Evidence-based recommendations for analgesic efficacy to treat pain of endodontic origin: A systematic review of randomized controlled trials.

PubMed

Aminoshariae, Anita; Kulild, James C; Donaldson, Mark; Hersh, Elliot V

2016-10-01

The purpose of this investigation was to identify evidence-based clinical trials to aid dental clinicians in establishing the efficacy for recommending or prescribing analgesics for pain of endodontic origin. The authors prepared and registered a protocol on PROSPERO and conducted electronic searches in MEDLINE, Scopus, the Cochrane Library, and ClinicalTrials.gov. In addition, the authors manually searched the bibliographies of all relevant articles, the gray literature, and textbooks for randomized controlled trials. Two authors selected the relevant articles independently. There were no disagreements between the authors. The authors analyzed 27 randomized, placebo-controlled trials. The authors divided the studies into 2 groups: preoperative and postoperative analgesic treatments. There was moderate evidence to support the use of steroids for patients with symptomatic irreversible pulpitis. Also, there was moderate evidence to support nonsteroidal anti-inflammatory drugs (NSAIDs) preoperatively or postoperatively to control pain of endodontic origin. When NSAIDs were not effective, a combination of NSAIDs with acetaminophen, tramadol, or an opioid appeared beneficial. NSAIDs should be considered as the drugs of choice to alleviate or minimize pain of endodontic origin if there are no contraindications for the patient to ingest an NSAID. In situations in which NSAIDs alone are not effective, the combination of an NSAID with acetaminophen or a centrally acting drug is recommended. Steroids appear effective in irreversible pulpitis. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

An investigation of the validity of the Work Assessment Triage Tool clinical decision support tool for selecting optimal rehabilitation interventions for workers with musculoskeletal injuries.

PubMed

Qin, Ziling; Armijo-Olivo, Susan; Woodhouse, Linda J; Gross, Douglas P

2016-03-01

To evaluate the concurrent validity of a clinical decision support tool (Work Assessment Triage Tool (WATT)) developed to select rehabilitation treatments for injured workers with musculoskeletal conditions. Methodological study with cross-sectional and prospective components. Data were obtained from the Workers' Compensation Board of Alberta rehabilitation facility in Edmonton, Canada. A total of 432 workers' compensation claimants evaluated between November 2011 and June 2012. Percentage agreement between the Work Assessment Triage Tool and clinician recommendations was used to determine concurrent validity. In claimants returning to work, frequencies of matching were calculated and compared between clinician and Work Assessment Triage Tool recommendations and the actual programs undertaken by claimants. The frequency of each intervention recommended by clinicians, Work Assessment Triage Tool, and case managers were also calculated and compared. Percentage agreement between clinician and Work Assessment Triage Tool recommendations was poor (19%) to moderate (46%) and Kappa = 0.37 (95% CI -0.02, 0.76). The Work Assessment Triage Tool did not improve upon clinician recommendations as only 14 out of 31 claimants returning to work had programs that contradicted clinician recommendations, but were consistent with Work Assessment Triage Tool recommendations. Clinicians and case managers were inclined to recommend functional restoration, physical therapy, or no rehabilitation while the Work Assessment Triage Tool recommended additional evidence-based interventions, such as workplace-based interventions. Our findings do not provide evidence of concurrent validity for the Work Assessment Triage Tool compared with clinician recommendations. Based on these results, we cannot recommend further implementation of the Work Assessment Triage Tool. However, the Work Assessment Triage Tool appeared more likely than clinicians to recommend interventions supported by evidence; thus warranting further research. © The Author(s) 2015.

Cardiovascular Risk Reduction in Children.

ERIC Educational Resources Information Center

Murray, David M.; And Others

1987-01-01

The paper presents a community model for reducing the risk of coronary heart disease in children and youth. The model addresses the individual, the family, social groups, and the larger social and physical environments. Exemplary programs are described and recommendations are made for additional research and program development. (Author/DB)

A Location Aware Middleware Framework for Collaborative Visual Information Discovery and Retrieval

DTIC Science & Technology

2017-09-14

Information Discovery and Retrieval Andrew J.M. Compton Follow this and additional works at: https://scholar.afit.edu/etd Part of the Digital...and Dissertations by an authorized administrator of AFIT Scholar. For more information , please contact richard.mansfield@afit.edu. Recommended Citation...

Guideline recommendations and antimicrobial resistance: the need for a change.

PubMed

Elias, Christelle; Moja, Lorenzo; Mertz, Dominik; Loeb, Mark; Forte, Gilles; Magrini, Nicola

2017-07-26

Antimicrobial resistance has become a global burden for which inappropriate antimicrobial use is an important contributing factor. Any decisions on the selection of antibiotics use should consider their effects on antimicrobial resistance. The objective of this study was to assess the extent to which antibiotic prescribing guidelines have considered resistance patterns when making recommendations for five highly prevalent infectious syndromes. We used Medline searches complemented with extensive use of Web engine to identify guidelines on empirical treatment of community-acquired pneumonia, urinary tract infections, acute otitis media, rhinosinusitis and pharyngitis. We collected data on microbiology and resistance patterns and identified discrete pattern categories. We assessed the extent to which recommendations considered resistance, in addition to efficacy and safety, when recommending antibiotics. We identified 135 guidelines, which reported a total of 251 recommendations. Most (103/135, 79%) were from developed countries. Community-acquired pneumonia was the syndrome mostly represented (51, 39%). In only 16 (6.4%) recommendations, selection of empirical antibiotic was discussed in relation to resistance and specific microbiological data. In a further 69 (27.5%) recommendations, references were made in relation to resistance, but the attempt was inconsistent. Across syndromes, 12 patterns of resistance with implications on recommendations were observed. 50% to 75% of recommendations did not attempt to set recommendation in the context of these patterns. There is consistent evidence that guidelines on empirical antibiotic use did not routinely consider resistance in their recommendations. Decision-makers should analyse and report the extent of local resistance patterns to allow better decision-making. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

What's next for dyslipidemia management? The 2013 ACC/AHA Guidelines, the NLA recommendations, and beyond.

PubMed

Waite, Laura H; Phan, Yvonne L; Spinler, Sarah A

2016-01-01

To compare and contrast the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines and the 2014/2015 National Lipid Association (NLA) Recommendations for Management of Dyslipidemia in the context of evolving evidence. Guidelines from the National Cholesterol Education Program (NCEP), ACC/AHA, and NLA; recent clinical trials involving non-statin therapies. Not applicable. At the authors' discretion, preference was given to references focusing on guidelines and recent clinical trials involving dyslipidemia management. In late 2013, the ACC/AHA released guidelines on the treatment of blood cholesterol to reduce risk for atherosclerotic cardiovascular disease (ASCVD) in adults. Reflecting contemporary evidence-based literature, low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) numeric treatment goals were eliminated, and a new method of risk assessment (the Pooled Cohort Equations) was recommended. The guidelines emphasized lipid lowering in 4 patient populations proven to benefit from statin therapy, recommending moderate to high-intensity statin dosing, with no additional drug therapies and limited ongoing monitoring. Clinical controversies ignited by these guidelines led to the publication of recommendations by the NLA in 2014 and 2015. Part 1 of the NLA recommendations incorporated parts of both the ATP III guidelines and the 2013 ACC/AHA guidelines along with updated original recommendations. These recommendations provided numeric LDL-C, non-HDL-C, and apolipoprotein B treatment goals and potential additional ASCVD risk factors, with stepwise risk assessment based on traditional cardiac risk factors and multiple assessment tools. In addition to statins, the 2014 NLA recommendations highlighted the benefit of additional or alternative lipid-lowering therapies. Part 2 of the NLA recommendations expanded the guidance for treatment of special populations and prioritized ezetimibe as a non-statin agent based on recent evidence. Finally, the US Food and Drug Administration recently approved 2 medications from a new class, the PCSK9 inhibitors, although their role in therapy remains unclear pending outcomes data. We aim to highlight the core recommendations of recent guideline publications and to discuss similarities and differences in the context of the future management of dyslipidemia. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

The Media and Suicide

ERIC Educational Resources Information Center

Sudak, Howard S.; Sudak, Donna M.

2005-01-01

Objective: The authors aim to inform readers of the theory that when newspapers, film, and television describe suicidal deaths, additional suicides may result by virtue of contagion or copy-cat effects; to review data that support and refute this theory; to present some promising and recommended ways to prevent copy-cat suicide; and to cite…

Sex Education for Deaf-Blind Youths and Adults.

ERIC Educational Resources Information Center

Ingraham, Cynthia L.; Vernon, McCay; Clemente, Brenda; Olney, Linda

2000-01-01

This article describes a model sex education program developed for youths and adults who are deafblind by the Helen Keller National Center for Deaf-Blind Youths and Adults. In addition, it also discusses major related issues and presents general recommendations and a resource for further information. (Contains 11 references.) (Author/CR)

Selection criteria for wet-nurses: Ancient recommendations that survived across time.

PubMed

Thorley, Virginia; Sioda, Tomasz

2016-11-01

This article will describe the content of the key criteria for the selection of wet nurses that persisted across time and the authors who transmitted this advice. Where relevant, it will include variations, such as additional recommendations or a different weighting being given to one or other criterion by a particular author. The focus is on the selection of a wet nurse for the employer's baby. The factors that led a woman to enter this employment and the consequences for her own baby will not be addressed here as they will be discussed elsewhere. The article is an historical one, drawing on primary sources, where possible, and important secondary sources. Guidelines for the selection of wet-nurses have existed from antiquity to the early 20th century. The key recommendations managed to survive across the centuries because they were considered useful by influential ancient and Early Modern and later authors who passed them on through copying and translations. It is tempting to assume that the prescriptive advice was followed by physicians and mothers. However, the discussion will raise doubts about whether the criteria were adhered to by physicians and parents, particularly when wet nurses were in scarce supply.

Report endorses data sharing

NASA Astrophysics Data System (ADS)

The potential benefits of sharing data so outweigh its costs that investigators should be required to include plans for sharing data as part of their grant proposals, according to recommendations issued recently by the Committee on National Statistics (CNSTAT) of the National Research Council (NRC).In their report Sharing Research Data, CNSTAT also recommended that “Journals should give more emphasis to reports of secondary analyses and to replications,” provided that the original collections of data receive full credit. In addition, “Journal editors should require authors to provide access to data during the peer review process.”

Providing sustainable catalytic solutions for a rapidly changing world: a summary and recommendations for urgent future action.

PubMed

Thomas, John Meurig

2018-01-13

In addition to summarizing the main thrusts of each paper presented at this Discussion, other urgent issues involving the role (and characterization) of new catalysts for eliminating oxides of nitrogen, for using CO 2 liberated from steel mills, for fuel cells and the need for rapid decarbonization of fossil fuels are outlined.This article is part of a discussion meeting issue 'Providing sustainable catalytic solutions for a rapidly changing world'. © 2017 The Author(s).

Resource needs of an occupational health service to accommodate a hepatitis B vaccination programme.

PubMed

Jachuck, S J; Jones, C; Nicholls, A; Bartlett, M

1990-01-01

The administrative, organizational and clinical commitment of an occupational health department to implement the DHSS recommendation for a hepatitis B vaccination programme for the health care workers in a District General Hospital was reviewed to evaluate the resource implications needed to accommodate the additional workload. The deficiencies observed in the existing DHSS guidance in implementing the plan are described. It is suggested that the Department of Health, while making future recommendations for vaccination, should be more precise in identifying those at risk, in describing the desired titre to be achieved after vaccination, and in describing the follow-up plan for those who accept the vaccination, those who refuse and those who do not seroconvert. The recommendation should describe the commitment of the Health Authorities and must include recommendations for appropriate and adequate resources to support such a programme. Vaccination for 1000 employees at risk required 4000 additional consultations necessitating 16 additional hours of occupational health commitment per week. Eighteen months after initiating the vaccination programme, 677 employees had accepted the vaccine. After receiving 3 vaccines 508 (75 per cent) recipients had protective seroconversion (anti-Hbs greater than 100 I.U.) and a further 61 (9 per cent) converted after the 4th injection, thereby offering protective immunity to 84 per cent of the recipients. During the period 84 (12.4 per cent) were lost to follow-up. Recommendations have been made to accommodate the additional commitment through the vaccination programme to standardize our care and prevent disruption of the existing service.

Writing Recommendation Letters: A Measure of Your Character, Too

ERIC Educational Resources Information Center

Weldy Boyd, Amanda C.

2011-01-01

The author considers how to approach a request for a personal recommendation from someone whom the author does not wish to advocate. Ultimately, the author proposes that those asked to write recommendations have a right to say "no," should they feel hesitant to recommend the candidate, and a responsibility to suggest that someone else might be a…

Nebraska family practitioners' infant feeding recommendations.

PubMed

Auerbach, K G; Walburn, J

1987-01-01

The authors conducted an anonymous survey of 220 Nebraska family and general practitioners' attitudes and practice recommendations for infant feeding. Most practitioners' attitudes reflect published American Academy of Pediatrics (AAP) guidelines regarding using commercial formula for bottle-feeding babies rather than evaporated milk-based formulations. Ninety-two per cent agreed with recommendations relating to the need for fluoride supplementation when fluoride was unavailable in the water supply and 93% agreed that whole cow's milk was inappropriate in the infant's first year. Another 68% felt similarly about evaporated milk formulas. However, 32% of board certified and 53% of nonboard certified physicians continue to believe that early solid foods will reduce night waking. In 80% of the cases, practice recommendations disagreed with AAP guidelines by prescribing vitamin supplements for bottle-feeding babies receiving proprietary infant formulas. Additionally, two-thirds of the practitioners recommended unnecessary water complements and 62% suggested formula supplementation for breastfeeding babies. Solid foods and whole cow's milk for both breastfeeding and bottle-feeding babies often were recommended earlier than the second half of the first year.

Recommended patient-reported core set of symptoms to measure in prostate cancer treatment trials.

PubMed

Chen, Ronald C; Chang, Peter; Vetter, Richard J; Lukka, Himansu; Stokes, William A; Sanda, Martin G; Watkins-Bruner, Deborah; Reeve, Bryce B; Sandler, Howard M

2014-07-01

The National Cancer Institute (NCI) Symptom Management and Health-Related Quality of Life Steering Committee convened four working groups to recommend core sets of patient-reported outcomes to be routinely incorporated in clinical trials. The Prostate Cancer Working Group included physicians, researchers, and a patient advocate. The group's process included 1) a systematic literature review to determine the prevalence and severity of symptoms, 2) a multistakeholder meeting sponsored by the NCI to review the evidence and build consensus, and 3) a postmeeting expert panel synthesis of findings to finalize recommendations. Five domains were recommended for localized prostate cancer: urinary incontinence, urinary obstruction and irritation, bowel-related symptoms, sexual dysfunction, and hormonal symptoms. Four domains were recommended for advanced prostate cancer: pain, fatigue, mental well-being, and physical well-being. Additional domains for consideration include decisional regret, satisfaction with care, and anxiety related to prostate cancer. These recommendations have been endorsed by the NCI for implementation. © The Author 2014. Published by Oxford University Press. All rights reserved.

Comparison of current recommended regimens of atropinization in organophosphate poisoning.

PubMed

Connors, Nicholas J; Harnett, Zachary H; Hoffman, Robert S

2014-06-01

Atropine is the mainstay of therapy in organophosphate (OP) toxicity, though research and consensus on dosing is lacking. In 2004, as reported by Eddleston et al. (J Toxicol Clin Toxicol 42(6):865-75, 2004), they noted variation in recommended regimens. We assessed revisions of original references, additional citations, and electronic sources to determine the current variability in atropine dosing recommendations. Updated editions of references from Eddleston et al.'s work, texts of Internal and Emergency Medicine, and electronic resources were reviewed for atropine dosing recommendations. For comparison, recommendations were assessed using the same mean dose (23.4 mg) and the highest dose (75 mg) of atropine as used in the original paper. Recommendations were also compared with the dosing regimen from the World Health Organization (WHO). Thirteen of the original recommendations were updated and 15 additional references were added giving a convenience sample of 28. Sufficient information to calculate time to targeted dose was provided by 24 of these samples. Compared to 2004, current recommendations have greatly increased the speed of atropinization with 13/24 able to reach the mean and high atropine dose within 30 min compared to 1/36 in 2004. In 2004, there were 13 regimens where the maximum time to reach 75 mg was over 18 h, whereas now, there are 2. While only one recommendation called for doubling the dose for faster escalation in 2004, 15 of the 24 current works include dose doubling. In 2004, Eddleston et al. called for an evidence-based guideline for the treatment of OP poisoning that could be disseminated worldwide. Many current recommendations can adequately treat patients within 1 h. While the WHO recommendations remain slow to treat patients with OP poisoning, other authorities are close to a consensus on rapid atropinization.

Prioritizing Sleep Health: Public Health Policy Recommendations.

PubMed

Barnes, Christopher M; Drake, Christopher L

2015-11-01

The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a public health issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders. © The Author(s) 2015.

Clinical practice recommendations for depression.

PubMed

Malhi, G S; Adams, D; Porter, R; Wignall, A; Lampe, L; O'Connor, N; Paton, M; Newton, L A; Walter, G; Taylor, A; Berk, M; Mulder, R T

2009-01-01

To provide clinically relevant evidence-based recommendations for the management of depression in adults that are informative, easy to assimilate and facilitate clinical decision making. A comprehensive literature review of over 500 articles was undertaken using electronic database search engines (e.g. MEDLINE, PsychINFO and Cochrane reviews). In addition articles, book chapters and other literature known to the authors were reviewed. The findings were then formulated into a set of recommendations that were developed by a multidisciplinary team of clinicians who routinely deal with mood disorders. The recommendations then underwent consultative review by a broader advisory panel that included experts in the field, clinical staff and patient representatives. The clinical practice recommendations for depression (Depression CPR) summarize evidence-based treatments and provide a synopsis of recommendations relating to each phase of the illness. They are designed for clinical use and have therefore been presented succinctly in an innovative and engaging manner that is clear and informative. These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of depression. Further, the novel style and practical approach should promote uptake and implementation.

A Comprehensive Treatment Program for a Case of Disturbed Anger

ERIC Educational Resources Information Center

DiGiuseppe, Raymond

2011-01-01

Santanello (2011) presented the case of a man with long-term anger problems who does not meet the criteria for any "DSM-IV-TR" diagnosis for treatment recommendations by several authors. This paper presents a comprehensive treatment package applied to this case. Of crucial importance is the building of a therapeutic alliance. In addition to…

Progress and Impact. A Report of Programs Funded for 1995-96 by the Comprehensive Health Education Act of 1990.

ERIC Educational Resources Information Center

Terrill, Jerry L.; Connell, Karen

During the 1995-96 school year, the Colorado Department of Education supported Comprehensive Health Education Programs as authorized by the Comprehensive Health Education Act of 1990. This report summarizes the projects funded under that grant along with additional observations and recommendations regarding the operation of such grants. Grant…

Promoting successful collaborations between domestic violence and substance abuse treatment service sectors: a review of the literature.

PubMed

Macy, Rebecca J; Goodbourn, Melissa

2012-10-01

Women who experience intimate partner violence (IPV) victimization are more likely to struggle with substance abuse problems than are women who do not experience IPV. Given the connection between IPV victimization and substance abuse, recommended practices urge collaboration between domestic violence service agencies and substance abuse treatment agencies to provide comprehensive services for women with these co-occurring problems. However, domestic violence and substance abuse services have unique histories of development that have led to distinct ways of service delivery. To promote successful collaborations, service providers and researchers are developing strategies to foster relationships across the two service sectors. The authors conducted a review of this emerging body of knowledge with the aim of assembling recommendations for strategies to foster collaboration between domestic violence and substance abuse services. The authors identified 15 documents for review inclusion and our analysis established 5 categories of documents. Findings yield key collaboration strategies and recommended service models. In addition, the review determined the existence of considerable challenges to promoting collaborative relationships between domestic violence and substance abuse treatment service sectors.

Identifying domestic and international sex-trafficking victims during human service provision.

PubMed

Macy, Rebecca J; Graham, Laurie M

2012-04-01

Children, youth, and adults of both genders are sex trafficked into and throughout the United States every day. Regrettably, little attention has been given to how human service providers might identify the sex-trafficking victims they are likely to encounter. To address this knowledge gap, the authors review 20 documents with the aim of detecting and synthesizing service identification recommendations in the scientific literature, government reports, and documents produced by organizations working with sex-trafficking victims. The review shows consensus regarding identification recommendations, including (a) trafficking indicators, (b) victim interaction strategies, (c) immediate response strategies, and (d) child-specific information. The review also shows consensus regarding screening questions that are important for service providers to use in identifying sex-trafficking victims. These questions relate to the victims' safety, employment, living environment, and travel and immigration status in addition to specific questions used with children and youth. The review results offer human service providers a preliminary set of screening strategies and questions that can be used to identify sex-trafficking victims in the context of human services. Building on the review findings, the authors offer policy and research recommendations.

Treating juvenile idiopathic arthritis to target: recommendations of an international task force.

PubMed

Ravelli, Angelo; Consolaro, Alessandro; Horneff, Gerd; Laxer, Ronald M; Lovell, Daniel J; Wulffraat, Nico M; Akikusa, Jonathan D; Al-Mayouf, Sulaiman M; Antón, Jordi; Avcin, Tadej; Berard, Roberta A; Beresford, Michael W; Burgos-Vargas, Ruben; Cimaz, Rolando; De Benedetti, Fabrizio; Demirkaya, Erkan; Foell, Dirk; Itoh, Yasuhiko; Lahdenne, Pekka; Morgan, Esi M; Quartier, Pierre; Ruperto, Nicolino; Russo, Ricardo; Saad-Magalhães, Claudia; Sawhney, Sujata; Scott, Christiaan; Shenoi, Susan; Swart, Joost F; Uziel, Yosef; Vastert, Sebastiaan J; Smolen, Josef S

2018-06-01

Recent therapeutic advances in juvenile idiopathic arthritis (JIA) have made remission an achievable goal for most patients. Reaching this target leads to improved outcomes. The objective was to develop recommendations for treating JIA to target. A Steering Committee formulated a set of recommendations based on evidence derived from a systematic literature review. These were subsequently discussed, amended and voted on by an international Task Force of 30 paediatric rheumatologists in a consensus-based, Delphi-like procedure. Although the literature review did not reveal trials that compared a treat-to-target approach with another or no strategy, it provided indirect evidence regarding an optimised approach to therapy that facilitated development of recommendations. The group agreed on six overarching principles and eight recommendations. The main treatment target, which should be based on a shared decision with parents/patients, was defined as remission, with the alternative target of low disease activity. The frequency and timeline of follow-up evaluations to ensure achievement and maintenance of the target depend on JIA category and level of disease activity. Additional recommendations emphasise the importance of ensuring adequate growth and development and avoiding long-term systemic glucocorticoid administration to maintain the target. All items were agreed on by more than 80% of the members of the Task Force. A research agenda was formulated. The Task Force developed recommendations for treating JIA to target, being aware that the evidence is not strong and needs to be expanded by future research. These recommendations can inform various stakeholders about strategies to reach optimal outcomes for JIA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Senate and INF ratification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jones, D.T.

1992-11-16

The Intermediate-Range Nuclear Forces (INF) Treaty represented one of the first major accomplishments of the post-cold war era. In contrast to all arms control agreements which preceded it, INF resulted in the elimination of a whole category of weapons systems. The author describes and analyzes many issues which impinged on the Senate ratification process and stimulated intense political debate. In addition to national and international security questions, these issues involved constitutional, political, jurisdictional, and bureaucratic factors. The author concludes with lessons and recommendations for more expeditious ratification for future agreements.

Students' trust judgements in online health information seeking.

PubMed

Rowley, Jennifer; Johnson, Frances; Sbaffi, Laura

2015-12-01

As one of the most active groups of Internet users, students and other young people are active users of digital health information. Yet, research into young people's evaluation of health information is limited, and no previous studies have focused on trust formation. In addition, prior studies on adults' use of digital information do not reach a consensus regarding the key factors in trust formation. This study seeks to address this gap. A questionnaire-based survey was used to collect data from undergraduate students studying a variety of disciplines in one UK university. The Trust in Online Health Information Scale is proposed, and it includes the following dimensions: authority, style, content, usefulness, brand, ease of use, recommendation, credibility, and verification. In addition, inspection of responses to specific items/questions provides further insights into aspects of the information that were of specific importance in influencing trust judgements. © The Author(s) 2014.

Inquiries into Malaysia's socio-technical disasters: recommendations and lessons learnt.

PubMed

Said, Aini Mat; Ahmadun, Fakhru'l-Razi; Abdul Kadir, Razali; Daud, Mohamed

2009-04-01

Most democratic countries hold inquiries into disasters. One of their key functions is to establish the cause of an event and to learn lessons in order to prevent a recurrence. In addition, they offer an opportunity for communal catharsis, permitting the public to vent anger, distress and frustration and to exert pressure for policy changes. Malaysia has experienced six landmark socio-technical disasters since 1968, which resulted in the proposal or amendment of various safety/emergency acts and regulations. The authors used a grounded theory approach utilising a constant comparative method to analyse the recommendations made by the inquiries into these events. Data indicate that social and technical recommendations comprise 85 and 15 per cent, respectively, of the total recommendations made by the inquiry committees. This paper offers suggestions for improving the management of inquiry tribunals, as they will remain a valuable source of information for society and corporations to learn from past incidents.

Using operations research to plan the british columbia registered nurses' workforce.

PubMed

Lavieri, Mariel S; Regan, Sandra; Puterman, Martin L; Ratner, Pamela A

2008-11-01

The authors explore the power and flexibility of using an operations research methodology known as linear programming to support health human resources (HHR) planning. The model takes as input estimates of the future need for healthcare providers and, in contrast to simulation, compares all feasible strategies to identify a long-term plan for achieving a balance between supply and demand at the least cost to the system. The approach is illustrated by using it to plan the British Columbia registered nurse (RN) workforce over a 20-year horizon. The authors show how the model can be used for scenario analysis by investigating the impact of decreasing attrition from educational programs, changing RN-to-manager ratios in direct care and exploring how other changes might alter planning recommendations. In addition to HHR policy recommendations, their analysis also points to new research opportunities. Copyright © 2008 Longwoods Publishing.

National Working Group Meeting on ALK diagnostics in lung cancer.

PubMed

Cooper, Wendy; Fox, Stephen; O'Toole, Sandra; Morey, Adrienne; Frances, Glenn; Pavlakis, Nick; O'Byrne, Kenneth; Dettrick, Andrew; Leong, Trishe; Rathi, Vivek; Spagnolo, Dominic; Hemmings, Chris; Singh, Mahendra; Moffat, David; Tsao, Ming-Sound; Wilner, Keith; Buller, Richard; Pitman Lowenthal, Susan; Arifeen, Shams; Binko, Justin; Alam, Mahmood

2014-04-01

The global landscape of molecular testing is rapidly changing, with the recent publication of the International Association for the Study of Lung Cancer (IASLC)/College of American Pathologists (CAP) guidelines and the ALK Atlas. The IASLC/CAP guidelines recommend that tumors from patients with non-small cell lung cancer (NSCLC) be tested for ALK rearrangements in addition to epidermal growth factor receptor (EGFR) mutations. The spur for this recommendation is the availability of novel therapies that target these rearrangements. This article is based on coverage of a Pfizer-sponsored National Working Group Meeting on ALK Diagnostics in Lung Cancer, held around the 15th World Lung Cancer Conference, in Sydney on October 31, 2013. It is based on the presentations given by the authors at the meeting and the discussion that ensued. The content for this article was discussed and agreed on by the authors. © 2014 Wiley Publishing Asia Pty Ltd.

Barriers and facilitators in the implementation of recommendations for hand eczema prevention among healthcare workers.

PubMed

van der Meer, Esther W C; van der Gulden, Joost W J; van Dongen, Diana; Boot, Cécile R L; Anema, Johannes R

2015-05-01

Evidence-based recommendations are available for the prevention of hand eczema among healthcare workers. However, the implementation of these recommendations is not always successful. To identify barriers and facilitators in the implementation of recommendations for the prevention of hand eczema among healthcare workers alongside a randomized controlled trial. A qualitative study was performed in which 19 healthcare workers were interviewed. The interview transcripts were open coded and also coded by means of a template by two researchers to identify relevant barriers and facilitators. Most barriers and facilitators reported for the recommendations were found at the level of the innovation (e.g. the recommendations), whereas for the guideline as a whole, multiple levels (socio-political, organization, user, and facilities) were identified. To enhance the implementation of recommendations for the prevention of hand eczema in a healthcare setting, having knowledge about these recommendations seems to be an important first step. In addition, maintaining the attention of the subject, testing the products beforehand and close collaboration with the infection control department might enhance implementation. Furthermore, it is important that the recommendations fit in with the work of the healthcare workers. When the implementation of the recommendations is prepared, these points should be taken into account. © 2015 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.

Utilizing technological innovations to enhance psychotherapy supervision, training, and outcomes.

PubMed

Barnett, Jeffrey E

2011-06-01

Recent technological advances in the use of the Internet and video technologies has greatly impacted the provision of psychotherapy and other clinical services as well as how the training of psychotherapists may be conducted. When utilized appropriately these technologies may provide greater access to needed services to include treatment, consultation, supervision, and training. Specific ethical challenges and pitfalls are discussed and recommendations are made for the ethical use of these technologies. Additionally, innovative practices from the seven articles in the special section that follows are highlighted and reviewed. These articles present a number of innovations that can take psychotherapy training, research, supervision, and treatment forward toward increased effectiveness. Recommendations for integrating these innovations into ongoing practices are provided and for additional research to build on the important work of the authors in this special section are provided.

The Evaluation of the Treatment of Egypt in American Primary and Secondary School Literature. Final Report.

ERIC Educational Resources Information Center

Ziadeh, Farhat J.; Allen, Calvin H.

In this study of the treatment of Egypt in elementary and secondary school literature, the content of 109 textbooks and 180 supplementary works is analyzed and evaluated and recommendations for specific corrections and additions are presented. The purpose is to alert the authors of educational materials and teachers about the imperfections in…

Testing if Social Services Prevent Fatal Child Maltreatment Among a Sample of Children Previously Known to Child Protective Services.

PubMed

Douglas, Emily M

2016-08-01

The purpose of this article was to examine the potential impact of child welfare services on the risk for fatal child maltreatment. This was conducted using a subsample of children who were identified as "prior victims" in the National Child Abuse and Neglect Data System from 2008 to 2012. At the multivariate level, the analyses show that case management services act to protect children from death as do family support services, family preservation services, and foster care, but that the results vary by type of maltreatment experienced. The author recommends that before strong conclusions are drawn, additional research in this area is warranted. © The Author(s) 2016.

Health Recommender Systems: Concepts, Requirements, Technical Basics and Challenges

PubMed Central

Wiesner, Martin; Pfeifer, Daniel

2014-01-01

During the last decades huge amounts of data have been collected in clinical databases representing patients' health states (e.g., as laboratory results, treatment plans, medical reports). Hence, digital information available for patient-oriented decision making has increased drastically but is often scattered across different sites. As as solution, personal health record systems (PHRS) are meant to centralize an individual's health data and to allow access for the owner as well as for authorized health professionals. Yet, expert-oriented language, complex interrelations of medical facts and information overload in general pose major obstacles for patients to understand their own record and to draw adequate conclusions. In this context, recommender systems may supply patients with additional laymen-friendly information helping to better comprehend their health status as represented by their record. However, such systems must be adapted to cope with the specific requirements in the health domain in order to deliver highly relevant information for patients. They are referred to as health recommender systems (HRS). In this article we give an introduction to health recommender systems and explain why they are a useful enhancement to PHR solutions. Basic concepts and scenarios are discussed and a first implementation is presented. In addition, we outline an evaluation approach for such a system, which is supported by medical experts. The construction of a test collection for case-related recommendations is described. Finally, challenges and open issues are discussed. PMID:24595212

9 CFR 72.16 - Designated dipping stations to be approved by the Administrator, APHIS on recommendations of...

Code of Federal Regulations, 2010 CFR

2010-01-01

... approved by the Administrator, APHIS on recommendations of State authorities; facilities. 72.16 Section 72... CATTLE § 72.16 Designated dipping stations to be approved by the Administrator, APHIS on recommendations of State authorities; facilities. When deemed advisable and upon recommendation by the proper...

Clinical practice recommendations for bipolar disorder.

PubMed

Malhi, G S; Adams, D; Lampe, L; Paton, M; O'Connor, N; Newton, L A; Walter, G; Taylor, A; Porter, R; Mulder, R T; Berk, M

2009-01-01

To provide clinically relevant evidence-based recommendations for the management of bipolar disorder in adults that are informative, easy to assimilate and facilitate clinical decision-making. A comprehensive literature review of over 500 articles was undertaken using electronic database search engines (e.g. MEDLINE, PsychINFO and Cochrane reviews). In addition articles, book chapters and other literature known to the authors were reviewed. The findings were then formulated into a set of recommendations that were developed by a multidisciplinary team of clinicians who routinely deal with mood disorders. These preliminary recommendations underwent extensive consultative review by a broader advisory panel that included experts in the field, clinical staff and patient representatives. The clinical practice recommendations for bipolar disorder (bipolar CPR) summarise evidence-based treatments and provide a synopsis of recommendations relating to each phase of the illness. They are designed for clinical use and have therefore been presented succinctly in an innovative and engaging manner that is clear and informative. These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of bipolar disorder. Further, the novel style and practical approach should promote their uptake and implementation.

The Effect of Physicians' Treatment Recommendations on Their Epistemic Authority: The Medical Expertise Bias.

PubMed

Stasiuk, Katarzyna; Bar-Tal, Yoram; Maksymiuk, Renata

2016-01-01

This study examines the hypothesis that patients perceive physicians who recommend more active and major treatment as having greater epistemic authority. The hypothesis is based on the assumption that patients expect that their physicians should advocate for an active treatment rather than abstention from treatment. The sample included 631 participants. Data were collected using a between-subjects design and scenarios that described a person who suffers from a medical problem and visits a physician (surgeon, orthopedist, or dentist). The physician gives a passive or active recommendation regarding treatment. Different levels of passive recommendation (against or wait on treatment) and active recommendation (minor, moderate, or major procedures) were used. The experience of the physician was also manipulated. The dependent measure was the patient's rating of the physician's epistemic authority. Physicians who prescribed an active mode of treatment were perceived as having a higher epistemic authority than physicians who gave a passive recommendation. We named this phenomenon the medical expertise bias, as people might be biased when judging the level of expertise of their physicians such that those physicians who recommend an active treatment are considered to have greater medical epistemic authority in general.

Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review.

PubMed

Armstrong, Sarah; Lazorick, Suzanne; Hampl, Sarah; Skelton, Joseph A; Wood, Charles; Collier, David; Perrin, Eliana M

2016-02-01

Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits. Copyright © 2016 by the American Academy of Pediatrics.

Brazilian Consensus Recommendation on the Use of Polymethylmethacrylate Filler in Facial and Corporal Aesthetics.

PubMed

Blanco Souza, Túlio Armanini; Colomé, Letícia Marques; Bender, Eduardo André; Lemperle, Gottfriede

2018-06-05

Considering that aesthetic benefits can be obtained with the use of permanent filling materials, this work focuses on the development of a consensus regarding the facial and corporal use of polymethylmethacrylate (PMMA) filler in Brazil. A questionnaire regarding PMMA treatment, which included items on the main indication, application site, volume of product applied, criteria for selection of the material, complications, contraindications, and individual professional experience, was distributed to the Expert Group members. In addition, the responses were summarized, constituting the starting point for the debate regarding the use of PMMA-based fillers on The First Brazilian PMMA Symposium to create a guideline to be followed in PMMA facial and corporal treatments. This survey involved 87,371 cases. PMMA treatment is recommended for restorative and aesthetic purposes in facial and corporal cases, particularly for facial balance. PMMA 30% filler is recommended in specific facial sites (nose, mentum, mandible angle, zygomatic arc, and malar). PMMA filler is contraindicated in other sites (lips) regardless of concentration. With regard to facial treatment, the juxtaperiostal is the application plane most recommended. For PMMA corporal application, intramuscular is the application plane most indicated, while intradermal and justadermal planes are contraindicated. The submuscular plane application is relative to PMMA filler concentration. The experts also inquired regarding the amount of PMMA recommended in each corporal site (50 mL in the calf, 100-150 mL in the gluteal region). These recommendations provide a guideline for physicians, supporting them to perform safe and efficacious treatment with PMMA fillers. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The correlation between HTA recommendations and reimbursement status of orphan drugs in Europe.

PubMed

Kawalec, Paweł; Sagan, Anna; Pilc, Andrzej

2016-09-06

The aim of this study was to review and compare types of reimbursement recommendations for orphan drugs issued by eight European health technology assessment (HTA) agencies and the reimbursement status of these drugs in the corresponding countries. Separate calculations were also performed for three sub-groups: ultra-orphan drugs, oncology orphan drugs and other (non-ultra, non-oncology) orphan drugs. We reviewed drugs authorized by the European Medicine Agency (EMA) between 1 November 2002 and 30 September 2015. Among these, we identified 101 orphan drugs. Seventy-nine of them were assessed by eight European HTA agencies. The average rates of positive, conditional and negative reimbursement recommendations issued by these agencies were 55.7 %, 15.3 % and 29.0 %, respectively. On average, 21.2 % of EMA-authorized orphan drugs were reimbursed in the eight European countries studied: 49.0 % of those with positive, 53.6 % of those with conditional, and 16.0 % of those with negative reimbursement recommendations. In addition, 5.4 % of orphan drugs that had not been assessed by any of the eight HTA agencies were also reimbursed. The shares of oncology, ultra, and other orphan drugs that were assessed by HTA agencies were similar, with the lowest share observed in ultra-orphan drugs (72 %) and the highest in other orphan drugs (80 %). In terms of reimbursement, 20 % of oncology orphan drugs, 25 % of ultra-orphan drugs and 21 % of other orphan drugs were reimbursed. Reimbursement of orphan drugs does not always correspond to the type of HTA recommendation. While the highest rate of reimbursement is observed (unsurprisingly) among drugs with positive or conditional recommendation, a high rate of reimbursement (11 %) is also observed among ultra-orphan drugs that had never been assessed by any HTA agency.

Personalizing lung cancer risk prediction and imaging follow-up recommendations using the National Lung Screening Trial dataset.

PubMed

Hostetter, Jason M; Morrison, James J; Morris, Michael; Jeudy, Jean; Wang, Kenneth C; Siegel, Eliot

2017-11-01

To demonstrate a data-driven method for personalizing lung cancer risk prediction using a large clinical dataset. An algorithm was used to categorize nodules found in the first screening year of the National Lung Screening Trial as malignant or nonmalignant. Risk of malignancy for nodules was calculated based on size criteria according to the Fleischner Society recommendations from 2005, along with the additional discriminators of pack-years smoking history, sex, and nodule location. Imaging follow-up recommendations were assigned according to Fleischner size category malignancy risk. Nodule size correlated with malignancy risk as predicted by the Fleischner Society recommendations. With the additional discriminators of smoking history, sex, and nodule location, significant risk stratification was observed. For example, men with ≥60 pack-years smoking history and upper lobe nodules measuring >4 and ≤6 mm demonstrated significantly increased risk of malignancy at 12.4% compared to the mean of 3.81% for similarly sized nodules (P < .0001). Based on personalized malignancy risk, 54% of nodules >4 and ≤6 mm were reclassified to longer-term follow-up than recommended by Fleischner. Twenty-seven percent of nodules ≤4 mm were reclassified to shorter-term follow-up. Using available clinical datasets such as the National Lung Screening Trial in conjunction with locally collected datasets can help clinicians provide more personalized malignancy risk predictions and follow-up recommendations. By incorporating 3 demographic data points, the risk of lung nodule malignancy within the Fleischner categories can be considerably stratified and more personalized follow-up recommendations can be made. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Instructions to Prospective Authors by Indian Biomedical Journals: An Opportunity to Promote Responsible Conduct of Research.

PubMed

Bhat, Anup; Shah, Akash; Sherighar, Swathi G

2017-04-01

Journals provide instructions to prospective authors to facilitate the process of manuscript publication. The information provided under such instructions could be a potential opportunity to promote responsible conduct of research (RCR). We analyzed 74 Indian biomedical journals for the type of information provided in the "instructions to authors" section and adherence to the International Committee of Medical Journal Editors (ICMJE) recommendations. Among the 71 journals that had an "instructions to authors" section, 53 journals adhered to ICMJE recommendations. We discuss sections of the ICMJE recommendations detailed by Indian biomedical journals under the "instructions to authors" section and emphasize components that require greater exposure.

Nurse practitioners in Taiwan: today and tomorrow.

PubMed

Wei, Ching-Wen; Tung, Heng-Hsin; Tsay, Shiow-Luan; Lin, Che-Wei

2012-03-01

To describe the barriers that nurse practitioners (NPs) face and their hopes for the future. The study used a qualitative research design, with 10 certified NPs who were recruited through convenience sampling. Data were collected through a face-to-face semi-structured interview, and content analysis was used to analyze the data. NPs in Taiwan are challenged by a number of barriers; however, they remain positive that their circumstances will improve. The results of this study suggest that there is a need for better communication between policymakers and NPs. Additionally, as recommended by the International Council of Nursing, there is a need for NPs to earn a master's degree and to have formal training prior to beginning work as an NP. Furthermore, to evaluate the NPs' performance, outcome studies need to be conducted. Implementing such recommendations should enable NPs to earn the respect and support of healthcare professionals and administrators. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

Do textbooks used in university reading education courses conform to the instructional recommendations of the national reading panel?

PubMed

Malatesha Joshi, R; Binks, Emily; Graham, Lori; Ocker-Dean, Emily; Smith, Dennie L; Boulware-Gooden, Regina

2009-01-01

Two reasons may be responsible for the poor grasp of the linguistic concepts related to literacy acquisition by preservice and in-service teachers: a lack of attention given to such concepts by teacher educators (college faculty members) and a lack of relevant information provided in the textbooks used in college courses. In an earlier study, the authors found that many teacher educators involved in the training of preservice and in-service teachers were not well acquainted with these concepts. In this study, the authors examined the extent to which textbooks used in reading education courses contain the information about the five components of literacy instruction (phonemic awareness, phonics, fluency, vocabulary, and text comprehension) recommended by the National Reading Panel. Such scrutiny shows that many textbooks do not adequately cover these five components and the related instructional procedures for teaching them. In addition to the paucity of information about teaching the five components, some textbooks present inaccurate information.

Operations & Maintenance Best Practices - A Guide to Achieving Operational Efficiency (Release 3)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sullivan, Greg; Pugh, Ray; Melendez, Aldo P.

This guide highlights operations and maintenance programs targeting energy and water efficiency that are estimated to save 5% to 20% on energy bills without a significant capital investment. The purpose of this guide is to provide you, the Operations and Maintenance (O&M)/Energy manager and practitioner, with useful information about O&M management, technologies, energy and water efficiency, and cost-reduction approaches. To make this guide useful and to reflect your needs and concerns, the authors met with O&M and Energy managers via Federal Energy Management Program (FEMP) workshops. In addition, the authors conducted extensive literature searches and contacted numerous vendors and industrymore » experts. The information and case studies that appear in this guide resulted from these activities. It needs to be stated at the outset that this guide is designed to provide information on effective O&M as it applies to systems and equipment typically found at Federal facilities. This guide is not designed to provide the reader with step-by-step procedures for performing O&M on any specific piece of equipment. Rather, this guide first directs the user to the manufacturer's specifications and recommendations. In no way should the recommendations in this guide be used in place of manufacturer's recommendations. The recommendations in this guide are designed to supplement those of the manufacturer, or, as is all too often the case, provide guidance for systems and equipment for which all technical documentation has been lost. As a rule, this guide will first defer to the manufacturer's recommendations on equipment operation and maintenance.« less

ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients.

PubMed

Tacconelli, E; Cataldo, M A; Dancer, S J; De Angelis, G; Falcone, M; Frank, U; Kahlmeter, G; Pan, A; Petrosillo, N; Rodríguez-Baño, J; Singh, N; Venditti, M; Yokoe, D S; Cookson, B

2014-01-01

Healthcare-associated infections due to multidrug-resistant Gram-negative bacteria (MDR-GNB) are a leading cause of morbidity and mortality worldwide. These evidence-based guidelines have been produced after a systematic review of published studies on infection prevention and control interventions aimed at reducing the transmission of MDR-GNB. The recommendations are stratified by type of infection prevention and control intervention and species of MDR-GNB and are presented in the form of 'basic' practices, recommended for all acute care facilities, and 'additional special approaches' to be considered when there is still clinical and/or epidemiological and/or molecular evidence of ongoing transmission, despite the application of the basic measures. The level of evidence for and strength of each recommendation, were defined according to the GRADE approach. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Nonpharmaceutical Interventions for Pandemic Influenza, National and Community Measures

PubMed Central

2006-01-01

The World Health Organization's recommended pandemic influenza interventions, based on limited data, vary by transmission pattern, pandemic phase, and illness severity and extent. In the pandemic alert period, recommendations include isolation of patients and quarantine of contacts, accompanied by antiviral therapy. During the pandemic period, the focus shifts to delaying spread and reducing effects through population-based measures. Ill persons should remain home when they first become symptomatic, but forced isolation and quarantine are ineffective and impractical. If the pandemic is severe, social distancing measures such as school closures should be considered. Nonessential domestic travel to affected areas should be deferred. Hand and respiratory hygiene should be routine; mask use should be based on setting and risk, and contaminated household surfaces should be disinfected. Additional research and field assessments during pandemics are essential to update recommendations. Legal authority and procedures for implementing interventions should be understood in advance and should respect cultural differences and human rights. PMID:16494723

Review: Malaria Chemoprophylaxis for Travelers to Latin America

PubMed Central

Steinhardt, Laura C.; Magill, Alan J.; Arguin, Paul M.

2011-01-01

Because of recent declining malaria transmission in Latin America, some authorities have recommended against chemoprophylaxis for most travelers to this region. However, the predominant parasite species in Latin America, Plasmodium vivax, can form hypnozoites sequestered in the liver, causing malaria relapses. Additionally, new evidence shows the potential severity of vivax infections, warranting continued consideration of prophylaxis for travel to Latin America. Individualized travel risk assessments are recommended and should consider travel locations, type, length, and season, as well as probability of itinerary changes. Travel recommendations might include no precautions, mosquito avoidance only, or mosquito avoidance and chemoprophylaxis. There are a range of good options for chemoprophylaxis in Latin America, including atovaquone-proguanil, doxycycline, mefloquine, and—in selected areas—chloroquine. Primaquine should be strongly considered for nonpregnant, G6PD-nondeficient patients traveling to vivax-endemic areas of Latin America, and it has the added benefit of being the only drug to protect against malaria relapses. PMID:22144437

The future of surgical training in the context of the 'Shape of Training' Review: Consensus recommendations by the Association of Surgeons in Training.

PubMed

Harries, Rhiannon L; Williams, Adam P; Ferguson, Henry J M; Mohan, Helen M; Beamish, Andrew J; Gokani, Vimal J

2016-11-01

ASiT has long maintained that in order to provide the best quality care to patients in the UK and Republic of Ireland, it is critical that surgeons are trained to the highest standards. In addition, it is imperative that surgery remains an attractive career choice, with opportunities for career progression and job satisfaction to attract and retain the best candidates. In 2013, the Shape of Training review report set out recommendations for the structure and delivery of postgraduate training in light of an ever increasingly poly-morbid and ageing population. This consensus statement outlines ASIT's position regarding recommendations for improving surgical training and aims to help guide discussions with regard to future proposed changes to surgical training. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

How does information on the harms and benefits of cervical cancer screening alter the intention to be screened?: a randomized survey of Norwegian women.

PubMed

Iyer, Anita L; Bundorf, M Kate; Gyrd-Hansen, Dorte; Goldhaber-Fiebert, Jeremy D; Cyr, Pascale-Renée; Sønbø Kristiansen, Ivar

2018-03-27

Cervical cancer (CC) is the 13th most frequent cancer among women in Norway, but the third most common among women aged 25-49 years. The national screening program sends information letters to promote screening participation. We aimed to evaluate how women's stated intention to participate in screening and pursue treatment changed with the provision of additional information on harms associated with screening, and to assess women's preferences on the timing and source of such information. We administered a web-based questionnaire to a panel of Norwegian women aged 25-69 years and randomized into three groups on the basis of when in the screening process additional information was introduced: (i) invited for routine screening, (ii) recommended an additional test following detection of cellular abnormalities, and (iii) recommended precancer treatment. A fourth (control) group did not receive any additional information. Results show that among 1060 respondents, additional information did not significantly alter women's stated intentions to screen. However, it created decision uncertainty on when treatment was recommended (8.76-9.09 vs. 9.40; 10-point Likert scale; P=0.004). Over 80% of women favored receiving information on harms and 59% preferred that information come from a qualified public health authority. Nearly 90% of women in all groups overestimated women's lifetime risk of CC. In conclusion, additional information on harms did not alter Norwegian women's stated intention to screen for CC; yet, it resulted in greater decision uncertainty to undergo precancer treatment. Incorporating information on harms into invitation letters is warranted as it would increase women's ability to make informed choices.

Essential medicines for emergency care in Africa.

PubMed

Broccoli, Morgan C; Pigoga, Jennifer L; Nyirenda, Mulinda; Wallis, Lee; Calvello Hynes, Emilie J

2018-04-07

Essential medicines lists (EMLs) are efficient means to ensure access to safe and effective medications. The WHO has led this initiative, generating a biannual EML since 1977. Nearly all countries have implemented national EMLs based on the WHO EML. Although EMLs have given careful consideration to many public health priorities, they have yet to comprehensively address the importance of medicines for treating acute illness and injury. We undertook a multistep consensus process to establish an EML for emergency care in Africa. After a review of existing literature and international EMLs, we generated a candidate list for emergency care. This list was reviewed by expert clinicians who ranked the medicines for overall inclusion and strength of recommendation. These medications and recommendations were then evaluated by an expert group. Medications that reached consensus in both the online survey and expert review were included in a draft emergency care EML, which underwent a final inperson consensus process. The final emergency care EML included 213 medicines, 25 of which are not in the 2017 WHO EML, but were deemed essential for clinical practice by regional emergency providers. The final EML has associated recommendations of desirable or essential and is subdivided by facility level. Thirty-nine medicines were recommended for basic facilities, an additional 96 for intermediate facilities (eg, district hospitals) and an additional 78 for advanced facilities (eg, tertiary centres). The 25 novel medications not currently on the WHO EML should be considered by planners when making rational formularies for developing emergency care systems. It is our hope that these resource-stratified lists will allow for easier implementation and will be a useful tool for practical expansion of emergency care delivery in Africa. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Policy Interpretation Network on Children's Health and Environment.

PubMed

van den Hazel, Peter; Zuurbier, Moniek; Bistrup, Marie Louise

2006-10-01

The main objective of PINCHE is to provide policy recommendations aiming at protecting children's health and environment based on completed scientific research. The project focused on four themes: indoor and outdoor air pollutants, carcinogens, neurotoxicants, and noise. The data were evaluated in workpackages on exposure assessment, epidemiology, toxicology, and risk and health impact assessment. The data were analysed according to a framework of questions. The workpackage on socioeconomic factors studied the influence of socioeconomic status on exposures and on health effects. In the workpackage on science-policy interface, recommendations on how to improve children's environmental health were formulated. The policy recommendations resulting from the analysis were grouped according to relevant policy levels: European Commission or the European Parliament, member states and other stakeholders at regional or local level. These recommendations are general guidelines for taking action. Regional differences and variation must be reflected when policy is actually implemented. In addition, recommendations related to education and personal behaviour are presented in the reports. The policy recommendations are important input for policy advisers, policy makers and public health authorities at all policy levels. The recommendations are also of direct relevance to interest groups, such as environmental NGOs including child health and advocacy groups. The policy recommendations for each policy level were prioritized. High priorities were given to reduce exposure to environmental tobacco smoke, transport related air pollution, indoor air and mercury.

Wiring for aerospace applications

NASA Astrophysics Data System (ADS)

Christian, J. L., Jr.; Dickman, J. E.; Bercaw, R. W.; Myers, I. T.; Hammoud, A. N.; Stavnes, M.; Evans, J.

1992-07-01

In this paper, the authors summarize the current state of knowledge of arc propagation in aerospace power wiring and efforts by the National Aeronautics and Space Administration (NASA) towards the understanding of the arc tracking phenomena in space environments. Recommendations will be made for additional testing. A database of the performance of commonly used insulating materials will be developed to support the design of advanced high power missions, such as Space Station Freedom and Lunar/Mars Exploration.

Wiring for aerospace applications

NASA Technical Reports Server (NTRS)

Christian, J. L., Jr.; Dickman, J. E.; Bercaw, R. W.; Myers, I. T.; Hammoud, A. N.; Stavnes, M.; Evans, J.

1992-01-01

In this paper, the authors summarize the current state of knowledge of arc propagation in aerospace power wiring and efforts by the National Aeronautics and Space Administration (NASA) towards the understanding of the arc tracking phenomena in space environments. Recommendations will be made for additional testing. A database of the performance of commonly used insulating materials will be developed to support the design of advanced high power missions, such as Space Station Freedom and Lunar/Mars Exploration.

Nature-based supportive care opportunities: a conceptual framework.

PubMed

Blaschke, Sarah; O'Callaghan, Clare C; Schofield, Penelope

2018-03-22

Given preliminary evidence for positive health outcomes related to contact with nature for cancer populations, research is warranted to ascertain possible strategies for incorporating nature-based care opportunities into oncology contexts as additional strategies for addressing multidimensional aspects of cancer patients' health and recovery needs. The objective of this study was to consolidate existing research related to nature-based supportive care opportunities and generate a conceptual framework for discerning relevant applications in the supportive care setting. Drawing on research investigating nature-based engagement in oncology contexts, a two-step analytic process was used to construct a conceptual framework for guiding nature-based supportive care design and future research. Concept analysis methodology generated new representations of understanding by extracting and synthesising salient concepts. Newly formulated concepts were transposed to findings from related research about patient-reported and healthcare expert-developed recommendations for nature-based supportive care in oncology. Five theoretical concepts (themes) were formulated describing patients' reasons for engaging with nature and the underlying needs these interactions address. These included: connecting with what is genuinely valued, distancing from the cancer experience, meaning-making and reframing the cancer experience, finding comfort and safety, and vital nurturance. Eight shared patient and expert recommendations were compiled, which address the identified needs through nature-based initiatives. Eleven additional patient-reported recommendations attend to beneficial and adverse experiential qualities of patients' nature-based engagement and complete the framework. The framework outlines salient findings about helpful nature-based supportive care opportunities for ready access by healthcare practitioners, designers, researchers and patients themselves. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Reporting of financial conflicts of interest in clinical practice guidelines: a case study analysis of guidelines from the Canadian Medical Association Infobase.

PubMed

Shnier, Adrienne; Lexchin, Joel; Romero, Mirna; Brown, Kevin

2016-08-15

Clinical practice guidelines are widely distributed by medical associations and relied upon by physicians for the best available clinical evidence. International findings report that financial conflicts of interest (FCOI) with drug companies may influence drug recommendations and are common among guideline authors. There is no comparable study on exclusively Canadian guidelines; therefore, we provide a case study of authors' FCOI declarations in guidelines from the Canadian Medical Association (CMA) Infobase. We also assess the financial relationships between guideline-affiliated organizations and drug companies. Using a population approach, we extracted first-line drug recommendations and authors' FCOI disclosures in guidelines from the CMA Infobase. We contacted the corresponding authors on guidelines when FCOI disclosures were missing for some or all authors. We also extracted guideline-affiliated organizations and searched each of their websites to determine if they had financial relationships with drug companies. We analyzed 350 authors from 28 guidelines. Authors were named on one, two, or three guidelines, yielding 400 FCOI statements. In 75.0 % of guidelines at least one author, and in 21.4 % of guidelines all authors, disclosed FCOI with drug companies. In 54.0 % of guidelines at least one author, and in 28.6 % of guidelines over half of the authors, disclosed FCOI with manufacturers of drugs that they recommended. Twenty of 48 authors on multiple guidelines reported different FCOI in their disclosures. Eight guidelines identified affiliated organizations with financial relationships with manufacturers of drugs recommended in those guidelines. This is the first study to systematically describe FCOI disclosures by authors of Canadian guidelines and financial relationships between guideline-affiliated organizations and pharmaceutical companies. These financial relationships are common. Because authoritative value is assigned to guidelines distributed by medical associations, we encourage them to develop formal policies to limit the potential influence of FCOI on guideline recommendations.

Noncaloric Sweeteners in Children: A Controversial Theme

PubMed Central

Escobar Contreras, Ma. Cristina; Rojas Gómez, Diana; de Assis Costa, Jorge

2018-01-01

Noncaloric sweeteners (NCS) are food additives used to provide sweetness without adding calories. Their consumption has become more widespread around the world in all age groups, including children. The aim of this study is to show the state of the art about the intake of noncaloric sweeteners in children, as well as their benefits and consumption risk. Scientific searchers were used (PUBMED, Scopus, and Scielo) to analyze articles that included keywords (noncaloric sweeteners/saccharin/cyclamate/acesulfame potassium/aspartame/sucralose/stevia/children) in English, Spanish, and Portuguese. Authors conclude that it is imperative that health professionals judiciously and individually evaluate the overall benefits and risks of NCS use in consumers before recommending their use. Different subgroups of the population incorporate products containing NCS in their diet with different objectives, which should be considered when recommending a diet plan for the consumer. In childhood, in earlier age groups, this type of additives should be used as a dietary alternative when other forms of prevention in obesity are not sufficient. PMID:29511682

State of the science on implementation research in early child development and future directions.

PubMed

Aboud, Frances E; Yousafzai, Aisha K; Nores, Milagros

2018-05-01

We summarize the state of the field of implementation research and practice for early child development and propose recommendations. First, conclusions are drawn regarding what is generally known about the implementation of early childhood development programs, based on papers and discussions leading to a published series on the topic. Second, recommendations for short-term activities emphasize the use of newly published guidelines for reporting data collection methods and results for implementation processes; knowledge of the guidelines and a menu of measures allows for planning ahead. Additional recommendations include careful documentation of early-stage implementation, such as adapting a program to a different context and assessing feasibility, as well as the process of sustaining and scaling up a program. Using existing implementation information by building on and improving past programs and translating them into policy are recommended. Longer term goals are to identify implementation characteristics of effective programs and determinants of these characteristics. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.

Guidance in author instructions of hematology and oncology journals: A cross sectional and longitudinal study

PubMed Central

Toews, Ingrid; Binder, Nadine; Wolff, Robert F.; Toprak, Guenes; von Elm, Erik; Meerpohl, Joerg J.

2017-01-01

Background The debate about the value of biomedical publications led to recommendations for improving reporting quality. It is unclear to what extent these recommendations have been endorsed by journals. We analyzed whether specific recommendations were included in author instructions, which journal characteristics were associated with their endorsement, how endorsement of the domains changed and whether endorsement was associated with change of impact factor between 2010 and 2015. Methods We considered two study samples consisting of “Hematology” and “Oncology” journals of the Journal Citation Report 2008 and 2014, respectively. We extracted information regarding endorsement of the (1) recommendations of the International Committee of Medical Journal Editors, of (2) reporting guidelines, (3) requirement for trial registration and (4) disclosure of conflicts of interest. Data extraction was done by reading the author instructions before conducting a text search with keywords. We calculated a global generalized linear mixed effects model for endorsement of each of the four domains followed by separate multivariable logistic regression models and a longitudinal analysis. We defined endorsement as the author instructions saying that they approve the use of the recommendations. Results In 2015, the ICMJE recommendations were mentioned in author instructions of 156 journals (67.5%). CONSORT was referred to by 77 journals (33.3%); MOOSE, PRISMA, STARD and STROBE were referred to by less than 15% of journals. There were 99 journals (42.9%) that recommended or required trial registration, 211 (91.3%) required authors to disclose conflicts of interest. Journal impact factor, journal start year and geographical region were positively associated with endorsement of any of the four domains. The overall endorsement of all domains increased between 2010 and 2015. The endorsement of any domain in 2010 seemed to be associated with an increased impact factor in 2014. Conclusion Hematology and oncology journals endorse major recommendations to various degrees. Endorsement is increasing slowly over time and might be positively associated with the journals’ impact factor. PMID:28453528

Guidance in author instructions of hematology and oncology journals: A cross sectional and longitudinal study.

PubMed

Toews, Ingrid; Binder, Nadine; Wolff, Robert F; Toprak, Guenes; von Elm, Erik; Meerpohl, Joerg J

2017-01-01

The debate about the value of biomedical publications led to recommendations for improving reporting quality. It is unclear to what extent these recommendations have been endorsed by journals. We analyzed whether specific recommendations were included in author instructions, which journal characteristics were associated with their endorsement, how endorsement of the domains changed and whether endorsement was associated with change of impact factor between 2010 and 2015. We considered two study samples consisting of "Hematology" and "Oncology" journals of the Journal Citation Report 2008 and 2014, respectively. We extracted information regarding endorsement of the (1) recommendations of the International Committee of Medical Journal Editors, of (2) reporting guidelines, (3) requirement for trial registration and (4) disclosure of conflicts of interest. Data extraction was done by reading the author instructions before conducting a text search with keywords. We calculated a global generalized linear mixed effects model for endorsement of each of the four domains followed by separate multivariable logistic regression models and a longitudinal analysis. We defined endorsement as the author instructions saying that they approve the use of the recommendations. In 2015, the ICMJE recommendations were mentioned in author instructions of 156 journals (67.5%). CONSORT was referred to by 77 journals (33.3%); MOOSE, PRISMA, STARD and STROBE were referred to by less than 15% of journals. There were 99 journals (42.9%) that recommended or required trial registration, 211 (91.3%) required authors to disclose conflicts of interest. Journal impact factor, journal start year and geographical region were positively associated with endorsement of any of the four domains. The overall endorsement of all domains increased between 2010 and 2015. The endorsement of any domain in 2010 seemed to be associated with an increased impact factor in 2014. Hematology and oncology journals endorse major recommendations to various degrees. Endorsement is increasing slowly over time and might be positively associated with the journals' impact factor.

Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group.

PubMed

Kossoff, Eric H; Zupec-Kania, Beth A; Auvin, Stéphane; Ballaban-Gil, Karen R; Christina Bergqvist, A G; Blackford, Robyn; Buchhalter, Jeffrey R; Caraballo, Roberto H; Cross, J Helen; Dahlin, Maria G; Donner, Elizabeth J; Guzel, Orkide; Jehle, Rana S; Klepper, Joerg; Kang, Hoon-Chul; Lambrechts, Danielle A; Liu, Y M Christiana; Nathan, Janak K; Nordli, Douglas R; Pfeifer, Heidi H; Rho, Jong M; Scheffer, Ingrid E; Sharma, Suvasini; Stafstrom, Carl E; Thiele, Elizabeth A; Turner, Zahava; Vaccarezza, Maria M; van der Louw, Elles J T M; Veggiotti, Pierangelo; Wheless, James W; Wirrell, Elaine C

2018-06-01

Ketogenic dietary therapies (KDTs) are established, effective nonpharmacologic treatments for intractable childhood epilepsy. For many years KDTs were implemented differently throughout the world due to lack of consistent protocols. In 2009, an expert consensus guideline for the management of children on KDT was published, focusing on topics of patient selection, pre-KDT counseling and evaluation, diet choice and attributes, implementation, supplementation, follow-up, side events, and KDT discontinuation. It has been helpful in outlining a state-of-the-art protocol, standardizing KDT for multicenter clinical trials, and identifying areas of controversy and uncertainty for future research. Now one decade later, the organizers and authors of this guideline present a revised version with additional authors, in order to include recent research, especially regarding other dietary treatments, clarifying indications for use, side effects during initiation and ongoing use, value of supplements, and methods of KDT discontinuation. In addition, authors completed a survey of their institution's practices, which was compared to responses from the original consensus survey, to show trends in management over the last 10 years.

OPERATIONAL TEST AND EVALUATION OF PHOTOTROPIC GOGGLES.

DTIC Science & Technology

Irreversible Phototropic Filter Device is one of many such systems. Forty-nine Air Defense Command and twenty-four Tactical Air Command aircrews evaluated the...indicated that: The goggles do not integrate with the oxygen mask, helmet and visor; It is not practicable to carry additional phototropic lenses for...in-flight changes. The Irreversible Phototropic Filter Device is operationally unacceptable for use by aircrew members. Recommend that ASD continue efforts to develop a suitable device for flashblindness protection. (Author)

Organizing Books and Authors by Multilayer SOM.

PubMed

Zhang, Haijun; Chow, Tommy W S; Wu, Q M Jonathan

2016-12-01

This paper introduces a new framework for the organization of electronic books (e-books) and their corresponding authors using a multilayer self-organizing map (MLSOM). An author is modeled by a rich tree-structured representation, and an MLSOM-based system is used as an efficient solution to the organizational problem of structured data. The tree-structured representation formulates author features in a hierarchy of author biography, books, pages, and paragraphs. To efficiently tackle the tree-structured representation, we used an MLSOM algorithm that serves as a clustering technique to handle e-books and their corresponding authors. A book and author recommender system is then implemented using the proposed framework. The effectiveness of our approach was examined in a large-scale data set containing 3868 authors along with the 10500 e-books that they wrote. We also provided visualization results of MLSOM for revealing the relevance patterns hidden from presented author clusters. The experimental results corroborate that the proposed method outperforms other content-based models (e.g., rate adapting poisson, latent Dirichlet allocation, probabilistic latent semantic indexing, and so on) and offers a promising solution to book recommendation, author recommendation, and visualization.

Is It PANS, CANS, or PANDAS? Neuropsychiatric Pediatric Disorders That Are Not Black and White--Implications for the School Nurse.

PubMed

Bagian, Kathy; Hartung, Sheila Q

2015-03-01

The terms pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), pediatric acute-onset neuropsychiatric syndrome (PANS), and childhood acute neuropsychiatric symptoms (CANS) have all been used to describe certain acute onset neuropsychiatric pediatric disorders. Additionally, controversy is ongoing concerning the diagnosis and etiology of the disorders. The school nurse, as a member of a multidisciplinary team, benefits from an awareness of these disorders, the resulting impact on school performance, and the recommended treatment. The school nurse assists the team through the development of an Individualized Healthcare Plan to help the student to achieve success in school. © 2014 The Author(s).

[Sedation with nitrous oxide in daily practice].

PubMed

Martens, Luc C; Marks, Luc A

2003-01-01

Conscious sedation is recommended, together with behaviour management techniques, to facilitate treatment of dental fear or dental phobia patients. In this article the authors focus on inhalation sedation by means of nitrous oxide. The procedures and indications are explained and illustrated with clinical cases. On the strength of the literature and their own experience the authors reach the conclusion that Inhalation sedation is a kind of pharmacological behaviour management and an important additional tool to increase patient cooperation. Inhalation sedation can only be performed by trained practitioners under internationally accepted safety conditions. Inhalation sedation has a future in Belgium providing the appropriate law is adapted. This technique deserves a place in the dental curriculum.

Automated detection using natural language processing of radiologists recommendations for additional imaging of incidental findings.

PubMed

Dutta, Sayon; Long, William J; Brown, David F M; Reisner, Andrew T

2013-08-01

As use of radiology studies increases, there is a concurrent increase in incidental findings (eg, lung nodules) for which the radiologist issues recommendations for additional imaging for follow-up. Busy emergency physicians may be challenged to carefully communicate recommendations for additional imaging not relevant to the patient's primary evaluation. The emergence of electronic health records and natural language processing algorithms may help address this quality gap. We seek to describe recommendations for additional imaging from our institution and develop and validate an automated natural language processing algorithm to reliably identify recommendations for additional imaging. We developed a natural language processing algorithm to detect recommendations for additional imaging, using 3 iterative cycles of training and validation. The third cycle used 3,235 radiology reports (1,600 for algorithm training and 1,635 for validation) of discharged emergency department (ED) patients from which we determined the incidence of discharge-relevant recommendations for additional imaging and the frequency of appropriate discharge documentation. The test characteristics of the 3 natural language processing algorithm iterations were compared, using blinded chart review as the criterion standard. Discharge-relevant recommendations for additional imaging were found in 4.5% (95% confidence interval [CI] 3.5% to 5.5%) of ED radiology reports, but 51% (95% CI 43% to 59%) of discharge instructions failed to note those findings. The final natural language processing algorithm had 89% (95% CI 82% to 94%) sensitivity and 98% (95% CI 97% to 98%) specificity for detecting recommendations for additional imaging. For discharge-relevant recommendations for additional imaging, sensitivity improved to 97% (95% CI 89% to 100%). Recommendations for additional imaging are common, and failure to document relevant recommendations for additional imaging in ED discharge instructions occurs frequently. The natural language processing algorithm's performance improved with each iteration and offers a promising error-prevention tool. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

An assessment of the schedule for schizotypal personalities and the DSM-III criteria for diagnosing schizotypal personality disorder.

PubMed

Perry, J C; O'Connell, M E; Drake, R

1984-11-01

The authors assessed the reliability and validity of the DSM-III criteria for schizotypal personality disorder (SPD) and their measurement by the Schedule for Schizotypal Personalities (SSP) developed by Baron. Additional criteria not in DSM-III were also explored. Consensual clinical ratings of videotaped interviews of subjects were used to validate item content of the SSP and the schizotypal diagnosis. The SSP assessments, with the exception of odd speech, were found to be reliable and valid. Higher cutoff scores than those recommended by Baron may be helpful in discriminating schizotypal from other psychiatric patients. Six of eight DSM-III criteria and all experimental criteria were highly specific for SPD cases but varied widely in their sensitivities. Based on these pilot data, the authors recommend combining all of the criteria into four conceptual categories: 1) self-report cognitive-perceptual disturbances, 2) observable disorders of thought and communication, 3) deficits in drive or affect, and 4) interpersonal difficulties. When three of these were required to make the SPD diagnosis, all of the subjects in the present data set were correctly identified.

Professional e-mail communication among health care providers: proposing evidence-based guidelines.

PubMed

Malka, S Terez; Kessler, Chad S; Abraham, John; Emmet, Thomas W; Wilbur, Lee

2015-01-01

E-mail is now a primary method of correspondence in health care, and proficiency with professional e-mail use is a vital skill for physicians. Fundamentals of e-mail courtesy can be derived from lay literature, but there is a dearth of scientific literature that addresses the use of e-mail between physicians. E-mail communication between providers is generally more familiar and casual than other professional interactions, which can promote unprofessional behavior or misunderstanding. Not only e-mail content but also wording, format, and tone may influence clinical recommendations and perceptions of the e-mail sender. In addition, there are serious legal and ethical implications when unprofessional or unsecured e-mails related to patient-identifying information are exchanged or included within an electronic medical record. The authors believe that the appropriate use of e-mail is a vital skill for physicians, with serious legal and ethical ramifications and the potential to affect professional development and patient care. In this article, the authors analyze a comprehensive literature search, explore several facets of e-mail use between physicians, and offer specific recommendations for professional e-mail use.

[Hydraulic fracturing - a hazard for drinking water?].

PubMed

Ewers, U; Gordalla, B; Frimmel, F

2013-11-01

Hydraulic fracturing (fracking) is a technique used to release and promote the extraction of natural gas (including shale gas, tight gas, and coal bed methane) from deep natural gas deposits. Among the German public there is great concern with regard to the potential environmental impacts of fracking including the contamination of ground water, the most important source of drinking water in Germany. In the present article the risks of ground water contamination through fracking are discussed. Due to the present safety requirements and the obligatory geological and hydrogeological scrutiny of the underground, which has to be performed prior to fracking, the risk of ground water contamination by fracking can be regarded as very low. The toxicity of chemical additives of fracking fluids is discussed. It is recommended that in the future environmental impact assessment and approval of fracs should be performed by the mining authorities in close cooperation with the water authorities. Furthermore, it is recommended that hydraulic fracturing in the future should be accompanied by obligatory ground water monitoring. © Georg Thieme Verlag KG Stuttgart · New York.

Protecting patients, protecting healthcare workers: a review of the role of influenza vaccination.

PubMed

Music, T

2012-06-01

Many health authorities recommend routine influenza vaccination for healthcare workers (HCWs), and during the 2009 A (H1N1) pandemic, the World Health Organization (WHO) recommended immunization of all HCWs worldwide. As this remains an important area of policy debate, this paper examines the case for vaccination, the role of local guidelines, barriers to immunization and initiatives to increase uptake. Seasonal influenza is a major threat to public health, causing up to 1 million deaths annually. Extensive evidence supports the vaccination of priority groups, including HCWs. Immunization protects HCWs themselves, and their vulnerable patients from nosocomial influenza infections. In addition, influenza can disrupt health services and impact healthcare organizations financially. Immunization can reduce staff absences, offer cost savings and provide economic benefits. This paper reviews official immunization recommendations and HCW vaccination studies, including a recent International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) survey of 26 countries from each region of the world. HCW immunization is widely recommended and supported by the WHO. In the IFPMA study, 88% of countries recommended HCW vaccination, and 61% supported this financially (with no correlation to country development status). Overall, coverage can be improved, and research shows that uptake may be impacted by lack of conveniently available vaccines and misconceptions regarding vaccine safety/efficacy and influenza risk. Many countries recommend HCW vaccination against influenza. In recent years, there has been an increased uptake rate among HCWs in some countries, but not in others. Several initiatives can increase coverage, including education, easy access to free vaccines and the use of formal declination forms. The case for HCW vaccination is clear, and in an effort to further accelerate uptake as a patient safety measure, an increasing number of healthcare organizations, particularly in the USA, are implementing mandatory immunization policies, similar to other obligatory hygiene measures. However, it would be desirable if similar high vaccination uptake rates could be achieved through voluntary procedures. © 2011 The Author. International Nursing Review © 2011 International Council of Nurses.

Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models

PubMed Central

Kowalczuk, Maria K; Dudbridge, Frank; Nanda, Shreeya; Harriman, Stephanie L; Patel, Jigisha; Moylan, Elizabeth C

2015-01-01

Objectives To assess whether reports from reviewers recommended by authors show a bias in quality and recommendation for editorial decision, compared with reviewers suggested by other parties, and whether reviewer reports for journals operating on open or single-blind peer review models differ with regard to report quality and reviewer recommendations. Design Retrospective analysis of the quality of reviewer reports using an established Review Quality Instrument, and analysis of reviewer recommendations and author satisfaction surveys. Setting BioMed Central biology and medical journals. BMC Infectious Diseases and BMC Microbiology are similar in size, rejection rates, impact factors and editorial processes, but the former uses open peer review while the latter uses single-blind peer review. The Journal of Inflammation has operated under both peer review models. Sample Two hundred reviewer reports submitted to BMC Infectious Diseases, 200 reviewer reports submitted to BMC Microbiology and 400 reviewer reports submitted to the Journal of Inflammation. Results For each journal, author-suggested reviewers provided reports of comparable quality to non-author-suggested reviewers, but were significantly more likely to recommend acceptance, irrespective of the peer review model (p<0.0001 for BMC Infectious Diseases, BMC Microbiology and the Journal of Inflammation). For BMC Infectious Diseases, the overall quality of reviewer reports measured by the Review Quality Instrument was 5% higher than for BMC Microbiology (p=0.042). For the Journal of Inflammation, the quality of reports was the same irrespective of the peer review model used. Conclusions Reviewers suggested by authors provide reports of comparable quality to non-author-suggested reviewers, but are significantly more likely to recommend acceptance. Open peer review reports for BMC Infectious Diseases were of higher quality than single-blind reports for BMC Microbiology. There was no difference in quality of peer review in the Journal of Inflammation under open peer review compared with single blind. PMID:26423855

Problems With Risk Reclassification Methods for Evaluating Prediction Models

PubMed Central

Pepe, Margaret S.

2011-01-01

For comparing the performance of a baseline risk prediction model with one that includes an additional predictor, a risk reclassification analysis strategy has been proposed. The first step is to cross-classify risks calculated according to the 2 models for all study subjects. Summary measures including the percentage of reclassification and the percentage of correct reclassification are calculated, along with 2 reclassification calibration statistics. The author shows that interpretations of the proposed summary measures and P values are problematic. The author's recommendation is to display the reclassification table, because it shows interesting information, but to use alternative methods for summarizing and comparing model performance. The Net Reclassification Index has been suggested as one alternative method. The author argues for reporting components of the Net Reclassification Index because they are more clinically relevant than is the single numerical summary measure. PMID:21555714

48 CFR 32.409-1 - Recommendation for approval.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Recommendation for... Recommendation for approval. If recommending approval, the contracting officer shall transmit the following... authorization (see 32.410). (g) The recommendation for approval of the advance payment request. (h...

Vaccination for seasonal influenza in patients with cancer: recommendations of the Italian Society of Medical Oncology (AIOM).

PubMed

Pedrazzoli, P; Baldanti, F; Donatelli, I; Castrucci, M R; Puglisi, F; Silvestris, N; Cinieri, S

2014-06-01

Influenza virus causes annual epidemics in the winter-spring season with significant morbidity in the general population and important mortality in high-risk groups, including cancer patients. Opinions on the suitability of patients with malignancies not undergoing active treatment and in different phases of antineoplastic therapy, to receive influenza vaccination, vary considerably among oncologists, sometimes even within one center. We reviewed available data, including recommendations by national health authorities, on impact of influenza in patients with cancer and their capacity to mount protective immunological responses to vaccination, thus allowing, on behalf of Italian Association of Medical Oncology, to make suitable recommendations for the prevention and treatment of seasonal influenza. Patients with cancer often have disease- or treatment-related immunosuppression, and as a consequence, they may have a suboptimal serologic response to influenza vaccination. The protective effect of the different preparations of influenza vaccines in patients with cancer has not been widely investigated, especially in adult patients harboring solid tumors. The optimal timing for administration of influenza vaccines in patients receiving chemotherapy is also not clearly defined. However, since vaccination is the most effective method, along with antiviral drugs in selected patients, for preventing influenza infection, it has to be recommended for cancer patients. Implementing vaccination of close contacts of oncology patients would be an additional tool for enhancing protection in fragile patient populations. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Medicaid Prior Authorization Policies for Medication Treatment of Attention-Deficit/Hyperactivity Disorder in Young Children, United States, 2015.

PubMed

Hulkower, Rachel L; Kelley, Meghan; Cloud, Lindsay K; Visser, Susanna N

In 2011, the American Academy of Pediatrics updated its guidelines for the diagnosis and treatment of children with attention-deficit/hyperactivity disorder (ADHD) to recommend that clinicians refer parents of preschoolers (aged 4-5) for training in behavior therapy and subsequently treat with medication if behavior therapy fails to sufficiently improve functioning. Data available from just before the release of the guidelines suggest that fewer than half of preschoolers with ADHD received behavior therapy and about half received medication. About half of those who received medication also received behavior therapy. Prior authorization policies for ADHD medication may guide physicians toward recommended behavior therapy. Characterizing existing prior authorization policies is an important step toward evaluating the impact of these policies on treatment patterns. We inventoried existing prior authorization policies and characterized policy components to inform future evaluation efforts. A 50-state legal assessment characterized ADHD prior authorization policies in state Medicaid programs. We designed a database to capture data on policy characteristics and authorization criteria, including data on age restrictions and fail-first behavior therapy requirements. In 2015, 27 states had Medicaid policies that prevented approval of pediatric ADHD medication payment without additional provider involvement. Seven states required that prescribers indicate whether nonmedication treatments were considered before Medicaid payment for ADHD medication could be approved. Medicaid policies on ADHD medication treatment are diverse; some policies are tied to the diagnosis and treatment guidelines of the American Academy of Pediatrics. Evaluations are needed to determine if certain policy interventions guide families toward the use of behavior therapy as the first-line ADHD treatment for young children.

Flight Attendant Fatigue Recommendation 2: Flight Attendant Work/Rest Patterns, Alertness, and Performance Assessment

DTIC Science & Technology

2010-12-01

Recommendation II: Flight Attendant Work/Rest Patterns, Alertness, and Performance Assessment DOT/FAA/AM-10/22 Office of Aerospace Medicine Washington, DC...Recipient’s Catalog No. DOT/FAA/AM-10/22 4. Title and Subtitle 5. Report Date December 2010 6. Performing Organization Code Flight...Attendant Fatigue Recommendation II: Flight Attendant Work/Rest Patterns, Alertness, and Performance Assessment 7. Author(s) 8. Performing

Overview of the CCITT Recommendations for Synchronous Digital Hierarchy

DTIC Science & Technology

1991-10-01

Recommendations for8 Synchronous Digital Hierarchy DCK RAPPORTENCEN’TRiLEAD-A245 680 Frederikkazerne, Geb. 140EN 1111 iNTelefcron: 070-3166394/6395... Synchronous Digital Hierarchy author(s) P.P. Copeland institute TNO Physics and Electronics Laboratory date October 1991 NDRO no A90KLu635 no in pow...recent International Consultative Committee for Telephone and Telegraph (CCITT) Recommendations for the Synchronous Digital Hierarchy (SDH). The

EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis.

PubMed

van Eijk-Hustings, Yvonne; van Tubergen, Astrid; Boström, Carina; Braychenko, Elena; Buss, Beate; Felix, José; Firth, Jill; Hammond, Alison; Harston, Benny; Hernandez, Cristina; Huzjak, Masa; Korandová, Jana; Kukkurainen, Marja Leena; Landewé, Robert; Mezieres, Maryse; Milincovic, Marijana; Moretti, Antonella; Oliver, Susan; Primdahl, Jette; Scholte-Voshaar, Marieke; de la Torre-Aboki, Jenny; Waite-Jones, Jennifer; Westhovens, Rene; Zangi, Heidi Andersen; Heiberg, Turid; Hill, Jackie

2012-01-01

The authors aim to develop European League Against Rheumatism recommendations for the role of the nurse in the management of patients with chronic inflammatory arthritis, to identify a research agenda and to determine an educational agenda. A task force made up of a multidisciplinary expert panel including nurses, rheumatologists, occupational therapist, physiotherapist, psychologist, epidemiologist and patient representatives, representing 14 European countries, carried out the development of the recommendations, following the European League Against Rheumatism standardised operating procedures. The task force met twice. In the first meeting, the aims of the task force were defined, and eight research questions were developed. This was followed by a comprehensive, systematic literature search. In the second meeting, the results from the literature review were presented to the task force that subsequently formulated the recommendations, research agenda and educational agenda. In total, 10 recommendations were formulated. Seven recommendations covered the contribution of nurses to care and management: education, satisfaction with care, access to care, disease management, psychosocial support, self-management and efficiency of care. Three recommendations focused on professional support for nurses: availability of guidelines or protocols, access to education and encouragement to undertake extended roles. The strength of the recommendations varied from A to C, dependent on the category of evidence (1A-3), and a high level of agreement was achieved. Additionally, the task force agreed upon 10 topics for future research and an educational agenda. 10 recommendations for the role of the nurse in the management of chronic inflammatory arthritis were developed using a combination of evidence-based and expert consensus approach.

Recommendations on risk-based strategies for detection and characterization of antibodies against biotechnology products.

PubMed

Koren, Eugen; Smith, Holly W; Shores, Elizabeth; Shankar, Gopi; Finco-Kent, Deborah; Rup, Bonita; Barrett, Yu-Chen; Devanarayan, Viswanath; Gorovits, Boris; Gupta, Shalini; Parish, Thomas; Quarmby, Valerie; Moxness, Michael; Swanson, Steven J; Taniguchi, Gary; Zuckerman, Linda A; Stebbins, Christopher C; Mire-Sluis, Anthony

2008-04-20

The appropriate evaluation of the immunogenicity of biopharmaceuticals is of major importance for their successful development and licensure. Antibodies elicited by these products in many cases cause no detectable clinical effects in humans. However, antibodies to some therapeutic proteins have been shown to cause a variety of clinical consequences ranging from relatively mild to serious adverse events. In addition, antibodies can affect drug efficacy. In non-clinical studies, anti-drug antibodies (ADA) can complicate interpretation of the toxicity, pharmacokinetic (PK) and pharmacodynamic (PD) data. Therefore, it is important to develop testing strategies that provide valid assessments of antibody responses in both non-clinical and clinical studies. This document provides recommendations for antibody testing strategies stemming from the experience of contributing authors. The recommendations are intended to foster a more unified approach to antibody testing across the biopharmaceutical industry. The strategies proposed are also expected to contribute to better understanding of antibody responses and to further advance immunogenicity evaluation.

Regulatory responses to over-the-counter codeine analgesic misuse in Australia, New Zealand and the United Kingdom.

PubMed

Tobin, Claire L; Dobbin, Malcolm; McAvoy, Brian

2013-10-01

Analysis of the policy response by Australia's National Drugs and Poisons Schedule Committee (NDPSC) and comparison with recommendations by expert advisory committees in New Zealand and the United Kingdom. Analysis of public policy documents of relevant regulatory authorities was conducted. Data were extracted regarding changes to over-the-counter (OTC) codeine analgesic scheduling, indications, maximum unit dose, maximum daily dose, maximum pack size, warning labels, consumer medicine information and advertising. Where available, public submissions and other issues considered by the committees and rationale for their recommendations were recorded and thematically analysed. Expert advisory committees in Australia, NZ and the UK defined the policy problem of OTC codeine misuse and harm as small relative to total use and responded by restricting availability. Pharmacist supervision was required at the point-of-sale and pack sizes were reduced to short-term use. Comparison with recommendations by expert advisory committees in NZ and the UK suggests the NDPSC's actions in response to OTC codeine misuse were appropriate given the available evidence of misuse and harm, but highlights opportunities to utilise additional regulatory levers. Framing policy problems as matters of public health in the context of limited evidence may support decision makers to implement cautionary incremental policy change. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Society of Behavioral Medicine (SBM) position statement: SBM urges Congress to preserve and extend funding for Medicaid services.

PubMed

Behrman, Pamela; Demirci, Jill; Yanez, Betina; Beharie, Nisha; Laroche, Helena

2018-05-08

In May 2017, the Trump administration proposed steep cuts to Medicaid funding. This proposal was met with bipartisan criticism, as this program provides vital healthcare coverage for vulnerable children, adults, and families, including those living below the federal poverty line. In addition to the proposed funding cuts, federally authorized state restrictions to Medicaid access (e.g., work requirements) have been proposed, putting the Medicaid coverage of scores of enrollees at risk. Overwhelming health costs from inadequate or absent insurance are found to contribute to financial problems, including bankruptcy. Financial strain, in turn, is related to serious and life-threatening health problems in both children and adults. Given these impacts, the Society of Behavioral Medicine (SBM) urges Congress to protect and extend Medicaid funding. To maintain subscriber access, SBM recommends that Congress continue to use percentage rather than block funding determinants and eliminate states' authority to enforce program qualification requirements, including work provisions and stipulations for locking out subscribers who do not pay their premiums on time. It is also recommended that Congress increase and improve the scope and quality of reporting Medicaid's evidence base. This could be achieved through regular evaluations, focusing on Medicaid's impact on the health and economic well-being of its participants. SBM further recommends efforts to increase the public's awareness of and participation in Medicaid for eligible individuals, children, and families.

Scientific Forum on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V)-An Invitation.

PubMed

Aboraya, Ahmed

2010-11-01

The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) is anticipated in May 2013 with many new additions and changes. In this article, the author summarizes the phases of psychiatric classification from the turn of the 20th century until today. Psychiatry 2010 offers a DSM-V Scientific Forum and invites readers to submit comments, recommendations, and articles to Psychiatry 2010 and DSM-V Task Force.

The solar abundance of Oxygen

NASA Astrophysics Data System (ADS)

Grevesse, N.

2009-07-01

With Martin Asplund (Max Planck Institute of Astrophysics, Garching) and Jacques Sauval (Observatoire Royal de Belgique, Brussels) I recently published detailed reviews on the solar chemical composition ({Asplund et al. 2005}, {Grevesse et al. 2007}). A new one, with Pat Scott (Stockholm University) as additional co-author, will appear in Annual Review of Astronomy and Astrophysics ({Asplund et al. 2009}). Here we briefly analyze recent works on the solar abundance of Oxygen and recommend a value of 8.70 in the usual astronomical scale.

Russian-American health care: bridging the communication gap between physicians and patients.

PubMed

Shpilko, Inna

2006-12-01

The objectives of this article are two-fold: (1) to gather in one place reliable information about Russian-Americans' past medical practices and their current outlook on health care and to provide health care professionals with an overview of the major afflictions suffered by this ethnic group; and (2) to educate Russian-speaking patients about the American heath care system and social services geared towards immigrants by locating and evaluating free, culturally appropriate patient education Web sites available in Russian. In order to draw data on specific diseases and conditions affecting the Russian-speaking population, the author searched various scholarly health-related electronic databases. A number of well-established U.S. government consumer-health Web sites were searched to locate patient education resources that can be utilized by recent Russian immigrants. The author provides an overview of the major health problems encountered by the Russian-speaking population before emigration and potential health concerns for Russian immigrant communities. In addition, the author provides a scholarly exploration of patient education materials available in Russian. In this increasingly diverse society, physicians are faced with the challenge of providing culturally sensitive health care. Multicultural Web-based health resources can serve as a valuable tool for reducing communication barriers between patients and health care providers, thus improving the delivery of quality health care services. Recommendations for further research are indicated. The author offers recommendations for practitioners serving Russian-speaking immigrants. Suggestions on utilization of Web resources are also provided.

Preventing HIV infection: educating the general public.

PubMed

Kroger, F

1991-01-01

This essay discusses the rationale for targeting HIV prevention programs to the general public, as opposed to focusing strictly on high-risk populations. The author first considers varying definitions of the term "general public," then explains the goal of general public education programs. Additionally, the author lays down the theoretical foundations of general audience education programs and weights related research findings. Finally, he offers recommendations for future practice. Noting the complex socioecological elements involved in health behavior, the author argues in favor of a broad definition for the general public. This broad outlook allows programs to still target high-risk population while not bypassing low-risk persons, who are sometimes treated as irrelevant because they do not contribute to excess morbidity or mortality. When it comes to HIV educational programs for the general public, their goals should be to instruct the public on how the virus is transmitted, to allay unfounded fears, and to increase the level of support for AIDS prevention and control. Such a program would require a theoretical basis drawn from multiple sources: health education, health communication, clinical and social psychology, and social marketing. The author concludes by proving recommendations designed to reinforce existing programs: 1) strengthen efforts to ensure that all people are educated about HIV and to encourage people to treat AIDS patients with compassion; 2) continue to explore for the most effective communication channels; 3) strengthen the communication infrastructure for those who are disenfranchised from health education; and 4) strengthen evaluation efforts of health communication programs.

How to Get the Recommender Out of the Lab?

NASA Astrophysics Data System (ADS)

Picault, Jérome; Ribière, Myriam; Bonnefoy, David; Mercer, Kevin

A personalised system is a complex system made of many interacting parts, from data ingestion to presenting the results to the users. A plethora of methods, tools, algorithms and approaches exist for each piece of such a system: many data and metadata processing methods, many user models, many filtering techniques, many accuracy metrics, many personalisation levels. In addition, a realworld recommender is a piece of an even larger and more complex environment on which there is little control: often the recommender is part of a larger application introducing constraints for the design of the recommender, e.g. the data may not be in a suitable format, or the environment may impose some architectural or privacy constraints. This can make the task of building such a recommender system daunting, and it is easy to make errors. Based on the experience of the authors and the study of other works, this chapter intends to be a guide on the design, implementation and evaluation of personalised systems. It presents the different aspects that must be studied before the design is even started, and how to avoid pitfalls, in a hands-on approach. The chapter presents the main factors to take into account to design a recommender system, and illustrates them through case studies of existing systems to help navigate in the many and complex choices that have to be faced.

[Experiences and recommendations of the German Federal Institute for Drugs and Medical Devices (BfArM) concerning clinical investigation of medical devices and the evaluation of serious adverse events (SAE)].

PubMed

Renisch, B; Lauer, W

2014-12-01

An integral part of the conformity assessment process for medical devices is a clinical evaluation based on clinical data. Particularly in the case of implantable devices and products of risk class III clinical trials must be performed. Since March 2010 applications for the authorization of clinical trials as well as for the waiver of the authorization requirement must be submitted centrally in Germany to the appropriate federal authority, the Federal Institute for Drugs and Medical Devices (BfArM) or the Paul Ehrlich Institute (PEI). In addition to authorization, approval by the responsible ethics committee is also required under law in order to begin clinical testing of medical devices in Germany. In this paper, the legal framework for the clinical testing of medical devices as well as those involved and possible procedures including evaluation criteria for the initial application of a trial and subsequent amendments are presented in detail. In addition, the reporting requirements for serious adverse events (SAEs) are explained and possible consequences of the evaluation are presented. Finally, a summary of application and registration numbers for all areas of extensive experience of the BfArM as well as requests and guidance for applicants are presented.

Design and Evaluation of a Net Zero Energy Low-Income Residential Housing Development in Lafayette, Colorado

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dean, J.; VanGeet, O.; Simkus, S.

This report outlines the lessons learned and sub-metered energy performance of an ultra low energy single family ranch home and duplex unit, called the Paradigm Pilot Project and presents the final design recommendations for a 153-unit net zero energy residential development called the Josephine Commons Project. Affordable housing development authorities throughout the United States continually struggle to find the most cost-effective pathway to provide quality, durable, and sustainable housing. The challenge for these authorities is to achieve the mission of delivering affordable housing at the lowest cost per square foot in environments that may be rural, urban, suburban, or withinmore » a designated redevelopment district. With the challenges the U.S. faces regarding energy, the environmental impacts of consumer use of fossil fuels and the increased focus on reducing greenhouse gas emissions, housing authorities are pursuing the goal of constructing affordable, energy efficient and sustainable housing at the lowest life-cycle cost of ownership. This report outlines the lessons learned and sub-metered energy performance of an ultra-low-energy single family ranch home and duplex unit, called the Paradigm Pilot Project and presents the final design recommendations for a 153-unit net zero energy residential development called the Josephine Commons Project. In addition to describing the results of the performance monitoring from the pilot project, this paper describes the recommended design process of (1) setting performance goals for energy efficiency and renewable energy on a life-cycle cost basis, (2) using an integrated, whole building design approach, and (3) incorporating systems-built housing, a green jobs training program, and renewable energy technologies into a replicable high performance, low-income housing project development model.« less

The President's Panel Recommendations - Today

ERIC Educational Resources Information Center

Luckey, Robert E.; Neman, Ronald S.

1975-01-01

State mental retardation program coordinators were surveyed regarding their opinions with respect to progress in achieving the President's Panel recommendations of 1962, and the continuing relevance of these recommendations today. (Author)

The iconicity of picture communication symbols for children with English additional language and mild intellectual disability.

PubMed

Dada, Shakila; Huguet, Alice; Bornman, Juan

2013-12-01

The purpose of this study was to examine the iconicity of 16 Picture Communication Symbols (PCS) presented on a themed bed-making communication overlay for South African children with English as an additional language and mild intellectual disability. The survey involved 30 participants. The results indicated that, overall, the 16 symbols were relatively iconic to the participants. The authors suggest that the iconicity of picture symbols could be manipulated, enhanced, and influenced by contextual effects (other PCS used simultaneously on the communication overlay). In addition, selection of non-target PCS for target PCS were discussed in terms of postulated differences in terms of distinctiveness. Potential clinical implications and limitations of the study, as well as recommendations for future research, are discussed.

77 FR 51965 - Southwest Mississippi Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

... Committee will meet in Meadville, MS. The committee is authorized under the Secure Rural Schools and... provide advice and recommendations to the Forest Service concerning projects and funding consistent with... and recommend projects authorized under title II of the Act. DATES: The meeting will be held Tuesday...

48 CFR 701.602-1 - Authority of contracting officers in resolving audit recommendations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Authority of contracting officers in resolving audit recommendations. 701.602-1 Section 701.602-1 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL FEDERAL ACQUISITION REGULATION SYSTEM Career...

The ethical commitments of academic faculty in psychiatric education.

PubMed

Green, Stephen A

2006-01-01

This article explores the commitment of faculty to ethics training in psychiatric education. Although psychiatry has insufficiently addressed the profession's need for ethics training in education, program directors acknowledge its critical importance, and its positive impact has been demonstrated. Additionally, residents often seek ethics training as part of their instruction. The author suggests that academic faculty could respond to the profession's inadequate treatment of ethics training by helping trainees develop moral agency--the ability to recognize, assess, and respond to ethical dilemmas; decide what constitutes right or wrong care; and act accordingly. The author also describes how this objective could be met by promoting professionalism and offering didactic instruction that address substantive and process issues regarding psychiatric care. Specific recommendations are provided.

Priority setting in a Canadian surgical department: a case study using program budgeting and marginal analysis

PubMed Central

Mitton, Craig; Donaldson, Cam; Shellian, Barb; Pagenkopf, Cort

2003-01-01

Introduction A key mandate of Canadian regional health authorities is to set priorities and allocate resources within a limited funding envelope. The objective in this study was to determine how resources within a surgical program in a Canadian rural hospital might be reallocated to better meet the needs of the local community. Methods Early in 2001, at the Canmore General Hospital, Canmore, Alta., an expert-panel working group, consisting of a community health service leader, operating-room nurse clinician, acute care head nurse and a general surgeon, assisted by a research assistant and 2 health economists carried out a program budgeting and marginal analysis project to assess multiple data inputs into the decision-making process and to develop recommendations for service expansion and resource release. They considered the cost and benefits of altering the mix of resources used, based on Headwaters Health Authority activity and financial data, and local expert opinion. Results The primary recommendation was to implement an additional surgery day per week (38 days of major surgery and 12 days of minor surgery over a 50-week year). However, the total dollars to fund such an expansion could not be released from within the Canmore budget, and additional dollars were not forthcoming from the health region. A secondary objective of implementing an additional minor surgery day every 3 weeks was pursued and the required resources were obtained. Conclusions Due to resource constraints in health care, efforts by both clinicians and administrators should be made to better spend available resources. The marginal analysis process used in this study served as a useful framework for priority setting, which is generalizable to other surgical and nonsurgical programs in Canada. PMID:12585790

Mediation analysis: a retrospective snapshot of practice and more recent directions.

PubMed

Gelfand, Lois A; Mensinger, Janell L; Tenhave, Thomas

2009-04-01

R. Baron and D. A. Kenny's (1986) paper introducing mediation analysis has been cited over 9,000 times, but concerns have been expressed about how this method is used. The authors review past and recent methodological literature and make recommendations for how to address 3 main issues: association, temporal order, and the no omitted variables assumption. The authors briefly visit the topics of reliability and the confirmatory-exploratory distinction. In addition, to provide a sense of the extent to which the earlier literature had been absorbed into practice, the authors examined a sample of 50 articles from 2002 citing R. Baron and D. A. Kenny and containing at least 1 mediation analysis via ordinary least squares regression. A substantial proportion of these articles included problematic reporting; as of 2002, there appeared to be room for improvement in conducting such mediation analyses. Future literature reviews will demonstrate the extent to which the situation has improved.

Judgment and judgment latency for freedom and responsibility relatedness as a function of subtle linguistic variations.

PubMed

Wilkerson, Keith; McGahan, Joseph R; Stevens, Rick; Williamson, David; Low, Jean

2009-12-01

The goal of this study was to determine whether differential response formats to covariation problems influence corresponding response latencies. The authors provided participants with 3 trials of 16 statements addressing positive and negative relations between freedom and responsibility. The authors framed half of the items around responsibility given freedom and the other half around freedom given responsibility. Response formats comprised true-false, agree-disagree, and yes-no answers as a between-participants factor. Results indicated that the manipulation of response format did not affect latencies. However, latencies differed according to the framing of the items. For items framed around freedom given responsibility, latencies were shorter. In addition, participants were more likely to report a positive relation between freedom and responsibility when items were framed around freedom given responsibility. The authors discuss implications relative to previous research in this area and give recommendations for future research.

77 FR 55799 - Eleven Point Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-11

... in Winona, Missouri. The committee is authorized under the Secure Rural Schools and Community Self... recommendations to the Forest Service concerning projects and funding consistent with title II of the Act. The meeting is open to the public. The purpose of the meeting is to review and recommend projects authorized...

77 FR 50081 - Eleven Point Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

... in Winona, Missouri. The committee is authorized under the Secure Rural Schools and Community Self... recommendations to the Forest Service concerning projects and funding consistent with the title II of the Act. The meeting is open to the public. The purpose of the meeting is to review and recommend projects authorized...

Case management helps prevent criminal justice recidivism for people with serious mental illness.

PubMed

Leutwyler, Heather; Hubbard, Erin; Zahnd, Elaine

2017-09-11

Purpose The purpose of this paper is to discuss how case management can decrease recidivism for people with serious mental illness (SMI) because people with SMI are at high risk for incarceration and recidivism. Design/methodology/approach Examples of successful case management models for formerly incarcerated individuals with SMI found through a secondary analysis of qualitative data and an analysis of the literature are presented. Findings Currently, no international, national, or statewide guidelines exist to ensure that formerly incarcerated individuals with SMI receive case management upon community reentry despite evidence that such services can prevent further criminal justice involvement. Recommendations include establishment of and evaluation of best practices for case management. In addition, the authors recommend additional funding for case management with the goal of greatly increasing the number of individuals with SMI leaving the criminal justice system in their ability to access adequate case management. Originality/value Providing effective case management tailored to the needs of formerly incarcerated people with SMI improves their quality of life and reduces their involvement in the criminal justice system with clear positive outcomes for public safety and public health.

Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models.

PubMed

Kowalczuk, Maria K; Dudbridge, Frank; Nanda, Shreeya; Harriman, Stephanie L; Patel, Jigisha; Moylan, Elizabeth C

2015-09-29

To assess whether reports from reviewers recommended by authors show a bias in quality and recommendation for editorial decision, compared with reviewers suggested by other parties, and whether reviewer reports for journals operating on open or single-blind peer review models differ with regard to report quality and reviewer recommendations. Retrospective analysis of the quality of reviewer reports using an established Review Quality Instrument, and analysis of reviewer recommendations and author satisfaction surveys. BioMed Central biology and medical journals. BMC Infectious Diseases and BMC Microbiology are similar in size, rejection rates, impact factors and editorial processes, but the former uses open peer review while the latter uses single-blind peer review. The Journal of Inflammation has operated under both peer review models. Two hundred reviewer reports submitted to BMC Infectious Diseases, 200 reviewer reports submitted to BMC Microbiology and 400 reviewer reports submitted to the Journal of Inflammation. For each journal, author-suggested reviewers provided reports of comparable quality to non-author-suggested reviewers, but were significantly more likely to recommend acceptance, irrespective of the peer review model (p<0.0001 for BMC Infectious Diseases, BMC Microbiology and the Journal of Inflammation). For BMC Infectious Diseases, the overall quality of reviewer reports measured by the Review Quality Instrument was 5% higher than for BMC Microbiology (p=0.042). For the Journal of Inflammation, the quality of reports was the same irrespective of the peer review model used. Reviewers suggested by authors provide reports of comparable quality to non-author-suggested reviewers, but are significantly more likely to recommend acceptance. Open peer review reports for BMC Infectious Diseases were of higher quality than single-blind reports for BMC Microbiology. There was no difference in quality of peer review in the Journal of Inflammation under open peer review compared with single blind. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Impact of High-Fidelity Simulation and Pharmacist-Specific Didactic Lectures in Addition to ACLS Provider Certification on Pharmacy Resident ACLS Performance.

PubMed

Bartel, Billie J

2014-08-01

This pilot study explored the use of multidisciplinary high-fidelity simulation and additional pharmacist-focused training methods in training postgraduate year 1 (PGY1) pharmacy residents to provide Advanced Cardiovascular Life Support (ACLS) care. Pharmacy resident confidence and comfort level were assessed after completing these training requirements. The ACLS training requirements for pharmacy residents were revised to include didactic instruction on ACLS pharmacology and rhythm recognition and participation in multidisciplinary high-fidelity simulation ACLS experiences in addition to ACLS provider certification. Surveys were administered to participating residents to assess the impact of this additional education on resident confidence and comfort level in cardiopulmonary arrest situations. The new ACLS didactic and simulation training requirements resulted in increased resident confidence and comfort level in all assessed functions. Residents felt more confident in all areas except providing recommendations for dosing and administration of medications and rhythm recognition after completing the simulation scenarios than with ACLS certification training and the didactic components alone. All residents felt the addition of lectures and simulation experiences better prepared them to function as a pharmacist in the ACLS team. Additional ACLS training requirements for pharmacy residents increased overall awareness of pharmacist roles and responsibilities and greatly improved resident confidence and comfort level in performing most essential pharmacist functions during ACLS situations. © The Author(s) 2013.

Preserving the Integrity of Citations and References by All Stakeholders of Science Communication.

PubMed

Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A; Gerasimov, Alexey N; Kostyukova, Elena I; Kitas, George D

2015-11-01

Citations to scholarly items are building bricks for multidisciplinary science communication. Citation analyses are currently influencing individual career advancement and ranking of academic and research institutions worldwide. This article overviews the involvement of scientific authors, reviewers, editors, publishers, indexers, and learned associations in the citing and referencing to preserve the integrity of science communication. Authors are responsible for thorough bibliographic searches to select relevant references for their articles, comprehend main points, and cite them in an ethical way. Reviewers and editors may perform additional searches and recommend missing essential references. Publishers, in turn, are in a position to instruct their authors over the citations and references, provide tools for validation of references, and open access to bibliographies. Publicly available reference lists bear important information about the novelty and relatedness of the scholarly items with the published literature. Few editorial associations have dealt with the issue of citations and properly managed references. As a prime example, the International Committee of Medical Journal Editors (ICMJE) issued in December 2014 an updated set of recommendations on the need for citing primary literature and avoiding unethical references, which are applicable to the global scientific community. With the exponential growth of literature and related references, it is critically important to define functions of all stakeholders of science communication in curbing the issue of irrational and unethical citations and thereby improve the quality and indexability of scholarly journals.

Preserving the Integrity of Citations and References by All Stakeholders of Science Communication

PubMed Central

Yessirkepov, Marlen; Voronov, Alexander A.; Gerasimov, Alexey N.; Kostyukova, Elena I.; Kitas, George D.

2015-01-01

Citations to scholarly items are building bricks for multidisciplinary science communication. Citation analyses are currently influencing individual career advancement and ranking of academic and research institutions worldwide. This article overviews the involvement of scientific authors, reviewers, editors, publishers, indexers, and learned associations in the citing and referencing to preserve the integrity of science communication. Authors are responsible for thorough bibliographic searches to select relevant references for their articles, comprehend main points, and cite them in an ethical way. Reviewers and editors may perform additional searches and recommend missing essential references. Publishers, in turn, are in a position to instruct their authors over the citations and references, provide tools for validation of references, and open access to bibliographies. Publicly available reference lists bear important information about the novelty and relatedness of the scholarly items with the published literature. Few editorial associations have dealt with the issue of citations and properly managed references. As a prime example, the International Committee of Medical Journal Editors (ICMJE) issued in December 2014 an updated set of recommendations on the need for citing primary literature and avoiding unethical references, which are applicable to the global scientific community. With the exponential growth of literature and related references, it is critically important to define functions of all stakeholders of science communication in curbing the issue of irrational and unethical citations and thereby improve the quality and indexability of scholarly journals. PMID:26538996

Psychiatric Management, Administration, and Leadership: a Continuum or Distinct Concepts?

PubMed

Saeed, Sy Atezaz; Silver, Stuart; Buwalda, Victor J A; Khin, Eindra Khin; Petit, Jorge R; Mohyuddin, Farooq; Weinberg, Pamela; Merlino, Joseph P; Lekwauwa, Nena; Levin, Saul

2018-06-01

To clarify the relationship between the concepts of management, administration, and leadership in psychiatry. The authors provide a review of the conceptual evolution of administrative psychiatry and develop operational definitions of these three domains. Based upon their experiences, they discuss relevant core competencies and personal attributes. The authors found that the terms psychiatric management, psychiatric administration, and psychiatric leadership are often used interchangeably, yet they each have a different and distinct focus. Additionally, some in the field consider the concepts overlapping, existing on a continuum, while others draw distinct conceptual boundaries between these terms. Psychiatrists in leadership positions function in all three domains. While these are distinct concepts, the authors recommend that administrative psychiatrists integrate all three in their everyday work. The authors suggest the distinctions among these concepts should inform training and identify core competencies related to these distinctions. Mentoring should focus on the practical integration of the concepts of management, administration, and leadership in administrative psychiatry. The authors present a cohesive framework for future development of a curriculum for education and research.

Adherence to national recommendations for safe methotrexate dispensing in community pharmacies.

PubMed

Koster, Ellen S; Walgers, Joelle C D; van Grinsven, Mariska C J; Winters, Nina A; Bouvy, Marcel L

2014-02-01

The number of patients using methotrexate (MTX) has increased during the last decade. Because of the narrow therapeutic range and potential risks of incorrect use, vigilance is required when dispensing MTX. In 2009, the Royal Dutch Pharmacists Society, in accordance with the Dutch Health Care Inspectorate, published safe MTX dispensing recommendations for community pharmacies. To examine adherence to recommendations aimed at safe 
MTX dispensing. This study was conducted within a convenience sample of 78 community pharmacies belonging to the Utrecht Pharmacy Practice Network for Education and Research (UPPER). Data were collected in May 2011. 95 pharmacists and 337 pharmacy technicians were interviewed to assess self-reported adherence with dispensing recommendations. In addition, medication records for patients using MTX were extracted in 52 pharmacies in order to objectively assess adoption of recommendations. More than 75% of the pharmacists and pharmacy technicians reported to be adherent to 6 of the 11 recommendations. There are variations in reported adherence between team members working in 1 pharmacy; higher adherence rates ( greater than 75%) for the pharmacy team as a whole were only shown for 2 recommendations (recording of day of intake on the label and moment of authorization by the pharmacist). The medication records showed that adherence with working procedures significantly increased: The number of dispensed records with notification of the day of intake on the medication label increased from 9.9% of the records per pharmacy in 2008 to 77.1% in 2010 (P  less than  0.001). Dutch community pharmacies seem to be adherent to most safe dispensing recommendations. However, inconsistencies exist between team members that emphasize the importance of addressing this issue and discussing recommendations within the team, as there is still room for improvement to ensure safe dispensing.

Neither aider nor abettor be: attorneys become prosecutorial targets for federal healthcare crimes.

PubMed

Schmidt, M M

1999-01-01

Attorneys representing healthcare entities are not immune to federal criminal prosecution for the assistance that they give their clients. This Article focuses on potential attorney liability for aiding and abetting a client's violation of law. The author examines the securities, tax, and white-collar crime fields for guidance regarding the interpretation and application of the federal aiding and abetting statute to attorneys practicing in the health law field. Based on these analogous areas, and upon the federal criminal statutes applicable in the healthcare field, he recommends steps that can be taken to minimize the possibility of aiding and abetting liability. In addition, he recommends that the courts require a prosecutorial showing of both actual knowledge of wrong-doing and wrongful intent before imposing aider and abettor liability upon health law practitioners.

Lifestyle recommendations for the prevention and management of metabolic syndrome: an international panel recommendation.

PubMed

Pérez-Martínez, Pablo; Mikhailidis, Dimitri P; Athyros, Vasilios G; Bullo, Mónica; Couture, Patrick; Covas, María I; de Koning, Lawrence; Delgado-Lista, Javier; Díaz-López, Andrés; Drevon, Christian A; Estruch, Ramón; Esposito, Katherine; Fitó, Montserrat; Garaulet, Marta; Giugliano, Dario; García-Ríos, Antonio; Katsiki, Niki; Kolovou, Genovefa; Lamarche, Benoît; Maiorino, Maria Ida; Mena-Sánchez, Guillermo; Muñoz-Garach, Araceli; Nikolic, Dragana; Ordovás, José M; Pérez-Jiménez, Francisco; Rizzo, Manfredi; Salas-Salvadó, Jordi; Schröder, Helmut; Tinahones, Francisco J; de la Torre, Rafael; van Ommen, Ben; Wopereis, Suzan; Ros, Emilio; López-Miranda, José

2017-05-01

The importance of metabolic syndrome (MetS) lies in its associated risk of cardiovascular disease and type 2 diabetes, as well as other harmful conditions such as nonalcoholic fatty liver disease. In this report, the available scientific evidence on the associations between lifestyle changes and MetS and its components is reviewed to derive recommendations for MetS prevention and management. Weight loss through an energy-restricted diet together with increased energy expenditure through physical activity contribute to the prevention and treatment of MetS. A Mediterranean-type diet, with or without energy restriction, is an effective treatment component. This dietary pattern should be built upon an increased intake of unsaturated fat, primarily from olive oil, and emphasize the consumption of legumes, cereals (whole grains), fruits, vegetables, nuts, fish, and low-fat dairy products, as well as moderate consumption of alcohol. Other dietary patterns (Dietary Approaches to Stop Hypertension, new Nordic, and vegetarian diets) have also been proposed as alternatives for preventing MetS. Quitting smoking and reducing intake of sugar-sweetened beverages and meat and meat products are mandatory. Nevertheless, there are inconsistencies and gaps in the evidence, and additional research is needed to define the most appropriate therapies for MetS. In conclusion, a healthy lifestyle is critical to prevent or delay the onset of MetS in susceptible individuals and to prevent cardiovascular disease and type 2 diabetes in those with existing MetS. The recommendations provided in this article should help patients and clinicians understand and implement the most effective approaches for lifestyle change to prevent MetS and improve cardiometabolic health. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

An economic evaluation of a chlorhexidine chip for treating chronic periodontitis: the CHIP (chlorhexidine in periodontitis) study.

PubMed

Henke, C J; Villa, K F; Aichelmann-Reidy, M E; Armitage, G C; Eber, R M; Genco, R J; Killoy, W J; Miller, D P; Page, R C; Polson, A M; Ryder, M I; Silva, S J; Somerman, M J; Van Dyke, T E; Wolff, L F; Evans, C J; Finkelman, R D

2001-11-01

The authors previously suggested that an adjunctive, controlled-release chlorhexidine, or CHX, chip may reduce periodontal surgical needs at little additional cost. This article presents an economic analysis of the CHX chip in general dental practice. In a one-year prospective clinical trial, 484 chronic periodontitis patients in 52 general practices across the United States were treated with either scaling and root planing, or SRP, plus any therapy prescribed by treating, unblinded dentists; or SRP plus other therapy as above but including the CHX chip. Economic data were collected from bills, case report forms and 12-month treatment recommendations from blinded periodontist evaluators. Total dental charges were higher for SRP + CHX chip patients vs. SRP patients when CHX chip costs were included (P = .027) but lower when CHX chip costs were excluded (P = .012). About one-half of the CHX chip acquisition cost was offset by savings in other charges. SRP + CHX chip patients were about 50 percent less likely to undergo surgical procedures than were SRP patients (P = .021). At the end of the trial, periodontist evaluators recommended similar additional procedures for both groups: SRP, about 46 percent; maintenance, about 37 percent; surgery, 56 percent for SRP alone and 63 percent for SRP + CHX chip. Adjunctive CHX chip use for general-practice patients with periodontitis increased costs but reduced surgeries over one year. At study's end, periodontists recommended similar additional surgical treatment for both groups. In general practice, routine use of the CHX chip suggests that costs will be partially offset by reduced surgery over at least one year.

Coming to terms about describing Golden Eagle reproduction

USGS Publications Warehouse

Steenhof, Karen; Kochert, Michael N.; McIntyre, Carol L.; Brown, Jessi L.

2017-01-01

Clearly defined terms are essential for reporting and understanding research findings, and inconsistent terminology can complicate efforts to compare findings from different studies. In this article, we reiterate and clarify recommended terms for describing Golden Eagle (Aquila chrysaetos) territory occupancy and reproduction. Several authors have provided recommendations for reporting data on raptor reproduction, but our literature review showed that authors continue to use different, often ambiguous and undefined, terms. The inconsistent use of terminology by researchers has been continued and expanded by lawmakers, regulators, and managers, perpetuating confusion. We recommend that authors clearly define and reference all terminology that they use, and we caution against use of the term “active” to describe a nest or nesting territory, because it is tainted with a history of inconsistent use. We provide a glossary of recommended terms for Golden Eagles and other large, long-lived raptors.

29 CFR 502.5 - Investigation authority of Secretary.

Code of Federal Regulations, 2010 CFR

2010-07-01

... corresponding employment, the WHD shall report such occurrence to ETA and may recommend that ETA revoke the... investigation, and the WHD may recommend to ETA the debarment of the employer from future certification for up... local office of the SWA, ETA, WHD, or any other authorized representative of the Secretary. The office...

Law No. 353, 3 June 1987.

PubMed

1987-01-01

This document summarizes Denmark's 1987 Law establishing an Ethical Council regulating health care services and biomedical research on human subjects. The work of the Council will be based on the assumption that human life begins at fertilization. The Council will recommend laws to protect fertilized human ova, living embryos, and fetuses. The Council will also make recommendations about: 1) the right to perform gene therapy on human gametes or fertilized human ova, embryos, and fetuses; 2) the right to use new diagnostic techniques to detect congenital defeats or diseases in fertilized human ova, embryos, and fetuses; and 3) the establishment of rules on deep freezing of human gametes and fertilized human ova. In addition, the Council will advise the scientific ethical committees on general ethical matters concerning experiments on human volunteers; advise health authorities on general ethical questions associated with new treatments, diagnostic techniques, and medical technology; and advise public authorities on matters relating to registration, release, and use of information on hereditary diseases. The Law prohibits experiments enabling the production of genetically identical human beings, those enabling the production of human beings by the fusion of genetically different embryos or parts of embryos prior to implantation, and those seeking to produce hybrids of human beings and other species.

Practice guideline: joint CCMG-SOGC recommendations for the use of chromosomal microarray analysis for prenatal diagnosis and assessment of fetal loss in Canada.

PubMed

Armour, Christine M; Dougan, Shelley Danielle; Brock, Jo-Ann; Chari, Radha; Chodirker, Bernie N; DeBie, Isabelle; Evans, Jane A; Gibson, William T; Kolomietz, Elena; Nelson, Tanya N; Tihy, Frédérique; Thomas, Mary Ann; Stavropoulos, Dimitri J

2018-04-01

The aim of this guideline is to provide updated recommendations for Canadian genetic counsellors, medical geneticists, maternal fetal medicine specialists, clinical laboratory geneticists and other practitioners regarding the use of chromosomal microarray analysis (CMA) for prenatal diagnosis. This guideline replaces the 2011 Society of Obstetricians and Gynaecologists of Canada (SOGC)-Canadian College of Medical Geneticists (CCMG) Joint Technical Update. A multidisciplinary group consisting of medical geneticists, genetic counsellors, maternal fetal medicine specialists and clinical laboratory geneticists was assembled to review existing literature and guidelines for use of CMA in prenatal care and to make recommendations relevant to the Canadian context. The statement was circulated for comment to the CCMG membership-at-large for feedback and, following incorporation of feedback, was approved by the CCMG Board of Directors on 5 June 2017 and the SOGC Board of Directors on 19 June 2017. Recommendations include but are not limited to: (1) CMA should be offered following a normal rapid aneuploidy screen when multiple fetal malformations are detected (II-1A) or for nuchal translucency (NT) ≥3.5 mm (II-2B) (recommendation 1); (2) a professional with expertise in prenatal chromosomal microarray analysis should provide genetic counselling to obtain informed consent, discuss the limitations of the methodology, obtain the parental decisions for return of incidental findings (II-2A) (recommendation 4) and provide post-test counselling for reporting of test results (III-A) (recommendation 9); (3) the resolution of chromosomal microarray analysis should be similar to postnatal microarray platforms to ensure small pathogenic variants are detected. To minimise the reporting of uncertain findings, it is recommended that variants of unknown significance (VOUS) smaller than 500 Kb deletion or 1 Mb duplication not be routinely reported in the prenatal context. Additionally, VOUS above these cut-offs should only be reported if there is significant supporting evidence that deletion or duplication of the region may be pathogenic (III-B) (recommendation 5); (4) secondary findings associated with a medically actionable disorder with childhood onset should be reported, whereas variants associated with adult-onset conditions should not be reported unless requested by the parents or disclosure can prevent serious harm to family members (III-A) (recommendation 8).The working group recognises that there is variability across Canada in delivery of prenatal testing, and these recommendations were developed to promote consistency and provide a minimum standard for all provinces and territories across the country (recommendation 9). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

22 CFR 1471.8 - Report and recommendations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Report and recommendations. 1471.8 Section 1471... FOREIGN SERVICE IMPASSE DISPUTES PANEL PROCEDURES OF THE PANEL § 1471.8 Report and recommendations. (a... be in writing and, when authorized by the Panel, shall contain recommendations. (b) A report of the...

22 CFR 1471.8 - Report and recommendations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Report and recommendations. 1471.8 Section 1471... FOREIGN SERVICE IMPASSE DISPUTES PANEL PROCEDURES OF THE PANEL § 1471.8 Report and recommendations. (a... be in writing and, when authorized by the Panel, shall contain recommendations. (b) A report of the...

Fertility preservation in children, adolescents, and young adults with cancer: Quality of clinical practice guidelines and variations in recommendations.

PubMed

Font-Gonzalez, Anna; Mulder, Renée L; Loeffen, Erik A H; Byrne, Julianne; van Dulmen-den Broeder, Eline; van den Heuvel-Eibrink, Marry M; Hudson, Melissa M; Kenney, Lisa B; Levine, Jennifer M; Tissing, Wim J E; van de Wetering, Marianne D; Kremer, Leontien C M

2016-07-15

Fertility preservation care for children, adolescents, and young adults (CAYAs) with cancer is not uniform among practitioners. To ensure high-quality care, evidence-based clinical practice guidelines (CPGs) are essential. The authors identified existing CPGs for fertility preservation in CAYAs with cancer, evaluated their quality, and explored differences in recommendations. A systematic search in PubMed (January 2000-October 2014); guideline databases; and Web sites of oncology, pediatric, and fertility organizations was performed. Two reviewers evaluated the quality of the identified CPGs using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II). From high-quality CPGs, the authors evaluated concordant and discordant areas among the recommendations. A total of 25 CPGs regarding fertility preservation were identified. The average AGREE II domain scores (scale of 0%-100%) varied from 15% on applicability to 100% on clarity of presentation. The authors considered 8 CPGs (32%) to be of high quality, which was defined as scores ≥60% in any 4 domains. Large variations in the recommendations of the high-quality CPGs were observed, with 87.2% and 88.6%, respectively, of discordant guideline areas among the fertility preservation recommendations for female and male patients with cancer. Only approximately one-third of the identified CPGs were found to be of sufficient quality. Of these CPGs, the fertility preservation recommendations varied substantially, which can be a reflection of inadequate evidence for specific recommendations, thereby hindering the ability of providers to deliver high-quality care. CPGs including a transparent decision process for fertility preservation can help health care providers to deliver optimal and uniform care, thus improving the quality of life of CAYAs with cancer and cancer survivors. Cancer 2016;122:2216-23. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Return to Learn: A review of cognitive rest versus rehabilitation after sports concussion.

PubMed

Eastman, Amelia; Chang, Douglas G

2015-01-01

Cognitive rest is the recommendation for all patients with acute sports concussion. A comprehensive literature search was conducted for the research question "What is the optimal cognitive load for patients with a sports concussion?" Seven studies met the inclusion criteria. The optimal cognitive load for patients after sports concussion is yet to be determined. Additional controlled trials of cognitive rehabilitation are needed to establish best clinical practice. The authors suggest memory training, cognitive behavioral therapy, and environmental interventions as areas of future research for sports concussion injuries.

Nevus sebaceous revisited.

PubMed

Moody, Megan N; Landau, Jennifer M; Goldberg, Leonard H

2012-01-01

Nevus sebaceous of Jadassohn is a hamartoma with a combination of abnormalities of the epidermis, hair follicles, and sebaceous and apocrine glands. Herein, we discuss the results of an extensive literature review on the topic of nevus sebaceous with a particular focus on the debate about the necessity for prophylactic excision. We also focus on the documentation of associated malignant tumors that were reported to develop within NS. In addition to reporting the number and types of neoplasms, we documented the recommendations of all authors for therapeutic handling of these nevi. © 2011 Wiley Periodicals, Inc.

[Prevention of medical device-related adverse events in hospitals: Specifying the recommendations of the German Coalition for Patient Safety (APS) for users and operators of anaesthesia equipment].

PubMed

Bohnet-Joschko, Sabine; Zippel, Claus; Siebert, Hartmut

2015-01-01

The use and organisation of medical technology has an important role to play for patient and user safety in anaesthesia. Specification of the recommendations of the German Coalition for Patient Safety (APS) for users and operators of anaesthesia equipment, explore opportunities and challenges for the safe use and organisation of anaesthesia devices. We conducted a literature search in Medline/PubMed for studies dealing with the APS recommendations for the prevention of medical device-related risks in the context of anaesthesia. In addition, we performed an internet search for reports and recommendations focusing on the use and organisation of medical devices in anaesthesia. Identified studies were grouped and assigned to the recommendations. The division into users and operators was maintained. Instruction and training in anaesthesia machines is sometimes of minor importance. Failure to perform functional testing seems to be a common cause of critical incidents in anaesthesia. There is a potential for reporting to the federal authority. Starting points for the safe operation of anaesthetic devices can be identified, in particular, at the interface of staff, organisation, and (anaesthesia) technology. The APS recommendations provide valuable information on promoting the safe use of medical devices and organisation in anaesthesia. The focus will be on risks relating to the application as well as on principles and materials for the safe operation of anaesthesia equipment. Copyright © 2015. Published by Elsevier GmbH.

S3-Guideline on allergy prevention: 2014 update: Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Society for Pediatric and Adolescent Medicine (DGKJ).

PubMed

Schäfer, Torsten; Bauer, Carl-Peter; Beyer, Kirsten; Bufe, Albrecht; Friedrichs, Frank; Gieler, Uwe; Gronke, Gerald; Hamelmann, Eckard; Hellermann, Mechthild; Kleinheinz, Andreas; Klimek, Ludger; Koletzko, Sibylle; Kopp, Matthias; Lau, Susanne; Müsken, Horst; Reese, Imke; Schmidt, Sabine; Schnadt, Sabine; Sitter, Helmut; Strömer, Klaus; Vagts, Jennifer; Vogelberg, Christian; Wahn, Ulrich; Werfel, Thomas; Worm, Margitta; Muche-Borowski, Cathleen

The continued high prevalence of allergic diseases in Western industrialized nations combined with the limited options for causal therapy make evidence-based primary prevention necessary. The recommendations last published in the S3-guideline on allergy prevention in 2009 have been revised and a consensus reached on the basis of an up-to-date systematic literature search. Evidence was sought for the period between May 2008 and May 2013 in the Cochrane and MEDLINE electronic databases, as well as in the reference lists of recent review articles. In addition, experts were surveyed for their opinions. The relevance of retrieved literature was checked by means of two filter processes: firstly according to title and abstract, and secondly based on the full text of the articles. Included studies were given an evidence grade, and a bias potential (low/high) was specified for study quality. A formal consensus on the revised recommendations was reached by representatives of the relevant specialist societies and (self-help) organizations (nominal group process). Of 3,284 hits, 165 studies (one meta-analysis, 15 systematic reviews, 31 randomized controlled trials, 65 cohort studies, 12 case-control studies and 41 cross-sectional studies) were included and evaluated. Recommendations on the following remain largely unaltered: full breastfeeding for 4 months as a means of allergy prevention (hypoallergenic infant formula in the case of infants at risk); avoidance of overweight; fish consumption (during pregnancy/lactation and in the introduction of solid foods for infants); vaccination according to the recommendations of the German Standing Committee on Vaccination (Ständige Impfkommission, STIKO); avoidance of air pollutants and tobacco exposure and avoidance of indoor conditions conducive to the development of mold. The assertion that a reduction in house-dust mite allergen content as a primary preventive measure is not recommended also remains unchanged. The introduction of solid foods into infant diet should not be delayed. In the case of children at risk cats should not be acquired as domestic pets. Keeping dogs is not associated with an increased risk of allergy. The updated guideline includes a new recommendation to consider the increased risk of asthma following delivery by cesarean section. Additional statements have been formulated on pre- and probiotic agents, psychosocial factors, medications, and various nutritional components. Revising the guideline by using an extensive evidence base has resulted not only in an endorsement of the existing recommendations, but also in modifications and in the addition of new recommendations. The updated guideline enables evidence-based and up-to-date recommendations to be made on allergy prevention. Supplementary material is available for this article at 10.1007/s40629-014-0022-4 and is accessible for authorized users.

European Psychiatric Association (EPA) guidance on quality assurance in mental healthcare.

PubMed

Gaebel, W; Großimlinghaus, I; Heun, R; Janssen, B; Johnson, B; Kurimay, T; Montellano, P; Muijen, M; Munk-Jorgensen, P; Rössler, W; Ruggeri, M; Thornicroft, G; Zielasek, J

2015-03-01

To advance the quality of mental healthcare in Europe by developing guidance on implementing quality assurance. We performed a systematic literature search on quality assurance in mental healthcare and the 522 retrieved documents were evaluated by two independent reviewers (B.J. and J.Z.). Based on these evaluations, evidence tables were generated. As it was found that these did not cover all areas of mental healthcare, supplementary hand searches were performed for selected additional areas. Based on these findings, fifteen graded recommendations were developed and consented by the authors. Review by the EPA Guidance Committee and EPA Board led to two additional recommendations (on immigrant mental healthcare and parity of mental and physical healthcare funding). Although quality assurance (measures to keep a certain degree of quality), quality control and monitoring (applying quality indicators to the current degree of quality), and quality management (coordinated measures and activities with regard to quality) are conceptually distinct, in practice they are frequently used as if identical and hardly separable. There is a dearth of controlled trials addressing ways to optimize quality assurance in mental healthcare. Altogether, seventeen recommendations were developed addressing a range of aspects of quality assurance in mental healthcare, which appear usable across Europe. These were divided into recommendations about structures, processes and outcomes. Each recommendation was assigned to a hierarchical level of analysis (macro-, meso- and micro-level). There was a lack of evidence retrievable by a systematic literature search about quality assurance of mental healthcare. Therefore, only after further topics and search had been added it was possible to develop recommendations with mostly medium evidence levels. Evidence-based graded recommendations for quality assurance in mental healthcare were developed which should next be implemented and evaluated for feasibility and validity in some European countries. Due to the small evidence base identified corresponding to the practical obscurity of the concept and methods, a European research initiative is called for by the stakeholders represented in this Guidance to improve the educational, methodological and empirical basis for a future broad implementation of measures for quality assurance in European mental healthcare. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

The ICMJE Recommendations and pharmaceutical marketing--strengths, weaknesses and the unsolved problem of attribution in publication ethics.

PubMed

Matheson, Alastair

2016-04-04

The International Committee of Medical Journal Editors (ICMJE) Recommendations set ethical and editorial standards for article publication in most leading medical journals. Here, I examine the strengths and weaknesses of the Recommendations in the prevention of commercial bias in industry-financed journal literature, on three levels - scholarly discourse, article content, and article attribution. With respect to overall discourse, the most important measures in the ICMJE Recommendations are for enforcing clinical trial registration and controlling duplicate publication. With respect to article content, the ICMJE promotes stringent author accountability and adherence to established reporting standards. However, the ICMJE accepts the use of commercial editorial teams to produce manuscripts, which is a potential source of bias, and accepts private company ownership and analysis of clinical trial data. New ICMJE guidance on data sharing will address but not eliminate problems of commercial data access. With respect to attribution, the Recommendations oppose guest authorship and encourage clear documentation of author contributions. However, they exclude writers from coauthorship; provide no specific advice on the attribution of commercial literature, for instance with respect to company authorship, author sequence or prominent commercial labeling; and endorse the use of fine print and euphemism. The ICMJE requires detailed author interest disclosures, but overlooks the interests of non-authors and companies, and does not recommend that interests most salient to the publication are highlighted. Together, these weaknesses facilitate "advocacy"-based marketing, in which literature planned, financed and produced by companies is fronted by academics, enabling commercial messages to be presented to customers by their respected clinical peers rather than companies themselves. The ICMJE Recommendations set important research and reporting standards, without which commercial bias would likely be a significantly greater problem than it is today. However, they also support practices of commercial data control, content development and attribution that run counter to science's values of openness, objectivity and truthfulness. These weaknesses could be addressed with appropriate modifications to the Recommendations. The ICMJE should also disclose its own commercial interests and funding - not least because publishing organizations that finance it and pay the salaries of some member editors derive substantial revenues from industry.

Community pharmacists' services for women during pregnancy and breast feeding in Kuwait: a cross-sectional study.

PubMed

Albassam, Abdullah; Awad, Abdelmoneim

2018-01-05

This study was designed to identify the services provided by community pharmacists in Kuwait and their views regarding self-care in pregnancy and lactation. In addition, it determined the pharmacists' recommendations for treatment of pregnancy-related and breast feeding-related ailments. Cross-sectional questionnaire-based survey. Community pharmacies in Kuwait. 207 pharmacies were randomly selected from the Ministry of Health database. One registered pharmacist was approached from each pharmacy. One hundred and ninety-two (92.8%) pharmacists agreed to participate and completed a self-administered questionnaire. The proportions of pharmacists offering particular advice for health conditions in pregnancy and lactation, pharmacists' recommendations for common and specific ailments during pregnancy and breast feeding, and pharmacists' views about self-care in pregnancy and breast feeding. The top services provided to pregnant and lactating women were recommending vitamins and food supplements (89.8%) and contraception advice (83.4%), respectively. More than half of participants indicated that they would recommend medications for headache, constipation, cough, runny nose, sore throat, nausea/vomiting, indigestion, sore or cracked nipple and insufficient milk. Diarrhoea, haemorrhoids, insomnia, varicose vein, swelling of the feet and legs, vaginal itching, back pain, fever, mastitis and engorgement were frequently referred to the physician. Recommendations on medication use were occasionally inappropriate in terms of unneeded drug therapy, off-label use and safety. In relation to offering advice and solving medication and health problems of pregnant and lactating women, more than half of pharmacists indicated that they have sufficient knowledge (61.5%; 50.5%) and confidence (58.3%; 53.1%), respectively. Most of the respondents (88.5%) agreed that a continuing education programme on this topic would be of value for their practice. The present findings show that respondents had different recommendations for treatment of pregnancy-related and lactation-related ailments; and also highlight the need for interventions, including continuing professional development and revision of the undergraduate pharmacy curriculum. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Moving beyond sex: Assessing the impact of gender identity on human papillomavirus vaccine recommendations and uptake among a national sample of rural-residing LGBT young adults.

PubMed

Bednarczyk, Robert A; Whitehead, Jennifer L; Stephenson, Rob

2017-06-01

While national human papillomavirus (HPV) vaccination estimates exist by sex, little is known about HPV vaccination rates by gender identity. We conducted a self-administered, anonymous online cross-sectional survey, with recruitment through Facebook ads, of lesbian, gay, bisexual, and transgender individuals in rural areas of the US. We compared HPV vaccine recommendation and uptake by self-reported sex assigned at birth and current gender identity. Six hundred sixty respondents were age eligible for HPV vaccination: 84% reported gender identity aligned with their sex assigned at birth, while 10% reported gender identity the differed from their sex assigned at birth; an additional 6% reported non-binary gender identity. Only 14% of male sex assigned at birth and 44% of female sex assigned at birth received HPV vaccine, similar to estimates by current gender identity. Transgender respondents' HPV vaccination experience mirrored that of cisgender respondents with regard to sex assigned at birth. Providers may base HPV vaccine recommendations on individuals' sex assigned at birth, which may impact transgender individuals' vaccine coverage. Future HPV vaccine uptake studies should account for gender identity. With sex-specific catch-up HPV vaccination recommendations, the role of gender identity on provider recommendation and reimbursement needs to be addressed. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Small renal mass biopsy--how, what and when: report from an international consensus panel.

PubMed

Tsivian, Matvey; Rampersaud, Edward N; del Pilar Laguna Pes, Maria; Joniau, Steven; Leveillee, Raymond J; Shingleton, William B; Aron, Monish; Kim, Charles Y; DeMarzo, Angelo M; Desai, Mihir M; Meler, James D; Donovan, James F; Klingler, Hans Christoph; Sopko, David R; Madden, John F; Marberger, Michael; Ferrandino, Michael N; Polascik, Thomas J

2014-06-01

To discuss the use of renal mass biopsy (RMB) for small renal masses (SRMs), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician. The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics. A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point. A consensus was established and lack of agreement to topics or specific items was noted at this point. Recommended biopsy technique: at least two cores, sampling different tumour regions with ultrasonography being the preferred method of image guidance. Pathological interpretation: 'non-diagnostic samples' should refer to insufficient material, inconclusive and normal renal parenchyma. For non-diagnostic samples, a repeat biopsy is recommended. Fine-needle aspiration may provide additional information but cannot substitute for core biopsy. Indications for RMB: biopsy is recommended in most cases except in patients with imaging or clinical characteristics indicative of pathology (syndromes, imaging characteristics) and cases whereby conservative management is not contemplated. RMB is recommended for active surveillance but not for watchful-waiting candidates. We report the results of an international consensus meeting on the use of RMB for SRMs, defining the technique, pathological interpretation and indications. © 2013 The Authors. BJU International © 2013 BJU International.

Assessment and d/Deaf and Hard of Hearing Multilingual Learners: Considerations and Promising Practices.

PubMed

Pizzo, Lianna; Chilvers, Amanda

2016-01-01

The authors address considerations and promising practices relating to assessment of d/Deaf and Hard of Hearing Multilingual Learners. DMLs' unique culture(s), language(s), and learning needs must be considered when assessments of this population are being planned, conducted, and interpreted. The authors address theory and research on (a) general considerations for the overarching assessment process, (b) specific assessment approaches used to assess DMLs, and (c) assessment of language proficiency for diverse language learners. In addition, basic recommendations for the assessment of DMLs are made, including increased availability of assessments in various languages, use of multiple sources of individual and family data, assessment of all languages, and incorporation of a strong assessment component (that includes nondiscrimination practices) into teacher preparation programs.

Recommendations on the use of biosimilars by the Brazilian Society of Rheumatology, Brazilian Society of Dermatology, Brazilian Federation of Gastroenterology and Brazilian Study Group on Inflammatory Bowel Disease--Focus on clinical evaluation of monoclonal antibodies and fusion proteins used in the treatment of autoimmune diseases.

PubMed

Azevedo, Valderílio Feijó; Meirelles, Eduardo de Souza; Kochen, Jussara de Almeida Lima; Medeiros, Ana Cristina; Miszputen, Sender J; Teixeira, Fábio Vieira; Damião, Adérson Osmar Mourão Cintra; Kotze, Paulo Gustavo; Romiti, Ricardo; Arnone, Marcelo; Magalhães, Renata Ferreira; Maia, Cláudia Pires Amaral; de Carvalho, André Vicente E

2015-09-01

The Brazilian Societies of Rheumatology (SBR) and Dermatology (SBD), the Brazilian Federation of Gastroenterology (FBG) and the Brazilian Study Group on Inflammatory Bowel Disease (GEDIIB) gathered a group of their respective specialists on the topic of interest to discuss the most relevant issues regarding the clinical use of biosimilar medicines in Brazil. The main aim of that meeting was to prepare a document with recommendations to guide medical specialists and to help the national regulatory and policy-making agencies as concerns the authorization for marketing biosimilars used in autoimmune diseases, such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Crohn's disease, juvenile idiopathic arthritis and ulcerative colitis. In addition to considerations on the typical differences between innovator medicines and biosimilars, the specialists established a set of seven recommendations on regulatory advances related to clinical studies, indication extrapolation, nomenclature, interchangeability, automatic substitution and pharmacovigilance. Copyright © 2015 Elsevier B.V. All rights reserved.

Scientific white paper on concentration-QTc modeling.

PubMed

Garnett, Christine; Bonate, Peter L; Dang, Qianyu; Ferber, Georg; Huang, Dalong; Liu, Jiang; Mehrotra, Devan; Riley, Steve; Sager, Philip; Tornoe, Christoffer; Wang, Yaning

2018-06-01

The International Council for Harmonisation revised the E14 guideline through the questions and answers process to allow concentration-QTc (C-QTc) modeling to be used as the primary analysis for assessing the QTc interval prolongation risk of new drugs. A well-designed and conducted QTc assessment based on C-QTc modeling in early phase 1 studies can be an alternative approach to a thorough QT study for some drugs to reliably exclude clinically relevant QTc effects. This white paper provides recommendations on how to plan and conduct a definitive QTc assessment of a drug using C-QTc modeling in early phase clinical pharmacology and thorough QT studies. Topics included are: important study design features in a phase 1 study; modeling objectives and approach; exploratory plots; the pre-specified linear mixed effects model; general principles for model development and evaluation; and expectations for modeling analysis plans and reports. The recommendations are based on current best modeling practices, scientific literature and personal experiences of the authors. These recommendations are expected to evolve as their implementation during drug development provides additional data and with advances in analytical methodology.

NASA Publications Guide for Authors

NASA Technical Reports Server (NTRS)

2015-01-01

This document presents guidelines for use by NASA authors in preparation and publication of their scientific and technical information (STI). Section 2 gives an overview. Section 2 describes types of publication. Section 3 discusses technical, data/information, and dissemination reviews. Section 4 provides recommended standards and gives the elements of a typical report. Section 5 presents miscellaneous preparation recommendations.

Building Scientific Data's list of recommended data repositories

NASA Astrophysics Data System (ADS)

Hufton, A. L.; Khodiyar, V.; Hrynaszkiewicz, I.

2016-12-01

When Scientific Data launched in 2014 we provided our authors with a list of recommended data repositories to help them identify data hosting options that were likely to meet the journal's requirements. This list has grown in size and scope, and is now a central resource for authors across the Nature-titled journals. It has also been used in the development of data deposition policies and recommended repository lists across Springer Nature and at other publishers. Each new addition to the list is assessed according to a series of criteria that emphasize the stability of the resource, its commitment to principles of open science and its implementation of relevant community standards and reporting guidelines. A preference is expressed for repositories that issue digital object identifiers (DOIs) through the DataCite system and that share data under the Creative Commons CC0 waiver. Scientific Data currently lists fourteen repositories that focus on specific areas within the Earth and environmental sciences, as well as the broad scope repositories, Dryad and figshare. Readers can browse and filter datasets published at the journal by the host repository using ISA-explorer, a demo tool built by the ISA-tools team at Oxford University1. We believe that well-maintained lists like this one help publishers build a network of trust with community data repositories and provide an important complement to more comprehensive data repository indices and more formal certification efforts. In parallel, Scientific Data has also improved its policies to better support submissions from authors using institutional and project-specific repositories, without requiring each to apply for listing individually. Online resources Journal homepage: http://www.nature.com/scientificdata Data repository criteria: http://www.nature.com/sdata/policies/data-policies#repo-criteria Recommended data repositories: http://www.nature.com/sdata/policies/repositories Archived copies of the list: https://dx.doi.org/10.6084/m9.figshare.1434640.v6 Reference Gonzalez-Beltran, A. ISA-explorer: A demo tool for discovering and exploring Scientific Data's ISA-tab metadata. Scientific Data Updates http://blogs.nature.com/scientificdata/2015/12/17/isa-explorer/ (2015).

78 FR 55727 - Draft Guidance for Industry on Recommendations for Preparation and Submission of Animal Food...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-11

...] Draft Guidance for Industry on Recommendations for Preparation and Submission of Animal Food Additive...) entitled ``Recommendations for Preparation and Submission of Animal Food Additive Petitions.'' This draft... guidance for industry (GFI 221) entitled ``Recommendations for Preparation and Submission of Animal Food...

Occupational Health in Community Health Centers: Practitioner Challenges and Recommendations.

PubMed

Simmons, Juliana M; Liebman, Amy K; Sokas, Rosemary K

2018-05-01

Primary care clinicians may be the only source of occupational healthcare for many low-wage, high-risk workers who experience disproportionate occupational hazards. The authors explored barriers to providing occupational healthcare and recommendations for overcoming these challenges. The team conducted six focus groups and eleven key-informant interviews in two community health centers and among clinicians, community health workers, and other personnel from similar settings. Clinicians reported not utilizing occupational information during clinical encounters and identified competing priorities, limited appointment time, and lack of training as key barriers. They cited workers' compensation as a source of confusion and frustration. However, most participants recognized occupation as an important social determinant of health and expressed interest in additional training and resources. Participants agreed that referral mechanisms for occupational medicine specialists and worker centers and changes in quality performance measures and electronic health records would be useful and that workers' compensation and immigration policies need reform.

Modification of motivational interviewing for use with people with mild intellectual disability and challenging behaviour.

PubMed

Frielink, Noud; Embregts, Petri

2013-12-01

Motivational interviewing is a promising method to increase treatment motivation for people with mild intellectual disability and challenging behaviour. The purpose of the present study was to identify how professionals could adapt motivational interviewing techniques for use with clients. We conducted semistructured qualitative interviews and focus groups with 26 clients, parents, and professionals. A general inductive approach led to the identification of multiple core themes. The authors recommend several modifications to accommodate motivational interviewing for use with clients: adapt to language level, adjust to cognitive abilities, and control for social desirability of responding. In addition, certain characteristics of professionals were also found to be critical for effective motivational interviewing: trustworthiness, engagement, acceptance, empathy, and honesty. Concrete recommendations for the adaptation of the motivational interviewing techniques for use with people with mild intellectual disability and challenging behaviour are identified. Certain characteristics of professionals are also critical for maximising the treatment motivation of clients.

Data and methods for studying commercial motor vehicle driver fatigue, highway safety and long-term driver health.

PubMed

Stern, Hal S; Blower, Daniel; Cohen, Michael L; Czeisler, Charles A; Dinges, David F; Greenhouse, Joel B; Guo, Feng; Hanowski, Richard J; Hartenbaum, Natalie P; Krueger, Gerald P; Mallis, Melissa M; Pain, Richard F; Rizzo, Matthew; Sinha, Esha; Small, Dylan S; Stuart, Elizabeth A; Wegman, David H

2018-03-09

This article summarizes the recommendations on data and methodology issues for studying commercial motor vehicle driver fatigue of a National Academies of Sciences, Engineering, and Medicine study. A framework is provided that identifies the various factors affecting driver fatigue and relating driver fatigue to crash risk and long-term driver health. The relevant factors include characteristics of the driver, vehicle, carrier and environment. Limitations of existing data are considered and potential sources of additional data described. Statistical methods that can be used to improve understanding of the relevant relationships from observational data are also described. The recommendations for enhanced data collection and the use of modern statistical methods for causal inference have the potential to enhance our understanding of the relationship of fatigue to highway safety and to long-term driver health. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Methodology for the development of policy brief in public health].

PubMed

Felt, Emily; Carrasco, José Miguel; Vives-Cases, Carmen

2018-01-10

A policy brief is a document that summarizes research to inform policy. In a brief and succinct way, it defines a policy problem, presents a synthesis of relevant evidence, identifies possible courses of action and makes recommendations or key points. The objective of this note is to describe the methodology used to produce a policy brief for communicating public health research. This note is based on the model presented by Eugene Bardach in addition to the authors' own experiences. We describe six steps: 1) identifying the audience; 2) defining the problem; 3) gathering information and evidence; 4) consideration of policy alternatives; 5) projecting results and designing recommendations; and 6) telling the story. We make a case for the use of policy briefs as a part of an overall communications strategy for research that aims to bring together research teams and stakeholders. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

[Schools meals in French secondary state schools: compliance to national recommendations and schools catering patterns].

PubMed

Bertin, M; Lafay, L; Calamassi-Tran, G; Volatier, J-L; Dubuisson, C

2011-02-01

Recent reports on the lack of nutritional quality of meals served in schools have led public authorities to draft, in 1999, recommendations for restoring a balanced food supply. Following the survey carried out by the French food safety Agency in 2005-2006, which highlighted gaps in the implementation of these recommendations, a law passed in July 2010 plans to make these recommendations mandatory, as their 2007 revised version. Thus, the objective of this study was to assess initial school compliance with regard to this last revised version of the recommendations and to identify school patterns through their catering management and implication in a dietary project. Seven hundred and seven secondary state schools were questioned (570 were administrated by the Ministry of Education and 137 by the Ministry of Agriculture) on their catering practices. Twenty consecutive menus from each school were also analyzed with a specific coding system to establish its nutritional composition for comparison with the 2007 recommendations. On average, schools complied with half of the recommendations. Good compliance was observed with the 2007 recommendations concerning fried products, starchy foods, fruits, and dairy products whereas very few schools were in compliance with recommendations concerning fish, cheeses and sweetened desserts containing less than 15 % fat and more than 20 g of sugar per portion. Furthermore, compliance with recommendations was significantly better for lunch meals, and even better for agricultural establishments. A 5-component meal was also associated with greater compliance with the recommendations. In addition, four school patterns were identified based on catering management practices. The first two categories of establishments had knowledge of the recommendations but exhibited different levels of application. The last two types of establishments had no knowledge of the recommendations and differed in their catering management practices. Compliance with recommendations was contrasted, with high adequacy for some guidelines and low for others. Nevertheless, application of the current guidelines and real implication of the school in a dietary project did improve the dietary offer in such schools. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Exploration of developmental approaches to companion animal antimicrobials: providing for the unmet therapeutic needs of dogs and cats.

PubMed

Apley, M; Claxton, R; Davis, C; DeVeau, I; Donecker, J; Lucas, A; Neal, A; Papich, M

2010-04-01

The American Academy of Veterinary Pharmacology and Therapeutics (AAVPT) and the United States Pharmacopeia (USP) co-sponsored a workshop to explore approaches for developing companion animal antimicrobials. This workshop was developed in response to the shortage of antimicrobials labeled for dogs and cats, as there is a shortage of approved antimicrobials for the range of infectious diseases commonly treated in small animal practice. The objective of the workshop was to identify alternative approaches to data development to support new indications consistent with the unmet therapeutic needs of dogs and cats. The indications for currently approved antimicrobials do not reflect the broader range of infectious diseases that are commonly diagnosed and treated by the veterinarian. Therefore, the labels for these approved antimicrobials provide limited information to the veterinarian for appropriate therapeutic decision-making beyond the few indications listed. Industry, veterinary practice, and regulatory challenges to the development of new antimicrobial indications were discussed. The workshop resulted in short- and long-term recommendations. Short-term recommendations focus on the use of additional data considerations for product labeling. Long-term recommendations center on legislative or regulatory legal initiatives. The workshop recommendations will need collaboration from industry, academia, and regulatory authorities and a legal shift in the drug approval and availability processes.

The Relationship between Qualified Personnel and Self-Reported Implementation of Recommended Physical Education Practices and Programs in U.S. Schools

ERIC Educational Resources Information Center

Davis, Kristen S.; Burgeson, Charlene R.; Brener, Nancy D.; McManus, Tim; Wechsler, Howell

2005-01-01

The authors analyzed data from the School Health Policies and Programs Study 2000 to assess the associations between the presence of a district physical education coordinator and district-level physical education policies and practices recommended by federal government agencies and national organizations. The authors also examined the relationship…

[From the licensure of vaccines to the recommendation of the Standing Committee on Vaccination in Germany : criteria for the assessment of benefits and risks].

PubMed

Pfleiderer, Michael; Wichmann, Ole

2015-03-01

Vaccines are among the most effective preventive measures in modern medicine and have led to a dramatic decline and-for a few diseases-even to the elimination of severely infectious diseases. There are some particularities of the risk-benefit assessment of vaccines compared with that of therapeutic drugs. These include the fact that vaccines are applied to healthy individuals with the aim of preventing an infectious disease, while therapeutic drugs are administered to sick people to cure them of an already acquired disease. The acceptable level of risk associated with the application of a vaccine is therefore much lower. In addition, high vaccination coverage can lead to population-level effects (e.g., the indirect protection of unvaccinated individuals) that can confer additional benefits to the population overall. When a marketing authorization application (MAA) for a novel vaccine is evaluated, conclusions are made regarding its quality, safety, and efficacy, and a benefit-risk assessment is carried out accordingly. In contrast, when deciding on the introduction of a new vaccine into a national immunization program or on a recommendation for a specific risk-group, the focus is shifted to considerations of how a licensed vaccine can be best used in a population (e.g., which immunization strategy is most effective in preventing deaths or hospitalizations, or in reducing treatment costs for the health care system). Stringent assessment criteria have been developed that require a robust safety analysis before a new vaccine is administered to humans for the first time in pre-licensure studies. Similarly, criteria are applied for calculating the benefit-risk ratio at the time of the licensure of a new vaccine in addition to during the entire post-licensure period. However, when deciding if and how a licensed vaccine can best be integrated into an existing immunization program, additional criteria are applied that are different, yet complementary to those applied for granting a marketing authorization. These decisions require-in addition to considerations of vaccine quality, vaccine efficacy and safety-conclusions regarding population-level effects combined with an integrative analysis of the local context (e.g., local epidemiology, cost-effectiveness, and acceptance by the population). To serve these objectives, national authorities such as the Standing Committee on Vaccination in Germany (STIKO) have been established to integrate globally developed vaccines into the national context of immunization strategies.

76 FR 65503 - Performance Review Board Membership

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-21

... executive and by any higher-level executive or executives. The PRB makes recommendations to the appointing authority relative to the performance of the senior executive, including recommendations on performance awards. The Department of Education's PRB also makes recommendations on SES pay adjustments for career...

Recommendations for snag retention in southwestern mixed-conifer and ponderosa pine forests: History and current status

Treesearch

Joseph L. Ganey

2016-01-01

Snags provide habitat for numerous species of wildlife. Several authors have provided recommendations for snag retention in southwestern mixed-conifer and ponderosa pine (Pinus ponderosa) forests. Most recommendations were presented in terms of minimum snag density and/or size. I summarized the history of recommendations for snag retention in these forest...

Primary Intraosseous Adenoid Cystic Carcinoma of the Mandible: A Comprehensive Review With Analysis of 2 Additional Cases.

PubMed

Hu, Hong Ying; Liu, Yuan Yuan; Wang, Hu; Jiang, Meng

2017-08-01

Primary intraosseous adenoid cystic carcinoma (IACC) of the mandible is poorly understood because of its rarity. This study performed a comprehensive literature review on IACC of the mandible. Forty-five cases of IACC reported in the literature and 2 additional cases in the authors' hospital were reviewed. IACC of the mandible generally occurred in the fourth to sixth decades, with no meaningful gender predilection. Pain and swelling were the most common clinical manifestations. Radical surgery combined with postsurgical radiotherapy was recommended as the best treatment. The diagnosis of IACC should be based on clinical, radiologic, and pathologic examinations. Radical surgery combined with postsurgical radiotherapy seems to be the best treatment. In addition, the histologic subtype of the tumor is an important prognostic factor in patients with IACC. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

32 CFR 2001.11 - Original classification authority.

Code of Federal Regulations, 2011 CFR

2011-07-01

... classification authority. Agencies not possessing such authority shall forward requests to the Director of ISOO... authority. The Director of ISOO shall forward the request, along with the Director's recommendation, to the... level of original classification authority shall forward requests in accordance with the procedures of...

48 CFR 1319.505 - Rejecting Small Business Administration recommendations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Rejecting Small Business Administration recommendations. 1319.505 Section 1319.505 Federal Acquisition Regulations System DEPARTMENT OF... Small Business Administration recommendations. (a) The designee authorized to render a decision on the...

48 CFR 1319.505 - Rejecting Small Business Administration recommendations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Rejecting Small Business Administration recommendations. 1319.505 Section 1319.505 Federal Acquisition Regulations System DEPARTMENT OF... Small Business Administration recommendations. (a) The designee authorized to render a decision on the...

77 FR 52707 - Notice of Membership of the Performance Review Board

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

... makes recommendations to the appointing authority relative to the performance of the senior executive, including recommendations on performance awards. The Department of Education's PRB also makes recommendations on SES pay adjustments for career senior executives. Membership The Secretary has selected the...

Critical Questions Regarding Gadolinium Deposition in the Brain and Body After Injections of the Gadolinium-Based Contrast Agents, Safety, and Clinical Recommendations in Consideration of the EMA's Pharmacovigilance and Risk Assessment Committee Recommendation for Suspension of the Marketing Authorizations for 4 Linear Agents.

PubMed

Runge, Val M

2017-06-01

For magnetic resonance, the established class of intravenous contrast media is the gadolinium-based contrast agents. In the 3 decades since initial approval, these have proven in general to be very safe for human administration. However, in 2006, a devastating late adverse reaction to administration of the less stable gadolinium-based contrast agents was identified, nephrogenic systemic fibrosis. The result of actions taken by the European Medicines Agency and the US Food and Drug Administration, stratifying the agents by risk and contraindicating specific agents in severe renal dysfunction, has led to no new cases being identified in North America or Europe. Subsequently, in 2014, long-term deposition in the brain of gadolinium was first shown, after administration of 2 nonionic linear chelates, gadodiamide, and gadopentetate dimeglumine. This has led to an intense focus on the question of in vivo distribution, possible dechelation, and subsequent deposition of gadolinium, together with substantial clarification of the phenomenon as well as stratification of the agents on this basis. This review focuses on 8 critical questions regarding gadolinium deposition in the brain and body, with the answers and discussion therein important for future regulatory decisions and clinical practice. It is now clear that dechelation of gadolinium occurs in vivo with the linear agents and is responsible for this phenomenon, with key experts in the field recommending, except where there is no suitable alternative, a shift in clinical practice from the linear to macrocyclic agents. In addition, on March 10, 2017, the Pharmacovigilance and Risk Assessment Committee of the European Medicines Agency recommended suspension of the marketing authorization for 4 linear gadolinium contrast agents-specifically Omniscan, Optimark, Magnevist, and MultiHance (gadodiamide, gadoversetamide, gadopentetate dimeglumine, and gadobenate dimeglumine)-for intravenous injection. Cited in the report was convincing evidence of gadolinium deposition in the brain months after injection of these linear agents. Primovist/Eovist (gadoxetic acid disodium) will remain available, being used at a lower dose for liver imaging, because it meets an important diagnostic need. In addition, a formulation of Magnevist for intra-articular injection will remain available because of its very low gadolinium concentration.

Historical Group Debriefing Following Combat

DTIC Science & Technology

1993-05-01

participants shortly after its termination. Debriefing has been recommended by several authors as a stress management technique suitable for groups which...termination. Debriefing has been recommended by several authors as a stress management technique suitable for groups which have been exposed to traumatic...the event and the participants’ reactions, and (b) application of a "stress management " technique (e.g., working-through negative emotions, psycho

Rehabilitation (exercise and strength training) and osteoarthritis: A critical narrative review.

PubMed

Nguyen, Christelle; Lefèvre-Colau, Marie-Martine; Poiraudeau, Serge; Rannou, François

2016-06-01

Rehabilitation is widely recommended in national and international guidelines for managing osteoarthritis (OA) in primary care settings. According to the 2014 OA Research Society International (OARSI) recommendations, rehabilitation is even considered the core treatment of OA and is recommended for all patients. Rehabilitation for OA widely includes land- and water-based exercise, strength training, weight management, self-management and education, biomechanical interventions, and physically active lifestyle. We performed a critical narrative review of the efficacy and safety of rehabilitation for managing OA and discuss evidence-based international recommendations. The process of article selection was unsystematic. Articles were selected based on authors' expertise, self-knowledge, and reflective practice. For the purpose of the review, we focused on land- and water-based exercise and strength training for knee, hip and hand OA. Other aspects of rehabilitation in OA are treated elsewhere in this special issue. Exercise therapy is widely recommended for managing knee, hip and hand OA. However, the level of evidence varies according to OA location. Overall, consistent evidence suggests that exercise therapy and specific strengthening exercise or strength training for the lower limb reduce pain and improve physical function in knee OA. Evidence for other OA sites are less consistent. Therefore, because of the lack of specific studies, recommendations for hip and hand OA are mainly derived from studies of knee OA. In addition, no recommendations have been established regarding the exercise regimen. The efficacy and safety of exercise therapy and strength training need to be further evaluated in randomized controlled trials of patients with hip and hand OA. The optimal delivery of exercise programs also has to be more clearly defined. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Chapter 5. Essential equipment, pharmaceuticals and supplies. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Sprung, Charles L; Kesecioglu, Jozef

2010-04-01

To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on essential equipment, pharmaceuticals and supplies. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including essential equipment, pharmaceuticals and supplies. Key recommendations include: (1) ensure that adequate essential medical equipment, pharmaceuticals and important supplies are available during a disaster; (2) develop a communication and coordination system between health care facilities and local/regional/state/country governmental authorities for the provision of additional support; (3) determine the required resources, order and stockpile adequate resources, and judiciously distribute them; (4) acquire additional mechanical ventilators that are portable, provide adequate gas exchange for a range of clinical conditions, function with low-flow oxygen and without high pressure, and are safe for patients and staff; (5) provide advanced ventilatory support and rescue therapies including high levels of inspired oxygen and positive end-expiratory pressure, volume and pressure control ventilation, inhaled nitric oxide, high-frequency ventilation, prone positioning ventilation and extracorporeal membrane oxygenation; (6) triage scarce resources including equipment, pharmaceuticals and supplies based on those who are likely to benefit most or on a 'first come, first served' basis. Judicious planning and adoption of protocols for providing adequate equipment, pharmaceuticals and supplies are necessary to optimize outcomes during a pandemic.

A writer's guide to education scholarship: Quantitative methodologies for medical education research (part 1).

PubMed

Thoma, Brent; Camorlinga, Paola; Chan, Teresa M; Hall, Andrew Koch; Murnaghan, Aleisha; Sherbino, Jonathan

2018-01-01

Quantitative research is one of the many research methods used to help educators advance their understanding of questions in medical education. However, little research has been done on how to succeed in publishing in this area. We conducted a scoping review to identify key recommendations and reporting guidelines for quantitative educational research and scholarship. Medline, ERIC, and Google Scholar were searched for English-language articles published between 2006 and January 2016 using the search terms, "research design," "quantitative," "quantitative methods," and "medical education." A hand search was completed for additional references during the full-text review. Titles/abstracts were reviewed by two authors (BT, PC) and included if they focused on quantitative research in medical education and outlined reporting guidelines, or provided recommendations on conducting quantitative research. One hundred articles were reviewed in parallel with the first 30 used for calibration and the subsequent 70 to calculate Cohen's kappa coefficient. Two reviewers (BT, PC) conducted a full text review and extracted recommendations and reporting guidelines. A simple thematic analysis summarized the extracted recommendations. Sixty-one articles were reviewed in full, and 157 recommendations were extracted. The thematic analysis identified 86 items, 14 categories, and 3 themes. Fourteen quality evaluation tools and reporting guidelines were found. Discussion This paper provides guidance for junior researchers in the form of key quality markers and reporting guidelines. We hope that quantitative researchers in medical education will be informed by the results and that further work will be done to refine the list of recommendations.

Cranberry Products for the Prophylaxis of Urinary Tract Infections in Pediatric Patients.

PubMed

Durham, Spencer H; Stamm, Pamela L; Eiland, Lea S

2015-12-01

To evaluate the existing data regarding the use of cranberry products for the prevention of urinary tract infections (UTIs) in pediatric patients. A literature search of Medline databases from 1966 to June 2015 was conducted. The databases were searched using the terms "pediatrics," "children," "cranberry," "cranberry juice," and "urinary tract infections." The identified trials were then searched for additional references applicable to this topic. A total of 8 clinical trials were identified that examined the use of cranberry products, mostly juice, for the prevention of UTIs in children. Three trials examined the use in otherwise healthy children. Five trials examined the use in pediatric patients with underlying urogenital abnormalities of which 2 compared cranberry to antibiotics. In healthy pediatric patients, cranberry use was associated with a reduction in the overall number of UTIs and a decrease in the number of antibiotic days per year for UTI treatment. In patients with urogenital abnormalities, results were conflicting, with some studies showing no reduction in UTIs compared with placebo, but others demonstrating a significant reduction. However, cranberry products had similar efficacy when compared with both cefaclor and trimethoprim. All studies used a wide variety of doses and frequencies of cranberry, making specific product recommendations difficult. Cranberry appears effective for the prevention of UTIs in otherwise healthy children and is at least as effective as antibiotics in children with underlying urogenital abnormalities. However, recommendations for cranberry dosing and frequency cannot be confidently made at this time. Larger, well-designed trials are recommended. © The Author(s) 2015.

[Potential lowering of sepsis-related mortality via screening and implementation of guidelines].

PubMed

van Zanten, Arthur R H; Arbous, M Sesmu; Brinkman, Sylvia

2014-01-01

The incidence of sepsis continues to increase. However, over the past decade marked reductions in sepsis-related in-hospital mortality have been reported. Large variations in the presentation and severity of illness may be encountered in ICU patients with severe sepsis, which might preclude the success of screening and guideline programmes. However, the authors of this article were able to prove that a national programme involving screening and a package of interventions did lower relative in-hospital mortality by 16.7% over 3.5 years in 52 participating hospitals in the Netherlands. In-hospital mortality did not change in 30 non-participating hospitals. Therefore, the authors recommend implementing updated guidelines, sepsis quality indicators and programmes with a package of interventions to further reduce sepsis mortality. Furthermore, additional research on long term consequences in sepsis survivors is warranted.

A case of metronidazole-resistant Trichomonas vaginalis in pregnancy.

PubMed

Forbes, Georgina L; Drayton, Rachel; Forbes, Gavin D

2016-09-01

Trichomonas vaginalis is a sexually transmitted protozoan infection resulting in vulvo-vaginitis and altered vaginal discharge in symptomatic women. Trichomoniasis has been implicated in causing adverse pregnancy outcomes such as low birth weight and pre-term labour. Metronidazole is the recommended first-line treatment for trichomonal infection. Other nitroimidazoles, such as tinidazole, are used as alternative regimens with similar activity but at a greater expense. Treatment failure usually represents patient non-compliance or re-infection, although metronidazole resistance has previously been documented. Antimicrobial susceptibility testing for T. vaginalis is currently not available in the UK. Patients with disease unresponsive to first-line treatments pose a major challenge, as therapeutic options are limited. We present the case of a patient with presumed resistant infection during pregnancy, and the additional treatment issues that this presented. © The Author(s) 2015.

[Drug Prescribing for Patients with Chronic Kidney Disease in General Practice: a Cross-Sectional Study].

PubMed

Mahner, Maria; Raus, Christina; Ludwig, Fabian; Weckmann, Gesine; Stracke, Sylvia; Chenot, Jean-François

2018-06-01

Many drugs require dose adjustment or are contraindicated in patients with chronic kidney disease (CKD) to avoid adverse events. The aims of this study were to assess if medication was appropriately dose adjusted in patients with CKD in primary care, to identify medications that were frequently prescribed inappropriately and to identify factors predicting mal-prescription. We conducted a cross-sectional observational study in 34 general practioners' offices, assessing the medication of patients with CKD stage ≥ 3 according to the corresponding pharmaceutical product information. Additional information was extracted from recommendations of scientific societies and regulatory authorities. Contraindicated and overdosed medications were identified. Predictive factors for inadequate prescribing were analyzed with multiple logistic regression. 589 patients (Ø 78 years, 63 % female) with CKD stage ≥ 3 were included. A total of 5102 medications were extracted from the medication sheets (94,6 % regular, 5,4 % "as needed"). 4,2 % were judged as being inadequate according to pharmaceutical information (2,1 % contraindicated, 2,1 % overdosed). 173 patients (29 %) had ≥ 1 inadequate prescription. The proportion of inadequate prescriptions fell to 3,5 % after adjustment for the most recent recommendations of scientific societies and regulatory authorities. Most frequent inappropriate prescriptions were ACE-inhibitors, diuretics, oral antidiabetic drugs, methotrexate and potassium supplements. Most important predictors for inadequate prescriptions were CKD stage ≥ 3b and number of medications. A quarter of all patients had a least one inadequate prescription. The overall proportion of inadequately prescribed drugs was low. Adjustment for recommendations by scientific societies and regulatory authorities further reduced the number of inadequate prescriptions. Valid data on the clinical relevance of inadequate prescriptions is scarce and further research is required. Because of the time and effort needed to assess all medications, future quality improvement projects should focus on CKD stage ≥ 3b, patients with polypharmacy and crucial medication. © Georg Thieme Verlag KG Stuttgart · New York.

Exercise recommendations for childhood cancer survivors exposed to cardiotoxic therapies: an institutional clinical practice initiative.

PubMed

Okada, Maki; Meeske, Kathleen A; Menteer, Jondavid; Freyer, David R

2012-01-01

Childhood cancer survivors who have received treatment with anthracyclines are at risk for developing cardiomyopathy in dose-dependent fashion. Historically, restrictions on certain types of physical activity that were intended to preserve cardiac function have been recommended, based on a mixture of evidence-based and consensus-based recommendations. In the LIFE Cancer Survivorship & Transition Program at Children's Hospital Los Angeles, the authors reevaluated their recommendations for exercise in survivors who were exposed to anthracyclines, with or without irradiation in proximity to the myocardium. The primary goal was to develop consistent, specific, practical, safe, and (where possible) evidence-based recommendations for at-risk survivors in the program. To accomplish this, the authors referred to current exercise guidelines for childhood cancer survivors, consulted recent literature for relevant populations, and obtained input from the program's pediatric cardiology consultant. The resulting risk-based exercise recommendations are designed to complement current published guidelines, maximize safe exercise, and help childhood cancer survivors return to a normal life that emphasizes overall wellness and physical activity. This article describes a single institution's experience in modifying exercise recommendations for at-risk childhood survivors and includes the methods, findings, and current institutional practice recommendations along with sample education materials.

48 CFR 36.602-4 - Selection authority.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Selection authority. 36... Selection authority. (a) The final selection decision shall be made by the agency head or a designated selection authority. (b) The selection authority shall review the recommendations of the evaluation board...

Is There a Role for Arnica and Bromelain in Prevention of Post-Procedure Ecchymosis or Edema? A Systematic Review of the Literature.

PubMed

Ho, Derek; Jagdeo, Jared; Waldorf, Heidi A

2016-04-01

The management of postprocedure skin care is of significant interest to dermatologists and other physicians. Ecchymosis and edema are common temporary postprocedure unwanted effects. Two botanically-derived products, arnica and bromelain, are used internationally by physicians to limit ecchymosis and edema that occur secondary to cosmetic, laser, and surgical skin procedures. The authors review the published literature and provide evidence-based recommendations on arnica and bromelain for prevention and treatment of postprocedure ecchymosis and edema. A search of the computerized bibliographic databases Medline, EMBASE, Scopus, and CINAHL was performed on March 23, 2015. The key terms used were "arnica," and "bromelain." This review contains clinical trials that evaluated prevention and/or treatment of postprocedure ecchymosis or edema with oral arnica (11), topical arnica (2), and oral bromelain (7). No studies on topical bromelain were found. Clinical trials on arnica and bromelain have demonstrated mixed results. Some randomized controlled trials reported improvement postprocedure with arnica (4/13) and bromelain (5/7). Based upon published studies, there is insufficient data to support use of arnica and bromelain post procedure, and the authors recommend additional research to determine the efficacy and safety of arnica and bromelain to prevent and/or treat ecchymosis and edema in patients.

Balancing between two goods: Health Insurance Portability and Accountability Act and ethical compliancy considerations for privacy-sensitive materials in health sciences archival and historical special collections.

PubMed

Wiener, Judith A; Gilliland, Anne T

2011-01-01

The investigation provides recommendations for establishing institutional collection guidelines and policies that protect the integrity of the historical record, while upholding the privacy and confidentiality of those who are protected by Health Insurance Portability and Accountability Act (HIPAA) or professional ethical standards. The authors completed a systematic historical investigation of the concepts of collection integrity, privacy, and confidentiality in the formal and informal legal and professional ethics literature and applied these standards to create best practices for institutional policies in these areas. Through an in-depth examination of the historical concepts of privacy and confidentiality in the legal and professional ethics literature, the authors were able to create recommendations that would allow institutions to provide access to important, yet sensitive, materials, while complying with the standards set by HIPAA regulations and professional ethical expectations. With thoughtful planning, it is possible to balance the integrity of and access to the historical record of sensitive documents, while supporting the privacy protections of HIPAA and professional ethical standards. Although it is theorized that collection development policies of institutions have changed due to HIPAA legislation, additional research is suggested to see how various legal interpretations have affected the integrity of the historical record in actuality.

Effect of muscle type and frozen storage on the quality parameters of Iberian restructured meat preparations.

PubMed

Antequera, Teresa; Pérez-Palacios, Trinidad; Rodas, Elena; Rodríguez, Mar; Córdoba, Juan J

2014-10-01

The main objective of this study was to evaluate the effect of muscle type and frozen storage on the quality of restructured meat preparations from undervalued Iberian muscle to make use of meat from a high-quality and natural pig production system. The effect of two muscle types (i.e. white-glycolytic (W) and red-oxidative (R)) and frozen storage (lasting 0, 30, 60 and 90 days) on quality characteristics were assessed. Significant differences were found between the W and R Iberian restructured preparations in most physicochemical and some colour, texture and sensory traits, and in the fatty acid profile and oxidative measurements, suggesting that the R muscles are more suitable; however, the microbial contamination should be reduced. Frozen storage reduced but did not eliminate the initial microbial contamination, and it enhanced some quality traits in the Iberian restructured preparations, i.e. increased a* values, cohesiveness and juiciness and decreased adhesiveness and pastiness, without negatively affecting any parameter. Thus, frozen Iberian restructured preparations are recommended to be commercialized. In addition, the implementation or revision of Hazard Analysis and Critical Control Point is recommended to reduce microbial contamination. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Standard operating procedures for female genital sexual pain.

PubMed

Fugl-Meyer, Kerstin S; Bohm-Starke, Nina; Damsted Petersen, Christina; Fugl-Meyer, Axel; Parish, Sharon; Giraldi, Annamaria

2013-01-01

Female genital sexual pain (GSP) is a common, distressing complaint in women of all ages that is underrecognized and undertreated. Definitions and terminology for female GSP are currently being debated. While some authors have suggested that GSP is not per se a sexual dysfunction, but rather a localized genial pain syndrome, others adhere to using clearly sexually related terms such as dyspareunia and vaginismus. The aims of this brief review are to present definitions of the different types of female GSP. Their etiology, incidence, prevalence, and comorbidity with somatic and psychological disorders are highlighted, and different somatic and psychological assessment and treatment modalities are discussed. The Standard Operating Procedures (SOP) committee was composed of a chair and five additional experts. No corporate funding or remuneration was received. The authors agreed to survey relevant databases, journal articles and utilize their own clinical experience. Consensus was guided by systematic discussions by e-mail communications. MAIN OUTCOME/RESULTS: There is a clear lack of epidemiological data defining female GSP disorders and a lack of evidence supporting therapeutic interventions. However, this international expert group will recommend guidelines for management of female GSP. GSP disorders are complex. It is recommended that their evaluation and treatment are performed through comprehensive somato-psychological multidisciplinary approach. © 2012 International Society for Sexual Medicine.

Community Response to Concentrating Solar Power in the San Luis Valley: October 9, 2008 - March 31, 2010

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farhar, B. C.; Hunter, L. M.; Kirkland, T. M.

2010-06-01

This report is about the social acceptance of utility-scale concentrating solar power (CSP) plants in the San Luis Valley, approximately 200 miles southwest of Denver, Colorado. The research focused on social factors that may facilitate and impede the adoption and implementation of CSP. During the winter of 2008-2009, interviews were conducted with a purposive sample of 25 CSP-related stakeholders inside and outside the Valley. Interviews focused on the perceived advantages and disadvantages of siting a hypothetical 100-MW CSP facility in the Valley, the level of community support and opposition to CSP development, and related issues, such as transmission. State policymore » recommendations based on the findings include developing education programs for Valley residents, integrating Valley decision makers into an energy-water-land group, providing training for Valley decision makers, offering workforce training, evaluating models of taxation, and forming landholder energy associations. In addition, the SLV could become a laboratory for new approaches to CSP facility and transmission siting decision-making. The author recommends that outside stakeholders address community concerns and engage Valley residents in CSP decisions. Engaging the residents in CSP and transmission decisions, the author says, should take parallel significance with the investment in solar technology.« less

A review of national health policies and professional guidelines on maternal obesity and weight gain in pregnancy.

PubMed

Schumann, N L; Brinsden, H; Lobstein, T

2014-08-01

Maternal obesity creates an additional demand for health-care services, as the routine obstetric care pathway requires alterations to ensure the most optimal care for obese women of childbearing age. This review examines the extent to which relevant national health documents reflect and respond to the health implications of maternal obesity and excessive gestational weight gain. A targeted search of peer-reviewed publications and grey literature was conducted for each country to identify national health documents, which were subsequently content analyzed according to an adapted framework. A total of 37 documents were identified, including one policy, 10 strategies and 26 guidelines, published within the last 10 years. Out of the 31 countries investigated, only 13 countries address maternal obesity while none address excessive gestational weight gain. We found inconsistencies and gaps in the recommendations to health-care service providers for the management of maternal obesity and weight gain in pregnancy. The findings show that only limited guidance on maternal obesity and gestational weight gain exists. The authors recommend that international, evidence-based guidelines on the management of maternal obesity and excessive gestational weight gain should be developed to reduce the associated health-care and economic costs. © 2014 The Authors. Clinical Obesity © 2014 World Obesity.

Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel

PubMed Central

Al-Shahi Salman, Rustam; A. Awad, Issam; Dahlem, Kristen; Flemming, Kelly; Hart, Blaine; Kim, Helen; Jusue-Torres, Ignacio; Kondziolka, Douglas; Lee, Cornelia; Morrison, Leslie; Rigamonti, Daniele; Rebeiz, Tania; Tournier-Lasserve, Elisabeth; Waggoner, Darrel; Whitehead, Kevin

2017-01-01

Abstract BACKGROUND: Despite many publications about cerebral cavernous malformations (CCMs), controversy remains regarding diagnostic and management strategies. OBJECTIVE: To develop guidelines for CCM management. METHODS: The Angioma Alliance (www.angioma.org), the patient support group in the United States advocating on behalf of patients and research in CCM, convened a multidisciplinary writing group comprising expert CCM clinicians to help summarize the existing literature related to the clinical care of CCM, focusing on 5 topics: (1) epidemiology and natural history, (2) genetic testing and counseling, (3) diagnostic criteria and radiology standards, (4) neurosurgical considerations, and (5) neurological considerations. The group reviewed literature, rated evidence, developed recommendations, and established consensus, controversies, and knowledge gaps according to a prespecified protocol. RESULTS: Of 1270 publications published between January 1, 1983 and September 31, 2014, we selected 98 based on methodological criteria, and identified 38 additional recent or relevant publications. Topic authors used these publications to summarize current knowledge and arrive at 23 consensus management recommendations, which we rated by class (size of effect) and level (estimate of certainty) according to the American Heart Association/American Stroke Association criteria. No recommendation was level A (because of the absence of randomized controlled trials), 11 (48%) were level B, and 12 (52%) were level C. Recommendations were class I in 8 (35%), class II in 10 (43%), and class III in 5 (22%). CONCLUSION: Current evidence supports recommendations for the management of CCM, but their generally low levels and classes mandate further research to better inform clinical practice and update these recommendations. The complete recommendations document, including the criteria for selecting reference citations, a more detailed justification of the respective recommendations, and a summary of controversies and knowledge gaps, was similarly peer reviewed and is available on line www.angioma.org/CCMGuidelines. PMID:28387823

Response to the Critique of "New Meningococcal Vaccine Recommendations under Consideration"

ERIC Educational Resources Information Center

Turner, James C.

2005-01-01

The CDC recently published the ACIP recommendations regarding the use of meningococcal conjugate vaccine. The report includes detailed epidemiologic and cost analysis information. At the conclusion of lengthy discussions, the ACIP voted unanimously to approve the recommendation as written. In this article, the author provides his counterreaction…

Use of recommended search strategies in systematic reviews and the impact of librarian involvement: a cross-sectional survey of recent authors.

PubMed

Koffel, Jonathan B

2015-01-01

Previous research looking at published systematic reviews has shown that their search strategies are often suboptimal and that librarian involvement, though recommended, is low. Confidence in the results, however, is limited due to poor reporting of search strategies the published articles. To more accurately measure the use of recommended search methods in systematic reviews, the levels of librarian involvement, and whether librarian involvement predicts the use of recommended methods. A survey was sent to all authors of English-language systematic reviews indexed in the Database of Abstracts of Reviews of Effects (DARE) from January 2012 through January 2014. The survey asked about their use of search methods recommended by the Institute of Medicine, Cochrane Collaboration, and the Agency for Healthcare Research and Quality and if and how a librarian was involved in the systematic review. Rates of use of recommended methods and librarian involvement were summarized. The impact of librarian involvement on use of recommended methods was examined using a multivariate logistic regression. 1560 authors completed the survey. Use of recommended search methods ranged widely from 98% for use of keywords to 9% for registration in PROSPERO and were generally higher than in previous studies. 51% of studies involved a librarian, but only 64% acknowledge their assistance. Librarian involvement was significantly associated with the use of 65% of recommended search methods after controlling for other potential predictors. Odds ratios ranged from 1.36 (95% CI 1.06 to 1.75) for including multiple languages to 3.07 (95% CI 2.06 to 4.58) for using controlled vocabulary. Use of recommended search strategies is higher than previously reported, but many methods are still under-utilized. Librarian involvement predicts the use of most methods, but their involvement is under-reported within the published article.

Use of Recommended Search Strategies in Systematic Reviews and the Impact of Librarian Involvement: A Cross-Sectional Survey of Recent Authors

PubMed Central

Koffel, Jonathan B.

2015-01-01

Background Previous research looking at published systematic reviews has shown that their search strategies are often suboptimal and that librarian involvement, though recommended, is low. Confidence in the results, however, is limited due to poor reporting of search strategies the published articles. Objectives To more accurately measure the use of recommended search methods in systematic reviews, the levels of librarian involvement, and whether librarian involvement predicts the use of recommended methods. Methods A survey was sent to all authors of English-language systematic reviews indexed in the Database of Abstracts of Reviews of Effects (DARE) from January 2012 through January 2014. The survey asked about their use of search methods recommended by the Institute of Medicine, Cochrane Collaboration, and the Agency for Healthcare Research and Quality and if and how a librarian was involved in the systematic review. Rates of use of recommended methods and librarian involvement were summarized. The impact of librarian involvement on use of recommended methods was examined using a multivariate logistic regression. Results 1560 authors completed the survey. Use of recommended search methods ranged widely from 98% for use of keywords to 9% for registration in PROSPERO and were generally higher than in previous studies. 51% of studies involved a librarian, but only 64% acknowledge their assistance. Librarian involvement was significantly associated with the use of 65% of recommended search methods after controlling for other potential predictors. Odds ratios ranged from 1.36 (95% CI 1.06 to 1.75) for including multiple languages to 3.07 (95% CI 2.06 to 4.58) for using controlled vocabulary. Conclusions Use of recommended search strategies is higher than previously reported, but many methods are still under-utilized. Librarian involvement predicts the use of most methods, but their involvement is under-reported within the published article. PMID:25938454

Qualification of Simulation Software for Safety Assessment of Sodium Cooled Fast Reactors. Requirements and Recommendations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, Nicholas R.; Pointer, William David; Sieger, Matt

2016-04-01

The goal of this review is to enable application of codes or software packages for safety assessment of advanced sodium-cooled fast reactor (SFR) designs. To address near-term programmatic needs, the authors have focused on two objectives. First, the authors have focused on identification of requirements for software QA that must be satisfied to enable the application of software to future safety analyses. Second, the authors have collected best practices applied by other code development teams to minimize cost and time of initial code qualification activities and to recommend a path to the stated goal.

Rethinking Normal: Benefits and Risks of Not Reporting Harmless Incidental Findings.

PubMed

Pandharipande, Pari V; Herts, Brian R; Gore, Richard M; Mayo-Smith, William W; Harvey, H Benjamin; Megibow, Alec J; Berland, Lincoln L

2016-07-01

The authors explore the benefits and risks of not reporting imaging findings that do not have clinical relevance, with the goal of developing recommendations to reduce their reporting. The authors review the example of incidentally detected, simple renal cysts (Bosniak category I), including medicolegal conditions required for such a shift in reporting practices to be acceptable. The authors propose four potential criteria for not reporting clinically unimportant findings and recommend that these criteria be debated in other contexts, so that they can be refined and implemented. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Supporting countries in establishing and strengthening NITAGs: lessons learned from 5 years of the SIVAC initiative.

PubMed

Adjagba, Alex; Senouci, Kamel; Biellik, Robin; Batmunkh, Nyambat; Faye, Pape Coumba; Durupt, Antoine; Gessner, Bradford D; da Silva, Alfred

2015-01-29

To empower governments to formulate rational policies without pressure from any group, and to increase the use of evidence-based decision-making to adapt global recommendations on immunization to their local context, the WHO has recommended on multiple occasions that countries should establish National Immunization Technical Advisory Groups (NITAGs). The World Health Assembly (WHA) reinforced those recommendations in 2012 when Member States endorsed the Decade of Vaccines Global Vaccine Action Plan (GVAP). NITAGs are multidisciplinary groups of national experts responsible for providing independent, evidence-informed advice to health authorities on all policy-related issues for all vaccines across all populations. In 2012, according to the WHO-UNICEF Joint Reporting Form, among 57 countries eligible for immunization program financial support from the GAVI Alliance, only 9 reported having a functional NITAG. Since 2008, the Supporting Independent Immunization and Vaccine Advisory Committees (SIVAC) Initiative (at the Agence de Médecine Préventive or AMP) in close collaboration with the WHO and other partners has been working to accelerate and systematize the establishment of NITAGs in low- and middle-income countries. In addition to providing direct support to countries to establish advisory groups, the initiative also supports existing NITAGs to strengthen their capacity in the use of evidence-based processes for decision-making aligned with international standards. After 5 years of implementation and based on lessons learned, we recommend that future efforts should target both expanding new NITAGs and strengthening existing NITAGs in individual countries, along three strategic lines: (i) reinforce NITAG institutional integration to promote sustainability and credibility, (ii) build technical capacity within NITAG secretariats and evaluate NITAG performance, and (iii) increase networking and regional collaborations. These should be done through the development and dissemination of tools and guidelines, and information through a variety of adapted mechanisms. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Physician Recommendation Coding System (PhyReCS): A Reliable and Valid Method to Quantify the Strength of Physician Recommendations During Clinical Encounters.

PubMed

Scherr, Karen A; Fagerlin, Angela; Williamson, Lillie D; Davis, J Kelly; Fridman, Ilona; Atyeo, Natalie; Ubel, Peter A

2017-01-01

Physicians' recommendations affect patients' treatment choices. However, most research relies on physicians' or patients' retrospective reports of recommendations, which offer a limited perspective and have limitations such as recall bias. To develop a reliable and valid method to measure the strength of physician recommendations using direct observation of clinical encounters. Clinical encounters (n = 257) were recorded as part of a larger study of prostate cancer decision making. We used an iterative process to create the 5-point Physician Recommendation Coding System (PhyReCS). To determine reliability, research assistants double-coded 50 transcripts. To establish content validity, we used 1-way analyses of variance to determine whether relative treatment recommendation scores differed as a function of which treatment patients received. To establish concurrent validity, we examined whether patients' perceived treatment recommendations matched our coded recommendations. The PhyReCS was highly reliable (Krippendorf's alpha = 0.89, 95% CI [0.86, 0.91]). The average relative treatment recommendation score for each treatment was higher for individuals who received that particular treatment. For example, the average relative surgery recommendation score was higher for individuals who received surgery versus radiation (mean difference = 0.98, SE = 0.18, P < 0.001) or active surveillance (mean difference = 1.10, SE = 0.14, P < 0.001). Patients' perceived recommendations matched coded recommendations 81% of the time. The PhyReCS is a reliable and valid way to capture the strength of physician recommendations. We believe that the PhyReCS would be helpful for other researchers who wish to study physician recommendations, an important part of patient decision making. © The Author(s) 2016.

Complementary Feeding Diets Made of Local Foods Can Be Optimized, but Additional Interventions Will Be Needed to Meet Iron and Zinc Requirements in 6- to 23-Month-Old Children in Low- and Middle-Income Countries.

PubMed

Osendarp, Saskia J M; Broersen, Britt; van Liere, Marti J; De-Regil, Luz M; Bahirathan, Lavannya; Klassen, Eva; Neufeld, Lynnette M

2016-12-01

The question whether diets composed of local foods can meet recommended nutrient intakes in children aged 6 to 23 months living in low- and middle-income countries is contested. To review evidence of studies evaluating whether (1) macro- and micronutrient requirements of children aged 6 to 23 months from low- and middle-income countries are met by the consumption of locally available foods ("observed intake") and (2) nutrient requirements can be met when the use of local foods is optimized, using modeling techniques ("modeled intake"). Twenty-three articles were included after conducting a systematic literature search. To allow for comparisons between studies, findings of 15 observed intake studies were compared against their contribution to a standardized recommended nutrient intake from complementary foods. For studies with data on intake distribution, %< estimated average requirements were calculated. Data from the observed intake studies indicate that children aged 6 to 23 months meet requirements of protein, while diets are inadequate in calcium, iron, and zinc. Also for energy, vitamin A, thiamin, riboflavin, niacin, folate, and vitamin C, children did not always fulfill their requirements. Very few studies reported on vitamin B6, B12, and magnesium, and no conclusions can be drawn for these nutrients. When diets are optimized using modeling techniques, most of these nutrient requirements can be met, with the exception of iron and zinc and in some settings calcium, folate, and B vitamins. Our findings suggest that optimizing the use of local foods in diets of children aged 6 to 23 months can improve nutrient intakes; however, additional cost-effective strategies are needed to ensure adequate intakes of iron and zinc. © The Author(s) 2016.

Appropriate proton pump inhibitors use in elderly outpatients according to recommendations.

PubMed

Schonheit, Claire; Le Petitcorps, Hélène; Pautas, Éric

2016-12-01

Proton pump inhibitors (PPI) are widely prescribed, particularly in elderly patients, and their side effects are underestimated. Recommendations of the french health authorities, some specific to the elderly, specify their indications. The main objective of this descriptive and prospective study was to assess in elderly patients the adequacy of PPI prescriptions to these recommendations and to the marketing authorization. Analysis of all patients hospitalized in an acute geriatric unit over a period of 2 years for which the drug prescription on admission included a PPI. For the 125 patients included (mean age 84 years), the PPI treatment period exceeded one year in 68% of cases and 49.6% of PPI prescriptions were not consistent with the recommendations; not recommended indications are mainly prevention of gastroduodenal lesions in case of antiplatelet, VKA or corticosteroid treatment (24%), anemia (12%) or epigastric pain (8.5%) without prior endoscopic exploration. Only 50.4% of patients treated with PPI had an upper gastro-intestinal endoscopy, which should be systematically performed in patients over 65 years according to the recommendations. Our study confirms the low appropriateness of PPI prescriptions, particularly in elderly patients. This can be explained by controversial issues or by difficulties in adapting these recommendations in geriatric practice.

Recommendations for Writing Case Study Articles for Publication in the "Journal of College Counseling"

ERIC Educational Resources Information Center

Scholl, Mark B.

2017-01-01

The author presents recommendations for writing case studies for publication in the "Journal of College Counseling." Recommendations fall into 2 categories: (a) ethical considerations and (b) criteria essential to methodological rigor (e.g., Hyett, Kenny, & Dickson-Swift, 2014). The article is intended to guide and encourage…

43 CFR 404.50 - What information will be included in the feasibility report prepared by Reclamation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PROGRAM Feasibility Studies § 404.50 What information will be included in the feasibility report prepared... determination; (b) A recommendation to Congress regarding whether or not the proposed rural water supply project should be authorized for construction, and the reasons supporting the recommendation. This recommendation...

Clinical trials recruitment planning: A proposed framework from the Clinical Trials Transformation Initiative.

PubMed

Huang, Grant D; Bull, Jonca; Johnston McKee, Kelly; Mahon, Elizabeth; Harper, Beth; Roberts, Jamie N

2018-03-01

Patient recruitment is widely recognized as a key determinant of success for clinical trials. Yet a substantial number of trials fail to reach recruitment goals-a situation that has important scientific, financial, ethical, and policy implications. Further, there are important effects on stakeholders who directly contribute to the trial including investigators, sponsors, and study participants. Despite efforts over multiple decades to identify and address barriers, recruitment challenges persist. To advance a more comprehensive approach to trial recruitment, the Clinical Trials Transformation Initiative (CTTI) convened a project team to examine the challenges and to issue actionable, evidence-based recommendations for improving recruitment planning that extend beyond common study-specific strategies. We describe our multi-stakeholder effort to develop a framework that delineates three areas essential to strategic recruitment planning efforts: (1) trial design and protocol development, (2) trial feasibility and site selection, and (3) communication. Our recommendations propose an upstream approach to recruitment planning that has the potential to produce greater impact and reduce downstream barriers. Additionally, we offer tools to help facilitate adoption of the recommendations. We hope that our framework and recommendations will serve as a guide for initial efforts in clinical trial recruitment planning irrespective of disease or intervention focus, provide a common basis for discussions in this area and generate targets for further analysis and continual improvement. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

76 FR 39035 - Airworthiness Directives; Airbus Model A310 Series Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... application of a similar regulation to the National Aviation Authorities (NAA). Under this regulation, all... National Aviation Authorities (NAA). Under this regulation, all holders of type certificates for passenger... Authorities] JAA recommended the application of a similar regulation to the National Aviation Authorities (NAA...

AAP Updates Recommendations on Car Seats

MedlinePlus

... Size Email Print Share AAP Updates Recommendations on Car Seats Page Content Article Body Children should ride ... of approved car safety seats. Healthy Children Radio: Car Seat Safety Dennis Durbin, MD, FAAP, lead author ...

Treatment modalities and medication recommended by health care professionals for treating recurrent herpes labialis.

PubMed

Raborn, G Wayne; Chan, Karen S; Grace, Michael

2004-01-01

The authors conducted a survey to determine how health care professionals respond to patients' inquiries about cold sores, also known as recurrent herpes labialis, and their choices of treatment modalities and medications. The authors mailed a one-page, pretested survey to a random sample of dentists, pharmacists and family physicians in Alberta, Canada. After receiving ethics approval from the University of Alberta, Edmonton, the authors mailed 998 surveys. The response rate was 51 percent. Topical antiviral medication was the most common treatment recommended (63 percent). Over-the-counter medication was the first choice for pharmacists (83 percent) as compared with dentists (15 percent) and physicians (16 percent). Emotional stress (60 percent) was reported by patients to be the most common trigger, and pain or discomfort (81 percent) was their primary concern. Acyclovir ointment was the most common antiviral drug recommended or prescribed by health care professionals (60 percent), and cost was the major reason they gave for not recommending or prescribing antiviral drugs (73 percent). The authors found variation in treatment modalities and recommendations by each health profession, despite the fact that patients reported similar triggers and concerns. This may be due to individual patient need and the health care professional's lack of knowledge. Survey results may serve as a reference for health care professionals to use to determine how their choices of medications and treatment modalities compare with those of other practitioners. Professionals should know the benefits and limitations of all therapies, discuss them with the patients and select a treatment.

A Guide for applying a revised version of the PARIHS framework for implementation

PubMed Central

2011-01-01

Background Based on a critical synthesis of literature on use of the Promoting Action on Research Implementation in Health Services (PARIHS) framework, revisions and a companion Guide were developed by a group of researchers independent of the original PARIHS team. The purpose of the Guide is to enhance and optimize efforts of researchers using PARIHS in implementation trials and evaluations. Methods Authors used a planned, structured process to organize and synthesize critiques, discussions, and potential recommendations for refinements of the PARIHS framework arising from a systematic review. Using a templated form, each author independently recorded key components for each reviewed paper; that is, study definitions, perceived strengths/limitations of PARIHS, other observations regarding key issues and recommendations regarding needed refinements. After reaching consensus on these key components, the authors summarized the information and developed the Guide. Results A number of revisions, perceived as consistent with the PARIHS framework's general nature and intent, are proposed. The related Guide is composed of a set of reference tools, provided in Additional files. Its core content is built upon the basic elements of PARIHS and current implementation science. Conclusions We invite researchers using PARIHS for targeted evidence-based practice (EBP) implementations with a strong task-orientation to use this Guide as a companion and to apply the revised framework prospectively and comprehensively. Researchers also are encouraged to evaluate its use relative to perceived strengths and issues. Such evaluations and critical reflections regarding PARIHS and our Guide could thereby promote the framework's continued evolution. PMID:21878092

Strengthening the dementia care triad: identifying knowledge gaps and linking to resources.

PubMed

Jensen, Christine J; Inker, Jennifer

2015-05-01

This article describes a project to identify the needs of family caregivers and health care providers caring for persons with dementia. Participants included 128 caregivers, who completed a survey, and 27 health care providers, who participated in a focus group and completed a survey. Caregivers reported their primary source of information about the disease was the doctor; however, the majority also reported they were primarily informed of medications and not about needed resources. Health care providers identified limited time with patients and families, and lack of awareness of community services, as their main challenges. Recommendations include strengthening the partnership between physicians, patients, and caregivers (the dementia care triad) through additional support and training for physicians and caregivers, increasing awareness of the Alzheimer's Association, and utilization of technology for families and professionals to track the needs of persons with dementia. © The Author(s) 2014.

Long-term treatment of an addictive personality.

PubMed

Seymour, Peter M

2003-01-01

There is infrequent discussion of long-term psychotherapy of persons with addiction, particularly in the self-psychology literature. In addition, some question whether long-term psychotherapy can be helpful in severe psychiatric disorders. The author describes the treatment of a woman with multiple diagnoses, including bulimia and alcohol and drug addiction, which took place over a period of almost 7 years. These issues are addressed from a self-psychological perspective, with progression of the treatment from early facilitation of a selfobject transference to more intense selfobject transference-countertransference states. Behavioral interventions (e.g., recommendation of inpatient chemical dependency treatment) are also discussed. The author describes the patient's dramatic progress and subsequent regression. Finally, there is a discussion of the addiction from self-psychological and biological perspectives of this woman's particular developmental and treatment issues, as well as a discussion of the confrontation and limit setting in a self-psychologically oriented treatment.

Acute Hemorrhagic Edema of Infancy: an unusual diagnosis for the general pediatrician

PubMed Central

Cunha, Diego Fontana Siqueira; Darcie, Ana Letícia Fornazieri; Ferronato, Angela Espósito; Hein, Noely; Lo, Denise Swei; Yoshioka, Cristina Ryoka Miyao; Hirose, Maki; Cardoso, Debora Morais; Gilio, Alfredo Elias

2015-01-01

Acute Hemorrhagic Edema of Infancy (AHEI) is a rare leukocytoclastic vasculitis, clinically characterized by the classical triad: palpable purpuric skin lesions, edema and fever, and is commonly misdiagnosed as Henoch-Schönlein purpura. In addition to its sudden onset, AHEI is also characterized by its self-limited course with complete and spontaneous recovery occurring between 1 and 3 weeks. Because of the scarcity of studies on therapy with corticosteroids, the conservative approach is usually recommended. The authors report an unusual case of an one-year-old boy who presented with typical cutaneous rash of AHEI and orchitis, the latter showing complete resolution after less than 24 hours of prednisolone therapy. The authors call attention to this entity mainly as a differential diagnosis of Henoch-Schönlein purpura and to the importance of new studies to establish the benefits of corticosteroid therapy for AHEI. PMID:26558246

Acute Hemorrhagic Edema of Infancy: an unusual diagnosis for the general pediatrician.

PubMed

Cunha, Diego Fontana Siqueira; Darcie, Ana Letícia Fornazieri; Benevides, Gabriel Nuncio; Ferronato, Angela Espósito; Hein, Noely; Lo, Denise Swei; Yoshioka, Cristina Ryoka Miyao; Hirose, Maki; Cardoso, Debora Morais; Gilio, Alfredo Elias

2015-01-01

Acute Hemorrhagic Edema of Infancy (AHEI) is a rare leukocytoclastic vasculitis, clinically characterized by the classical triad: palpable purpuric skin lesions, edema and fever, and is commonly misdiagnosed as Henoch-Schönlein purpura. In addition to its sudden onset, AHEI is also characterized by its self-limited course with complete and spontaneous recovery occurring between 1 and 3 weeks. Because of the scarcity of studies on therapy with corticosteroids, the conservative approach is usually recommended. The authors report an unusual case of an one-year-old boy who presented with typical cutaneous rash of AHEI and orchitis, the latter showing complete resolution after less than 24 hours of prednisolone therapy. The authors call attention to this entity mainly as a differential diagnosis of Henoch-Schönlein purpura and to the importance of new studies to establish the benefits of corticosteroid therapy for AHEI.

[Regulation, innovation, and improvement of health care. The pharmaceutical sector].

PubMed

López-Casasnovas, Guillem

2008-01-01

The paper comments on present and future scenarios for the pharmaceutical sector in Spain, framed a highly regulated system. So far the drug industry has evolved under the short term public financial constraints for additional health care spending and the long term efforts to innovate. This has not proved to offer a stable setting for the relationship between the industry and Health Authorities. The author offers from the economic analysis and a subjective appraisal from his experience some recommendations for regulatory changes in order to better align the incentives of the parts for improving the health system as a whole. The basic point is that 'consumption levels' (quantities) and not (unit costs) are the main challenge to tackle today in our Public Health Care system, and for this the decentralisation of financial responsibility is not in itself 'the' problem but it may well be a part of the solution.

A Guide for Health Professionals Working with Aboriginal Peoples: Executive Summary

PubMed Central

2013-01-01

Objective to provide Canadian health professionals with a network of information and recommendations regarding Aboriginal health. Options health professionals working with Aboriginal individuals and communities in the area of women’s health care. Outcomes improved health status of Aboriginal peoples in Canada. Appropriateness and accessibility of women’s health services for Aboriginal peoples. Improved communication and clinical skills of health professionals in the area of Aboriginal health. Improved quality of relationship between health professionals and Aboriginal individuals and communities. Improved quality of relationship between health care professionals and Aboriginal individuals and communities. Evidence recommendations are based on expert opinion and a review of the literature. Published references were identified by a Medline search of all review articles, randomized clinical control trials, meta-analyses, and practice guidelines from 1966 to February 1999, using the MeSH headings “Indians, North American or Eskimos” and “Health.”* Subsequently published articles were brought to the attention of the authors in the process of writing and reviewing the document. Ancillary and unpublished references were recommended by members of the SOGC Aboriginal Health Issues Committee and the panel of expert reviewers. Values information collected was reviewed by the principal author. The social, cultural, political, and historic context of Aboriginal peoples in Canada, systemic barriers regarding the publication of information by Aboriginal authors, the diversity of Aboriginal peoples in Canada, and the need for a culturally appropriate and balanced presentation were carefully considered in addition to more traditional scientific evaluation. The majority of information collected consisted of descriptive health and social information and such evaluation tools as the evidence guidelines of the Canadian Task Force on the Periodic Health exam were not appropriate. Benefits, costs, and harms utilization of the information and recommendations by Canadian health professionals will enhance understanding, communication, and clinical skills in the area of Aboriginal health. The resulting enhancement of collaborative relationships between Aboriginal peoples and their women’s health providers may contribute to health services that are more appropriate, effective, efficient, and accessible for Aboriginal peoples in Canada. The educational process may require an initial investment of time from the health professional. Recommendations Recommendations were grouped according to four themes: sociocultural context, health concerns, cross-cultural understanding, and Aboriginal health resources. Health professionals are encouraged to learn the appropriate names, demographics, and traditional geographic territories and language groups of the various Aboriginal groups in Canada. In addition, sensitivity to the impact of colonization and current socioeconomic challenges to the health status of Aboriginal peoples is warranted. Health services for Aboriginal peoples should take place as close to home as possible. Governmental obligations and policies regarding determination are recognized. With respect to health concerns, holistic definitions of health, based on Aboriginal perspectives, are put forward. Aboriginal peoples continue to experience a disproportionate burden of health problems. Health professionals are encouraged to become familiar with several key areas of morbidity and mortality. Relationships between Aboriginal peoples and their care providers need to be based on a foundation of mutual respect. Gaps and barriers in the current health care system for Aboriginal peoples are identified. Health professionals are encouraged to work with Aboriginal individuals and communities to address these gaps and barriers. Aboriginal peoples require culturally appropriate health care, including treatment in their own languages when possible. This may require interpreters or Aboriginal health advocates. Health professionals are encouraged to recognize the importance of family and community roles, and to respect traditional medicines and healers. Health professionals can develop their sensitivities towards Aboriginal peoples by participating in workshops, making use of educational resources, and by spending time with Aboriginal peoples in their communities. Aboriginal communities and health professionals are encouraged to support community-based, community-directed health services and health research for Aboriginal peoples. In addition, the education of more Aboriginal health professionals is essential. The need for a preventative approach to health programming in Aboriginal communities is stressed. Validation recommendations were reviewed and revised by the SOGC Aboriginal Health Issues Committee, a panel of expert reviewers, and the SOGC Council. In addition, this document was also reviewed and supported by the Assembly of First Nations, Canadian Institute of Child Health, Canadian Paediatric Society, College of Family Physicians of Canada, Congress of Aboriginal Peoples, Federation of Medical Women of Canada, Inuit Tapirisat of Canada, Metis National Council, National Indian and Inuit Community Health Representatives Organization, and Pauktuutit Inuit Women’s Association. Sponsor Society of Obstetricians and Gynaecologists of Canada. PMID:23682204

Canadian guidelines for acute bacterial rhinosinusitis

PubMed Central

Kaplan, Alan

2014-01-01

Objective To provide a clinical summary of the Canadian clinical practice guidelines for acute bacterial rhinosinusitis (ABRS) that includes relevant considerations for family physicians. Quality of evidence Guideline authors performed a systematic literature search and drafted recommendations. Recommendations received both strength of evidence and strength of recommendation ratings. Input from external content experts was sought, as was endorsement from Canadian medical societies (Association of Medical Microbiology and Infectious Disease Canada, Canadian Society of Allergy and Clinical Immunology, Canadian Society of Otolaryngology—Head and Neck Surgery, Canadian Association of Emergency Physicians, and the Family Physicians Airways Group of Canada). Main message Diagnosis of ABRS is based on the presence of specific symptoms and their duration; imaging or culture are not needed in uncomplicated cases. Treatment is dependent on symptom severity, with intranasal corticosteroids (INCSs) recommended as monotherapy for mild and moderate cases, although the benefit might be modest. Use of INCSs plus antibiotics is reserved for patients who fail to respond to INCSs after 72 hours, and for initial treatment of patients with severe symptoms. Antibiotic selection must account for the suspected pathogen, the risk of resistance, comorbid conditions, and local antimicrobial resistance trends. Adjunct therapies such as nasal saline irrigation are recommended. Failure to respond to treatment, recurrent episodes, and signs of complications should prompt referral to an otolaryngologist. The guidelines address situations unique to the Canadian health care environment, including actions to take during prolonged wait periods for specialist referral or imaging. Conclusion The Canadian guidelines provide up-to-date recommendations for diagnosis and treatment of ABRS that reflect an evolving understanding of the disease. In addition, the guidelines offer useful tools to help clinicians discern viral from bacterial episodes, as well as optimally manage their patients with ABRS. PMID:24627376

GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo development of trustworthy recommendations: GRADE-ADOLOPMENT.

PubMed

Schünemann, Holger J; Wiercioch, Wojtek; Brozek, Jan; Etxeandia-Ikobaltzeta, Itziar; Mustafa, Reem A; Manja, Veena; Brignardello-Petersen, Romina; Neumann, Ignacio; Falavigna, Maicon; Alhazzani, Waleed; Santesso, Nancy; Zhang, Yuan; Meerpohl, Jörg J; Morgan, Rebecca L; Rochwerg, Bram; Darzi, Andrea; Rojas, Maria Ximenas; Carrasco-Labra, Alonso; Adi, Yaser; AlRayees, Zulfa; Riva, John; Bollig, Claudia; Moore, Ainsley; Yepes-Nuñez, Juan José; Cuello, Carlos; Waziry, Reem; Akl, Elie A

2017-01-01

Guideline developers can: (1) adopt existing recommendations from others; (2) adapt existing recommendations to their own context; or (3) create recommendations de novo. Monetary and nonmonetary resources, credibility, maximization of uptake, as well as logical arguments should guide the choice of the approach and processes. To describe a potentially efficient model for guideline production based on adoption, adaptation, and/or de novo development of recommendations utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision (EtD) frameworks. We applied the model in a new national guideline program producing 22 practice guidelines. We searched for relevant evidence that informs the direction and strength of a recommendation. We then produced GRADE EtDs for guideline panels to develop recommendations. We produced a total of 80 EtD frameworks in approximately 4 months and 146 EtDs in approximately 6 months in two waves. Use of the EtD frameworks allowed panel members understand judgments of others about the criteria that bear on guideline recommendations and then make their own judgments about those criteria in a systematic approach. The "GRADE-ADOLOPMENT" approach to guideline production combines adoption, adaptation, and, as needed, de novo development of recommendations. If developers of guidelines follow EtD criteria more widely and make their work publically available, this approach should prove even more useful. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

Biallelic Mutations in NBAS Cause Recurrent Acute Liver Failure with Onset in Infancy.

PubMed

Haack, Tobias B; Staufner, Christian; Köpke, Marlies G; Straub, Beate K; Kölker, Stefan; Thiel, Christian; Freisinger, Peter; Baric, Ivo; McKiernan, Patrick J; Dikow, Nicola; Harting, Inga; Beisse, Flemming; Burgard, Peter; Kotzaeridou, Urania; Kühr, Joachim; Himbert, Urban; Taylor, Robert W; Distelmaier, Felix; Vockley, Jerry; Ghaloul-Gonzalez, Lina; Zschocke, Johannes; Kremer, Laura S; Graf, Elisabeth; Schwarzmayr, Thomas; Bader, Daniel M; Gagneur, Julien; Wieland, Thomas; Terrile, Caterina; Strom, Tim M; Meitinger, Thomas; Hoffmann, Georg F; Prokisch, Holger

2015-07-02

Acute liver failure (ALF) in infancy and childhood is a life-threatening emergency. Few conditions are known to cause recurrent acute liver failure (RALF), and in about 50% of cases, the underlying molecular cause remains unresolved. Exome sequencing in five unrelated individuals with fever-dependent RALF revealed biallelic mutations in NBAS. Subsequent Sanger sequencing of NBAS in 15 additional unrelated individuals with RALF or ALF identified compound heterozygous mutations in an additional six individuals from five families. Immunoblot analysis of mutant fibroblasts showed reduced protein levels of NBAS and its proposed interaction partner p31, both involved in retrograde transport between endoplasmic reticulum and Golgi. We recommend NBAS analysis in individuals with acute infantile liver failure, especially if triggered by fever. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Engagement Skills Trainer: The Commander’s Perspective

DTIC Science & Technology

2017-06-09

recommends using EST as a record of fire for a sustainment training event . This record of fire event can only occur once per year and after a live fire...mandatory part of marksmanship training. The author also recommends using EST as a record of fire for a sustainment training event . This record of fire... event can only occur once per year and after a live fire qualification. v ACKNOWLEDGMENTS The author would like to thank the following persons

Beliefs and Recommendations Regarding Child Custody and Visitation in Cases Involving Domestic Violence: A Comparison of Professionals in Different Roles.

PubMed

Saunders, Daniel G; Faller, Kathleen C; Tolman, Richard M

2016-05-01

Research is lacking on differing perspectives regarding custody cases involving domestic violence (DV). In a survey of judges, legal aid attorneys, private attorneys, DV program workers, and child custody evaluators (n = 1,187), judges, private attorneys, and evaluators were more likely to believe that mothers make false DV allegations and alienate their children. In response to a vignette, evaluators and private attorneys were most likely to recommend joint custody and least likely to recommend sole custody to the survivor. Legal aid attorneys and DV workers were similar on many variables. Gender, DV knowledge, and knowing victims explained many group differences. © The Author(s) 2015.

Reshaping Time: Recommendations for Suicide Prevention in LBGT Populations. Reflections on "Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations" from Journal of Homosexuality 58(1).

PubMed

Mullaney, Clare

2016-01-01

This article serves as one of the supplementary pieces of this special issue on "Mapping Queer Bioethics," in which we take a solipsistic turn to "map" the Journal of Homosexuality itself. Here, the author examines the journal's 2011 consensus recommendations for the prevention of LGBT suicide. Invoking the axiom approach of Eve Kosovsky Sedgwick's seminal Epistemology of the Closet, the author argues that merely offering practical guidelines at the level of the demonstrative and the instructive may not be sufficient models to address the urgency of suicide rates in LGBTQ youth populations.

Voided urine versus bladder washing cytology for detection of urothelial carcinoma: which is better?

PubMed

Keller, Anna Krarup; Jensen, Jørgen Bjerggaard

2017-08-01

Cytology is recommended as part of the follow-up of high-grade non-muscle-invasive bladder cancer (NMIBC). However, currently there are no solid guideline recommendations regarding the use of voided urine versus bladder washing for cytology as part of the diagnosis or follow-up of NMIBC. The aim of this study was to investigate whether the cytological outcome was equal regarding the two techniques. The authors reviewed all outpatient flexible cystoscopies carried out in their department in 2013. Patient records in the registry of pathology were examined and those with simultaneous urine and bladder washing cytology were included. Previous urothelial disease and positive histology within 3 months after the cystoscopy were registered. A total of 1458 patients had both voided urine and bladder washing cytology and were included in the study, of whom 643 (44%) had a history of urothelial disease. An equal outcome of urine and bladder washing cytology was found in 1447 patients (99.2%). For the remaining 11 patients, only four patients underwent further examinations based on cytology findings in addition to what had already been planned after cystoscopy. Of the included patients, 100 (6.9%) had a positive histological outcome within 3 months. In most patients, no relevant difference between voided urine and bladder washing cytology was observed. Therefore, if cytology is indicated, it is recommended to use the test that is most readily available locally. The additional gain in using both urine and bladder wash is minimal, and can therefore be discarded.

Recommendations for successful sensory screening in older adults with dementia in long-term care: a qualitative environmental scan of Canadian specialists.

PubMed

Wittich, Walter; Höbler, Fiona; Jarry, Jonathan; McGilton, Katherine S

2018-01-26

This study aimed to identify screening tools, technologies and strategies that vision and hearing care specialists recommend to front-line healthcare professionals for the screening of older adults in long-term care homes who have dementia. An environmental scan of healthcare professionals took place via telephone interviews between December 2015 and March 2016. All interviews were audio recorded, transcribed, proofed for accuracy, and their contents thematically analysed by two members of the research team. A convenience sample of 11 professionals from across Canada specialising in the fields of vision and hearing healthcare and technology for older adults with cognitive impairment were included in the study. As part of a larger mixed-methods project, this qualitative study used semistructured interviews and their subsequent content analysis. Following a two-step content analysis of interview data, coded citations were grouped into three main categories: (1) barriers, (2) facilitators and (3) tools and strategies that do or do not work for sensory screening of older adults with dementia. We report on the information offered by participants within each of these themes, along with a summary of tools and strategies that work for screening older adults with dementia. Recommendations from sensory specialists to nurses working in long-term care included the need for improved interprofessional communication and collaboration, as well as flexibility, additional time and strategic use of clinical intuition and ingenuity. These suggestions at times contradicted the realities of service provision or the need for standardised and validated measures. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Committee on Diabetes Mellitus Indices of the Japan Society of Clinical Chemistry-recommended reference measurement procedure and reference materials for glycated albumin determination.

PubMed

Takei, Izumi; Hoshino, Tadao; Tominaga, Makoto; Ishibashi, Midori; Kuwa, Katsuhiko; Umemoto, Masao; Tani, Wataru; Okahashi, Mikiko; Yasukawa, Keiko; Kohzuma, Takuji; Sato, Asako

2016-01-01

Glycated albumin is an intermediate glycaemic control marker for which there are several measurement procedures with entirely different reference intervals. We have developed a reference measurement procedure for the purpose of standardizing glycated albumin measurements. The isotope dilution liquid chromatography/tandem mass spectrometry method was developed as a reference measurement procedure for glycated albumin. The stable isotopes of lysine and fructosyl-lysine, which serve as an internal standard, were added to albumin isolated from serum, followed by hydrogenation. After hydrolysis of albumin with hot hydrochloric acid, the liberated lysine and fructosyl-lysine were measured by liquid chromatography/tandem mass spectrometry, and their concentrations were determined from each isotope ratio. The reference materials (JCCRM611) for determining of glycated albumin were prepared from pooled patient blood samples. The isotope dilution-tandem mass spectrometry calibration curve of fructosyl-lysine and lysine showed good linearity (r = 0.999). The inter-assay and intra-assay coefficient of variation values of glycated albumin measurement were 1.2 and 1.4%, respectively. The glycated albumin values of serum in patients with diabetes assessed through the use of this method showed a good relationship with routine measurement procedures (r = 0.997). The relationship of glycated albumin values of the reference material (JCCRM611) between these two methods was the same as the relationship with the patient serum samples. The Committee on Diabetes Mellitus Indices of the Japan Society of Clinical Chemistry recommends the isotope dilution liquid chromatography/tandem mass spectrometry method as a reference measurement procedure, and JCCRM611 as a certified reference material for glycated albumin measurement. In addition, we recommend the traceability system for glycated albumin measurement. © The Author(s) 2015.

43 CFR 404.49 - What criteria will Reclamation use to determine whether to recommend that a proposed rural water...

Code of Federal Regulations, 2010 CFR

2010-10-01

... determine whether to recommend that a proposed rural water supply project be authorized for construction... RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Feasibility Studies § 404.49 What criteria will Reclamation use to determine whether to recommend that a proposed rural water supply...

Acromegaly: an endocrine society clinical practice guideline.

PubMed

Katznelson, Laurence; Laws, Edward R; Melmed, Shlomo; Molitch, Mark E; Murad, Mohammad Hassan; Utz, Andrea; Wass, John A H

2014-11-01

The aim was to formulate clinical practice guidelines for acromegaly. The Task Force included a chair selected by the Endocrine Society Clinical Guidelines Subcommittee (CGS), five experts in the field, and a methodologist. The authors received no corporate funding or remuneration. This guideline is cosponsored by the European Society of Endocrinology. This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. The Task Force reviewed primary evidence and commissioned two additional systematic reviews. One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society and the European Society of Endocrinology reviewed drafts of the guidelines. Using an evidence-based approach, this acromegaly guideline addresses important clinical issues regarding the evaluation and management of acromegaly, including the appropriate biochemical assessment, a therapeutic algorithm, including use of medical monotherapy or combination therapy, and management during pregnancy.

Update on epinephrine (adrenaline) for pediatric emergencies.

PubMed

Walker, David M

2009-06-01

Epinephrine (adrenaline) is a medication widely used in the pediatric emergency department. This article reviews the most recent evidence and recommendations behind the many applications of epinephrine as they apply to the care of children in emergency departments. Recent publications address epinephrine's role in the treatment of anaphylaxis, croup, asthma, bronchiolitis and as an adjunct to local anesthesia. Additionally, authors discuss epinephrine autoinjectors and the various routes of epinephrine administration. Epinephrine is the recommended first-line treatment for anaphylaxis and moderate-to-severe croup. Its role in asthma and bronchiolitis is less clear. Traditional beta2-agonists are seen as first-line therapies for moderate bronchiolitis and asthma exacerbations. Epinephrine may have a role for subsets of patients with both of these illnesses. The preferred route for parenteral treatment is intramuscular. Epinephrine is well tolerated as an adjunct to local anesthesia when used in digital blocks in digits with normal perfusion. Although autoinjectors allow faster access to epinephrine for anaphylaxis, there are many issues surrounding their use and indications.

[Assessment of allergenicity of genetically modified food crops].

PubMed

Schauzu, M; Pöting, A; Rubin, D; Lampen, A

2012-03-01

The placing on the European Union's market of genetically modified crops requires authorization by the European Commission which is based on the proof that the derived foods are as safe as their conventional counterparts. The assessment of potential allergenicity is part of the necessary investigations recommended in the updated Guidance Document of the Scientific Panel on Genetically Modified Organisms (GMO) of the European Food Safety Authority (EFSA), which is based on internationally agreed recommendations. All genetically modified crops which so far have been authorized in the European Union were evaluated by the EFSA GMO Panel which considered it unlikely that their overall allergenicity has been altered.

Measures of spiritual and transpersonal constructs for use in yoga research

PubMed Central

MacDonald, Douglas A; Friedman, Harris L

2009-01-01

This article presents information on standardized paper-and-pencil measures of spiritual and transpersonal constructs that hold promise for use in yoga research. Nine instruments are discussed at length including the Assessment Schedule for Altered States of Consciousness, Ego Grasping Orientation, Expressions of Spirituality Inventory, Hindu Religious Coping Scale, Measures of Hindu Pathways, Self-Expansiveness Level Form, Spiritual Orientation Inventory, Spiritual Transcendence Scale, and the Vedic Personality Inventory. As well, a listing of an additional 14 measures, along with primary citations, is provided. In conclusion, the authors proffer recommendations for the use of psychometric tests and provide a general proposal for programmatic research. PMID:21234209

Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists.

PubMed

Bahn Chair, Rebecca S; Burch, Henry B; Cooper, David S; Garber, Jeffrey R; Greenlee, M Carol; Klein, Irwin; Laurberg, Peter; McDougall, I Ross; Montori, Victor M; Rivkees, Scott A; Ross, Douglas S; Sosa, Julie Ann; Stan, Marius N

2011-06-01

Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This article describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspeciality physicians and others providing care for patients with this condition. The development of these guidelines was commissioned by the American Thyroid Association in association with the American Association of Clinical Endocrinologists. The American Thyroid Association and American Association of Clinical Endocrinologists assembled a task force of expert clinicians who authored this report. The task force examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to develop the text and a series of specific recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' ophthalmopathy; and management of other miscellaneous causes of thyrotoxicosis. One hundred evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.

Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists.

PubMed

Bahn, Rebecca S; Burch, Henry B; Cooper, David S; Garber, Jeffrey R; Greenlee, M Carol; Klein, Irwin; Laurberg, Peter; McDougall, I Ross; Montori, Victor M; Rivkees, Scott A; Ross, Douglas S; Sosa, Julie Ann; Stan, Marius N

2011-01-01

Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This article describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspeciality physicians and others providing care for patients with this condition. The development of these guidelines was commissioned by the American Thyroid Association in association with the American Association of Clinical Endocrinologists. The American Thyroid Association and American Association of Clinical Endocrinologists assembled a task force of expert clinicians who authored this report. The task force examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to develop the text and a series of specific recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' ophthalmopathy; and management of other miscellaneous causes of thyrotoxicosis. One hundred evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.

Primary care workforce shortages and career recommendations from practicing clinicians.

PubMed

DesRoches, Catherine M; Buerhaus, Peter; Dittus, Robert S; Donelan, Karen

2015-05-01

The success of efforts to bolster the primary care workforce rests in part on how these clinicians view their professions and their willingness to recommend their careers to others. The authors sought to examine career and job satisfaction, perceptions of workforce shortages, and willingness to make career recommendations among primary care physicians (PCPs) and primary care nurse practitioners (PCNPs). In 2012, the authors mailed a national survey concerning the issues above to 1,914 randomly chosen clinicians found on national databases: 957 PCPs and 957 PCNPs. A total of 972 eligible clinicians (505 PCPs, 467 PCNPs) returned the survey. Using standard opinion research procedures, the authors estimated there were approximately 1,589 eligible clinicians in their sample (response rate, 61.2%). PCNPs and PCPs were more likely to recommend a career as a PCNP than as a PCP, despite the perception among all clinicians of a serious shortage of PCPs nationally and in their own communities. This finding held among PCNPs who reported low workplace autonomy and among PCPs reporting that they were satisfied with their own careers. Efforts to solve the primary care workforce shortage that ignore the significant dissatisfaction of PCPs with their own careers are unlikely to be successful. Simply adding training slots and increasing reimbursement rates will do little to solve the problem if PCPs continue to view their own careers as ones they cannot recommend to others.

Training for Today's Office

ERIC Educational Resources Information Center

Wise, Elva Lea

1974-01-01

After observing several large company offices in Denver in operation, the author suggests course content slantings and recommendations to better meet office requirements of today and tomorrow. Recommendations are categorized according to clerical practice, data processing, shorthand, and typewriting. (EA)

"European Resuscitation Council 2015 burn 1st Aid recommendations-concerns and issues for first responders".

PubMed

Goodwin, Nicholas S

2016-08-01

As the lead author of a recently published systematic review on hydrogel burn dressings in pre-hospital, I was alarmed to read the claim by the authors to the effect no one method of burn wound cooling was superior to any other; "There is no evidence to recommend a specific temperature or method of cooling". The reputation and prominence of the ERC within the circle of resuscitation councils now delving into 1st Aid recommendations leads to the conclusion that misguided recommendations may cause confusion amongst first responders, may falsely misdirect 1st Aid providers to unsupported practices or alternatively create a window of opportunity for marketers or sellers of alternative burn 1st Aid technologies to make unsupported claims in respect of comparable efficacy of their own product versus "traditional" methods. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Discovery and preclinical development of dasabuvir for the treatment of hepatitis C infection.

PubMed

El Kassas, Mohamed; Elbaz, Tamer; Hafez, Enas; Wifi, Mohamed Naguib; Esmat, Gamal

2017-06-01

Hepatitis C virus (HCV) is a leading cause of liver-related morbidity and mortality. Positively, the introduction of new directly-acting antivirals (DAAs) have led to dramatic improvements in response rates to antiviral therapy. Furthermore, newer generations of DAAs have demonstrated better safety profiles as well as efficacy than older generations. Current treatment recommendations are based on different combinations of DAAs. Current combination therapies rely on agents that target the different steps of viral replication by using different molecules from various DAAs families. Areas covered: In this review, the authors summarize data from of one of the recently developed NS5B polymerase inhibitors, dasabuvir, formerly known as ABT-333. Herein, the authors discuss the drug discovery data for dasabuvir including data from preclinical, toxicological resistance studies. The authors also review dasabuvir's clinical efficacy across various clinical challenges, in addition to its limitations in clinical practice. Expert opinion: Dasabuvir represents an important medical advance when used as a combination therapy for HCV. Unfortunately, it does present limitations like low genotypic coverage and further research is still required to address some of the lingering issues.

Keys to a drug-free workplace

NASA Astrophysics Data System (ADS)

Fortuna, Joseph J.; Fortuna, Patricia B.

1997-01-01

What does it take to establish a drug free work place. Are technologies available other than urine testing for pre- employment screening and monitoring of employees. Various methods are now available to screen for illicit drug residues on items handled by individuals. The residues can be acquired from the surfaces of items such as telephones, door knobs, steering wheels, lockers, clothing, identification cards, etc. Test kits are also available for urine testing at NIDA threshold levels. Analysis of hair, saliva, and sweat is now possible. How good ar these methods and kits. What value are they to the public. What are the legal concerns facing employers. What do the screening test show. These questions and others are addressed in this paper. The authors review for the reader how drug abuse by US workers costs businesses. The paper then addresses the various aspects of the DOT regulations to determine why urine analysis (UA) is insufficient to eliminate drug abuse. The authors present applications of screening technologies in addition to UA. Finally, the authors provide a conclusion of findings and recommendations for businesses that truly want or need drug free work places.

Advancing infection control in dental care settings: factors associated with dentists' implementation of guidelines from the Centers for Disease Control and Prevention.

PubMed

Cleveland, Jennifer L; Bonito, Arthur J; Corley, Tammy J; Foster, Misty; Barker, Laurie; Gordon Brown, G; Lenfestey, Nancy; Lux, Linda

2012-10-01

The authors set out to identify factors associated with implementation by U.S. dentists of four practices first recommended in the Centers for Disease Control and Prevention's Guidelines for Infection Control in Dental Health-Care Settings-2003. In 2008, the authors surveyed a stratified random sample of 6,825 U.S. dentists. The response rate was 49 percent. The authors gathered data regarding dentists' demographic and practice characteristics, attitudes toward infection control, sources of instruction regarding the guidelines and knowledge about the need to use sterile water for surgical procedures. Then they assessed the impact of those factors on the implementation of four recommendations: having an infection control coordinator, maintaining dental unit water quality, documenting percutaneous injuries and using safer medical devices, such as safer syringes and scalpels. The authors conducted bivariate analyses and proportional odds modeling. Responding dentists in 34 percent of practices had implemented none or one of the four recommendations, 40 percent had implemented two of the recommendations and 26 percent had implemented three or four of the recommendations. The likelihood of implementation was higher among dentists who acknowledged the importance of infection control, had practiced dentistry for less than 30 years, had received more continuing dental education credits in infection control, correctly identified more surgical procedures that require the use of sterile water, worked in larger practices and had at least three sources of instruction regarding the guidelines. Dentists with practices in the South Atlantic, Middle Atlantic or East South Central U.S. Census divisions were less likely to have complied. Implementation of the four recommendations varied among U.S. dentists. Strategies targeted at raising awareness of the importance of infection control, increasing continuing education requirements and developing multiple modes of instruction may increase implementation of current and future Centers for Disease Control and Prevention guidelines.

Advancing infection control in dental care settings

PubMed Central

Cleveland, Jennifer L.; Bonito, Arthur J.; Corley, Tammy J.; Foster, Misty; Barker, Laurie; Brown, G. Gordon; Lenfestey, Nancy; Lux, Linda

2015-01-01

Background and Overview The authors set out to identify factors associated with implementation by U.S. dentists of four practices first recommended in the Centers for Disease Control and Prevention’s Guidelines for Infection Control in Dental Health-Care Settings—2003. Methods In 2008, the authors surveyed a stratified random sample of 6,825 U.S. dentists. The response rate was 49 percent. The authors gathered data regarding dentists’ demographic and practice characteristics, attitudes toward infection control, sources of instruction regarding the guidelines and knowledge about the need to use sterile water for surgical procedures. Then they assessed the impact of those factors on the implementation of four recommendations: having an infection control coordinator, maintaining dental unit water quality, documenting percutaneous injuries and using safer medical devices, such as safer syringes and scalpels. The authors conducted bivariate analyses and proportional odds modeling. Results Responding dentists in 34 percent of practices had implemented none or one of the four recommendations, 40 percent had implemented two of the recommendations and 26 percent had implemented three or four of the recommendations. The likelihood of implementation was higher among dentists who acknowledged the importance of infection control, had practiced dentistry for less than 30 years, had received more continuing dental education credits in infection control, correctly identified more surgical procedures that require the use of sterile water, worked in larger practices and had at least three sources of instruction regarding the guidelines. Dentists with practices in the South Atlantic, Middle Atlantic or East South Central U.S. Census divisions were less likely to have complied. Conclusions Implementation of the four recommendations varied among U.S. dentists. Strategies targeted at raising awareness of the importance of infection control, increasing continuing education requirements and developing multiple modes of instruction may increase implementation of current and future Centers for Disease Control and Prevention guidelines. PMID:23024311

Balancing between two goods: Health Insurance Portability and Accountability Act and ethical compliancy considerations for privacy-sensitive materials in health sciences archival and historical special collections

PubMed Central

Gilliland, Anne T

2011-01-01

Objective: The investigation provides recommendations for establishing institutional collection guidelines and policies that protect the integrity of the historical record, while upholding the privacy and confidentiality of those who are protected by Health Insurance Portability and Accountability Act (HIPAA) or professional ethical standards. Methods: The authors completed a systematic historical investigation of the concepts of collection integrity, privacy, and confidentiality in the formal and informal legal and professional ethics literature and applied these standards to create best practices for institutional policies in these areas. Results: Through an in-depth examination of the historical concepts of privacy and confidentiality in the legal and professional ethics literature, the authors were able to create recommendations that would allow institutions to provide access to important, yet sensitive, materials, while complying with the standards set by HIPAA regulations and professional ethical expectations. Conclusion: With thoughtful planning, it is possible to balance the integrity of and access to the historical record of sensitive documents, while supporting the privacy protections of HIPAA and professional ethical standards. Although it is theorized that collection development polices of institutions have changed due to HIPAA legislation, additional research is suggested to see how various legal interpretations have affected the integrity of the historical record in actuality. PMID:21243051

Key Recommendations from the MedtecHTA Project.

PubMed

Tarricone, Rosanna; Torbica, Aleksandra; Drummond, Michael

2017-02-01

There are particular characteristics of Medical Devices, such as the device-user interaction, the incremental nature of innovation and the broader organizational impact that lead to additional challenges for health technology assessment (HTA). The project explored key aspects of the conduct and methods of HTA for MDs. Systematic reviews and original research studies were conducted to determine improvements in processes and methods that could enhance the potential for HTA and optimize the diffusion of MDs. Regulatory processes for MDs should be more closely aligned, the HTA evaluative framework should be harmonized and processes for conditional coverage and evidence development should be used. The methods for HTA should consider MDs as complex interventions, require the establishment of high quality registries, consider an iterative approach to the evaluation over time, recognize and allow for the particular characteristics of devices and use appropriate approaches for confounder adjustment in comparative effectiveness studies. To optimize the diffusion, a common classification should be developed across countries in order to facilitate international comparisons, factors driving diffusion should be explored in HTA reports and physicians' personal goals and motivation should be better understood. The key recommendations of the MedtecHTA project should improve the conduct and use of HTA for MDs. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd.

Visual function, driving safety, and the elderly.

PubMed

Keltner, J L; Johnson, C A

1987-09-01

The authors have conducted a survey of the Departments of Motor Vehicles in all 50 states, the District of Columbia, and Puerto Rico requesting information about the visual standards, accidents, and conviction rates for different age groups. In addition, we have reviewed the literature on visual function and traffic safety. Elderly drivers have a greater number of vision problems that affect visual acuity and/or peripheral visual fields. Although the elderly are responsible for a small percentage of the total number of traffic accidents, the types of accidents they are involved in (e.g., failure to yield the right-of-way, intersection collisions, left turns onto crossing streets) may be related to peripheral and central visual field problems. Because age-related changes in performance occur at different rates for various individuals, licensing of the elderly driver should be based on functional abilities rather than age. Based on information currently available, we can make the following recommendations: (1) periodic evaluations of visual acuity and visual fields should be performed every 1 to 2 years in the population over age 65; (2) drivers of any age with multiple accidents or moving violations should have visual acuity and visual fields evaluated; and (3) a system should be developed for physicians to report patients with potentially unsafe visual function. The authors believe that these recommendations may help to reduce the number of traffic accidents that result from peripheral visual field deficits.

A Study of Personal Health Record User's Behavioral Model Based on the PMT and UTAUT Integrative Perspective.

PubMed

Hsieh, Hui-Lung; Kuo, Yu-Ming; Wang, Shiang-Ru; Chuang, Bi-Kun; Tsai, Chung-Hung

2016-12-23

The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1) The PMT and UTAUT were effective at predicting PHR usage behaviors; (2) Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3) Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management.

49 CFR 1562.29 - Armed security officer requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... place of birth. (iv) Social security number, (submission is voluntary, although recommended). (v...) Suspension or withdrawal of authorization. At the discretion of TSA, authorization under this subpart and 49...

Negative Statements in Letters of Recommendation: From Defamation to Defense.

ERIC Educational Resources Information Center

Clear, Delbert K.

1978-01-01

The law clearly provides protection for those who write negative recommendations; however, the standard tests for libel and slander that are used in tort suits where damages are sought for defamation of character are applicable. (Author/MLF)

A Recording System for Your Program.

ERIC Educational Resources Information Center

Abdoo, Frank B.

1981-01-01

The author explains terminology and recommends components for a semiprofessional recording facility suitable to a school or small college music program with a limited budget. The recommended system costs approximately $13,000. Equipment prices and purchasing plans are discussed. (SJL)

A Guide to the Field Guides.

ERIC Educational Resources Information Center

Natural History, 1987

1987-01-01

Provides a compilation of recommended field guides which deal with birds, mammals, trees, and wildflowers. Each recommended volume is described, noting its distinguishing features and evaluating its organization, photography, and text. Includes the author, publisher, and suggested retail price. (TW)

Senior GRADE methodologists encounter challenges as part of WHO guideline development panels: an inductive content analysis.

PubMed

Alexander, Paul E; Li, Shelly-Anne; Gionfriddo, Michael R; Stoltzfus, Rebecca J; Neumann, Ignacio; Brito, Juan P; Djulbegovic, Benjamin; Montori, Victor M; Schünemann, Holger J; Guyatt, Gordon H

2016-02-01

The World Health Organization (WHO) classifies a substantial proportion of their recommendations as strong despite low or very low confidence (certainty) in estimates of effect. Such discordant recommendations are often inconsistent with Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance. To gain the perspective of senior WHO methodology chairs regarding panels' use of GRADE, particularly regarding discordant recommendations. Senior active GRADE methodologists who had served on at least two WHO panels and were an author on at least one peer-reviewed published article on GRADE methodology. Five eligible methodologists participated in detailed semistructured interviews. Respondents answered questions regarding how they were viewed by other panelists and WHO leadership, and how they handled situations when panelists made discordant recommendations they felt were inappropriate. They also provided information on how the process can be improved. Interviews were recorded and transcribed, and inductive content analysis was used to derive codes, categories, and emergent themes. Three themes emerged from the interviews of five methodologists: (1) The perceived role of methodologists in the process, (2) Contributors to discordant recommendations, and (3) Strategies for improvement. Salient findings included (1) a perceived tension between methodologists and WHO panels as a result of panel members' resistance to adhering to GRADE guidance; (2) both financial and nonfinancial conflicts of interest among panel members as an explanation for discordant recommendations; and (3) the need for greater clarity of, and support for, the role of methodologists as co-chairs of panels. These findings suggest that the role of the GRADE methodologist as a co-chair needs to be clarified by the WHO leadership. They further suggest the need for additional training for panelists, quality monitoring, and feedback to ensure optimal use of GRADE in guideline development at WHO. Copyright © 2016 Elsevier Inc. All rights reserved.

The American Society for Radiation Oncology's 2015 Core Physics Curriculum for Radiation Oncology Residents.

PubMed

Burmeister, Jay; Chen, Zhe; Chetty, Indrin J; Dieterich, Sonja; Doemer, Anthony; Dominello, Michael M; Howell, Rebecca M; McDermott, Patrick; Nalichowski, Adrian; Prisciandaro, Joann; Ritter, Tim; Smith, Chadd; Schreiber, Eric; Shafman, Timothy; Sutlief, Steven; Xiao, Ying

2016-07-15

The American Society for Radiation Oncology (ASTRO) Physics Core Curriculum Subcommittee (PCCSC) has updated the recommended physics curriculum for radiation oncology resident education to improve consistency in teaching, intensity, and subject matter. The ASTRO PCCSC is composed of physicists and physicians involved in radiation oncology residency education. The PCCSC updated existing sections within the curriculum, created new sections, and attempted to provide additional clinical context to the curricular material through creation of practical clinical experiences. Finally, we reviewed the American Board of Radiology (ABR) blueprint of examination topics for correlation with this curriculum. The new curriculum represents 56 hours of resident physics didactic education, including a 4-hour initial orientation. The committee recommends completion of this curriculum at least twice to assure both timely presentation of material and re-emphasis after clinical experience. In addition, practical clinical physics and treatment planning modules were created as a supplement to the didactic training. Major changes to the curriculum include addition of Fundamental Physics, Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy, and Safety and Incidents sections, and elimination of the Radiopharmaceutical Physics and Dosimetry and Hyperthermia sections. Simulation and Treatment Verification and optional Research and Development in Radiation Oncology sections were also added. A feedback loop was established with the ABR to help assure that the physics component of the ABR radiation oncology initial certification examination remains consistent with this curriculum. The ASTRO physics core curriculum for radiation oncology residents has been updated in an effort to identify the most important physics topics for preparing residents for careers in radiation oncology, to reflect changes in technology and practice since the publication of previous recommended curricula, and to provide practical training modules in clinical radiation oncology physics and treatment planning. The PCCSC is committed to keeping the curriculum current and consistent with the ABR examination blueprint. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of lifestyle diet and exercise interventions for osteoarthritis.

PubMed

Messier, S P; Callahan, L F; Golightly, Y M; Keefe, F J

2015-05-01

The objective was to develop a set of "best practices" for use as a primer for those interested in entering the clinical trials field for lifestyle diet and/or exercise interventions in osteoarthritis (OA), and as a set of recommendations for experienced clinical trials investigators. A subcommittee of the non-pharmacologic therapies committee of the OARSI Clinical Trials Working Group was selected by the Steering Committee to develop a set of recommended principles for non-pharmacologic diet/exercise OA randomized clinical trials. Topics were identified for inclusion by co-authors and reviewed by the subcommittee. Resources included authors' expert opinions, traditional search methods including MEDLINE (via PubMed), and previously published guidelines. Suggested steps and considerations for study methods (e.g., recruitment and enrollment of participants, study design, intervention and assessment methods) were recommended. The recommendations set forth in this paper provide a guide from which a research group can design a lifestyle diet/exercise randomized clinical trial in patients with OA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Education - How To Do It

ERIC Educational Resources Information Center

Kriebel, David

1974-01-01

The author presents twenty recommendations on how to organize a strong environmental program, based on experiences with environmental studies at the University of California at Santa Barbara. The recommendations come from a report by Roderick Nash entitled "Environmental Studies: The Santa Barbara Experience." (BT)

Sexual Discrimination in the Use of Letters of Recommendation: A Case of Reverse Discrimination

ERIC Educational Resources Information Center

Kryger, Barbara Rosenblum; Shikiar, Richard

1978-01-01

Possible sexual discrimination was examined in the use of letters of recommendation. Female applicants were preferred over male applicants in terms of proceeding with an interview, thus demonstrating a case of reverse discrimination. (Author)

14 CFR 141.63 - Examining authority qualification requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of those students passed the required practical or knowledge test, or any combination thereof, for... students in the training course for which examining authority is sought and recommended those students for...

The Scorer Reliability of Self-Scored Interest Inventories.

ERIC Educational Resources Information Center

O'Shea, Arthur J.; Harrington, Thomas F.

1980-01-01

Describes the procedures the authors of the System for Career Decision-Making (CDM) followed in establishing client scoring reliability. Authors recommend that manuals of self-scored inventories provide data establishing scorer reliability, that scoring be supervised, and that APGA test standards deal directly with scorer reliability. (Author)

76 FR 73486 - Airworthiness Directives; Airbus Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-29

... (NAA) the application of a similar regulation. The aim of this [EASA] regulation is to require * * * a... Authorities] recommended to the National Aviation Authorities (NAA) the application of a similar regulation... Aviation Authorities (NAA) the application of a similar regulation. The aim of this [EASA] regulation is to...

76 FR 34075 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-10

...) determines, recommends, and implements procedural changes needed to maintain effective management of CDC... Organization, Functions, and Delegations of Authority Part C (Centers for Disease Control and Prevention) of the Statement of Organization, Functions, and Delegations of Authority of the Department of Health and...

Community Healthcare and Technology to Enhance Communication in Pediatric Obesity Care: Expert Exchange Workgroup's Views.

PubMed

Siegel, Robert M; Haemer, Matthew; Kharofa, Roohi Y; Christison, Amy L; Hampl, Sarah E; Tinajero-Deck, Lydia; Lockhart, Mary Kate; Reich, Sarah; Pont, Stephen J; Stratbucker, William; Robinson, Thomas N; Shaffer, Laura A; Woolford, Susan J

2018-06-07

Childhood obesity continues to be a critical healthcare issue and a paradigm of a pervasive chronic disease affecting even our youngest children. When considered within the context of the socioecological model, the factors that influence weight status, including the social determinants of health, limit the impact of multidisciplinary care that occurs solely within the medical setting. Coordinated care that incorporates communication between the healthcare and community sectors is necessary to more effectively prevent and treat obesity. In this article, the Expert Exchange authors, with input from providers convened at an international pediatric meeting, provide recommendations to address this critical issue. These recommendations draw upon examples from the management of other chronic conditions that might be applied to the treatment of obesity, such as the use of care plans and health assessment forms to allow weight management specialists and community personnel (e.g., school counselors) to communicate about treatment recommendations and responses. To facilitate communication across the healthcare and community sectors, practical considerations regarding the development and/or evaluation of communication tools are presented. In addition, the use of technology to enhance healthcare-community communication is explored as a means to decrease the barriers to collaboration and to create a web of connection between the community and healthcare providers that promote wellness and a healthy weight status.

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia - a short version for primary care.

PubMed

Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas; Lieberman, Jeffrey; Glenthøj, Birte; Gattaz, Wagner F; Thibaut, Florence; Möller, Hans-Jürgen

2017-06-01

Schizophrenia is a severe mental disorder and many patients are treated in primary care settings. Apart from the pharmacological management of disease-associated symptoms, the detection and treatment of side effects is of the utmost importance in clinical practice. The purpose of this publication is to offer relevant evidence-based recommendations for the biological treatment of schizophrenia in primary care. This publication is a short and practice-oriented summary of Parts I-III of the World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia. The recommendations were developed by the authors and consented by a task force of international experts. Guideline recommendations are based on randomized-controlled trials and supplemented with non-randomized trials and meta-analyses where necessary. Antipsychotics of different chemical classes are the first-line pharmacological treatments for schizophrenia. Specific circumstances (e.g., suicidality, depression, substance dependence) may need additional treatment options. The pharmacological and non-pharmacological management of side effects is of crucial importance for the long-term treatment in all settings of the healthcare system. This summary of the three available evidence-based guidelines has the potential to support clinical decisions and can improve treatment of schizophrenia in primary care settings.

Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study

PubMed Central

2012-01-01

Background The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS) development and implementation and for knowledge management (KM) processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. Methods Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices. Results The team identified ten themes related to CDS and KM. These include: 1) workflow; 2) knowledge management; 3) data as a foundation for CDS; 4) user computer interaction; 5) measurement and metrics; 6) governance; 7) translation for collaboration; 8) the meaning of CDS; 9) roles of special, essential people; and 10) communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction. Conclusions These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors. PMID:22333210

Governance for clinical decision support: case studies and recommended practices from leading institutions

PubMed Central

Sittig, Dean F; Ash, Joan S; Bates, David W; Feblowitz, Joshua; Fraser, Greg; Maviglia, Saverio M; McMullen, Carmit; Nichol, W Paul; Pang, Justine E; Starmer, Jack; Middleton, Blackford

2011-01-01

Objective Clinical decision support (CDS) is a powerful tool for improving healthcare quality and ensuring patient safety; however, effective implementation of CDS requires effective clinical and technical governance structures. The authors sought to determine the range and variety of these governance structures and identify a set of recommended practices through observational study. Design Three site visits were conducted at institutions across the USA to learn about CDS capabilities and processes from clinical, technical, and organizational perspectives. Based on the results of these visits, written questionnaires were sent to the three institutions visited and two additional sites. Together, these five organizations encompass a variety of academic and community hospitals as well as small and large ambulatory practices. These organizations use both commercially available and internally developed clinical information systems. Measurements Characteristics of clinical information systems and CDS systems used at each site as well as governance structures and content management approaches were identified through extensive field interviews and follow-up surveys. Results Six recommended practices were identified in the area of governance, and four were identified in the area of content management. Key similarities and differences between the organizations studied were also highlighted. Conclusion Each of the five sites studied contributed to the recommended practices presented in this paper for CDS governance. Since these strategies appear to be useful at a diverse range of institutions, they should be considered by any future implementers of decision support. PMID:21252052

Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementation.

PubMed

Shiffman, Richard N; Michel, George; Essaihi, Abdelwaheb; Thornquist, Elizabeth

2004-01-01

A gap exists between the information contained in published clinical practice guidelines and the knowledge and information that are necessary to implement them. This work describes a process to systematize and make explicit the translation of document-based knowledge into workflow-integrated clinical decision support systems. This approach uses the Guideline Elements Model (GEM) to represent the guideline knowledge. Implementation requires a number of steps to translate the knowledge contained in guideline text into a computable format and to integrate the information into clinical workflow. The steps include: (1) selection of a guideline and specific recommendations for implementation, (2) markup of the guideline text, (3) atomization, (4) deabstraction and (5) disambiguation of recommendation concepts, (6) verification of rule set completeness, (7) addition of explanations, (8) building executable statements, (9) specification of origins of decision variables and insertions of recommended actions, (10) definition of action types and selection of associated beneficial services, (11) choice of interface components, and (12) creation of requirement specification. The authors illustrate these component processes using examples drawn from recent experience translating recommendations from the National Heart, Lung, and Blood Institute's guideline on management of chronic asthma into a workflow-integrated decision support system that operates within the Logician electronic health record system. Using the guideline document as a knowledge source promotes authentic translation of domain knowledge and reduces the overall complexity of the implementation task. From this framework, we believe that a better understanding of activities involved in guideline implementation will emerge.

Marijuana as medicine?

PubMed

Grodeck, B

1997-01-01

Recent laws in California and Arizona allow doctors to legally recommend marijuana for the pain and discomfort associated with AIDS and other serious illnesses. Federal authorities continue to oppose this legislation, and promise to prosecute physicians who recommend or prescribe the drug. A 1990 survey of cancer specialists showed that 54 percent were in favor of the law, and 44 percent had already broken the law by recommending marijuana to their patients.

Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients.

PubMed

Lucas, Philippe; Walsh, Zach

2017-04-01

In 2014 Health Canada replaced the Marihuana for Medical Access Regulations (MMAR) with the Marihuana for Medical Purposes Regulations (MMPR). One of the primary changes in the new program has been to move from a single Licensed Producer (LP) of cannabis to multiple Licensed Producers. This is the first comprehensive survey of patients enrolled in the MMPR. Patients registered to purchase cannabis from Tilray, a federally authorized Licenced Producer (LP) within the MMPR, were invited to complete an online survey consisting of 107 questions on demographics, patterns of use, and cannabis substitution effect. The survey was completed by 271 respondents. Cannabis is perceived to be an effective treatment for diverse conditions, with pain and mental health the most prominent. Findings include high self-reported use of cannabis as a substitute for prescription drugs (63%), particularly pharmaceutical opioids (30%), benzodiazepines (16%), and antidepressants (12%). Patients also reported substituting cannabis for alcohol (25%), cigarettes/tobacco (12%), and illicit drugs (3%). A significant percentage of patients (42%) reported accessing cannabis from illegal/unregulated sources in addition to access via LPs, and over half (55%) were charged to receive a medical recommendation to use cannabis, with nearly 25% paying $300 or more. The finding that patients report its use as a substitute for prescription drugs supports prior research on medical cannabis users; however, this study is the first to specify the classes of prescription drugs for which cannabis it is used as a substitute, and to match this substitution to specific diagnostic categories. The findings that some authorized patients purchase cannabis from unregulated sources and that a significant percentage of patients were charged for medical cannabis recommendations highlight ongoing policy challenges for this federal program. Copyright © 2017 Elsevier B.V. All rights reserved.

Chondrosarcoma of the temporomandibular joint: a case report and review of the literature.

PubMed

Oh, Kyu-Young; Yoon, Hye-Jung; Lee, Jae-Il; Hong, Sam-Pyo; Hong, Seong-Doo

2016-07-01

Chondrosarcoma is the second most common sarcoma arising in the bone, but it rarely involves the temporomandibular joint (TMJ). To date, 30 cases of TMJ chondrosarcoma have been reported in the English literature, and the authors report an additional case arising from a cystic lesion in a 60-year-old female patient. The clinical and radiological diagnosis of the lesion was initially synovial cyst, and periodic check-ups were done after aspiration of the lesion. After three years, the patient perceived swelling of the lesion, and surgical excision was performed. The final diagnosis was grade I chondrosarcoma. When clinicians detect a cystic lesion in the radiographic imaging of the TMJ, chondrosarcoma should be included in the differential diagnosis. In addition, computed tomography (CT) as well as magnetic resonance imaging (MRI) is recommended for the accurate diagnosis and proper preoperative planning in TMJ chondrosarcoma.

Mind the Scales: Harnessing Spatial Big Data for Infectious Disease Surveillance and Inference.

PubMed

Lee, Elizabeth C; Asher, Jason M; Goldlust, Sandra; Kraemer, John D; Lawson, Andrew B; Bansal, Shweta

2016-12-01

Spatial big data have the velocity, volume, and variety of big data sources and contain additional geographic information. Digital data sources, such as medical claims, mobile phone call data records, and geographically tagged tweets, have entered infectious diseases epidemiology as novel sources of data to complement traditional infectious disease surveillance. In this work, we provide examples of how spatial big data have been used thus far in epidemiological analyses and describe opportunities for these sources to improve disease-mitigation strategies and public health coordination. In addition, we consider the technical, practical, and ethical challenges with the use of spatial big data in infectious disease surveillance and inference. Finally, we discuss the implications of the rising use of spatial big data in epidemiology to health risk communication, and public health policy recommendations and coordination across scales. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

Integrated, Kerberized Login on MacOS X

NASA Technical Reports Server (NTRS)

Hotz, Henry B.

2006-01-01

Context for this information. MacOS X login process and available hooks. Authorization Services configuration. Authorization Services plug-in s. Kerberos plug-in s. Other bugs and recommendations. Authorization Services Called by loginwindow, screen saver and fast user switching. It calls Directory Services, Login Hook, and Login Items (System Preferences).

LARC2: Integrated Children's Services and the CAF Process

ERIC Educational Resources Information Center

Easton, Claire; Morris, Marian; Gee, Geoff

2010-01-01

The local authority research consortium (LARC), established in 2007, supports children's service authorities in using and conducting research to evaluate progress, to inform practice, share findings and make recommendations locally and nationally. This summary reports the collective findings of the 24 authorities involved in the LARC2 project…

Genotoxicity testing approaches for the safety assessment of substances used in food contact materials prior to their authorization in the European Union.

PubMed

Bolognesi, Claudia; Castoldi, Anna F; Crebelli, Riccardo; Barthélémy, Eric; Maurici, Daniela; Wölfle, Detlef; Volk, Katharina; Castle, Laurence

2017-06-01

Food contact materials are all materials and articles intended to come directly or indirectly into contact with food. Before being included in the positive European "Union list" of authorized substances (monomers, other starting substances and additives) for plastic food contact materials, the European Food Safety Authority (EFSA) must assess their safety "in use". If relevant for risk, the safety of the main impurities, reaction and degradation products originating from the manufacturing process is also evaluated. Information on genotoxicity is always required irrespective of the extent of migration and the resulting human exposure, in view of the theoretical lack of threshold for genotoxic events. The 2008 EFSA approach, requiring the testing of food contact materials in three in vitro mutagenicity tests, though still acceptable, is now superseded by the 2011 EFSA Scientific Committee's recommendation for only two complementary tests including a bacterial gene mutation test and an in vitro micronucleus test, to detect two main genetic endpoints (i.e., gene mutations and chromosome aberrations). Follow-up of in vitro positive results depends on the type of genetic effect and on the substance's systemic availability. In this study, we provide an analysis of the data on genotoxicity testing gathered by EFSA on food contact materials for the period 1992-2015. We also illustrate practical examples of the approaches that EFSA took when evaluating "non standard" food contact chemicals (e.g., polymeric additives, oligomer or other reaction mixtures, and nanosubstances). Additionally, EFSA's experience gained from using non testing methods and/or future possibilities in this area are discussed. Environ. Mol. Mutagen. 58:361-374, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Rigour of development does not AGREE with recommendations in practice guidelines on the use of ice for acute ankle sprains.

PubMed

Van de Velde, S; Heselmans, A; Donceel, P; Vandekerckhove, P; Ramaekers, D; Aertgeerts, B

2011-09-01

OBJECTIVE This study evaluated whether the Appraisal of Guidelines Research and Evaluation (AGREE) rigour of development score of practice guidelines on ice for acute ankle sprains is related to the convergence between recommendations. DESIGN The authors systematically reviewed guidelines on ice for acute ankle sprains. Four appraisers independently used the AGREE instrument to evaluate the rigour of development of selected guidelines. For each guideline, one reviewer listed the cited evidence on ice and calculated a cited evidence score. The authors plotted the recommended durations and numbers of ice applications over the standardised rigour of development score to explore the relationships. DATA SOURCES Three reviewers searched for guidelines in Medline, Embase, Sportdiscus, PEDro, G-I-N Guideline Library, Trip Database, SumSearch, National Guideline Clearinghouse and the Health Technology Assessment database, and conducted a web-based search for guideline development organisations. ELIGIBILITY CRITERIA Eligible guidelines had a development methodology that included a process to search or use results from scientific studies and the participation of an expert group to formulate recommendations. RESULTS The authors identified 21 guidelines, containing clinically significant variations in recommended durations and numbers of ice applications. The median standardised rigour of development score was 57% (IQR 18 to 77). Variations occurred evenly among guidelines with low moderate or high rigour scores. The median evidence citation score in the guidelines was 7% (IQR 0 to 61). CONCLUSIONS There is no relationship between the rigour of development score and the recommendations in guidelines on ice for acute ankle sprains. The guidelines suffered from methodological problems which were not captured by the AGREE instrument.

Assessing the relationship between Section 404 and wetland losses: a feasibility study

USGS Publications Warehouse

Gladwin, Douglas N.; Roelle, James E.; Asherin, Duane A.

1989-01-01

The primary objective of the Clean Water Act of 1977 (33 U.S.C. 1251) is to restore and maintain the physical, chemical, and biological integrity of the Nation's waters. Section 404 of the Act regulates the discharge of dredged or fill materials into wetlands and represents the primary Federal authority for regulation of wetland alterations. Since its inception, the Section 404 program has been controversial in regard to the extent to which it was intended to provide wetlands regulation. Section 404 requires those who wish to discharge dredged or fill material into waters of the United States, which include many wetlands, to first obtain a Federal permit. The Environmental Protection Agency (EPA) has overall responsibility for administration of the Section 404 program and promulgates guidelines that must be followed in issuing permits. In addition, EPA has the final authority to prohibit specific discharges if the environmental impacts are unacceptable. The U.S. Army Corps of Engineers (Corps) issues Section 404 permits, which can be of two types. Individual Permits are issued following case-by-case reviews of proposed discharges. General Permits, which can be either nationwide or regional in scope, are authorized by the Corps for categories of activities that are similar in nature and that have only minimal individual and cumulative adverse environmental impacts. EPA, the National Marine Fisheries Service (NMFS), the Fish and Wildlife Service (Service), and State natural resource agencies review and comment on permit applications and offer recommendations on appropriate mitigation measures. Although comments from the Service and other natural resource agencies are advisory in nature (EPA's veto authority excepted), they can serve as the basis for modifying, conditioning, or denying a Section 404 permit. In 1986, in a survey conducted by the National Ecology Research Center, Service personnel indicated interest in additional information concerning both wetland trends and the impacts of activities authorized by the Corps under Section 404 (Roelle 1986). Although there is some information concerning wetland losses for certain geographic areas and for the Nation as a whole (Frayer et al. 1983; Tiner 1984), there appears to be little information on how these losses relate to the Section 404 permitting process. The primary objective of this study was to determine the feasibility of estimating wetland losses in relationship to Individual and General Permits issued under Section 404. A secondary objective was to assemble data on acceptance and implementation of specific mitigation recommendations offered by the Service and other natural resource agencies in connection with development activities on wetlands examined. At present, 26 categories of Nationwide permits have been authorized by the Corps. Nationwide permit 26 was of particular interest in this study because it specifically authorizes discharges into wetlands under certain circumstances (see Figure 1 and related text for a more complete discussion of circumstances under which Nationwide Permit 26 is applicable). All subsequent references to Nationwide or General permits pertain to Nationwide Permit 26.

Starlink Document Styles

NASA Astrophysics Data System (ADS)

Lawden, M. D.

This document describes the various styles which are recommended for Starlink documents. It also explains how to use the templates which are provided by Starlink to help authors create documents in a standard style. This paper is concerned mainly with conveying the ``look and feel" of the various styles of Starlink document rather than describing the technical details of how to produce them. Other Starlink papers give recommendations for the detailed aspects of document production, design, layout, and typography. The only style that is likely to be used by most Starlink authors is the Standard style.

A Framework for Measurement Feedback to Improve Decision-Making in Mental Health

PubMed Central

Chorpita, Bruce F.; Reay, William E.; Stelk, Wayne; Garland, Ann F.; Kutash, Krista; Mullican, Charlotte; Ringeisen, Heather

2009-01-01

The authors present a multi-level framework for conceptualizing and designing measurement systems to improve decision-making in the treatment and prevention of child and adolescent mental health problems as well as the promotion of well-being. Also included is a description of the recommended drivers of the development and refinement of these measurement systems and the importance of the architecture upon which these measurement systems are built. The authors conclude with a set of recommendations for the next steps for the field. PMID:20041342

Do Managers Clone Themselves?

ERIC Educational Resources Information Center

Baron, Alma S.

1981-01-01

A recent questionnaire survey provides statistics on male managers' views of female managers. The author recommends that male managers break out of their cloning behavior and that the goal ought to be a plurality in management. (Author/WD)

Time trends in alcohol intake in early pregnancy and official recommendations in Denmark, 1998-2013.

PubMed

Kesmodel, Ulrik S; Petersen, Gitte L; Henriksen, Tine B; Strandberg-Larsen, Katrine

2016-07-01

In 1999, Danish health authorities modified their recommendation to pregnant women, condoning some alcohol intake. In 2007, the recommendation was changed to one of alcohol abstention. We aimed to assess changes in average alcohol intake (drinks/week) and alcohol binge drinking in early pregnancy from 1998 to 2013 in relation to the changes in official recommendations in 1999 (condoning some intake) and 2007 (abstention). All Danish-speaking pregnant women attending routine antenatal care at the Department of Obstetrics and Gynecology, Aarhus University Hospital, Denmark, between September 1998 and June 2013 were invited to participate. During the study period, 68 395 pregnant women filled in a self-administered questionnaire at gestational week 11 (median). From 1998, questions on binge drinking included data on the number of binge episodes (≥5 drinks on a single occasion), and the timing (gestational week) of these episodes. Additional questions on binge drinking defined as ≥3 drinks on a single occasion were asked separately from 2000. A question assessed the average number of alcohol-containing drinks per week the woman consumed currently at the time of filling in the questionnaire. From 1998 to 2013 the proportion of women reporting no alcohol intake increased from 31.2 to 83.3% (p < 0.001), the main decline occurring between 1998 and 2007. The proportion of binge drinkers decreased (p < 0.001) but remained more stable across the period. The decline in the proportion of pregnant women consuming alcohol occurred independently of official recommendations. Increasing national and international awareness may partly explain the changes. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

ICH E14 Q & A (R1) document: perspectives on the updated recommendations on thorough QT studies.

PubMed

Shah, Rashmi R; Morganroth, Joel

2013-04-01

The International Conference on Harmonization (ICH) guidance ICH E14 provides recommendations, focusing on a clinical 'thorough QT/QTc (TQT) study', to evaluate the QT liability of a drug during its development. An Implementation Working Group (IWG) was also established to assist the sponsors with any uncertainties and clarify any ambiguities. In April 2012, the IWG updated its June 2008 version of the Questions and Answers document to address additional issues. These include the gender of the study population, a reasonable approach to evaluating QTc changes in late stage clinical development and the recommended approach to correcting the measured QT interval. This commentary provides our observations and, when appropriate, recommendations, on these issues. We review briefly evidence that suggests that (i) the greater QT effect observed in females is not entirely related to differences in drug exposure and (ii) the Fridericia correction of measured QT interval is adequate for a majority of TQT studies. Until further evidence suggests otherwise, we recommend balanced gender representation in TQT studies, unless warranted otherwise, and for positive studies, subgroup analysis of key data by common demographic variables including the gender and ethnicity. We provide a general scheme for ECG monitoring in late phase clinical trials and consider that while intensive monitoring and centralized reading of ECGs in late phase clinical trials is the norm when a TQT study is positive, there are other circumstances that also call for high quality ECG reading. Therefore, locally read ECGs should only be acceptable as long as accurate high quality ECG data can be guaranteed. © 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

Mercedes Benz pattern craniosynostosis.

PubMed

Rhodes, Jennifer L; Kolar, John C; Fearon, Jeffrey A

2010-01-01

The complex craniosynostoses, which include all nonsyndromic multiple sutural fusions, represent a small fraction of patients presenting with craniosynostosis. Among these are a trisutural fusion, dubbed the "Mercedes Benz pattern," involving the sagittal and both lambdoid sutures. The purpose of this report is to review the authors' series of this unusual form of craniosynostosis, to identify associated anomalies, and to assess treatment outcomes. The authors conducted a retrospective clinical outcome assessment of all patients presenting with Mercedes Benz pattern craniosynostosis. Growth was assessed by direct anthropologic measurements, and significance was assessed by the t test. Over a 17-year period, 11 of 802 patients presenting with craniosynostosis were identified with Mercedes Benz pattern synostosis (1.4 percent). Three patients had additional sutural involvement and two had identifiable genetic syndromes. Seven of 11 (64 percent) had cerebellar tonsillar herniation on preoperative imaging, and four symptomatic patients (36 percent) have required Chiari decompressions. Three patients have required more than one remodeling procedure. Serial postoperative anthropologic measurements identified progressive brachycephaly, with diminished growth in both head circumference and skull length (mean follow-up, 3.75 years). Cognitive function was grossly normal, except for one syndromic patient. Despite fusion of the sagittal suture, the surgical treatment for Mercedes Benz pattern craniosynostosis should include skull lengthening, not reduction. The authors' findings for diminished postoperative growth suggest that an overcorrection be considered. Fourth or fifth sutural involvement correlated with additional corrections. Given the observed high incidence for symptomatic cerebellar tonsillar herniation, routine magnetic resonance evaluations are recommended for affected individuals.

[The effect of daily controlled oral hygiene on the oral health of children in a town with drinking water fluoridation (Karl Marx Stadt)].

PubMed

Georgi, J; Künzel, W

1976-03-01

Under the conditions of an optimized (with regard to caries prevention) fluoride content of the drinking uater, the authors studied (in the framework of an oral hygiene measure covering 32 months) in 149 children 6.5-8 years of age the effects of supervised daily dental and oral care on dental health. The improvement in oral hygiene (OHI) by 33% is in harmony with an additional caries reduction by 33.3% (DMF/S index) and a decrease of the PM index by 47%. A wider use of oral hygiene actions as secondary preventive measures is, therefore, recommended also for towns with fluoridated drinking water.

The use of oxygen in cluster headache treatment worldwide - a survey of the International Headache Society (IHS).

PubMed

Evers, Stefan; Rapoport, Alan

2017-04-01

Background Oxygen is recommended for the treatment of acute cluster headache attacks. However, it is not available worldwide. Methods The International Headache Society performed a survey among its national member societies on the availability and the restrictions for oxygen in the treatment of cluster headache. Results Oxygen is reimbursed in 50% of all countries responding ( n = 22). There are additional restrictions in the reimbursement of the facial mask and with respect to age. Conclusion Oxygen for the treatment of cluster headache attack is not reimbursed worldwide. Headache societies should pressure national/public health authorities to reimburse oxygen for cluster headache in all countries.

Evaluation and development of integrated technology of rare metal concentrate production in high-level ore processing at Zashikhinsk deposit

NASA Astrophysics Data System (ADS)

Khokhulya, MS; Mukhina, TN; Ivanova, V. A.; Mitrofanova, G. V.; Fomin, A. V.; Sokolov, VD

2017-02-01

The authors discuss material constitution of columbite ore sample and recommend optimized pretreatment modes to obtain ball milling products at the maximum dissociation of ore minerals in aggregates. A concentration technology is proposed, with division of material into two flows -0.315 mm and -0.2 mm in sizes, generated in the milling and screening cycles and subjected to gravity-magnetic and magnetic-gravity treatment, respectively. It is shown that the technology ensures production of both tantalum-niobium and zircon concentrates. It has become possible to additionally recover rare metal components Nb2O5 and ZrO2 from tailings through flotation.

PROJECT W-551 INTERIM PRETREATMENT SYSTEM PRECONCEPTUAL CANDIDATE TECHNOLOGY DESCRIPTIONS

DOE Office of Scientific and Technical Information (OSTI.GOV)

MAY TH

The Office of River Protection (ORP) has authorized a study to recommend and select options for interim pretreatment of tank waste and support Waste Treatment Plant (WTP) low activity waste (LAW) operations prior to startup of all the WTP facilities. The Interim Pretreatment System (IPS) is to be a moderately sized system which separates entrained solids and 137Cs from tank waste for an interim time period while WTP high level waste vitrification and pretreatment facilities are completed. This study's objective is to prepare pre-conceptual technology descriptions that expand the technical detail for selected solid and cesium separation technologies. This revisionmore » includes information on additional feed tanks.« less

Le Fort I Maxillary Advancement Using Distraction Osteogenesis

PubMed Central

Combs, Patrick D.; Harshbarger, Raymond J.

2014-01-01

Treatment of maxillary hypoplasia has traditionally involved conventional Le Fort I osteotomies and advancement. Advancements of greater than 10 mm risk significant relapse. This risk is greater in the cleft lip and palate population, whose anatomy and soft tissue scarring from prior procedures contributes to instability of conventional maxillary advancement. Le Fort I advancement with distraction osteogenesis has emerged as viable, stable treatment modality correction of severe maxillary hypoplasia in cleft, syndromic, and noncleft patients. In this article, the authors provide a review of current data and recommendations concerning Le Fort I advancement with distraction osteogenesis. In addition, they outline their technique for treating severe maxillary hypoplasia with distraction osteogenesis using internal devices. PMID:25383054

Employer involvement in defined contribution investment education.

PubMed

Blau, G; VanDerhei, J L

2000-01-01

In this paper the authors consider the personnel problems that may arise for defined contribution plan sponsors if major market corrections cause older employees to delay retirement beyond previous expectations. We move from that basic premise to argue that, given the continued evolution from defined benefit (DB) to defined contribution (DC) retirement plans, employers need to be more "proactive" in educating their employees about their retirement planning. A human resources perspective is used to support this argument, apart from and in addition to legal considerations such as ERISA Section 404(c). Specifics of employer involvement and its place as a component of an organization's culture are discussed. Finally, recommendations are given for employers to consider.

BRIGHTEN YOUR CORNER, BROADCAST NO. 7464. UNIVERSITY EXPLORER.

ERIC Educational Resources Information Center

LEVY, CHARLES; HOWE, WILLIAM

LIGHTING RECOMMENDATIONS ALONG WITH DESIGN IMPLICATIONS ARE DISCUSSED. COMMENTS OF SEVERAL LEADING LIGHTING AUTHORITIES ARE INCLUDED. A SERIES OF LIGHTING CONSIDERATIONS RECOMMENDS--(1) CHILDREN CAN ACQUIRE AN AWARENESS OF THEIR LUMINOUS ENVIRONMENT THROUGH EARLY TRAINING, (2) INTENSITY, DISTRIBUTION, HORIZONTAL OR VERTICAL POLARIZATION AND THE…

77 FR 55180 - Bridger-Teton Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... collaborative relationships and to provide advice and recommendations to the Forest Service concerning projects... the meeting is to review and recommend projects authorized under Title II of the Act. DATES: The... into the building to view comments. FOR FURTHER INFORMATION CONTACT: Adam Mendonca, Greys River...

48 CFR 1319.505 - Rejecting Small Business Administration recommendations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Rejecting Small Business... COMMERCE SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 1319.505 Rejecting Small Business Administration recommendations. (a) The designee authorized to render a decision on the...

48 CFR 1319.505 - Rejecting Small Business Administration recommendations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Rejecting Small Business... COMMERCE SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 1319.505 Rejecting Small Business Administration recommendations. (a) The designee authorized to render a decision on the...

48 CFR 1319.505 - Rejecting Small Business Administration recommendations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Rejecting Small Business... COMMERCE SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 1319.505 Rejecting Small Business Administration recommendations. (a) The designee authorized to render a decision on the...

Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations.

PubMed

Sommers, Juultje; Engelbert, Raoul H H; Dettling-Ihnenfeldt, Daniela; Gosselink, Rik; Spronk, Peter E; Nollet, Frans; van der Schaaf, Marike

2015-11-01

To develop evidence-based recommendations for effective and safe diagnostic assessment and intervention strategies for the physiotherapy treatment of patients in intensive care units. We used the EBRO method, as recommended by the 'Dutch Evidence Based Guideline Development Platform' to develop an 'evidence statement for physiotherapy in the intensive care unit'. This method consists of the identification of clinically relevant questions, followed by a systematic literature search, and summary of the evidence with final recommendations being moderated by feedback from experts. Three relevant clinical domains were identified by experts: criteria to initiate treatment; measures to assess patients; evidence for effectiveness of treatments. In a systematic literature search, 129 relevant studies were identified and assessed for methodological quality and classified according to the level of evidence. The final evidence statement consisted of recommendations on eight absolute and four relative contra-indications to mobilization; a core set of nine specific instruments to assess impairments and activity restrictions; and six passive and four active effective interventions, with advice on (a) physiological measures to observe during treatment (with stopping criteria) and (b) what to record after the treatment. These recommendations form a protocol for treating people in an intensive care unit, based on best available evidence in mid-2014. © The Author(s) 2015.

Assessing network scale-up estimates for groups most at risk of HIV/AIDS: evidence from a multiple-method study of heavy drug users in Curitiba, Brazil.

PubMed

Salganik, Matthew J; Fazito, Dimitri; Bertoni, Neilane; Abdo, Alexandre H; Mello, Maeve B; Bastos, Francisco I

2011-11-15

One of the many challenges hindering the global response to the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic is the difficulty of collecting reliable information about the populations most at risk for the disease. Thus, the authors empirically assessed a promising new method for estimating the sizes of most at-risk populations: the network scale-up method. Using 4 different data sources, 2 of which were from other researchers, the authors produced 5 estimates of the number of heavy drug users in Curitiba, Brazil. The authors found that the network scale-up and generalized network scale-up estimators produced estimates 5-10 times higher than estimates made using standard methods (the multiplier method and the direct estimation method using data from 2004 and 2010). Given that equally plausible methods produced such a wide range of results, the authors recommend that additional studies be undertaken to compare estimates based on the scale-up method with those made using other methods. If scale-up-based methods routinely produce higher estimates, this would suggest that scale-up-based methods are inappropriate for populations most at risk of HIV/AIDS or that standard methods may tend to underestimate the sizes of these populations.

45 CFR 1801.23 - Recommendation by panel.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Recommendation by panel. 1801.23 Section 1801.23... HARRY S. TRUMAN SCHOLARSHIP PROGRAM The Competition § 1801.23 Recommendation by panel. (a) Each Panel is... recommend additional Scholars from the States in its region. (b) A panel's recommendations are based on the...

45 CFR 1801.23 - Recommendation by panel.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Recommendation by panel. 1801.23 Section 1801.23... HARRY S. TRUMAN SCHOLARSHIP PROGRAM The Competition § 1801.23 Recommendation by panel. (a) Each Panel is... recommend additional Scholars from the States in its region. (b) A panel's recommendations are based on the...

The case for full practice authority.

PubMed

Holmes, Olivia; Kinsey-Weathers, Shanieka

2016-03-01

The Institute of Medicine (IOM) recommended in its 2010 report on the future of nursing that advanced practice registered nurses (APRNs) should factor prominently in providing care to the millions of Americans who access healthcare services under the Affordable Care Act (ACA). The IOM also recommended that APRNs practice to the full extent of their education and training.However, many states have laws in place that limit full practice authority for APRNs, specifically NPs, in providing basic health services such as primary care. These laws place restrictions on independent practice and Medicaid and Medicare reimbursement, which prevent nurses from “responding effectively to rapidly changing health care settings and an evolving health care system.” Less than half of the United States has adopted full practice authority licensure and practice laws (see APRN practice authority at a glance). This article discusses how the primary care needs of millions of Americans can be met by granting full practice authority to APRNs nationwide and provides evidence to support the high level of care these practitioners can provide independently.

Getting Students to Read: New Materials and Methods.

ERIC Educational Resources Information Center

Matthews, Dorothy, Ed.

1987-01-01

Focusing on young adult reading and instruction, this issue addresses teachers' concerns about recommended recent authors and books, integrating independent reading into the reading program, and student motivation. The titles of the articles and their authors are as follows: (1) "Some YA Authors Worth Knowing, and a Few Books, Too" (Ken Donelson);…

38 CFR 2.6 - Secretary's delegations of authority to certain officials (38 U.S.C. 512).

Code of Federal Regulations, 2011 CFR

2011-07-01

... selection recommendations submitted to the Secretary by the Under Secretary for Health, the Under Secretary... are delegated authority as indicated: (a) Veterans Health Administration. The Under Secretary for Health is delegated authority: (1) To act on all matters assigned to the Veterans Health Administration...

Biochemia Medica's editorial policy on authorship.

PubMed

Supak-Smolcic, Vesna; Simundic, Ana-Maria

2015-01-01

Recent findings of authorship criteria violations in the manuscripts submitted to Biochemia Medica show that almost 40% of authors do not meet necessary criteria for authorship and thus indicate the need for better dissemination of editorial policy on authorship in our journal. We believe that such cases are mostly due to the authors' unawareness or the lack of understanding of the authorship criteria. With this article we therefore wish to declare our editorial policy on authorship and authorship criteria. Biochemia Medica endorses the authorship policy provided by the International Committee of Medical Journal Editors (ICMJE). Information on authorship is assessed by self-reported authorship claims during on-line manuscript submission. Those who meet ICMJE criteria shall be listed as authors, and all listed authors shall fulfill ICMJE criteria. All authors should be responsible for content of the article and have to know other authors' contributions to the study. Biochemia Medica will follow recommendations provided by Committee on Publication Ethics (COPE) flowcharts for possible disputes. By adhering to this procedure we hope to raise awareness about the importance of compliance with ICMJE authorship recommendations.

Evaluation Design Recommendations for the Certified Community Behavioral Health Clinic Demonstration Program.

PubMed

Breslau, Joshua; Ashwood, J Scott; Kase, Courtney Ann; Pincus, Harold Alan; Lovejoy, Susan L

2017-06-01

This article provides information and recommendations regarding the evaluation design of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Mandated by Congress in Section 223 of the Protecting Access to Medicare Act of 2014, the CCBHC is a new model of specialty behavioral health clinic, designed to provide comprehensive and integrated care for adults with mental health or substance-use disorders and children with serious emotional distress. Certification criteria for the CCBHCs have been specified by Substance Abuse and Mental Health Services Administration covering six core areas: staffing; accessibility; care coordination; scope of services; quality and other reporting; and organizational authority, governance, and accreditation. In addition, services provided to Medicaid enrollees in CCBHCs will be reimbursed through one of two alternative prospective payment systems. At present, 24 states have been awarded grants to begin the planning process for implementing CCBHCs. Of these states, eight will be selected to participate in the demonstration project beginning in January 2017. Results from the evaluation will inform mandated reports to Congress over the two-year demonstration period and the three years following the end of the demonstration, providing information to policymakers on the program's impact and value. In addition, the results can inform the direction of future efforts at integration of behavioral health into the health care system at this critical time of transformation.

A Conceptual Framework for Evolving, Recommender Online Learning Systems

ERIC Educational Resources Information Center

Peiris, K. Dharini Amitha; Gallupe, R. Brent

2012-01-01

A comprehensive conceptual framework is developed and described for evolving recommender-driven online learning systems (ROLS). This framework describes how such systems can support students, course authors, course instructors, systems administrators, and policy makers in developing and using these ROLS. The design science information systems…

Calcium Intake: A Lifelong Proposition.

ERIC Educational Resources Information Center

Amschler, Denise H.

1985-01-01

This article reviews the current problem of low calcium intake in the United States among all age groups, the role of calcium in the formation and maintenance of bone mass, and major factors influencing absorption. Osteoporosis is discussed, and current recommendations for Recommended Dietary allowance are provided. (Author/MT)

77 FR 48948 - Sierra County Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-15

... Community Self-Determination Act (Pub. L. 112-141) (the Act) and operates in compliance with the Federal... provide advice and recommendations to the Forest Service concerning projects and funding consistent with... and recommend projects authorized under title II of the Act. DATES: The meetings will be held...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Diamond, P.

Monsanto Corp., a factory where monochlorobenzene (MCB) was produced; was surveyed. The factory employed 1300 persons, including 14 workers involved in MCB production. The factory produced over 100,000,000 pounds of MCB in a year. The MCB process equipment was outdoors, and no ventilation system was noted. Equipment consisted of a 10-year-old closed system. During most of the operation, the workers remained indoors in a control-room block house located in the middle of the MCB production facility. A portable, total organic vapor analyzer was used to sample vapor concentrations on the walk-through survey. Less than 3 parts per million (ppm) totalmore » hydrocarbons, calibrated as MCB were detected. Charcoal tube air samples were also collected for 4.5 hours in the MCB area. They were in the 1 to 2ppm range for benzene and MCB. The author concludes that there is insignificant exposure to MCB, but that the facility requires further investigation. The author recommends additional monitoring to determine combined solvent exposure and exposure to nitrochlorobenzene, one of the products derived from MCB.« less

Nonlesions, misdiagnoses, missed diagnoses, and other interpretive challenges in fish histopathology studies: a guide for investigators, authors, reviewers, and readers

USGS Publications Warehouse

Wolf, Jeffrey C.; Baumgartner, Wes A.; Blazer, Vicki; Camus, Alvin C.; Engelhardt, Jeffrey A.; Fournie, John W.; Frasca, Salvatore; Groman, David B.; Kent, Michael L.; Khoo, Lester H.; Law, Jerry M.; Lombardini, Eric D.; Ruehl-Fehlert, Christine; Segner, Helmut E.; Smith, Stephen A.; Spitsbergen, Jan M.; Weber, Klaus; Wolfe, Marilyn J.

2015-01-01

Differentiating salient histopathologic changes from normal anatomic features or tissue artifacts can be decidedly challenging, especially for the novice fish pathologist. As a consequence, findings of questionable accuracy may be reported inadvertently, and the potential negative impacts of publishing inaccurate histopathologic interpretations are not always fully appreciated. The objectives of this article are to illustrate a number of specific morphologic findings in commonly examined fish tissues (e.g., gills, liver, kidney, and gonads) that are frequently either misdiagnosed or underdiagnosed, and to address related issues involving the interpretation of histopathologic data. To enhance the utility of this article as a guide, photomicrographs of normal and abnormal specimens are presented. General recommendations for generating and publishing results from histopathology studies are additionally provided. It is hoped that the furnished information will be a useful resource for manuscript generation, by helping authors, reviewers, and readers to critically assess fish histopathologic data.

L'Aquila's reconstruction challenges: has Italy learned from its previous earthquake disasters?

PubMed

Ozerdem, Alpaslan; Rufini, Gianni

2013-01-01

Italy is an earthquake-prone country and its disaster emergency response experiences over the past few decades have varied greatly, with some being much more successful than others. Overall, however, its reconstruction efforts have been criticised for being ad hoc, delayed, ineffective, and untargeted. In addition, while the emergency relief response to the L'Aquila earthquake of 6 April 2009-the primary case study in this evaluation-seems to have been successful, the reconstruction initiative got off to a very problematic start. To explore the root causes of this phenomenon, the paper argues that, owing to the way in which Italian Prime Minister Silvio Berlusconi has politicised the process, the L'Aquila reconstruction endeavour is likely to suffer problems with local ownership, national/regional/municipal coordination, and corruption. It concludes with a set of recommendations aimed at addressing the pitfalls that may confront the L'Aquila reconstruction process over the next few years. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

A small effect of adding antiviral agents in treating patients with severe Bell palsy.

PubMed

van der Veen, Erwin L; Rovers, Maroeska M; de Ru, J Alexander; van der Heijden, Geert J

2012-03-01

In this evidence-based case report, the authors studied the following clinical question: What is the effect of adding antiviral agents to corticosteroids in the treatment of patients with severe or complete Bell palsy? The search yielded 250 original research articles. The 6 randomized trials of these that could be used all reported low-quality data for answering the clinical question; apart from apparent flaws, they did not primarily include patients with severe or complete Bell palsy. Complete functional facial nerve recovery was seen in 75% of the patients receiving prednisolone only and in 83% with additional antiviral treatment. The pooled risk difference of 7% (95% confidence interval, -1% to 15%) results in a number needed to treat of 14 (ie, slightly favors adding an antiviral agent). The authors conclude that although a strong recommendation for adding antiviral agents to corticosteroids to further improve the recovery of patients with severe Bell palsy is precluded by the lack of robust evidence, it should be discussed with the patient.

Accelerated Stability Studies on Dried Extracts of Centella asiatica Through Chemical, HPLC, HPTLC, and Biological Activity Analyses.

PubMed

Kaur, Ishtdeep; Suthar, Nancy; Kaur, Jasmeen; Bansal, Yogita; Bansal, Gulshan

2016-10-01

Regulatory guidelines recommend systematic stability studies on a herbal product to establish its shelf life. In the present study, commercial extracts (Types I and II) and freshly prepared extract (Type III) of Centella asiatica were subjected to accelerated stability testing for 6 months. Control and stability samples were evaluated for organoleptics, pH, moisture, total phenolic content (TPC), asiatic acid, kaempherol, and high-performance thin layer chromatography fingerprints, and for antioxidant and acetylcholinesterase inhibitory activities. Markers and TPC and both the activities of each extract decreased in stability samples with respect to control. These losses were maximum in Type I extract and minimum in Type III extract. Higher stability of Type III extract than others might be attributed to the additional phytoconstituents and/or preservatives in it. Pearson correlation analysis of the results suggested that TPC, asiatic acid, and kaempferol can be taken as chemical markers to assess chemical and therapeutic shelf lives of herbal products containing Centella asiatica. © The Author(s) 2016.

Risk factors, diagnosis and non-surgical treatment for meniscal tears: evidence and recommendations: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF).

PubMed

Thorlund, Jonas Bloch; Juhl, Carsten Bogh; Ingelsrud, Lina Holm; Skou, Søren Thorgaard

2018-05-01

This statement aimed at summarising and appraising the available evidence for risk factors, diagnostic tools and non-surgical treatments for patients with meniscal tears. We systematically searched electronic databases using a pragmatic search strategy approach. Included studies were synthesised quantitatively or qualitatively, as appropriate. Strength of evidence was determined according to the Grading of Recommendations Assessment Development and Evaluation framework. Low-quality evidence suggested that overweight (degenerative tears, k=3), male sex (k=4), contact and pivoting sports (k=2), and frequent occupational kneeling/squatting (k=3) were risk factors for meniscal tears. There was low to moderate quality evidence for low to high positive and negative predictive values, depending on the underlying prevalence of meniscal tears for four common diagnostic tests (k=15, n=2474). Seven trials investigated exercise versus surgery (k=2) or the effect of surgery in addition to exercise (k=5) for degenerative meniscal tears. There was moderate level of evidence for exercise improving self-reported pain (Effect Size (ES)-0.51, 95% CI -1.16 to 0.13) and function (ES -0.06, 95% CI -0.23 to 0.11) to the same extent as surgery, and improving muscle strength to a greater extent than surgery (ES -0.45, 95% CI -0.62 to -0.29). High-quality evidence showed no clinically relevant effect of surgery in addition to exercise on pain (ES 0.18, 95% 0.05 to 0.32) and function (ES, 0.13 95% CI -0.03 to 0.28) for patients with degenerative meniscal tears. No randomised trials comparing non-surgical treatments with surgery in patients younger than 40 years of age or patients with traumatic meniscal tears were identified. Diagnosis of meniscal tears is challenging as all clinical diagnostic tests have high risk of misclassification. Exercise therapy should be recommended as the treatment of choice for middle-aged and older patients with degenerative meniscal lesions. Evidence on the best treatment for young patients and patients with traumatic meniscal tears is lacking. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Critical Analysis of Strategies for Determining Rigor in Qualitative Inquiry.

PubMed

Morse, Janice M

2015-09-01

Criteria for determining the trustworthiness of qualitative research were introduced by Guba and Lincoln in the 1980s when they replaced terminology for achieving rigor, reliability, validity, and generalizability with dependability, credibility, and transferability. Strategies for achieving trustworthiness were also introduced. This landmark contribution to qualitative research remains in use today, with only minor modifications in format. Despite the significance of this contribution over the past four decades, the strategies recommended to achieve trustworthiness have not been critically examined. Recommendations for where, why, and how to use these strategies have not been developed, and how well they achieve their intended goal has not been examined. We do not know, for example, what impact these strategies have on the completed research. In this article, I critique these strategies. I recommend that qualitative researchers return to the terminology of social sciences, using rigor, reliability, validity, and generalizability. I then make recommendations for the appropriate use of the strategies recommended to achieve rigor: prolonged engagement, persistent observation, and thick, rich description; inter-rater reliability, negative case analysis; peer review or debriefing; clarifying researcher bias; member checking; external audits; and triangulation. © The Author(s) 2015.

Israeli nurses' attitudes to the holistic approach to health and their use of complementary and alternative therapies.

PubMed

Orkaby, Brurya; Greenberger, Chaya

2015-03-01

To examine nurses' attitudes to holistic and biomedical approaches to health care and the correlation between the two and to explore the extent of recommending and using complementary and alternative medicine (CAM) by nurses and its correlation with attitudes toward the holistic approach to care. In this cross-sectional correlational study, a structured questionnaire was completed anonymously by 213 Israeli hospital-based nurses from various departments. Nurses perceived both approaches as critical to optimal health care: a positive correlation emerged of attitudes to the two approaches. Nurses recommended and used CAM extensively; most therapies were recommended and/or used by 70% or more of the respondents. Nurses with more positive attitudes toward holistic care tended to recommend and use CAM to a greater extent. Biomedical and holistic approaches are perceived by nurses to coexist within nursing professional boundaries and form a broad basis for optimal health care. Nurses' attitudes to the holistic approach appear to promote recommendation and/or use of CAM in practice. More training in CAM should be offered in nursing educational frameworks and research should continue to establish evidence for CAM's effectiveness. © The Author(s) 2014.

High self-assessment of disability and the surgeon's recommendation against surgical intervention may negatively impact satisfaction scores in patients with spinal disorders.

PubMed

Mazur, Marcus D; McEvoy, Sara; Schmidt, Meic H; Bisson, Erica F

2015-06-01

OBJECT Patient satisfaction scores have become a common metric for health care quality. Because satisfaction scores are right-skewed, even small differences in mean scores can have a large impact. Little information, however, is available on the specific factors that play a role in satisfaction in patients with spinal disorders. The authors investigated whether disability severity and the surgeon's recommendation for or against surgical intervention were associated with patient satisfaction scores. METHODS The authors conducted a retrospective cohort study involving adult patients who were referred to a spine surgeon for an outpatient evaluation of back pain. Patients completed the Oswestry Disability Index (ODI) before their clinic appointment and a Press Ganey patient satisfaction survey after their visit. Patients were grouped by self-assessed disability severity: mild to moderate (ODI < 40%) and severe (≥ 40%). Satisfaction scores were graded from 0 (very poor) to 100 (very good). Nonparametric tests were used to evaluate the association between patient satisfaction and current disability self-assessment. The authors also investigated whether the surgeon's recommendation against surgery negatively affected patient satisfaction. RESULTS One hundred thirty patients completed the ODI questionnaire before and satisfaction surveys after seeing a spine surgeon for a new outpatient back pain consultation. Of these, 68 patients had severe disability, 62 had mild to moderate disability, 67 received a recommendation for surgery, and 63 received a recommendation against surgery. Composite satisfaction scores were lower among patients who had severe disability than among those with mild to moderate disability (median [interquartile range]: 91.7 [83.7-96.4] vs 95.8 [91.0-99.3], respectively; p = 0.0040). Patients who received a recommendation against surgery reported lower satisfaction scores than those who received a recommendation for surgery (91.7 [83.5-95.8] vs 95.8 [88.5-99.8]; p = 0.0059). CONCLUSIONS High self-assessment of disability and a surgeon's recommendation against surgical intervention are associated with lower satisfaction scores in patients with spinal disorders.

[Historical trauma. Systematic review of a different approach to armed conflict].

PubMed

Borda Bohigas, Juan Pablo; Carrillo, Juan O; Garzón, Daniel F; Ramírez, María P; Rodríguez, Nicolás

2015-01-01

Historical trauma (HT) is a collective trauma inflicted on a group of people who share an identity or affiliation, and is often characterized by the transgenerational legacy of traumatic experiences, and expressed through various psychological and social responses. This construct is proposed in contrast to post-traumatic stress disorder (PTSD) due to limitations identified with the latter diagnostic category when addressing collective trauma, especially in situations of political and social violence. The purpose of this article is to review the literature published so far on HT. A search was performed using the terms "historical trauma" and "mental health" or "trauma histórico" and "salud mental" in the scientific databases, EMBASE, Ebscohost, JSTOR, ProQuest, LILACS, SciELO, PsycARTICLES, ISI Web of Science and PubMed. The authors reviewed HT definition, paramount characteristics of its traumatic experience, and several theories of on the transgenerational succession if these experiences occur, as well as possible consequences of traumatic events at individual, family and social level. Common characteristics of different therapeutic models are highlighted, in addition to some recommendations for their application. PTSD has clear limitations in addressing community and cumulative traumatic experiences related to specific social and historical contexts. The authors discuss the potential utility of HT in this task. Finally, several gaps in current knowledge regarding this construct are mentioned, and some recommendations for future research are indicated. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Interval Exercise Therapy for Type 2 Diabetes.

PubMed

Hamasaki, Hidetaka

2018-01-01

Regular exercise improves glycemic control and reduces cardiovascular risk and mortality in patients with type 2 diabetes. Continuous moderate- to high-intensity exercise has been recommended to manage type 2 diabetes; however, only approximately 30% of diabetic patients achieve the recommended levels of physical activity. The reasons for not engaging in regular exercise vary; however, one of the common reasons is lack of time. Recently, the effectiveness of shortduration interval exercise such as high-intensity interval training and interval walking has been observed. Thus, the author aimed to summarize the current knowledge and discuss recent literature regarding the effects of interval exercise therapy in type 2 diabetes. The author searched the English literature on interval training and type 2 diabetes using Pub- Med. A total of 8 studies met the criteria. Interval exercise is feasible and effective in obtaining glycemic control in patients with type 2 diabetes. It may also improve body composition, insulin sensitivity, aerobic capacity, and oxidative stress more effectively than continuous exercise. As a novel exercise therapy, interval training appears to be effective in managing type 2 diabetes. However, the safety and efficacy of this exercise modality in patients with progressed diabetic complications or a history of cardiovascular disease and in extremely older individuals remain unknown. Additionally, there is considerable heterogeneity in exercise interventions (intensity and duration) between clinical studies. Further studies are needed. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Regulatory Forum Opinion Piece*: Retrospective Evaluation of Doses in the 26-week Tg.rasH2 Mice Carcinogenicity Studies: Recommendation to Eliminate High Doses at Maximum Tolerated Dose (MTD) in Future Studies.

PubMed

Paranjpe, Madhav G; Denton, Melissa D; Vidmar, Tom J; Elbekai, Reem H

2015-07-01

High doses in Tg.rasH2 carcinogenicity studies are usually set at the maximum tolerated dose (MTD), although this dose selection strategy has not been critically evaluated. We analyzed the body weight gains (BWGs), mortality, and tumor response in control and treated groups of 29 Tg.rasH2 studies conducted at BioReliance. Based on our analysis, it is evident that the MTD was exceeded at the high and/or mid-doses in several studies. The incidence of tumors in high doses was lower when compared to the low and mid-doses of both sexes. Thus, we recommend that the high dose in male mice should not exceed one-half of the estimated MTD (EMTD), as it is currently chosen, and the next dose should be one-fourth of the EMTD. Because females were less sensitive to decrements in BWG, the high dose in female mice should not exceed two-third of EMTD and the next dose group should be one-third of EMTD. If needed, a third dose group should be set at one-eighth EMTD in males and one-sixth EMTD in females. In addition, for compounds that do not show toxicity in the range finding studies, a limit dose should be applied for the 26-week carcinogenicity studies. © 2014 by The Author(s).

A Review of Periprosthetic Femoral Fractures Associated With Total Hip Arthroplasty

PubMed Central

Marsland, Daniel; Mears, Simon C.

2012-01-01

Periprosthetic fractures of the femur in association with total hip arthroplasty are increasingly common and often difficult to treat. Patients with periprosthetic fractures are typically elderly and frail and have osteoporosis. No clear consensus exists regarding the optimal management strategy because there is limited high-quality research. The Vancouver classification facilitates treatment decisions. In the presence of a stable prosthesis (type-B1 and -C fractures), most authors recommend surgical stabilization of the fracture with plates, strut grafts, or a combination thereof. In up to 20% of apparent Vancouver type-B1 fractures, the femoral stem is loose, which may explain the high failure rates associated with open reduction and internal fixation. Some authors recommend routine opening and dislocation of the hip to perform an intraoperative stem stability test to rule out a loose component. Advances in plating techniques and technology are improving the outcomes for these fractures. For fractures around a loose femoral prosthesis (types B2 and 3), revision using an extensively porous-coated uncemented long stem, with or without additional fracture fixation, appears to offer the most reliable outcome. Cement-in-cement revision using a long-stem prosthesis is feasible in elderly patients with a well-fixed cement mantle. It is essential to treat the osteoporosis to help fracture healing and to prevent further fractures. We provide an overview of the causes, classification, and management of periprosthetic femoral fractures around a total hip arthroplasty based on the current best available evidence. PMID:23569704

A Study of Personal Health Record User’s Behavioral Model Based on the PMT and UTAUT Integrative Perspective

PubMed Central

Hsieh, Hui-Lung; Kuo, Yu-Ming; Wang, Shiang-Ru; Chuang, Bi-Kun; Tsai, Chung-Hung

2016-01-01

The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1) The PMT and UTAUT were effective at predicting PHR usage behaviors; (2) Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3) Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management. PMID:28025557

Is Peer Interaction Necessary for Optimal Active Learning?

PubMed

Linton, Debra L; Farmer, Jan Keith; Peterson, Ernie

2014-01-01

Meta-analyses of active-learning research consistently show that active-learning techniques result in greater student performance than traditional lecture-based courses. However, some individual studies show no effect of active-learning interventions. This may be due to inexperienced implementation of active learning. To minimize the effect of inexperience, we should try to provide more explicit implementation recommendations based on research into the key components of effective active learning. We investigated the optimal implementation of active-learning exercises within a "lecture" course. Two sections of nonmajors biology were taught by the same instructor, in the same semester, using the same instructional materials and assessments. Students in one section completed in-class active-learning exercises in cooperative groups, while students in the other section completed the same activities individually. Performance on low-level, multiple-choice assessments was not significantly different between sections. However, students who worked in cooperative groups on the in-class activities significantly outperformed students who completed the activities individually on the higher-level, extended-response questions. Our results provide additional evidence that group processing of activities should be the recommended mode of implementation for in-class active-learning exercises. © 2014 D. L. Linton et al. CBE—Life Sciences Education © 2014 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Factor Structure and Psychometric Properties of the Posttraumatic Stress Disorder (PTSD) Checklist and DSM-5 PTSD Symptom Set in a Long-Term Postearthquake Cohort in Armenia.

PubMed

Demirchyan, Anahit; Goenjian, Armen K; Khachadourian, Vahe

2015-10-01

Psychometric properties of the Armenian-language posttraumatic stress disorder (PTSD) Checklist-Civilian version (PCL-C) and the DSM-5 PTSD symptom set were examined in a long-term cohort of earthquake survivors. In 2012, 725 survivors completed the instruments. Item-/scale-level analysis and confirmatory factor analysis (CFA) were performed for both scales. In addition, exploratory factor analysis (EFA) was conducted for DSM-5 symptoms. Also, the differential internal versus external specificity of PTSD symptom clusters taken from the most supported PTSD structural models was examined. Both scales had Cronbach's alpha greater than .9. CFA of PCL-C structure demonstrated an excellent fit by a four-factor (reexperiencing, avoidance, numbing, and hyperarousal) model known as numbing model; however, a superior fit was achieved by a five-factor model (Elhai et al.). EFA yielded a five-factor structure for DSM-5 symptoms with the aforementioned four domains plus a negative state domain. This model achieved an acceptable fit during CFA, whereas the DSM-5 criteria-based model did not. The Armenian-language PCL-C was recommended as a valid PTSD screening tool. The study findings provided support to the proposed new classification of common mental disorders, where PTSD, depression, and generalized anxiety are grouped together as a subclass of distress disorders. Recommendations were made to further improve the PTSD diagnostic criteria. © The Author(s) 2014.

2017 publication guidelines for structural modelling of small-angle scattering data from biomolecules in solution: an update

PubMed Central

Duff, Anthony P.; Durand, Dominique; Gabel, Frank; Hendrickson, Wayne A.; Hura, Greg L.; Jacques, David A.; Kirby, Nigel M.; Kwan, Ann H.; Pérez, Javier; Pollack, Lois; Ryan, Timothy M.; Sali, Andrej; Schneidman-Duhovny, Dina; Vachette, Patrice; Westbrook, John

2017-01-01

In 2012, preliminary guidelines were published addressing sample quality, data acquisition and reduction, presentation of scattering data and validation, and modelling for biomolecular small-angle scattering (SAS) experiments. Bio­molecular SAS has since continued to grow and authors have increasingly adopted the preliminary guidelines. In parallel, integrative/hybrid determination of biomolecular structures is a rapidly growing field that is expanding the scope of structural biology. For SAS to contribute maximally to this field, it is essential to ensure open access to the information required for evaluation of the quality of SAS samples and data, as well as the validity of SAS-based structural models. To this end, the preliminary guidelines for data presentation in a publication are reviewed and updated, and the deposition of data and associated models in a public archive is recommended. These guidelines and recommendations have been prepared in consultation with the members of the International Union of Crystallography (IUCr) Small-Angle Scattering and Journals Commissions, the Worldwide Protein Data Bank (wwPDB) Small-Angle Scattering Validation Task Force and additional experts in the field. PMID:28876235

New guidelines for geriatric EDs: guidance focused on boosting environment, care processes.

PubMed

2014-05-01

A cadre of prominent medical groups, including the ACEP, ENA, AGS, and SAEM, has unveiled a comprehensive set of Geriatric Emergency Department Guidelines to aid hospitals that are either in the process of opening senior-focused EDs or revamping their policies and procedures to better meet the needs of an aging population. The guidelines offer recommendations related to staffing, infrastructure, education, and transition-of-care strategies. In addition, they outline a host of screenings that studies have shown are beneficial for older adults. Experts note that hospital systems around the country have already opened 50 geriatric EDs, with many more facilities in development. Guideline authors state that the guidelines take an evidence-based approach to managing senior patients. While more cost and outcomes data are needed, experts say that senior-focused improvements to emergency care can reduce admissions and return visits to the ED while also boosting patient satisfaction. Future efforts will focus on prioritizing the guideline recommendations so that ED administrators concerned with improving senior care will tackle the most important changes first.

Outpatient Management of Children With World Health Organization Chest Indrawing Pneumonia: Implementation Risks and Proposed Solutions.

PubMed

McCollum, Eric D; Ginsburg, Amy Sarah

2017-10-16

This Viewpoints article details our recommendation for the World Health Organization Integrated Management of Childhood Illness guidelines to consider additional referral or daily monitoring criteria for children with chest indrawing pneumonia in low-resource settings. We review chest indrawing physiology in children and relate this to the risk of adverse pneumonia outcomes. We believe there is sufficient evidence to support referring or daily monitoring of children with chest indrawing pneumonia and signs of severe respiratory distress, oxygen saturation <93% (when not at high altitude), moderate malnutrition, or an unknown human immunodeficiency virus (HIV) status in an HIV-endemic setting. Pulse oximetry screening should be routine and performed at the earliest point in the patient care pathway as possible. If outpatient clinics lack capacity to conduct pulse oximetry, nutritional assessment, or HIV testing, then we recommend considering referral to complete the evaluation. When referral is not possible, careful daily monitoring should be performed. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Guidelines and recommendations on yeast cell death nomenclature

PubMed Central

Carmona-Gutierrez, Didac; Bauer, Maria Anna; Zimmermann, Andreas; Aguilera, Andrés; Austriaco, Nicanor; Ayscough, Kathryn; Balzan, Rena; Bar-Nun, Shoshana; Barrientos, Antonio; Belenky, Peter; Blondel, Marc; Braun, Ralf J.; Breitenbach, Michael; Burhans, William C.; Büttner, Sabrina; Cavalieri, Duccio; Chang, Michael; Cooper, Katrina F.; Côrte-Real, Manuela; Costa, Vítor; Cullin, Christophe; Dawes, Ian; Dengjel, Jörn; Dickman, Martin B.; Eisenberg, Tobias; Fahrenkrog, Birthe; Fasel, Nicolas; Fröhlich, Kai-Uwe; Gargouri, Ali; Giannattasio, Sergio; Goffrini, Paola; Gourlay, Campbell W.; Grant, Chris M.; Greenwood, Michael T.; Guaragnella, Nicoletta; Heger, Thomas; Heinisch, Jürgen; Herker, Eva; Herrmann, Johannes M.; Hofer, Sebastian; Jiménez-Ruiz, Antonio; Jungwirth, Helmut; Kainz, Katharina; Kontoyiannis, Dimitrios P.; Ludovico, Paula; Manon, Stéphen; Martegani, Enzo; Mazzoni, Cristina; Megeney, Lynn A.; Meisinger, Chris; Nielsen, Jens; Nyström, Thomas; Osiewacz, Heinz D.; Outeiro, Tiago F.; Park, Hay-Oak; Pendl, Tobias; Petranovic, Dina; Picot, Stephane; Polčic, Peter; Powers, Ted; Ramsdale, Mark; Rinnerthaler, Mark; Rockenfeller, Patrick; Ruckenstuhl, Christoph; Schaffrath, Raffael; Segovia, Maria; Severin, Fedor F.; Sharon, Amir; Sigrist, Stephan J.; Sommer-Ruck, Cornelia; Sousa, Maria João; Thevelein, Johan M.; Thevissen, Karin; Titorenko, Vladimir; Toledano, Michel B.; Tuite, Mick; Vögtle, F.-Nora; Westermann, Benedikt; Winderickx, Joris; Wissing, Silke; Wölfl, Stefan; Zhang, Zhaojie J.; Zhao, Richard Y.; Zhou, Bing; Galluzzi, Lorenzo; Kroemer, Guido; Madeo, Frank

2018-01-01

Elucidating the biology of yeast in its full complexity has major implications for science, medicine and industry. One of the most critical processes determining yeast life and physiology is cellular demise. However, the investigation of yeast cell death is a relatively young field, and a widely accepted set of concepts and terms is still missing. Here, we propose unified criteria for the definition of accidental, regulated, and programmed forms of cell death in yeast based on a series of morphological and biochemical criteria. Specifically, we provide consensus guidelines on the differential definition of terms including apoptosis, regulated necrosis, and autophagic cell death, as we refer to additional cell death routines that are relevant for the biology of (at least some species of) yeast. As this area of investigation advances rapidly, changes and extensions to this set of recommendations will be implemented in the years to come. Nonetheless, we strongly encourage the authors, reviewers and editors of scientific articles to adopt these collective standards in order to establish an accurate framework for yeast cell death research and, ultimately, to accelerate the progress of this vibrant field of research. PMID:29354647

Panacea, a semantic-enabled drug recommendations discovery framework.

PubMed

Doulaverakis, Charalampos; Nikolaidis, George; Kleontas, Athanasios; Kompatsiaris, Ioannis

2014-03-06

Personalized drug prescription can be benefited from the use of intelligent information management and sharing. International standard classifications and terminologies have been developed in order to provide unique and unambiguous information representation. Such standards can be used as the basis of automated decision support systems for providing drug-drug and drug-disease interaction discovery. Additionally, Semantic Web technologies have been proposed in earlier works, in order to support such systems. The paper presents Panacea, a semantic framework capable of offering drug-drug and drug-diseases interaction discovery. For enabling this kind of service, medical information and terminology had to be translated to ontological terms and be appropriately coupled with medical knowledge of the field. International standard classifications and terminologies, provide the backbone of the common representation of medical data while the medical knowledge of drug interactions is represented by a rule base which makes use of the aforementioned standards. Representation is based on a lightweight ontology. A layered reasoning approach is implemented where at the first layer ontological inference is used in order to discover underlying knowledge, while at the second layer a two-step rule selection strategy is followed resulting in a computationally efficient reasoning approach. Details of the system architecture are presented while also giving an outline of the difficulties that had to be overcome. Panacea is evaluated both in terms of quality of recommendations against real clinical data and performance. The quality recommendation gave useful insights regarding requirements for real world deployment and revealed several parameters that affected the recommendation results. Performance-wise, Panacea is compared to a previous published work by the authors, a service for drug recommendations named GalenOWL, and presents their differences in modeling and approach to the problem, while also pinpointing the advantages of Panacea. Overall, the paper presents a framework for providing an efficient drug recommendations service where Semantic Web technologies are coupled with traditional business rule engines.

Florida High Speed Rail Authority - 2002 report to the legislature

DOT National Transportation Integrated Search

2002-01-01

This report addresses a legislative requirement that the Authority issue a report of its actions, findings and recommendations. Previous high speed ground transportation studies were reviewed as part of the preparation of this report. Independent ana...

5 CFR 2638.502 - Recommendations and advice.

Code of Federal Regulations, 2010 CFR

2010-01-01

... recommendation may be made or the advice given either orally or in writing. In addition, the Director shall... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Recommendations and advice. 2638.502... Cases Involving Individual Executive Agency Employees § 2638.502 Recommendations and advice. The...

5 CFR 2638.502 - Recommendations and advice.

Code of Federal Regulations, 2011 CFR

2011-01-01

... recommendation may be made or the advice given either orally or in writing. In addition, the Director shall... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Recommendations and advice. 2638.502... Cases Involving Individual Executive Agency Employees § 2638.502 Recommendations and advice. The...

Context-Aware Recommender Systems

NASA Astrophysics Data System (ADS)

Adomavicius, Gediminas; Tuzhilin, Alexander

The importance of contextual information has been recognized by researchers and practitioners in many disciplines, including e-commerce personalization, information retrieval, ubiquitous and mobile computing, data mining, marketing, and management. While a substantial amount of research has already been performed in the area of recommender systems, most existing approaches focus on recommending the most relevant items to users without taking into account any additional contextual information, such as time, location, or the company of other people (e.g., for watching movies or dining out). In this chapter we argue that relevant contextual information does matter in recommender systems and that it is important to take this information into account when providing recommendations. We discuss the general notion of context and how it can be modeled in recommender systems. Furthermore, we introduce three different algorithmic paradigms - contextual prefiltering, post-filtering, and modeling - for incorporating contextual information into the recommendation process, discuss the possibilities of combining several contextaware recommendation techniques into a single unifying approach, and provide a case study of one such combined approach. Finally, we present additional capabilities for context-aware recommenders and discuss important and promising directions for future research.

Influence of Strong versus Weak Fair Employment Policies and Applicant's Sex on Selection Decisions and Salary Recommendations in a Management Simulation.

ERIC Educational Resources Information Center

Rosen, Benson; Mericle, Mary F.

1979-01-01

Strong and weak policies on fair employment were equally effective in counteracting sex bias in selection decisions; however, lower starting salaries were recommended for females compared to males in the strong fair employment policy condition. (Author/IRT)

An Exploration of Giving among Gay Male College Alumni

ERIC Educational Resources Information Center

Vervoort, Alex; Gasman, Marybeth

2016-01-01

This study explores the influence of sexual orientation and race on college alumni giving. The authors use qualitative methods, interviewing alumni at one university in the Northeast. They also provide recommendations for fundraising and alumni practitioners as well as recommendations for those scholars interested in student identity, fundraising,…

Towards a Campus Culture of Environmental Sustainability: Recommendations for a Large University

ERIC Educational Resources Information Center

Levy, Brett L. M.; Marans, Robert W.

2012-01-01

Purpose: The authors led an interdisciplinary team that developed recommendations for building a "culture of environmental sustainability" at the University of Michigan (UM), and the purpose of this paper is to provide guidance on how other institutions might promote pro-environmental behaviors on their campuses.…

15 CFR 400.34 - Examiner's review-application for production authority.

Code of Federal Regulations, 2014 CFR

2014-01-01

... domestic industry, considering both producers of like products and producers of components/materials used... new material shall be made available for public inspection and the Federal Register notice shall... rebuttal comments. (C) If the bases for an examiner's recommendation(s) change as a result of new evidence...

The Role of Construct Maps in Standard Setting

ERIC Educational Resources Information Center

Kane, Michael T.; Tannenbaum, Richard J.

2013-01-01

The authors observe in this commentary that construct maps can help standard-setting panels to make realistic and internally consistent recommendations for performance-level descriptions (PLDs) and cut-scores, but the benefits may not be realized if policymakers do not fully understand the rationale for the recommendations provided by the…

42 CFR 1004.90 - Basis for recommended sanction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Basis for recommended sanction. 1004.90 Section 1004.90 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES IMPOSITION OF SANCTIONS ON HEALTH CARE PRACTITIONERS AND PROVIDERS OF HEALTH CARE...

77 FR 52309 - Southwest Montana Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... Community Self-Determination Act (Pub. L. 112-141) (the Act) and operates in compliance with the Federal... provide advice and recommendations to the Forest Service concerning projects and funding consistent with... recommend projects authorized under title II of the Act. DATES: The meeting will be held September 20, 2012...

77 FR 51752 - Medbow-Routt Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

... Community Self-Determination Act (Pub. L. 112- 141) (the Act) and operates in compliance with the Federal... provide advice and recommendations to the Forest Service concerning projects and funding consistent with... recommend projects authorized under title II of the Act, as well as to update RAC members on the progress of...

77 FR 49776 - El Dorado County Resource Advisory COMMITTEE

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-17

... and Community Self-Determination Act (Pub. L. 112-141) (the Act) and operates in compliance with the... to provide advice and recommendations to the Forest Service concerning projects and funding... to review and recommend projects authorized under title II of the Act. DATES: The meetings will be...

77 FR 51513 - Lawrence County Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-24

... Community Self-Determination Act (Pub. L. 112-141) (the Act) and operates in compliance with the Federal... provide advice and recommendations to the Forest Service concerning projects and funding consistent with... and recommend projects authorized under title II of the Act. DATES: The meeting will be held September...

A systematic review of recommendations and guidelines for the management of osteoarthritis: The chronic osteoarthritis management initiative of the U.S. bone and joint initiative.

PubMed

Nelson, Amanda E; Allen, Kelli D; Golightly, Yvonne M; Goode, Adam P; Jordan, Joanne M

2014-06-01

Although a number of osteoarthritis (OA) management guidelines exist, uptake has been suboptimal. Our aim was to review and critically evaluate existing OA management guidelines to better understand potential issues and barriers. A systematic review of the literature in MEDLINE published from January 1, 2000 to April 1, 2013 was performed and supplemented by bibliographic reviews, following PRISMA guidelines and a written protocol. Following initial title and abstract screening, 2 authors independently reviewed full-text articles; a third settled disagreements. Two independent reviewers extracted data into a standardized form. Two authors independently assessed guideline quality using the AGREE II instrument; three generated summary recommendations based on the extracted guideline data. Overall, 16 articles were included in the final review. There was broad agreement on recommendations by the various organizations. For non-pharmacologic modalities, education/self-management, exercise, weight loss if overweight, walking aids as indicated, and thermal modalities were widely recommended. For appropriate patients, joint replacement was recommended; arthroscopy with debridement was not recommended for symptomatic knee OA. Pharmacologic modalities most recommended included acetaminophen/paracetamol (first line) and NSAIDs (topical or oral, second line). Intra-articular corticosteroids were generally recommended for hip and knee OA. Controversy remains about the use of acupuncture, knee braces, heel wedges, intra-articular hyaluronans, and glucosamine/chondroitin. The relative agreement on many OA management recommendations across organizations indicates a problem with dissemination and implementation rather than a lack of quality guidelines. Future efforts should focus on optimizing implementation in primary care settings, where the majority of OA care occurs. Copyright © 2014 Elsevier Inc. All rights reserved.

Evidence-based recommendations for antibiotic usage to treat endodontic infections and pain: A systematic review of randomized controlled trials.

PubMed

Aminoshariae, Anita; Kulild, James C

2016-03-01

The purpose of this investigation was to identify evidence-based scientific methodologies to aid dental clinicians in establishing the indications for prescribing antibiotics for endodontic infection or pain. The authors prepared and registered a protocol on PROSPERO. They conducted electronic searches in MEDLINE, Scopus, Cochrane Library, and ClinicalTrials.gov. In addition, the authors hand searched the bibliographies of all relevant articles, the gray literature, and textbooks for randomized controlled clinical studies. The authors independently selected the relevant articles. The overall quality of the studies was fair with a low risk of bias, but 2 studies had a moderate risk of bias. The best available clinical evidence signals no indications for prescribing antibiotics preoperatively or postoperatively to prevent endodontic infection or pain unless the spread of infection is systemic, the patient is febrile, or both. Generally, an accurate diagnosis coupled with effective endodontic treatment will decrease microbial flora enough for healing to occur. To help decrease the number of drug-resistant microbes, oral health care providers should not prescribe antibiotics when they are not indicated. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Experience of maintaining laboratory educational website's sustainability

PubMed Central

Dimenstein, Izak B.

2016-01-01

Laboratory methodology websites are specialized niche websites. The visibility of a niche website transforms it into an authority site on a particular “niche of knowledge.” This article presents some ways in which a laboratory methodology website can maintain its sustainability. The optimal composition of the website includes a basic content, a blog, and an ancillary part. This article discusses experimenting with the search engine optimization query results page. Strategic placement of keywords and even phrases, as well as fragmentation of the post's material, can improve the website's visibility to search engines. Hyperlinks open a chain reaction of additional links and draw attention to the previous posts. Publications in printed periodicals are a substantial part of a niche website presence on the Internet. Although this article explores a laboratory website on the basis of our hands-on expertise maintaining “Grossing Technology in Surgical Pathology” (www.grossing-technology.com) website with a high volume of traffic for more than a decade, the recommendations presented here for developing an authority website can be applied to other professional specialized websites. The authority websites visibility and sustainability are preconditions for aggregating them in a specialized educational laboratory portal. PMID:27688928

Experience of maintaining laboratory educational website's sustainability.

PubMed

Dimenstein, Izak B

2016-01-01

Laboratory methodology websites are specialized niche websites. The visibility of a niche website transforms it into an authority site on a particular "niche of knowledge." This article presents some ways in which a laboratory methodology website can maintain its sustainability. The optimal composition of the website includes a basic content, a blog, and an ancillary part. This article discusses experimenting with the search engine optimization query results page. Strategic placement of keywords and even phrases, as well as fragmentation of the post's material, can improve the website's visibility to search engines. Hyperlinks open a chain reaction of additional links and draw attention to the previous posts. Publications in printed periodicals are a substantial part of a niche website presence on the Internet. Although this article explores a laboratory website on the basis of our hands-on expertise maintaining "Grossing Technology in Surgical Pathology" (www.grossing-technology.com) website with a high volume of traffic for more than a decade, the recommendations presented here for developing an authority website can be applied to other professional specialized websites. The authority websites visibility and sustainability are preconditions for aggregating them in a specialized educational laboratory portal.

A Review of Facebook Research in the Social Sciences.

PubMed

Wilson, Robert E; Gosling, Samuel D; Graham, Lindsay T

2012-05-01

With over 800 million active users, Facebook is changing the way hundreds of millions of people relate to one another and share information. A rapidly growing body of research has accompanied the meteoric rise of Facebook as social scientists assess the impact of Facebook on social life. In addition, researchers have recognized the utility of Facebook as a novel tool to observe behavior in a naturalistic setting, test hypotheses, and recruit participants. However, research on Facebook emanates from a wide variety of disciplines, with results being published in a broad range of journals and conference proceedings, making it difficult to keep track of various findings. And because Facebook is a relatively recent phenomenon, uncertainty still exists about the most effective ways to do Facebook research. To address these issues, the authors conducted a comprehensive literature search, identifying 412 relevant articles, which were sorted into 5 categories: descriptive analysis of users, motivations for using Facebook, identity presentation, the role of Facebook in social interactions, and privacy and information disclosure. The literature review serves as the foundation from which to assess current findings and offer recommendations to the field for future research on Facebook and online social networks more broadly. © The Author(s) 2012.

Grounded theory and feminist inquiry: revitalizing links to the past.

PubMed

Plummer, Marilyn; Young, Lynne E

2010-04-01

Grounded theory has served feminist research endeavors since the mid-1990s. Researchers from a variety of disciplines claim methodological compatibility and incorporate feminist principles into their grounded theory studies. This article seeks to demonstrate the epistemological affinity between feminist inquiry and grounded theory. Although this relationship is not necessarily unique, the authors contend that when combined, it loosens the androcentric moorings of the empirical processes underpinning grounded theory, enabling the researchers to design inquiry with greater potential to reveal issues particular to the lives and experiences of marginalized women. The article begins by retracing the roots of grounded theory and feminist inquiry to identify six key areas where the underpinnings of GT are enriched by a feminist perspective when working with women. In addition, the authors draw on the literature and their experience from a 2005 study of peer support and lone mothers' health to demonstrate the advantages of combining these theoretical perspectives. Finally, the authors recommend that nurse researchers draw on feminist principles to guide their use of grounded theory to better serve the interests of women by surfacing issues of gender and power that influence the health experience.

2015 UK national guideline for the management of infection with Chlamydia trachomatis.

PubMed

Nwokolo, Nneka C; Dragovic, Bojana; Patel, Sheel; Tong, C Y William; Barker, Gary; Radcliffe, Keith

2016-03-01

This guideline offers recommendations on the diagnostic tests, treatment regimens and health promotion principles needed for the effective management of Chlamydia trachomatis genital infection. It covers the management of the initial presentation, as well the prevention of transmission and future infection. The guideline is aimed at individuals aged 16 years and older presenting to healthcare professionals working in departments offering Level 3 care in sexually transmitted infections management within the UK. However, the principles of the recommendations should be adopted across all levels, using local care pathways where appropriate. © The Author(s) 2016.

The Vienna consensus: report of an expert meeting on the development of ART laboratory performance indicators.

PubMed

2017-11-01

This proceedings report presents the outcomes from an international workshop supported by the European Society of Human Reproduction and Embryology (ESHRE) and Alpha Scientists in Reproductive Medicine, designed to establish consensus on definitions and recommended values for Indicators for the assisted reproductive technology (ART) laboratory. Minimum performance-level values ('competency') and aspirational ('benchmark') values were recommended for a total of 19 Indicators, including 12 Key Performance Indicators (KPIs), five Performance Indicators (PIs), and two Reference Indicators (RIs). Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Department of Defense Congressional Action on FY 1984 Authorization Request.

DTIC Science & Technology

1983-10-11

AUTHORIZATION NOTE: The Military Construction Bill authorization recommendation totaIS dIO not include projects authorized using savings or authorized for...change from the request). &DE9rooi)00 ti M S in Million (Zallocki- Proc. of Ammunition. Armsy Nerve gas artillery shells .185 Bethune) Proc. of...Ammunitioin. Army Nerve gas production -96S (Gore) Missile Proc, Air Force MX Production funds -357 8 (Byron) ROTE, Air Force T-46A Trainer Aircraft . 200

Pathway to Prevention of Nosocomial Clostridium difficile Infection.

PubMed

Goldstein, Ellie J C; Johnson, Stuart; Maziade, Pierre-Jean; McFarland, Lynne V; Trick, William; Dresser, Linda; Millette, Mathieu; Mazloum, Hadi; Low, Donald E

2015-05-15

To address the significant morbidity and mortality rates associated with nosocomial Clostridium difficile-associated diarrhea (CDAD), a series of recommendations and a pathway to prevention were developed. An expert panel of infectious disease (ID) specialists participated in a modified Delphi process with specific objectives: (1) conduct a review for CDAD and prevention; (2) develop statements based upon panel members' opinions; (3) hold a panel meeting during the 2012 IDWeek; and (4) review the final recommendations and prevention pathway prior to submission for publication. The panel voted on (1) antibiotic stewardship (7 of 8 panelists); (2) reduction of other potentially modifiable risk factors (variable); (3) utilization of specific probiotics to prevent C. difficile overgrowth (8/8); (4) staff education regarding CDAD preventive measures (8/8); (5) appropriate hand hygiene for everyone (7/8); (6) environmental cleaning (8/8); (7) medical equipment disinfection (7/8); (8) early detection of CDAD in symptomatic patients (7/8); (9) usage of protective clothing/gloves (8/8); (10) proper measures during outbreak (8/8); and (11) surveillance to monitor efficacy data of preventive measures (8/8). The panel members agreed with 11 of 17 recommendations presented. The additional recommendations by the panel were proton pump inhibitor use as a risk factor and the use of adjunctive therapy with specific probiotic, as it was approved by Health Canada for the risk reduction of CDAD in hospitalized patients. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Bridging the Guideline Implementation Gap: A Systematic, Document-Centered Approach to Guideline Implementation

PubMed Central

Shiffman, Richard N.; Michel, George; Essaihi, Abdelwaheb; Thornquist, Elizabeth

2004-01-01

Objective: A gap exists between the information contained in published clinical practice guidelines and the knowledge and information that are necessary to implement them. This work describes a process to systematize and make explicit the translation of document-based knowledge into workflow-integrated clinical decision support systems. Design: This approach uses the Guideline Elements Model (GEM) to represent the guideline knowledge. Implementation requires a number of steps to translate the knowledge contained in guideline text into a computable format and to integrate the information into clinical workflow. The steps include: (1) selection of a guideline and specific recommendations for implementation, (2) markup of the guideline text, (3) atomization, (4) deabstraction and (5) disambiguation of recommendation concepts, (6) verification of rule set completeness, (7) addition of explanations, (8) building executable statements, (9) specification of origins of decision variables and insertions of recommended actions, (10) definition of action types and selection of associated beneficial services, (11) choice of interface components, and (12) creation of requirement specification. Results: The authors illustrate these component processes using examples drawn from recent experience translating recommendations from the National Heart, Lung, and Blood Institute's guideline on management of chronic asthma into a workflow-integrated decision support system that operates within the Logician electronic health record system. Conclusion: Using the guideline document as a knowledge source promotes authentic translation of domain knowledge and reduces the overall complexity of the implementation task. From this framework, we believe that a better understanding of activities involved in guideline implementation will emerge. PMID:15187061

[Optimizing post-operative pain management in Latin America].

PubMed

Garcia, João Batista Santos; Bonilla, Patricia; Kraychete, Durval Campos; Flores, Fernando Cantú; Valtolina, Elizabeth Diaz Perez de; Guerrero, Carlos

Post-operative pain management is a significant problem in clinical practice in Latin America. Insufficient or inappropriate pain management is in large part due to insufficient knowledge, attitudes and education, and poor communications at various levels. In addition, the lack of awareness of the availability and importance of clear policies and guidelines for recording pain intensity, the use of specific analgesics and the proper approach to patient education have led to the consistent under-treatment of pain management in the region. However, these problems are not insurmountable and can be addressed at both the provider and patient level. Robust policies and guidelines can help insure continuity of care and reduce unnecessary variations in practice. The objective of this paper is to call attention to the problems associated with Acute Post-Operative Pain (APOP) and to suggest recommendations for their solutions in Latin America. A group of experts on anesthesiology, surgery and pain developed recommendations that will lead to more efficient and effective pain management. It will be necessary to change the knowledge and behavior of health professionals and patients, and to obtain a commitment of policy makers. Success will depend on a positive attitude and the commitment of each party through the development of policies, programs and the promotion of a more efficient and effective system for the delivery of APOP services as recommended by the authors of this paper. The writing group believes that implementation of these recommendations should significantly enhance efficient and effective post-operative pain management in Latin America. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Expert Opinion and Recommendations for the Management of Attention-Deficit/Hyperactivity Disorder in Correctional Facilities.

PubMed

Scott, Duncan A; Gignac, Martin; Kronfli, Risk N; Ocana, Anthony; Lorberg, Gunter W

2016-01-01

There has been considerably less research on the management of adult attention-deficit/hyperactivity disorder (ADHD) among the inmates of correctional facilities than in the general community. While the successful identification and management of ADHD in the adult correctional setting offer potential benefits to the individuals themselves, to institutional staff, and to wider society, their implementation represents significant challenges. These include high prevalence rates, the low level of ADHD recognition, the high incidence of comorbid psychiatric disorders, and the high risk of abuse and diversion of prescribed medications. Here, the authors provide an overview of current recommendations for the identification and management of adults with ADHD in correctional settings and discuss possible strategies for their further development. © The Author(s) 2015.

Analysis of the track- and dose-averaged LET and LET spectra in proton therapy using the geant4 Monte Carlo code

PubMed Central

Guan, Fada; Peeler, Christopher; Bronk, Lawrence; Geng, Changran; Taleei, Reza; Randeniya, Sharmalee; Ge, Shuaiping; Mirkovic, Dragan; Grosshans, David; Mohan, Radhe; Titt, Uwe

2015-01-01

Purpose: The motivation of this study was to find and eliminate the cause of errors in dose-averaged linear energy transfer (LET) calculations from therapeutic protons in small targets, such as biological cell layers, calculated using the geant 4 Monte Carlo code. Furthermore, the purpose was also to provide a recommendation to select an appropriate LET quantity from geant 4 simulations to correlate with biological effectiveness of therapeutic protons. Methods: The authors developed a particle tracking step based strategy to calculate the average LET quantities (track-averaged LET, LETt and dose-averaged LET, LETd) using geant 4 for different tracking step size limits. A step size limit refers to the maximally allowable tracking step length. The authors investigated how the tracking step size limit influenced the calculated LETt and LETd of protons with six different step limits ranging from 1 to 500 μm in a water phantom irradiated by a 79.7-MeV clinical proton beam. In addition, the authors analyzed the detailed stochastic energy deposition information including fluence spectra and dose spectra of the energy-deposition-per-step of protons. As a reference, the authors also calculated the averaged LET and analyzed the LET spectra combining the Monte Carlo method and the deterministic method. Relative biological effectiveness (RBE) calculations were performed to illustrate the impact of different LET calculation methods on the RBE-weighted dose. Results: Simulation results showed that the step limit effect was small for LETt but significant for LETd. This resulted from differences in the energy-deposition-per-step between the fluence spectra and dose spectra at different depths in the phantom. Using the Monte Carlo particle tracking method in geant 4 can result in incorrect LETd calculation results in the dose plateau region for small step limits. The erroneous LETd results can be attributed to the algorithm to determine fluctuations in energy deposition along the tracking step in geant 4. The incorrect LETd values lead to substantial differences in the calculated RBE. Conclusions: When the geant 4 particle tracking method is used to calculate the average LET values within targets with a small step limit, such as smaller than 500 μm, the authors recommend the use of LETt in the dose plateau region and LETd around the Bragg peak. For a large step limit, i.e., 500 μm, LETd is recommended along the whole Bragg curve. The transition point depends on beam parameters and can be found by determining the location where the gradient of the ratio of LETd and LETt becomes positive. PMID:26520716

HIM Correlational Study

ERIC Educational Resources Information Center

Powell, Evan R.

1977-01-01

This study uses two methods of analysis to examine the degree to which items within the cells of the Hill Interaction Matrix correlate. It is found that the table of specifications does not hold up. But the author recommends caution in interpreting this finding. (Author/BP)

The Rules of the Game Have Changed.

ERIC Educational Resources Information Center

Keiser, Thomas C.

1986-01-01

The author states that the challenge for training and development is to help retrain managers for turbulent times. The objective is to change managers' mentality. The author makes recommendations concerning adapting to conditions, managing change and innovation, and establishing direction. (CT)

Commercial Fishing Port Development in North Florida. [Escambia, Bay, Gulf, Franklin, Wakulla, Nassau, and Duval Counties

NASA Technical Reports Server (NTRS)

Mathis, K. (Principal Investigator); Cato, J. C.; Degner, P. D.; Landrum, P. D.; Prochaska, F. J.

1978-01-01

The author has identified the following significant results. Seven major counties were examined: Escambia, Bay, Gulf, Franklin, Wakulla, Nassau, and Duval. Population and economic activity were reviewed, along with commercial fishing and port facilities. Recommendations for five northwest Florida counties were based on interpretation of aerial photographs, satellite imagery, an aerial survey site visit, and published data. Major needs in Pensacola included docking, ice supply, and net and engine repair services. Costs for additional docks, an ice plant, and gear storage were estimated at $3,658,600. Port users in Panama City identified additional docking and gear storage as primary needs, along with gear repair and a marine railway. Estimated costs for dock and gear storage were $2,860,000. Added docking, gear storage, and ice supply, as well as gear electronics and diesel repair were needed in Port St. Joe. Costs were calculated at $1,231,500. Franklin County has three ports (Apalachicola - $1,107,000 for docks and gear storage, Eastpoint - $420,000 for additional docks, and Carrabella - $2,824,100 for docks, gear storage, and ice plant).

The relationship between waiting times and 'adherence' to the Scottish Intercollegiate Guidelines Network 98 guideline in autism spectrum disorder diagnostic services in Scotland.

PubMed

McKenzie, Karen; Forsyth, Kirsty; O'Hare, Anne; McClure, Iain; Rutherford, Marion; Murray, Aja; Irvine, Linda

2016-05-01

The aim of this study was to explore the extent to which the Scottish Intercollegiate Guidelines Network 98 guidelines on the assessment and diagnosis of autism spectrum disorder were adhered to in child autism spectrum disorder diagnostic services in Scotland and whether there was a significant relationship between routine practice which more closely reflected these recommendations (increased adherence) and increased waiting times. Retrospective, cross-sectional case note analysis was applied to data from 80 case notes. Adherence ranged from a possible 0 (no adherence) to 19 (full adherence). Overall, 17/22 of the recommendations were adhered to in over 50 of the 80 cases and in 70 or more cases for 11/22 of the recommendations, with a mean adherence score of 16 (standard deviation = 1.9). No significant correlation was found between adherence and total wait time for untransformed (r = 0.15, p = 0.32) or transformed data (r = 0.12, p = 0.20). The results indicated that the assessment and diagnostic practices were consistent with the relevant Scottish Intercollegiate Guidelines Network 98 guideline recommendations. Increased adherence to the 19 included recommendations was not significantly related to increased total waiting times, indicating that the Scottish Intercollegiate Guidelines Network 98 recommendations have generally been integrated into practice, without a resultant increase in patient waits. © The Author(s) 2015.

A systematic review of nosocomial waterborne infections in neonates and mothers.

PubMed

Moffa, Michelle; Guo, Wilson; Li, Trudy; Cronk, Ryan; Abebe, Lydia S; Bartram, Jamie

2017-11-01

Water is an important, overlooked, and controllable source of nosocomial infection. Hospitalized neonates and their mothers are particularly vulnerable to nosocomial waterborne infections. Our objectives through this systematic review were to: investigate water sources, reservoirs, and transmission routes that lead to nosocomial waterborne infections in neonates and their mothers; establish patient risk factors; compile measures for controlling outbreaks and recommended strategies for prevention; and identify information gaps to improve guidelines for reporting future outbreaks. We searched PubMed, Web of Science, Embase, and clinicaltrials.gov. Peer-reviewed studies reporting contaminated water as a route of transmission to neonates and/or their mothers were included. Twenty-five studies were included. The most common contaminated water sources in healthcare facilities associated with infection transmission were tap water, sinks, and faucets. Low birthweights, preterm or premature birth, and underlying disease increased neonatal risk of infection. Effective control measures commonly included replacing or cleaning faucets and increased or alternative methods for hand disinfection, and recommendations for prevention of future infections highlighted the need for additional surveillance. The implementation of control measures and recommended prevention strategies by healthcare workers and managing authorities of healthcare facilities and improved reporting of future outbreaks may contribute to a reduction in the incidence of nosocomial waterborne infections in neonates and their mothers. Copyright © 2017 Elsevier GmbH. All rights reserved.

Methods to estimate the between‐study variance and its uncertainty in meta‐analysis†

PubMed Central

Jackson, Dan; Viechtbauer, Wolfgang; Bender, Ralf; Bowden, Jack; Knapp, Guido; Kuss, Oliver; Higgins, Julian PT; Langan, Dean; Salanti, Georgia

2015-01-01

Meta‐analyses are typically used to estimate the overall/mean of an outcome of interest. However, inference about between‐study variability, which is typically modelled using a between‐study variance parameter, is usually an additional aim. The DerSimonian and Laird method, currently widely used by default to estimate the between‐study variance, has been long challenged. Our aim is to identify known methods for estimation of the between‐study variance and its corresponding uncertainty, and to summarise the simulation and empirical evidence that compares them. We identified 16 estimators for the between‐study variance, seven methods to calculate confidence intervals, and several comparative studies. Simulation studies suggest that for both dichotomous and continuous data the estimator proposed by Paule and Mandel and for continuous data the restricted maximum likelihood estimator are better alternatives to estimate the between‐study variance. Based on the scenarios and results presented in the published studies, we recommend the Q‐profile method and the alternative approach based on a ‘generalised Cochran between‐study variance statistic’ to compute corresponding confidence intervals around the resulting estimates. Our recommendations are based on a qualitative evaluation of the existing literature and expert consensus. Evidence‐based recommendations require an extensive simulation study where all methods would be compared under the same scenarios. © 2015 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd. PMID:26332144

Framework of outcome measures recommended for use in the evaluation of childhood obesity treatment interventions: the CoOR framework.

PubMed

Bryant, M; Ashton, L; Nixon, J; Jebb, S; Wright, J; Roberts, K; Brown, J

2014-12-01

Consensus is lacking in determining appropriate outcome measures for assessment of childhood obesity treatments. Inconsistency in the use and reporting of such measures impedes comparisons between treatments and limits consideration of effectiveness. This study aimed to produce a framework of recommended outcome measures: the Childhood obesity treatment evaluation Outcomes Review (CoOR) framework. A systematic review including two searches was conducted to identify (1) existing trial outcome measures and (2) manuscripts describing development/evaluation of outcome measures. Outcomes included anthropometry, diet, eating behaviours, physical activity, sedentary time/behaviour, fitness, physiology, environment, psychological well-being and health-related quality of life. Eligible measures were appraised by the internal team using a system developed from international guidelines, followed by appraisal from national external expert collaborators. A total of 25,486 papers were identified through both searches. Eligible search 1 trial papers cited 417 additional papers linked to outcome measures, of which 56 were eligible. A further 297 outcome development/evaluation papers met eligibility criteria from search 2. Combined, these described 191 outcome measures. After internal and external appraisal, 52 measures across 10 outcomes were recommended for inclusion in the CoOR framework. Application of the CoOR framework will ensure greater consistency in choosing robust outcome measures that are appropriate to population characteristics. © 2014 The Authors. Pediatric Obesity © 2014 International Association for the Study of Obesity.

Recommendations from the INHAND Apoptosis/Necrosis Working Group.

PubMed

Elmore, Susan A; Dixon, Darlene; Hailey, James R; Harada, Takanori; Herbert, Ronald A; Maronpot, Robert R; Nolte, Thomas; Rehg, Jerold E; Rittinghausen, Susanne; Rosol, Thomas J; Satoh, Hiroshi; Vidal, Justin D; Willard-Mack, Cynthia L; Creasy, Dianne M

2016-02-01

Historically, there has been confusion relating to the diagnostic nomenclature for individual cell death. Toxicologic pathologists have generally used the terms "single cell necrosis" and "apoptosis" interchangeably. Increased research on the mechanisms of cell death in recent years has led to the understanding that apoptosis and necrosis involve different cellular pathways and that these differences can have important implications when considering overall mechanisms of toxicity, and, for these reasons, the separate terms of apoptosis and necrosis should be used whenever differentiation is possible. However, it is also recognized that differentiation of the precise pathway of cell death may not be important, necessary, or possible in routine toxicity studies and so a more general term to indicate cell death is warranted in these situations. Morphological distinction between these two forms of cell death can sometimes be straightforward but can also be challenging. This article provides a brief discussion of the cellular mechanisms and morphological features of apoptosis and necrosis as well as guidance on when the pathologist should use these terms. It provides recommended nomenclature along with diagnostic criteria (in hematoxylin and eosin [H&E]-stained sections) for the most common forms of cell death (apoptosis and necrosis). This document is intended to serve as current guidance for the nomenclature of cell death for the International Harmonization of Nomenclature and Diagnostic Criteria Organ Working Groups and the toxicologic pathology community at large. The specific recommendations are:Use necrosis and apoptosis as separate diagnostic terms.Use modifiers to denote the distribution of necrosis (e.g., necrosis, single cell; necrosis, focal; necrosis, diffuse; etc.).Use the combined term apoptosis/single cell necrosis whenThere is no requirement or need to split the processes, orWhen the nature of cell death cannot be determined with certainty, orWhen both processes are present together. The diagnosis should be based primarily on the morphological features in H&E-stained sections. When needed, additional, special techniques to identify and characterize apoptosis can also be used. © The Author(s) 2016.

Treatment of Soft Tissue Filler Complications: Expert Consensus Recommendations.

PubMed

Urdiales-Gálvez, Fernando; Delgado, Nuria Escoda; Figueiredo, Vitor; Lajo-Plaza, José V; Mira, Mar; Moreno, Antonio; Ortíz-Martí, Francisco; Del Rio-Reyes, Rosa; Romero-Álvarez, Nazaret; Del Cueto, Sofía Ruiz; Segurado, María A; Rebenaque, Cristina Villanueva

2018-04-01

Dermal fillers have been increasingly used in minimally invasive facial esthetic procedures. This widespread use has led to a rise in reports of associated complications. The aim of this expert consensus report is to describe potential adverse events associated with dermal fillers and to provide guidance on their treatment and avoidance. A multidisciplinary group of experts in esthetic treatments convened to discuss the management of the complications associated with dermal fillers use. A search was performed for English, French, and Spanish language articles in MEDLINE, the Cochrane Database, and Google Scholar using the search terms "complications" OR "soft filler complications" OR "injectable complications" AND "dermal fillers" AND "Therapy". An initial document was drafted by the Coordinating Committee, and it was reviewed and modified by the experts, until a final text was agreed upon and validated. The panel addressed consensus recommendations about the classification of filler complications according to the time of onset and about the clinical management of different complications including bruising, swelling, edema, infections, lumps and bumps, skin discoloration, and biofilm formation. Special attention was paid to vascular compromise and retinal artery occlusion. Clinicians should be fully aware of the signs and symptoms related to complications and be prepared to confidently treat them. Establishing action protocols for emergencies, with agents readily available in the office, would reduce the severity of adverse outcomes associated with injection of hyaluronic acid fillers in the cosmetic setting. This document seeks to lay down a set of recommendations and to identify key issues that may be useful for clinicians who are starting to use dermal fillers. Additionally, this document provides a better understanding about the diagnoses and management of complications if they do occur. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

[Polish guidelines for the prevention and treatment of venous thromboembolism. 2012 update].

PubMed

Zawilska, Krystyna; Bała, Małgorzata M; Błędowski, Piotr; Chmielewski, Dariusz W; Dobrowolski, Zygmunt; Frączek, Mariusz; Frołow, Marzena; Gajewski, Piotr; Guzik, Tomasz; Jaeschke, Roman; Korman, Tomasz; Kotarski, Jan; Kozubski, Wojciech; Krawczyk, Marek; Kruszewski, Wiesław; Kulikowski, Jerzy; Kutaj-Wąsikowska, Halina; Mayzner-Zawadzka, Ewa; Mrozikiewicz, Przemysław M; Musiał, Jacek; Niżankowski, Rafał; Pasierski, Tomasz; Poręba, Ryszard; Tomkowski, Witold; Torbicki, Adam; Undas, Anetta; Urbanek, Tomasz; Wojtukiewicz, Marek Z; Woroń, Jarosław; Wroński, Jacek

2012-01-01

The overall objective of the Polish guidelines for the prevention and treatment of venous thromboembolism is to increase patient benefit and safety by appropriate prevention and treatment of deep vein thrombosis and pulmonary embolism as well as proper management of the complications associated with antithrombotic and thrombolytic therapy. These guidelines apply to adult trauma, cancer, surgical, and medical patients as well as those at increased risk of venous thromboembolism. Specific recommendations have been formulated for pregnant women, patients requiring surgery while receiving long-term oral anticoagulant treatment, and patients undergoing regional anesthesia and/or analgesia. We chose to update the existing Polish guidelines with the use of the most recent high-quality international guidelines that we identified and adjusted the final product to Polish cultural and organizational setting. We based our recommendations primarily on the 9th edition of the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines on Antithrombotic Therapy and Prevention of Thrombosis, the European Society of Cardiology Guidelines on the Diagnosis and Management of Acute Pulmonary Embolism, the 3rd edition of the American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines on Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy, the ACOG practice bulletin on thromboembolism in pregnancy (Number 123), and Guidance from the Scientific and Standardisation Committee of the International Society on Thrombosis and Haemostasis on the Duration of Anticoagulant Therapy after a First Episode of Unprovoked Pulmonary Embolus or Deep Vein Thrombosis, as well as two other Polish practice guidelines on the prophylaxis and treatment of venous thromboembolism and the management of patients treated with oral direct inhibitors of factor X or factor II. To make recommendations regarding specific management issues that had not been addressed in other guidelines, or whenever the panel members felt they needed additional information to reach the decision, we also consulted the authors of guidelines developed by other professional societies and organizations as well as additional sources of evidence. For each adapted recommendation, we explicitly assessed its relevance and applicability in the context of the healthcare system in Poland. When necessary, we explicitly stated the rationale for modification of the previously published recommendations and judgements about the values and preferences we assumed. The information regarding reimbursement of drugs mentioned in the recommendations was added in chapters 6-9 and 13 and approved by the National Health Fund. The final version of the practice guidelines was officially approved by the scientific societies and institutions listed at the beginning of the document.  

Improving the readability of online foot and ankle patient education materials.

PubMed

Sheppard, Evan D; Hyde, Zane; Florence, Mason N; McGwin, Gerald; Kirchner, John S; Ponce, Brent A

2014-12-01

Previous studies have shown the need for improving the readability of many patient education materials to increase patient comprehension. This study's purpose was to determine the readability of foot and ankle patient education materials and to determine the extent readability can be improved. We hypothesized that the reading levels would be above the recommended guidelines and that decreasing the sentence length would also decrease the reading level of these patient educational materials. Patient education materials from online public sources were collected. The readability of these articles was assessed by a readability software program. The detailed instructions provided by the National Institutes of Health (NIH) were then used as a guideline for performing edits to help improve the readability of selected articles. The most quantitative guideline, lowering all sentences to less than 15 words, was chosen to show the effect of following the NIH recommendations. The reading levels of the sampled articles were above the sixth to seventh grade recommendations of the NIH. The MedlinePlus website, which is a part of the NIH website, had the lowest reading level (8.1). The articles edited had an average reduction of 1.41 grade levels, with the lowest reduction in the Medline articles of 0.65. Providing detailed instructions to the authors writing these patient education articles and implementing editing techniques based on previous recommendations could lead to an improvement in the readability of patient education materials. This study provides authors of patient education materials with simple editing techniques that will allow for the improvement in the readability of online patient educational materials. The improvement in readability will provide patients with more comprehendible education materials that can strengthen patient awareness of medical problems and treatments. © The Author(s) 2014.

Visual Representation in Mathematics: Special Education Teachers' Knowledge and Emphasis for Instruction

ERIC Educational Resources Information Center

van Garderen, Delinda; Scheuermann, Amy; Poch, Apryl; Murray, Mary M.

2018-01-01

The use of visual representations (VRs) in mathematics is a strongly recommended practice in special education. Although recommended, little is known about special educators' knowledge of and instructional emphasis about VRs. Therefore, in this study, the authors examined special educators' own knowledge of and their instructional emphasis with…

Cracking the NAPLAN Code: Numeracy in Action

ERIC Educational Resources Information Center

Perso, Thelma

2009-01-01

In this paper, the author recommends that every teacher of mathematics should undertake an analysis using their own data. She further recommends that they reflect on the outcomes of their analysis and share it with colleagues. Teachers can look at an individual student's results, variations in results between student sub-groups in their classes,…

77 FR 28600 - Draft publication: Coal Dust Explosibility Meter Evaluation and Recommendations for Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [Docket Number... Recommendations for Application Authority: 30 U.S.C. 95l. AGENCY: National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC), Department of Health and Human...

Twelve Recommendations for Strengthening Mathematics and Science Programs Serving a Diverse Population

ERIC Educational Resources Information Center

Kaser, Joyce S.

2010-01-01

Based on the data gathered and the interviews with administrators, the author makes the following suggestions. These twelve recommendations are targeted primarily toward educators wanting to strengthen their own mathematics and science offerings, possibly by establishing a school-within-a school or launching a charter school. The recommendations…

When a Student Does Not Qualify for Special Education: Issues and Recommendations

ERIC Educational Resources Information Center

Schultz, Edward; Stephens, Tammy L.; Lindt, Suzanne F.

2015-01-01

The authors describe the issues that assessment specialists confront when a student referred for special education testing does not qualify for services. This article reviews some of the causes for students not meeting the eligibility requirements and concludes with recommendations to prevent as well as respond appropriately when a designation of…

43 CFR 404.49 - What criteria will Reclamation use to determine whether to recommend that a proposed rural water...

Code of Federal Regulations, 2013 CFR

2013-10-01

... opportunities for water conservation through structural or non-structural approaches and demonstration... determine whether to recommend that a proposed rural water supply project be authorized for construction... RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Feasibility Studies § 404.49...

Hopes for Intergroup Dialogue: Affirmation and Allies

ERIC Educational Resources Information Center

Dessel, Adrienne; Bolen, Rebecca; Shepardson, Christine

2012-01-01

This article is an invited response to "Toward a Learning Environment That Supports Diversity and Difference: A Response to Dessel, Bolen, and Shepardson," by David R. Hodge ("Journal of Social Work Education," 47(2), pp. 235-251). The authors agree with a number of Hodge's recommendations. First, they support Hodge's recommendation to use common…

Demonstration of the Effects of an Increased Praise Ratio on Student On-Task Behavior

ERIC Educational Resources Information Center

White, Rachel L.

2010-01-01

Many authors recommend various praise to reprimand ratios for teachers to use to manage their classrooms (e.g., Flora, 2000; Nafpaktitis, Mayer, & Butterworth, 1985; Wheldall, 2005); however, these recommendations are based on correlational data or secondary findings from studies not directly manipulating the praise to reprimand ratio. The…

Recommended Syllabus Components: What Do Higher Education Faculty Include in Their Syllabi?

ERIC Educational Resources Information Center

Doolittle, Peter E.; Siudzinski, Robert A.

2010-01-01

Syllabus use in higher education instruction is ubiquitous, yet what actually constitutes a syllabus remains unclear. The authors assessed the contents of 1000 syllabi, sampled from the Internet, based on 26 criteria determined from a literature review of recommended syllabus components. Syllabi contents were assessed according to four categories:…

Recommendations for Benchmarking Web Site Usage among Academic Libraries.

ERIC Educational Resources Information Center

Hightower, Christy; Sih, Julie; Tilghman, Adam

1998-01-01

To help library directors and Web developers create a benchmarking program to compare statistics of academic Web sites, the authors analyzed the Web server log files of 14 university science and engineering libraries. Recommends a centralized voluntary reporting structure coordinated by the Association of Research Libraries (ARL) and a method for…

The Donaldson Review and Scottish Baccalaureates--A Model for Implementation in Schools

ERIC Educational Resources Information Center

Ritchie, Margaret R.; Keith, David; Jones, Deuan; Ramnarine, Sabrina; Spiers, Andrew

2012-01-01

In January 2011, a review about teacher education in Scotland included 50 recommendations designed to improve the learning of young people in Scotland. A feature of the recommendations was enhancement of teacher education via new national initiatives and strengthened partnerships between schools, local authorities and universities. The Scottish…

Teaching about Bullying and Cyberbullying with the Internet

ERIC Educational Resources Information Center

Risinger, C. Frederick

2011-01-01

Bullying and cyber bullying are important issues in schools, not only in the United States but in many other nations. In this article, the author recommends sites that he thinks would be helpful for teachers and schools combating bullying and cyber bullying. These recommended sites provide teacher lesson plans and other resources dealing with…

Response to "Expanding Access to Learning with Mobile Digital Devices"

ERIC Educational Resources Information Center

Vanek, Jen

2017-01-01

In his article "Expanding Access to Learning with Mobile Digital Devices" (EJ1150752), Jeff Carter recommended a balanced perspective when measuring the potential of mobile learning to redefine teaching and learning for adults with basic skills needs. In response to Carter's article, the author makes some recommendations that she thinks…

Evidence-Based Assessment of Attention-Deficit/Hyperactivity Disorder: Using Multiple Sources of Information

ERIC Educational Resources Information Center

Frazier, Thomas W.; Youngstrom, Eric A.

2006-01-01

In this article, the authors illustrate a step-by-step process of acquiring and integrating information according to the recommendations of evidence-based practices. A case example models the process, leading to specific recommendations regarding instruments and strategies for evidence-based assessment (EBA) of attention-deficit/hyperactivity…

Commission on Teacher Credentialing Approves 8 ELL-Related Credential Options

ERIC Educational Resources Information Center

Frost, Jeff; Cadiero-Kaplan, Karen; Kuhlman, Natalie

2011-01-01

On September 30, 2010, the California Commission on Teacher Credentialing (CTC) voted unanimously to approve a set of eight recommendations for authorization to teach English language learners. These recommendations approved by the CTC had been in development for almost two years and they focused on several issues, including: (1) a specific focus…

The Cost Effectiveness of Hepatitis Immunization for US College Students

ERIC Educational Resources Information Center

Jacobs, R. Jake; Saab, Sammy; Meyerhoff, Allen S.

2003-01-01

Hepatitis B immunization is recommended for all American children, and hepatitis A immunization is recommended for children who live in areas with elevated disease rates. Because hepatitis A and B occur most commonly in young adults, the authors examined the cost effectiveness of college-based vaccination. They developed epidemiologic models to…

77 FR 53169 - Uinta-Wasatch-Cache National Forest Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-31

... Secure Rural Schools and Community Self-Determination Act (Pub. L. 112-141) (the Act) and operates in... relationships and to provide advice and recommendations to the Forest Service concerning projects and funding... review and recommend projects authorized under Title II of the Act. DATES: The meeting will be held via...

77 FR 15053 - Manual for Courts-Martial; Proposed Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-14

... the M.R.E. and a Word document using color-coded text and comments to explain amendments. Updated... evidence. f. Commenter recommended using the words ``pursuant to statutory authority'' in M.R.E. 807. JSC... the rule to findings. i. Commenter recommended removing the word ``allegedly'' from proposed M.R.E...

Working with Hispanic Women Who Are Deaf: Recommendations from the Literature

ERIC Educational Resources Information Center

Feist, Amber M.; Saladin, Shawn P.; Hansmann, Sandra

2013-01-01

The authors used the hermeneutics approach within social cognitive career theory to explore employment trends and issues over the past 20 years relevant to Hispanic women who are deaf. Barriers to employment were discovered including discrepancies due to gender, race/ethnicity, and severity of hearing loss. Recommendations for policymakers and…

"What Works": Recommendations on Improving Academic Experiences and Outcomes for Black Males

ERIC Educational Resources Information Center

Howard, Tyrone C.; Douglas, Ty-Ron, M. O.; Warren, Chezare A.

2016-01-01

This brief presents the most significant recommendations based on a review of key findings from research presented in this special issue. The authors offer what they believe to be the most important considerations of what works for improving Black male school achievement in the domains of research, practice, and policy.

Compliance with recommended protective actions during an H7N9 emergency: a risk perception perspective.

PubMed

Wang, Fei; Wei, Jiuchang; Shi, Xing

2018-04-01

This study investigates the factors determining an individual's response to official recommended protective measures, based on the Health Belief Model and the Protective Action Decision Model, to understand the adoption of protective behaviour during an H7N9 (Avian Influenza A) emergency. A public survey involving 1,375 respondents was conducted in Anhui Province, China, during the 2013 H7N9 outbreak to test the research model and hypotheses. The results indicate that protective, stakeholder, and risk perceptions influence positively an individual's willingness to take recommended actions. Protective and stakeholder perceptions also have a positive bearing on lay people's risk perceptions. A stakeholder perception is a vital determinant of a protective perception. More importantly, the effects of protective and stakeholder perceptions on behavioural responses to recommendations are mediated in part by risk perception. These findings can help public health officials to develop messages to encourage members of the population to protect themselves effectively during an influenza crisis. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Deafness and Rubella: A Challenge and a Charge to Rehabilitation.

ERIC Educational Resources Information Center

Mills, Craig

1980-01-01

Summarizing salient information from the preceding papers (EC 132 316-326), the author cites nine major issues and recommendations, including the fact that considerable underutilized legislation should be brought to bear on the needs of children and adults with rubella. (Author)

Author-Publisher-Educator Relationships and Curriculum Reform.

ERIC Educational Resources Information Center

McFadden, Charles P.

1992-01-01

Discusses relationships among teachers, curriculum package authors, and publishers. Describes the Atlantic Science Curriculum Project's reform efforts. Recommends that curriculum development projects include: (1) lengthy informal development; (2) combined testing of design and materials; (3) the withholding of contracts until materials are in…

Books on Renewable Energy for Elementary Grades.

ERIC Educational Resources Information Center

Conservation and Renewable Energy Inquiry and Referral Service (DOE), Silver Spring, MD.

Presented is a list of 20 books on renewable energy resources. These books are suitable for children in the elementary grades. Each entry includes the title, author(s) or editor(s), number of pages, price, publication date, recommended grade level(s), and source. (JN)

Brief Communication: On direct impact probability of landslides on vehicles

NASA Astrophysics Data System (ADS)

Nicolet, P.; Jaboyedoff, M.; Cloutier, C.; Crosta, G. B.; Lévy, S.

2015-12-01

When calculating the risk of railway or road users to be killed by a natural hazard, one has to calculate a "spatio-temporal probability", i.e. the probability for a vehicle to be in the path of the falling mass when the mass falls, or the expected number of affected vehicles in case of an event. To calculate this, different methods are used in the literature, and, most of the time, they consider only the dimensions of the falling mass or the dimensions of the vehicles. Some authors do however consider both dimensions at the same time, and the use of their approach is recommended. Finally, a method considering an impact on the front of the vehicle in addition is discussed.

Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 4: does size matter? Chest drains in haemothorax following trauma.

PubMed

2013-11-01

A short-cut review was carried out to establish whether the size of chest drain inserted is important in haemothoraces. Forty-nine papers were found of which four presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are shown in table 4. The clinical bottom line is that while the available evidence suggests that small bore drains may be as effective as large bore drains in resolving traumatic haemothoraces without additional complications, there is insufficient evidence currently available to recommend a change to standard practice (ie, large bore drains).

UROTRAUMA: AUA GUIDELINE

PubMed Central

Morey, Allen F.; Brandes, Steve; Dugi, Daniel David; Armstrong, John H.; Breyer, Benjamin N.; Broghammer, Joshua A.; Erickson, Bradley A.; Holzbeierlein, Jeff; Hudak, Steven J.; Mirvis, Stuart; Pruitt, Jeffrey H.; Reston, James T.; Santucci, Richard A.; Smith, Thomas G.; Wessells, Hunter

2014-01-01

Purpose The authors of this guideline reviewed the urologic trauma literature to guide clinicians in the appropriate methods of evaluation and management of genitourinary injuries. Methods A systematic review of the literature using the MEDLINE® and EMBASE databases (search dates 1/1/90-9/19/12) was conducted to identify peer-reviewed publications relevant to urotrauma. The review yielded an evidence base of 372 studies after application of inclusion/exclusion criteria. These publications were used to inform the statements presented in the guideline as Standards, Recommendations or Options. When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A (high), B (moderate) or C (low). In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions. PMID:24857651

Environmental and policy interventions to control tobacco use and prevent cardiovascular disease.

PubMed

Brownson, R C; Koffman, D M; Novotny, T E; Hughes, R G; Eriksen, M P

1995-11-01

Despite its declining prevalence during the past few decades, tobacco use remains one of the most significant public health issues of the 1990s. Environmental and policy interventions are among the most cost-effective approaches to control tobacco use and prevent cardiovascular diseases. In this article, the authors review and offer to state and local health departments and other public health partners a summary of recommended policy and environmental interventions that have either reduced or show potential to reduce tobacco use. Priority recommendations include clean indoor air policies, restrictions on tobacco advertising and promotion, policies limiting youth access to tobacco, comprehensive school health programs, and excise taxes and other economic incentives. Many of these recommendations should be integrated with other health promotion interventions to also improve nutrition and physical activity. The authors also highlight several successful interventions and strategies used to establish policies at the state and local levels.

The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass--Temperature Management During Cardiopulmonary Bypass.

PubMed

Engelman, Richard; Baker, Robert A; Likosky, Donald S; Grigore, Alina; Dickinson, Timothy A; Shore-Lesserson, Linda; Hammon, John W

2015-08-01

In order to improve our understanding of the evidence-based literature supporting temperature management during adult cardiopulmonary bypass, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiology and the American Society of ExtraCorporeal Technology tasked the authors to conduct a review of the peer-reviewed literature, including: 1) optimal site for temperature monitoring, 2) avoidance of hyperthermia, 3) peak cooling temperature gradient and cooling rate, and 4) peak warming temperature gradient and rewarming rate. Authors adopted the American College of Cardiology/American Heart Association method for development clinical practice guidelines, and arrived at the following recommendations: No Recommendation No recommendation for a guideline is provided concerning optimal temperature for weaning from CPB due to insufficient published evidence. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Evaluation of Hospital-Based Palliative Care Programs.

PubMed

Hall, Karen Lynn; Rafalson, Lisa; Mariano, Kathleen; Michalek, Arthur

2016-02-01

This study evaluated current hospital-based palliative care programs using recommendations from the Center to Advance Palliative Care (CAPC) as a framework. Seven hospitals located in Buffalo, New York were included based on the existence of a hospital-based palliative care program. Data was collected from August through October of 2013 by means of key informant interviews with nine staff members from these hospitals using a guide comprised of questions based on CAPC's recommendations. A gap analysis was conducted to analyze the current state of each hospital's program based upon CAPC's definition of a quality palliative care program. The findings identify challenges facing both existing/evolving palliative care programs, and establish a foundation for strategies to attain best practices not yet implemented. This study affirms the growing availability of palliative care services among these selected hospitals along with opportunities to improve the scope of services in line with national recommendations. © The Author(s) 2014.

Personalized recommendation via an improved NBI algorithm and user influence model in a Microblog network

NASA Astrophysics Data System (ADS)

Lian, Jie; Liu, Yun; Zhang, Zhen-jiang; Gui, Chang-ni

2013-10-01

Bipartite network based recommendations have attracted extensive attentions in recent years. Differing from traditional object-oriented recommendations, the recommendation in a Microblog network has two crucial differences. One is high authority users or one’s special friends usually play a very active role in tweet-oriented recommendation. The other is that the object in a Microblog network corresponds to a set of tweets on same topic instead of an actual and single entity, e.g. goods or movies in traditional networks. Thus repeat recommendations of the tweets in one’s collected topics are indispensable. Therefore, this paper improves network based inference (NBI) algorithm by original link matrix and link weight on resource allocation processes. This paper finally proposes the Microblog recommendation model based on the factors of improved network based inference and user influence model. Adjusting the weights of these two factors could generate the best recommendation results in algorithm accuracy and recommendation personalization.

Age differences in understanding precedent-setting decisions and authorities' responses to violations of deontic rules.

PubMed

Klaczynski, Paul A

2011-05-01

To examine age trends in precedent-setting decisions and the effects of these decisions on perceptions of authorities, preadolescents and adolescents were presented with deontic rule infractions that occurred in the absence or presence of mitigating circumstances. In Study 1, in the absence of mitigating circumstances, adolescents recommended punishing rule violations more than preadolescents; when mitigating circumstances were present, adolescents recommended punishing infractions less than preadolescents. In Study 2, before and after receiving information that authorities had punished or permitted rule violations, participants indicated their beliefs in authority legitimacy, rule strength, and rule deterrence value. In the absence of mitigating circumstances, beliefs strengthened when infractions were punished and beliefs weakened when infractions were permitted. When mitigating circumstances were present and authorities punished violations, preadolescents' legitimacy and deterrence beliefs strengthened. Adolescents' deterrence beliefs strengthened, but their beliefs in authority legitimacy weakened. When justifiable infractions were permitted, preadolescents' legitimacy and deterrence beliefs weakened, whereas adolescents' beliefs strengthened. Discussion focuses on age differences in legitimacy beliefs and understanding the consequences of setting precedents and on the relevance of the findings to theories of deontic reasoning, moral judgments, and epistemological development. Copyright © 2010 Elsevier Inc. All rights reserved.

State Law and Standing Orders for Immunization Services

PubMed Central

Stewart, Alexandra M.; Lindley, Megan C.; Cox, Marisa A.

2015-01-01

Introduction This study determined whether state laws permit the implementation of standing orders programs (SOPs) for immunization practice. SOPs are an effective strategy to increase uptake of vaccines. Successful SOPs require a legal foundation authorizing delegation of immunization services performed by a wide range of providers, administered to broad patient populations, in several settings. Without legal permission to administer vaccines, non-physician health professionals (NPHPs) are unable to provide preventive services. Methods From 2012 through 2013, researchers analyzed the legal environment in 50 states and the District of Columbia to determine whether NPHPs are authorized to: (1) assess patient immunization status; (2) prescribe vaccines; and (3) administer vaccines under their own practice license or delegated authority. Laws governing the following NPHPs were included: (1) medical assistants; (2) midwives; (3) nurses in advanced practice; (4) registered, practical, and vocational nurses; (5) physician assistants; and (6) pharmacists. Additionally, the review determined which vaccines may be administered, permissible patient populations, and allowable practice settings for each category of NPHP. Results The laws are highly variable and no state authorizes all NPHPs to conduct all elements of immunization practice for all patients. The laws frequently indicate where NPHPs may or may not administer vaccines and outline permissible vaccines, eligible patients, and required level of supervision. Conclusions The variation in the laws could potentially present a challenge to successful implementation of public health goals to improve immunization rates. Expanded authorization of SOPs in all states could increase health practitioners’ ability to deliver recommended vaccines. PMID:26651424

Towards fair health policies for migrants and ethnic minorities: the case-study of ETHEALTH in Belgium

PubMed Central

2012-01-01

Background In Europe, progress in the development of health policies that address the needs of migrants and ethnic minorities has been slow. This is partly due to the absence of a strategic commitment by the health authorities. The Ministry of Public Health commissioned the ETHEALTH (EThnicity &HEALTH) group to formulate relevant recommendations to the public authorities with a view to reducing health inequalities among ethnic minorities. This paper describes the political process and the outcomes of the ETHEALTH expert group. Results After ten meetings, the ETHEALTH group came up with 46 recommendations, which were presented at a national press conference in December 2011. Target groups concerned by these recommendations covered both irregular migrants and migrants entitled to the national insurance coverage. Recommendations were supported by the need of combining universal approaches to health care with more specific approaches. The scope of the recommendations concerned health care as well as prevention, health promotion and access to health care. When analysing the content of the recommendations, some ETHEALTH recommendations were not fully measurable, and time-related; they were, however, quite specific and realistic within the Belgian context. The weak political commitment of an executive agency was identified as a major obstacle to the implementation of the recommendations. Conclusions The ETHEALTH group was an example of scientific advice on a global health issue. It also demonstrated the feasibility of coming up with a comprehensive strategy to decrease ethnic health inequalities, even in a political context where migration issues are sensitive. Two final lessons may be highlighted at the end of the first phase of the ETHEALTH project: firstly, the combination of scientific knowledge and practical expertise makes recommendations SMART; and, secondly, the low level of commitment on the part of policymakers might jeopardise the effective implementation of the recommendations. PMID:22938597

Relationship between Physicians' Uncertainty about Clinical Assessments and Patient-Centered Recommendations for Colorectal Cancer Screening in the Elderly.

PubMed

Dalton, Alexandra F; Golin, Carol E; Esserman, Denise; Pignone, Michael P; Pathman, Donald E; Lewis, Carmen L

2015-05-01

The goal of this study was to examine associations between physicians' clinical assessments, their certainty in these assessments, and the likelihood of a patient-centered recommendation about colorectal cancer (CRC) screening in the elderly. Two hundred seventy-six primary care physicians in the United States read 3 vignettes about an 80-year-old female patient and answered questions about her life expectancy, their confidence in their life expectancy estimate, the balance of benefits/downsides of CRC screening, their certainty in their benefit/downside assessment, and the best course of action regarding CRC screening. We used logistic regression to determine the relationship between these variables and patient-centered recommendations about CRC screening. In bivariate analyses, physicians had higher odds of making a patient-centered recommendation about CRC screening when their clinical assessments did not lead to a clear screening recommendation or when they experienced uncertainty in their clinical assessments. However, in a multivariate regression model, only benefit/downside assessment and best course of action remained statistically significant predictors of a patient-centered recommendation. Our findings demonstrate that when the results of clinical assessments do not lead to obvious screening decisions or when physicians feel uncertain about their clinical assessments, they are more likely to make patient-centered recommendations. Existing uncertainty frameworks do not adequately describe the uncertainty associated with patient-centered recommendations found in this study. Adapting or modifying these frameworks to better reflect the constructs associated with uncertainty and the interactions between uncertainty and the complexity inherent in clinical decisions will facilitate a more complete understanding of how and when physicians choose to include patients in clinical decisions. © The Author(s) 2015.

Consensus-based recommendations for the management of uveitis associated with juvenile idiopathic arthritis: the SHARE initiative.

PubMed

Constantin, Tamas; Foeldvari, Ivan; Anton, Jordi; de Boer, Joke; Czitrom-Guillaume, Severine; Edelsten, Clive; Gepstein, Raz; Heiligenhaus, Arnd; Pilkington, Clarissa A; Simonini, Gabriele; Uziel, Yosef; Vastert, Sebastian J; Wulffraat, Nico M; Haasnoot, Anne-Mieke; Walscheid, Karoline; Pálinkás, Annamária; Pattani, Reshma; Györgyi, Zoltán; Kozma, Richárd; Boom, Victor; Ponyi, Andrea; Ravelli, Angelo; Ramanan, Athimalaipet V

2018-03-28

In 2012, a European initiative called S ingle Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate diagnostic and management regimens in Europe for children and young adults with rheumatic diseases. Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and uveitis is possibly its most devastating extra-articular manifestation. Evidence-based guidelines are sparse and management is mostly based on physicians' experience. Consequently, treatment practices differ widely, within and between nations. To provide recommendations for the diagnosis and treatment of JIA-associated uveitis. Recommendations were developed by an evidence-informed consensus process using the European League Against Rheumatism standard operating procedures. A committee was constituted, consisting of nine experienced paediatric rheumatologists and three experts in ophthalmology from Europe. Recommendations derived from a validated systematic literature review were evaluated by an Expert Committee and subsequently discussed at two consensus meetings using nominal group techniques. Recommendations were accepted if >80% agreement was reached (including all three ophthalmologists). In total, 22 recommendations were accepted (with >80% agreement among experts): 3 on diagnosis, 5 on disease activity measurements, 12 on treatment and 2 on future recommendations. The SHARE initiative aims to identify best practices for treatment of patients suffering from JIA-associated uveitis. Within this remit, recommendations for the diagnosis and treatment of JIA-associated uveitis have been formulated by an evidence-informed consensus process to suggest a standard of care for JIA-associated uveitis patients throughout Europe. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Guidelines of the First International Consensus Conference on Endovenous Thermal Ablation for Varicose Vein Disease--ETAV Consensus Meeting 2012.

PubMed

Pavlović, Miloš D; Schuller-Petrović, Sanja; Pichot, Olivier; Rabe, Eberhard; Maurins, Uldis; Morrison, Nick; Pannier, Felizitas

2015-05-01

Endovenous thermal ablation (ETA) procedures are catheter-directed, ultrasound (US)-guided thermal methods for treatment in varicose veins disease. Radiofrequency, laser or steam energy thermally denatures vein wall collagen, leading first to vein wall inflammation, then fibrosis and finally to occlusion. The aim of this guideline is to give evidence-based recommendations for ETA procedures. These guidelines were drafted during a consensus meeting of a group of experts in the field of ETA in June 2012 (Hvar, Croatia) under the auspices of the International Union of Phlebology (IUP). These guidelines review the present state of knowledge as reflected in peer-reviewed published medical literature. The recommendations of these guidelines are graded according to the American College of Chest Physicians Task Force recommendations on Grading Strength of Recommendations and Quality of Evidence in Clinical Guidelines. Recommendations on the use of ETA procedures were made based on the quality of evidence for efficacy, safety, tolerability, cosmetic outcome, patient satisfaction/preference and, where appropriate, on the experts' opinion. Health economics were not considered, since differences in national health systems and pricing make it difficult to form general conclusions that are relevant at an international level. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

BWR Servicing and Refueling Improvement Program: Phase I summary report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Perry, D.R.

1978-09-01

Under the U.S. Department of Energy sponsorship, General Electric Co. (GE) undertook a study of boiling water reactor (BWR) refueling outages for the purpose of recommending the development and demonstration of critical path time savings improvements. The Tennessee Valley Authority (TVA) joined the study as a subcontractor, providing monitoring assistance and making the Browns Ferry Site available for improvement demonstrations. Agreement was also reached with Georgia Power Co., Power Authority of the State of New York, and Commonwealth Edison Co. for monitoring and data collection at Hatch 1, FitzPatrick, and Quad Cities 1 nuclear plants, respectively. The objective was tomore » identify, develop, and demonstrate improved refueling, maintenance, and inspection procedures and equipment. The improvements recommended in this study are applicable to BWR nuclear plants currently in operation as well as those in the design and construction phases. The recommendations and outage information can be used as a basis to plan and conduct the first outages of new plants and to improve the planning and facilities of currently operating plants. Many of the recommendations can readily be incorporated in plants currently in the design and construction phases as well as in the design of future plants. Many of these recommended improvements can be implemented immediately by utilities without further technical development.« less

Rejoinder to Lemberger

ERIC Educational Resources Information Center

Hansen, James T.

2012-01-01

Lemberger (2012) argues that the author (Hansen, 2012) has no basis for recommending differential weightings or priorities to humanism and science, because those ideologies are only meaningful as they are subjectively interpreted within the counseling encounter. The author responds that their positions are completely compatible, but his focus was…

48 CFR 836.602-4 - Selection authority.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Selection authority. 836.602-4 Section 836.602-4 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SPECIAL... those capacities, are designated as the approving officials for the recommendations of the respective...

Answering medical questions at the point of care: a cross-sectional study comparing rapid decisions based on PubMed and Epistemonikos searches with evidence-based recommendations developed with the GRADE approach.

PubMed

Izcovich, Ariel; Criniti, Juan Martín; Popoff, Federico; Ragusa, Martín Alberto; Gigler, Cristel; Gonzalez Malla, Carlos; Clavijo, Manuela; Manzotti, Matias; Diaz, Martín; Catalano, Hugo Norberto; Neumann, Ignacio; Guyatt, Gordon

2017-08-07

Using the best current evidence to inform clinical decisions remains a challenge for clinicians. Given the scarcity of trustworthy clinical practice guidelines providing recommendations to answer clinicians' daily questions, clinical decision support systems (ie, assistance in question identification and answering) emerge as an attractive alternative. The trustworthiness of the recommendations achieved by such systems is unknown. To evaluate the trustworthiness of a question identification and answering system that delivers timely recommendations. Cross-sectional study. We compared the responses to 100 clinical questions related to inpatient management provided by two rapid response methods with 'Gold Standard' recommendations. One of the rapid methods was based on PubMed and the other on Epistemonikos database. We defined our 'Gold Standard' as trustworthy published evidence-based recommendations or, when unavailable, recommendations developed locally by a panel of six clinicians following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Recommendations provided by the rapid strategies were classified as potentially misleading or reasonable. We also determined if the potentially misleading recommendations could have been avoided with the appropriate implementation of searching and evidence summary tools. We were able to answer all of the 100 questions with both rapid methods. Of the 200 recommendations obtained, 6.5% (95% CI 3% to 9.9%) were classified as potentially misleading and 93.5% (95% CI 90% to 96.9%) as reasonable. 6 of the 13 potentially misleading recommendations could have been avoided by the appropriate usage of the Epistemonikos matrix tool or by constructing summary of findings tables. No significant differences were observed between the evaluated rapid response methods. A question answering service based on the GRADE approach proved feasible to implement and provided appropriate guidance for most identified questions. Our approach could help stakeholders in charge of managing resources and defining policies for patient care to improve evidence-based decision-making in an efficient and feasible manner. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Reporting Guidelines: Optimal Use in Preventive Medicine and Public Health

PubMed Central

Popham, Karyn; Calo, William A.; Carpentier, Melissa Y.; Chen, Naomi E.; Kamrudin, Samira A.; Le, Yen-Chi L.; Skala, Katherine A.; Thornton, Logan R.; Mullen, Patricia Dolan

2012-01-01

Numerous reporting guidelines are available to help authors write higher quality manuscripts more efficiently. Almost 200 are listed on the EQUATOR (Enhancing the Quality and Transparency of Health Research) Network’s website and they vary in authority, usability, and breadth, making it difficult to decide which one(s) to use. This paper provides consistent information about guidelines for preventive medicine and public health and a framework and sequential approach for selecting them. EQUATOR guidelines were reviewed for relevance to target audiences; selected guidelines were classified as “core” (frequently recommended) or specialized, and the latter were grouped by their focus. Core and specialized guidelines were coded for indicators of authority (simultaneous publication in multiple journals, rationale, scientific background supporting each element, expertise of designers, permanent website/named group), usability (presence of checklists and examples of good reporting), and breadth (manuscript sections covered). Discrepancies were resolved by consensus. Selected guidelines are presented in four tables arranged to facilitate selection: core guidelines, all of which pertain to major research designs; guidelines for additional study designs, topical guidelines, and guidelines for particular manuscript sections. A flow diagram provides an overview. The framework and sequential approach will enable authors as well as editors, peer reviewers, researchers, and systematic reviewers to make optimal use of available guidelines to improve the transparency, clarity, and rigor of manuscripts and research protocols and the efficiency of conducing systematic reviews and meta-analyses. PMID:22992369

Effect of liver transplantation on brain magnetic resonance imaging pathology in Wilson disease: a case report.

PubMed

Litwin, T; Dzieżyc, K; Poniatowska, R; Członkowska, A

2013-01-01

The authors present a case report of a 28-year-old patient with hepatic, but no neurological, signs of Wilson disease, with pathological changes in both the globi pallidi and caudate found with routine brain magnetic resonance imaging (MRI). The patient was recommended for liver transplantation by hepatologists, and during the two years of observation after liver transplantation, MRI brain abnormalities due to Wilson disease completely regressed. On the basis of this case, the authors present an argument for the prognostic significance of brain MRI in Wilson disease as well as current recommendations concerning liver transplantation in Wilson disease.

Electroconvulsive therapy: administrative codes, legislation, and professional recommendations.

PubMed

Harris, Victoria

2006-01-01

Government regulatory involvement in electroconvulsive therapy (ECT) is due to several factors, including patient advocate groups, prior abuse by psychiatrists, and a general trend of state authority to move into areas traditionally governed by medical authorities. Regardless of the specific reasons, ECT is both highly effective in the treatment of many psychiatric disorders and heavily regulated by state administrative codes and legislation. The purpose of this article is to conduct a systematic review of the state administrative codes and legislation for the 50 states, the District of Columbia, and Puerto Rico and to compare the findings with professional recommendations for the administration of ECT.

Sharing Your Practice Expertise: Writing Clinical Manuscripts for Publication.

PubMed

McGrath, Jacqueline M; Brandon, Debra

2015-08-01

Please do not be afraid of the writing process; we are here to help you through this journey. If you need mentorship through the process, consider looking to an expert or mentor on your unit or at a nearby university. If you do not find the mentorship you are seeking nearby, please let us know. We will put you in contact with 1 of our editorial board members to help guide you through the writing process. We want you to be successful so please have an outline of your idea and the type of manuscript you are planning to write developed. When you contact us, please share your questions openly—there are no “dumb” questions. Please refer often to our author guidelines during the writing process. Details for how best to submit a manuscript for the Clinical Issues in Neonatal Care section are outlined within the author guidelines. Finally, it is important to remember that ANC is a 4-color journal, so please submit full-color tables, graphs, and pictures to enhance the readability of your manuscript. During the editorial process we will do everything we can to facilitate and enhance your work. We will make recommendations that we believe will increase its scholarly application to improving neonatal care and outcomes. Revisions are often requested. After peer review, the section editor and coeditors will review the manuscript well in advance of the production deadline and provide additional feedback as needed. The end goal is excellent presentation of materials for our readers. If you are a reviewer for ANC , the next time you are asked to review a Clinical Issues in Neonatal Care manuscript, please consider the quality of the manuscript in relationship to guiding clinical care at the bedside and make recommendations to improve the manuscript so that staff nurses will best relate to the content. Do not be afraid to make recommendations about missing content or suggestions about ways to enhance the content and make it easier for clinicians to understand. Help us and the authors to increase their creativity and enhance their work. We want ANC to be the best clinical and research journal in neonatal care with articles of all styles that help us to enhance our caregiving and patient outcomes!

75 FR 37457 - Maintenance Wage Rate Wage Recommendation and Maintenance Wage Survey; Report of Additional...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5376-N-54] Maintenance Wage Rate Wage Recommendation and Maintenance Wage Survey; Report of Additional Classification and Wage Rate AGENCY: Office of... requirement described below has been submitted to the Office of Management and Budget (OMB) for review, as...

75 FR 4099 - Maintenance Wage Rate Wage Recommendation and Maintenance Wage Survey; Report of Additional...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5376-N-06] Maintenance Wage Rate Wage Recommendation and Maintenance Wage Survey; Report of Additional Classification and Wage Rate AGENCY: Office of... requirement described below has been submitted to the Office of Management and Budget (OMB) for review, as...

A Health Informatics Curriculum Congruent with IS 2010 and IMIA Recommendations for an Undergraduate Degree

ERIC Educational Resources Information Center

Longenecker, Herbert E., Jr.; Campbell, S. Matt; Landry, Jeffrey P.; Pardue, Harold; Daigle, Roy J.

2012-01-01

In addition to being a relevant program for health information technology workers, a recently proposed Health Informatics program was designed with additional objectives in mind: that the program is compatible with the IS 2010 Model Curriculum and that it satisfies the International Medical Informatics Association recommendation for undergraduate…

78 FR 74154 - Draft Guidance for Industry on Recommendations for Preparation and Submission of Animal Food...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-10

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-D-0928] Draft Guidance for Industry on Recommendations for Preparation and Submission of Animal Food Additive... Preparation and Submission of Animal Food Additive Petitions.'' DATES: Submit either electronic or written...

Sunlight reflection off the spacecraft with a solar sail on the surface of mars

NASA Astrophysics Data System (ADS)

Starinova, O. L.; Rozhkov, M. A.; Gorbunova, I. V.

2018-05-01

Modern technologies make it possible to fulfill many projects in the field of space exploration. One such project is the colonization of Mars and providing favorable conditions for living on it. Authors propose principles of functioning of the spacecraft with a solar sail, intended to create a thermal and light spot in a predetermined area of the Martian surface. This additional illumination can maintain and support certain climatic conditions on a small area where a Mars base could be located. This paper investigate the possibility of the spacecraft continuously reflect the sunlight off the solar sail on the small area of the Mars surface. The mathematical motion model in such condition of the solar sail's orientation is considered and used for motion simulation session. Moreover, the analysis of this motion is performed. Thus, were obtained parameters of the synchronic non-Keplerian orbit and spacecraft construction. In addition, were given recommendations for further applying satellites to reflect the sunlight on a planet's surface.

The Effect of Team Pentathlon on Ten- to Eleven-Year-Old Childrens' Engagement in Physical Activity

ERIC Educational Resources Information Center

Michaud, Valerie; Nadeau, Luc; Martel, Denis; Gagnon, Jocelyn; Godbout, Paul

2012-01-01

Background: To promote regular physical activity (PA) among children and adolescents, authors recommend that physical education (PE) teachers offer their students programmes that would allow them to be physically active outside PE classes. However, such programmes are rarely rigorously assessed and it is recommended that further studies be…

Commentary on "Childhood Leukemia Survivors and Their Return to School: A Literature Review, Case Study, and Recommendations"

ERIC Educational Resources Information Center

Schmitt, Ara

2011-01-01

This commentary pertains to the article, "Childhood Leukemia Survivors and Their Return to School: A Literature Review, Case Study, and Recommendations" by D. Scott Hermann, Jill R. Thurber, Kenneth Miles, and Gloria Gilbert in this issue (2011) regarding pediatric leukemia. The authors present a literature review regarding leukemia in…

Accolades and Recommendations: A Longitudinal Analysis of Monitoring Reports for Two Charter Schools Serving Native American Students

ERIC Educational Resources Information Center

Anderson, Derek L.; Holder, K. C.

2012-01-01

This longitudinal case study examines 10 years' worth of annual monitoring reports for two rural Native American Charter Schools. Using data from multiple sources including interviews, site visits, and document analyses, the authors used provisional coding and constant comparison analysis to categorize the accolades and recommendations embedded in…

75 FR 3516 - Invitation for Recommendations for U.S. Authors and Reviewers to the Fifth Assessment Report of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-21

... Reviewers to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC) ACTION... Intergovernmental Panel on Climate Change (IPCC). SUMMARY: The U.S. Department of State invites recommendations for... Intergovernmental Panel on Climate Change (IPCC), which will be developed and finalized over the coming four years...

28 CFR 0.165 - Recommendations to the Deputy Attorney General or Associate Attorney General, as appropriate...

Code of Federal Regulations, 2010 CFR

2010-07-01

... General or Associate Attorney General, as appropriate, that certain claims be closed. 0.165 Section 0.165... Recommendations to the Deputy Attorney General or Associate Attorney General, as appropriate, that certain claims... the authority delegated by §§ 0.160(a) and 0.164, the Assistant Attorney General concerned shall, when...

Social Ecological Approaches to Individuals and Their Contexts: Twenty Years of "Health Education & Behavior" Health Promotion Interventions

ERIC Educational Resources Information Center

Golden, Shelley D.; Earp, Jo Anne L.

2012-01-01

Social ecological models that describe the interactive characteristics of individuals and environments that underlie health outcomes have long been recommended to guide public health practice. The extent to which such recommendations have been applied in health promotion interventions, however, is unclear. The authors developed a coding system to…

Teaching Elementary School Students to Be Effective Writers: Instructional Tips Based on the Educator's Practice Guide

ERIC Educational Resources Information Center

What Works Clearinghouse, 2017

2017-01-01

Instructional tips help educators carry out recommendations contained in IES Educator's Practice Guides. The tips, based on a practice guide authored by Steve Graham, Alisha Bollinger, Carol Booth Olson, Catherine D'Aoust, Charles MacArthur, Deborah McCutchen, and Natalie Olinghouse, translate these recommendations into actionable approaches that…

Commentary: Recommendations and remaining questions for health care leadership training programs.

PubMed

Stoller, James K

2013-01-01

Effective leadership is critical for optimizing cost, access, and quality in health care. Creating a pipeline of effective health care leaders requires developing leadership competencies that differ from the usual criteria of clinical and scientific excellence by which physicians have traditionally been promoted to leadership positions. Specific competencies that differentiate effective leaders from average leaders, especially emotional intelligence and its component abilities, are essential for effective leadership.Adopting a long-standing practice from successful corporations, some health care institutions, medical societies, and business schools now offer leadership programs that address these differentiating leadership competencies. The author draws on experience with such programs through the Cleveland Clinic Academy to provide recommendations for health care leadership training and to identify unanswered questions about such programs.The author recommends that such training should be broadly available to all health care leadership communities (i.e., nurses, administrators, and physicians). A progressive curriculum, starting with foundational concepts and extending to coaching and feedback opportunities through experiential learning, recognizes the challenge of becoming an effective leader and the long time line needed to do so. Linking leadership courses to continuing medical education and to graduate credit opportunities is appealing to participants. Other recommendations focus on the importance of current leaders' involvement in nominating emerging leaders for participation, embedding leadership development discussions in faculty's professional reviews, and blending discussion of frameworks and theory with practical, experiential lessons. The author identifies questions about the benefits of formal health care leadership training that remain to be answered.

Proposing application of results in sport and exercise research reports.

PubMed

Knudson, Duane; Elliott, Bruce; Hamill, Joseph

2014-09-01

The application of sport and exercise research findings to practice requires careful interpretation and integration of evidence. This paper reviews principles of evidence-based practice and the application of research in sports and exercise, in order to provide recommendations on developing appropriate application sections in research reports for sport and exercise journals. The strength of recommendations for application fall into one of four levels, with potential applications qualified as strong, limited, preliminary, or hypothesized. Specific limitations that should be discussed in framing recommendations for practice are also noted for each of these levels that should be useful for authors, and for practitioners and clinicians in interpreting these recommendations.

Meta-Analysis of Group Learning Activities: Empirically Based Teaching Recommendations

ERIC Educational Resources Information Center

Tomcho, Thomas J.; Foels, Rob

2012-01-01

Teaching researchers commonly employ group-based collaborative learning approaches in Teaching of Psychology teaching activities. However, the authors know relatively little about the effectiveness of group-based activities in relation to known psychological processes associated with group dynamics. Therefore, the authors conducted a meta-analytic…

48 CFR 1946.704 - Authority for use of warranties.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Authority for use of warranties. 1946.704 Section 1946.704 Federal Acquisition Regulations System BROADCASTING BOARD OF GOVERNORS... procurement request initiator is responsible for preparing a written recommendation for those purchases deemed...

77 FR 50983 - Ozark-Ouachita Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... meet in Waldron, Arkansas. The committee is authorized under the Secure Rural Schools and Community... and recommendations to the Forest Service concerning projects and funding consistent with the title II... projects authorized under title II of the Act. DATES: The meeting will be held September 25, 2012...

40 CFR 240.200-2 - Recommended procedures: Design.

Code of Federal Regulations, 2011 CFR

2011-07-01

....200-2 Section 240.200-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-2 Recommended procedures: Design. (a) In addition to the residential and commercial wastes...

40 CFR 240.200-2 - Recommended procedures: Design.

Code of Federal Regulations, 2010 CFR

2010-07-01

....200-2 Section 240.200-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-2 Recommended procedures: Design. (a) In addition to the residential and commercial wastes...

40 CFR 240.200-2 - Recommended procedures: Design.

Code of Federal Regulations, 2013 CFR

2013-07-01

... processing. These include: Certain bulky wastes (e.g., combustible demolition and construction debris, tree... WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-2 Recommended procedures: Design. (a) In addition to the residential and commercial wastes...

Recognition and management of depression in skilled-nursing and long-term care settings: evolving targets for quality improvement.

PubMed

Boyle, Vicki L; Roychoudhury, Canopy; Beniak, Renee; Cohn, Lisa; Bayer, Albert; Katz, Ira

2004-01-01

Depression is a common disorder associated with suffering, morbidity, and mortality in nursing home residents. It is treatable, and improving the quality of treatment can have a major impact. MPRO, Michigan's Quality Improvement Organization, initiated a quality-improvement project in 14 nursing facilities to improve the accuracy of assessments, targeting, and monitoring of care. Electronic Minimum Data Set (MDS) data and medical-record abstraction results were combined to form the analytic dataset. Findings from the baseline phase demonstrated that, according to medical and administrative records, 26% of newly admitted nursing home residents had symptoms of depression that were apparent at admission, and an additional 12% were recognized early in their stay. Eighty-one percent of residents with depression were receiving treatment on admission to the facility, and 79% of those with depression recognized by Day 14 were treated by then. These data demonstrate progress toward improving the initiation of treatment for depression in nursing homes; however, there are still opportunities for improving the quality of care and, especially, the quality of assessments. The authors recommend the addition of the Geriatric Depression Scale to the federally mandated MDS for cognitively intact patients. There could also be mechanisms to ensure that providers and facilities follow recommended practice guidelines. Initiating treatment with antidepressant medications should be followed with monitoring of residents to identify those who still have depressive symptoms and to modify or intensify their treatment.

Is video review of patient encounters an effective tool for medical student learning? A review of the literature

PubMed Central

Hammoud, Maya M; Morgan, Helen K; Edwards, Mary E; Lyon, Jennifer A; White, Casey

2012-01-01

Purpose To determine if video review of student performance during patient encounters is an effective tool for medical student learning. Methods Multiple bibliographic databases that include medical, general health care, education, psychology, and behavioral science literature were searched for the following terms: medical students, medical education, undergraduate medical education, education, self-assessment, self-evaluation, self-appraisal, feedback, videotape, video recording, televised, and DVD. The authors examined all abstracts resulting from this search and reviewed the full text of the relevant articles as well as additional articles identified in the reference lists of the relevant articles. Studies were classified by year of student (preclinical or clinical) and study design (controlled or non-controlled). Results A total of 67 articles met the final search criteria and were fully reviewed. Most studies were non-controlled and performed in the clinical years. Although the studies were quite variable in quality, design, and outcomes, in general video recording of performance and subsequent review by students with expert feedback had positive outcomes in improving feedback and ultimate performance. Video review with self-assessment alone was not found to be generally effective, but when linked with expert feedback it was superior to traditional feedback alone. Conclusion There are many methods for integrating effective use of video-captured performance into a program of learning. We recommend combining student self-assessment with feedback from faculty or other trained individuals for maximum effectiveness. We also recommend additional research in this area. PMID:23761999

Assuring Crew Health Protection

NASA Technical Reports Server (NTRS)

Robinson, Judith L.

2007-01-01

Amongst the recommendation of the Columbia Accident Investigation Board (CAIB) were the establishment of an independent technical authorities, one of which is the Health and Medical Technical Authority. This viewgraph presentation reviews the work of this Technical Authority in maintaining standards that are aimed at implementing health and medical policy, responding to medical events and emergencies consistent with acceptable levels defined by standards and providing expertise for program milestones.

The relationship between qualified personnel and self-reported implementation of recommended physical education practices and programs in U.S. schools.

PubMed

Davis, Kristen S; Burgeson, Charlene R; Brener, Nancy D; McManus, Tim; Wechsler, Howell

2005-06-01

The authors analyzed data from the School Health Policies and Programs Study 2000 to assess the associations between the presence of a district physical education coordinator and district-level physical education policies and practices recommended by federal government agencies and national organizations. The authors also examined the relationship between teacher qualifications and staff development related to physical education and self-reported implementation of recommended teachingpractices. District-level data were collected by self-administered mail questionnaires from a nationally representative sample of school districts. Classroom-level data were collected by computer-assisted personal interviews with teachers of randomly selected classes in elementary schools and randomly selected required physical education courses in middle/junior high and senior high schools. Nearly two thirds (62.2%) of districts had a physical education coordinator, and those were generally more likely than other districts to report having policies and practices that corresponded with national recommendations for high-quality physical education programs. More than two thirds of teachers (66.9%) met the criteria for teacher qualifications based on their education and certification. These teachers were more likely than others to report use of certain recommended physical education teaching practices. Teachers who participated in staff development also were more likely to use recommended teaching practices in their classrooms. Using a district physical education coordinator and teachers with appropriate qualifications as well as offering staff development opportunities on physical education may enhance school physical education programs.

Evaluation of Industry Relationships Among Authors of Otolaryngology Clinical Practice Guidelines.

PubMed

Horn, Jarryd; Checketts, Jake Xavier; Jawhar, Omar; Vassar, Matt

2018-03-01

Financial relationships between physicians and industry have influence on patient care. Therefore, organizations producing clinical practice guidelines (CPGs) must have policies limiting financial conflicts during guideline development. To evaluate payments received by physician authors of otolaryngology CPGs, compare disclosure statements for accuracy, and investigate the extent to which the American Academy of Otolaryngology-Head and Neck Surgery complied with standards for guideline development from the Institute of Medicine (IOM). This cross-sectional analysis retrieved CPGs from the American Academy of Otolaryngology-Head and Neck Surgery Foundation that were published or revised from January 1, 2013, through December 31, 2015, by 49 authors. Data were retrieved from December 1 through 31, 2016. Industry payments received by authors were extracted using the Centers for Medicare & Medicaid Services Open Payments database. The values and types of these payments were then evaluated and used to determine whether self-reported disclosure statements were accurate and whether guidelines adhered to applicable IOM standards. The monetary amounts and types of payments received by physicians who author otolaryngology guidelines and the accuracy of disclosure statements. Of the 49 physicians in this sample, 39 (80%) received an industry payment. Twenty-one authors (43%) accepted more than $1000; 12 (24%), more than $10 000; 7 (14%), more than $50 000; and 2 (4%), more than $100 000. Mean (SD) financial payments amounted to $18 431 ($53 459) per physician. Total reimbursement for all authors was $995 282. Disclosure statements disagreed with the Open Payments database for 3 authors, amounting to approximately $20 000 among them. Of the 3 IOM standards assessed, only 1 was consistently enforced. Some CPG authors failed to fully disclose all financial conflicts of interest, and most guideline development panels and chairpersons had conflicts. In addition, adherence to IOM standards for guideline development was lacking. This study is relevant to CPG panels authoring recommendations, physicians implementing CPGs to guide patient care, and the organizations establishing policies for guideline development.

The American Academy of Neurology's top five choosing wisely recommendations.

PubMed

Langer-Gould, Annette M; Anderson, Wayne E; Armstrong, Melissa J; Cohen, Adam B; Eccher, Matthew A; Iverson, Donald J; Potrebic, Sonja B; Becker, Amanda; Larson, Rod; Gedan, Alicia; Getchius, Thomas S D; Gronseth, Gary S

2013-09-10

To discuss the American Academy of Neurology (AAN)'s Top Five Recommendations in the Choosing Wisely campaign promoting high-value neurologic medicine and physician-patient communication. The AAN published its Top Five Recommendations in February 2013 in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports. A Choosing Wisely Working Group of 10 AAN members was formed to oversee the process and craft the evidence-based recommendations. AAN members were solicited for recommendations, the recommendations were sent out for external review, and the Working Group members (article authors) used a modified Delphi process to select their Top Five Recommendations. The Working Group submitted 5 neurologic recommendations to the AAN Practice Committee and Board of Directors; all 5 were approved by both entities in September 2012. Recommendation 1: Don't perform EEGs for headaches. Recommendation 2: Don't perform imaging of the carotid arteries for simple syncope without other neurologic symptoms. Recommendation 3: Don't use opioids or butalbital for treatment of migraine, except as a last resort. Recommendation 4: Don't prescribe interferon-β or glatiramer acetate to patients with disability from progressive, nonrelapsing forms of multiple sclerosis. Recommendation 5: Don't recommend carotid endarterectomy for asymptomatic carotid stenosis unless the complication rate is low (<3%).

Long-term Mechanical Circulatory Support System reliability recommendation by the National Clinical Trial Initiative subcommittee.

PubMed

Lee, James

2009-01-01

The Long-Term Mechanical Circulatory Support (MCS) System Reliability Recommendation was published in the American Society for Artificial Internal Organs (ASAIO) Journal and the Annals of Thoracic Surgery in 1998. At that time, it was stated that the document would be periodically reviewed to assess its timeliness and appropriateness within 5 years. Given the wealth of clinical experience in MCS systems, a new recommendation has been drafted by consensus of a group of representatives from the medical community, academia, industry, and government. The new recommendation describes a reliability test methodology and provides detailed reliability recommendations. In addition, the new recommendation provides additional information and clinical data in appendices that are intended to assist the reliability test engineer in the development of a reliability test that is expected to give improved predictions of clinical reliability compared with past test methods. The appendices are available for download at the ASAIO journal web site at www.asaiojournal.com.

[Maternal discharge: conditions and organization for mothers and newborns returning home. The French National Authority for Health recommendations update].

PubMed

Hascoët, J-M; Petitprez, K

2014-09-01

In light of changes in both medical practices and the organization of medical care, the French National Authority for Health (Haute Autorité de santé, HAS) proposed new recommendations on the discharge of mothers and newborns, updating its 2004 recommendations on early discharge of mothers and newborns. This decision in turn made it necessary to define optimal discharge conditions and accompanying measures for mothers and infants returning home. The problem was approached by adopting the usual HAS methodology for drafting good practice recommendations. This involved establishing a working group bringing together representatives of all medical and care fields related to perinatology as well as patient representatives. This working group submitted draft recommendations, based on updated published references, to a committee. The committee then proposed amendments to the recommendations, which the working group was free to accept or reject. The updated recommendations that emerged from this process apply four essential principles : first, preparing for discharge as early as the prenatal period, ideally during the third trimester of pregnancy, in particular by providing expectant mothers with information on how the discharge will be organized and anticipating problems that might arise; second, ensuring care continuity between hospitalization, discharge to home, and follow-up; third, ensuring optimal conditions for discharge after a maternity stay of 72-96 h for normal delivery or 96-120 h in case of caesarean section (this hospital stay duration allows for neonatal screening); and fourth, defining how mothers and children are to be accompanied during the first postnatal month. In conclusion, these recommendations resulted in an increase in the duration of as well as an improvement in routine newborn surveillance, whether in hospital or after discharge, in what is a critical phase of infant development. They encourage ambulatory postnatal monitoring. The new recommendations ensure continuity of care while taking into account mothers' and couples' wish to take responsibility for organizing their own healthcare. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Low-density lipoprotein cholesterol levels and lipid-modifying therapy prescription patterns in the real world: An analysis of more than 33,000 high cardiovascular risk patients in Japan.

PubMed

Teramoto, Tamio; Uno, Kiyoko; Miyoshi, Izuru; Khan, Irfan; Gorcyca, Katherine; Sanchez, Robert J; Yoshida, Shigeto; Mawatari, Kazuhiro; Masaki, Tomoya; Arai, Hidenori; Yamashita, Shizuya

2016-08-01

Low-density lipoprotein cholesterol (LDL-C) is a key modifiable risk factor in the development of cardiovascular (CV) disease. In 2012, the Japan Atherosclerosis Society (JAS) issued guidelines recommending statins as first-line pharmacotherapy for lowering LDL-C in patients at high risk for CV events. This study assessed achievement of recommended LDL-C goals and lipid-modifying therapy (LMT) use in a high CV risk population in Japan. Patients from the Medical Data Vision (MDV) database, an electronic hospital-based claims database in Japan, who met the following inclusion criteria were included in this study: LDL-C measurement in 2013; ≥20 years of age; ≥2 years representation in the database; and a high CV risk condition (recent acute coronary syndrome (ACS), other coronary heart disease (CHD), ischemic stroke, peripheral arterial disease (PAD) or diabetes). LDL-C goal attainment was assessed based on LDL-C targets in the JAS guidelines. A total of 33,325 high CV risk patients met the inclusion criteria. Overall, 68% of the cohort achieved guideline recommended LDL-C targets, with only 42% receiving current treatment with statins. Attainment of LDL-C goals was 68% for ACS, 55% for CHD, and 80% each for ischemic stroke, PAD, and diabetes patients. Concomitant use of non-statin LMTs was low. In a high CV risk population in a routine care setting in Japan, guideline recommended LDL-C goal attainment and utilization of statins and other LMT was low. In addition, physicians appeared to be more likely to consider the initiation of statins in patients with higher baseline LDL-C levels. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Psychology Needs Realism, Not Instrumentalism

ERIC Educational Resources Information Center

Haig, Brian D.

2005-01-01

In this article, the author presents his comments on "Realism, Instrumentalism, and Scientific Symbiosis: Psychological Theory as a Search for Truth and the Discovery of Solutions" by John T. Cacioppo, Gun R. Semin and Gary G. Berntson. In the original article, the authors recommended the combined use of the philosophies of scientific realism and…

Strategic Reporting Tool: Balanced Scorecards in Higher Education

ERIC Educational Resources Information Center

Lyddon, Jan W.; McComb, Bruce E.

2008-01-01

In this toolbox article, the authors describe the recommended steps for creating a community college balanced scorecard that measures and reports on key performance indicators based on targets and signal values to end-users, college constituents and external stakeholders. Based on extensive experience in the field, the authors provide a…

75 FR 56662 - Proposed Information Collection (Application for Authority To Close Loans on an Automatic Basis...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0252] Proposed Information Collection (Application for Authority To Close Loans on an Automatic Basis--Nonsupervised Lenders) Activity: Comment... on an automatic basis. DATES: Written comments and recommendations on the proposed collection of...

Selecting Spanish Books in the Elementary School

ERIC Educational Resources Information Center

Corona, Elia

2007-01-01

In this article, the author recommends a certain criteria for selecting Spanish-language books for elementary students such as cultural factors, setting, time, age, language and visuals. She also enumerates some authors and a listing of their many bilingual texts, which can be used to enrich a school or classroom library.

76 FR 10420 - Delegation of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-24

... Standard Operating Procedure 00 01 2, Chapter 3, paragraph 2, or is unable to perform the functions and... to the Administrator for approval applications for licenses to operate as a small business investment... authorities granted by the Administrator to recommend and approve applications for a license to operate as a...

33 CFR 263.17 - Planning, design and construction procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... recommendations. Public notices are not required when a feasibility study is terminated without submittal of a DPR...) WASH DC 20314, depending on the study authority, as provided for in § 263.16(a). (a) Initiation of... sufficient justification for authorizing a feasibility study. Reporting officers are to notify the Division...

33 CFR 263.17 - Planning, design and construction procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... recommendations. Public notices are not required when a feasibility study is terminated without submittal of a DPR...) WASH DC 20314, depending on the study authority, as provided for in § 263.16(a). (a) Initiation of... sufficient justification for authorizing a feasibility study. Reporting officers are to notify the Division...

Longleaf pine site zones

Treesearch

Phillip J. Craul; John S. Kush; William D. Boyer

2005-01-01

The authors delineate six major climatic areas of the longleaf pine (Pinus palustris Mill.) region. They subdivide these areas into 21 site zones, each of which is deemed homogenous with respect to climate, physiography, and soils. The site zones are mapped and their climate, physiography, and soils described. The authors recommend that plantings of...

45 CFR 2101.1 - Statutory and Executive Order Authority.

Code of Federal Regulations, 2011 CFR

2011-10-01

... government, the Commission advises upon their location in public squares, streets, and parks, and the merits... texture of exterior materials as would be seen from public space; and the Commission makes recommendations... 45 Public Welfare 4 2011-10-01 2011-10-01 false Statutory and Executive Order Authority. 2101.1...

45 CFR 2101.1 - Statutory and Executive Order Authority.

Code of Federal Regulations, 2010 CFR

2010-10-01

... government, the Commission advises upon their location in public squares, streets, and parks, and the merits... texture of exterior materials as would be seen from public space; and the Commission makes recommendations... 45 Public Welfare 4 2010-10-01 2010-10-01 false Statutory and Executive Order Authority. 2101.1...

Critical Quantitative Study of Immigrant Students

ERIC Educational Resources Information Center

Conway, Katherine M.

2014-01-01

The author discusses the importance of critical quantitative research for studies of immigrant students, a large and growing group, whose higher education experience is crucial to the future of the United States. The author outlines some of the distinctions to be made among immigrant students and recommends areas of future inquiry.

Weaving Authenticity and Legitimacy: Latina Faculty Peer Mentoring

ERIC Educational Resources Information Center

Núñez, Anne-Marie; Murakami, Elizabeth T.; Gonzales, Leslie D.

2015-01-01

As an alternative to typical top-down mentoring models, the authors advance a conception of peer mentoring that is based on research about collectivist strategies that Latina faculty employ to navigate the academy. The authors advance recommendations for institutional agents to support mentoring for faculty who are members of historically…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wainman, B.

The author discusses her thoughts on prospects for an energy policy from this Congress. She doesn`t believe the country will see any big sweeping energy policy acts or even utility deregulation in the next two years. Education on the issues is necessary. The author discusses the impacts for clean coal technologies and recommends continued aggressive work on deployment.

77 FR 47812 - Yakutat Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... Yakutat, Alaska. The committee is authorized under the Secure Rural Schools and Community Self... recommendations to the Forest Service concerning projects and funding consistent with the title II [[Page 47813... projects authorized under title II of the Act. DATES: The meeting will be held September 7, 2012, 6 p.m...

77 FR 50676 - Hood/Willamette Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-22

... will meet in Salem, Oregon. The committee is authorized under the Secure Rural Schools and Community... and recommendations to the Forest Service concerning projects and funding consistent with the title II... projects authorized under title II of the Act. DATES: The meeting will be held on September 27, 2012, at 9...

Recommendations for harmonization of data collection and analysis of developmental neurotoxicity endpoints in regulatory guideline studies: Proceedings of workshops presented at Society of Toxicology and joint Teratology Society and Neurobehavioral Teratology Society meetings.

PubMed

Li, Abby A; Sheets, Larry P; Raffaele, Kathleen; Moser, Virginia; Hofstra, Angela; Hoberman, Alan; Makris, Susan L; Garman, Robert; Bolon, Brad; Kaufmann, Wolfgang; Auer, Roland; Lau, Edmund; Vidmar, Thomas; Bowers, Wayne J

2017-09-01

The potential for developmental neurotoxicity (DNT) of environmental chemicals may be evaluated using specific test guidelines from the US Environmental Protection Agency or the Organisation for Economic Cooperation and Development (OECD). These guidelines generate neurobehavioral, neuropathological, and morphometric data that are evaluated by regulatory agencies globally. Data from these DNT guideline studies, or the more recent OECD extended one-generation reproductive toxicity guideline, play a pivotal role in children's health risk assessment in different world areas. Data from the same study may be interpreted differently by regulatory authorities in different countries resulting in inconsistent evaluations that may lead to inconsistencies in risk assessment decisions internationally, resulting in regional differences in public health protection or in commercial trade barriers. These issues of data interpretation and reporting are also relevant to juvenile and pre-postnatal studies conducted more routinely for pharmaceuticals and veterinary medicines. There is a need for development of recommendations geared toward the operational needs of the regulatory scientific reviewers who apply these studies in risk assessments, as well as the scientists who generate DNT data sets. The workshops summarized here draw upon the experience of the authors representing government, industry, contract research organizations, and academia to discuss the scientific issues that have emerged from diverse regulatory evaluations. Although various regulatory bodies have different risk management decisions and labeling requirements that are difficult to harmonize, the workshops provided an opportunity to work toward more harmonized scientific approaches for evaluating DNT data within the context of different regulatory frameworks. Five speakers and their coauthors with neurotoxicology, neuropathology, and regulatory toxicology expertise discussed issues of variability, data reporting and analysis, and expectations in DNT data that are encountered by regulatory authorities. In addition, principles for harmonized evaluation of data were suggested using guideline DNT data as case studies. Copyright © 2017. Published by Elsevier Inc.

Physician 'defiance' towards hand hygiene compliance: Is there a theory-practice-ethics gap?

PubMed

Mortell, Manfred; Balkhy, Hanan H; Tannous, Elias B; Jong, Mei Thiee

2013-07-01

The theory-practice gap has always existed [1,2]. This gap is often cited as a culmination of theory being idealistic and impractical, even if practical and beneficial, is often ignored. Most of the evidence relating to the non-integration of theory and practice assumes that environmental factors are responsible and will affect learning and practice outcomes, hence the gap. Therefore, the author believes that to 'bridge the gap' between theory and practice, an additional dimension is required: ethics. A moral duty and obligation ensuring theory and practice integrate. In order to effectively implement new practices, one must deem these practices as worthy and relevant to their role as healthcare providers (HCP). Hence, this introduces a new concept which the author refers to as the theory-practice-ethics gap. This theory-practice-ethics gap must be considered when reviewing some of the unacceptable outcomes in healthcare practice [3]. The literature suggests that there is a crisis of ethics where theory and practice integrate, and healthcare providers are failing to fulfill our duty as patient advocates. Physician hand hygiene practices and compliance at King Abdulaziz Cardiac Centre (KACC) are consistent with those of other physicians in the global healthcare arena. That is one of noncompliance to King Abdulaziz Medical City (KAMC) organizational expectations and the World Health Organization (WHO) requirements? An observational study was conducted on the compliance of cardiac surgeons, cardiologists and nurses in the authors' cardiac center from January 2010 to December 2011. The hand hygiene (HH) compliance elements that were evaluated pertained to the WHO's five moments of HH recommendations. The data was obtained through direct observation by KAMC infection prevention and control practitioners. Physician hand hygiene compliance at KACC was consistently less than 60%, with nurses regularly encouraging physicians to be diligent with hand hygiene practices in the clinical area. Hand hygiene compliance will not improve unless evidence-based recommendations are adopted and endorsed by all healthcare professionals and providers.

Ocular toxocariasis: new diagnostic and therapeutic perspectives.

PubMed

Martínez-Pulgarín, Dayron F; Muñoz-Urbano, Marcela; Gomez-Suta, Luz D; Delgado, Olinda M; Rodriguez-Morales, Alfonso J

2015-01-01

To provide an updated insight of concepts regarding the overview, epidemiology, risk factors, clinical manifestations, diagnosis, treatment and prevention of ocular toxocariasis. Perspective of literature review. Review and synthesis of literature about toxocariasis, with interpretation and perspective. A literature search for "ocular toxocariasis" was performed using PubMed, ScienceDirect, Scopus, SciELO and LILACS databases. Mild to moderate infections are frequently reported in ocular toxocariasis which usually occurs in children and typically presents as unilateral vision impairment, blindness is common and could present invasion of the retina. There are three groups of presentation of toxocariasis (according to the physical examination): chronic endophthalmitis, posterior granuloma and peripheral granuloma. Standard diagnosis of ocular toxocariasis is based on the identification of clinical signs, supported by additional diagnostic methods. Regarding treatment, there is no commonly accepted regimen but most of the authors prefer to use steroids and anthelminthic agents, but nowadays there are no standardized parameters in terms of dosage, duration and route of administration. Surgery has been recommended in some cases. Toxocariasis is still a problem of public health, particularly in developing countries with an increasing epidemiological burden in terms of morbidity and mortality and most of the authors agree on the utmost relevance of its prevention. Clinical experience and suspicion of ophthalmologists make an important role in its diagnosis, but always with supportive diagnostic methods. Additional studies should explore new therapeutic options for toxocariasis.

Weighing the cost of educational inflation in undergraduate medical education.

PubMed

Cusano, Ronald; Busche, Kevin; Coderre, Sylvain; Woloschuk, Wayne; Chadbolt, Karen; McLaughlin, Kevin

2017-08-01

Despite the fact that the length of medical school training has remained stable for many years, the expectations of graduating medical students (and the schools that train them) continue to increase. In this Reflection, the authors discuss motives for educational inflation and suggest that these are likely innocent, well-intentioned, and subconscious-and include both a propensity to increase expectations of ourselves and others over time, and a reluctance to reduce training content and expectations. They then discuss potential risks of educational inflation, including reduced emphasis on core knowledge and clinical skills, and adverse effects on the emotional, psychological, and financial wellbeing of students. While acknowledging the need to change curricula to improve learning and clinical outcomes, the authors proffer that it is naïve to assume that we can inflate educational expectations at no additional cost. They suggest that before implementing and/or mandating change, we should consider of all the costs that medical schools and students might incur, including opportunity costs and the impact on the emotional and financial wellbeing of students. They propose a cost-effectiveness framework for medical education and advocate prioritization of interventions that improve learning outcomes with no additional costs or are cost-saving without adversely impacting learning outcomes. When there is an additional cost for improved learning outcomes or a decline in learning outcomes as a result of cost saving interventions, they suggest careful consideration and justification of this trade-off. And when there are neither improved learning outcomes nor cost savings they recommend resisting the urge to change.

Hybrid employment recommendation algorithm based on Spark

NASA Astrophysics Data System (ADS)

Li, Zuoquan; Lin, Yubei; Zhang, Xingming

2017-08-01

Aiming at the real-time application of collaborative filtering employment recommendation algorithm (CF), a clustering collaborative filtering recommendation algorithm (CCF) is developed, which applies hierarchical clustering to CF and narrows the query range of neighbour items. In addition, to solve the cold-start problem of content-based recommendation algorithm (CB), a content-based algorithm with users’ information (CBUI) is introduced for job recommendation. Furthermore, a hybrid recommendation algorithm (HRA) which combines CCF and CBUI algorithms is proposed, and implemented on Spark platform. The experimental results show that HRA can overcome the problems of cold start and data sparsity, and achieve good recommendation accuracy and scalability for employment recommendation.

Do published studies of educational outreach provide documentation of potentially important characteristics?

PubMed

Van Hoof, Thomas J; Miller, Nicole E; Meehan, Thomas P

2013-01-01

Educational outreach is a common intervention used to translate research findings into practice; however, the intervention has a mixed effect on changing clinician behavior and improving patient outcomes. Based on a published set of characteristics aimed at standardizing the approach to educational outreach, the authors undertook a careful review of the literature to determine the consistency and completeness of documentation. Using a 25-item abstraction tool, the authors reviewed 68 published studies of a recent Cochrane meta-analysis to determine the extent to which educational outreach studies provide recommended documentation of important characteristics. The results indicate that studies are generally inconsistent (documentation range of 0% to 100% across characteristics) and incomplete (documentation average of 43.1% across studies) in their descriptions. Documentation shortcomings of educational outreach studies make understanding the intervention and interpreting its findings particularly challenging. The authors recommend the creation of a guideline to help improve documentation of educational outreach efforts.

A report on syphilis control in Turkey

PubMed Central

Christiansen, Sven

1954-01-01

This report presents the results of a six-month survey of the nature and extent of venereal diseases in Turkey which was undertaken by the author, on behalf of WHO, at the request of the Turkish Government. The first part of the report outlines the present venereal-disease-control system and includes descriptions of the work undertaken by public authorities, hospitals and dispensaries, mobile venereal-disease-control teams, and laboratories; in the second part, the author enumerates certain recommendations for the intensification of the current control programme. These recommendations are particularly concerned with the control of syphilis (since the incidence of other venereal diseases in Turkey is of very secondary importance), and with the expansion, standardization, and co-ordination of serodiagnostic facilities and services. It is suggested that there might be a gradual intensification and reorientation of the present programme. A proposed plan of operations for an eight-year period is described. PMID:13182590

An examination of gender differences in the American Fisheries Society peer-review process

USGS Publications Warehouse

Handley, Grace; Frantz, Cynthia M; Kocovsky, Patrick; DeVries, Dennis R.; Cooke, Steven J.; Claussen, Julie

2015-01-01

This study investigated the possibility of gender differences in outcomes throughout the peer review process of American Fisheries Society (AFS) journals. For each manuscript submitted to four AFS journals between January 2003 and December 2010, we collated information regarding the gender and nationality of authors, gender of associate editor, gender of reviewers, reviewer recommendations, associate editor's decision, and publication status of the manuscript. We used hierarchical linear modeling to test for differences in manuscript decision outcomes associated with author, reviewer, and associate editor gender. Gender differences were present at some but not every stage of the review process and were not equal among the four journals. Although there was a small gender difference in decision outcomes, we found no evidence of bias in editors’ and reviewers’ recommendations. Our results support the conclusion that the current single-blind review system does not result in bias against female authors within AFS journals.

Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline.

PubMed

Lenders, Jacques W M; Duh, Quan-Yang; Eisenhofer, Graeme; Gimenez-Roqueplo, Anne-Paule; Grebe, Stefan K G; Murad, Mohammad Hassan; Naruse, Mitsuhide; Pacak, Karel; Young, William F

2014-06-01

The aim was to formulate clinical practice guidelines for pheochromocytoma and paraganglioma (PPGL). The Task Force included a chair selected by the Endocrine Society Clinical Guidelines Subcommittee (CGS), seven experts in the field, and a methodologist. The authors received no corporate funding or remuneration. This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. The Task Force reviewed primary evidence and commissioned two additional systematic reviews. One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, European Society of Endocrinology, and Americal Association for Clinical Chemistry reviewed drafts of the guidelines. The Task Force recommends that initial biochemical testing for PPGLs should include measurements of plasma free or urinary fractionated metanephrines. Consideration should be given to preanalytical factors leading to false-positive or false-negative results. All positive results require follow-up. Computed tomography is suggested for initial imaging, but magnetic resonance is a better option in patients with metastatic disease or when radiation exposure must be limited. (123)I-metaiodobenzylguanidine scintigraphy is a useful imaging modality for metastatic PPGLs. We recommend consideration of genetic testing in all patients, with testing by accredited laboratories. Patients with paraganglioma should be tested for SDHx mutations, and those with metastatic disease for SDHB mutations. All patients with functional PPGLs should undergo preoperative blockade to prevent perioperative complications. Preparation should include a high-sodium diet and fluid intake to prevent postoperative hypotension. We recommend minimally invasive adrenalectomy for most pheochromocytomas with open resection for most paragangliomas. Partial adrenalectomy is an option for selected patients. Lifelong follow-up is suggested to detect recurrent or metastatic disease. We suggest personalized management with evaluation and treatment by multidisciplinary teams with appropriate expertise to ensure favorable outcomes.

2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis.

PubMed

Ross, Douglas S; Burch, Henry B; Cooper, David S; Greenlee, M Carol; Laurberg, Peter; Maia, Ana Luiza; Rivkees, Scott A; Samuels, Mary; Sosa, Julie Ann; Stan, Marius N; Walter, Martin A

2016-10-01

Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This document describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspecialty physicians and others providing care for patients with this condition. The American Thyroid Association (ATA) previously cosponsored guidelines for the management of thyrotoxicosis that were published in 2011. Considerable new literature has been published since then, and the ATA felt updated evidence-based guidelines were needed. The association assembled a task force of expert clinicians who authored this report. They examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to update the 2011 text and recommendations. The strength of the recommendations and the quality of evidence supporting them were rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' orbitopathy; and management of other miscellaneous causes of thyrotoxicosis. New paradigms since publication of the 2011 guidelines are presented for the evaluation of the etiology of thyrotoxicosis, the management of Graves' hyperthyroidism with antithyroid drugs, the management of pregnant hyperthyroid patients, and the preparation of patients for thyroid surgery. The sections on less common causes of thyrotoxicosis have been expanded. One hundred twenty-four evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.

Enhancement of NRC station blackout requirements for nuclear power plants

DOE Office of Scientific and Technical Information (OSTI.GOV)

McConnell, M. W.

2012-07-01

The U.S. Nuclear Regulatory Commission (NRC) established a Near-Term Task Force (NTTF) in response to Commission direction to conduct a systematic and methodical review of NRC processes and regulations to determine whether the agency should make additional improvements to its regulatory system and to make recommendations to the Commission for its policy direction, in light of the accident at the Fukushima Dai-ichi Nuclear Power Plant. The NTTF's review resulted in a set of recommendations that took a balanced approach to defense-in-depth as applied to low-likelihood, high-consequence events such as prolonged station blackout (SBO) resulting from severe natural phenomena. Part 50,more » Section 63, of Title 10 of the Code of Federal Regulations (CFR), 'Loss of All Alternating Current Power,' currently requires that each nuclear power plant must be able to cool the reactor core and maintain containment integrity for a specified duration of an SBO. The SBO duration and mitigation strategy for each nuclear power plant is site specific and is based on the robustness of the local transmission system and the transmission system operator's capability to restore offsite power to the nuclear power plant. With regard to SBO, the NTTF recommended that the NRC strengthen SBO mitigation capability at all operating and new reactors for design-basis and beyond-design-basis external events. The NTTF also recommended strengthening emergency preparedness for prolonged SBO and multi-unit events. These recommendations, taken together, are intended to clarify and strengthen US nuclear reactor safety regarding protection against and mitigation of the consequences of natural disasters and emergency preparedness during SBO. The focus of this paper is on the existing SBO requirements and NRC initiatives to strengthen SBO capability at all operating and new reactors to address prolonged SBO stemming from design-basis and beyond-design-basis external events. The NRC initiatives are intended to enhance core and spent fuel pool cooling, reactor coolant system integrity, and containment integrity. (authors)« less

The Author’s Guide to Writing Air Force Flight Test Center Technical Reports

DTIC Science & Technology

2009-08-01

or designated technical expert 2. Author(s): you and anyone also listed as an author 3. Author’s lead at the test organization 4. An operator...it was designed to do, not what it actually did (it should not sound like results). 4. Objectives: State the general objective(s). Do not list the...met or could not meet design objectives and whether or not it was cleared for operational release, as applicable. Do not provide recommendations

Hanford waste-form release and sediment interaction: A status report with rationale and recommendations for additional studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Serne, R.J.; Wood, M.I.

1990-05-01

This report documents the currently available geochemical data base for release and retardation for actual Hanford Site materials (wastes and/or sediments). The report also recommends specific laboratory tests and presents the rationale for the recommendations. The purpose of this document is threefold: to summarize currently available information, to provide a strategy for generating additional data, and to provide recommendations on specific data collection methods and tests matrices. This report outlines a data collection approach that relies on feedback from performance analyses to ascertain when adequate data have been collected. The data collection scheme emphasizes laboratory testing based on empiricism. 196more » refs., 4 figs., 36 tabs.« less

Key pharmacovigilance stakeholders' experiences of direct patient reporting of adverse drug reactions and their prospects of future development in the European Union.

PubMed

Inácio, P; Cavaco, A; Allan, E; Airaksinen, M

2018-02-01

In the European Union (EU), legislation allows patients to directly report adverse drug reactions (ADRs) to competent authorities. Five years after its implementation, patient reporting is not equal in all countries. This study aimed to explore key stakeholders' perceptions of patient reporting in four EU countries. Qualitative study design. Twelve representatives from national pharmacovigilance centres and/or authorities as well as national pharmaceutical industry bodies in four EU countries participated in the study. Supranational organizations were also included. Data collection was via face-semi-structured interviews. Inductive content analysis was performed thereafter, applying principles of risk management as a theoretical framework. Four themes (attitudes and beliefs, system maturation factors, regulatory improvements, and cultural shifts) emerged, conceptually interconnected. Participants from countries introducing patient reporting recently expressed a negative attitude. Participants highlighted the need for additional resources, both human and financial, to address patient reporting and associated advantages. The findings identified perceived barriers and facilitators of patient reporting. The involvement of patients, use of information, and dissemination of patient reporting are far from optimal. A better integration of the work by EU regulatory authorities is recommended. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Extraction of depth-dependent perturbation factors for silicon diodes using a plastic scintillation detector.

PubMed

Lacroix, Frederic; Guillot, Mathieu; McEwen, Malcolm; Gingras, Luc; Beaulieu, Luc

2011-10-01

This work presents the experimental extraction of the perturbation factor in megavoltage electron beams for three models of silicon diodes (IBA Dosimetry, EFD and SFD, and the PTW 60012 unshielded) using a plastic scintillation detector (PSD). The authors used a single scanning PSD mounted on a high-precision scanning tank to measure depth-dose curves in 6-, 12-, and 18-MeV clinical electron beams. They also measured depth-dose curves using the IBA Dosimetry, EFD and SFD, and the PTW 60012 unshielded diodes. The authors used the depth-dose curves measured with the PSD as a perturbation-free reference to extract the perturbation factors of the diodes. The authors found that the perturbation factors for the diodes increased substantially with depth, especially for low-energy electron beams. The experimental results show the same trend as published Monte Carlo simulation results for the EFD diode; however, the perturbations measured experimentally were greater. They found that using an effective point of measurement (EPOM) placed slightly away from the source reduced the variation of perturbation factors with depth and that the optimal EPOM appears to be energy dependent. The manufacturer recommended EPOM appears to be incorrect at low electron energy (6 MeV). In addition, the perturbation factors for diodes may be greater than predicted by Monte Carlo simulations.

Prevention of diabetes in Mexico: pragmatic solutions for a complex problem.

PubMed

Aguilar-Salinas, Carlos A; Rodriguez, Hector Bourges; Oteyza, Ernestina Polo

2017-01-01

The Tenth Nestlé Nutrition Conference, held in Mexico City in November 2014, focused on prevention of type 2 diabetes considering environment, lifestyles, and nutrition. Based on the evidence and recommendations presented during the conference, which are summarized in another article within this supplemental issue, a series of pragmatic proposals to address the environmental, social, and medical factors that have contributed to the growing prevalence of type 2 diabetes in Mexico was formulated. For this article, the actions were organized into 2 conceptual models: one that is applicable for the whole population and the other for at-risk individuals. In addition, each of the items includes the personal views of the authors regarding feasible actions that could be implemented in Mexico. Readers will find a large number of initiatives that could be applied at various levels and for particular subsets of the population. This makes it feasible for improvements to be induced through environmental changes and/or via increased access for at-risk individuals to validated interventions that prevent or delay the onset of diabetes. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

New Coke, Rosetta Stones, and Functional Data Analysis: Recommendations for Developing and Validating New Measures of Depression

ERIC Educational Resources Information Center

Santor, Darcy A.

2006-01-01

In this article, the author outlines six recommendations that may guide the continued development and validation of measures of depression. These are (a) articulate and revise a formal theory of signs and symptoms; (b) differentiate complex theoretical goals from pragmatic evaluation needs; (c) invest heavily in new methods and analytic models;…

Improving Synthetic Biology Communication: Recommended Practices for Visual Depiction and Digital Submission of Genetic Designs.

PubMed

Hillson, Nathan J; Plahar, Hector A; Beal, Jacob; Prithviraj, Ranjini

2016-06-17

Research is communicated more effectively and reproducibly when articles depict genetic designs consistently and fully disclose the complete sequences of all reported constructs. ACS Synthetic Biology is now providing authors with updated guidance and piloting a new tool and publication workflow that facilitate compliance with these recommended practices and standards for visual representation and data exchange.

STS/Spacelab payload utilization planning study: Executive summary

NASA Technical Reports Server (NTRS)

1976-01-01

The planning process recommended to meet the orbital flight requirements for the Space Transportation System and payload development, procurement, operations, and support leading to authorization and funding of STS and payload project activities is described. The rationale and rp primary products of STS utilization planning are summarized along with the implementation of the system. Major recommendations of the study are included.

Interagency Report on Orbital Debris, 1995

NASA Technical Reports Server (NTRS)

1995-01-01

This 1995 report updates the findings and recommendations of the 1989 report and reflects the authors' progress in understanding and managing the orbital debris environment. It provides an up-to-date portrait of their measurement, modeling, and mitigation efforts; and a set of recommendations outlining specific steps they should pursue, both domestically and internationally, to minimize the potential hazard posed by orbital debris.

More Recommended Favorites/Bookmarks for Teaching Social Studies with the Internet

ERIC Educational Resources Information Center

Risinger, C. Frederick

2011-01-01

Just about three years ago, the author wrote a column titled "What Websites Are on My Favorites List." He received a great deal of e-mail about his selections. While some readers criticized one or more of his selections, many more sent him recommendations for other websites they found helpful in their planning and instruction. He thought it was…

Typhoid fever in Fiji: a reversible plague?

PubMed

Thompson, Corinne N; Kama, Mike; Acharya, Shrish; Bera, Una; Clemens, John; Crump, John A; Dawainavesi, Aggie; Dougan, Gordon; Edmunds, W John; Fox, Kimberley; Jenkins, Kylie; Khan, M Imran; Koroivueta, Josefa; Levine, Myron M; Martin, Laura B; Nilles, Eric; Pitzer, Virginia E; Singh, Shalini; Raiwalu, Ratu Vereniki; Baker, Stephen; Mulholland, Kim

2014-10-01

The country of Fiji, with a population of approximately 870 000 people, faces a growing burden of several communicable diseases including the bacterial infection typhoid fever. Surveillance data suggest that typhoid has become increasingly common in rural areas of Fiji and is more frequent amongst young adults. Transmission of the organisms that cause typhoid is facilitated by faecal contamination of food or water and may be influenced by local behavioural practices in Fiji. The Fijian Ministry of Health, with support from Australian Aid, hosted a meeting in August 2012 to develop comprehensive control and prevention strategies for typhoid fever in Fiji. International and local specialists were invited to share relevant data and discuss typhoid control options. The resultant recommendations focused on generating a clearer sense of the epidemiology of typhoid in Fiji and exploring the contribution of potential transmission pathways. Additionally, the panel suggested steps such as ensuring that recommended ciprofloxacin doses are appropriate to reduce the potential for relapse and reinfection in clinical cases, encouraging proper hand hygiene of food and drink handlers, working with water and sanitation agencies to review current sanitation practices and considering a vaccination policy targeting epidemiologically relevant populations. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

Reshaping policy to deliver holistic care for adolescents with Crohn's disease.

PubMed

Smith, Claudia; Gettings, Sheryl

2016-12-08

The number of adolescents with Crohn's disease (CD) is rising, with one third of cases diagnosed before turning 21 years old. Evidence shows that long-term medical intervention, school absence and the physical toll of CD on the growing adolescent also have a psychological effect on patients. In addition, poorly defined transition pathways are extending these problems into adulthood. The National Institute for Health and Care Excellence (NICE) guidelines are important in shaping service delivery and distribution. However, analysis of the full 2012 NICE CD management guidelines indicates they fall short of providing adequate recommendations for holistic management of the disease in young populations. An update in 2016 added a new clinical recommendation to the guidelines, but no further exploration of the psychosocial aspects of the impact of the disease. The authors of this article used a critical review of literature and concluded that service provision for adolescents with CD could be made better by improving CD support networks, involving young people in the development of policy centred on their care, as well as incorporating other (non-NICE) well-researched CD guidelines in national policy. These changes would improve quality of life for this vulnerable population.

Guidelines and recommendations on yeast cell death nomenclature.

PubMed

Carmona-Gutierrez, Didac; Bauer, Maria Anna; Zimmermann, Andreas; Aguilera, Andrés; Austriaco, Nicanor; Ayscough, Kathryn; Balzan, Rena; Bar-Nun, Shoshana; Barrientos, Antonio; Belenky, Peter; Blondel, Marc; Braun, Ralf J; Breitenbach, Michael; Burhans, William C; Büttner, Sabrina; Cavalieri, Duccio; Chang, Michael; Cooper, Katrina F; Côrte-Real, Manuela; Costa, Vítor; Cullin, Christophe; Dawes, Ian; Dengjel, Jörn; Dickman, Martin B; Eisenberg, Tobias; Fahrenkrog, Birthe; Fasel, Nicolas; Fröhlich, Kai-Uwe; Gargouri, Ali; Giannattasio, Sergio; Goffrini, Paola; Gourlay, Campbell W; Grant, Chris M; Greenwood, Michael T; Guaragnella, Nicoletta; Heger, Thomas; Heinisch, Jürgen; Herker, Eva; Herrmann, Johannes M; Hofer, Sebastian; Jiménez-Ruiz, Antonio; Jungwirth, Helmut; Kainz, Katharina; Kontoyiannis, Dimitrios P; Ludovico, Paula; Manon, Stéphen; Martegani, Enzo; Mazzoni, Cristina; Megeney, Lynn A; Meisinger, Chris; Nielsen, Jens; Nyström, Thomas; Osiewacz, Heinz D; Outeiro, Tiago F; Park, Hay-Oak; Pendl, Tobias; Petranovic, Dina; Picot, Stephane; Polčic, Peter; Powers, Ted; Ramsdale, Mark; Rinnerthaler, Mark; Rockenfeller, Patrick; Ruckenstuhl, Christoph; Schaffrath, Raffael; Segovia, Maria; Severin, Fedor F; Sharon, Amir; Sigrist, Stephan J; Sommer-Ruck, Cornelia; Sousa, Maria João; Thevelein, Johan M; Thevissen, Karin; Titorenko, Vladimir; Toledano, Michel B; Tuite, Mick; Vögtle, F-Nora; Westermann, Benedikt; Winderickx, Joris; Wissing, Silke; Wölfl, Stefan; Zhang, Zhaojie J; Zhao, Richard Y; Zhou, Bing; Galluzzi, Lorenzo; Kroemer, Guido; Madeo, Frank

2018-01-01

Elucidating the biology of yeast in its full complexity has major implications for science, medicine and industry. One of the most critical processes determining yeast life and physiology is cel-lular demise. However, the investigation of yeast cell death is a relatively young field, and a widely accepted set of concepts and terms is still missing. Here, we propose unified criteria for the defi-nition of accidental, regulated, and programmed forms of cell death in yeast based on a series of morphological and biochemical criteria. Specifically, we provide consensus guidelines on the differ-ential definition of terms including apoptosis, regulated necrosis, and autophagic cell death, as we refer to additional cell death rou-tines that are relevant for the biology of (at least some species of) yeast. As this area of investigation advances rapidly, changes and extensions to this set of recommendations will be implemented in the years to come. Nonetheless, we strongly encourage the au-thors, reviewers and editors of scientific articles to adopt these collective standards in order to establish an accurate framework for yeast cell death research and, ultimately, to accelerate the pro-gress of this vibrant field of research.

Anorexia/cachexia-related quality of life for children with cancer.

PubMed

Lai, Jin-Shei; Cella, David; Peterman, Amy; Barocas, Joshua; Goldman, Stewart

2005-10-01

Anorexia is a common symptom in patients with cancer, which can lead to poor tolerance of treatment and can contribute to cachexia in extreme cases. Children with advanced-stage cancer are especially vulnerable to malnutrition resulting from anorexia and cachexia. Currently, there are no instruments that measure common concerns specifically associated with anorexia and cachexia in children with cancer. The purpose of the current article was to test the psychometric properties of a newly developed pediatric Functional Assessment of Anorexia and Cachexia Therapy (peds-FAACT) for children with cancer. Ninety-six patients (ages 7-17 yrs) receiving cancer treatment and their parents were asked to complete the 12-item peds-FAACT. The authors implemented both classical test theory and item response theory to evaluate the agreement between parents and patients, internal consistency and unidimensionality of the scale, and stability of items across subgroups. As a result, a patient-reported six-item scale was recommended as the core measure for all pediatric patients with cancer and four additional peripheral items were recommended for adolescent patients. The peds-FAACT demonstrated good psychometric properties, differentiated patients with different functional performance status, and was determined to be a useful tool for future clinical trials.

[The German program for disease management guidelines: type 2 diabetes--diabetic retinopathy/maculopathy guideline 2006. Short review].

PubMed

Ollenschläger, Günter; Kopp, Ina; Thole, Henning; Lelgemann, Monika

2007-02-15

In Germany, the first national consensus between six medical scientific associations on evidence-based recommendations for prevention and therapy of retinopathy/maculopathy in type 2 diabetes was reached in fall 2006. The recommendations' main sources are the NICE Retinopathy Guideline 2002, and existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Type 2 Diabetes-Retinopathy/Maculopathy 2006 (www.diabetes.versorgungsleitlinien.de).

Whole dietary patterns to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field.

PubMed

Teo, Lynn; Crawford, Cindy; Yehuda, Rachel; Jaghab, Danny; Bingham, John J; Gallon, Matthew D; O'Connell, Meghan L; Chittum, Holly K; Arzola, Sonya M; Berry, Kevin

2017-06-01

Optimizing cognitive performance, particularly during times of high stress, is a prerequisite to mission-readiness among military personnel. It has been of interest to determine whether such performance could be enhanced through diet. This systematic review assesses the quality of the evidence for whole dietary patterns across various outcomes related to cognitive function in healthy adult populations to develop research recommendations for the military. PubMed, CINAHL, Embase, PsycInfo, and the Cochrane Library were searched. Peer-reviewed randomized controlled trials published in the English language were eligible. Fifteen included trials were assessed for methodological quality, and descriptive data were extracted. Of the 6 acceptable-quality studies, 1 demonstrated statistically nonsignificant results, whereas the other 5 showed conflicting results across the cognitive outcomes assessed. Due to the heterogeneity across the included studies, no recommendations could be reached concerning whether certain whole dietary patterns have an effect on cognitive outcomes in healthy populations. Specific recommendations for future research are offered. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Examining the front lines of local environmental public health practice: a Maryland case study.

PubMed

Resnick, Beth; Zablotsky, Joanna; Nachman, Keeve; Burke, Thomas

2008-01-01

Local environmental public health (EPH) is the foundation of a nation's environmental protection infrastructure. With increasing pressure to demonstrate the ability of EPH activities to effectively protect health, the Johns Hopkins Center for Excellence in EPH Practice, as part of the Centers for Disease Control and Prevention's (CDC's) EPH capacity-building effort, developed the Profile of Maryland Environmental Public Health Practice. This profile offers an examination of front-line local EPH strengths, needs, challenges, and provides recommendations to strengthen the EPH infrastructure. A multistep process was conducted, including site visits to all of Maryland's 24 local EPH agencies and a questionnaire addressing administrative structure, communication, funding, workforce, crisis management, technology, and legal authority, completed by local EPH directors. The Maryland Profile revealed a dedicated and responsive workforce limited by a neglected, fragmented, and underfunded EPH infrastructure. Recommendations regarding leadership, workforce, training, technology, communication, and legal authority are offered. This research has implications for the national EPH infrastructure. Recommendations offered are consistent with the CDC's findings in A National Strategy to Revitalize Environmental Public Health Services. These findings and recommendations offer opportunities to facilitate the advancement of an EPH system to better protect the nation's health.

Detecting and correcting the bias of unmeasured factors using perturbation analysis: a data-mining approach.

PubMed

Lee, Wen-Chung

2014-02-05

The randomized controlled study is the gold-standard research method in biomedicine. In contrast, the validity of a (nonrandomized) observational study is often questioned because of unknown/unmeasured factors, which may have confounding and/or effect-modifying potential. In this paper, the author proposes a perturbation test to detect the bias of unmeasured factors and a perturbation adjustment to correct for such bias. The proposed method circumvents the problem of measuring unknowns by collecting the perturbations of unmeasured factors instead. Specifically, a perturbation is a variable that is readily available (or can be measured easily) and is potentially associated, though perhaps only very weakly, with unmeasured factors. The author conducted extensive computer simulations to provide a proof of concept. Computer simulations show that, as the number of perturbation variables increases from data mining, the power of the perturbation test increased progressively, up to nearly 100%. In addition, after the perturbation adjustment, the bias decreased progressively, down to nearly 0%. The data-mining perturbation analysis described here is recommended for use in detecting and correcting the bias of unmeasured factors in observational studies.

Computing tools for implementing standards for single-case designs.

PubMed

Chen, Li-Ting; Peng, Chao-Ying Joanne; Chen, Ming-E

2015-11-01

In the single-case design (SCD) literature, five sets of standards have been formulated and distinguished: design standards, assessment standards, analysis standards, reporting standards, and research synthesis standards. This article reviews computing tools that can assist researchers and practitioners in meeting the analysis standards recommended by the What Works Clearinghouse: Procedures and Standards Handbook-the WWC standards. These tools consist of specialized web-based calculators or downloadable software for SCD data, and algorithms or programs written in Excel, SAS procedures, SPSS commands/Macros, or the R programming language. We aligned these tools with the WWC standards and evaluated them for accuracy and treatment of missing data, using two published data sets. All tools were tested to be accurate. When missing data were present, most tools either gave an error message or conducted analysis based on the available data. Only one program used a single imputation method. This article concludes with suggestions for an inclusive computing tool or environment, additional research on the treatment of missing data, and reasonable and flexible interpretations of the WWC standards. © The Author(s) 2015.

Organisation of care for pregnancy in patients with congenital heart disease.

PubMed

Roos-Hesselink, Jolien W; Budts, Werner; Walker, Fiona; De Backer, Julie F A; Swan, Lorna; Stones, William; Kranke, Peter; Sliwa-Hahnle, Karen; Johnson, Mark R

2017-12-01

Improvements in surgery have resulted in more women with repaired congenital heart disease (CHD) surviving to adulthood. Women with CHD, who wish to embark on pregnancy require prepregnancy counselling. This consultation should cover several issues such as the long-term prognosis of the mother, fertility and miscarriage rates, recurrence risk of CHD in the baby, drug therapy during pregnancy, estimated maternal risk and outcome, expected fetal outcomes and plans for pregnancy. Prenatal genetic testing is available for those patients with an identified genetic defect using pregestational diagnosis or prenatal diagnosis chorionic villus sampling or amniocentesis. Centralisation of care is needed for high-risk patients. Finally, currently there are no recommendations addressing the issue of the delivery. It is crucial that a dedicated plan for delivery should be available for all cardiac patients. The maternal mortality in low-income to middle-income countries is 14 times higher than in high-income countries and needs additional aspects and dedicated care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Conflicts and natural disaster management: a comparative study of flood control in the Republic of Korea and the United States.

PubMed

Chung, Jibum

2016-07-01

The purpose of this research is to analyse the conflicts that arise among major stakeholders during the process of disaster management and to suggest policy recommendations for improving disaster management systems. It describes several important conflict cases that have occurred among major stakeholders, such as governments, private-sector entities, and non-governmental organisations, during natural disaster management. In addition, it probes the similarities and the differences between such conflicts in the Republic of Korea and the United States. The differences between them may originate from a range of factors, such as the disaster itself, cultural features, management practices, and government organisation. However, the conflicts also are very similar in some ways, as the motivations and the behaviour of stakeholders during a disaster are alike in both countries. Based on this comparison, the study presents some common and important implications for successful disaster management practices in Korea and the US, as well as in many other nations around the world. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

42 CFR 137.419 - What authority does the IBIA have under §§ 137.415 through 137.436?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false What authority does the IBIA have under §§ 137...-GOVERNANCE Appeals Pre-Award Disputes § 137.419 What authority does the IBIA have under §§ 137.415 through... to engage in full discovery relevant to any issue raised in the matter; (c) to issue a recommended...

OrderRex: clinical order decision support and outcome predictions by data-mining electronic medical records

PubMed Central

Chen, Jonathan H; Podchiyska, Tanya

2016-01-01

Objective: To answer a “grand challenge” in clinical decision support, the authors produced a recommender system that automatically data-mines inpatient decision support from electronic medical records (EMR), analogous to Netflix or Amazon.com’s product recommender. Materials and Methods: EMR data were extracted from 1 year of hospitalizations (>18K patients with >5.4M structured items including clinical orders, lab results, and diagnosis codes). Association statistics were counted for the ∼1.5K most common items to drive an order recommender. The authors assessed the recommender’s ability to predict hospital admission orders and outcomes based on initial encounter data from separate validation patients. Results: Compared to a reference benchmark of using the overall most common orders, the recommender using temporal relationships improves precision at 10 recommendations from 33% to 38% (P < 10−10) for hospital admission orders. Relative risk-based association methods improve inverse frequency weighted recall from 4% to 16% (P < 10−16). The framework yields a prediction receiver operating characteristic area under curve (c-statistic) of 0.84 for 30 day mortality, 0.84 for 1 week need for ICU life support, 0.80 for 1 week hospital discharge, and 0.68 for 30-day readmission. Discussion: Recommender results quantitatively improve on reference benchmarks and qualitatively appear clinically reasonable. The method assumes that aggregate decision making converges appropriately, but ongoing evaluation is necessary to discern common behaviors from “correct” ones. Conclusions: Collaborative filtering recommender algorithms generate clinical decision support that is predictive of real practice patterns and clinical outcomes. Incorporating temporal relationships improves accuracy. Different evaluation metrics satisfy different goals (predicting likely events vs. “interesting” suggestions). PMID:26198303

Enacting the Carnegie Foundation call for reform of medical school and residency.

PubMed

O'Brien, Bridget C; Irby, David M

2013-01-01

On the 100th anniversary of the Flexner Report, the Carnegie Foundation for the Advancement of Teaching published a new study of medical education. This study, titled Educating Physicians: A Call for Reform of Medical Schools and Residency Programs, contained four primary recommendations intended to stimulate innovation and improvement in medical education. In this article, the authors examined the ways others have applied the four recommendations from Educating Physicians within and beyond medical education. In their review of 246 publications citing the Carnegie work, they found that the recommendation for integration was addressed most frequently, often through descriptions of integration of curricular content in undergraduate medical education. The recommendation to focus on professional identity formation was the second most frequently addressed, followed by standardization and individualization, then inquiry, innovation, and improvement. The publications related to these latter three recommendations tended to be conceptual rather than descriptive or empirical. Publications spanned the continuum of medical education (from medical school to residency to physicians in practice) and even into other fields, but undergraduate medical education received the most attention. The authors discuss common themes among the citing publications and highlight opportunities for further discussion and innovation. Many exciting developments have occurred in medical education and beyond since the publication of Educating Physicians in 2010. Thus far, most of the publications citing the Carnegie recommendations describe incremental changes in medical education, particularly in the area of integration. Some of the conceptual work around these recommendations, coupled with a variety of external factors such as changes in health care and accreditation systems, suggests the potential for changes that are more transformative in nature.

FELASA recommendations for the health monitoring of mouse, rat, hamster, guinea pig and rabbit colonies in breeding and experimental units.

PubMed

Mähler Convenor, M; Berard, M; Feinstein, R; Gallagher, A; Illgen-Wilcke, B; Pritchett-Corning, K; Raspa, M

2014-07-01

The microbiological quality of experimental animals can critically influence animal welfare and the validity and reproducibility of research data. It is therefore important for breeding and experimental facilities to establish a laboratory animal health monitoring (HM) programme as an integrated part of any quality assurance system. FELASA has published recommendations for the HM of rodent and rabbit colonies in breeding and experimental units (Nicklas et al. Laboratory Animals, 2002), with the intention of harmonizing HM programmes. As stated in the preamble, these recommendations need to be adapted periodically to meet current developments in laboratory animal medicine. Accordingly, previous recommendations have been revised and shall be replaced by the present recommendations. These recommendations are aimed at all breeders and users of laboratory mice, rats, Syrian hamsters, guinea pigs and rabbits as well as diagnostic laboratories. They describe essential aspects of HM, such as the choice of agents, selection of animals and tissues for testing, frequency of sampling, commonly used test methods, interpretation of results and HM reporting. Compared with previous recommendations, more emphasis is put on the role of a person with sufficient understanding of the principles of HM, opportunistic agents, the use of sentinel animals (particularly under conditions of cage-level containment) and the interpretation and reporting of HM results. Relevant agents, testing frequencies and literature references are updated. Supplementary information on specific agents and the number of animals to be monitored and an example of a HM programme description is provided in the appendices. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Methodological criteria for the assessment of moderators in systematic reviews of randomised controlled trials: a consensus study

PubMed Central

2011-01-01

Background Current methodological guidelines provide advice about the assessment of sub-group analysis within RCTs, but do not specify explicit criteria for assessment. Our objective was to provide researchers with a set of criteria that will facilitate the grading of evidence for moderators, in systematic reviews. Method We developed a set of criteria from methodological manuscripts (n = 18) using snowballing technique, and electronic database searches. Criteria were reviewed by an international Delphi panel (n = 21), comprising authors who have published methodological papers in this area, and researchers who have been active in the study of sub-group analysis in RCTs. We used the Research ANd Development/University of California Los Angeles appropriateness method to assess consensus on the quantitative data. Free responses were coded for consensus and disagreement. In a subsequent round additional criteria were extracted from the Cochrane Reviewers' Handbook, and the process was repeated. Results The recommendations are that meta-analysts report both confirmatory and exploratory findings for sub-groups analysis. Confirmatory findings must only come from studies in which a specific theory/evidence based a-priori statement is made. Exploratory findings may be used to inform future/subsequent trials. However, for inclusion in the meta-analysis of moderators, the following additional criteria should be applied to each study: Baseline factors should be measured prior to randomisation, measurement of baseline factors should be of adequate reliability and validity, and a specific test of the interaction between baseline factors and interventions must be presented. Conclusions There is consensus from a group of 21 international experts that methodological criteria to assess moderators within systematic reviews of RCTs is both timely and necessary. The consensus from the experts resulted in five criteria divided into two groups when synthesising evidence: confirmatory findings to support hypotheses about moderators and exploratory findings to inform future research. These recommendations are discussed in reference to previous recommendations for evaluating and reporting moderator studies. PMID:21281501

[On the interdisciplinary S3 guidelines for the treatment of chronic idiopathic tinnitus].

PubMed

Zenner, H-P; Delb, W; Kröner-Herwig, B; Jäger, B; Peroz, I; Hesse, G; Mazurek, B; Goebel, G; Gerloff, C; Trollmann, R; Biesinger, E; Seidler, H; Langguth, B

2015-06-01

Tinnitus is a frequent symptom, which, particularly in combination with comorbidities, can result in a severe disease-related burden. Chronic idiopathic tinnitus (CIT) is the most frequent type of tinnitus. A considerable number of treatment strategies are used to treat CIT-for many of which there is no evidence of efficacy. In order to enable scientific evidence-based treatment of CIT, German interdisciplinary S3 guidelines have recently been constructed for the first time. Here we present a short form of these S3 guidelines. The guidelines were constructed based on a meta-analysis of the treatment of chronic tinnitus performed by the authors. Additionally, a systematic literature search was performed in the PubMed and Cochrane Library databases. Furthermore, a systematic search for international guidelines was performed in Google, as well as in the Guidelines International Network and National Guideline Clearinghouse (USA) database. Evidence was classified according to the Oxford Centre for Evidence-Based Medicine system. According to the guidelines, alongside counselling, manualized structured tinnitus-specific cognitive behavioral therapy (tCBT) with a validated treatment manual is available as evidence-based therapy. In addition, the guidelines recommend concurrent treatment of comorbidities, including drug-based treatment, where appropriate. Particularly important is treatment of anxiety and depression. Where a psychic or psychiatric comorbidity is suspected, further diagnosis and treatment should be performed by an appropriately qualified specialist (psychiatrist, neurologist, psychosomatic medicine consultant) or psychological psychotherapist. In cases accompanied by deafness or hearing loss bordering on deafness, cochlear implants may be indicated. No recommendations can be made for drug-based treatment of CIT, audiotherapy, transcranial magnetic or electrical stimulation, specific forms of acoustic stimulation or music therapy; or such recommendations must remain open due to the lack of available evidence. Polypragmatic tinnitus treatment with therapeutic strategies for which there is no evidence of efficacy from controlled studies is to be refused.

Clinical implications of using the arm motor ability test in stroke rehabilitation.

PubMed

O'Dell, Michael W; Kim, Grace; Finnen, Lisa Rivera; Polistena, Caitlin

2011-05-01

To identify all published studies using the Arm Motor Ability Test (AMAT), a standardized, laboratory-based measure for selected upper extremity activities of daily living (ADLs); and to summarize its current uses and provide recommendations for its future use. An Ovid online search was performed using the terms "Arm Motor Ability Test" and "AMAT." The reference lists of all articles obtained were reviewed for additional studies not appearing in the literature search. In addition, the original manual for the use and administration of the AMAT was reviewed. All studies examining the psychometric properties of the AMAT or using the AMAT as an outcome measure were identified. Articles simply mentioning the AMAT without providing data and case reports or abstracts (other than those addressing a specific aspect of the scale of interest) were excluded. Studies were reviewed by the primary author. No formal system of quality review was used. The AMAT has been used as an outcome measure in stroke rehabilitation research examining upper extremity robotics, functional electrical stimulation, and cortical stimulation. The most recent version contains 10 ADL tasks, each of which is composed of 1 to 3 subtasks. Of the 3 domains originally proposed, only the "functional ability" domain is routinely assessed. Psychometric studies have demonstrated good reliability and at least reasonable construct validity. The instrument's sensitivity to change over time is less well established, and no recommendation can be made regarding a minimal clinically important difference. We recommend that the 10-item version of the AMAT and assessment of only the functional ability domain be adopted as standard going forward. Further research should include examination of sensitivity over time, minimal clinically important change, reliability and validity in the mid and lower range of scores, and in neurologic diagnoses other than stroke. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

UK national guidelines on the management of syphilis 2015.

PubMed

Kingston, M; French, P; Higgins, S; McQuillan, O; Sukthankar, A; Stott, C; McBrien, B; Tipple, C; Turner, A; Sullivan, A K; Radcliffe, Keith; Cousins, Darren; FitzGerald, Mark; Fisher, Martin; Grover, Deepa; Higgins, Stephen; Kingston, Margaret; Rayment, Michael; Sullivan, Ann

2016-05-01

These guidelines are an update for 2015 of the 2008 UK guidelines for the management of syphilis. The writing group have piloted the new BASHH guideline methodology, notably using the GRADE system for assessing evidence and making recommendations. We have made significant changes to the recommendations for screening infants born to mothers with positive syphilis serology and to facilitate accurate and timely communication between the teams caring for mother and baby we have developed a birth plan. Procaine penicillin is now an alternative, not preferred treatment, for all stages of syphilis except neurosyphilis, but the length of treatment for this is shortened. Other changes are summarised at the start of the guideline. © The Author(s) 2016.

Same behavior, different consequences: reactions to men's and women's altruistic citizenship behavior.

PubMed

Heilman, Madeline E; Chen, Julie J

2005-05-01

In 2 experimental studies, the authors hypothesized that the performance of altruistic citizenship behavior in a work setting would enhance the favorability of men's (but not women's) evaluations and recommendations, whereas the withholding of altruistic citizenship behavior would diminish the favorability of women's (but not men's) evaluations and recommendations. Results supported the authors' predictions. Together with the results of a 3rd study demonstrating that work-related altruism is thought to be less optional for women than for men, these results suggest that gender-stereotypic prescriptions regarding how men and women should behave result in different evaluative reactions to the same altruistic behavior, depending on the performer's sex.

The Future of Home Health Care

PubMed Central

Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica

2016-01-01

The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670

Improving the Quality of Web Surveys: The Checklist for Reporting Results of Internet E-Surveys (CHERRIES)

PubMed Central

2004-01-01

Analogous to checklists of recommendations such as the CONSORT statement (for randomized trials), or the QUORUM statement (for systematic reviews), which are designed to ensure the quality of reports in the medical literature, a checklist of recommendations for authors is being presented by the Journal of Medical Internet Research (JMIR) in an effort to ensure complete descriptions of Web-based surveys. Papers on Web-based surveys reported according to the CHERRIES statement will give readers a better understanding of the sample (self-)selection and its possible differences from a “representative” sample. It is hoped that author adherence to the checklist will increase the usefulness of such reports. PMID:15471760

Do editorial policies support ethical research? A thematic text analysis of author instructions in psychiatry journals.

PubMed

Strech, Daniel; Metz, Courtney; Knüppel, Hannes

2014-01-01

According to the Declaration of Helsinki and other guidelines, clinical studies should be approved by a research ethics committee and seek valid informed consent from the participants. Editors of medical journals are encouraged by the ICMJE and COPE to include requirements for these principles in the journal's instructions for authors. This study assessed the editorial policies of psychiatry journals regarding ethics review and informed consent. The information given on ethics review and informed consent and the mentioning of the ICMJE and COPE recommendations were assessed within author's instructions and online submission procedures of all 123 eligible psychiatry journals. While 54% and 58% of editorial policies required ethics review and informed consent, only 14% and 19% demanded the reporting of these issues in the manuscript. The TOP-10 psychiatry journals (ranked by impact factor) performed similarly in this regard. Only every second psychiatry journal adheres to the ICMJE's recommendation to inform authors about requirements for informed consent and ethics review. Furthermore, we argue that even the ICMJE's recommendations in this regard are insufficient, at least for ethically challenging clinical trials. At the same time, ideal scientific design sometimes even needs to be compromised for ethical reasons. We suggest that features of clinical studies that make them morally controversial, but not necessarily unethical, are analogous to methodological limitations and should thus be reported explicitly. Editorial policies as well as reporting guidelines such as CONSORT should be extended to support a meaningful reporting of ethical research.

Public Response to Cost-Quality Tradeoffs in Clinical Decisions

PubMed Central

Beach, Mary Catherine; Asch, David A.; Jepson, Christopher; Hershey, John C.; Mohr, Tara; McMorrow, Stacey; Ubel, Peter A.

2011-01-01

Purpose To explore public attitudes toward the incorporation of cost-effectiveness analysis into clinical decisions. Methods The authors presented 781 jurors with a survey describing 1 of 6 clinical encounters in which a physician has to choose between cancer screening tests. They provided cost-effectiveness data for all tests, and in each scenario, the most effective test was more expensive. They instructed respondents to imagine that he or she was the physician in the scenario and asked them to choose which test to recommend and then explain their choice in an open-ended manner. The authors then qualitatively analyzed the responses by identifying themes and developed a coding scheme. Two authors separately coded the statements with high overall agreement (kappa = 0.76). Categories were not mutually exclusive. Results Overall, 410 respondents (55%) chose the most expensive option, and 332 respondents (45%) choose a less expensive option. Explanatory comments were given by 82% respondents. Respondents who chose the most expensive test focused on the increased benefit (without directly acknowledging the additional cost) (39%), a general belief that life is more important than money (22%), the significance of cancer risk for the patient in the scenario (20%), the belief that the benefit of the test was worth the additional cost (8%), and personal anecdotes/preferences (6%). Of the respondents who chose the less expensive test, 40% indicated that they did not believe that the patient in the scenario was at significant risk for cancer, 13% indicated that they thought the less expensive test was adequate or not meaningfully different from the more expensive test, 12% thought the cost of the test was not worth the additional benefit, 9% indicated that the test was too expensive (without mention of additional benefit), and 7% responded that resources were limited. Conclusions Public response to cost-quality tradeoffs is mixed. Although some respondents justified their decision based on the cost-effectiveness information provided, many focused instead on specific features of the scenario or on general beliefs about whether cost should be incorporated into clinical decisions. PMID:14570295

Risk of eye lens radiation exposure for members of the public.

PubMed

Chevallier, M-A; Rannou, A; Villagrasa, C; Clairand, I

2016-01-01

In 2011, the International Commission on Radiological Protection (ICRP) reviewed its recommendation concerning the equivalent dose limit for the eye lens, lowering it to 20 mSv in a year, for occupational exposure in planned exposure situations. The ICRP's statement does not contain any explicit recommendations regarding the organ dose limit for the eye lens for public exposure. For the moment, no change is proposed. But, to be coherent in the overall approach, the current equivalent limit for the public might be lowered. A similar yardstick than in the former recommendation may be used, that is to say a reduction of 10 times lower than that for occupational exposure. In this context, additional data on potential scenarios for public exposure of the eye lens are necessary. This paper, mainly based on a literature study, aims to provide, as far as possible, an exhaustive list of the situations in which members of the public can be exposed at the level of the eye lens. Once these situations have been defined, some calculations, made to assess the associated doses to the eye lens, are presented. This literature study did not reveal any current situations where members of the public would receive significant radiation doses to the eye lens. Indeed, the situations in which the dose to the eye lens might reach around 1 mSv per year for the public are extremely rare. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Molecular Systematics of the Cape Parrot (Poicephalus robustus): Implications for Taxonomy and Conservation

PubMed Central

Coetzer, Willem G.; Downs, Colleen T.; Perrin, Mike R.; Willows-Munro, Sandi

2015-01-01

The taxonomic position of the Cape Parrot (Poicephalus robustus robustus) has been the focus of much debate. A number of authors suggest that the Cape Parrot should be viewed as a distinct species separate from the other two P. robustus subspecies (P. r. fuscicollis and P. r. suahelicus). These recommendations were based on morphological, ecological, and behavioural assessments. In this study we investigated the validity of these recommendations using multilocus DNA analyses. We genotyped 138 specimens from five Poicephalus species (P. cryptoxanthus, P. gulielmi, P. meyeri, P. robustus, and P. rueppellii) using 11 microsatellite loci. Additionally, two mitochondrial (cytochrome oxidase I gene and 16S ribosomal RNA) and one nuclear intron (intron 7 of the β-fibrinogen gene) markers were amplified and sequenced. Bayesian clustering analysis and pairwise FST analysis of microsatellite data identified P. r. robustus as genetically distinct from the other P. robustus subspecies. Phylogenetic and molecular clock analyses on sequence data also supported the microsatellite analyses, placing P. r. robustus in a distinct clade separate from the other P. robustus subspecies. Molecular clock analysis places the most recent common ancestor between P. r. robustus and P. r. fuscicollis / P. r. suahelicus at 2.13 to 2.67 million years ago. Our results all support previous recommendations to elevate the Cape Parrot to species level. This will facilitate better planning and implementation of international and local conservation management strategies for the Cape Parrot. PMID:26267261

Neuromuscular Electrical Stimulation for Treatment of Muscle Impairment: Critical Review and Recommendations for Clinical Practice

PubMed Central

Houghton, Pamela; Anthony, Joseph; Rennie, Sandy; Shay, Barbara L.; Hoens, Alison M.

2017-01-01

Purpose: In response to requests from physiotherapists for guidance on optimal stimulation of muscle using neuromuscular electrical stimulation (NMES), a review, synthesis, and extraction of key data from the literature was undertaken by six Canadian physical therapy (PT) educators, clinicians, and researchers in the field of electrophysical agents. The objective was to identify commonly treated conditions for which there was a substantial body of literature from which to draw conclusions regarding the effectiveness of NMES. Included studies had to apply NMES with visible and tetanic muscle contractions. Method: Four electronic databases (CINAHL, Embase, PUBMED, and SCOPUS) were searched for relevant literature published between database inceptions until May 2015. Additional articles were identified from bibliographies of the systematic reviews and from personal collections. Results: The extracted data were synthesized using a consensus process among the authors to provide recommendations for optimal stimulation parameters and application techniques to address muscle impairments associated with the following conditions: stroke (upper or lower extremity; both acute and chronic), anterior cruciate ligament reconstruction, patellofemoral pain syndrome, knee osteoarthritis, and total knee arthroplasty as well as critical illness and advanced disease states. Summaries of key details from each study incorporated into the review were also developed. The final sections of the article outline the recommended terminology for describing practice using electrical currents and provide tips for safe and effective clinical practice using NMES. Conclusion: This article provides physiotherapists with a resource to enable evidence-informed, effective use of NMES for PT practice. PMID:29162949

A systematic review of physical activity levels in Native American populations in Canada and the United States in the last 50 years.

PubMed

Foulds, H J A; Warburton, D E R; Bredin, S S D

2013-07-01

Physical activity is beneficial for many chronic conditions. However, activity levels of Native Americans are not well known. This systematic review investigated if Native American populations achieve the recommended physical activity levels, compared current and past activity levels, and assessed the ability of exercise training programmes to improve health outcomes among this population. Electronic databases (e.g. MEDLINE, EMBASE) were searched and citations were cross-referenced. Included articles reported physical activity levels or investigations among Native Americans. This search identified 89 articles: self-report (n = 61), accelerometry and pedometry (n = 10), metabolic monitoring (n = 10) and physical activity interventions (n = 17). Few adults were found to meet the physical activity recommendations (27.2% [95% confidence interval = 26.9-27.5%] self-report, 9% [4-14%] accelerometry). Among children/youth, 26.5% (24.6-28.4%) (self-report) to 45.7% (42.3-49.1%) (pedometry/accelerometry) met the recommendations. Adults and children/youth were generally identified as physically inactive (via doubly labelled water). Overall, Native American adults reported lower activity levels since 2000, compared to 1990s, although similar to 1980s. Few physical activity interventions employed strong methodologies, large sample sizes and objective outcome measures. There is a clear need to increase Native American populations' physical activity. Additional research is required to evaluate exercise training programmes among this population. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.

Laboratory Diagnosis of Zika Virus Infection.

PubMed

Landry, Marie Louise; St George, Kirsten

2017-01-01

-The rapid and accurate diagnosis of Zika virus infection is an international priority. -To review current recommendations, methods, limitations, and priorities for Zika virus testing. -Sources include published literature, public health recommendations, laboratory procedures, and testing experience. -Until recently, the laboratory diagnosis of Zika infection was confined to public health or research laboratories that prepared their own reagents, and test capacity has been limited. Furthermore, Zika cross-reacts serologically with other flaviviruses, such as dengue, West Nile, and yellow fever. Current or past infection, or even vaccination with another flavivirus, will often cause false-positive or uninterpretable Zika serology results. Detection of viral RNA during acute infection using nucleic acid amplification tests provides more specific results, and a number of commercial nucleic acid amplification tests have received emergency use authorization. In addition to serum, testing of whole blood and urine is recommended because of the higher vial loads and longer duration of shedding. However, nucleic acid amplification testing has limited utility because many patients are asymptomatic or present for testing after the brief period of Zika shedding has passed. Thus, the greatest need and most difficult challenge is development of accurate antibody tests for the diagnosis of recent Zika infection. Research is urgently needed to identify Zika virus epitopes that do not cross-react with other flavivirus antigens. New information is emerging at a rapid pace and, with ongoing public-private and international collaborations and government support, it is hoped that rapid progress will be made in developing robust and widely applicable diagnostic tools.

Evaluating postdoctoral dental candidates: assessing the need and recommendations for a national qualifying examination.

PubMed

Brodie, Abby J; Crow, Heidi C; Eber, Robert M; Handysides, Robert; Holexa, Roy; Kiat-amnuay, Sudarat; Spallek, Heiko

2011-06-01

Increasingly, U.S. dental schools report pass/fail grades and do not rank students. In addition, the Joint Commission on National Dental Examinations will report National Board Dental Examination (NBDE) scores as pass/fail after January 1, 2012. This article discusses how these changes will force postdoctoral dental program directors to modify how they assess candidates and how noncognitive evaluations might enhance those assessments. The authors propose developing a national qualifying examination for postdoctoral dental programs that will measure knowledge, decision making, and noncognitive traits including empathy, self-confidence, integrity, and emotional intelligence. Without NBDE scores, class rank, and GPA as a basis for decision making, a single national qualifying examination would assist postdoctoral programs in selecting high-quality candidates based on knowledge, critical thinking skills, and noncognitive traits.

[Equipping the bacteriological laboratories of a tuberculosis service as the most important element of assurance of the quality and safety of their work].

PubMed

Sevast'ianova, E V; Martynova, L P; Barilo, V N; Golyshevskaia, V I; Shul'gina, M V

2009-01-01

By taking into account the present requirements for the equipping of the laboratories, the authors have drawn up the minimum standard list of equipment, as well as a list of additional equipment for the specialized bacteriological laboratory of a tuberculosis-controlling institution, which performs microbiological studies for the diagnosis and control of chemotherapy for tuberculosis. The specifications and characteristics of the baric types of equipment used to fit out the laboratories under the present conditions are described. Equipping the laboratories in accordance with the draw-up lists is shown to ensure a qualitative, effective, and safe work. Recommendations on how to supply the laboratories with equipment, to make the optimal choice, and to use consumables for tests are given.

Design and Implementation of an International Training Program on Repository Development and Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vugrin, K.W.; Twitchell, Ch.A.

2008-07-01

Korea Hydro and Nuclear Power Co., Ltd. (KHNP) is an electric company in the Republic of Korea with twenty operational nuclear power plants and eight additional units that are either planned or currently under construction. Regulations require that KHNP manage the radioactive waste generated by their nuclear power plants. In the course of planning low, intermediate, and high level waste storage facilities, KHNP sought interaction with an acknowledged expert in the field of radioactive waste management and, consequently, contacted Sandia National Laboratories (SNL). KHNP has contracted with SNL to provide a year long training program on repository science. This papermore » discusses the design of the curriculum, specific plans for execution of the training program, and recommendations for smooth implementation of international training programs. (authors)« less

Access and Costs: Recommendations for Title IV. Hearing on Examining Proposals Authorizing Funds for Title IV Student Aid Programs and Issues Relating to Access to Costs of Postsecondary Education of the Higher Education Act, Including S. 1036, To Revise Section 435 of the Higher Education Act To Allow for the Young Americans Bank and Similar Small, Nonprofit Organizations to Provide Additional Funds for Educational Programming, of the Committee on Labor and Human Resources. United States Senate, One Hundred Fifth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

This 10th and final hearing in a series related to the reauthorization of the Higher Education Act, focused on three specific areas: (1) the challenges posed by demographic changes in the college student population--nearly half of all students attend community colleges where the average age of students is 29; (2) the challenges and opportunities…

Analysis of the track- and dose-averaged LET and LET spectra in proton therapy using the GEANT4 Monte Carlo code

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guan, Fada; Peeler, Christopher; Taleei, Reza

Purpose: The motivation of this study was to find and eliminate the cause of errors in dose-averaged linear energy transfer (LET) calculations from therapeutic protons in small targets, such as biological cell layers, calculated using the GEANT 4 Monte Carlo code. Furthermore, the purpose was also to provide a recommendation to select an appropriate LET quantity from GEANT 4 simulations to correlate with biological effectiveness of therapeutic protons. Methods: The authors developed a particle tracking step based strategy to calculate the average LET quantities (track-averaged LET, LET{sub t} and dose-averaged LET, LET{sub d}) using GEANT 4 for different tracking stepmore » size limits. A step size limit refers to the maximally allowable tracking step length. The authors investigated how the tracking step size limit influenced the calculated LET{sub t} and LET{sub d} of protons with six different step limits ranging from 1 to 500 μm in a water phantom irradiated by a 79.7-MeV clinical proton beam. In addition, the authors analyzed the detailed stochastic energy deposition information including fluence spectra and dose spectra of the energy-deposition-per-step of protons. As a reference, the authors also calculated the averaged LET and analyzed the LET spectra combining the Monte Carlo method and the deterministic method. Relative biological effectiveness (RBE) calculations were performed to illustrate the impact of different LET calculation methods on the RBE-weighted dose. Results: Simulation results showed that the step limit effect was small for LET{sub t} but significant for LET{sub d}. This resulted from differences in the energy-deposition-per-step between the fluence spectra and dose spectra at different depths in the phantom. Using the Monte Carlo particle tracking method in GEANT 4 can result in incorrect LET{sub d} calculation results in the dose plateau region for small step limits. The erroneous LET{sub d} results can be attributed to the algorithm to determine fluctuations in energy deposition along the tracking step in GEANT 4. The incorrect LET{sub d} values lead to substantial differences in the calculated RBE. Conclusions: When the GEANT 4 particle tracking method is used to calculate the average LET values within targets with a small step limit, such as smaller than 500 μm, the authors recommend the use of LET{sub t} in the dose plateau region and LET{sub d} around the Bragg peak. For a large step limit, i.e., 500 μm, LET{sub d} is recommended along the whole Bragg curve. The transition point depends on beam parameters and can be found by determining the location where the gradient of the ratio of LET{sub d} and LET{sub t} becomes positive.« less

NASA SpaceWire Activities/Comments/Recommendations

NASA Technical Reports Server (NTRS)

Rakow, Glenn

2006-01-01

This viewgraph presentation reviews NASA's activities, and proposes recommendations for the further use of the SpaceWire (SpW). The areas covered in this presentation are: (1) Protocol ID assignment, (2) Protocol development, (3) Plug & Play (PnP), (4) Recommended additions t o SpW protocol and (5) SpaceFibre trade.

Contexts in a Paper Recommendation System with Collaborative Filtering

ERIC Educational Resources Information Center

Winoto, Pinata; Tang, Tiffany Ya; McCalla, Gordon

2012-01-01

Making personalized paper recommendations to users in an educational domain is not a trivial task of simply matching users' interests with a paper topic. Therefore, we proposed a context-aware multidimensional paper recommendation system that considers additional user and paper features. Earlier experiments on experienced graduate students…

Limitations of the evidence base used to set recommended nutrient intakes for infants and lactating women.

USDA-ARS?s Scientific Manuscript database

Reported values for the concentrations of micronutrients in human milk form the basis of the majority of micronutrient intake recommendations for infants and the additional maternal requirements for lactation. The infant recommendations may also be extrapolated to provide estimates for young childre...

Promises to Keep, Indeed, and Miles to Go Before We Sleep.

ERIC Educational Resources Information Center

Myers, Carmel

The recommendation of the California Postsecondary Education Commission (CPEC) to reduce remedial activities is considered, along with arguments against reducing activities. In addition, the University of California's (UC) response to the recommendation is reviewed. CPEC's recommendation, which was first publicized in its 1983 report,…

Pharmacy journal abstracts published in PubMed that abide by the CONsolidated Standards Of Reporting Trials (CONSORT) guidelines

PubMed Central

Blair, Daniel A.; Woolley, Thomas W.

2014-01-01

The purpose of this research was to determine the proportion of abstracts in pharmacy journals that are prepared according to the CONsolidated Standards Of Reporting Trials (CONSORT) criteria for abstracts. Certain abstracts for randomized controlled clinical trials (RCTs) indexed in PubMed were eligible for inclusion, with the primary endpoint being median overall compliance to CONSORT recommendations for abstracts. A total of 63 RCT abstracts were included in the analysis, with only 56% of the recommended CONSORT items represented in the sample. It is recommended that pharmacy journals encourage authors to follow CONSORT recommendations for abstracts when submitting RCTs for publication. PMID:24860268

Automatic detection of omissions in medication lists

PubMed Central

Duncan, George T; Neill, Daniel B; Padman, Rema

2011-01-01

Objective Evidence suggests that the medication lists of patients are often incomplete and could negatively affect patient outcomes. In this article, the authors propose the application of collaborative filtering methods to the medication reconciliation task. Given a current medication list for a patient, the authors employ collaborative filtering approaches to predict drugs the patient could be taking but are missing from their observed list. Design The collaborative filtering approach presented in this paper emerges from the insight that an omission in a medication list is analogous to an item a consumer might purchase from a product list. Online retailers use collaborative filtering to recommend relevant products using retrospective purchase data. In this article, the authors argue that patient information in electronic medical records, combined with artificial intelligence methods, can enhance medication reconciliation. The authors formulate the detection of omissions in medication lists as a collaborative filtering problem. Detection of omissions is accomplished using several machine-learning approaches. The effectiveness of these approaches is evaluated using medication data from three long-term care centers. The authors also propose several decision-theoretic extensions to the methodology for incorporating medical knowledge into recommendations. Results Results show that collaborative filtering identifies the missing drug in the top-10 list about 40–50% of the time and the therapeutic class of the missing drug 50%–65% of the time at the three clinics in this study. Conclusion Results suggest that collaborative filtering can be a valuable tool for reconciling medication lists, complementing currently recommended process-driven approaches. However, a one-size-fits-all approach is not optimal, and consideration should be given to context (eg, types of patients and drug regimens) and consequence (eg, the impact of omission on outcomes). PMID:21447497

Automatic detection of omissions in medication lists.

PubMed

Hasan, Sharique; Duncan, George T; Neill, Daniel B; Padman, Rema

2011-01-01

Evidence suggests that the medication lists of patients are often incomplete and could negatively affect patient outcomes. In this article, the authors propose the application of collaborative filtering methods to the medication reconciliation task. Given a current medication list for a patient, the authors employ collaborative filtering approaches to predict drugs the patient could be taking but are missing from their observed list. The collaborative filtering approach presented in this paper emerges from the insight that an omission in a medication list is analogous to an item a consumer might purchase from a product list. Online retailers use collaborative filtering to recommend relevant products using retrospective purchase data. In this article, the authors argue that patient information in electronic medical records, combined with artificial intelligence methods, can enhance medication reconciliation. The authors formulate the detection of omissions in medication lists as a collaborative filtering problem. Detection of omissions is accomplished using several machine-learning approaches. The effectiveness of these approaches is evaluated using medication data from three long-term care centers. The authors also propose several decision-theoretic extensions to the methodology for incorporating medical knowledge into recommendations. Results show that collaborative filtering identifies the missing drug in the top-10 list about 40-50% of the time and the therapeutic class of the missing drug 50%-65% of the time at the three clinics in this study. Results suggest that collaborative filtering can be a valuable tool for reconciling medication lists, complementing currently recommended process-driven approaches. However, a one-size-fits-all approach is not optimal, and consideration should be given to context (eg, types of patients and drug regimens) and consequence (eg, the impact of omission on outcomes).

[Dietary supplements from ground fish meat with DNA for treatment and prophylaxis].

PubMed

Boiarkina, L G; Kas'ianenko, Iu I; Epshteĭn, L M; Iakush, E V

1998-01-01

It has been developed a receipt of a new treatment-and-prophylactic products based on fish farce with treatment-and-prophylactic additive--DNA. It is recommended to be produced. As biological active additive keeps its initial pharmacological characteristics under technological processing this product is recommended for rendering general effect and increasing of physical and mental activity of organism.

Protecting patients, protecting healthcare workers: a review of the role of influenza vaccination

PubMed Central

Music, T

2012-01-01

MUSIC T. (2012) A review of the role the role of influenza vaccination in protecting patients, protecting healthcare workers the role of influenza vaccination. International Nursing Review59, 161–167 Aim: Many health authorities recommend routine influenza vaccination for healthcare workers (HCWs), and during the 2009 A (H1N1) pandemic, the World Health Organization (WHO) recommended immunization of all HCWs worldwide. As this remains an important area of policy debate, this paper examines the case for vaccination, the role of local guidelines, barriers to immunization and initiatives to increase uptake. Background: Seasonal influenza is a major threat to public health, causing up to 1 million deaths annually. Extensive evidence supports the vaccination of priority groups, including HCWs. Immunization protects HCWs themselves, and their vulnerable patients from nosocomial influenza infections. In addition, influenza can disrupt health services and impact healthcare organizations financially. Immunization can reduce staff absences, offer cost savings and provide economic benefits. Methods: This paper reviews official immunization recommendations and HCW vaccination studies, including a recent International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) survey of 26 countries from each region of the world. Results: HCW immunization is widely recommended and supported by the WHO. In the IFPMA study, 88% of countries recommended HCW vaccination, and 61% supported this financially (with no correlation to country development status). Overall, coverage can be improved, and research shows that uptake may be impacted by lack of conveniently available vaccines and misconceptions regarding vaccine safety/efficacy and influenza risk. Conclusions: Many countries recommend HCW vaccination against influenza. In recent years, there has been an increased uptake rate among HCWs in some countries, but not in others. Several initiatives can increase coverage, including education, easy access to free vaccines and the use of formal declination forms. The case for HCW vaccination is clear, and in an effort to further accelerate uptake as a patient safety measure, an increasing number of healthcare organizations, particularly in the USA, are implementing mandatory immunization policies, similar to other obligatory hygiene measures. However, it would be desirable if similar high vaccination uptake rates could be achieved through voluntary procedures. PMID:22591085