210 - Good faith.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Good faith. 93.210 Section 93.210 Public Health... MISCONDUCT Definitions § 93.210 Good faith. Good faith as applied to a complainant or witness, means having a... allegation or cooperation with a research misconduct proceeding is not in good faith if made with knowing...

  12. 42 CFR 93.210 - Good faith.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Good faith. 93.210 Section 93.210 Public Health... MISCONDUCT Definitions § 93.210 Good faith. Good faith as applied to a complainant or witness, means having a... allegation or cooperation with a research misconduct proceeding is not in good faith if made with knowing...

  13. The Common Good in Classical Political Philosophy

    ERIC Educational Resources Information Center

    Lewis, V. Bradley

    2006-01-01

    The term "common good" names the end (or final cause) of political and social life in the tradition of moral thought that owes its main substance to Aristotle and St. Thomas Aquinas. It names a genuine good ("bonum honestum") and not merely an instrumental or secondary good defeasible in the face of particular goods. However, at the same time, it…

  14. The "Good Enough" Parent: Implications for Child Protection

    ERIC Educational Resources Information Center

    Choate, Peter W.; Engstrom, Sandra

    2014-01-01

    Child protection workers must determine under what conditions a child should be sustained within the family system. A standard that is often referred to is "good enough" parenting or minimal parenting competence. Research and clinical literature fails to offer workers guidance on the practical application of this terminology. Such…

  15. Predictors of European League Against Rheumatism (EULAR) good response, DAS-28 remission and sustained responses to TNF-inhibitors in rheumatoid arthritis: a prospective study in refractory disease.

    PubMed

    Mohammed, Reem Hamdy A; Farahat, Faisal; Kewan, Hanady H; Bukhari, Mohammed A

    2015-01-01

    The aim of this study was to survey factors related to EULAR good response, the DAS-28 definition of remission, ACR 50 response, sustained response to tumor necrosis factor inhibitors (TNF-I) therapy in biologic naïve patients with refractory rheumatoid arthritis. This was a single center observational clinical prospective 2 years' study, EULAR response criteria, DAS 28, HAQ and radiographic changes were recorded. Eighty patients included (64 females and 16 males, mean age was 48.4 + -17.9 years, mean disease duration 7.3 + -5.9 years). At 6 months 70% achieved EULAR good response, 51.8% achieved DAS-28 remission. Good response/sustained responses inversely correlated with baseline DAS-28 and radiographic erosions P <0.05. EULAR good response/remission by 6 months, sustained response at 2 years positively correlated with the decline in RF titers (r = 0.33, P < 0.05 & r = 0.30, P < 0.03 respectively), negatively correlated with the baseline HAQ. Regression analysis identified higher serum hemoglobin concentration, lower baseline HAQ scores, and the absence of radiographic erosions as significant predictors of good as well as sustained responses after adjustment for potential covariates. Methotrexate was associated with favorable responses and remission at 6 months (ORs = 1.13, 1.30 respectively). The study concluded that a lower baseline DAS-28 and HAQ scores, the lack of radiographic erosions favored EULAR good response and were significant predictors of sustained response to TNF-I.

  16. Brexpiprazole: so far so good

    PubMed Central

    Das, Saibal; Barnwal, Preeti; Winston A, Blessed; Mondal, Somnath; Saha, Indranil

    2016-01-01

    This article describes the role of a newly approved antipsychotic agent brexpiprazole in the treatment of schizophrenia and major depressive disorder. This drug has high affinity for 5-HT1A, 5-HT2A, D2 and α1B,2C receptors. It displays partial agonism at 5-HT1A and D2 receptors and potent antagonism at 5-HT2A and α1B,2C adrenergic receptors. It also has some affinity (antagonism) for D3, 5-HT2B, 5-HT7 and α1A,1D receptors, and moderate affinity for H1 and low affinity for M1 receptors. These all lead to a favorable antipsychotic profile in terms of improvement of cognitive performance and sleep patterns, as well as effects on affective states and potential to treat core symptoms in schizophrenia and major depressive disorder, including cognitive deficits with a low risk of adverse effects (extrapyramidal symptoms, metabolic complications, weight gain, akathisia potential) that are commonly encountered with other typical and second-generation antipsychotic drugs. In our review, we have made an attempt to decipher the pharmacological profile of brexpiprazole from two major trials (VECTOR and BEACON). We have also tried to give a concise but detailed overview of brexpiprazole by head to head comparison of the pharmacological profile of brexpiprazole and its earlier congeners aripiprazole and prototype antipsychotic drug chlorpromazine by accessing individual summaries of product characteristics from the US Food and Drug Administration database, 2015. Relevant preclinical and clinical studies associated with this drug have been discussed with emphasis on efficacy and safety concerns. From the studies done so far, it can be concluded that brexpiprazole can be an effective monotherapy for schizophrenia and as an adjunct to other antidepressant medications in major depressive disorder. PMID:26913177

  17. Breastfeeding and educational achievement at age 5.

    PubMed

    Heikkilä, Katriina; Kelly, Yvonne; Renfrew, Mary J; Sacker, Amanda; Quigley, Maria A

    2014-01-01

    Our aim was to investigate whether the duration of breastfeeding, at all or exclusively, is associated with educational achievement at age 5. We used data from a prospective, population-based UK cohort study, the Millennium Cohort Study (MCS). 5489 children from White ethnic background born at term in 2000-2001, attending school in England in 2006, were included in our analyses. Educational achievement was measured using the Foundation Stage Profile (FSP), a statutory assessment undertaken by teachers at the end of the child's first school year. Breastfeeding duration was ascertained from interviews with the mother when the child was 9 months old. We used modified Poisson's regression to model the association of breastfeeding duration with having reached a good level of achievement overall (≥78 overall points and ≥6 in 'personal, social and emotional development' and 'communication, language and literacy' points) and in specific areas (≥6 points) of development. Children who had been breastfed for up to 2 months were more likely to have reached a good level of overall achievement [adjusted rate ratio (RR): 1.09, 95% confidence interval (CI): 1.01, 1.19] than never breastfed children. This association was more marked in children breastfed for 2-4 months (adjusted RR: 1.17, 95% CI: 1.07, 1.29) and in those breastfed for longer than 4 months (adjusted RR: 1.16, 95% CI: 1.07, 1.26). The associations of exclusive breastfeeding with the educational achievement were similar. Our findings suggest that longer duration of breastfeeding, at all or exclusively, is associated with better educational achievement at age 5.

  18. Female teachers' math anxiety affects girls' math achievement.

    PubMed

    Beilock, Sian L; Gunderson, Elizabeth A; Ramirez, Gerardo; Levine, Susan C

    2010-02-02

    People's fear and anxiety about doing math--over and above actual math ability--can be an impediment to their math achievement. We show that when the math-anxious individuals are female elementary school teachers, their math anxiety carries negative consequences for the math achievement of their female students. Early elementary school teachers in the United States are almost exclusively female (>90%), and we provide evidence that these female teachers' anxieties relate to girls' math achievement via girls' beliefs about who is good at math. First- and second-grade female teachers completed measures of math anxiety. The math achievement of the students in these teachers' classrooms was also assessed. There was no relation between a teacher's math anxiety and her students' math achievement at the beginning of the school year. By the school year's end, however, the more anxious teachers were about math, the more likely girls (but not boys) were to endorse the commonly held stereotype that "boys are good at math, and girls are good at reading" and the lower these girls' math achievement. Indeed, by the end of the school year, girls who endorsed this stereotype had significantly worse math achievement than girls who did not and than boys overall. In early elementary school, where the teachers are almost all female, teachers' math anxiety carries consequences for girls' math achievement by influencing girls' beliefs about who is good at math.

  19. What is good medical ethics? A clinician's perspective.

    PubMed

    Kong, Wing May

    2015-01-01

    Speaking from the perspective of a clinician and teacher, good medical ethics needs to make medicine better. Over the past 50 years medical ethics has helped shape the culture in medicine and medical practice for the better. However, recent healthcare scandals in the UK suggest more needs to be done to translate ethical reasoning into ethical practice. Focusing on clinical practice and individual patient care, I will argue that, to be good, medical ethics needs to become integral to the activities of health professionals and healthcare organisations. Ethics is like a language which brings a way of thinking and responding to the world. For ethics to become embedded in clinical practice, health professionals need to progress from classroom learners to fluent social speakers through ethical dialogue, ethical reflection and ethical actions. I will end by discussing three areas that need to be addressed to enable medical ethics to flourish and bring about change in everyday clinical care.

  20. Faking Good and Faking Bad on the Personality Inventory for Children-Revised, Shortened Format.

    ERIC Educational Resources Information Center

    Daldin, Herman

    1985-01-01

    Examined the detection of faking good and faking bad on the Personality Inventory for Children-Revised with an outpatient mental health clinic population. Results show that faking influences all 12 clinical scales and the four broad-band scales. Detection of faking good is recommended by the use of the Lie scale and the Adjustment scale.…

  1. Community-Based Interventions to Improve and Sustain Antiretroviral Therapy Adherence, Retention in HIV Care and Clinical Outcomes in Low- and Middle-Income Countries for Achieving the UNAIDS 90-90-90 Targets

    PubMed Central

    Adetokunboh, Olatunji; Uthman, Olalekan A.; Knowlton, Amy W.; Altice, Frederick L.; Schechter, Mauro; Galárraga, Omar; Geng, Elvin; Peltzer, Karl; Chang, Larry W.; Van Cutsem, Gilles; Jaffar, Shabbar S.; Ford, Nathan; Mellins, Claude A.; Remien, Robert H.; Mills, Edward J.

    2017-01-01

    Little is known about the effect of community versus health facility-based interventions to improve and sustain antiretroviral therapy (ART) adherence, virologic suppression, and retention in care among HIV-infected individuals in low-and middle-income countries (LMICs). We systematically searched four electronic databases for all available randomized controlled trials (RCTs) and comparative cohort studies in LMICs comparing community versus health facility-based interventions. Relative risks (RRs) for pre-defined adherence, treatment engagement (linkage and retention in care), and relevant clinical outcomes were pooled using random effect models. Eleven cohort studies and eleven RCTs (N = 97,657) were included. Meta-analysis of the included RCTs comparing community- versus health facility-based interventions found comparable outcomes in terms of ART adherence (RR = 1.02, 95 % CI 0.99 to 1.04), virologic suppression (RR = 1.00, 95 % CI 0.98 to 1.03), and all-cause mortality (RR = 0.93, 95 % CI 0.73 to 1.18). The result of pooled analysis from the RCTs (RR = 1.03, 95 % CI 1.01 to 1.06) and cohort studies (RR = 1.09, 95 % CI 1.03 to 1.15) found that participants assigned to community-based interventions had statistically significantly higher rates of treatment engagement. Two studies found community-based ART delivery model either cost-saving or cost-effective. Community- versus facility-based models of ART delivery resulted in at least comparable outcomes for clinically stable HIV-infected patients on treatment in LMICs and are likely to be cost-effective. PMID:27475643

  2. Lifting Minority Achievement: Complex Answers. The Achievement Gap.

    ERIC Educational Resources Information Center

    Viadero, Debra; Johnston, Robert C.

    2000-01-01

    This fourth in a four-part series on why academic achievement gaps exist describes the Minority Achievement Committee scholars program at Shaker Heights High School in Cleveland, Ohio, a powerful antidote to the achievement gap between minority and white and Asian American students. It explains the need to break down stereotypes about academic…

  3. Achievement Motivation of Women: Effects of Achievement and Affiliation Arousal.

    ERIC Educational Resources Information Center

    Gama, Elizabeth Maria Pinheiro

    1985-01-01

    Assigned 139 Brazilian women to neutral, affiliation arousal, and achievement arousal conditions based on their levels of achievement (Ach) and affiliative (Aff) needs. Results of story analyses revealed that achievement arousal increased scores of high Ach subjects and that high Aff subjects obtained higher scores than low Aff subjects. (BL)

  4. Attitude Towards Physics and Additional Mathematics Achievement Towards Physics Achievement

    ERIC Educational Resources Information Center

    Veloo, Arsaythamby; Nor, Rahimah; Khalid, Rozalina

    2015-01-01

    The purpose of this research is to identify the difference in students' attitude towards Physics and Additional Mathematics achievement based on gender and relationship between attitudinal variables towards Physics and Additional Mathematics achievement with achievement in Physics. This research focused on six variables, which is attitude towards…

  5. The Impact of Reading Achievement on Overall Academic Achievement

    ERIC Educational Resources Information Center

    Churchwell, Dawn Earheart

    2009-01-01

    This study examined the relationship between reading achievement and achievement in other subject areas. The purpose of this study was to determine if there was a correlation between reading scores as measured by the Standardized Test for the Assessment of Reading (STAR) and academic achievement in language arts, math, science, and social studies…

  6. 76 FR 52662 - Good Neighbor Environmental Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Good Neighbor Environmental Board AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of... meeting of the Good Neighbor Environmental Board (Board). The Board usually meets three times...

  7. 76 FR 31328 - Good Neighbor Environmental Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Good Neighbor Environmental Board AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of... meeting of the Good Neighbor Environmental Board (Board). The Board usually meets three times...

  8. 76 FR 76973 - Good Neighbor Environmental Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-09

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Good Neighbor Environmental Board AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of... meeting of the Good Neighbor Environmental Board (Board). The Board usually meets three times...

  9. 76 FR 12731 - Good Neighbor Environmental Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-08

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Good Neighbor Environmental Board AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of... meeting of the Good Neighbor Environmental Board (Board). The Board usually meets three times...

  10. 75 FR 8699 - Good Neighbor Environmental Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-25

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Good Neighbor Environmental Board AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of... meeting of the Good Neighbor Environmental Board (Board). The Board usually meets three times...

  11. 76 FR 73631 - Good Neighbor Environmental Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-29

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Good Neighbor Environmental Board AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of... meeting of the Good Neighbor Environmental Board (Board). The Board usually meets three times...

  12. 76 FR 7845 - Good Neighbor Environmental Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Good Neighbor Environmental Board AGENCY: Environmental Protection Agency (EPA). ACTION: Request for Nominations to the Good Neighbor Environmental Board. SUMMARY: The U.S. Environmental...

  13. Good Health Before Pregnancy: Preconception Care

    MedlinePlus

    ... Login Join Pay Dues Follow us: Women's Health Care Physicians Contact Us My ACOG ACOG Departments Donate ... Patients About ACOG Good Health Before Pregnancy: Preconception Care Home For Patients Search FAQs Good Health Before ...

  14. 29 CFR 779.14 - Goods.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... states that goods, as used in the Act, means “goods (including ships and marine equipment), wares... the ultimate consumer thereof other than a producer, manufacturer, or processor thereof.”...

  15. 29 CFR 779.14 - Goods.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... states that goods, as used in the Act, means “goods (including ships and marine equipment), wares... the ultimate consumer thereof other than a producer, manufacturer, or processor thereof.”...

  16. 29 CFR 779.14 - Goods.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... states that goods, as used in the Act, means “goods (including ships and marine equipment), wares... the ultimate consumer thereof other than a producer, manufacturer, or processor thereof.”...

  17. 29 CFR 779.14 - Goods.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... states that goods, as used in the Act, means “goods (including ships and marine equipment), wares... the ultimate consumer thereof other than a producer, manufacturer, or processor thereof.”...

  18. 29 CFR 779.14 - Goods.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... states that goods, as used in the Act, means “goods (including ships and marine equipment), wares... the ultimate consumer thereof other than a producer, manufacturer, or processor thereof.”...

  19. Personal and family factors as predictors of pupils' mathematics achievement.

    PubMed

    Alomar, Bader O

    2007-08-01

    This study examined personal and family factors in prediction of mathematics achievement by Kuwaiti fourth graders (395 boys, 501 girls; M age=10.0 yr., SD=8.0 mo.). Personal variables included sex, total achievement, perception of parental involvement, pupil's attitude towards school, and mathematics achievement. Family variables included parental education and parental involvement, views of school, and income. The data had good fit with the suggested model. Analysis showed variables which had significant direct association with mathematics achievement were total achievement and sex. Parental education, pupil's sex, and attitude towards school had significant indirect associations with mathematical achievement. Associations were direct for boys and indirect for girls on mathematics achievement, so sex had minimal total effects on mathematics achievement.

  20. Is the Good Life the Easy Life?

    ERIC Educational Resources Information Center

    Scollon, Christie Napa; King, Laura A.

    2004-01-01

    Three studies examined folk concepts of the good life. Participants rated the desirability and moral goodness of a life as a function of the happiness, meaning, and effort experienced. Happiness and meaning were solid predictors of the good life, replicating King and Napa (1998). Study 1 (N = 381) included wealth as an additional factor. Results…

  1. Meal replacements and fibre supplement as a strategy for weight loss. Proprietary PGX® meal replacement and PGX® fibre supplement in addition to a calorie-restricted diet to achieve weight loss in a clinical setting.

    PubMed

    Reichert, Ronald G; Reimer, Raylene A; Kacinik, Veronica; Pal, Sebely; Gahler, Roland J; Wood, Simon

    2013-01-01

    Meal replacements and viscous soluble fibre represent safe and sustainable aids for weight loss. Our purpose was to determine if PGX® meal replacements and PGX(®) fibre complex in combination with a calorie-restricted diet would aid in weight loss in a clinical setting. Fifty-two overweight and obese participants (49 women, 3 men; average age 47.1 years) with a mean body mass index (BMI) of 33.8 ± 6.4 kg/m(2) consumed 57 g of proprietary PGX® meal replacement product at breakfast and another 57 g at lunch for 12 weeks. In addition to the meal replacements, they were also asked to consume 5 g/day of PGX® fibre in the form of granules, powder or capsules together with 250 mlwater. A registered dietician recommended low-fat, low-glycaemic-index foods for snacks and the dinner menus such that each volunteer was consuming a total of 1200 kcal/day. All participants (n = 52) lost a significant amount of weight from baseline (-4.69 ± 3.73 kg), which was further reflected in the reductions in their waist (-7.11 ± 6.35 cm) and hip circumference (-5.59 ± 3.58 cm) over the 12-week study (p < 0.0001). BMI scores (n = 51) were reduced by 1.6 ± 1.4 kg/m(2). The use of PGX® meal replacements and PGX(®) fibre along with a controlled dietary caloric intake is of benefit for short-term weight loss.

  2. Can one do good medical ethics without principles?

    PubMed

    Macklin, Ruth

    2015-01-01

    The criteria for determining what it is to do good medical ethics are the quality of ethical analysis and ethical justifications for decisions and actions. Justifications for decisions and actions rely on ethical principles, be they the 'famous four' or subsidiary ethical principles relevant to specific contexts. Examples from clinical ethics, research ethics and public health ethics reveal that even when not stated explicitly, principles are involved in ethical justifications. Principles may come into conflict, however, and the resolution of an ethical dilemma requires providing good reasons for preferring one principle over another.

  3. Achievements in Stratospheric Ozone Protection

    EPA Pesticide Factsheets

    This report describes achievements in protecting the ozone layer, the benefits of these achievements, and strategies involved (e.g., using alternatives to ozone-depleting substances, phasing out harmful substances, and creating partnerships).

  4. Students’ Achievement Goals, Learning-Related Emotions and Academic Achievement

    PubMed Central

    Lüftenegger, Marko; Klug, Julia; Harrer, Katharina; Langer, Marie; Spiel, Christiane; Schober, Barbara

    2016-01-01

    In the present research, the recently proposed 3 × 2 model of achievement goals is tested and associations with achievement emotions and their joint influence on academic achievement are investigated. The study was conducted with 388 students using the 3 × 2 Achievement Goal Questionnaire including the six proposed goal constructs (task-approach, task-avoidance, self-approach, self-avoidance, other-approach, other-avoidance) and the enjoyment and boredom scales from the Achievement Emotion Questionnaire. Exam grades were used as an indicator of academic achievement. Findings from CFAs provided strong support for the proposed structure of the 3 × 2 achievement goal model. Self-based goals, other-based goals and task-approach goals predicted enjoyment. Task-approach goals negatively predicted boredom. Task-approach and other-approach predicted achievement. The indirect effects of achievement goals through emotion variables on achievement were assessed using bias-corrected bootstrapping. No mediation effects were found. Implications for educational practice are discussed. PMID:27199836

  5. How to Set Focal Categories for Brief Implicit Association Test? "Good" Is Good, "Bad" Is Not So Good.

    PubMed

    Shi, Yuanyuan; Cai, Huajian; Shen, Yiqin Alicia; Yang, Jing

    2016-01-01

    Three studies were conducted to examine the validity of the four versions of BIATs that are supposed to measure the same construct but differ in shared focal category. Study 1 investigated the criterion validity of four BIATs measuring attitudes toward flower versus insect. Study 2 examined the experimental sensitivity of four BIATs by considering attitudes toward induced ingroup versus outgroup. Study 3 examined the predictive power of the four BIATs by investigating attitudes toward the commercial beverages Coke versus Sprite. The findings suggested that for the two attributes "good" and "bad," "good" rather than "bad" proved to be good as a shared focal category; for two targets, so long as they clearly differed in goodness or valence, the "good" rather than "bad" target emerged as good for a shared focal category. Beyond this case, either target worked well. These findings may facilitate the understanding of the BIAT and its future applications.

  6. Current Good Manufacturing Practice Production of an Oncolytic Recombinant Vesicular Stomatitis Viral Vector for Cancer Treatment

    PubMed Central

    Meseck, M.; Derecho, I.; Lopez, P.; Knoblauch, C.; McMahon, R.; Anderson, J.; Dunphy, N.; Quezada, V.; Khan, R.; Huang, P.; Dang, W.; Luo, M.; Hsu, D.; Woo, S.L.C.; Couture, L.

    2011-01-01

    Abstract Vesicular stomatitis virus (VSV) is an oncolytic virus currently being investigated as a promising tool to treat cancer because of its ability to selectively replicate in cancer cells. To enhance the oncolytic property of the nonpathologic laboratory strain of VSV, we generated a recombinant vector [rVSV(MΔ51)-M3] expressing murine gammaherpesvirus M3, a secreted viral chemokine-binding protein that binds to a broad range of mammalian chemokines with high affinity. As previously reported, when rVSV(MΔ51)-M3 was used in an orthotopic model of hepatocellular carcinoma (HCC) in rats, it suppressed inflammatory cell migration to the virus-infected tumor site, which allowed for enhanced intratumoral virus replication leading to increased tumor necrosis and substantially prolonged survival. These encouraging results led to the development of this vector for clinical translation in patients with HCC. However, a scalable current Good Manufacturing Practice (cGMP)-compliant manufacturing process has not been described for this vector. To produce the quantities of high-titer virus required for clinical trials, a process that is amenable to GMP manufacturing and scale-up was developed. We describe here a large-scale (50-liter) vector production process capable of achieving crude titers on the order of 109 plaque-forming units (PFU)/ml under cGMP. This process was used to generate a master virus seed stock and a clinical lot of the clinical trial agent under cGMP with an infectious viral titer of approximately 2 × 1010 PFU/ml (total yield, 1 × 1013 PFU). The lot has passed all U.S. Food and Drug Administration-mandated release testing and will be used in a phase 1 clinical translational trial in patients with advanced HCC. PMID:21083425

  7. Current good manufacturing practice production of an oncolytic recombinant vesicular stomatitis viral vector for cancer treatment.

    PubMed

    Ausubel, L J; Meseck, M; Derecho, I; Lopez, P; Knoblauch, C; McMahon, R; Anderson, J; Dunphy, N; Quezada, V; Khan, R; Huang, P; Dang, W; Luo, M; Hsu, D; Woo, S L C; Couture, L

    2011-04-01

    Vesicular stomatitis virus (VSV) is an oncolytic virus currently being investigated as a promising tool to treat cancer because of its ability to selectively replicate in cancer cells. To enhance the oncolytic property of the nonpathologic laboratory strain of VSV, we generated a recombinant vector [rVSV(MΔ51)-M3] expressing murine gammaherpesvirus M3, a secreted viral chemokine-binding protein that binds to a broad range of mammalian chemokines with high affinity. As previously reported, when rVSV(MΔ51)-M3 was used in an orthotopic model of hepatocellular carcinoma (HCC) in rats, it suppressed inflammatory cell migration to the virus-infected tumor site, which allowed for enhanced intratumoral virus replication leading to increased tumor necrosis and substantially prolonged survival. These encouraging results led to the development of this vector for clinical translation in patients with HCC. However, a scalable current Good Manufacturing Practice (cGMP)-compliant manufacturing process has not been described for this vector. To produce the quantities of high-titer virus required for clinical trials, a process that is amenable to GMP manufacturing and scale-up was developed. We describe here a large-scale (50-liter) vector production process capable of achieving crude titers on the order of 10(9) plaque-forming units (PFU)/ml under cGMP. This process was used to generate a master virus seed stock and a clinical lot of the clinical trial agent under cGMP with an infectious viral titer of approximately 2 × 10(10) PFU/ml (total yield, 1 × 10(13) PFU). The lot has passed all U.S. Food and Drug Administration-mandated release testing and will be used in a phase 1 clinical translational trial in patients with advanced HCC.

  8. Good manufacturing practices for medicinal products for human use

    PubMed Central

    Gouveia, Bruno G.; Rijo, Patrícia; Gonçalo, Tânia S.; Reis, Catarina P.

    2015-01-01

    At international and national levels, there are public and private organizations, institutions and regulatory authorities, who work and cooperate between them and with Pharmaceutical Industry, in order to achieve a consensus of the guidelines and laws of the manufacturing of medicinal products for human use. This article includes an explanation of how operate and cooperate these participants, between them and expose the current regulations, following the line of European Community/European Economic Area, referencing, wherever appropriate, the practiced guidelines, outside of regulatory action of space mentioned. In this way, it is intended to achieve quality, security and effectiveness exceptional levels in the manufacturing of health products. Good Manufacturing Practice aim the promotion of the human health and consequently, to the improvement of quality of life. For achieve the proposed objectives, it is necessary to ensure the applicability of the presented concepts and show the benefits arising from this applicability. PMID:25883511

  9. Good manufacturing practices for medicinal products for human use.

    PubMed

    Gouveia, Bruno G; Rijo, Patrícia; Gonçalo, Tânia S; Reis, Catarina P

    2015-01-01

    At international and national levels, there are public and private organizations, institutions and regulatory authorities, who work and cooperate between them and with Pharmaceutical Industry, in order to achieve a consensus of the guidelines and laws of the manufacturing of medicinal products for human use. This article includes an explanation of how operate and cooperate these participants, between them and expose the current regulations, following the line of European Community/European Economic Area, referencing, wherever appropriate, the practiced guidelines, outside of regulatory action of space mentioned. In this way, it is intended to achieve quality, security and effectiveness exceptional levels in the manufacturing of health products. Good Manufacturing Practice aim the promotion of the human health and consequently, to the improvement of quality of life. For achieve the proposed objectives, it is necessary to ensure the applicability of the presented concepts and show the benefits arising from this applicability.

  10. Good-Parent Beliefs of Parents of Seriously Ill Children

    PubMed Central

    Feudtner, Chris; Walter, Jennifer K.; Faerber, Jennifer A.; Hill, Douglas L.; Carroll, Karen W.; Mollen, Cynthia J.; Miller, Victoria A.; Morrison, Wynne E.; Munson, David; Kang, Tammy I.; Hinds, Pamela S.

    2016-01-01

    IMPORTANCE Parents’ beliefs about what they need to do to be a good parent when their children are seriously ill influence their medical decisions, and better understanding of these beliefs may improve decision support. OBJECTIVE To assess parents’ perceptions regarding the relative importance of 12 good-parent attributes. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional, discrete-choice experiment was conducted at a children’s hospital. Participants included 200 parents of children with serious illness. MAIN OUTCOMES AND MEASURES Ratings of 12 good-parent attributes, with subsequent use of latent class analysis to identify groups of parents with similar ratings of attributes, and ascertainment of whether membership in a particular group was associated with demographic or clinical characteristics. RESULTS The highest-ranked good-parent attribute was making sure that my child feels loved, followed by focusing on my child’s health, making informed medical care decisions, and advocating for my child with medical staff. We identified 4 groups of parents with similar patterns of good-parent–attribute ratings, which we labeled as: child feels loved (n = 68), child’s health (n = 56), advocacy and informed (n = 55), and spiritual well-being (n = 21). Compared with the other groups, the child’s health group reported more financial difficulties, was less educated, and had a higher proportion of children with new complex, chronic conditions. CONCLUSIONS AND RELEVANCE Parents endorse a broad range of beliefs that represent what they perceive they should do to be a good parent for their seriously ill child. Common patterns of how parents prioritize these attributes exist, suggesting future research to better understand the origins and development of good-parent beliefs among these parents. More important, engaging parents individually regarding what they perceive to be the core duties they must fulfill to be a good parent may enable more customized and

  11. [Future roles of clinical laboratories and clinical laboratory technologists in university hospitals].

    PubMed

    Yokota, Hiromitsu; Yatomi, Yutaka

    2013-08-01

    Clinical laboratories in university hospitals should be operated with a good balance of medical practice, education, research, and management. The role of a clinical laboratory is to promptly provide highly reliable laboratory data to satisfy the needs of clinicians involved in medical practice and health maintenance of patients. Improvement and maintenance of the quality of the laboratory staff and environment are essential to achieve this goal. In order to implement these requirements efficiently, an appropriate quality management system should be introduced and established, and evaluated objectively by a third party (e.g. by obtaining ISO 15189 certification). ISO 15189 is an international standard regarding the quality and competence of clinical laboratories, and specifies a review of the efficient operational system and technical requirements such as competence in implementing practical tests and calibration. This means the results of laboratory tests reported by accredited laboratories withstand any international evaluation, which is very important to assure the future importance of the existence and management of clinical laboratories as well as internationalization of medical practice. "Education" and "research" have important implications in addition to "medical practice" and "management", as the roles that clinical laboratories should play in university hospitals. University hospital laboratories should be operated by keeping these four factors in good balance. Why are "education" and "research" required in addition to "medical practice" services? If individual clinical laboratory technologists can provide an appropriate response to this question, the importance of the existence of clinical laboratories would be reinforced, without being compromised.

  12. The Mechanics of Human Achievement.

    PubMed

    Duckworth, Angela L; Eichstaedt, Johannes C; Ungar, Lyle H

    2015-07-01

    Countless studies have addressed why some individuals achieve more than others. Nevertheless, the psychology of achievement lacks a unifying conceptual framework for synthesizing these empirical insights. We propose organizing achievement-related traits by two possible mechanisms of action: Traits that determine the rate at which an individual learns a skill are talent variables and can be distinguished conceptually from traits that determine the effort an individual puts forth. This approach takes inspiration from Newtonian mechanics: achievement is akin to distance traveled, effort to time, skill to speed, and talent to acceleration. A novel prediction from this model is that individual differences in effort (but not talent) influence achievement (but not skill) more substantially over longer (rather than shorter) time intervals. Conceptualizing skill as the multiplicative product of talent and effort, and achievement as the multiplicative product of skill and effort, advances similar, but less formal, propositions by several important earlier thinkers.

  13. The Mechanics of Human Achievement

    PubMed Central

    Duckworth, Angela L.; Eichstaedt, Johannes C.; Ungar, Lyle H.

    2015-01-01

    Countless studies have addressed why some individuals achieve more than others. Nevertheless, the psychology of achievement lacks a unifying conceptual framework for synthesizing these empirical insights. We propose organizing achievement-related traits by two possible mechanisms of action: Traits that determine the rate at which an individual learns a skill are talent variables and can be distinguished conceptually from traits that determine the effort an individual puts forth. This approach takes inspiration from Newtonian mechanics: achievement is akin to distance traveled, effort to time, skill to speed, and talent to acceleration. A novel prediction from this model is that individual differences in effort (but not talent) influence achievement (but not skill) more substantially over longer (rather than shorter) time intervals. Conceptualizing skill as the multiplicative product of talent and effort, and achievement as the multiplicative product of skill and effort, advances similar, but less formal, propositions by several important earlier thinkers. PMID:26236393

  14. 19 CFR 10.605 - Goods classifiable as goods put up in sets.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Goods classifiable as goods put up in sets. 10.605... put up in sets. Notwithstanding the specific rules set forth in General Note 29(n), HTSUS, goods classifiable as goods put up in sets for retail sale as provided for in General Rule of Interpretation 3,...

  15. Toward an Aristotelian Conception of Good Listening

    ERIC Educational Resources Information Center

    Rice, Suzanne

    2011-01-01

    In this essay Suzanne Rice examines Aristotle's ideas about virtue, character, and education as elements in an Aristotelian conception of good listening. Rice begins by surveying of several different contexts in which listening typically occurs, using this information to introduce the argument that what should count as "good listening" must be…

  16. Highlights of Good Manufacturing Practice in Japan.

    PubMed

    Morita, K

    1990-01-01

    Good Manufacturing Practice (GMP) in the pharmaceutical industry originated in the United States. Japan, having absorbed many things from the U.S., is actively seeking to establish Good Manufacturing Practice to match the pharmaceutical manufacturing climate in Japan. Several of the themes which highlight Japanese GMP efforts are presented below.

  17. Student View: What Do Good Teachers Do?

    ERIC Educational Resources Information Center

    Educational Horizons, 2012

    2012-01-01

    Students know what good teaching looks like--but educators rarely ask them. See what these high school students, who are members of the Future Educators Association[R] and want to be teachers themselves, said. FEA is a part of the PDK family of education associations, which includes Pi Lambda Theta. Get insider advice on good teaching from some…

  18. Paleolithic Counseling - The Good Old Days.

    ERIC Educational Resources Information Center

    King, Paul T.

    This paper outlines what clients were like in the "Good Ol' Days", as compared with what they are like now. Formerly clients appeared to come in with a plethora of ego energy, while now it seems more like a depletion. Explicit in our culture now is the idea that it is almost healthy and good to publicize one's private experience. Some of…

  19. 19 CFR 10.303 - Originating goods.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Originating goods. 10.303 Section 10.303 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... amended from time to time by the Customs Cooperation Council. (d) Articles of feather. The goods...

  20. Feedback after Good Trials Enhances Learning

    ERIC Educational Resources Information Center

    Chiviacowsky, Suzete; Wulf, Gabriele

    2007-01-01

    Recent studies (Chiviacowsky & Wulf, 2002, 2005) have shown that learners prefer to receive feedback after they believe they had a "good" rather than "poor" trial. The present study followed up on this finding and examined whether learning would benefit if individuals received feedback after good relative to poor trials. Participants practiced a…

  1. 7 CFR 276.6 - Good cause.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Good cause. 276.6 Section 276.6 Agriculture... FOOD STAMP AND FOOD DISTRIBUTION PROGRAM STATE AGENCY LIABILITIES AND FEDERAL SANCTIONS § 276.6 Good.../disallowance and injunctive relief provisions in §§ 276.4 and 276.5, FNS may determine that the State had...

  2. 7 CFR 276.6 - Good cause.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Good cause. 276.6 Section 276.6 Agriculture... FOOD STAMP AND FOOD DISTRIBUTION PROGRAM STATE AGENCY LIABILITIES AND FEDERAL SANCTIONS § 276.6 Good.../disallowance and injunctive relief provisions in §§ 276.4 and 276.5, FNS may determine that the State had...

  3. 7 CFR 276.6 - Good cause.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Good cause. 276.6 Section 276.6 Agriculture... FOOD STAMP AND FOOD DISTRIBUTION PROGRAM STATE AGENCY LIABILITIES AND FEDERAL SANCTIONS § 276.6 Good.../disallowance and injunctive relief provisions in §§ 276.4 and 276.5, FNS may determine that the State had...

  4. 7 CFR 276.6 - Good cause.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Good cause. 276.6 Section 276.6 Agriculture... FOOD STAMP AND FOOD DISTRIBUTION PROGRAM STATE AGENCY LIABILITIES AND FEDERAL SANCTIONS § 276.6 Good.../disallowance and injunctive relief provisions in §§ 276.4 and 276.5, FNS may determine that the State had...

  5. 7 CFR 276.6 - Good cause.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Good cause. 276.6 Section 276.6 Agriculture... FOOD STAMP AND FOOD DISTRIBUTION PROGRAM STATE AGENCY LIABILITIES AND FEDERAL SANCTIONS § 276.6 Good.../disallowance and injunctive relief provisions in §§ 276.4 and 276.5, FNS may determine that the State had...

  6. A Good Teacher Can Teach Anything?

    ERIC Educational Resources Information Center

    Shimon, Jane M.; Brawdy, Paul

    This paper examines issues fundamental to educating thoughtful, competent, intelligent teachers by highlighting arguments against out-of-field teaching in physical education teacher education programs. It discusses the inaccurate notion among some people that a good teacher can teach anything, noting what actually constitutes a good teacher in…

  7. Achieving reuse of computable guideline systems.

    PubMed

    Johnson, P; Tu, S; Jones, N

    2001-01-01

    We describe an architecture for reusing computable guidelines and the programs used to interpret them across varied legacy clinical systems. Developed for the PRODIGY 3 project, our architecture aims to support interactive, point of care use of guidelines in primary care. Legacy medical record systems in UK primary care are diverse, using different terminologies, different data models, and varying user-interface philosophies. However, our goal is to provide common guideline knowledge bases and system components, while achieving full integration with the host medical record system, and a user interface tailored to that system. In conjunction with system suppliers, we identified areas of standardization required to achieve this goal. Firstly, standardized interfaces were created for mediation with the legacy system medical record and for act management. Secondly, a standard interface was developed for communication with the User Interface for guideline interaction. Thirdly, a terminology mapping knowledge base and system component was provided. Lastly, we developed a numeric unit conversion knowledge base and system component. The standardization of this architecture was achieved by close collaboration with existing vendors of Primary Care computing systems in the UK. The work has been verified by two suppliers successfully building and deploying systems with User Interfaces which mirror their normal look and feel, communicating fully with existing medical records, while using identical Guideline Interpreter components and knowledge bases. Encouragingly further experiments in other areas of clinical decision support have not required extension of our interfaces.

  8. EDUCATIONAL ACHIEVEMENT AND THE NAVAJO.

    ERIC Educational Resources Information Center

    HAAS, JOHN; MELVILLE, ROBERT

    A STUDY WAS DEVISED TO APPRAISE THE ACADEMIC ACHIEVEMENT OF NAVAJO STUDENTS LIVING IN DORMITORIES AWAY FROM THE INDIAN RESERVATION. THE FOLLOWING SEVEN FACTORS WERE CHOSEN TO BE INVESTIGATED AS BEING DIRECTLY RELATED TO ACHIEVEMENT--(1) INTELLIGENCE, (2) READING ABILITY, (3) ANXIETY, (4) SELF-CONCEPT, (5) MOTIVATION, (6) VERBAL DEVELOPMENT, (7)…

  9. Sociocultural Origins of Achievement Motivation

    ERIC Educational Resources Information Center

    Maehr, Martin L.

    1977-01-01

    Presents a theoretical review of work on sociocultural influences on achievement, focusing on a critical evaluation of the work of David McClellan. Offers an alternative conception of achievement motivation which stresses the role of contextual and situational factors in addition to personality factors. Available from: Transaction Periodicals…

  10. Teaching the Low Level Achiever.

    ERIC Educational Resources Information Center

    Salomone, Ronald E., Ed.

    1986-01-01

    Intended for teachers of the English language arts, the articles in this issue offer suggestions and techniques for teaching the low level achiever. Titles and authors of the articles are as follows: (1) "A Point to Ponder" (Rachel Martin); (2) "Tracking: A Self-Fulfilling Prophecy of Failure for the Low Level Achiever" (James Christopher Davis);…

  11. Early Intervention and Student Achievement

    ERIC Educational Resources Information Center

    Hormes, Mridula T.

    2009-01-01

    The United States Department of Education has been rigorous in holding all states accountable with regard to student achievement. The No Child Left Behind Act of 2001 clearly laid out federal mandates for all schools to follow. K-12 leaders of public schools are very aware of the fact that results in terms of student achievement need to improve…

  12. Parental Involvement and Academic Achievement

    ERIC Educational Resources Information Center

    Goodwin, Sarah Christine

    2015-01-01

    This research study examined the correlation between student achievement and parent's perceptions of their involvement in their child's schooling. Parent participants completed the Parent Involvement Project Parent Questionnaire. Results slightly indicated parents of students with higher level of achievement perceived less demand or invitations…

  13. Asperger Syndrome and Academic Achievement.

    ERIC Educational Resources Information Center

    Griswold, Deborah E.; Barnhill, Gena P.; Myles, Brenda Smith; Hagiwara, Taku; Simpson, Richard L.

    2002-01-01

    A study focused on identifying the academic characteristics of 21 children and youth who have Asperger syndrome. Students had an extraordinary range of academic achievement scores, extending from significantly above average to far below grade level. Lowest achievement scores were shown for numerical operations, listening comprehension, and written…

  14. Perils of Standardized Achievement Testing

    ERIC Educational Resources Information Center

    Haladyna, Thomas M.

    2006-01-01

    This article argues that the validity of standardized achievement test-score interpretation and use is problematic; consequently, confidence and trust in such test scores may often be unwarranted. The problem is particularly severe in high-stakes situations. This essay provides a context for understanding standardized achievement testing, then…

  15. Stress Correlates and Academic Achievement.

    ERIC Educational Resources Information Center

    Bentley, Donna Anderson; And Others

    An ongoing concern for educators is the identification of factors that contribute to or are associated with academic achievement; one such group of variables that has received little attention are those involving stress. The relationship between perceived sources of stress and academic achievement was examined to determine if reactions to stress…

  16. School Size and Student Achievement

    ERIC Educational Resources Information Center

    Riggen, Vicki

    2013-01-01

    This study examined whether a relationship between high school size and student achievement exists in Illinois public high schools in reading and math, as measured by the Prairie State Achievement Exam (PSAE), which is administered to all Illinois 11th-grade students. This study also examined whether the factors of socioeconomic status, English…

  17. [Clinical research=design*measurements*statistical analyses].

    PubMed

    Furukawa, Toshiaki

    2012-06-01

    A clinical study must address true endpoints that matter for the patients and the doctors. A good clinical study starts with a good clinical question. Formulating a clinical question in the form of PECO can sharpen one's original question. In order to perform a good clinical study one must have a knowledge of study design, measurements and statistical analyses: The first is taught by epidemiology, the second by psychometrics and the third by biostatistics.

  18. Immunopharmacology 2011: an updated report of clinical achievements and perspectives.

    PubMed

    Landys Chovel, Mario; Perea, Silvio; de los Ángeles Robinson, María; Rodeiro, Idania; Delgado, René; Ochoa, Rolando F; Hernández, Ana María

    2011-11-01

    On 26-30 June 2011 the Cuban Society of Pharmacology organized the Second International Congress on Immunopharmacology (Immunopharmacology 2011), held at the beautiful Convention Centre 'Plaza América' and the Meliá Varadero Hotel, in Varadero beach, Cuba. The main topics of the congress were immunopharmacology (including inflammation, cancer immunotherapy and immunomodulation), neuroimmunology, and the pharmacology of cytochrome P450 and transporters, among other relevant and updated related topics. Immunopharmacology 2011 offered an outstanding scientific program with the active contribution of 90 speakers from 23 foreign countries, as well as more than 170 Cuban researchers from the most important local institutions devoted to the development of immunology and pharmacology sciences.

  19. The role of the clinical research coordinator – data manager – in oncology clinical trials

    PubMed Central

    Rico-Villademoros, Fernando; Hernando, Teresa; Sanz, Juan-Luis; López-Alonso, Antonio; Salamanca, Oscar; Camps, Carlos; Rosell, Rafael

    2004-01-01

    Background The purpose of this study was to determine the standard tasks performed by clinical research coordinators (CRCs) in oncology clinical trials. Methods Forty-one CRCs were anonymously surveyed, using a four-page self-administered questionnaire focused on demographics, qualifications, and professional experience. The survey questions on responsibilities consisted of an ad-hoc 32-item questionnaire where respondents had to rate the frequency of involvement in the listed activities using a 3-point scale. We defined as "standard" a task that was rated as "in all or nearly all trials" by at least half of the respondents. Results A response rate of 90% (37 out of 41) was achieved after two mailings. Less than half of the respondents had received additional training in oncology, clinical research or Good Clinical Practices (GCP). Overall, all standard tasks performed by CRCs were in the category of "monitoring activities" (those usually performed by a Clinical Research Associate "CRA") and included patient registration/randomization, recruitment follow-up, case report form completion, collaboration with the CRA, serious adverse events reporting, handling of investigator files, and preparing the site for and/or attending audits. Conclusions CRCs play a key role in the implementation of oncology clinical trials, which goes far beyond mere data collection and/or administrative support, and directly contributes to the gathering of good quality data. PMID:15043760

  20. Clinical Governance: from clinical risk management to continuous quality improvement.

    PubMed

    Chiozza, Maria Laura; Plebani, Mario

    2006-01-01

    Reducing medical errors has become an international concern. Population-based studies from a number of nations around the world have consistently demonstrated unacceptably high rates of medical injury and preventable deaths. The introduction of effective reporting systems is a cornerstone of safe practice within hospitals and other healthcare organisations. Reporting can help to identify hazards and risks. However, reporting in itself does not improve safety. It is the response to reports that leads to change. Clinical teams must feel empowered to change the way in which they deliver their services, promoting effective clinical risk management. Process analysis, implementation of evidence-based practices, and a clear accountability system are effective tools not only for decreasing error rates, but also for improving effectiveness. Clinical Governance represents the context in which effective clinical risk management should be promoted and continuously improved. It should not be regarded as a separate activity, but should form part of the everyday practice of all healthcare professionals. It requires good multidisciplinary working and a willingness to reflect on and learn from errors to achieve a patient-centred and safer system.

  1. How Good Are Statistical Models at Approximating Complex Fitness Landscapes?

    PubMed

    du Plessis, Louis; Leventhal, Gabriel E; Bonhoeffer, Sebastian

    2016-09-01

    Fitness landscapes determine the course of adaptation by constraining and shaping evolutionary trajectories. Knowledge of the structure of a fitness landscape can thus predict evolutionary outcomes. Empirical fitness landscapes, however, have so far only offered limited insight into real-world questions, as the high dimensionality of sequence spaces makes it impossible to exhaustively measure the fitness of all variants of biologically meaningful sequences. We must therefore revert to statistical descriptions of fitness landscapes that are based on a sparse sample of fitness measurements. It remains unclear, however, how much data are required for such statistical descriptions to be useful. Here, we assess the ability of regression models accounting for single and pairwise mutations to correctly approximate a complex quasi-empirical fitness landscape. We compare approximations based on various sampling regimes of an RNA landscape and find that the sampling regime strongly influences the quality of the regression. On the one hand it is generally impossible to generate sufficient samples to achieve a good approximation of the complete fitness landscape, and on the other hand systematic sampling schemes can only provide a good description of the immediate neighborhood of a sequence of interest. Nevertheless, we obtain a remarkably good and unbiased fit to the local landscape when using sequences from a population that has evolved under strong selection. Thus, current statistical methods can provide a good approximation to the landscape of naturally evolving populations.

  2. DPAL: historical perspective and summary of achievements

    NASA Astrophysics Data System (ADS)

    Zhdanov, B. V.; Knize, R. J.

    2013-10-01

    Alkali vapor lasers are under extensive research and development during the past decade because of their potential for scaling to high powers while maintaining a good beam quality. Also, a possibility of using efficient diode lasers for pumping alkali vapor promises high total wall plug efficiency for a Diode Pumped Alkali Laser (DPAL). Since the first DPAL demonstration with output power of 130 mW in 20051, a significant progress in this field was achieved. The output power of about 1 kW in continuous wave (CW) operation with optical efficiency close to 50% was recently demonstrated for a Cs DPAL2. Also, the DPALs based on other alkali metals (Rubidium and Potassium) were demonstrated3,4 . In spite of these significant achievements, there are still several problems in DPAL power scaling exist that must be addressed. Among them are the thermal5 and photoionization6 issues that become important even at power level about several tens of watts. In this paper we present a historical review of the alkali laser research and development, discuss the most important achievements and future perspectives in this field of research.

  3. Good coercion: patients' moral evaluation of coercion in mental health care.

    PubMed

    Lorem, Geir F; Hem, Marit H; Molewijk, Bert

    2015-06-01

    The use of coercion in mental health care is not self-evident and requires moral justification. A joint understanding is difficult to achieve, because patients and health professionals often evaluate coercion differently. The present study aims to discuss patients' 'moral' evaluation of coercion. We believe that such a focus can form the basis for a better and more differentiated understanding of how we evaluate coercion. This is a qualitative study based on participant observation and interviews with patients. In order to focus specifically on the moral evaluation of coercion, we looked within patients' narratives to examine whether we could differentiate between how they experienced coercion and how they morally evaluated its use, and how they envision/describe good coercion. We found that patients differentiated implicitly between experiences and moral evaluation. The findings have been ordered into three types of reactions: agreeing and accepting, fighting or resisting, and resignation. Further reflection upon patients' positive and negative moral evaluations of coercion resulted in the formulation of different concrete elements at three levels: threshold elements, process elements, and empathic elements. These elements helped us to understand what these patients considered 'good coercion'. The implications are that good clinical practice cannot be separated from the formal, moral evaluation of coercion. A differentiated moral understanding of coercion can form the basis for better and more sensitive communication about coercion among all those involved. A more respectful dialogue on the moral evaluation of coercion might also raise awareness during both the decision-making process and the actual practising of coercion.

  4. Gender Issues in Gifted Achievement: Are Girls Making Inroads While Boys Fall Behind?

    ERIC Educational Resources Information Center

    Rimm, Sylvia B.

    2015-01-01

    School and life achievement patterns for girls and women differ from those of boys and men. While girls have made dramatic progress in school, they need to be inspired to connect to lifelong achievement. Both research and clinical work at the Ohio-based Family Achievement Clinic find that more boys than girls underachieve in school. There is much…

  5. Health expenditures, health outcomes and the role of good governance.

    PubMed

    Farag, Marwa; Nandakumar, A K; Wallack, Stanley; Hodgkin, Dominic; Gaumer, Gary; Erbil, Can

    2013-03-01

    This paper examines the relationship between country health spending and selected health outcomes (infant mortality and child mortality), using data from 133 low and middle-income countries for the years 1995, 2000, 2005, and 2006. Health spending has a significant effect on reducing infant and under-5 child mortality with an elasticity of 0.13 to 0.33 for infant mortality and 0.15 to 0.38 for under-5 child mortality in models estimated using fixed effects methods (depending on models employed). Government health spending also has a significant effect on reducing infant and child mortality and the size of the coefficient depends on the level of good governance achieved by the country, indicating that good governance increases the effectiveness of health spending. This paper contributes to the new evidence pointing to the importance of investing in health care services and the importance of governance in improving health outcomes.

  6. On research in clinical practice.

    PubMed

    Nanivadekar, Arun

    2010-01-01

    Clinical research implies advancing current knowledge about health care by continually developing and testing new ideas about diseases, products, procedures, and strategies. Although this trait is inherent in human nature, it needs to be encouraged, nurtured, groomed, and channelized by creating a suitable atmosphere for it, providing the necessary resources, inculcating the necessary conceptual and manual skills, and rewarding the efforts and achievements suitably. Language, logic, statistics, and psychology play an important role in acquiring and developing research capability. To be socially relevant and economically viable, clinical research will need to partner with patients and their doctors in identifying what their goals of health care are, what they value, and what they are willing to "buy" in terms of goods and services. Besides, clinical research will need to bring on one platform the sponsors, the researchers, the patients, the payers, and the regulators to ensure that they do not work at cross purposes, that the cost of developing health care measures is scaled down through innovative approaches such as large simple trials, sequential trials, early marketing conditional on post-marketing surveillance, and so on. All these will be possible if day-to-day practice is slowly and systemically transformed into the largest laboratory of clinical research, which it ought to be, by forming networks of research-oriented practices, and popularizing the use of data collection and analysis tools such as Epi Info which are in the public domain.

  7. Very good partial response in a patient with MALT-lymphoma of the lung after treatment with low-dose thalidomide.

    PubMed

    Kees, Mathias; Raderer, Markus; Metz-Schimmerl, Sylvia; Chott, Andreas; Gisslinger, Heinz

    2005-09-01

    Pulmonary MALT lymphoma is a rare disease entity and generally follows an indolent clinical course. Due to scarce information from randomized prospective trials, no standardized therapy protocols exist. Besides irradiation and chemotherapy, novel biological agents such as the anti CD20-antibody rituximab and thalidomide constitute a promising new approach. In this report we demonstrate the case of a 52-year-old male patient with extra-intestinal MALT lymphoma of the lung. After 10 months of treatment with low dose thalidomide (100mg/d), very good partial response of the intrapulmonary lesions was achieved.

  8. Finding Good Health Information on the Internet

    MedlinePlus

    ... Health Information Finding Good Health Information on the Internet Past Issues / Fall 2016 Table of Contents Stephanie ... conditions, medications, and wellness issues. Our site provides access to information produced by the National Library of ...

  9. 19 CFR 10.594 - Originating goods.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... entirely in the territory of one or more of the Parties and: (1) Each non-originating material used in the production of the good undergoes an applicable change in tariff classification specified in General Note...

  10. 19 CFR 10.531 - Originating goods.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the Parties; (b) The good is transformed in one or both of the Parties so that: (1) Each non-originating material undergoes an applicable change in tariff classification specified in General Note...

  11. Tips for Getting a Good Night's Sleep

    MedlinePlus

    ... of this page please turn JavaScript on. Feature: Sleep Disorders Tips for Getting A Good Night's Sleep Past ... in bed at night, you may have a sleep disorder. Your family healthcare provider or a sleep specialist ...

  12. The Goodness of Simultaneous Fits in ISIS

    NASA Astrophysics Data System (ADS)

    Kühnel, Matthias; Falkner, Sebastian; Grossberger, Christoph; Ballhausen, Ralf; Dauser, Thomas; Schwarm, Fritz-Walter; Kreykenbohm, Ingo; Nowak, Michael A.; Pottschmidt, Katja; Ferrigno, Carlo; Rothschild, Richard E.; Martínez-Núñez, Silvia; Torrejón, José Miguel; Fürst, Felix; Klochkov, Dmitry; Staubert, Rüdiger; Kretschmar, Peter; Wilms, Jörn

    2016-02-01

    In a previous work, we introduced a tool for analyzing multiple datasets simultaneously, which has been implemented into ISIS. This tool was used to fit many spectra of X-ray binaries. However, the large number of degrees of freedom and individual datasets raise an issue about a good measure for a simultaneous fit quality. We present three ways to check the goodness of these fits: we investigate the goodness of each fit in all datasets, we define a combined goodness exploiting the logical structure of a simultaneous fit, and we stack the fit residuals of all datasets to detect weak features. These tools are applied to all RXTE-spectra from GRO 1008-57, revealing calibration features that are not detected significantly in any single spectrum. Stacking the residuals from the best-fit model for the Vela X-1 and XTE J1859+083 data evidences fluorescent emission lines that would have gone undetected otherwise.

  13. Childhood Obesity and Cognitive Achievement.

    PubMed

    Black, Nicole; Johnston, David W; Peeters, Anna

    2015-09-01

    Obese children tend to perform worse academically than normal-weight children. If poor cognitive achievement is truly a consequence of childhood obesity, this relationship has significant policy implications. Therefore, an important question is to what extent can this correlation be explained by other factors that jointly determine obesity and cognitive achievement in childhood? To answer this question, we exploit a rich longitudinal dataset of Australian children, which is linked to national assessments in math and literacy. Using a range of estimators, we find that obesity and body mass index are negatively related to cognitive achievement for boys but not girls. This effect cannot be explained by sociodemographic factors, past cognitive achievement or unobserved time-invariant characteristics and is robust to different measures of adiposity. Given the enormous importance of early human capital development for future well-being and prosperity, this negative effect for boys is concerning and warrants further investigation.

  14. Using Design To Achieve Sustainability

    EPA Science Inventory

    Sustainability is defined as meeting the needs of this generation without compromising the ability of future generations to meet their needs. This is a conditional statement that places the responsibility for achieving sustainability squarely in hands of designers and planners....

  15. Wisdom, technology, and the good life.

    PubMed Central

    Markey, H T

    1979-01-01

    Wisdom lies in extraction of good from new and old. Wisdom alone produces a society of wise men unable to leave their caves. Technology alone produces a society ruled by cold, despotic facts. A proper combination of wisdom and technology can produce the good life. That requires recognition of our ambivalence toward technology, a move away from our superspecialization of technologists and nontechnologists and toward a clearer understanding of technology as a most important servant of man. PMID:396156

  16. Achieving Efficiencies in Army Installations.

    DTIC Science & Technology

    2007-11-02

    34" ’■■"■" 1 USAWC STRATEGY RESEARCH PROJECT Achieving Efficiencies in Army Installations by Richard Fliss Col. Richard M. Meinhart Project...government agency. STRATEGY RESEARCH PROJECT ACHIEVING EFFICIENCIES IN ARMY INSTALLATIONS BY RICHARD FLISS DISTRIBUTION STATEMENT A: Approved...for public release. Distribution is unlimited. DTIC QUALITY INSPECTED & USAWC CLASS OF 1998 U.S. ARMY WAR COLLEGE, CARLISLE BARRACKS, PA 17013-5050

  17. Feeling good and bad about the past and future self.

    PubMed

    Pillemer, David B; Thomsen, Dorthe; Kuwabara, Kie J; Ivcevic, Zorana

    2013-01-01

    Prior research has shown that memories of feeling good about the self often focus on achievement themes, whereas memories of feeling bad about the self often focus on interpersonal themes. This study examined whether a similar relationship would be evident for imagined future events. Young adults in the United States and Denmark provided memories and imagined future events that are associated with positive or negative self-regard. Across cultures, achievement themes were prominently represented in memories of positive self-regard and interpersonal themes were prominently represented in memories of negative self-regard. In contrast, relationships between the emotional valence and thematic content of imagined future events were weak and inconsistent. Our results raise new questions for the theory that imagined future episodes are constructed primarily from recombinations of past episodes.

  18. Concept analysis of good death in long term care residents.

    PubMed

    Krishnan, Preetha

    2017-01-02

    The purpose of this concept analysis paper is to delineate the meaning of good death in long term care (LTC) settings and examine its implications for nursing. The Walker and Avant (2011) method was chosen for this analysis. An in depth literature review identifies uses of the concept and determines the defining attributes of the good death. This paper also illustrates case presentations, antecedents, consequences, empirical referents and implications for clinical practice to clarify the concept of 'good death' in this population. In LTC, death is experienced frequently and is considered the ultimate outcome for most admissions. Much of the existing research on end-of-life care has focused on community dwelling cancer patients whose death trajectory is predictable and who may remain cognitively intact until actively dying. In contrast, the LTC population is older and more likely to suffer from dementia and experience chronic illness for long periods prior to death, and they follow a less predictable death trajectory. In this century, death became the province of older people and the assurance of a good death became the responsibility of those caring for them.

  19. Study on achieving speech privacy using masking noise

    NASA Astrophysics Data System (ADS)

    Tamesue, Takahiro; Yamaguchi, Shizuma; Saeki, Tetsuro

    2006-11-01

    This study focuses on achieving speech privacy using a meaningless steady masking noise. The most effective index for achieving a satisfactory level of speech privacy was selected, choosing between spectral distance and the articulation index. From a result, spectral distance was selected as the best and most practical index for achieving speech privacy. Next, speech along with a masking noise with a sound pressure level value corresponding to various speech privacy levels were presented to subjects who judged the psychological impression of the particular speech privacy level. Theoretical calculations were in good agreement with the experimental results.

  20. Regulatory aspects for translating gene therapy research into the clinic.

    PubMed

    Laurencot, Carolyn M; Ruppel, Sheryl

    2009-01-01

    Gene therapy products are highly regulated, therefore moving a promising candidate from the laboratory into the clinic can present unique challenges. Success can only be achieved by proper planning and communication within the clinical development team, as well as consultation with the regulatory scientists who will eventually review the clinical plan. Regulators should not be considered as obstacles but rather as collaborators whose advice can significantly expedite the product development. Sound scientific data is required and reviewed by the regulatory agencies to determine whether the potential benefit to the patient population outweighs the risk. Therefore, compliance with Good Manufacturing Practice (GMP) and Good Laboratory Practice (GLP) principles to ensure quality, safety, purity, and potency of the product, and to establish "proof of concept" for efficacy, and for safety information, respectively, is essential. The design and conduct of the clinical trial must adhere to Good Clinical Practice (GCP) principals. The clinical protocol should contain adequate rationale, supported by nonclinical data, to justify the starting dose and regimen, and adequate safety monitoring based on the patient population and the anticipated toxicities. Proper review and approval of gene therapy clinical studies by numerous committees, and regulatory agencies before and throughout the study allows for ongoing risk assessment of these novel and innovative products. The ethical conduct of clinical trials must be a priority for all clinical investigators and sponsors. As history has shown us, only a few fatal mistakes can dramatically alter the regulation of investigational products for all individuals involved in gene therapy clinical research, and further delay the advancement of gene therapy to licensed medicinal products.

  1. Cambodian Early Adolescents' Academic Achievement: The Role of Social Capital

    ERIC Educational Resources Information Center

    Eng, Sothy

    2013-01-01

    This study examined the associations of parents' cultural beliefs and attitudes with respect to fate, traditional gender roles, aspirations, and involvement in children's academic achievement in Cambodia. Based on Coleman's social capital theory, a good parent-child relationship enables children's school success because resources are created as a…

  2. Student Achievement in New York State, 1982-83.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Div. of Educational Testing.

    Analysis of the available data suggests that New York's elementary and secondary schools, taken as a whole, compiled a good record of achievement during the 1982-83 school year. Three kinds of test data were analyzed. One was the result of a study which involved the collection of scores on three commercially available standardized tests: the…

  3. Is Good Fit Related to Good Behaviour? Goodness of Fit between Daycare Teacher-Child Relationships, Temperament, and Prosocial Behaviour

    ERIC Educational Resources Information Center

    Hipson, Will E.; Séguin, Daniel G.

    2016-01-01

    The Goodness-of-Fit model [Thomas, A., & Chess, S. (1977). Temperament and development. New York: Brunner/Mazel] proposes that a child's temperament interacts with the environment to influence child outcomes. In the past, researchers have shown how the association between the quality of the teacher-child relationship in daycare and child…

  4. Childhood vaccination: achievements and challenges.

    PubMed

    Ndumbe, P

    1996-09-01

    As the goal of eradicating smallpox was being met, the World Health Organization created its Expanded Programme on Immunisation (EPI) in 1974 and reached its initial goal of achieving full vaccination of 80% of the world's children by 1990. This effort was aided by the creation of "cold chain" delivery systems and resulted in the annual saving of 3.5 million children in less-developed countries. Current EPI vaccination goals include 1) eradication of poliomyelitis by the year 2000, 2) elimination of neonatal tetanus by the year 1995, 3) control of measles and hepatitis B, and 4) immunization of 90% of the world's children 1 year or younger by the year 2000. Goals of the Children's Vaccine Initiative (formed in 1991) include 1) provision of an adequate supply of affordable, safe, and effective vaccines; 2) production of improved and new vaccines; and 3) simplification of the logistics of vaccine delivery. Future challenges are to sustain high vaccination coverage, reach the unreached, achieve proper storage of vaccines and reduce waste, integrate new vaccines into national programs, and achieve vaccine self-sufficiency. The fact that these challenges will be difficult to achieve is illustrated by the situation in Africa where the high immunization levels achieved in 1990 have dropped dramatically. Those who must act to implement immunization programs are health personnel, families, governments, and development partners. In order to achieve equity in health, every child must be reached, governments must be made accountable for programs, health workers must convince families of the importance of vaccination, delivery systems must be in place to take advantage of the new vaccines being delivered, and a multisectoral approach must be taken to assure sustainability.

  5. Paying for international environmental public goods.

    PubMed

    Arriagada, Rodrigo; Perrings, Charles

    2011-11-01

    Supply of international environmental public goods must meet certain conditions to be socially efficient, and several reasons explain why they are currently undersupplied. Diagnosis of the public goods failure associated with particular ecosystem services is critical to the development of the appropriate international response. There are two categories of international environmental public goods that are most likely to be undersupplied. One has an additive supply technology and the other has a weakest link supply technology. The degree to which the collective response should be targeted depends on the importance of supply from any one country. In principle, the solution for the undersupply lies in payments designed to compensate local providers for the additional costs they incur in meeting global demand. Targeted support may take the form of direct investment in supply (the Global Environment Facility model) or of payments for the benefits of supply (the Payments for Ecosystem Services model).

  6. Rainmakers: why bad weather means good productivity.

    PubMed

    Lee, Jooa Julia; Gino, Francesca; Staats, Bradley R

    2014-05-01

    People believe that weather conditions influence their everyday work life, but to date, little is known about how weather affects individual productivity. Contrary to conventional wisdom, we predict and find that bad weather increases individual productivity and that it does so by eliminating potential cognitive distractions resulting from good weather. When the weather is bad, individuals appear to focus more on their work than on alternate outdoor activities. We investigate the proposed relationship between worse weather and higher productivity through 4 studies: (a) field data on employees' productivity from a bank in Japan, (b) 2 studies from an online labor market in the United States, and (c) a laboratory experiment. Our findings suggest that worker productivity is higher on bad-, rather than good-, weather days and that cognitive distractions associated with good weather may explain the relationship. We discuss the theoretical and practical implications of our research.

  7. [Can tobacco companies be good corporate citizens?].

    PubMed

    Palazzo, G; Mena, S

    2009-07-01

    Tobacco companies have jumped on the Corporate social responsibility (CSR) bandwagon as a tentative to be societally accepted as responsible actors and good corporate citizens. This is however not possible for two reasons. First, the product they sell is lethal and thus not compatible with the precondition of doing no harm to be a good corporate citizen. Second, the behavior of tobacco firms is not responsible, being illustrated by four examples: junk science versus sound science strategy, seducing young smokers, political lobbying and getting customers on new markets. To conclude, three implications for regulating the activities of the tobacco industry are given.

  8. The Heart of the Matter. About Good Nursing and Telecare

    PubMed Central

    2010-01-01

    Nurses and ethicists worry that the implementation of care at a distance or telecare will impoverish patient care by taking out ‘the heart’ of the clinical work. This means that telecare is feared to induce the neglect of patients, and to possibly hinder the development of a personal relation between nurse and patient. This study aims to analyse whether these worries are warranted by analysing Dutch care practices using telemonitoring in care for chronic patients in the Netherlands. How do clinical practices of nursing change when telecare devices are introduced and what this means for notions and norms of good nursing? The paper concludes that at this point the practices studied do not warrant the fear of negligence and compromised relations. Quite the contrary; in the practices studied, telecare lead to more frequent and more specialised contacts between nurses and patients. The paper concludes by reflecting on the ethical implications of these changes. PMID:20063198

  9. A good growth in a child with scurvy.

    PubMed

    Valentini, Diletta; Barbuti, Domenico; Grandin, Annalisa; De Horatio, Laura Tanturri; Villani, Alberto

    2011-04-13

    We report on a 13-month-old boy who experienced pain while mobilising, and had bruising and swelling of the lower limbs. Laboratory examinations revealed anaemia and skeletal x-rays showed irregularity and thickening of the provisional zones of calcification of lower and upper limbs. The boy had been fed with only goat milk, homogenised meat, fruits and vegetables, all of which had been boiled together. Forty-eight hours after starting oral vitamin C supplementation, the patient showed dramatic clinical improvement. The clinical presentation, laboratory and imaging findings, together with the good response to vitamin C intake, allowed us to confirm the diagnosis of infantile scurvy. Scurvy is a disease that can be found among children, especially among groups with restrictive eating pattern. Fortunately, once diagnosed, scurvy is an easily treatable disease by administration of vitamin C and a correct diet that is rich in fruits, vegetables and fresh meat, all of which contained vitamin C.

  10. Recognising `good at mathematics': using a performative lens for identity

    NASA Astrophysics Data System (ADS)

    Darragh, Lisa

    2015-03-01

    Many students do not recognise in themselves positive learner identities in mathematics and thus exclude themselves from further mathematics education, limiting their life opportunities. In this study, I use a performance metaphor for identity, drawing on G.H. Mead, Erving Goffman and Judith Butler to analyse interviews with students, taken at four time points as they make the transition from primary to secondary school. The question I focus on is `How do you recognise someone who is "good at mathematics"?' The students' responses reveal that there is a wide variety of scripts available when enacting the role of `good at mathematics', and these include getting high marks, knowing the answer quickly, helping others and demonstrating the confidence to put up their hand to answer questions. Despite the variety of ways in which to demonstrate `good at mathematics', most of the students did not recognise themselves in their own descriptions. This goes some way towards explaining why students may opt out of further study in mathematics, despite high achievement in this subject.

  11. Washington State's Student Achievement Initiative

    ERIC Educational Resources Information Center

    Pettitt, Maureen; Prince, David

    2010-01-01

    This article describes Washington State's Student Achievement Initiative, an accountability system implemented in 2005-06 that measures students' gains in college readiness, college credits earned, and degree or certificate completion. The goal of the initiative is to increase educational attainment by focusing on the critical momentum points…

  12. Meeting a Math Achievement Crisis

    ERIC Educational Resources Information Center

    Jennings, Lenora; Likis, Lori

    2005-01-01

    An urban community spotlighted declining mathematics achievement and took some measures, in which the students' performance increased substantially. The Benjamin Banneker Charter Public School in Cambridge, Massachusetts, engaged the entire community and launched the campaign called "Math Everywhere", which changed Benjamin Banneker's…

  13. Socioeconomic Determinants of Academic Achievement

    ERIC Educational Resources Information Center

    Tomul, Ekber; Savasci, Havva Sebile

    2012-01-01

    This study aims to investigate the relationship between academic achievement and the socioeconomic characteristics of elementary school 7th grade students in Burdur. The population of the study are 7th grade students who had education at elementary schools in Burdur in the 2007-2008 academic year. Two staged sampling was chosen as suitable for the…

  14. Goal Setting to Achieve Results

    ERIC Educational Resources Information Center

    Newman, Rich

    2012-01-01

    Both districts and individual schools have a very clear set of goals and skills for their students to achieve and master. In fact, except in rare cases, districts and schools develop very detailed goals they wish to pursue. In most cases, unfortunately, only the teachers and staff at a particular school or district-level office are aware of the…

  15. School Districts and Student Achievement

    ERIC Educational Resources Information Center

    Chingos, Matthew M.; Whitehurst, Grover J.; Gallaher, Michael R.

    2015-01-01

    School districts are a focus of education reform efforts in the United States, but there is very little existing research about how important they are to student achievement. We fill this gap in the literature using 10 years of student-level, statewide data on fourth- and fifth-grade students in Florida and North Carolina. A variance decomposition…

  16. Student Achievement, 1986-87.

    ERIC Educational Resources Information Center

    Mangino, Evangelina

    This report summarizes results of student achievement in the Austin (Texas) Independent School District (AISD) on the Texas Educational Assessment of Minimum Skills (TEAMS) tests in 1986-87. Major findings indicate the following: (1) 99.4% of AISD seniors to graduate in May 1987 passed the Exit-Level TEAMS tests, with only 17 denied diplomas in…

  17. Sociocultural Variation in Literacy Achievement

    ERIC Educational Resources Information Center

    Verhoeven, Ludo

    2006-01-01

    The purpose of this study was to describe the variations in literacy achievement among native and non-native upper primary school children (grades three to six) in the Netherlands. Various measures of word decoding, reading literacy and writing skill were collected from 1091 native Dutch children, 753 children with a former Dutch colonial…

  18. Game Addiction and Academic Achievement

    ERIC Educational Resources Information Center

    Sahin, Mehmet; Gumus, Yusuf Yasin; Dincel, Sezen

    2016-01-01

    The primary aim of this study was to investigate the correlation between game addiction and academic achievement. The secondary aim was to adapt a self-report instrument to measure game addiction. Three hundred and seventy high school students participated in this study. Data were collected via an online questionnaire that included a brief…

  19. The Widening Income Achievement Gap

    ERIC Educational Resources Information Center

    Reardon, Sean F.

    2013-01-01

    Has the academic achievement gap between high-income and low-income students changed over the last few decades? If so, why? And what can schools do about it? Researcher Sean F. Reardon conducted a comprehensive analysis of research to answer these questions and came up with some striking findings. In this article, he shows that income-related…

  20. Attribution Theory in Science Achievement

    ERIC Educational Resources Information Center

    Craig, Martin

    2013-01-01

    Recent research reveals consistent lags in American students' science achievement scores. Not only are the scores lower in the United States compared to other developed nations, but even within the United States, too many students are well below science proficiency scores for their grade levels. The current research addresses this problem by…

  1. Grouping Students for Increased Achievements.

    ERIC Educational Resources Information Center

    Holloway, John H.

    2001-01-01

    Reviews results of four recent studies exploring the effects of various student-grouping schemes on academic achievement. Grouping plans included multiage classrooms, full-time ability grouping, and within-classroom grouping. Two studies investigated administrator attitudes toward student grouping. Several studies found that grouping plans…

  2. Achievement, Hedonism and the Teacher.

    ERIC Educational Resources Information Center

    Ryan, Kevin

    1991-01-01

    The problem of poor school achievement is in part because students lack work and discipline values. The article suggests moral and ethical teachings inspire students to be better scholars and people; and teacher education must prepare teachers to be moral educators by reintroducing moral education into the curriculum. (SM)

  3. School Desegregation and Black Achievement.

    ERIC Educational Resources Information Center

    Cook, Thomas; And Others

    Seven papers commissioned by the National Institute of Education in order to clarify the state of recent knowledge about the effects of school desegregation on the academic achievement of black students are contained in this report. The papers, which analyze 19 "core" empirical studies on this topic, include: (1) "What Have Black Children Gained…

  4. Institutional Climate and Minority Achievement.

    ERIC Educational Resources Information Center

    Richardson, Richard C.

    This paper discusses ways that institutions can change the higher education system and environment to accommodate more minority students. The first section, "Institutional Climate and Minority Achievement," presents an overview of the problems facing colleges and universities with respect to recruiting and retaining minority students. In the…

  5. Faculty Development: Assessing Learner Achievement.

    ERIC Educational Resources Information Center

    Frey, Barbara A.; Overfield, Karen

    This study addressed the challenges of developing a faculty professional development workshop on assessment, measurement, and evaluation of achievement in adult learners. The setting for the workshop was a system of postsecondary career colleges throughout the United States. The curriculum development model of D. Kirkpatrick (1994) was used as a…

  6. Can Judges Improve Academic Achievement?

    ERIC Educational Resources Information Center

    Greene, Jay P.; Trivitt, Julie R.

    2008-01-01

    Over the last 3 decades student achievement has remained essentially unchanged in the United States, but not for a lack of spending. Over the same period a myriad of education reforms have been suggested and per-pupil spending has more than doubled. Since the 1990s the education reform attempts have frequently included judicial decisions to revise…

  7. Achieving a sustainable service advantage.

    PubMed

    Coyne, K P

    1993-01-01

    Many managers believe that superior service should play little or no role in competitive strategy; they maintain that service innovations are inherently copiable. However, the author states that this view is too narrow. For a company to achieve a lasting service advantage, it must base a new service on a capability gap that competitors cannot or will not copy.

  8. Teacher Dispositions and Student Achievement

    ERIC Educational Resources Information Center

    Vaughn, Kathleen Adams

    2012-01-01

    In an effort to close the achievement gap between students of minority and majority populations and between students in higher and lower economic circumstances, the National Council for the Accreditation of Teacher Education (NCATE) added instruction and evaluation of teacher dispositions to its requirements for credentialing prospective teachers.…

  9. Epistemological Beliefs and Academic Achievement

    ERIC Educational Resources Information Center

    Arslantas, Halis Adnan

    2016-01-01

    This study aimed to identify the relationship between teacher candidates' epistemological beliefs and academic achievement. The participants of the study were 353 teacher candidates studying their fourth year at the Education Faculty. The Epistemological Belief Scale was used which adapted to Turkish through reliability and validity work by…

  10. Achieving breakthrough outcomes: measurable ROI.

    PubMed

    Orkin, Fredric I; Aruffo, Sylvia

    2006-01-01

    You're a case manager. Your boss is talking return on investment (ROI). Your patients don't want to be numbers on a spreadsheet. What does it take to be a hero to both the boss and the patient? Case managers frequently try to argue that great gains in quality of life for the patient are so valuable that management ought to ease up on case managers when talking about budget and returns. An experienced quality professional might respond, "Good luck."

  11. Good Laboratory Practice. Part 1. An Introduction

    ERIC Educational Resources Information Center

    Wedlich, Richard C.; Libera, Agata E.; Pires, Amanda; Therrien, Matthew T.

    2013-01-01

    The Good Laboratory Practice (GLP) regulations were put into place in 1978. They establish a standard of practice to ensure that results from the nonclinical laboratory study reported to the U.S. Food and Drug Administration (FDA) are valid and that the study report accurately reflects the conduct of the study. While the GLP regulations promulgate…

  12. Omega-3 fats: Good for your heart

    MedlinePlus

    ... arteries - omega-3s; Coronary artery disease - omega-3s; Heart disease - omega-3s ... Omega-3s are good for your heart and blood vessels in several ways. They reduce triglycerides , a type of fat in your blood. They reduce the risk of an ...

  13. Very Good Medicine: Indigenous Humor and Laughter

    ERIC Educational Resources Information Center

    Mala, Cynthia Lindquist

    2016-01-01

    Humor is not only instinctive and a basic human need, but it also is very good medicine. Laughter boosts the immune system, lowers blood pressure, reduces stress hormones, and is linked to healthy functioning organs. [This article was written with Mylo Redwater Smith.

  14. 19 CFR 10.914 - Originating goods.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Originating goods. 10.914 Section 10.914 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Peru Trade Promotion...

  15. 19 CFR 10.914 - Originating goods.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Originating goods. 10.914 Section 10.914 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Peru Trade Promotion...

  16. 19 CFR 10.914 - Originating goods.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Originating goods. 10.914 Section 10.914 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Peru Trade Promotion...

  17. 19 CFR 10.1014 - Originating goods.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Originating goods. 10.1014 Section 10.1014 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Korea Free Trade Agreement...

  18. 19 CFR 10.1014 - Originating goods.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Originating goods. 10.1014 Section 10.1014 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Korea Free Trade Agreement...

  19. 19 CFR 10.1014 - Originating goods.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Originating goods. 10.1014 Section 10.1014 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Korea Free Trade Agreement...

  20. Athletics: The Good It Should Do

    ERIC Educational Resources Information Center

    Stoll, Sharon Kay

    2011-01-01

    The purpose of this article is to discuss a coach's perspective of the good that sport should do. The author argues that the relationships developed through the coaching experience are powerful, formative, and exceptional. She discusses the important moral values of sharing and caring and how these are important in the moral development of the…

  1. Planning Behaviour in Good and Poor Readers

    ERIC Educational Resources Information Center

    Mahapatra, Shamita

    2016-01-01

    A group of 50 good readers and a group of 50 poor readers of Grade 5 matched for age and intelligence and selected on the basis of their proficiency in reading comprehension were tested for their competence in word reading and the process of planning at three different levels, namely, perceptual, memory and conceptual in order to study the…

  2. Planning Good Change with Technology and Literacy.

    ERIC Educational Resources Information Center

    McKenzie, Jamie

    This book describes strategies to put information literacy and student learning at the center of technology planning. Filled with stories of success and with models of good planning, the book shows how to clarify purpose, involve important stakeholders, and pace the change process to maximize the daily use of new technologies. The following…

  3. Globalizing Students Acting for the Common Good

    ERIC Educational Resources Information Center

    Bencze, Larry; Carter, Lyn

    2011-01-01

    It is apparent that many of us live in a hyper-economized world, in which personal identities and routine practices are significantly oriented towards production and consumption of for-profit goods and services. Extreme consumerism resulting from this orientation often is associated with many personal, social, and environmental problems.…

  4. 19 CFR 10.770 - Originating goods.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Originating goods. 10.770 Section 10.770 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Morocco Free Trade...

  5. Virtual Goods Recommendations in Virtual Worlds

    PubMed Central

    Chen, Kuan-Yu; Liao, Hsiu-Yu; Chen, Jyun-Hung; Liu, Duen-Ren

    2015-01-01

    Virtual worlds (VWs) are computer-simulated environments which allow users to create their own virtual character as an avatar. With the rapidly growing user volume in VWs, platform providers launch virtual goods in haste and stampede users to increase sales revenue. However, the rapidity of development incurs virtual unrelated items which will be difficult to remarket. It not only wastes virtual global companies' intelligence resources, but also makes it difficult for users to find suitable virtual goods fit for their virtual home in daily virtual life. In the VWs, users decorate their houses, visit others' homes, create families, host parties, and so forth. Users establish their social life circles through these activities. This research proposes a novel virtual goods recommendation method based on these social interactions. The contact strength and contact influence result from interactions with social neighbors and influence users' buying intention. Our research highlights the importance of social interactions in virtual goods recommendation. The experiment's data were retrieved from an online VW platform, and the results show that the proposed method, considering social interactions and social life circle, has better performance than existing recommendation methods. PMID:25834837

  6. Can Suicide Be a Good Death?

    ERIC Educational Resources Information Center

    Lester, David

    2006-01-01

    The issue of whether suicide can be a good death was separated into two different questions: (1) can suicide be an appropriate death, and (2) can suicide be a rational death? Several definitions of an "appropriate" death were proposed, and suicide was seen as potentially appropriate. Similarly, several criteria for rationality were proposed and…

  7. 19 CFR 10.810 - Originating goods.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., that has been grown, produced, or manufactured in the territory of one or both of the Parties, is... considered an originating good under the BFTA only if the sum of the value of materials produced in one or... having undergone simple combining or packaging operations, or mere dilution with water or...

  8. Postwar Headteachers' Perspectives of "Good" Teachers

    ERIC Educational Resources Information Center

    Whitehead, Kay

    2003-01-01

    In this article, the author focuses in what counted as a "good" teacher on the cusp of a significant change in the profile of the teaching workforce from single to married women. As Jackie Blount notes, single women had dominated state school systems numerically for the century preceding the Second World War but by the late 1940s the…

  9. Spatial dynamics of ecological public goods

    PubMed Central

    Wakano, Joe Yuichiro; Nowak, Martin A.; Hauert, Christoph

    2009-01-01

    The production, consumption, and exploitation of common resources ranging from extracellular products in microorganisms to global issues of climate change refer to public goods interactions. Individuals can cooperate and sustain common resources at some cost or defect and exploit the resources without contributing. This generates a conflict of interest, which characterizes social dilemmas: Individual selection favors defectors, but for the community, it is best if everybody cooperates. Traditional models of public goods do not take into account that benefits of the common resource enable cooperators to maintain higher population densities. This leads to a natural feedback between population dynamics and interaction group sizes as captured by “ecological public goods.” Here, we show that the spatial evolutionary dynamics of ecological public goods in “selection-diffusion” systems promotes cooperation based on different types of pattern formation processes. In spatial settings, individuals can migrate (diffuse) to populate new territories. Slow diffusion of cooperators fosters aggregation in highly productive patches (activation), whereas fast diffusion enables defectors to readily locate and exploit these patches (inhibition). These antagonistic forces promote coexistence of cooperators and defectors in static or dynamic patterns, including spatial chaos of ever-changing configurations. The local environment of cooperators and defectors is shaped by the production or consumption of common resources. Hence, diffusion-induced self-organization into spatial patterns not only enhances cooperation but also provides simple mechanisms for the spontaneous generation of habitat diversity, which denotes a crucial determinant of the viability of ecological systems. PMID:19416839

  10. Teacher Dispositions as Predictors of Good Teaching

    ERIC Educational Resources Information Center

    Helm, Carroll M.

    2006-01-01

    In this article, the author seeks to discern whether it is possible to identify people who are predisposed to become good teachers as if it was a kind of calling in the same manner in which ministers are called to the ministry. The author cites a 2005 study by Wayda and Lund, who developed rubrics to address the student's suitability for the…

  11. Higher Education for the Public Good

    ERIC Educational Resources Information Center

    Perez, Angel B.

    2012-01-01

    In his 1988 article, Nathaniel Jackson inspired NACAC with four objectives to meet the challenge of leading the charge in minority students access. In this article, the author discusses three more that he believes will challenge colleges in the decades ahead: (1) Focus on the Public Good; (2) Honor Transparency; and (3) Measure Collective Success.…

  12. 42 CFR 93.210 - Good faith.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Good faith. 93.210 Section 93.210 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  13. Spiritual Development as a Social Good

    ERIC Educational Resources Information Center

    Hicks, Mona; Tran-Parsons, Uyen

    2013-01-01

    The skill development of equanimity and empathy gained through spiritual growth equips students to examine solutions to complex problems in a diverse, global society. This chapter explores intentional multicultural initiatives designed to foster spiritual development and interfaith engagement as means to navigate difference and social good.

  14. Good governance of national veterinary services.

    PubMed

    Schneider, H

    2011-04-01

    The beginning of the 21st Century has been characterised by changed political and economic realities affecting the prevention, control and eradication of animal diseases and zoonoses and presenting new challenges to the veterinary profession. Veterinary Services (VS) need to have the capacity and capabilities to face these challenges and be able to detect, prevent, control and eradicate disease threats. Animal health and VS, being a public good, require global initiatives and collective international action to be able to implement global animal disease eradication. The application of the 'One World, One Health' strategy at the animal-human interface will strengthen veterinary capacity to meet this challenge. Good governance of VS at the national, regional and global level is at the heart of such a strategy. In this paper, the author lists the key elements comprising good veterinary governance and discusses the World Organisation for Animal Health (OIE) standards for the quality of VS. The OIE Tool for the Evaluation of the Performance of Veterinary Services (OIE PVS Tool) is introduced and its relevance in assessing compliance with OIE standards to prevent the spread of pathogens through trade is highlighted. A firm political commitment at the national, regional and international level, with provision of the necessary funding at all levels, is an absolute necessity in establishing good governance of VS to meet the ever-increasing threats posed by animal and human pathogens.

  15. What is Good University Financial Management?

    ERIC Educational Resources Information Center

    Taylor, Mark P.

    2013-01-01

    In the current and foreseeable harsh UK higher education environment, aspiring to best-practice financial management will be key to ensuring the prosperity--and indeed the survival--of any university. In this article I argue that good university financial management should provide stability to the institution, allow for investment as well as…

  16. Good Teaching: What Matters to University Students

    ERIC Educational Resources Information Center

    Lee, Hwee Hoon; Kim, Grace May Lin; Chan, Ling Ling

    2015-01-01

    Institutions assess teaching effectiveness in various ways, such as classroom observation, peer evaluation and self-assessment. In higher education, student feedback continues to be the main teaching evaluation tool. However, most of such forms include characteristics of good teaching that the institutions deem important and may not adequately…

  17. 19 CFR 10.770 - Originating goods.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false Originating goods. 10.770 Section 10.770 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Morocco Free Trade...

  18. 19 CFR 10.770 - Originating goods.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Originating goods. 10.770 Section 10.770 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Morocco Free Trade...

  19. 19 CFR 10.770 - Originating goods.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Originating goods. 10.770 Section 10.770 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Morocco Free Trade...

  20. 19 CFR 10.770 - Originating goods.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Originating goods. 10.770 Section 10.770 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Morocco Free Trade...

  1. Good Intentions, Bad Advice for Bilingual Families

    ERIC Educational Resources Information Center

    Harlin, Rebecca; Paneque, Oneyda M.

    2006-01-01

    Quite often, educators tell families of children who are learning English as a second language to speak only English, and not their native language, at home. Although these educators may have good intentions, the authors argue that the educators' advice to families is misguided and stems from misunderstandings about the nature of bilingualism and…

  2. Learners' Epistemic Criteria for Good Scientific Models

    ERIC Educational Resources Information Center

    Pluta, William J.; Chinn, Clark A.; Duncan, Ravit Golan

    2011-01-01

    Epistemic criteria are the standards used to evaluate scientific products (e.g., models, evidence, arguments). In this study, we analyzed epistemic criteria for good models generated by 324 middle-school students. After evaluating a range of scientific models, but before extensive instruction or experience with model-based reasoning practices,…

  3. Alternative Pathways to Apprenticeships. Good Practice Guide

    ERIC Educational Resources Information Center

    National Centre for Vocational Education Research (NCVER), 2015

    2015-01-01

    Apprenticeships are changing. The increasing proportions of people entering apprenticeships at various levels of ability and backgrounds are stimulating demand for alternative pathways to completions. This good practice guide assembles the key findings for education practitioners and workplace supervisors from three related research reports on…

  4. A Good Teaching Technique: WebQuests

    ERIC Educational Resources Information Center

    Halat, Erdogan

    2008-01-01

    In this article, the author first introduces and describes a new teaching tool called WebQuests to practicing teachers. He then provides detailed information about the structure of a good WebQuest. Third, the author shows the strengths and weaknesses of using Web-Quests in teaching and learning. Last, he points out the challenges for practicing…

  5. Why Union Activists Write Good Stories

    ERIC Educational Resources Information Center

    Worthen, Helena H.

    2013-01-01

    The representative structure of a union is a maze which, when travelled as a narrative, has drama at every turn. It sets up expectations, pits good against evil, involves many characters with different interests, keeps the clock ticking, and offers opportunities for happy endings (and disappointments) at every level. Union members who are not…

  6. Middle School Physical Education: Good Sport Checklist.

    ERIC Educational Resources Information Center

    Tenoschok, Mike

    2001-01-01

    Presents a checklist for monitoring middle school students' behavior during athletics. The checklist highlights: sportsmanship (e.g., playing by the rules, being a good loser, and playing fair); respect (refraining from fighting, avoiding alcohol and other drugs, and shaking hands with opponents); and teamwork (practicing hard, not embarrassing…

  7. Getting Good Board Members and Holding Them.

    ERIC Educational Resources Information Center

    Goble, Nick

    Although serving on a school board is frequently a thankless and difficult task, good board members must be recruited, since the elected school board is a cornerstone of our representative form of government and is a central element of local control. A recent increase in board member turnover is assignable to the large amount of time it takes to…

  8. Rewarding Good Teachers. A Research Brief.

    ERIC Educational Resources Information Center

    Educational Service District 189, Mt. Vernon, WA.

    According to research of the 1980's in the ERIC system and elsewhere, there seem to be three schools of thought about the most effective ways to reward good teachers and provide incentives for improving teacher performance. The schools of thought described include (1) intrinsic rewards only; (2) specific additional monetary rewards for specific…

  9. Community Living Skills Guide: Looking Good: Hygiene.

    ERIC Educational Resources Information Center

    Kreps, Alice Roelofs; Dreith, Rita Vallero

    One of twenty course guides in the Community Living Skills Guide for the College for Living series, this document provides guidelines and workbook activities for the course, Looking Good: Hygiene. The series of courses for developmentally disabled adults is intended to supplement residential programs and to aid in orienting institutionalized…

  10. Reflecting on the Good Life: Intergenerational Dialogue.

    ERIC Educational Resources Information Center

    Hernandez-Lemus, Alberto

    2003-01-01

    Describes a course designated for incoming students as an introduction to liberal arts education, which proposes a close relationship between ethics and aesthetics. Students are exposed to different philosophical definitions of the good life as well as different definitions of beauty. Underlying is the course's working metaphor of life as a work…

  11. Motivational Techniques for Good Human Relations.

    ERIC Educational Resources Information Center

    Greene, Betty J.

    Negative motivators like threats, intimidation, criticism, denigration, the withholding of information, and the exercise of power produce temporary results but engender resentment and close the door of communication. Good leaders use positive motivators to meet people's needs, enhance efficiency, and improve working relationships. Some of these…

  12. "Good" and "Bad" Criticism: A Descriptive Analysis.

    ERIC Educational Resources Information Center

    Tracy, Karen; And Others

    1987-01-01

    Identifies salient features that distinguish between criticisms perceived by their recipients as "good" from those perceived as "bad." Considers five primary areas for criticism: appearance, skill performance, relationships, general personhood, and decision making, as well as stylistic characteristics of criticism. (NKA)

  13. Tourism. Leonardo da Vinci Series: Good Practices.

    ERIC Educational Resources Information Center

    Commission of the European Communities, Brussels (Belgium). Directorate-General for Education and Culture.

    This brochure, part of a series about good practices in vocational training in the European Union, describes 10 projects that have promoted investment in human resources through training in the tourism sector to promote sustainable, or responsible, tourism. The projects and their countries of origin are as follows: (1) BEEFT, training of mobility…

  14. 19 CFR 102.12 - Fungible goods.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Fungible goods. 102.12 Section 102.12 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... determined on the basis of an inventory management method provided under the appendix to part 181 of...

  15. Creating and Maintaining a Good Flute Embouchure

    ERIC Educational Resources Information Center

    Criswell, Chad

    2009-01-01

    Learning to produce a good tone on the flute is easy for some people and incredibly difficult for others. Not every flute student will be successful, but the suggestions offered in this article may make the difference between a positive musical experience and one that turns the student off to playing an instrument forever. Claire-Anne Williams,…

  16. Public Schools and the Common Good.

    ERIC Educational Resources Information Center

    Reese, William J.

    1988-01-01

    Improving public school education, especially for the poor, requires defining and articulating some vision of the common good. This article reviews key positions taken by liberals and conservatives regarding educational reform during the 19th and 20th centuries and critiques these positions with regard to their disservice to the poor. (IAH)

  17. 19 CFR 10.451 - Originating goods.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Chile Free Trade Agreement Rules... produced entirely in the territory of Chile or of the United States, or both; or (b) The good is produced entirely in the territory of Chile or of the United States, or both, satisfies all other...

  18. Doing Good Science In Middle School

    ERIC Educational Resources Information Center

    Jorgenson, Olaf; Cleveland, Jackie; Vanosdall, Rick

    2004-01-01

    Just as middle schoolers are "wired" to learn in active, hands-on ways, this book is wired to help teachers spark a vital connection to these students to keep them tuned-in to science. "Doing Good Science in Middle School" combines practical insights about adolescent learners with what master teachers know about how to shift from passive,…

  19. The Diffusion of "Shocking" Good News.

    ERIC Educational Resources Information Center

    Haroldsen, Edwin O.; Harvey, Kenneth

    1979-01-01

    A study of the diffusion of news about the Mormon Church's approval of Blacks for the priesthood revealed that "shocking" good news can ignite the interpersonal communications system, that news has more credibility when obtained from media than when obtained interpersonally, and that people use mass media to verify news obtained…

  20. A Submillimeter Perspective on the GOODS Fields (SUPER GOODS). I. An Ultradeep SCUBA-2 Survey of the GOODS-N

    NASA Astrophysics Data System (ADS)

    Cowie, L. L.; Barger, A. J.; Hsu, L.-Y.; Chen, Chian-Chou; Owen, F. N.; Wang, W.-H.

    2017-03-01

    In this first paper in the SUPER GOODS series on powerfully star-forming galaxies in the two GOODS fields, we present a deep SCUBA-2 survey of the GOODS-N at both 850 and 450 μm (central rms noise of 0.28 mJy and 2.6 mJy, respectively). In the central region, the 850 μm observations cover the GOODS-N to near the confusion limit of ∼1.65 mJy, while over a wider 450 arcmin2 region—well complemented by Herschel far-infrared imaging—they have a median 4σ limit of 3.5 mJy. We present ≥slant 4σ catalogs of 186 850 μm and 31 450 μm selected sources. We use interferometric observations from the Submillimeter Array (SMA) and the Karl G. Jansky Very Large Array (VLA) to obtain precise positions for 114 SCUBA-2 sources (28 from the SMA, all of which are also VLA sources). We present new spectroscopic redshifts and include all existing spectroscopic or photometric redshifts. We also compare redshifts estimated using the 20 cm/850 μm and the 250 cm/850 μm flux ratios. We show that the redshift distribution increases with increasing flux, and we parameterize the dependence. We compute the star formation history and the star formation rate (SFR) density distribution functions in various redshift intervals, finding that they reach a peak at z=2{--}3 before dropping to higher redshifts. We show that the number density per unit volume of {SFR} ≳ 500 {M}ȯ {{yr}}-1 galaxies measured from the SCUBA-2 sample does not change much relative to that of lower SFR galaxies from UV selected samples over z=2{--}5, suggesting that, apart from changes in the normalization, the shape in the number density as a function of SFR is invariant over this redshift interval.

  1. Youth who sexual offended: primary human goods and offense pathways.

    PubMed

    Chu, Chi Meng; Koh, Li Lian; Zeng, Gerald; Teoh, Jennifer

    2015-04-01

    There has been an increased focus on understanding youth sexual offending in recent years, but there has been limited empirical research on the causes, pathways, and treatment of youth who have sexually offended-especially within a non-Western context. The Good Lives and Self-Regulation Models have often been used to understand and rehabilitate adult sexual offenders, but (unfortunately) there is scant research on youth who sexually offended using these models. The present study aims to describe the different primary goods that are associated with youth sexual offending behaviors in an Asian context. In addition, the study sought to explore whether the age of victim (child vs. nonchild) and nature of sexual offense (penetrative vs. nonpenetrative) influenced the youth's engagement in offense pathways. The results suggest that pleasure, relatedness, and inner peace were the primary human goods that were most sought after by a sample of 168 youth who sexually offended in Singapore. In addition, offender classification (in relation to the age of victim and nature of sexual offense) influenced the pathways to sexual offending. Therefore, these findings have important clinical implications for assessment, management, and intervention planning for youth who sexually offended.

  2. Metacognition, Achievement Goals, Study Strategies and Academic Achievement: Pathways to Achievement

    ERIC Educational Resources Information Center

    Vrugt, Anneke; Oort, Frans J.

    2008-01-01

    The purpose of this research was to develop and test a model of effective self-regulated learning. Based on effort expenditure we discerned effective self-regulators and less effective self-regulators. The model comprised achievement goals (mastery, performance-approach and -avoidance goals), metacognition (metacognitive knowledge, regulation and…

  3. The incongruous achiever in adolescence.

    PubMed

    Kline, S A; Golombek, H

    1974-06-01

    The authors wished to study some of the internal psychological dynamics of achievement in a nonpatient identified high school population. Questionnaires were administered to the Grade 13 students and their parents in a large high school. A number of students whose achievement and educational plans were not congruous with their general background were selected for interview. The findings suggest that a wide variety of ages and developmental stages can be discerned as critical points in the development of a student's attitude toward higher education. These students have many values in common, and their values appear related to a positive or negative identification with parental values. The students themselves show a wide range of personality integration. They relate in a special way to a wide variety of teachers' personalities.

  4. Beam cooling: Principles and achievements

    SciTech Connect

    Mohl, Dieter; Sessler, Andrew M.

    2003-05-18

    After a discussion of Liouville's theorem, and its implications for beam cooling, a brief description is given of each of the various methods of beam cooling: stochastic, electron, radiation, laser, ionization, etc. For each, we present the type of particle for which it is appropriate, its range of applicability, and the currently achieved degree of cooling. For each method we also discuss the present applications and, also, possible future developments and further applications.

  5. Predicting educational achievement from DNA

    PubMed Central

    Selzam, S; Krapohl, E; von Stumm, S; O'Reilly, P F; Rimfeld, K; Kovas, Y; Dale, P S; Lee, J J; Plomin, R

    2017-01-01

    A genome-wide polygenic score (GPS), derived from a 2013 genome-wide association study (N=127,000), explained 2% of the variance in total years of education (EduYears). In a follow-up study (N=329,000), a new EduYears GPS explains up to 4%. Here, we tested the association between this latest EduYears GPS and educational achievement scores at ages 7, 12 and 16 in an independent sample of 5825 UK individuals. We found that EduYears GPS explained greater amounts of variance in educational achievement over time, up to 9% at age 16, accounting for 15% of the heritable variance. This is the strongest GPS prediction to date for quantitative behavioral traits. Individuals in the highest and lowest GPS septiles differed by a whole school grade at age 16. Furthermore, EduYears GPS was associated with general cognitive ability (~3.5%) and family socioeconomic status (~7%). There was no evidence of an interaction between EduYears GPS and family socioeconomic status on educational achievement or on general cognitive ability. These results are a harbinger of future widespread use of GPS to predict genetic risk and resilience in the social and behavioral sciences. PMID:27431296

  6. Achievable standard of care in low-resource settings.

    PubMed

    Luo, C

    2000-11-01

    The gap between rich and resource-poor countries has continued to grow as reproductive care providers integrate interventions to limit mother-to-child transmission (MTCT) of HIV in a manner consistent with existing information. There are two major reasons for this difference: access to prophylactic antiretroviral therapy (ARV) for HIV-infected pregnant mothers and availability of alternative feeding for babies. In resource-poor settings, these options are beyond reach for the majority of the women. Infant and under-five mortality rates from other infections are high in these settings and breastfeeding remains the norm. Answering the question, What is an achievable standard of care in resource-poor settings? still remains a major challenge today. Dialogue has begun in most resource-poor settings to address the key elements in the package of interventions to reduce MTCT of HIV. These elements include the following: (1) overall prevention of HIV in mothers and fathers; (2) provision of good-quality voluntary testing and counseling (VCT) in antenatal clinics; (3) a comprehensive package of interventions during pregnancy, during labor, and after delivery, including screening for sexually transmitted diseases (STDs), family planning, and--where possible--ARVs; (4) provision of infant and maternal nutrition within the socioeconomic realities; (5) advocacy and program communication; and (6) other supportive measures, including community mobilization to address issues such as stigmatization of and violence against HIV-infected women. This paper discusses the challenges faced by most resource-poor settings in integrating some of these activities into reproductive care services.

  7. Is Green Tea Really Good for You?

    ERIC Educational Resources Information Center

    Chiu, Stephanie

    2006-01-01

    One of the core competencies in the IFT Education standards is for students to achieve competency in communications skills (that is, oral and written communication, listening, interviewing, and so on). According to the IFT guidelines, by the time students graduate, they should not only be able to search for and condense information but also be…

  8. Literacy as Commodity: Redistributing the Goods.

    ERIC Educational Resources Information Center

    Elsasser, Nan; Irvine, Patricia

    1992-01-01

    A rationale is presented for educational change and the strategies to achieve it. The model of speech communities of Dell Hymes is used to show how language differences are connected to social and economic disparities. Efforts to create new speech communities to overcome inequalities are discussed. (SLD)

  9. Buildings' integral role in good health.

    PubMed

    Hall, Chris

    2014-05-01

    As reported in last month's HEJ, the new Sustainable Development Strategy for the Health, Public Health and Social Care System for 2014-20 rightly emphasises the importance of the built environment to health and well-being. Chris Hall, the BRE's health sector lead, says this message 'stretches far beyond hospitals and healthcare buildings into the communities and homes that people live in'. Here he highlights some of the key elements relating to the current carbon efficiency of healthcare buildings, considers the impact of 'good' housing on health and preventing illness, and looks forward to a series of joint IHEEM and BRE 'Building Sustainable Development' mini-conference events planned in the run-up to October's Healthcare Estates 2014 event in response to the new Strategy, designed to share ideas and good practice on sustainable estates issues. The first takes place in London later this month (see panel below).

  10. Editorial: A Note on Good Research Practice

    SciTech Connect

    Dooley, James J.

    2013-07-01

    Good scientific practice and research misconduct have been concerns of mine for more than a decade (Dooley and Kerch, 2000) and in my role as an editor of the International Journal of Greenhouse Gas Control, I feel it is time to speak up and at the very least share my concerns and suggestions as they relate to the integrity of the research published in this journal. Rather than wait to write an editorial on good research practices in response to a major incident, I thought it might be best to be proactive and address some of the trends we see in submissions to this peer reviewed journal and to offer some suggestions for improvement improving the level of scholarship in some – but by no means all – of the papers submitted.

  11. Creating Good Schools--What if?

    ERIC Educational Resources Information Center

    Sanders, Tim

    2010-01-01

    Done right, green is not only the right thing to do, it's a good business move. During the past year, the author has talked with quite a few school business officials. Some are on board with "going green," whereas others are still leery. Some aren't quite sure what "green schools" are. Some say that it doesn't matter to the community how green the…

  12. Good laboratory practice and laboratory accreditation.

    PubMed

    Lawrence, J; McQuaker, N

    1993-12-01

    Principles of good laboratory practice (GLP) and laboratory accreditation programs, particularly as they pertain to the environmental sector, are reviewed. The multitude of programs is proving costly for many laboratories and there is mounting pressure to develop reciprocity agreements between programs and to consolidate nationally and internationally. Inclusion of GLP and laboratory accreditation requirements in government regulations is resulting in a significantly increased number of laboratories participating in these programs.

  13. Developing high quality low cost healthcare goods.

    PubMed

    Fox, Stephen

    2002-06-01

    The quality and cost of healthcare is a major concern in both Britain and America. Yet, despite much debate and many initiatives, the provision of healthcare is often unreliable and expensive (Goldsmith, 2001). In this article by Dr Stephen Fox, it is proposed that wider application of design methodologies during the development of healthcare goods could make a significant contribution to increasing quality and reducing costs.

  14. 19 CFR 10.921 - Goods classifiable as goods put up in sets.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Goods classifiable as goods put up in sets. 10.921 Section 10.921 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United...

  15. 19 CFR 10.921 - Goods classifiable as goods put up in sets.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Goods classifiable as goods put up in sets. 10.921 Section 10.921 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United...

  16. 19 CFR 10.921 - Goods classifiable as goods put up in sets.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Goods classifiable as goods put up in sets. 10.921 Section 10.921 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United...

  17. 19 CFR 10.1021 - Goods classifiable as goods put up in sets.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Goods classifiable as goods put up in sets. 10.1021 Section 10.1021 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United...

  18. 19 CFR 10.1021 - Goods classifiable as goods put up in sets.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Goods classifiable as goods put up in sets. 10.1021 Section 10.1021 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United...

  19. 19 CFR 10.1021 - Goods classifiable as goods put up in sets.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Goods classifiable as goods put up in sets. 10.1021 Section 10.1021 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United...

  20. Conceptions of Good Teaching by Good Teachers: Case Studies from an Australian University

    ERIC Educational Resources Information Center

    Duarte, Fernanda P.

    2013-01-01

    This paper contributes to the debate on what constitutes good teaching in early 21st Century higher education, through an examination of the experience of five outstanding lecturers from a business school in an Australian university. It is based on a qualitative study that explored their perceptions on what constitutes "good teaching".…