Film viewing conditions in mammography.

PubMed

Hill, S J; Faulkner, K; Law, J; Starritt, H C

1997-04-01

A requirement for a minimum viewing box brightness of 3000 cd m-2 for reading mammograms has been widely advocated. Some recent work has challenged that opinion by reporting no significant variation in visibility of low contrast and fine detail objects over a wide range of brightness levels. This paper provides further experimental evidence to support the latter conclusion, at least over the range 1340-4190 cd m-2, and suggests that the currently recommended minimum viewing box brightness levels need to be revised. The importance of reducing room lighting levels is fully confirmed.

Dissipation kinetics of spinosad on cauliflower (Brassica oleracea var. botrytis. L.) under subtropical conditions of Punjab, India.

PubMed

Mandal, Kousik; Jyot, Gagan; Singh, Balwinder

2009-12-01

Residues of spinosad were estimated in cauliflower curds using high performance liquid chromatography (HPLC) and confirmed by high performance thin layer chromatography (HPTLC). Following three application of spinosad (Success 2.5 SC) at 15 and 30 g a.i. ha−1, the average initial deposits of spinosad were observed to be 0.57 and 1.34 mg kg−1, respectively. These residues dissipated below the limit of quantification (LOQ) of 0.02 mg kg−1 after 10 days at both the dosages. The half-life values (T 1/2) of spinosad were worked out to be 1.20 and 1.58 days, respectively, at recommended and double the recommended dosages. Thus, a waiting period of 6 days is suggested for the safe consumption of spinosad treated cauliflower.

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.

Guideline recommendations for post-acute postoperative physiotherapy in total hip and knee arthroplasty: are they used in daily clinical practice?

PubMed

Peter, W F; Nelissen, R G H H; Vlieland, T P M Vliet

2014-09-01

In a Dutch guideline on physiotherapy (PT) in hip and knee osteoarthritis, a number of recommendations on post-acute (i.e. after discharge from hospital) PT following total hip (THA) and total knee (TKA) arthroplasty were included. Little is known about the uptake of these recommendations in daily clinical practice. The aim of the present study was to determine the extent to which the guideline recommendations regarding post-acute PT after THA and TKA are followed in daily clinical practice. An online pilot survey on the delivery of post-acute, postoperative PT was sent to a random sample of 957 Dutch physiotherapists. The survey included questions on the application of recommended, neither recommended nor advised against, and advised against treatment modalities and various treatment modalities for which there were no formulated recommendations. A total of 219 physiotherapists completed the questionnaire, with a mean age of 40 years (standard deviation 12.6), 55% female and 95% working in primary care. The vast majority reported the use of the recommended exercise modalities (muscle strengthening exercises (96%), and functional exercises (99%). Continuous passive motion, which was neither recommended nor advised against, and electrical muscle stimulation, which was not recommended, were provided by 1%. Reported treatment modalities for which there were no formulated recommendations included patient education (99%), gait training (95%), active range of motion (ROM) exercises (93%), balance exercises (86%), passive ROM exercises (58%), aerobic exercises (50%), massage (18%) and cold therapy (11%). The vast majority of physiotherapists reported adhering to recommendations on post-acute postoperative PT in THA and TKA patients after discharge from hospital. Although yet to be confirmed in a larger nationwide survey, the relatively high frequency of use of many other treatment modalities, for which there were no formulated recommendations, suggests the need to extend the current set of recommendations to include evidence-based statements on additional treatment modalities. Copyright © 2014 John Wiley & Sons, Ltd.

Program review: resource evaluation, reservoir confirmation, and exploration technology

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

Ward, S.H.

1978-05-01

The details of the program review are reported. A summary of the recommendations, means for their implementation, and a six year program of expenditures which would accomplish the objectives of the recommendations are presented. Included in appendices are the following: DOE/DGE consortia participants; program managers contacted for opinion; communications received from program managers; participants, program review panel; and program strategy for resource evaluation and reservoir confirmation. (MHR)

PREVENtion of HeartMate II Pump Thrombosis Through Clinical Management: The PREVENT multi-center study.

PubMed

Maltais, Simon; Kilic, Ahmet; Nathan, Sriram; Keebler, Mary; Emani, Sitaramesh; Ransom, John; Katz, Jason N; Sheridan, Brett; Brieke, Andreas; Egnaczyk, Gregory; Entwistle, John W; Adamson, Robert; Stulak, John; Uriel, Nir; O'Connell, John B; Farrar, David J; Sundareswaran, Kartik S; Gregoric, Igor

2017-01-01

Recommended structured clinical practices including implant technique, anti-coagulation strategy, and pump speed management (PREVENT [PREVENtion of HeartMate II Pump Thrombosis Through Clinical Management] recommendations) were developed to address risk of early (<3 months) pump thrombosis (PT) risk with HeartMate II (HMII; St. Jude Medical, Inc. [Thoratec Corporation], Pleasanton, CA). We prospectively assessed the HMII PT rate in the current era when participating centers adhered to the PREVENT recommendations. PREVENT was a prospective, multi-center, single-arm, non-randomized study of 300 patients implanted with HMII at 24 participating sites. Confirmed PT (any suspected PT confirmed visually and/or adjudicated by an independent assessor) was evaluated at 3 months (primary end-point) and at 6 months after implantation. The population included 83% men (age 57 years ± 13), 78% destination therapy, and 83% Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Profile 1-3. Primary end-point analysis showed a confirmed PT of 2.9% at 3 months and 4.8% at 6 months. Adherence to key recommendations included 78% to surgical recommendations, 95% to heparin bridging, and 79% to pump speeds ≥9,000 RPMs (92% >8,600 RPMs). Full adherence to implant techniques, heparin bridging, and pump speeds ≥9,000 RPMs resulted in a significantly lower risk of PT (1.9% vs 8.9%; p < 0.01) and lower composite risk of suspected thrombosis, hemolysis, and ischemic stroke (5.7% vs 17.7%; p < 0.01) at 6 months. Adoption of all components of a structured surgical implant technique and clinical management strategy (PREVENT recommendations) is associated with low rates of confirmed PT. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Probabilistic Fracture Mechanics Analysis of the Orbiter's LH2 Feedline Flowliner

NASA Technical Reports Server (NTRS)

Bonacuse, Peter J. (Technical Monitor); Hudak, Stephen J., Jr.; Huyse, Luc; Chell, Graham; Lee, Yi-Der; Riha, David S.; Thacker, Ben; McClung, Craig; Gardner, Brian; Leverant, Gerald R.;

[Fibroepithelial polyp of the ureter. Report of one case].

PubMed

Morales, Raúl; Manrique, Eduardo; Casanova, Rubén; Molina, Pedro; Falcón, Ramón

2004-05-01

To report the rare case of a patient with a ureteral polyp. We describe the case of a 55-year-old female patient receiving care at the Celia Sanchez Manduley University Hospital in Manzanillo, Cuba, who was fortuitously diagnosed of a fibroepithelial polyp of the right ureter during the work up and treatment of an ovarian tumor. This case is the first of its kind in this hospital after 22 years, which confirms the rarity of ureteral tumors, specifically those of benign etiology. The absence of symptoms, specifically hematuria and pain, does not correspond to the reviewed articles. The chosen treatment was exeresis of the polyp at its base and frozen biopsy, followed by re-establishment of the urinary passage, as various authors recommend. Currently the endoscopical approach is recommended for its multiple advantages. We conclude that this disease is very rare, may have a symptomatic course and the treatment of choice is surgery with very good results.

A Recommendation Algorithm for Automating Corollary Order Generation

PubMed Central

Klann, Jeffrey; Schadow, Gunther; McCoy, JM

2009-01-01

Manual development and maintenance of decision support content is time-consuming and expensive. We explore recommendation algorithms, e-commerce data-mining tools that use collective order history to suggest purchases, to assist with this. In particular, previous work shows corollary order suggestions are amenable to automated data-mining techniques. Here, an item-based collaborative filtering algorithm augmented with association rule interestingness measures mined suggestions from 866,445 orders made in an inpatient hospital in 2007, generating 584 potential corollary orders. Our expert physician panel evaluated the top 92 and agreed 75.3% were clinically meaningful. Also, at least one felt 47.9% would be directly relevant in guideline development. This automated generation of a rough-cut of corollary orders confirms prior indications about automated tools in building decision support content. It is an important step toward computerized augmentation to decision support development, which could increase development efficiency and content quality while automatically capturing local standards. PMID:20351875

A recommendation algorithm for automating corollary order generation.

PubMed

Klann, Jeffrey; Schadow, Gunther; McCoy, J M

2009-11-14

Manual development and maintenance of decision support content is time-consuming and expensive. We explore recommendation algorithms, e-commerce data-mining tools that use collective order history to suggest purchases, to assist with this. In particular, previous work shows corollary order suggestions are amenable to automated data-mining techniques. Here, an item-based collaborative filtering algorithm augmented with association rule interestingness measures mined suggestions from 866,445 orders made in an inpatient hospital in 2007, generating 584 potential corollary orders. Our expert physician panel evaluated the top 92 and agreed 75.3% were clinically meaningful. Also, at least one felt 47.9% would be directly relevant in guideline development. This automated generation of a rough-cut of corollary orders confirms prior indications about automated tools in building decision support content. It is an important step toward computerized augmentation to decision support development, which could increase development efficiency and content quality while automatically capturing local standards.

Aetiological diagnosis of child deafness: CODEPEH recommendations.

PubMed

Núñez-Batalla, Faustino; Jáudenes-Casaubón, Carmen; Sequí-Canet, Jose Miguel; Vivanco-Allende, Ana; Zubicaray-Ugarteche, Jose; Cabanillas-Farpón, Rubén

Important progress in the fields of molecular genetics (principally) and diagnostic imaging, together with the lack of a consensus protocol for guiding the diagnostic process after confirming deafness by neonatal screening, have led to this new work document drafted by the Spanish Commission for the Early Detection of Child Deafness (Spanish acronym: CODEPEH). This 2015 Recommendations Document, which is based on the most recent scientific evidence, provides guidance to professionals to support them in making decisions regarding aetiological diagnosis. Such diagnosis should be performed without delay and without impeding early intervention. Early identification of the causes of deafness offers many advantages: it prevents unnecessary trouble for the families, reduces health system expenses caused by performing different tests, and provides prognostic information that may guide therapeutic actions. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Microscopic or occult hematuria, when reflex testing is not good laboratory practice.

PubMed

Froom, Paul; Barak, Mira

2010-01-01

Consensus opinion suggests that hematuria found by dipstick and not confirmed on microscopic examination (<2 erythrocytes per high power field) signifies a false-positive reagent strip test result. Standard practice is to repeat the dipstick test several days later and if still positive to confirm by microscopic examination. If discordant results are obtained, experts recommend reflex testing for urinary myoglobin and hemoglobin concentrations. The question is whether or not this approach represents good laboratory practice. These recommendations are not evidence based. We conclude that the reference range for red blood cells on the reagent strip should be increased to 25x10(6) cells/L for young men, and 50x10(6) cells/L for the rest of the adult population, ranges consistent with flow cytometry reports. Confirmation reflex testing using tests that have inferior sensitivity, precision and probably accuracy is not recommended.

Effect of Communication Errors During Calls to an Antimicrobial Stewardship Program

PubMed Central

Linkin, Darren R.; Fishman, Neil O.; Landis, J. Richard; Barton, Todd D.; Gluckman, Steven; Kostman, Jay; Metlay, Joshua P.

2011-01-01

Objective To determine the effect of inaccurate communication of patient data—from clinicians caring for inpatients to prior-approval antimicrobial stewardship programs (ASP) staff (practitioners)—on the incidence of inappropriate antimicrobial recommendations by ASP practitioners Design A retrospective cohort design was utilized. The accuracy of communicated patient data was evaluated against patients’ medical records for pre-determined, clinically significant inaccuracies. Inappropriate antimicrobial recommendations were defined when an expert panel unanimously rated the actual recommendations as inappropriate after reviewing vignettes derived from inpatients’ medical records. Setting The setting was an academic medical center with a prior-approval ASP. Patients All inpatient subjects of ASP prior-approval calls were eligible for inclusion. Results The panel agreed on whether the antimicrobial recommendation was inappropriate or not in 163 (82%) of 200 ASP calls; the 163 calls were then the basis for further analyses. After controlling for confounders, inaccurate communications were associated with inappropriate antimicrobial recommendations with an odds ratio (OR) of 2.2 (p=0.03). In secondary analyses of specific data types, only inaccuracies of microbiological data were associated with the study outcome (OR 7.5, p=0.002). The most common reason given by panelists for an inappropriate rating was that antimicrobials were not indicated. Conclusions Inaccurate communication of patient data, particularly microbiological data, during prior-approval calls is associated with an increased risk of inappropriate antimicrobial recommendations from the ASP. Clinicians and ASP practitioners should work to confirm critical communicated data prior to use in prescribing decisions. PMID:17994518

A Socio-Demographic Examination of Adults Responding to Governmental Vaccination Recommendations during the Japanese Rubella Outbreak of 2013.

PubMed

Hori, Ai; Wada, Koji; Smith, Derek R

2015-01-01

In 2013 a rubella outbreak occurred among Japanese people of working-age which resulted in 14,357 reported cases. The Japanese government subsequently recommended voluntary vaccination or rubella antibody testing for young women (15-49 years of age) who were planning to conceive and for adult men, children, and other persons in potential contact with pregnant women at home. However, the expense and time involved for vaccination, antibody testing and visiting a clinic may represent a major barrier to voluntary compliance among this busy demographic. The aim of the current study was, therefore, to examine potential relationships between the social background of Japanese working-age individuals affected by the 2013 voluntary vaccination campaign. A web-based survey of 1,889 Japanese men and women aged 20-49 years was conducted in early 2014. Statistical analyses were used to explore the associations between social background and testing for rubella antibody and / or vaccination uptake during the previous year. Twenty-four percent of respondents who were planning a pregnancy had been tested for rubella antibody or vaccinated in 2013. However, among those without a current desire for pregnancy, 3% of men and 7% of women, respectively, were tested or vaccinated. Regardless of whether they were planning to conceive, testing for rubella antibodies or vaccination was statistically associated with having acquaintances who had been vaccinated, understanding the government recommendations, and being able to confirm their lack of rubella vaccination history using Maternal and Child Health Handbook records in both men and women. To help eliminate rubella in Japan, additional initiatives need to target Japanese individuals who cannot envisage a direct benefit from vaccination. The results of this study suggest that disseminating the government recommendation to all potentially affected subpopulations, along with maintaining life-time vaccination records might offer a solution to encourage vaccination uptake among working-age adults in Japan, as elsewhere.

A Socio-Demographic Examination of Adults Responding to Governmental Vaccination Recommendations during the Japanese Rubella Outbreak of 2013

PubMed Central

Hori, Ai; Wada, Koji; Smith, Derek R.

2015-01-01

Background In 2013 a rubella outbreak occurred among Japanese people of working-age which resulted in 14,357 reported cases. The Japanese government subsequently recommended voluntary vaccination or rubella antibody testing for young women (15–49 years of age) who were planning to conceive and for adult men, children, and other persons in potential contact with pregnant women at home. However, the expense and time involved for vaccination, antibody testing and visiting a clinic may represent a major barrier to voluntary compliance among this busy demographic. The aim of the current study was, therefore, to examine potential relationships between the social background of Japanese working-age individuals affected by the 2013 voluntary vaccination campaign. Methods A web-based survey of 1,889 Japanese men and women aged 20–49 years was conducted in early 2014. Statistical analyses were used to explore the associations between social background and testing for rubella antibody and / or vaccination uptake during the previous year. Results Twenty-four percent of respondents who were planning a pregnancy had been tested for rubella antibody or vaccinated in 2013. However, among those without a current desire for pregnancy, 3% of men and 7% of women, respectively, were tested or vaccinated. Regardless of whether they were planning to conceive, testing for rubella antibodies or vaccination was statistically associated with having acquaintances who had been vaccinated, understanding the government recommendations, and being able to confirm their lack of rubella vaccination history using Maternal and Child Health Handbook records in both men and women. Conclusion To help eliminate rubella in Japan, additional initiatives need to target Japanese individuals who cannot envisage a direct benefit from vaccination. The results of this study suggest that disseminating the government recommendation to all potentially affected subpopulations, along with maintaining life-time vaccination records might offer a solution to encourage vaccination uptake among working-age adults in Japan, as elsewhere. PMID:26057740

Installation-restoration program. Phase 2. Confirmation/quantification. Stage 1 for Mather AFB, Sacramento, California. Volume 1. Final report, September 1983-June 1986

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

Not Available

A Problem Confirmation Study was performed at three sites on Mather AFB identified in the Phase I investigation as requiring further study (the Air command and warning Area, the 7100 Area, the West Ditch) and the Northeast Perimeter. The field investigation was conducted from February 1984 to June 1985 and included installation of 11 monitor wells, collection of groundwater samples from the monitor wells and 15 base production wells, and collection of sediment samples from two locations on the West Ditch. Analytes included oil and grease, TOC, volatile organic compounds (VOA), as well as dimethylnitrosamine, phenols, pesticides, and dissolved metalsmore » at some specific sites. Based on the hydrogeologic complexity of the physical setting and the findings of the sampling and analytical work, follow-on investigations were recommended at all three sites.« less

Scientific decision-making and stakeholder consultations: the case of salt recommendations.

PubMed

Timotijevic, Lada; Barnett, Julie; Brown, Kerry; Raats, Monique M; Shepherd, Richard

2013-05-01

Scientific advisory committees (SACs) are seen as "boundary organisations" working at the interface between science, policy and society. Although their narrowly defined remit of risk assessment is anchored in notions of rationality, objectivity, and reason, in reality, their sources for developing recommendations are not limited to scientific evidence. There is a growing expectation to involve non-scientific sources of information in the formation of knowledge, including the expectation of stakeholder consultation in forming recommendations. Such a move towards "democratisation" of scientific processes of decision-making within SACs has been described and often studied as "post-normal science" (PNS) (Funtowicz & Ravetz, 1993). In the current paper we examine the application of PNS in practice through a study of stakeholder consultations within the workings of the UK Scientific Advisory Committee for Nutrition (SACN). We use the theoretical insights from PNS-related studies to structure the analysis and examine the way in which PNS tenets resonate with the practices of SACN. We have selected a particular case of the SACN UK recommendations for salt as it is characterized by scientific controversy, uncertainty, vested interests and value conflict. We apply the tenets of PNS through documentary analysis of the SACN Salt Subgroup (SSG) consultation documents published in 2002/2003: the minutes of the 5 SACN SSG's meetings which included summary of the SACN SSG's stakeholder consultation and the SSG's responses to the consultation. The analysis suggests that the SACN consultation can be construed as a process of managing sources of risk to its organisation. Thus, rather than being an evidence of post-normal scientific practice, engagement became a mechanism for confirming the specific framing of science that is resonant with technocratic models of science holding authority over the facts. The implications for PNS theory are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Experience in operating earth dams of the NIVA cascade of the Kola Regional Power administration constructed in 1930-1960

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

Nosova, O.N.; Margolina, O.G.; Sergeeva, N.S.

1995-08-01

This article discusses Russian experiences in monitoring earth-filled dams of the Niva region. These are low and medium head facilities in operation from 30 to 60 years. As shown by the experiences of long-term operation of earth structures in this area and on embankments being constructed by the method of dumping soil into water, it is necessary to impose more stringent requirements with respect to determining the steepness of these slopes to increase their stability, as is done when the structures are constructed dry. To organize successful monitoring of seepage processes in the investigated structures having substantial anisotropy of themore » soil, special recommendations of the disposition of piezometers under such specific conditions should be worked out. Recommendations on the disposition of piezometers under conditions of a noticeable effect of the groundwater regime of the surrounding territory on the seepage regime of the hydro development should be worked out accordingly. Since the calculations made in the work, as a result of which instability of many slopes was detected, are not always confirmed by practice, it is advisable to correct the method of such calculations with consideration of the characteristics of the formation of the seepage flow in the downstream shoulder of dams with pronounced anisotropy of the soil.« less

Relationships between occupational functioning and stress among radio journalists--Assessment by means of the Psychosocial Risk Scale.

PubMed

Najder, Anna; Merecz-Kot, Dorota; Wójcik, Aleksandra

2016-01-01

Job characteristics and the consequences of everyday stress among radio journalists who are not exposed to traumatic events have not been studied sufficiently before. We aimed at determining the most common job characteristics and their stressfulness; relationships between stress exposure, health and occupational functioning; differences between radio journalists and other journalists, and also the psychosocial risk for health and functioning in this group. The studied group involved 208 journalists, 134 of whom worked in radio stations. The respondents filled in the Psychosocial Risks Scale (PRS) developed by the Department of Health and Work Psychology of the Nofer Institute of Occupational Medicine, Łódź, Poland. Requirement of mental effort and readiness to response quickly for most of the time as well as limited possibilities for promotion were the most frequent journalists' complaints. We confirmed that higher levels of stress resulted in worse functioning--the radio journalists who experienced lower stress assessed their health status and ability to work better, were more satisfied with particular aspects of their work, and were more involved in their work. They also presented a significantly lower turnover intention. Moreover, the radio journalists were more involved in their work than other journalists, but experienced lower satisfaction, took more sick leaves and had more days of absence. Well-known relationships between stress level, satisfaction and occupational functioning were confirmed. The most important conclusion refers to the fact that psychosocial risks and stress analysis should be based on the understanding of specificity of each occupation or even position. It is so, because the same job characteristic may pose a challenge for one person, while for another--it can result in extreme discomfort and anxiety--such an attitude broadens understanding of the phenomenon. We also confirmed that the PRS is a well-designed method, appropriate to investigate an individual perception of job environment and its stressfulness. Future research on causal relationships between the variables is recommended. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Guiding principles for vortex flow controls

NASA Technical Reports Server (NTRS)

Wu, J. Z.; Wu, J. M.

1991-01-01

In the practice of vortex flow controls, the most important factor is that the persistency and obstinacy of a concentrated vortex depend on its stability and dissipation. In this paper, the modern nonlinear stability theory for circulation-preserving flows is summarized, and the dissipation for general viscous flows is analyzed in terms of the evolution of total enstrophy. These analyses provide a theoretical base for understanding relevant physics of vortex flows, and lead to some guiding principles and methods for their controls. Case studies taken from various theoretical and/or experimental works of vortex controls, due to the present authors as well as others, confirm the feasibility of the recommended principles and methods.

Music therapy with bereaved teenagers: a mixed methods perspective.

PubMed

McFerran, Katrina; Roberts, Melina; O'Grady, Lucy

2010-07-01

Qualitative investigations have indicated that music therapy groups may be beneficial for bereaved teenagers. The existing relationship between young people and music serves as a platform for connectedness and emotional expression that is utilised within a therapeutic, support group format. This investigation confirms this suggestion through grounded theory analysis of focus group interviews. Changes in self-perception were not found as a result of participation, however practically significant results were found on adolescent coping. These cannot be generalized because of the small sample size. Grief specific tools are recommended for use in future investigations in order to capture the emotional impact of music therapy grief work with adolescents.

Integrated Requirements Analysis and Technology Roadmaps

NASA Technical Reports Server (NTRS)

1997-01-01

In fiscal year 1997, Strategic Insight performed analytical studies for NASA's Highly Reusable Space Transportation (HRST) program, creating program documents which illuminated technical requirements and critical research opportunities. Studies were performed to structure and confirm HRST's evolving technical requirements, building on Marshall's Phase 1 work, which defined HRST system concepts, analytical tools and high-level issues for assessment in Phase 2. Specifically, Strategic Insight: (1) Performed a requirements analysis to update HRST: An Advanced Concepts Study, Study Guidelines, Version 2.0 of January 22, 1996; only minor changes were recommended for the given parameters of interest to concept designers; (2) Conducted mini-workshops during HRST Working Group meetings on April 14-15, 1997 and July 22-24, 1997; and (3) Created structures for technology road maps of candidate HRST concepts, both subsystem and end-to-end concepts, emerging from the 13 cooperative agreement projects.

Intraoperative Consultation and Macroscopic Handling: The International Society of Urological Pathology (ISUP) Testicular Cancer Consultation Conference Recommendations.

PubMed

Verrill, Clare; Perry-Keene, Joanna; Srigley, John R; Zhou, Ming; Humphrey, Peter A; Lopez-Beltran, Antonio; Egevad, Lars; Ulbright, Thomas M; Tickoo, Satish K; Epstein, Jonathan I; Compérat, Eva; Berney, Daniel M

2018-06-01

The International Society of Urological Pathology held a conference on issues in testicular and penile pathology in Boston in March 2015, which included a presentation by the testis macroscopic features working group. The presentation focused on current published guidance for macroscopic handling of testicular tumors and retroperitoneal lymph node dissections with a summary of results from an online survey of members preceding the conference. The survey results were used to initiate discussions, but decisions on practice were made by expert consensus rather than voting. The importance of comprehensive assessment at the time of gross dissection with confirmation of findings by microscopic assessment was underscored. For example, the anatomic landmarks denoting the distinction of hilar soft tissue invasion (pT2) from spermatic cord invasion (pT3 category) can only be determined by careful macroscopic assessment in many cases. Other recommendations were to routinely sample epididymis, rete testis, hilar soft tissue, and tunica vaginalis in order to confirm macroscopic invasion of these structures or if not macroscopically evident, to exclude subtle microscopic invasion. Tumors 2 cm or less in greatest dimension should be completely embedded. If the tumor is >2 cm in greatest dimension, 10 blocks or a minimum of 1 to 2 additional blocks per centimeter should be taken (whichever is greater).

The Mine Working's Roof Stress-strain State Research in the Perspective of Development of New Coal Deposits of Kuzbass

NASA Astrophysics Data System (ADS)

Kostyuk, Svetlana; Bedarev, Nikolay; Lyubimov, Oleg; Shaikhislamov, Arthur

2017-11-01

The present now normative and information base is regulating of the Kuzbass coal seams treatment but is not considering of the mining-geological and mining-engineering conditions for new coal deposits. The analysis of works for the research of the rock pressure manifestation shows that in many cases numerous results require of the practical confirmation in mine conditions directly, and also confirmation by the physical models. This work reflects one of the stages of research on changing the stress-strain state of the massif with the formation of unloading zones, increased rock pressure, and recovery. As an example, the results of the information analysis obtained by means of contour and depth benchmarks on the ventilation drift in the course of the 34 seam treatment at the "Tagaryshskaya" mine are presented. The differences of the analyzed results from the results obtained in the conditions of other mines are established. The values of the drift's roof stratification on the contour and at the distance from the contour of 1.0 to 4.0 m are given. The revealed maximums of the rock pressure and pressure changes in the hydraulic supports of the complex used for movement are presented. Recommendations on the choice of the anchor's length taking into account the roof stratification size are given. The further research stages on models from equivalent materials at various geometric scales are proposed.

Confirmed clinical case of chronic kidney disease of nontraditional causes in agricultural communities in Central America: a case definition for surveillance.

PubMed

Ferreiro, Alejandro; Álvarez-Estévez, Guillermo; Cerdas-Calderón, Manuel; Cruz-Trujillo, Zulma; Mena, Elio; Reyes, Marina; Sandoval-Diaz, Mabel; Sánchez-Polo, Vicente; Valdés, Régulo; Ordúnez, Pedro

2016-11-01

Over the last 20 years, many reports have described an excess of cases of chronic kidney disease (CKD) in the Pacific coastal area of Central America, mainly affecting male farmworkers and signaling a serious public health problem. Most of these cases are not associated with traditional risk factors for CKD, such as aging, diabetes mellitus, and hypertension. This CKD of nontraditional causes (CKDnT) might be linked to environmental and/or occupational exposure or working conditions, limited access to health services, and poverty. In response to a resolution approved by the Directing Council of the Pan American Health Organization (PAHO) in 2013, PAHO, the U.S. Centers for Disease Control and Prevention, and the Latin American Society of Nephrology and Hypertension (SLANH) organized a consultation process in order to expand knowledge on the epidemic of CKDnT and to develop appropriate surveillance instruments. The Clinical Working Group from SLANH was put in charge of finding a consensus definition of a confirmed clinical case of CKDnT. The resulting definition establishes mandatory criteria and exclusion criteria necessary for classifying a case of CKDnT. The definition includes a combination of universally accepted definitions of CKD and the main clinical manifestations of CKDnT. Based on the best available evidence, the Clinical Working Group also formulated general recommendations about clinical management that apply to any patient with CKDnT. Adhering to the definition of a confirmed clinical case of CKDnT and implementing it appropriately is expected to be a powerful instrument for understanding the prevalence of the epidemic, evaluating the results of interventions, and promoting appropriate advocacy and planning efforts.

Breast milk transmission of flaviviruses in the context of Zika virus: A systematic review.

PubMed

Mann, Taylor Z; Haddad, Lisa B; Williams, Tonya R; Hills, Susan L; Read, Jennifer S; Dee, Deborah L; Dziuban, Eric J; Pérez-Padilla, Janice; Jamieson, Denise J; Honein, Margaret A; Shapiro-Mendoza, Carrie K

2018-06-08

Since the Zika virus epidemic in the Americas began in 2015, Zika virus transmission has occurred throughout the Americas. However, limited information exists regarding possible risks of transmission of Zika virus and other flaviviruses through breast feeding and human milk. We conducted a systematic review of the evidence regarding flaviviruses detection in and transmission through milk, specifically regarding Zika virus, Japanese encephalitis virus, tick-borne encephalitis virus, Powassan virus, West Nile virus, dengue virus, and yellow fever virus. Medline, Embase, Global Health, CINAHL, Cochrane Library, Scopus, Popline, Virtual Health Library, and WorldCat were searched through June 2017. Two authors independently screened potential studies for inclusion and extracted data. Human and nonhuman (animal) studies describing: 1) confirmed or suspected cases of mother-to-child transmission through milk; or 2) the presence of flavivirus genomic material in milk. Seventeen studies were included, four animal models and thirteen observational studies. Dengue virus, West Nile virus, and Zika virus viral ribonucleic acid was detected in human milk, including infectious Zika virus and dengue virus viral particles. Human breast-feeding transmission was confirmed for only yellow fever virus. There was evidence of milk-related transmission of dengue virus, Powassan virus, and West Nile virus in animal studies. Because the health advantages of breast feeding are considered greater than the potential risk of transmission, the World Health Organization recommends that mothers with possible or confirmed Zika virus infection or exposure continue to breast feed. This review did not identify any data that might alter this recommendation. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Standardized assessment of psychosocial factors and their influence on medically confirmed health outcomes in workers: a systematic review.

PubMed

Rosário, Susel; Fonseca, João A; Nienhaus, Albert; da Costa, José Torres

2016-01-01

Previous studies of psychosocial work factors have indicated their importance for workers' health. However, to what extent health problems can be attributed to the nature of the work environment or other psychosocial factors is not clear. No previous systematic review has used inclusion criteria based on specific medical evaluation of work-related health outcomes and the use of validated instruments for the assessment of the psychosocial (work) environment. The aim of this systematic review is to summarize the evidence assessing the relationship between the psychosocial work environment and workers' health based on studies that used standardized and validated instruments to assess the psychosocial work environment and that focused on medically confirmed health outcomes. A systematic review of the literature was carried out by searching the databases PubMed, B-ON, Science Direct, Psycarticles, Psychology and Behavioral Sciences Collection and the search engine (Google Scholar) using appropriate words for studies published from 2004 to 2014. This review follows the recommendations of the Statement for Reporting Systematic Reviews (PRISMA). Studies were included in the review if data on psychosocial validated assessment method(s) for the study population and specific medical evaluation of health-related work outcome(s) were presented. In total, the search strategy yielded 10,623 references, of which 10 studies (seven prospective cohort and three cross-sectional) met the inclusion criteria. Most studies (7/10) observed an adverse effect of poor psychosocial work factors on workers' health: 3 on sickness absence, 4 on cardiovascular diseases. The other 3 studies reported detrimental effects on sleep and on disease-associated biomarkers. A more consistent effect was observed in studies of higher methodological quality that used a prospective design jointly with the use of validated instruments for the assessment of the psychosocial (work) environment and clinical evaluation. More prospective studies are needed to assess the evidence of work-related psychosocial factors on workers´ health.

77 FR 69916 - Aviation Rulemaking Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

... Expectations 3. Recommendation Reports a. Rulemaking Prioritization Working Group (RPWG) Recommendation Report (ARAC) b. Avionics Systems Harmonization Working Group--Low Speed Alerting, Phase 2 Recommendation Report (TAE) 4. Status Reports From Active Working Groups a. Airman Testing Standards and Training...

Effects of welfare and maternal work on recommended preventive care utilization among low-income children.

PubMed

Holl, Jane L; Oh, Elissa H; Yoo, Joan; Amsden, Laura B; Sohn, Min-Woong

2012-12-01

We examined how maternal work and welfare receipt are associated with children receiving recommended pediatric preventive care services. We identified American Academy of Pediatrics-recommended preventive care visits from medical records of children in the 1999-2004 Illinois Families Study: Child Well-Being. We used Illinois administrative data to identify whether mothers received welfare or worked during the period the visit was recommended, and we analyzed the child visit data using random-intercept logistic regressions that adjusted for child, maternal, and visit-specific characteristics. The 485 children (95%) meeting inclusion criteria made 41% of their recommended visits. Children were 60% more likely (adjusted odds ratios [AOR` = 1.60; 95% confidence interval [CI] = 1.27, 2.01) to make recommended visits when mothers received welfare but did not work compared with when mothers did not receive welfare and did not work. Children were 25% less likely (AOR = 0.75; 95% CI = 0.60, 0.94) to make preventive care visits during periods when mothers received welfare and worked compared with welfare only periods. The Temporary Assistance for Needy Families maternal work requirement may be a barrier to receiving recommended preventive pediatric health care.

Pet-associated Campylobacteriosis: A persisting public health concern.

PubMed

Campagnolo, E R; Philipp, L M; Long, J M; Hanshaw, N L

2018-05-01

Campylobacter is regarded as a leading cause of human bacterial gastroenteritis in the United States. We report on a case of laboratory-confirmed Campylobacter jejuni infection in the Commonwealth of Pennsylvania among members of a household living with a laboratory-confirmed but non-speciated Campylobacter-infected puppy. We describe an outbreak of likely dog-associated campylobacteriosis, the risk factors, potential routes of exposure and the clinical features in the exposed family members, which began shortly after exposure to the recently purchased dog. We also provide public health recommendations to prevent Campylobacter infections in veterinary care providers, pet owners and those planning to adopt pets in the future. Finally, this report underscores the importance of the One Health approach when public health responders, human and animal healthcare providers and clinical diagnostic laboratories are tasked with developing effective strategies when investigating, detecting and responding to zoonoses (diseases shared between animals and humans). Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Consensus on performing skin biopsies, laboratory workup, evaluation of tissue samples and reporting of the results in patients with suspected cutaneous graft-versus-host disease.

PubMed

Hillen, U; Häusermann, P; Massi, D; Janin, A; Wolff, D; Lawitschka, A; Greinix, H; Meyer, R; Ziemer, M

2015-05-01

Histopathological diagnosis including selection of lesions, the determination of the best point of time for biopsy and workup is not trivial in cutaneous graft-versus-host disease (GvHD). To develop interdisciplinary recommendations on performing, the laboratory work up and reporting of the results of skin biopsies in patients with suspected cutaneous GvHD. A working group consisting of dermatopathologists, dermatologists, transplant-physicians and transplant-pathologists prepared recommendations for performing skin biopsies, laboratory workup and evaluation of tissue samples, and reporting of the results in patients with cutaneous GvHD. After achieving a consensus within the working group, a survey that comprised the core issues of the recommendations was electronically sent out to 72 alloHSCT centres within Germany, Austria, and Switzerland and their Departments of Pathology. The answers were discussed in a Consensus Conference and final recommendations were established. Twenty-five centres responded to the clinical and 17 centres to the histopathological survey. Questions addressed to the clinicians comprised the indication for skin biopsy in chronic GvHD (cGvHD) and acute GvHD (aGvHD) and the appropriate point of time for skin biopsy. Eighty-eight per cent agreed that the skin biopsy is generally indicated in patients with suspected cGvHD lacking diagnostic features. In contrast, with suspected aGvHD, only 62% of respondents felt that skin biopsy was necessary even if GvHD had not been confirmed in another organ. Although restricted due to the fact that immunosuppression is often applied in an emergency setting most centres supported skin biopsies before initiation of topical or systemic immunosuppression. The majority of pathologists agreed that in non-sclerotic GvHD a punch biopsy is adequate, whereas in sclerotic GvHD a scalpel biopsy is preferred. While a consensus on the need for biopsies in cGvHD was reached the value of skin biopsies in aGvHD and subsequent biopsies during therapy requires further evaluation. © 2014 European Academy of Dermatology and Venereology.

[Tool of nutrition education for allergic to egg and cow's milk protein in pediatric age].

PubMed

San Mauro Martín, Ismael

2014-05-01

Food allergy affects a large part of the population and their numbers are increasing. Although the knowing of this pathology is growing, allergic patients have really difficulties to lead a normal life, especially with food. Until now,this group hadn t practical tools that would help them in the development of a balanced daily diet, as there are for the general population in the form of pyramids and dietary guidelines . This work has covered this need for two of the most prevalent allergies in early life. gather information on the allergy of cow's milk protein and egg, to design a food pyramid for these patients, based on the consensus, recommendations and scientific guidance. After confirming the absence of a similar work, food pyramids allergy to egg and cow's milk protein, adapted to each, and a joint pyramid is designed to both allergies. Besides basic recommendations for healthy eating were included in general and in particular individuals, with special interest for the collective (food hygiene, food additives, cosmetics, medicines, etc). Due to the importance of nutrition in childhood and acquires the underlying difficulties this group, to properly plan the diet is very important as it can prevent accidents and long-term nutritional deficiencies. Therefore provide graphical tools and practices to this goal, is importance for population and medical and scientific community, and is the result of this work. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Medical follow-up of workers exposed to lung carcinogens: French evidence-based and pragmatic recommendations.

PubMed

Delva, Fleur; Margery, Jacques; Laurent, François; Petitprez, Karine; Pairon, Jean-Claude

2017-02-14

The aim of this work was to establish recommendations for the medical follow-up of workers currently or previously exposed to lung carcinogens. A critical synthesis of the literature was conducted. Occupational lung carcinogenic substances were listed and classified according to their level of lung cancer risk. A targeted screening protocol was defined. A clinical trial, National Lung Screnning Trial (NLST), showed the efficacy of chest CAT scan (CT) screening for populations of smokers aged 55-74 years with over 30 pack-years of exposure who had stopped smoking for less than 15 years. To propose screening in accordance with NLST criteria, and to account for occupational risk factors, screening among smokers and former smokers needs to consider the types of occupational exposure for which the risk level is at least equivalent to the risk of the subjects included in the NLST. The working group proposes an algorithm that estimates the relative risk of each occupational lung carcinogen, taking into account exposure to tobacco, based on available data from the literature. Given the lack of data on bronchopulmonary cancer (BPC) screening in occupationally exposed workers, the working group proposed implementing a screening experiment for bronchopulmonary cancer in subjects occupationally exposed or having been occupationally exposed to lung carcinogens who are confirmed as having high risk factors for BPC. A specific algorithm is proposed to determine the level of risk of BPC, taking into account the different occupational lung carcinogens and tobacco smoking at the individual level.

Transferring learning from faculty development to the classroom.

PubMed

Rock, Kim Z

2014-12-01

This study’s purpose was to better understand the transfer of learning by uncovering how various factors supported the integration of health information technology knowledge and skills gleaned from the Health Resources and Services Administration–funded faculty development programs into nursing education curricula. Through interviews with 20 participants from four programs, this study confirmed the importance of findings related to faculty, program, and work environment characteristics for supporting successful transfer of learning and substantiates a variety of other transfer-of-learning research. New or seldom discussed supportive individual characteristics were found, including leadership abilities, lifelong learning, ability to recognize limitations, persistence, creativity, and risk taking. The importance of networking, diversity of perspectives, postconference support, and teams in program designs were found to positively influence transfer. The variety of supportive factors and barriers in the participants’ work environments strengthens the assertions that transfer may be context dependent. Findings provided insight for recommendations to improve learning transfer. Copyright 2014, SLACK Incorporated.

Effects of Welfare and Maternal Work on Recommended Preventive Care Utilization Among Low-Income Children

PubMed Central

Holl, Jane L.; Oh, Elissa H.; Yoo, Joan; Amsden, Laura B.

2012-01-01

Objectives. We examined how maternal work and welfare receipt are associated with children receiving recommended pediatric preventive care services. Methods. We identified American Academy of Pediatrics–recommended preventive care visits from medical records of children in the 1999–2004 Illinois Families Study: Child Well-Being. We used Illinois administrative data to identify whether mothers received welfare or worked during the period the visit was recommended, and we analyzed the child visit data using random-intercept logistic regressions that adjusted for child, maternal, and visit-specific characteristics. Results. The 485 children (95%) meeting inclusion criteria made 41% of their recommended visits. Children were 60% more likely (adjusted odds ratios [AOR` = 1.60; 95% confidence interval [CI] = 1.27, 2.01) to make recommended visits when mothers received welfare but did not work compared with when mothers did not receive welfare and did not work. Children were 25% less likely (AOR = 0.75; 95% CI = 0.60, 0.94) to make preventive care visits during periods when mothers received welfare and worked compared with welfare only periods. Conclusion. The Temporary Assistance for Needy Families maternal work requirement may be a barrier to receiving recommended preventive pediatric health care. PMID:23078495

Carboxylated nanodiamonds can be used as negative reference in in vitro nanogenotoxicity studies.

PubMed

Moche, H; Paget, V; Chevalier, D; Lorge, E; Claude, N; Girard, H A; Arnault, J C; Chevillard, S; Nesslany, F

2017-08-01

Nanodiamonds (NDs) are promising nanomaterials for biomedical applications. However, a few studies highlighted an in vitro genotoxic activity for detonation NDs, which was not evidenced in one of our previous work quantifying γ-H2Ax after 20 and 100 nm high-pressure high-temperature ND exposures of several cell lines. To confirm these results, in the present work, we investigated the genotoxicity of the same 20 and 100 nm NDs and added intermediate-sized NDs of 50 nm. Conventional in vitro genotoxicity tests were used, i.e., the in vitro micronucleus and comet assays that are recommended by the French National Agency for Medicines and Health Products Safety for the toxicological evaluation of nanomedicines. In vitro micronucleus and in vitro comet assays (standard and hOGG1-modified) were therefore performed in two human cell lines, the bronchial epithelial 16HBE14o- cells and the colon carcinoma T84 cells. Our results did not show any genotoxic activity, whatever the test, the cell line or the size of carboxylated NDs. Even though these in vitro results should be confirmed in vivo, they reinforce the potential interest of carboxylated NDs for biomedical applications or even as a negative reference nanoparticle in nanotoxicology. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Consensus report of the Working Group on: "Molecular and Biochemical Markers of Alzheimer's Disease". The Ronald and Nancy Reagan Research Institute of the Alzheimer's Association and the National Institute on Aging Working Group.

PubMed

1998-01-01

The ideal biomarker for Alzheimer's disease (AD) should detect a fundamental feature of neuropathology and be validated in neuropathologically-confirmed cases; it should have a sensitivity >80% for detecting AD and a specificity of >80% for distinguishing other dementias; it should be reliable, reproducible, non-invasive, simple to perform, and inexpensive. Recommended steps to establish a biomarker include confirmation by at least two independent studies conducted by qualified investigators with the results published in peer-reviewed journals. Our review of current candidate markers indicates that for suspected early-onset familial AD, it is appropriate to search for mutations in the presenilin 1, presenilin 2, and amyloid precursor protein genes. Individuals with these mutations typically have increased levels of the amyloid Abeta42 peptide in plasma and decreased levels of APPs in cerebrospinal fluid. In late-onset and sporadic AD, these measures are not useful, but detecting an apolipoprotein E e4 allele can add confidence to the clinical diagnosis. Among the other proposed molecular and biochemical markers for sporadic AD, cerebrospinal fluid assays showing low levels of Abeta42 and high levels of tau come closest to fulfilling criteria for a useful biomarker.

Notes from the Field: Health Care-Associated Hepatitis A Outbreak - Texas, 2015.

PubMed

Wiseman, Rachel; Weil, Lauren M; Lozano, Catalina; Johnson, Thomas J; Jin, Sherry; Moorman, Anne C; Foster, Monique A; Mixson-Hayden, Tonya; Khudyakov, Yury; Kuhar, David T; Graves, Julie

2016-04-29

On August 27-28, 2015, the Texas Department of State Health Services received calls from Fort Bend County and Harris County health departments requesting postexposure prophylaxis (PEP) recommendations for contacts of two nurses (patients A and B) with confirmed hepatitis A virus (HAV) infection. Both nurses had symptom onset during August 15-19 and worked for the same pediatric home health care agency in another jurisdiction. Because of the proximity of the onset dates, a common source exposure was suspected. The state and local health departments began an investigation to identify potentially exposed patients, their families, and other agency personnel; offer PEP; and identify the source of exposure.

Pregnancy loss: French clinical practice guidelines.

PubMed

Huchon, C; Deffieux, X; Beucher, G; Capmas, P; Carcopino, X; Costedoat-Chalumeau, N; Delabaere, A; Gallot, V; Iraola, E; Lavoue, V; Legendre, G; Lejeune-Saada, V; Leveque, J; Nedellec, S; Nizard, J; Quibel, T; Subtil, D; Vialard, F; Lemery, D

2016-06-01

In intrauterine pregnancies of uncertain viability with a gestational sac without a yolk sac (with a mean of three orthogonal transvaginal ultrasound measurements <25mm), the suspected pregnancy loss should only be confirmed after a follow-up scan at least 14 days later shows no embryo with cardiac activity (Grade C). In intrauterine pregnancies of uncertain viability with an embryo <7mm on transvaginal ultrasound, the suspected pregnancy loss should only be confirmed after a follow-up scan at least 7 days later (Grade C). In pregnancies of unknown location after transvaginal ultrasound (i.e. not visible in the uterus), a threshold of at least 3510IU/l for the serum human chorionic gonadotrophin assay is recommended; above that level, a viable intrauterine pregnancy can be ruled out (Grade C). Postponing conception after an early miscarriage in women who want a new pregnancy is not recommended (Grade A). A work-up for women with recurrent pregnancy loss should include the following: diabetes (Grade A), antiphospholipid syndrome (Grade A), hypothyroidism with anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibodies (Grade A), vitamin deficiencies (B9, B12) (Grade C), hyperhomocysteinaemia (Grade C), hyperprolactinaemia (Grade B), diminished ovarian reserve (Grade C), and a uterine malformation or an acquired uterine abnormality amenable to surgical treatment (Grade C). The treatment options recommended for women with a missed early miscarriage are vacuum aspiration (Grade A) or misoprostol (Grade B); and the treatment options recommended for women with an incomplete early miscarriage are vacuum aspiration (Grade A) or expectant management (Grade A). In the absence of both chorioamnionitis and rupture of the membranes, women with a threatened late miscarriage and an open cervix, with or without protrusion of the amniotic sac into the vagina, should receive McDonald cerclage, tocolysis with indomethacin, and antibiotics (Grade C). Among women with a threatened late miscarriage and an isolated undilated shortened cervix (<25mm on ultrasound), cerclage is only indicated for those with a history of either late miscarriage or preterm delivery (Grade A). Among women with a threatened late miscarriage, an isolated undilated shortened cervix (<25mm on ultrasound) and no uterine contractions, daily treatment with vaginal progesterone up to 34 weeks of gestation is recommended (Grade A). Hysteroscopic section of the septum is recommended for women with a uterine septum and a history of late miscarriage (Grade C). Correction of acquired abnormalities of the uterine cavity (e.g. polyps, myomas, synechiae) is recommended after three early or late miscarriages (Grade C). Prophylactic cerclage is recommended for women with a history of three late miscarriages or preterm deliveries (Grade B). Low-dose aspirin and low-molecular-weight heparin at a preventive dose are recommended for women with obstetric antiphospholipid syndrome (Grade A). Glycaemic levels should be controlled before conception in women with diabetes (Grade A). Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Recommendations for the Use of Serious Games in Neurodegenerative Disorders: 2016 Delphi Panel.

PubMed

Manera, Valeria; Ben-Sadoun, Grégory; Aalbers, Teun; Agopyan, Hovannes; Askenazy, Florence; Benoit, Michel; Bensamoun, David; Bourgeois, Jérémy; Bredin, Jonathan; Bremond, Francois; Crispim-Junior, Carlos; David, Renaud; De Schutter, Bob; Ettore, Eric; Fairchild, Jennifer; Foulon, Pierre; Gazzaley, Adam; Gros, Auriane; Hun, Stéphanie; Knoefel, Frank; Olde Rikkert, Marcel; Phan Tran, Minh K; Politis, Antonios; Rigaud, Anne S; Sacco, Guillaume; Serret, Sylvie; Thümmler, Susanne; Welter, Marie L; Robert, Philippe

2017-01-01

The use of Serious Games (SG) in the health domain is expanding. In the field of neurodegenerative disorders (ND) such as Alzheimer's disease, SG are currently employed both to support and improve the assessment of different functional and cognitive abilities, and to provide alternative solutions for patients' treatment, stimulation, and rehabilitation. As the field is quite young, recommendations on the use of SG in people with ND are still rare. In 2014 we proposed some initial recommendations (Robert et al., 2014). The aim of the present work was to update them, thanks to opinions gathered by experts in the field during an expert Delphi panel. Results confirmed that SG are adapted to elderly people with mild cognitive impairment (MCI) and dementia, and can be employed for several purposes, including assessment, stimulation, and improving wellbeing, with some differences depending on the population (e.g., physical stimulation may be better suited for people with MCI). SG are more adapted for use with trained caregivers (both at home and in clinical settings), with a frequency ranging from 2 to 4 times a week. Importantly, the target of SG, their frequency of use and the context in which they are played depend on the SG typology (e.g., Exergame, cognitive game), and should be personalized with the help of a clinician.

Recommendation in evolving online networks

NASA Astrophysics Data System (ADS)

Hu, Xiao; Zeng, An; Shang, Ming-Sheng

2016-02-01

Recommender system is an effective tool to find the most relevant information for online users. By analyzing the historical selection records of users, recommender system predicts the most likely future links in the user-item network and accordingly constructs a personalized recommendation list for each user. So far, the recommendation process is mostly investigated in static user-item networks. In this paper, we propose a model which allows us to examine the performance of the state-of-the-art recommendation algorithms in evolving networks. We find that the recommendation accuracy in general decreases with time if the evolution of the online network fully depends on the recommendation. Interestingly, some randomness in users' choice can significantly improve the long-term accuracy of the recommendation algorithm. When a hybrid recommendation algorithm is applied, we find that the optimal parameter gradually shifts towards the diversity-favoring recommendation algorithm, indicating that recommendation diversity is essential to keep a high long-term recommendation accuracy. Finally, we confirm our conclusions by studying the recommendation on networks with the real evolution data.

Prediction of microbe-disease association from the integration of neighbor and graph with collaborative recommendation model.

PubMed

Huang, Yu-An; You, Zhu-Hong; Chen, Xing; Huang, Zhi-An; Zhang, Shanwen; Yan, Gui-Ying

2017-10-16

Accumulating clinical researches have shown that specific microbes with abnormal levels are closely associated with the development of various human diseases. Knowledge of microbe-disease associations can provide valuable insights for complex disease mechanism understanding as well as the prevention, diagnosis and treatment of various diseases. However, little effort has been made to predict microbial candidates for human complex diseases on a large scale. In this work, we developed a new computational model for predicting microbe-disease associations by combining two single recommendation methods. Based on the assumption that functionally similar microbes tend to get involved in the mechanism of similar disease, we adopted neighbor-based collaborative filtering and a graph-based scoring method to compute association possibility of microbe-disease pairs. The promising prediction performance could be attributed to the use of hybrid approach based on two single recommendation methods as well as the introduction of Gaussian kernel-based similarity and symptom-based disease similarity. To evaluate the performance of the proposed model, we implemented leave-one-out and fivefold cross validations on the HMDAD database, which is recently built as the first database collecting experimentally-confirmed microbe-disease associations. As a result, NGRHMDA achieved reliable results with AUCs of 0.9023 ± 0.0031 and 0.9111 in the validation frameworks of fivefold CV and LOOCV. In addition, 78.2% microbe samples and 66.7% disease samples are found to be consistent with the basic assumption of our work that microbes tend to get involved in the similar disease clusters, and vice versa. Compared with other methods, the prediction results yielded by NGRHMDA demonstrate its effective prediction performance for microbe-disease associations. It is anticipated that NGRHMDA can be used as a useful tool to search the most potential microbial candidates for various diseases, and therefore boosts the medical knowledge and drug development. The codes and dataset of our work can be downloaded from https://github.com/yahuang1991/NGRHMDA .

Anthrax: Diagnosis

MedlinePlus

... Laboratory Testing Confirming Anthrax Through the Laboratory Response Network FAQs Information for Specific Groups Laboratory Professionals Collecting Specimens Recommended Specimens Worker Safety ...

Experimental Confirmation of Lenz's Law

ERIC Educational Resources Information Center

Mayer, V. V.; Varaksina, E. I.

2017-01-01

The paper presents a series of experiments that demonstrate the phenomenon of electromagnetic induction. These make it possible to determine the direction of the induced current and so confirm Lenz's Law. The simple experiments can be reproduced in a school laboratory and can be recommended for students' project activity.

Experimental confirmation of Lenz’s law

NASA Astrophysics Data System (ADS)

Mayer, V. V.; Varaksina, E. I.

2017-11-01

The paper presents a series of experiments that demonstrate the phenomenon of electromagnetic induction. These make it possible to determine the direction of the induced current and so confirm Lenz’s Law. The simple experiments can be reproduced in a school laboratory and can be recommended for students’ project activity.

Vaccines for preventing influenza in healthy adults.

PubMed

Demicheli, V; Rivetti, D; Deeks, J J; Jefferson, T O

2004-01-01

Three different types of influenza vaccines are currently produced worldwide. None is traditionally targeted to healthy adults. Despite the publication of a large number of clinical trials, there is still substantial uncertainty about the clinical effectiveness of influenza vaccines and this has negative impact on the vaccines acceptance and uptake. To assess the effects of vaccines on influenza in healthy adults. To assess the effectiveness of vaccines in preventing cases of influenza in healthy adults. To estimate the frequency of adverse effects associated with influenza vaccination in healthy adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 1, 2004) which contains the Cochrane Acute Respiratory Infections Group trials register; MEDLINE (January 1966 to December 2003); and EMBASE (1990 to December 2003). We wrote to vaccine manufacturers and first or corresponding authors of studies in the review. Any randomised or quasi-randomised studies comparing influenza vaccines in humans with placebo, control vaccines or no intervention, or comparing types, doses or schedules of influenza vaccine. Live, attenuated or killed vaccines or fractions thereof administered by any route, irrespective of antigenic configuration were considered. Only studies assessing protection from exposure to naturally occurring influenza in healthy individuals aged 14 to 60 (irrespective of influenza immune status) were considered. Two reviewers independently assessed trial quality and extracted data. Twenty five reports of studies involving 59,566 people were included. The recommended live aerosol vaccines reduced the number of cases of serologically confirmed influenza by 48% (95% confidence interval (CI) 24% to 64%), whilst recommended inactivated parenteral vaccines had a vaccine efficacy of 70% (95% CI 56% to 80%). The yearly recommended vaccines had low effectiveness against clinical influenza cases: 15%(95% CI 8% to 21%) and 25% (95% CI 13% to 35%) respectively. Overall the percentage of participants experiencing clinical influenza decreased by 6%. Use of the vaccine significantly reduced time off work but only by 0.16 days for each influenza episode (95% CI 0.04 to 0.29 days); Analysis of vaccines matching the circulating strain gave higher estimates of efficacy, whilst inclusion of all other vaccines reduced the efficacy. Influenza vaccines are effective in reducing serologically confirmed cases of influenza. However, they are not as effective in reducing cases of clinical influenza and number of working days lost. Universal immunisation of healthy adults is not supported by the results of this review.

Recognition Confidence under Violated and Confirmed Memory Expectations

ERIC Educational Resources Information Center

Jaeger, Antonio; Cox, Justin C.; Dobbins, Ian G.

2012-01-01

Individuals' memory experiences typically covary with those of others' around them, and on average, an item is more likely to be familiar if a companion recommends it as such. Although it would be ideal if observers could use the external recommendations of others' as statistical priors during recognition decisions, it is currently unclear how or…

Meta-analysis on shift work and risks of specific obesity types.

PubMed

Sun, M; Feng, W; Wang, F; Li, P; Li, Z; Li, M; Tse, G; Vlaanderen, J; Vermeulen, R; Tse, L A

2018-01-01

This systematic review and meta-analysis evaluated the associations between shift work patterns and risks of specific types of obesity. PubMed was searched until March 2017 for observational studies that examined the relationships between shift work patterns and obesity. Odds ratio for obesity was extracted using a fixed-effects or random-effects model. Subgroup meta-analyses were carried out for study design, specific obesity types and characteristics of shift work pattern. A total of 28 studies were included in this meta-analysis. The overall odds ratio of night shift work was 1.23 (95% confidence interval = 1.17-1.29) for risk of obesity/overweight. Cross-sectional studies showed a higher risk of 1.26 than those with the cohort design (risk ratio = 1.10). Shift workers had a higher frequency of developing abdominal obesity (odds ratio = 1.35) than other obesity types. Permanent night workers demonstrated a 29% higher risk than rotating shift workers (odds ratio 1.43 vs. 1.14). This meta-analysis confirmed the risks of night shift work for the development of overweight and obesity with a potential gradient association suggested, especially for abdominal obesity. Modification of working schedules is recommended, particularly for prolonged permanent night work. More accurate and detailed measurements on shift work patterns should be conducted in future research. © 2017 World Obesity Federation.

Recommender systems in knowledge-mining

NASA Astrophysics Data System (ADS)

Volna, Eva

2017-07-01

The subject of the paper is to analyse the possibilities of application of recommender systems in the field of data mining. The work focuses on three basic types of recommender systems (collaborative, content-based and hybrid). The goal of the article is to evaluate which of these three concepts of recommender systems provides forecast with the lowest error rate in the domain of recommending movies. This target is fulfilled by the practical part of the work - at first, the own recommender system was designed and created, capable of obtaining movies recommendation from the database based on the user's preferences. Next, we verified experimentally which recommender system produces more accurate results.

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%).

The relationship between meeting of recommendations on physical activity for health and perceived work ability among white-collar workers.

PubMed

Nawrocka, Agnieszka; Garbaciak, Wiesław; Cholewa, Jarosław; Mynarski, Władysław

2018-04-01

The aim of this study was to evaluate the association between meeting recommendations on physical activity for health in leisure-time and the ability to work among Polish white-collar workers. The study used a cross-sectional design with a convenience sample of 360 white-collar workers. Participants recorded 7-day physical activity logs, including form, duration and intensity of leisure-time physical activities. The results were compared to health recommendations. A standardized Work Ability Index (WAI) questionnaire was used in assessing the ability to work. Participants who met health recommendations achieved higher scores of the WAI (mean score = 41.93) in comparison to those who were not sufficiently physically active (mean score = 39.35) (p < .001). The results of binary logistic regression show that meeting health-related physical activity recommendations almost double the odds of reaching at least good work ability (OR = 1.94, 95% CI = 1.12-3.36). Meeting leisure-time physical activity recommendations (especially the criterion of vigorous physical activity) is significantly related to higher self-assessed ability to work among white-collar workers.

Phase I Recommendations by the Air Quality Management Work Group to the Clean Air Act Advisory Committee

EPA Pesticide Factsheets

Recommendations to the Clean Air Act Advisory Committee by Air Quality Management Work Group addressing the recommendations made by the National Research Council to improve the U.S. air quality management system.

Malaria in the Republic of Djibouti, 1998–2009

PubMed Central

Ollivier, Lénaïck; Nevin, Remington L.; Darar, Houssein Y.; Bougère, Jacques; Saleh, Moustapha; Gidenne, Stéphane; Maslin, Jérôme; Anders, Dietmar; Decam, Christophe; Todesco, Alain; Khaireh, Bouh A.; Ahmed, Ammar A.

2011-01-01

Historically, native populations in the Republic of Djibouti have experienced only low and unstable malaria transmission and intermittent epidemics. In recent years, efforts at malaria control have been aggressively pursued. This study was performed to inform revised malaria prevention recommendations for military service members and international travelers to the country. Laboratory-confirmed cases of malaria documented at large medical facilities and within military and civilian health care systems in the Republic of Djibouti from 1998 to 2009 were reviewed. In recent years, fewer than 5% of febrile cases among the three largest passive surveillance systems were laboratory-confirmed as malaria, and incidence of confirmed malaria was well below 1/1,000 persons/year. As efforts in the Republic of Djibouti progress toward elimination, and in conjunction with continued efforts at surveillance, emphasizing mosquito-avoidance measures and standby emergency treatment will become reasonable recommendations for malaria prevention. PMID:21896822

Malaria in the Republic of Djibouti, 1998-2009.

PubMed

Ollivier, Lénaïck; Nevin, Remington L; Darar, Houssein Y; Bougère, Jacques; Saleh, Moustapha; Gidenne, Stéphane; Maslin, Jérôme; Anders, Dietmar; Decam, Christophe; Todesco, Alain; Khaireh, Bouh A; Ahmed, Ammar A

2011-09-01

Historically, native populations in the Republic of Djibouti have experienced only low and unstable malaria transmission and intermittent epidemics. In recent years, efforts at malaria control have been aggressively pursued. This study was performed to inform revised malaria prevention recommendations for military service members and international travelers to the country. Laboratory-confirmed cases of malaria documented at large medical facilities and within military and civilian health care systems in the Republic of Djibouti from 1998 to 2009 were reviewed. In recent years, fewer than 5% of febrile cases among the three largest passive surveillance systems were laboratory-confirmed as malaria, and incidence of confirmed malaria was well below 1/1,000 persons/year. As efforts in the Republic of Djibouti progress toward elimination, and in conjunction with continued efforts at surveillance, emphasizing mosquito-avoidance measures and standby emergency treatment will become reasonable recommendations for malaria prevention.

Impact of childhood cancer on maternal employment in Japan.

PubMed

Okada, Hiromi; Maru, Mitsue; Maeda, Rumi; Iwasaki, Fuminori; Nagasawa, Masayuki; Takahashi, Miyako

2015-01-01

Family members of children with cancer experience various long-term effects as a result of cancer diagnosis and treatment. Therefore, comprehensive and long-term support is needed. As the employment rate of women has increased in recent years, support for working mothers with children diagnosed with cancer is also required. We investigated the following issues and relevant changes that working mothers of children diagnosed with cancer must deal with: (1) work change, (2) stress, (3) social support, (4) work motivation, and (5) employment status after diagnosis. A cross-sectional exploratory study design was used. Data were collected from 62 mothers of children who were diagnosed with cancer using self-report questionnaires. Of the 32 mothers who worked at the time of diagnosis, 10 continued to work, 12 took an extended leave, and 10 quit working, and 70% lost motivation for work following diagnosis. Half of mothers who continued to work during treatment reported financial reasons. These findings indicate that mothers who quit work following diagnosis did not initially consider a long leave of absence. Even mothers who continued to work during treatment desired a long leave of absence to care for their children. Nurses should provide mothers with explanations of the prospects after the completion of cancer treatment and determine their expectations for their lifestyle and work during treatment. We recommend that nurses confirm mothers' willingness to take a long leave of absence from work and give relevant advice about seeking financial assistance.

[Diagnosis and treatment with steroids for patients with Duchenne muscular dystrophy: experience and recommendations for Mexico. Administración del Patrimonio de la Beneficencia Pública. Asociación de Distrofia Muscular de Occidente].

PubMed

Vázquez-Cárdenas, Norma A; Ibarra-Hernández, Francisco; López-Hernández, Luz B; Escobar-Cedillo, Rosa E; Ruano-Calderón, Luis A; Gómez-Díaz, Benjamín; García-Calderón, Noemí; Carriedo-Dávila, M Fernanda; Rojas-Hurtado, Liliana G; Luna-Padrón, Emilia; Coral-Vázquez, Ramón M

2013-11-16

Duchenne muscular dystrophy is a severe, debilitating and progressive disease that affects 1 in 3,500 live male births in the world. The diagnosis should be confirmed by genetic testing to identify the mutation in the DMD gene or muscle biopsy and immunostaining to demonstrate the absence of dystrophin. Although up to now continues to be an incurable disease, this does not mean it has no treatment. Treatment should be multidisciplinary, looking for the functionality of the patient and avoiding or correcting complications, mainly cardio-respiratory and skeletal. Many proposals have been evaluated and implemented with the aim of improving the quality of life for these patients. The long-term steroids have shown significant benefits, such as prolonging ambulation, reduce the need for spinal surgery, improve cardiorespiratory function and increase survival and the quality of life. This document presents the recommendations based on the experience of the working group and experts worldwide on the diagnosis and treatment with steroids for patients with Duchenne muscular dystrophy.

Helping the healer: population-informed workplace wellness recommendations for physician well-being.

PubMed

Brooks, E; Early, S R; Gendel, M H; Miller, L; Gundersen, D C

2018-05-23

The need to keep physicians healthy and in practice is critical as demand for doctors grows faster than the supply. Workplace wellness programmes can improve employee health and retain skilled workers. To broaden our understanding about ways to help doctors coping with mental health problems and to develop population-informed workplace wellness recommendations for physician populations. Researchers surveyed physicians to document potential warning signs and prevention strategies. A survey was issued to doctors who presented to a physician health programme with mental health complaints. The survey captured respondents' feedback about how to identify and prevent mental health problems. Data were analyzed using simple descriptive statistics. There were 185 participants. Half of respondents believed their problems could have been recognized sooner and 60% said they exhibited signs that could aid in earlier detection. Potential warnings included fluctuations in mood (67%), increased comments about stress/burnout (49%) and behavioural changes (32%). To improve detection, prevention and care-seeking for mental health problems, doctors endorsed multiple items related to the use of interpersonal supports, personal factors and organizational dynamics throughout the survey. The findings confirmed earlier work demonstrating the value of social and organizational support in maintaining physician health. It further indicated that earlier identification and/or prevention of mental health problems is not only possible, but that medical organizations are uniquely situated to carry out this work.

OARSI Clinical Trials Recommendations: Design, conduct, and reporting of clinical trials for knee osteoarthritis.

PubMed

McAlindon, T E; Driban, J B; Henrotin, Y; Hunter, D J; Jiang, G-L; Skou, S T; Wang, S; Schnitzer, T

2015-05-01

The goal of this document is to update the original OARSI recommendations specifically for the design, conduct, and reporting of clinical trials that target symptom or structure modification among individuals with knee osteoarthritis (OA). To develop recommendations for the design, conduct, and reporting of clinical trials for knee OA we initially drafted recommendations through an iterative process. Members of the working group included representatives from industry and academia. After the working group members reviewed a final draft, they scored the appropriateness for recommendations. After the members voted we calculated the median score among the nine members of the working group who completed the score. The document includes 25 recommendations regarding randomization, blocking and stratification, blinding, enhancing accuracy of patient-reported outcomes (PRO), selecting a study population and index knee, describing interventions, patient-reported and physical performance measures, structural outcome measures, biochemical biomarkers, and reporting recommendations. In summary, the working group identified 25 recommendations that represent the current best practices regarding clinical trials that target symptom or structure modification among individuals with knee OA. These updated recommendations incorporate novel technologies (e.g., magnetic resonance imaging (MRI)) and strategies to address the heterogeneity of knee OA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Position statement: hypoglycemia management in patients with diabetes mellitus. Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition.

PubMed

Mezquita-Raya, Pedro; Reyes-García, Rebeca; Moreno-Pérez, Óscar; Muñoz-Torres, Manuel; Merino-Torres, Juan Francisco; Gorgojo-Martínez, Juan José; Jódar-Gimeno, Esteban; Escalada San Martín, Javier; Gargallo-Fernández, Manuel; Soto-Gonzalez, Alfonso; González Pérez de Villar, Noemí; Becerra Fernández, Antonio; Bellido Guerrero, Diego; Botella-Serrano, Marta; Gómez-Peralta, Fernando; López de la Torre Casares, Martín

2013-11-01

To provide practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus. Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition. Recommendations were formulated according to the Grading of Recommendations, Assessment, Development, and Evaluation system to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (PubMed). Papers in English and Spanish with publication date before 15 February 2013 were included. For recommendations about drugs only those approved by the European Medicines Agency were included. After formulation of recommendations, they were discussed by the Working Group. The document provides evidence-based practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

Preference-Inconsistent Recommendations: An Effective Approach for Reducing Confirmation Bias and Stimulating Divergent Thinking?

ERIC Educational Resources Information Center

Schwind, Christina; Buder, Jurgen; Cress, Ulrike; Hesse, Friedrich W.

2012-01-01

The Web is a perfect backdrop for opinion formation as a multitude of different opinions is publicly available. However, the different opinions often remain unexploited: Learners prefer preference-consistent over preference-inconsistent information, a phenomenon called confirmation bias. Two experiments were designed to test whether technologies…

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

Determination of the density of air: a comparison of the CIPM thermodynamic formula and the gravimetric method

NASA Astrophysics Data System (ADS)

Madec, Tanguy; Meury, Paul-André; Sutour, Christophe; Rabault, Thierry; Zerbib, Serge; Gosset, André

2007-12-01

Today, the determination of the density of air is the main source of uncertainty (10 µg) in a comparison of a platinum-iridium alloy national prototype with a stainless steel reference standard. The method currently recommended by the BIPM is to calculate this density, using a formula developed in 1981 and revised in 1991 by the CIPM, from the measured values of the pressure, temperature, hygrometry and molar fraction of CO2 in air. Recent work has found significant differences between the values given by this formula and those given by a method using artefacts having identical masses and very different volumes (6.4 × 10-5 with a relative uncertainty of 1.2 × 10-5). To investigate this difference, the BIPM asked the member laboratories of the Consultatitve Committee for Mass (CCM) to investigate two lines of approach: check the composition of the air, in particular the argon content, which may explain the discrepancies found; this is the object of a study by the chemical metrology unit of LNE (see the article by Sutour et al in this issue), study the behavior of artefacts during the air-vacuum transfer in a comparator that can work both in a controlled atmosphere and in a vacuum, to confirm or not confirm the discrepancies; this latter study is the object of this paper.

Development and validation of a method for the analysis of cafenstrole and its metabolite in brown rice grains and rice straw using high-performance liquid chromatography.

PubMed

Abd El-Aty, A M; Lee, Go-Woon; Mamun, M I R; Choi, Jeong-Heui; Cho, Soon-Kil; Shin, Ho-Chul; Shim, Jae-Han

2008-03-01

The present work reports the extraction and clean-up procedures, as well as the chromatographic conditions developed, for the determination of cafenstrole and its metabolite (CHM-03) residues in brown rice grains and rice straw using HPLC-UV detection. The method makes use of an Apollo C(18) column and acetonitrile : water : acetic acid as a mobile phase for both cafenstrole and its metabolite in rice and rice straw. Using these conditions cafenstrole and its metabolite were resolved with a retention time (R(t)) of less than 14 min. The analytes were confirmed using positive atmospheric pressure ionization LC-MS with selected ion monitoring. The average recoveries of cafenstrole were found to be 87.0-92.5 and 87.6-88.3%. However, they ranged from 81.5 to 81.6% and from 76.1 to 78.5% for cafenstrole metabolite (CHM-03), in rice grains and rice straw, respectively, with relative standard deviations ranging from 1.4 to 6.6%. The limits of detection (LODs) of both cafenstrole and its metabolite were 0.002 and 0.02 ppm and 0.025 and 0.04 ppm, respectively. Field trials with recommended or double the recommended dose revealed that the herbicide could safely be recommended for application in rice and rice straw as no residues were detected in the harvest samples.

End-of-life choices for African-American and white infants in a neonatal intensive-care unit: a pilot study.

PubMed Central

Moseley, Kathryn L.; Church, Annamaria; Hempel, Bridget; Yuan, Harry; Goold, Susan Door; Freed, Gary L.

2004-01-01

BACKGROUND: African-American adults are more likely than white adults to desire the continuation of life-sustaining medical treatment (LSMT) at the end of life. No studies have examined racial differences in parental end-of-life decisions for neonates. OBJECTIVE: To collect preliminary data to determine whether differences exist in the choices made by parents of African-American and white infants when a physician has recommended withholding or withdrawing LSMT from their infant to develop hypotheses for future work. DESIGN/METHODS: A retrospective chart review of African-American and white infants who died in an urban neonatal intensive care unit (NICU) over a two-year period. Charts were abstracted for demographics, cause of death, and documentation of meetings where the physician recommended withholding or withdrawing LSMT. RESULTS: Thirty-eight infant charts met study criteria (58% African-American, 42% white). Documentation of physician recommendations to limit LSMT was present in 61% of charts. Approached families of white infants agreed to limit LSMT 80% of the time compared to 62% of the families of African-American infants. CONCLUSIONS: In this pilot study, parents of African-American and white infants appeared to make different end-of-life choices for their children. A larger study is needed to confirm these findings and further explore contributing factors such as mistrust, religiosity, and perceived discrimination. PMID:15253324

Risk factors for first trimester miscarriage--results from a UK-population-based case-control study.

PubMed

Maconochie, N; Doyle, P; Prior, S; Simmons, R

2007-02-01

The aim of this study was to examine the association between biological, behavioural and lifestyle risk factors and risk of miscarriage. Population-based case-control study. Case-control study nested within a population-based, two-stage postal survey of reproductive histories of women randomly sampled from the UK electoral register. Six hundred and three women aged 18-55 years whose most recent pregnancy had ended in first trimester miscarriage (<13 weeks of gestation; cases) and 6116 women aged 18-55 years whose most recent pregnancy had progressed beyond 12 weeks (controls). Women were questioned about socio-demographic, behavioural and other factors in their most recent pregnancy. First trimester miscarriage. After adjustment for confounding, the following were independently associated with increased risk: high maternal age; previous miscarriage, termination and infertility; assisted conception; low pre-pregnancy body mass index; regular or high alcohol consumption; feeling stressed (including trend with number of stressful or traumatic events); high paternal age and changing partner. Previous live birth, nausea, vitamin supplementation and eating fresh fruits and vegetables daily were associated with reduced risk, as were feeling well enough to fly or to have sex. After adjustment for nausea, we did not confirm an association with caffeine consumption, smoking or moderate or occasional alcohol consumption; nor did we find an association with educational level, socio-economic circumstances or working during pregnancy. The results confirm that advice to encourage a healthy diet, reduce stress and promote emotional wellbeing might help women in early pregnancy (or planning a pregnancy) reduce their risk of miscarriage. Findings of increased risk associated with previous termination, stress, change of partner and low pre-pregnancy weight are noteworthy, and we recommend further work to confirm these findings in other study populations.

The physician as disability advisor for patients with musculoskeletal complaints.

PubMed

Rainville, James; Pransky, Glenn; Indahl, Aage; Mayer, Eric K

2005-11-15

Literature review. To review the literature about the performance of physicians as mediators of temporary and permanent disability for patients with chronic musculoskeletal complaints. To assess specifically the nature and variance of recommendations from physicians, factors influencing physician performance, and efforts to influence physician behavior in this area. While caring for patients with musculoskeletal injuries, physicians are often asked to recommend appropriate levels of activity and work. These recommendations have significant consequences for patients' general health, employment, and financial well-being. Medical literature search. Physician recommendations limiting activity and work after injury are highly variable, often reflecting their own pain attitudes and beliefs. Patients' desires strongly predict disability recommendations (i.e., physicians often acquiesce to patients' requests). Other influences include jurisdiction, employer, insurer, and medical system factors. The most successful efforts to influence physician recommendations have used mass communication to influence public attitudes, while reinforcing the current standard of practice for physicians. Physician recommendations for work and activity have important health and financial implications. Systemic, multidimensional approaches are necessary to improve performance.

Youth Employment. Final Recommendations of the State Superintendent's Task Force.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison.

This report contains the final recommendations of the task force on youth employment for the state of Wisconsin. The task force was specifically charged with studying issues related to working teenagers, reviewing existing laws and regulations on child labor, and developing recommendations to ensure that when teenagers work, their jobs do not…

76 FR 62894 - Following Procedures When Going Between Rolling Equipment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

... Operations Fatality Analysis (SOFA) Working Group. In October 1999, the Working Group issued a report titled ``Findings and Recommendations of the SOFA Working Group.'' The report can be found on FRA's Web site at http... recommendation reads as follows: \\1\\ More recently, in March 2011, the SOFA Working Group issued a report titled...

[Update of recommendations for evaluation and treatment of osteoporosis associated to endocrine and nutritional conditions. Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology].

PubMed

Reyes-García, Rebeca; García-Martín, Antonia; Varsavsky, Mariela; Rozas-Moreno, Pedro; Cortés-Berdonces, María; Luque-Fernández, Inés; Gómez Sáez, José Manuel; Vidal Casariego, Alfonso; Romero Muñoz, Manuel; Guadalix Iglesias, Sonsoles; Fernández García, Diego; Jódar Gimeno, Esteban; Muñoz Torres, Manuel

2015-05-01

To update previous recommendations developed by the Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology and Nutrition for the evaluation and treatment of osteoporosis associated to different endocrine and nutritional diseases. Members of the Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology and Nutrition. Recommendations were formulated according to the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the following terms associated to the name of each condition: AND "osteoporosis", "fractures", "bone mineral density", and "treatment". Papers in English with publication date between 18 October 2011 and 30 October 2014 were included. The recommendations were discussed and approved by all members of the Working Group. This update summarizes the new data regarding evaluation and treatment of osteoporosis associated to endocrine and nutritional conditions. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

SPREADSHEET-BASED PROGRAM FOR ERGONOMIC ADJUSTMENT OF NOTEBOOK COMPUTER AND WORKSTATION SETTINGS.

PubMed

Nanthavanij, Suebsak; Prae-Arporn, Kanlayanee; Chanjirawittaya, Sorajak; Paripoonyo, Satirajit; Rodloy, Somsak

2015-06-01

This paper discusses a computer program, ErgoNBC, which provides suggestions regarding the ergonomic settings of a notebook computer (NBC), workstation components, and selected accessories in order to help computer users to assume an appropriate work posture during the NBC work. From the users' body height, NBC and workstation component data, ErgoNBC computes the recommended tilt angle of NBC base unit, NBC screen angle, distance between the user and NBC, seat height and work surface height. If necessary, the NBC base support, seat cushion and footrest, including their settings, are recommended. An experiment involving twenty-four university students was conducted to evaluate the recommendations provided by ErgoNBC. The Rapid Upper Limb Assessment (RULA) technique was used to analyze their work postures both before and after implementing the Ergo NBC's recommendations. The results clearly showed that ErgoNBC could significantly help to improve the subjects' work postures.

Effect of antiviral prophylaxis on influenza outbreaks in aged care facilities in three local health districts in New South Wales, Australia, 2014

PubMed Central

Hope, Kirsty; Butler, Michelle; Durrheim, David; Gupta, Leena; Najjar, Zeina; Conaty, Stephen; Boonwatt, Leng; Fletcher, Stephanie

2016-01-01

Background There was a record number (n = 111) of influenza outbreaks in aged care facilities in New South Wales, Australia during 2014. To determine the impact of antiviral prophylaxis recommendations in practice, influenza outbreak data were compared for facilities in which antiviral prophylaxis and treatment were recommended and for those in which antivirals were recommended for treatment only. Methods Routinely collected outbreak data were extracted from the Notifiable Conditions Information Management System for two Local Health Districts where antiviral prophylaxis was routinely recommended and one Local Health District where antivirals were recommended for treatment but not routinely for prophylaxis. Data collected on residents included counts of influenza-like illness, confirmed influenza, hospitalizations and related deaths. Dates of onset, notification, influenza confirmation and antiviral recommendations were also collected for analysis. The Mann–Whitney U test was used to assess the significance of differences between group medians for key parameters. Results A total of 41 outbreaks (12 in the prophylaxis group and 29 in the treatment-only group) were included in the analysis. There was no significant difference in overall outbreak duration; outbreak duration after notification; or attack, hospitalization or case fatality rates between the two groups. The prophylaxis group had significantly higher cases with influenza-like illness (P = 0.03) and cases recommended antiviral treatment per facility (P = 0.01). Discussion This study found no significant difference in key outbreak parameters between the two groups. However, further high quality evidence is needed to guide the use of antivirals in responding to influenza outbreaks in aged care facilities. PMID:27757249

Effect of antiviral prophylaxis on influenza outbreaks in aged care facilities in three local health districts in New South Wales, Australia, 2014.

PubMed

Merritt, Tony; Hope, Kirsty; Butler, Michelle; Durrheim, David; Gupta, Leena; Najjar, Zeina; Conaty, Stephen; Boonwatt, Leng; Fletcher, Stephanie

2016-01-01

There was a record number ( n  = 111) of influenza outbreaks in aged care facilities in New South Wales, Australia during 2014. To determine the impact of antiviral prophylaxis recommendations in practice, influenza outbreak data were compared for facilities in which antiviral prophylaxis and treatment were recommended and for those in which antivirals were recommended for treatment only. Routinely collected outbreak data were extracted from the Notifiable Conditions Information Management System for two Local Health Districts where antiviral prophylaxis was routinely recommended and one Local Health District where antivirals were recommended for treatment but not routinely for prophylaxis. Data collected on residents included counts of influenza-like illness, confirmed influenza, hospitalizations and related deaths. Dates of onset, notification, influenza confirmation and antiviral recommendations were also collected for analysis. The Mann-Whitney U test was used to assess the significance of differences between group medians for key parameters. A total of 41 outbreaks (12 in the prophylaxis group and 29 in the treatment-only group) were included in the analysis. There was no significant difference in overall outbreak duration; outbreak duration after notification; or attack, hospitalization or case fatality rates between the two groups. The prophylaxis group had significantly higher cases with influenza-like illness ( P  = 0.03) and cases recommended antiviral treatment per facility ( P  = 0.01). This study found no significant difference in key outbreak parameters between the two groups. However, further high quality evidence is needed to guide the use of antivirals in responding to influenza outbreaks in aged care facilities.

The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline.

PubMed

Funder, John W; Carey, Robert M; Mantero, Franco; Murad, M Hassan; Reincke, Martin; Shibata, Hirotaka; Stowasser, Michael; Young, William F

2016-05-01

To develop clinical practice guidelines for the management of patients with primary aldosteronism. The Task Force included a chair, selected by the Clinical Guidelines Subcommittee of the Endocrine Society, six additional experts, a methodologist, and a medical writer. The guideline was cosponsored by American Heart Association, American Association of Endocrine Surgeons, European Society of Endocrinology, European Society of Hypertension, International Association of Endocrine Surgeons, International Society of Endocrinology, International Society of Hypertension, Japan Endocrine Society, and The Japanese Society of Hypertension. The Task Force received no corporate funding or remuneration. We searched for systematic reviews and primary studies to formulate the key treatment and prevention recommendations. We used the Grading of Recommendations, Assessment, Development, and Evaluation group criteria to describe both the quality of evidence and the strength of recommendations. We used "recommend" for strong recommendations and "suggest" for weak recommendations. We achieved consensus by collecting the best available evidence and conducting one group meeting, several conference calls, and multiple e-mail communications. With the help of a medical writer, the Endocrine Society's Clinical Guidelines Subcommittee, Clinical Affairs Core Committee, and Council successfully reviewed the drafts prepared by the Task Force. We placed the version approved by the Clinical Guidelines Subcommittee and Clinical Affairs Core Committee on the Endocrine Society's website for comments by members. At each stage of review, the Task Force received written comments and incorporated necessary changes. For high-risk groups of hypertensive patients and those with hypokalemia, we recommend case detection of primary aldosteronism by determining the aldosterone-renin ratio under standard conditions and recommend that a commonly used confirmatory test should confirm/exclude the condition. We recommend that all patients with primary aldosteronism undergo adrenal computed tomography as the initial study in subtype testing and to exclude adrenocortical carcinoma. We recommend that an experienced radiologist should establish/exclude unilateral primary aldosteronism using bilateral adrenal venous sampling, and if confirmed, this should optimally be treated by laparoscopic adrenalectomy. We recommend that patients with bilateral adrenal hyperplasia or those unsuitable for surgery should be treated primarily with a mineralocorticoid receptor antagonist.

Work Factors, Work-Family Conflict, the Theory of Planned Behaviour and Healthy Intentions: A Cross-Cultural Study.

PubMed

Shukri, Madihah; Jones, Fiona; Conner, Mark

2016-12-01

The present study examined the roles of work factors (i.e. job demands and job resources), work-family conflicts and culture on predictors of healthy intentions (fruit and vegetable consumption, low-fat diet and physical activity) within the framework of the theory of planned behaviour (TPB). Employees from the United Kingdom (N = 278) and Malaysia (N = 325) participated in the study. Results indicated that higher job demands were significantly related to lower intentions to eat a low-fat diet. Women reported higher intentions to eat a low-fat diet than men did, while participants from the United Kingdom had lower intentions to engage in physical activity compared with those from Malaysia. The efficacy of TPB variables in explaining intentions was verified, with perceived behavioural control (i.e. self-efficacy), attitudes and descriptive norms combined with past behaviour predictive across the samples. The results also suggest the roles of culture and work interference with family variables in moderating TPB-intention relationships and confirm that TPB variables mediate the effects of job demands and job resources on intentions. Practically, to promote health, identifying strategies to reduce stress factors; specifying important cognitive factors affecting work factors and thus, healthy intentions; and acknowledging cultural-specific determinants of healthy intentions are recommended. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

The proactive approach--is it worthwhile? A prospective controlled ergonomic intervention study in office workers.

PubMed

Laestadius, Jasminka Goldoni; Ye, Jian; Cai, Xiaodong; Ross, Sandra; Dimberg, Lennart; Klekner, Meg

2009-10-01

Does proactive ergonomics program enhance office worker health and productivity? The investigation was conducted in connection with the move of 1500 office staff to a building with improved ergonomics. It was focused on associations between workstation features, working postures, musculoskeletal pain symptoms, and eye strain before and 18 months after implementation of a proactive ergonomic program. The outcomes were compared between the intervention and a similar reference group. Associations between improvement of postures and less musculoskeletal pain and eye strain were confirmed. A cross association between several features and postures and improved symptoms was noted, along with improved productivity. The study suggests that a proactive program adhering to the OSHA recommendations needs to include an individual workstation assessment to be effective in reducing symptoms and increasing productivity.

The Development of Best Practice Recommendations to Support the Hiring, Recruitment, and Advancement of Women Physicians in Emergency Medicine.

PubMed

Choo, Esther K; Kass, Dara; Westergaard, Mary; Watts, Susan H; Berwald, Nicole; Regan, Linda; Promes, Susan B; Clem, Kathleen J; Schneider, Sandra M; Kuhn, Gloria J; Abbuhl, Stephanie; Nobay, Flavia

2016-11-01

Women in medicine continue to experience disparities in earnings, promotion, and leadership roles. There are few guidelines in place defining organization-level factors that promote a supportive workplace environment beneficial to women in emergency medicine (EM). We assembled a working group with the goal of developing specific and feasible recommendations to support women's professional development in both community and academic EM settings. We formed a working group from the leadership of two EM women's organizations, the Academy of Women in Academic Emergency Medicine (AWAEM) and the American Association of Women Emergency Physicians (AAWEP). Through a literature search and discussion, working group members identified four domains where organizational policies and practices supportive of women were needed: 1) global approaches to supporting the recruitment, retention, and advancement of women in EM; 2) recruitment, hiring, and compensation of women emergency physicians; 3) supporting development and advancement of women in EM; and 4) physician health and wellness (in the context of pregnancy, childbirth, and maternity leave). Within each of these domains, the working group created an initial set of specific recommendations. The working group then recruited a stakeholder group of EM physician leaders across the country, selecting for diversity in practice setting, geographic location, age, race, and gender. Stakeholders were asked to score and provide feedback on each of the recommendations. Specific recommendations were retained by the working group if they achieved high rates of approval from the stakeholder group for importance and perceived feasibility. Those with >80% agreement on importance and >50% agreement on feasibility were retained. Finally, recommendations were posted in an open online forum (blog) and invited public commentary. An initial set of 29 potential recommendations was created by the working group. After stakeholder voting and feedback, 16 final recommendations were retained. Recommendations were refined through qualitative comments from stakeholders and blog respondents. Using a consensus building process that included male and female stakeholders from both academic and community EM settings, we developed recommendations for organizations to implement to create a workplace environment supportive of women in EM that were perceived as acceptable and feasible. This process may serve as a model for other medical specialties to establish clear, discrete organization-level practices aimed at supporting women physicians. © 2016 by the Society for Academic Emergency Medicine.

Nutrition recommendations and the Children's Food and Beverage Advertising Initiative's 2014 approved food and beverage product list.

PubMed

Schermbeck, Rebecca M; Powell, Lisa M

2015-04-23

We compare the Children's Food and Beverage Advertising Initiative's (CFBAI's) April 2014 list of food and beverage products approved to be advertised on children's television programs with the federal Interagency Working Group's nutrition recommendations for such advertised products. Products were assessed by using the nutrients to limit (saturated fat, trans fat, sugar, and sodium) component of the Interagency Working Group's recommendations. Fifty-three percent of the listed products did not meet the nutrition recommendations and, therefore, were ineligible to be advertised. We recommend continued monitoring of food and beverage products marketed to children.

Honeywell's Working Parents Task Force. Final Report and Recommendations.

ERIC Educational Resources Information Center

Honeywell, Inc., Minneapolis, Minn.

This publication provides a summary of the Honeywell Working Parent Task Force's recommendations on how to solve problems experienced by working parents. The Task Force consisted of three committees: the Employment Practices Committee (EPC); the Parent Education Committee (PEC); and the Child Care Facilities Committee (CCFC). After examining a…

78 FR 37242 - Draft Report and Recommendations Prepared by the Research Committee of the Scientific Working...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... Recommendations Prepared by the Research Committee of the Scientific Working Group on Medicolegal Death... Justice Programs, National Institute of Justice, Scientific Working Group for Medicolegal Death.../Medicolegal Death Investigation''. The opportunity to provide comments on this document is open to coroner...

Associations of work-family conflicts with food habits and physical activity.

PubMed

Roos, Eva; Sarlio-Lähteenkorva, Sirpa; Lallukka, Tea; Lahelma, Eero

2007-03-01

This study examines the relationship between family-work conflicts with food habits and physical activity, and whether the relationship is dependent on family structure and work-related factors. Cross-sectional postal surveys were carried out in 2001 and 2002 among employees of the City of Helsinki, Finland, aged 40-60 years (n = 5346, response rate 66%; for women 70% and for men 60%). Dependent variables in logistic regression analyses were nationally recommended food habits and physical activity. Independent variables were work-family conflicts and family-work conflicts. Covariates included age, marital status, number of children, occupational class, working hours, time travelling to work, and physical and mental work load. Women reporting strong work-family conflicts were more likely to follow recommended food habits (odds ratio (OR) and 95% confidence intervals 1.49 (1.19-1.86)), but this relationship weakened when adjusting for work-related factors (OR 1.20 (0.93-1.55)). Women and men with strong family-work conflicts were less likely to report recommended food habits after adjusting for family structure and work-related factors (women OR 0.75 (0.61-0.92), men OR 0.57 (0.34-0.96)). Women and men with strong work-family conflicts were less likely to follow the recommended amount of physical activity (women OR 0.76 (0.60-0.96), men OR 0.54 (0.34-0.87)). Additionally, women with strong family-work conflicts were less likely to follow the recommended amount of physical activity (OR 0.77 (0.63-0.94)). Adjusting for family and work-related factors did not affect these associations. Conflicts between paid work and family life are likely to constitute barriers for a physically active lifestyle and possibly also for healthy food habits. Improving the balance between work and family may provide a route for promoting health-related behaviours.

Consensus recommendations for the postmortem diagnosis of Alzheimer's disease. The National Institute on Aging, and Reagan Institute Working Group on Diagnostic Criteria for the Neuropathological Assessment of Alzheimer's Disease.

PubMed

1997-01-01

This report summarizes the consensus recommendations of a panel of neuropathologists from the United States and Europe to improve the postmortem diagnostic criteria for Alzheimer's disease. The recommendations followed from a two-day workshop sponsored by the National Institute on Aging (NIA) and the Ronald and Nancy Reagan Institute of the Alzheimer's Association to reassess the original NIA criteria for the postmortem diagnosis of Alzheimer's disease published in 1985. The consensus recommendations for improving the neuropathological criteria for the postmortem diagnosis of Alzheimer's disease are reported here, and the "position papers" by members of the Working Group that accompany this report elaborate on the research findings and concepts upon which these recommendations were based. Further, commentaries by other experts in the field also are included here to provide additional perspectives on these recommendations. Finally, it is anticipated that future meetings of the Working Group will reassess these recommendations and the implementation of postmortem diagnostic criteria for Alzheimer's disease.

Recommendations from the Health and Safety at Work Sub-Committee

ERIC Educational Resources Information Center

Education in Science, 1976

1976-01-01

Provides additional recommendations as the Health and Safety at Work Act of 1974 applies to the storage of flammable liquids, provision of safety equipment, responsibility for technicians and faulty apparatus. (GS)

Weighted hybrid technique for recommender system

NASA Astrophysics Data System (ADS)

Suriati, S.; Dwiastuti, Meisyarah; Tulus, T.

2017-12-01

Recommender system becomes very popular and has important role in an information system or webpages nowadays. A recommender system tries to make a prediction of which item a user may like based on his activity on the system. There are some familiar techniques to build a recommender system, such as content-based filtering and collaborative filtering. Content-based filtering does not involve opinions from human to make the prediction, while collaborative filtering does, so collaborative filtering can predict more accurately. However, collaborative filtering cannot give prediction to items which have never been rated by any user. In order to cover the drawbacks of each approach with the advantages of other approach, both approaches can be combined with an approach known as hybrid technique. Hybrid technique used in this work is weighted technique in which the prediction score is combination linear of scores gained by techniques that are combined.The purpose of this work is to show how an approach of weighted hybrid technique combining content-based filtering and item-based collaborative filtering can work in a movie recommender system and to show the performance comparison when both approachare combined and when each approach works alone. There are three experiments done in this work, combining both techniques with different parameters. The result shows that the weighted hybrid technique that is done in this work does not really boost the performance up, but it helps to give prediction score for unrated movies that are impossible to be recommended by only using collaborative filtering.

Analysis of regional radiotherapy dosimetry audit data and recommendations for future audits

PubMed Central

Palmer, A; Mzenda, B; Kearton, J; Wills, R

2011-01-01

Objectives Regional interdepartmental dosimetry audits within the UK provide basic assurances of the dosimetric accuracy of radiotherapy treatments. Methods This work reviews several years of audit results from the South East Central audit group including megavoltage (MV) and kilovoltage (kV) photons, electrons and iodine-125 seeds. Results Apart from some minor systematic errors that were resolved, the results of all audits have been within protocol tolerances, confirming the long-term stability and agreement of basic radiation dosimetric parameters between centres in the audit region. There is some evidence of improvement in radiation dosimetry with the adoption of newer codes of practice. Conclusion The value of current audit methods and the limitations of peer-to-peer auditing is discussed, particularly the influence of the audit schedule on the results obtained, where no “gold standard” exists. Recommendations are made for future audits, including an essential requirement to maintain the monitoring of basic fundamental dosimetry, such as MV photon and electron output, but audits must also be developed to include new treatment technologies such as image-guided radiotherapy and address the most common sources of error in radiotherapy. PMID:21159805

[Work accommodation at the time of Return-to-Work for workers on sick leave: a qualitative systematic review with recommendations for Return-to-work Guidance 2017].

PubMed

Nogawa, Kazuhiro; Kojimahara, Noriko

2018-05-31

We conducted a systematic review to determine whether work accommodation at the time of return-to-work (RTW) following a period of sick leave would improve work-related outcomes. Using a Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, we developed recommendations applicable to the field of occupational health in Japan. We approached our review question for "Evidence-based Return-to-work Guidance in Occupational Health 2017 (RTW 2017) " using a PICO framework (P: workers on sick leave; I: work accommodation; C: usual care; O: improvement of work-related outcomes, such as shortened sick leave period or lower rate of sick leave recurrence). To identify relevant intervention studies about work accommodation at the time of RTW, for example, modified work or partial RTW, we searched Cochrane Library, PubMed, and ICHUSHI Web using keywords/phrases such as workplace accommodation, partial RTW, rehabilitation, and modified work. Although we found no systematic reviews, we did identify 632 randomized controlled trials and cohort studies. Two researchers screened them independently using selection and exclusion criteria defined by the RTW guidance committee in the scope. For intervention studies, we extracted PICO and evaluated risk of bias using RevMan 5.3. For cohort studies, we applied the Newcastle-Ottawa scale for evaluation of risk of bias. We then evaluated the body of evidence based on risk of bias, indirectness, inconsistency, imprecision, and publication bias using GRADEPro GDT. Finally, we adopted Evidence to Decision from GRADE and developed recommendations based on anonymous panels' votes. We identified three relevant studies, which were one randomized controlled trial and two cohort studies, on Partial RTW or modified work for musculoskeletal disorders. Although we could not conduct a meta-analysis, our qualitative systematic review of these studies led us to conclude that partial RTW could shorten the period of sick leave and modified work could lower the recurrence rates of sick leave. Therefore, "Work accommodation at the time of RTW could be provided for workers on sick leave for musculoskeletal disorders" was weakly recommended on the basis of low evidence. Our recommendation, though plausible, is weak, as it is based on evidence from a small number of studies of foreign occupational health systems. Development of robust recommendations will require accumulation of additional information on diverse factors, such as cost-effectiveness, and on other diseases, for example, mental health disorders or malignant diseases, in Japan.

Partnerships for better mental health worldwide: WPA recommendations on best practices in working with service users and family carers

PubMed Central

WALLCRAFT, JAN; AMERING, MICHAELA; FREIDIN, JULIAN; DAVAR, BHARGAVI; FROGGATT, DIANE; JAFRI, HUSSAIN; JAVED, AFZAL; KATONTOKA, SYLVESTER; RAJA, SHOBA; RATAEMANE, SOLOMON; STEFFEN, SIGRID; TYANO, SAM; UNDERHILL, CHRISTPHER; WAHLBERG, HENRIK; WARNER, RICHARD; HERRMAN, HELEN

2011-01-01

WPA President M. Maj established the Task Force on Best Practice in Working with Service Users and Carers in 2008, chaired by H. Herrman. The Task Force had the remit to create recommendations for the international mental health community on how to develop successful partnership working. The work began with a review of literature on service user and carer involvement and partnership. This set out a range of considerations for good practice, including choice of appropriate terminology, clarifying the partnership process and identifying and reducing barriers to partnership working. Based on the literature review and on the shared knowledge in the Task Force, a set of ten recommendations for good practice was developed. These recommendations were the basis for a worldwide consultation of stakeholders with expertise as service users, families and carers, and the WPA Board and Council. The results showed a strong consensus across the international mental health community on the ten recommendations, with the strongest agreement coming from service users and carers. This general consensus gives a basis for Task Force plans to seek support for activities to promote shared work worldwide to identify best practice examples and create a resource to assist others to begin successful collaboration. PMID:21991284

Work-life integration in neuropsychology: a review of the existing literature and preliminary recommendations.

PubMed

Feigon, Maia; Block, Cady; Guidotti Breting, Leslie; Boxley, Laura; Dawson, Erica; Cobia, Derin

2018-02-01

The purpose of the current review paper is to identify and describe challenges to work-life integration in neuropsychology, and from this review extrapolate an initial set of recommendations and present a set of scenarios in which the recommendations might apply in the hopes of improving quality of life for current and prospective neuropsychologists. Specific areas of focus include diversity, early and mid-career transitions, and potential barriers to advancement in specific practice settings. A broad review was conducted of extant literature on work-life integration. There is scant scientific literature in this area that is specific to neuropsychologists, or even psychology as a whole. Subsequently, the majority of this review was collected from more developed literatures in business and medical fields. The authors then provided recommendations based on experiences in their respective careers. Attempts were made to promote generalizability of recommendations for neuropsychologists in different settings. Evidence supports a potentially adverse impact on quality of life and overall life satisfaction when work and personal lives conflict. This manuscript identifies some of the potential risks when work and life responsibilities are not well integrated. It is anticipated this will serve as a catalyst for future studies on work-life integration in the field of neuropsychology, specifically.

Working conditions and effort-reward imbalance of German physicians in Sweden respective Germany: a comparative study.

PubMed

Ohlander, Johan; Weigl, Matthias; Petru, Raluca; Angerer, Peter; Radon, Katja

2015-05-01

Work stress among physicians is a growing concern in various countries and has led to migration. We compared the working conditions and the work stress between a migrated population of German physicians in Sweden and a population of physicians based in Germany. Additionally, specific risk factors for work stress were examined country wise. Using a cross-sectional design, 85 German physicians employed in Sweden were surveyed on working conditions and effort-reward imbalance and compared with corresponding data on 561 physicians working in Germany. Multiple linear regression analyses were applied on both populations separately to model the associations between working conditions and effort-reward ratio (ERR), adjusted for a priori confounders. German physicians in Sweden had a significantly lower ERR than physicians in Germany: mean (M) = 0.47, standard deviation (SD) = 0.24 vs. M = 0.80, SD = 0.35. Physicians in Sweden worked on average 8 h less per week and reported higher work support and responsibility. Multivariate analyses showed in both populations a negative association between work support and the ERR (β = -0.148, 95% CI -0.215 to (-0.081) for physicians in Sweden and β = -0.174, 95% CI -0.240 to (-0.106) for physicians in Germany). Further significant associations with the ERR were found among physicians in Sweden for daily breaks (β = -0.002, 95% CI -0.004 to (-0.001)) and among physicians in Germany for working hours per week (β = 0.006, 95% CI 0.002-0.009). Our findings show substantial differences in work stress and working conditions in favor of migrated German physicians in Sweden. To confirm our results and to explain demonstrated differences in physicians' work stress, longitudinal studies are recommended.

OMERACT Filter Evidence Supporting the Measurement of At-work Productivity Loss as an Outcome Measure in Rheumatology Research.

PubMed

Beaton, Dorcas E; Dyer, Sarah; Boonen, Annelies; Verstappen, Suzanne M M; Escorpizo, Reuben; Lacaille, Diane V; Bosworth, Ailsa; Gignac, Monique A M; Leong, Amye; Purcaru, Oana; Leggett, Sarah; Hofstetter, Cathy; Peterson, Ingemar F; Tang, Kenneth; Fautrel, Bruno; Bombardier, Claire; Tugwell, Peter S

2016-01-01

Indicators of work role functioning (being at work, and being productive while at work) are important outcomes for persons with arthritis. As the worker productivity working group at OMERACT (Outcome Measures in Rheumatology), we sought to provide an evidence base for consensus on standardized instruments to measure worker productivity [both absenteeism and at-work productivity (presenteeism) as well as critical contextual factors]. Literature reviews and primary studies were done and reported to the OMERACT 12 (2014) meeting to build the OMERACT Filter 2.0 evidence for worker productivity outcome measurement instruments. Contextual factor domains that could have an effect on scores on worker productivity instruments were identified by nominal group techniques, and strength of influence was further assessed by literature review. At OMERACT 9 (2008), we identified 6 candidate measures of absenteeism, which received 94% endorsement at the plenary vote. At OMERACT 11 (2012) we received over the required minimum vote of 70% for endorsement of 2 at-work productivity loss measures. During OMERACT 12 (2014), out of 4 measures of at-work productivity loss, 3 (1 global; 2 multiitem) received support as having passed the OMERACT Filter with over 70% of the plenary vote. In addition, 3 contextual factor domains received a 95% vote to explore their validity as core contextual factors: nature of work, work accommodation, and workplace support. Our current recommendations for at-work productivity loss measures are: WALS (Workplace Activity Limitations Scale), WLQ PDmod (Work Limitations Questionnaire with modified physical demands scale), WAI (Work Ability Index), WPS (Arthritis-specific Work Productivity Survey), and WPAI (Work Productivity and Activity Impairment Questionnaire). Our future research focus will shift to confirming core contextual factors to consider in the measurement of worker productivity.

Update on asthma and cleaners

PubMed Central

Zock, Jan-Paul; Vizcaya, David; Le Moual, Nicole

2010-01-01

Purpose of review This paper summarises the recent literature on the relation between cleaning exposures and respiratory health, in particular asthma, including reviews, epidemiological surveys, surveillance programmes and exposure studies. The authors also aimed to identify gaps in the current knowledge and to recommend future research on the topic. Recent findings A large international general population study showed an increased risk of new-onset asthma associated with cleaning work, with professional use of cleaning products, and with domestic use of cleaning sprays. Three surveillance studies confirm the recognition of occupational asthma cases among cleaners and among others who use cleaning products at work. Six workforce-based studies show that respiratory symptoms are partly work-related, and are associated with certain specific exposures including sprays, chlorine bleach and other disinfectants. Summary Recent studies have strengthened the evidence of asthma and other adverse respiratory effects in cleaning workers. Similar effects were seen in other settings where cleaning products are used such as healthcare professionals and homemakers. Both new-onset asthma and work-exacerbated asthma due to cleaning exposures may play a role. Exposure to cleaning sprays, chlorine bleach and other disinfectants may be particularly relevant. The predominant effect mechanisms remain largely unclear and may include both specific sensitisation and irritant-related features. PMID:20093933

Allergy-related disorders in the construction industry.

PubMed

Carino, Mauro; Romita, Paolo; Foti, Caterina

2013-01-01

Working conditions in the construction industry have improved in many industrialized countries, but heavy physical work with recurrent exposure to chemical agents, dust, and climatic influences still represents considerable risk for construction workers and may affect their health. The aim of this review is to analyze available data of the literature on allergy-related respiratory and skin disorders with emphasis on a preventive appraisal in order to produce statements and recommendations based on research evidence. The most common agents involved in the construction industry as a cause of occupational asthma (OA) in industrialized countries are isocyanates, wood dust, resins, glues, cobalt, and chromium. Allergic contact dermatitis (ACD) is an immunologic cell-mediated response to a sensitizing agent and the most common sensitizing agents associated with construction workers are epoxy resins, thiurams and thiazoles, and chromates. Medical surveillance must consider individual risk factors such as differences in individual susceptibility and sensitization to agents at workplace. Once work-related disorder is confirmed, adequate fitness for work should be assessed for the worker impaired by health condition. A reliable diagnosis of an index case is a sentinel event that may reveal risks for workers with similar exposure, leading to a revised risk assessment at the workplace that should reduce the risk and prevent further cases.

Patient and provider perspectives on adherence to and care coordination of lynch syndrome surveillance recommendations: findings from qualitative interviews.

PubMed

Schneider, Jennifer L; Goddard, Katrina A B; Muessig, Kristin R; Davis, James V; Rope, Alan F; Hunter, Jessica E; Peterson, Susan K; Acheson, Louise S; Syngal, Sapna; Wiesner, Georgia L; Reiss, Jacob A

2018-01-01

Patients with a genetic variant associated with Lynch syndrome (LS) are recommended to undergo frequent and repeated cancer surveillance activities to minimize cancer-related morbidity and mortality. Little is known about how patients and primary care providers (PCPs) track and manage these recommendations. We conducted a small exploratory study of patient and PCP experiences with recommended LS surveillance activities and communication with family members in an integrated health care system. We used in-depth interviews with patients and providers to understand how surveillance is coordinated and monitored following confirmation of LS. We recruited patients with a range of ages/gender, and providers with at least at least one patient with a molecular diagnosis of LS. All interviews were recorded, transcribed, and content analyzed by a trained qualitative methodologist. Twenty-two interviews were completed with 12 patients and 10 providers. Most patients (10) had detailed knowledge of surveillance recommendations, but were less sure of time intervals. While all patients reported receiving initial education about their surveillance recommendations from a genetic counselor, seven did not follow-up with a genetic counselor in subsequent years. A third of patients described taking sole responsibility for managing their LS surveillance care. Lack of routine communication from the health system (e.g., prompts for surveillance activities), and provider engagement were surveillance barriers. PCPs were generally aware of LS, but had limited familiarity with surveillance recommendations. Most PCPs (7) viewed LS as rare and relied on patient and specialist expertise and support. Providers typically had 1 patient with LS in a panel of 1800 patients overall. Providers felt strongly that management of LS should be coordinated by a dedicated team of specialists. Most patients (92%) had at least one family member that sought LS testing, and common barriers for family members included lack of insurance, affordability, and fear of result. The maximal benefits of screening for confirmation of LS will only be realized with adherence to recommended preventive care. Important factors to ensure patients receive recommended LS care include a comprehensive and coordinated monitoring program that includes reminder prompts, and increased PCP education of LS and associated surveillance recommendations.

Occupational asthma and rhinitis due to detergent enzymes in healthcare.

PubMed

Adisesh, A; Murphy, E; Barber, C M; Ayres, J G

2011-08-01

The use of proteolytic enzymes to improve the cleaning efficacy of washing powders was introduced in the mid 1960s. Many microbial enzymes are known to be potent respiratory sensitizers but previously there has been only one case of occupational asthma associated with workplace exposure in a healthcare worker. To report two cases of occupational asthma associated with exposure to biological enzymes in health-care workers and related occupational cases. Reporting of clinical case reports from three different work places. One case of occupational asthma and three other cases with work-related asthma or rhinitis occurred in one workplace. A single case of probable occupational asthma presented at a second workplace with another case of work-related asthma at a third workplace. Exposures occurred in areas used for cleaning medical instruments and endoscopy suites. Hygiene measurements confirmed the potential for exposure. Control measures were not in place and recognition of the hazard was missing in these workplaces. Detergent enzymes when used in healthcare settings should be recognized as potential respiratory sensitizers. Healthcare institutions and professional bodies that recommend the use of detergent enzymes should review their risk assessments to ensure that the most appropriate methods for preventing or reducing exposure are in place.

A multi-method evaluation of interprofessional education for healthcare professionals caring for women during and after pregnancy.

PubMed

Olander, Ellinor; Coates, Rose; Brook, Judy; Ayers, Susan; Salmon, Debra

2018-02-09

This multi-method evaluation assessed the perceived impact of interprofessional workshops targeting enhanced collaboration between healthcare professionals who care for women during and after pregnancy. Current policy recommends partnership working to improve care for women and babies, however, there is little interprofessional education in this area. Five one-day workshops were delivered to 18 healthcare professionals (47.4% of the 38 healthcare professionals registered). The workshop was evaluated through questionnaires before and after the workshop measuring attitudes and willingness towards collaboration; observations of the workshops by a researcher and follow-up interviews 2 months' post-workshop to explore changes in practice. Workshops were attended by midwives, health visitors (trained nurses specialising in community care for children 0-5 years), dietitians, nurses, a general practitioner and a breastfeeding specialist. Attitudes and willingness to participate in interprofessional collaborative practice improved after the workshop. Observations made at the workshop included engaged participants who reported numerous barriers towards collaboration. Follow-up contact with 12 participants identified several examples of collaboration in practice resulting from workshop attendance. These findings suggest that the workshops influenced attendees to change their practice towards more collaborative working. Future work needs to confirm these results with more participants.

World Health Organization Guidelines: Use of cryotherapy for cervical intraepithelial neoplasia.

PubMed

Santesso, Nancy; Schünemann, Holger; Blumenthal, Paul; De Vuyst, Hugo; Gage, Julia; Garcia, Francisco; Jeronimo, Jose; Lu, Ricky; Luciani, Silvana; Quek, Swee C; Awad, Tahany; Broutet, Nathalie

2012-08-01

In 2008, cervical cancer was responsible for 275000 deaths, of which approximately 88% occurred in low- and middle-income countries. In 2009, the World Health Organization (WHO) committed to updating recommendations for use of cryotherapy for cervical intraepithelial neoplasia (CIN). We followed the WHO Handbook for Guidelines Development to develop present guidelines. An expert panel was established, which included clinicians, researchers, program directors, and methodologists. An independent group conducted systematic reviews and produced evidence summaries following the GRADE approach. GRADE evidence profiles were created for 16 key questions about the effects of cryotherapy in the presence of histologically confirmed CIN compared with no treatment and with loop electrosurgical excision procedure, as well as the use of different cryotherapy techniques. We identified a small number of randomized controlled trials or independently controlled observational studies. Surrogate outcomes were reported when evidence about outcomes critical to decision making were not available. The panel made 14 recommendations and documented factors that determined the strength and direction of the recommendations in decision tables. The present document summarizes new evidence-based WHO recommendations about the use of cryotherapy in women with histologically confirmed CIN for low-, middle-, and high-income countries. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Diphenhydramine and Pregnancy

MedlinePlus

... have not been confirmed. Can use of diphenhydramine cause other pregnancy complications? At recommended doses, diphenhydramine has not been shown to cause problems in pregnancy. There are rare reports of problems with the ...

An updated Asia Pacific Consensus Recommendations on colorectal cancer screening.

PubMed

Sung, J J Y; Ng, S C; Chan, F K L; Chiu, H M; Kim, H S; Matsuda, T; Ng, S S M; Lau, J Y W; Zheng, S; Adler, S; Reddy, N; Yeoh, K G; Tsoi, K K F; Ching, J Y L; Kuipers, E J; Rabeneck, L; Young, G P; Steele, R J; Lieberman, D; Goh, K L

2015-01-01

Since the publication of the first Asia Pacific Consensus on Colorectal Cancer (CRC) in 2008, there are substantial advancements in the science and experience of implementing CRC screening. The Asia Pacific Working Group aimed to provide an updated set of consensus recommendations. Members from 14 Asian regions gathered to seek consensus using other national and international guidelines, and recent relevant literature published from 2008 to 2013. A modified Delphi process was adopted to develop the statements. Age range for CRC screening is defined as 50-75 years. Advancing age, male, family history of CRC, smoking and obesity are confirmed risk factors for CRC and advanced neoplasia. A risk-stratified scoring system is recommended for selecting high-risk patients for colonoscopy. Quantitative faecal immunochemical test (FIT) instead of guaiac-based faecal occult blood test (gFOBT) is preferred for average-risk subjects. Ancillary methods in colonoscopy, with the exception of chromoendoscopy, have not proven to be superior to high-definition white light endoscopy in identifying adenoma. Quality of colonoscopy should be upheld and quality assurance programme should be in place to audit every aspects of CRC screening. Serrated adenoma is recognised as a risk for interval cancer. There is no consensus on the recruitment of trained endoscopy nurses for CRC screening. Based on recent data on CRC screening, an updated list of recommendations on CRC screening is prepared. These consensus statements will further enhance the implementation of CRC screening in the Asia Pacific region. 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.

Addressing barriers to emergency anaphylaxis care: from emergency medical services to emergency department to outpatient follow-up.

PubMed

Fineman, Stanley M; Bowman, Steven H; Campbell, Ronna L; Dowling, Paul; O'Rourke, Dianne; Russell, W Scott; Sublett, J Wesley; Wallace, Dana

2015-10-01

Anaphylaxis is a systemic life-threatening allergic reaction that presents unique challenges for emergency care practitioners. Allergists and emergency physicians have a history of collaborating to promote an evidence-based, multidisciplinary approach to improve the emergency management and follow-up of patients with or at risk of anaphylaxis. To review recent scientific literature about anaphylaxis, discuss barriers to care, and recommend strategies to support improvement in emergency anaphylaxis care. An expert panel of allergists and emergency physicians was convened by the American College of Allergy, Asthma and Immunology in November 2014 to discuss current knowledge about anaphylaxis, identify opportunities for emergency practitioners and allergists to partner to address barriers to care, and recommend strategies to improve medical management of anaphylaxis along the continuum of care: from emergency medical systems and emergency department practitioners for acute management through appropriate outpatient follow-up with allergists to confirm diagnosis, identify triggers, and plan long-term care. The panel identified key barriers to anaphylaxis care, including difficulties in making an accurate diagnosis, low rates of epinephrine administration during acute management, and inadequate follow-up. Strategies to overcome these barriers were discussed and recommendations made for future allergist/emergency physician collaborations, and key messages to be communicated to emergency practitioners were proposed. The panel recommended that allergists and emergency physicians continue to work in partnership, that allergists be proactive in outreach to emergency care practitioners, and that easy-to-access educational programs and materials be developed for use by emergency medical systems and emergency department practitioners in the training environment and in practice. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Advancing Tobacco Product Warning Labels Research Methods and Theory: A Summary of a Grantee Meeting Held by the US National Cancer Institute.

PubMed

Thrasher, James F; Brewer, Noel T; Niederdeppe, Jeff; Peters, Ellen; Strasser, Andrew A; Grana, Rachel; Kaufman, Annette R

2018-02-10

The World Health Organization's Framework Convention on Tobacco Control recommends prominent pictorial health warnings on tobacco products. To advance research methods, theory and understanding of how tobacco product warning labels (TPWLs) work, the US National Cancer Institute convened a grantee meeting. Our article describes the key insights that emerged from the meeting, situated within the context of the scientific literature. First, presentations confirmed that large, pictorial TPWLs motivate people to try to quit and encourage smoking cessation. Second, pictorial TPWLs increase attention, knowledge, negative affect, and thinking about the warning. Third, TPWL studies have primarily used brief-exposure laboratory studies and observational studies of sustained exposure through national policy implementation, with a few randomized trials involving several weeks of exposure-with generally consistent results found across study designs. Fourth, novel assessment methods include brain imaging, eye tracking and "best-worst" discrete choice experiments. To make TPWL even more effective, research is needed to confirm the mechanisms of their influence, their impact across vulnerable populations, and their effect on social media posts about tobacco products. Research is also needed on the effect of trial design choices, the predictive validity of new measurement approaches, and warning labels for non-cigarette tobacco products. To improve scientific understanding of TPWL effects, this grantee meeting summary describes emerging research methods, theory and study results. Directions for future research include examination of the mechanisms of how warning labels work across diverse tobacco products and across different populations and contexts. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Interstitial cystitis patients' use and rating of complementary and alternative medicine therapies.

PubMed

O'Hare, Peter Gregory; Hoffmann, Amy Rejba; Allen, Penny; Gordon, Barbara; Salin, Linda; Whitmore, Kristene

2013-06-01

The purpose of this study was to describe the use of complementary and alternative medicine (CAM) therapies among interstitial cystitis (IC) patients, patients' perception of CAM therapies' effectiveness, and the association of time since diagnosis with perceived effectiveness of these therapies. In April 2009, the Interstitial Cystitis Association (ICA) initiated an Internet-based survey on CAM. Respondents indicated whether they received an IC diagnosis and how long ago, whether they tried CAM, and who recommended it. On a 5-point scale, respondents rated 49 therapies. For respondents confirming a diagnosis, we used a chi-square goodness-of-fit test to assess which therapies were rated positively or negatively by a majority of patients who tried them. Using separate one-way analyses of variance, we assessed differences in mean perceived effectiveness among groups based on time since diagnosis and conducted post hoc tests, if necessary. Using chi-square tests, we explored the association of time since diagnosis with the use of CAM and the number of therapies tried. A total of 2,101 subjects responded to the survey; 1,982 confirmed an IC diagnosis. Most (84.2 %) had tried CAM, and 55 % said physicians had recommended CAM. Of those trying CAM, 82.8 % had tried diet or physical therapy and 69.2 % other therapies. Of the therapies, 22 were rated positively and 20 negatively; 7 were inconclusive. Therapies patients perceived to be helpful included dietary management and pain management adjuncts such as physical therapy, heat and cold, meditation and relaxation, acupuncture, stress reduction, exercise, and sleep hygiene. Many therapies worked better for those diagnosed recently than for those diagnosed long before. Randomized, placebo-controlled studies are needed to demonstrate which therapies may indeed control IC symptoms and help send research in new and productive directions.

Pulmonary hypertension in interstitial lung disease: Limitations of echocardiography compared to cardiac catheterization.

PubMed

Keir, Gregory J; Wort, S John; Kokosi, Maria; George, Peter M; Walsh, Simon L F; Jacob, Joseph; Price, Laura; Bax, Simon; Renzoni, Elisabetta A; Maher, Toby M; MacDonald, Peter; Hansell, David M; Wells, Athol U

2018-01-12

In interstitial lung disease (ILD), pulmonary hypertension (PH) is a major adverse prognostic determinant. Transthoracic echocardiography (TTE) is the most widely used tool when screening for PH, although discordance between TTE and right heart catheter (RHC) measured pulmonary haemodynamics is increasingly recognized. We evaluated the predictive utility of the updated European Society of Cardiology/European Respiratory Society (ESC/ERS) TTE screening recommendations against RHC testing in a large, well-characterized ILD cohort. Two hundred and sixty-five consecutive patients with ILD and suspected PH underwent comprehensive assessment, including RHC, between 2006 and 2012. ESC/ERS recommended tricuspid regurgitation (TR) velocity thresholds for assigning high (>3.4 m/s), intermediate (2.9-3.4 m/s) and low (<2.8 m/s) probabilities of PH were evaluated against RHC testing. RHC testing confirmed PH in 86% of subjects with a peak TR velocity >3.4 m/s, and excluded PH in 60% of ILD subjects with a TR velocity <2.8 m/s. Thus, the ESC/ERS guidelines misclassified 40% of subjects as 'low probability' of PH, when PH was confirmed on subsequent RHC. Evaluating alternative TR velocity thresholds for assigning a low probability of PH did not significantly improve the ability of TR velocity to exclude a diagnosis of PH. In patients with ILD and suspected PH, currently recommended ESC/ERS TR velocity screening thresholds were associated with a high positive predictive value (86%) for confirming PH, but were of limited value in excluding PH, with 40% of patients misclassified as low probability when PH was confirmed at subsequent RHC. © 2018 Asian Pacific Society of Respirology.

Myofibroblastoma of the male breast: a rare entity with radiologic-pathologic correlation

PubMed Central

Comer, John D.; Cui, Xiaoyan; Eisen, Carolyn Sharyn; Abbey, Genevieve; Arleo, Elizabeth Kagan

2016-01-01

A 73-year old man with a history of multiple genitourinary malignancies was found to have a left retroareolar soft tissue mass on CT assessment of disease, and dedicated breast imaging was recommended. Diagnostic mammography and ultrasonography confirmed a solid mass, for which biopsy was recommended. Pathologic analysis demonstrated a spindle cell neoplasm with an immunoreactivity pattern consistent with myofibroblastoma. While this entity is benign, nonspecific imaging features necessitate tissue sampling for pathologic diagnosis, and, given pathologic rarity, open communication between the radiologist and pathologist is important to establish the correct diagnosis and to recommend appropriate management. PMID:27936420

White House Conference on Families: Work and Families.

ERIC Educational Resources Information Center

J.C. Penney Co., Inc., New York, NY.

This report on the White House Conference on Families (WHCF) was prepared by the J.C. Penney Company for corporate leaders. Background information on the WHCF, issues related to families and work, a depiction of the changing work force, and policy recommendations are included in the report. Recommendations focus on flextime, flexible leave…

Employment in a cohort of cancer patients in Spain. A predictive model of working outcomes.

PubMed

Molina, Raquel; Feliu, Jaime; Villalba, Alejandro; San José, Belén; Jiménez, Ana María; Espinosa, Enrique; Alvarez-Mon, Melchor; González-Barón, Manuel

2008-12-01

Cancer patients can have problems remaining in employment but the importance of this issue has until now received little attention in Spain. The study included 347 consecutive cancer patients who were employed at diagnosis. Diagnosis had been confirmed at least 6 months before the interview. Participants completed a questionnaire concerning cancer-related symptoms and work-related factors and clinical details were obtained from their medical records. The study was approved by the Ethical Committee of La Paz Hospital. All patients gave consent to participate. Eighty-five percent of patients were unable to work after diagnosis, but 59% returned to work at the end of treatment. Gender, age, type of worker and type of treatment were independently associated with the ability to work after diagnosis. At the end of treatment these factors were age, education, tumour stage, overall response to the therapy, associated co-morbidity and sequelae of the disease or its treatment. Twenty-one percent noticed changes in their relationship with co-workers and managers, usually in the sense that they tried to be helpful. In a multivariate logistic regression analysis, the strongest predictors for remaining in employment were age, overall response and sequelae of the disease or its treatment. Cancer survivors in this study encountered some problems in returning to work, mainly linked to the sequelae of their disease and its treatment, rather than to discrimination by employers or colleagues. Prediction of working outcomes is possible to recommend interventions.

Multi-modal management of acromegaly: a value perspective.

PubMed

Kimmell, Kristopher T; Weil, Robert J; Marko, Nicholas F

2015-10-01

The Acromegaly Consensus Group recently released updated guidelines for medical management of acromegaly patients. We subjected these guidelines to a cost analysis. We conducted a cost analysis of the recommendations based on published efficacy rates as well as publicly available cost data. The results were compared to findings from a previously reported comparative effectiveness analysis of acromegaly treatments. Using decision tree software, two models were created based on the Acromegaly Consensus Group's recommendations and the comparative effectiveness analysis. The decision tree for the Consensus Group's recommendations was subjected to multi-way tornado analysis to identify variables that most impacted the value analysis of the decision tree. The value analysis confirmed the Consensus Group's recommendations of somatostatin analogs as first line therapy for medical management. Our model also demonstrated significant value in using dopamine agonist agents as upfront therapy as well. Sensitivity analysis identified the cost of somatostatin analogs and growth hormone receptor antagonists as having the most significant impact on the cost effectiveness of medical therapies. Our analysis confirmed the value of surgery as first-line therapy for patients with surgically accessible lesions. Surgery provides the greatest value for management of patients with acromegaly. However, in accordance with the Acromegaly Consensus Group's recent recommendations, somatostatin analogs provide the greatest value and should be used as first-line therapy for patients who cannot be managed surgically. At present, the substantial cost is the most significant negative factor in the value of medical therapies for acromegaly.

False positive results using calcitonin as a screening method for medullary thyroid carcinoma.

PubMed

Batista, Rafael Loch; Toscanini, Andrea Cecilia; Brandão, Lenine Garcia; Cunha-Neto, Malebranche Berardo C

2013-05-01

The role of serum calcitonin as part of the evaluation of thyroid nodules has been widely discussed in literature. However there still is no consensus of measurement of calcitonin in the initial evaluation of a patient with thyroid nodule. Problems concerning cost-benefit, lab methods, false positive and low prevalence of medullary thyroid carcinoma (MTC) are factors that limit this approach. We have illustrated two cases where serum calcitonin was used in the evaluation of thyroid nodule and rates proved to be high. A stimulation test was performed, using calcium as secretagogue, and calcitonin hyper-stimulation was confirmed, but anatomopathologic examination did not evidence medullar neoplasia. Anatomopathologic diagnosis detected Hashimoto thyroiditis in one case and adenomatous goiter plus an occult papillary thyroid carcinoma in the other one. Recommendation for routine use of serum calcitonin in the initial diagnostic evaluation of a thyroid nodule, followed by a confirming stimulation test if basal serum calcitonin is showed to be high, is the most currently recommended approach, but questions concerning cost-benefit and possibility of diagnosis error make the validity of this recommendation discussible.

Determination of the absolute configuration of 2-hydroxyglutaric acid and 5-oxoproline in urine samples by high-resolution NMR spectroscopy in the presence of chiral lanthanide complexes.

PubMed

Bal, Dominika; Gradowska, Wanda; Gryff-Keller, Adam

2002-06-15

Determination of the absolute configuration of some metabolites in body fluids is important for the diagnosis of some inborn errors of metabolism. Presently available methods of such determinations are tedious and usually require highly specialized instrumentation. In this work, an alternative method, based on high-resolution nuclear magnetic resonance spectroscopy in the presence of the chiral lanthanide shift reagent as an auxiliary additive, has been proposed (NMR/LSR). The method involves the lineshape analysis of a chosen multiplet of the one-dimensional 1H NMR spectrum or application of the two-dimensional 1H-13C correlation spectroscopy (HSQC). In order to confirm the resonance assignments and to boost the signal-noise ratio, the addition of an amount of racemic analyte to the urine sample is recommended. The entire procedure is simple in application and demands minimal or no preprocessing of urine samples. The effectiveness of the method has been confirmed by finding the expected forms of 2-hydroxyglutaric acid and 5-oxoproline in the urine samples of an independently diagnosed patient with 2-D-hydroxyglutaric aciduria and 5-L-oxoprolinuria, respectively.

Evidence-based treatment of atopic dermatitis with topical moisturizers.

PubMed

Micali, Giuseppe; Paternò, Valentina; Cannarella, Rossella; Dinotta, Franco; Lacarrubba, Francesco

2018-06-01

Skin barrier restoration represents the mainstay of the treatment of atopic dermatitis and the use of moisturizers is recommended by several international guidelines. The aim of the study was to investigate through an evidence-based medicine analysis the effectiveness and safety of different moisturizing products available for a non-pharmacological treatment of atopic dermatitis. A total of 92 randomized controlled trials (RCTs) have been identified and analyzed. The results confirm the presence of a reasonable number of studies highlighting moisturizers safety and effectiveness in the treatment of atopic dermatitis by improving disease severity, increasing the time of relapse and reducing the time of flares. Moisturizers containing urea, glycerin or glycyrrhetinic acid seem to show the greater evidence of efficacy being supported by more clinical trials. Among the existing moisturizers, those containing a single agent generally work although the heterogeneity of RCTs does not allow reaching more definitive conclusions. Moisturizers made of a mixture of substances seem to be more effective thanks to the presence of different active substances that may exert a synergistic effect. A meta-analysis of 4 RCTs confirms the efficacy of a medical device containing glycyrrhetinic acid, hyaluronic acid, shea butter, telmesteine, and vitis vinifera in the treatment of atopic dermatitis.

Alternaria and Cladosporium Fungal Allergen Epitopes are Denatured by Sodium Hypochlorite

PubMed Central

2009-01-01

Background Fungal allergens are ubiquitous; however, little progress has been made understanding fungal allergenic material removal from indoor environments. Purpose We investigated removal of environmental allergenic material derived from Alternaria and Cladosporium using sodium hypochlorite in vivo and in vitro. Methods Freeze dried allergen extract from Alternaria alternata and Cladosporium herbarum was treated with hypochlorite concentrations of 322, 88, 38, 16, 3, 0.3, and 0 mM, respectively. Remaining native allergenic material was quantified using enzyme immunoassay and remaining viable fungal material was evaluated. Results The results of treating Alternaria or Cladosporium extract with sodium hypochlorite are immediate and obvious. Concentrations greater than 100 mM remove color and concentrations between 100 and 38 mM partially uncolored the extract. Immunoassay for total antigenic and allergenic material remaining after treatment with sodium hypochlorite including 2 concentrations recommended for killing fungus confirmed a general destruction of antigenic and allergenic material at concentrations of 38 mM or greater. Conclusions This work confirms the ability of solutions of sodium hypochlorite to denature fungal allergenic material from common outdoor and indoor fungi A. alternata and C. herbarum. Destruction of recognized antigenic and allergenic epitopes occurs at hypochlorite concentrations commonly used for household cleaning. PMID:23282316

Better concrete mixes for rapid repair in Wisconsin : research brief.

DOT National Transportation Integrated Search

2017-07-04

Research Benefits : Confirmed that Wisconsins current CIP rapid-repair concretes perform adequately : Recommended mixture improvements to alleviate construction difficulties : Determined that increasing the durability of rapid repair c...

Stakeholder Analysis for the CF Counter-IED Training Courses

DTIC Science & Technology

2010-05-01

for more than purely research purposes when the experimenter is present. 3.1.3 Learning Style- based Adaptation The Index of Learning Styles (Felder...student. It is recommended that the Adaption Module uses the same ontology based reasoning approach as the Evaluation Module. RacerPro is the recommended...reasoner. RacerPro is used as a system for managing semantic web ontologies based on Web Ontology Language (OWL). The design phase will confirm

Nutrition Recommendations and the Children’s Food and Beverage Advertising Initiative’s 2014 Approved Food and Beverage Product List

PubMed Central

Powell, Lisa M.

2015-01-01

We compare the Children’s Food and Beverage Advertising Initiative’s (CFBAI’s) April 2014 list of food and beverage products approved to be advertised on children’s television programs with the federal Interagency Working Group’s nutrition recommendations for such advertised products. Products were assessed by using the nutrients to limit (saturated fat, trans fat, sugar, and sodium) component of the Interagency Working Group’s recommendations. Fifty-three percent of the listed products did not meet the nutrition recommendations and, therefore, were ineligible to be advertised. We recommend continued monitoring of food and beverage products marketed to children. PMID:25906434

Mediating the Maltreatment-Delinquency Relationship: The Role of Triad Gang Membership.

PubMed

Chui, Wing Hong; Khiatani, Paul Vinod

2018-02-01

The primary aim of this article is to examine the role of triad affiliation in mediating the relationship between child maltreatment (neglect, punishment, emotional abuse, and sexual abuse) and delinquency among active young gang members in Hong Kong. A sample of 177 gang members aged 12 to 24 was recruited to complete a questionnaire with the assistance of a youth outreach social work team. Neglect was identified as the most common form of maltreatment, followed by emotional abuse, punishment, and sexual abuse. Mediation analyses confirmed that triad affiliation acts as a mediating variable in the child maltreatment-delinquency relationship, except in cases of sexual abuse. Only the relationship between punishment and delinquency was found to be fully mediated by triad affiliation; partial mediation effects were found for neglect and emotional abuse. Recommendations for child protection and youth workers are provided.

Switching operations fatality analysis : findings and recommendations of the SOFA working group

DOT National Transportation Integrated Search

1999-10-01

On February 1998, a Switching Operations Fatality Analysis (SOFA) Working Group (WG) was formed at the request of the Federal Railroad Administration (FRA) to review recent fatal incidents and develop recommendations for reducing fatalities in switch...

A Comparison of Three Job Engagement Measures: Examining their Factorial and Criterion-Related Validity.

PubMed

Wefald, Andrew J; Mills, Maura J; Smith, Michael R; Downey, Ronald G

2012-03-01

Engagement is an emerging job attitude that purports to measure employees' psychological presence at and involvement in their work. This research compares three academic approaches to engagement, and makes recommendations regarding the most appropriate conceptualisation and measurement of the construct in future research. The current research also investigates whether any of these three approaches to engagement contribute unique variance to the prediction of turnover intentions above and beyond the predictive capacity of alternative constructs. An online survey was taken by 382 employees and managers from a mid-sized financial institution. Results failed to support either a multi- or unidimensional factor structure for the Utrecht Work Engagement Scale (UWES) engagement measure. For the Shirom-Melamed Vigor Measure (SMVM), a multi-dimensional structure was identified as a good fit, while a unidimensional structure fit poorly. The uni-factorial structure of Britt's engagement measure was confirmed. The Schaufeli measure of engagement was a strong predictor of work outcomes; however, when controlling for job satisfaction and affective commitment, that measure lost its ability to predict intentions to leave. Two components of the Shirom vigor measure held their predictive validity. Collectively, these findings suggest that the Shirom vigor measure may provide better insight into whether and how much a person is 'into' his or her job. The Schaufeli measure was a good predictor of important work outcomes, but when job satisfaction and affective commitment were controlled, it lost its predictive validity. We were not able to confirm the three-factor structure of the Schaufeli measure. Two components of the Shirom vigor measure predicted turnover intentions after controlling for job satisfaction and affective commitment, suggesting less overlap with those constructs than the Schaufeli measure of engagement. This research adds important information on the nature of engagement and is expected to contribute toward a better understanding of the construct itself, as well as its measurement. © 2011 The Authors. Applied Psychology: Health and Well-Being © 2011 The International Association of Applied Psychology.

[The best of valvular heart disease in 2002].

PubMed

Hanania, G; Acar, C; Michel, P L; Maroni, J P

2003-01-01

For AS, besides a very thorough update by Carabello on their management, new experimental work confirms that the pathophysiology of the condition is closer to atherosclerotic and inflammatory processes than pure degeneration. Moreover this year brings a batch of long term post-operative results, one of which is an important series relating to 2194 bioprostheses followed up for 15 years. The choice of valvular substitute between 60 and 70 years old is the subject for several studies. A series of 259 re-operations for bioprosthesis deterioration allows quantification of the operative risk to which those with this substitute are subjected in case of degeneration. Finally, the strategy to adopt in a patient with an indication for aortocoronary bypass but also with a not-tight AS is discussed (abstention, decalcification, or "preventive" valvular replacement?). For aortic insufficiency (AI) some new results for the Ross operation have been published and the first publications reporting on the attempts of experimental positioning of bioprostheses via the percutaneous route in animals are appearing. As for mitral valvulopathies, MI has carved a privileged place. Much work this year relates amongst other things to functional MI in dilated cardiomyopathies with dilatation of the ring, to the natural history of mitral valvular prolapse detailed in an important series of 833 patients, and to the evolutive risk of atrial fibrillation (AF) with MI and its treatment during plasty or mitral valvular replacement procedures. Anticoagulant treatment for mechanical prostheses is the subject of much work drawn from a large German prospective study (GELIA) confirming the general tendency for alleviation of intensity in aortic especially but also mitral valvulopathies, stressing the advantages of autocontrol. Finally, the Valvulopathy Working Group of the European Society of Cardiology publishes its recommendations for asymptomatic valvulopathies, recalling the echographic criteria of dilatation and left ventricular function to be retained for operative indications, emphasising furthermore the significance of the stress test in the follow up of asymptomatic AS.

Stroke treatment academic industry roundtable: research priorities in the assessment of neurothrombectomy devices.

PubMed

Saver, Jeffrey L; Jovin, Tudor G; Smith, Wade S; Albers, Gregory W; Baron, Jean-Claude; Boltze, Johannes; Broderick, Joseph P; Davis, Lisa A; Demchuk, Andrew M; DeSena, Salvatore; Fiehler, Jens; Gorelick, Philip B; Hacke, Werner; Holt, Bill; Jahan, Reza; Jing, Hui; Khatri, Pooja; Kidwell, Chelsea S; Lees, Kennedy R; Lev, Michael H; Liebeskind, David S; Luby, Marie; Lyden, Patrick; Megerian, J Thomas; Mocco, J; Muir, Keith W; Rowley, Howard A; Ruedy, Richard M; Savitz, Sean I; Sipelis, Vitas J; Shimp, Samuel K; Wechsler, Lawrence R; Wintermark, Max; Wu, Ona; Yavagal, Dileep R; Yoo, Albert J

2013-12-01

The goal of the Stroke Treatment Academic Industry Roundtable (STAIR) meetings is to advance the development of stroke therapies. At STAIR VIII, consensus recommendations were developed for clinical trial strategies to demonstrate the benefit of endovascular reperfusion therapies for acute ischemic stroke. Prospects for success with forthcoming endovascular trials are robust, because new neurothrombectomy devices have superior reperfusion efficacy compared with earlier-generation interventions. Specific recommendations are provided for trial designs in 3 populations: (1) patients undergoing intravenous fibrinolysis, (2) early patients ineligible for or having failed intravenous fibrinolysis, and (3) wake-up and other late-presenting patients. Among intravenous fibrinolysis-eligible patients, key principles are that CT or MRI confirmation of target arterial occlusions should precede randomization; endovascular intervention should be pursued with the greatest rapidity possible; and combined intravenous and neurothrombectomy therapy is more promising than neurothrombectomy alone. Among patients ineligible for or having failed intravenous fibrinolysis, scientific equipoise was affirmed and the need to randomize all eligible patients emphasized. Vessel imaging to confirm occlusion is mandatory, and infarct core and penumbral imaging is desirable in later time windows. Additional STAIR VIII recommendations include approaches to test multiple devices in a single trial, utility weighting of disability end points, and adaptive designs to delineate time and tissue injury thresholds at which benefits from intervention no longer accrue. Endovascular research priorities in acute ischemic stroke are to perform trials testing new, highly effective neuro thrombectomy devices rapidly deployed in patients confirmed to have target vessel occlusions.

Cleaning products and work-related asthma.

PubMed

Rosenman, Kenneth D; Reilly, Mary Jo; Schill, Donald P; Valiante, David; Flattery, Jennifer; Harrison, Robert; Reinisch, Florence; Pechter, Elise; Davis, Letitia; Tumpowsky, Catharine M; Filios, Margaret

2003-05-01

To describe the characteristics of individuals with work-related asthma associated with exposure to cleaning products, data from the California-, Massachusetts-, Michigan-, and New Jersey state-based surveillance systems of work-related asthma were used to identify cases of asthma associated with exposure to cleaning products at work. From 1993 to 1997, 236 (12%) of the 1915 confirmed cases of work-related asthma identified by the four states were associated with exposure to cleaning products. Eighty percent of the reports were of new-onset asthma and 20% were work-aggravated asthma. Among the new-onset cases, 22% were consistent with reactive airways dysfunction syndrome. Individuals identified were generally women (75%), white non-Hispanic (68%), and 45 years or older (64%). Their most likely exposure had been in medical settings (39%), schools (13%), or hotels (6%), and they were most likely to work as janitor/cleaners (22%), nurse/nurses' aides (20%), or clerical staff (13%). However, cases were reported with exposure to cleaning products across a wide range of job titles. Cleaning products contain a diverse group of chemicals that are used in a wide range of industries and occupations as well as in the home. Their potential to cause or aggravate asthma has recently been recognized. Further work to characterize the specific agents and the circumstances of their use associated with asthma is needed. Additional research to investigate the frequency of adverse respiratory effects among regular users, such as housekeeping staff, is also needed. In the interim, we recommend attention to adequate ventilation, improved warning labels and Material Safety Data Sheets, and workplace training and education.

Strength and gas dynamic methods of development of the axial turbine turbocharger

NASA Astrophysics Data System (ADS)

Baturin, O. V.; Popov, G. M.; Kolmakova, D. A.; Goryachkin, E. S.

2017-01-01

The results of strength and gas dynamic improvement of the turbocharger TK-32 axial turbine are presented. The turbocharger is manufactured by LLC “Penzadieselmash” (Penza, Russian) and is used as unit boost for a diesel locomotive. The aim of this work was to ensure the turbine work capacity when the rotor speed is increased by 10% without efficiency reduction. The strain-stress state analysis indicated the region of high stresses on the rotor blade body at the level of 2/3 of root. These stresses exceed allowable values when the rotor speed increased. The variant of tangential displacement of the peripheral rotor blade section, allowing reducing the level of stress by 20%, was found. Gas dynamic calculation showed that the variant of rotor blade modernization results in an increase of efficiency by 0.4%. Also it was shown that the increase in turbine efficiency by 1% can be reached if the number of rotor blades is reduced by 13%. This recommendation was implemented and confirmed experimentally by the example of mass turbocharger TK-32 [1].

Physical-chemical processes of diamond grinding

NASA Astrophysics Data System (ADS)

Lobanov, D. V.; Arhipov, P. V.; Yanyushkin, A. S.; Skeeba, V. Yu

2017-10-01

The article focuses on the relevance of the research into the problem of diamond abrasive metal-bonded tool performance loss with a view to enhancing the effectiveness of high-strength materials finishing processing. The article presents the results of theoretical and empirical studies of loading layer formation on the surface of diamond wheels during processing high-strength materials. The theoretical part deals with the physical and chemical processes at the contact area of the diamond wheel and work surface with the viewpoint of the electrochemical potentials equilibrium state. We defined dependencies for calculating the loading layer dimensions. The practical part of work centers on various electron-microscopic, spectral and X-ray diffraction studies of the metal-bonded wheel samples during diamond grinding. The analysis of the research results revealed the composition and structure of the loading layer. The validity of the theoretical data is confirmed by sufficient convergence of the calculated values with the results of empirical research. In order to reduce the intensity of loading and improve the cutting properties of metal-bonded diamond abrasive tools, it is recommended to use combined methods for more efficient processing of high-strength materials.

Questionnaire-based evaluation of mobile phone interference with medical-electrical equipment in Swedish hospitals.

PubMed

Wiinberg, Stig; Samuelsson, Göran; Larsson, Stefan; Nilsson, Barbro; Jönsson, Patrik X; Ivarsson, Bodil; Olofsson, Per-Åke

2017-08-09

National recommendations in Sweden recommend a safety distance of 3 meter (m) between mobile phones and medical-electrical (ME) equipment in hospitals. A questionnaire was used to investigate how often mobile phones were reported to interfere with ME products in clinical practice across Sweden. The results confirmed that ME equipment can be affected by mobile phone use but, the risk of the patient's outcome being affected were minimal; no cases were identified which led to injury or death. In conclusion, the results support recommendations for a general safety distance of 0.5 m between mobile phones and ME equipment in care environments.

Recommended vitamin D levels in the general population.

PubMed

Varsavsky, Mariela; Rozas Moreno, Pedro; Becerra Fernández, Antonio; Luque Fernández, Inés; Quesada Gómez, José Manuel; Ávila Rubio, Verónica; García Martín, Antonia; Cortés Berdonces, María; Naf Cortés, Silvia; Romero Muñoz, Manuel; Reyes García, Rebeca; Jódar Gimeno, Esteban; Muñoz Torres, Manuel

2017-03-01

To provide recommendations based on evidence on the management of vitaminD deficiency in the general population. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the term VitaminD and the name of each issue. Papers in English and Spanish with publication date before 17 March 2016 were included. Recommendations were jointly discussed by the Working Group. This document summarizes the data about vitaminD deficiency in terms of prevalence, etiology, screening indications, adequate levels and effects of supplementation on bone and non-skeletal health outcomes. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Confirmed inguinal lymphogranuloma venereum genovar L2c in a man who had sex with men, Slovenia, 2015.

PubMed

Matičič, Mojca; Klavs, Irena; Videčnik Zorman, Jerneja; Vidmar Vovko, Darja; Kogoj, Rok; Keše, Darja

2016-01-01

A laboratory-confirmed lymphogranuloma venereum (LGV) case in Slovenia was reported in 2015, in a human immunodeficiency virus (HIV)-negative man presenting with inguinal lymphadenopathy. He reported unprotected insertive anal intercourse with two male partners in Croatia. Variant L2c of Chlamydia trachomatis was detected in clinical samples. Although the patient was eventually cured, the recommended treatment regimen with doxycycline had to be prolonged.

[Clinical practice guidelines for evaluation and treatment of osteoporosis associated to endocrine and nutritional conditions. Bone Metabolism Working Group of the Spanish Society of Endocrinology].

PubMed

Reyes García, Rebeca; Jódar Gimeno, Esteban; García Martín, Antonia; Romero Muñoz, Manuel; Gómez Sáez, José Manuel; Luque Fernández, Inés; Varsavsky, Mariela; Guadalix Iglesias, Sonsoles; Cano Rodriguez, Isidoro; Ballesteros Pomar, María Dolores; Vidal Casariego, Alfonso; Rozas Moreno, Pedro; Cortés Berdonces, María; Fernández García, Diego; Calleja Canelas, Amparo; Palma Moya, Mercedes; Martínez Díaz-Guerra, Guillermo; Jimenez Moleón, José J; Muñoz Torres, Manuel

2012-03-01

To provide practical recommendations for evaluation and treatment of osteoporosis associated to endocrine diseases and nutritional conditions. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology, a methodologist, and a documentalist. Recommendations were formulated according to the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed), using the following terms associated to the name of each condition: AND "osteoporosis", "fractures", "bone mineral density", and "treatment". Papers in English with publication date before 18 October 2011 were included. Current evidence for each disease was reviewed by two group members, and doubts related to the review process or development of recommendations were resolved by the methodologist. Finally, recommendations were discussed in a meeting of the Working Group. The document provides evidence-based practical recommendations for evaluation and management of endocrine and nutritional diseases associated to low bone mass or an increased risk of fracture. For each disease, the associated risk of low bone mass and fragility fractures is given, recommendations for bone mass assessment are provided, and treatment options that have shown to be effective for increasing bone mass and/or to decreasing fragility fractures are listed. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

National Athletic Trainers' Association Position Statement: Environmental Cold Injuries

PubMed Central

Cappaert, Thomas A; Stone, Jennifer A; Castellani, John W; Krause, Bentley Andrew; Smith, Daniel; Stephens, Bradford A

2008-01-01

Objective: To present recommendations for the prevention, recognition, and treatment of environmental cold injuries. Background: Individuals engaged in sport-related or work-related physical activity in cold, wet, or windy conditions are at risk for environmental cold injuries. An understanding of the physiology and pathophysiology, risk management, recognition, and immediate care of environmental cold injuries is an essential skill for certified athletic trainers and other health care providers working with individuals at risk. Recommendations: These recommendations are intended to provide certified athletic trainers and others participating in athletic health care with the specific knowledge and problem-solving skills needed to address environmental cold injuries. Each recommendation has been graded (A, B, or C) according to the Strength of Recommendation Taxonomy criterion scale. PMID:19030143

77 FR 1937 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-12

... All Age Influenza Hospitalization Surveillance (Flu Hosp)--OMB 0920-0806, revision Expiration March 31... data collection instrument for monitoring laboratory-confirmed influenza hospitalizations (OMB 0920... for pediatric influenza hospitalizations (persons ...

Surgical versus injection treatment for injection-confirmed chronic sacroiliac joint pain

PubMed Central

Spiker, William Ryan; Lawrence, Brandon D.; Raich, Annie L.; Skelly, Andrea C.; Brodke, Darrel S.

2012-01-01

Study design: Systematic review. Study rationale: Chronic sacroiliac joint pain (CSJP) is a common clinical entity with highly controversial treatment options. A recent systematic review compared surgery with denervation, but the current systematic review compares outcomes of surgical intervention with therapeutic injection for the treatment of CSJP and serves as the next step for evaluating current evidence on the comparative effectiveness of treatments for non-traumatic sacroiliac joint pain. Objective or clinical question: In adult patients with injection-confirmed CSJP, does surgical treatment lead to better outcomes and fewer complications than injection therapy? Methods: A systematic review of the English-language literature was undertaken for articles published between 1970 and June 2012. Electronic databases and reference lists of key articles were searched to identify studies evaluating surgery or injection treatment for injection-confirmed CSJP. Studies involving traumatic onset or non-injection–confirmed CSJP were excluded. Two independent reviewers assessed the level of evidence quality using the grading of recommendations assessment, development and evaluation (GRADE) system, and disagreements were resolved by consensus. Results: We identified twelve articles (seven surgical and five injection treatment) meeting our inclusion criteria. Regardless of the type of treatment, most studies reported over 40% improvement in pain as measured by Visual Analog Scale or Numeric rating Scale score. Regardless of the type of treatment, most studies reported over 20% improvement in functionality. Most complications were reported in the surgical studies. Conclusion: Surgical fusion and therapeutic injections can likely provide pain relief, improve quality of life, and improve work status. The comparative effectiveness of these interventions cannot be evaluated with the current literature. PMID:23526911

Recommendations for NRC policy on shift scheduling and overtime at nuclear power plants

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

Lewis, P.M.

1985-07-01

This report contains the Pacific Northwest Laboratory's (PNL's) recommendations to the US Nuclear Regulatory Commission (NRC) for an NRC policy on shift scheduling and hours of work (including overtime) for control room operators and other safety-related personnel in nuclear power plants. First, it is recommended that NRC make three additions to its present policy on overtime: (1) limit personnel to 112 hours of work in a 14-day period, 192 hours in 28 days, and 2260 hours in one year; exceeding these limits would require plant manager approval; (2) add a requirement that licensees obtain approval from NRC if plant personnelmore » are expected to exceed 72 hours of work in a 7-day period, 132 hours in 14 days, 228 hours in 28 days, and 2300 hours in one year; and (3) make the policy a requirement, rather than a nonbinding recommendation. Second, it is recommended that licensees be required to obtain NRC approval to adopt a routine 12-hour/day shift schedule. Third, it is recommended that NRC add several nonbinding recommendations concerning routine 8-hour/day schedules. Finally, because additional data can strengthen the basis for future NRC policy on overtime, five methods are suggested for collecting data on overtime and its effects. 44 refs., 10 tabs.« less

Strategy for Sensitive and Specific Detection of Yersinia pestis in Skeletons of the Black Death Pandemic

PubMed Central

Seifert, Lisa; Harbeck, Michaela; Thomas, Astrid; Hoke, Nadja; Zöller, Lothar; Wiechmann, Ingrid; Grupe, Gisela; Scholz, Holger C.; Riehm, Julia M.

2013-01-01

Yersinia pestis has been identified as the causative agent of the Black Death pandemic in the 14th century. However, retrospective diagnostics in human skeletons after more than 600 years are critical. We describe a strategy following a modern diagnostic algorithm and working under strict ancient DNA regime for the identification of medieval human plague victims. An initial screening and DNA quantification assay detected the Y. pestis specific pla gene of the high copy number plasmid pPCP1. Results were confirmed by conventional PCR and sequence analysis targeting both Y. pestis specific virulence plasmids pPCP1 and pMT1. All assays were meticulously validated according to human clinical diagnostics requirements (ISO 15189) regarding efficiency, sensitivity, specificity, and limit of detection (LOD). Assay specificity was 100% tested on 41 clinically relevant bacteria and 29 Y. pseudotuberculosis strains as well as for DNA of 22 Y. pestis strains and 30 previously confirmed clinical human plague samples. The optimized LOD was down to 4 gene copies. 29 individuals from three different multiple inhumations were initially assessed as possible victims of the Black Death pandemic. 7 samples (24%) were positive in the pPCP1 specific screening assay. Confirmation through second target pMT1 specific PCR was successful for 4 of the positive individuals (14%). A maximum of 700 and 560 copies per µl aDNA were quantified in two of the samples. Those were positive in all assays including all repetitions, and are candidates for future continuative investigations such as whole genome sequencing. We discuss that all precautions taken here for the work with aDNA are sufficient to prevent external sample contamination and fulfill the criteria of authenticity. With regard to retrospective diagnostics of a human pathogen and the uniqueness of ancient material we strongly recommend using a careful strategy and validated assays as presented in our study. PMID:24069445

Strategy for sensitive and specific detection of Yersinia pestis in skeletons of the black death pandemic.

PubMed

Seifert, Lisa; Harbeck, Michaela; Thomas, Astrid; Hoke, Nadja; Zöller, Lothar; Wiechmann, Ingrid; Grupe, Gisela; Scholz, Holger C; Riehm, Julia M

2013-01-01

Yersinia pestis has been identified as the causative agent of the Black Death pandemic in the 14(th) century. However, retrospective diagnostics in human skeletons after more than 600 years are critical. We describe a strategy following a modern diagnostic algorithm and working under strict ancient DNA regime for the identification of medieval human plague victims. An initial screening and DNA quantification assay detected the Y. pestis specific pla gene of the high copy number plasmid pPCP1. Results were confirmed by conventional PCR and sequence analysis targeting both Y. pestis specific virulence plasmids pPCP1 and pMT1. All assays were meticulously validated according to human clinical diagnostics requirements (ISO 15189) regarding efficiency, sensitivity, specificity, and limit of detection (LOD). Assay specificity was 100% tested on 41 clinically relevant bacteria and 29 Y. pseudotuberculosis strains as well as for DNA of 22 Y. pestis strains and 30 previously confirmed clinical human plague samples. The optimized LOD was down to 4 gene copies. 29 individuals from three different multiple inhumations were initially assessed as possible victims of the Black Death pandemic. 7 samples (24%) were positive in the pPCP1 specific screening assay. Confirmation through second target pMT1 specific PCR was successful for 4 of the positive individuals (14%). A maximum of 700 and 560 copies per µl aDNA were quantified in two of the samples. Those were positive in all assays including all repetitions, and are candidates for future continuative investigations such as whole genome sequencing. We discuss that all precautions taken here for the work with aDNA are sufficient to prevent external sample contamination and fulfill the criteria of authenticity. With regard to retrospective diagnostics of a human pathogen and the uniqueness of ancient material we strongly recommend using a careful strategy and validated assays as presented in our study.

The damaging effect of confirming feedback on the relation between eyewitness certainty and identification accuracy.

PubMed

Bradfield, Amy L; Wells, Gary L; Olson, Elizabeth A

2002-02-01

The authors investigated eyewitnesses' retrospective certainty (see G. L. Wells & A. L. Bradfield, 1999). The authors hypothesized that extemal influence from the lineup administrator would damage the certainty-accuracy relation by inflating the retrospective certainty of inaccurate eyewitnesses more than that of accurate eyewitnesses (N = 245). Two variables were manipulated: eyewitness accuracy (through the presence or absence of the culprit in the lineup) and feedback (confirming vs. control). Confirming feedback inflated retrospective certainty more for inaccurate eyewitnesses than for accurate eyewitnesses, significantly reducing the certainty-accuracy relation (from r = .58 in the control condition to r = .37 in the confirming feedback condition). Double-blind testing is recommended for lineups to prevent these external influences on eyewitnesses.

Inadequate Diagnostic Evaluation in Young Patients Registered with a Diagnosis of Dementia: A Nationwide Register-Based Study

PubMed Central

Salem, Lise Cronberg; Andersen, Birgitte Bo; Nielsen, T. Rune; Stokholm, Jette; Jørgensen, Martin Balslev; Waldemar, Gunhild

2014-01-01

Background Establishing a diagnosis of dementia in young patients may be complex and have significant implications for the patient. The aim of this study was to evaluate the quality of the diagnostic work-up in young patients diagnosed with dementia in the clinical routine. Methods Two hundred patients were randomly selected from 891 patients aged ≤65 years registered with a diagnosis of dementia for the first time in 2008 in Danish hospitals, and 159 medical records were available for review. Three raters evaluated their medical records for the completeness of the diagnostic work-up on which the diagnosis of dementia had been based, using evidence-based guidelines for the diagnostic evaluation of dementia as reference standards. Results According to the rater review, only 111 (70%) patients met the clinical criteria for dementia. An acceptable diagnostic work-up including all items of recommended basic diagnostic evaluation was performed in only 24%, although more often (28%) in the subgroup of patients where dementia was confirmed by raters. Conclusion This first nationwide study of unselected young patients registered with a diagnosis of dementia indicated that the concept of dementia may be misinterpreted by clinicians and that a diagnosis of dementia in the young is only rarely based on a complete basic diagnostic work-up, calling for increased competency. PMID:24711812

Approaches to the diagnosis and management of occupational asthma amongst UK respiratory physicians.

PubMed

Barber, C M; Naylor, S; Bradshaw, L M; Francis, M; Harris-Roberts, J; Rawbone, R; Curran, A D; Fishwick, D

2007-09-01

This study aimed to assess the approach to the diagnosis and management of occupational asthma amongst general (non-specialist) respiratory consultants in the UK. A random sample of 100 UK general respiratory physicians were invited to participate, and asked to provide information on their diagnostic approach to a case scenario of a patient with possible occupational asthma relating to flour exposure. Participation rates were 42% for the main part of the study. Less than half of consultants specifically reported they would ask whether symptoms improved away from work, and just over a third mentioned examining the patient. All of those interviewed recommended a chest X-ray, and 98% simple spirometry. Eighty-six per cent suggested measurement of serial peak flows, recorded for between 2 and 8 weeks, with measurements taken half-twelve hourly. Less than half advocated a specific flour allergy test, and almost one-quarter (23%) would not perform any immunological test at all. Once a diagnosis of occupational asthma was confirmed, less than two-thirds of those interviewed commented they would recommend some form of exposure reduction, and only 28% specifically stated they would offer compensation advice. The diagnosis of occupational asthma by general respiratory physicians within the UK lacks standardisation, and in some cases falls short of evidence-based best practise.

Are pertussis cases reported too late for public health interventions? Retrospective analysis of cases in London and South East England, 2010 to 2015

PubMed Central

Crabbe, Helen; Saavedra-Campos, María; Verlander, Neville Q; Leonard, Anusha; Morris, Jill; Wright, Amanda; Balasegaram, Sooria

2017-01-01

In the United Kingdom, pertussis guidance recommends prophylaxis for household contacts within 21 days of case symptom onset if the household includes a vulnerable contact. The aim of our study was to identify characteristics associated with cases reported late for public health action. We reviewed the epidemiology of cases reported in London and South East England for the period 2010 to 2015. We characterised risk factors associated with late reporting of cases and described public health actions taken on timely reported cases. From 2010 to 2015, 9,163 cases of pertussis were reported to health protection teams. Only 11% of cases were reported within 21 days of onset, limiting opportunities for secondary prevention. Timely reporting was associated with younger age groups, pregnancy, being a healthcare worker and being reported by schools or hospital clinicians. Late reporting was associated with older age groups and general practitioner or laboratory reporting. Delays, such as those due to insidious onset and late presentation to healthcare, may be unavoidable; however, delay in reporting once a patient presents can be reduced since cases can be reported before laboratory confirmation. Thus we recommend working with clinicians and laboratories to determine causes and improve early reporting to public health. PMID:28749334

Nonclinical safety biomarkers of drug-induced vascular injury: current status and blueprint for the future.

PubMed

Mikaelian, Igor; Cameron, Mark; Dalmas, Deidre A; Enerson, Bradley E; Gonzalez, Raymond J; Guionaud, Silvia; Hoffmann, Peter K; King, Nicholas M P; Lawton, Michael P; Scicchitano, Marshall S; Smith, Holly W; Thomas, Roberta A; Weaver, James L; Zabka, Tanja S

2014-06-01

Better biomarkers are needed to identify, characterize, and/or monitor drug-induced vascular injury (DIVI) in nonclinical species and patients. The Predictive Safety Testing Consortium (PSTC), a precompetitive collaboration of pharmaceutical companies and the U.S. Food and Drug Administration (FDA), formed the Vascular Injury Working Group (VIWG) to develop and qualify translatable biomarkers of DIVI. The VIWG focused its research on acute DIVI because early detection for clinical and nonclinical safety monitoring is desirable. The VIWG developed a strategy based on the premise that biomarkers of DIVI in rat would be translatable to humans due to the morphologic similarity of vascular injury between species regardless of mechanism. The histomorphologic lexicon for DIVI in rat defines degenerative and adaptive findings of the vascular endothelium and smooth muscles, and characterizes inflammatory components. We describe the mechanisms of these changes and their associations with candidate biomarkers for which advanced analytical method validation was completed. Further development is recommended for circulating microRNAs, endothelial microparticles, and imaging techniques. Recommendations for sample collection and processing, analytical methods, and confirmation of target localization using immunohistochemistry and in situ hybridization are described. The methods described are anticipated to aid in the identification and qualification of translational biomarkers for DIVI. © 2014 by The Author(s).

Information Filtering via Heterogeneous Diffusion in Online Bipartite Networks

PubMed Central

Zhang, Fu-Guo; Zeng, An

2015-01-01

The rapid expansion of Internet brings us overwhelming online information, which is impossible for an individual to go through all of it. Therefore, recommender systems were created to help people dig through this abundance of information. In networks composed by users and objects, recommender algorithms based on diffusion have been proven to be one of the best performing methods. Previous works considered the diffusion process from user to object, and from object to user to be equivalent. We show in this work that it is not the case and we improve the quality of the recommendation by taking into account the asymmetrical nature of this process. We apply this idea to modify the state-of-the-art recommendation methods. The simulation results show that the new methods can outperform these existing methods in both recommendation accuracy and diversity. Finally, this modification is checked to be able to improve the recommendation in a realistic case. PMID:26125631

The CanPain SCI Clinical Practice Guidelines for Rehabilitation Management of Neuropathic Pain after Spinal Cord: screening and diagnosis recommendations.

PubMed

Mehta, S; Guy, S D; Bryce, T N; Craven, B C; Finnerup, N B; Hitzig, S L; Orenczuk, S; Siddall, P J; Widerström-Noga, E; Casalino, A; Côté, I; Harvey, D; Kras-Dupuis, A; Lau, B; Middleton, J W; Moulin, D E; O'Connell, C; Parrent, A G; Potter, P; Short, C; Teasell, R; Townson, A; Truchon, C; Wolfe, D; Bradbury, C L; Loh, E

2016-08-01

Clinical practice guidelines. To develop the first Canadian clinical practice guidelines for screening and diagnosis of neuropathic pain in people with spinal cord injury (SCI). The guidelines are relevant for inpatient and outpatient SCI rehabilitation settings in Canada. The CanPainSCI Working Group reviewed evidence to address clinical questions regarding screening and diagnosis of neuropathic pain after SCI. A consensus process was followed to achieve agreement on recommendations and clinical considerations. Twelve recommendations, based on expert consensus, were developed for the screening and diagnosis of neuropathic pain after SCI. The recommendations address methods for assessment, documentation tools, team member accountability, frequency of screening and considerations for diagnostic investigation. Important clinical considerations accompany each recommendation. The expert Working Group developed recommendations for the screening and diagnosis of neuropathic pain after SCI that should be used to inform practice.

Nuclear safety policy working group recommendations on nuclear propulsion safety for the space exploration initiative

NASA Technical Reports Server (NTRS)

Marshall, Albert C.; Lee, James H.; Mcculloch, William H.; Sawyer, J. Charles, Jr.; Bari, Robert A.; Cullingford, Hatice S.; Hardy, Alva C.; Niederauer, George F.; Remp, Kerry; Rice, John W.

1993-01-01

An interagency Nuclear Safety Working Group (NSPWG) was chartered to recommend nuclear safety policy, requirements, and guidelines for the Space Exploration Initiative (SEI) nuclear propulsion program. These recommendations, which are contained in this report, should facilitate the implementation of mission planning and conceptual design studies. The NSPWG has recommended a top-level policy to provide the guiding principles for the development and implementation of the SEI nuclear propulsion safety program. In addition, the NSPWG has reviewed safety issues for nuclear propulsion and recommended top-level safety requirements and guidelines to address these issues. These recommendations should be useful for the development of the program's top-level requirements for safety functions (referred to as Safety Functional Requirements). The safety requirements and guidelines address the following topics: reactor start-up, inadvertent criticality, radiological release and exposure, disposal, entry, safeguards, risk/reliability, operational safety, ground testing, and other considerations.

Information Filtering via Heterogeneous Diffusion in Online Bipartite Networks.

PubMed

Zhang, Fu-Guo; Zeng, An

2015-01-01

The rapid expansion of Internet brings us overwhelming online information, which is impossible for an individual to go through all of it. Therefore, recommender systems were created to help people dig through this abundance of information. In networks composed by users and objects, recommender algorithms based on diffusion have been proven to be one of the best performing methods. Previous works considered the diffusion process from user to object, and from object to user to be equivalent. We show in this work that it is not the case and we improve the quality of the recommendation by taking into account the asymmetrical nature of this process. We apply this idea to modify the state-of-the-art recommendation methods. The simulation results show that the new methods can outperform these existing methods in both recommendation accuracy and diversity. Finally, this modification is checked to be able to improve the recommendation in a realistic case.

ACOEM practice guidelines: opioids and safety-sensitive work.

PubMed

Hegmann, Kurt T; Weiss, Michael S; Bowden, Kirk; Branco, Fernando; DuBrueler, Kimberly; Els, Charl; Mandel, Steven; McKinney, David W; Miguel, Rafael; Mueller, Kathryn L; Nadig, Robert J; Schaffer, Michael I; Studt, Larry; Talmage, James B; Travis, Russell L; Winters, Thomas; Thiese, Matthew S; Harris, Jeffrey S

2014-07-01

ACOEM has updated the treatment guidelines concerning opioids. This report highlights the safety-sensitive work recommendation that has been developed. Comprehensive literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel to develop evidence-based guidance. A total of 12 moderate-quality studies were identified to address motor vehicle crash risk, and none regarding other work among opioid-using patients. Acute or chronic opioid use is not recommended for patients who perform safety-sensitive jobs. These jobs include operating motor vehicles, other modes of transportation, forklift driving, overhead crane operation, heavy equipment operation and tasks involving high levels of cognitive function and judgment. Quality evidence consistently demonstrates increased risk of vehicle crashes and is recommended as the surrogate for other safety-sensitive work tasks.

Evidence-Based Consensus Recommendations for Colposcopy Practice for Cervical Cancer Prevention in the United States.

PubMed

Wentzensen, Nicolas; Massad, L Stewart; Mayeaux, Edward J; Khan, Michelle J; Waxman, Alan G; Einstein, Mark H; Conageski, Christine; Schiffman, Mark H; Gold, Michael A; Apgar, Barbara S; Chelmow, David; Choma, Kim K; Darragh, Teresa M; Gage, Julia C; Garcia, Francisco A R; Guido, Richard S; Jeronimo, Jose A; Liu, Angela; Mathews, Cara A; Mitchell, Martha M; Moscicki, Anna-Barbara; Novetsky, Akiva P; Papasozomenos, Theognosia; Perkins, Rebecca B; Silver, Michelle I; Smith, Katie M; Stier, Elizabeth A; Tedeschi, Candice A; Werner, Claudia L; Huh, Warner K

2017-10-01

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of colposcopy and directed biopsy for cervical cancer prevention in the United States (US). The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. An extensive literature review was conducted and supplemented by a systematic review and meta-analysis of unpublished data. In addition, a survey of practicing colposcopists was conducted to assess current colposcopy practice in the US. Recommendations were approved by the working group members, and the final revisions were made based on comments received from the public. The recommendations cover terminology, risk-based colposcopy, colposcopy procedures, and colposcopy adjuncts. The ASCCP Colposcopy Standards recommendations are an important step toward raising the standard of colposcopy services delivered to women in the US. Because cervical cancer screening programs are currently undergoing important changes that may affect colposcopy performance, updates to some of the current recommendations may be necessary in the future.

Court-Recommended Guidelines for Managing Unethical Students and Working with University Lawyers.

ERIC Educational Resources Information Center

Cobb, Norman H.

1994-01-01

Management of social work students engaging in unethical behavior is discussed, drawing on litigation decisions and a professional association ethics code. The role of university lawyers is also examined, and recommendations for informing lawyers about the special circumstances of professional education and potential liability of problem students…

Determination of synthetic food dyes in commercial soft drinks by TLC and ion-pair HPLC.

PubMed

de Andrade, Francisca Ivani; Florindo Guedes, Maria Izabel; Pinto Vieira, Ícaro Gusmão; Pereira Mendes, Francisca Noélia; Salmito Rodrigues, Paula Alves; Costa Maia, Carla Soraya; Marques Ávila, Maria Marlene; de Matos Ribeiro, Luzara

2014-08-15

Synthetic food colourings were analyzed on commercial carbonated orange and grape soft drinks produced in Ceará State, Brazil. Tartrazine (E102), Amaranth (E123), Sunset Yellow (E110) and Brilliant Blue (E133) were extracted from soft drinks using C18 SPE and identified by thin layer chromatography (TLC), this method was used to confirm the composition of food colouring in soft drinks stated on label. The concentration of food colouring in soft drink was determined by ion-pair high performance liquid chromatography with photodiode array detection. The results obtained with the samples confirm that the identification and quantification methods are recommended for quality control of the synthetic colours in soft drinks, as well as to determine whether the levels and lables complies with the recommendations of food dyes legislation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Night shift work and modifiable lifestyle factors.

PubMed

Pepłońska, Beata; Burdelak, Weronika; Krysicka, Jolanta; Bukowska, Agnieszka; Marcinkiewicz, Andrzej; Sobala, Wojciech; Klimecka-Muszyńska, Dorota; Rybacki, Marcin

2014-10-01

Night shift work has been linked to some chronic diseases. Modification of lifestyle by night work may partially contribute to the development of these diseases, nevertheless, so far epidemiological evidence is limited. The aim of the study was to explore association between night shift work and lifestyle factors using data from a cross-sectional study among blue-collar workers employed in industrial plants in Łódź, Poland. The anonymous questionnaire was self-administered among 605 employees (236 women and 369 men, aged 35 or more) - 434 individuals currently working night shifts. Distribution of the selected lifestyle related factors such as smoking, alcohol drinking, physical activity, body mass index (BMI), number of main meals and the hour of the last meal was compared between current, former, and never night shift workers. Adjusted ORs or predicted means were calculated, as a measure of the associations between night shift work and lifestyle factors, with age, marital status and education included in the models as covariates. Recreational inactivity (defined here as less than one hour per week of recreational physical activity) was associated with current night shift work when compared to never night shift workers (OR = 2.43, 95% CI: 1.13-5.22) among men. Alcohol abstinence and later time of the last meal was associated with night shift work among women. Statistically significant positive relationship between night shift work duration and BMI was observed among men (p = 0.029). This study confirms previous studies reporting lower exercising among night shift workers and tendency to increase body weight. This finding provides important public health implication for the prevention of chronic diseases among night shift workers. Initiatives promoting physical activity addressed in particular to the night shift workers are recommended.

Research on Intelligent Interface in Double-front Work Machines

NASA Astrophysics Data System (ADS)

Kamezaki, Mitsuhiro; Iwata, Hiroyasu; Sugano, Shigeki

This paper proposes a work state identification method with full independent of work environmental conditions and operator skill levels for construction machinery. Advanced operated-work machines, which have been designed for complicated tasks, require intelligent systems that can provide the quantitative work analysis needed to determine effective work procedures and that can provide operational and cognitive support for operators. Construction work environments are extremely complicated, however, and this makes state identification, which is a key technology for an intelligent system, difficult. We therefore defined primitive static states (PSS) that are determined using on-off information for the lever inputs and manipulator loads for each part of the grapple and front and that are completely independent of the various environmental conditions and variation in operator skill level that can cause an incorrect work state identification. To confirm the usefulness of PSS, we performed experiments with a demolition task by using our virtual reality simulator. We confirmed that PSS could robustly and accurately identify the work states and that untrained skills could be easily inferred from the results of PSS-based work analysis. We also confirmed in skill-training experiments that advice information based on PSS-based skill analysis greatly improved operator's work performance. We thus confirmed that PSS can adequately identify work states and are useful for work analysis and skill improvement.

Recommendations for the Use of Automated Gray Matter Segmentation Tools: Evidence from Huntington’s Disease

PubMed Central

Johnson, Eileanoir B.; Gregory, Sarah; Johnson, Hans J.; Durr, Alexandra; Leavitt, Blair R.; Roos, Raymund A.; Rees, Geraint; Tabrizi, Sarah J.; Scahill, Rachael I.

2017-01-01

The selection of an appropriate segmentation tool is a challenge facing any researcher aiming to measure gray matter (GM) volume. Many tools have been compared, yet there is currently no method that can be recommended above all others; in particular, there is a lack of validation in disease cohorts. This work utilizes a clinical dataset to conduct an extensive comparison of segmentation tools. Our results confirm that all tools have advantages and disadvantages, and we present a series of considerations that may be of use when selecting a GM segmentation method, rather than a ranking of these tools. Seven segmentation tools were compared using 3 T MRI data from 20 controls, 40 premanifest Huntington’s disease (HD), and 40 early HD participants. Segmented volumes underwent detailed visual quality control. Reliability and repeatability of total, cortical, and lobular GM were investigated in repeated baseline scans. The relationship between each tool was also examined. Longitudinal within-group change over 3 years was assessed via generalized least squares regression to determine sensitivity of each tool to disease effects. Visual quality control and raw volumes highlighted large variability between tools, especially in occipital and temporal regions. Most tools showed reliable performance and the volumes were generally correlated. Results for longitudinal within-group change varied between tools, especially within lobular regions. These differences highlight the need for careful selection of segmentation methods in clinical neuroimaging studies. This guide acts as a primer aimed at the novice or non-technical imaging scientist providing recommendations for the selection of cohort-appropriate GM segmentation software. PMID:29066997

Recommendations for the Use of Automated Gray Matter Segmentation Tools: Evidence from Huntington's Disease.

PubMed

Johnson, Eileanoir B; Gregory, Sarah; Johnson, Hans J; Durr, Alexandra; Leavitt, Blair R; Roos, Raymund A; Rees, Geraint; Tabrizi, Sarah J; Scahill, Rachael I

2017-01-01

The selection of an appropriate segmentation tool is a challenge facing any researcher aiming to measure gray matter (GM) volume. Many tools have been compared, yet there is currently no method that can be recommended above all others; in particular, there is a lack of validation in disease cohorts. This work utilizes a clinical dataset to conduct an extensive comparison of segmentation tools. Our results confirm that all tools have advantages and disadvantages, and we present a series of considerations that may be of use when selecting a GM segmentation method, rather than a ranking of these tools. Seven segmentation tools were compared using 3 T MRI data from 20 controls, 40 premanifest Huntington's disease (HD), and 40 early HD participants. Segmented volumes underwent detailed visual quality control. Reliability and repeatability of total, cortical, and lobular GM were investigated in repeated baseline scans. The relationship between each tool was also examined. Longitudinal within-group change over 3 years was assessed via generalized least squares regression to determine sensitivity of each tool to disease effects. Visual quality control and raw volumes highlighted large variability between tools, especially in occipital and temporal regions. Most tools showed reliable performance and the volumes were generally correlated. Results for longitudinal within-group change varied between tools, especially within lobular regions. These differences highlight the need for careful selection of segmentation methods in clinical neuroimaging studies. This guide acts as a primer aimed at the novice or non-technical imaging scientist providing recommendations for the selection of cohort-appropriate GM segmentation software.

Advanced Dental Education: Recommendations for the 80's. Issues in Dental Health Policy.

ERIC Educational Resources Information Center

American Association of Dental Schools, Washington, DC.

Six statements of working principles and 11 major recommendations falling within those areas, as established by the Task Force on Advanced Dental Education, are presented. Supporting recommendations are also provided. The six principles include: (1) no change is recommended in the present goal of predoctoral education, to prepare students for…

Optimization of turning process through the analytic flank wear modelling

NASA Astrophysics Data System (ADS)

Del Prete, A.; Franchi, R.; De Lorenzis, D.

2018-05-01

In the present work, the approach used for the optimization of the process capabilities for Oil&Gas components machining will be described. These components are machined by turning of stainless steel castings workpieces. For this purpose, a proper Design Of Experiments (DOE) plan has been designed and executed: as output of the experimentation, data about tool wear have been collected. The DOE has been designed starting from the cutting speed and feed values recommended by the tools manufacturer; the depth of cut parameter has been maintained as a constant. Wear data has been obtained by means the observation of the tool flank wear under an optical microscope: the data acquisition has been carried out at regular intervals of working times. Through a statistical data and regression analysis, analytical models of the flank wear and the tool life have been obtained. The optimization approach used is a multi-objective optimization, which minimizes the production time and the number of cutting tools used, under the constraint on a defined flank wear level. The technique used to solve the optimization problem is a Multi Objective Particle Swarm Optimization (MOPS). The optimization results, validated by the execution of a further experimental campaign, highlighted the reliability of the work and confirmed the usability of the optimized process parameters and the potential benefit for the company.

Treatment of Hypochondriasis in Two Schizophrenia Patients Using Clozapine

PubMed Central

2017-01-01

Hypochondriasis (HYPO), an obsessive-compulsive spectrum disorder, is frequent in patients with schizophrenia (SCH) (20%), especially among those treated with clozapine (36.7%). Treatment options for OCS/OCD in patients under clozapine (CLZ) include combining clozapine with amisulpride/aripiprazole or a mood stabilizer, augmenting clozapine with a serotoninergic reuptake inhibitor, adding cognitive behavioural therapy, and gradually reducing dosage. No treatments have been proposed for HYPO in patients using clozapine so we examine these options in 2 cases and report the results. Among treatments delivered, only dosage reduction adequately worked. We recommend caution when thinking about escalating treatment and suggest trying it only when alternative interventions were not successful and weighing risk and benefits of this therapeutic strategy. Further research is needed to confirm the hypothesis that CLZ treatment induces hypochondriac symptoms, to investigate the prevalence of the phenomenon, and, mostly, to identify possible treatment strategies. PMID:28642831

Developing and testing a web-based survey to assess educational needs of palliative and end-of-life health care professionals in Connecticut.

PubMed

Schulman-Green, Dena; Ercolano, Elizabeth; Lacoursiere, Sheryl; Ma, Tony; Lazenby, Mark; McCorkle, Ruth

2011-06-01

Institute of Medicine reports have identified gaps in health care professionals' knowledge of palliative and end-of-life care, recommending improved education. Our purpose was to develop and administer a Web-based survey to identify the educational needs of multidisciplinary health care professionals who provide this care in Connecticut to inform educational initiatives. We developed an 80-item survey and recruited participants through the Internet and in person. Descriptive and correlational statistics were calculated on 602 surveys. Disciplines reported greater agreement on items related to their routine tasks. Reported needs included dealing with cultural and spiritual matters and having supportive resources at work. Focus groups confirmed results that are consistent with National Consensus Project guidelines for quality palliative care and indicate the End-of-Life Nursing Education Consortium modules for education.

Update on the epidemiology of the rheumatic diseases.

PubMed

Gabriel, S E

1996-03-01

Epidemiologic studies continue to enhance our understanding of the rheumatic diseases. Such studies now indicate that 26 million American women are at risk for osteoporotic fractures. Contrary to previous recommendations, the identification and treatment of patients at risk for osteoporosis may be valuable even among very elderly people. Other epidemiologic studies suggest that the incidence of rheumatoid arthritis is decreasing and that it is a more benign disease than previously recognized. Osteoarthritis remains a leading cause of physical and work disability in North America. The roles of occupational physical activity, obesity, and highly competitive (though not low-impact) exercise as risk factors for osteoarthritis continue to be explored. Pharmacoepidemiologic research has recently demonstrated that a policy of prior authorization for prescription of nonsteroidal anti-inflammatory drugs may be highly cost effective. Finally, controlled epidemiologic studies have not confirmed an association between silicone breast implants and connective tissue diseases, a conclusion recently endorsed by the American College of Rheumatology.

Improving student critical thinking skills through a root cause analysis pilot project.

PubMed

Tschannen, Dana; Aebersold, Michelle

2010-08-01

The Essentials of Baccalaureate Education for Professional Nursing Practice provides a framework for building the baccalaureate education for the twenty-first century. One of the exemplars included in the essentials toolkit includes student participation in an actual root cause analysis (RCA) or failure mode effects analysis. To align with this exemplar, faculty at the University of Michigan School of Nursing developed a pilot RCA project for the senior-level Leadership and Management course. While working collaboratively with faculty and unit liaisons at the University Health System, students completed an RCA on a nursing sensitive indicator (pain assessment or plan of care compliance). An overview of the pilot project, including the implementation process, is described. Each team of students identified root causes and recommendations for improvement on clinical and documentation practice within the context of the unit. Feedback from both the unit liaisons and the students confirmed the pilot's success.

Using logic models to enhance the methodological quality of primary health-care interventions: guidance from an intervention to promote nutrition care by general practitioners and practice nurses.

PubMed

Ball, Lauren; Ball, Dianne; Leveritt, Michael; Ray, Sumantra; Collins, Clare; Patterson, Elizabeth; Ambrosini, Gina; Lee, Patricia; Chaboyer, Wendy

2017-04-01

The methodological designs underpinning many primary health-care interventions are not rigorous. Logic models can be used to support intervention planning, implementation and evaluation in the primary health-care setting. Logic models provide a systematic and visual way of facilitating shared understanding of the rationale for the intervention, the planned activities, expected outcomes, evaluation strategy and required resources. This article provides guidance for primary health-care practitioners and researchers on the use of logic models for enhancing methodological rigour of interventions. The article outlines the recommended steps in developing a logic model using the 'NutriCare' intervention as an example. The 'NutriCare' intervention is based in the Australian primary health-care setting and promotes nutrition care by general practitioners and practice nurses. The recommended approach involves canvassing the views of all stakeholders who have valuable and informed opinions about the planned project. The following four targeted, iterative steps are recommended: (1) confirm situation, intervention aim and target population; (2) document expected outcomes and outputs of the intervention; (3) identify and describe assumptions, external factors and inputs; and (4) confirm intervention components. Over a period of 2 months, three primary health-care researchers and one health-services consultant led the collaborative development of the 'NutriCare' logic model. Primary health-care practitioners and researchers are encouraged to develop a logic model when planning interventions to maximise the methodological rigour of studies, confirm that data required to answer the question are captured and ensure that the intervention meets the project goals.

Risk to police officers from biohazards encountered in police work.

PubMed

Trottier, A; Brown, J

1995-06-01

The risk of contracting infectious disease in the course of police work is reviewed. The specific focus is on Acquired Immune Deficiency Syndrome (AIDS), hepatitis and tuberculosis. A review of the relevant literature and an assessment of the biohazard risk specific to police work is provided. The risk of AIDS and hepatitis C is seen to be less than the risk of hepatitis B. For these blood borne diseases, universal precautions are recommended. The application of such precautions to policing is outlined. Immunisation against hepatitis B is recommended. Tuberculosis is seen as a possibly increasing risk. A programme of surveillance is recommended. A review of post-exposure management is provided.

Recommendations for In Vitro and In Vivo Testing of Magnetic Nanoparticle Hyperthermia Combined with Radiation Therapy †

PubMed Central

Costa Lima, Sofia A.; Bouziotis, Penelope; Vranješ-Djurić, Sanja; Efthimiadou, Eleni Κ.; Laurenzana, Anna; Barbosa, Ana Isabel; Jones, Carlton; Jankovic, Drina; Gobbo, Oliviero L.

2018-01-01

Magnetic nanoparticle (MNP)-mediated hyperthermia (MH) coupled with radiation therapy (RT) is a novel approach that has the potential to overcome various practical difficulties encountered in cancer treatment. In this work, we present recommendations for the in vitro and in vivo testing and application of the two treatment techniques. These recommendations were developed by the members of Working Group 3 of COST Action TD 1402: Multifunctional Nanoparticles for Magnetic Hyperthermia and Indirect Radiation Therapy (“Radiomag”). The purpose of the recommendations is not to provide definitive answers and directions but, rather, to outline those tests and considerations that a researcher must address in order to perform in vitro and in vivo studies. The recommendations are divided into 5 parts: (a) in vitro evaluation of MNPs; (b) in vitro evaluation of MNP-cell interactions; (c) in vivo evaluation of the MNPs; (d) MH combined with RT; and (e) pharmacokinetic studies of MNPs. Synthesis and characterization of the MNPs, as well as RT protocols, are beyond the scope of this work. PMID:29734795

Recommendations for In Vitro and In Vivo Testing of Magnetic Nanoparticle Hyperthermia Combined with Radiation Therapy.

PubMed

Spirou, Spiridon V; Costa Lima, Sofia A; Bouziotis, Penelope; Vranješ-Djurić, Sanja; Efthimiadou, Eleni Κ; Laurenzana, Anna; Barbosa, Ana Isabel; Garcia-Alonso, Ignacio; Jones, Carlton; Jankovic, Drina; Gobbo, Oliviero L

2018-05-06

Magnetic nanoparticle (MNP)-mediated hyperthermia (MH) coupled with radiation therapy (RT) is a novel approach that has the potential to overcome various practical difficulties encountered in cancer treatment. In this work, we present recommendations for the in vitro and in vivo testing and application of the two treatment techniques. These recommendations were developed by the members of Working Group 3 of COST Action TD 1402: Multifunctional Nanoparticles for Magnetic Hyperthermia and Indirect Radiation Therapy ("Radiomag"). The purpose of the recommendations is not to provide definitive answers and directions but, rather, to outline those tests and considerations that a researcher must address in order to perform in vitro and in vivo studies. The recommendations are divided into 5 parts: (a) in vitro evaluation of MNPs; (b) in vitro evaluation of MNP-cell interactions; (c) in vivo evaluation of the MNPs; (d) MH combined with RT; and (e) pharmacokinetic studies of MNPs. Synthesis and characterization of the MNPs, as well as RT protocols, are beyond the scope of this work.

Aspergillus antibody detection: diagnostic strategy and technical considerations from the Société Française de Mycologie Médicale (French Society for Medical Mycology) expert committee.

PubMed

Persat, F; Hennequin, C; Gangneux, J P

2017-04-01

Until now, there has been no consensus on the best method for the detection of anti-Aspergillus antibodies, a key diagnostic tool for chronic aspergilloses. To better appreciate the usage of and confidence in these techniques, the Société Française de Mycologie Médicale (French Society for Medical Mycology; SFMM) performed a two-step survey of French experts. First, we administered an initial survey to French labs performing Aspergillus serology to depict usage of the different techniques available for Aspergillus serology. Second, an opinion poll was conducted of 40 experts via an online questionnaire. Each item was rated from 1 to 9 according to the level of agreement. The initial survey revealed that enzyme-linked immunosorbent assay (ELISA) (81%) and immunoelectrophoresis (IEP) (67%) were the most commonly used techniques for screening and confirmation, respectively. The distinction between screening and confirmation techniques was confirmed by the experts (median = 7) with a 44.2% variation coefficient. Only ELISA for screening and IEP and Western blot (WB) for confirmation were clearly considered valuable methods (median ≥8 with variation coefficients less than 30%). The use of a confirmation technique was recommended in the case of a positive result in a compatible clinical context (cystic fibrosis, for example) or during the patient's follow-up. In the case of discordant results between the screening and confirmation techniques, the experts recommended greater confidence in the results obtained with the confirmation technique. All experts emphasized the need to standardize Aspergillus serology techniques and to better define the place of each of them in the diagnosis of aspergillosis. © The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Development of clinical recommendations for progressive return to activity after military mild traumatic brain injury: guidance for rehabilitation providers.

PubMed

McCulloch, Karen L; Goldman, Sarah; Lowe, Lynn; Radomski, Mary Vining; Reynolds, John; Shapiro, Rita; West, Therese A

2015-01-01

Previously published mild traumatic brain injury (mTBI) management guidelines provide very general recommendations to return individuals with mTBI to activity. This lack of specific guidance creates variation in military rehabilitation. The Office of the Army Surgeon General in collaboration with the Defense and Veterans Brain Injury Center, a component center of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, convened an expert working group to review the existing literature and propose clinical recommendations that standardize rehabilitation activity progression following mTBI. A Progressive Activity Working Group consisted of 11 Department of Defense representatives across all service branches, 7 Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury representatives, and 8 academic/research/civilian experts with experience assessing and treating individuals with mTBI for return to activity. An expert working group meeting included the Progressive Activity Working Group and 15 additional subject matter experts. In February 2012, the Progressive Activity Working Group was established to determine the need and purpose of the rehabilitation recommendations. Following literature review, a table was created on the basis of the progression from the Zurich consensus statement on concussion in sport. Issues were identified for discussion with a meeting of the larger expert group during a July 2012 conference. Following development of rehabilitation guidance, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury coordinated a similar process for military primary care providers. End products for rehabilitation and primary care providers include specific recommendations for return to activity after concussion. A 6-stage progression specifies activities in physical, cognitive, and balance/vestibular domains and allows for resumption of activity for those with low-level or preinjury symptom complaints. The clinical recommendations for progressive return to activity represent an important effort to standardize activity progression across functional domains and offer providers duty-specific activities to incorporate into intervention. Recommendations were released in January 2014.

Undocumented Aliens: A Study of Mexican Families.

ERIC Educational Resources Information Center

Salcido, Ramon M.

1979-01-01

The personal histories described here confirm that the primary impetus of undocumented aliens to emigrate is the desire for jobs and better socioeconomic opportunities. Amnesty, aid to families with dependent children, and increased social services are recommended. (Author/BEF)

A Draft Science Management Plan for Returned Samples from Mars: Recommendations from the International Mars Architecture for the Return of Samples (iMARS) Phase II Working Group

NASA Astrophysics Data System (ADS)

Haltigin, T.; Lange, C.; Mugnuolo, R.; Smith, C.

2018-04-01

This paper summarizes the findings and recommendations of the International Mars Architecture for the Return of Samples (iMARS) Phase II Working Group, an international team comprising 38 members from 16 countries and agencies.

"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.

Use of Simulators to Explore Specialty Recommendation for a Palpable Breast Mass

PubMed Central

Laufer, Shlomi; Ray, Rebecca D.; D'Angelo, Anne-Lise D.; Jones, Grace F.; Pugh, Carla M.

2015-01-01

Background The study aim was to evaluate recommendation patterns of different specialties for the work-up of a palpable breast mass using simulated scenarios and clinical breast examination (CBE) models. Methods Study participants were a convenience sample of physicians (n=318) attending annual surgical, family practice and obstetrics and gynecology (OB/GYN) conferences. Two different silicone-based breast models (superficial mass vs chest wall mass) were used to test CBE skills and recommendation patterns (imaging, tissue sampling, and follow-up). Results Participants were more likely to recommend mammography (p<.001) and core biopsy (p<.0001) and less likely to recommend needle aspiration (p<.043) and 1-month follow up (p<.001) for the chest wall mass compared to the superficial mass. Family practitioners were less likely to recommend ultrasound (p<.001) and OB/GYNs were less likely to recommend mammogram (p<.006) across models. Surgeons were more likely to recommend core biopsy and less likely to recommend needle aspiration across models (p<.001) Conclusions Recommendation patterns differed across the two models in line with existing practice guidelines. Additionally, differences in practice patterns between primary care and specialty providers may represent varying clinician capabilities, health care resources, and individual preferences. Our work shows that simulation may be used to track adherence to practice guidelines for breast masses. PMID:26198334

Management of influenza infection in solid-organ transplant recipients: consensus statement of the Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI).

PubMed

López-Medrano, Francisco; Cordero, Elisa; Gavaldá, Joan; Cruzado, Josep M; Marcos, M Ángeles; Pérez-Romero, Pilar; Sabé, Nuria; Gómez-Bravo, Miguel Ángel; Delgado, Juan Francisco; Cabral, Evelyn; Carratalá, Jordi

2013-10-01

Solid organ transplant (SOT) recipients are at greater risk than the general population for complications and mortality from influenza infection. Researchers and clinicians with experience in SOT infections have developed this consensus document in collaboration with several Spanish scientific societies and study networks related to transplant management. We conducted a systematic review to assess the management and prevention of influenza infection in SOT recipients. Evidence levels based on the available literature are given for each recommendation. This article was written in accordance with international recommendations on consensus statements and the recommendations of the Appraisal of Guidelines for Research and Evaluation II (AGREE II). Recommendations are provided on the procurement of organs from donors with suspected or confirmed influenza infection. We highlight the importance of the possibility of influenza infection in any SOT recipient presenting upper or lower respiratory symptoms, including pneumonia. The importance of early antiviral treatment of SOT recipients with suspected or confirmed influenza infection and the necessity of annual influenza vaccination are emphasized. The microbiological techniques for diagnosis of influenza infection are reviewed. Guidelines for the use of antiviral prophylaxis in inpatients and outpatients are provided. Recommendations for household contacts of SOT recipients with influenza infection and health care workers in close contact with transplant patients are also included. Finally antiviral dose adjustment guidelines are presented for cases of impaired renal function and for pediatric populations. The latest scientific information available regarding influenza infection in the context of SOT is incorporated into this document. Copyright © 2013 Elsevier España, S.L. All rights reserved.

The Use of Ancillary Stains in the Diagnosis of Barrett Esophagus and Barrett Esophagus-associated Dysplasia: Recommendations From the Rodger C. Haggitt Gastrointestinal Pathology Society.

PubMed

Srivastava, Amitabh; Appelman, Henry; Goldsmith, Jeffrey D; Davison, Jon M; Hart, John; Krasinskas, Alyssa M

2017-05-01

Barrett esophagus (BE) is a known risk factor for the development of esophageal adenocarcinoma. Pathologists play a critical role in confirming the diagnosis of BE and BE-associated dysplasia. As these diagnoses are not always straightforward on routine hematoxylin and eosin-stained slides, numerous ancillary stains have been used in an attempt to help pathologists confirm the diagnosis. On the basis of an in-depth review of the literature, the Rodger C. Haggitt Gastrointestinal Pathology Society provides recommendations regarding the use of ancillary stains in the diagnosis of BE and BE-associated dysplasia. Because goblet cells are almost always identifiable on routine hematoxylin and eosin-stained sections, there is insufficient evidence to justify reflexive use of Alcian blue (at pH 2.5) and/or periodic-acid Schiff stains on all esophageal biopsies to diagnose BE. In addition, the use of mucin glycoprotein immunostains and markers of intestinal phenotype (CDX2, Das-1, villin, Hep Par 1, and SOX9) are not indicated to aid in the diagnosis of BE at this time. A diagnosis of dysplasia in BE remains a morphologic diagnosis, and hence, ancillary stains are not recommended for diagnosing dysplasia. Although p53 is a promising marker for identifying high-risk BE patients, it is not recommended for routine use at present; additional studies are needed to address questions regarding case selection, interpretation, integration with morphologic diagnosis, and impact on clinical outcome. We hope that this review and our recommendations will provide helpful information to pathologists, gastroenterologists, and others involved in the evaluation of patients with BE and BE-associated dysplasia.

Exploring Selective Exposure and Confirmation Bias as Processes Underlying Employee Work Happiness: An Intervention Study.

PubMed

Williams, Paige; Kern, Margaret L; Waters, Lea

2016-01-01

Employee psychological capital (PsyCap), perceptions of organizational virtue (OV), and work happiness have been shown to be associated within and over time. This study examines selective exposure and confirmation bias as potential processes underlying PsyCap, OV, and work happiness associations. As part of a quasi-experimental study design, school staff (N = 69) completed surveys at three time points. After the first assessment, some staff (n = 51) completed a positive psychology training intervention. Results of descriptive statistics, correlation, and regression analyses on the intervention group provide some support for selective exposure and confirmation bias as explanatory mechanisms. In focusing on the processes through which employee attitudes may influence work happiness this study advances theoretical understanding, specifically of selective exposure and confirmation bias in a field study context.

Laboratory-acquired vaccinia virus infection in a recently immunized person--Massachusetts, 2013.

PubMed

Hsu, Christopher H; Farland, Julien; Winters, Thomas; Gunn, Julia; Caron, Donna; Evans, Jennifer; Osadebe, Lynda; Bethune, Leon; McCollum, Andrea M; Patel, Nishi; Wilkins, Kimberly; Davidson, Whitni; Petersen, Brett; Barry, M Anita

2015-05-01

On November 26, 2013, the CDC poxvirus laboratory was notified by the Boston Public Health Commission (BPHC) of an inadvertent inoculation of a recently vaccinated (ACAM2000 smallpox vaccine) laboratory worker with wild type vaccinia virus (VACV) Western Reserve. A joint investigation by CDC and BPHC confirmed orthopoxvirus infection in the worker, who had reported a needle stick in his thumb while inoculating a mouse with VACV. He experienced a non-tender, red rash on his arm, diagnosed at a local emergency department as cellulitis. He subsequently developed a necrotic lesion on his thumb, diagnosed as VACV infection. Three weeks after the injury, the thumb lesion was surgically debrided and at 2 months post-injury, the skin lesion had resolved. The investigation confirmed that the infection was the first reported VACV infection in the United States in a laboratory worker vaccinated according to the Advisory Committee on Immunization Practices (ACIP) recommendations. The incident prompted the academic institution to outline biosafety measures for working with biologic agents, such as biosafety training of laboratory personnel, vaccination (if appropriate), and steps in incident reporting. Though vaccination has been shown to be an effective measure in protecting personnel in the laboratory setting, this case report underscores the importance of proper safety measures and incident reporting.

Diagnosis of Richter transformation in chronic lymphocytic leukemia: histology tips the scales.

PubMed

Federmann, Birgit; Mueller, Martin R; Steinhilber, Julia; Horger, Marius S; Fend, Falko

2018-06-12

Development of diffuse large B-cell lymphoma in chronic lymphocytic leukemia, so-called Richter transformation (RT), occurs in 2-5% of patients and is associated with poor outcome. The clinical features of RT are fairly non-specific and unable to discriminate transformation from other mimics. In case of clinically suspected RT, a CT/MRT is recommended, and FDG-PET/CT may help to select the site of biopsy. Radiological features suggestive of RT have been defined, but there are only limited data about their predictive value, and histological confirmation is still considered the gold standard for RT diagnosis. We retrospectively analyzed 34 patients with clinically suspected RT and available radiological and histological data. A histopathological diagnosis of RT with concordant clinical and radiological findings was obtained in 13 patients. In 18 patients, CT did not show features of transformation, concordant with lack of RT in the biopsy. Of interest, a distinct lymphoma other than DLBCL was identified in two of these cases. A false-positive radiological diagnosis of RT was rendered in two patients, including a case of Herpes simplex virus lymphadenitis. In conclusion, our findings confirm the central role of tissue biopsy in the diagnostic work up in case of clinically suspected RT.

An item-oriented recommendation algorithm on cold-start problem

NASA Astrophysics Data System (ADS)

Qiu, Tian; Chen, Guang; Zhang, Zi-Ke; Zhou, Tao

2011-09-01

Based on a hybrid algorithm incorporating the heat conduction and probability spreading processes (Proc. Natl. Acad. Sci. U.S.A., 107 (2010) 4511), in this letter, we propose an improved method by introducing an item-oriented function, focusing on solving the dilemma of the recommendation accuracy between the cold and popular items. Differently from previous works, the present algorithm does not require any additional information (e.g., tags). Further experimental results obtained in three real datasets, RYM, Netflix and MovieLens, show that, compared with the original hybrid method, the proposed algorithm significantly enhances the recommendation accuracy of the cold items, while it keeps the recommendation accuracy of the overall and the popular items. This work might shed some light on both understanding and designing effective methods for long-tailed online applications of recommender systems.

ASCCP Colposcopy Standards: Colposcopy Quality Improvement Recommendations for the United States.

PubMed

Mayeaux, Edward J; Novetsky, Akiva P; Chelmow, David; Garcia, Francisco; Choma, Kim; Liu, Angela H; Papasozomenos, Theognosia; Einstein, Mark H; Massad, L Stewart; Wentzensen, Nicolas; Waxman, Alan G; Conageski, Christine; Khan, Michelle J; Huh, Warner K

2017-10-01

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. The ASCCP Quality Improvement Working Group developed evidence-based guidelines to promote best practices and reduce errors in colposcopy and recommended indicators to measure colposcopy quality. The working group performed a systematic review of existing major society and national guidelines and quality indicators. An initial list of potential quality indicators was developed and refined through successive iterative discussions, and draft quality indicators were proposed. The draft recommendations were then reviewed and commented on by the entire Colposcopy Standards Committee, posted online for public comment, and presented at the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered, additional adjustments made, and the final recommendations approved by the entire Task Force. Eleven quality indicators were selected spanning documentation, biopsy protocols, and time intervals between index screening tests and completion of diagnostic evaluation. The proposed quality indicators are intended to serve as a starting point for quality improvement in colposcopy at a time when colposcopy volume is decreasing and individual procedures are becoming technically more difficult to perform.

GPS Integrity Channel RTCA Working Group recommendations

NASA Astrophysics Data System (ADS)

Kalafus, Rudolph M.

Recommendations made by a working group established by the Radio Technical Commission for Aeronautics are presented for the design of a wide-area broadcast service to provide indications on the status of GPS satellites. The integrity channel requirements and operational goals are outlined. Six integrity channel system concepts are considered and system design and time-to-alarm considerations are examined. The recommended system includes the broadcast of a coarse range measurement for each satellite which will enable the on-board GPS receiver to determine whether or not the navigation accuracy is within prescribed limits.

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.

Progress Report on the Airborne Metadata and Time Series Working Groups of the 2016 ESDSWG

NASA Astrophysics Data System (ADS)

Evans, K. D.; Northup, E. A.; Chen, G.; Conover, H.; Ames, D. P.; Teng, W. L.; Olding, S. W.; Krotkov, N. A.

2016-12-01

NASA's Earth Science Data Systems Working Groups (ESDSWG) was created over 10 years ago. The role of the ESDSWG is to make recommendations relevant to NASA's Earth science data systems from users' experiences. Each group works independently focusing on a unique topic. Participation in ESDSWG groups comes from a variety of NASA-funded science and technology projects, including MEaSUREs and ROSS. Participants include NASA information technology experts, affiliated contractor staff and other interested community members from academia and industry. Recommendations from the ESDSWG groups will enhance NASA's efforts to develop long term data products. The Airborne Metadata Working Group is evaluating the suitability of the current Common Metadata Repository (CMR) and Unified Metadata Model (UMM) for airborne data sets and to develop new recommendations as necessary. The overarching goal is to enhance the usability, interoperability, discovery and distribution of airborne observational data sets. This will be done by assessing the suitability (gaps) of the current UMM model for airborne data using lessons learned from current and past field campaigns, listening to user needs and community recommendations and assessing the suitability of ISO metadata and other standards to fill the gaps. The Time Series Working Group (TSWG) is a continuation of the 2015 Time Series/WaterML2 Working Group. The TSWG is using a case study-driven approach to test the new Open Geospatial Consortium (OGC) TimeseriesML standard to determine any deficiencies with respect to its ability to fully describe and encode NASA earth observation-derived time series data. To do this, the time series working group is engaging with the OGC TimeseriesML Standards Working Group (SWG) regarding unsatisfied needs and possible solutions. The effort will end with the drafting of an OGC Engineering Report based on the use cases and interactions with the OGC TimeseriesML SWG. Progress towards finalizing recommendations will be presented at the meeting.

Annual report to the Chairman and Ranking Minority Members, House and Senate Committees on Appropriations. Status of open recommendations: Improving operations of federal departments and agencies

NASA Technical Reports Server (NTRS)

1995-01-01

Each year, GAO's work contributes to many legislative and executive branch actions that result in significant financial savings and other improvements in government operations. Some, but not all, are identified through GAO's system for periodically following up to determine the status of actions taken on the recommendations made in its audit and evaluation reports. In fiscal year 1994, GAO made 1,450 recommendations, but, more importantly, about 4,400 GAO recommendations made over the past 5 years have been implemented. This report includes summary information on the status of all GAO recommendations that have not been fully implemented and highlights some of the key ones. This information should help congressional and agency leaders prepare for upcoming appropriations and oversight activities and stimulate further actions to achieve the desired improvements in government operations. In addition to including printed issue area summaries highlighting the ipact of GAO's work and the key open recommendations, this volume includes a set of computer diskettes with details on all open recommendations.

What Work of Literature Do You Recommend for Its Use of a Strong Oral Tradition?

ERIC Educational Resources Information Center

Adams, Cindy S.; Lujan, Alfredo Celedon; Schulze, Patricia

2003-01-01

Presents three teachers' recommendations for works of literature that use a strong oral tradition. Discusses each of the teacher selections: "Harry Potter and the Sorcerer's Stone (J.K. Rowling); "Cuentos: Tales from the Hispanic Southwest" (compiled by Juan B. Rael); and "The Way to Rainy Mountain" (N. Scott Momaday). (SG)

Online Educators' Recommendations for Teaching Online: Crowdsourcing in Action

ERIC Educational Resources Information Center

Dunlap, Joanna C.; Lowenthal, Patrick R.

2018-01-01

Over the years, online educators have learned a great deal about what works and does not work when designing and facilitating online courses. During the past few years, we have used crowdsourcing to invite experienced online educators to share their recommendations for teaching online. In this article, we describe our use of crowdsourcing to…

Rockford Public Library's Circulation Services: A Work Flow Analysis and Spacial Analysis Study with Recommendations and Comments.

ERIC Educational Resources Information Center

Titus, Elizabeth; Grant, Wallace

The purpose of this project was to perform an analysis of the Rockford Public Library (Illinois) circulation services department and provide recommendations leading to customer service improvement, better space utilization, and improved departmental work flow. Based on an analysis of input from individual interviews with staff, review of…

Work and Childcare: Implementing the Council Recommendation on Childcare. A Guide to Good Practice. Social Europe Supplement.

ERIC Educational Resources Information Center

Commission des Communautes Europeennes (Luxembourg).

In 1992, the Council of European Community Member States adopted the Childcare Recommendation, describing the elements of effective childcare systems, to assist in the development of public policy to help parents reconcile work and family roles. This guide provides detailed suggestions for implementing these elements. Following an introduction…

Consensus document on osteoporosis in males.

PubMed

Varsavsky, Mariela; Romero Muñoz, Manuel; Ávila Rubio, Verónica; Becerra, Antonio; García Martín, Antonia; Martínez Díaz-Guerra, Guillermo; Rozas Moreno, Pedro; Jódar Gimeno, Esteban; Muñoz Torres, Manuel

2018-03-01

To provide practical recommendations to assess and treat osteoporosis in males. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in Medline (PubMed) using the following associated terms: «osteoporosis», «men», «fractures», «bone mineral density», «treatment», «hypogonadism», and «prostate cancer». Papers in English and Spanish with publication date before 30 August 2017 were included. Current evidence for each disease was reviewed by 2group members. Finally, recommendations were discussed in a meeting of the working group. The document provides evidence-based practical recommendations for diagnosis, assessment, and management of osteoporosis in men and special situations such as hypogonadism and prostate cancer. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

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.

Progress report of the IAU Commission 4 Working Group on Ephemeris Access and the comparison of high accuracy planetary ephemerides

NASA Astrophysics Data System (ADS)

Hilton, J. L.

2012-12-01

In September 2010 IAU Commission 4, Ephemerides, organized a working group to provide a recommendation for a preferred format for solar system ephemerides. The purpose of this recommendation is to provide easy access to a wide range of solar system ephemerides for users. The working group, chaired by Hilton, includes representatives from each of the major planetary ephemeris groups and representatives from the satellite and asteroid ephemeris communities. The working group has tentatively decided to recommend the SPK format developed by the Jet Propulsion Laboratory's Navigation and Ancillary Information Facility for use with its SPICE Toolkit. Certain details, however, must still be resolved before a final recommendation is made by the working group. An update is also provided to ongoing analysis comparing the three high accuracy planetary ephemerides, DE421, EPM2008, and INPOP10a. The principal topics of this update are: replacing the INPOP08 ephemeris with the INPOP10a ephemeris, making the comparisons with respect to DE421 rather than DE405, and comparing the TT - TDB values determined in EPM2008 and INPOP10a with the Fairhead & Bretagnon (1990, A&A, 229, 240) model used in DE421 as T_eph.

Soft Regulation with Crowd Recommendation: Coordinating Self-Interested Agents in Sociotechnical Systems under Imperfect Information.

PubMed

Luo, Yu; Iyengar, Garud; Venkatasubramanian, Venkat

2016-01-01

Regulating emerging industries is challenging, even controversial at times. Under-regulation can result in safety threats to plant personnel, surrounding communities, and the environment. Over-regulation may hinder innovation, progress, and economic growth. Since one typically has limited understanding of, and experience with, the novel technology in practice, it is difficult to accomplish a properly balanced regulation. In this work, we propose a control and coordination policy called soft regulation that attempts to strike the right balance and create a collective learning environment. In soft regulation mechanism, individual agents can accept, reject, or partially accept the regulator's recommendation. This non-intrusive coordination does not interrupt normal operations. The extent to which an agent accepts the recommendation is mediated by a confidence level (from 0 to 100%). Among all possible recommendation methods, we investigate two in particular: the best recommendation wherein the regulator is completely informed and the crowd recommendation wherein the regulator collects the crowd's average and recommends that value. We show by analysis and simulations that soft regulation with crowd recommendation performs well. It converges to optimum, and is as good as the best recommendation for a wide range of confidence levels. This work sheds a new theoretical perspective on the concept of the wisdom of crowds.

Soft Regulation with Crowd Recommendation: Coordinating Self-Interested Agents in Sociotechnical Systems under Imperfect Information

PubMed Central

2016-01-01

Regulating emerging industries is challenging, even controversial at times. Under-regulation can result in safety threats to plant personnel, surrounding communities, and the environment. Over-regulation may hinder innovation, progress, and economic growth. Since one typically has limited understanding of, and experience with, the novel technology in practice, it is difficult to accomplish a properly balanced regulation. In this work, we propose a control and coordination policy called soft regulation that attempts to strike the right balance and create a collective learning environment. In soft regulation mechanism, individual agents can accept, reject, or partially accept the regulator’s recommendation. This non-intrusive coordination does not interrupt normal operations. The extent to which an agent accepts the recommendation is mediated by a confidence level (from 0 to 100%). Among all possible recommendation methods, we investigate two in particular: the best recommendation wherein the regulator is completely informed and the crowd recommendation wherein the regulator collects the crowd’s average and recommends that value. We show by analysis and simulations that soft regulation with crowd recommendation performs well. It converges to optimum, and is as good as the best recommendation for a wide range of confidence levels. This work sheds a new theoretical perspective on the concept of the wisdom of crowds. PMID:26977699

Exploring Selective Exposure and Confirmation Bias as Processes Underlying Employee Work Happiness: An Intervention Study

PubMed Central

Williams, Paige; Kern, Margaret L.; Waters, Lea

2016-01-01

Employee psychological capital (PsyCap), perceptions of organizational virtue (OV), and work happiness have been shown to be associated within and over time. This study examines selective exposure and confirmation bias as potential processes underlying PsyCap, OV, and work happiness associations. As part of a quasi-experimental study design, school staff (N = 69) completed surveys at three time points. After the first assessment, some staff (n = 51) completed a positive psychology training intervention. Results of descriptive statistics, correlation, and regression analyses on the intervention group provide some support for selective exposure and confirmation bias as explanatory mechanisms. In focusing on the processes through which employee attitudes may influence work happiness this study advances theoretical understanding, specifically of selective exposure and confirmation bias in a field study context. PMID:27378978

[Adherence to the recommendations in respiratory rehabilitation of the British Thoracic Society in patients with cystic fibrosis: a study of Colombian physiotherapists].

PubMed

Duran-Palomino, Diana; Chapetón, Olga; Martínez-Santa, Jaime; Campos-Rodríguez, Adriana; Ramírez-Vélez, Robinson

2013-04-01

The aim was to evaluate compliance with the recommendations in respiratory rehabilitation (ReR), raised by the British Thoracic Society (BTS) in patients with cystic fibrosis. A cross-sectional study was conducted in 224 Colombian physiotherapists to identify interventions and components of ReR programs as recommended by the BTS. Interventions with high level of evidence (Grade A) such as: Bronchial Hygiene Therapy (54.0%), and Active Cycle of Breathing Techniques (35.3%) were identified. However, high percentage of physiotherapists practiced interventions with lower grade of recommendation (Grade D) such as: hypertonic saline and bronchodilator to prevent bronchospasm (33.9%), and using manual therapy techniques and thoracic mobility exercises (38.4%) to correct postural and breathing problems. In conclusions we confirm important differences in therapeutic assistant components of the ReR raised by the BTS for patients with cystic fibrosis.

PERSON-Personalized Expert Recommendation System for Optimized Nutrition.

PubMed

Chen, Chih-Han; Karvela, Maria; Sohbati, Mohammadreza; Shinawatra, Thaksin; Toumazou, Christofer

2018-02-01

The rise of personalized diets is due to the emergence of nutrigenetics and genetic tests services. However, the recommendation system is far from mature to provide personalized food suggestion to consumers for daily usage. The main barrier of connecting genetic information to personalized diets is the complexity of data and the scalability of the applied systems. Aiming to cross such barriers and provide direct applications, a personalized expert recommendation system for optimized nutrition is introduced in this paper, which performs direct to consumer personalized grocery product filtering and recommendation. Deep learning neural network model is applied to achieve automatic product categorization. The ability of scaling with unknown new data is achieved through the generalized representation of word embedding. Furthermore, the categorized products are filtered with a model based on individual genetic data with associated phenotypic information and a case study with databases from three different sources is carried out to confirm the system.

Dangerous mixture of household detergents in an old-style toilet: a case report with simulation experiments of the working environment and warning of potential hazard relevant to the general environment.

PubMed

Minami, M; Katsumata, M; Miyake, K; Inagaki, H; Fan, X H; Kubota, H; Yamano, Y; Kimura, O

1992-01-01

A housewife cleaned toilet porcelain connected directly to a sewage storage tank with a mixture of cleaning agents; sodium hypochlorite (NaOCl) and hydrochloric acid (HCl) solutions. She complained of insomnia on the night after cleaning and suffered from severe metabolic acidosis with extremely low blood pH, PCO2 and bicarbonate values. She recovered from the acidosis after bicarbonate transfusion, plasmapheresis and plasma exchange. Permanent blindness ensued, however, from the third day after the event. These clinical symptoms suggested that the toxic substances responsible were chloramine and methyl chloride. Their generation was confirmed by in-vitro experiments, mixing NaOCl, HCl and pooled urine from normal people. In the simulation, the methyl chloride level far exceeded (100,000 ppm) the maximal allowable concentration recommended (ca 400 ppm) by the American Conference of Governmental Industrial Hygienists (ACGIH). Chloramine's toxic actions were confirmed using purified enzyme assay, and the inhibition of carbonic anhydrase and aldehyde dehydrogenase and the enhancement of superoxide dismutase activity were confirmed in neutral pH. The patient's clinical symptoms suggested that insomnia and permanent blindness seemed to be partly ascribable to chronic repetitive exposure to methyl chloride; catching a cold, drug intake and alcohol intake, in addition, precipitated the patient's visual loss. The possibility of this kind of intoxication with such a mixture of agents may lie latent in any situation where sewage or garbage are exposed to the open air.

National Athletic Trainers' Association position statement: environmental cold injuries.

PubMed

Cappaert, Thomas A; Stone, Jennifer A; Castellani, John W; Krause, Bentley Andrew; Smith, Daniel; Stephens, Bradford A

2008-01-01

To present recommendations for the prevention, recognition, and treatment of environmental cold injuries. Individuals engaged in sport-related or work-related physical activity in cold, wet, or windy conditions are at risk for environmental cold injuries. An understanding of the physiology and pathophysiology, risk management, recognition, and immediate care of environmental cold injuries is an essential skill for certified athletic trainers and other health care providers working with individuals at risk. These recommendations are intended to provide certified athletic trainers and others participating in athletic health care with the specific knowledge and problem-solving skills needed to address environmental cold injuries. Each recommendation has been graded (A, B, or C) according to the Strength of Recommendation Taxonomy criterion scale.

Laboratory Medicine Best Practice Guideline: Vitamins A, E and the Carotenoids in Blood

PubMed Central

Greaves, Ronda F; Woollard, Gerald A; Hoad, Kirsten E; Walmsley, Trevor A; Johnson, Lambro A; Briscoe, Scott; Koetsier, Sabrina; Harrower, Tamantha; Gill, Janice P

2014-01-01

Despite apparent method similarities between laboratories there appear to be confounding factors inhibiting uniform reporting and standardisation of vitamin assays. The Australasian Association of Clinical Biochemists (AACB) Vitamins Working Party, in conjunction with The Royal College of Pathologists of Australasia Quality Assurance Programs, has formulated a guideline to improve performance, reproducibility and accuracy of fat-soluble vitamin results. The aim of the guideline is to identify critical pre-analytical, analytical and post-analytical components of the analysis of vitamins A, E and carotenoids in blood to promote best practice and harmonisation. This best practice guideline has been developed with reference to the Centers for Disease Control and Prevention (CDC) “Laboratory Medicine Best Practices: Developing an Evidence-Based Review and Evaluation Process”. The CDC document cites an evaluation framework for generating best practice recommendations that are specific to laboratory medicine. These 50 recommendations proposed herein, were generated from a comprehensive literature search and the extensive combined experience of the AACB Vitamins Working Party members. They were formulated based on comparison between an impact assessment rating and strength of evidence and were classified as either: (1) strongly recommend, (2) recommend, (3) no recommendation for or against, or (4) recommend against. These best practice recommendations represent the consensus views, in association with peer reviewed evidence of the AACB Vitamins Working Party, towards best practice for the collection, analysis and interpretation of vitamins A, E and carotenoids in blood. PMID:25210208

A pan-European ring trial to validate an International Standard for detection of Vibrio cholerae, Vibrio parahaemolyticus and Vibrio vulnificus in seafoods.

PubMed

Hartnell, R E; Stockley, L; Keay, W; Rosec, J-P; Hervio-Heath, D; Van den Berg, H; Leoni, F; Ottaviani, D; Henigman, U; Denayer, S; Serbruyns, B; Georgsson, F; Krumova-Valcheva, G; Gyurova, E; Blanco, C; Copin, S; Strauch, E; Wieczorek, K; Lopatek, M; Britova, A; Hardouin, G; Lombard, B; In't Veld, P; Leclercq, A; Baker-Austin, C

2018-02-10

Globally, vibrios represent an important and well-established group of bacterial foodborne pathogens. The European Commission (EC) mandated the Comite de European Normalisation (CEN) to undertake work to provide validation data for 15 methods in microbiology to support EC legislation. As part of this mandated work programme, merging of ISO/TS 21872-1:2007, which specifies a horizontal method for the detection of V. parahaemolyticus and V. cholerae, and ISO/TS 21872-2:2007, a similar horizontal method for the detection of potentially pathogenic vibrios other than V. cholerae and V. parahaemolyticus was proposed. Both parts of ISO/TS 21872 utilized classical culture-based isolation techniques coupled with biochemical confirmation steps. The work also considered simplification of the biochemical confirmation steps. In addition, because of advances in molecular based methods for identification of human pathogenic Vibrio spp. classical and real-time PCR options were also included within the scope of the validation. These considerations formed the basis of a multi-laboratory validation study with the aim of improving the precision of this ISO technical specification and providing a single ISO standard method to enable detection of these important foodborne Vibrio spp.. To achieve this aim, an international validation study involving 13 laboratories from 9 countries in Europe was conducted in 2013. The results of this validation have enabled integration of the two existing technical specifications targeting the detection of the major foodborne Vibrio spp., simplification of the suite of recommended biochemical identification tests and the introduction of molecular procedures that provide both species level identification and discrimination of putatively pathogenic strains of V. parahaemolyticus by the determination of the presence of theromostable direct and direct related haemolysins. The method performance characteristics generated in this have been included in revised international standard, ISO 21872:2017, published in July 2017. Copyright © 2018. Published by Elsevier B.V.

[Normocalcemic primary hyperparathyroidism: recommendations for management and follow-up].

PubMed

Martínez Díaz-Guerra, Guillermo; Jódar Gimeno, Esteban; Reyes García, Rebeca; Gómez Sáez, José Manuel; Muñoz-Torres, Manuel

2013-10-01

To provide practical recommendations for evaluation and follow-up of patients with normocalcemic primary hyperparathyroidism. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. A systematic search was made in MEDLINE (PubMed), using the terms normocalcemic primary hyperparathyroidism and primary hyperparathyroidism, for articles in English published before 22 November 2012. Literature was reviewed by 2 members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology, and after development of recommendations, the manuscript was reviewed by all other members of the Group, and their suggestions were incorporated. The document provides practical recommendations for evaluation and follow-up of patients with normocalcemic primary hyperparathyroidism. There is however little evidence available about different aspects of this disease, mainly progression rate and clinical impact. More data are therefore needed before definite recommendations may be made. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

Recommendations on the effect of antidiabetic drugs in bone.

PubMed

Rozas-Moreno, Pedro; Reyes-García, Rebeca; Jódar-Gimeno, Esteban; Varsavsky, Mariela; Luque-Fernández, Inés; Cortés-Berdonces, María; Muñoz-Torres, Manuel

2017-03-01

To provide recommendations on the effect of antidiabetic drugs on bone fragility to help select the most adequate antidiabetic treatment, especially in diabetic patients with high risk of fracture. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. The GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) was used to establish both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the following terms associated to the name of each antidiabetic drug: AND "osteoporosis", "fractures", "bone mineral density", "bone markers", "calciotropic hormones". Papers in English with publication date before 30 April 2016 were reviewed. Recommendations were jointly discussed by the Working Group. The document summaries the data on the potential effects of antidiabetic drugs on bone metabolism and fracture risk. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Professionals who sexually offend: evaluation procedures and preliminary findings.

PubMed

Levine, S B; Risen, C B; Althof, S E

1994-01-01

Methods and results of the psychiatric evaluations of 31 professionals who have been accused of sexually inappropriate behaviors within their work context are presented. Eight types of professionals were evaluated; the majority were clergy, physicians, and teachers. Paraphilia was diagnosed in 26%, a nonparaphilic sexual compulsive syndrome in another 29%, and some form of character disorder in 58%. Seven professionals had offended six or more times. The ethical failures of the professionals were diverse and could not simply be explained by psychiatric diagnoses. Approximately half of the professionals were thought to be safe to return to work, often with a recommendation for psychotherapy and monitoring of their professional activities. A recommendation to no longer practice their professional roles was given for 47% of those evaluated, and the referring agency followed through with the recommendation. Outpatient psychotherapy was recommended for 84% of the sample. Psychotropic medications were occasionally recommended.

75 FR 47780 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

...; observer coverage and portside sampling; and measures to require electronic monitoring. 2. Provide AP... follows: 1. Review and provide AP recommendations regarding catch monitoring alternatives under...: quota monitoring and reporting; measures to confirm the accuracy of self-reporting; catch monitoring and...

Towards a coherent global framework for health financing: recommendations and recent developments.

PubMed

Ottersen, Trygve; Elovainio, Riku; Evans, David B; McCoy, David; Mcintyre, Di; Meheus, Filip; Moon, Suerie; Ooms, Gorik; Røttingen, John-Arne

2017-04-01

The articles in this special issue have demonstrated how unprecedented transitions have come with both challenges and opportunities for health financing. Against the background of these challenges and opportunities, the Working Group on Health Financing at the Chatham House Centre on Global Health Security laid out, in 2014, a set of policy responses encapsulated in 20 recommendations for how to make progress towards a coherent global framework for health financing. These recommendations pertain to domestic financing of national health systems, global public goods for health, external financing for national health systems and the cross-cutting issues of accountability and agreement on a new global framework. Since the Working Group concluded its work, multiple events have reinforced the group's recommendations. Among these are the agreement on the Addis Ababa Action Agenda, the adoption of the Sustainable Development Goals, the outbreak of Ebola in West Africa and the release of the Panama Papers. These events also represent new stepping stones towards a new global framework.

Cross-Cultural Adaptation, Reliability and Validity of the Danish Version of the Readiness for Return to Work Instrument.

PubMed

Stapelfeldt, Christina Malmose; Momsen, Anne-Mette Hedeager; Lund, Thomas; Grønborg, Therese Koops; Hogg-Johnson, Sheilah; Jensen, Chris; Skakon, Janne; Labriola, Merete

2018-06-06

The objective of the present study was to translate and validate the Canadian Readiness for Return To Work instrument (RRTW-CA) into a Danish version (RRTWDK) by testing its test-retest and internal consistency reliability and its structural and construct validity. Cross-cultural adaptation of the six-staged RRTW-CA instrument was performed in a standardised, systematic five-step-procedure; forward translation, panel synthesis of the translation, back translation, consolidation and revision by researchers, and finally pre-testing. This RRTW-DK beta-version was tested for its psychometric properties by intra-class correlation coefficient and standard error of measurement (n = 114), Cronbach's alpha (n = 471), confirmatory factor analyses (n = 373), and Spearman's rank correlation coefficient (n = 436) in sickness beneficiaries from a municipal employment agency and hospital wards. The original RRTW-CA stage structure could not be confirmed in the RRTWDK. The psychometric properties were thus inconclusive. The RRTW-DK cannot be recommended for use in the current version as the RRTW construct is questionable. The RRTW construct needs further exploration, preferably in a population that is homogeneous with regard to cause of sickness, disability duration and age.

Participatory design of an integrated information system design to support public health nurses and nurse managers.

PubMed

Reeder, Blaine; Hills, Rebecca A; Turner, Anne M; Demiris, George

2014-01-01

The objectives of the study were to use persona-driven and scenario-based design methods to create a conceptual information system design to support public health nursing. We enrolled 19 participants from two local health departments to conduct an information needs assessment, create a conceptual design, and conduct a preliminary design validation. Interviews and thematic analysis were used to characterize information needs and solicit design recommendations from participants. Personas were constructed from participant background information, and scenario-based design was used to create a conceptual information system design. Two focus groups were conducted as a first iteration validation of information needs, personas, and scenarios. Eighty-nine information needs were identified. Two personas and 89 scenarios were created. Public health nurses and nurse managers confirmed the accuracy of information needs, personas, scenarios, and the perceived usefulness of proposed features of the conceptual design. Design artifacts were modified based on focus group results. Persona-driven design and scenario-based design are feasible methods to design for common work activities in different local health departments. Public health nurses and nurse managers should be engaged in the design of systems that support their work. © 2013 Wiley Periodicals, Inc.

Participatory Design of an Integrated Information System Design to Support Public Health Nurses and Nurse Managers

PubMed Central

Reeder, Blaine; Hills, Rebecca A.; Turner, Anne M.; Demiris, George

2014-01-01

Objectives The objectives of the study were to use persona-driven and scenario-based design methods to create a conceptual information system design to support public health nursing. Design and Sample We enrolled 19 participants from two local health departments to conduct an information needs assessment, create a conceptual design, and conduct a preliminary design validation. Measures Interviews and thematic analysis were used to characterize information needs and solicit design recommendations from participants. Personas were constructed from participant background information, and scenario-based design was used to create a conceptual information system design. Two focus groups were conducted as a first iteration validation of information needs, personas, and scenarios. Results Eighty-nine information needs were identified. Two personas and 89 scenarios were created. Public health nurses and nurse managers confirmed the accuracy of information needs, personas, scenarios, and the perceived usefulness of proposed features of the conceptual design. Design artifacts were modified based on focus group results. Conclusion Persona-driven design and scenario-based design are feasible methods to design for common work activities in different local health departments. Public health nurses and nurse managers should be engaged in the design of systems that support their work. PMID:24117760

Consensus on the leadership of hospital CEOs and its impact on the participation of physicians in improvement projects.

PubMed

Dückers, Michel L A; Stegeman, Inge; Spreeuwenberg, Peter; Wagner, Cordula; Sanders, Karin; Groenewegen, Peter P

2009-08-01

The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation, between the extent to which physicians notice their CEOs stimulate improvement initiatives and the number of projects joined by physicians, is moderated by the consensus among physicians working in the same hospital. Multilevel analyses are applied on data of 286 physicians from eight hospitals to: (1) estimate whether participation depends on noticing if CEOs stimulate improvement, (2) test if an individual's participation differs when more colleagues have the same opinion (effect modification). Significant moderator effects are found. The participation of physicians, noticing that CEOs stimulate improvement is higher when more colleagues share this opinion. For physicians not knowing whether improvement is encouraged, higher consensus coincides with lower participation. Project involvement of physicians depends on their consensus about encouragement by CEOs. This confirms the importance of strategic leaders in dissemination programs. Further research is recommended into causes of CEO leadership visibility and methods to strengthen leadership climate.

Health promotores' perceptions of their communities' health needs, knowledge, and resource needs in rural Nicaragua.

PubMed

McDermott-Levy, Ruth; Weatherbie, Katherine

2013-03-01

This study was conducted to determine rural Nicaraguan health promotores' perceptions of their community's health problems, their self-identified learning needs, and resource needs. Despite the valuable contributions of promotores, there is limited research regarding unpaid volunteer promotores' perceptions of their needs in providing care to remote communities. A qualitative descriptive study of 13 unpaid, volunteer promotores in Waslala, Nicaragua, was conducted. Data were collected during individual interviews with seven promotores and two focus groups with 13 promotores. Data were analyzed by reading verbatim transcripts repeatedly and establishing general themes. Promotores confirmed the findings. Waslalan promotores described a synergy of traditional folk health beliefs and natural practices along with use of modern medications while working to meet the health needs of their communities. Without much formal training, the promotores used public health strategies to influence health behaviors and address health disparities in the communities they serve. Serving their communities and God were their motivation in their work. Recommendations include supporting efforts to meet promotores' needs regarding community health education with messages from community leaders and nurses, finding methods to financially compensate promotores, and including promotores in health program planning and evaluation. © 2012 Wiley Periodicals, Inc.

Robustness analysis of a green chemistry-based model for the ...

EPA Pesticide Factsheets

This paper proposes a robustness analysis based on Multiple Criteria Decision Aiding (MCDA). The ensuing model was used to assess the implementation of green chemistry principles in the synthesis of silver nanoparticles. Its recommendations were also compared to an earlier developed model for the same purpose to investigate concordance between the models and potential decision support synergies. A three-phase procedure was adopted to achieve the research objectives. Firstly, an ordinal ranking of the evaluation criteria used to characterize the implementation of green chemistry principles was identified through relative ranking analysis. Secondly, a structured selection process for an MCDA classification method was conducted, which ensued in the identification of Stochastic Multi-Criteria Acceptability Analysis (SMAA). Lastly, the agreement of the classifications by the two MCDA models and the resulting synergistic role of decision recommendations were studied. This comparison showed that the results of the two models agree between 76% and 93% of the simulation set-ups and it confirmed that different MCDA models provide a more inclusive and transparent set of recommendations. This integrative research confirmed the beneficial complementary use of MCDA methods to aid responsible development of nanosynthesis, by accounting for multiple objectives and helping communication of complex information in a comprehensive and traceable format, suitable for stakeholders and

Online Tonsillectomy Resources: Are Parents Getting Consistent and Readable Recommendations?

PubMed

Wozney, Lori; Chorney, Jill; Huguet, Anna; Song, Jin Soo; Boss, Emily F; Hong, Paul

2017-05-01

Objective Parents frequently refer to information on the Internet to confirm or broaden their understanding of surgical procedures and to research postoperative care practices. Our study evaluated the readability, comprehensiveness, and consistency around online recommendations directed at parents of children undergoing tonsillectomy. Study Design A cross-sectional study design was employed. Setting Thirty English-language Internet websites. Subjects and Methods Three validated measures of readability were applied and content analysis was employed to evaluate the comprehensiveness of information in domains of perioperative education. Frequency effect sizes and percentile ranks were calculated to measure dispersion of recommendations across sites. Results The mean readability level of all sites was above a grade 10 level with fewer than half of the sites (n = 14, 47%) scoring at or below the eight-grade level. Provided information was often incomplete with a noted lack of psychosocial support and skills-training recommendations. Content analysis showed 67 unique recommendations spanning the full perioperative period. Most recommendations had low consensus, being reported in 5 or fewer sites (frequency effect size <16%). Conclusion Many online parent-focused resources do not meet readability recommendations, portray incomplete education about perioperative care and expectations, and provide recommendations with low levels of consensus. Up-to-date mapping of the research evidence around recommendations is needed as well as improved efforts to make online information easier to read.

Lifestyle change recommendations in major depression: Do they work?

PubMed

Serrano Ripoll, M J; Oliván-Blázquez, B; Vicens-Pons, E; Roca, M; Gili, M; Leiva, A; García-Campayo, J; Demarzo, M P; García-Toro, M

2015-09-01

Modifying some lifestyle factors can be useful in depression, at least as an adjuvant treatment. Combining different lifestyle interventions seems to be an adequate strategy to increase their antidepressant efficacy according with preliminary studies, but this issue has not been enough investigated. The present study is a randomized, double-blinded, multicentre, two arm-parallel clinical trials, with a 12 month follow-up. The sample consisted of 273 Primary Care patients. Four combined hygienic-dietary written recommendations were given to the patients about diet, exercise, light exposure and sleep hygiene. Both active and control interventions were associated with improvement on BDI (Beck Depression Inventory) scores. However, there were not statistically significant differences (7.0 vs. 7.6; p=0.594). We were unable to monitor whether patients carry out recommendations. Intervention could be too difficult to accomplish for depressed patients without enough support and supervision. Just giving written lifestyle recommendations are not enough for depressive patients to benefit from them, so perhaps lifestyle change recommendations work or do not work on Depression depending on how they are presented to patients and on monitoring systems of their implementation. Copyright © 2015 Elsevier B.V. All rights reserved.

[Clinical recommendations for sport practice in diabetic patients (RECORD Guide). Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN)].

PubMed

Gargallo-Fernández, Manuel; Escalada San Martín, Javier; Gómez-Peralta, Fernando; Rozas Moreno, Pedro; Marco Martínez, Amparo; Botella-Serrano, Marta; Tejera Pérez, Cristina; López Fernández, Judith

2015-01-01

Sporting activity is becoming a common practice in patients with diabetes mellitus (DM). This situation requires both a preliminary medical assessment and a wide range of changes in treatment which have scarcely been addressed in medical literature. To prepare a clinical guideline on the medical approach to patients with diabetes who practice sport regularly. An expert panel from the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN) reviewed the most relevant literature in each of the sections. Based both on this review and on data from the experience of a number of athletes with DM, a number of recommendations were agreed within each section. Finally, the Working Group and representatives of the SEEN jointly discussed all these recommendations. The guideline provides recommendations ranging from medical assessment before patients with DM start to practice sport to actions during and after physical activity. Recommendations are also given on aspects such as the impact of sport on blood glucose control, training schemes, or special risk situations. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Towards a phenotypic screening strategy for emerging β-lactamases in Gram-negative bacilli.

PubMed

Willems, Elise; Verhaegen, Jan; Magerman, Koen; Nys, Sita; Cartuyvels, Reinoud

2013-02-01

The purpose of this manuscript was to review recent literature and guidelines regarding phenotypic detection of emerging β-lactamases [extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases and carbapenemases] in Gram-negative bacilli (GNB) in order to formulate recommendations on best practice to screen for them. We conclude that chromogenic ESBL screening agar plates are suitable to screen for ESBL-producing Enterobacteriaceae directly from clinical samples. Furthermore, ceftazidime (CAZ) and ceftriaxone or cefotaxime (CTX) are the indicator antimicrobial agents of choice for ESBL detection in GNB. In non-inducible Enterobacteriaceae, the combined double-disk synergy test (CDDST) with at least CTX and CAZ and additionally cefepime as indicators is the preferred ESBL confirmation assay. The two most suitable ESBL confirmation strategies in AmpC co-producing Enterobacteriaceae are adapted CDDSTs: (i) with addition of 3-aminophenylboronic acid to CTX and CAZ disks; and (ii) with addition of cloxacillin (CLOX) to Mueller-Hinton agar. Reduced cefoxitin susceptibility and decreased susceptibility to cefotetan are regarded as suitable screening tests for plasmid-mediated and derepressed AmpC production. A CLOX-based CDDST with CTX and CAZ as indicators is considered to be the best AmpC confirmation assay. Finally, in Enterobacteriaceae isolates we suggest to screen for carbapenemases with a 0.5 μg/mL meropenem screening breakpoint. For class A carbapenemase confirmation, the home-prepared as well as the commercially available boronic acid-based CDDST can be considered. For metallo-β-lactamase confirmation, ethylene diamine tetra-acetic-acid-based home-prepared assays are recommended. The most suitable method (CDDST or DDST) and indicator antimicrobial agent(s) vary depending on the bacterial genus. Copyright © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Safety and pharmacokinetics of ramucirumab in combination with docetaxel in Japanese patients with locally advanced or metastatic breast cancer: a Phase Ib study.

PubMed

Masuda, Norikazu; Iwata, Hiroji; Aogi, Kenjiro; Xu, Yihuan; Ibrahim, Ayman; Gao, Ling; Dalal, Rita; Yoshikawa, Reigetsu; Sasaki, Yasutsuna

2016-12-01

The primary objective of this study was to investigate the safety and tolerability and to confirm the recommended dose of the anti-vascular endothelial growth factor receptor 2 monoclonal antibody ramucirumab in combination with docetaxel in Japanese patients with metastatic/locally advanced breast cancer. In this multicenter, single-arm, Phase Ib trial, eligibility criteria included: 20 years or older, Eastern Cooperative Oncology Group performance status of 0/1 and confirmed diagnosis of human epidermal growth factor receptor 2-negative metastatic/locally recurrent inoperable breast adenocarcinoma. Patients received docetaxel (75 mg/m 2 ) followed by ramucirumab (10 mg/kg) on Day 1 of 21-day cycles. Recommended dose was defined as <33% dose-limiting toxicities in dose-limiting toxicity-evaluable patients in Cycle 1. The safety, pharmacokinetics, immunogenicity and antitumor activity were examined. Seven patients were treated. Most adverse events were mild to moderate. Two patients during Cycle 1 experienced a dose-limiting toxicity; one patient each experienced Grade 3 febrile neutropenia and Grade 3 gingivitis. Both dose-limiting toxicities subsequently resolved. No patients discontinued study therapies during Cycle 1. Four serious adverse events were possibly related to ramucirumab in combination with docetaxel. Anti-ramucirumab antibodies were not detected. Pharmacokinetic analysis revealed low total body clearance and long apparent terminal elimination half-life (~7-12 days). Partial response was reported in four patients. The combination of ramucirumab and docetaxel was tolerable in female Japanese patients with breast cancer. Ramucirumab 10 mg/kg in combination with docetaxel (75 mg/m 2 ) was confirmed as the recommended dose among Japanese patients, supporting its use in future studies. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Repeated Vaccination Does Not Appear to Impact Upon Influenza Vaccine Effectiveness Against Hospitalization With Confirmed Influenza.

PubMed

Cheng, Allen C; Macartney, Kristine K; Waterer, Grant W; Kotsimbos, Tom; Kelly, Paul M; Blyth, Christopher C

2017-06-01

Annual influenza vaccine is recommended for those at greatest risk of severe influenza infection. Recent reports of a negative impact of serial influenza vaccination on vaccine effectiveness (VE) raises concerns about the recommendation for annual influenza vaccines, particularly in persons at greatest risk. The Influenza Complications Alert Network (FluCAN) is an Australian hospital-based sentinel surveillance program. In this observational study, cases were defined as subjects aged >9 years admitted with influenza confirmed by polymerase chain reaction. Controls were subjects with acute respiratory illness testing negative for influenza. Propensity scores were used to adjust for the likelihood of being vaccinated. VE was calculated as 1 - adjusted odds ratio of vaccination in cases compared with test-negative controls. Over 2010-2015, 6223 cases and 6505 controls were hospitalized with confirmed influenza and influenza test-negative acute respiratory illness, respectively. Following stratification by quintile of propensity score, site, and year, VE was estimated to be 43% (95% confidence interval [CI], 37%-49%) overall. VE was estimated to be 51% (95% CI, 45%-57%) in those vaccinated in both the current and previous season, compared with 33% (95% CI, 17%-47%) vaccinated in the current season only and 35% (95% CI, 21%-46%) in the previous season only. Similar results were observed for influenza A/H1N1, influenza A/H3N2, and influenza B strains. Vaccination in both the current and previous seasons was associated with a higher VE against hospitalization with influenza than vaccination in either single season. These findings reinforce current recommendations for annual influenza vaccination, particularly those at greatest risk of influenza disease. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com

A Preliminary Study of the Validity of Memory Tests Recommended by the Working Group for Individuals with Moderate to Severe Intellectual Disability

ERIC Educational Resources Information Center

Pyo, G.; Kripakaran, K.; Curtis, K.; Curtis, R.; Markwell, S.

2007-01-01

Background: Normal aging and Dementia of Alzheimer's Type (DAT) among higher functioning individuals with intellectual disability (ID) have been relatively well studied using a variety of cognitive tests. However, cognitive studies for lower functioning individuals with ID are scarce in the literature. The Working Group recommended the Test…

Clinical Practice Guidelines for Diagnosis and Treatment of Chronic Lymphocytic Leukemia (CLL) in The Netherlands.

PubMed

Kersting, Sabina; Neppelenbroek, Suzanne I M; Visser, Hein P J; van Gelder, Michel; Levin, Mark-David; Mous, Rogier; Posthuma, Ward; van der Straaten, Hanneke M; Kater, Arnon P

2018-01-01

In recent years, considerable progress has been made in the treatment of patients with chronic lymphocytic leukemia (CLL), and new potent drugs have become available. Therefore, the CLL working party revised the Dutch guidelines. Not only efficacy but also quality of life and socio-economic impact were taken into account in the formulation of treatment recommendations. The working party discussed a set of questions regarding diagnostic tests and treatment and wrote the draft guideline. This was evidence-based whenever possible, but in cases of low evidence, an expert-based recommendation was formulated with input of the entire working party. The draft guideline was sent to all hematologists in the Netherlands for comment and was subsequently approved. Recommendations were formulated on diagnostic tests and work-up before treatment. Also, recommendations were made for treatment with fludarabine-cyclophosphamide-rituximab, bendamustine-rituximab, chlorambucil with anti-CD20 antibody, ibrutinib, idelalisib-rituximab, venetoclax, and allogeneic stem cell transplantation. In the revised Dutch CLL guidelines, chemo-immunotherapy is still the cornerstone of CLL treatment with novel targeted drugs for specific risk groups. Copyright © 2017 Elsevier Inc. All rights reserved.

Distribution automation and control support; Analysis and interpretation of DAC working group results for use in project planning

NASA Technical Reports Server (NTRS)

Klock, P.; Evans, D.

1979-01-01

The Executive Summary and Proceedings of the Working Group Meeting was analyzed to identify specific projects appropriate for Distribution Automation and Control DAC RD&D. Specific projects that should be undertaken in the DAC RD&D program were recommended. The projects are presented under broad categories of work selected based on ESC's interpretation of the results of the Working Group Meeting. Some of the projects are noted as utility industry projects. The ESC recommendations regarding program management are presented. Utility versus Government management responsibilities are noted.

[Croatian and international regulations on the protection and rights of workers exposed to asbestos at work].

PubMed

Zavalić, Marija; Macan, Jelena

2009-11-01

New regulations on the protection and rights of workers occupationally exposed to asbestos were introduced in Croatia in 2007 and 2008. They have been harmonised with the European Union (EU) and International Labour Organization (ILO) regulations, and make a step forward in safety at work, health protection, social rights, and pension schemes for Croatian workers occupationally exposed to asbestos. The 2007 Croatian regulation on the protection of workers from the risks related to exposure to asbestos at work defines and describes activities in which workers can be occupationally exposed to asbestos, defines the threshold value of asbestos in the air at work, defines valid methods for measurement of asbestos concentrations in the air, and establishes measures to reduce asbestos exposure at work or protect the exposed workers. Croatian law regulating obligatory health surveillance of workers occupationally exposed to asbestos from year 2007 defines activities and competent authorities to implement health surveillance of workers occupationally exposed to asbestos and to diagnose occupational diseases related to asbestos. This law also defines "occupational exposure to asbestos", and "occupational asbestos-related diseases", including asbestosis (pulmonary asbestos-related fibrosis), pleural asbestos-related disorders (plaques, pleural thickening, and benign effusion), lung and bronchial cancer, and malignant mesothelioma of serous membranes. These regulations have been harmonised with ILO, Directive 2003/18/EC amending Council Directive 83/477/EEC on the protection of workers from the risks related to exposure to asbestos at work, and with the Commission Recommendation 2003/670/EC concerning the European schedule of occupational diseases. The 2008 Croatian regulation on conditions of health surveillance, diagnostic procedures and criteria for confirmation of occupational asbestos-related diseases "defines the terms and the content of medical examination of workers exposed to asbestos, and criteria for the confirmation of occupational asbestos-related diseases which are harmonised with the Helsinki criteria acknowledged by ILO and EU, particularly concerning the level and length of exposure. Croatian law on compensation of workers occupationally exposed to asbestos from 2007 regulates compensation claims for workers with occupational asbestos-related disease, authorities competent to process these claims, and funds and coefficients for compensation payments. Accordingly, Croatia is responsible for compensation claims payment for workers with occupational asbestos-related disease. The 2007 law on conditions for entitlement to full pension for workers exposed to asbestos at work defines the conditions for fulfilling criteria for retirement pension for workers exposed to asbestos at work.

Transforming Clinical Documentation in EHRs for 2020: Recommendations from University of Minnesota's Big Data Conference Working Group.

PubMed

Weaver, Charlotte; O'Brien, Ann

2016-01-01

In 2014, a group of diverse informatics leaders from practice, academia, and the software industry formed to address how best to transform electronic documentation to provide knowledge at the point of care and to deliver value to front line nurses and nurse leaders. This presentation reports the recommendations from this Working Group geared towards a 2020 framework. The recommendations propose redesign to optimize nurses' documentation efficiency while contributing to knowledge generation and attaining a balance that ensures the capture of nursing's impact on safety, quality, yet minimizes "death by data entry."

The differences in electrocardiogram interpretation in top-level athletes.

PubMed

Jakubiak, Agnieszka A; Burkhard-Jagodzińska, Krystyna; Król, Wojciech; Konopka, Marcin; Bursa, Dominik; Sitkowski, Dariusz; Kuch, Marek; Braksator, Wojciech

2017-01-01

The Ministry of Health in Poland recommends electrocardiogram (ECG)-based cardiovascular screening in athletes, but so far there has been a lack of guidelines on preparticipation assessment. We compared different criteria of ECG screening assessment in a group of top-level athletes. The aims were to evaluate the prevalence of ECG changes in athletes that necessitate further cardiological work-up according to three criteria in various age groups as well as to identify factors determining the occurrence of changes related and unrelated to the training. 262 high-dynamic, high-static Polish athletes (rowers, cyclists, canoeists) were divided into two age categories: young (≤ 18 years of age; n = 177, mean age 16.9 ± 0.8; 15-18 years) and elite (> 18 years of age; n = 85, mean age 22.9 ± 3.4; 19-34 years). All sports persons had a 12-lead ECG performed and evaluated according to 2010 European Society of Cardiology (ESC) recommendations, 2012 Seattle criteria, and 2014 Refined criteria. The Refined criteria reduced (p < 0.001) the number of training-unrelated ECG findings to 8.0% vs. 12.6% (Seattle criteria) and 30.5% (ESC recommendations). All three criteria revealed more training-related changes in the group of older athletes (76.5% vs. 55.9%, p = 0.001). Predictors that significantly (p < 0.005) affected the occurrence of adaptive changes were the age of the athlete, training duration (in years), and male gender. 1. The ESC criteria identified a group of athletes that was unacceptably large, as for the screening test, requiring verification with other methods (every fourth athlete). 2. The use of the Refined criteria helps to significantly reduce the frequency and necessity for additional tests. 3. The dependence of adaptive changes on training duration and athletes' age confirms the benign nature of those ECG findings.

NASA Aerospace Flight Battery Program: Recommendations for Technical Requirements for Inclusion in Aerospace Battery Procurements. Volume 1, Part 2

NASA Technical Reports Server (NTRS)

Jung, David S.; Manzo, Michelle A.

2010-01-01

This NASA Aerospace Flight Battery Systems Working Group was chartered within the NASA Engineering and Safety Center (NESC). The Battery Working Group was tasked to complete tasks and to propose proactive work to address battery related, agency-wide issues on an annual basis. In its first year of operation, this proactive program addressed various aspects of the validation and verification of aerospace battery systems for NASA missions. Studies were performed, issues were discussed and in many cases, test programs were executed to generate recommendations and guidelines to reduce risk associated with various aspects of implementing battery technology in the aerospace industry. This document contains Part 2 - Volume I: Recommendations for Technical Requirements for Inclusion in Aerospace Battery Procurements of the program's operations.

A Comparative Study of Average, Linked Mastoid, and REST References for ERP Components Acquired during fMRI

PubMed Central

Yang, Ping; Fan, Chenggui; Wang, Min; Li, Ling

2017-01-01

In simultaneous electroencephalogram (EEG) and functional magnetic resonance imaging (fMRI) studies, average reference (AR), and digitally linked mastoid (LM) are popular re-referencing techniques in event-related potential (ERP) analyses. However, they may introduce their own physiological signals and alter the EEG/ERP outcome. A reference electrode standardization technique (REST) that calculated a reference point at infinity was proposed to solve this problem. To confirm the advantage of REST in ERP analyses of synchronous EEG-fMRI studies, we compared the reference effect of AR, LM, and REST on task-related ERP results of a working memory task during an fMRI scan. As we hypothesized, we found that the adopted reference did not change the topography map of ERP components (N1 and P300 in the present study), but it did alter the task-related effect on ERP components. LM decreased or eliminated the visual working memory (VWM) load effect on P300, and the AR distorted the distribution of VWM location-related effect at left posterior electrodes as shown in the statistical parametric scalp mapping (SPSM) of N1. ERP cortical source estimates, which are independent of the EEG reference choice, were used as the golden standard to infer the relative utility of different references on the ERP task-related effect. By comparison, REST reference provided a more integrated and reasonable result. These results were further confirmed by the results of fMRI activations and a corresponding EEG-only study. Thus, we recommend the REST, especially with a realistic head model, as the optimal reference method for ERP data analysis in simultaneous EEG-fMRI studies. PMID:28529472

A Comparative Study of Average, Linked Mastoid, and REST References for ERP Components Acquired during fMRI.

PubMed

Yang, Ping; Fan, Chenggui; Wang, Min; Li, Ling

2017-01-01

In simultaneous electroencephalogram (EEG) and functional magnetic resonance imaging (fMRI) studies, average reference (AR), and digitally linked mastoid (LM) are popular re-referencing techniques in event-related potential (ERP) analyses. However, they may introduce their own physiological signals and alter the EEG/ERP outcome. A reference electrode standardization technique (REST) that calculated a reference point at infinity was proposed to solve this problem. To confirm the advantage of REST in ERP analyses of synchronous EEG-fMRI studies, we compared the reference effect of AR, LM, and REST on task-related ERP results of a working memory task during an fMRI scan. As we hypothesized, we found that the adopted reference did not change the topography map of ERP components (N1 and P300 in the present study), but it did alter the task-related effect on ERP components. LM decreased or eliminated the visual working memory (VWM) load effect on P300, and the AR distorted the distribution of VWM location-related effect at left posterior electrodes as shown in the statistical parametric scalp mapping (SPSM) of N1. ERP cortical source estimates, which are independent of the EEG reference choice, were used as the golden standard to infer the relative utility of different references on the ERP task-related effect. By comparison, REST reference provided a more integrated and reasonable result. These results were further confirmed by the results of fMRI activations and a corresponding EEG-only study. Thus, we recommend the REST, especially with a realistic head model, as the optimal reference method for ERP data analysis in simultaneous EEG-fMRI studies.

43 CFR 1784.5-3 - Records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... records. (b) All records, reports, transcripts, minutes, recommendations, studies, working papers, and... conclusions reached; (7) A list of recommendations made by the advisory committee; (8) Copies of all reports...

A Non-Linear Model of Information Seeking Behaviour

ERIC Educational Resources Information Center

Foster, Allen

2005-01-01

Introduction:The results of a study of information seeking behaviour of inter-disciplinary academic and postgraduate researchers are reported. Method. The study applied the naturalistic methods recommended by Lincoln and Guba for maximising credibility, transferability, dependability, and confirmability in data collection and analysis. Sampling…

Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update.

PubMed

Rodrigues, A M; Canhão, H; Marques, A; Ambrósio, C; Borges, J; Coelho, P; Costa, L; Fernandes, S; Gonçalves, I; Gonçalves, M; Guerra, M; Marques, M L; Pimenta, S; Pinto, P; Sequeira, G; Simões, E; Teixeira, L; Vaz, C; Vieira-Sousa, E; Vieira, R; Alvarenga, F; Araújo, F; Barcelos, A; Barcelos, F; Barros, R; Bernardes, M; Canas da Silva, J; Cordeiro, A; Costa, M; Cunha-Miranda, L; Cruz, M; Duarte, A C; Duarte, C; Faustino, A; Figueiredo, G; Fonseca, J E; Furtado, C; Gomes, J; Lopes, C; Mourão, A F; Oliveira, M; Pimentel-Santos, F M; Ribeiro, A; Sampaio da Nóvoa, T; Santiago, M; Silva, C; Silva-Dinis, A; Sousa, S; Tavares-Costa, J; Terroso, G; Vilar, A; Branco, J C; Tavares, V; Romeu, J C; da Silva, Jap

2018-01-01

Advances in osteoporosis (OP)case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated the Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007. SPR bone diseases' working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts' opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey. The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed. Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people. Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations - clinicians are encouraged to consider this information together with updated evidence and their best clinical judgment in individual cases.

Evaluation and Management of Traumatic Diaphragmatic Injuries: A Practice Management Guideline from the Eastern Association for the Surgery of Trauma.

PubMed

McDonald, Amy A; Robinson, Bryce R H; Alarcon, Louis; Bosarge, Patrick L; Dorion, Heath; Haut, Elliott R; Juern, Jeremy; Madbak, Firas; Reddy, Srinivas; Weiss, Patricia; Como, John J

2018-04-02

Traumatic diaphragm injuries (TDI) pose both diagnostic and therapeutic challenges in both the acute and chronic phases. There are no published practice management guidelines to date for TDI. We aim to formulate a practice management guideline for TDI using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group formulated five Patient, Intervention, Comparator, Outcome (PICO) questions regarding the following topics: 1) diagnostic approach (laparoscopy vs. computed tomography); 2) non-operative management of penetrating right-sided injuries; 3) surgical approach (abdominal or thoracic) for acute TDI, including 4) the use of laparoscopy; and 5) surgical approach (abdominal or thoracic) for delayed TDI. A systematic review was undertaken and last updated December 2016. RevMan 5 (Cochran Collaboration) and GRADEpro (Grade Working Group) software were utilized. Recommendations were voted on by working group members. Consensus was obtained for each recommendation. A total of 56 articles were utilized to formulate the recommendations. Most studies were retrospective case series with variable reporting of outcomes measures and outcomes frequently not stratified to intervention or comparator. The overall quality of the evidence was very low for all PICOs. Therefore, only conditional recommendations could be made. Recommendations were made in favor of laparoscopy over CT for diagnosis, non-operative vs. operative approach for right-sided penetrating injuries, abdominal vs. thoracic approach for acute TDI, and laparoscopy (with the appropriate skill set and resources) vs. open approach for isolated TDI. No recommendation could be made for the preferred operative approach for delayed TDI. Very low-quality evidence precluded any strong recommendations. Further study of the diagnostic and therapeutic approaches to TDI is warranted. Guideline LEVEL OF EVIDENCE: 4.

[Molecular diagnostics of ALK-positive lung cancer].

PubMed

Tímár, József; Lotz, Gábor; Rásó, Erzsébet; Moldvay, Judit

2017-09-20

ALK translocation is the 3rd most frequent genetic aberration in lung adenocarcinoma, and several inhibitors are now clinically available in first and second line settings. Accordingly, molecular diagnostics of ALK-positive lung cancer is very important and can be done with the rational combination of several methods. All international recommendations suggest that, except for cytological samples, screening technology for ALK-positive tumors is immunohistochemistry using a validated test. It is highly recommended that in case of ALK protein positive samples gene translocation must be confirmed by fluorescent in situ hybridization (FISH). In case of cytological samples FISH technique must be used as ALK diagnostics. In equivocal cases the genetic alteration of ALK can be confirmed by alternative molecular techniques such as next generation sequencing or RNAbased PCR methods. Upon administration of ALK inhibitors, acquired resistance is frequent which is mostly due to ALK amplification and/or mutation. It is evident that the diagnostics of these secondary ALK gene alterations must be done from recurrent tumors or circulating nucleic acids.

Hereditary diffuse gastric cancer: updated consensus guidelines for clinical management and directions for future research.

PubMed

Fitzgerald, Rebecca C; Hardwick, Richard; Huntsman, David; Carneiro, Fatima; Guilford, Parry; Blair, Vanessa; Chung, Daniel C; Norton, Jeff; Ragunath, Krishnadath; Van Krieken, J Han; Dwerryhouse, Sarah; Caldas, Carlos

2010-07-01

25-30% of families fulfilling the criteria for hereditary diffuse gastric cancer have germline mutations of the CDH1 (E-cadherin) gene. In light of new data and advancement of technologies, a multidisciplinary workshop was convened to discuss genetic testing, surgery, endoscopy and pathology reporting. The updated recommendations include broadening of CDH1 testing criteria such that: histological confirmation of diffuse gastric criteria is only required for one family member; inclusion of individuals with diffuse gastric cancer before the age of 40 years without a family history; and inclusion of individuals and families with diagnoses of both diffuse gastric cancer (including one before the age of 50 years) and lobular breast cancer. Testing is considered appropriate from the age of consent following counselling and discussion with a multidisciplinary team. In addition to direct sequencing, large genomic rearrangements should be sought. Annual mammography and breast MRI from the age of 35 years is recommended for women due to the increased risk for lobular breast cancer. In mutation positive individuals prophylactic total gastrectomy at a centre of excellence should be strongly considered. Protocolised endoscopic surveillance in centres with endoscopists and pathologists experienced with these patients is recommended for: those opting not to have gastrectomy, those with mutations of undetermined significance, and in those families for whom no germline mutation is yet identified. The systematic histological study of prophylactic gastrectomies almost universally shows pre-invasive lesions including in situ signet ring carcinoma with pagetoid spread of signet ring cells. Expert histopathological confirmation of these early lesions is recommended.

Genomic identification and characterization of the elite strains Bradyrhizobium yuanmingense BR 3267 and Bradyrhizobium pachyrhizi BR 3262 recommended for cowpea inoculation in Brazil.

PubMed

Leite, Jakson; Passos, Samuel Ribeiro; Simões-Araújo, Jean Luiz; Rumjanek, Norma Gouvêa; Xavier, Gustavo Ribeiro; Zilli, Jerri Édson

2017-03-31

The leguminous inoculation with nodule-inducing bacteria that perform biological nitrogen fixation is a good example of an "eco-friendly agricultural practice". Bradyrhizobium strains BR 3267 and BR 3262 are recommended for cowpea (Vigna unguiculata) inoculation in Brazil and showed remarkable responses; nevertheless neither strain was characterized at species level, which is our goal in the present work using a polyphasic approach. The strains presented the typical phenotype of Bradyrhizobium with a slow growth and a white colony on yeast extract-mannitol medium. Strain BR 3267 was more versatile in its use of carbon sources compared to BR 3262. The fatty acid composition of BR 3267 was similar to the type strain of Bradyrhizobium yuanmingense; while BR 3262 was similar to Bradyrhizobium elkanii and Bradyrhizobium pachyrhizi. Phylogenetic analyses based on 16S rRNA and three housekeeping genes placed both strains within the genus Bradyrhizobium: strain BR 3267 was closest to B. yuanmingense and BR 3262 to B. pachyrhizi. Genome average nucleotide identity and DNA-DNA reassociation confirmed the genomic identification of B. yuanmingense BR 3267 and B. pachyrhizi BR 3262. The nodC and nifH gene analyses showed that strains BR 3267 and BR 3262 hold divergent symbiotic genes. In summary, the results indicate that cowpea can establish effective symbiosis with divergent bradyrhizobia isolated from Brazilian soils. Published by Elsevier Editora Ltda.

An Evolving Ecosystem for Natural Language Processing in Department of Veterans Affairs.

PubMed

Garvin, Jennifer H; Kalsy, Megha; Brandt, Cynthia; Luther, Stephen L; Divita, Guy; Coronado, Gregory; Redd, Doug; Christensen, Carrie; Hill, Brent; Kelly, Natalie; Treitler, Qing Zeng

2017-02-01

In an ideal clinical Natural Language Processing (NLP) ecosystem, researchers and developers would be able to collaborate with others, undertake validation of NLP systems, components, and related resources, and disseminate them. We captured requirements and formative evaluation data from the Veterans Affairs (VA) Clinical NLP Ecosystem stakeholders using semi-structured interviews and meeting discussions. We developed a coding rubric to code interviews. We assessed inter-coder reliability using percent agreement and the kappa statistic. We undertook 15 interviews and held two workshop discussions. The main areas of requirements related to; design and functionality, resources, and information. Stakeholders also confirmed the vision of the second generation of the Ecosystem and recommendations included; adding mechanisms to better understand terms, measuring collaboration to demonstrate value, and datasets/tools to navigate spelling errors with consumer language, among others. Stakeholders also recommended capability to: communicate with developers working on the next version of the VA electronic health record (VistA Evolution), provide a mechanism to automatically monitor download of tools and to automatically provide a summary of the downloads to Ecosystem contributors and funders. After three rounds of coding and discussion, we determined the percent agreement of two coders to be 97.2% and the kappa to be 0.7851. The vision of the VA Clinical NLP Ecosystem met stakeholder needs. Interviews and discussion provided key requirements that inform the design of the VA Clinical NLP Ecosystem.

University nurse graduates: perspectives on factors of retention and mobility.

PubMed

Gillis, Angela; Jackson, Winston; Beiswanger, Donna

2004-03-01

This descriptive study explored the perspectives of 51 university nurse graduates from the St. Francis Xavier University School of Nursing. Qualitative and quantitative data were collected using telephone interviews to study a range of variables including geographic mobility patterns, career satisfaction and attitudes towards recruitment and retention factors. Given the negative perceptions in the media about nursing, the results of the study were unexpected and offer a sense of hope to those considering nursing as a career. Results indicate that graduates remained enthusiastic about their career choice and would choose nursing again as a career given the opportunity to do so. Furthermore, they would recommend nursing to others as a desirable career. The majority of graduates entered nursing because of a desire to make a meaningful difference in people's lives, and they were strongly influenced by positive nurse role models. Participants remained committed to a career in nursing, enjoyed considerable geographic mobility with migration to other Canadian provinces and the USA, but the majority returned to Canada for employment in nursing. The study confirms that the supportive nature of the work environment in which care is practised, the presence of visible and empowering nurse leaders, adequate compensation and benefits, and appropriate investment in continuing education and professional development of staff are significant factors in retaining nurses. Additional recommendations for enhanced recruitment and retention strategies are provided.

75 FR 60089 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-29

... Evidence-Based Metrics Recommendations. The Board will vote on recommendations regarding proposed revisions... Medication and Complementary and Alternative Medicine Use Work Groups, and Military Occupational...

[Development process of Evidence-based "Return-to-work Guidance in Occupational Health 2017"].

PubMed

Kojimahara, Noriko; Fukumoto, Masakatsu; Yoshikawa, Etsuko; Shinada, Kayoko; Tsuiki, Hirokazu

2018-06-05

Objective"Return-to-work Guidance in Occupational Health 2017 (RTW Guidance 2017) " is the first occupational health guide in Japan that evaluates the quality of evidence and offers recommendations based on results of the systematic review of randomized controlled trials. Details of the systematic review of each review question (RQs) will be described separately. This article presents an overview of the method and process of developing the "RTW Guidance 2017."Materials and MethodsThe guidance was developed following the previously-published "Method for developing evidence based occupational health guidance," which included the composition of a highly-transparent guidance developing group as well as the recruitment and selection of RQs. Using the Cochrane Library, PubMed, and Ichushi-Web, a literature search for the six RQs was conducted in January 2016 by partly modifying the search terms of the existing systematic review. Articles were selected according to the inclusion criteria, and the quality of evidence was evaluated using the GRADE approach. Meta-analysis was conducted for RQ2 and RQ4, and a qualitative systematic review was conducted for RQ5, RQ6, and cost-effectiveness. Recommendations were subsequently made after a thorough consideration for feasibility in Japan by examining the costs and available resources.ResultsBased on a comprehensive literature search, eleven RQ2, four RQ4, one RQ5, and three RQ6 were selected. Support program for returning to work, such as "Re-work" for those who are temporarily not working due to musculoskeletal disorders or mental health disorder, was recommended based on moderate evidence (RQ2). For RQ4, the collaboration between occupational health practice and clinical practice was weakly recommended based on low evidence. For RQ5 that evaluated the usefulness of social support, intervention by the manager/co-worker was proposed as a "best practice statement" without indicating it as a recommendation. Work accommodation was weakly recommended based on low evidence in RQ6.Discussion and ConclusionFrom the result of systematic reviews, it was recommended for workers on sick leave more than four weeks regardless of sick leave and sickness absence that interventions during leave would improve work-related outcomes, such as earlier reinstatement. Although there is limited evidence regarding occupational health in Japan, it is important for many occupational health professionals to learn the method of developing guidance and to identify issues for future studies with priority in Japan.

Report of the IAU Working Group on Cartographic Coordinates and Rotational Elements: 2015

NASA Astrophysics Data System (ADS)

Archinal, B. A.; Acton, C. H.; A'Hearn, M. F.; Conrad, A.; Consolmagno, G. J.; Duxbury, T.; Hestroffer, D.; Hilton, J. L.; Kirk, R. L.; Klioner, S. A.; McCarthy, D.; Meech, K.; Oberst, J.; Ping, J.; Seidelmann, P. K.; Tholen, D. J.; Thomas, P. C.; Williams, I. P.

2018-03-01

This report continues the practice where the IAU Working Group on Cartographic Coordinates and Rotational Elements revises recommendations regarding those topics for the planets, satellites, minor planets, and comets approximately every 3 years. The Working Group has now become a "functional working group" of the IAU, and its membership is open to anyone interested in participating. We describe the procedure for submitting questions about the recommendations given here or the application of these recommendations for creating a new or updated coordinate system for a given body. Regarding body orientation, the following bodies have been updated: Mercury, based on MESSENGER results; Mars, along with a refined longitude definition; Phobos; Deimos; (1) Ceres; (52) Europa; (243) Ida; (2867) Šteins; Neptune; (134340) Pluto and its satellite Charon; comets 9P/Tempel 1, 19P/Borrelly, 67P/Churyumov-Gerasimenko, and 103P/Hartley 2, noting that such information is valid only between specific epochs. The special challenges related to mapping 67P/Churyumov-Gerasimenko are also discussed. Approximate expressions for the Earth have been removed in order to avoid confusion, and the low precision series expression for the Moon's orientation has been removed. The previously online only recommended orientation model for (4) Vesta is repeated with an explanation of how it was updated. Regarding body shape, text has been included to explain the expected uses of such information, and the relevance of the cited uncertainty information. The size of the Sun has been updated, and notation added that the size and the ellipsoidal axes for the Earth and Jupiter have been recommended by an IAU Resolution. The distinction of a reference radius for a body (here, the Moon and Titan) is made between cartographic uses, and for orthoprojection and geophysical uses. The recommended radius for Mercury has been updated based on MESSENGER results. The recommended radius for Titan is returned to its previous value. Size information has been updated for 13 other Saturnian satellites and added for Aegaeon. The sizes of Pluto and Charon have been updated. Size information has been updated for (1) Ceres and given for (16) Psyche and (52) Europa. The size of (25143) Itokawa has been corrected. In addition, the discussion of terminology for the poles (hemispheres) of small bodies has been modified and a discussion on cardinal directions added. Although they continue to be used for planets and their satellites, it is assumed that the planetographic and planetocentric coordinate system definitions do not apply to small bodies. However, planetocentric and planetodetic latitudes and longitudes may be used on such bodies, following the right-hand rule. We repeat our previous recommendations that planning and efforts be made to make controlled cartographic products; newly recommend that common formulations should be used for orientation and size; continue to recommend that a community consensus be developed for the orientation models of Jupiter and Saturn; newly recommend that historical summaries of the coordinate systems for given bodies should be developed, and point out that for planets and satellites planetographic systems have generally been historically preferred over planetocentric systems, and that in cases when planetographic coordinates have been widely used in the past, there is no obvious advantage to switching to the use of planetocentric coordinates. The Working Group also requests community input on the question submitting process, posting of updates to the Working Group website, and on whether recommendations should be made regarding exoplanet coordinate systems.

Failure to Confirm the Macrophage Electrophoretic Mobility Test in Cancer

PubMed Central

Forrester, J. A.; Dando, P. M.; Smith, W. J.; Turberville, C.

1977-01-01

A series of patients with a variety of histopathologically confirmed cancers have been examined using the MOD-MEM test as described by Pritchard et al. (1973). Despite the closest possible adherence to the experimental protocols recommended by these authors, no positive reactions to the test were observed in this series: neither were we able to demonstrate the release of a “macrophage-slowing factor” by a panel of normal donors when challenged with tubercle PPD. We conclude that the test has no present application to the diagnosis of cancer.

Occupational health and safety experiences among self-identified immigrant workers living or working in Somerville, MA by ethnicity, years in the US, and English proficiency.

PubMed

Panikkar, Bindu; Woodin, Mark A; Brugge, Doug; Desmarais, Anne Marie; Hyatt, Raymond; Goldman, Rose; Pirie, Alex; Goldstein-Gelb, Marcy; Galvão, Heloisa; Chianelli, Monica; Vasquez, Ismael; McWhinney, Melissa; Dalembert, Franklin; Gute, David M

2012-12-06

In this community based research initiative, we employed a survey instrument predominately developed and administered by Teen Educators to assess occupational health risks for Haitian, Salvadoran, and Brazilian immigrants (n = 405) in Somerville, MA, USA. We demonstrate that a combined analysis of ethnicity, years in the US, and English proficiency better characterized the occupational experience of immigrant workers than considering these variables individually. While years in the US (negatively) and English proficiency (positively) explained the occurrence of health risks, the country of origin identified the most vulnerable populations in the community. Brazilians, Salvadorans, and other Hispanic, all of whom who have been in the US varying length of time, with varying proficiency in English language had twice the odds of reporting injuries due to work compared to other immigrants. Although this observation was not significant it indicates that years in the US and English proficiency alone do not predict health risks among this population. We recommend the initiation of larger studies employing c community based participatory research methods to confirm these differences and to further explore work and health issues of immigrant populations. This study is one of the small number of research efforts to utilize a contemporaneous assessment of occupational health problems in three distinct immigrant populations at the community level within a specific Environmental Justice context and social milieu.

[Study of the supra-glottic pressure during partial constriction of the vocal tract].

PubMed

Suares, M; Cayrayre, F; Ouaknine, M; de la Brèteque, B Amy; Giovanni, A

2004-01-01

Phonation in a small plastic tube 22 cm length and 5 mms diameter (basic exercise of the method of Dr Amy de la Brèteque), is current practice in vocal rehabilitation in France. This work aims to show the effects of this method on the glottic vibration. The hypothesis was that at the time of phonation in the tube with a strong flow as recommended in the method, the vocal cords vibrate without contact. This limits the mechanical trauma at this level. We have analyzed the sound production in a tube in 11 trained and not trained subjects. We simultaneously collected the intra-oral air pressure and the vocal signal which was subjected to a spectral analysis. Spectral analysis confirmed that the signal was produced correctly i.e. with a strong flow and without interruption of the sound less rich in harmonics. We interpreted these results in the light of our preceding works on the glottic vibration and we show that this vocal production was of the sinusoidal type; this implies the absence of physical contact between the vocal cords, which validates our hypothesis. Further works are necessary to better understand the physical relations between the supra-glottic aerodynamic phenomena and the vibratory functioning of the vocal cords and also to analyze the therapeutic potential ofthe method within speech therapy rehabilitation.

Achieving equal opportunity in NASA: An assessment of needs and recommendations for action

NASA Technical Reports Server (NTRS)

1976-01-01

Measures designed by NASA to improve its equal opportunity program are reported. Attempts made to increase the ratios and level of placement of women and minority men in the work force were emphasized, upward mobility for those employees already in the work force was also studied. Ways for improving the track record for NASA's equal opportunity profile are recommended.

Efforts to Bridge the Gap between Research and Practice in Social Work: Precedents and Prospects: Keynote Address at the Bridging the Gap Symposium

ERIC Educational Resources Information Center

Rubin, Allen

2015-01-01

This keynote address discusses previous and ongoing efforts to reduce the persistent gap between research and practice in social work and offers recommendations for further bridging that gap. Key among those recommendations is the need to conduct descriptive outcome studies of efforts to adapt research-supported interventions in everyday practice…

ASCCP Colposcopy Standards: How Do We Perform Colposcopy? Implications for Establishing Standards.

PubMed

Waxman, Alan G; Conageski, Christine; Silver, Michelle I; Tedeschi, Candice; Stier, Elizabeth A; Apgar, Barbara; Huh, Warner K; Wentzensen, Nicolas; Massad, L Stewart; Khan, Michelle J; Mayeaux, Edward J; Einstein, Mark H; Schiffman, Mark H; Guido, Richard S

2017-10-01

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. Working group 3 defined colposcopy procedure guidelines for minimum and comprehensive colposcopy practice and evaluated the use of colposcopy adjuncts. The working group performed a systematic literature review to identify best practices in colposcopy methodology and to evaluate the use of available colposcopy adjuncts. The literature provided little evidence to support specific elements of the procedure. The working group, therefore, implemented a national survey of current and recent ASCCP members to evaluate common elements of the colposcopy examination. The findings of this survey were modified by expert consensus from the ASCCP Colposcopy Standards Committee members to create guidelines for performing colposcopy. The draft recommendations were posted online for public comment and presented at an open session of the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered in the development of final recommendations. Minimum and comprehensive colposcopy practice guidelines were developed. These guidelines represent recommended practice in all parts of the examination including the following: precolposcopy evaluation, performing the procedure, documentation of findings, biopsy practice, and postprocedure follow-up. These guidelines are intended to serve as a guide to standardize colposcopy across the United States.

Confronting Virginia's transportation challenge. Phase 1 report of the Commission on Transportation in the Twenty-First Century.

DOT National Transportation Integrated Search

1986-08-01

The findings and recommendations are presented of a study which attempted to (1) confirm the critical highway and transportation needs of the Commonwealth of Virginia; (2) explore alternative means of financing transportation; and (3) examine the fea...

Linking Course Web Sites to Library Collections and Services

ERIC Educational Resources Information Center

Rieger, Oya Y.; Horne, Angela K.; Revels, Ira

2004-01-01

A five-month research study at Cornell University Library (CUL) confirmed the strategic importance of a library presence in faculty-created course Web sites. It sparked specific recommendations to support the seamless integration of the CUL digital library within the virtual learning environments created by faculty.

78 FR 54509 - Tenth Meeting: RTCA Next Gen Advisory Committee (NAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... Capabilities Work Group. Recommendation for Future Metroplex Optimization Activity. [cir] Recommendation for Future Use of Optimization of Airspace and Procedures in the Metroplex (OAPM) developed by the...

"We get them up, moving, and out the door. How do we get them to do what is recommended?" Using behaviour change theory to put exercise evidence into action for rehabilitation professionals.

PubMed

McArthur, Caitlin; Ziebart, Christina; Papaioannou, Alexandra; Cheung, Angela M; Laprade, Judi; Lee, Linda; Jain, Ravi; Giangregorio, Lora M

2018-01-25

Recommendations suggest a multicomponent exercise for people with osteoporosis. We identified rehabilitation professionals' barriers and facilitators to implementing exercise recommendations with people with osteoporosis, and used those to make suggestions for targeted knowledge translation interventions. Future work will report on development and evaluation of the interventions informed by our study. Rehabilitation professionals can help people with osteoporosis to engage in a multicomponent exercise program and perform activities of daily living safely. However, rehabilitation professional face barriers to implementing exercise evidence, especially for specific disease conditions like osteoporosis. We performed a behavioural analysis and identified rehabilitation professionals' barriers to and facilitators of implementing disease-specific physical activity and exercise recommendations (Too Fit to Fracture recommendations), and used the Behaviour Change Wheel to select interventions. Semi-structured interviews and focus groups were conducted with rehabilitation professionals, including physical therapists, kinesiologists, and occupational therapists, and transcribed verbatim. Two researchers coded data and identified emerging themes. Using the Behaviour Change Wheel framework, themes were categorized into capability, opportunity, and motivation, and relevant interventions were identified. Ninety-four rehabilitation professionals (mean age 40.5 years, 88.3% female) participated. Identified barriers were as follows: capability-lack of training in behaviour change, how to modify recommendations for physical and cognitive impairments; opportunity-lack of resources, time, and team work; motivation-lack of trust between providers, fear in providing interventions that may cause harm. Interventions selected were as follows: education, training, enablement, modelling and persuasion. Policy categories are communication/marketing, guidelines, service provision and environmental/social planning. Key barriers to implementing the recommendations are rehabilitation professionals' ability to use behaviour change techniques, to modify the recommendations for physical and cognitive limitations and to feel comfortable with delivering challenging but safe interventions for people with osteoporosis, and lacking trust and team work across sectors. Future work will report on development and evaluation of knowledge translation interventions informed by our study.

Patient-reported outcome measures in arthroplasty registries

PubMed Central

Bohm, Eric; Franklin, Patricia; Lyman, Stephen; Denissen, Geke; Dawson, Jill; Dunn, Jennifer; Eresian Chenok, Kate; Dunbar, Michael; Overgaard, Søren; Garellick, Göran; Lübbeke, Anne

2016-01-01

Abstract — The International Society of Arthroplasty Registries (ISAR) Patient-Reported Outcome Measures (PROMs) Working Group have evaluated and recommended best practices in the selection, administration, and interpretation of PROMs for hip and knee arthroplasty registries. The 2 generic PROMs in common use are the Short Form health surveys (SF-36 or SF-12) and EuroQol 5-dimension (EQ-5D). The Working Group recommends that registries should choose specific PROMs that have been appropriately developed with good measurement properties for arthroplasty patients. The Working Group recommend the use of a 1-item pain question (“During the past 4 weeks, how would you describe the pain you usually have in your [right/left] [hip/knee]?”; response: none, very mild, mild, moderate, or severe) and a single-item satisfaction outcome (“How satisfied are you with your [right/left] [hip/knee] replacement?”; response: very unsatisfied, dissatisfied, neutral, satisfied, or very satisfied). Survey logistics include patient instructions, paper- and electronic-based data collection, reminders for follow-up, centralized as opposed to hospital-based follow-up, sample size, patient- or joint-specific evaluation, collection intervals, frequency of response, missing values, and factors in establishing a PROMs registry program. The Working Group recommends including age, sex, diagnosis at joint, general health status preoperatively, and joint pain and function score in case-mix adjustment models. Interpretation and statistical analysis should consider the absolute level of pain, function, and general health status as well as improvement, missing data, approaches to analysis and case-mix adjustment, minimal clinically important difference, and minimal detectable change. The Working Group recommends data collection immediately before and 1 year after surgery, a threshold of 60% for acceptable frequency of response, documentation of non-responders, and documentation of incomplete or missing data. PMID:27228230

[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.

Evaluation and recommendations for work group integration within the Materials and Processes Lab

NASA Technical Reports Server (NTRS)

Farrington, Phillip A.

1992-01-01

The goal of this study was to evaluate and make recommendations for improving the level of integration of several work groups within the Materials and Processes Lab at the Marshall Space Flight Center. This evaluation has uncovered a variety of projects that could improve the efficiency and operation of the work groups as well as the overall integration of the system. In addition, this study provides the foundation for specification of a computer integrated manufacturing test bed environment in the Materials and Processes Lab.

Stress in hospice at home nurses: a qualitative study of their experiences of their work and wellbeing.

PubMed

Tunnah, Karen; Jones, Angela; Johnstone, Rosalynde

2012-06-01

The literature has evaluated studies of hospice nurses and stress but very few studies have focused on community hospice nurses. This study explored hospice at home nurses' experiences of caring for palliative and dying patients. Hospice at home nurses working in the community across North West Wales were interviewed and a grounded theory approach was used to categorise the data into the following themes: job satisfaction, stressors, coping strategies, and support. Recommendations arising from the study include encouraging the use of clinical supervision, attendance at multidisciplinary meetings, and the provision of stress-awareness training, and raising awareness of the role of hospice at home nurses in primary care. Implementation of these recommendations might be beneficial for staff wellbeing. Further work would identify whether such recommendations can help to prevent sickness and promote staff retention.

OSHA medical and workplace surveillance requirements and NIOSH recommendations (for employees exposed to toxic substances and other work hazards)

NASA Technical Reports Server (NTRS)

Cooper, L. P.

1983-01-01

Both OSHA medical and work place surveillance requirements and NIOSH recommendations were prepared as a desk reference to help occupational health professionals to perform their duties. The medical surveillance information focuses on frequency of physical examinations, specific problems that may arise as a result of exposure (e.g., decreased immunocompetence, weight loss, ets.), conditions that intensify the harmful effects of exposure (e.g., medication an exposed employee may be taking, cigarette smoking, etc.), the areas that should be scrutinized in medical and work histories and during the physical exam, and specific clinical tests that should be conducted. Recordkeeping requirements are also specified. The workplace surveillance information consists of monitoring requirements, personal protective equipment requirements, and recordkeeping requirements. Such details as the sampling devices that should be used, the type of respirators that should be worn, and the frequency of inspections are included. This document does not specify the training, labeling and posting, and safe work practice requirements and recommendations due to space considerations.

Infectious mononucleosis: return to play.

PubMed

Auwaerter, Paul G

2004-07-01

Infectious mononucleosis most commonly affects adolescents and young adults with a febrile illness accompanied by pharyngitis,lymph node enlargement, and transient fatigue. The diagnosis is usually confirmed with demonstration of heterophile antibodies. Typical signs and symptoms are reviewed, along with pitfalls in diagnosis and management. The rare complication of splenic rupture serves to focus recommendations for returning athletes to strenuous physical activities. Because careful prospective studies of infectious mononucleosis in athletes are lacking, review of available literature suggests that clinicians may recommend a return to all sports in those without spleen enlargement 4 weeks after the onset of illness.

Laboratory-based investigation of suspected mumps cases submitted to the German National Reference Centre for Measles, Mumps, and Rubella, 2008 to 2013.

PubMed

Mankertz, Annette; Beutel, Ulrike; Schmidt, Franz-Josef; Borgmann, Stefan; Wenzel, Jürgen J; Ziegler, Peter; Weißbrich, Benedikt; Santibanez, Sabine

2015-10-01

From 2008 to 2013, sample sets from 534 patients displaying clinical symptoms of mumps were submitted to the German Reference Centre for Measles, Mumps and Rubella. Mumps virus infection was confirmed in 216 cases (40%) by PCR and/or serology. Confirmed cases were more frequently seen in male than in female patients (128 vs. 81); the age group predominantly affected was 15 to 29 years old (65%, median age: 26.4 years). The majority of the confirmed cases had a remote history of vaccination with one or two doses of a mumps-containing vaccine (69%). Our results indicate that mumps virus caused two outbreaks in Bavaria in 2008 and 2010/2011 and a third one in Lower Saxony in 2011. Mumps virus genotype G was preponderantly detected from 2008 to 2013. For 107 of the 216 patients with a confirmed mumps infection, we correlated the results from PCR and serology. PCR detected cases during the first week after onset of symptoms (74% positive results). PCR worked best with throat swabs and oral fluids (61% and 60% positive results, respectively). IgM was more reliable with a longer time after onset of symptoms (67%), but indirect IgM serology was of insufficient sensitivity for vaccinated mumps cases (30%); the IgM μ-capture assay detected more cases in this group. Mumps virus is able to initiate an infection in vaccinated patients (secondary vaccine failure, SVF) although it is unclear to what extent. Since SVF does occur in highly vaccinated populations and IgM will not increase to detectable levels in all SVF patients, we strongly recommend using PCR plus serology tests to avoid false-negative diagnoses in vaccinated individuals with clinical signs of mumps. Copyright © 2015 Elsevier GmbH. All rights reserved.

Best practices for clinical pathology testing in carcinogenicity studies.

PubMed

Young, Jamie K; Hall, Robert L; O'Brien, Peter; Strauss, Volker; Vahle, John L

2011-02-01

The Society of Toxicologic Pathology (STP) and American Society for Veterinary Clinical Pathology (ASCVP) convened a Clinical Pathology in Carcinogenicity Studies Working Group to recommend best practices for inclusion of clinical pathology testing in carcinogenicity studies. Regulatory guidance documents and literature were reviewed, and veterinary pathologists from North America, Japan, and Europe were surveyed regarding current practices, perceived value, and recommendations for clinical pathology testing in carcinogenicity studies. For two-year rodent carcinogenicity studies, the Working Group recommends that clinical pathology testing be limited to collection of blood smears at scheduled and unscheduled sacrifices to be examined only if indicated to aid in the diagnosis of possible hematopoietic neoplasia following histopathologic evaluation. Additional clinical pathology testing is most appropriately used to address specific issues from prior toxicity studies or known test article-related class effects. Inadequate data were available to make a recommendation concerning clinical pathology testing for alternative six-month carcinogenicity assays using genetically modified mice, although the Working Group suggests that it may be appropriate to use the same approach as for two-year carcinogenicity studies since the study goal is the same.

Effects of body height, notebook computer size, and workstation height on recommended adjustments for proper work posture when operating a notebook computer.

PubMed

Nanthavanij, Suebsak; Jalil, Sakib; Ammarapala, Veeris

2008-12-01

Factors which are likely to affect recommended workstation and notebook computer (NBC) adjustments to obtain ergonomic work posture during NBC operation are investigated. They are: (1) body height, (2) NBC size, and (3) workstation height (i.e., seat and work surface heights). Six recommended adjustments which are evaluated include: (1) footrest height, (2) seat support height, (3) NBC base support height, (4) distance between the user's body and NBC (or user-NBC distance), (5) tilt angle of NBC base, and (6) screen angle. It is found that body height has a significant effect on footrest height and user-NBC distance while NBC size has a significant effect on user-NBC distance, tilt angle of NBC base, and screen angle. Workstation height, on the other hand, does not show any effect on the six recommended adjustments. However, the results suggest that there are interactions between body height and NBC size, and between body height and workstation height when evaluating their effects on footrest height, tilt angle of NBC base, and screen angle.

Long-term effects of user preference-oriented recommendation method on the evolution of online system

NASA Astrophysics Data System (ADS)

Shi, Xiaoyu; Shang, Ming-Sheng; Luo, Xin; Khushnood, Abbas; Li, Jian

2017-02-01

As the explosion growth of Internet economy, recommender system has become an important technology to solve the problem of information overload. However, recommenders are not one-size-fits-all, different recommenders have different virtues, making them be suitable for different users. In this paper, we propose a novel personalized recommender based on user preferences, which allows multiple recommenders to exist in E-commerce system simultaneously. We find that output of a recommender to each user is quite different when using different recommenders, the recommendation accuracy can be significantly improved if each user is assigned with his/her optimal personalized recommender. Furthermore, different from previous works focusing on short-term effects on recommender, we also evaluate the long-term effect of the proposed method by modeling the evolution of mutual feedback between user and online system. Finally, compared with single recommender running on the online system, the proposed method can improve the accuracy of recommendation significantly and get better trade-offs between short- and long-term performances of recommendation.

Taxonomy Working Group Final Report

NASA Technical Reports Server (NTRS)

Parsons, Vickie S.; Beil, Robert J.; Terrone, Mark; Barth, Timothy S.; Panontin, Tina L.; Wales, Roxana; Rackley, Michael W.; Milne, James S.; McPherson, John W.; Dutra, Jayne E.;

Factors affecting Polish nurses' willingness to recommend the hospital as a place of care.

PubMed

Kózka, Maria; Brzostek, Tomasz; Cisek, Maria; Brzyski, Piotr; Przewoźniak, Lucyna; Gabryś, Teresa; Ogarek, Maria; Gajda, Krzysztof; Ksykiewicz-Dorota, Anna

Nurses constitute the major professional group offering constant hospital patients' care. Willingness to recommend their hospital reflects confidence in the offered care, satisfaction and identification with the work place. The aim of the present study has been to investigate which elements of hospital environment and nurse personal related factors predict recommendation of the hospital as a place of care by employed nurses. Cross-sectional, correlation study was, based on 1723 self-reported, anonymous questionnaires of nurses working in 30 acute hospitals. Data was analyzed using the logistic regression model, with general estimation equations. About 25% of nurses were unwilling to recommend their hospital as the place of care. The odds ratio (OR) of the lack of willingness to recommend the hospital was related to assessment of patients' safety (OR = 0.28, 95% confidence interval (CI): 0.18-0.46, p = 0.00), decrease in the quality of patient care during the preceding year (OR = 0.62, 95% CI: 0.41-0.93, p = 0.02), overall work conditions (OR = 0.35, 95% CI: 0.22-0.57, p = 0.00), weak cooperation between nurses and physicians (OR = 0.37, 95% CI: 0.25-0.54, p = 0.00), poor work schedule flexibility (OR = 0.74, 95% CI: 0.55- 0.99, p = 0.04) and educational opportunities (OR = 0.71, 95% CI: 0.54-0.95, p = 0.02) and the level of nurses depersonalization (OR = 1.78, 95% CI: 1.18-1.68, p = 0.00). The hospital manager should consider strategies which improve patients' safety and the staff working conditions. Thanks to that they will also achieve better and more competitive image of the hospital in the local community. Med Pr 2016;67(4):447-454. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Perceptions of Effectiveness among College Students: Toward Marriage and Family Counseling and Therapy

ERIC Educational Resources Information Center

Tse, Luke M.; Wantz, Richard A.; Firmin, Michael

2010-01-01

Unlike perceptions toward professional counseling, public opinions do not typically associate marriage and family counseling or therapy with treatments of mental disorders. The current survey of college students in this sample confirmed that most would not recommend, specifically, marriage and family therapists (MFTs) for mental health…

18 CFR 401.88 - Findings, report and Commission review.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Findings, report and... Findings, report and Commission review. (a) The Hearing Officer shall prepare a report of his findings and... findings of a recommended allocation which may increase, reduce or confirm the Executive Director's...

Management Reform. GAO's Comments on the National Performance Review's Recommendations. Report to Congressional Requesters.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

This report provides comments from the General Accounting Office (GAO) on recommendations contained in the National Performance Review's (NPR) September 7, 1993, report which addressed ways to make the government work better and cost less. Generally, the GAO agrees with most of the NPR's recommendations and believes that successful implementation…

A Work of Justice and Progress. The Story of the UNESCO/ILO 1966 Recommendation Concerning the Status of Teachers.

ERIC Educational Resources Information Center

Towsley, Lona

The paper presents a history of the 1966 United Nations Educational, Scientific, and Cultural Organisation (UNESCO)/International Labour Organisation (ILO) recommendation concerning the status of teachers. It spans the years 1945-1966, explaining how the recommendation evolved into the present text designed to improve teacher status and working…

Community Action Guide to Policies for Prevention: The Recommendations of the Join Together Policy Panel on Preventing Substance Abuse.

ERIC Educational Resources Information Center

Join Together, Boston, MA.

This guide accompanies Join Together's recommendations for drug and alcohol abuse prevention for policymakers and communities. It presents strategic examples of how major institutions and residents in communities have paid attention to substance abuse and worked to overcome its effects. Part 1 contains the recommendations and key policies…

Analysis of a genetically structured variance heterogeneity model using the Box-Cox transformation.

PubMed

Yang, Ye; Christensen, Ole F; Sorensen, Daniel

2011-02-01

Over recent years, statistical support for the presence of genetic factors operating at the level of the environmental variance has come from fitting a genetically structured heterogeneous variance model to field or experimental data in various species. Misleading results may arise due to skewness of the marginal distribution of the data. To investigate how the scale of measurement affects inferences, the genetically structured heterogeneous variance model is extended to accommodate the family of Box-Cox transformations. Litter size data in rabbits and pigs that had previously been analysed in the untransformed scale were reanalysed in a scale equal to the mode of the marginal posterior distribution of the Box-Cox parameter. In the rabbit data, the statistical evidence for a genetic component at the level of the environmental variance is considerably weaker than that resulting from an analysis in the original metric. In the pig data, the statistical evidence is stronger, but the coefficient of correlation between additive genetic effects affecting mean and variance changes sign, compared to the results in the untransformed scale. The study confirms that inferences on variances can be strongly affected by the presence of asymmetry in the distribution of data. We recommend that to avoid one important source of spurious inferences, future work seeking support for a genetic component acting on environmental variation using a parametric approach based on normality assumptions confirms that these are met.

Experimental derivation of the fluence non-uniformity correction for air kerma near brachytherapy linear sources

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

Vianello, E. A.; Almeida, C. E. de

2008-07-15

In brachytherapy, one of the elements to take into account for measurements free in air is the non-uniformity of the photon fluence due to the beam divergence that causes a steep dose gradient near the source. The correction factors for this phenomenon have been usually evaluated by two available theories by Kondo and Randolph [Radiat. Res. 13, 37-60 (1960)] and Bielajew [Phys. Med. Biol. 35, 517-538 (1990)], both conceived for point sources. This work presents the experimental validation of the Monte Carlo calculations made by Rodriguez and deAlmeida [Phys. Med. Biol. 49, 1705-1709 (2004)] for the non-uniformity correction specifically formore » a Cs-137 linear source measured using a Farmer type ionization chamber. The experimental values agree very well with the Monte Carlo calculations and differ from the results predicted by both theoretical models widely used. This result confirms that for linear sources there are some important differences at short distances from the source and emphasizes that those theories should not be used for linear sources. The data provided in this study confirm the limitations of the mentioned theories when linear sources are used. Considering the difficulties and uncertainties associated with the experimental measurements, it is recommended to use the Monte Carlo data to assess the non-uniformity factors for linear sources in situations that require this knowledge.« less

[Non-muscle-invasive bladder cancer: Information transfer from the clinic to the doctor's office : Results of a questionnaire study and presentation of a software solution].

PubMed

Lebentrau, S; May, M; Weckermann, D; Speck, T; Wick, A-K; Mathew, M; Schostak, M

2017-02-01

The adjuvant treatment of non-muscle-invasive bladder cancer (NMIBC) is based on the individual risk profile (RP) and its sufficient transfer from the clinic to the doctor's office. The objectives of our study were to verify the importance and degree of transfer of RP and recommendation for risk-adapted adjuvant treatment (RAAT) in patients with NMIBC as well as to develop appropriate tools for this purpose, if necessary. An email-based survey distributed to urologists in Brandenburg, Berlin, Bavaria and Lower Saxony explored the questions mentioned above. In addition, a tool for risk stratification and information transfer for patients with NMIBC was developed and validated. From a total of 134 questionnaires analyzed, 55 were from clinic urologists (CUs) and 79 were from ambulant urologists (AUs). Although 9 out of 10 urologists considered the RP of importance, only 29 % of CUs and 24 % of AUs (p = 0.553) confirmed that the RP was always mentioned in medical reports. The recommendation for RAAT was confirmed from 62 % of CUs and 20 % of AUs (p < 0.001). A recommendation for RAAT in the medical report was requested by 86 % of AUs. The risk calculator presented here - to our knowledge the first with integration of the 2004 WHO grading - is delivered in all mathematically possible constellations a RP, according to guideline recommendations. Urologists in the clinic and doctor's office both attach considerable importance to the determination and transfer of RP and the recommendation for RAAT. There was evidence to suggest an overestimation of the quality of medical reports by the CU. The risk calculator provides an easy and cost-neutral option to improve risk stratification and information transfer from the clinic to the doctor's office.

Assessment of upper limb musculoskeletal pain and posture in workers of packaging units of pharmaceutical industries.

PubMed

Labbafinejad, Yasser; Danesh, Hossein; Imanizade, Zahra

2017-01-01

Work-related musculoskeletal disorders are defined as the disabling or painful injury to the muscles, nerves or tendons that are caused by work or aggravated by it. Some studies confirm the association between working in packaging units in various industries and the pain in the upper limb, but also there are controversies about the possible risk factors among different working populations. The present study aims to define the potential ergonomic risk factors for musculoskeletal pain in the upper limb. The Nordic Musculoskeletal Questionnaire was used for assessment of the musculoskeletal pain. Some other questions about the possible risk factors were included in the questionnaire. In order to assess posture, rapid upper limb assessment (RULA) test was performed by trained ergonomists. The findings of the study reveals that shoulder pain is associated with work history (P-value = 0.01), smoking (P-value = 0.02), the level of education (P-value = 0.04) and age more than 40 years old (P-value = 0.01). Wrist pain was associated with shiftwork (P-value = 0.04) and especially fixed shiftwork (P-value = 0.04) and also age more than 40(P-value = 0.03) and missed days from work with a cut point of 7 days (P-value = 0.03). After regression, only the work history (OR = 14.4 for 10 to 20 years and OR = 32.2 for more than 20 years) and shiftwork (OR = 2.35) remained statistically significant. In this study, RULA was not associated with symptoms in the upper limb in non-heavy working industries so we do not recommend it for screening purposes. The use of decades of working history and shiftwork can be considered for this purpose in the shoulder and wrist pain respectively.

Implications of NGA for NEHRP site coefficients

USGS Publications Warehouse

Borcherdt, Roger D.

2012-01-01

Three proposals are provided to update tables 11.4-1 and 11.4-2 of Minimum Design Loads for Buildings and Other Structures (7-10), by the American Society of Civil Engineers (2010) (ASCE/SEI 7-10), with site coefficients implied directly by NGA (Next Generation Attenuation) ground motion prediction equations (GMPEs). Proposals include a recommendation to use straight-line interpolation to infer site coefficients at intermediate values of ̅vs (average shear velocity). Site coefficients are recommended to ensure consistency with ASCE/SEI 7-10 MCER (Maximum Considered Earthquake) seismic-design maps and simplified site-specific design spectra procedures requiring site classes with associated tabulated site coefficients and a reference site class with unity site coefficients. Recommended site coefficients are confirmed by independent observations of average site amplification coefficients inferred with respect to an average ground condition consistent with that used for the MCER maps. The NGA coefficients recommended for consideration are implied directly by the NGA GMPEs and do not require introduction of additional models.

Classical Hodgkin's lymphoma in adults: guidelines of the Italian Society of Hematology, the Italian Society of Experimental Hematology, and the Italian Group for Bone Marrow Transplantation on initial work-up, management, and follow-up.

PubMed

Brusamolino, Ercole; Bacigalupo, Andrea; Barosi, Giovanni; Biti, Giampaolo; Gobbi, Paolo G; Levis, Alessandro; Marchetti, Monia; Santoro, Armando; Zinzani, Pier Luigi; Tura, Sante

2009-04-01

The Italian Society of Hematology (SIE), the Italian Society of Experimental Haematology (SIES) and the Italian Group for Bone Marrow Transplantation (GITMO) commissioned a project to develop practice guidelines for the initial work-up, therapy and follow-up of classical Hodgkin's lymphoma. Key questions to the clinical evaluation and treatment of this disease were formulated by an Advisory Committee, discussed and approved by an Expert Panel (EP) composed of senior hematologists and one radiotherapist. After a comprehensive and systematic literature review, the EP recommendations were graded according to their supporting evidence. An explicit approach to consensus methodologies was used for evidence interpretation and for producing recommendations in the absence of a strong evidence. The EP decided that the target domain of the guidelines should include only classical Hodgkin's lymphoma, as defined by the WHO classification, and exclude lymphocyte predominant histology. Distinct recommendations were produced for initial work-up, first-line therapy of early and advanced stage disease, monitoring procedures and salvage therapy, including hemopoietic stem cell transplant. Separate recommendations were formulated for elderly patients. Pre-treatment volumetric CT scan of the neck, thorax, abdomen, and pelvis is mandatory, while FDG-PET is recommended. As to the therapy of early stage disease, a combined modality approach is still recommended with ABVD followed by involved-field radiotherapy; the number of courses of ABVD will depend on the patient risk category (favorable or unfavorable). Full-term chemotherapy with ABVD is recommended in advanced stage disease; adjuvant radiotherapy in patients without initial bulk who achieved a complete remission is not recommended. In the elderly, chemotherapy regimens more intensive than ABVD are not recommended. Early evaluation of response with FDG-PET scan is suggested. Relapsed or refractory patients should receive high-dose chemotherapy and autologous hemopoietic stem cells transplant. Allogeneic transplant is recommended in patients relapsing after autologous transplant. All fertile patients should be informed of the possible effects of therapy on gonadal function and fertility preservation measures should be taken before the initiation of therapy.

A systematic review of interventions to promote work participation in older workers.

PubMed

Steenstra, Ivan; Cullen, Kimberley; Irvin, Emma; Van Eerd, Dwayne

2017-02-01

The objective of this systematic review was to synthesize evidence on the effectiveness of interventions aimed at promoting work participation in older workers. We followed a systematic review process developed by the Institute for Work & Health and a best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Seven electronic databases were searched from inception to March 2014. Evidence from 14 studies were synthesized in 4 different intervention categories: multi-component, exercise, medication and other interventions. There was moderate evidence that work participation was improved by multi-component interventions encompassing at least two of three components (health service delivery, coordination of services, and work modifications). There was not enough evidence to recommend the other interventions. Although there is a vast body of research on work participation of older workers, there are only a few high quality intervention studies aimed at improving work participation in this population. We recommend that multi-component interventions could be considered for implementation by practitioners to help improve work participation in older workers. With a moderate level of evidence, multi-component interventions could be considered for use in practice if practitioners deem it suitable for their setting. There is not enough evidence to recommend exercise interventions, pharmaceutical interventions, different types of surgeries, patient education or work accommodation alone to improve work participation. However, the lack of evidence should not be considered, as absence of effect and practitioners should continue to be creative in developing solutions. Copyright © 2016. Published by Elsevier Ltd.

A bottom-up approach to MEDLINE indexing recommendations.

PubMed

Jimeno-Yepes, Antonio; Wilkowski, Bartłomiej; Mork, James G; Van Lenten, Elizabeth; Fushman, Dina Demner; Aronson, Alan R

2011-01-01

MEDLINE indexing performed by the US National Library of Medicine staff describes the essence of a biomedical publication in about 14 Medical Subject Headings (MeSH). Since 2002, this task is assisted by the Medical Text Indexer (MTI) program. We present a bottom-up approach to MEDLINE indexing in which the abstract is searched for indicators for a specific MeSH recommendation in a two-step process. Supervised machine learning combined with triage rules improves sensitivity of recommendations while keeping the number of recommended terms relatively small. Improvement in recommendations observed in this work warrants further exploration of this approach to MTI recommendations on a larger set of MeSH headings.

Investigation of an Outbreak of Variant Influenza A(H3N2) Virus Infection Associated With an Agricultural Fair-Ohio, August 2012.

PubMed

Greenbaum, Adena; Quinn, Celia; Bailer, Jennifer; Su, Su; Havers, Fiona; Durand, Lizette O; Jiang, Victoria; Page, Shannon; Budd, Jeremy; Shaw, Michael; Biggerstaff, Matthew; de Fijter, Sietske; Smith, Kathleen; Reed, Carrie; Epperson, Scott; Brammer, Lynnette; Feltz, Dave; Sohner, Kevin; Ford, Jared; Jain, Seema; Gargiullo, Paul; Weiss, Edward; Burg, Pat; DiOrio, Mary; Fowler, Brian; Finelli, Lyn; Jhung, Michael A

2015-11-15

In 2012, one third of cases in a multistate outbreak of variant influenza A(H3N2) virus ([H3N2]v) infection occurred in Ohio. We conducted an investigation of (H3N2)v cases associated with agricultural Fair A in Ohio. We surveyed Fair A swine exhibitors and their household members. Confirmed cases had influenza-like illness (ILI) and a positive laboratory test for (H3N2)v, and probable cases had ILI. We calculated attack rates. We determined risk factors for infection, using multivariable log-binomial regression. We identified 20 confirmed and 94 probable cases associated with Fair A. Among 114 cases, the median age was 10 years, there were no hospitalizations or deaths, and 82% had swine exposure. In the exhibitor household cohort of 359 persons (83 households), we identified 6 confirmed cases (2%) and 40 probable cases (11%). An age of <10 years was a significant risk factor (P < .01) for illness. One instance of likely human-to-human transmission was identified. In this (H3N2)v outbreak, no evidence of sustained human-to-human (H3N2)v transmission was found. Our risk factor analysis contributed to the development of the recommendation that people at increased risk of influenza-associated complications, including children aged <5 years, avoid swine barns at fairs during the 2012 fair season. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Developmental Neurotoxicology: History and Outline of ...

EPA Pesticide Factsheets

The present work provides a brief review of basic concepts in developmental neurotoxicology, as well as current representative testing guidelines for evaluating developmental neurotoxicity (DNT) of xenobiotics. Historically, DNT was initially recognized as a “functional” teratogenicity: the main concern was that prenatal and/or early postnatal exposures to chemicals during critical periods of central nervous system (CNS) development would cause later functional abnormalities of the brain. Current internationally harmonized DNT study guidelines are thus intended to predict adverse effects of test compounds on the developing CNS by observing such postnatal parameters as motor activity, startle response, and learning and memory, as well as neropathological alterations. The reliability of current DNT study guidelines and sensitivity of testing methodologies recommended in these guidelines have been confirmed by retrospective evaluations of the many international and domestic collaborative validation studies in developed nations including Japan. Invited review with brief review of basic concepts in developmental neurotoxicology, as well as current representative testing guidelines for evaluating developmental neurotoxicity (DNT) of xenobiotics.

The experience of international doctoral education in nursing: an exploratory survey of staff and international nursing students in a British university.

PubMed

Evans, Catrin

2007-07-01

As part of the internationalization of higher education, increasing numbers of international doctoral students are coming to study in British nursing schools. This paper reports on a small-scale exploratory survey that sought to investigate the educational experiences of these students and their supervisors in one British School of Nursing. Both staff and students saw great value in international education. However both groups identified the need for greater support to facilitate adjustment in a number of areas, including: understanding the PhD process, studying in a second language, working within a different academic culture, managing the supervision relationship, and finding a sense of community. This was a small study, but the findings confirm key issues identified in the limited available literature. Recommendations include staff training and the development of additional in-puts for students. Future research should include qualitative, longitudinal and multi-site studies to more thoroughly assess the process and outcomes of international doctoral education in nursing.

Prediction of problematic wine fermentations using artificial neural networks.

PubMed

Román, R César; Hernández, O Gonzalo; Urtubia, U Alejandra

2011-11-01

Artificial neural networks (ANNs) have been used for the recognition of non-linear patterns, a characteristic of bioprocesses like wine production. In this work, ANNs were tested to predict problems of wine fermentation. A database of about 20,000 data from industrial fermentations of Cabernet Sauvignon and 33 variables was used. Two different ways of inputting data into the model were studied, by points and by fermentation. Additionally, different sub-cases were studied by varying the predictor variables (total sugar, alcohol, glycerol, density, organic acids and nitrogen compounds) and the time of fermentation (72, 96 and 256 h). The input of data by fermentations gave better results than the input of data by points. In fact, it was possible to predict 100% of normal and problematic fermentations using three predictor variables: sugars, density and alcohol at 72 h (3 days). Overall, ANNs were capable of obtaining 80% of prediction using only one predictor variable at 72 h; however, it is recommended to add more fermentations to confirm this promising result.

T-cell immunity of SARS-CoV: Implications for vaccine development against MERS-CoV.

PubMed

Liu, William J; Zhao, Min; Liu, Kefang; Xu, Kun; Wong, Gary; Tan, Wenjie; Gao, George F

2017-01-01

Over 12 years have elapsed since severe acute respiratory syndrome (SARS) triggered the first global alert for coronavirus infections. Virus transmission in humans was quickly halted by public health measures and human infections of SARS coronavirus (SARS-CoV) have not been observed since. However, other coronaviruses still pose a continuous threat to human health, as exemplified by the recent emergence of Middle East respiratory syndrome (MERS) in humans. The work on SARS-CoV widens our knowledge on the epidemiology, pathophysiology and immunology of coronaviruses and may shed light on MERS coronavirus (MERS-CoV). It has been confirmed that T-cell immunity plays an important role in recovery from SARS-CoV infection. Herein, we summarize T-cell immunological studies of SARS-CoV and discuss the potential cross-reactivity of the SARS-CoV-specific immunity against MERS-CoV, which may provide useful recommendations for the development of broad-spectrum vaccines against coronavirus infections. Copyright © 2016 Elsevier B.V. All rights reserved.

Workflow interruptions, cognitive failure and near-accidents in health care.

PubMed

Elfering, Achim; Grebner, Simone; Ebener, Corinne

2015-01-01

Errors are frequent in health care. A specific model was tested that affirms failure in cognitive action regulation to mediate the influence of nurses' workflow interruptions and safety conscientiousness on near-accidents in health care. One hundred and sixty-five nurses from seven Swiss hospitals participated in a questionnaire survey. Structural equation modelling confirmed the hypothesised mediation model. Cognitive failure in action regulation significantly mediated the influence of workflow interruptions on near-accidents (p < .05). An indirect path from conscientiousness to near-accidents via cognitive failure in action regulation was also significant (p < .05). Compliance with safety regulations was significantly related to cognitive failure and near-accidents; moreover, cognitive failure mediated the association between compliance and near-accidents (p < .05). Contrary to expectations, compliance with safety regulations was not related to workflow interruptions. Workflow interruptions caused by colleagues, patients and organisational constraints are likely to trigger errors in nursing. Work redesign is recommended to reduce cognitive failure and improve safety of nurses and patients.

Professional Ethics for Astronomers

NASA Astrophysics Data System (ADS)

Marvel, K. B.

2005-05-01

There is a growing recognition that professional ethics is an important topic for all professional scientists, especially physical scientists. Situations at the National Laboratories have dramatically proven this point. Professional ethics is usually only considered important for the health sciences and the legal and medical professions. However, certain aspects of the day to day work of professional astronomers can be impacted by ethical issues. Examples include refereeing scientific papers, serving on grant panels or telescope allocation committees, submitting grant proposals, providing proper references in publications, proposals or talks and even writing recommendation letters for job candidates or serving on search committees. This session will feature several speakers on a variety of topics and provide time for questions and answers from the audience. Confirmed speakers include: Kate Kirby, Director Institute for Theoretical Atomic and Molecular Physics - Professional Ethics in the Physical Sciences: An Overview Rob Kennicutt, Astrophysical Journal Editor - Ethical Issues for Publishing Astronomers Peggy Fischer, Office of the NSF Inspector General - Professional Ethics from the NSF Inspector General's Point of View

Social, occupational and cultural adaptation in Antarctica

NASA Astrophysics Data System (ADS)

Nicolas, Michel; Bishop, Sheryl; Weiss, Karine; Gaudino, Marvin

2016-07-01

Life in isolated and confined environments (ICEs, e.g., polar stations, submarine or space missions), is subject to important constraints which can generate psychosociological impaired outcomes. This study investigated psychological, social, occupational and cultural variables which are among the most important determinants in adaptation to a one-year wintering in Antarctica with 13 international participants. Our findings confirm and give further insight into the role of social (Cohesiveness, Social Support) and occupational (Implementation / Preparedness, Counterproductive Activity, Decision Latitude and Psychological Job Demands) dimensions of adaptation to ICE environments. Relationships between various social and occupational dimensions studies reflected detrimental effects ranging from decrements in cohesiveness, social support and work performance which differed across professional status and multicultural factors. These psychosocial issues have important implications for pre-mission selection and training, monitoring and support of crews during the mission and post-mission readaptation. Operational recommendations are suggested to improve adaptation, success and well-being for long-term ICE missions, e.g., to Mars and beyond.

[Temporary employment and health: a multivariate analysis of occupational injury risk by job tenure].

PubMed

Bena, Antonella; Giraudo, Massimiliano

2013-01-01

To study the relationship between job tenure and injury risk, controlling for individual factors and company characteristics. Analysis of incidence and injury risk by job tenure, controlling for gender, age, nationality, economic activity, firm size. Sample of 7% of Italian workers registered in the INPS (National Institute of Social Insurance) database. Private sector employees who worked as blue collars or apprentices. First-time occupational injuries, all occupational injuries, serious occupational injuries. Our findings show an increase in injury risk among those who start a new job and an inverse relationship between job tenure and injury risk. Multivariate analysis confirm these results. Recommendations for improving this situation include the adoption of organizational models that provide periods of mentoring from colleagues already in the company and the assignment to simple and not much hazardous tasks. The economic crisis may exacerbate this problem: it is important for Italy to improve the systems of monitoring relations between temporary employment and health.

Antibiotic managment in renal failure.

PubMed

Winter, R E

1976-06-01

This is a brief compilation of the work of many investigators. It includes facts about toxicity and recommendations about antibiotic management in patients with renal failure. As new data are accrued, changes in these recommendations will be necessary.

Screening for Glaucoma

MedlinePlus

... independent group of national experts in prevention and evidence- based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo.

PubMed

Mohammad, Tasneem F; Al-Jamal, Mohammed; Hamzavi, Iltefat H; Harris, John E; Leone, Giovanni; Cabrera, Raúl; Lim, Henry W; Pandya, Amit G; Esmat, Samia M

2017-05-01

Treatment of vitiligo with narrowband ultraviolet B light (NBUVB) is an important component of the current standard of care. However, there are no consistent guidelines regarding the dosing and administration of NBUVB in vitiligo, reflected by varied treatment practices around the world. To create phototherapy recommendations to facilitate clinical management and identify areas requiring future research. The Vitiligo Working Group (VWG) Phototherapy Committee addressed 19 questions regarding the administration of phototherapy over 3 conference calls. Members of the Photomedicine Society and a group of phototherapy experts were surveyed regarding their phototherapy practices. Based on comparison and analysis of survey results, expert opinion, and discussion held during conference calls, expert recommendations for the administration of NBUVB phototherapy in vitiligo were created. There were several areas that required further research before final recommendations could be made. In addition, no standardized methodology was used during literature review and to assess the strength of evidence during the development of these recommendations. This set of expert recommendations by the VWG is based on the prescribing practices of phototherapy experts from around the world to create a unified, broadly applicable set of recommendations on the use of NBUVB in vitiligo. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. 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.

Meeting Summary, Credit Trading Work Group

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

Kevin Bryan

2000-12-07

OAK-B135 Credit Trading Work Group Meeting Summary. The purpose of the meeting is to: (1) Provide an opportunity for NWCC Work Group Members, NWCC Members, and invited expert participants to hear an overview of the draft NWCC Credit Trading Report and to critically review and discuss the report's recommendations and principles. (2) Hear presentations from several perspectives of other experts on credit trading which provide: (a) a brief summary of credit trading activities they are involved in, and (b) critical responses to the NWCC draft report. (3) Identify how the report can be improved at the big picture level. Attemptmore » to resolve issues or concerns if necessary. (4) Discuss the recommendations and credit trading principles in detail and attempt to reach consensus on these sections for presentation to the NWCC. (5) Discuss if any of the outreach and communication recommendations in the report should be conducted by the NWCC.« less

76 FR 14017 - Call for Comments on the Draft Report of the Adult Immunization Working Group to the National...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-15

... and recommendations could be found on the Web at http://www.hhs.gov/nvpo/nvac/subgroups/adultimmunization . The Web address where the draft report and recommendations can be found is http://www.hhs.gov...) The draft report and recommendations are available on the Web at http://www.hhs.gov/nvpo/nvac...

A Semantically Enriched Context-Aware OER Recommendation Strategy and Its Application to a Computer Science OER Repository

ERIC Educational Resources Information Center

Ruiz-Iniesta, Almudena; Jiménez-Díaz, Guillermo; Gómez-Albarrán, Mercedes

2014-01-01

This paper describes a knowledge-based strategy for recommending educational resources-worked problems, exercises, quiz questions, and lecture notes-to learners in the first two courses in the introductory sequence of a computer science major (CS1 and CS2). The goal of the recommendation strategy is to provide support for personalized access to…

Screening for Ovarian Cancer

MedlinePlus

... independent group of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Screening for Prostate Cancer

MedlinePlus

... independent group of national experts in prevention and evidence- based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Screening for Cervical Cancer

MedlinePlus

... independent group of national experts in prevention and evidence- based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Screening for Chronic Kidney Disease

MedlinePlus

... independent group of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Recommendations for UAS Crew Ratings. Pilot Ratings and Authorization Requirements for UAS

NASA Technical Reports Server (NTRS)

2005-01-01

This position paper is intended to recommend the minimum certificate and rating requirements for a pilot to operate an Unmanned Aircraft System (UAS) in the National Airspace System. The paper will recommend the minimum requirements based on the Knowledge, Skills, and Abilities (KSA) required of a UAS pilot and show how those compare to the KSAs required by regulation for manned-aircraft pilots. The paper will provide substantiation based on studies conducted using analyses, simulation and flight experience. The paper is not yet complete; only initial working material is included. The material provided describes the body of work completed thus far and the plan for remaining tasks to complete the recommendation. The HSI Pilot KSA document provides an analysis of the knowledge, skills, and abilities required for UAS operation in the NAS. It is the source document used for the position paper.

Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the International Society of Urological Pathology consensus conference.

PubMed

Amin, Mahul B; Epstein, Jonathan I; Ulbright, Thomas M; Humphrey, Peter A; Egevad, Lars; Montironi, Rodolfo; Grignon, David; Trpkov, Kiril; Lopez-Beltran, Antonio; Zhou, Ming; Argani, Pedram; Delahunt, Brett; Berney, Daniel M; Srigley, John R; Tickoo, Satish K; Reuter, Victor E

2014-08-01

Members of the International Society of Urological Pathology (ISUP) participated in a half-day consensus conference to discuss guidelines and recommendations regarding best practice approaches to use of immunohistochemistry (IHC) in differential diagnostic situations in urologic pathology, including bladder, prostate, testis and, kidney lesions. Four working groups, selected by the ISUP leadership, identified several high-interest topics based on common or relevant challenging diagnostic situations and proposed best practice recommendations, which were discussed by the membership. The overall summary of the discussions and the consensus opinion forms the basis of a series of articles, one for each organ site. This Special Article summarizes the overall recommendations made by the four working groups. It is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.

[The general criteria and recommendations for the elaboration of programs for the early detection of breast cancer and cervical cancer in Spain. The Working Group for the Early Detection of Breast Cancer and Cervical Cancer].

PubMed

Ascunze Elizaga, N; González Enríquez, J; González Navarro, A; Herranz Fernández, C; Marqués Bravo, A; Martín Pérez, J

1993-01-01

Cancer screening and primary prevention of cancer are effective strategies to reduce cancer morbidity and mortality. The experience gained in several European countries about breast and cervical cancer has been growing in the last decades. This fact facilitates the adoption of the most convenient strategies to implement screening programmes in Spain. The Spanish Ministry of Health and Consumer Affairs set up a work group of experts and health managers to make recommendations and to define the basic criteria to take into account when planning and implementing these programmes. The article describes those recommendations as well as the priorities to be established regarding the target population, and the strategies to increase efficiency of those programmes. Recommendations were made according with scientific evidences and the current situation and resources in Spain.

Health Transportation Working Group 2016 Annual Report

DOT National Transportation Integrated Search

2017-06-30

The Health in Transportation Working Group 2016 Annual Report provides an overview of the Working Groups activities and accomplishments in 2016, summarizes other USDOT health-related accomplishments, and documents its progress toward the recommend...

Endosonography and cytology in diagnosing and staging pancreatic body and tail carcinoma: Preliminary results of endosonographic guided puncture

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

Tio, T.L.; Sie, L.H.; Tytgat, G.N.J.

1993-01-01

Endosonography was performed in diagnosing and staging pancreatic body and tail carcinoma in two patients. In the first case endoscopy, abdominal ultrasound, and computed tomography were nondiagnostic in diagnosing the origin of submucosal gastric abnormalities. Endosonography diagnosed a pancreatic tail carcinoma with submucosal gastric involvement, and this was confirmed by endosonographic-guided cytology. Fundus varices due to segmented splenic vein involvement were found. Surgery was not recommended due to the advanced disease. In the second case pancreatic body carcinoma was diagnosed by ERCP and computed tomography. Transcutaneous ultrasonographic-guided cytological puncture confirmed the diagnosis. Endosonography revealed additional information of segmental portal hypertensionmore » with fundic varices due to splenic vein involvement. Autopsy confirmed the endosonographic diagnosis. 18 refs., 5 figs.« less

Occupational health of self-employed women workers. Experiences from community based studies of the Self-Employed Women's Association (SEWA).

PubMed

Chatterjee, M

1993-02-01

The Self-Employed Workers' Association (SEWA) has conducted 4 longitudinal, community-based studies to survey the occupational health of self-employed women in Ahmedabad and Indore, India. It included the workers in all stages of research. SEWA staff examined women in readymade garment, bidi, agarbatti, and masala fields. Since SEWA did not use control groups, they could not establish cause and effect relationships. Masala workers had the highest illiteracy rate (66%). At least 50% of all workers (89% of readymade garment workers) worked 8-12 hours/day. Daily wages of most workers did not exceed Rs.10, confirming their low poverty level. The most common occupational health problem while working was pain in the limbs for bidi (63%) and readymade garment workers (80%). They also experienced back pain and headaches. After work, back pain was common among agarbatti (73%) and masala (39%) workers. Masala workers also suffered from blisters and calluses (51%) and burning sensation (45%), particularly in their hands. Gynecological problems (e.g., early periods, white discharge, and burning sensation while urinating) and abdominal pain were common in all 4 groups. These results demonstrated a need for further research on occupational health and gynecological diseases; health facilities to adjust services to meet self-employed workers needs; provision of safe and subsidized tools, safety equipment, benefits (e.g., sick leave and child care), and health insurance; and health education. SEWA recommends that self-employed workers receive identity cards, the government enforce minimum wage laws and regulate working hours, and workers are provided basic amenities (e.g., potable water and sanitation).

A survey of the Queensland healthcare workforce: attitudes towards dementia care and training

PubMed Central

2013-01-01

Background Positive attitudes of healthcare staff towards people with dementia promote higher quality care, although little is known about important factors that underlie positive attitudes. Key aims of this project were to explore the relationships between staff attitudes towards dementia, self-confidence in caring for people with dementia, experience and dementia education and training. Methods A brief online survey was developed and widely distributed to registered nurses and allied health professionals working in Queensland in 2012. Regression analyses were performed to identify important predictors of self-confidence in caring for people with dementia and positive attitudes towards people with dementia. Results Five hundred and twenty-four surveys were completed by respondents working in a range of care settings across Queensland. Respondents were predominantly female (94.1%), and most were registered nurses (60%), aged between 41 and 60 years (65.6%). Around 40% regularly worked with people with dementia and high levels of self-confidence in caring for this population and positive attitudes towards people with dementia were reported. The majority of respondents (67%) had participated in a dementia education/training activity in the past 12 months. More experience working with people with dementia predicted greater self-confidence while recent participation in a dementia education/training and higher self-confidence in caring for a person with dementia significantly predicted more positive attitudes towards people with dementia. Conclusions These results confirm the importance of self-confidence and dementia education in fostering positive attitudes and care practices towards people with dementia. Our results also indicate that the demand for ongoing dementia education is high amongst health care workers and it is recommended that regular dementia education/ training be provided and promoted for all healthcare personnel who work with people with dementia. PMID:24073708

The Evidence Base for Interventions Targeting Individuals With Work-Related PTSD: A Systematic Review and Recommendations.

PubMed

Torchalla, Iris; Strehlau, Verena

2018-03-01

The purpose of this study was to summarize the evidence base for interventions targeting individuals with work-related posttraumatic stress disorder (PTSD), to make recommendations for clinicians and administrative decision makers involved in their rehabilitation, and to guide future research in this area. Particular attention was given to studies that were conducted in naturalistic clinical settings or in a workers' compensation claim context. Electronic searches of Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, PsycINFO, CINAHL, PILOTS, and EMBASE identified 11 articles. Study populations included railroad personnel, police officers, disaster workers, and individuals with industrial injuries. Interventions included trauma-focused cognitive-behavioral therapy and eye movement desensitization and reprocessing. Several studies specifically targeted workers who had failed to return to work (RTW) after standard PTSD treatment. The results suggest that psychotherapy interventions are beneficial for helping clients recover from PTSD symptoms and RTW. In studies that reported on work status, RTW rates increased over time and generally lay between 58% and 80% across follow-up time points. Narrative impressions were supplemented by calculation of Risk Differences for individuals working at pretreatment versus posttreatment. Clinical consideration, methodological issues limiting the current body of work, and recommendations for future research are discussed.

Recommendations for the detection and therapeutic management of cognitive impairment in multiple sclerosis.

PubMed

Bensa, C; Bodiguel, E; Brassat, D; Laplaud, D; Magy, L; Ouallet, J-C; Zephir, H; De Seze, J; Blanc, F

2012-11-01

The aim of the Multiple Sclerosis Think Tank (Groupe de réflexion sur la sclérose en plaques [GRESEP]) is to prescribe recommendations following a systematic literature search and using a Rand Corporation and California University (RAND/UCLA) appropriateness derived method, in response to practical questions that are raised in the management of patients with multiple sclerosis (MS). The topics of this working program were chosen because they were not addressed in the French recommendations and because of the few data in the literature that enabled practices to be based on validated data. Following the theme on useful serum testing with suspected multiple sclerosis, the subjects of the present work concern the detection and management of cognitive impairment in the beginning stages of the disease course. Two clinical questions were asked: which complementary exams (besides physical examination and neuropsychological tests) would help in the screening of cognitive impairment at the beginning of the disease? What care management should the person with MS and cognitive impairment be offered (treatments and neurocognitive rehabilitation)? The recommendations are the result of a consensus amongst a working group, a rating group and a reading group comprised of hospital neurologists involved in the management of patients with multiple sclerosis. Each recommendation is presented with the degree of consensus that it was accorded. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Atomization of a liquid by a spray nozzle

NASA Technical Reports Server (NTRS)

Kutateladze, S. S. (Editor)

1980-01-01

The theory of atomization by mechanical and pneumatic (or vapor) spray nozzles is discussed. Basic design recommendations resulting from generalization of the material and confirmed by experiments are given. Sprayers which are widely used in the furnaces of stationary steam boilers, the combustion chambers of gas turbines, and industrial furnaces are examined.

Use of APTIMA Combo 2: The Experience of a Child Advocacy Center

ERIC Educational Resources Information Center

Leder, M. Ranee; Leber, Amy L.; Marcon, Mario J.; Scribano, Philip V.

2013-01-01

The Centers for Disease Control and Prevention recommends nucleic acid amplification testing for chlamydia and gonorrhea in sexually abused girls. No studies describe performance of APTIMA Combo 2 Assay with second target confirmation on the same testing platform. This nucleic acid amplification testing is evaluated within a large child advocacy…

New Foci of Buruli Ulcer, Angola and Democratic Republic of Congo

PubMed Central

Kibadi, Kapay; Panda, Mbutu; Tamfum, Jean-Jacques Muyembe; Fraga, Alexandra G.; Filho, Adhemar Longatto; Anyo, Gladys; Pedrosa, Jorge; Nakazawa, Yoshinori; Suykerbuyk, Patrick; Meyers, Wayne M.

2008-01-01

We report 3 patients with laboratory-confirmed Buruli ulcer in Kafufu/Luremo, Angola, and Kasongo-Lunda, Democratic Republic of Congo. These villages are near the Kwango/Cuango River, which flows through both countries. Further investigation of artisanal alluvial mining as a risk factor for Buruli ulcer is recommended. PMID:18976574

75 FR 81613 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

...-O157 Shiga Toxin-Producing E. coli Study: Assessment of Risk Factors for Laboratory-Confirmed... Brief Description Each year many Shiga toxin-producing E. coli (STEC) infections occur in the United... an e-mail to [email protected] . Comments are invited on: (a) Whether the proposed collection of...

The Great Fallacy of the H Plus Ion and the True Nature of H30 Plus.

ERIC Educational Resources Information Center

Giguere, Paul A.

1979-01-01

Experimental and theoretical data are presented which verifies the existence of the hydronium ion. This existence was confirmed directly by x-ray and neutron diffraction in hydrochloric acid. Recommended is the abandonment of the erroneous hydrogen ion formulation and names such as proton hydrate. (BT)

Formulation of diazepam containing rectal suppositories and experiences of their biopharmaceutical study.

PubMed

Regdon, G; Bácskay, I; Kata, M; Selmeczi, B; Szikszay, M; Sánta, A; Bálint, G S

1994-05-01

Methodology and the results of the in vitro membrane diffusion and in vivo bioavailability studies are presented. The results confirm a correlation between in vitro and in vivo findings. Hydrophilic macrogol-mixture with great molecular mass can be recommended as the optimal vehicle for formulation of diazepam suppositories.

Quality of work life in doctors working with cancer patients.

PubMed

Bragard, I; Dupuis, G; Razavi, D; Reynaert, C; Etienne, A-M

2012-01-01

Although studies have shown that medical residents experience poor psychological health and poor organizational conditions, their quality of work life (QWL) had not been measured. A new tool, the Quality of Work Life Systemic Inventory (QWLSI), proposes to fill the gap in the definition and assessment of this concept. To confirm the convergent validity of the QWLSI, analyse Belgian medical residents' QWL with the QWLSI and discuss an intervention methodology based on the analysis of the QWLSI. One hundred and thirteen medical residents participated between 2002 and 2006. They completed the QWLSI, the Maslach Burnout Inventory and the Job Stress Survey to confirm the correspondence between these three tools. Residents' low QWL predicted high emotional exhaustion (β = 0.282; P < 0.01) and job stress (β = 0.370; P < 0.001) levels, confirming the convergent validity. This sample of medical residents had an average QWL (μ = 5.8; SD = 3.1). However, their QWL was very low for three subscales: arrangement of work schedule (μ = 9; SD = 6.3), support offered to employee (μ = 7.6; SD = 6.1) and working relationship with superiors (μ = 6.9; SD = 5.3). The results confirm that the QWLSI can provide an indication of workers' health well-being and of organizational performance in different areas of work life. The problem factors found among Belgian medical residents suggest that prevention should focus on reduction of work hours, development of support and change in leadership style.

Aeromedical evacuation using an aircraft transit isolator of a patient with Lassa fever.

PubMed

Lotz, Eric; Raffin, Hervé

2012-05-01

Lassa fever is a viral hemorrhagic fever only present in West Africa. The mortality rate is 1% and may reach 15% among hospitalized patients. Transmission between humans is mostly due to direct contact with infected body fluids. Aeromedical evacuation of patients with viral hemorrhagic fevers (such as Lassa fever) demands strict isolation measures. Only a few cases of such evacuations have been reported in the literature during the last 40 yr. The use of an aircraft transit isolator device could be helpful. We report the aeromedical evacuation of a confirmed Lassa fever patient from Sierra Leone to Sweden with a dedicated air ambulance using an aircraft transit isolator. The patient was a 30-yr-old physician working for a nonprofit organization. The patient contracted the disease working with infected hospitalized patients. The duration of the mission between activation and arrival at the Swedish hospital was 36 h, which is within the World Health Organization recommendations. Evacuation of patients with potentially lethal contagious infections is possible, but only with strict isolation measures. Specific protective equipment and isolator are mandatory. Medical and technical crews performing such evacuations should be trained in proper equipment use and the isolator should first be used with a low-risk patient to create minimal risk transport conditions.

Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings

PubMed Central

Modesti, Pietro A.; Agostoni, Piergiuseppe; Agyemang, Charles; Basu, Sanjay; Benetos, Athanase; Cappuccio, Francesco P.; Ceriello, Antonio; Del Prato, Stefano; Kalyesubula, Robert; O’Brien, Eoin; Kilama, Michael O.; Perlini, Stefano; Picano, Eugenio; Reboldi, Gianpaolo; Remuzzi, Giuseppe; Stuckler, David; Twagirumukiza, Marc; Van Bortel, Luc M.; Watfa, Ghassan; Zhao, Dong; Parati, Gianfranco

2014-01-01

The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on ‘Hypertension and Cardiovascular risk in low resource settings’, which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs. PMID:24577410

Biperiden for treatment of somnambulism in adolescents and adults with or without epilepsy: clinical observations.

PubMed

Hodoba, Danilo; Schmidt, Dieter

2012-12-01

Sleepwalking in adolescents and adults may lead to serious injuries and require treatment. Anecdotal treatment recommendations include benzodiazepines (which also work in focal seizures of the frontal lobe that are an important differential diagnosis), imipramine and amitriptyline. We assessed in a follow-up study of 4 years (medium, range: 2-7 years) the usefulness of the antiparkinsonian drug biperiden (Akineton©), an acetylcholine antagonist with high affinity for muscarinic M1-type receptors, in four consecutive cases of arousal disorder with sleepwalking and confusional behavior in adolescents and adults with or without epilepsy who did not respond to diazepam, clonazepam or amitriptyline. The adjunctive use of biperiden was associated with reduction or remission of sleepwalking episodes in four consecutive treatment-refractory cases of arousal disorder with sleepwalking and confusional behavior. In contrast, biperiden showed no effect in a patient with REM behavioral disorder. Although our observations do not and cannot establish the efficacy or safety of biperiden, it may be useful to consider biperiden for treatment of sleepwalking, if needed. A putative cholinergic mechanism of arousal disorders, including sleepwalking, provides a reasonable hypothesis why the anticholinergic agent biperiden might work. Evidence for efficacy and safety from randomized controlled trials is needed to confirm our preliminary observations. Copyright © 2012 Elsevier Inc. All rights reserved.

Immunotherapy Response Assessment in Neuro-Oncology (iRANO): A Report of the RANO Working Group

PubMed Central

Okada, Hideho; Weller, Michael; Huang, Raymond; Finocchiaro, Gaetano; Gilbert, Mark R.; Wick, Wolfgang; Ellingson, Benjamin M.; Hashimoto, Naoya; Pollack, Ian F.; Brandes, Alba A.; Franceschi, Enrico; Herold-Mende, Christel; Nayak, Lakshmi; Panigrahy, Ashok; Pope, Whitney B.; Prins, Robert; Sampson, John H.; Wen, Patrick Y.; Reardon, David A.

2015-01-01

Immunotherapy represents a promising area of therapy among neuro-oncology patients. However, early phase studies reveal unique challenges associated with assessment of radiological changes reflecting delayed responses or therapy-induced inflammation. Clinical benefit, including long-term survival and tumor regression, can still occur following initial apparent progression or appearance of new lesions. Refinement of response assessment criteria for neuro-oncology patients undergoing immunotherapy is therefore warranted. A multinational and multidisciplinary panel of neuro-oncology immunotherapy experts describes immunotherapy response assessment for neuro-oncology (iRANO) criteria that are based on guidance for determination of tumor progression outlined by the immune-related response criteria (irRC) and the response assessment in neuro-oncology (RANO) working group. Among patients who demonstrate imaging findings meeting RANO criteria for progressive disease (PD) within six months of initiating immunotherapy including the development of new lesions, confirmation of radiographic progression on follow-up imaging is recommended provided that the patient is not significantly worse clinically. The proposed criteria also include guidelines for use of corticosteroids. The role of advanced imaging techniques and measurement of clinical benefit endpoints including neurologic and immunologic functions are reviewed. The iRANO guidelines put forth herein will evolve successively to improve their utility as further experience from immunotherapy trials in neuro-oncology accumulate. PMID:26545842

Evaluating spatial memory function in mice: a within-subjects comparison between the water maze test and its adaptation to dry land.

PubMed

Llano Lopez, L; Hauser, J; Feldon, J; Gargiulo, P A; Yee, B K

2010-05-01

The Morris water maze (WM) is a common spatial memory test in rats. It has been adapted for evaluating genetic manipulations in mice. One major acknowledged problem of this cross-species translation is floating. We investigated here in mice the feasibility and practicality of an alternative paradigm-the cheeseboard (CB), which is a dry version of the WM, in a within-subject design allowing direct comparison with the conventional WM. Under identical task demands (reference or working memory), mice learned in the CB as efficiently as in the WM. Furthermore, individual differences in learning rate correlated between the two reference memory tests conducted separately in the two mazes. However, no such correlation was found with respect to reference memory retention or working memory performance. This study demonstrated that the CB is an effective alternative to the WM as spatial cognition test. Additional tests in the CB confirmed that the mice relied on extra maze cues in their spatial search. We would recommend the CB as a valuable addition to, rather than a replacement of the WM in phenotyping transgenic mice, because the two apparatus might diverge in the ability to detect individual differences in various domains of mnemonic functions.

Helicobacter pylori and non-malignant diseases.

PubMed

Furuta, Takahisa; Delchier, Jean-Charles

2009-09-01

It is well known that Helicobacter pylori infection is associated with many nonmalignant disorders such as gastritis, peptic ulcer, gastroesophageal reflux disease (GERD), gastric polyp, nonsteroidal anti-inflammatory drug (NSAID)/aspirin-induced gastric injury, and functional dyspepsia. In 2008, interesting articles on the association of H. pylori infection with these disorders were presented, some of which intended to reveal the mechanisms of inter-individual differences in response to H. pylori infection, and have demonstrated that genetic differences in host and bacterial factors as well as environmental factors account for these differences. A decline in the occurrence of peptic ulcer related to H. pylori was confirmed. An inverse relationship between H. pylori infection and GERD was also confirmed but the impact of gastric atrophy on the prevention of GERD remained debatable. For NSAID-induced gastric injury, eradication of H. pylori infection has been recommended. During this year, eradication of H. pylori infection was recommended for patients treated with antiplatelet therapy as well as aspirin and NSAID. It was also reported that for patients with functional dyspepsia, eradication of H. pylori offers a modest but significant benefit.

Introduction of the UNIX International Performance Management Work Group

NASA Technical Reports Server (NTRS)

Newman, Henry

1993-01-01

In this paper we presented the planned direction of the UNIX International Performance Management Work Group. This group consists of concerned system developers and users who have organized to synthesize recommendations for standard UNIX performance management subsystem interfaces and architectures. The purpose of these recommendations is to provide a core set of performance management functions and these functions can be used to build tools by hardware system developers, vertical application software developers, and performance application software developers.

76 FR 2150 - NASA Advisory Council; Education and Public Outreach Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

... Outreach Committee of the NASA Advisory Council (NAC). DATES: Tuesday, February 8, 2011, 9 a.m. to 5 p.m... Recommendations Status Joint Recommendation with the NAC Commercial Space Committee Committee Work Plan Action...

Final Recommendations of the Air Toxics Work Group

EPA Pesticide Factsheets

The Air Toxics Workgroup was organized under the Clean Air Act Advisory Committee for the purpose of discussing and identifying recommendations related to Urban Air Toxics. The workgroup is part of the Permits, New Source Review and Toxics Subcommittee.

Screening for Human Immunodeficiency Virus (HIV)

MedlinePlus

... independent group of national experts in prevention and evidence- based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Screening for Coronary Heart Disease with Electrocardiography

MedlinePlus

... independent group of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Behavioral Counseling to Prevent Skin Cancer

MedlinePlus

... independent group of national experts in prevention and evidence- based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Screening for Cognitive Impairment in Older Adults

MedlinePlus

... independent group of national experts in prevention and evidence- based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

78 FR 54482 - Charter Renewal, Glen Canyon Dam Adaptive Management Work Group

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

.... SUMMARY: Following consultation with the General Services Administration, notice is hereby given that the... Work Group. The purpose of the Adaptive Management Work Group is to provide advice and recommendations...

[Yellow fever: reemerging in the state of Sao Paulo, Brazil, 2009].

PubMed

Mascheretti, Melissa; Tengan, Ciléa H; Sato, Helena Keiko; Suzuki, Akemi; de Souza, Renato Pereira; Maeda, Marina; Brasil, Roosecelis; Pereira, Mariza; Tubaki, Rosa Maria; Wanderley, Dalva M V; Fortaleza, Carlos Magno Castelo Branco; Ribeiro, Ana Freitas

2013-10-01

To describe the investigation of a sylvatic yellow fever outbreak in the state of Sao Paulo and the main control measures undertaken. This is a descriptive study of a sylvatic yellow fever outbreak in the Southwestern region of the state from February to April 2009. Suspected and confirmed cases in humans and in non-human primates were evaluated. Entomological investigation in sylvatic environment involved capture at ground level and in the tree canopy to identify species and detect natural infections. Control measures were performed in urban areas to control Aedes aegypti . Vaccination was directed at residents living in areas with confirmed viral circulation and also at nearby cities according to national recommendation. Twenty-eight human cases were confirmed (39.3% case fatality rate) in rural areas of Sarutaiá, Piraju, Tejupá, Avaré and Buri. The deaths of 56 non-human primates were also reported, 91.4% were Allouatta sp. Epizootics was confirmed in two non-human primates in the cities of Itapetininga and Buri. A total of 1,782 mosquitoes were collected, including Haemagogus leucocelaenus , Hg. janthinomys/capricornii , and Sabethes chloropterus, Sa. purpureus and Sa. undosus . Yellow fever virus was isolated from a group of Hg. Leucocelaenus from Buri. Vaccination was carried out in 49 cities, with a total of 1,018,705 doses. Nine serious post-vaccination adverse events were reported. The cases occurred between February and April 2009 in areas with no recorded yellow fever virus circulation in over 60 years. The outbreak region occurred outside the original recommended vaccination area with a high percentage of susceptible population. The fast adoption of control measures interrupted the human transmission within a month and the confirmation of viral circulation in humans, monkeys and mosquitoes. The results allowed the identification of new areas of viral circulation but further studies are required to clarify the dynamics of the spread of this disease.

International Collegium of Rehabilitative Audiology (ICRA) recommendations for the construction of multilingual speech tests. ICRA Working Group on Multilingual Speech Tests.

PubMed

Akeroyd, Michael A; Arlinger, Stig; Bentler, Ruth A; Boothroyd, Arthur; Dillier, Norbert; Dreschler, Wouter A; Gagné, Jean-Pierre; Lutman, Mark; Wouters, Jan; Wong, Lena; Kollmeier, Birger

2015-01-01

To provide guidelines for the development of two types of closed-set speech-perception tests that can be applied and interpreted in the same way across languages. The guidelines cover the digit triplet and the matrix sentence tests that are most commonly used to test speech recognition in noise. They were developed by a working group on Multilingual Speech Tests of the International Collegium of Rehabilitative Audiology (ICRA). The recommendations are based on reviews of existing evaluations of the digit triplet and matrix tests as well as on the research experience of members of the ICRA Working Group. They represent the results of a consensus process. The resulting recommendations deal with: Test design and word selection; Talker characteristics; Audio recording and stimulus preparation; Masking noise; Test administration; and Test validation. By following these guidelines for the development of any new test of this kind, clinicians and researchers working in any language will be able to perform tests whose results can be compared and combined in cross-language studies.

Environmental health research recommendations from the Inter-Environmental Health Sciences Core Center Working Group on unconventional natural gas drilling operations.

PubMed

Penning, Trevor M; Breysse, Patrick N; Gray, Kathleen; Howarth, Marilyn; Yan, Beizhan

2014-11-01

Unconventional natural gas drilling operations (UNGDO) (which include hydraulic fracturing and horizontal drilling) supply an energy source that is potentially cleaner than liquid or solid fossil fuels and may provide a route to energy independence. However, significant concerns have arisen due to the lack of research on the public health impact of UNGDO. Environmental Health Sciences Core Centers (EHSCCs), funded by the National Institute of Environmental Health Sciences (NIEHS), formed a working group to review the literature on the potential public health impact of UNGDO and to make recommendations for needed research. The Inter-EHSCC Working Group concluded that a potential for water and air pollution exists that might endanger public health, and that the social fabric of communities could be impacted by the rapid emergence of drilling operations. The working group recommends research to inform how potential risks could be mitigated. Research on exposure and health outcomes related to UNGDO is urgently needed, and community engagement is essential in the design of such studies.

Adherence to the World Cancer Research Fund/American Institute for Cancer Research Recommendations for Cancer Prevention Is Associated With Better Health-Related Quality of Life Among Elderly Female Cancer Survivors

PubMed Central

Inoue-Choi, Maki; Lazovich, DeAnn; Prizment, Anna E.; Robien, Kim

2013-01-01

Purpose The 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) diet and physical activity guidelines encourage cancer survivors to follow its cancer prevention recommendations. We evaluated whether adherence to the WCRF/AICR recommendations was associated with health-related quality of life (HRQOL) among elderly female cancer survivors. Patients and Methods A total of 2,193 women with a confirmed cancer diagnosis (1986 through 2002) in the Iowa Women's Health Study were identified. We calculated a WCRF/AICR recommendation adherence score (range, 0 to 7), assigning one point each for seven recommendations. Physical and mental component summary scores (PCS, MCS) from the Medical Outcomes Study Short Form–36 Health Survey were compared by recommendation adherence scores. Results Mean adherence score was 4.0 ± 1.2. Overall, higher adherence to the WCRF/AICR guidelines was significantly associated with better PCS and MCS after adjustment for age, education, marital status, number of comorbidities, smoking, cancer stage, and current cancer treatment (Ptrend < .001 for both). PCS was 43.5 versus 37.0 and MCS was 54.2 versus 52.0 among women with adherence scores ≥ 5 compared with women scoring ≤ 3. Adherence to the physical activity recommendation was associated with higher PCS and MCS after adjusting for demographic and medical confounders, body mass index, and dietary recommendation adherence. For the body weight recommendation, adherence was associated with higher PCS but lower MCS, whereas adherence to the dietary recommendations was associated with higher MCS only. Conclusion Following the lifestyle guidelines for cancer prevention may improve HRQOL among elderly female cancer survivors. Physical activity may be a key lifestyle factor to improve HRQOL. PMID:23569318

Thoracic multidisciplinary tumor board routinely impacts therapeutic plans in patients with lung and esophageal cancer: a prospective cohort study.

PubMed

Schmidt, Henner M; Roberts, John M; Bodnar, Artur M; Kunz, Sonia; Kirtland, Steven H; Koehler, Richard P; Hubka, Michal; Low, Donald E

2015-05-01

National and subspecialty guidelines for lung and esophageal cancers recommend treatment decisions to be made in a multidisciplinary tumor board (MTB). This study prospectively analyzes the actual impact of presentation at the thoracic tumor board on decision making in thoracic cancer cases. During the electronic submission process for presentation at MTB managing physicians documented their current treatment plan. The initial treatment plan was compared with the MTB final recommendation. Patient demographics, physician's proposed treatment plan, MTB recommendation, and documentation of application of MTB recommendations were prospectively recorded in an Institutional Review Board approved database. Between June 2010 and December 2012, 185 patients with esophageal and 294 patients with lung cancer were presented at the MTB. One hundred sixty-six patients were presented on more than 1 occasion, resulting in 724 assessments of 479 patients. In 48 esophageal cancer patients (26%) and 118 lung cancer patients (40%) MTB recommendations differed from the initial treatment plan. Overall, a differing MTB recommendation from the primary treatment plan occurred in 330 of 724 case presentations (46%). The MTB recommendations changed treatment plans in 40% and staging and assessment plans in 60% of patients. Follow-up in a cohort of 249 patients confirmed that MTB recommendations were followed in 97% of cases. This study validates the impact of the thoracic MTB. Recommendations will differ from the managing providers' initial plan in 26% to 40% of cases. However, MTB recommendations can be successfully initiated in the majority of patients. Complex thoracic cancer patients will benefit from multidisciplinary review and should ideally be presented at tumor board. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Prophylaxis and treatment of HIV-1 infection in pregnancy: Swedish recommendations 2010.

PubMed

Navér, Lars; Albert, Jan; Belfrage, Erik; Flamholc, Leo; Gisslén, Magnus; Gyllensten, Katarina; Josephson, Filip; Karlström, Olof; Lindgren, Susanne; Pettersson, Karin; Svedhem, Veronica; Sönnerborg, Anders; Westling, Katarina; Yilmaz, Aylin; Swedish Reference Group for Antiviral Therapy

2011-07-01

Prophylaxis and treatment with antiretroviral drugs and the use of elective caesarean section have resulted in a very low mother-to-child transmission of human immunodeficiency virus (HIV) during recent years. The availability of new antiretroviral drugs, updated general treatment guidelines and increasing knowledge of the importance of drug resistance, have necessitated regular revisions of the "Prophylaxis and treatment of HIV-1 infection in pregnancy" recommendations. For these reasons, The Swedish Reference Group for Antiviral Therapy (RAV) updated the 2007 recommendations at an expert meeting that took place on 25 March 2010. The most important revisions from the previous recommendations are: (1) it is recommended that treatment during pregnancy starts at the latest at gestational week 14-18; (2) ongoing efficient treatment at confirmed pregnancy may, with a few exceptions, be continued; (3) lopinavir/r and atazanavir/r are equally recommended protease inhibitors; (4) if maternal HIV RNA is >50 copies/ml close to delivery, a planned caesarean section, intravenous zidovudine, oral nevirapine for the mother and post-exposure prophylaxis for the infant with 3 antiretroviral drugs are recommended; (5) for delivery at <34 gestational weeks, intravenous zidovudine and oral nevirapine for the mother and at 48-72 h for the infant is recommended, in addition to other prophylaxis; (6) intravenous zidovudine is not recommended when HIV RNA is <50 copies/ml and a caesarean section is performed; (7) it is recommended that prophylaxis for the infant is started within 4 h; (8) prophylactic zidovudine for the infant may be administered twice daily instead of 4 times a day, as was the case previously; and (9) the number of sampling occasions for the infant has been decreased.

The Press Coverage of Celebrity Suicide and the Development of Suicide Frequencies in Germany.

PubMed

Schäfer, Markus; Quiring, Oliver

2015-01-01

The existence of the so-called "Werther effect" is well confirmed, and there are several recommendations on how the media should (not) report suicide to minimize the risk of copycat behavior. Unfortunately, very little is known about how suicide is actually reported. The article examines the German press coverage of six celebrity suicides with respect to compliance with guidelines on suicide reporting and analyzes changes in suicides in the wake of the reporting. It concludes that German media do not respect the recommendations in a substantial number of their articles. In addition, a significant increase in suicides and similar suicides is found.

2014 Update of the Canadian Rheumatology Association/spondyloarthritis research consortium of Canada treatment recommendations for the management of spondyloarthritis. Part I: principles of the management of spondyloarthritis in Canada.

PubMed

Rohekar, Sherry; Chan, Jon; Tse, Shirley M L; Haroon, Nigil; Chandran, Vinod; Bessette, Louis; Mosher, Dianne; Flanagan, Cathy; Keen, Kevin J; Adams, Karen; Mallinson, Michael; Thorne, Carter; Rahman, Proton; Gladman, Dafna D; Inman, Robert D

2015-04-01

The Canadian Rheumatology Association (CRA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) have collaborated to update the recommendations for the management of spondyloarthritis (SpA). A working group was assembled and consisted of the SPARCC executive committee, rheumatologist leaders from SPARCC collaborating sites, Canadian rheumatologists from across the country with an interest in SpA (both academic and community), a rheumatology trainee with an interest in SpA, an epidemiologist/health services researcher, a member of the CRA executive, a member of the CRA therapeutics committee, and a patient representative from the Canadian Spondylitis Association. An extensive review was conducted of literature published from 2007 to 2014 involving the management of SpA. The working group created draft recommendations using multiple rounds of Web-based surveys and an in-person conference. A survey was sent to the membership of the CRA to obtain an extended review that was used to finalize the recommendations. Guidelines for the management of SpA were created. Part I focuses on the principles of management of SpA in Canada and includes 6 general management principles, 5 ethical considerations, target groups for treatment recommendations, 2 wait time recommendations, and recommendations for disease monitoring. Also included are 6 modifications for application to juvenile SpA. These recommendations were developed based on current literature and applied to a Canadian healthcare context. It is hoped that the implementation of these recommendations will promote best practices in the treatment of SpA.

SemCiR: A Citation Recommendation System Based on a Novel Semantic Distance Measure

ERIC Educational Resources Information Center

Zarrinkalam, Fattane; Kahani, Mohsen

2013-01-01

Purpose: The purpose of this paper is to propose a novel citation recommendation system that inputs a text and recommends publications that should be cited by it. Its goal is to help researchers in finding related works. Further, this paper seeks to explore the effect of using relational features in addition to textual features on the quality of…

[Recommendations for the Stepwise Occupational Reintegration: Can the Characteristic of the Patients Explain the Differences Between the Rehabilitation Centers?].

PubMed

Schmid, L; Jankowiak, S; Kaluscha, R; Krischak, G

2016-06-01

The first step to initiate a stepwise occupational reintegration (SOR) is the recommendation of the rehabilitation centers. Therefore rehabilitation centers have a significant impact on the use of SOR. There is evidence that the recommendation rate between the rehabilitation centers differs clearly. The present survey therefore analyses in detail the differences of the recommendation rate and examines which patient-related factors could explain the differences. This study is based on analysis of routine data provided by the German pension insurance in Baden-Württemberg (Rehabilitationsstatistikdatenbasis 2013; RSD). In the analyses rehabilitation measures were included if they were conducted by employed patients (18-64 years) with a muscular-skeletal system disease or a disorder of the connective tissue. Logistic regression models were performed to explain the differences in the recommendation rate of the rehabilitation centers. The data of 134 853 rehabilitation measures out of 32 rehabilitation centers were available. The recommendation rate differed between the rehabilitation centers from 1.36-18.53%. The logistic regression analysis showed that the period of working incapacity 12 month before the rehabilitation and the working capacity on the current job were the most important predictors for the recommendation of a SOR by the rehabilitation centers. Also the rehabilitation centers themselves have an important influence. The results of this survey indicate that the characteristic of the patients is an important factor for the recommendation of SOR. Additionally the rehabilitation centers themselves have an influence on the recommendation of SOR. The results point to the fact that the rehabilitation centers use different criteria by making a recommendation. © Georg Thieme Verlag KG Stuttgart · New York.

Raising the quality of rheumatology management recommendations: lessons from the EULAR process 10 years after provision of standard operating procedures.

PubMed

Colebatch-Bourn, Alexandra N; Conaghan, Philip G; Arden, Nigel K; Cooper, Cyrus; Dougados, Maxime; Edwards, Christopher J

2015-08-01

To increase understanding of how to raise the quality of rheumatology guidelines by reviewing European League Against Rheumatism (EULAR) management recommendations, using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, 10 years after publication of the EULAR standardized operating procedures (SOP) for the production of recommendations. It was hoped that this work could help inform improvements in guideline development by other societies and organizations. The SOP were published in 2004 to ensure the quality of EULAR-endorsed recommendations. We reviewed 27 published EULAR recommendations for management using the AGREE II tool. This provides a framework to assess the quality of guidelines across six broad domains using 23 specific questions. Overall the EULAR recommendations reviewed have been performed to a high standard. There are particular strengths in the methodology and presentation of the guidelines; however, the results indicate areas for development in future recommendations: in particular, stakeholder involvement and applicability of the recommendations. Improvements in quality were evident in recent years, with patient representation in 9 of 15 (60.0%) recommendations published 2010-14 compared with 4 of 12 (33.3%) published 2000-09. In the last 10 years the overall quality of recommendations was good, with standards improving over the decade following publication of the SOP. However, this review process has identified potential areas for improvement, especially in patient representation and provision of implementation tools. The lessons from this work can be applied to the development of rheumatology guidelines by other societies and organizations. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Pre-test probability of obstructive coronary stenosis in patients undergoing coronary CT angiography: Comparative performance of the modified diamond-Forrester algorithm versus methods incorporating cardiovascular risk factors.

PubMed

Ferreira, António Miguel; Marques, Hugo; Tralhão, António; Santos, Miguel Borges; Santos, Ana Rita; Cardoso, Gonçalo; Dores, Hélder; Carvalho, Maria Salomé; Madeira, Sérgio; Machado, Francisco Pereira; Cardim, Nuno; de Araújo Gonçalves, Pedro

2016-11-01

Current guidelines recommend the use of the Modified Diamond-Forrester (MDF) method to assess the pre-test likelihood of obstructive coronary artery disease (CAD). We aimed to compare the performance of the MDF method with two contemporary algorithms derived from multicenter trials that additionally incorporate cardiovascular risk factors: the calculator-based 'CAD Consortium 2' method, and the integer-based CONFIRM score. We assessed 1069 consecutive patients without known CAD undergoing coronary CT angiography (CCTA) for stable chest pain. Obstructive CAD was defined as the presence of coronary stenosis ≥50% on 64-slice dual-source CT. The three methods were assessed for calibration, discrimination, net reclassification, and changes in proposed downstream testing based upon calculated pre-test likelihoods. The observed prevalence of obstructive CAD was 13.8% (n=147). Overestimations of the likelihood of obstructive CAD were 140.1%, 9.8%, and 18.8%, respectively, for the MDF, CAD Consortium 2 and CONFIRM methods. The CAD Consortium 2 showed greater discriminative power than the MDF method, with a C-statistic of 0.73 vs. 0.70 (p<0.001), while the CONFIRM score did not (C-statistic 0.71, p=0.492). Reclassification of pre-test likelihood using the 'CAD Consortium 2' or CONFIRM scores resulted in a net reclassification improvement of 0.19 and 0.18, respectively, which would change the diagnostic strategy in approximately half of the patients. Newer risk factor-encompassing models allow for a more precise estimation of pre-test probabilities of obstructive CAD than the guideline-recommended MDF method. Adoption of these scores may improve disease prediction and change the diagnostic pathway in a significant proportion of patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effects of accessible website design on nondisabled users: age and device as moderating factors.

PubMed

Schmutz, Sven; Sonderegger, Andreas; Sauer, Juergen

2018-05-01

This study examined how implementing recommendations from Web accessibility guidelines affects nondisabled people in different age groups using different technical devices. While recent research showed positive effects of implementing such recommendations for nondisabled users, it remains unclear whether such effects would apply to different age groups and kind of devices. A 2 × 2 × 2 design was employed with website accessibility (high accessibility vs. very low accessibility), age (younger adults vs. older adults) and type of device (laptop vs. tablet) as independent variables. 110 nondisabled participants took part in a usability test, in which performance and satisfaction were measured as dependent variables. The results showed that higher accessibility increased task completion rate, task completion time and satisfaction ratings of nondisabled users. While user age did not have any effects, users showed faster task completion time under high accessibility when using a tablet rather than a laptop. The findings confirmed previous findings, which showed benefits of accessible websites for nondisabled users. These beneficial effects may now be generalised to a wide age range and across different devices. Practitioner Summary: This work is relevant to the design of websites since it emphasises the need to consider the characteristics of different user groups. Accessible website design (aimed at users with disabilities) leads to benefits for nondisabled users across different ages. These findings provide further encouragement for practitioners to apply WCAG 2.0.

Developing and validating a nutrition knowledge questionnaire: key methods and considerations.

PubMed

Trakman, Gina Louise; Forsyth, Adrienne; Hoye, Russell; Belski, Regina

2017-10-01

To outline key statistical considerations and detailed methodologies for the development and evaluation of a valid and reliable nutrition knowledge questionnaire. Literature on questionnaire development in a range of fields was reviewed and a set of evidence-based guidelines specific to the creation of a nutrition knowledge questionnaire have been developed. The recommendations describe key qualitative methods and statistical considerations, and include relevant examples from previous papers and existing nutrition knowledge questionnaires. Where details have been omitted for the sake of brevity, the reader has been directed to suitable references. We recommend an eight-step methodology for nutrition knowledge questionnaire development as follows: (i) definition of the construct and development of a test plan; (ii) generation of the item pool; (iii) choice of the scoring system and response format; (iv) assessment of content validity; (v) assessment of face validity; (vi) purification of the scale using item analysis, including item characteristics, difficulty and discrimination; (vii) evaluation of the scale including its factor structure and internal reliability, or Rasch analysis, including assessment of dimensionality and internal reliability; and (viii) gathering of data to re-examine the questionnaire's properties, assess temporal stability and confirm construct validity. Several of these methods have previously been overlooked. The measurement of nutrition knowledge is an important consideration for individuals working in the nutrition field. Improved methods in the development of nutrition knowledge questionnaires, such as the use of factor analysis or Rasch analysis, will enable more confidence in reported measures of nutrition knowledge.

Characterizing nonconstant instrumental variance in emerging miniaturized analytical techniques.

PubMed

Noblitt, Scott D; Berg, Kathleen E; Cate, David M; Henry, Charles S

2016-04-07

Measurement variance is a crucial aspect of quantitative chemical analysis. Variance directly affects important analytical figures of merit, including detection limit, quantitation limit, and confidence intervals. Most reported analyses for emerging analytical techniques implicitly assume constant variance (homoskedasticity) by using unweighted regression calibrations. Despite the assumption of constant variance, it is known that most instruments exhibit heteroskedasticity, where variance changes with signal intensity. Ignoring nonconstant variance results in suboptimal calibrations, invalid uncertainty estimates, and incorrect detection limits. Three techniques where homoskedasticity is often assumed were covered in this work to evaluate if heteroskedasticity had a significant quantitative impact-naked-eye, distance-based detection using paper-based analytical devices (PADs), cathodic stripping voltammetry (CSV) with disposable carbon-ink electrode devices, and microchip electrophoresis (MCE) with conductivity detection. Despite these techniques representing a wide range of chemistries and precision, heteroskedastic behavior was confirmed for each. The general variance forms were analyzed, and recommendations for accounting for nonconstant variance discussed. Monte Carlo simulations of instrument responses were performed to quantify the benefits of weighted regression, and the sensitivity to uncertainty in the variance function was tested. Results show that heteroskedasticity should be considered during development of new techniques; even moderate uncertainty (30%) in the variance function still results in weighted regression outperforming unweighted regressions. We recommend utilizing the power model of variance because it is easy to apply, requires little additional experimentation, and produces higher-precision results and more reliable uncertainty estimates than assuming homoskedasticity. Copyright © 2016 Elsevier B.V. All rights reserved.

Diagnostic management of chronic obstructive pulmonary disease.

PubMed

Broekhuizen, B D L; Sachs, A P E; Hoes, A W; Verheij, T J M; Moons, K G M

2012-01-01

Detection of early chronic obstructive pulmonary disease (COPD) in patients presenting with respiratory symptoms is recommended; however, diagnosing COPD is difficult because a single gold standard is not available. The aim of this article is to review and interpret the existing evidence, theories and consensus on the individual parts of the diagnostic work-up for COPD. Relevant articles are discussed under the subheadings: history taking, physical examination, spirometry and additional lung function assessment. Wheezing, cough, phlegm and breathlessness on exertion are suggestive signs for COPD. The diagnostic value of the physical examination is limited, except for auscultated pulmonary wheezing or reduced breath sounds, increasing the probability of COPD. Spirometric airflow obstruction after bronchodilation, defined as a lowered ratio of the forced volume in one second to the forced vital capacity (FEV1/FVC ratio), is a prerequisite, but can only confirm COPD in combination with suggestive symptoms. Different thresholds are being recommended to define low FEV1/FVC, including a fixed threshold, and one varying with gender and age; however, the way physicians interpret these thresholds in their assessment is not well known. Body plethysmography allows a more complete assessment of pulmonary function, providing results on the total lung capacity and the residual volume and is indicated when conventional spirometry results are inconclusive. Chest radiography has no diagnostic value for COPD but is useful to exclude alternative diagnoses such as heart failure or lung cancer. Extensive history taking is of key importance in diagnosing COPD.

The A's and B's of vaccine-preventable hepatitis: improving prevention in high-risk adults.

PubMed

Oldfield, Edward C; Keeffe, Emmet B

2007-01-01

Acute hepatitis A and acute hepatitis B are associated with significant morbidity, time away from work or usual activities, substantial cost to the healthcare system, and some mortality. Despite the availability of vaccines against hepatitis B and hepatitis A since 1981 and 1995, respectively, and a combined hepatitis A and B vaccine since 2001, immunization rates against these vaccine-preventable diseases are appallingly low. In particular, several groups of adults, such as men who have sex with men, heterosexuals with multiple partners, injection drug users, persons with human immunodeficiency virus infection, travelers to endemic areas, and persons with chronic liver disease, are at particularly high risk for acute hepatitis A and B or for a more severe illness or a higher rate of chronicity in the case of hepatitis B. Studies have confirmed that hepatitis A and hepatitis B vaccines are safe and immunogenic in patients in these populations, although patients with more advanced disease may respond less well. These observations have led to the recommendation that patients falling into the above risk groups undergo hepatitis A and B vaccination early in the natural history of their underlying risk behavior or diseases. Vaccination rates are low in clinical practice, and public health and educational programs are needed to overcome barriers to facilitate timely implementation of these recommendations. The use of a combined vaccination, possibly using an accelerated administration schedule, provides convenience and may increase compliance.

Diagnostic accuracy of a uniform research case definition for TBM in children: a prospective study.

PubMed

Solomons, R S; Visser, D H; Marais, B J; Schoeman, J F; van Furth, A M

2016-07-01

Bacteriological confirmation of tuberculous meningitis (TBM) is problematic, and rarely guides initial clinical management. A uniform TBM case definition has been proposed for research purposes. We prospectively enrolled patients aged 3 months to 13 years with meningitis confirmed using cerebrospinal fluid analysis at Tygerberg Hospital, Cape Town, South Africa. Criteria that differentiated TBM from other causes were explored and the accuracy of a probable TBM score assessed by comparing bacteriologically confirmed cases to 'non-TBM' controls. Of 139 meningitis patients, 79 were diagnosed with TBM (35 bacteriologically confirmed), 10 with bacterial meningitis and 50 with viral meningitis. Among those with bacteriologically confirmed TBM, 15 were Mycobacterium tuberculosis culture-positive and 20 were culture-negative but positive on GenoType(®) MTBDRplus or Xpert(®) MTB/RIF; 18 were positive on only a single commercial nucleic acid amplification test. A probable TBM score provided a sensitivity of 74% (95%CI 57-88) and a specificity of 97% (95%CI 86-99) compared to bacteriologically confirmed TBM. A probable TBM score demonstrated excellent specificity compared to bacteriological confirmation. However, 26% of children with TBM would be missed due to the limited accuracy of the case definition. Further prospective testing of an algorithm-based approach to TBM is advisable before recommendation for general clinical practice.

Summary of the Italian inter-society recommendations for radiation protection optimization in interventional radiology.

PubMed

Compagnone, Gaetano; Padovani, Renato; D'Avanzo, Maria Antonietta; Grande, Sveva; Campanella, Francesco; Rosi, Antonella

2018-05-01

A Working Group coordinated by the Italian National Institute of Health (Istituto Superiore di Sanità) and the National Workers Compensation Authority (Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro, INAIL) and consisting of 11 Italian scientific/professional societies involved in the fluoroscopically guided interventional practices has been established to define recommendations for the optimization of patients and staff radiation protection in interventional radiology. A summary of these recommendations is here reported. A multidisciplinary approach was used to establish the Working Group by involving radiologists, interventional radiologists, neuroradiologists, interventional cardiologists, occupational health specialists, medical physicists, radiation protection experts, radiographers and nurses. The Group operated as a "Consensus Conference". Three main topics have been addressed: patient radiation protection (summarized in ten "golden rules"); staff radiation protection (summarized in ten "golden rules"); and education/training of interventional radiology professionals. In the "golden rules", practical and operational recommendations were provided to help the professionals in optimizing dose delivered to patients and reducing their own exposure. Operative indications dealt also with continuing education and training, and recommendations on professional accreditation and certification. The "Consensus Conference" was the methodology adopted for the development of these recommendations. Involvement of all professionals is a winning approach to improve practical implementation of the recommendations, thus getting a real impact on the optimization of the interventional radiology practices.

Analysis and recommendation of separation requirements for rotorcraft operation at airports and heliports

DOT National Transportation Integrated Search

1986-09-01

The analysis work presented in this report is part of an ongoing effort by the Federal Aviation Administration (FAA) to develop improved rotorcraft separation standards. The subject of this report, Analysis and Recommendation of Separation Requiremen...

Vitamin D and Calcium Supplementation to Prevent Fractures

MedlinePlus

... volunteer panel of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

The Relationship Between Burnout and Occupational Stress in Genetic Counselors.

PubMed

Johnstone, Brittney; Kaiser, Amy; Injeyan, Marie C; Sappleton, Karen; Chitayat, David; Stephens, Derek; Shuman, Cheryl

2016-08-01

Burnout represents a critical disruption in an individual's relationship with work, resulting in a state of exhaustion in which one's occupational value and capacity to perform are questioned. Burnout can negatively affect an individual's personal life, as well as employers in terms of decreased work quality, patient/client satisfaction, and employee retention. Occupational stress is a known contributor to burnout and occurs as a result of employment requirements and factors intrinsic to the work environment. Empirical research examining genetic counselor-specific burnout is limited; however, existing data suggests that genetic counselors are at increased risk for burnout. To investigate the relationship between occupational stress and burnout in genetic counselors, we administered an online survey to members of three genetic counselor professional organizations. Validated measures included the Maslach Burnout Inventory-General Survey (an instrument measuring burnout on three subscales: exhaustion, cynicism, and professional efficacy) and the Occupational Stress Inventory-Revised (an instrument measuring occupational stress on 14 subscales). Of the 353 respondents, more than 40 % had either considered leaving or left their job role due to burnout. Multiple regression analysis yielded significant predictors for burnout risk. The identified sets of predictors account for approximately 59 % of the variance in exhaustion, 58 % of the variance in cynicism, and 43 % of the variance in professional efficacy. Our data confirm that a significant number of genetic counselors experience burnout and that burnout is correlated with specific aspects of occupational stress. Based on these findings, practice and research recommendations are presented.

Occupational Health and Safety Experiences among Self-Identified Immigrant Workers Living or Working in Somerville, MA by Ethnicity, Years in the US, and English Proficiency

PubMed Central

Panikkar, Bindu; Woodin, Mark A.; Brugge, Doug; Desmarais, Anne Marie; Hyatt, Raymond; Goldman, Rose; Pirie, Alex; Goldstein-Gelb, Marcy; Galvão, Heloisa; Chianelli, Monica; Vasquez, Ismael; McWhinney, Melissa; Dalembert, Franklin; Gute, David M.

2012-01-01

In this community based research initiative, we employed a survey instrument predominately developed and administered by Teen Educators to assess occupational health risks for Haitian, Salvadoran, and Brazilian immigrants (n = 405) in Somerville, MA, USA. We demonstrate that a combined analysis of ethnicity, years in the US, and English proficiency better characterized the occupational experience of immigrant workers than considering these variables individually. While years in the US (negatively) and English proficiency (positively) explained the occurrence of health risks, the country of origin identified the most vulnerable populations in the community. Brazilians, Salvadorans, and other Hispanic, all of whom who have been in the US varying length of time, with varying proficiency in English language had twice the odds of reporting injuries due to work compared to other immigrants. Although this observation was not significant it indicates that years in the US and English proficiency alone do not predict health risks among this population. We recommend the initiation of larger studies employing c community based participatory research methods to confirm these differences and to further explore work and health issues of immigrant populations. This study is one of the small number of research efforts to utilize a contemporaneous assessment of occupational health problems in three distinct immigrant populations at the community level within a specific Environmental Justice context and social milieu. PMID:23222180

Ergonomic intervention for improving work postures during notebook computer operation.

PubMed

Jamjumrus, Nuchrawee; Nanthavanij, Suebsak

2008-06-01

This paper discusses the application of analytical algorithms to determine necessary adjustments for operating notebook computers (NBCs) and workstations so that NBC users can assume correct work postures during NBC operation. Twenty-two NBC users (eleven males and eleven females) were asked to operate their NBCs according to their normal work practice. Photographs of their work postures were taken and analyzed using the Rapid Upper Limb Assessment (RULA) technique. The algorithms were then employed to determine recommended adjustments for their NBCs and workstations. After implementing the necessary adjustments, the NBC users were then re-seated at their workstations, and photographs of their work postures were re-taken, to perform the posture analysis. The results show that the NBC users' work postures are improved when their NBCs and workstations are adjusted according to the recommendations. The effectiveness of ergonomic intervention is verified both visually and objectively.

Multiracial competence in social work: recommendations for culturally attuned work with multiracial people.

PubMed

Jackson, Kelly E; Samuels, Gina M

2011-07-01

According to the 2010 U.S. census, approximately 9 million individuals report multiracial identities. By the year 2050, as many as one in five Americans could claim a multiracial background. Despite this population growth, a review of recent empirical and theoretical literature in social work suggests a disproportionate lack of attention to issues ofmultiraciality. Instead, social work practice models remain embedded in traditional societal discourses of race and culture that often exclude or marginalize the experiences of multiracial individuals and families.This article summarizes recommendations following the domains of awareness, knowledge, and skills in the NASW Standards for Cultural Competence in Social Work Practice to support culturally attuned social work practice with multiracial people. The authors argue that a culturally attuned practice approach--one that is inclusive of multiraciality--is not only timely, but also consistent with the profession's ethical obligation to provide culturally relevant services to all consumers and clients.

Work Overload.

ERIC Educational Resources Information Center

Bateman, Thomas S.

1980-01-01

To investigate managerial use of work (or role) overload to increase productivity, the author studied 77 nonclerical white-collar employees and found that work overload had negative effects on productivity, supervisors' ratings, employee attitudes, job satisfaction, and health. He recommends ways for managers and employees to reduce work overload.…

78 FR 49595 - Aviation Rulemaking Advisory Committee-New Task

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-14

... the new ARAC activity and solicits membership for the Maintenance Reliability Program Working Group... establish the Maintenance Reliability Program Working Group. The working group will serve as staff to ARAC... programs. The Maintenance Reliability Program Working Group will provide advice and recommendations on the...

Illness Severity and Work Productivity Loss Among Working Adults With Medically Attended Acute Respiratory Illnesses: US Influenza Vaccine Effectiveness Network 2012–2013

PubMed Central

Petrie, Joshua G.; Cheng, Caroline; Malosh, Ryan E.; VanWormer, Jeffrey J.; Flannery, Brendan; Zimmerman, Richard K.; Gaglani, Manjusha; Jackson, Michael L.; King, Jennifer P.; Nowalk, Mary Patricia; Benoit, Joyce; Robertson, Anne; Thaker, Swathi N.; Monto, Arnold S.; Ohmit, Suzanne E.

2016-01-01

Background. Influenza causes significant morbidity and mortality, with considerable economic costs, including lost work productivity. Influenza vaccines may reduce the economic burden through primary prevention of influenza and reduction in illness severity. Methods. We examined illness severity and work productivity loss among working adults with medically attended acute respiratory illnesses and compared outcomes for subjects with and without laboratory-confirmed influenza and by influenza vaccination status among subjects with influenza during the 2012–2013 influenza season. Results. Illnesses laboratory-confirmed as influenza (ie, cases) were subjectively assessed as more severe than illnesses not caused by influenza (ie, noncases) based on multiple measures, including current health status at study enrollment (≤7 days from illness onset) and current activity and sleep quality status relative to usual. Influenza cases reported missing 45% more work hours (20.5 vs 15.0; P < .001) than noncases and subjectively assessed their work productivity as impeded to a greater degree (6.0 vs 5.4; P < .001). Current health status and current activity relative to usual were subjectively assessed as modestly but significantly better for vaccinated cases compared with unvaccinated cases; however, no significant modifications of sleep quality, missed work hours, or work productivity loss were noted for vaccinated subjects. Conclusions. Influenza illnesses were more severe and resulted in more missed work hours and productivity loss than illnesses not confirmed as influenza. Modest reductions in illness severity for vaccinated cases were observed. These findings highlight the burden of influenza illnesses and illustrate the importance of laboratory confirmation of influenza outcomes in evaluations of vaccine effectiveness. PMID:26565004

How Do They Do It: Working Women Meeting Physical Activity Recommendations

PubMed Central

Gell, Nancy M.; Wadsworth, Danielle D.

2014-01-01

Objective To identify factors that facilitate adherence to physical activity among employed women. Methods Participants were 103 employed women (Mean 44.4 years ±11.8). Measures included physical activity by accelerometry, location by global positioning systems, and psychosocial constructs, perception of worksite policies and the built environment by questionnaire. Results Meeting physical activity recommendations was significantly associated with use of the built environment, self-regulation, perception of higher land-use mix diversity, and perception of lower infrastructure and safety for walking. Perception of worksite policies, self-efficacy, and social support were not associated with meeting recommendations. Conclusions The findings provide evidence that working women’s physical activity behavior is influenced by both psychosocial and environmental factors. PMID:24765681

Evidence-based drug treatment practice and the child welfare system: the example of methadone.

PubMed

Lundgren, Lena M; Schilling, Robert F; Peloquin, Susan D

2005-01-01

This article examined the extent to which methadone maintenance (MM) is considered a treatment alternative for drug-dependent parents, as reflected in the social work and child welfare literature and in child welfare policies. Findings were derived from a review of 15 social work journals published from 1996 through 2002 and from a review of child welfare policies in 27 states in regard to treatment recommendations for substance-abusing parents. These reviews found that 23 articles focused on child welfare-substance abuse issues; no article specifically discussed MM as a treatment option for heroin-using parents; and of the 27 states, only three included methadone as a treatment option in their child welfare policy recommendations. Practice and policy recommendations are discussed.

New strategies for higher professional education.

PubMed Central

Pietroni, R

1992-01-01

Since the original recommendation in 1968 for a period of higher professional education, the development of this form of education has been slow. However, in 1990 a working party was established by the education division of the Royal College of General Practitioners to report on higher professional education. This paper describes some of the early work of the working party and its recommendations with particular emphasis on educational strategies, assessment and accreditation. A flexible, learner centred approach needs to be developed to encourage autonomy. Educational strategies are described which value previous experience and allow for a shift of responsibility for learning from the teacher to the learner. PMID:1419264

International geomagnetic reference field 1980: a report by IAGA Division I working group.

USGS Publications Warehouse

Peddie, N.W.

1982-01-01

Describes the recommendations of the working group, which suggested additions to IGRF because of the cumulative effect of the inevitable uncertainties in the secular variation models which had led to unacceptable inaccuracies in the IGRF by the late 1970's. The recommendations were accepted by the International Association of Geomagnetism and Aeronomy on August 15, 1981 at the 4th Scientific Assembly, Edinburgh. An extended table sets out spherical harmonic coefficients of the IGRF 1980.-R.House

Progress Towards a Space-Based Gravitational-Wave Observatory Since 2010

NASA Technical Reports Server (NTRS)

Stebbins, Robin T.

2015-01-01

Laser Interferometer Space Antenna (LISA): Focus of all work since 1993; Unchanged since 1997; Project in Phase A since 2004; Extensive formulation work and products; Reviewed and recommended in many major reviews: AANM (NRC, 2001), TRIP (HQ, 2003), Connecting Quarks with the Cosmos (NRC, 2003), AETD (GSFC, 2005). Beyond Einstein Program: (NRC, 2007), NWNH (NRC, 2010): Second in large space projects after WFIRST. Recommended for a new start. Contingent on Lisa Pathfinder success and a roughly 50-50 European partnership.

Uncovering the information core in recommender systems

NASA Astrophysics Data System (ADS)

Zeng, Wei; Zeng, An; Liu, Hao; Shang, Ming-Sheng; Zhou, Tao

2014-08-01

With the rapid growth of the Internet and overwhelming amount of information that people are confronted with, recommender systems have been developed to effectively support users' decision-making process in online systems. So far, much attention has been paid to designing new recommendation algorithms and improving existent ones. However, few works considered the different contributions from different users to the performance of a recommender system. Such studies can help us improve the recommendation efficiency by excluding irrelevant users. In this paper, we argue that in each online system there exists a group of core users who carry most of the information for recommendation. With them, the recommender systems can already generate satisfactory recommendation. Our core user extraction method enables the recommender systems to achieve 90% of the accuracy of the top-L recommendation by taking only 20% of the users into account. A detailed investigation reveals that these core users are not necessarily the large-degree users. Moreover, they tend to select high quality objects and their selections are well diversified.

Outbreak of Leptospirosis after a Race in the Tropical Forest of Martinique

PubMed Central

Hochedez, Patrick; Rosine, Jacques; Théodose, Rafaelle; Abel, Sylvie; Bourhy, Pascale; Picardeau, Mathieu; Quénel, Philippe; Cabié, André

2011-01-01

Three athletes who participated in a race in the tropical forest of the Caribbean island of Martinique were subsequently diagnosed with leptospirosis using polymerase chain reaction (PCR). We investigated an outbreak to evaluate possible risk factors, and to determine the appropriate public health recommendations. Of 230 athletes, we contacted 148 (64%) and 20 (13.5%) met our case definition. Five were hospitalized and none were fatal. Ten (91%) of the 11 ill athletes who were tested were confirmed by PCR or serology. Serogroup Pyrogenes was commonly found. Cutaneous cuts, reported by 14 (73.7%), was the only potential risk factor using univariate analysis. Sporting event participants in tropical areas should be made aware of specific warnings and recommendations concerning the risk of leptospirosis, especially after periods of heavy rainfall or flooding. Rapid diagnostic assays such as PCR are particularly appropriate in this setting for early diagnosis and for formulating public health recommendations. PMID:21460020

A rapid and high-precision method for sulfur isotope δ(34)S determination with a multiple-collector inductively coupled plasma mass spectrometer: matrix effect correction and applications for water samples without chemical purification.

PubMed

Lin, An-Jun; Yang, Tao; Jiang, Shao-Yong

2014-04-15

Previous studies have indicated that prior chemical purification of samples, although complex and time-consuming, is essential in obtaining precise and accurate results for sulfur isotope ratios using multiple-collector inductively coupled plasma mass spectrometry (MC-ICP-MS). In this study, we introduce a new, rapid and precise MC-ICP-MS method for sulfur isotope determination from water samples without chemical purification. The analytical work was performed on an MC-ICP-MS instrument with medium mass resolution (m/Δm ~ 3000). Standard-sample bracketing (SSB) was used to correct samples throughout the analytical sessions. Reference materials included an Alfa-S (ammonium sulfate) standard solution, ammonium sulfate provided by the lab of the authors and fresh seawater from the South China Sea. A range of matrix-matched Alfa-S standard solutions and ammonium sulfate solutions was used to investigate the matrix (salinity) effect (matrix was added in the form of NaCl). A seawater sample was used to confirm the reliability of the method. Using matrix-matched (salinity-matched) Alfa-S as the working standard, the measured δ(34)S value of AS (-6.73 ± 0.09‰) was consistent with the reference value (-6.78 ± 0.07‰) within the uncertainty, suggesting that this method could be recommended for the measurement of water samples without prior chemical purification. The δ(34)S value determination for the unpurified seawater also yielded excellent results (21.03 ± 0.18‰) that are consistent with the reference value (20.99‰), thus confirming the feasibility of the technique. The data and the results indicate that it is feasible to use MC-ICP-MS and matrix-matched working standards to measure the sulfur isotopic compositions of water samples directly without chemical purification. In comparison with the existing MC-ICP-MS techniques, the new method is better for directly measuring δ(34)S values in water samples with complex matrices; therefore, it can significantly accelerate analytical turnover. Copyright © 2014 John Wiley & Sons, Ltd.

Friend suggestion in social network based on user log

NASA Astrophysics Data System (ADS)

Kaviya, R.; Vanitha, M.; Sumaiya Thaseen, I.; Mangaiyarkarasi, R.

2017-11-01

Simple friend recommendation algorithms such as similarity, popularity and social aspects is the basic requirement to be explored to methodically form high-performance social friend recommendation. Suggestion of friends is followed. No tags of character were followed. In the proposed system, we use an algorithm for network correlation-based social friend recommendation (NC-based SFR).It includes user activities like where one lives and works. A new friend recommendation method, based on network correlation, by considering the effect of different social roles. To model the correlation between different networks, we develop a method that aligns these networks through important feature selection. We consider by preserving the network structure for a more better recommendations so that it significantly improves the accuracy for better friend-recommendation.

Implementing AORN recommended practices for prevention of transmissible infections.

PubMed

Patrick, Marcia R; Hicks, Rodney W

2013-12-01

Preventing infection in the perioperative setting is a critical element of patient and health care worker safety. This article reviews the recommendations in the AORN "Recommended practices for prevention of transmissible infections in the perioperative practice setting." The recommended practices are intended to help perioperative nurses implement standard and transmission-based precautions (ie, contact, droplet, airborne), including use of personal protective equipment as well as interventions to prevent surgical site infections and exposure to bloodborne pathogens. Additional recommendations cover vaccination programs and how to manage personnel who require work restrictions. Hospital and ambulatory patient scenarios are included to help perioperative nurses apply the recommendations in daily practice. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Psychological Assessment via the Internet: A Reliability and Validity Study of Online (vs Paper-and-Pencil) Versions of the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R)

PubMed Central

Jordán, Carlos M; Díaz, Marta I; Comeche, María I; Ortega, José

2007-01-01

Background Internet psychology services are rapidly increasing and that implies online assessment. To guarantee the results of these new online evaluation procedures, it is necessary to have reliable and valid assessment tools. Objective In this work we analyzed the online versions of two popular psychopathology screening questionnaires: the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R). Methods A total of 185 psychology students were recruited from two universities in Madrid, Spain. All of them had Internet access at home. A test-retest situation and factorial analysis were used to generate reliability and validity data. Both paper-and-pencil questionnaires (test) and their online versions (retest) were completed by 100 participants (median gap = 17 days). Results Results suggest that both online questionnaires were fairly equivalent to their paper-and-pencil versions, with higher reliability values for the SCL-90-R. Factorial analysis tended to reproduce the structure shown in former investigations of both questionnaires, replicating the four-factor structure of the GHQ-28 but failing to do so with the nine-factor structure of the SCL-90-R. Instead, a large unrotated factor appeared. Conclusions Further research should be carried out to confirm these data, but our work supports the online use of both assessment tools. The psychometric properties of the online version of GHQ-28 is similar to the paper-and-pencil and we can recommend its utilization in a Web environment. In contrast, SCL-90-R can only be recommended as a global index for psychological distress, using the Global Severity Index (GSI), not necessarily its subscales; and it should be considered that the online scores were lower than the ones with the paper-and-pencil version. PMID:17478411

Psychological assessment via the internet: a reliability and validity study of online (vs paper-and-pencil) versions of the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R).

PubMed

Vallejo, Miguel A; Jordán, Carlos M; Díaz, Marta I; Comeche, María I; Ortega, José

2007-01-31

Internet psychology services are rapidly increasing and that implies online assessment. To guarantee the results of these new online evaluation procedures, it is necessary to have reliable and valid assessment tools. In this work we analyzed the online versions of two popular psychopathology screening questionnaires: the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R). A total of 185 psychology students were recruited from two universities in Madrid, Spain. All of them had Internet access at home. A test-retest situation and factorial analysis were used to generate reliability and validity data. Both paper-and-pencil questionnaires (test) and their online versions (retest) were completed by 100 participants (median gap = 17 days). Results suggest that both online questionnaires were fairly equivalent to their paper-and-pencil versions, with higher reliability values for the SCL-90-R. Factorial analysis tended to reproduce the structure shown in former investigations of both questionnaires, replicating the four-factor structure of the GHQ-28 but failing to do so with the nine-factor structure of the SCL-90-R. Instead, a large unrotated factor appeared. Further research should be carried out to confirm these data, but our work supports the online use of both assessment tools. The psychometric properties of the online version of GHQ-28 is similar to the paper-and-pencil and we can recommend its utilization in a Web environment. In contrast, SCL-90-R can only be recommended as a global index for psychological distress, using the Global Severity Index (GSI), not necessarily its subscales; and it should be considered that the online scores were lower than the ones with the paper-and-pencil version.

65 Main-Track Train Collisions, 1997 through 2002 - Review, Analysis, Findings and Recommendations

DOT National Transportation Integrated Search

2006-08-01

The Collision Analysis Working Group (CAWG) reviewed and analyzed main-track collision of both freight and passenger trainss involving human factor issues and to make safety findings and recommendations. CAWG agreed to review main track train collisi...

Notification: Follow-up Audit of Prior OIG Recommendations on EPA's Workforce Management

EPA Pesticide Factsheets

October 16, 2012. The U.S. Environmental Protection Agency (EPA), Office of Inspector General (OIG), plans to begin audit work to evaluate the status of the Agency’s corrective actions for recommendations we made in 3 specific audit reports.

Medications for the Risk Reduction of Primary Breast Cancer in Women

MedlinePlus

... independent group of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of all Americans by making evidence- based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Screening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults

MedlinePlus

... independent group of national experts in prevention and evidence- based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions

MedlinePlus

... independent group of national experts in prevention and evidence- based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Working Party on the Future of Professional Qualifications: Recommendations of the Implementation Board.

ERIC Educational Resources Information Center

Library Association Record, 1978

1978-01-01

This report and recommendations by the Implementation Board of the Library Association Council outlines the training and experience required for certification of library assistants, licensing of librarians, and registration of Library Association Associates and Chartered Libraries. (JAB)

Manager and Business Student Work Goals: Implications and Recommendations for Educators

ERIC Educational Resources Information Center

Richards, Clinton H.; Corney, William J.

2011-01-01

The correspondence between work goals, work requirements, and available organizational rewards is a primary determinant of job satisfaction and motivation and is also likely to impact job performance. Research suggests managers' but not business students' work goal priorities are well matched with the work requirements and available rewards of…

Employer Policies and Practices to Manage and Prevent Disability: Foreword to the Special Issue.

PubMed

Shaw, William S; Main, Chris J; Pransky, Glenn; Nicholas, Michael K; Anema, Johannes R; Linton, Steven J

2016-12-01

Purpose Employer policies and practices have been shown to impact workplace disability, but research in this area has waned in recent years despite an aging workforce, a growing prevalence of chronic health conditions, and a larger proportion of working-age adults on permanent work disability in many jurisdictions. The purpose of this article is to describe the background rationale and methodology for an invited conference designed to improve research of employer strategies to curtail work disability. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The overall goal was to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. Working groups were organized and draft manuscripts were prepared in advance. Conference activities included working group presentations and critiques, discussions with a panel of industry consultants and advisors, group interaction and debate, generation of final recommendations, and manuscript revision. Results/Conclusion Six principal domains were established with respect to future research: (a) further elucidation of the key workplace factors that buffer the disabling effects of injury and illness; (b) more innovative and feasible options for workplace intervention; (c) measurement of workplace-relevant disability outcomes; (d) a stronger theoretical framework for understanding the factors behind employer uptake and implementation; (e) a focus on special clinical populations and occupations where disability risk is most troubling; and (f) better representation of workers and employers that reflect the diverse and changing nature of work. Final comments and recommendations of the working groups are presented in the following six articles in this special issue of the Journal of Occupational Rehabilitation. Conference attendees recommended changes in methodology, collaboration strategies, and theoretical perspectives to improve the practical and scientific impact of future research of employer practices.

Validation of Technical Recommendations. Final Report. ISSOE Managing Student Progress.

ERIC Educational Resources Information Center

Ridley, Dennis; And Others

This report is organized to provide a complete, logical presentation of the major steps taken in the third phase of research on dynamics of dissemination of the Instructional Support System for Occupational Education (ISSOE). It reports on the confirmation and validation of the Phase II Final Report on Dissemination Issues and the Phase III…

The Changing Face of Scientific Discourse: Analysis of Genomic and Proteomic Database Usage and Acceptance.

ERIC Educational Resources Information Center

Brown, Cecelia

2003-01-01

Discusses the growth in use and acceptance of Web-based genomic and proteomic databases (GPD) in scholarly communication. Confirms the role of GPD in the scientific literature cycle, suggests GPD are a storage and retrieval mechanism for molecular biology information, and recommends that existing models of scientific communication be updated to…

Treatment Options for Back Pain Provided Online in Canadian Magazines: Comparison against Evidence from a Clinical Practice Guideline

ERIC Educational Resources Information Center

Sniderman, Jhase A.; Roffey, Darren M.; Lee, Richard; Papineau, Gabrielle D.; Miles, Isabelle H.; Wai, Eugene K.; Kingwell, Stephen P.

2017-01-01

Background: Evidence-based treatments for adult back pain have long been confirmed, with research continuing to narrow down the scope of recommended practices. However, a tension exists between research-driven treatments and unsubstantiated modalities and techniques promoted to the public. This disparity in knowledge translation, which results in…

School Enrolment and Attendance for Children with Disabilities in Kenya: An Examination of Household Survey Data

ERIC Educational Resources Information Center

Moyi, Peter

2017-01-01

While evidence confirms that children with disabilities face significant obstacles to schooling, especially in low-income countries like Kenya, there is limited empirical research on which to develop policy. The government of Kenya has long neglected the plight of people with disabilities. Despite numerous policy recommendations from the various…

Promoting Self-Explanation to Improve Mathematics Learning: A Meta-Analysis and Instructional Design Principles

ERIC Educational Resources Information Center

Rittle-Johnson, Bethany; Loehr, Abbey M.; Durkin, Kelley

2017-01-01

Promoting self-explanation (i.e., generating explanations for oneself in an attempt to make sense of new information) is a recommended study strategy and instructional practice. A meta-analysis of the literature on prompting self-explanation to improve mathematics learning confirmed that prompted self-explanation leads to a small to moderate…

Solid state electro-optic color filter and iris

NASA Technical Reports Server (NTRS)

1974-01-01

Test results obtained have confirmed the practicality of the solid state electro-optic filters as an optical control element in a television system. Neutral-density control range in excess of 1000:1 has been obtained on sample filters. Test results, measurements in a complete camera system, discussions of problem areas, analytical comparisons, and recommendations for future investigations are included.

Time To Move from Presumptive Malaria Treatment to Laboratory-Confirmed Diagnosis and Treatment in African Children with Fever

PubMed Central

D'Acremont, Valérie; Lengeler, Christian; Mshinda, Hassan; Mtasiwa, Deo; Tanner, Marcel; Genton, Blaise

2009-01-01

Background to the debate: Current guidelines recommend that all fever episodes in African children be treated presumptively with antimalarial drugs. But declining malarial transmission in parts of sub-Saharan Africa, declining proportions of fevers due to malaria, and the availability of rapid diagnostic tests mean it may be time for this policy to change. This debate examines whether enough evidence exists to support abandoning presumptive treatment and whether African health systems have the capacity to support a shift toward laboratory-confirmed rather than presumptive diagnosis and treatment of malaria in children under five. PMID:19127974

Australian developments in marine science

NASA Astrophysics Data System (ADS)

Coffin, Millard F.

2012-07-01

Australia is an island nation with about two thirds of its jurisdiction underwater. On 25 May 2012, Australia instituted the Seas and Submerged Lands (Limits of Continental Shelf) Proclamation 2012, confirming areas of seabed where Australia has exclusive rights to explore and exploit marine resources. This proclamation follows recommendations by the Commission on the Limits of the Continental Shelf, a body established under the United Nations Convention on the Law of the Sea, confirming Australia's entitlement to extended continental shelf, i.e., that beyond 200 nautical miles from the coastline, of some 2.56 million square kilometers, excluding Australian Antarctic Territory [Symonds et al., 2009] (Figure 1a).

Cutaneous Lyme borreliosis: Guideline of the German Dermatology Society.

PubMed

Hofmann, Heidelore; Fingerle, Volker; Hunfeld, Klaus-Peter; Huppertz, Hans-Iko; Krause, Andreas; Rauer, Sebastian; Ruf, Bernhard

2017-01-01

This guideline of the German Dermatology Society primarily focuses on the diagnosis and treatment of cutaneous manifestations of Lyme borreliosis. It has received consensus from 22 German medical societies and 2 German patient organisations. It is the first part of an AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.) interdisciplinary guideline: "Lyme Borreliosis - Diagnosis and Treatment, development stage S3". The guideline is directed at physicians in private practices and clinics who treat Lyme borreliosis. Objectives of this guideline are recommendations for confirming a clinical diagnosis, recommendations for a stage-related laboratory diagnosis (serological detection of IgM and IgG Borrelia antibodies using the 2-tiered ELISA/immunoblot process, sensible use of molecular diagnostic and culture procedures) and recommendations for the treatment of the localised, early-stage infection (erythema migrans, erythema chronicum migrans, and borrelial lymphocytoma), the disseminated early-stage infection (multiple erythemata migrantia, flu-like symptoms) and treatment of the late-stage infection (acrodermatitis chronica atrophicans with and without neurological manifestations). In addition, an information sheet for patients containing recommendations for the prevention of Lyme borreliosis is attached to the guideline.

Cutaneous Lyme borreliosis: Guideline of the German Dermatology Society

PubMed Central

Hofmann, Heidelore; Fingerle, Volker; Hunfeld, Klaus-Peter; Huppertz, Hans-Iko; Krause, Andreas; Rauer, Sebastian; Ruf, Bernhard

2017-01-01

This guideline of the German Dermatology Society primarily focuses on the diagnosis and treatment of cutaneous manifestations of Lyme borreliosis. It has received consensus from 22 German medical societies and 2 German patient organisations. It is the first part of an AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.) interdisciplinary guideline: “Lyme Borreliosis – Diagnosis and Treatment, development stage S3”. The guideline is directed at physicians in private practices and clinics who treat Lyme borreliosis. Objectives of this guideline are recommendations for confirming a clinical diagnosis, recommendations for a stage-related laboratory diagnosis (serological detection of IgM and IgG Borrelia antibodies using the 2-tiered ELISA/immunoblot process, sensible use of molecular diagnostic and culture procedures) and recommendations for the treatment of the localised, early-stage infection (erythema migrans, erythema chronicum migrans, and borrelial lymphocytoma), the disseminated early-stage infection (multiple erythemata migrantia, flu-like symptoms) and treatment of the late-stage infection (acrodermatitis chronica atrophicans with and without neurological manifestations). In addition, an information sheet for patients containing recommendations for the prevention of Lyme borreliosis is attached to the guideline. PMID:28943834

Detection of comorbidities and synchronous primary tumours via thoracic radiography and abdominal ultrasonography and their influence on treatment outcome in dogs with soft tissue sarcomas, primary brain tumours and intranasal tumours.

PubMed

Bigio Marcello, A; Gieger, T L; Jiménez, D A; Granger, L Abbigail

2015-12-01

Canine soft tissue sarcomas (STS), primary brain tumours and intranasal tumours are commonly treated with radiotherapy (RT). Given the low metastatic potential of these tumours, recommendations regarding imaging tests as staging are variable among institutions. The purpose of our study was to describe thoracic radiographic and abdominal ultrasonographic findings in dogs with these neoplasms and to investigate association of abnormal findings with alterations in recommended treatment. Medical records from 101 dogs, each having thoracic radiographs and abdominal ultrasound performed as part of their staging, were reviewed. In 98 of 101 (97%), imaging abnormalities were detected, 27% of which were further investigated with fine needle aspiration cytology or biopsy. Nine percent of the detected abnormalities were considered serious comorbidities that altered treatment recommendations, including 3 (3%) which were confirmed as synchronous primary neoplasms. These findings may influence recommendations regarding the decision to perform thoracic radiographs and abdominal ultrasound prior to initiation of RT. © 2013 John Wiley & Sons Ltd.

Recommendations and Ongoing Efforts within the NASA Data Quality Working Group

NASA Astrophysics Data System (ADS)

Moroni, D. F.; Ramapriyan, H.; Bagwell, R.; Downs, R. R.

2015-12-01

Since its inception in March 2014, the NASA Data Quality Working Group (DQWG) has procured a set of 12 high level recommendations which had been sifted from and aggregated from a prioritized subset of nearly 100 unique recommendations spanning four unique data quality management phases and distributed between two actionable categories. The four data quality management phases as identified by the DQWG are: 1. Capturing (i.e., deriving, collecting and organizing the information), 2. Describing (i.e., documenting and procuring the information for public consumption), 3. Facilitating Discovery (i.e., publishing and providing access to the information), and 4. Enabling Use (i.e., enhancing the utility of the information). Mapping each of our recommendations to one or more of the above management phases is intended to enable improved assessment of cost, feasibility, and relevancy to the entities responsible for implementing such recommendations. The DQWG further defined two distinct actionable categories: 1) Data Systems and 2) Science. The purpose of these actionable categories is to define specifically who is responsible for the implementation and adherence toward these recommendations; we refer to the responsible entities as the "actionees". Here we will summarize each of the high level recommendations along with their corresponding management phases and actionees. We will present what has recently been identified as our set of "low-hanging fruit" recommendations, which are intended for near-term implementation. Finally, we will present the status and motivation for continuing and future planned activities, which include but are not limited to: engaging inter-agency and international communities, more direct feedback from Earth observation missions, and mapping of "low-hanging fruit" recommendations to existing solutions.

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.

Recommendations for the surgical treatment of endometriosis-part 1: ovarian endometrioma.

PubMed

Saridogan, Ertan; Becker, Christian M; Feki, Anis; Grimbizis, Grigoris F; Hummelshoj, Lone; Keckstein, Joerg; Nisolle, Michelle; Tanos, Vasilios; Ulrich, Uwe A; Vermeulen, Nathalie; De Wilde, Rudy Leon

2017-01-01

What does this document on the surgical treatment of endometriosis jointly prepared by the European Society for Gynaecological Endoscopy (ESGE), ESHRE, and the World Endometriosis Society (WES) provide? This document provides recommendations covering technical aspects of different methods of surgery for endometriomas in women of reproductive age. Endometriomas (ovarian endometriotic cysts) are a commonly diagnosed form of endometriosis, owing to the relative ease and accuracy of ultrasound diagnosis. They frequently present a clinical dilemma as to whether and how to treat them when found during imaging or incidentally during surgery. Previously published guidelines have provided recommendations based on the best available evidence, but without technical details on the management of endometriosis. A working group of ESGE, ESHRE and WES collaborated on writing recommendations on the practical aspects of endometrioma surgery. This document focused on endometrioma surgery. Further documents in this series will provide recommendations for surgery of deep and peritoneal endometriosis. The document presents general recommendations for surgery of endometrioma and specific recommendations for cystectomy, ablation by laser or by plasma energy, electrocoagulation and a combination of these techniques applied together or with an interval between them. Owing to the limited evidence available, recommendations are mostly based on clinical expertise. These recommendations complement previous guidelines on the management of endometriosis. The meetings of the working group were funded by ESGE, ESHRE and WES. CB declares to be a member of the independent data monitoring committee for a clinical study by ObsEva and receiving research grants from Bayer, Roche Diagnostics, MDNA Life Sciences and Volition. ES received honoraria for provision of training to healthcare professionals from Ethicon, Olympus and Gedeon Richter. The other authors declare that they have no conflict of interest.

Working hours, sleep duration and the risk of acute coronary heart disease: a case-control study of middle-aged men in Taiwan.

PubMed

Cheng, Yawen; Du, Chung-Li; Hwang, Juey-Jen; Chen, I-Shin; Chen, Ming-Fong; Su, Ta-Chen

2014-02-15

This study aimed to examine whether long working hours and short sleep duration were associated with an increased risk of acute myocardial infarction (AMI) or severe coronary heart diseases (SCHD), independent of established psychosocial work-related factors. A case-control study was conducted. Cases were 322 men, aged <60 years and economically active, who were admitted to hospital with a first diagnosed AMI or SCHD during 2008-2011, of whom 134 were confirmed AMI and the other 188 were angiography-confirmed SCHD. Controls were 644 men who were drawn from a national survey and were matched to the cases on age, education and area of residence. Odds ratios of total CHD and confirmed AMI in relation to average weekly working hours and daily hours of sleep were calculated. Men with average working hours longer than 60 h/week were found to have significantly increased risks for total CHD (OR=2.2) as compared to those with weekly working hours in 40-48 h, and those with daily hours of sleep fewer than 6 h were found to have increased risks for CHD (OR=3.0) as compared to those with sleeping hours in 6-9 h. Restriction to confirmed AMI yielded a greater risk and these associations remained consistent with adjustment of smoking status, body mass index and psychosocial work factors including job demands, job control, workplace justice, job insecurity and shift work. The results support the hypothesis that long working hours and short sleep duration contribute independently to the risk of cardiovascular diseases in men. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

75 FR 67803 - Data Collection Available for Public Comments and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

... used to provide loans to start-up, newly established, and growing small business concerns for working... SMALL BUSINESS ADMINISTRATION Data Collection Available for Public Comments and Recommendations..., this notice announces the Small Business Administration's intentions to request approval on a new and...

Non-Renewal of Probationary Teachers: Negative Retention

ERIC Educational Resources Information Center

Nixon, Andy; Packard, Abbot; Douvanis, Gus

2010-01-01

For students, quality teaching means the difference between a bright or potentially dim future. School principals face several challenges that work against recommending contract non-renewal for incompetent teachers. This study investigates the reasons that school principals recommend contract non-renewal of probationary teachers. Targeted…

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer in Women

MedlinePlus

... independent group of national experts in prevention and evidence- based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical ... or preventive medicines. The recommendations apply to people with no signs ...

Peter Drucker, Knowledge Work, and the Structure of Schools.

ERIC Educational Resources Information Center

Tucker, Marc S.

1988-01-01

Discusses Peter Drucker's recommendations in "The Age of Discontinuity" (1969) concerning the decline of manual work, the ascendancy of knowledge work, and the relationship between economic stability and an educated, productive work force. Applies Drucker's principles to the movement to restructure schools, which aims to make line…

76 FR 67558 - Proposed Information Collection (Application for Work-Study Allowance) Activity: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... (Application for Work-Study Allowance) Activity: Comment Request AGENCY: Veterans Benefits Administration... claimant's eligibility for work-study benefits. DATES: Written comments and recommendations on the proposed... use of other forms of information technology. Titles: a. Application for Work-Study Allowance, VA Form...

76 FR 54487 - Charter Renewal, Glen Canyon Dam Adaptive Management Work Group

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-01

... Management Work Group AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of renewal. SUMMARY: Following... Interior (Secretary) is renewing the charter for the Glen Canyon Dam Adaptive Management Work Group. The purpose of the Adaptive Management Work Group is to advise and to provide recommendations to the Secretary...

Standardising the descriptive epidemiology of osteoporosis: recommendations from the Epidemiology and Quality of Life Working Group of IOF.

PubMed

Kanis, J A; Adachi, J D; Cooper, C; Clark, P; Cummings, S R; Diaz-Curiel, M; Harvey, N; Hiligsmann, M; Papaioannou, A; Pierroz, D D; Silverman, S L; Szulc, P

2013-11-01

The Committee of Scientific Advisors of International Osteoporosis Foundation (IOF) recommends that papers describing the descriptive epidemiology of osteoporosis using bone mineral density (BMD) at the femoral neck include T-scores derived from an international reference standard. The prevalence of osteoporosis as defined by the T-score is inconsistently reported in the literature which makes comparisons between studies problematic. The Epidemiology and Quality of Life Working Group of IOF convened to make its recommendations and endorsement sought thereafter from the Committee of Scientific Advisors of IOF. The Committee of Scientific Advisors of IOF recommends that papers describing the descriptive epidemiology of osteoporosis using BMD at the femoral neck include T-scores derived from the National Health and Nutrition Examination Survey III reference database for femoral neck measurements in Caucasian women aged 20-29 years. It is expected that the use of the reference standard will help resolve difficulties in the comparison of results between studies and the comparative assessment of new technologies.

A hybrid personalized data recommendation approach for geoscience data sharing

NASA Astrophysics Data System (ADS)

WANG, M.; Wang, J.

2016-12-01

Recommender systems are effective tools helping Internet users overcome information overloading. The two most widely used recommendation algorithms are collaborating filtering (CF) and content-based filtering (CBF). A number of recommender systems based on those two algorithms were developed for multimedia, online sells, and other domains. Each of the two algorithms has its advantages and shortcomings. Hybrid approaches that combine these two algorithms are better choices in many cases. In geoscience data sharing domain, where the items (datasets) are more informative (in space and time) and domain-specific, no recommender system is specialized for data users. This paper reports a dynamic weighted hybrid recommendation algorithm that combines CF and CBF for geoscience data sharing portal. We first derive users' ratings on items with their historical visiting time by Jenks Natural Break. In the CBF part, we incorporate the space, time, and subject information of geoscience datasets to compute item similarity. Predicted ratings were computed with k-NN method separately using CBF and CF, and then combined with weights. With training dataset we attempted to find the best model describing ideal weights and users' co-rating numbers. A logarithmic function was confirmed to be the best model. The model was then used to tune the weights of CF and CBF on user-item basis with test dataset. Evaluation results show that the dynamic weighted approach outperforms either solo CF or CBF approach in terms of Precision and Recall.

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015.

PubMed

Gorter, Ramon R; Eker, Hasan H; Gorter-Stam, Marguerite A W; Abis, Gabor S A; Acharya, Amish; Ankersmit, Marjolein; Antoniou, Stavros A; Arolfo, Simone; Babic, Benjamin; Boni, Luigi; Bruntink, Marlieke; van Dam, Dieuwertje A; Defoort, Barbara; Deijen, Charlotte L; DeLacy, F Borja; Go, Peter Mnyh; Harmsen, Annelieke M K; van den Helder, Rick S; Iordache, Florin; Ket, Johannes C F; Muysoms, Filip E; Ozmen, M Mahir; Papoulas, Michail; Rhodes, Michael; Straatman, Jennifer; Tenhagen, Mark; Turrado, Victor; Vereczkei, Andras; Vilallonga, Ramon; Deelder, Jort D; Bonjer, Jaap

2016-11-01

Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis.

Cosmetic allergy: incidence, diagnosis, and management.

PubMed

Orton, David I; Wilkinson, John D

2004-01-01

A recent epidemiologic survey in the UK revealed that 23% of women and 13.8% of men experience some sort of adverse reaction to a personal care product over the course of a year. Although most of these reactions may be due to subjective sensory irritation, various studies reveal that up to 10% of dermatologic patients who are patch tested are allergic to cosmetic products or their constituent ingredients. Causative products include deodorants and perfumes, skin care products, hair care products, and nail cosmetics. Allergic contact dermatitis mainly results from fragrance chemicals and preservatives. Recent work has suggested that additional fragrance chemicals may need to be tested in order to identify those patients 'missed' by the current fragrance mix; in particular, hydroxy-isohexyl-3-cyclohexene carboxaldehyde (HMPPC Lyral) has been singled out as an important sensitizing agent. The increased usage of natural fragrances and botanic extracts can also cause problems in their own right or through co-reactivity. The preservative methyldibromo glutaronitrile has also been recognized as an increasingly important sensitizer in Europe, which has led to the recent recommendation that it should be prohibited from 'leave-on' products until information on 'safe' consumer levels becomes available. Other emerging allergens include UV filters, tosylamide/formaldehyde resin, and nail acrylates. The diagnosis of cosmetic allergy should be confirmed with patch testing, including testing of 'whole' products, when necessary, and repeat open application tests can be used to confirm the relevance of reactions in cases of doubt.

76 FR 21936 - Aviation Rulemaking Advisory Committee-New Task

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-19

... ARAC activity and solicits membership for the new Rulemaking Prioritization Working Group. FOR FURTHER... Rulemaking Prioritization Working Group will specifically address, in part, Recommendation 22: ``The... available * * *.'' The objective of the Rulemaking Prioritization Working Group is to provide advice and...

Recommended values of clean metal surface work functions

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

Derry, Gregory N., E-mail: gderry@loyola.edu; Kern, Megan E.; Worth, Eli H.

2015-11-15

A critical review of the experimental literature for measurements of the work functions of clean metal surfaces of single-crystals is presented. The tables presented include all results found for low-index crystal faces except cases that were known to be contaminated surfaces. These results are used to construct a recommended value of the work function for each surface examined, along with an uncertainty estimate for that value. The uncertainties are based in part on the error distribution for all measured work functions in the literature, which is included here. The metals included in this review are silver (Ag), aluminum (Al), goldmore » (Au), copper (Cu), iron (Fe), iridium (Ir), molybdenum (Mo), niobium (Nb), nickel (Ni), palladium (Pd), platinum (Pt), rhodium (Rh), ruthenium (Ru), tantalum (Ta), and tungsten (W)« less

Aggregation Trade Offs in Family Based Recommendations

NASA Astrophysics Data System (ADS)

Berkovsky, Shlomo; Freyne, Jill; Coombe, Mac

Personalized information access tools are frequently based on collaborative filtering recommendation algorithms. Collaborative filtering recommender systems typically suffer from a data sparsity problem, where systems do not have sufficient user data to generate accurate and reliable predictions. Prior research suggested using group-based user data in the collaborative filtering recommendation process to generate group-based predictions and partially resolve the sparsity problem. Although group recommendations are less accurate than personalized recommendations, they are more accurate than general non-personalized recommendations, which are the natural fall back when personalized recommendations cannot be generated. In this work we present initial results of a study that exploits the browsing logs of real families of users gathered in an eHealth portal. The browsing logs allowed us to experimentally compare the accuracy of two group-based recommendation strategies: aggregated group models and aggregated predictions. Our results showed that aggregating individual models into group models resulted in more accurate predictions than aggregating individual predictions into group predictions.

The Invisible Work of Being a Patient and Implications for Health Care: “[the doctor is] my business partner in the most important business in my life, staying alive”

PubMed Central

UNRUH, KENTON T.; PRATT, WANDA

2010-01-01

In a distributed system of care, patients shuffle among many clinicians and spend the majority of their time away from the treatment center. Although we see the results of patients’ work (e.g., medication taken, arrived at appointment) we do not see the work itself. By failing to see this work, industry overlooks issues with vital implications for their business. To lift the veil of invisibility from patients’ work, we conducted a longitudinal field study to uncover the invisible work breast cancer patients do to obtain information, bridge inter-institutional care, manage dependencies and resolve inconsistent recommendations. In this paper we provide detailed examples of this work and explore the impact on patients and health-care operations; identify patterns of work with implications for patient-centered research and design; and propose common information spaces to improve patients’ work through designs that highlight dependencies, preserve state information, link recommendations to justifications, and track task progress. PMID:21709742

Physical Activity Levels Among Adults in Uganda: Findings From a Countrywide Cross-Sectional Survey.

PubMed

Guwatudde, David; Kirunda, Barbara E; Wesonga, Ronald; Mutungi, Gerald; Kajjura, Richard; Kasule, Hafisa; Muwonge, James; Bahendeka, Silver K

2016-09-01

Being physically active is associated with lower risk of many noncommunicable diseases (NCDs). We analyzed physical activity (PA) data collected as part of Uganda's countrywide NCD risk factor survey conducted in 2014, to describe PA levels in Uganda. PA data were collected on the domains of work, travel and leisure. We calculated the percentage of participants meeting the World Health Organization (WHO) PA recommendations, and the types of intense-specific duration of PA. Prevalence ratios (PR) were used to identify factors associated with meeting WHO PA recommendations. Of the 3987 participants, 3758 (94.3%) met the WHO PA recommendations. Work-related PA of moderate intensity, and travel-related PA contributed most to participants' overall weekly duration of PA, each contributing 49.6% and 25.2% respectively. The median weekly duration of all moderate-intensity PA was 1470 minutes (interquartile range [IQR] = 540 to 2460). Weekly duration of all vigorous-intensity PA was low with a median of 0 minutes (IQR = 0 to 1080). The median daily sedentary time was 120 minutes (IQR = 60 to 240). Factors significantly associated with meeting WHO PA recommendations were body mass index and level of education. PA levels in Uganda are high, mostly achieved through travel and work-related activities of moderate intensity.

USGS River Ecosystem Modeling: Where Are We, How Did We Get Here, and Where Are We Going?

USGS Publications Warehouse

Hanson, Leanne; Schrock, Robin; Waddle, Terry; Duda, Jeffrey J.; Lellis, Bill

2009-01-01

This report developed as an outcome of the USGS River Ecosystem Modeling Work Group, convened on February 11, 2008 as a preconference session to the second USGS Modeling Conference in Orange Beach, Ala. Work Group participants gained an understanding of the types of models currently being applied to river ecosystem studies within the USGS, learned how model outputs are being used by a Federal land management agency, and developed recommendations for advancing the state of the art in river ecosystem modeling within the USGS. During a break-out session, participants restated many of the recommendations developed at the first USGS Modeling Conference in 2006 and in previous USGS needs assessments. All Work Group recommendations require organization and coordination across USGS disciplines and regions, and include (1) enhancing communications, (2) increasing efficiency through better use of current human and technologic resources, and (3) providing a national infrastructure for river ecosystem modeling resources, making it easier to integrate modeling efforts. By implementing these recommendations, the USGS will benefit from enhanced multi-disciplinary, integrated models for river ecosystems that provide valuable risk assessment and decision support tools for adaptive management of natural and managed riverine ecosystems. These tools generate key information that resource managers need and can use in making decisions about river ecosystem resources.

Managerial practices regarding workers working while ill.

PubMed

Norton, D M; Brown, L G; Frick, R; Carpenter, L R; Green, A L; Tobin-D'Angelo, M; Reimann, D W; Blade, H; Nicholas, D C; Egan, J S; Everstine, K

2015-01-01

Surveillance data indicate that handling of food by an ill worker is a cause of almost half of all restaurant-related outbreaks. The U.S. Food and Drug Administration (FDA) Food Code contains recommendations for food service establishments, including restaurants, aimed at reducing the frequency with which food workers work while ill. However, few data exist on the extent to which restaurants have implemented FDA recommendations. The Centers for Disease Control and Prevention's Environmental Health Specialists Network (EHS-Net) conducted a study on the topic of ill food workers in restaurants. We interviewed restaurant managers (n = 426) in nine EHS-Net sites. We found that many restaurant policies concerning ill food workers do not follow FDA recommendations. For example, one-third of the restaurants' policies did not specifically address the circumstances under which ill food workers should be excluded from work (i.e., not be allowed to work). We also found that, in many restaurants, managers are not actively involved in decisions about whether ill food workers should work. Additionally, almost 70% of managers said they had worked while ill; 10% said they had worked while having nausea or "stomach flu," possible symptoms of foodborne illness. When asked why they had worked when ill, a third of the managers said they felt obligated to work or their strong work ethic compelled them to work. Other reasons cited were that the restaurant was understaffed or no one was available to replace them (26%), they felt that their symptoms were mild or not contagious (19%), they had special managerial responsibilities that no one else could fulfill (11%), there was non-food handling work they could do (7%), and they would not get paid if they did not work or the restaurant had no sick leave policy (5%). Data from this study can inform future research and help policy makers target interventions designed to reduce the frequency with which food workers work while ill.

Managerial Practices regarding Workers Working while III†

PubMed Central

Norton, D. M.; Brown, L. G.; Frick, R.; Carpenter, L. R.; Green, A. L.; Tobin-D’Angelo, M.; Reimann, D. W.; Blade, H.; Nicholas, D. C.; Egan, J. S.; Everstine, K.

2017-01-01

Surveillance data indicate that handling of food by an ill worker is a cause of almost half of all restaurant-related outbreaks. The U.S. Food and Drug Administration (FDA) Food Code contains recommendations for food service establishments, including restaurants, aimed at reducing the frequency with which food workers work while ill. However, few data exist on the extent to which restaurants have implemented FDA recommendations. The Centers for Disease Control and Prevention’s Environmental Health Specialists Network (EHS-Net) conducted a study on the topic of ill food workers in restaurants. We interviewed restaurant managers (n = 426) in nine EHS-Net sites. We found that many restaurant policies concerning ill food workers do not follow FDA recommendations. For example, one-third of the restaurants’ policies did not specifically address the circumstances under which ill food workers should be excluded from work (i.e., not be allowed to work). We also found that, in many restaurants, managers are not actively involved in decisions about whether ill food workers should work. Additionally, almost 70% of managers said they had worked while ill; 10% said they had worked while having nausea or “stomach flu,” possible symptoms of foodborne illness. When asked why they had worked when ill, a third of the managers said they felt obligated to work or their strong work ethic compelled them to work. Other reasons cited were that the restaurant was understaffed or no one was available to replace them (26%), they felt that their symptoms were mild or not contagious (19%), they had special managerial responsibilities that no one else could fulfill (11%), there was non–food handling work they could do (7%), and they would not get paid if they did not work or the restaurant had no sick leave policy (5%). Data from this study can inform future research and help policy makers target interventions designed to reduce the frequency with which food workers work while ill. PMID:25581195

Empirical validation of guidelines for the management of pharyngitis in children and adults.

PubMed

McIsaac, Warren J; Kellner, James D; Aufricht, Peggy; Vanjaka, Anita; Low, Donald E

2004-04-07

Recent guidelines for management of pharyngitis vary in their recommendations concerning empirical antibiotic treatment and the need for laboratory confirmation of group A streptococcus (GAS). To assess the impact of guideline recommendations and alternative approaches on identification and treatment of GAS pharyngitis in children and adults. Throat cultures and rapid antigen tests were performed on 787 children and adults aged 3 to 69 years with acute sore throat attending a family medicine clinic in Calgary, Alberta, from September 1999 to August 2002. Recommendations from 2 guidelines (those of the Infectious Diseases Society of America and of the American College of Physicians-American Society of Internal Medicine/American Academy of Family Physicians/US Centers for Disease Control and Prevention) were compared with rapid testing alone, a clinical prediction rule (ie, the modified Centor score), and a criterion standard of treatment for positive throat culture results only. Sensitivity and specificity of each strategy for identifying GAS pharyngitis, total antibiotics recommended, and unnecessary antibiotic prescriptions. In children, sensitivity for streptococcal infection ranged from 85.8% (133/155; 95% confidence interval [CI], 79.3%-90.0%) for rapid testing to 100% for culturing all. In adults, sensitivity ranged from 76.7% (56/73; 95% CI, 65.4%-85.8%) for rapid testing without culture confirmation of negative results to 100% for culturing all. In children, specificity ranged from 90.3% (270/299; 95% CI, 86.4%-93.4%) for use of modified Centor score and throat culture to 100% for culturing all. In adults, specificity ranged from 43.8% (114/260; 95% CI, 37.7%-50.1%) for empirical treatment based on a modified Centor score of 3 or 4 to 100% for culturing all. Total antibiotic prescriptions were lowest with rapid testing (24.7% [194/787]; 95% CI, 21.7%-27.8%) and highest with empirical treatment of high-risk adults (45.7% [360/787]; 95% CI, 42.2%-49.3%), due to a high rate of unnecessary prescriptions in adults (43.8% [146/333]; 95% CI, 38.4%-49.4%). Guideline recommendations for the selective use of throat cultures but antibiotic treatment based only on positive rapid test or throat culture results can reduce unnecessary use of antibiotics for treatment of pharyngitis. However, empirical treatment of adults having a Centor score of 3 or 4 is associated with a high rate of unnecessary antibiotic use. In children, strategies incorporating throat culture or throat culture confirmation of negative rapid antigen test results are highly sensitive and specific. Throat culture of all adults or those selected on the basis of a clinical prediction rule had the highest sensitivity and specificity.

Nursing lives in the blogosphere: A thematic analysis of anonymous online nursing narratives.

PubMed

Castro, Aimee; Andrews, Gavin

2018-02-01

The aim of this study was to explore the work-life narratives of nurses through a thematic analysis of the nursing accounts they post in their publicly accessible, anonymous blogs. Many nurses participate on social media. Blogs have been advocated as a self-reflective tool in nursing practice, yet as far as the authors are aware, no previous studies have explored nurses' individual blogs for their potential to reveal nurses' perceptions of nursing work. The research design was qualitative description. Between May-August 2015, Internet search engines were used to discover lists of nursing blogs recommended by organizations representing nurses' interests. Recommended blogs were purposively sampled. Four anonymous blogs written by nurses from different nursing specialties met the sampling criteria. All 520 of their entries from 2014 were read and copied into NVivo 10, where an inductive coding process was followed. Three major themes arose in these nurses' online discussions of their work lives: they truly care about and value their nursing work, but they are feeling stressed and burnt out and they are using their anonymous blogs to share factors that frustrate them in their nursing work. Three main areas of frustration were revealed: teamwork problems, challenging patients and families, and management issues. Anonymous nursing blogs offer valuable, longitudinal insights into nurses' perceptions of their work lives. Nursing blogs should be further explored for ongoing insights into nurses' experiences of nursing work, as well as nurses' recommendations for addressing issues causing them to feel frustrated in their work environments. © 2017 John Wiley & Sons Ltd.

European Policies to Promote Children's Rights and Combat Child Poverty.

PubMed

Sandbæk, Mona

2017-07-26

The upbringing of children relies heavily on shared responsibilities between parents and society. The Council of Europe Recommendation (2006) 19 on Policy to Support Positive Parenting and the European Commission Recommendation (2013) Investing in Children: Breaking the Cycle of Disadvantage, both aim at supporting parents to care and provide for their children in accordance with the UN Convention on the Rights of the Child. By means of a document analysis this article examines what kind of parental practices and provision to parents the recommendations suggest to safeguard children's rights in the family. Three findings are highlighted: first, both recommendations reflect a commitment to respecting children's rights while at the same time acknowledging parents as children's primary caregivers. Second, both recognize parents' rights to work, while also recognizing the necessity of adequate income support if work is not available or income too low. Third, adequate resources are defined as a combination of universal policies and services, which guarantee a minimum level for all, and targeted measures reaching out to the most disadvantaged. The recommendations' emphasis on children and parents as partners and on the families' economic situations are valuable for future development of family and child policy and support programs.

PROSPECT: a practical method for formulating evidence-based expert recommendations for the management of postoperative pain.

PubMed

Neugebauer, E A M; Wilkinson, R C; Kehlet, H; Schug, S A

2007-07-01

Many patients still suffer severe acute pain in the postoperative period. Although guidelines for treating acute pain are widely published and promoted, most do not consider procedure-specific differences in pain experienced or in techniques that may be most effective and appropriate for different surgical settings. The procedure-specific postoperative pain management (PROSPECT) Working Group provides procedure-specific recommendations for postoperative pain management together with supporting evidence from systematic literature reviews and related procedures at http://www.postoppain.org The methodology for PROSPECT reviews was developed and refined by discussion of the Working Group, and it adapts existing methods for formulation of consensus recommendations to the specific requirements of PROSPECT. To formulate PROSPECT recommendations, we use a methodology that takes into account study quality and source and level of evidence, and we use recognized methods for achieving group consensus, thus reducing potential bias. The new methodology is first applied in full for the 2006 update of the PROSPECT review of postoperative pain management for laparoscopic cholecystectomy. Transparency in PROSPECT processes allows the users to be fully aware of any limitations of the evidence and recommendations, thereby allowing for appropriate decisions in their own practice setting.

Letters, numbers, symbols and words: how to communicate grades of evidence and recommendations

PubMed Central

Schünemann, Holger J.; Best, Dana; Vist, Gunn; Oxman, Andrew D.

2003-01-01

THE GRADE WORKING GROUP IS DEVELOPING and evaluating a common, sensible approach to grading quality of evidence and strength of recommendations in health care. In this article, we discuss the advantages and disadvantages of using letters, numbers, symbols or words to represent grades of evidence and recommendations. Using multiple strategies, we searched for comparative studies of alternative ways of representing ordered categories in any context. In addition, we contacted experts and reviewed theoretical work and qualitative research on how best to communicate grades of any kind quickly and clearly. We were unable to identify health care research that addressed, either directly or indirectly, the best way to present grades of evidence and recommendations. We found examples of symbols used by government, commercial and consumer organizations to communicate quality of evidence or strength of recommendations, but no comparative studies. Although a number of grading systems are used in health care and other fields, there is little or no evidence of how well various presentations are understood. Before promoting the use of specific symbols, numbers, letters or words, the extent to which the intended message is comprehended should be evaluated. PMID:14517128

The Application of Standards and Recommendations to Clinical Ethics Consultation in Practice: An Evaluation at German Hospitals.

PubMed

Schochow, Maximilian; Rubeis, Giovanni; Steger, Florian

2017-06-01

The executive board of the Academy for Ethics in Medicine (AEM) and two AEM working groups formulated standards and recommendations for clinical ethics consultation in 2010, 2011, and 2013. These guidelines comply with the international standards like those set by the American Society for Bioethics and Humanities. There is no empirical data available yet that could indicate whether these standards and recommendations have been implemented in German hospitals. This desideratum is addressed in the present study. We contacted 1.858 German hospitals between September 2013 and January 2014. A follow-up survey was conducted between October 2014 and January 2015. The data of the initial survey and the follow-up survey were merged and evaluated. The statements of the participants were compared with the standards and recommendations. The standards of the AEM concerning the tasks of clinical ethics consultation (including ethics consultation, ethics training and the establishment of policy guidelines) are employed by a majority of participants of the study. Almost all of these participants document their consultation activities by means of protocols or entries in the patient file. There are deviations from the recommendations of the AEM working groups regarding the drafting of statutes, activity reports, and financial support. The activities of clinical ethics consultation predominantly comply with the standards of the AEM and recommendations for the documentation. The recommendations for evaluation should be improved in practice. This applies particularly for activity reports in order to evaluate the activities. Internal evaluation could take place accordingly.

Assessing website pharmacy drug quality: safer than you think?

PubMed

Bate, Roger; Hess, Kimberly

2010-08-13

Internet-sourced drugs are often considered suspect. The World Health Organization reports that drugs from websites that conceal their physical address are counterfeit in over 50 percent of cases; the U.S. Food and Drug Administration (FDA) works with the National Association of Boards of Pharmacy (NABP) to regularly update a list of websites likely to sell drugs that are illegal or of questionable quality. This study examines drug purchasing over the Internet, by comparing the sales of five popular drugs from a selection of websites stratified by NABP or other ratings. The drugs were assessed for price, conditions of purchase, and basic quality. Prices and conditions of purchase varied widely. Some websites advertised single pills while others only permitted the purchase of large quantities. Not all websites delivered the exact drugs ordered, some delivered no drugs at all; many websites shipped from multiple international locations, and from locations that were different from those advertised on the websites. All drug samples were tested against approved U.S. brand formulations using Raman spectrometry. Many (17) websites substituted drugs, often in different formulations from the brands requested. These drugs, some of which were probably generics or perhaps non-bioequivalent copy versions, could not be assessed accurately. Of those drugs that could be assessed, none failed from "approved", "legally compliant" or "not recommended" websites (0 out of 86), whereas 8.6% (3 out of 35) failed from "highly not recommended" and unidentifiable websites. Of those drugs that could be assessed, all except Viagra(R) passed spectrometry testing. Of those that failed, few could be identified either by a country of manufacture listed on the packaging, or by the physical location of the website pharmacy. If confirmed by future studies on other drug samples, then U.S. consumers should be able to reduce their risk by relying on credentialing agencies recommended lists and by using common sense when examining packaging and pills.

Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus.

PubMed

Fock, Kwong Ming; Talley, Nicholas; Goh, Khean Lee; Sugano, Kentaro; Katelaris, Peter; Holtmann, Gerald; Pandolfino, John E; Sharma, Prateek; Ang, Tiing Leong; Hongo, Michio; Wu, Justin; Chen, Minhu; Choi, Myung-Gyu; Law, Ngai Moh; Sheu, Bor-Shyang; Zhang, Jun; Ho, Khek Yu; Sollano, Jose; Rani, Abdul Aziz; Kositchaiwat, Chomsri; Bhatia, Shobna

2016-09-01

Since the publication of the Asia-Pacific consensus on gastro-oesophageal reflux disease in 2008, there has been further scientific advancement in this field. This updated consensus focuses on proton pump inhibitor-refractory reflux disease and Barrett's oesophagus. A steering committee identified three areas to address: (1) burden of disease and diagnosis of reflux disease; (2) proton pump inhibitor-refractory reflux disease; (3) Barrett's oesophagus. Three working groups formulated draft statements with supporting evidence. Discussions were done via email before a final face-to-face discussion. We used a Delphi consensus process, with a 70% agreement threshold, using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria to categorise the quality of evidence and strength of recommendations. A total of 32 statements were proposed and 31 were accepted by consensus. A rise in the prevalence rates of gastro-oesophageal reflux disease in Asia was noted, with the majority being non-erosive reflux disease. Overweight and obesity contributed to the rise. Proton pump inhibitor-refractory reflux disease was recognised to be common. A distinction was made between refractory symptoms and refractory reflux disease, with clarification of the roles of endoscopy and functional testing summarised in two algorithms. The definition of Barrett's oesophagus was revised such that a minimum length of 1 cm was required and the presence of intestinal metaplasia no longer necessary. We recommended the use of standardised endoscopic reporting and advocated endoscopic therapy for confirmed dysplasia and early cancer. These guidelines standardise the management of patients with refractory gastro-oesophageal reflux disease and Barrett's oesophagus in the Asia-Pacific region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Screening for Hypertension and Lowering Blood Pressure for Prevention of Cardiovascular Disease Events.

PubMed

Viera, Anthony J

2017-07-01

Hypertension affects 1 in 3 American adults. Blood pressure (BP)-lowering therapy reduces the risk of cardiovascular disease. The United States Preventive Services Task Force recommends all adults be screened for hypertension. Most patients whose office BP is elevated should have out-of-office monitoring to confirm the diagnosis. Ambulatory BP monitoring is preferred for out-of-office measurement, but home BP monitoring is a reasonable alternative. Guidelines for treatment are stratified by age (<60 vs >60 years) and include cutoffs for recommended treatment BPs and target BP goals. Quality of hypertension care is improved by incorporating population health management using registries and medication titration. Copyright © 2017 Elsevier Inc. All rights reserved.

[Treatment with metformin in type 2 diabetes mellitus - new routines when renal function is reduced and in connection with administration of iodine contrast media].

PubMed

Sterner, Gunnar; Frid, Anders

2018-04-03

Metformin is eliminated through glomerular filtration and tubular secretion in the kidneys. New guidelines recommend use of metformin down to a GFR of 30 mL/min under the condition that the dose is adjusted. As the risk of inducing lactic acidosis is very low in connection with administration of iodine contrast media, new recommendations in Sweden say that metformin must be stopped only when GFR is below 45 mL/min. Determination of metformin levels in serum is useful to guide therapeutic dose when GFR is low but also to confirm that lactic acidosis is caused by metformin.

Extrusion-mixing compared with hand-mixing of polyether impression materials?

PubMed

McMahon, Caroline; Kinsella, Daniel; Fleming, Garry J P

2010-12-01

The hypotheses tested were two-fold (a) whether altering the base:catalyst ratio influences working time, elastic recovery and strain in compression properties of a hand-mixed polyether impression material and (b) whether an extrusion-mixed polyether impression material would have a significant advantage over a hand-mixed polyether impression material mixed to the optimum base:catalyst ratio. The polyether was hand-mixed at the optimum (manufacturers recommended) base:catalyst ratios (7:1) and further groups were made by increasing or decreasing the catalyst length by 25%. Additionally specimens were also made from an extrusion-mixed polyether impression material and compared with the optimum hand-mixed base:catalyst ratio. A penetrometer assembly was used to measure the working time (n=5). Five cylindrical specimens for each hand-mixed and extrusion mixed group investigated were employed for elastic recovery and strain in compression testing. Hand-mixing polyether impression materials with 25% more catalyst than that recommended significantly decreased the working time while hand-mixing with 25% less catalyst than that recommended significantly increased the strain in compression. The extrusion-mixed polyether impression material provided similar working time, elastic recovery and strain in compression to the hand-mixed polyether mixed at the optimum base:catalyst ratio.

Recommendations to Improve Employee Thermal Comfort When Working in 40°F Refrigerated Cold Rooms.

PubMed

Ceballos, Diana; Mead, Kenneth; Ramsey, Jessica

2015-01-01

Cold rooms are commonly used for food storage and preparation, and are usually kept around 40°F following food safety guidelines. Some food preparation employees may spend 8 or more hours inside cold rooms. These employees may not be aware of the risks associated with mildly cold temperatures, dampness, and limited ventilation. We performed an evaluation of cold rooms at an airline catering facility because of concerns with exposure to cold temperatures. We spoke with and observed employees in two cold rooms, reviewed daily temperature logs, evaluated employee's physical activity, work/rest schedule, and protective clothing. We measured temperature, percent relative humidity, and air velocities at different work stations inside the cold rooms. We concluded that thermal comfort concerns perceived by cold room employees may have been the result of air drafts at their workstations, insufficient use of personal protective equipment due to dexterity concerns, work practices, and lack of knowledge about good health and safety practices in cold rooms. These moderately cold work conditions with low air velocities are not well covered in current occupational health and safety guidelines, and wind chill calculations do not apply. We provide practical recommendations to improve thermal comfort of cold room employees. Engineering control recommendations include the redesigning of air deflectors and installing of suspended baffles. Administrative controls include the changing out of wet clothing, providing hand warmers outside of cold rooms, and educating employees on cold stress. We also recommended providing more options on personal protective equipment. However, there is a need for guidelines and educational materials tailored to employees in moderately cold environments to improve thermal comfort and minimize health and safety problems.

Recommendations to Improve Employee Thermal Comfort When Working in 40°F Refrigerated Cold Rooms

PubMed Central

Ceballos, Diana; Mead, Kenneth; Ramsey, Jessica

2015-01-01

Cold rooms are commonly used for food storage and preparation, and are usually kept around 40°F following food safety guidelines. Some food preparation employees may spend 8 or more hours inside cold rooms. These employees may not be aware of the risks associated with mildly cold temperatures, dampness, and limited ventilation. We performed an evaluation of cold rooms at an airline catering facility because of concerns with exposure to cold temperatures. We spoke with and observed employees in two cold rooms, reviewed daily temperature logs, evaluated employee’s physical activity, work/rest schedule, and protective clothing. We measured temperature, percent relative humidity, and air velocities at different work stations inside the cold rooms. We concluded that thermal comfort concerns perceived by cold room employees may have been the result of air drafts at their workstations, insufficient use of personal protective equipment due to dexterity concerns, work practices, and lack of knowledge about good health and safety practices in cold rooms. These moderately cold work conditions with low air velocities are not well covered in current occupational health and safety guidelines, and wind chill calculations do not apply. We provide practical recommendations to improve thermal comfort of cold room employees. Engineering control recommendations include the redesigning of air deflectors and installing of suspended baffles. Administrative controls include the changing out of wet clothing, providing hand warmers outside of cold rooms, and educating employees on cold stress. We also recommended providing more options on personal protective equipment. However, there is a need for guidelines and educational materials tailored to employees in moderately cold environments to improve thermal comfort and minimize health and safety problems. PMID:25961447

Strategies for Promoting a Work-Family Agenda. Report Number 973.

ERIC Educational Resources Information Center

Friedman, Dana E.; Johnson, Arlene A.

This document, which is intended to help individual managers and task forces committed to development of a work-family agenda, is based on recommendations of the Work and Family Research Council, which is composed of 35 advocates of work-family policies within U.S. firms. Basic strategies for promoting (marketing) work-family programs within…

Assessment in the Service of Teaching and Learning: Changes in Practice Enabled by Recommended Changes in Policy

ERIC Educational Resources Information Center

Pellegrino, James W.

2014-01-01

This article summarizes major points about the transformation of educational assessment that emerged from the work of Gordon Commission and it presents recommendations to different stakeholders as to needed changes in policy, practice, and research and development.

New Meningococcal Vaccine Recommendations under Consideration

ERIC Educational Resources Information Center

Turner, James C.

2004-01-01

The Advisory Committee on Immunization Practices (ACIP) at the Center for Disease Control and Prevention (CDC) will be considering a new vaccination recommendation for the prevention of invasive "N. meningitidis" infection when meningococcal conjugate vaccines are licensed in the United States. The CDC has also updated the Working Group…

Who Recommends Long-Term Care Matters

ERIC Educational Resources Information Center

Kane, Robert L.; Bershadsky, Boris; Bershadsky, Julie

2006-01-01

Purpose: Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. Design and Methods: We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we…

28 CFR 523.11 - Meritorious good time.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., AND TRANSFER COMPUTATION OF SENTENCE Extra Good Time § 523.11 Meritorious good time. (a) Staff are responsible for recommending meritorious good time based upon work performance. Each recommendation must... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Meritorious good time. 523.11 Section 523...

28 CFR 523.11 - Meritorious good time.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., AND TRANSFER COMPUTATION OF SENTENCE Extra Good Time § 523.11 Meritorious good time. (a) Staff are responsible for recommending meritorious good time based upon work performance. Each recommendation must... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Meritorious good time. 523.11 Section 523...

28 CFR 523.11 - Meritorious good time.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., AND TRANSFER COMPUTATION OF SENTENCE Extra Good Time § 523.11 Meritorious good time. (a) Staff are responsible for recommending meritorious good time based upon work performance. Each recommendation must... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Meritorious good time. 523.11 Section 523...

28 CFR 523.11 - Meritorious good time.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., AND TRANSFER COMPUTATION OF SENTENCE Extra Good Time § 523.11 Meritorious good time. (a) Staff are responsible for recommending meritorious good time based upon work performance. Each recommendation must... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Meritorious good time. 523.11 Section 523...

28 CFR 523.11 - Meritorious good time.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., AND TRANSFER COMPUTATION OF SENTENCE Extra Good Time § 523.11 Meritorious good time. (a) Staff are responsible for recommending meritorious good time based upon work performance. Each recommendation must... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Meritorious good time. 523.11 Section 523...

Automatic Generation of Conditional Diagnostic Guidelines.

PubMed

Baldwin, Tyler; Guo, Yufan; Syeda-Mahmood, Tanveer

2016-01-01

The diagnostic workup for many diseases can be extraordinarily nuanced, and as such reference material text often contains extensive information regarding when it is appropriate to have a patient undergo a given procedure. In this work we employ a three task pipeline for the extraction of statements indicating the conditions under which a procedure should be performed, given a suspected diagnosis. First, we identify each instance in the text where a procedure is being recommended. Next we examine the context around these recommendations to extract conditional statements that dictate the conditions under which the recommendation holds. Finally, corefering recommendations across the document are linked to produce a full recommendation summary. Results indicate that each underlying task can be performed with above baseline performance, and the output can be used to produce concise recommendation summaries.

Post-exposure rabies prophylaxis in humans exposed to animals in Lublin province (Eastern Poland) in 2012–2015 – A retrospective study

PubMed Central

Krzowska-Firych, Joanna; Tomasiewicz, Krzysztof; Kozøowska, Agata

2017-01-01

ABSTRACT Rabies continues to be one of the most important viral diseases and remains a significant threat to public health across the globe. The post-exposure prophylaxis in humans can effectively prevent death after exposure to a potentially infected animal. In Poland, recommendations for rabies PEP followed the national guidelines which recommend that people should receive PEP when bitten by an animal suspected to be infected by rabies. PEP in humans includes cleansing and disinfecting the wound or point of contact, and administering anti-rabies immunization. Rabies vaccine should be given for contacts of category II and category III exposures. RIG should be given for category III contact. The vaccination schedule includes 5 doses given within a 30 day period (the Essen regimen). The aim. The aim of our study was to determine the frequency of post-exposure prophylaxis among patients exposed to animals and also to assess the animal species suspected as a source of rabies exposure. Methods. We have retrospectively analyzed medical records from the years 2012–2015 of all adult patients who were exposed to animals and consulted at the Dispensary of Rabies Prophylaxis in the Department of Infectious Diseases at the Medical University in Lublin, Poland. All consulted patients were asked to give an informed consent in case of decision to use collected data for future research work. Ethical approval was obtained from the Ethics Committee of the Medical University of Lublin, Poland, and all patients included in this study gave an informed consent during consultation after the exposure to animals. Results. During the studied 4-year period, 511 persons exposed to animals were consulted and prophylactic procedure consisting of active immunization were applied in 54.2% of the total consulted. Dogs and cats were the most common animal species suspected as the source of the rabies exposure. Anti-rabies prophylaxis was applied in 45.8% of all vaccinated patients exposed to dogs, and in 24.2% exposed to cats. All patients with bite wounds were consulted at the Department of Surgery and wound care followed surgical recommendations. In the study group, 45 patients had category III contact. There were 38 patients exposed to dogs, and 7 exposed to cats. There were no people exposed to wildlife in this group. All animals were available for veterinary observation. During and after exposure, none of the animals that serve as a potential source of infection presented with symptoms of rabies. The local epidemiological data indicated that during exposures of our patients, there were no confirmed cases of rabies among animals in Lublin province. Based on the data mentioned above, RIG was not applied. During the studied period in Lublin province, rabies was confirmed mainly in wildlife, and only in 2 dogs. Conclusions. In Lublin province, people are still at risk of exposure to rabid animals. The majority of our patients were vaccinated after domestic animals exposure, but rabies was confirmed mainly in wildlife, and since 2013, there were no cases of rabies among domestic animals. PMID:28166482

Post-exposure rabies prophylaxis in humans exposed to animals in Lublin province (Eastern Poland) in 2012-2015 - A retrospective study.

PubMed

Krzowska-Firych, Joanna; Tomasiewicz, Krzysztof; Kozøowska, Agata

2017-06-03

Rabies continues to be one of the most important viral diseases and remains a significant threat to public health across the globe. The post-exposure prophylaxis in humans can effectively prevent death after exposure to a potentially infected animal. In Poland, recommendations for rabies PEP followed the national guidelines which recommend that people should receive PEP when bitten by an animal suspected to be infected by rabies. PEP in humans includes cleansing and disinfecting the wound or point of contact, and administering anti-rabies immunization. Rabies vaccine should be given for contacts of category II and category III exposures. RIG should be given for category III contact. The vaccination schedule includes 5 doses given within a 30 day period (the Essen regimen). The aim of our study was to determine the frequency of post-exposure prophylaxis among patients exposed to animals and also to assess the animal species suspected as a source of rabies exposure. We have retrospectively analyzed medical records from the years 2012-2015 of all adult patients who were exposed to animals and consulted at the Dispensary of Rabies Prophylaxis in the Department of Infectious Diseases at the Medical University in Lublin, Poland. All consulted patients were asked to give an informed consent in case of decision to use collected data for future research work. Ethical approval was obtained from the Ethics Committee of the Medical University of Lublin, Poland, and all patients included in this study gave an informed consent during consultation after the exposure to animals. During the studied 4-year period, 511 persons exposed to animals were consulted and prophylactic procedure consisting of active immunization were applied in 54.2% of the total consulted. Dogs and cats were the most common animal species suspected as the source of the rabies exposure. Anti-rabies prophylaxis was applied in 45.8% of all vaccinated patients exposed to dogs, and in 24.2% exposed to cats. All patients with bite wounds were consulted at the Department of Surgery and wound care followed surgical recommendations. In the study group, 45 patients had category III contact. There were 38 patients exposed to dogs, and 7 exposed to cats. There were no people exposed to wildlife in this group. All animals were available for veterinary observation. During and after exposure, none of the animals that serve as a potential source of infection presented with symptoms of rabies. The local epidemiological data indicated that during exposures of our patients, there were no confirmed cases of rabies among animals in Lublin province. Based on the data mentioned above, RIG was not applied. During the studied period in Lublin province, rabies was confirmed mainly in wildlife, and only in 2 dogs. In Lublin province, people are still at risk of exposure to rabid animals. The majority of our patients were vaccinated after domestic animals exposure, but rabies was confirmed mainly in wildlife, and since 2013, there were no cases of rabies among domestic animals.

Micronutrients on the Menu: Enhancing the Quality of Food in Long-term Care for Regular, Nontherapeutic Menus.

PubMed

Lam, Ivy T; Keller, Heather H; Duizer, Lisa; Stark, Ken

2015-06-01

Micronutrient (vitamin and mineral) deficiencies may exacerbate prevalent health conditions occurring in long-term care (LTC) residents, and current food provision may potentiate this problem. A micronutrient-focused, food-first approach to menu planning may address this gap by emphasizing nutrient-dense foods. The objectives were to determine if: (i) selected LTC menus met micronutrient and Canada's Food Guide (CFG) recommendations, and (ii) recommendations can be met through food alone with strategic menu planning. Regular, nontherapeutic menus (week 1, all meals) from diverse LTC homes (n = 5) across Canada were analyzed for micronutrient content using Food Processor and CFG servings. Site dietitians confirmed menu analyses. Five super-menus were created and analyzed for comparison. The nutrient content of the menus varied significantly across homes. Micronutrients of greatest concern were (mean ± SD) vitamin D (8.90 ± 5.29 µg/d) and vitamin E (5.13 ± 1.74 mg/d). Folate, magnesium, and potassium were also below recommendations. Super-menus of equal food volume met recommendations for all micronutrients except vitamin D (56%), vitamin E (84%), and potassium (85%). Meeting most micronutrient recommendations is possible with creative and deliberate menu planning. Knowledge translation of best practices is needed.

Worksheets for computing recommended notebook computer and workstation adjustments.

PubMed

Nanthavanij, Suebsak; Udomratana, Chatkate; Hansawad, Saowalak; Thepkanjana, Jayaporn; Tantasuwan, Wanchalerm

2013-01-01

This paper discusses the design and development of worksheets for helping notebook computer (NBC) users to compute NBC and workstation adjustments so as to assume an appropriate seated posture. The worksheets (one for male users, the other for female ones) require the following information: body height, NBC screen size, work surface height, and seat height. The worksheets contain tables for estimating recommended NBC base angle, NBC screen angle, body-NBC distance, work surface height, and seat height. Additionally, they include flow charts to help NBC users to determine necessary adjustment accessories and their settings.

INDEPENDENT REVIEW OF THE X-701B GROUNDWATER REMEDY, PORTSMOUTH, OHIO: TECHNICAL EVALUATION AND RECOMMENDATIONS

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

Looney, B.; Eddy-Dilek, C.; Costanza, J.

2008-12-15

The Department of Energy Portsmouth Paducah Project Office requested assistance from Department of Energy Office of Environmental Management (EM-22) to provide independent technical experts to evaluate past and ongoing remedial activities at the Portsmouth facility that were completed to address TCE contamination associated with the X-701B groundwater plume and to make recommendations for future efforts. The Independent Technical Review team was provided with a detailed and specific charter. The charter requested that the technical team first review the past and current activities completed for the X-701B groundwater remedy for trichloroethene (TCE) in accordance with a Decision Document that was issuedmore » by Ohio EPA on December 8, 2003 and a Work Plan that was approved by Ohio EPA on September 22, 2006. The remedy for X-701B divides the activities into four phases: Phase I - Initial Source Area Treatment, Phase II - Expanded Source Area Treatment, Phase III - Evaluation and Reporting, and Phase IV - Downgradient Remediation and Confirmation of Source Area Treatment. Phase I of the remedy was completed during FY2006, and DOE has now completed six oxidant injection events within Phase II. The Independent Technical Review team was asked to evaluate Phase II activities, including soil and groundwater results, and to determine whether or not the criteria that were defined in the Work Plan for the Phase II end point had been met. The following criteria are defined in the Work Plan as an acceptable Phase II end point: (1) Groundwater samples from the identified source area monitoring wells have concentrations below the Preliminary Remediation Goal (PRG) for TCE in groundwater, or (2) The remedy is no longer effective in removing TCE mass from the source area. In addition, the charter specifies that if the Review Team determines that the Phase II endpoint has not been reached, then the team should address the following issues: (1) If additional injection events are recommended, the team should identify the type of injection and target soil horizon for these injections; (2) Consider the feasibility of declaring Technical Impracticability and proceeding with the RCRA Cap for the X-701B; and (3) Provide a summary of other cost-effective technologies that could be implemented (especially for the lower Gallia). The Independent Technical Review team focused its evaluation solely on the X-701B source zone and contaminant plume. It did not review current or planned remedial activities at other plumes, waste areas, or landfills at the Portsmouth site, nor did it attempt to integrate such activities into its recommendations for X-701B. However, the ultimate selection of a remedy for X-701B by site personnel and regulators should take into account potentially synergistic efforts at other waste areas. Assessment of remedial alternatives in the context of site-wide management practices may reveal opportunities for leveraging and savings that would not otherwise be identified. For example, the cost of source-zone excavation or construction of a permeable reactive barrier at X-701B might be substantially reduced if contaminated soil could be buried on site at an existing or planned landfill. This allowance would improve the feasibility and competitiveness of both remedies. A comprehensive examination of ongoing and future environmental activities across the Portsmouth Gaseous Diffusion Plant is necessary to optimize the selection and timing of X-701B remediation with respect to cleanup efficiency, safety, and economics. A selected group of technical experts attended the technical workshop at the Portsmouth Gaseous Diffusion Plant from November 18 through 21, 2008. During the first day of the workshop, both contractor and DOE site personnel briefed the workshop participants and took them on a tour of the X-701B site. The initial briefing was attended by representatives of Ohio EPA who participated in the discussions. On subsequent days, the team reviewed baseline data and reports, were provided additional technical information from site personnel, evaluated work plans, determined critical issues and uncertainties, and recommended alternatives. This report documents the findings and recommendations of the independent technical review team.« less

User Evaluation of the NASA Technical Report Server Recommendation Service

NASA Technical Reports Server (NTRS)

Nelson, Michael L.; Bollen, Johan; Calhoun, JoAnne R.; Mackey, Calvin E.

2004-01-01

We present the user evaluation of two recommendation server methodologies implemented for the NASA Technical Report Server (NTRS). One methodology for generating recommendations uses log analysis to identify co-retrieval events on full-text documents. For comparison, we used the Vector Space Model (VSM) as the second methodology. We calculated cosine similarities and used the top 10 most similar documents (based on metadata) as recommendations . We then ran an experiment with NASA Langley Research Center (LaRC) staff members to gather their feedback on which method produced the most quality recommendations. We found that in most cases VSM outperformed log analysis of co-retrievals. However, analyzing the data revealed the evaluations may have been structurally biased in favor of the VSM generated recommendations. We explore some possible methods for combining log analysis and VSM generated recommendations and suggest areas of future work.

User Evaluation of the NASA Technical Report Server Recommendation Service

NASA Technical Reports Server (NTRS)

Nelson, Michael L.; Bollen, Johan; Calhoun, JoAnne R.; Mackey, Calvin E.

2004-01-01

We present the user evaluation of two recommendation server methodologies implemented for the NASA Technical Report Server (NTRS). One methodology for generating recommendations uses log analysis to identify co-retrieval events on full-text documents. For comparison, we used the Vector Space Model (VSM) as the second methodology. We calculated cosine similarities and used the top 10 most similar documents (based on metadata) as 'recommendations'. We then ran an experiment with NASA Langley Research Center (LaRC) staff members to gather their feedback on which method produced the most 'quality' recommendations. We found that in most cases VSM outperformed log analysis of co-retrievals. However, analyzing the data revealed the evaluations may have been structurally biased in favor of the VSM generated recommendations. We explore some possible methods for combining log analysis and VSM generated recommendations and suggest areas of future work.

Recommender system based on scarce information mining.

PubMed

Lu, Wei; Chung, Fu-Lai; Lai, Kunfeng; Zhang, Liang

2017-09-01

Guessing what user may like is now a typical interface for video recommendation. Nowadays, the highly popular user generated content sites provide various sources of information such as tags for recommendation tasks. Motivated by a real world online video recommendation problem, this work targets at the long tail phenomena of user behavior and the sparsity of item features. A personalized compound recommendation framework for online video recommendation called Dirichlet mixture probit model for information scarcity (DPIS) is hence proposed. Assuming that each clicking sample is generated from a representation of user preferences, DPIS models the sample level topic proportions as a multinomial item vector, and utilizes topical clustering on the user part for recommendation through a probit classifier. As demonstrated by the real-world application, the proposed DPIS achieves better performance in accuracy, perplexity as well as diversity in coverage than traditional methods. Copyright © 2017 Elsevier Ltd. All rights reserved.

Can group-based reassuring information alter low back pain behavior? A cluster-randomized controlled trial

PubMed Central

Indahl, Aage; Andersen, Lars L.; Burton, Kim; Hertzum-Larsen, Rasmus

2017-01-01

Background Low back pain (LBP) is common in the population and multifactorial in nature, often involving negative consequences. Reassuring information to improve coping is recommended for reducing the negative consequences of LBP. Adding a simple non-threatening explanation for the pain (temporary muscular dysfunction) has been successful at altering beliefs and behavior when delivered with other intervention elements. This study investigates the isolated effect of this specific information on future occupational behavior outcomes when delivered to the workforce. Design A cluster-randomized controlled trial. Methods Publically employed workers (n = 505) from 11 Danish municipality centers were randomized at center-level (cluster) to either intervention (two 1-hour group-based talks at the workplace) or control. The talks provided reassuring information together with a simple non-threatening explanation for LBP—the ‘functional-disturbance’-model. Data collections took place monthly over a 1-year period using text message tracking (SMS). Primary outcomes were self-reported days of cutting down usual activities and work participation. Secondary outcomes were self-reported back beliefs, work ability, number of healthcare visits, bothersomeness, restricted activity, use of pain medication, and sadness/depression. Results There was no between-group difference in the development of LBP during follow-up. Cumulative logistic regression analyses showed no between-group difference on days of cutting down activities, but increased odds for more days of work participation in the intervention group (OR = 1.83 95% CI: 1.08–3.12). Furthermore, the intervention group was more likely to report: higher work ability, reduced visits to healthcare professionals, lower bothersomeness, lower levels of sadness/depression, and positive back beliefs. Conclusion Reassuring information involving a simple non-threatening explanation for LBP significantly increased the odds for days of work participation and higher work ability among workers who went on to experience LBP during the 12-month follow-up. Our results confirm the potential for public-health education for LBP, and add to the discussion of simple versus multidisciplinary interventions. PMID:28346472

Temporary Work in Transnational Labor Regulation: SER-Centrism and the Risk of Exacerbating Gendered Precariousness

ERIC Educational Resources Information Center

Vosko, Leah F.

2008-01-01

This article explores the transnational regulation of temporary work. Analyzing the terms of the EU "Directive on Fixed-Term Work (1999), the ILO "Convention on Private Employment Agencies" (1997), the ILO "Recommendation on the Employment Relationship" (2006), and a draft EU Directive on "Temporary Agency Work"…

Learning To Compete.

ERIC Educational Resources Information Center

National Advisory Commission on Work-Based Learning (DOL), Washington, DC.

The National Advisory Commission on Work-Based Learning worked to identify practical steps that the Labor Department could take to help increase the skill levels of the U.S. work force and expand work-based training. The findings gained from a series of roundtables and further studies were synthesized into a set of recommendations in five major…

Bending strength of water-soaked glued laminated beams

Treesearch

Ronald W. Wolfe; Russell C. Moody

1978-01-01

The effects of water soaking on the bending strength and stiffness of laminated timber were determined by deriving wet-dry ratios for these properties. Values for these ratios, when compared to currently recommended wet use factors, confirm the value now used for modulus of rupture. For modulus of elasticity, the reduction due to water soaking was found to be less than...

Increasing Access to Preschool: Recommendations for Reducing Barriers to Providing Full-day, Full-year Programs. Policy Brief

ERIC Educational Resources Information Center

Miller, Kate

2008-01-01

More than ever before, Californians recognize that preschool provides young children with a strong start in school and life. Research confirms that effective preschool not only prepares children for kindergarten, but benefits them in the long-term. Despite the benefits, only 48% of 3- and 4-year-old children attend preschool in California. While…

A Library Service Center for Suburban Maryland County Library Systems, Anne Arundel, Baltimore, Montgomery, Prince George's; An Establishment Proposal.

ERIC Educational Resources Information Center

Duchac, Kenneth F.

Based on a year of inquiry and consultation, this report of the Suburban Maryland Project confirms the feasibility of cooperative technical service functions for the four public library systems of suburban Maryland. It is recommended that the proposed Library Service Center be assigned the ordering, acquisition, cataloging, preparation for book…

United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU).

PubMed

Löhr, J Matthias; Dominguez-Munoz, Enrique; Rosendahl, Jonas; Besselink, Marc; Mayerle, Julia; Lerch, Markus M; Haas, Stephan; Akisik, Fatih; Kartalis, Nikolaos; Iglesias-Garcia, Julio; Keller, Jutta; Boermeester, Marja; Werner, Jens; Dumonceau, Jean-Marc; Fockens, Paul; Drewes, Asbjorn; Ceyhan, Gürlap; Lindkvist, Björn; Drenth, Joost; Ewald, Nils; Hardt, Philip; de Madaria, Enrique; Witt, Heiko; Schneider, Alexander; Manfredi, Riccardo; Brøndum, Frøkjer J; Rudolf, Sasa; Bollen, Thomas; Bruno, Marco

2017-03-01

There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed these European guidelines using an evidence-based approach. Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions. Recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation system and the answers were assessed by the entire group in a Delphi process online. The review groups presented their recommendations during the 2015 annual meeting of United European Gastroenterology. At this one-day, interactive conference, relevant remarks were voiced and overall agreement on each recommendation was quantified using plenary voting (Test and Evaluation Directorate). After a final round of adjustments based on these comments, a draft version was sent out to external reviewers. The 101 recommendations covered 12 topics related to the clinical management of chronic pancreatitis: aetiology (working party (WP)1), diagnosis of chronic pancreatitis with imaging (WP2 and WP3), diagnosis of pancreatic exocrine insufficiency (WP4), surgery in chronic pancreatitis (WP5), medical therapy (WP6), endoscopic therapy (WP7), treatment of pancreatic pseudocysts (WP8), pancreatic pain (WP9), nutrition and malnutrition (WP10), diabetes mellitus (WP11) and the natural course of the disease and quality of life (WP12). Using the Grading of Recommendations Assessment, Development and Evaluation system, 70 of the 101 (70%) recommendations were rated as 'strong' and plenary voting revealed 'strong agreement' for 99 (98%) recommendations. The 2016 HaPanEU/United European Gastroenterology guidelines provide evidence-based recommendations concerning key aspects of the medical and surgical management of chronic pancreatitis based on current available evidence. These recommendations should serve as a reference standard for existing management of the disease and as a guide for future clinical research.

Assessment of clinical practice guideline methodology for the treatment of knee osteoarthritis with intra-articular hyaluronic acid.

PubMed

Altman, Roy D; Schemitsch, Emil; Bedi, Asheesh

2015-10-01

Clinical practice guidelines are of increasing importance in the decision making for the treatment of knee osteoarthritis. Inconsistent recommendations regarding the use of intra-articular hyaluronic acid for the treatment of knee osteoarthritis have led to confusion among treating physicians. Literature search to identify clinical practice guidelines that provide recommendations regarding the use of intra-articular hyaluronic acid treatment for knee osteoarthritis was conducted. Included guidelines were appraised using the AGREE II instrument. Guideline development methodologies, how the results were assessed, the recommendation formation, and work group composition were summarized. Overall, 10 clinical practice guidelines were identified that met our inclusion criteria. AGREE II domain scores were variable across the included guidelines. The methodology utilized across the guidelines was heterogeneous regarding the evidence inclusion criteria, analysis of evidence results, formulation of clinical practice recommendations, and work group composition. The recommendations provided by the guidelines for intra-articular hyaluronic acid treatment for knee osteoarthritis are highly inconsistent as a result of the variability in guideline methodology. Overall, 30% of the included guidelines recommended against the use of intra-articular hyaluronic acid in the treatment of knee osteoarthritis, while 30% deemed the treatment an appropriate intervention under certain scenarios. The remaining 40% of the guidelines provided either an uncertain recommendation or no recommendation at all, based on the high variability in reviewed evidence regarding efficacy and trial quality. There is a need for a standard "appropriate methodology" that is agreed upon for osteoarthritis clinical practice guidelines in order to prevent the development of conflicting recommendations for intra-articular hyaluronic acid treatment for knee osteoarthritis, and to assure that treating physicians who are utilizing these guidelines are making their clinical decisions on the best available evidence. At present, the inconsistent recommendations provided for intra-articular hyaluronic acid treatment make it difficult for clinical professionals to determine its appropriateness when treating patients with knee osteoarthritis. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

[Thyroid gland and the heart : Pathophysiological background, diagnostic and therapeutic consequences].

PubMed

Dischinger, U; Fassnacht, M

2018-05-23

Irregularities in thyroid-specific laboratory parameters are frequent in the general population. Observational studies have shown associations between dysfunction of the thyroid gland and cardiovascular morbidity and mortality. The aim of this review is to give a critical overview of the relationship and treatment recommendations for the simultaneous occurrence of functional disorders of the thyroid gland and the heart. Literature searches were conducted in PubMed and Medline. Overt and also to a lesser extent subclinical hyperthyroidism are of relevance for cardiovascular mortality and morbidity, even though interventional studies are missing. Therefore, basic thyroid diagnostics are recommended when cardiovascular diseases occur or deteriorate. Whereas overt hyperthyroidism and hypothyroidism are treated immediately, subclinical thyroid dysfunction disorders require confirmation by laboratory testing. In cases with confirmed subclinical hyperthyroidism and heart disease, a thyroid-specific treatment is meaningful (e. g. with radioiodine). At what point a subclinical hypothyroidism should be treated is controversial. We usually initiate substitution treatment with levothyroxine only in patients with a thyroid-stimulating hormone (TSH) level > 10 mIU/l. A control of baseline thyroid parameters is necessary prior to initiation of any treatment with amiodarone or with deterioration of the general condition.

Misrepresentation of academic accomplishments by applicants for gastroenterology fellowships.

PubMed

Sekas, G; Hutson, W R

1995-07-01

To determine whether two applicants who misrepresented their accomplishments in applications for gastroenterology fellowships reflected isolated incidents or whether misrepresentation was more wide-spread. Retrospective review of all 236 applications submitted for fellowship in a recent year for confirmation of research experience and cited publications. 138 applicants (58.5%) reported research experience during residency in a U.S. training program. Research activity could not be confirmed for 47 of 138 applicants (34.1%). Fifty-three applicants (22.4%) reported published articles, and 16 of these applicants (30.2%) misrepresented articles. Misrepresentation included citations of nonexistent articles in actual journals, articles in nonexistent journals, or articles noted as "in press." Misrepresentation on applications for gastroenterology fellowships was common. The following steps are recommended: 1) Fellowship programs should require that copies of all publications and letters of acceptance for manuscripts in press be submitted with fellowship applications; 2) applications should contain a statement to be signed by the applicant that the information provided is accurate; 3) persons writing letters of recommendation should verify the information being submitted by applicants; 4) medical students and residents should be taught that embellishment of curricula vitae constitutes misconduct; and 5) institutions and professional organizations should develop policies to deal with this problem.

Chronic Diarrhea in Dogs: What Do We Actually Know About It?

PubMed

Westermarck, Elias

2016-06-01

There is a paucity of research based knowledge about chronic diarrhoea in dogs. In the literature no studies can be found that confirms that round worm, whip worm, hook worm or giardia cause chronic diarrhoea in dogs. For this reason, it is questionable to study endoparasites when clarifying the reason for chronic diarrhoea in dogs. No study confirms that clostridium-, campylobacter- or salmonella species cause chronic diarrhoea signs in dogs. There is no research-based information to-date that endoscopy would be helpful in the diagnosis of dogs with chronic diarrhoea or to monitor how the disease progresses. Neither no reliable laboratory test can be recommended to be used in evaluating the seriousness of the disease or to monitor the progress of the disease. There is no evidence based information on what food should be recommended for dogs suffering from diarrhoea. Only a few studies have been published that show how effective antibiotics are in the treatment of diarrhoeal dogs. Many more studies are needed before it is possible to determine how effective corticosteroids are in the treatment of diarrhoea in dogs. Copyright © 2016 Elsevier Inc. All rights reserved.

Recommendations to Revise the Regulation of Private Post-Secondary Institutions

ERIC Educational Resources Information Center

Roedler, George; Grimes, Tricia

2006-01-01

The purpose of this report is to summarize the Minnesota Office of Higher Education's work to develop recommendations to revise the regulation of private post-secondary institutions in Minnesota and public postsecondary institutions located outside of Minnesota that offer instruction to residents in Minnesota pursuant to Minnesota Statutes Chapter…

Analysis performed in support of the Ad-Hoc Working Group of RTCA SC-159 on RAIM/FDE issues

DOT National Transportation Integrated Search

2002-01-01

In 1999, the FAA requested that RTCA SC-159 address one of the recommendations from the study performed by the Johns Hopkins University (JHU) Applied Physics Lab (APL) on the use of GPS and augmented GPS for aviation applications. This recommendation...

Program Intensity and Service Delivery Models in the Schools: SLP Survey Results

ERIC Educational Resources Information Center

Brandel, Jayne; Loeb, Diane Frome

2011-01-01

Purpose: School-based speech-language pathologists (SLPs) routinely work with team members to make recommendations regarding an intervention program's intensity and method of service delivery for children with speech and language impairments. In this study, student, SLP, and workplace characteristics that may influence SLPs' recommendations were…

78 FR 28940 - Ninth Meeting: RTCA Next Gen Advisory Committee (NAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

.... Huerta FAA NextGen Performance SnapShots Featured PBN Implementation Location Data Sources for Measuring... by the Business Case and Performance Metrics Work Group Recommendation for Implementing Categorical Exclusion Contained in FAA Modernization Act of 2012 Recommendation developed by CatEx2 Task Group for...

Recommendations for Induction Training for Operators, Craftsmen and Ancillary Workers.

ERIC Educational Resources Information Center

Chemical and Allied Products Industry Training Board, Staines (England).

These recommendations by the Chemical and Allied Products Industry Training Board of Great Britain concerning employee induction or orientation cover such aspects as pay and pensions, working conditions, discipline, safety, medical services. Topics and time allocations are suggested for the initial interview, the first day, and subsequent…

Technical Communication in the International Workplace: Some Implications for Curriculum Development.

ERIC Educational Resources Information Center

Barclay, Rebecca O.; And Others

1991-01-01

Reports survey results of U.S. and European aerospace engineers concerning the kinds of communication products they actually use, the kinds they produce, and recommendations they would offer designers of academic courses. Recommends relevant faculty work and educational background, advisory boards, professional contacts, research, and feedback as…

Telemetry, Tracking, and Control Working Group report

NASA Technical Reports Server (NTRS)

Campbell, Richard; Rogers, L. Joseph

1986-01-01

After assessing the design implications and the criteria to be used in technology selection, the technical problems that face the telemetry, tracking, and control (TTC) area were defined. For each of the problems identified, recommendations were made for needed technology developments. These recommendations are listed and ranked according to priority.

Occupational Exposure to Asbestos; Criteria for a Recommended Standard.

ERIC Educational Resources Information Center

National Inst. for Occupational Safety and Health (DHEW/PHS), Rockville, MD.

Recommended standards for control of exposure to asbestos dust in the workplace are set out from the following standpoints: environmental, medical, labeling, personal protective equipment and clothing, apprisal of employees, work practices, and monitoring and recordkeeping requirements. The goal is maintenance of a low level of concentration to…

Evaluation of performance and maximum length of continuous decks in bridges : part 1.

DOT National Transportation Integrated Search

2011-06-01

The purpose of this research was to evaluate the performance history of continuous bridge decks in the State of Georgia, to determine why the current design detail works, to recommend a new design detail, and to recommend the maximum and/or optimum l...

75 FR 56491 - Technical Amendments for Marine Spark-Ignition Engines and Vessels

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... spillage, incorporating safe recommended practices will result in a net benefit to the environment and lead... spillage, incorporating safe recommended practices will result in a net benefit to the environment and lead... portable fuel tanks to these new requirements, manufacturers working together on systems integration...

Great Books. A Collection of Titles Educators Swear By.

ERIC Educational Resources Information Center

Urbanski, Adam; And Others

1995-01-01

Seventeen prominent educators recommend favorite works they think all teachers should read, explaining why. The books range from science fiction to morality to Ghandi. Several are newly published, some are classics. The article concludes with a list of the recommended titles, including publishers, suggested list prices, and phone numbers for…

76 FR 10369 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-24

... technology. Written comments should be received within 60 days of this notice. Proposed Project Coal Workers... and work histories, and participating physicians report radiographic findings. The Centers for Disease... history and spirometry tests have been recommended by NIOSH for both surface and underground coal miners...

Pilot trial of IOM duty hour recommendations in neurology residency programs: unintended consequences.

PubMed

Schuh, L A; Khan, M A; Harle, H; Southerland, A M; Hicks, W J; Falchook, A; Schultz, L; Finney, G R

2011-08-30

To study the potential effect of the 2008 Institute of Medicine (IOM) work duty hour (WDH) recommendations on neurology residency programs. This study evaluated resident sleepiness, personal study hours, quality of life, and satisfaction and faculty satisfaction during a control month using the Accreditation Council for Graduate Medical Education WDH requirements and during an intervention month using the IOM WDH recommendations. Resident participation in both schedules was mandatory, but both resident and faculty participation in the outcome measures was voluntary. Thirty-four residents (11 postgraduate year [PGY]-4, 9 PGY-3, and 14 PGY-2) participated. End-of-work shift sleepiness, mean weekly sleep hours, personal study hours, and hours spent in lectures did not differ between the control and intervention months. Resident quality of life measured by the Maslach Burnout Inventory declined for 1 subscore in the intervention month (p = 0.03). Resident education satisfaction declined during the intervention month for issues related to continuity of care, patient hand-offs, and knowledge of their patients. Faculty satisfaction declined during the intervention month, without a decline in quality of life. The results from 3 residency programs suggest that the IOM WDH recommendations may negatively affect neurology resident education. This study was limited by the short duration of implementation, negative bias against the IOM recommendations, and inability to blind faculty. Additional study of the IOM WDH recommendations is warranted before widespread implementation.

A Narrative Review of the Confluence of Breast Cancer and Low-wage Employment and Its Impact on Receipt of Guideline-recommended Treatment.

PubMed

Vanderpool, Robin C; Swanberg, Jennifer E; Chambers, Mara D

2013-09-01

Breast cancer is the leading cause of cancer among women in the United States, costing the healthcare system, employers, and society billions of dollars each year. Despite improvements in screening and treatment, significant breast cancer treatment and survivorship disparities exist among various groups of women. One variable that has not been explored extensively as a possible contributor to breast cancer treatment disparities is employment. This is concerning, given the changing economic and employment trends in the United States favoring low-wage employment. Currently, one-quarter to one-third of all US workers are considered to be working poor, and women are disproportionally represented in this group. Characteristics of low-wage work-limited paid time off, minimal health benefits, schedule inflexibility, and economic insecurity-may become even more significant in the event of a breast cancer diagnosis. To date, there has been limited research into how job conditions inherent to low-wage work may influence working poor survivors' receipt of guideline-recommended breast cancer treatment. Therefore, the purpose of this narrative review was to critically examine the current literature to further our understanding of how employment context may impact treatment decisions and adherence-and therefore receipt of guideline-recommended care-among newly diagnosed, working poor breast cancer survivors. After undertaking a comprehensive review, we failed to identify any published literature that explicitly addressed low-wage employment and receipt of guideline-recommended breast cancer treatment. Four articles reported circumstances where women delayed, missed, or quit treatments due to work interference, or alternatively, developed strategies that allowed them to continue to work and obtain their breast cancer treatment concurrent with medical and economic challenges. An additional five articles, while focused on other cancer and employment outcomes, described the need for increased patient-provider communication about the influence of work on treatment decisions and the development of alternative treatment plans. Due to the paucity of research in this area, future policy, practice, and research efforts should focus on the employment context of working poor breast cancer survivors as a potential contributor to cancer disparities. Engagement of women, employers, oncology providers, healthcare systems, and interdisciplinary researchers is warranted to improve cancer outcomes among this disparate population of working women.

The use of ambulatory blood pressure monitoring to confirm a diagnosis of high blood pressure by primary-care physicians in Oregon.

PubMed

Carter, Brittany U; Kaylor, Mary Beth

2016-04-01

Hypertension is the most commonly diagnosed medical condition in the USA. Unfortunately, patients are misdiagnosed in primary care because of inaccurate office-based blood pressure measurements. Several US healthcare organizations currently recommend confirming an office-based hypertension diagnosis with ambulatory blood pressure monitoring to avoid overtreatment; however, its use for the purpose of confirming an office-based hypertension diagnosis is relatively unknown. This descriptive study surveyed 143 primary-care physicians in Oregon with regard to their current use of ambulatory blood pressure monitoring. Nineteen percent of the physicians reported that they would use ambulatory blood pressure monitoring to confirm an office-based hypertension diagnosis, although over half had never ordered it. The most frequent indication for ordering ambulatory blood pressure monitoring was to investigate suspected white-coat hypertension (37.3%). In addition, many of the practices did not own an ambulatory blood pressure monitoring device (79.7%) and, therefore, had to refer patients to other clinics or departments for testing. Many primary-care physicians will need to change their current clinical practice to align with the shift toward a confirmation process for office-based hypertension diagnoses to improve population health.

Individual medication management system (IMMS) as a proposition of obeying the doctor's recommendation with pharmacist cooperation.

PubMed

Waszyk-Nowaczyk, Magdalena; Simon, Marek; Matwij, Karolina

2012-01-01

The pharmacist is an expert with the knowledge of drugs, who has a possibility to follow the patient's individual pharmacotherapy, which is the basis of the pharmaceutical care programme. The implementation of the Individual Medication Management System (IMMS) may be one of the proposals which will enable an analysis of the course of pharmacotherapy and elimination of drug problems, which are the chief goals of pharmaceutical care. In order to determine community pharmacy patients' degree of interest in the IMMS and to evaluate the degree of patients' discipline concerning the application of doctors' recommendations they were given an anonymous questionnaire. The research was done from August 2009 to May 2010 on a sample of 179 people selected at random. They were patients of community pharmacies in Poznań, where 70% were women and 30% were men, all of them aged between 20 and 85 years. The individual age groups were: 20-40 years--27.0%, 41-50 years--10.8%, 51-64 years--43.6%, 65 years or more--18.6%. The patients' education was as follows: primary--4.7%, vocational--8.0%, secondary--31.0%, incomplete university--12.0% and university--44.3%. The chi2 and Fisher-Freeman-Halton tests were used for statistical analysis of the results. Each time the level of statistical significance was assumed at p < 0.05. The collected results confirmed the fact that there is a higher number of specialists involved in patients' treatment with their age (p = 0.001), which indirectly leads to a higher number of prescribed drugs (p = 0.00000002). It was proved that more than 90% of the patients aged over 50 years take the prescribed drugs for more than a year (p = 0.00000002). The analysis confirmed the fact that there are mostly men which do not abide the indications concerning the dosage regimen (p = 0.049). The answers to the questions evaluating the patients' attitude to the IMMS revealed that 47.2% of the respondents indicate the advantages of the system. However, it was mostly women and respondents with university education that were the most interested in it. More than 50% of the patients aged 20-40 years and those aged over 65 years indicate the purposefulness of the systems. It is mainly the group aged 20-40 years that confirms facilitation in following the doctor's recommendations (p = 0.02). The respondents indicated their interest and confirmed the purposefulness of the IMMS mainly due to the fact that it helps to avoid drug-related problems resulting from omitting doses and helps to keep the dosage time and frequency in a long-term therapy. The research confirms the fact that individualized therapy will contribute to its higher efficacy, economy and safety.

Mixed methods analysis of eighteen worksite policies, programs, and environments for physical activity.

PubMed

Hipp, J Aaron; Dodson, Elizabeth A; Lee, Jung Ae; Marx, Christine M; Yang, Lin; Tabak, Rachel G; Hoehner, Christine; Marquet, Oriol; Brownson, Ross C

2017-06-14

This study examined whether specific worksite supports for physical activity (PA) were associated with total and domain-specific PA. A cross-sectional, telephone-based study was conducted in four Missouri, USA, metropolitan areas in 2012 and 2013. Outcome variables included total PA and sub-domains (leisure, work, travel) measured using the International Physical Activity Questionnaire. Logistic regression determined odds of meeting PA recommendations, given access to and use of 18 unique PA worksite supports. A subsample of 119 participants also wore hip accelerometry for seven consecutive days and maintained a wear-time diary. Access to worksite supports were associated with odds of meeting objective moderate and vigorous (MV) PA above 150 min per week. Among 2013 survey participants, meeting PA recommendations while performing work-related tasks was significantly associated with several supports (e.g., walking maps, stair prompts), as was meeting recommendations during travel (e.g., flextime for PA, incentives for public transportation, walking/bicycling to work). Access to 11 worksite supports increased odds of meeting PA recommendations through leisure-time PA; five supports were associated with total PA. There were significant differences between access to and use of supports. Using objective MVPA, access to worksite challenges and bike storage were significantly associated with five and three times greater odds of meeting 150 min of MVPA per week, respectively. Worksite wellness plans are increasing across the US and employers are eager for evidence-based supports for increasing PA. This study provides insights into the utility of multiple worksite supports for PA to increase odds that employees meet PA recommendations.

Identifying problems and generating recommendations for enhancing complex systems: applying the abstraction hierarchy framework as an analytical tool.

PubMed

Xu, Wei

2007-12-01

This study adopts J. Rasmussen's (1985) abstraction hierarchy (AH) framework as an analytical tool to identify problems and pinpoint opportunities to enhance complex systems. The process of identifying problems and generating recommendations for complex systems using conventional methods is usually conducted based on incompletely defined work requirements. As the complexity of systems rises, the sheer mass of data generated from these methods becomes unwieldy to manage in a coherent, systematic form for analysis. There is little known work on adopting a broader perspective to fill these gaps. AH was used to analyze an aircraft-automation system in order to further identify breakdowns in pilot-automation interactions. Four steps follow: developing an AH model for the system, mapping the data generated by various methods onto the AH, identifying problems based on the mapped data, and presenting recommendations. The breakdowns lay primarily with automation operations that were more goal directed. Identified root causes include incomplete knowledge content and ineffective knowledge structure in pilots' mental models, lack of effective higher-order functional domain information displayed in the interface, and lack of sufficient automation procedures for pilots to effectively cope with unfamiliar situations. The AH is a valuable analytical tool to systematically identify problems and suggest opportunities for enhancing complex systems. It helps further examine the automation awareness problems and identify improvement areas from a work domain perspective. Applications include the identification of problems and generation of recommendations for complex systems as well as specific recommendations regarding pilot training, flight deck interfaces, and automation procedures.

Improving information filtering via network manipulation

NASA Astrophysics Data System (ADS)

Zhang, Fuguo; Zeng, An

2012-12-01

The recommender system is a very promising way to address the problem of overabundant information for online users. Although the information filtering for the online commercial systems has received much attention recently, almost all of the previous works are dedicated to design new algorithms and consider the user-item bipartite networks as given and constant information. However, many problems for recommender systems such as the cold-start problem (i.e., low recommendation accuracy for the small-degree items) are actually due to the limitation of the underlying user-item bipartite networks. In this letter, we propose a strategy to enhance the performance of the already existing recommendation algorithms by directly manipulating the user-item bipartite networks, namely adding some virtual connections to the networks. Numerical analyses on two benchmark data sets, MovieLens and Netflix, show that our method can remarkably improves the recommendation performance. Specifically, it not only improves the recommendations accuracy (especially for the small-degree items), but also helps the recommender systems generate more diverse and novel recommendations.

Management of shoulder pain by UK general practitioners (GPs): a national survey

PubMed Central

Artus, Majid; van der Windt, Danielle A; Afolabi, Ebenezer K; Buchbinder, Rachelle; Chesterton, Linda S; Hall, Alison; Roddy, Edward; Foster, Nadine E

2017-01-01

Objectives Studies in Canada, the USA and Australia suggested low confidence among general practitioners (GPs) in diagnosing and managing shoulder pain, with frequent use of investigations. There are no comparable studies in the UK; our objective was to describe the diagnosis and management of shoulder pain by GPs in the UK. Methods A national survey of a random sample of 5000 UK GPs collected data on shoulder pain diagnosis and management using two clinical vignettes that described primary care presentations with rotator cuff tendinopathy (RCT) and adhesive capsulitis (AdhC). Results Seven hundred and fourteen (14.7%) responses were received. 56% and 83% of GPs were confident in their diagnosis of RCT and AdhC, respectively, and a wide range of investigations and management options were reported. For the RCT presentation, plain radiographs of the shoulder were most common (60%), followed by blood tests (42%) and ultrasound scans (USS) (38%). 19% of those who recommended a radiograph and 76% of those who recommended a USS did so ‘to confirm the diagnosis’. For the AdhC presentation, the most common investigations were blood tests (60%), plain shoulder radiographs (58%) and USS (31%). More than two-thirds of those recommending a USS did so ‘to confirm the diagnosis’. The most commonly recommended treatment for both presentations was physiotherapy (RCT 77%, AdhC 71%) followed by non-steroidal anti-inflammatory drugs (RCT 58%, AdhC 74%). 17% opted to refer the RCT to secondary care (most often musculoskeletal interface service), compared with 31% for the AdhC. Conclusions This survey of GPs in the UK highlights reliance on radiographs and blood tests in the management of common shoulder pain presentations. GPs report referring more than 7 out of 10 patients with RCT and AdhC to physiotherapists. These findings need to be viewed in the context of low response to the survey and, therefore, potential non-response bias. PMID:28637737

A study of the work and home domain characteristics of anaesthetists in Nigeria.

PubMed

Adudu, O P; Amadasun, F E

2008-03-01

To examine the work and home domain characteristics of anaesthetists in Nigeria, and the impact of these on work and family life. A total of 200 self-administered questionnaires were distributed to anaesthetists in various health institutions in Nigeria. Of these, 114 (57%) were returned. Information contained in the questionnaire included demographic characteristics, qualification, rank and years spent in the specialty, spouse occupation and details of work and family life. The 114 respondents consisted of 86 males (77%) and 28 females (22.8%), aged between 30 and 59 years. The average weekly working hours were 58.4 hours. About half of the respondents could study anaesthesia at home sometimes, while 25% each could do so always or not at all. About 41% of the respondents could respond to emergencies at home immediately, while 45% could only do so after first reporting to work. Respondents' recommendation to enhance work and family life included reduced work load, more flexible work schedule, accommodation close to place of work, among others. Positive impact on service output as well as enhanced job satisfaction will ensue if the recommendations in this study are implemented by the relevant authorities.

Variable implementation of good practice recommendations for the assessment and management of UK children with neurodisability.

PubMed

Gray, L; Gibbs, J; Jolleff, N; Williams, J; McConachie, H; Parr, J R

2015-11-01

The aims of this study were to determine whether UK child development teams (CDTs) have implemented good practice recommendations for the co-ordinated assessment and support of children with neurodisability and to explore some of the factors associated with variations in good practice implementation. Surveys were sent to every UK CDT in 2009/2010. Responses about CDT provision and ways of working were compared with good practice recommendations from national policy documents and professional organizations. The extent to which CDTs in England and Wales met 11 selected good practice recommendations was scored; teams in Scotland and Northern Ireland were given a score out of 9 to reflect the optional use of the common assessment framework and early support materials in these countries. Responses were received from 225/240 (94%) UK CDTs. Thirty-seven per cent of CDTs in England and Wales had implemented nine or more of the 11 recommendations. Fifty-nine per cent of teams in Scotland and 78% of teams in Northern Ireland met between six and nine recommendations of good working practice. Higher levels of implementation of recommendations were found when the CDT had a Child Development Centre base and for teams who had received increased funding in the 5 years preceding the survey. There was considerable variability in the degree to which CDTs implemented good practice recommendations for the diagnosis and management of children with neurodisability. Evidence about child and parent satisfaction, and the effectiveness of CDT practices and provision, is required, so policymakers, healthcare commissioners and clinicians can provide the most appropriate services to children with neurodisability and their families. © 2015 John Wiley & Sons Ltd.

Temporary Thermocouple Attachment for Thermal/Vacuum Testing at Non-Extreme Temperatures - Test Results

NASA Technical Reports Server (NTRS)

Wright, Sarah E.; Ungar, Eugene K.

2017-01-01

Post-test examination and data analysis that followed a two week long vacuum test showed that numerous self-stick thermocouples became detached from the test article. The thermocouples were reattached with thermally conductive epoxy and the test was repeated to obtain the required data. Because the thermocouple detachment resulted in significant expense and rework, it was decided to investigate the temporary attachment methods used around NASA and to perform a test to assess their efficacy. The present work describes the testing that was performed in early and mid-2017. The test article and the temporary thermocouple attachment methods tested are described. During the first test, fully half of the thermocouples detached - although the detachment showed subtly in the data for some. The second test was performed to confirm the data from the first test and to investigate the effect of test article and thermocouple grounding. The results of the testing over temperatures ranging from -150 to 200degF are detailed and preliminary recommendations are made for temporary thermocouple attachment methods.

Evaluating the Validity of the Client Evaluation of Motivational Interviewing Scale in a Brief Motivational Intervention for College Student Drinkers.

PubMed

Madson, Michael B; Villarosa, Margo C; Schumacher, Julie A; Mohn, Richard S

2016-06-01

The Client Evaluation of Motivational Interviewing scale (CEMI) is a measure for assessing client perceptions of clinicians' use of motivational interviewing (MI). This study explored the factorial, convergent and predictive validity of the CEMI with a sample of 137 college students who completed a brief motivational intervention for alcohol harm reduction. A two factor structure was confirmed, supporting previous findings of relational and technical subscales. The CEMI technical subscale partially mediated an increase in readiness to change drinking, while the relational subscale did not. Higher scores on CEMI technical subscale predicted higher scores on the tasks, bond and goals subscales of the Working Alliance Inventory while higher scores on the CEMI relationship subscale predicted an increase in the goals subscale. Finally, the correlations between the CEMI subscales and observer-rated MI spirit score and MI adherent and non-adherent behavioral counts were in the expected directions but did not reach statistical significance. Further revision and evaluation of the CEMI is recommended. Clinical, training and research implications are provided. Copyright © 2016 Elsevier Inc. All rights reserved.

Shifting from presumptive to test-based management of malaria - technical basis and implications for malaria control in Ghana.

PubMed

Baiden, F; Malm, K; Bart-Plange, C; Hodgson, A; Chandramohan, D; Webster, J; Owusu-Agyei, S

2014-06-01

The presumptive approach was the World Health Organisation (WHO) recommended to the management of malaria for many years and this was incorporated into syndromic guidelines such as the Integrated Management of Childhood Illnesses (IMCI). In early 2010 however, WHO issued revised treatment guidelines that call for a shift from the presumptive to the test-based approach. Practically, this implies that in all suspected cases, the diagnosis of uncomplicated malaria should be confirmed using rapid test before treatment is initiated. This revision effectively brings to an end an era of clinical practice that span several years. Its implementation has important implications for the health systems in malaria-endemic countries. On the basis of research in Ghana and other countries, and evidence from program work, the Ghana National Malaria Control Program has issued revised national treatment guidelines that call for implementation of test-based management of malaria in all cases, and across all age groups. This article reviews the evidence and the technical basis for the shift to test-based management and examines the implications for malaria control in Ghana.

The mineral resource potential of the Wadi al Jarir and Al Jurdhawiyah quadrangles, sheets 25/42C and 25/42D, Kingdom of Saudi Arabia

USGS Publications Warehouse

Fenton, Michael D.

1983-01-01

Areas with potential for metallic mineral deposits in the Wadi al Jarir and Al Jurdhawiyah quadrangles, northeastern Arabian Shield, have been identified by reconnaissance rock geochemistry, inspection of ancient prospects, and interpretation of previous work. The ancient prospects of Abraq Shawfan, Abraq Shawfan South, Ad Du'ibi, Ad Du'ibi West, and Ad Dirabi are not recommended for further study. The Bald al Jimalah East ancient lead-silver mine should be drilled to investigate its mineral potential at depth and to.determine its apparent relationship to the nearby Baid al Jimalah West tungsten-tin prospect. High precious metal and copper contents confirmed at the Jarrar ancient prospect suggest additional study. Preliminary results of core and percussion drilling at the Bald al Jimalah West tungsten-tin prospect indicate that the mineralized rocks decrease in grade with depth and are not suitable for current economic exploitation. Geochemically anomalous areas in both plutonic and layered volcanic and clastic terrane are possible sites of significant base metal, molybdenum, tin, tungsten, and rare-earth element mineralization.

Leptospirosis in Franche-Comté (FRANCE): clinical, biological, and therapeutic data.

PubMed

Estavoyer, J M; Chirouze, C; Faucher, J F; Floret, N; Couetdic, G; Leroy, J; Hoen, B

2013-09-01

We report the patient data in 77 cases of leptospirosis confirmed by PCR and/or serology (micro-agglutination), observed between 1994 and 2008 at the Besançon teaching hospital. Our aim was to compare the epidemiological, clinical, biological, and therapeutic characteristics of leptospirosis in the Franche-Comté region, to those reported in other regions. The median age was 42years and 95% were male patients. Leptospirosis acquisition was likely related to aquatic leisure activities (50.6%), professional exposure (28.6%), building maintenance works (11.7%), or unknown (9.1%). Forty-eight cases were uncomplicated and 29 were severe presentations of leptospirosis. Among severe cases, eight patients had to be managed in an intensive care unit, and one patient died. L. grippotyphosa and L. icterohaemorrhagiae were the main serogroups involved. Age above 50years and serogroup L. icterohaemorrhagiae were positively associated with clinical severity. The outcome was favorable for 15 patients treated with ceftriaxone for less than 7days. We recommended conducting clinical trials aiming at validating short courses of ceftriaxone to treat leptospirosis. Copyright © 2013. Published by Elsevier SAS.

Attitudes and intentions of Greek teachers towards teaching pupils with dyslexia: An application of the theory of planned behaviour.

PubMed

Stampoltzis, Aglaia; Tsitsou, Elisavet; Papachristopoulos, George

2018-05-01

The present study aims to examine Greek public primary school teachers' attitudes and intention towards teaching pupils with dyslexia using a model of the theory of planned behaviour (TPB). Toward that aim, 304 teachers aged between 22 and 59 years old, with an average overall work experience of 16.6 years completed a TPB questionnaire which assessed their attitudes, subjective norms and perceived behavioural control, their intention, as well as other exogenous factors. The validity and the reliability of the questionnaire were found to be adequate. Overall, the participating teachers report a wide range of educational interventions for pupils with dyslexia emphasizing the psychological aspects of support. They also face a number of barriers, but in general they express neutral to positive attitudes to dyslexia. Results show that attitudes, subjective norms and perceived behavioural control significantly predicted the teachers' intention towards teaching dyslexic pupils, thus confirming the applicability of the selected TPB model. Recommendations for teachers' training and limitations of the study are discussed. Copyright © 2018 John Wiley & Sons, Ltd.

Making cross-racial therapy work: A phenomenological study of clients’ experiences of cross-racial therapy

PubMed Central

Chang, Doris F.; Berk, Alexandra

2010-01-01

A phenomenological/consensual qualitative study of clients’ lived experiences of cross-racial therapy was conducted to enhance our understanding of whether, how, and under what conditions race matters in the therapy relationship. The sample consisted of 16 racial/ethnic minority clients who received treatment from 16 White, European American therapists across a range of treatment settings. Participants who reported a satisfying experience of cross-racial therapy (n=8) were examined in relation to gender- and in most cases, race/ethnicity-matched controls (n=8) who reported an overall unsatisfying experience. Therapy satisfaction was assessed during the screening process and confirmed during the research interview. Therapy narratives were analyzed using consensual qualitative research to identify the client, therapist, and relational factors that distinguished satisfied from unsatisfied cases. Findings reveal substantial differences at the level of individual characteristics and relational processes, providing evidence of both universal (etic) as well as culture/context-specific (emic) aspects of healing relationships. Recommendations for facilitating positive alliance formation in cross-racial therapy are provided based on clients’ descriptions of facilitative conditions in the therapy relationship. PMID:20414342

Precision of dehydroascorbic acid quantitation with the use of the subtraction method--validation of HPLC-DAD method for determination of total vitamin C in food.

PubMed

Mazurek, Artur; Jamroz, Jerzy

2015-04-15

In food analysis, a method for determination of vitamin C should enable measuring of total content of ascorbic acid (AA) and dehydroascorbic acid (DHAA) because both chemical forms exhibit biological activity. The aim of the work was to confirm applicability of HPLC-DAD method for analysis of total content of vitamin C (TC) and ascorbic acid in various types of food by determination of validation parameters such as: selectivity, precision, accuracy, linearity and limits of detection and quantitation. The results showed that the method applied for determination of TC and AA was selective, linear and precise. Precision of DHAA determination by the subtraction method was also evaluated. It was revealed that the results of DHAA determination obtained by the subtraction method were not precise which resulted directly from the assumption of this method and the principles of uncertainty propagation. The proposed chromatographic method should be recommended for routine determinations of total vitamin C in various food. Copyright © 2014 Elsevier Ltd. All rights reserved.

PubMed

Monaca, C; Franco, P; Philip, P; Dauvilliers, Y

In the new international classification of sleep disorders (ICSD-3), narcolepsy is differentiated into two distinct pathologies: type 1 narcolepsy (NT1) and type 2 narcolepsy (NT2). NT1 is characterised by periods of an irrepressible need to sleep, cataplexy (a sudden loss of muscle tone triggered by emotion) and in some cases the presence of symptoms such as hypnagogic hallucinations, sleep paralysis and disturbed night-time sleep. Its physiopathology is based on the loss of hypocretin neurons in the hypothalamus, seemingly connected to an auto-immune process. By definition, cataplexy is absent and the hypocretin levels in the CSF are normal in NT2. Confirming the diagnosis requires polysomnography and multiple sleep latency tests. The choice of further investigations is based on the presence or absence of typical cataplexy. Further investigations include HLA typing, lumbar puncture to measure the hypocretin level in the CSF, or even brain imagery in the case of narcolepsy suspected to be secondary to an underlying pathology. In this consensus we propose recommendations for the work-up to be carried out during diagnosis and follow-up for patients suffering from narcolepsy. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Willingness of veterinarians in Australia to recommend Q fever vaccination in veterinary personnel: Implications for workplace health and safety compliance.

PubMed

Sellens, Emily; Norris, Jacqueline M; Dhand, Navneet K; Heller, Jane; Hayes, Lynne; Gidding, Heather F; Willaby, Harold; Wood, Nicholas; Bosward, Katrina L

2018-01-01

Q fever vaccine uptake among veterinary nurses in Australia is low, suggesting veterinarians are not recommending the vaccination to veterinary personnel. This study aimed to determine the willingness of veterinarians to recommend Q fever vaccination to veterinary personnel and to identify factors influencing Q fever vaccine uptake by veterinary nurses in Australia. An online cross sectional survey targeted veterinarians and veterinary nurses in Australia in 2014. Responses were analysed using multivariable logistic regression. Factors significantly (p<0.05) associated with a willingness to recommend the vaccination, expressed by 35% (95% CI 31-38%) of veterinarians (n = 828), were (1) being very concerned for colleagues regarding Coxiella burnetii (OR 4.73), (2) disagreeing the vaccine is harmful (OR 3.80), (3) high Q fever knowledge (OR 2.27), (4) working within small animal practice (OR 1.67), (5) disagreeing the vaccine is expensive (OR 1.55), and (6) age, with veterinarians under 39 years most likely to recommend vaccination. Of the veterinary nursing cohort who reported a known Q fever vaccination status (n = 688), 29% (95% CI 26-33%) had sought vaccination. This was significantly (p<0.05) associated with (1) agreeing the vaccine is important (OR 8.34), (2) moderate/high Q fever knowledge (OR 5.51), (3) working in Queensland (OR 4.00), (4) working within livestock/mixed animal practice (OR 3.24), (5) disagreeing the vaccine is expensive (OR 1.86), (6) strong reliance on work culture for biosecurity information (OR 2.5), (7) perceiving personal exposure to Coxiella burnetii to be at least low/moderate (OR 2.14), and (8) both agreeing the vaccine is safe and working within a corporate practice structure (OR 4.28). The study identified the need for veterinarians to take greater responsibility for workplace health and safety promotion, and calls for better education of veterinary personnel to raise awareness of the potential for occupational exposure to C. burnetii and improve the perception of the Q fever vaccine as being important, safe and cost-effective.

Willingness of veterinarians in Australia to recommend Q fever vaccination in veterinary personnel: Implications for workplace health and safety compliance

PubMed Central

Norris, Jacqueline M.; Dhand, Navneet K.; Heller, Jane; Hayes, Lynne; Gidding, Heather F.; Willaby, Harold; Wood, Nicholas; Bosward, Katrina L.

2018-01-01

Q fever vaccine uptake among veterinary nurses in Australia is low, suggesting veterinarians are not recommending the vaccination to veterinary personnel. This study aimed to determine the willingness of veterinarians to recommend Q fever vaccination to veterinary personnel and to identify factors influencing Q fever vaccine uptake by veterinary nurses in Australia. An online cross sectional survey targeted veterinarians and veterinary nurses in Australia in 2014. Responses were analysed using multivariable logistic regression. Factors significantly (p<0.05) associated with a willingness to recommend the vaccination, expressed by 35% (95% CI 31–38%) of veterinarians (n = 828), were (1) being very concerned for colleagues regarding Coxiella burnetii (OR 4.73), (2) disagreeing the vaccine is harmful (OR 3.80), (3) high Q fever knowledge (OR 2.27), (4) working within small animal practice (OR 1.67), (5) disagreeing the vaccine is expensive (OR 1.55), and (6) age, with veterinarians under 39 years most likely to recommend vaccination. Of the veterinary nursing cohort who reported a known Q fever vaccination status (n = 688), 29% (95% CI 26–33%) had sought vaccination. This was significantly (p<0.05) associated with (1) agreeing the vaccine is important (OR 8.34), (2) moderate/high Q fever knowledge (OR 5.51), (3) working in Queensland (OR 4.00), (4) working within livestock/mixed animal practice (OR 3.24), (5) disagreeing the vaccine is expensive (OR 1.86), (6) strong reliance on work culture for biosecurity information (OR 2.5), (7) perceiving personal exposure to Coxiella burnetii to be at least low/moderate (OR 2.14), and (8) both agreeing the vaccine is safe and working within a corporate practice structure (OR 4.28). The study identified the need for veterinarians to take greater responsibility for workplace health and safety promotion, and calls for better education of veterinary personnel to raise awareness of the potential for occupational exposure to C. burnetii and improve the perception of the Q fever vaccine as being important, safe and cost-effective. PMID:29856835

Welfare, maternal work, and on-time childhood vaccination rates.

PubMed

Sohn, Min-Woong; Yoo, Joan; Oh, Elissa H; Amsden, Laura B; Holl, Jane L

2011-12-01

To examine effects of Temporary Assistance for Needy Families welfare cash assistance and maternal work requirements on "on-time" childhood vaccination rates. A stratified random sample of Illinois children from low-income families affected by welfare reform was monitored from 1997 to 2004. Medical records from pediatricians' offices and Medicaid claims data were used to identify the timeliness of 18 recommended vaccinations. Random-intercept logistic models were used to estimate on-time vaccine administration as a function of welfare receipt and maternal work with adjustment for characteristics of the children and mothers and time-varying covariates pertaining to the administration window for each recommended vaccine dose. Of all recommended vaccinations, 55.9% were administered on time. On-time vaccination rates were higher when families were receiving welfare than not (57.4% vs 52.8%). Children in families that either were receiving welfare or had working mothers were 1.7 to 2.1 times more likely to receive vaccinations on time compared with children in families that were not receiving welfare and did not have working mothers. When vaccine doses were stratified according to welfare status, maternal work was associated with decreased on-time vaccination rates (odds ratio: 0.73 [95% confidence interval: 0.59-0.90]) when families received welfare but increased on-time vaccination rates (odds ratio: 1.68 [95% confidence interval: 1.27-2.22]) when they did not receive welfare. These results indicate that maternal work requirements of Temporary Assistance for Needy Families had negative effects on timely administration of childhood vaccinations, although receipt of welfare itself was associated with increased on-time rates.

Histochemical stains as promising means for the laser histochemical surgery of a number of pathologies

NASA Astrophysics Data System (ADS)

Piruzyan, L. A.; Mikhailovskiy, Ye. M.; Piruzyan, A. L.

1999-12-01

The directions of laboratory and clinical studies oriented to experimental confirmation of the priority concept of `laser histochemical surgery' are presented. The goal of the studies is reproduction on experimental model of a number of pathologies (in vivo and in vitro) of the `sensitization to laser radiation by staining' effect. Testing of the histochemical stains as sensitizers to laser irradiation of their `address substrates', i.e. vitally stained intracellular structures which participate in the pathologic processes evolution is under planning. The processes include: (a) metabolic disorders in the brain cells, i.e. disseminated sclerosis; (b) generalized metabolic disorders- -mucopolysaccharidosis and collagenosises (periarteritis nodosa, rheumatism, rheumatoid arthritis, sclerodermia); (3) metabolic disorders in individual organs--vessel atherosclerosis, hypercholesterolemia, myocardial infarction, cardiosclerosis, caries and parodontosis. The conditions of the studies are detailed in the recommendations along the positions: (1) disease name; (2) disease characteristics: (a) pathomorphologic, (b) biochemical; (3) stains revealing the disease signs and recommended for testing; (4) `address substrates' of the stains that are targets for laser radiation; (5) lasers recommended for the testing after the cells staining in vivo in the corresponding pathology; (6) experimental models of the pathologies suggested for the testing; (7) criteria of the stain efficiency as target sensitizer to the laser light (criteria of the `laser sensitization by staining' efficiency). Possible perspectives for the experimental clinical medicine are indicated of common histochemical stains and lasers use and of practice introduction of the `laser histochemical surgery' in the case the described concept is confirmed in experiments and clinically.

Efficiency of four currently used decontamination conditionings in Romania against Aspergillus and Candida strains.

PubMed

Lorin, D; Cristina, R T; Teusdea, V; Mitrănescu, E; Muselin, F; Butnariu, M; David, G; Dumitrescu, E

2017-09-01

Efficacy of four commercial biocidal products (noted A to D), using manufacturers' recommendations, and a contact time of 30minutes, were evaluated in the purpose of standard SR EN1657: 2006 adapted. Were used four strains, two as reference: Aspergillus brasiliensis (niger) (ATCC 16404) and Candida albicans (ATCC 10231), and two isolates: Aspergillus flavus and respectively Aspergillus fumigatus. The inoculum plates containing Malt Extract Agar (MEA) were incubated 48h for C. albicans and 72hours for Aspergillus spp. The standard SR EN1657: 2006 adapted was conducted in two phases: the test cultures preparation and the method validation. Method validation included: the control of experimental conditions and of neutralizant solution, and the method verification. Results revealed that three from the four tested products (A, B and D) had exerted biocidal effect on the studied strains at the recommended concentrations, the registered CFU values being reduced by more than 4 log 10 , conversely in the case of the product (C), applied against A. fumigatus at the recommended concentration of 2%, the biocidal effect was not detected, fact confirmed also by the CFU's value (3.59 log 10 ). The biocide retested at a greater concentration (of 5%), showed a biocidal effect against A. fumigatus after 30minutes, the CFU value being reduced, by more than 5.29 log 10 , evidencing the resistance emergence of A. fumigatus under the repeated pressure of biocides. It is re-confirming that merely the "chemical" defense measures to defuse the fungi's strategies become unproductive. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A method for evaluating discoverability and navigability of recommendation algorithms.

PubMed

Lamprecht, Daniel; Strohmaier, Markus; Helic, Denis

2017-01-01

Recommendations are increasingly used to support and enable discovery, browsing, and exploration of items. This is especially true for entertainment platforms such as Netflix or YouTube, where frequently, no clear categorization of items exists. Yet, the suitability of a recommendation algorithm to support these use cases cannot be comprehensively evaluated by any recommendation evaluation measures proposed so far. In this paper, we propose a method to expand the repertoire of existing recommendation evaluation techniques with a method to evaluate the discoverability and navigability of recommendation algorithms. The proposed method tackles this by means of first evaluating the discoverability of recommendation algorithms by investigating structural properties of the resulting recommender systems in terms of bow tie structure, and path lengths. Second, the method evaluates navigability by simulating three different models of information seeking scenarios and measuring the success rates. We show the feasibility of our method by applying it to four non-personalized recommendation algorithms on three data sets and also illustrate its applicability to personalized algorithms. Our work expands the arsenal of evaluation techniques for recommendation algorithms, extends from a one-click-based evaluation towards multi-click analysis, and presents a general, comprehensive method to evaluating navigability of arbitrary recommendation algorithms.

Recommendations of the Global Multiple System Atrophy Research Roadmap Meeting.

PubMed

Walsh, Ryan R; Krismer, Florian; Galpern, Wendy R; Wenning, Gregor K; Low, Phillip A; Halliday, Glenda; Koroshetz, Walter J; Holton, Janice; Quinn, Niall P; Rascol, Olivier; Shaw, Leslie M; Eidelberg, David; Bower, Pam; Cummings, Jeffrey L; Abler, Victor; Biedenharn, Judy; Bitan, Gal; Brooks, David J; Brundin, Patrik; Fernandez, Hubert; Fortier, Philip; Freeman, Roy; Gasser, Thomas; Hewitt, Art; Höglinger, Günter U; Huentelman, Matt J; Jensen, Poul H; Jeromin, Andreas; Kang, Un Jung; Kaufmann, Horacio; Kellerman, Lawrence; Khurana, Vikram; Klockgether, Thomas; Kim, Woojin Scott; Langer, Carol; LeWitt, Peter; Masliah, Eliezer; Meissner, Wassilios; Melki, Ronald; Ostrowitzki, Susanne; Piantadosi, Steven; Poewe, Werner; Robertson, David; Roemer, Cyndi; Schenk, Dale; Schlossmacher, Michael; Schmahmann, Jeremy D; Seppi, Klaus; Shih, Lily; Siderowf, Andrew; Stebbins, Glenn T; Stefanova, Nadia; Tsuji, Shoji; Sutton, Sharon; Zhang, Jing

2018-01-09

Multiple system atrophy (MSA) is a rare neurodegenerative disorder with substantial knowledge gaps despite recent gains in basic and clinical research. In order to make further advances, concerted international collaboration is vital. In 2014, an international meeting involving leaders in the field and MSA advocacy groups was convened in Las Vegas, Nevada, to identify critical research areas where consensus and progress was needed to improve understanding, diagnosis, and treatment of the disease. Eight topic areas were defined: pathogenesis, preclinical modeling, target identification, endophenotyping, clinical measures, imaging biomarkers, nonimaging biomarkers, treatments/trial designs, and patient advocacy. For each topic area, an expert served as a working group chair and each working group developed priority-ranked research recommendations with associated timelines and pathways to reach the intended goals. In this report, each groups' recommendations are provided. Copyright © 2017 American Academy of Neurology.

Conducting Science in Disasters: Recommendations from the NIEHS Working Group for Special IRB Considerations in the Review of Disaster Related Research.

PubMed

Packenham, Joan P; Rosselli, Richard T; Ramsey, Steve K; Taylor, Holly A; Fothergill, Alice; Slutsman, Julia; Miller, Aubrey

2017-09-25

Research involving human subjects after public health emergencies and disasters may pose ethical challenges. These challenges may include concerns about the vulnerability of prospective disaster research participants, increased research burden among disaster survivors approached by multiple research teams, and potentially reduced standards in the ethical review of research by institutional review boards (IRBs) due to the rush to enter the disaster field. The NIEHS Best Practices Working Group for Special IRB Considerations in the Review of Disaster Related Research was formed to identify and address ethical and regulatory challenges associated with the review of disaster research. The working group consists of a diverse collection of disaster research stakeholders across a broad spectrum of disciplines. The working group convened in July 2016 to identify recommendations that are instrumental in preparing IRBs to review protocols related to public health emergencies and disasters. The meeting included formative didactic presentations and facilitated breakout discussions using disaster-related case studies. Major thematic elements from these discussions were collected and documented into 15 working group recommendations, summarized in this article, that address topics such as IRB disaster preparedness activities, informed consent, vulnerable populations, confidentiality, participant burden, disaster research response integration and training, IRB roles/responsibilities, community engagement, and dissemination of disaster research results. https://doi.org/10.1289/EHP2378.

Conducting Science in Disasters: Recommendations from the NIEHS Working Group for Special IRB Considerations in the Review of Disaster Related Research

PubMed Central

Rosselli, Richard T.; Ramsey, Steve K.; Taylor, Holly A.; Fothergill, Alice; Slutsman, Julia; Miller, Aubrey

2017-01-01

Summary: Research involving human subjects after public health emergencies and disasters may pose ethical challenges. These challenges may include concerns about the vulnerability of prospective disaster research participants, increased research burden among disaster survivors approached by multiple research teams, and potentially reduced standards in the ethical review of research by institutional review boards (IRBs) due to the rush to enter the disaster field. The NIEHS Best Practices Working Group for Special IRB Considerations in the Review of Disaster Related Research was formed to identify and address ethical and regulatory challenges associated with the review of disaster research. The working group consists of a diverse collection of disaster research stakeholders across a broad spectrum of disciplines. The working group convened in July 2016 to identify recommendations that are instrumental in preparing IRBs to review protocols related to public health emergencies and disasters. The meeting included formative didactic presentations and facilitated breakout discussions using disaster-related case studies. Major thematic elements from these discussions were collected and documented into 15 working group recommendations, summarized in this article, that address topics such as IRB disaster preparedness activities, informed consent, vulnerable populations, confidentiality, participant burden, disaster research response integration and training, IRB roles/responsibilities, community engagement, and dissemination of disaster research results. https://doi.org/10.1289/EHP2378 PMID:28949918

[Results and recommendations for vocational rehabilitation from the development project RehaFutur].

PubMed

Riedel, H-P; Schmidt, C; Reinsberg, B; Klügel, T

2012-06-01

The overall project RehaFutur, which has been initiated and funded by the Federal Ministry of Labour and Social Affairs and which involves all the actors of the vocational rehabilitation system, is aimed at advancing the development of the vocational rehabilitation system, so as to prepare it for the challenges ahead. The project started with a group of scientific experts, who formulated 8 fields of action for further developing the vocational rehab system. On this basis, 4 working groups were set up in the framework of a development project to elaborate concrete recommendations on how to implement the necessary changes in vocational rehabilitation. The topics dealt with by the working groups were "self-determination and self-responsibility", "regulation of the overall process", "occupation and working environment" as well as "research". The process was supervised by a steering group, the results were moreover discussed in workshops. Recommendations have been made for 10 subject areas: "consultation and information", "joint service points", "use of the internet", "quality assurance", "individualisation and greater flexibility", "orientation towards the working environment", "participation of the beneficiaries", "research", "legislation", "cooperation of the actors". The next step of the RehaFutur overall project is implementation of those recommendations. This needs to be done in an interdisciplinary manner and conjointly by the agencies and providers involved, including the beneficiaries as experts. As different framework conditions have to be taken into account, the process is a complex one and needs to be supported by systematic research. © Georg Thieme Verlag KG Stuttgart · New York.

Antioxidant, antimutagenic, and anticarcinogenic effects of Papaver rhoeas L. extract on Saccharomyces cerevisiae.

PubMed

Todorova, Teodora; Pesheva, Margarita; Gregan, Fridrich; Chankova, Stephka

2015-04-01

The aim of this work was to analyze the antioxidant and antimutagenic/anticarcinogenic capacity of Papaver rhoeas L. water extract against standard mutagen/carcinogen methyl methanesulfonate (MMS) and radiomimetic zeocin (Zeo) on a test system Saccharomyces cerevisiae. The following assays were used: 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity, quantitative determination of superoxide anion (antireactive oxygen species [antiROS test]), DNA topology assay, D7ts1 test--for antimutagenic--and Ty1 transposition test--for anticarcinogenic effects. Strong pro-oxidative capacity of Zeo was shown to correlate with its well-expressed mutagenic and carcinogenic properties. The mutagenic and carcinogenic effects of MMS were also confirmed. Our data concerning the antioxidant activity of P. rhoeas L. extract revealed that concentration corresponding to IC(50) in the DPPH assay possessed the highest antioxidant activity in the antiROS biological assay. It was also observed that a concentration with 50% scavenging activity expressed the most pronounced antimutagenic properties decreasing Zeo-induced gene conversion twofold, reverse mutation fivefold, and total aberrations fourfold. The same concentration possessed well-expressed anticarcinogenic properties measured as reduction of MMS-induced Ty1 transposition rate fivefold and fourfold when Zeo was used as an inductor. Based on the well-expressed antioxidant, antimutagenic, and anticarcinogenic properties obtained in this work, the P. rhoeas L. extract could be recommended for further investigations and possible use as a food additive.

Thymic Carcinoma Management Patterns among International Thymic Malignancy Interest Group (ITMIG) Physicians with Consensus from the Thymic Carcinoma Working Group.

PubMed

Shepherd, Annemarie; Riely, Gregory; Detterbeck, Frank; Simone, Charles B; Ahmad, Usman; Huang, James; Korst, Robert; Rajan, Arun; Rimner, Andreas

2017-04-01

Thymic carcinomas are rare epithelial malignancies with limited data to guide management. To identify areas of agreement and variability in current clinical practice, a 16-question electronic survey was given to members of the International Thymic Malignancy Interest Group (ITMIG). Areas of controversy were discussed with the Thymic Carcinoma Working Group and consensus was achieved, as described. A total of 100 ITMIG members responded. There was general agreement regarding the role for multimodality therapy with definitive surgical resection in physically fit patients with advanced but resectable disease. Areas of controversy included the need for histologic confirmation before surgery, the role of adjuvant therapy, the optimal first-line chemotherapy regimen, and the recommended treatment course for marginally resectable disease with invasion into the great vessels, pericardium, and lungs. The results of the questionnaire provide a description of the management of thymic carcinoma by 100 ITMIG members with a specific interest or expertise in thymic malignancies. Although there was agreement in some areas, clinical practice appears to vary significantly. There is a great need for collaborative research to identify optimal evaluation and treatment strategies. Given the need for multimodality therapy in many cases, a multidisciplinary discussion of the management of patients with thymic carcinoma is critical. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Biomechanical evaluation of oversized drilling technique on primary implant stability measured by insertion torque and resonance frequency analysis

PubMed Central

Santamaría-Arrieta, Gorka; Brizuela-Velasco, Aritza; Fernández-González, Felipe J.; Chávarri-Prado, David; Chento-Valiente, Yelko; Solaberrieta, Eneko; Diéguez-Pereira, Markel; Yurrebaso-Asúa, Jaime

2016-01-01

Background This study evaluated the influence of implant site preparation depth on primary stability measured by insertion torque and resonance frequency analysis (RFA). Material and Methods Thirty-two implant sites were prepared in eight veal rib blocks. Sixteen sites were prepared using the conventional drilling sequence recommended by the manufacturer to a working depth of 10mm. The remaining 16 sites were prepared using an oversize drilling technique (overpreparation) to a working depth of 12mm. Bone density was determined using cone beam computerized tomography (CBCT). The implants were placed and primary stability was measured by two methods: insertion torque (Ncm), and RFA (implant stability quotient [ISQ]). Results The highest torque values were achieved by the conventional drilling technique (10mm). The ANOVA test confirmed that there was a significant correlation between torque and drilling depth (p<0.05). However, no statistically significant differences were obtained between ISQ values at 10 or 12 mm drilling depths (p>0.05) at either measurement direction (cortical and medullar). No statistical relation between torque and ISQ values was identified, or between bone density and primary stability (p >0.05). Conclusions Vertical overpreparation of the implant bed will obtain lower insertion torque values, but does not produce statistically significant differences in ISQ values. Key words:Implant stability quotient, overdrilling, primary stability, resonance frequency analysis, torque. PMID:27398182